STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

SAUK PRAIRIE HEALTHCARE INC: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
SAUK PRAIRIE HEALTHCARE INC (EIN 39-0872080)
Tax period
2019-01-01 to 2019-12-31
Filed
2020-10-27
IRS object ID
202013019349300216
Schema version
2019v5.1
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

FieldValueIRS element (for citing)
Return2020-10-27T08:42:59-05:00ReturnTs
Tax Period End2019-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1220 S 6TH STREET SUITE 300AddressLine1Txt
CityMINNEAPOLISCityNm
State AbbreviationMNStateAbbreviationCd
ZIP55402ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN390872080EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SAUK PRAIRIE HEALTHCARE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSAUKBusinessNameControlTxt
Phone6086433311PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1260 26TH STREETAddressLine1Txt
CityPRAIRIE DU SACCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53578ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJAMES DREGNEYPersonNm
Person TitleCFOPersonTitleTxt
Phone6086433311PhoneNum
Signature2020-10-21SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKOREY BOELTERPreparerPersonNm
PTINP00775161PTIN
Phone6123764500PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address66.188.188.148IPv4AddressTxt
FieldValueIRS element (for citing)
IP2020-10-21IPDt
IP Tm13:42:43IPTm
IP TimezoneCDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdE4741269E891B2A6D94612CFE194BACCC4D0E92EAtSubmissionCreationDeviceId
At Submission Filing Device Id8DF0D5A1DBF8E44DE93554FEEDBEEE801640FE4CAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerSHAWN LERCHPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1260 26TH STREETAddressLine1Txt
CityPRAIRIE DU SACCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53578ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$102,196,910GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.SAUKPRAIRIEHEALTHCARE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1956FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionEXTRAORDINARY HEALTHCARE FROM THE HEART - ONE PERSON AT A TIME.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee731TotalEmployeeCnt
Total Volunteers117TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$238,288PYContributionsGrantsAmt
CY Contributions Grants$108,179CYContributionsGrantsAmt
PY Program Service Revenue$90,943,792PYProgramServiceRevenueAmt
CY Program Service Revenue$94,387,884CYProgramServiceRevenueAmt
PY Investment Income$3,134,736PYInvestmentIncomeAmt
CY Investment Income$842,311CYInvestmentIncomeAmt
PY Other Revenue-$50,574PYOtherRevenueAmt
CY Other Revenue-$69,713CYOtherRevenueAmt
PY Total Revenue$94,266,242PYTotalRevenueAmt
CY Total Revenue$95,268,661CYTotalRevenueAmt
PY Grants And Similar Paid$54,942PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$55,484CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$51,929,798PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$53,940,222CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$123,442CYTotalFundraisingExpenseAmt
PY Other Expenses$39,658,309PYOtherExpensesAmt
CY Other Expenses$39,898,275CYOtherExpensesAmt
PY Total Expenses$91,643,049PYTotalExpensesAmt
CY Total Expenses$93,893,981CYTotalExpensesAmt
PY Revenues Less Expenses$2,623,193PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,374,680CYRevenuesLessExpensesAmt
Total Assets BOY$147,187,959TotalAssetsBOYAmt
Total Assets EOY$150,202,911TotalAssetsEOYAmt
Total Liabilities BOY$73,943,490TotalLiabilitiesBOYAmt
Total Liabilities EOY$72,257,474TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$73,244,469NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$77,945,437NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionEXTRAORDINARY HEALTHCARE FROM THE HEART - ONE PERSON AT A TIME.VISION: WE WILL SET THE STANDARD FOR COMMUNITY-BASED HEALTHCARE THAT IMPROVES THE HEALTH AND QUALITY OF LIFE OF THE PEOPLE WE SERVE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$62,495,107ExpenseAmt
Grant$55,484GrantAmt
Revenue$78,991,735RevenueAmt
DescSAUK PRAIRIE HEALTHCARE ("THE HOSPITAL"), A 36-BED ACUTE CARE GENERAL HOSPITAL, IS A NONPROFIT, NONSTOCK WISCONSIN CORPORATION PROVIDING SERVICES TO SAUK CITY, PRAIRIE DU SAC, AND THE SURROUNDING COMMUNITIES.TOTAL ADMISSIONS FOR 2019 WERE 1,988 WITH PATIENT DAYS OF 4,049. KEY PATIENT SERVICES INCLUDING 354 BIRTHS IN THE NURSERY, 5,249 SURGICAL PROCEDURES, 66,097 REHABILITATION THERAPY SERVICES, 28,049 MEDICAL IMAGING SERVICES, AND 14,305 EMERGENCY ROOM VISITS ARE AMONG MANY OF THE SERVICES PROVIDED TO PATIENTS DURING 2019.THE HOSPITAL FULFILLS ITS MISSION AND VISION BY OFFERING HIGH-QUALITY SERVICES IN RURAL COMMUNITIES, THEREBY ALLOWING OUR PATIENTS TO BE TREATED LOCALLY WITHOUT LENGTHY COMMUTES OR WAITING. THE HOSPITAL HAS GAINED A REGIONAL REPUTATION OF EXCELLENCE IN ORTHOPEDICS, GENERAL SURGERY, SPINE SURGERY, AND GYNECOLOGY SURGERY. THE HOSPITAL OPERATES FOUR CLINICS IN RURAL AREAS: LODI, SPRING GREEN, PLAIN, AND BLACK EARTH, BRINGING PRIMARY CARE TO THOSE COMMUNITIES. THE CLINICS HAD OVER 35,750 VISITS IN 2019. AS A CHARITABLE ORGANIZATION, THE HOSPITAL PROVIDED ALMOST $2 MILLION IN FREE CARE TO PATIENTS IN OUR SERVICE AREA IN 2019, IN ADDITION TO SUBSIDIZING SERVICES THAT DO NOT COVER COSTS, FREE HEALTH SCREENINGS, EDUCATION PROGRAMS, AND YOUTH OUTREACH.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$16,283,316ExpenseAmt
Grant$0GrantAmt
Revenue$15,396,149RevenueAmt
DescTHE HOSPITAL ALSO OWNS AND OPERATES CLINICS IN SPRING GREEN (DBA RIVER VALLEY CLINIC), MAZOMANIE (DBA WISCONSIN HEIGHTS CLINIC), PLAIN, AND LODI, WISCONSIN, AS WELL AS OPERATES ORTHOPEDIC AND SURGICAL PHYSICIAN PRACTICES AND THE BETTER HEALTH CENTER IN PRAIRIE DU SAC, WISCONSIN. TOTAL CLINIC VISITS TO THESE SITES IN 2019 WERE 53,334.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$78,778,423TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash ContriYes (1)DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document42IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee731EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org DocumentsYes (1)ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldWIStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonJAMES DREGNEYPersonNm
Phone6086433311PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1260 26TH STREETAddressLine1Txt
CityPRAIRIE DU SACCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53578ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtHighest Compensated EmployeeHighestCompensatedEmployeeIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
ANDREW ERTL MD
SURGEON40.00Yes (X)$1,088,712$0$51,848
MICHAEL LAMSON MD
SURGEON40.00Yes (X)$963,741$0$44,787
MATTHEW HERBERT MD
SURGEON40.00Yes (X)$910,945$0$44,583
DAVID MARCU MD
SURGEON40.00Yes (X)$903,741$0$44,787
NATHAN GRUNEWALD MD
SURGEON40.00Yes (X)$509,124$0$48,971
SHAWN LERCH
CEO50.00$306,438$0$42,629Yes (X)
JAMES DREGNEY
CFO50.00$287,507$0$44,379Yes (X)
DENISE COLE-OUZOUNIAN
VP PATIENT SVCS (THROUGH OCT 2019)50.00$170,347$0$41,091Yes (X)
LISA PICKARTS
VP PATIENT SERVICES50.00$127,406$0$35,067Yes (X)
ALLAN PECKHAM
TRUSTEE2.00$14,233$0$0Yes (X)
VICKIE WENZEL
SECRETARY & PRESIDENT5.00$11,075$0$0Yes (X)Yes (X)
TOM SCHWARZ
TREASURER2.80$9,633$0$0Yes (X)Yes (X)
NANCY BREUNIG
TRUSTEE2.50$9,438$0$0Yes (X)
TAMMY ADLER
SECRETARY3.00$8,433$0$0Yes (X)Yes (X)
TODD SCHAD MD
TRUSTEE2.00$8,017$0$0Yes (X)
RICHARD MARINO
PRES. & TRUSTEE (THROUGH APR 2019)1.00$7,800$0$0Yes (X)Yes (X)
RYAN KRAEMER
VICE PRESIDENT3.00$7,538$0$0Yes (X)Yes (X)
JASON BRICKL
TRUSTEE2.00$6,033$0$0Yes (X)
NEIL BISHOP
TRUSTEE2.50$4,567$0$0Yes (X)
KARI APEL
TRUSTEE2.50$3,233$0$0Yes (X)
GEOFF LORENZ
TRUSTEE2.00$3,033$0$0Yes (X)
ROXI MAIER
VP & TRUSTEE (THROUGH APRIL 2019)1.60$1,700$0$0Yes (X)Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$5,362,694TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$398,142TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K80IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
CENTRAL MINNESOTA DIAGNOSTICS
150 10TH STREET NWMILACAMN563531221CT & MRI SERVICES$1,470,096
SHARED IMAGING
PO BOX 88450MILWAUKEEWI532880450ULTRASOUNDS, CARDIAC ECHO & NUCLEAR MED$1,425,655
NTT DATA SERVICE
2300 W PLANO PARKWAYPLANOTX75075SERVER STORAGE$323,536
FASTAFF LLC
PO BOX 911452DENVERCO802911452CONTRACTED NURSING CARE$316,061
MERITER LABORATORIES
PO BOX 681166CHICAGOIL606952166LABORATORY TESTING SERVICE$291,353
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K11CntrctRcvdGreaterThan100KCnt
Related Organizations$31,179RelatedOrganizationsAmt
All Other Contributions$77,000AllOtherContributionsAmt
Noncash Contributions$77,000NoncashContributionsAmt
Total Contributions$108,179TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
HOSPITAL PATIENT REVENUE621990$77,194,421$77,194,421
CLINIC REVENUE621110$15,396,149$15,396,149
OTHER HOSPITAL SERVICES621990$1,501,944$1,501,944
CAFETERIA AND VENDING621990$295,370$295,370
FieldValueIRS element (for citing)
Total Program Service Revenue$94,387,884TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$922,123TotalRevenueColumnAmt
Exclusion$922,123ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$124,669RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$194,382RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$69,713RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$69,713TotalRevenueColumnAmt
Exclusion-$69,713ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$6,581,083SecuritiesAmt
Other$72,972OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$6,718,940SecuritiesAmt
Other$14,927OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$137,857SecuritiesAmt
Other$58,045OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$79,812TotalRevenueColumnAmt
Exclusion-$79,812ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$95,268,661TotalRevenueColumnAmt
Related Or Exempt Func Income$92,590,570RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$2,569,912ExclusionAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$55,484TotalAmt
Program Services$55,484ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,054,865TotalAmt
Management And General$1,054,865ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$42,993,036TotalAmt
Program Services$38,107,583ProgramServicesAmt
Management And General$4,797,017ManagementAndGeneralAmt
Fundraising$88,436FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,670,632TotalAmt
Program Services$1,556,219ProgramServicesAmt
Management And General$110,801ManagementAndGeneralAmt
Fundraising$3,612FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$5,592,381TotalAmt
Program Services$4,885,046ProgramServicesAmt
Management And General$695,870ManagementAndGeneralAmt
Fundraising$11,465FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,629,308TotalAmt
Program Services$2,252,800ProgramServicesAmt
Management And General$370,292ManagementAndGeneralAmt
Fundraising$6,216FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$203,795TotalAmt
Management And General$203,795ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$50,355TotalAmt
Management And General$50,355ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$7,506,162TotalAmt
Program Services$6,058,671ProgramServicesAmt
Management And General$1,447,491ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$353,036TotalAmt
Program Services$58,485ProgramServicesAmt
Management And General$294,551ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,876,864TotalAmt
Program Services$1,234,530ProgramServicesAmt
Management And General$629,463ManagementAndGeneralAmt
Fundraising$12,871FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,020,315TotalAmt
Management And General$1,020,315ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$994,318TotalAmt
Program Services$167,603ProgramServicesAmt
Management And General$825,873ManagementAndGeneralAmt
Fundraising$842FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$36,826TotalAmt
Program Services$27,133ProgramServicesAmt
Management And General$9,693ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$2,882,801TotalAmt
Program Services$2,882,801ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$5,568,005TotalAmt
Program Services$4,926,293ProgramServicesAmt
Management And General$641,712ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$263,950TotalAmt
Program Services$83,597ProgramServicesAmt
Management And General$180,353ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$12,624,565$12,624,565
REPAIRS & MAINTENANCE$2,054,151$1,601,928$452,223
MISCELLANEOUS EXPENSES$1,460,684$1,062,972$397,712
MEDICAID ASSESSMENT TAX$1,280,648$1,280,648

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,721,800TotalAmt
Program Services$1,192,713ProgramServicesAmt
Management And General$529,087ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$93,893,981TotalAmt
Program Services$78,778,423ProgramServicesAmt
Management And General$14,992,116ManagementAndGeneralAmt
Fundraising$123,442FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY-$379,165BOYAmt
EOY-$285,898EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$20,666,164BOYAmt
EOY$22,153,196EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$10,939,125BOYAmt
EOY$12,076,375EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,019,233BOYAmt
EOY$991,629EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$982,313BOYAmt
EOY$1,126,617EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$132,180,909LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$58,185,864LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$78,350,557BOYAmt
EOY$73,995,045EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$30,690,916BOYAmt
EOY$34,551,987EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$1,131,726BOYAmt
EOY$1,248,831EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$3,787,090BOYAmt
EOY$4,345,129EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$147,187,959BOYAmt
EOY$150,202,911EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$10,137,032BOYAmt
EOY$9,947,280EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$61,058,177BOYAmt
EOY$59,531,090EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$146,856BOYAmt
EOY$273,459EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,601,425BOYAmt
EOY$2,505,645EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$73,943,490BOYAmt
EOY$72,257,474EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$69,457,379BOYAmt
EOY$73,600,308EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,787,090BOYAmt
EOY$4,345,129EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$73,244,469BOYAmt
EOY$77,945,437EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$147,187,959BOYAmt
EOY$150,202,911EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$1,374,680ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$2,740,075NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$586,213OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings MembersYes (1)MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact LegislatorsYes (1)DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$12,752OtherActivitiesAmt
Total Lobbying Expenditures$12,752TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationPART II-B, LINE 1: SAUK PRAIRIE HEALTHCARE ("THE HOSPITAL) PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THESE DUES ARE PRIMARILY FOR ACCESS TO EDUCATIONAL MATERIALS AND STAFF TRAINING DEVELOPMENT. THE HOSPITAL IS ALSO A MEMBER OF THE RURAL WISCONSIN HEALTH COOPERATIVE (RWHC). EACH YEAR, THE HOSPITAL PAYS MEMBERSHIP FEES TO THE RWHC. THE RWHC PROVIDES SUPPORT SERVICES FOR A NUMBER OF ITS MEMBER HOSPITALS THROUGHOUT THE STATE OF WISCONSIN. SOME OF THE MANY SERVICES PROVIDED TO MEMBER HOSPITALS INCLUDE PROVIDING ASSISTANCE TO ORGANIZATIONS IN FINDING GRANT FUNDING FOR NEW PROGRAMS, LEGAL SERVICES, REIMBURSEMENT REVIEW SERVICES, ACCOUNTING ASSISTANCE, CONTRACTING FOR THERAPIST AND EMERGENCY ROOM PATIENT CARE COVERAGE, AND ADMINISTRATIVE CONSULTING SERVICES. AS A PART OF THESE SERVICES, THE RWHC ALSO DOES PROVIDE ANALYSIS ON CURRENT HEALTHCARE ISSUES IN AN EFFORT TO PROMOTE AND BETTER HEALTHCARE FOR HOSPITALS IN RURAL COMMUNITIES THROUGHOUT WISCONSIN. ONE OF THESE EFFORTS ALSO INCLUDES SOME LOBBYING ON THE PART OF THE MEMBER ORGANIZATIONS. PART II-B, LINE 1 (D AND G): REPRESENTATIVES FROM THE HOSPITAL ANNUALLY PARTICIPATE IN THE WISCONSIN HOSPITAL ASSOCIATION'S ADVOCACY DAY WHERE THE REPRESENTATIVES ARE GIVEN THE OPPORTUNITY TO GATHER WITH OTHER HEALTHCARE ORGANIZATIONS IN THE STATE OF WISCONSIN AND ALSO MEET WITH STATE GOVERNMENT REPRESENTATIVES WITH THE PURPOSE OF IMPROVING THE DELIVERY OF HEALTHCARE NOT ONLY AT SAUK PRAIRIE HEALTHCARE BUT ALSO COLLECTIVELY IN THE STATE OF WISCONSIN. AS ISSUES OR PROPOSED LEGISLATION ARISE THROUGHOUT THE YEAR, OFFICIALS OF THE HOSPITAL WILL SEND LETTERS OF COMMENT TO LOCAL, STATE, AND FEDERAL GOVERNMENT REPRESENTITIVES TO EITHER SHOW SUPPORT OF PROPOSED CHANGES OR VOICE AN OPINION TO IMPROVE THE OUTCOME OF PROPOSED LEGISLATION OR OTHER CHANGES. THESE ACTIVITIES RESULT IN MINIMAL COST TO THE OPERATION OF THE HOSPITAL.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,047,424BeginningYearBalanceAmt
Investment Earnings Or Losses$420,881InvestmentEarningsOrLossesAmt
End Year Balance$2,468,306EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,075,699BeginningYearBalanceAmt
Investment Earnings Or Losses-$28,275InvestmentEarningsOrLossesAmt
End Year Balance$2,047,424EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,843,376BeginningYearBalanceAmt
Investment Earnings Or Losses$232,323InvestmentEarningsOrLossesAmt
End Year Balance$2,075,699EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,688,056BeginningYearBalanceAmt
Investment Earnings Or Losses$155,320InvestmentEarningsOrLossesAmt
End Year Balance$1,843,376EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,654,555BeginningYearBalanceAmt
Investment Earnings Or Losses$33,501InvestmentEarningsOrLossesAmt
End Year Balance$1,688,056EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.71400PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.28600TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$7,338,643OtherCostOrOtherBasisAmt
Book Value$7,338,643BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$65,052,221OtherCostOrOtherBasisAmt
Depreciation$21,130,881DepreciationAmt
Book Value$43,921,340BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,615,010OtherCostOrOtherBasisAmt
Depreciation$559,933DepreciationAmt
Book Value$1,055,077BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$58,085,066OtherCostOrOtherBasisAmt
Depreciation$36,495,050DepreciationAmt
Book Value$21,590,016BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$89,969OtherCostOrOtherBasisAmt
Book Value$89,969BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$73,995,045TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
DEFERRED COMPENSATION LIABILITY$2,408,366
THIRD PARTY SETTLEMENTS$97,279
FieldValueIRS element (for citing)
Total Liability$2,505,645TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$93,334,741TotalRevEtcAuditedFinclStmtAmt
Other Revenue$222,556OtherRevenueAmt
Revenue Not Reported$222,556RevenueNotReportedAmt
Revenue Subtotal$93,112,185RevenueSubtotalAmt
Other Revenues Not Included$2,156,476OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$2,156,476RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$95,268,661TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$93,303,099TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$194,382OtherExpensesIncludedAmt
Expenses Not Reported$194,382ExpensesNotReportedAmt
Expenses Subtotal$93,108,717ExpensesSubtotalAmt
Other Expenses Not Included$785,264OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$785,264ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$93,893,981TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:THE SCHNELLER SISTERS FUND SHALL BE HELD AS A SEPARATE PERMANENT ENDOWMENT FUND ON THE BOOKS AND RECORDS OF THE FOUNDATION, THE INCOME FROM WHICH SHALL BE DISTRIBUTED TO SAUK PRAIRIE HEALTHCARE FOR UNRESTRICTED NEEDS. ALL DISTRIBUTIONS FROM THE SCHNELLER SISTERS FUND SHALL BE DESIGNATED AS HAVING BEEN MADE "IN MEMORY OF THE SCHNELLER SISTERS: CECELIA SCHNELLER MUELLER, ADLYNN F. BALFANZ, AND MARY ANN ROSAR."
PART X, LINE 2:IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE HOSPITAL ASSESSES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE LIKELY THAN NOT RECOGNITION THRESHOLD, THE BENEFIT OF THE TAX POSITION IS NOT RECOGNIZED IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE HOSPITAL HAS NOT RECORDED ANY ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS AS OF DECEMBER 31, 2019 OR 2018.
PART XI, LINE 2D - OTHER ADJUSTMENTS:NET ASSETS RELEASED FROM RESTRICTION 28,174. RENTAL EXPENSES 194,382.
PART XI, LINE 4B - OTHER ADJUSTMENTS:GOOD NEIGHBOR CLINIC SERVICES PROVIDED 233,946. CONTRIBUTION FROM RELATED ORGANIZATION 91,087. BAD DEBT EXPENSE 551,318. INVESTMENT INCOME 776,449. OTHER INCOME 503,676.
PART XII, LINE 2D - OTHER ADJUSTMENTS:RENTAL EXPENSES 194,382.
PART XII, LINE 4B - OTHER ADJUSTMENTS:GOOD NEIGHBOR CLINIC SERVICES PROVIDED 233,946. BAD DEBT EXPENSE 551,318.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent100Yes (X)Percent100Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$821,842TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$821,842NetCommunityBenefitExpnsAmt
Total Expense0.00880TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,629,330TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,422,082DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,207,248NetCommunityBenefitExpnsAmt
Total Expense0.03420TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,451,172TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,422,082DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,029,090NetCommunityBenefitExpnsAmt
Total Expense0.04300TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$323,269TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$323,269NetCommunityBenefitExpnsAmt
Total Expense0.00340TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$247,874TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$247,874NetCommunityBenefitExpnsAmt
Total Expense0.00260TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$15,739,998TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$13,206,883DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,533,115NetCommunityBenefitExpnsAmt
Total Expense0.02700TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$162,396TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$162,396NetCommunityBenefitExpnsAmt
Total Expense0.00170TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$16,473,537TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$13,206,883DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,266,654NetCommunityBenefitExpnsAmt
Total Expense0.03470TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$23,924,709TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$16,628,965DirectOffsettingRevenueAmt
Net Community Benefit Expns$7,295,744NetCommunityBenefitExpnsAmt
Total Expense0.07770TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$15,307TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$15,307NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$174TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$174NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$13,479TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$13,479NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,180TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$4,180NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$48,506TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$48,506NetCommunityBenefitExpnsAmt
Total Expense0.00050TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$81,646TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$81,646NetCommunityBenefitExpnsAmt
Total Expense0.00080TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$551,318BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$18,733,576ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$23,223,271CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$4,489,695MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SAUK PRAIRIE HEALTHCARE INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1260 26TH STREETAddressLine1Txt
CityPRAIRIE DU SACCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53578ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.SAUKPRAIRIEHEALTHCARE.ORGWebsiteAddressTxt
State License122StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1SAUK PRAIRIE HEALTHCARE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
OtherYes (X)OtherInd
CHNA Conducted18CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE LINE 10AOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt18ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLWWW.SAUKPRAIRIEHEALTHCARE.ORG/ABOUT/COMMUNITY-HEALTHStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care100.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLHTTP://WWW.SAUKPRAIRIEHEALTHCARE.ORG/PATIENTS/BILLING/COMMUNITY-CAREFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLHTTP://WWW.SAUKPRAIRIEHEALTHCARE.ORG/PATIENTS/BILLING/COMMUNITY-CAREFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLHTTP://WWW.SAUKPRAIRIEHEALTHCARE.ORG/PATIENTS/BILLING/COMMUNITY-CAREFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
FAP TranslatedYes (X)FAPTranslatedInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr PrvtYes (X)LookBackMedicaidMedcrPrvtInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SAUK PRAIRIE HEALTHCARE, INC.PART V, SECTION B, LINE 3J: THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORT INCLUDES STRATEGY PLANNING INPUT AND FINDINGS FROM THE COMMUNITY INPUT SESSIONS CONDUCTED BY NEIGHBORING HOSPITALS AND COUNTY HEALTH DEPARTMENTS.
SAUK PRAIRIE HEALTHCARE, INC.PART V, SECTION B, LINE 5: ALONG WITH COLLECTING AND ANALYZING DATA FROM THE SAUK COUNTY HEALTH AND WELLNESS COALITION SURVEY (INCLUDING 648 RESPONDENTS FROM THE SPH SERVICE AREA) AND ONLINE DATA SOURCES, SIX KEY INFORMANT FOCUS GROUP MEETINGS WERE CONDUCTED WITH STAKEHOLDERS REPRESENTING BROAD INTERESTS OF THE AREA. THE GROUPS INCLUDED, BUT WERE NOT LIMITED TO, SCHOOL REPRESENTATIVES, LAW ENFORCEMENT OFFICERS, HEALTHCARE PROVIDERS, EMERGENCY RESPONSE PROFESSIONALS, CLERGY MEMBERS, MUNICIPAL OFFICIALS, AND COMMUNITY GROUP LEADERS. THE QUESTIONS ASKED WERE RELATED TO GENERAL COMMUNITY ISSUES AND CONCERNS, AT-RISK POPULATIONS, ISSUES IN THE COMMUNITY THAT PROMOTE POOR HEALTH, AND ISSUES RELATED TO HEALTHCARE ACCESS. AT THE MEETINGS, HEALTH CONCERNS WERE IDENTIFIED AND PRIORITIZED. IN ADDITION TO THE KEY INFORMANT MEETINGS FACILITATED BY SPH, MANY OTHER COMMUNITY FORUMS WERE HELD BY MEMBERS OF THE SAUK COUNTY HEALTH AND WELLNESS COALITION. ON JANUARY 16, 2019, A "CREATING OUR HEALTH COMMUNITY PLAN" FORUM AND PRIORITY SESSION WAS HELD IN SAUK PRAIRIE.
SAUK PRAIRIE HEALTHCARE, INC.PART V, SECTION B, LINE 6A: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED IN JOINT EFFORT WITH THE FOLLOWING OTHER HOSPITALS: SSM-ST. CLARE HOSPITAL (BARABOO, WI) AND REEDSBURG AREA MEDICAL CENTER (REEDSBURG, WI). SAUK PRAIRIE HEALTHCARE, INC. ALSO WORKED WITH THE RICHLAND HOSPITAL (RICHLAND CENTER) AND UPLAND HILLS HEALTH (DODGEVILLE), BUT TO A LESSER DEGREE THAN SSM-ST. CLARE AND REEDSBURG.
SAUK PRAIRIE HEALTHCARE, INC.PART V, SECTION B, LINE 6B: SAUK PRAIRIE HEALTHCARE, INC. WORKED WITH REEDSBURG AREA MEDICAL CENTER (REEDSBURG, WI) AND SSM-ST. CLARE HOSPITAL (BARABOO, WI) AND THE SAUK COUNTY DEPARTMENT OF HEALTH TO IDENTIFY AND PRIORITIZE HEALTH NEEDS. THIS GROUP MEETS ON AT LEAST A QUARTERLY BASIS TO CONTINUALLY ASSESS NEEDS AND COORDINATE AND REPORT ON HEALTH INITIATIVE PROGRESS IN EACH MEMBER'S RESPECTIVE SERVICE AREA.
SAUK PRAIRIE HEALTHCARE, INC.PART V, SECTION B, LINE 7D: THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS MADE PUBLICLY AVAILABLE IN JANUARY 2019 AND ITS AVAILABILITY WAS ANNOUNCED VIA A COMMUNITY NEWSLETTER TO MORE THAN 20,000 HOUSEHOLDS IN APRIL 2019. THE CHNA WAS INTERNALLY ANNOUNCED TO EMPLOYEES AND MEDICAL STAFF OF THE HOSPITAL IN JANUARY 2019.
SAUK PRAIRIE HEALTHCARE, INC.PART V, SECTION B, LINE 11: THE FOLLOWING STEPS ACTIONS WERE TAKEN IN 2018 TO ADDRESS SIGNIFICANT HEALTH NEEDS IDENTIFIED IN PRIOR COMMUNITY HEALTH NEEDS ASSESSMENTS. (1) SAUK PRAIRIE HEALTHCARE FOUNDATION ("SPHF") FUNDED MENTAL HEALTH FIRST AID CLASSES TO TEACH STAFF AND COMMUNITY MEMBERS HOW TO IDENTIFY THE SIGNS OF MENTAL ILLNESS AND THE RESOURCES AVAILABLE FOR HELP. (2) TO PREVENT SUICIDE AND SHARE RESOURCES AND EDUCATION TO LOWER THE LIKELIHOOD THAT OUR COMMUNITY WILL LOSE A MEMBER TO SUICIDE, SPH HAD THREE REPRESENTATIVES PARTICIPATE IN HOPE SAUK PRAIRIE. (3) IN OUR EFFORTS TO REDUCE THE PREVALENCE OF TYPE 2 DIABETES, SPH SPONSORS A 16 SESSION/12-MONTH PRE-DIABETIC CLASSROOM PROGRAM AIMED AT EDUCATING PARTICIPANTS ON LIFESTYLE CHANGES TO REDUCE THEIR RISK OF DEVELOPING DIABETES. (4) TO CREATE AN ENVIRONMENT OF HEART HEALTH AWARENESS, SPH AND SPH FOUNDATION CONTINUED OUR SUPPORT OF THE HEART ZONES PROGRAM IN ALL 4 SCHOOL DISTRICTS IN THE SPH COMMUNITY. (5) THROUGH EFFORTS TO EDUCATE STUDENTS ON THE HEALTH BENEFITS OF FRUITS AND VEGETABLES, 8 CLASSES WERE TAUGHT IN A RURAL GRADE SCHOOL IN THE 2017/2018 SCHOOL YEAR. (6) SPH AND SPH FOUNDATION DONATED A COMBINED $1,000 TO THE LONE ROCK SPLASH PAD COALITION TO HELP PHYSICAL ACTIVITY IN THAT COMMUNITY. (7) SPH PROVIDED A CLASSROOM PROGRAM FOR THOSE IN THE COMMUNITY WHO WANT ASSISTANCE QUITTING SMOKING. (8) SPH COORDINATED EIGHT PHYSICIAN-LED WALKS TO PROMOTE FITNESS AND ACTIVITY IN THREE OF THE SPH COMMUNITIES.THE FOLLOWING ACTIONS WERE DONE IN 2019 TO ADDRESS SIGNIFICANT HEALTH NEEDS IDENTIFIED IN SPH'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT. (1) SAUK PRAIRIE HEALTHCARE FOUNDATION ("SPHF") FUNDED 3 MENTAL HEALTH FIRST AID CLASSES TO TEACH STAFF AND COMMUNITY MEMBERS HOW TO IDENTIFY THE SIGNS OF MENTAL ILLNESS AND THE RESOURCES AVAILABLE FOR HELP. (2) TO HELP PREVENT SUICIDE AND SHARE RESOURCES AND EDUCATION TO LOWER THE LIKELIHOOD THAT OUR COMMUNITY WILL LOSE A MEMBER TO SUICIDE, SPH HAD ONE REPRESENTATIVE PARTICIPATE IN HOPE SAUK PRAIRIE AS WELL AS THE FARMERS STRESS WORKGROUP. (3) SPH HAD 1 REPRESENTATIVE PARTICIPATE IN ACTIVATE LODI TO ENCOURAGE COMMUNITY ACTIVITY AND INVOLVEMENT. (4) IN OUR EFFORTS TO REDUCE THE PREVALENCE OF TYPE 2 DIABETES, SPH SPONSORED TWO 12 SESSION/4-MONTH PRE-DIABETIC CLASSROOM PROGRAM AIMED AT EDUCATING PARTICIPANTS ON LIFESTYLE CHANGES TO REDUCE THEIR RISK OF DEVELOPING DIABETES. THESE EFFORTS ALSO INCLUDED SEVERAL GROCERY STORE EDUCATIONAL TOURS TO TEACH HEALTHIER SHOPPING IDEAS. (5) TO CREATE AN ENVIRONMENT OF HEART HEALTH AWARENESS, SPH AND SPH FOUNDATION CONTINUED OUR SUPPORT OF THE HEART ZONES PROGRAM IN ALL 4 SCHOOL DISTRICTS IN THE SPH COMMUNITY. (6) THROUGH EFFORTS TO EDUCATE STUDENTS ON THE HEALTH BENEFITS OF FRUITS AND VEGETABLES, SPH'S STIR IT UP PROGRAM HELD 8 CLASSES WERE TAUGHT IN A RURAL GRADE SCHOOL IN THE 2018/2019 SCHOOL YEAR. (7) SPH FOUNDATION DONATED A COMBINED $25,000 TO COMMUNITY PROJECTS THAT CONTRIBUTE TO THE HEALTH OF THE COMMUNITY AS PART OF THE "HEALTHY LIFE GRANTS" PROGRAM. (8) SPH COORDINATED PHYSICIAN-LED WALKS 2/MONTH FROM MAY TO SEPTEMBER 2019 TO PROMOTE FITNESS AND ACTIVITY IN THE WISCONSIN HEIGHTS COMMUNITY. (9) SPH BEGAN AN EFFORT TO REDUCE MORAL DISTRESS AMONG FAMILIES AND PHYSICIANS FACED WITH CRITICAL CHOICES ABOUT TREATMENTS FOR PATIENTS WHO LACK DECISION-MAKING CAPACITY BY FORMING AN ADVANCE DIRECTIVE TASK COMMITTEE. (10) SPH BEGAN AN EFFORT TO ADDRESS YOUTH VAPING BY EXPANDING THE SMOKING CESSATION TASK GROUP AND MEETINGS WERE HELD WITH LOCAL SCHOOLS TO PROVIDE THEM SUPPORT IF/WHERE THEY MAY NEED ASSISTANCE IN ADDITION TO PROVIDING A CLASSROOM PROGRAM FOR THOSE IN COMMUNITY WHO WANT ASSISTANCE QUITTING SMOKING. (11) THROUGH EFFORTS TO EDUCATE COMMUNITY MEMBERS REGARDING VARIOUS DIET AND EXERCISE, SPH HAD REPRESENTATIVES PRESENT AT REACH OUT LODI AND BARABOO LIONS CLUB THREE TIMES IN 2019. (12) SPH FOUNDATION PROVIDED A YOUTH FEMALE EMPOWERMENT CLASS TO 12 STUDENTS FROM THE WISCONSIN HEIGHTS SCHOOL DISTRICT.
SAUK PRAIRIE HEALTHCARE, INC.PART V, SECTION B, LINE 13B: PATIENTS WHO ARE UNABLE TO COMPLETE AN APPLICATION FORM MAY BE ELIGIBLE FOR COMMUNITY CARE IF OTHER EVIDENCE IS AVAILABLE WHICH MAY INDICATE FINANCIAL HARDSHIP. THIS INFORMATION MAY BE OBTAINED FROM A PATIENT INTERVIEW, CREDIT REPORT, OR OTHER AVAILABLE RECORDS. CONSIDERATION WILL BE GIVEN ON AN INDIVIDUAL BASIS.OTHER PROVISIONS UNDER PRESUMPTIVE ELIGIBILITY:I. DECEASED WITH NO ESTATE - BASED ON THE CONCLUSION THAT THE DESCENDANT HAS NO ASSETS, AND THEREFORE NO ABILITY TO PAY. *II. ACCOUNTS UNCOLLECTIBLE DUE TO DISCHARGE OF DEBTOR BY BANKRUPTCY. *III. IF IT HAS BEEN DETERMINED THAT A PATIENT HAS BEEN APPROVED FOR MEDICAL ASSISTANCE, ALL ACCOUNTS CURRENTLY IN THE A/R WITH SPH WILL BE WRITTEN OFF TO COMMUNITY CARE AFTER PAYMENT IS RECEIVED FROM THE INSURANCE. *IV. ANY ACCOUNT RETURNED BY THE COLLECTION AGENCY THAT HAS BEEN DETERMINED TO BE UNCOLLECTIBLE WILL BE CONSIDERED COMMUNITY CARE. *V. QUALIFIED INDIVIDUALS UNDER ANOTHER ORGANIZATION'S SIMILAR COMMUNITY CARE APPLICATION PROCESS.* NO COMMUNITY CARE APPLICATION NEEDS TO BE COMPLETED IN THESE INSTANCES.
SAUK PRAIRIE HEALTHCARE, INC.PART V, SECTION B, LINE 16J: INFORMATION ABOUT THE POLICY IS INCLUDED ON BILLING INVOICES, ON ADMISSION INFORMATION, ON THE WEBSITE, AND IS REFERENCED IN COLLECTION EFFORTS. IT IS ALSO MENTIONED IN COMMUNITY TALKS ON HEALTH INSURANCE.
FieldValueIRS element (for citing)
Facility6FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - ORTHOPEDIC ASSOCIATES OF SAUK PRAIRIE
250 26TH STREET SUITE 150PRAIRIE DU SACWI53578ORTHOPEDIC CLINIC
2 - LODI MEDICAL CENTER
160 VALLEY DRIVELODIWI53555PHYSICIAN CLINIC
3 - RIVER VALLEY MEDICAL CENTER
436 SUNRISE DRIVESPRING GREENWI53588RURAL HEALTH CLINIC
4 - WISCONSIN HEIGHTS CLINIC
506 CROCKER STREET SUITE 3MAZOMANIEWI53560PHYSICIAN CLINIC
5 - PLAIN MEDICAL CLINIC
825 MAIN STREETPLAINWI53577RURAL HEALTH CLINIC
6 - SURGICAL ASSOCIATES
250 26TH STREET SUITE 210PRAIRIE DU SACWI53577SURGICAL CLINIC

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:ELIGIBILITY FOR SAUK PRAIRIE HEALTHCARE'S COMMUNITY CARE (FINANCIAL ASSISTANCE) PROGRAM IS CONSIDERED FOR INDIVIDUALS WHO ARE UNINSURED, UNDERINSURED, INELIGIBLE FOR GOVERNMENTAL HEALTH PLANS, AND WHO ARE UNABLE TO PAY FOR THEIR CARE. ABILITY TO PAY IS DETERMINED BY COMPARING FAMILY INCOME TO FEDERAL POVERTY LEVELS, BUT IT ALSO CONSIDERS THE FAMILY'S ASSETS. DETERMINATIONS ARE BASED UPON AN INDIVIDUAL'S FINANCIAL NEED AND DO NOT TAKE INTO ACCOUNT GENDER, RACE, SOCIAL STATUS, SEXUAL ORIENTATION, OR RELIGIOUS AFFILIATION. INDIVIDUALS MUST RESIDE OR HAVE A PRIMARY CARE PHYSICIAN IN SAUK PRAIRIE HEALTHCARE'S SERVICE AREA TO BE ELIGIBLE. PATIENTS WHO ARE UNABLE TO COMPLETE A COMMUNITY CARE APPLICATION MAY BE ELIGIBLE FOR ASSISTANCE IF OTHER EVIDENCE IS AVAILABLE THAT MAY INDICATE FINANCIAL HARDSHIP. THIS INFORMATION MAY BE OBTAINED FROM A PATIENT INTERVIEW, CREDIT REPORT, OR OTHER AVAILABLE RECORDS. THIS INCLUDES THE FOLLOWING SITUATIONS:1. DECEASED WITH NO ESTATE2. DISCHARGE OF DEBTOR BY BANKRUPTCY3. PATIENT HAS BEEN APPROVED FOR MEDICAL ASSISTANCE4. ACCOUNT IS RETURNED BY THE COLLECTION AGENCY AS UNCOLLECTIBLE5. QUALIFICATION UNDER ANOTHER ORGANIZATION'S SIMILAR FINANCIAL ASSISTANCE APPLICATION PROCESS
PART I, LINE 7:THE COSTING METHODOLOGY USED ON FORM 990 IS PRIMARILY BASED ON A COST TO CHARGE RATIO WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBTS DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST TO CHARGE RATIO IS APPLIED AGAINST VARIOUS REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER SUGGESTED COSTING METHODS FOR THE FORM 990. THE COSTING METHOD FOR SUBSIDIZED HEALTH SERVICES IS BASED ON INTERNAL RECORDS ALLOCATIONS WHICH ARE SIMILAR TO A DIRECT COSTING ACCOUNTING SYSTEM FOR THESE SERVICES NOTED AS SUBSIDIZED HEALTH SERVICES.
PART I, LINE 7G:SUBSIDIZED HEALTH SERVICES AT SAUK PRAIRIE HEALTHCARE, INC. INCLUDE THE OPERATION OF SEVERAL HOSPITAL DEPARTMENTS THAT OPERATE AT A LOSS FROM OPERATIONS, BUT ARE CONSIDERED VITAL HOSPITAL AND CLINIC SERVICES SUCH AS THE INTENSIVE CARE UNIT, OUTPATIENT PHYSICIAN CLINICS, INCLUDING INTERNAL MEDICINE (HOSPITAL MEDICINE), AND SEVERAL OTHER DEPARTMENTS. A LARGE PORTION OF THESE SERVICES ARE ACCESSED BY COMMUNITY MEMBERS THROUGH THE HOSPITAL'S EMERGENCY SERVICES DEPARTMENT. IT IS THE GOAL OF SAUK PRAIRIE HEALTHCARE, INC. TO PROVIDE THESE SERVICES TO THE COMMUNITY REGARDLESS OF A PATIENT'S ABILITY TO PAY.
PART II, COMMUNITY BUILDING ACTIVITIES:THE HOSPITAL'S COMMUNITY BUILDING EFFORTS PROMOTE BOTH THE PHYSICAL AND ECONOMIC HEALTH OF THE COMMUNITIES IT SERVES. FROM AN ECONOMIC PERSPECTIVE, SAUK PRAIRIE HEALTHCARE, INC. STAFF CONTRIBUTES HUNDREDS OF HOURS TO CHAMBERS OF COMMERCE ACTIVITIES AND SUPPORT WORKFORCE DEVELOPMENT THROUGH COMMUNITY AND EDUCATIONAL PROGRAMS. THE PHYSICAL HEALTH OF THE COMMUNITY IS SUPPORTED THROUGH THE DEVELOPMENT OF HEALTH-RELATED COALITIONS, PARTICULARLY THE SAUK PRAIRIE WELLNESS MOVEMENT AND THE SAUK COUNTY HEALTH AND WELLNESS COALITION.
PART III, LINE 2:THE COSTING METHODOLOGY USED ON FORM 990 IS BASED ON A COST-TO-CHARGE RATIO, WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES EXCLUDING THE PROVISION FOR BAD DEBT, DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST THE TOTAL CHARGES THAT ARE WRITTEN OFF DURING THE YEAR TO ESTIMATE THE COST OF CARE FOR INDIVIDUALS WHO HAVE ACCOUNTS THAT ARE DEEMED TO BE BAD DEBTS TO THE HOSPITAL. THE HOSPITAL ALSO RECOGNIZES THAT IT ALSO PROVIDES A DISCOUNT TO SELF-PAY OR UNINSURED PATIENTS. THESE AMOUNTS ARE EXCLUDED FROM GROSS PATIENT SERVICE REVENUE ON THE FINANCIAL STATEMENTS AND ARE NOT INCLUDED IN THE RATIO AS DESCRIBED ABOVE AND APPROVED BY THE IRS FOR USE ON FORM 990. IF CONSIDERED, THESE ADDITIONAL WRITE-OFF AMOUNTS TO UNINSURED ACCOUNTS WOULD ALSO INCREASE THE ESTIMATED BAD DEBT EXPENSE AMOUNT ASSOCIATED WITH THESE UNCOLLECTIBLE ACCOUNTS TO THE HOSPITAL.
PART III, LINE 3:MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY UNINSURED PATIENTS AND AMOUNTS PATIENTS ARE PERSONALLY RESPONSIBLE FOR, THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO A VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF HISTORICAL COLLECTION LIKELIHOOD AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUTSTANDING AFTER THE ORGANIZATION HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO ACCOUNTS RECEIVEABLE.
PART III, LINE 4:FOR AN EXPLANATION OF THE ORGANIZATION'S BAD DEBT EXPENSE, SEE THE "PATIENT ACCOUNTS RECEIVABLES AND CREDIT POLICY" PARAGRAPHS IN NOTE 1 OF THE AUDITED FINANCIAL STATEMENTS, LOCATED ON PAGES 7-8 OF THE ATTACHED FINANCIAL STATEMENTS.
PART III, LINE 8:WHETHER THERE IS SHORTFALL OR A SURPLUS ON SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THESE PATIENTS, WHO ARE TYPICALLY ELDERLY MEMBERS OF THE COMMUNITY, ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE PATIENT SERVICES, THE CENTERS FOR MEDICARE AND MEDICAID (CMS) WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY. THE TOTAL MEDICARE REVENUE SHOWN ON SCHEDULE H IS BASED ON THE IRS FORM 990 INSTRUCTIONS AND ONLY INCLUDE THE CHARGES FROM MEDICARE PROGRAM BENEFICIARIES THAT ARE REPORTED ON THE HOSPITAL'S MEDICARE COST REPORT. THE AMOUNTS LISTED FOR MEDICARE REVENUES DO NOT INCLUDE PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT AT SAUK PRAIRIE HEALTHCARE, INC., PHYSICIAN SERVICES FOR THE INTERNAL MEDICINE (HOSPITALIST) PROGRAM, PHYSICIAN SERVICES PROVIDED TO TWO OF THE FOUR OUTLYING PHYSICIAN CLINICS, CRNA SERVICES PROVIDED TO PATIENTS UNDERGOING ANESTHESIA AT THE HOSPITAL, AND A SIGNIFICANT PORTION OF LAB AND PHYSICAL THERAPY SERVICES WHICH ARE REIMBURSED BY THE MEDICARE PROGRAM UNDER ANOTHER METHODOLOGY. PHYSICIAN COVERAGE OUTPATIENT LAB SERVICES AND OUTPATIENT PHYSICAL THERAPY SERVICES ARE REIMBURSED PRIMARILY ON A FEE SCHEDULE REIMBURSEMENT AT RATES THAT ARE OFTEN BELOW THE COST OF CARING FOR PATIENTS. EMERGENCY PHYSICIAN SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND AS SUCH THESE COSTS AND SHORTFALLS SHOULD ALSO BE CONSIDERED AS AN ADDITIONAL BENEFIT THAT SAUK PRAIRIE HEALTHCARE, INC. PROVIDES TO THE COMMUNITY AND SURROUNDING AREAS. THE COSTING METHODOLOGY USED ABOVE FOR IRS FORM 990 COMPLIANCE REPORTING IS ALSO BASED ON AN OVERALL AVERAGE COST TO CHARGE RATIO AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES AS IT IS BASED ON TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBT EXPENSE DIVIDED BY HOSPITAL PATIENT SERVICE REVENUES (IGNORING CONTRACTUAL ADJUSTMENT ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE). THIS RATIO IS THEN MULTIPLIED BY THE TOTAL MEDICARE SERVICES, WHICH ARE REIMBURSED ON A COST REPORTING METHODOLOGY. INCLUDING THE FEE SCHEDULE ITEMS, SUCH AS PHYSICIAN SERVICES, WOULD PRODUCE A LARGER LOSS OR SHORTFALL ON THESE SERVICES TO BE REPORTED ON THE FORM 990 IN ANY GIVEN YEAR.
PART III, LINE 9B:IT IS THE POLICY OF SAUK PRAIRIE HEALTHCARE, INC. THAT EACH PATIENT RECEIVES CARE REGARDLESS OF THE ABILITY TO PAY. IF DURING THE COLLECTION PROCESS A PATIENT DOES NOT COMPLETE THE NECESSARY PAPERWORK OR RESPOND TO ATTEMPTS BY THE HOSPITAL TO PROVIDE CHARITY SERVICES, THE PATIENT MAY STILL REQUEST CHARITY INFORMAITON AND COMPLETE THE INFORMATION AT ANY TIME DURING THE COLLECTION PROCESS. THE PATIENT WILL BE REFERRED TO THE HOSPITAL'S CHARITY CARE POLICY AND CAN QUALIFY FOR CHARITY CARE, AND HAVE ANY COLLECTION ISSUES REVERSED BY THE ORGANIZATION, IF THEY SHOW A NEED FOR CARE BASED ON THE HOSPITAL'S POLICY.
PART VI, LINE 2:THE HOSPITAL ENGAGES IN THE FOLLOWING ACTIVITIES TO ASSESS THE HEALTHCARE NEEDS OF THE 42,000 RESIDENTS THROUGHOUT ITS 700 SQUARE MILE PRIMARY SERVICE AREA: ANALYZE HEALTH STATUS INFORMATION, EPIDEMIOLOGICAL DATA, AND HOSPITAL DISCHARGE DATA FURNISHED BY THE STATE OF WISCONSIN AND SAUK COUNTY TO IDENTIFY ISSUES AND TRENDS; MEET MONTHLY WITH THE COUNTY HEALTH DEPARTMENT AND TWO OTHER NEARBY HOSPITALS TO ASSESS HIGH PRIORITY HEALTH NEEDS AND COORDINATE ACTION; PARTICIPATE IN AND HELP COORDINATE COUNTY-WIDE INPUT SESSIONS WITH THE COUNTY HEALTH DEPARTMENT; LEAD AND PARTICIPATE IN COMMUNITY WELLNESS GROUPS AND INITIATIVES THROUGHOUT THE SERVICE AREA; CONDUCT "COMMUNITY HEALTH NEED" FOCUS GROUPS CONSISTING OF COMMUNITY LEADERS AND RANDOMLY SELECTED RESIDENTS; ANALYZE THE POPULATION-BASED NEED FOR MEDICAL PROVIDERS BY SPECIALTY. THIS INFORMATION IS ASSESSED AND MODIFIED BY MEMBERS OF THE HOSPITAL MEDICAL STAFF; LEADER PARTICIPATION AND LEADERSHIP IN CIVIC AND COMMUNITY SERVICE ORGANIZATIONS; ACTIVELY ENGAGE HOSPITAL BOARD MEMBERS IN COMMUNITY HEALTH IMPROVEMENT INITIATIVES AND PROVIDE THE BOARD WITH MONTHLY UPDATES REGARDING COMMUNITY HEALTH ACTIVITIES.
PART VI, LINE 3:AT THE TIME OF REGISTRATION, A REGISTRATION SPECIALIST WILL INQUIRE IF THERE IS HEALTH INSURANCE. IF NOT, THEY WILL BE ADVISED OF THE HOSPITAL'S COMMUNITY CARE PROGRAM IF THEY RESIDE WITHIN OUR SERVICE AREA. THOSE WHO HAVE A SAUK PRAIRIE BASED PHYSICIAN WILL ALSO BE CONSIDERED FOR ELIGIBILITY. COMMUNITY CARE INFORMATION IS ALSO POSTED ON THE HOSPITAL WEBSITE AND BILLS STATE THAT IF THE PATIENT IS HAVING DIFFICULTY PAYING THEY SHOULD CONTACT A HOSPITAL REPRESENTATIVE, AS THEY MAY BE ELIGIBLE FOR FREE OR REDUCED FEES.ANY PATIENT REQUESTING ADDITIONAL INFORMATION ABOUT THE COMMUNITY CARE PROGRAM WILL BE REFERRED TO THE PATIENT ACCOUNTS SPECIALIST, WHO WILL EXPLAIN THE PROGRAM AND ITS ELIGIBLITY CRITERIA. WHEN APPLICABLE, ALL GOVERNMENT ASSISTANCE PROGRAMS SUCH AS MEDICAID, BADGER CARE, AND CRIME VICTIMS MUST BE EXHAUSTED BEFORE APPLYING FOR COMMUNITY CARE (EXCEPTION: THE GOVERNMENT ASSISTANCE PROGRAM APPLICATION MAY BE WAIVED BASED ON RELIGIOUS BELIEFS). COMMUNITY CARE IS NOT AVAILABLE FOR ELECTIVE PROCEDURES. PERSONS RESIDING IN SAUK PRAIRIE MEMORIAL HOSPITAL, INC.'S PRIMARY SERVICE AREA WILL BE CONSIDERED FOR ELIGIBLITY DETERMINATION. IN THE CASE OF EMERGENCY SERVICES, COMMUNITY CARE MAY BE EXTENDED TO THOSE RESIDING OUTSIDE OF THE PRIMARY SERVICE AREA.THE INFORMATION IS ALSO POSTED ON OUR WEBSITE UNDER "PREPARING FOR YOUR STAY." IF AT ANY TIME PRIOR TO, DURING, OR AFTER THE SERVICES ARE PROVIDED THE PATIENT EXPRESSED CONCERNS ABOUT PAYMENT, THE COMMUNITY CARE PROGRAM IS EXPLAINED. INFORMATION IS ALSO PRINTED ON PATIENT STATEMENTS AND DISCUSSED WITH THE PATIENT DURING THE BILLING PROCESS.
PART VI, LINE 4:THE HOSPITAL'S PRIMARY SERVICE AREA ENCOMPASSES A 700 SQUARE MILE REGION IN RURAL SOUTH CENTRAL WISCONSIN, INCLUDING SAUK, SOUTHERN COLUMBIA, NORTHWEST DANE, NORTHERN IOWA AND EASTERN RICHLAND COUNTIES. THE HOSPITAL IS LOCATED IN SAUK PRAIRIE (COMMON NAME FOR THE NEIGHBORING MUNICIPALITIES OF SAUK CITY AND PRAIRIE DU SAC) AND THE CLINICS ARE LOCATED IN FOUR TOWNS SURROUNDING SAUK PRAIRIE (MAZOMANIE, SPRING GREEN, PLAIN, AND LODI). NO OTHER HOSPITALS ARE LOCATED WITHIN THE PRIMARY SERVICE AREA, BUT EIGHT INPATIENT HOSPITALS (INCLUDING 5 RURAL AND 3 TERTIARY FACILITIES) ARE LOCATED WITHIN A 30 MILES RADIUS OF SAUK PRAIRIE HEALTHCARE, INC. DEMOGRAPHIC ANALYSIS INDICATES A 5-YEAR GROWTH RATE OF 2.5% COMPARED TO THE STATE OF WISCONSIN'S RATE OF 1.9%. AGE GROUPS THAT WILL GROW AT A CONSIDERABLY FASTER RATE THAN THE STATE INCLUDE 0-17 YEAR OLDS (1.9%), 25-34 (15.2%), AND 65+ (16.65%). HEALTH ISSUES AFFECTING THESE AGE SEGMENTS INCLUDE PRENATAL SCREENING, TEEN PREGNANCY, LACK OF ACCESS TO HEALTHCARE, AND MEDICAL ISSUES ASSOCIATED WITH AGING. THE AREA HAS LITTLE RACIAL AND ETHNIC DIVERSITY, ALTHOUGH THE NUMBER OF HISPANIC RESIDENTS HAS INCREASED CONSIDERABLY SINCE 2000. SPECIFIC HEALTH-RELATED ISSUES CONFRONTING THIS POPULATION INCLUDE DIABETES, ACCESS TO CARE, AND LANGUAGE BARRIERS. AVERAGE HOUSEHOLD INCOME OF SERVICE AREA RESIDENTS IS 10% HIGHER THAN THE STATE AVERAGE. THIS DIFFERENCE IS DUE IN LARGE PART BECAUSE OF THE RELATIVELY STRONG JOB MARKET IN MADISON, WHICH ATTRACTS COMMUTERS FROM THE SERVICE AREA. THROUGHOUT THE SERVICE AREA, HOWEVER, AGRICULTURE AND TOURISM REPRESENT A CONSIDERABLE NUMBER OF LOW-PAYING JOBS, TYPCIALLY WITHOUT HEALTH BENEFITS. A PORTION OF THE HOSPITAL PRIMARY SERVICE AREA IS DESIGNATED AS A MEDICALLY UNDERSERVED AREA/POPULAITON. THIS AREA IS LOCATED IN THE TOWN OF ARENA (MCD 02575). SAUK COUNTY IS ALSO DESIGNATED AS A HEALTH MANPOWER SHORTAGE AREA FOR PSYCHIATRY.
PART VI, LINE 5:SAUK PRAIRIE HEALTHCARE, INC. IS AN INDEPENDENT COMMUNITY HOSPITAL GOVERNED BY AN 11-MEMBER BOARD OF DIRECTORS WHO RESIDE WITHIN THE PRIMARY SERVICE AREA. THE BOARD IS ELECTED BY THE 120 MEMBER COMMUNITY HOSPITAL ASSOCIATION. AN INDEPENDENT HOSPITAL IS A CRUCIAL PART OF THE HOSPITAL'S VISION, BECAUSE IT KEEPS CONTROL AT THE LOCAL LEVEL, NOT IN A CORPORATE HEADQUARTERS LOCATED ELSEWHERE. LOCAL CONTROL ALLOWS THE HOSPITAL TO MAKE DECISIONS THAT ARE BEST FOR THE LOCAL COMMUNITIES. THE SAUK PRAIRIE MEMORIAL HOSPITAL, INC. MEDICAL STAFF PRIVILEGES QUALIFIED PHYSICIANS IN ITS COMMUNITIES. THE VAST MAJORITY OF THE ACTIVE MEDICAL STAFF PRACTICE SOLELY AT THE SAUK PRAIRE MEMORIAL HOSPITAL, INC. OR ASSOCIATED CLINICS. THE HOSPITAL STRATEGIC PLAN SPECIFICALLY ADDRESSES OUR DESIRE TO "IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE AND THE ORGANIZATION'S EFFORTS TO ASSESS THE NEEDS OF THE COMMUNITY AND ADDRESS THOSE NEEDS. SAUK PRAIRIE HEALTHCARE, INC. PROMOTES COMMUNITY HEALTH THROUGH A BROAD ARRAY OF APPROACHES. THE FOLLOWING LIST DESCRIBES SPECIFIC PROGRAMS AND ACTIVITIES THAT CONTRIBUTE TO IMPROVING THE HEALTH OF THE COMMUNITY AND ENHANCING THE PROVISION OF MEDICAL CARE: TRAINING MEDICAL STUDENTS, NURSING STUDENTS, AND OTHER HEALTH PROFESSIONS; CONTRIBUTE TIME AND FINANCIAL RESOURCES IN THE DEVELPOMENT OF A DENTAL CLINIC, COLLABORATION WITH OTHER INDIVIDUALS AND ORGANIZATIONS IN THE COMMUNITY, TO PROVIDE DENTAL SERVICES TO UNINSURED AND UNDERINSURED MEMBERS OF THE COMMUNITIES SERVED WHO WOULD OTHERWISE NOT HAVE ACCESS OR THE ABILITY TO ACCESS THESE SERVICES ON A REGULAR BASIS; ORGANIZE AND/OR PARTICIPATE IN HEALTH FAIRS; OFFER CPR/FIRST AID CLASSES; ISSUE EDUCATIONAL NEWS RELEASES; CONDUCT COMMUNITY-BASED CLINICAL SCREENINGS (HEARING AID CHECKS, BLOOD PRESSURE, AND CHOLESTERAL SCREENING); PROVIDE SERVICES FOR THE GOOD NEIGHBOR CLINIC OF SAUK PRAIRIE, INC. (LOCAL FREE CLINIC); MEDICATION TAKE BACK DAY; DISCOUNTED EQUIPMENT AND SUPPLIES; ADVANCED DIRECTIVES COUNSELING; BLOOD DRIVES; BREASTFEEDING EDUCATION; CANCER EDUCATION; CLINICS FOR UNDERINSURED/LAB & MEDICATION COSTS; COMMUNITY GARDEN; COMMUNITY HEALTH IMPROVEMENT ADVOCACY; DIABETES EDUCATION; FAMILY/PARENTING/SIBLING EDUCATION; IMMUNIZATIONS/PERTUSSIS; MOBILE MEALS; PRESCRIPTION DRUG COLLECTION; SCHOOL-BASED HEALTH EDUCATION PROGRAMS; SCREENING/HEARING; SELF-HELP/CARDIAC REHAB; SELF-HELP/FITNESS AND EXERCISE; SELF-HELP/NUTRITION AND WEIGHT MANAGEMENT; SELF-HELP/SPORTS INJURY PREVENTION; SHARPS COLLECTION; SUPPORT GROUPS-BEREAVEMENT/GRIEF; SUPPORT GROUPS-BREASTFEEDING; SUPPORT GROUP-DIABETES; SUPPORT GROUPS-NEW MOM; SUPPORT GROUPS-SLEEP APNEA; AND TRANSPORTATION TOCKENS (BUS, CAB FARE).
PART VI, LINE 7, REPORTS FILED WITH STATESWI

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeTUITION REIMBURSEMENTGrantTypeTxt
Recipient22RecipientCnt
Cash Grant$55,484CashGrantAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationTO SUPPORT THE NEEDS OF LOW-INCOME COMMUNITY MEMBERS, SAUK PRAIRIE HEALTHCARE (SPH) PROVIDES SPACE IN OUR OLD HOSPITAL TO GOOD NEIGHBOR CLINIC TO SERVE THOSE INDIVIDUALS. ANY PRODUCTS GIVEN TO GOOD NEIGHBOR CLINIC ARE HAND-DELIVERED. THE SHARED SPACE ENABLES SPH TO SEE HOW THE SUPPLIES ARE BEING USED. SPH ALSO PROVIDES FINANCIAL ASSISTANCE TO EMPLOYEES OF SPH TO ADVANCE THEIR KNOWLEDGE, SKILLS AND ABILITIES THROUGH POST-SECONDARY EDUCATION. APPLICATION FOR TUITION REIMBURSEMENT MUST BE MADE AT LEAST TWO WEEKS PRIOR TO THE COURSE STARTING DATE. THE APPLICATION MATERIALS MUST INCLUDE A COPY OF THE CLASS OR CURRICULUM DESCRIPTION BEING SUBMITTED FOR APPROVAL AND THE COST PER COURSE OR PER CREDIT. THE TUITION REIMBURSEMENT REQUEST FORM MUST BE COMPLETED AND SIGNED BY THE EMPLOYEE, DEPARTMENT DIRECTOR, AND VICE PRESIDENT PRIOR TO THE FIRST DATE OF CLASS. WITHIN 60 DAYS OF COMPLETION OF THE COURSE(S), THE EMPLOYEE MUST SUBMIT RECEIPTS FOR TUITION PAID BY THE EMPLOYEE AND PROOF OF SATISFACTORY COMPLETION TO THE HUMAN RESOURCES DEPARTMENT. UPON VERIFICATION OF ALL INFORMATION, HUMAN RESOURCES WILL ARRANGE FOR A REIMBURSEMENT CHECK TO BE ISSUED TO THE EMPLOYEE.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
ANDREW ERTL MD
SURGEON$842,477$0$230,778$0$15,457$0$14,000$0$37,848$0$1,140,560$0$0$0
MICHAEL LAMSON MD
SURGEON$815,145$0$147,876$0$720$0$14,000$0$30,787$0$1,008,528$0$0$0
MATTHEW HERBERT MD
SURGEON$774,220$0$136,005$0$720$0$14,000$0$30,583$0$955,528$0$0$0
DAVID MARCU MD
SURGEON$732,229$0$171,032$0$480$0$14,000$0$30,787$0$948,528$0$0$0
NATHAN GRUNEWALD MD
SURGEON$500,864$0$0$0$8,260$0$14,000$0$34,971$0$558,095$0$0$0
SHAWN LERCH
CEO$283,079$0$21,900$0$1,459$0$12,192$0$30,437$0$349,067$0$0$0
JAMES DREGNEY
CFO$245,954$0$15,000$0$26,553$0$14,000$0$30,379$0$331,886$0$0$0
DENISE COLE-OUZOUNIAN
VP PATIENT SVCS (THROUGH OCT 2019)$149,059$0$11,905$0$9,383$0$8,915$0$32,176$0$211,438$0$0$0
LISA PICKARTS
VP PATIENT SERVICES$122,072$0$4,729$0$605$0$6,548$0$28,519$0$162,473$0$0$0

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY
A39133785597710B6V92013-01-19$38,000,000CONSTRUCTION OF NEW HOSPITAL000
WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY
B3913378552013-01-19$30,000,000CONSTRUCTION OF NEW HOSPITAL000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdTotal ProceedsTotalProceedsAmtIn Reserve FundInReserveFundAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCapital ExpendituresCapitalExpendituresAmtSubstantial CompletionSubstantialCompletionYrRefunding Tax Exempt BondsRefundingTaxExemptBondsIndRefunding Taxable BondsRefundingTaxableBondsIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintIndRetiredRetiredAmt
A$38,000,000$3,384,222$562,253$34,053,525201400Yes (1)Yes (1)
B$30,000,000$1,987,633$542,647$27,469,720201400Yes (1)Yes (1)$7,592,891

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A000000Yes (1)
B000000Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A000Yes (1)0000Yes (1)
B000Yes (1)Yes (1)000Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (1)
BYes (1)

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceDATE REBATE COMPUTATION PERFORMEDFormAndLineReferenceDesc
ExplanationISSUER NAME: WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 02/26/2018 ISSUER NAME: WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 04/03/2018ExplanationTxt

Schedule M IRS990ScheduleM

Real Estate Commercial RealEstateCommercialGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution1ContributionCnt
Noncash Contributions Rpt F990$77,000NoncashContributionsRptF990Amt
Method Of Determining RevenuesAPPRAISALMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Form8283 Received0Form8283ReceivedCnt
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsYes (1)ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1THE BOARD HAS AN EXECUTIVE COMMITTEE CONSISTING OF THE BOARD'S OFFICERS AND THE IMMEDIATE PAST-PRESIDENT OF THE BOARD SO LONG AS THE IMMEDIATE PAST-PRESIDENT IS A MEMBER OF THE BOARD. WHEN A MEETING OF THE WHOLE IS NOT PRACTICAL OR FEASIBLE DUE TO AN EMERGENCY OR URGENCY OF A MATTER, THE EXECUTIVE COMMITTEE MAY EXERCISE ALL POWERS OF THE BOARD WITH RESPECT TO THE MANAGEMENT OF THE ORGANIZATION'S AFFAIRS WHEN THE BOARD IS NOT MEETING, EXCEPT FOR ELECTING OFFICERS OR FILLING VACANCIES ON THE BOARD OR ANY COMMITTEE OF THE BOARD.
FORM 990, PART VI, SECTION A, LINE 4THE BYLAWS WERE AMENDED IN 2019 TO MAKE THE FOLLOWING SIGNIFICANT CHANGES: (A) CLARIFY THAT THE ORGANIZATION'S EMPLOYEES ARE NOT ELIGIBLE TO SERVE AS BOARD MEMBERS, (B) TO LIMIT A BOARD MEMBER'S SERVICE TO NO MORE THAN 4 CONSECUTIVE 3-YEAR TERMS, AND (C) TO ALLOW FOR REASONABLE BOARD MEMBER COMPENSATION.
FORM 990, PART VI, SECTION A, LINE 6MEMBERSHIP IN SAUK PRAIRIE HEALTHCARE IS OPEN TO ALL PERSONS RESIDING IN THE ORGANIZATION'S SERVICE AREA AND TO THE ORGANIZATION'S CURRENT EMPLOYEES AND MEDICAL STAFF REGARDLESS OF PLACE OF RESIDENCE. THE ORGANIZATION'S SERVICE AREA IS FROM TIME TO TIME DETERMINED BY THE BOARD. MEMBERSHIP IS OPEN TO NATURAL PERSONS ONLY. CORPORATIONS, PARTNERSHIPS, LIMITED LIABILITIY COMPANIES, TRUSTS AND OTHER ENTITIES THAT ARE NOT NATURAL PERSONS ARE NOT ELIGIBLE FOR MEMBERSHIP. ANY NATURAL PERSON WHO PAYS DUES AS PROVIDED HEREIN SHALL BE A MEMBER OF THE ORGANIZATION AND SHALL BE ENTITLED TO VOTE AT THE ANNUAL OR ANY SPECIAL MEETING OF THE MEMBERSHIP. A NATURAL PERSON WHO CONTRIBUTES BY VOLUNTARY DONATION AN AGGREGATE OF $100.00 TO THE ORGANIZATION, WHICH SHALL CONSTITUTE THE DUES ENTITLING SUCH PERSON TO MEMBERSHIP, AND IS EITHER A RESIDENT OF THE SERVICE AREA, A CURRENT EMPLOYEE, OR MEMBER OF THE MEDICAL STAFF, SHALL BE A MEMBER AND SUCH MEMBERSHIP SHALL NOT TERMINATE AS THE RESULT OF SUBSEQUENT RESIDENCE OUTSIDE OF THE SERVICE AREA. MONETARY CONTRIBUTIONS TO THE SAUK PRAIRIE HEALTHCARE FOUNDATION, LTD. SHALL BE APPLIED TOWARD DUES FOR MEMBERSHIP.
FORM 990, PART VI, SECTION A, LINE 7ATHE BOARD OF DIRECTORS SHALL BE ELECTED BY THE MEMBERS AT THE ANNUAL MEETING OF THE MEMBERS.
FORM 990, PART VI, SECTION A, LINE 7BAN ANNUAL MEMBERSHIP SHALL BE ENTITLED TO ONE VOTE AT THE ANNUAL MEETING OR AT ANY SPECIAL MEETINGS OF THE MEMBERSHIP. MEMBERS MAY VOTE ON ELECTIONS OF BOARD MEMBERS, CHANGES TO THE BYLAWS, AND OTHER BUSINESS ALLOWED BY LAW.
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 WAS REVIEWED IN DETAIL BY THE DIRECTOR OF FINANCE, THE CFO, AND A DISCUSSION WAS HELD WITH THE CEO FOR ANY NEW OR UNUSUAL ITEMS. UPON APPROVAL, THE BOARD OF DIRECTORS RECEIVED AN ELECTRONIC COPY OF THE FORM 990 PRIOR TO SUBMISSION WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CSINCE SAUK PRAIRIE HEALTHCARE, INC. IS A PART OF A SMALL COMMUNITY. CONFLICTS ARE GENERALLY KNOWN, IF NOT DISCLOSED THROUGH THE ANNUAL PROCESS CONDUCTED BY HUMAN RESOURCES. THE ANNUAL PROCESS INCLUDES ALL DIRECTOR LEVEL EMPLOYEES AND ABOVE OF THE HOSPITAL. THE BOARD OF DIRECTORS HAS A CONFLICT OF INTEREST POLICY AND MUST ANNUALLY SIGN A DISCLOSURE FORM STATING ANY POTENTIAL CONFLICTS OF INTEREST. THE BOARD PRESIDENT THEN DISCLOSES ANY CONFLICTS OF INTEREST TO THE FULL BOARD OF DIRECTORS. CONFLICT OF INTEREST STATEMENTS COMPLETED BY BOARD MEMBERS ARE REVIEWED BY THE BOARD PRESIDENT AND EMPLOYEE'S CONFLICT OF INTEREST STATEMENTS ARE REVIEWED BY STAFF LEADERSHIP AND/OR ADMINISTRATION. THESE INDIVIDUALS ARE CHARGED WITH THE RESPONSIBILITY OF ENSURING THAT BUSINESS IS CONDUCTED IN A MANNER THAT ADHERES TO THE HOSPITAL'S FORMALLY APPROVED CONFLICT OF INTEREST POLICY.
FORM 990, PART VI, SECTION B, LINE 15ATHE BOARD OF DIRECTORS HAS ESTABLISHED POLICY BG-8 TO ESTABLISH ITS COMPENSATION PHILOSOPHY WITH RESPECT TO EXECUTIVE COMPENSATION AND TO DEFINE PRACTICES ASSOCIATED IN ACCORDANCE WITH IRC 4958. HOSPITAL EXECUTIVE SALARY IS SET ANNUALLY USING COMPARABILITY DATA FROM OUTSIDE CONSULTANTS AND THIRD-PARTY SURVEY DATA. THE HOSPITAL ALSO ENGAGES THE SERVICES OF THIRD PARTY VENDORS FROM TIME TO TIME IN ORDER TO OBTAIN AN OBJECTIVE, EXTERNAL REVIEW OF PAY RANGES IN TERMS OF MARKET COMPARABILITY. THE EXECUTIVE COMMITTEE IS RESPONSIBLE FOR SETTING SALARY FOR THE CEO BASED ON THE CEO'S JOB PERFORMANCE. THE COMMITTEE RELIES UPON COMPARABILITY DATA DEVELOPED BY OUTSIDE CONSULTANTS TO SUPPORT ITS DECISION MAKING PROCESS AND TO ENSURE COMPETITIVE SALARY LEVELS. THE BOARD REVIEWS BG-8 ANNUALLY AT THE GOVERNANCE COMMITTEE. COMPENSATION FOR OTHER KEY EMPLOYEES IS ESTABLISHED BY APPLICATION OF THE HOSPITAL'S COMPENSATION PHILOSOPHY, WHEREIN RATES OF PAY ARE COMPARED TO MARKET RATES OBTAINED THROUGH PARTICIPATION IN WAGE AND BENEFIT SURVEYS. PAY RANGES ARE OBTAINED FROM SURVEYS OF SIMILARLY SITUATED HOSPITALS LOCATED WITHIN THE STATE OF WISCONSIN IN TERMS OF SIZE AND REVENUE CATEGORY. THE HOSPITAL ADOPTED A "MEET THE MARKET" APPROACH TO COMPENSATION FOR POSITIONS AT THESE LEVELS. THIS MEANS THAT SAUK PRAIRIE HEALTHCARE, INC. TARGETS THE MIDPOINT OF THE PAY RANGE ASSOCIATED WITH EACH POSITION. THE CEO APPROVES COMPENSATION FOR ALL OTHER OFFICERS AND KEY EMPLOYEES BASED ON THE CRITERIA ABOVE.
FORM 990, PART VI, SECTION C, LINE 19THE ABBREVIATED FINANCIAL STATEMENTS ARE A PART OF THE HOSPITAL'S ANNUAL REPORT PRESENTED TO THE PUBLIC AT THE ANNUAL MEETING AND POSTED ON THE HOSPITAL'S WEBSITE. THE ABBREVIATED FINANCIAL STATEMENTS ARE ALSO MADE PUBLICLY AVAILABLE THROUGH THE WISCONSIN HOSPITAL ASSOCIATION. THE HOSPITAL'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9:CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION 586,213.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationInd
SAUK PRAIRIE HEALTHCARE FOUNDATION LTD
80 FIRST STREETPRAIRIE DU SACWI53578930841113FUNDRAISINGWI501(C)(3)LINE 10N/A0
FRIENDS OF SAUK PRAIRIE HEALTHCARE
260 26TH STREETPRAIRIE DU SACWI53578391453754VOLUNTEERINGWI501(C)(3)LINE 12C, III-FIN/A0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd