FLAMBEAU HOSPITAL INC: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- FLAMBEAU HOSPITAL INC (EIN 39-0973724)
- Tax period
- 2018-07-01 to 2019-06-30
- Filed
- 2020-07-15
- IRS object ID
- 202041979349302339
- Schema version
- 2018v3.2
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-07-15T11:40:14-05:00 | ReturnTs |
| Tax Period End | 2019-06-30 | 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 | 2018-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390973724 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FLAMBEAU HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FLAM | BusinessNameControlTxt |
| Phone | 7157622484 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 98 SHERRY AVENUE | AddressLine1Txt |
| City | PARK FALLS | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54552 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JAMES BRAUN | PersonNm |
| Person Title | CHIEF ADMINISTRATIVE OFFICER/CFO | PersonTitleTxt |
| Phone | 7157622484 | PhoneNum |
| Signature | 2020-07-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MICHAEL J PETERSON CPA | PreparerPersonNm |
| PTIN | P01833529 | PTIN |
| Phone | 2187224705 | PhoneNum |
| Preparation | 2020-07-14 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 4.4.25.242 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-07-14 | IPDt |
| IP Tm | 18:44:12 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 9747BB8E0DC0E78824B7C9EDF76D609BB7F00C05 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-09-23 17:36:50Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JAMES BRAUN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 98 SHERRY AVENUE | AddressLine1Txt |
| City | PARK FALLS | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54552 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $24,420,118 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTP://MINISTRYHEALTH.ORG/FH/HOME.NWS | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1961 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE HIGH QUALITY, ACCESSIBLE HEALTH CARE SERVICES IN OUR COMMUNITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 267 | TotalEmployeeCnt |
| Total Volunteers | 127 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $266,441 | PYContributionsGrantsAmt |
| CY Contributions Grants | $94,569 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $22,908,241 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $24,301,148 | CYProgramServiceRevenueAmt |
| PY Investment Income | $21,688 | PYInvestmentIncomeAmt |
| CY Investment Income | $10,668 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,399 | PYOtherRevenueAmt |
| CY Other Revenue | $9,130 | CYOtherRevenueAmt |
| PY Total Revenue | $23,198,769 | PYTotalRevenueAmt |
| CY Total Revenue | $24,415,515 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $24,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $13,162,156 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $13,245,570 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $9,989,496 | PYOtherExpensesAmt |
| CY Other Expenses | $11,684,572 | CYOtherExpensesAmt |
| PY Total Expenses | $23,151,652 | PYTotalExpensesAmt |
| CY Total Expenses | $24,954,142 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $47,117 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$538,627 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $13,798,564 | TotalAssetsBOYAmt |
| Total Assets EOY | $14,919,663 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,207,141 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,858,847 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $11,591,423 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $11,060,816 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE FOLLOWING OBJECTIVES PROVIDE THE DIRECTION FOR FLAMBEAU HOSPITAL IN FULFILLING ITS VISION:- TO CONTINUOUSLY IMPROVE QUALITY SERVICES TO CUSTOMERS BY BUILDING EXCELLENCE INTO EVERY ASPECT AND PROCESS OF THE HOSPITAL. CUSTOMERS INCLUDE PATIENTS AND STAFF MEMBERS. THIS EXCELLENCE DEVELOPS FROM TOTAL QUALITY IMPROVEMENT, AN ENVIRONMENT THAT ENCOURAGES EVERYONE TO CONTRIBUTE TO THE HOSPITAL'S MISSION.- TO ENCOURAGE HEALTH PROMOTION AND WELLNESS THROUGH EDUCATIONAL ACTIVITIES. WHEN FEASIBLE, THESE ACTIVITIES WILL BE PURSUED IN CONJUNCTION WITH AREA HEALTH CARE PROVIDERS.- TO COLLABORATE WITH AND PROVIDE REFERRALS TO AGENCIES PROVIDING SERVICES NOT DIRECTLY AVAILABLE AT THE HOSPITAL.- TO MAINTAIN AN OPEN RELATIONSHIP WITH THE MEDICAL AND HOSPITAL STAFF TO ENSURE EFFICIENT AND EFFECTIVE UTILIZATION OF HOSPITAL RESOURCES.- TO PROVIDE IN-SERVICE AND CONTINUING EDUCATIONAL OPPORTUNITIES FOR HEALTH CARE PERSONNEL AS A MEANS OF PROVIDING QUALITY PATIENT CARE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $19,583,786 | ExpenseAmt |
| Grant | $24,000 | GrantAmt |
| Revenue | $24,224,297 | RevenueAmt |
| Desc | FLAMBEAU HOSPITAL PROVIDES WELLNESS ACTIVITIES, EDUCATION AND PRIMARY HEALTHCARE SERVICES TO APPROXIMATELY 17,000 RESIDENTS IN OUR SERVICE AREA. HEALTHCARE SERVICE INCLUDES INPATIENT CARE AND SWING BED SERVICES ALONG WITH LABORATORY, RADIOLOGY, PHARMACY, REHABILITATION, SURGERY, AND OTHER OUTPATIENT SERVICES. SERVICES FOR THE YEAR ENDED JUNE 30, 2019 INCLUDED 1,350 INPATIENT DAYS, 6 SWING BED DAYS AND 26,455 OUTPATIENT REGISTRATIONS.FLAMBEAU HOME HEALTH PROVIDES HEALTH CARE SERVICES FOR HOMEBOUND PATIENTS INCLUDING PRIMARY CARE, WOUND AND INFECTION SERVICES, PERSONAL CARE SERVICES, PAIN MANAGEMENT AND OTHER MEDICAL SERVICES THAT CAN BE PROVIDED IN THE HOME. THESE SERVICES ARE PROVIDED TO THE SAME SERVICE AREA AND INCLUDED UNDUPLICATED PATIENT DAYS AND SERVICES TO PATIENTS.FLAMBEAU HOSPICE PROVIDES END OF LIFE CARE TO PATIENTS AND THEIR FAMILIES IN THEIR HOMES OR OTHER APPROPRIATE FACILITIES. ALSO PROVIDED ARE CHAPLAIN, VOLUNTEER AND BEREAVEMENT SERVICES. BEREAVEMENT SERVICES CONTINUE AFTER A PATIENT'S DEATH FOR ONE YEAR OR MORE. THESE SERVICES ARE PROVIDED TO THE SAME SERVICE AREA AND INCLUDED UNDUPLICATED PATIENT DAYS AND SERVICES TO PATIENTS. | Desc |
| Total Program Service Expenses | $19,583,786 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| 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 | 0 | 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 | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | 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 With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| 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 | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 51 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 267 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| 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 | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | 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 | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JAMES BRAUN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7157622484 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 98 SHERRY AVE | AddressLine1Txt |
| City | PARK FALLS | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54552 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| SCOTT CARPENTER MD | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| LOUAY DANIAL MD | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DAVE DEDA | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MOQUIN DOUG | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| BECKY MICHELS | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JEREMY NORMINGTON-SLAY | ||||||||
| DIRECTOR (TERM 10/2018) | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| THOMAS PREBBLE MD | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $352,173 | $52,254 | |||
| KRISTEN REUKAUF | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DEB STANDRIDGE | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| GAYLE STANGLE | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | 0.20 | ||
| MATTHEW THOMAS MD | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| LAURIE WAGNER | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ROGER STRAND | ||||||||
| CHAIRPERSON | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| CAROL MADER | ||||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| JULIA RUFF | ||||||||
| VICE CHAIRPERSON/TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| JAMES BRAUN | ||||||||
| CAO/CFO | 40.00 | $0 | $219,236 | $49,448 | 0.20 | Yes (X) | ||
| JANE EATON-NYMAN | ||||||||
| CIO | 40.00 | $182,651 | $0 | $38,647 | Yes (X) | |||
| ELIZABETH SCHREIBER | ||||||||
| DON | 40.00 | $121,737 | $0 | $36,226 | Yes (X) | |||
| SARA BABLICK | ||||||||
| PHARMACY DIRECTOR | 40.00 | $151,520 | $0 | $20,732 | Yes (X) | |||
| ROBERT PFLANZ | ||||||||
| SNR. DIRECTOR SUPP SVCS | 40.00 | $107,946 | $0 | $38,147 | Yes (X) | |||
| THOMAS KASTER | ||||||||
| SNR. DIRECTOR FIN (TERM 11/2018) | 40.00 | $120,979 | $0 | $38,439 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $684,833 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $571,409 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $273,893 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 9 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ALEXANDER KORITTNIG | |||||
| 442 S 3RD AVENUE | PARK FALLS | WI | 54552 | ANESTHESIA | $506,398 |
| SHARED MEDICAL TECHNOLOGY | |||||
| 202 W NEWTON ST | RICE LAKE | WI | 54868 | MEDICAL SERVICES | $347,283 |
| FUSION MEDICAL STAFFING | |||||
| PO BOX 82674 | LINCOLN | NE | 68501 | AGENCY STAFFING | $272,688 |
| READYLINK HEALTHCARE | |||||
| PO BOX 1047 | THOUSAND PALMS | CA | 92276 | CONTRACTED NURSING SERVICES | $114,858 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $9,070 | FundraisingAmt |
| All Other Contributions | $85,499 | AllOtherContributionsAmt |
| Total Contributions | $94,569 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621110 | $23,811,823 | $23,811,823 | |
| AFFILIATED ORG RENT | 900099 | $245,325 | $245,325 | |
| CAFETERIA REVENUE | 900099 | $76,851 | $76,851 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $167,149 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $167,149 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $24,301,148 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,668 | TotalRevenueColumnAmt |
| Exclusion | $10,668 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $13,733 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $9,070 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $4,603 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,130 | TotalRevenueColumnAmt |
| Exclusion | $9,130 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $24,415,515 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $24,224,297 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $96,649 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,000 | TotalAmt |
| Program Services | $24,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $673,112 | TotalAmt |
| Program Services | $404,428 | ProgramServicesAmt |
| Management And General | $268,684 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,761,829 | TotalAmt |
| Program Services | $7,058,497 | ProgramServicesAmt |
| Management And General | $1,703,332 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $268,422 | TotalAmt |
| Program Services | $228,996 | ProgramServicesAmt |
| Management And General | $39,426 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,881,137 | TotalAmt |
| Program Services | $2,300,279 | ProgramServicesAmt |
| Management And General | $580,858 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $661,070 | TotalAmt |
| Program Services | $524,895 | ProgramServicesAmt |
| Management And General | $136,175 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,195 | TotalAmt |
| Management And General | $46,195 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,172,351 | TotalAmt |
| Program Services | $4,457,411 | ProgramServicesAmt |
| Management And General | $714,940 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $81,943 | TotalAmt |
| Management And General | $81,943 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,426,083 | TotalAmt |
| Program Services | $1,404,408 | ProgramServicesAmt |
| Management And General | $21,675 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $800,076 | TotalAmt |
| Program Services | $2,725 | ProgramServicesAmt |
| Management And General | $797,351 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $311,910 | TotalAmt |
| Program Services | $246,417 | ProgramServicesAmt |
| Management And General | $65,493 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $168,727 | TotalAmt |
| Program Services | $123,927 | ProgramServicesAmt |
| Management And General | $44,800 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,843 | TotalAmt |
| Management And General | $32,843 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $784,267 | TotalAmt |
| Program Services | $784,267 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,157,886 | TotalAmt |
| Program Services | $1,099,590 | ProgramServicesAmt |
| Management And General | $58,296 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $112,481 | TotalAmt |
| Management And General | $112,481 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| EQUIPMENT RENTAL | $744,340 | $574,209 | $170,131 |
| BAD DEBT | $370,847 | $370,847 | |
| FOOD | $130,992 | $104,498 | $26,494 |
| ASSOCIATION DUES | $84,273 | $41,947 | $42,326 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $259,358 | TotalAmt |
| Program Services | $203,292 | ProgramServicesAmt |
| Management And General | $56,066 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,954,142 | TotalAmt |
| Program Services | $19,583,786 | ProgramServicesAmt |
| Management And General | $5,370,356 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $165,298 | BOYAmt |
| EOY | $172,230 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,204,453 | BOYAmt |
| EOY | $1,465,224 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,543,271 | BOYAmt |
| EOY | $4,750,154 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $200,229 | BOYAmt |
| EOY | $214,749 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $112,181 | BOYAmt |
| EOY | $60,137 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $27,014,875 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $19,161,934 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,417,557 | BOYAmt |
| EOY | $7,852,941 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,155,575 | BOYAmt |
| EOY | $404,228 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,798,564 | BOYAmt |
| EOY | $14,919,663 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,300,990 | BOYAmt |
| EOY | $2,963,141 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $726,744 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $653,690 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $179,407 | BOYAmt |
| EOY | $242,016 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,207,141 | BOYAmt |
| EOY | $3,858,847 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,517,703 | BOYAmt |
| EOY | $10,100,976 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,073,720 | BOYAmt |
| EOY | $959,840 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,591,423 | BOYAmt |
| EOY | $11,060,816 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,798,564 | BOYAmt |
| EOY | $14,919,663 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$538,627 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $8,020 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $5,263 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $5,263 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | FLAMBEAU HOSPITAL PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THESE DUES ARE PRIMARILY FOR ACCESS TO EDUCATIONAL MATERIALS AND STAFF TRAINING AND DEVELOPMENT. THE AHA AND WHA HAVE NOTIFIED FLAMBEAU HOSPITAL THAT $5,263 OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $73,128 | OtherCostOrOtherBasisAmt |
| Book Value | $73,128 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $15,133,838 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,193,571 | DepreciationAmt |
| Book Value | $3,940,267 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,892,059 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,968,363 | DepreciationAmt |
| Book Value | $2,923,696 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $915,850 | OtherCostOrOtherBasisAmt |
| Book Value | $915,850 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $7,852,941 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| ASBESTOS ABATEMENT LIABILITY | $201,213 |
| ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS | $40,803 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $242,016 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $24,044,668 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $24,044,668 | RevenueSubtotalAmt |
| Other Revenues Not Included | $370,847 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $370,847 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $24,415,515 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $23,799,028 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $23,799,028 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $1,155,114 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $1,155,114 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $24,954,142 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE HOSPITAL IS A NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND IS EXEMPT FROM FEDERAL INCOME TAX ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE HOSPITAL IS ALSO EXEMPT FROM STATE INCOME TAX ON RELATED INCOME. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT NET AGAINST REVENUE 370,847. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT NET AGAINST REVENUE 370,847. PAYMENTS TO AFFILIATES 784,267. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GOLF OUTING | Event1Nm |
| Gross Receipts Event1 | $17,633 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $7,900 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $9,733 | GrossRevenueEvent1Amt |
| Cash Prizes Event1 | $150 | CashPrizesEvent1Amt |
| Non Cash Prizes Event1 | $150 | NonCashPrizesEvent1Amt |
| Other Direct Expenses Event1 | $2,350 | OtherDirectExpensesEvent1Amt |
| Event2 | LIGHTS OF LOVE | Event2Nm |
| Gross Receipts Event2 | $5,170 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $1,170 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $4,000 | GrossRevenueEvent2Amt |
| Food And Beverage Event2 | $300 | FoodAndBeverageEvent2Amt |
| Entertainment Event2 | $200 | EntertainmentEvent2Amt |
| Other Direct Expenses Event2 | $1,453 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $22,803 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $9,070 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $13,733 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $150 | CashPrizesTotalEventsAmt |
| Non Cash Prizes Total Events | $150 | NonCashPrizesTotalEventsAmt |
| Food And Beverage Total Events | $300 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $200 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $3,803 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $4,603 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $9,130 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 250.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | 0 | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $210,574 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $210,574 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00890 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,440,290 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,416,203 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,024,087 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04350 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,650,864 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,416,203 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,234,661 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05240 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $79,433 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $79,433 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00340 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 1943 | PersonsServedCnt |
| Total Community Benefit Expns | $24,614 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $24,614 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 50 | PersonsServedCnt |
| Total Community Benefit Expns | $4,901,495 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,736,035 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,165,460 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.13450 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 6625 | PersonsServedCnt |
| Total Community Benefit Expns | $131,564 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $131,564 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00560 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 8618 | PersonsServedCnt |
| Total Community Benefit Expns | $5,137,106 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,736,035 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,401,071 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.14450 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 8618 | PersonsServedCnt |
| Total Community Benefit Expns | $7,787,970 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,152,238 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,635,732 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.19690 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,949 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,949 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 320 | PersonsServedCnt |
| Total Community Benefit Expns | $7,410 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $7,410 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 246 | PersonsServedCnt |
| Total Community Benefit Expns | $3,616 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,616 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,444 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $4,444 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $456 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $456 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 16 | PersonsServedCnt |
| Total Community Benefit Expns | $2,735 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,735 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 582 | PersonsServedCnt |
| Total Community Benefit Expns | $20,610 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $20,610 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $824,759 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $9,385,280 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $9,937,043 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$551,763 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FLAMBEAU HOSPITAL INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 98 SHERRY AVENUE | AddressLine1Txt |
| City | PARK FALLS | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54552 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FLAMBEAU HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE SUPPLEMENTAL INFORMATION | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 18 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE SUPPLEMENTAL INFORMATION | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 250.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.MARSHFIELDCLINIC.ORG/LOCATIONS/CENTERS/FLAMBEAU%20HOSPITAL/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.MARSHFIELDCLINIC.ORG/LOCATIONS/CENTERS/FLAMBEAU%20HOSPITAL/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.MARSHFIELDCLINIC.ORG/LOCATIONS/CENTERS/FLAMBEAU%20HOSPITAL/ | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FLAMBEAU HOSPITAL, INC. | PART V, SECTION B, LINE 5: FLAMBEAU HOSPITAL WORKED CLOSELY WITH THE PRICE COUNTY HEALTH DEPARTMENT IN ORDER TO HAVE INPUT FROM A BROAD SPECTRUM OF COMMUNITY PROFESSIONALS. INDIVIDUALS INCLUDED IN THE FOLLOWING ALL PROVIDED VALUABLE INPUT THROUGH THEIR ATTENDANCE AT THE COMMUNITY NEEDS FORUM: PRICE COUNTY BOARD OF SUPERVISORS, PRICE COUNTY AGING AND DISABILITY RESOURCE CENTER UNIT, PRICE COUNTY CHILDREN AND YOUTH UNIT, PRICE COUNTY BEHAVIORAL HEALTH UNIT, PRICE COUNTY PUBLIC HEALTH UNIT, PRICE COUNTY SHERIFF'S DEPARTMENT, PARK FALLS POLICE DEPARTMENT, CHEQUAMEGON SCHOOL DISTRICT, PHILLIPS SCHOOL DISTRICT, EXTENSION PRICE COUNTY, PHILLIPS PUBLIC LIBRARY, NEW HORIZONS NORTH, EMBRACE, FLAMBEAU HOME HEALTH & HOSPICE, FALMBEAU HOSPITAL, LIMBERG & ASSOCIATES COUNSELING, LLC, MARSHFIELD CLINIC HEALTH SYSTEM AND ASCENSION WISCONSIN. |
| FLAMBEAU HOSPITAL, INC. | PART V, SECTION B, LINE 6B: PRICE COUNTY, PRICE COUNTY PUBLIC HEALTH AND FLAMBEAU HOSPITAL |
| FLAMBEAU HOSPITAL, INC. | PART V, SECTION B, LINE 7D: HTTPS://WWW.MARSHFIELDCLINIC.ORG/LOCATIONS/FLAMBEAU-HOSPITAL/COMMUNITY-HEALTH-NEEDSLINE 10A:WWW.MARSHFIELDCLINIC.ORG/LOCATIONS/FLAMBEAU-HOSPITAL/COMMUNITY-HEALTH-NEEDS |
| FLAMBEAU HOSPITAL, INC. | PART V, SECTION B, LINE 11: FLAMBEAU HOSPITAL AND PRICE COUNTY PUBLIC HEALTH CONDUCTED THE ASSESSMENT AND PRIORITIZATION PROCESS FROM JULY 2018 TO DECEMBER 2018. BASED ON THE DATA REVIEWED, COMMUNITY INPUT AND THE PRIORITIZATION PROCESS, THE FOLLOWING PRIORITIES WERE SELECTED: 1) MENTAL HEALTH 2) ALCOHOL AND OTHER DRUG ABUSE 3) CHRONIC DISEASES THIS IMPROVEMENT PLAN IS PART OF A BROAD COMMUNITY EFFORT TO ADDRESS THE PRIORITY HEALTH NEEDS IN THE COMMUNITY. THIS IMPROVEMENT PLAN OUTLINES THE ACTIONS FLAMBEAU HOSPITAL AND PRICE COUNTY PUBLIC HEALTH WILL TAKE TO ADDRESS THE LOCAL HEALTH NEEDS. AS NOTED BELOW, MANY OF THESE STRATEGIES WILL BE IMPLEMENTED COLLABORATIVELY. RECOGNIZING THAT NO ONE ORGANIZATION CAN AFFECT SUBSTANTIAL COMMUNITY CHANGE ALONE, THE LONG-TERM OUTCOMES IDENTIFIED IN THIS PLAN WILL BE ACHIEVED AS MANY COMMUNITY ORGANIZATIONS WORK TOGETHER FOR COLLECTIVE IMPACT. COALITIONS HAVE BEEN FORMED TO NOT ONLY MEET ON A REGULAR BASIS, BUT ALSO TO EXECUTE OUR SMART METRICS - METRICS THAT ARE SPECIFIC, MEASURABLE, ACHIEVABLE, REALISTIC, AND TIME-RELATED. REPORTS ARE FILED QUARTERLY TO RECORD THE STATUS OF EACH STRATEGY/PRIORITY. MINOR NEEDS THAT ARE NOT OUTLINED IN THE MOST RECENT CHNA HAVE BEEN IDENTIFIED AND FLAMBEAU HOSPITAL HAS MADE COLLECTIVE EFFORTS TO ESTABLISH SUPPORT FOR SUCH NEEDS. |
| FLAMBEAU HOSPITAL, INC. | PART V, SECTION B, LINE 16J: IN ADDITION TO POSTING THE POLICY IN THE ADMISSIONS OFFICE AND WAITING ROOMS, ALL PATIENTS WHO REGISTER AS SELF-PAY ARE CONTACTED AND GIVEN INFORMATION ABOUT THE HOSPITAL'S CHARITY CARE POLICY. |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | THE COSTING METHODOLOGY USED ON FORM 990 IS BASED ON A COST TO CHARGE RATIO WHICH IS DEVELOPED BASED ON THE HOSPITALS TOTAL OPERATING EXPENSES, EXCLUDING THE PROVISION FOR BAD DEBTS DIVIDED BY GROSS PATIENT SERVICE REVENUES. THIS COST TO CHARGE RATIO IS APPLIED AGAINST VARIOUS REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER IRS SUGGESTED COSTING METHODS FOR THE FORM 990. |
| PART I, LINE 7G: | SUBSIDIZED HEALTH SERVICES AT FLAMBEAU HOSPITAL INCLUDE THE OPERATION OF THE EMERGENCY ROOM DEPARTMENT, AND THE COMMUNITY BASED HOSPICE AND HOMECARE PROGRAMS. THE HOSPITAL EMERGENCY DEPARTMENT OPERATES 24 HOURS PER DAY, SEVEN DAYS PER WEEK AND IS STAFFED BY A GROUP OF HIGHLY TRAINED NURSING STAFF INCLUDING REGISTERED NURSES, LICENSED PRACTICED NURSES, AND OTHER SUPPORT STAFF. MANY OF THE ADMISSIONS TO THE HOSPITAL EMERGENCY DEPARTMENT COME FROM THE COMMUNITY AND SURROUNDING AREAS. THE HOSPICE AND HOMECARE PROGRAMS ARE PROVIDED AS COMMUNITY SUPPORT SERVICES TO THE AREA OF PRICE COUNTY, WISCONSIN. ALL OF THESE SUBSIDIZED HEALTH SERVICES WORK IN SUPPORT AND COOPERATION WITH THE COMBINED EFFORTS OF FLAMBEAU HOSPITAL AND SHARE MANY SUPPORT FUNCTIONS OF THE HOSPITAL IN AN EFFORT TO PROVIDE EXCELLENT LOW COST CARE TO PATIENTS IN THEIR LOCAL COMMUNITY AND AREA. A SIGNIFICANT PAYOR FOR THESE PROGRAMS IS THE MEDICARE PROGRAM WHICH DOES NOT REIMBURSE THE HOSPITAL FOR THESE SERVICES IN ALL CASES BASED ON COST SO A SIGNIFICANT LOSS IS ABSORBED BY THE HOSPITAL TO PROVIDE THESE SERVICES TO MEMBERS OF THE COMMUNITY. IT IS THE GOAL OF FLAMBEAU HOSPITAL, INC. TO PROVIDE THESE SERVICES TO THE COMMUNITY REGARDLESS OF A PATIENTS ABILITY TO PAY. |
| PART I, LN 7 COL(F): | BAD DEBT EXPENSE IN THE AMOUNT OF $1,420,847 INCLUDED ON FORM 990, PART IX, LINE 25 WAS NOT INCLUDED IN TOTAL EXPENSES FOR PURPOSES OF CALCULATING COMMUNITY BENEFIT PERCENTAGES. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | FLAMBEAU HOSPITAL, INC. PROVIDES SIGNIFICANT CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS AND IN ADDITION, THE HOSPITAL BELIEVES THAT IT PROVIDES A CRITICALLY IMPORTANT COMMUNITY BENEFIT WHICH IS NOT QUANTIFIED. FLAMBEAU HOSPITAL, INC., LIKE MOST RURAL HOSPITALS, WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE CARE LOCALLY WHICH WITHOUT THE HOSPITAL, WOULD NOT BE AVAILABLE LOCALLY. BEYOND INPATIENT HOSPITALIZATIONS, THE HOSPITAL PROVIDES LOCAL ACCESS TO MANY HEALTH SERVICES INCLUDING: BIRTHING SERVICES, DIAGNOSTICS, EMERGENCY SERVICES & URGENT CARE, HOME CARE, HOSPICE, SWING BED SERVICES, LABORATORY SERVICES, OCCUPATIONAL HEALTH, REHABILITATION SERVICES, SLEEP CENTER, SURGICAL SERVICES, AND WOMENS SERVICES, TO NAME SOME OF THE MAJOR SERVICES PROVIDED. |
| PART III, LINE 4: | ATTACHED ARE UNAUDITED FINANCIAL STATEMENTS FOR FLAMBEAU HOSPITAL FOR THE YEAR ENDED JUNE 30, 2019. COMPLETION OF THE AUDIT HAS BEEN DELAYED AS A RESULT OF A PENDING TRANSACTION INVOLVING THE HOSPITAL'S CORPORATE MEMBERS AND, AS A RESULT, AUDITED STATEMENTS ARE NOT AVAILABLE AT THIS TIME. |
| PART III, LINE 8: | THE TOTAL MEDICARE REVENUE SHOWN IN SCHEDULE H OF THE FORM 990 IS BASED ON THE IRS 990 INSTRUCTIONS AND INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE OF THE ORGANIZATION AND ALSO DOES NOT CONSIDER CONTRACTUAL ADJUSTMENTS FOR THE REIMBURSEMENT THAT IS ACTUALLY RECEIVED FROM THE MEDICARE PROGRAM. AMOUNTS LISTED FOR MEDICARE REVENUES DO NOT INCLUDE SIGNIFICANT PORTIONS OF LABORATORY, RADIOLOGY, AMBULANCE AND REHABILITATION SERVICES PROVIDED TO MEDICARE BENEFICIARIES AS WELL AS PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT, ANETHESIA PROFESSIONAL SERVICES, CLINICAL PHYSICIAN PROFESSIONAL SERVICES, SURGICAL PHYSICIAN PROFESSIONAL SERVICES AND REVENUES FOR ANY PATIENTS COVERED UNDER MEDICARE ADVANTAGE PLAN PROGRAMS. PHYSICIAN SERVICES ARE REIMBURSED PRIMARILY ON FEE SCHEDULE REIMBURSEMENT AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY, SURGICAL, AND CLINICAL SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND AS SUCH THESE COSTS AND SHORTFALLS SHOULD BE CONSIDERED AS AN ADDITIONAL BENEFIT THAT FLAMBEAU HOSPITAL PROVIDES TO THE COMMUNITY AND SURROUNDING AREASS. THE COSTING METHOD USED ABOVE FOR IRS 990 COMPLIANCE REPORTING IS ALSO BASED ON THE FILED MEDICARE COST REPORT FOR THE YEAR ENDED JUNE 30, 2019 AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICE REVENUES (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE.) |
| PART III, LINE 9B: | ONCE A PERSON IS KNOWN TO QUALIFY FOR CHARITY CARE, THE HOSPITAL WILL KEEP THAT INFORMATION ON FILE AND AUTOMATICALLY GRANT CHARITY CARE FOR UP TO A YEAR. AT THAT POINT, THE PATIENT WOULD NEED TO REAPPLY OR VERIFY THAT THEIR SITUATION HAS NOT CHANGED SIGNIFICANTLY SINCE THEIR LAST APPLICATION.CHARITY CARE IS APPLIED FIRST BEFORE ANY COLLECTION EFFORTS ARE PURSUED. |
| PART VI, LINE 2: | THE HOSPITAL COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT REPORT IN FISCAL YEAR 2019 AND USED THE DATA AND FINDINGS OF THIS REPORT TO GUIDE THE ORGANIZATION IN THE FUTURE TO BE ABLE TO RESPOND TO THOSE NEEDS. IN ADDITION, THE HOSPITAL IS PARTICIPATING WITH PRICE COUNTY ON THE COUNTY HEALTH ASSESSMENT AND HEALTH PLAN. |
| PART VI, LINE 3: | INFORMATION IS POSTED IN THE FACILITY AND ALL PATIENTS WHO REGISTER AS SELF-PAY ARE CONTACTED FOR ANY ASSISTANCE NEEDS THEY MAY HAVE. THE INFORMATION IS ALSO PROVIDED IN ALL BILLING STATEMENTS AND WITH ANY LETTERS FOR COLLECTIONS. |
| PART VI, LINE 4: | FLAMBEAU HOSPITAL, INC. PROVIDES SERVICES TO RESIDENTS OF PRICE COUNTY, WI AND PORTIONS OF THREE OTHER COUNTIES. THE NEXT CLOSEST HOSPITAL IS 45 MILES AWAY, AND FLAMBEAU HOSPITAL IS DESIGNATED AS UNDERSERVED. THE HOSPITAL PROVIDES A SIGNIFICANT PORTION OF ITS PATIENT CARE SERVICES TO BENEFICIARIES OF THE MEDICARE AND MEDICAID PROGRAMS ESPECIALLY THOSE BENEFICIARIES WHO RECEIVE HOME HEALTH SERVICES FROM THE ORGANIZATION. IN THE SHORT PERIOD ENDING JUNE 30, 2019, THESE MEDICARE AND MEDICAID PATIENTS ACCOUNTED FOR APPROXIMATELY 74 PERCENT OF THE PATIENT SERVICES PROVIDED BY THE ORGANIZATION DURING THE YEAR. |
| PART VI, LINE 5: | FLAMBEAU HOSPITAL PROVIDES EDUCATION, NEEDED SUBSIDIZED SERVICES AND SUPPORT TO THE COMMUNITY THROUGH SERVICES IT PROVIDES AND COLLABORATION WITH OTHER GROUPS TO IMPROVE THE HEALTH STATUS OF THE COMMUNITY. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | WI |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | SCHOLARSHIPS | GrantTypeTxt |
| Recipient | 5 | RecipientCnt |
| Cash Grant | $24,000 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION HAS A PROCESS OF SELECTING, AWARDING AND MONITORING SCHOLARSHIP RECIPIENTS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Severance Payment | Yes (1) | 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 (6 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| THOMAS PREBBLE MD | ||||||||||||||
| DIRECTOR | $0 | $285,247 | $0 | $59,496 | $0 | $7,430 | $0 | $29,497 | $0 | $22,757 | $0 | $404,427 | $0 | $0 |
| JAMES BRAUN | ||||||||||||||
| CAO/CFO | $0 | $208,481 | $0 | $6,000 | $0 | $4,755 | $0 | $27,635 | $0 | $21,813 | $0 | $268,684 | $0 | $0 |
| JANE EATON-NYMAN | ||||||||||||||
| CIO | $179,603 | $0 | $0 | $0 | $3,048 | $0 | $0 | $0 | $38,647 | $0 | $221,298 | $0 | $0 | $0 |
| ELIZABETH SCHREIBER | ||||||||||||||
| DON | $120,696 | $0 | $0 | $0 | $1,041 | $0 | $0 | $0 | $36,226 | $0 | $157,963 | $0 | $0 | $0 |
| SARA BABLICK | ||||||||||||||
| PHARMACY DIRECTOR | $151,346 | $0 | $0 | $0 | $174 | $0 | $0 | $0 | $20,732 | $0 | $172,252 | $0 | $0 | $0 |
| THOMAS KASTER | ||||||||||||||
| SNR. DIRECTOR FIN (TERM 11/2018) | $120,813 | $0 | $0 | $0 | $166 | $0 | $0 | $0 | $38,439 | $0 | $159,418 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4A | FormAndLineReferenceDesc |
| Explanation | THOMAS KASTER - $59,520 | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | MARSHFIELD CLINIC AND MINISTRY HEALTH CARE, INC. ("MINISTRY"), BOTH WISCONSIN TAX-EXEMPT CORPORATIONS, ARE JOINT CORPORATE MEMBERS OF THE HOSPITAL. MINISTRY ALSO, VIA CONTRACT, SHARES CERTAIN GOVERNANCE AUTHORITIES WITH MARSHFIELD CLINIC WITH RESPECT TO THE PARK FALLS AND PHILLIPS ("PRICE COUNTY CLINICS") CLINIC OPERATIONS OF MARSHFIELD CLINIC, WITH MARSHFIELD CLINIC RETAINING THE REMAINING AUTHORITIES. MARSHFIELD CLINIC HAS CONTRACTED TO PROVIDE OPERATING MANAGEMENT TO THE HOSPITAL AND PRICE COUNTY CLINICS. THE GOAL OF THE MEMBERSHIP ARRANGEMENTS IS TO PROVIDE FOR THE EFFECTIVE, ECONOMICAL, AND COORDINATED MANAGEMENT AND OPERATION OF HEALTH CARE SERVICES IN PRICE COUNTY. COLLECTIVELY, THE PARTIES HAVE ESTABLISHED AN INTEGRATED HEALTH CARE DELIVERY SYSTEM FOR PRICE COUNTY. |
| FORM 990, PART VI, SECTION A, LINE 7A | CORPORATE MEMBERS HAVE APPROVED RIGHT FOR DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7B | APPROVAL OF BUDGET, ADMINISTRATOR, PROPERTY PURCHASED, AND DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 8B | NOT APPLICABLE AS THERE ARE NO SUB-COMMITTEES. |
| FORM 990, PART VI, SECTION B, LINE 11B | A COPY OF THE FORM 990 WAS PROVIDED TO ALL MEMBERS OF THE BOARD PRIOR TO FILING. IF THE BOARD MEMBERS WOULD LIKE ANY EXPLANATION OR CHANGES, THEY WOULD HAVE AN OPPORTUNITY TO COMMENT ON THE RETURN BEFORE ITS FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE BOARD OF DIRECTORS AND KEY EMPLOYEES OF THE HOSPITAL ANNUALLY SIGN TO ADHERE TO THE CONFLICT OF INTEREST POLICY AT FLAMBEAU HOSPITAL, INC. IT IS ASSUMED THAT THE BOARD OF DIRECTORS AND KEY EMPLOYEES WILL RECOGNIZE CONFLICTS OF INTEREST WITH ANY PERSONS OR FIRMS MENTIONED IN THE POLICY. IT IS THE POLICY OF THE BOARD THAT THE EXISTENCE OF ANY INTEREST DESCRIBED IN THE POLICY SHALL BE DISCLOSED BEFORE ANY TRANSACTION IS CONSUMMATED. IT IS THE BOARD OF DIRECTORS AND KEY EMPLOYEES RESPONSIBILITY TO REVIEW POTENTIAL CONFLICTS OF INTEREST AND IF A CONFLICT EXISTS THE INDIVIDUAL IS PROHIBITED TO VOTE ON TRANSACTIONS WHERE THE POTENTIAL CONFLICT EXISTS. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE MARSHFIELD CLINIC PREPARES A COMPENSATION SCHEDULE THAT IS USED TO DETERMINE TOP MANAGEMENT AND KEY EMPLOYEE COMPENSATION. COMPENSATION STUDIES ARE ALSO USED TO PROVIDE COMPARABILITY DATA. THIS DATA IS REVIEWED AND APPROVED BY INDEPENDENT PERSONS AND ALL DECISIONS ARE SUBSTANTIATED. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE HOSPITAL DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. |
| FORM 990, PART IX, LINE 11G | ER SERVICES: PROGRAM SERVICE EXPENSES 1,888,349. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,888,349. ANESTHESIOLOGY SERVICES: PROGRAM SERVICE EXPENSES 532,675. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 532,675. MED SURG SERVICES: PROGRAM SERVICE EXPENSES 404,493. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 404,493. OTHER SERVICES: PROGRAM SERVICE EXPENSES 1,631,894. MANAGEMENT AND GENERAL EXPENSES 714,940. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,346,834. |
| FORM 990, PART XI, LINE 9: | CHANGE IN INTEREST OF FOUNDATION 8,020. |
| FORM 990, PART XII, LINE 2 | ATTACHED ARE UNAUDITED FINANCIAL STATEMENTS FOR FLAMBEAU HOSPITAL FOR THE YEAR ENDED JUNE 30, 2019. COMPLETION OF THE AUDIT HAS BEEN DELAYED AS A RESULT OF A PENDING TRANSACTION INVOLVING THE HOSPITAL'S CORPORATE MEMBERS AND, AS A RESULT, AUDITED STATEMENTS ARE NOT AVAILABLE AT THIS TIME. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FLAMBEAU HOSPITAL FOUNDATION INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 310 | AddressLine1Txt |
| City | PARK FALLS | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54552 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 205957150 | EIN |
| Primary Activities | SUPPORT OF FLAMBEAU HOSPITAL | PrimaryActivitiesTxt |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Exempt Code Section | 501 (C) 3 | ExemptCodeSectionTxt |
| Public Charity Status | LINE 12A, I | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FLAMBEAU HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| 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 | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | 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 | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |