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THEDACARE REGIONAL MEDICAL CENTER - NEENAH INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
THEDACARE REGIONAL MEDICAL CENTER - NEENAH INC (EIN 39-0830664)
Tax period
2018-01-01 to 2018-12-31
Filed
2019-11-13
IRS object ID
201943179349302574
Schema version
2018v3.1
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)
Return2019-11-13T13:56:38-06:00ReturnTs
Tax Period End2018-12-31TaxPeriodEndDt

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 Line110401 W INNOVATION DRIVE SUITE 300AddressLine1Txt
CityWAUWATOSACityNm
State AbbreviationWIStateAbbreviationCd
ZIP53226ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN390830664EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THEDACARE REGIONAL MEDICAL CENTER -BusinessNameLine1Txt
Business Name Line2NEENAH INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlTHEDBusinessNameControlTxt
Phone9207355560PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 8025AddressLine1Txt
CityAPPLETONCityNm
State AbbreviationWIStateAbbreviationCd
ZIP549128025ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMARK THOMPSONPersonNm
Person TitleCFO & COOPersonTitleTxt
Phone9207355560PhoneNum
Signature2019-10-31SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKURT BENNIONPreparerPersonNm
PTINP01469618PTIN
Phone4144761880PhoneNum
Preparation2019-10-31PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address67.137.57.251IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-10-31IPDt
IP Tm05:04:42IPTm
IP TimezonePDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id33F877C3ABFBB78B8EF2964D67A95BC3B590144CAtSubmissionCreationDeviceId
At Submission Filing Device Id72C56C6F533A7CAE8F7235CA15DC6DF10360C772AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-03-31 21:24:44ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerIMRAN ANDRABI MDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 8025AddressLine1Txt
CityAPPLETONCityNm
State AbbreviationWIStateAbbreviationCd
ZIP549128025ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$237,747,332GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.THEDACARE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1909FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionIMPROVING THE HEALTH OF OUR COMMUNITY.ActivityOrMissionDesc
Voting Members Governing Body14VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers262TotalVolunteersCnt
Total Gross UBI$1,395,145TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$274,296NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$157,262PYContributionsGrantsAmt
CY Contributions Grants$138,749CYContributionsGrantsAmt
PY Program Service Revenue$213,778,738PYProgramServiceRevenueAmt
CY Program Service Revenue$234,679,964CYProgramServiceRevenueAmt
PY Investment Income$94,769PYInvestmentIncomeAmt
CY Investment Income$216,447CYInvestmentIncomeAmt
PY Other Revenue$2,700,358PYOtherRevenueAmt
CY Other Revenue$2,712,172CYOtherRevenueAmt
PY Total Revenue$216,731,127PYTotalRevenueAmt
CY Total Revenue$237,747,332CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$4,299CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$80,798,745PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$82,974,684CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$100,836,021PYOtherExpensesAmt
CY Other Expenses$98,140,905CYOtherExpensesAmt
PY Total Expenses$181,634,766PYTotalExpensesAmt
CY Total Expenses$181,119,888CYTotalExpensesAmt
PY Revenues Less Expenses$35,096,361PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$56,627,444CYRevenuesLessExpensesAmt
Total Assets BOY$394,614,293TotalAssetsBOYAmt
Total Assets EOY$459,075,023TotalAssetsEOYAmt
Total Liabilities BOY$830TotalLiabilitiesBOYAmt
Total Liabilities EOY$74,541TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$394,613,463NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$459,000,482NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO PROVIDE THE HIGHEST QUALITY HEALTH CARE, DELIVERED IN THE MOST EFFICIENT AND COST-EFFECTIVE WAYS, AND ACCESSIBLE TO ALL MEMBERS OF THE COMMUNITY.MissionDesc
Significant New Program SrvcYes (1)SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$164,628,770ExpenseAmt
Grant$4,299GrantAmt
Revenue$233,284,819RevenueAmt
DescTHEDACARE IS A TAX-EXEMPT, NON-PROFIT CORPORATION, AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE.THEDACARE REGIONAL MEDICAL CENTER-NEENAH IS A 151-BED ACUTE CARE HOSPITAL, EMPLOYING MORE THAN 1,000 TEAM MEMBERS. THE CAMPUS OFFERS DIAGNOSTIC SERVICES SUCH AS X-RAY, ULTRASOUND, MRI, CAT SCAN, MAMMOGRAPHY AND MEDICAL LABORATORY TESTING. SPECIALTY PATIENT CARE SERVICES OFFERED INCLUDE CANCER, CARDIOVASCULAR, ORTHOPEDIC, SPINE, FAMILY BIRTH CARE, BARIATRIC WEIGHT LOSS, DIABETES, INTERNAL MEDICINE, EMERGENCY, OCCUPATIONAL HEALTH, PULMONOLOGY, UROLOGY, WOMEN'S CARE, NEPHROLOGY, THERAPY SERVICES, LEVEL II TRAUMA CENTER, NEUROLOGY, OUTPATIENT SURGERY CENTERS AND WELLNESS PROGRAMS. A SIGNIFICANT FEATURE OF THE THEDACARE TRAUMA PROGRAM IS THEDASTAR. THE AIR MEDICAL PROGRAM PROVIDES IMMEDIATE MEDICAL CARE, HELICOPTER TRANSPORTS AND TRANSFERS FOR TRAUMA PATIENTS AND CRITICALLY ILL PATIENTS, INCLUDING TRANSPORT FROM OUR RURAL HOSPITALS. THIS COLLABORATION ALLOWS FOR OUR TEAMS, ACROSS THE ENTIRE REGION, TO WORK IN CONCERT WITH EACH OTHER. THERE ARE 17 COUNTIES SERVED WITHIN THE PRIMARY AND SECONDARY SERVICE AREAS. CHILDREN'S HOSPITAL OF WISCONSIN-FOX VALLEY OPENED IN 2011 AND IS LOCATED WITHIN THEDACARE REGIONAL MEDICAL CENTER-NEENAH. THEDACARE AND CHW PARTNER TO ENSURE THE COMMUNITY HAS ACCESS TO HIGH LEVELS OF CARE. MORE THAN 109,740 UNIQUE PATIENTS ACCOUNT FOR MORE THAN 257,550 VISITS ANNUALLY.WITH CORPORATE PARENT THEDACARE, INC., WE OFFER PUBLIC AWARENESS CAMPAIGNS, CHARITY CARE, SUPPORT GROUPS, AND EDUCATION PROGRAMS TARGETED TO LOCAL COMMUNITY NEEDS.THEDACARE IS COMMITTED TO COMMUNITY FOCUSED EFFORTS IDENTIFIED IN THE COMMUNITY NEEDS HEALTH ASSESSMENT IN COUNTIES (WINNEBAGO) WHERE SERVICES ARE PROVIDED. EFFORTS INCLUDE PARTNERSHIPS WITH GOLD CROSS AMBULANCE SERVICE, CATALPA MENTAL HEALTH (MENTAL HEALTH AND WELLNESS FOR CHILDREN), MOSAIC (COMMUNITY PHYSICIAN TRAINING), UNITED WAY, THE WEIGHT OF THE FOX VALLEY (HEALTHY WEIGHT INITIATIVE) & PARTNERSHIP COMMUNITY HEALTH CENTER (AFFORDABLE MEDICAL, DENTAL AND BEHAVIORAL HEALTH SERVICES), STAR PROJECT (DIVERSITY), EARLY CHILDHOOD EDUCATION, VOICES OF MEN (SEXUAL ASSUALT AND DOMESTIC VIOLENCE), REACH OUT AND READ (CHILDHOOD LITERACY).THEDACARE PROVIDES SCHOLARSHIPS, CHARITY CARE, INTERPRETING AND EDUCATIONAL SERVICES AND VARIOUS OTHER COMMUNITY BENEFITS.THEDACARE OPERATES ON A NON-DISCRIMINATORY BASIS REGARDLESS OF RACE, COLOR, SEX, RELIGION, OR NATIONAL ORIGIN. THEDACARE PROVIDES A VARIETY OF FINANCIAL ASSISTANCE OPTIONS TO PATIENTS WHO MEET ESTABLISHED CRITERIA. SERVICES ARE ALSO PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS AT SUBSTANTIAL DISCOUNTS FROM STANDARD FEES. HOSPITAL INPATIENT DAYS TOTALED 29,336 WITH 2,728 ADDITIONAL DAYS FOR NEWBORN CARE. AS PART OF THEDACARE, EMERGENCY MEDICAL HELICOPTER SERVICE IS PROVIDED THROUGHOUT THE 20 COUNTIES SERVED. THE HELICOPTER PROVIDES RAPID PATIENT TRANSPORT TO THE APPROPRIATE HEALTH CARE FACILITY ALONG WITH DELIVERING HIGH-LEVEL CRITICAL CARE.Desc
Total Program Service Expenses$164,628,770TotalProgramServiceExpensesAmt
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
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
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 Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
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 With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
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 Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
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 Members14GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
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 OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1NATHANIEL CHERNEBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone9207355560PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 8025AddressLine1Txt
CityAPPLETONCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54912ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (29 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
TERRY TIMM
CHAIR1.002.00Yes (X)Yes (X)$0$0$0
JIM KOTEK
VICE CHAIR & SECRETARY1.002.00Yes (X)Yes (X)$0$0$0
IMRAN ANDRABI MD
PRESIDENT & CEO - SYSTEM4.0036.00Yes (X)Yes (X)$105,831$952,477$33,641
TIM BERGSTROM
BOARD MEMBER1.003.00Yes (X)$0$0$0
PATRICK BRENNAN MD
BOARD MEMBER1.002.00Yes (X)$0$0$0
MARK BURSTEIN
BOARD MEMBER1.002.00Yes (X)$0$0$0
JOHN DAVIS
BOARD MEMBER1.002.00Yes (X)$0$0$0
GARY EDELMAN MD
BOARD MEMBER / PHYSICIAN1.0042.00Yes (X)$0$499,600$30,264
DAVID KOEPER MD
BOARD MEMBER1.002.00Yes (X)$0$0$0
GRANT LAMONTAGNE
BOARD MEMBER (THROUGH FEB 2018)1.002.00Yes (X)$0$0$0
JIM MEYER
BOARD MEMBER1.003.00Yes (X)$0$0$0
DOUGLAS MOARD MD
BOARD MEMBER / PHYSICIAN1.0042.00Yes (X)$0$320,712$35,726
KAREN TIMBERLAKE
BOARD MEMBER1.002.00Yes (X)$0$0$0
NORMA TURK MD
BOARD MEMBER / PHYSICIAN1.0042.00Yes (X)$0$351,579$20,462
MARIA VAN LAANEN
BOARD MEMBER1.002.00Yes (X)$0$0$0
CYRIL WALSH MD
BOARD MEMBER1.002.00Yes (X)$0$0$0
MARK THOMPSON
SENIOR VP, CFO & COO - SYSTEM4.0036.00Yes (X)$58,437$525,934$31,595
TIM OLSON
CFO - CLINICALLY INTEGRATED NETWORK4.0036.00Yes (X)$30,901$278,105$19,727
VICTORIA BARNTHOUSE
CNO8.0032.00$65,686$262,742$18,954Yes (X)
JAMES ALBIN
CIO4.0036.00$37,439$336,952$31,617Yes (X)
MAGGIE LUND
CHRO4.0036.00$30,195$271,744$14,724Yes (X)
BRIAN STERNS
CHIEF OF STAFF4.0036.00$16,409$147,674$25,502Yes (X)
JENNIFER REDMAN-SCHELL
SR VP, CLINICALLY INTEGRATED NETWORK2.0038.00$18,657$354,483$31,200Yes (X)
GIANINA SIBLA MD
PHYSICIAN40.000.00$337,692$0$29,902Yes (X)
GREGORY LONG MD
CMO4.0036.00$55,382$498,436$24,977Yes (X)
NICKOLAS DEMARK MD
PHYSICIAN40.000.00$331,627$0$18,682Yes (X)
WILLIAM MANN
SENIOR VP, MANAGED CARE4.0036.00$48,432$435,890$19,124Yes (X)
BRIAN BURMEISTER
FORMER KEY EMPLOYEE8.0032.00$93,641$374,563$21,779Yes (X)
MAUREEN PISTONE
FORMER KEY EMPLOYEE4.0036.00$37,190$334,708$6,826Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,267,519TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$5,945,599TotReportableCompRltdOrgAmt
Total Other Compensation$414,702TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K45IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
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
MEDSPEED LLC
140 INDUSTRIAL DRIVEELMHURSTIL60126MEDICAL SERVICES$1,051,688
NEUROSCIENCE GROUP OF NE WISCONSIN
1305 W AMERICAN DRIVENEENAHWI54956MEDICAL SERVICES$1,009,420
SURGICAL ASSOCIATES OF NEENAH
100 THEDA CLARK MED PLAZA STE 400NEENAHWI54956MEDICAL SERVICES$882,695
BIOFIRE DIAGNOSTICS LLC
PO BOX 581463SALT LAKE CITYUT84158MEDICAL SERVICES$504,034
NEUROSPINE CENTER OF WISCONSIN
5320 W MICHAELS DRIVEAPPLETONWI54913MEDICAL SERVICES$446,742
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K9CntrctRcvdGreaterThan100KCnt
Related Organizations$98,232RelatedOrganizationsAmt
All Other Contributions$40,517AllOtherContributionsAmt
Total Contributions$138,749TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
INPATIENT REVENUE621990$200,881,168$200,881,168
OUTPATIENT REVENUE621400$31,633,649$31,633,649
LAB REFERRAL REVENUE621500$1,395,145$1,395,145
OTHER REVENUE621990$770,002$770,002
FieldValueIRS element (for citing)
Total Program Service Revenue$234,679,964TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$213,957TotalRevenueColumnAmt
Exclusion$213,957ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$2,712,172RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$2,712,172RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,712,172TotalRevenueColumnAmt
Exclusion$2,712,172ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$2,490OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$2,490OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,490TotalRevenueColumnAmt
Exclusion$2,490ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$237,747,332TotalRevenueColumnAmt
Related Or Exempt Func Income$233,284,819RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$1,395,145UnrelatedBusinessRevenueAmt
Exclusion$2,928,619ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$4,299TotalAmt
Program Services$4,299ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$358,749TotalAmt
Program Services$282,397ProgramServicesAmt
Management And General$76,352ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$135,870TotalAmt
Program Services$128,295ProgramServicesAmt
Management And General$7,575ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$66,455,916TotalAmt
Program Services$56,363,695ProgramServicesAmt
Management And General$10,092,221ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$16,024,149TotalAmt
Program Services$13,608,298ProgramServicesAmt
Management And General$2,415,851ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$8,492,898TotalAmt
Program Services$5,148,631ProgramServicesAmt
Management And General$3,344,267ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$145,375TotalAmt
Program Services$145,375ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,232,865TotalAmt
Program Services$801,419ProgramServicesAmt
Management And General$431,446ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$5,998,894TotalAmt
Program Services$5,956,618ProgramServicesAmt
Management And General$42,276ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$142,244TotalAmt
Program Services$142,244ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$170,125TotalAmt
Program Services$170,125ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$10,353TotalAmt
Program Services$10,353ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$9,217,724TotalAmt
Program Services$9,217,724ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$224,663TotalAmt
Program Services$224,663ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
PATIENT & CLIENT SERVIC$64,807,802$64,807,802
EQUIPMENT MAINTENANCE$3,893,108$3,893,108
BAD DEBT EXPENSE$3,723,724$3,723,724
UBI TAXES$81,130$81,130

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$181,119,888TotalAmt
Program Services$164,628,770ProgramServicesAmt
Management And General$16,491,118ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$33,044,149BOYAmt
EOY$31,974,218EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$2,330,774BOYAmt
EOY$2,795,440EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$241,627,471LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$162,891,354LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$80,843,452BOYAmt
EOY$78,736,117EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$278,395,918BOYAmt
EOY$345,569,248EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$394,614,293BOYAmt
EOY$459,075,023EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
EOY$73,931EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$830BOYAmt
EOY$610EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$830BOYAmt
EOY$74,541EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$394,613,463BOYAmt
EOY$459,000,482EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$394,613,463BOYAmt
EOY$459,000,482EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$394,614,293BOYAmt
EOY$459,075,023EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$56,627,444ReconcilationRevenueExpnssAmt
Prior Period Adjustments$7,759,575PriorPeriodAdjustmentsAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
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 Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$7,550OtherActivitiesAmt
Total Lobbying Expenditures$7,550TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationA PORTION OF THE WHA DUES REPRESENT LOBBYING PERFORMED IN REGARD TO HEALTHCARE ISSUES. TOTAL DUES PAID IN 2018 WERE $55,514. 13.6% OF THIS AMOUNT WAS SPENT ON LOBBYING.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,271,775OtherCostOrOtherBasisAmt
Book Value$6,271,775BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$154,642,562OtherCostOrOtherBasisAmt
Depreciation$95,907,245DepreciationAmt
Book Value$58,735,317BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,674,963OtherCostOrOtherBasisAmt
Depreciation$2,169,654DepreciationAmt
Book Value$505,309BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$78,038,171OtherCostOrOtherBasisAmt
Depreciation$64,814,455DepreciationAmt
Book Value$13,223,716BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$78,736,117TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescDUE FROM AFFILIATESDesc
Book Value$345,569,248BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$345,569,248TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescOTHER LIABILITIESDesc
Amt$610Amt
FieldValueIRS element (for citing)
Total Liability$610TotalLiabilityAmt

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
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Discounted Care Other410.000000000000DiscountedCareOtherPct
FieldValueIRS element (for citing)
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance Budget0FinancialAssistanceBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Persons Served1266PersonsServedCnt
Total Community Benefit Expns$1,095,992TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,095,992NetCommunityBenefitExpnsAmt
Total Expense0.00620TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Persons Served34367PersonsServedCnt
Total Community Benefit Expns$24,630,286TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$23,590,420DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,039,866NetCommunityBenefitExpnsAmt
Total Expense0.00590TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Persons Served35633PersonsServedCnt
Total Community Benefit Expns$25,726,278TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$23,590,420DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,135,858NetCommunityBenefitExpnsAmt
Total Expense0.01210TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs19ActivitiesOrProgramsCnt
Persons Served773924PersonsServedCnt
Total Community Benefit Expns$1,540,823TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,540,823NetCommunityBenefitExpnsAmt
Total Expense0.00870TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Activities Or Programs4ActivitiesOrProgramsCnt
Persons Served1829PersonsServedCnt
Total Community Benefit Expns$650,439TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$650,439NetCommunityBenefitExpnsAmt
Total Expense0.00370TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs3ActivitiesOrProgramsCnt
Persons Served1380PersonsServedCnt
Total Community Benefit Expns$1,059,024TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,059,024NetCommunityBenefitExpnsAmt
Total Expense0.00600TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Activities Or Programs6ActivitiesOrProgramsCnt
Persons Served668814PersonsServedCnt
Total Community Benefit Expns$2,048,343TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,048,343NetCommunityBenefitExpnsAmt
Total Expense0.01150TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs32ActivitiesOrProgramsCnt
Persons Served1445947PersonsServedCnt
Total Community Benefit Expns$5,298,629TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$5,298,629NetCommunityBenefitExpnsAmt
Total Expense0.02990TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs32ActivitiesOrProgramsCnt
Persons Served1481580PersonsServedCnt
Total Community Benefit Expns$31,024,907TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$23,590,420DirectOffsettingRevenueAmt
Net Community Benefit Expns$7,434,487NetCommunityBenefitExpnsAmt
Total Expense0.04200TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served87633PersonsServedCnt
Total Community Benefit Expns$3,479TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,479NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served1772PersonsServedCnt
Total Community Benefit Expns$55,757TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,500DirectOffsettingRevenueAmt
Net Community Benefit Expns$53,257NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served47PersonsServedCnt
Total Community Benefit Expns$1,512TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,512NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Persons Served100PersonsServedCnt
Total Community Benefit Expns$9,685TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$9,685NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Activities Or Programs4ActivitiesOrProgramsCnt
Persons Served89552PersonsServedCnt
Total Community Benefit Expns$70,433TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,500DirectOffsettingRevenueAmt
Net Community Benefit Expns$67,933NetCommunityBenefitExpnsAmt
Total Expense0.00040TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$1,406,926BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$28,068,403ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$28,028,224CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$40,179MedicareSurplusOrShortfallAmt

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 Line1THEDACARE REGIONAL MEDICAL CENTER - NEENAHBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1120 SECOND STREETAddressLine1Txt
CityNEENAHCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54956ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.THEDACARE.ORGWebsiteAddressTxt
State License32StateLicenseNum
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 Line1THEDACARE REGIONAL MEDICAL CENTER - NEENBusinessNameLine1Txt
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
CHNA Conducted16CHNAConductedYr
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 7DOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt16ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSEE LINE 7DStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care410.000000000000FPGFamilyIncmLmtDscntCarePct
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
Other MethodYes (X)OtherMethodInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLHTTPS://WWW.THEDACARE.ORG/POLICIES-AND-LEGAL-FORMS/PAYMENT-OPTIONSFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLHTTPS://WWW.THEDACARE.ORG/POLICIES-AND-LEGAL-FORMS/PAYMENT-OPTIONSFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLHTTPS://WWW.THEDACARE.ORG/POLICIES-AND-LEGAL-FORMS/PAYMENT-OPTIONSFAPSummaryOnWebsiteURLTxt
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
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
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
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
THEDACARE REGIONAL MEDICAL CENTER - NEENAHPART V, SECTION B, LINE 5: THEDACARE CONSULTED WITH THE PUBLIC HEALTH DEPARTMENTS OF OUTAGAMIE COUNTY, WINNEBAGO COUNTY AND CALUMET COUNTY. IN ADDITION, OVER THE COURSE OF A ONE YEAR PERIOD, SECONDARY DATA WAS COLLECTED, KEY INFORMANT INTERVIEWS WERE CONDUCTED, THEDACARE CHAT TEAMS (COMMUNITY HEALTH ACTION TEAM) PROVIDED INPUT AND PATIENT HEALTH DATA WAS STUDIED. VULNERABLE POPULATIONS INCLUDED THOSE LIVING IN POVERTY, RURAL FARM FAMILIES, THE ELDERLY, GRANDPARENTS AS CARETAKERS, SINGLE-PARENTS, HOMELESS, VETERANS AND HEADSTART POPULATION. INPUT WAS COLLECTED FROM REPRESENTATIVES OF:- RURAL HEALTH/FARM FAMILIES- LESBIAN GAY BISEXUAL TRANSGENDER (LGBT)- SENIORS/ELDERLY- LATINO- IMPOVERISHED- HMONG- YOUTH- AFRICAN AMERICAN
THEDACARE REGIONAL MEDICAL CENTER - NEENAHPART V, SECTION B, LINE 6A: THEDACARE REGIONAL MEDICAL CENTER-NEENAH IS A MEMBER OF THE FOX VALLEY COMMUNITY HEALTH IMPROVEMENT COALITION WHOSE MEMBERS INCLUDE THE PUBLIC HEALTH DEPARTMENTS OF CALUMET, OUTAGAMIE AND WINNEBAGO COUNTIES AND THE HEALTH DEPARTMENTS OF THE CITY OF APPLETON AND CITY OF MENASHA. MEMBERSHIP ALSO INCLUDES REPRESENTATIVES FROM CHILDREN'S HOSPITAL OF WISCONSIN, PARTNERSHIP COMMUNITY HEALTH CENTER (FQHC), AURORA HEALTH IN OSHKOSH AND AFFINITY HEALTH IN APPLETON. THIS COALITION WAS PART OF A JOINT CHNA PROCESS DURING 2015/2016.
THEDACARE REGIONAL MEDICAL CENTER - NEENAHPART V, SECTION B, LINE 7D: THE COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND IMPLEMENTATION STRATEGY ARE AVAILABLE ONLINE AT:HTTPS://WWW.THEDACARE.ORG/GETTING-INVOLVED/IMPROVING-COMMUNITY-HEALTH.ASPX.
THEDACARE REGIONAL MEDICAL CENTER - NEENAHPART V, SECTION B, LINE 11: THE THEDACARE COMMUNITY HEALTH IMPLEMENTATION STRATEGY WAS APPROVED BY THE THEDACARE BOARD OF TRUSTEES IN DECEMBER OF 2016.OBESITY1. WEIGHT OF THE FOX VALLEY INITIATIVE:- CONTRIBUTED $20,000 TO WOTFV, WITH PRESENCE ON LEADERSHIP AND CORE TEAMS. LEADING EFFORT TO REFOCUS WOTFV ON HEALTHY LIFESTYLE AND WELLBEING VS. OBESITY.- THEDACARE PRODUCED AGGREGATE PATIENT BMI DATA FROM 3 HEALTH SYSTEMS; 91,000 ADULT PATIENTS, 29,000 PEDIATRIC PATIENTS (30% OF POPULATION).- SUPPORTED SECURING $75,000 AMERICORPS PLANNING GRANT TO BRING 20 AMERICORPS VOLUNTEERS IN 2018-19 TO WORK ON OBESITY GOALS.- WOTFV ACTION TEAMS: - KICKED OFF EARLY CARE/EDUCATION ACTION TEAM - FOCUS ON INCREASING FRUIT AND VEG CONSUMPTION AND BREASTFEEDING AGE BIRTH - 5 (WORKING ON HEALTHY SIDES AND BEVERAGES IN KIDS MEALS IN RESTAURANTS. - WORKSITE - ENGAGED 21 ADDITIONAL WORKSITES TO HOST WORKSITE WELLNESS PROGRAMS. GAINED 12 WORKSITES/EARLY CARE PROGRAMS PROVIDING BREASTFEEDING FRIENDLY DESIGNATIONS. SUPPORTED MAINTAIN DON'T GAIN CHALLENGE. - ACTIVE COMMUNITIES - GAINED ACCEPTANCE OF COMPLETE STREETS POLICIES IN FIVE MUNICIPALITIES; ADDED 40 WAYFARING SIGNS AND 3.2 MILES OF TRAILS. - LAUNCHING SCHOOLS AND HEALTHCARE ACTION TEAMS - THEDACARE PROVIDERS HELPING TO DETERMINE FOCUS. 2. SPONSOR HEALTHY KIDS EVENTS - $6000 SPONSORSHIP WITH YMCA HELD AT 6 LOCATIONS WITH 4000 CHILDREN ATTENDING. IN 2018 THE EVENTS FOCUSED ON HEALTHY COOKING. 3. FARMERS MARKETS - IN 2018, PROVIDED SPONSORSHIP TO LOCAL FARMER'S MARKET. THE MARKET PROMOTES PURCHASING AND PREPARING HEALTHY FOODS.MENTAL HEALTH/AODA: 1. CATALPA HEALTH: IN 2018, THEDACARE PROVIDED IN-KIND LEADERSHIP AND FINANCIAL SUPPORT TO CATALPA HEALTH - CHILDREN'S MENTAL HEALTH PROVIDER WHICH PROVIDES MENTAL HEALTH SERVICES TO CHILDREN THROUGHOUT NORTHEAST WISCONSIN. 2. NEW MH CONNECTION SUPPORT- THEDACARE CHAIRS THE BOARD OF NEW MH CONNECTION, A COALITION OF 70+ MENTAL HEALTH AGENCIES, TO ADDRESS ACCESS TO MENTAL HEALTH CARE; PROVIDES IN-KIND OFFICE SPACE AT TCBH ETC. CONTRIBUTES $15,000 FUNDING ANNUALLY. - MYCONNECTIONNEW.ORG, SERVICE NAVIGATION SITE FOR ALL MENTAL HEALTH AND SUBSTANCE ABUSE PROVIDERS IN OUTAGAMIE, CALUMET, WINNEBAGO AND NOW BROWN COUNTY - IN PARTNERSHIP WITH UNITED WAY'S 2-1-1. - IN 2018, THERE WERE 52,076 PAGE VIEWS. 673 PEOPLE COMPLETED ONLINE SCREENING FOR DEPRESSION OR OTHER MENTAL HEALTH CONDITIONS. 65% INDICATED FURTHER EVALUATION WAS NEEDED. - TOP VIEWED PAGES: MENTAL HEALTH SERVICE DIRECTORY, EMERGENCY SERVICES PAGE, LIBRARY, CALENDAR; TOP LIBRARY SEARCHES: DEPRESSION, ANXIETY, OPIOID ADDICTION, ANOREXIA, EARLY SOCIAL EMOTIONAL DEVELOPMENT.3. FQHC SUPPORT: PROVIDED LEADERSHIP AND FUNDING FOR THE PARTNERSHIP COMMUNITY HEALTH CENTER WORKING TO IMPROVE THE HEALTH STATUS OF THE MEDICALLY UNDERSERVED BY PROVIDING COMPREHENSIVE PRIMARY CARE AND BEHAVIORAL HEALTH SERVICES.4. PROVIDED OVER $800,000 IN SUBSIDIZED MENTAL HEALTH SERVICES. 5. IN THE FALL OF 2018, THEDACARE SPONSORED PARTY AT THE PAC FOR THOUSANDS OF AREA YOUTH TO EDUCATE ON THE PERILS OF RISKY BEHAVIOR WHILE TEXTING/DRINKING AND DRIVING. 6. OPIOID ABUSE PREVENTION: LAUNCHED OPIOID INITIATIVE TO ADDRESS ACADEMIC DETAILING, MAT EXPANSION, DRUG TAKE BACK BOXES THROUGHOUT SYSTEM, COMMUNITY AWARENESS CAMPAIGN, AND SCHOOL-BASED RESILIENCY PROGRAMMING CALLED SOURCES OF STRENGTH. THEDACARE COMMITTED $300,000 OVER 3 YEARS TO IMPLEMENT THE SCHOOL BASED PROGRAM. 7. BEHAVIORAL HEALTH OPERATIONS: INITIATED PRIMARY CARE CONSULT. DR. PANZER AND DR. BELD DO INITIAL REVIEW OF ALL REFERRALS AND IF URGENT, GET THEM INTO EXPEDITED CARE (PSYCH, MH OR AODA). OTHERWISE, CONSULT WITH PC. HELPS PCP MANAGE PATIENTS IF ON WAIT LIST. WAIT LIST FOR PSYCHIATRIC NEEDS DROPPED FROM 600+ TO 0. 8. INITIATED NPPP (NORTH PRIMARY CARE PSYCHIATRIC PARTNERSHIP) - PROVIDER INTEGRATED IN PCP CLINIC. SEES PATIENTS ON WAIT LIST UP TO 4 TIMES. REFERS TO PSYCHIATRIST FOR INITIAL TRIAGE AND IF URGENT GETS THEM INTO PSYCH, MH OR AODA CARE RIGHT AWAY. EXPANDING TO NEENAH AND TRAINING ANOTHER PROVIDER. SHAWANO PSYCHIATRIST EMBEDDED IN PCP CLINIC.9. INPATIENT PSYCH WENT TO 7 DAYS ON/7 OFF FOR HOSPITALIST. FREES UP OUTPATIENT PSYCH TIME. 10. DEPRESSION SCREENING: DEPRESSION SCREENING IS TAKING PLACE IN 100% OF TC PEDS AND FP CLINICS FOR PEOPLE AGE 12+. 11. IN ADDITION:- CONDUCTING COLUMBIA SCREENING AT EVERY MENTAL HEALTH INITIAL APPOINTMENT; AND- CONDUCTING PHQ9 AT EVERY AODA INITIAL APPOINTMENT.EARLY CHILDHOOD/FAMILY SUPPORT:1. REACH OUT AND READ: THEDACARE COMMITTED TO PROVIDING EVIDENCE-BASED REACH OUT AND READ EARLY CHILDHOOD READING PROGRAM IN ALL CLINICS BY 2019. IN 2018, TCP SHAWANO, DARBOY, TIGERTON, NEENAH/MENASHA PEDS PROVIDED BOOKS TO 4000 KIDS. (A CHILD 1 YEAR BEHIND IN READING BY 3RD GRADE HAS 26% OF DROPPING OUT OF HIGH SCHOOL VS. 10% OF STUDENTS READING AT GRADE LEVEL.)2. HOSTED REACH OUT AND READ TC EMPLOYEE VOLUNTEERISM EVENT IN 5 AREA SCHOOLS FOR 1 WEEK. READ TO ELEMENTARY STUDENTS AND ENCOURAGED CHILDREN TO READ. 3. IMPROVED BIRTH CENTER ASSESSMENT AND REFERRAL PROCESS TO HOME VISITATION PROGRAMS. TRIPLED THE NUMBER OF REFERRALS FOR PARENTS AS TEACHERS IN HOME SUPPORT. 4. HOSTED EARLY CHILDHOOD PLUNGE APRIL 28, 2017: 60+ COMMUNITY LEADERS ATTENDED. TWO FOLLOW-UP DEBRIEFING MEETINGS RESULTING IN TOP PRIORITY OF DEVELOPING COMMUNITY-WIDE UMBRELLA MODEL THAT CREATES COMMON VISION, ALIGNED PRIORITIES, FACILITATES ACCESS TO ALL EC SERVICES IN THE COMMUNITY AND PROVIDES CONSISTENT MEASUREMENT AND CONDUIT TO RESOURCES, LOCAL, STATE AND NATIONAL. CHAT RESEARCH TEAM EXPLORING NATIONAL MODELS.5. GREAT FUTURES START HERE MENTORING: TC HELPED LAUNCH AND PROVIDED 5 YEARS OF SUPPORT FOR GREAT FUTURES THROUGH OSHKOSH BOYS & GIRLS CLUB. 191 AT-RISK YOUTH MENTORED SINCE PROGRAM START UP.POVERTY:POINT - THEDACARE IS A PARTNER WITH THE POVERTY OUTCOMES & IMPROVEMENT TEAM (POINT), AN 18 MONTH INITIATIVE EQUIPPING THE ENTIRE FOX VALLEY REGION WITH CONTINUOUS IMPROVEMENT METHODOLOGIES FOCUSED ON POVERTY. POINT IS USING THESE PROCESSES TO STRENGTHEN EXISTING POVERTY REDUCTION EFFORTS, ADDRESS SERVICE GAPS, AND MEASURE PROGRESS ON REDUCING POVERTY IN NORTHEAST WISCONSIN. TC CONTRIBUTED $200,000 PLUS PRESENCE ON THE LEADERSHIP TEAM. POINT COLLABORATED WITH BOSTON-BASED INSTITUTE FOR HEALTHCARE IMPROVEMENT TO USE LEAN PROCESSES AND TOOLS TO HELP NON-PROFIT AGENCIES HELP PEOPLE BECOME SELF-SUFFICIENT. MORE THAN 40 NON-PROFIT AGENCIES ARE PARTICIPATINGHEALTH DISPARITIES:1. OPPORTUNITY GAP - FOLLOWING "BEING BLACK IN FOX CITIES" PLUNGE OCTOBER 2015, TC LED PROCESS WITH AFRICAN HERITAGE, INC., APPLETON/MENASHA SCHOOL DISTRICTS, BOYS & GIRLS CLUB, UNITED WAY, FOUR AREA COLLEGES AND OTHERS TO DEVELOP STAR PROGRAM (SCHOLARS ON TARGET TO ACHIEVE RESULTS) TO HELP REDUCE GRADUATION GAP BETWEEN BLACK AND WHITE STUDENTS. CHAT FUNDED $30,000 PROGRAM DIRECTOR START-UP PERIOD WITH $50,000 PER YEAR FOR THREE YEARS FOR PROGRAM OPERATIONS. IN 2018-19 SCHOOL YEAR, 340 YOUTH WERE SERVED. ADDITIONAL METRICS INCLUDE "ON-TRACK TO GRADUATE" SCORES, POST-SECONDARY ENROLLMENT AND FAMILY ENGAGEMENT.2. RURAL HEALTH INITIATIVE - THEDACARE IS A MAJOR SUPPORTER OF THE RURAL HEALTH INITIATIVE, WHICH TAKES HEALTHCARE SERVICES TO THE FARM REACHING A SIGNIFICANT VULNERABLE POPULATION OF LOW-INCOME FARMERS AND MIGRANT WORKERS, MANY OF WHOM ARE UNINSURED. RHI HAS SERVED 420 FAMILIES IN 2018 WITH 100 BEING LATINO. 572 HEALTH SCREENINGS WERE CONDUCTED WITH 106 UNMANAGED HEALTH CONDITIONS IDENTIFIED. 266 REFERRALS WERE MADE TO HEALTH CARE PROVIDERS. END OF LIFE:1. FOX VALLEY ADVANCE CARE PLANNING PARTNERSHIP: TC LEADERS SERVED ON FV ADVANCE CARE PLANNING PARTNERSHIP LEADERSHIP TEAM. CHAT COMMITTED $160,000 OVER THREE YEARS TO SUPPORT START-UP OF PARTNERSHIP WHICH INCLUDES THEDACARE, ASCENSION, MOSAIC AND END OF LIFE COALITION. STRATEGIC PLAN DEVELOPED TO INCLUDE COMMUNITY-BASED AND HEALTH-SYSTEM BASED GOALS. TC HIRED AN ADVANCE CARE PLANNING COORDINATOR. SURVEY OF PROVIDER ATTITUDES TOWARD END OF LIFE CONVERSATIONS, PALLIATIVE CARE AND HOSPICE COMPLETED SPRING 2018. GENERAL:1. THEDACARE PARTNERS WITH ASCENSION HEALTH SYSTEM TO SPONSOR FOX VALLEY FAMILY RESIDENCY PROGRAM PROVIDING HANDS ON EXPERIENCE FOR MEDICAL STUDENTS AND ACCESS TO PRIMARY CARE AND MENTAL HEALTH SERVICES.2. THEDACARE ALSO PARTNERS WITH AREA NURSING SCHOOLS SUCH AS UW OSHKOSH AND FOX VALLEY TECHNICAL COLLEGE TO PROVIDE PROFESSIONAL MENTORS FOR THEIR NURSING PROGRAMS AND VENUES FOR NURSING STUDENTS TO PRACTICE THEIR SKILLS.3. THEDACARE HOSPITALS PROVIDE FINANCIAL AS WELL AS DIAGNOSTIC AND LAB SUPPORT TO A PARTNERSHIP COMMUNTIY HEALTH CENTER (FQHC) PROVIDING MEDICAL, BEHAVIORAL AND DENTAL CARE TO THE UNDERSERVED IN OUR SERVICE AREA.IDENTIFIED BUT NOT ADDRESSED:1. SMOKING - EXISTING EFFORTS ARE UNDER WAY2. HOMELESSNESS - BEYOND SCOPE OF RESOURCES3. STD'S - BEYOND SCOPE OF RESOURCES
THEDACARE REGIONAL MEDICAL CENTER - NEENAHPART V, SECTION B, LINE 13H: PATIENTS ARE SENT AN OVERVIEW LETTER EXPLAINING THE PROCESS FOR APPLYING FOR OUR ASSISTANCE PROGRAM OR OUR STAFF WALKS THEM THROUGH THE PROCESS. THEY ARE ASKED TO COMPLETE AN APPLICATION THAT INCLUDES REQUESTS FOR INFORMATION. THIS INFORMATION IS NEEDED IN ORDER TO MAKE A DECISION AS TO WHETHER THE PATIENT MEETS THE CRITERIA FOR ACCEPTANCE, AND IF ACCEPTED, WHAT LEVEL OF ASSISTANCE WILL BE PROVIDED. ONCE THE DECISION IS MADE, WE WILL NOTIFY THE PATIENT AND IF ACCEPTABLE, WRITE OFF THE BALANCE AS DETERMINED.
THEDACARE REGIONAL MEDICAL CENTER - NEENAHPART V, SECTION B, LINE 16J: THE FAP AND APPLICATION WERE AVAILABLE AT HOSPITAL CASHIER OFFICES, ON OUR WEB SITE AND OFFERED TO ALL PATIENTS THAT EXPRESSED A FINANCIAL HARDSHIP WHEN CALLING THE BILLING OFFICE. THE PLS WAS PRINTED ON EVERY STATEMENT AND A FOOTER WAS ADDED TO THE FRONT OF THE STATEMENT ADVISING PATIENT TO SEE REVERSE SIDE OF STATEMENT FOR FINANCIAL ASSISTANCE AND PAYMENT OPTIONS. NOTIFICATION OF FINANCIAL ASSISTANCE AVAILABILITY WAS ADDED TO THE INITIAL LETTER SENT BY THE THIRD PARTY COLLECTION AGENCY.
FieldValueIRS element (for citing)
Facility2FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - AYLWARD SURGERY CENTER
120 SECOND STREETNEENAHWI54956OUTPATIENT SURGERY CENTER
2 - RENAIISANCE SURGERY CENTER
2400 WITZEL AVENUEOSHKOSHWI54904OUTPATIENT SURGERY CENTER

Supplemental Information Detail SupplementalInformationDetail (16 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:IT IS THE ORGANIZATION'S POLICY THAT NO PATIENT SHOULD BE DENIED APPROPRIATE AND NECESSARY CARE ON THE BASIS OF INCOME. IN RESPONSE TO THIS POLICY, THE CARING HEARTS FINANCIAL ASSISTANCE PROGRAM WAS SET UP TO PROVIDE SHELTER TO THOSE PATIENTS WHO ARE UNABLE TO PAY FOR THEIR MEDICAL SERVICES. MEDICAL SERVICE FEES ARE WRITTEN OFF UNDER THE FINANCIAL ASSISTANCE PROGRAM THAT WOULD OTHERWISE HAVE BEEN SENT TO A COLLECTION AGENCY.
PART I, LINE 7:THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS IN THE TABLE IS A COMBINATION OF AVERAGE COSTS AND ACTUAL COSTS PERTAINING TO SUPPLIES, WAGES, AND BENEFITS. FOR SUPPLIES, THE ACTUAL COST OF ITEMS USED FOR EACH EVENT IS APPLIED. IF NO ACTUAL COST IS AVAILABLE, WE THEN USE AN ESTIMATE. WAGES ARE CALCULATED BY MULTIPLYING THE AVERAGE WAGE RATE TIMES ACTUAL HOURS WORKED. THE BENEFIT RATE USED INCLUDES A FRINGE RATIO OF ALL BENEFITS RELATED TO THE ABOVE WAGE CALCULATION. THE COST ACCOUNTING SYSTEM DOES NOT DIFFERENTIATE BETWEEN DIFFERENT PAYER TYPES AND NO COST-TO-CHARGE RATIO IS USED.
PART I, LINE 7G:NO PHYSICIAN CLINICS ARE INCLUDED IN SUBSIDIZED HEALTH SERVICES.
PART I, LINE 7, COLUMN (F):THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 3,723,724.
PART II, COMMUNITY BUILDING ACTIVITIES:ECONOMIC DEVELOPMENT: THE PRIMARY AIM OF THE CHAMBER IS TO PROTECT THE INTEREST OF THE BUSINESS COMMUNITY AS A WHOLE. STRONG EMPLOYMENT IS A SOCIAL DETERMINANT OF HEALTH, REDUCING POVERTY AND PROVIDING INDIVIDUAL AND FAMILY SUSTAINABILITY. THEDACARE WORKS TOGETHER WITH THE LOCAL CHAMBER OF COMMERCE AND ALL OF THE COMMUNITIES IT SERVES. COMMUNITY SUPPORT: CARING HEARTS IS A FINANCIAL ASSISTANCE PROGRAM DESIGNED FOR PATIENTS WHO ARE UNABLE TO PAY FOR MEDICALLY NECESSARY SERVICES PROVIDED BY ALL DIVISIONS WITHIN THEDACARE. THE CARING HEARTS PROGRAM COVERS SERVICES WHICH ARE DEEMED TO BE MEDICALLY NECESSARY AS DETERMINED BY YOUR PHYSICIAN. THIS COST IS FOR TIME AND EXPENSE NEEDED TO SUPPORT CARING HEARTS.THE CARING HEARTS FINANCIAL ASSISTANCE PROGRAM IS IN EFFECT AT ALL THEDACARE FACILITIES: THEDACARE REGIONAL MEDICAL CENTERS IN APPLETON AND NEENAH, THEDACARE MEDICAL CENTER-BERLIN, THEDACARE MEDICAL CENTER-NEW LONDON, THEDACARE MEDICAL CENTER-SHAWANO, THEDACARE MEDICAL CENTER-WAUPACA AND THEDACARE MEDICAL CENTER-WILD ROSE.ENVIRONMENTAL IMPROVEMENTS: SHARPS COLLECTION. COMMUNITY SHARPS CAN BE TAKEN FOR COLLECTION AND DISPOSAL TO ANY OF THE 7 THEDACARE HOSPITALS.COMMUNITY SHARPS CAN BE DISPOSED OF AT THEDACARE REGIONAL MEDICAL CENTER-APPLETON AND NEENAH, THEDACARE MEDICAL CENTER-BERLIN, THEDACARE MEDICAL CENTER-NEW LONDON, THEDACARE MEDICAL CENTER-SHAWANO, THEDACARE MEDICAL CENTER-WAUPACA AND THEDACARE MEDICAL CENTER-WILD ROSE.COMMUNITY SUPPORT: CISM DEBRIEFING - CRITICAL INCIDENT STRESS MANAGEMENT IS AN ADAPTIVE, SHORT-TERM PSYCHOLOGICAL HELPING-PROCESS THAT FOCUSES SOLELY ON AN IMMEDIATE AND IDENTIFIABLE PROBLEM. IT CAN INCLUDE PRE-INCIDENT PREPAREDNESS TO ACUTE CRISIS MANAGEMENT TO POST-CRISIS FOLLOW-UP. ITS PURPOSE IS TO ENABLE PEOPLE TO RETURN TO THEIR DAILY ROUTINE MORE QUICKLY AND WITH LESS LIKELIHOOD OF EXPERIENCING POST-TRAUMATIC STRESS DISORDER. THEDACARE WORKS WITH THE LOCAL COMMUNITY IN CASES OF DEATH, SEVERE INJURY AND INFANT DEATH.OTHER: TRAUMA INJURY PREVENTION OUTREACH - THEDACARE WORKS WITH THE LOCAL COMMUNITY TO PROVIDE INJURY PREVENTION TACTICS INCLUDING HOW TO STOP SEVERE BLEEDING, HOW TO RESPOND TO AN EMERGENCY SUCH AS CARDIAC ARREST OR STROKE.
PART III, LINE 2:PATIENT ACCOUNTS RECEIVABLE ARE UNCOLLATERALIZED PATIENT OBLIGATIONS THAT ARE STATED AT THE AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH THEDACARE EXPECTS TO BE ENTITLED IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE OBLIGATIONS ARE PRIMARILY FROM LOCAL RESIDENTS, MOST OF WHOM ARE INSURED UNDER THIRD-PARTY PAYOR AGREEMENTS. THEDACARE BILLS THIRD-PARTY PAYORS ON THE PATIENTS' BEHALF, OR IF A PATIENT IS UNINSURED, THE PATIENT IS BILLED DIRECTLY. ONCE CLAIMS ARE SETTLED WITH THE PRIMARY PAYOR, ANY SECONDARY INSURANCE IS BILLED, AND PATIENTS ARE BILLED FOR COPAY AND DEDUCTIBLE AMOUNTS THAT ARE THE PATIENTS' RESPONSIBILITY. PAYMENTS ON ACCOUNTS RECEIVABLE ARE APPLIED TO THE SPECIFIC CLAIM IDENTIFIED ON THE REMITTANCE ADVICE OR STATEMENTS. THEDACARE DOES NOT HAVE A POLICY TO CHARGE INTEREST ON PAST DUE ACCOUNTS.PATIENT ACCOUNTS RECEIVABLE ARE RECORDED AT NET REALIZABLE VALUE BASED ON CERTAIN ASSUMPTIONS. FOR THIRD-PARTY PAYORS, INCLUDING MEDICARE, MEDICAID, MANAGED CARE AND COMMERCIAL PAYORS, THE NET REALIZABLE VALUE IS BASED ON THE ESTIMATED CONTRACTUAL REIMBURSEMENT PERCENTAGE, WHICH IS BASED ON CURRENT CONTRACT PRICES OR HISTORICAL PAID CLAIMS DATA BY PAYOR. FOR UNINSURED PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR A PORTION OF THE BILL), THE NET REALIZABLE VALUE IS DETERMINED USING ESTIMATES OF HISTORICAL COLLECTION EXPERIENCE. THESE ESTIMATES ARE ADJUSTED FOR EXPECTED RECOVERIES AND ANY ANTICIPATED CHANGES IN TRENDS, INCLUDING SIGNIFICANT CHANGES IN PAYOR MIX, ECONOMIC CONDITIONS OR TRENDS IN FEDERAL AND STATE GOVERNMENTAL HEALTH CARE COVERAGE.
PART III, LINE 3:THE HOSPITAL IS REPORTING $0 BECAUSE IT DOES NOT HAVE A METHOD OF REASONABLY ESTIMATING THE PORTION OF ITS BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE BUT WHO DID NOT COMPLETE A FINANCIAL ASSISTANCE APPLICATION.
PART III, LINE 4:SEE "PATIENT ACCOUNTS RECEIVABLE AND CREDIT POLICY" OF NOTE 1 ON PAGES 10-11 IN THE ATTACHED FINANCIAL STATEMENTS.
PART III, LINE 8:HOSPITALS MUST ACCEPT MEDICARE PATIENTS REGARDLESS OF WHETHER THEY MAKE A SURPLUS OR DEFICIT FROM PROVIDING SERVICES TO THOSE PATIENTS. WE DID NOT REPORT ANY SHORTFALL AS A COMMUNITY BENEFIT. THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE ORGANIZATIONS MEDICARE COST REPORT IS STEP DOWN.
PART III, LINE 9B:OUR POLICY IS NOT TO PURSUE PATIENT ACCOUNTS TO THE EXTENT ANY CHARGES ARE ELIGIBLE AND WRITTEN OFF THROUGH OUR CHARITY CARE/FINANCIAL ASSISTANCE PROGRAM. IF ONLY A PORTION OF THE CHARGES ARE ELIGIBLE AND WRITTEN OFF THROUGH OUR CHARITY CARE/FINANCIAL ASSISTANCE PROGRAM, THE REMAINING BALANCE WILL BE BILLED TO THE PATIENT AND COLLECTED IN ACCORDANCE WITH OUR NORMAL COLLECTION POLICY.
PART VI, LINE 2:THEDACARE COVERS A 9-COUNTY PRIMARY SERVICE AREA SERVED BY 7 HOSPITALS. THEDACARE CONDUCTS A COMMUNITY NEEDS ASSESSMENT EVERY THREE YEARS FOR EACH HOSPITAL GATHERING DATA PERTINENT TO THAT COMMUNITY AND THE SURROUNDING AREAS. INFORMATION COLLECTED INCLUDES DATA FROM THE WISCONSIN COUNTY HEALTH RANKINGS, FOX CITIES LIFE STUDY (LOCAL INDICATORS FOR EXCELLENCE), THE BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY, INSIGHTS FROM INTERVIEWS OF PUBLIC HEALTH OFFICIALS, INSIGHTS FROM INTERVIEWS WITH REPRESENTATIVES OF VULNERABLE POPULATIONS, EMERGENCY DEPARTMENT PATIENT DATA AND INSIGHTS GATHERED FROM MONTHLY MEETINGS OF THE THEDACARE-LED CHAT TEAM (COMMUNITY HEALTH ACTION TEAM) COMPRISED OF COMMUNITY LEADERS IN BUSINESS, NON-PROFIT, CLERGY, EDUCATION, DIVERSE POPULATION GROUPS, HEALTHCARE, UNITED WAY, PUBLIC HEALTH AND THE LOCAL COMMUNITY FOUNDATIONS.
PART VI, LINE 3:PATIENT EDUCATION BEGINS WHEN A PATIENT IS ADMITTED TO A THEDACARE HOSPITAL. ADMISSION SPECIALISTS MEET WITH EACH PERSON INDIVIDUALLY TO ASSESS INSURANCE STATUS AND FINANCIAL NEED. IF NECESSARY, SPECIALISTS REFER PATIENTS TO CARE MANAGEMENT SPECIALISTS WHO ASSIST WITH THE ENROLLMENT OF PATIENTS IN AN APPLICABLE PROGRAM. THE HOSPITAL PATIENT HANDBOOK IS PROVIDED TO ALL IN-PATIENTS. INTERNAL POLICIES SUCH AS DISCOUNTED SERVICES POLICY, CARING HEARTS POLICY AND PAYMENT FOR SERVICE POLICY FOR SELF-PAY BALANCES PROVIDE GUIDANCE.THE THEDACARE WEBSITE, WWW.THEDACARE.ORG, PROVIDES EDUCATION REGARDING THE AFFORDABLE CARE ACT IN EASY TO UNDERSTAND LANGUAGE. IT DISCUSSES OPTIONS AND WHERE TO GO FOR ASSISTANCE.
PART VI, LINE 4:THEDACARE REGIONAL MEDICAL CENTER - NEENAH'S SERVICE AREA CONSISTS OF WINNEBAGO COUNTY AND IS LOCATED IN EAST-CENTRAL WISCONSIN. THE COUNTY HOSTS A POPULATION OF OVER 170,000 COMBINED WITH CONCENTRATION IN THE FOX CITIES URBAN AREA.WINNEBAGO COUNTY: - WINNEBAGO COUNTY HIGH SCHOOL GRADUATION RATE IS 91%.- HAS HAD A LOWER UNEMPLOYMENT RATE THAN THE STATE OR NATION PRIMARILY DUE TO A STRONG MANUFACTURING BASE. TRADE/TRANSPORTATION/UTILITIES, EDUCATION/HEALTH AND MANUFACTURING EMPLOY THE MOST PEOPLE IN THE COUNTY. - SIX PERCENT OF WINNEBAGO COUNTY LIVE BELOW 100% OF THE FEDERAL POVERTY LEVEL. 13% PERCENT OF WINNEBAGO COUNTY CHILDREN ARE UNINSURED.- THE LARGEST MINORITY POPULATIONS ARE LATINO AND ASIAN (4.1%). NATIVE AMERICANS ACCOUNT FOR APPROXIMATELY 0.7% OF THE POPULATION AND AFRICAN-AMERICANS REPRESENT 2.1%.
PART VI, LINE 5:EACH YEAR THEDACARE SETS ASIDE A PERCENTAGE OF ANY MARGIN AND DESIGNATES THESE FUNDS TO SUPPORT EFFORTS AND INITIATIVES COMING FROM CHAT (COMMUNITY HEALTH ACTION TEAM). CHAT IS A GROUP OF COMMUNITY LEADERS WHO STUDY SYSTEMIC HEALTH ISSUES OUTSIDE THE WALLS OF OUR HOSPITALS AND CLINICS AND WORK TO IDENTIFY INNOVATIVE, COLLABORATIVE SOLUTIONS THAT DRAW UPON THE WIDE ARRAY OF RESOURCES AND STRENGTHS OF OUR COMMUNITY. THERE ARE THEDACARE-LED CHAT'S IN EACH HOSPITAL AREA: WILD ROSE, WAUPACA, FOX CITIES, SHAWANO, BERLIN AND NEW LONDON. THEDACARE PROVIDES FUNDING AND DEDICATED STAFF TO MAKE CHAT COMMUNITY HEALTH EFFORTS POSSIBLE.
PART VI, LINE 6:THEDACARE, THE PARENT ORGANIZATION, PROVIDES DIRECTION RELATED TO COMMUNITY HEALTH NEEDS ASSESSMENT FOR EACH HOSPITAL AND SURROUNDING COMMUNITIES WITHIN ITS SERVICE AREA. PLANS ARE APPROVED BY LOCAL HOSPITAL BOARDS. EACH THEDACARE HOSPITAL, ALONG WITH CHI STAFF AND COMMUNITY MEMBERS DETERMINE HOW BEST TO MEET LOCAL NEEDS. IMPLEMENTATION OF COMMUNITY PROGRAMMING OCCURS AT THE LOCAL LEVEL.
PART VI, LINE 7, REPORTS FILED WITH STATESWI

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Idemnification Gross Up PmtsYes (X)IdemnificationGrossUpPmtsInd
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
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 PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (17 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
IMRAN ANDRABI MD
PRESIDENT & CEO - SYSTEM$92,048$828,429$13,597$122,371$186$1,677$825$7,425$2,539$22,852$109,195$982,754$0$0
GARY EDELMAN MD
BOARD MEMBER / PHYSICIAN$0$461,856$0$37,744$0$0$0$8,250$0$22,014$0$529,864$0$0
DOUGLAS MOARD MD
BOARD MEMBER / PHYSICIAN$0$320,584$0$128$0$0$0$8,250$0$27,476$0$356,438$0$0
NORMA TURK MD
BOARD MEMBER / PHYSICIAN$0$257,047$0$94,532$0$0$0$8,250$0$12,212$0$372,041$0$0
MARK THOMPSON
SENIOR VP, CFO & COO - SYSTEM$55,688$501,192$144$1,294$2,605$23,448$905$8,142$2,255$20,293$61,597$554,369$0$0
TIM OLSON
CFO - CLINICALLY INTEGRATED NETWORK$22,345$201,104$13$115$8,543$76,886$680$6,124$1,292$11,631$32,873$295,860$0$0
VICTORIA BARNTHOUSE
CNO$61,375$245,498$0$0$4,311$17,244$1,650$6,600$2,141$8,563$69,477$277,905$0$0
JAMES ALBIN
CIO$35,099$315,890$1,865$16,785$475$4,277$825$7,425$2,337$21,030$40,601$365,407$0$0
MAGGIE LUND
CHRO$24,503$220,523$3,214$28,923$2,478$22,298$761$6,846$712$6,405$31,668$284,995$0$0
BRIAN STERNS
CHIEF OF STAFF$15,633$140,694$0$0$776$6,980$371$3,342$2,179$19,610$18,959$170,626$0$0
JENNIFER REDMAN-SCHELL
SR VP, CLINICALLY INTEGRATED NETWORK$13,947$264,992$890$16,909$3,820$72,582$413$7,838$1,147$21,802$20,217$384,123$0$0
GIANINA SIBLA MD
PHYSICIAN$267,535$0$70,157$0$0$0$8,250$0$21,652$0$367,594$0$0$0
GREGORY LONG MD
CMO$299$2,695$13$115$55,070$495,626$103$931$2,394$21,549$57,879$520,916$0$0
NICKOLAS DEMARK MD
PHYSICIAN$267,651$0$63,976$0$0$0$8,046$0$10,636$0$350,309$0$0$0
WILLIAM MANN
SENIOR VP, MANAGED CARE$39,646$356,815$1,983$17,845$6,803$61,230$825$7,425$1,087$9,787$50,344$453,102$0$0
BRIAN BURMEISTER
FORMER KEY EMPLOYEE$2,164$8,656$26$103$91,451$365,804$235$940$4,121$16,483$97,997$391,986$0$0
MAUREEN PISTONE
FORMER KEY EMPLOYEE-$155-$1,396$13$115$37,332$335,989$683$6,143$0$0$37,873$340,851$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 1AALL EXECUTIVES AT THE LEVEL OF VICE PRESIDENT OR ABOVE RECEIVE REIMBURSEMENT FOR PERSONAL MEDICAL EXPENSES AT A MAXIMUM AMOUNT OF $6,800, THAT IS TAXED UPON REIMBURSEMENT. ALL EXECUTIVES AT A LEVEL OF VICE PRESIDENT AND ABOVE ARE ELIGIBLE TO HAVE HEALTH OR FITNESS CLUB FEES REIMBURSED TO THEM, AND TAXED UPON REIMBURSEMENT.
PART I, LINE 4BSENIOR LEVEL EXECUTIVES OF THE COMPANY ARE ENTITLED TO AN ANNUAL FLEXIBLE BENEFIT EQUAL TO 20% OF THE MIDPOINT OF THEIR SALARY RANGE. THIS 457(F) SUPPLEMENTAL BENEFIT PLAN COMPLIES WITH THE FINAL REGULATIONS UNDER SECTION 409A AND 457(F) OF THE INTERNAL REVENUE CODE. PARTICIPANTS MAY ELECT THE BENEFIT TO BE USED TO PURCHASE PARTICULAR INSURANCE BENEFITS, INVEST IN A CAPITAL ACCUMULATION ACCOUNT OR A COMBINATION OF THE TWO. BENEFITS ARE ACCRUED ON A MONTHLY BASIS AND ARE SUBJECT TO THE SUBSTANTIAL RISK OF FORFEITURE AGREEMENT SIGNED BY THE PARTICIPANTS. PLAN CONTRIBUTIONS ARE MADE ON A QUARTERLY BASIS.
PART I, LINE 7EXECUTIVE AT RISK COMPENSATION PLAN: THE PLAN OBJECTIVES ARE TO ENHANCE THEDACARE INC'S ABILITY TO ACHIEVE ITS GOALS BY PROVIDING A TOOL FOR STIMULATING AND REWARDING SUPERIOR LEVELS OF PERFORMANCE AMONG LEADERS AND TO WORK TOGETHER AS A COHESIVE GROUP TOWARD COMMON GOALS. LEADERS FROM MANAGER LEVEL TO THE PRESIDENT AND CEO ARE ELIGIBLE TO PARTICIPATE IN THIS PLAN. THE PERCENTAGE FOR WHICH AN INDIVIDUAL IS ELIGIBLE IS DETERMINED BY THE PARAMETERS LISTED FOR THE LEADERSHIP POSITION AND IN THE PLAN DOCUMENT ON FILE. LEADERS MAKE RECOMMENDATIONS FOR THEIR MANAGEMENT LEVEL DIRECT REPORTS TO THEIR EXECUTIVE LEADER BASED ON PERFORMANCE RESULTS. THE PRESIDENT AND CEO ALSO REVIEWS AND APPROVES. FOR SENIOR VICE PRESIDENTS, THE EXECUTIVE LEADERSHIP TEAM, AND THE PRESIDENT AND CEO, THE RECOMMENDATIONS ARE REVIEWED AND APPROVED BY THE HUMAN RESOURCES AND GOVERNANCE COMMITTEE OF THE BOARD AND THE EXECUTIVE COMMITTEE OF THE BOARD. THESE COMMITTEES ALSO REVIEW THE TOTAL SPEND FOR THE INCENTIVE PLANS. THESE LEADERS MUST BE IN ACTIVE REGULAR SERVICE OF THEDACARE INC. FOR THE ENTIRE PLAN YEAR (JANUARY 1, 2018 TO DECEMBER 31, 2018) TO RECEIVE A 2019 BONUS. CARING FOR SUCCESS: THE PLAN OBJECTIVES ARE TO PROVIDE INCENTIVE TO FOCUS THE ORGANIZATION'S RESOURCES, ENERGY AND ATTENTION ON THE FULFILLMENT OF THEDACARE'S MISSION. EMPLOYEE ELIGIBILITY IS BASED ON THE NUMBER OF HOURS WORKED. ALL ELIGIBLE EMPLOYEES SHARE IN THE PAYOUT. THE PAYOUT AMOUNT IS A FLAT DOLLAR AMOUNT, DETERMINED BASED ON BOTH FINANCIAL AND QUALITY THRESHOLDS. THE AMOUNT PER EMPLOYEE IS DETERMINED BY DIVIDING THE TOTAL GAIN REALIZED (THE EMPLOYEE SHARE) BY HOURS PAID TO ALL ELIGIBLE EMPLOYEES. THE THEDACARE BOARD OF TRUSTEES APPROVES THE SPEND FOR THE PLAN.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART III, LINE 2ON JUNE 13, 2018, THEDACARE FINALIZED THE ACQUISITION OF THE ASSETS OF THE PHYSICIAN GROUP FOX VALLEY HEMATOLOGY & ONCOLOGY. THE ACQUISITION EXPANDS ACCESS TO ONCOLOGY EXCELLENCE FOR THE PATIENTS IN THE COMMUNITIES WHERE THEY LIVE AND WORK INCLUDING APPLETON, NEENAH AND OSHKOSH, AND ESPECIALLY IN THE RURAL AREAS INCLUDING BERLIN, SHAWANO, NEW LONDON AND WAUPACA WHERE THEDACARE IS NOW OFFERING CANCER CARE MULTIPLE DAYS PER WEEK.
FORM 990, PART VI, SECTION A, LINE 1THE BOARD OF TRUSTEES HAS AN EXECUTIVE COMMITTEE CONSISTING OF THE BOARD'S CHAIR, VICE CHAIR, PRESIDENT, SECRETARY AND TREASURER. THE EXECUTIVE COMMITTEE HAS AND MAY EXERCISE, WHEN THE BOARD OF TRUSTEES IS NOT IN SESSION, THE POWER OF THE BOARD OF TRUSTEES IN THE MANAGEMENT OF THE ORGANIZATION'S AFFAIRS, EXCEPT ACTION WITH RESPECT TO ELECTION OF OFFICERS OR TRUSTEES.
FORM 990, PART VI, SECTION A, LINE 3ALL MANAGEMENT AND ADMINISTRATIVE FUNCTIONS ARE PROVIDED BY EMPLOYEES OF THEDACARE, INC., THE SOLE MEMBER AND PARENT COMPANY OF THEDACARE REGIONAL MEDICAL CENTER - NEENAH, INC.
FORM 990, PART VI, SECTION A, LINE 6THEDACARE REGIONAL MEDICAL CENTER - NEENAH, INC.'S SOLE MEMBER OF THE SINGLE CLASS OF VOTING MEMBERS IS THEDACARE, INC.
FORM 990, PART VI, SECTION A, LINE 7ATHEDACARE, INC. HAS SOLE AUTHORITY IN THE CORPORATION TO VOTE AND TAKE ANY ACTION WITH RESPECT TO THE ELECTION OF DIRECTORS AND OFFICERS.
FORM 990, PART VI, SECTION A, LINE 7BTHEDACARE, INC. HAS THE SOLE AUTHORITY WITH RESPECT TO THE FOLLOWING MATTERS: 1. AMENDMENT OF THE ARTICLES OF INCORPORATION; 2. ADOPTION AND AMENDMENT OF BYLAWS OF THE CORPORATION; 3. CONSOLIDATION, MERGER AND DISSOLUTION OF THE CORPORATION; 4. MONITORING COMPLIANCE WITH LAWS AND REGULATIONS; 5. SELECTION, APPOINTMENT, AND REMOVAL OF A CHIEF OPERATING OFFICER; 6. PROVISION FOR LONG-RANGE FINANCIAL STABILITY OF THE HOSPITAL AND PROVISION FOR THE CONTROL AND USE OF THE PHYSICAL AND FINANCIAL RESOURCES OF THE HOSPITAL; 7. ESTABLISHMENT OF A LONG-RANGE PLANNING MECHANISM; 8. APPROVAL OF A HOSPITAL ORGANIZATION AND MAJOR AUTHORITY DELEGATION PATTERNS; 9. APPROVAL OF FINANCIAL, CAPITAL, AND OTHER ITEMS; 10. APPROVAL OF DEBT OR LEASES; AND 11. CONSIDERATION AND ACTION UPON POLICIES CONCERNING RELATIONS WITH EXTERNAL GROUPS AND ORGANIZATIONS.
FORM 990, PART VI, SECTION B, LINE 11BA DRAFT OF THE FORM 990 IS PROVIDED TO THE ORGANIZATION'S DESIGNATED COMMITTEE OF THE BOARD OF DIRECTORS FOR REVIEW AND DISCUSSION AT A BOARD MEETING. THE FINAL VERSION OF THE FORM 990 IS EMAILED TO THE ENTIRE BOARD BEFORE THE RETURN IS FILED.
FORM 990, PART VI, SECTION B, LINE 12CQUESTIONNAIRES ARE SENT TO ALL MANAGERS, TRUSTEES, AND OFFICERS ANNUALLY. COMPLETED FORMS ARE RETURNED TO THE COMPLIANCE OFFICER. THE COMPLIANCE OFFICER REVIEWS THE QUESTIONNAIRES AND FOLLOWS UP WITH ANY QUESTIONS ABOUT THE MANAGERS' ANSWERS ON THE CONFLICT OF INTEREST FORMS. ALL EMPLOYEES AND BOARD MEMBERS ARE COVERED UNDER THE CONFLICT OF INTEREST POLICY. THE CORPORATE COMPLIANCE COMMITTEE REVIEWS THE POTENTIAL CONFLICT AND THE CFO/BOARD OF TRUSTEES REVIEW ALL CONFLICTS. AFTER DISCLOSURE OF THE CONFLICT, THE EMPLOYEE SHALL NOT PARTICIPATE IN THE DECISION WHETHER TO ENGAGE IN THE TRANSACTION IN WHICH THE EMPLOYEE HAS AN INTEREST.
FORM 990, PART VI, SECTION B, LINE 15THEDACARE HIRES AN OUTSIDE CONSULTING FIRM TO CONDUCT A THOROUGH MARKET REVIEW OF EXECUTIVE COMPENSATION EVERY OTHER YEAR. THE HUMAN RESOURCES AND GOVERNANCE COMMITTEE OF THE BOARD WAS FORMED IN DECEMBER 2018. THE OUTSIDE CONSULTANT PRESENTED HIS FINDINGS TO THE CHIEF HUMAN RESOURCES OFFICER, THE PRESIDENT AND CEO. THE INFORMATION WAS THEN PRESENTED TO THE HUMAN RESOURCES AND GOVERNANCE COMMITTEE OF THE BOARD AND THEN TO THE EXECUTIVE COMMITTEE OF THE BOARD. BOTH COMMITTEES WERE PROVIDED THE INFORMATION FOR REVIEW, EDUCATION AND ACCEPTANCE IN DECEMBER 2018 AND JANUARY 2019.
FORM 990, PART VI, SECTION C, LINE 19THEDACARE REGIONAL MEDICAL CENTER - NEENAH, INC. DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND INTERNAL FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
THEDACARE INC
PO BOX 8025APPLETONWI549128025391509362HEALTHCAREWI501(C)(3)LINE 10N/A0
THEDACARE MEDICAL CENTER - NEW LONDON INC
PO BOX 8025APPLETONWI549128025390869788HOSPITALWI501(C)(3)LINE 30THEDACARE INC
THEDACARE MEDICAL CENTER - WAUPACA INC
PO BOX 8025APPLETONWI549128025390871113HOSPITALWI501(C)(3)LINE 30THEDACARE INC
THEDACARE REGIONAL MEDICAL CENTER - APPLETON INC
PO BOX 8025APPLETONWI549128025390824015HOSPITALWI501(C)(3)LINE 30THEDACARE INC
THEDACARE MEDICAL CENTER - SHAWANO INC
PO BOX 8025APPLETONWI549128025390807068HOSPITALWI501(C)(3)LINE 30THEDACARE INC
THEDACARE MEDICAL CENTER - BERLIN INC
PO BOX 8025APPLETONWI549128025390806359HOSPITALWI501(C)(3)LINE 30THEDACARE INC
THEDACARE MEDICAL CENTER - WILD ROSE INC
PO BOX 8025APPLETONWI549128025396089134HOSPITALWI501(C)(3)LINE 30THEDACARE INC
THEDACARE FAMILY OF FOUNDATIONS INC
PO BOX 8025APPLETONWI549128025464112255FOUNDATIONWI501(C)(3)LINE 70THEDACARE INC

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1NORTH APPLETON AMBULATORY CARE CENTER BUILDING COMPANY LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12500 E CAPITOL DRAddressLine1Txt
CityAPPLETONCityNm
State AbbreviationWIStateAbbreviationCd
ZIP54911ZIPCd
FieldValueIRS element (for citing)
EIN262497187EIN
Primary ActivitiesRENTALPrimaryActivitiesTxt
Legal Domicile StateWILegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
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 Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd