HARMONY COMMUNITY HEALTHCARE INC: Form 990, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- HARMONY COMMUNITY HEALTHCARE INC (EIN 41-0711606)
- Tax period
- 2023-10-01 to 2024-09-30
- Filed
- 2025-08-13
- IRS object ID
- 202532259349300143
- Schema version
- 2023v6.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2025-08-13T12:21:25-05:00 | ReturnTs |
| Tax Period End | 2024-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1502 LONDON ROAD SUITE 200 | AddressLine1Txt |
| City | DULUTH | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55812 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2023-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410711606 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HARMONY COMMUNITY HEALTHCARE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HARM | BusinessNameControlTxt |
| Phone | 5078866544 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 815 MAIN AVENUE S | AddressLine1Txt |
| City | HARMONY | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55939 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BRENDA MOSER | PersonNm |
| Person Title | FINANCE ADMINISTRATOR | PersonTitleTxt |
| Phone | 5078866544 | PhoneNum |
| Signature | 2025-08-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MICHAEL J PETERSON CPA | PreparerPersonNm |
| PTIN | P01833529 | PTIN |
| Phone | 2187224705 | PhoneNum |
| Preparation | 2025-08-06 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2023 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GUNDERSEN HARMONY CARE CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | BRENDA MOSER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 815 MAIN AVENUE S | AddressLine1Txt |
| City | HARMONY | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55939 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $4,979,131 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTPS://WWW.GUNDERSENHEALTH.ORG/LOCATIONS/GUNDERS | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1948 | FormationYr |
| Legal Domicile State | MN | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE CARE TO THE ELDERLY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 3 | VotingMembersIndependentCnt |
| Total Employee | 78 | TotalEmployeeCnt |
| Total Volunteers | 5 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $37,263 | PYContributionsGrantsAmt |
| CY Contributions Grants | $498,439 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $3,222,703 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $4,460,353 | CYProgramServiceRevenueAmt |
| PY Investment Income | $4,347 | PYInvestmentIncomeAmt |
| CY Investment Income | $20,339 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $3,264,313 | PYTotalRevenueAmt |
| CY Total Revenue | $4,979,131 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $2,285,725 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $3,527,561 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $931,666 | PYOtherExpensesAmt |
| CY Other Expenses | $1,285,711 | CYOtherExpensesAmt |
| PY Total Expenses | $3,217,391 | PYTotalExpensesAmt |
| CY Total Expenses | $4,813,272 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $46,922 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $165,859 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,059,124 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,133,287 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $979,268 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $885,191 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,079,856 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,248,096 | NetAssetsOrFundBalancesEOYAmt |
| Mission | HARMONY COMMUNITY HEALTHCARE IS COMMITTED TO ENHANCING THE QUALITY OF LIFE OF THOSE WE SERVICE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $3,476,485 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $4,460,353 | RevenueAmt |
| Desc | THE ORGANIZATION PROVIDES HOUSING AND NURSING CARE TO THE ELDERLY BY OPERATING A 42-BED NURSING FACILITY IN HARMONY, MN. DURING FY24, THERE WERE 11,156 RESIDENT DAYS. | Desc |
| Total Program Service Expenses | $3,476,485 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | Yes (1) | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 15 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 78 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 3 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRENDA MOSER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5078866544 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 815 MAIN AVENUE S | AddressLine1Txt |
| City | HARMONY | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55939 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| VICKI BAKALARS | |||||||||
| PRESIDENT | 2.00 | 48.00 | Yes (X) | Yes (X) | $0 | $151,403 | $46,248 | ||
| CHUCK JOHNSON | |||||||||
| VICE PRESIDENT | 2.00 | 48.00 | Yes (X) | Yes (X) | $0 | $150,958 | $49,570 | ||
| CHRIS SKAALEN | |||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| JEN BERENDES | |||||||||
| DIRECTOR THRU (12/2023) | 2.00 | 40.00 | Yes (X) | $0 | $111,090 | $38,432 | |||
| MANDI PERICAK | |||||||||
| SECRETARY/TREASURER | 2.00 | 48.00 | Yes (X) | Yes (X) | $0 | $119,202 | $40,172 | ||
| DONNA SCHEEVEL | |||||||||
| SECRETARY/TREASURER (BEG. 01/2024) | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| KAREN JOHNSON | |||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| SARAH MELDE | |||||||||
| DIRECTOR | 2.00 | 48.00 | Yes (X) | $0 | $89,971 | $31,941 | |||
| MICHELLE BORRESON | |||||||||
| ADMIN./CEO (THRU 03/2024) | 25.00 | 25.00 | Yes (X) | $0 | $128,057 | $56,645 | |||
| JOHN CEELEN | |||||||||
| CFO-BGHS (BEG. 02/2024) | 2.00 | 48.00 | Yes (X) | $0 | $0 | $0 | |||
| THOMAS WOAHLOE | |||||||||
| INTERIM ADMIN. (03/24 THRU 12/24) | 25.00 | 25.00 | Yes (X) | $0 | $0 | $0 | |||
| BRENDA MOSER | |||||||||
| FINANCE ADMINISTRATOR | 4.00 | 46.00 | Yes (X) | $0 | $177,022 | $51,157 | |||
| SCOTT RATHGABER | |||||||||
| CEO-BGHS | 2.00 | 48.00 | Yes (X) | $0 | $1,644,221 | $68,728 | |||
| STEVE LITTLE | |||||||||
| CFO-BGHS (THRU 02/2024) | 2.00 | 48.00 | Yes (X) | $0 | $333,317 | $0 | |||
| SUE LENZ | |||||||||
| DIRECTOR OF NURSING | 50.00 | $116,344 | $0 | $19,885 | Yes (X) | ||||
| GERALD OETZEL | |||||||||
| FORMER CFO-BGHS | 0.00 | 0.00 | $0 | $555,068 | $18,108 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $116,344 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,460,309 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $420,886 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| STAFFENCY | |||||
| 221 W COLLEGE AVE FLOOR 2 | APPLETON | WI | 54911 | STAFFING | $330,570 |
| AEGIS THERAPIES INC | |||||
| PO BOX 936653 | ATLANTA | GA | 311936653 | CONTRACTED PT, OT & ST SERVICES | $233,736 |
| MARTIN BROTHERS DISTRIBUTING COMPANY | |||||
| 406 VIKING ROAD | CEDAR FALLS | IA | 50613 | FOOD DISTRIBUTOR | $124,912 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $300,000 | RelatedOrganizationsAmt |
| Government Grants | $191,386 | GovernmentGrantsAmt |
| All Other Contributions | $7,053 | AllOtherContributionsAmt |
| Total Contributions | $498,439 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| RESIDENT SERVICE REVEN | 623000 | $4,372,255 | $4,372,255 |
| RENTAL REVENUE | 900099 | $83,088 | $83,088 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,010 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,010 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $4,460,353 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20,339 | TotalRevenueColumnAmt |
| Exclusion | $20,339 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,979,131 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,460,353 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $20,339 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,933,741 | TotalAmt |
| Program Services | $2,236,157 | ProgramServicesAmt |
| Management And General | $697,584 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $172,351 | TotalAmt |
| Program Services | $132,499 | ProgramServicesAmt |
| Management And General | $39,852 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $261,108 | TotalAmt |
| Program Services | $170,558 | ProgramServicesAmt |
| Management And General | $90,550 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $160,361 | TotalAmt |
| Program Services | $120,253 | ProgramServicesAmt |
| Management And General | $40,108 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $99,540 | TotalAmt |
| Management And General | $99,540 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $538 | TotalAmt |
| Management And General | $538 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,450 | TotalAmt |
| Management And General | $12,450 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $264,878 | TotalAmt |
| Program Services | $228,894 | ProgramServicesAmt |
| Management And General | $35,984 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,132 | TotalAmt |
| Program Services | $244 | ProgramServicesAmt |
| Management And General | $1,888 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,298 | TotalAmt |
| Program Services | $10,863 | ProgramServicesAmt |
| Management And General | $30,435 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,503 | TotalAmt |
| Program Services | $1,503 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $202,212 | TotalAmt |
| Program Services | $196,152 | ProgramServicesAmt |
| Management And General | $6,060 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,620 | TotalAmt |
| Program Services | $832 | ProgramServicesAmt |
| Management And General | $788 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,531 | TotalAmt |
| Program Services | $8,276 | ProgramServicesAmt |
| Management And General | $255 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $133,648 | TotalAmt |
| Program Services | $105,795 | ProgramServicesAmt |
| Management And General | $27,853 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,825 | TotalAmt |
| Management And General | $13,825 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| FOOD EXPENSE | $136,256 | $136,256 | |
| DHS SURCHARGE | $121,045 | $121,045 | |
| MEDICAL SUPPLIES | $118,753 | $117,633 | $1,120 |
| BAD DEBT EXPENSE | $51,219 | $51,219 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,263 | TotalAmt |
| Program Services | $10,570 | ProgramServicesAmt |
| Management And General | $65,693 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,813,272 | TotalAmt |
| Program Services | $3,476,485 | ProgramServicesAmt |
| Management And General | $1,336,787 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $651,404 | BOYAmt |
| EOY | $642,441 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $265,015 | BOYAmt |
| EOY | $443,457 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,877 | BOYAmt |
| EOY | $21,653 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $3,274,508 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,296,828 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,063,129 | BOYAmt |
| EOY | $977,680 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,699 | BOYAmt |
| EOY | $48,056 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,059,124 | BOYAmt |
| EOY | $2,133,287 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $304,815 | BOYAmt |
| EOY | $499,367 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $198,855 | BOYAmt |
| EOY | $342,993 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,169 | BOYAmt |
| EOY | $2,611 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $300,000 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $172,429 | BOYAmt |
| EOY | $40,220 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $979,268 | BOYAmt |
| EOY | $885,191 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,043,413 | BOYAmt |
| EOY | $1,209,272 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,443 | BOYAmt |
| EOY | $38,824 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,079,856 | BOYAmt |
| EOY | $1,248,096 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,059,124 | BOYAmt |
| EOY | $2,133,287 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $165,859 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $2,381 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $339,334 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $110,302 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $359,256 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $37,263 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $498,439 | CurrentTaxYearAmt |
| Total | $1,344,594 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,402,808 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,170,925 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,341,514 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,222,703 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,460,353 | CurrentTaxYearAmt |
| Total | $17,598,303 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,742,142 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,281,227 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,700,770 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,259,966 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,958,792 | CurrentTaxYearAmt |
| Total | $18,942,897 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,571,306 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,365,479 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,042,839 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,513,332 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,621,494 | CurrentTaxYearAmt |
| Total | $7,114,450 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,571,306 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,365,479 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,042,839 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,513,332 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,621,494 | CurrentTaxYearAmt |
| Total | $7,114,450 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $11,828,447 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,935 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,564 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,886 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,347 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $20,339 | CurrentTaxYearAmt |
| Total | $34,071 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,935 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,564 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,886 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,347 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $20,339 | CurrentTaxYearAmt |
| Total | $34,071 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,745,077 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,283,791 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,704,656 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,264,313 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,979,131 | CurrentTaxYearAmt |
| Total | $18,976,968 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.62330 | PublicSupportCY509Pct |
| Public Support PY509 | 0.62720 | PublicSupportPY509Pct |
| Investment Income CY | 0.00180 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00090 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART III, SHORT YEAR EXPLANATION: | FormAndLineReferenceDesc |
| Explanation | THE 2022 COLUMN OF PART III REPRESENTS A SHORT-YEAR PERIOD FROM JANUARY 1, 2023 THROUGH SEPTEMBER 30, 2023 DUE TO A CHANGE IN YEAR END. THE REASON FOR THIS CHANGE IS DUE TO A MERGER WITH THE BELLIN GUNDERSEN HEALTH SYSTEM. | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $24,650 | OtherCostOrOtherBasisAmt |
| Book Value | $24,650 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,579,466 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,720,758 | DepreciationAmt |
| Book Value | $858,708 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $670,392 | OtherCostOrOtherBasisAmt |
| Depreciation | $576,070 | DepreciationAmt |
| Book Value | $94,322 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $977,680 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO AFFILIATES | $29,176 |
| ADVANCE COVID PAYMENTS | $11,044 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $40,220 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE SYSTEM HAS REVIEWED TAX POSITIONS FOR ALL OPEN YEARS AND HAS CONCLUDED THAT NO LIABILITIES EXIST FOR UNCERTAIN TAX POSITIONS. THE SYSTEM'S INCOME TAX RETURNS ARE NO LONGER SUBJECT TO EXAMINATION FOR 2018 AND PRIOR YEARS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SCOTT RATHGABER | ||||||||||||||
| CEO-BGHS | $0 | $1,274,504 | $0 | $200,000 | $0 | $169,717 | $0 | $45,225 | $0 | $23,503 | $0 | $1,712,949 | $0 | $0 |
| GERALD OETZEL | ||||||||||||||
| FORMER CFO-BGHS | $0 | $480,094 | $0 | $70,000 | $0 | $4,974 | $0 | $12,220 | $0 | $5,888 | $0 | $573,176 | $0 | $0 |
| STEVE LITTLE | ||||||||||||||
| CFO-BGHS (THRU 02/2024) | $0 | $258,317 | $0 | $75,000 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $333,317 | $0 | $0 |
| BRENDA MOSER | ||||||||||||||
| FINANCE ADMINISTRATOR | $0 | $170,926 | $0 | $5,736 | $0 | $360 | $0 | $26,423 | $0 | $24,734 | $0 | $228,179 | $0 | $0 |
| CHUCK JOHNSON | ||||||||||||||
| VICE PRESIDENT | $0 | $143,632 | $0 | $533 | $0 | $6,793 | $0 | $22,566 | $0 | $27,004 | $0 | $200,528 | $0 | $0 |
| VICKI BAKALARS | ||||||||||||||
| PRESIDENT | $0 | $151,089 | $0 | $314 | $0 | $0 | $0 | $22,564 | $0 | $23,684 | $0 | $197,651 | $0 | $0 |
| MICHELLE BORRESON | ||||||||||||||
| ADMIN./CEO (THRU 03/2024) | $0 | $128,033 | $0 | $24 | $0 | $0 | $0 | $19,759 | $0 | $36,886 | $0 | $184,702 | $0 | $0 |
| MANDI PERICAK | ||||||||||||||
| SECRETARY/TREASURER | $0 | $118,290 | $0 | $751 | $0 | $161 | $0 | $17,732 | $0 | $22,440 | $0 | $159,374 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | A RELATED ORGANIZATION OF THE FILING ORGANIZATION USES ONE OR MORE OF THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -COMPENSATION SURVEY OR STUDY, AND -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE PLEASE REFER TO THE FORM 990, PART VI, LINE 15A DISCLOSURE IN SCHEDULE O FOR ADDITIONAL DETAILS ON HOW COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL IS ESTABLISHED. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE VOTING MEMBER OF HARMONY COMMUNITY HEALTHCARE, INC. IS GUNDERSEN LUTHERAN HEALTH SYSTEM, INC. |
| FORM 990, PART VI, SECTION A, LINE 7A | FOUR OUT OF THE SEVEN DIRECTORS SHALL BE ELECTED BY GUNDERSEN LUTHERAN HEALTH SYSTEM, INC.'S BOARD OF GOVERNORS AND BOARD OF TRUSTEES. |
| FORM 990, PART VI, SECTION A, LINE 7B | GUNDERSEN LUTHERAN HEALTH SYSTEM, INC.'S FINANCE COMMITTEE APPROVES THE BUDGET AND CAPITAL BUDGET. |
| FORM 990, PART VI, SECTION A, LINE 8B | THERE ARE NO COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE BOARD. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE DRAFT FORM 990 WILL FIRST BE REVIEWED BY THE CEO/ADMINISTRATOR AND FINANCE ADMINISTRATOR. THE RETURN WILL THEN BE PROVIDED TO THE BOARD OF DIRECTORS AFTER FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST POLICY COVERS BOARD MEMBERS AND OFFICERS. BOARD MEMBERS ARE ASKED TO DISCLOSE ANY POTENTIAL CONFLICTS AS THEY ARISE. IF THE BOARD OF DIRECTORS DETERMINES THERE IS A CONFLICT THE BOARD MEMBER WITH THE CONFLICT MUST REFRAIN FROM VOTING. A STATEMENT OF CONFLICT OF INTEREST DISCLOSURE IS MADE ON AN ANNUAL BASIS BY OFFICERS AND DIRECTORS. THE DISCLOSURE FORMS ARE REVIEWED BY HARMONY COMMUNITY HEALTHCARE'S COMPLIANCE COMMITTEE ANNUALLY. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE ADMINISTRATOR IS COMPENSATED BY GUNDERSEN LUTHERAN HEALTH SYSTEM, INC., WHO USES YEARS OF SERVICE, SALARY SURVEY DATA AND INTERNAL EQUITY TO DETERMINE THE COMPENSATION RATE. THERE IS A WRITTEN CONTRACT IN PLACE FOR THE ADMINISTRATOR. COMPENSATION IS REVIEWED ON AN ANNUAL BASIS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | CHANGE IN INTEREST IN FOUNDATION 2,381. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (28 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| BELLIN GUNDERSEN HEALTH SYSTEM INC | |||||||||||
| 1836 SOUTH AVENUE | LA CROSSE | WI | 54601 | 920504278 | PARENT | WI | 501(C)(3) | LINE 12B, II | N/A | 0 | |
| BELLIN HEALTH SYSTEMS INC | |||||||||||
| 744 SOUTH WEBSTER AVE | GREEN BAY | WI | 54301 | 391512904 | SUPPORT OF HEALTHCARE ORGANIZATIONS | WI | 501(C)(3) | LINE 12B, II | Yes (1) | BELLIN GUNDERSEN HEALTH SYSTEMS INC | |
| BELLIN COLLEGE INC | |||||||||||
| 3201 EATON ROAD | GREEN BAY | WI | 54311 | 391620530 | NURSING AND RADIOLOGIC SCIENCE COLLEGE | WI | 501(C)(3) | LINE 2 | Yes (1) | BELLIN HEALTH SYSTEMS INC | |
| LAKE MICHIGAN HEALTH SERVICES INC | |||||||||||
| 744 SOUTH WEBSTER AVE | GREEN BAY | WI | 54301 | 391512903 | SUPPORT PURPOSES OF BELLIN MEMORIAL HOSPITAL | WI | 501(C)(3) | LINE 12B, II | Yes (1) | BELLIN HEALTH SYSTEMS INC | |
| THE BELLIN HEALTH FOUNDATION INC | |||||||||||
| PO BOX 23400 | GREEN BAY | WI | 54301 | 391809171 | FOUNDATION | WI | 501(C)(3) | LINE 7 | Yes (1) | BELLIN HEALTH SYSTEMS INC | |
| BELLIN PSYCHIATRIC CENTER INC | |||||||||||
| PO BOX 23725 | GREEN BAY | WI | 54305 | 391657627 | PSYCHIATRIC HOSPITAL | WI | 501(C)(3) | LINE 3 | Yes (1) | BELLIN HEALTH SYSTEMS INC | |
| BELLIN MEMORIAL HOSPITAL INC | |||||||||||
| 744 SOUTH WEBSTER AVE | GREEN BAY | WI | 54301 | 390884478 | HEALTH CARE | WI | 501(C)(3) | LINE 3 | Yes (1) | BELLIN HEALTH SYSTEMS INC | |
| OCONTO HOSPITAL & MEDICAL CENTER INC | |||||||||||
| 820 ARBUTUS AVENUE | OCONTO | WI | 54153 | 061745397 | HEALTH CARE | WI | 501(C)(3) | LINE 3 | Yes (1) | BELLIN MEMORIAL HOSPITAL INC | |
| GUNDERSEN LUTHERAN HEALTH SYSTEM INC | |||||||||||
| 1836 SOUTH AVENUE | LA CROSSE | WI | 54601 | 391866425 | SUPPORTING ORGANIZATION | WI | 501(C)(3) | LINE 12B, II | Yes (1) | BELLIN GUNDERSEN HEALTH SYSTEMS INC | |
| GUNDERSEN LUTHERAN MEDICAL CENTER INC | |||||||||||
| 1910 SOUTH AVENUE | LA CROSSE | WI | 54601 | 390813416 | HEALTH CARE | WI | 501(C)(3) | LINE 3 | Yes (1) | GUNDERSEN LUTHERAN HEALTH SYSTEM INC | |
| GUNDERSEN CLINIC LTD | |||||||||||
| 1910 SOUTH AVENUE | LA CROSSE | WI | 54601 | 391028657 | HEALTH CARE | WI | 501(C)(3) | LINE 3 | Yes (1) | GUNDERSEN LUTHERAN HEALTH SYSTEM INC | |
| GUNDERSEN LUTHERAN ADMINISTRATIVE SERVICES INC | |||||||||||
| 1910 SOUTH AVENUE | LA CROSSE | WI | 54601 | 391606449 | SUPPORTING ORGANIZATION | WI | 501(C)(3) | LINE 12B, II | Yes (1) | GUNDERSEN LUTHERAN HEALTH SYSTEM INC | |
| GUNDERSEN LUTHERAN MEDICAL FOUNDATION INC | |||||||||||
| 1836 SOUTH AVENUE | LA CROSSE | WI | 54601 | 391249705 | FOUNDATION | WI | 501(C)(3) | LINE 7 | Yes (1) | GUNDERSEN LUTHERAN HEALTH SYSTEM INC | |
| TWEETEN LUTHERAN HEALTHCARE CENTER INC | |||||||||||
| 125 FIFTH AVENUE | SE SPRING GROVE | MN | 55974 | 411565003 | HEALTH CARE | MN | 501(C)(3) | LINE 10 | Yes (1) | GUNDERSEN LUTHERAN HEALTH SYSTEM INC | |
| TRI-STATE AMBULANCE INC | |||||||||||
| 235 CAUSEWAY BLVD | LA CROSSE | WI | 54601 | 391965415 | MEDICAL TRANSPORTATION | WI | 501(C)(3) | LINE 3 | Yes (1) | GUNDERSEN LUTHERAN HEALTH SYSTEM INC | |
| TRI-STATE REGIONAL AMBULANCE INC | |||||||||||
| 235 CAUSEWAY BLVD | LA CROSSE | WI | 54603 | 391962965 | MEDICAL TRANSPORTATION | WI | 501(C)(3) | LINE 11 | Yes (1) | GUNDERSEN LUTHERAN HEALTH SYSTEM INC | |
| LUTHERAN REAL ESTATE HOLDING CORP | |||||||||||
| 1910 SOUTH AVENUE | LA CROSSE | WI | 54601 | 391480826 | HOUSING | WI | 501(C)(3) | LINE 12C, III-FI | Yes (1) | GUNDERSEN LUTHERAN HEALTH SYSTEM INC | |
| COMMUNITY HOUSING OF LA CROSSE INC | |||||||||||
| 1900 SOUTH AVENUE | LA CROSSE | WI | 54601 | 391586700 | INDEPENDENT LIVING | WI | 501(C)(3) | LINE 10 | Yes (1) | LUTHERAN REAL ESTATE HOLDING CORP | |
| LUTHERAN HOUSING OF LA CROSSE INC | |||||||||||
| 1900 SOUTH AVENUE | LA CROSSE | WI | 54601 | 391751934 | INDEPENDENT LIVING | WI | 501(C)(3) | LINE 10 | Yes (1) | LUTHERAN REAL ESTATE HOLDING CORP | |
| ST JOSEPH'S MEMORIAL FOUNDATION INC | |||||||||||
| 400 WATER AVE | HILLSBORO | WI | 54634 | 391455787 | FOUNDATION | WI | 501(C)(3) | LINE 12A, I | Yes (1) | ST JOSEPH'S HEALTH SERVICES INC | |
| TRI-COUNTY MEMORIAL HOSPITAL INC | |||||||||||
| 18601 LINCOLN STREET | WHITEHALL | WI | 54773 | 390704510 | HEALTH CARE | WI | 501(C)(3) | LINE 3 | Yes (1) | GUNDERSEN LUTHERAN HEALTH SYSTEM INC | |
| TRI-COUNTY MEMORIAL FOUNDATION INC | |||||||||||
| 18601 LINCOLN STREET | WHITEHALL | WI | 54773 | 300093022 | FOUNDATION | WI | 501(C)(3) | LINE 12A, I | Yes (1) | TRI-COUNTY MEMORIAL HOSPITAL INC | |
| MEMORIAL HOSPITAL OF BOSCOBEL | |||||||||||
| 205 PARKER STREET | BOSCOBEL | WI | 53805 | 390845590 | HEALTH CARE | WI | 501(C)(3) | LINE 3 | Yes (1) | GUNDERSEN LUTHERAN HEALTH SYSTEM INC | |
| PALMER LUTHERAN HEALTH CENTER | |||||||||||
| 112 JEFFERSON STREET | WEST UNION | IA | 52175 | 421320763 | HEALTH CARE | IA | 501(C)(3) | LINE 3 | Yes (1) | GUNDERSEN LUTHERAN HEALTH SYSTEM INC | |
| MEMORIAL HEALTHCARE FOUNDATION INC | |||||||||||
| PO BOX 40 | FRIENDSHIP | WI | 53934 | 391775074 | FOUNDATION | WI | 501(C)(3) | LINE 12A, I | Yes (1) | MOUNDVIEW MEMORIAL HOSPITAL & CLINICS INC | |
| MOUNDVIEW MEMORIAL HOSPITAL & CLINICS INC | |||||||||||
| 402 W LAKE STREET | FRIENDSHIP | WI | 53934 | 390944012 | HEALTH CARE | WI | 501(C)(3) | LINE 3 | Yes (1) | GUNDERSEN LUTHERAN HEALTH SYSTEM INC | |
| SAINT ELIZABETH'S HOSPITAL OF WABASHA | |||||||||||
| 1200 GRANT BLVD WEST | WABASHA | MN | 55981 | 410693877 | HEALTH CARE | MN | 501(C)(3) | LINE 3 | Yes (1) | GUNDERSEN LUTHERAN HEALTH SYSTEM INC | |
| ST JOSEPH'S HEALTH SERVICES | |||||||||||
| PO BOX 527 400 WATER AVENUE | HILLSBORO | WI | 54634 | 390929538 | HEALTH CARE | WI | 501(C)(3) | LINE 3 | Yes (1) | GUNDERSEN LUTHERAN HEALTH SYSTEM INC | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | Province Or StateForeignAddress/ProvinceOrStateNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BEL-REGIONAL HOME MEDICAL INC | ||||||||||||||
| 617 S ROOSEVELT | GREEN BAY | WI | 54301 | 391504766 | DURABLE MEDICAL EQUIPMENT, RETAIL PHARMACY, FITNESS | WI | N/A | C | 0 | |||||
| BG ASSURANCE COMPANY | ||||||||||||||
| SELF INSURANCE | N/A | C | 0 | 20 GENESIS CLOSE PO BOX 30600 | GEORGE TOWN | GRAND CAYMAN, KY1 | CJ | CJ | ||||||
| GUNDERSEN EDGE LLC | ||||||||||||||
| 1836 SOUTH AVENUE | LA CROSSE | WI | 54601 | 921783811 | INNOVATION | WI | N/A | C | 0 | |||||
| GUNDERSEN LUTHERAN ENVISION LLC | ||||||||||||||
| 1836 SOUTH AVENUE | LA CROSSE | WI | 54601 | 264706546 | RENEWABLE ENERGY | WI | N/A | C | 0 | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BELLIN GUNDERSEN HEALTH SYSTEM INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | C | TransactionTypeTxt |
| Involved | $300,000 | InvolvedAmt |
| Method Of Amount Determination | COST | MethodOfAmountDeterminationTxt |