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VERNON MEMORIAL HEALTHCARE INC: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
VERNON MEMORIAL HEALTHCARE INC (EIN 39-0806404)
Tax period
2017-10-01 to 2018-09-30
Filed
2019-08-15
IRS object ID
201932279349302403
Schema version
2017v2.3
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)
Return2019-08-15T12:37:55-05:00ReturnTs
Tax Period End2018-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390758449PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1WIPFLI LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line14890 OWEN AYRES COURT SUITE 200AddressLine1Txt
CityEAU CLAIRECityNm
State AbbreviationWIStateAbbreviationCd
ZIP54701ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN390806404EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1VERNON MEMORIAL HEALTHCARE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlVERNBusinessNameControlTxt
Phone6086372101PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1507 SOUTH MAIN STREETAddressLine1Txt
CityVIROQUACityNm
State AbbreviationWIStateAbbreviationCd
ZIP54665ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKYLE BAKKUMPersonNm
Person TitleCEOPersonTitleTxt
Phone6086372101PhoneNum
Signature2019-08-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonHOLLY POKRANDT CPAPreparerPersonNm
PTINP00449155PTIN
Phone7158323407PhoneNum
Preparation2019-08-12PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address137.26.200.211IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-08-15IPDt
IP Tm12:36:53IPTm
IP TimezoneCDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdDA39A3EE5E6B4B0D3255BFEF95601890AFD80709AtSubmissionCreationDeviceId
At Submission Filing Device IdE4255D669FE7A429B540D12C0E645A16D05D3497AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerKYLE BAKKUMPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1507 SOUTH MAIN STREETAddressLine1Txt
CityVIROQUACityNm
State AbbreviationWIStateAbbreviationCd
ZIP54665ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$79,886,719GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.VMH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1946FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionVERNON MEMORIAL HEALTHCARE, INC. WILL STRIVE TO HAVE THE VISION TO CONTINUALLY PROVIDE THE HIGHEST STANDARD OF CARE TO OUR PATIENTS AND THEIR FAMILIES WHILE BEING 'CLOSE TO HOME.' OUR MISSION IS TO PROVIDE COST-EFFECTIVE, ACCESSIBLE CARE AND SERVICES USING PROFESSIONAL TREATMENT TO THE INJURED, AFFLICTED, AND WELL PEOPLE WHO NEED THE RESOURCES WE HAVE AT OUR COMMAND, WITHOUT REGARD TO RACE, CREED, COLOR, SEX, HANDICAP, NATIONAL ORIGIN, OR ABILITY TO PAY. IT IS OUR INTENTION TO ENSURE THAT IN EACH AND EVERY CASE OUR PATIENTS SHALL BE TREATED WITH COMPASSION, UNDERSTANDING AND DIGNITY. FURTHER, THE RIGHTS AND PRIVILEGES OF THE PEOPLE WE SERVE SHALL ALWAYS BE HELD IN THE HIGHEST REGARD, AND THEIR WELL-BEING MUST ALWAYS HAVE FIRST CONSIDERATION.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee657TotalEmployeeCnt
Total Volunteers101TotalVolunteersCnt
Total Gross UBI$3,851,678TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$1,295,397NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$470,436PYContributionsGrantsAmt
CY Contributions Grants$422,794CYContributionsGrantsAmt
PY Program Service Revenue$73,915,166PYProgramServiceRevenueAmt
CY Program Service Revenue$76,452,508CYProgramServiceRevenueAmt
PY Investment Income$1,456,232PYInvestmentIncomeAmt
CY Investment Income$664,483CYInvestmentIncomeAmt
PY Other Revenue-$27,645PYOtherRevenueAmt
CY Other Revenue-$16,285CYOtherRevenueAmt
PY Total Revenue$75,814,189PYTotalRevenueAmt
CY Total Revenue$77,523,500CYTotalRevenueAmt
PY Grants And Similar Paid$327,023PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$175,076CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$43,027,422PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$45,349,313CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$32,927,367PYOtherExpensesAmt
CY Other Expenses$35,519,447CYOtherExpensesAmt
PY Total Expenses$76,281,812PYTotalExpensesAmt
CY Total Expenses$81,043,836CYTotalExpensesAmt
PY Revenues Less Expenses-$467,623PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$3,520,336CYRevenuesLessExpensesAmt
Total Assets BOY$104,422,124TotalAssetsBOYAmt
Total Assets EOY$101,829,663TotalAssetsEOYAmt
Total Liabilities BOY$30,859,736TotalLiabilitiesBOYAmt
Total Liabilities EOY$31,758,110TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$73,562,388NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$70,071,553NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionWE ARE COMMITTED TO BEING THE BEST COMMUNITY HEALTHCARE SYSTEM IN THE REGION.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$51,556,945ExpenseAmt
Grant$175,076GrantAmt
Revenue$54,089,194RevenueAmt
DescOUR ORGANIZATION PROVIDES SIGNIFICANT CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE INTERNAL REVENUE SERVICE (IRS). BUT IN ADDITION, WE BELIEVE WE PROVIDE A CRITICALLY IMPORTANT COMMUNITY BENEFIT WHICH CANNOT BE QUANTIFIED. OUR ORGANIZATION WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE CARE LOCALLY-CARE THAT WITHOUT THE PRESENCE OF OUR ORGANIZATION, WOULD NOT BE AVAILABLE TO THE PEOPLE IN OUR SERVICE AREA. IN ADDITION TO PROVIDING INPATIENT MEDICAL, OBSTETRICAL, NEWBORN AND SURGICAL INPATIENT SERVICES, WE OFFER A WIDE VARIETY OF OUTPATIENT AND ANCILLARY SERVICES TO THE PEOPLE IN OUR SERVICE AREA. THESE INCLUDE A DIAGNOSTIC SERVICES-LABORATORY, IMAGING AND CARDIAC REHABILITATION PROGRAM, SLEEP STUDY SERVICES, 24-HOUR EMERGENCY SERVICES, URGENT CARE SERVICES, INFUSION AND GASTROINTESTINAL SERVICES, REHABILITATION SERVICES-PHYSICAL, OCCUPATIONAL, RESPIRATORY AND SPEECH THERAPY, SPECIALTY MEDICINE, AND PRIMARY CARE CLINICS. WE ALSO PROVIDE LOCAL ACCESS TO MANY OTHER HEALTH SERVICES INCLUDING HOME HEALTH CARE, HOSPICE INPATIENT AND OUTPATIENT CARE. NEW SERVICES FOR 2018 TO INCLUDE; ONSITE ULTRASOUND, UPGRADED MAMMOGRAPHY TECHNOLOGY ,EXPANSION OF BEHAVIORAL HEALTH SERVICES AND AN EXPANDED CARDIAC REHABILITATION SERVICE.IN FISCAL 2018, HOSPITAL AND HOSPICE INPATIENT SERVICES INCLUDED 3602 ACUTE CARE PATIENT DAYS, AND 273 NEWBORN PATIENT DAYS (ALSO INCLUDED IN ACUTE PATIENT DAYS). THERE WERE 1374 SURGERY CASES, 6493 EMERGENCY ROOM VISITS, 2284 URGENT CARE VISITS, 5574 VISITS TO THE SPECIALTY CLINIC.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$14,221,988ExpenseAmt
Revenue$15,052,304RevenueAmt
DescVERNON MEMORIAL HEALTHCARE, INC. OPERATES FOUR RURAL HEALTH CLINICS LOCATED IN VIROQUA, LAFARGE, SOLDIERS GROVE, AND WESTBY. TOGETHER, THE RURAL HEALTH CLINICS STRIVE TO MEET THE HEALTHCARE NEEDS OF PATIENTS AND FAMILIES WHO LIVE AND WORK IN THE COMMUNITIES THEY SERVE. A TOTAL OF 44,704 CLINIC VISITS OCCURRED IN FISCAL YEAR 2018.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$3,001,897ExpenseAmt
Revenue$1,699,408RevenueAmt
DescVERNON MEMORIAL HEALTHCARE, INC. ALSO PROVIDES HOME HEALTH AND HOSPICE SERVICES. THE HOME CARE AGENCY PROVIDES QUALITY HEALTHCARE TO PATIENTS IN THE COMFORT OF THEIR OWN HOME. THE HOME CARE TEAM WORKS TOGETHER TO PROVIDE INSTRUCTION, CARE AND SUPPORT. DURING FISCAL YEAR 2018, A TOTAL OF 2916 HOME HEALTH VISITS WERE MADE TO 166 INDIVIDUALS. VERNON MEMORIAL HEALTHCARE HOSPICE OFFERS CARE, COMFORT, AND SUPPORT WHEN IT IS NEEDED MOST. HOSPICE IS FOR PATIENTS, FAMILIES, FRIENDS, AND CAREGIVERS DEALING WITH THE END OF LIFE. THIS SUPPORT BRINGS COMFORT, HOPE AND REASSURANCE. VERNON MEMORIAL HEALTHCARE HOSPICE SERVES PATIENTS AT HOME, IN THE BLAND BEKKEDAL HOSPICE HOUSE, IN LONG-TERM CARE FACILITIES, OR AT VERNON MEMORIAL HOSPITAL. HOSPICE CARE WAS PROVIDED TO 165 INDIVIDUALS IN FISCAL YEAR 2018.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$2,084,778ExpenseAmt
Revenue$1,759,924RevenueAmt
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$2,084,778TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue$1,759,924TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$70,865,608TotalProgramServiceExpensesAmt
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 Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln 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 Document76IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee657EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
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
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
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 Policy0WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldWIStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1KAREN TRAYNORBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6086374964PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1507 SOUTH MAIN STREETAddressLine1Txt
CityVIROQUACityNm
State AbbreviationWIStateAbbreviationCd
ZIP54665ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
BRANDON MUNSON
MEMBER1.00Yes (X)$0$0$0
CHARLES NORTON
MEMBER1.00Yes (X)$0$0$0
DAVE SARNOWSKI
MEMBER (STARTED IN 2018)1.00Yes (X)$0$0$0
KATHY STITTLEBURG
MEMBER (STARTED IN 2018)1.00Yes (X)$0$0$0
LUKE LUKASZEWSKI
MEMBER (STARTED IN 2018)1.00Yes (X)$0$0$0
MARILYN CLAUSON
MEMBER1.00Yes (X)$0$0$0
SHARON NELSON
MEMBER1.00Yes (X)$0$0$0
BONNIE RATH
SECRETARY1.00Yes (X)$0$0$01.00Yes (X)
NATHAN CAMPBELL
TREASURER1.00Yes (X)$0$0$0Yes (X)
BLANE CHARLES
VICE CHAIR1.00Yes (X)$0$0$0Yes (X)
TRUDY WALLIN
CHAIR1.00Yes (X)$0$0$0Yes (X)
MARY KOENIG
CFO40.00$236,834$0$47,702Yes (X)
KYLE BAKKUM
CEO40.00$278,990$0$34,123Yes (X)
DR ANTHONY MACASAET
PHYSICIAN36.00$416,997$0$53,204Yes (X)
ARNOLD NOMANN
CRNA40.00$373,506$0$29,654Yes (X)
BRIAN MILLER
CRNA40.00$405,287$0$57,273Yes (X)
GREGORY SAUER
CRNA36.00$416,699$0$53,847Yes (X)
DR PATRICK SCOTT
PHYSICIAN39.00$365,965$0$25,102Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,494,278TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$300,905TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K59IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
GUNDERSON HEALTH SYSTEM
1900 SOUTH AVELA CROSSEWI54601LAB/RADIOLOGY$2,806,973
MARKET & JOHNSON
2350 GALLOWAY STEAU CLAIREWI54702CONSTRUCTION$1,490,528
SHARED MEDICAL SERVICES
209 LIMESTONE PASSCOTTAGE GROVEWI53527IMAGING SERVICES$222,059
RURAL WI HEALTH COOP
880 INDEPENDENCE LANESAUK CITYWI53583LEGAL SERVICES$202,127
GIT-ER-DONE HOME IMPROVEMENT
6773 S STATE HWY 27VIROQUAWI54665GENERAL CONTRACTOR$154,378
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K11CntrctRcvdGreaterThan100KCnt
Related Organizations$262,987RelatedOrganizationsAmt
All Other Contributions$159,807AllOtherContributionsAmt
Total Contributions$422,794TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
HOSPITAL621990$50,591,034$50,591,034
CLINIC621110$15,052,304$15,052,304
RETAIL PHARMACY446110$7,170,003$3,414,177$3,755,826
CBRF623000$1,759,924$1,759,924
HOME HEALTH & HOSPICE621610$1,699,408$1,699,408

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$179,835TotalRevenueColumnAmt
Related Or Exempt Func Income$83,983RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$95,852UnrelatedBusinessRevenueAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$76,452,508TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$500,353TotalRevenueColumnAmt
Exclusion$500,353ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$283,092RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$299,377RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$16,285RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$16,285TotalRevenueColumnAmt
Exclusion-$16,285ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$2,205,737SecuritiesAmt
Other$22,235OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$2,023,300SecuritiesAmt
Other$40,542OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$182,437SecuritiesAmt
Other-$18,307OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$164,130TotalRevenueColumnAmt
Exclusion$164,130ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$77,523,500TotalRevenueColumnAmt
Related Or Exempt Func Income$72,600,830RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$3,851,678UnrelatedBusinessRevenueAmt
Exclusion$648,198ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$175,076TotalAmt
Program Services$175,076ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$617,272TotalAmt
Management And General$617,272ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$33,309,057TotalAmt
Program Services$29,868,866ProgramServicesAmt
Management And General$3,440,191ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,318,057TotalAmt
Program Services$1,181,927ProgramServicesAmt
Management And General$136,130ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$7,901,963TotalAmt
Program Services$7,085,841ProgramServicesAmt
Management And General$816,122ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,202,964TotalAmt
Program Services$1,936,300ProgramServicesAmt
Management And General$266,664ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$306,365TotalAmt
Management And General$306,365ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$132,390TotalAmt
Management And General$132,390ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$5,362,301TotalAmt
Program Services$4,640,539ProgramServicesAmt
Management And General$721,762ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$144,153TotalAmt
Management And General$144,153ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$257,795TotalAmt
Program Services$204,941ProgramServicesAmt
Management And General$52,854ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$880,447TotalAmt
Management And General$880,447ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,453,304TotalAmt
Program Services$2,453,304ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$93,223TotalAmt
Program Services$63,632ProgramServicesAmt
Management And General$29,591ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$4,449,699TotalAmt
Program Services$2,850,123ProgramServicesAmt
Management And General$1,599,576ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$240,078TotalAmt
Management And General$240,078ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
SUPPLIES$15,606,187$15,567,923$38,264
EQUIPMENT RENTAL & MAIN$2,913,048$2,664,095$248,953
BAD DEBT EXPENSE$1,762,718$1,762,718
DUES AND SUBSCRIPTIONS$615,485$364,825$250,660

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$302,254TotalAmt
Program Services$45,498ProgramServicesAmt
Management And General$256,756ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$81,043,836TotalAmt
Program Services$70,865,608ProgramServicesAmt
Management And General$10,178,228ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,914,200BOYAmt
EOY$1,899,384EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$16,915,552BOYAmt
EOY$11,057,084EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$797,301BOYAmt
EOY$951,353EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$9,698,229BOYAmt
EOY$8,612,122EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$2,592,073BOYAmt
EOY$2,508,056EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$685,688BOYAmt
EOY$681,335EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$90,266,963LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$38,220,463LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$51,001,006BOYAmt
EOY$52,046,500EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$17,737,008BOYAmt
EOY$18,745,060EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$442,099BOYAmt
EOY$381,212EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$249,730BOYAmt
EOY$235,393EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$2,389,238BOYAmt
EOY$4,712,164EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$104,422,124BOYAmt
EOY$101,829,663EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$6,182,168BOYAmt
EOY$5,550,757EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$18,734,528BOYAmt
EOY$17,970,832EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$4,065,921BOYAmt
EOY$6,077,221EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,877,119BOYAmt
EOY$2,159,300EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$30,859,736BOYAmt
EOY$31,758,110EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$72,664,726BOYAmt
EOY$69,050,317EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$897,662BOYAmt
EOY$1,021,236EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$73,562,388BOYAmt
EOY$70,071,553EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$104,422,124BOYAmt
EOY$101,829,663EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$3,520,336ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$29,501NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

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$4,447OtherActivitiesAmt
Total Lobbying Expenditures$4,447TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationVERNON MEMORIAL HEALTHCARE, INC. PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE WISCONSIN HOSPITAL ASSOCIATION AND RURAL WISCONSIN HEALTH COOPERATIVE. THESE DUES ARE PRIMARILY FOR ACCESS TO EDUCATIONAL MATERIALS AND STAFF TRAINING AND DEVELOPMENT. A SMALL PORTION OF THE ANNUAL DUES WERE USED IN CONJUCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,757,582OtherCostOrOtherBasisAmt
Book Value$1,757,582BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$67,355,262OtherCostOrOtherBasisAmt
Depreciation$27,781,355DepreciationAmt
Book Value$39,573,907BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$21,079,773OtherCostOrOtherBasisAmt
Depreciation$10,439,108DepreciationAmt
Book Value$10,640,665BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$74,346OtherCostOrOtherBasisAmt
Book Value$74,346BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$52,046,500TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDEFERRED COMPENSATION PLAN LIABILITY - FUNDEDDesc
Amt$2,159,300Amt
FieldValueIRS element (for citing)
Total Liability$2,159,300TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$75,627,419TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$29,501NetUnrealizedGainsInvstAmt
Other Revenue$299,377OtherRevenueAmt
Revenue Not Reported$328,878RevenueNotReportedAmt
Revenue Subtotal$75,298,541RevenueSubtotalAmt
Other Revenues Not Included$2,224,959OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$2,224,959RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$77,523,500TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$79,118,254TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$299,377OtherExpensesIncludedAmt
Expenses Not Reported$299,377ExpensesNotReportedAmt
Expenses Subtotal$78,818,877ExpensesSubtotalAmt
Other Expenses Not Included$2,224,959OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$2,224,959ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$81,043,836TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART XI, LINE 2D - OTHER ADJUSTMENTS:RENTAL EXPENSES NET AGAINST REVENUE 299,377.
PART XI, LINE 4B - OTHER ADJUSTMENTS:EXPENSES NET AGAINST REVENUE 462,241. BAD DEBT EXPENSE NET AGAINST REVENUE 1,762,718.
PART XII, LINE 2D - OTHER ADJUSTMENTS:RENTAL EXPENSES NET AGAINST REVENUE 299,377.
PART XII, LINE 4B - OTHER ADJUSTMENTS:EXPENSES NET AGAINST REVENUE 462,241. BAD DEBT EXPENSE NET AGAINST REVENUE 1,762,718. IMPAIRMENT LOSS

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free Care0FPGReferenceFreeCareInd
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Discounted Care Other600.000000000000DiscountedCareOtherPct
FieldValueIRS element (for citing)
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,203,475TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,203,475NetCommunityBenefitExpnsAmt
Total Expense0.01520TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$9,133,388TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,265,442DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,867,946NetCommunityBenefitExpnsAmt
Total Expense0.03610TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$10,336,863TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,265,442DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,071,421NetCommunityBenefitExpnsAmt
Total Expense0.05130TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$301,634TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,390DirectOffsettingRevenueAmt
Net Community Benefit Expns$292,244NetCommunityBenefitExpnsAmt
Total Expense0.00360TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$718,541TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$718,541NetCommunityBenefitExpnsAmt
Total Expense0.00890TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$196,030TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$196,030NetCommunityBenefitExpnsAmt
Total Expense0.00240TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,216,205TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,390DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,206,815NetCommunityBenefitExpnsAmt
Total Expense0.01490TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$11,553,068TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,274,832DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,278,236NetCommunityBenefitExpnsAmt
Total Expense0.06620TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$568TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$568NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$385TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$385NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$61,545TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$61,545NetCommunityBenefitExpnsAmt
Total Expense0.00080TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$62,498TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$62,498NetCommunityBenefitExpnsAmt
Total Expense0.00080TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$1,762,718BadDebtExpenseAmt
Bad Debt Expense Attributable$771,527BadDebtExpenseAttributableAmt
Reimbursed By Medicare$16,714,417ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$17,579,947CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$865,530MedicareSurplusOrShortfallAmt

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 Line1VERNON MEMORIAL HOSPITAL INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1507 SOUTH MAIN STAddressLine1Txt
CityVIROQUACityNm
State AbbreviationWIStateAbbreviationCd
ZIP54665ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.VMH.ORGWebsiteAddressTxt
State License1053StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1VERNON MEMORIAL HEALTHCARE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
OtherYes (X)OtherInd
CHNA Conducted15CHNAConductedYr
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 PART V, LINE 7DOwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLSEE PART V, LINE 7DOtherWebsiteURLTxt
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 URLHTTP://WWW.VMH.ORG/CONTENT/COMMUNITY-NEEDS-ASSESSMENTStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care0.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care600.000000000000FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLWWW.VMH.ORG/CONTENT/FINANCIAL-ASSISTANCE-PROGRAMFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLWWW.VMH.ORG/CONTENT/FINANCIAL-ASSISTANCE-PROGRAMFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLWWW.VMH.ORG/CONTENT/FINANCIAL-ASSISTANCE-PROGRAMFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr PrvtYes (X)LookBackMedicaidMedcrPrvtInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
VERNON MEMORIAL HEALTHCARE, INC.PART V, SECTION B, LINE 3J: THE COMMUNITY HEALTH NEEDS ASSESSMENT ("COMPASS NOW 2015") PROCESS INCLUDED A VARIETY OF DATA COLLECTION METHODS USED TO CREATE AN OVERALL DESCRIPTION OF THE ISSUES FACING OUR COMMUNITIES. THESE METHODS INCLUDE A RANDOM HOUSEHOLD SURVEY, FOCUS GROUP DISCUSSIONS HELD WITH COMMUNITY MEMBERS, AN EXTENSIVE REVIEW OF SOCIO-ECONOMIC INDICATORS, AND AN INVENTORY OF COMMUNITY RESOURCES. THE DATA COLLECTED GUIDED THE DEVELOPMENT OF 4 PILLAR PROFILES. WE REFER TO THEM AS PILLARS SINCE THEY CREATE THE BUILDING BLOCKS TO A BETTER LIFE. THE PILLARS OF THE COMPASS ARE: HEALTH, INCOME, EDUCATION, AND COMMUNITY.
VERNON MEMORIAL HEALTHCARE, INC.PART V, SECTION B, LINE 5: IN ADDITION TO THE RANDOM HOUSEHOLD SURVEY, THE COMPASS NOW 2015 COMMUNITY NEEDS ASSESSMENT ALSO INCLUDED A CONVENIENCE SAMPLE THAT FOCUSED ON SPECIFIC SUBGROUPS IN THE GREAT RIVERS REGION. THE OVERALL OBJECTIVE OF THIS SAMPLING WAS TO COLLECT FEEDBACK FROM POPULATIONS WITHIN THE COMMUNITY THAT WERE POTENTIALLY UNDERREPRESENTED IN THE RANDOM HOUSEHOLD SURVEY DUE TO THE SMALL NUMBER IN WHICH THEY EXIST IN THE COMMUNITY. THESE SMALLER POPULATIONS INCLUDED, BUT WERE NOT LIMITED TO, AFRICAN AMERICANS, HISPANICS, LBGT YOUTH, YOUTH AT-RISK, LOW-INCOME ADULTS, AND SENIOR CITIZENS. RESULTS FROM THIS SURVEY WERE COMPARED TO THE RESPONSES OF THE RANDOM HOUSEHOLD SURVEY RESPONDENTS IN AN ATTEMPT TO DETERMINE ANY SIGNIFICANT DIFFERENCES THAT EXISTED BETWEEN THE GENERAL POPULATION AND THOSE IN SMALL SUBGROUPS WITHIN THE COMMUNITY. IN TOTAL, 753 COMMUNITY MEMBERS SHARED FEEDBACK THROUGH THE CONVENIENCE SAMPLE PROCESS. ANOTHER WAY IN WHICH COMMUNITY FEEDBACK WAS GATHERED WAS THROUGH COMMUNITY CONVERSATIONS. COMPASS COUNCILS WERE ADVISORY GROUPS OF LOCAL EXPERTS IN THE FIELDS OF EDUCATION, INCOME, HEALTH, AND A VARIETY OF COMMUNITY ISSUES. THESE MEMBERS COLLECTED AND REVIEWED DATA, ANALYZED THE SURVEY RESULTS, AND OFFERED PROFESSIONAL INSIGHTS ABOUT TOPIC-SPECIFIC ISSUES IN THE GREAT RIVERS REGION. AFTER SIGNIFICANT REVIEW OF THE DATA AND SURVEY RESULTS, PRIORITY ISSUES WERE IDENTIFIED BY COMPASS COUNCIL MEMBERS. THESE ISSUES WERE THEN RANKED BY COUNCIL MEMBERS USING THE CRITERIA BELOW:1. HOW WIDESPREAD IS THE ISSUE IN OUR COMMUNITY?2. HOW SERIOUS ARE THE EFFECTS OF THE ISSUE IN OUR COMMUNITY?3. HOW IMPORTANT IS THE ISSUE TO THE COMMUNITY?
VERNON MEMORIAL HEALTHCARE, INC.PART V, SECTION B, LINE 6A: THE COMPASS NOW 2015 PARTNERSHIP WAS CONDUCTED IN JOINT EFFORT WITH THE FOLLOWING OTHER HOSPITALS:1. GUNDERSEN HEALTH SYSTEM2. MAYO CLINIC HEALTH SYSTEM - LACROSSE3. TOMAH MEMORIAL HOSPITAL4. GUNDERSEN TRI-COUNTY MEMORIAL HOSPITAL AND CLINICS5. MAYO CLINIC HEALTH SYSTEM - SPARTA6. GUNDERSEN ST. JOSEPH'S HOSPITAL AND CLINICS
VERNON MEMORIAL HEALTHCARE, INC.PART V, SECTION B, LINE 6B: THE COMPASS NOW 2015 PARTNERSHIP WAS CONDUCTED IN JOINT EFFORT WITH THE FOLLOWING ORGANIZATIONS:1. GREAT RIVERS UNITED WAY2. LA CROSSE COMMUNITY FOUNDATION3. FIVE LOCAL COUNTY HEALTH DEPARTMENTS4. OTTO BREMER FOUNDATION
VERNON MEMORIAL HEALTHCARE, INC.PART V, SECTION B, LINE 7D: THE CHNA IS AVAILABLE ON THE HOSPITAL'S WEBSITE: HTTP://WWW.VMH.ORG/CONTENT/COMMUNITY-NEEDS-ASSESSMENTTHE CHNA IS ALSO AVAILABLE ON THE FOLLOWING WEBSITES: HTTP://WWW.GREATRIVERSUNITEDWAY.ORG/OUR-WORK/COMMUNITY-NEEDS-ASSESSMENT/
VERNON MEMORIAL HEALTHCARE, INC.PART V, SECTION B, LINE 11: THERE WERE ITEMS IDENTIFIED IN THE CHNA WHICH WERE NOT ADDRESSED BY VERNON MEMORIAL HEALTHCARE, INC.; HOWEVER, ALL ITEMS WERE CONSIDERED IF A NEED WAS BROUGHT TO THE ATTENTION OF THE GROUP DURING THE INFORMATION GATHERING PHASE OF THE CHNA PROCESS. THE ITEMS THAT WERE NOT ADDRESSED PRIMARILY WERE NOT ADDRESSED DUE TO THE FINANCIAL CONSTRAINT OF PROVIDING A NEW SERVICE FOR A LIMITED POPULATION OF PEOPLE WITHIN THE PRIMARY SERVICE AREA.THREE IDENTIFIED ITEMS WERE ADDRESSED AS FOLLOWS BY VERNON MEMORIAL HEALTHCARE, INC.CHRONIC DISEASE AND CONTRIBUTING FACTORS - CHRONIC DISEASES SUCH AS HEART DISEASE, HYPERTENSION, HIGH CHOLESTEROL, CANCERS AND LUNG DISEASES LIKE ASTHMA AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE ARE ALL TOO COMMON AMONG COMMUNITY MEMBERS. VERNON MEMORIAL HEALTHCARE HAS IMPLEMENTED AN ELECTRONIC HEALTH RECORD SYSTEM THAT HAS A ROBUST POPULATION HEALTH MANAGEMENT MODULE WHICH ASSISTS IN THE MONITORING PROCESS. VERNON MEMORIAL HEALTHCARE HAS DEVELOPED A PROGRAM UTILIZING LIFESTYLE HEALTH COACHES, WHO ARE HIGHLY TRAINED, CERTIFIED, EXPERT FACILITATORS OF MINDSET AND BEHAVIOR CHANGE WHO WILL WORK WITH CLIENTS TO HELP THEM FIND THE WILLPOWER, CONFIDENCE AND SELF-DISCIPLINE NECESSARY TO TAKE BACK CONTROL OF THEIR LIFESTYLE CHOICES. WE ARE ABLE TO HELP CLIENTS STRUGGLING WITH SEDENTARY LIFESTYLES, POOR NUTRITION, TOBACCO USE, CHRONIC STRESS AND OTHER AREAS OF CONCERN. ALSO A CANCER EXERCISE PROGRAM BASED ON A PROGRAM CREATED COLLABORATIVELY BY THE AMERICAN CANCER SOCIETY AND THE AMERICAN COLLEGE OF SPORTS MEDICINE, CERTIFIED CANCER EXERCISE TRAINERS (CETS) DESIGN AND ADMINISTER FITNESS ASSESSMENTS AND EXERCISE PROGRAMS SPECIFIC TO A PERSON'S CANCER DIAGNOSIS, TREATMENT AND CURRENT RECOVERY STATUS HAS BEEN STARTED. AN AQUATIC CARDIAC REHABILITATION PROGRAM IS IN PLACE FOR PEOPLE WHO COULD BENEFIT FROM CARDIAC REHABILITATION DUE TO CHRONIC STABLE ANGINA OR CONGESTIVE HEART FAILURE (CHF), OR FOLLOWING A HEART ATTACK, CORONARY ARTERY BYPASS SURGERY, PTCA/STENT PLACEMENT, VALVE REPLACEMENT OR REPAIR, OR HEART OR HEART/LUNG TRANSPLANTATION. A DIABETIC EDUCATION PROGRAM OFFERS PATIENTS A MULTI-DISCIPLINARY TEAM (RN, RD, EP) TO PROVIDE EDUCATION AND SUPPORT ON MANAGING DIABETES TO IMPROVE OVERALL HEALTH AND PREVENT DIABETES RELATED COMPLICATIONS. VERNON MEMORIAL HEALTHCARE ALSO UTILIZES A RN-SOCIAL WORKER TEAM TO COORDINATE SERVICES/RESOURCES TO ASSIST PATIENTS IN REACHING THEIR OPTIMAL HEALTH.MENTAL HEALTH AND OR SUBSTANCE ABUSE - THE NATIONAL INSTITUTE OF MENTAL HEALTH ESTIMATES 26.2% OF AMERICANS (AGES 18 AND OLDER) SUFFER FROM A DIAGNOSABLE MENTAL ILLNESS IN ANY GIVEN YEAR. ADDITIONALLY, MENTAL DISORDERS ARE THE LEADING CAUSE OF DISABILITY IN THE U.S. FOR PEOPLE AGES 15 TO 44. MENTAL ILLNESS HAS A SIGNIFICANT IMPACT ON THE WORKPLACE THAT OFTEN GOES UNRECOGNIZED. MENTAL ILLNESS CAUSES MORE DAYS OF WORK LOSS AND WORK IMPAIRMENT THAN CHRONIC HEALTH CONDITIONS SUCH AS ASTHMA, DIABETES AND HEART DISEASE. VERNON MEMORIAL HEALTHCARE IN COLLABORATION WITH CENTER POINT COUNSELING, HAS HIRED A PSYCHIATRIST AND A LICENSED CLINICAL SOCIAL WORKER TO IMPROVE ACCESS TO MENTAL HEALTH SERVICES IN OUR REGION. VERNON MEMORIAL HEALTHCARE WILL CONTINUE TO PARTNER WITH THE VERNON COUNTY PARTNERSHIP COUNCIL IN IMPLEMENTING ACTIVITIES AIMED AT EDUCATING YOUTH ABOUT THE CONSEQUENCES OF ILLEGAL DRUG USE AND REDUCING YOUTH ACCESS. THE VERNON COUNTY PARTNERSHIP COUNCIL, EXISTS TO DEVELOP AND SUPPORT PROGRAMMING WHICH ADDRESSES DRUG, ALCOHOL AND TOBACCO CONCERNS RELATED TO YOUTH RISK BEHAVIORS.ORAL HEALTH - ORAL HEALTH IS NOT ONLY IMPORTANT FOR QUALITY OF LIFE, BUT IS RELATED TO THE HEALTH OF THE REST OF THE BODY. ORAL DISEASE CONTINUES TO BE A KEY HEALTH CONCERN FOR THE STATE. ACCORDING TO THE WISCONSIN FAMILY HEALTH SURVEY, IN 2015, 25.8% OF WISCONSIN RESIDENTS IN THE GREAT RIVERS REGION DID NOT RECEIVE A DENTAL VISIT WITHIN THE LAST TWELVE MONTHS. VERNON MEMORIAL HEALTHCARE AND SCENIC BLUFFS COMMUNITY HEALTH CENTER, CASHTON WI HAVE PARTNERED TOGETHER TO PROVIDE NEW/ADDITIONAL ACCESS TO DENTAL SERVICES IN VERNON AND CRAWFORD COUNTIES.
VERNON MEMORIAL HEALTHCARE, INC.PART V, SECTION B, LINE 13B: PATIENTS' RELIANCE ON MEDICARE OR MEDICAL ASSISTANCE.
VERNON MEMORIAL HEALTHCARE, INC.PART V, SECTION B, LINE 16J: NO SIGNIFICANT POPULATION WITHIN SERVICE AREA WITH LIMITED ENGLISH PROFICIENCY.
FieldValueIRS element (for citing)
Facility13FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (13 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - HIRSCH CLINIC
407 S MAIN ST SUITE 400VIROQUAWI54665PROVIDER BASED RURAL HEALTH CLINIC
2 - VERNON MEMORIAL HEALTHCARE PHARMACY
407 S MAIN ST SUITE 400VIROQUAWI54665PHARMACY
3 - SOLAR TOWN PHARMACY
104 SUNSET AVESOLDIERS GROVEWI54655PHARMACY
4 - LAFARGE MEDICAL CLINIC
206 N MILL STLAFARGEWI54639PROVIDER BASED RURAL HEALTH CLINIC
5 - BLAND CLINIC
100 MELBY STWESTBYWI54667PROVIDER BASED RURAL HEALTH CLINIC
6 - VERNON MEMORIAL HEALTHCARE INC
705 ARENA DRIVEVIROQUAWI54665HOSPICE
7 - KICKAPOO VALLEY MEDICAL CLINIC
102 SUNSET AVESOLDIERS GROVEWI54655PROVIDER BASED RURAL HEALTH CLINIC
8 - VERNON MEMORIAL PHARMACY - LAFARGE
206 N MILL STREETLAFARGEWI54639PHARMACY
9 - VERNON MEMORIAL PHARMACY - WESTBY
115 W STATE STREETWESTBYWI54667PHARMACY
10 - FAIR HAVEN
601 ARENA DRIVEVIROQUAWI54665ASSISTED LIVING
11 - OLD TIMES
206 POLLY RUDE WAYWESTBYWI54667ASSISTED LIVING
12 - BOTHNE HOUSE
100 BOTHNE DRIVECOON VALLEYWI54623ASSISTED LIVING
13 - VERNON MEMORIAL HEALTHCARE INC
705 ARENA DRIVEVIROQUAWI54665HOME HEALTH AGENCY

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 7:THE COSTING METHOD USED ON FORM 990 IS BASED ON A COST-TO-CHARGE RATIO WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBTS DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER IRS COSTING METHODS FOR THE FORM 990.
PART II, COMMUNITY BUILDING ACTIVITIES:WHILE THERE IS A GROWING AGREEMENT IN THE UNITED STATES ABOUT WHAT CONSTITUTES A NON-PROFIT HOSPITAL'S COMMUNITY BENEFIT, THIS IS A WORK IN PROGRESS. OUR HOSPITAL PROVIDES CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS. BUT IN ADDITION, WE BELIEVE THAT WE PROVIDE A CRITICALLY IMPORTANT COMMUNITY BENEFIT WHICH IS NOT QUANTIFIED. OUR HOSPITAL, LIKE MOST RURAL HOSPITALS, WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE LOCAL ACCESS TO MANY HEALTH SERVICES: BIRTHING CENTER, DIAGNOSTICS, EMERGENCY SERVICES AND URGENT CARE, HOME CARE, HOSPICE, INFUSION SERVICES, INPATIENT CARE, LABORATORY SERVICES, OCCUPATIONAL HEALTH, REHABILITATION SERVICES, SPECIALTY MEDICINE, SPEECH AND AUDIOLOGY, SURGICAL SERVICES, AND WOMENS HEALTH.
PART III, LINE 4:ACCOUNTS RECEIVABLE AND CREDIT POLICY: IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE ORGANIZATION ANALYZES PAST RESULTS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. SPECIFICALLY, FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE ORGANIZATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS AND PATIENTS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE ORGANIZATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A SEPARATE FOOTNOTE REGARDING BAD DEBT EXPENSE.
PART III, LINE 8:VERNON MEMORIAL HEALTHCARE, INC. IS DESIGNATED AS A CRITICAL ACCESS HOSPITAL AND AS SUCH A PORTION OF ITS REVENUES ARE PAID UNDER A COST REIMBURSEMENT SYSTEM. BASED ON THE INSTRUCTIONS, THE TOTAL MEDICARE REVENUE SHOWN ON THIS FORM 990 INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE THAT IS ACTUALLY RECEIVED BY THE HOSPITAL FROM THE MEDICARE PROGRAM. THE AMOUNTS LISTED FOR MEDICARE DO NOT INCLUDE PHYSICIAN AND MID-LEVEL PRACTITIONER SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT. PHYSICIAN COVERAGE IS REIMBURSED PRIMARILY ON A FEE SCHEDULE REIMBURSEMENT METHODOLOGY AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND AS SUCH THESE COSTS AND SHORTFALLS SHOULD ALSO BE CONSIDERED AS AN ADDITIONAL BENEFIT THAT VERNON MEMORIAL HEALTHCARE, INC. PROVIDES TO THE COMMUNITY AND SURROUNDING AREA. THE COSTING METHOD USED ABOVE FOR IRS FORM 990 COMPLIANCE REPORTING IS ALSO BASED ON AN OVERALL AVERAGE COST-TO-CHARGE RATIO AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICE REVENUES (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE) DIVIDED BY TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBT EXPENSE. THIS RATIO IS THEN MULTIPLIED BY THE TOTAL MEDICARE SERVICES WHICH ARE REIMBURSED ON A COST METHODOLOGY EXCLUDING THE FEE SCHEDULE ITEMS LIKE PHYSICIAN AND MID-LEVEL PRACTITIONER SERVICES WHICH THE HOSPITAL WOULD SHOW A LARGE LOSS ON THESE SERVICES.WHETHER THERE IS A SHORTFALL OR SURPLUS FROM SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THE RECIPIENTS ARE TYPICALLY ELDERLY AND/OR DISABLED MEMBERS OF THE COMMUNITY AND ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE PATIENT SERVICES, THE CENTERS FOR MEDICARE AND MEDICAID (CMS) WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY.
PART III, LINE 9B:IN ORDER TO PROVIDE THE LEVEL OF AID NECESSARY TO THE GREATEST NUMBER OF PATIENTS IN NEED, AND PROTECT THE RESOURCES NEEDED TO DO SO, THE FOLLOWING GUIDELINES APPLY:1) SERVICES ARE PROVIDED UNDER CHARITY CARE ONLY WHEN DEEMED MEDICALLY NECESSARY AND AFTER PATIENTS ARE FOUND TO HAVE MET ALL FINANCIAL CRITERIA BASED ON THE DISCLOSURE OF PROPER INFORMATION AND DOCUMENTATION. 2) CHARITY CARE IS NOT AVAILABLE FOR ELECTIVE PROCEDURES.3) PATIENTS ARE EXPECTED TO CONTRIBUTE PAYMENT FOR CARE BASED ON THEIR INDIVIDUAL FINANCIAL SITUATION; THEREFORE, EACH CASE WILL BE REVIEWED SEPARATELY.4) CHARITY CARE IS NOT CONSIDERED AN ALTERNATIVE OPTION FOR PAYMENT AND PATIENTS MAY BE ASSISTED IN FINDING OTHER MEANS OF PAYMENT OR FINANCIAL ASSISTANCE BEFORE APPROVAL FOR CHARITY CARE. 5) UNINSURED PATIENTS WHO ARE BELIEVED TO HAVE THE FINANCIAL ABILITY TO PURCHASE HEALTH INSURANCE MAY BE ENCOURAGED TO DO SO IN ORDER TO ENSURE HEALTHCARE ACCESSIBILITY AND OVERALL WELL-BEING.
PART VI, LINE 2:IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) RECENTLY CONDUCTED IN CONJUNCTION WITH AREA HEALTH CARE FACILITIES, THE GREAT RIVERS UNITED WAY AND COUNTY HEALTH DEPARTMENTS, VERNON MEMORIAL HEALTHCARE CONTINUALLY GATHERS AND REVIEWS DATA RELATED TO COMMUNITY NEEDS BY UTILIZING MORE INFORMAL FOCUS AND ADVISORY GROUPS, DISCUSSIONS WITH AREA EMPLOYERS AND WEB SURVEYS, AS WELL AS THROUGH SERVING ON LOCAL AND STATE BOARDS AND COMMITTEES. THE ORGANIZATION COLLABORATES WITH COMMUNITY ORGANIZATIONS, CHURCHES, BUSINESSES, AGENCIES, AND LOCAL COLLEGES AND UNIVERSITIES TO DETERMINE THE NEEDS OF THE COMMUNITIES SERVED. BOARD MEMBERS REPRESENT NOT ONLY THE CITY OF VIROQUA, BUT COME FROM THE DIFFERENT AREAS SERVED BY THE ORGANIZATION. THESE BOARD MEMBERS REGULARLY MEET WITH THE PEOPLE IN THEIR AREAS TO UTILIZE THE SERVICES OFFERED BY THE ORGANIZATION AND BRING BACK THEIR ISSUES AND CONCERNS. ADDITIONAL RESOURCES ADDED TO COLLECTING DATA AND UNDERSTANDING THE COMMUNITIES VERNON MEMORIAL HOSPITAL SERVES ARE INSIGHT DATA COLLECTED ON SOCIAL MEDIA AND FOLLOWING ONLINE AREA TRENDS. INFORMATION HAS ALSO BEEN COLLECTED VIA PATIENT SURVEYS SENT TO PATIENTS POST-VISIT REGARDING THE CARE THEY RECEIVED.
PART VI, LINE 3:VERNON MEMORIAL HEALTHCARE MAKES EVERY EFFORT TO EDUCATE PATIENTS ABOUT FINANCIAL ASSISTANCE AVAILABLE AT THE TIME OF REGISTRATION AND FOLLOWING DISCHARGE. REGISTRATION HAS A HARD STOP IN EPIC TO REMIND STAFF TO OFFER FINANCIAL ASSISTANCE TO THE PATIENTS. IF A PATIENT REFUSES FINANCIAL ASSISTANCE AT TIME OF REGISTRATION, IT IS DOCUMENTED. FORMS AND INSTRUCTIONS ARE AVAILABLE AT ALL REGISTRATION AREAS, INCLUDING THE MAIN ENTRANCE TO THE HOSPITAL, OUTPATIENT SERVICES, EMERGENCY ROOM, HOME HEALTH, HOSPICE AND OUTLYING CLINICS. FINANCIAL COUNSELORS ARE AVAILABLE DURING DAYTIME HOURS TO ASSIST PATIENTS WITH THE COMPLETION OF FORMS, EITHER IN PERSON, OVER THE PHONE OR THRU MYCARE. INFORMATION ABOUT CHARITY CARE AND DISCOUNT PROGRAMS IS ALSO AVAILABLE ON THE ORGANIZATION'S WEBSITE. SIGNS AND PAMPHLETS REGARDING THE FINANCIAL ASSISTANCE PROGRAM ARE POSTED AT ALL REGISTRATION LOCATIONS.
PART VI, LINE 4:VERNON MEMORIAL HEALTHCARE SERVES THE CITY OF VIROQUA AND THE SURROUNDING AREA. OTHER TOWNS IN THE PRIMARY SERVICE AREA INCLUDE WESTBY, READSTOWN, SOLDIERS GROVE, CASHTON, AND LAFARGE. THE SECONDARY SERVICE AREA EXTENDS TO THE CITIES OF DESOTO, FERRYVILLE, HILLSBORO, COON VALLEY, RICHLAND CENTER, GAYS MILLS AND ONTARIO. THE COMMUNITIES AND SURROUNDING RURAL AREAS IN THE PRIMARY SERVICE ARE HAVE AN APPROXIMATE POPULATION OF 28,000. THE SECONDARY SERVICE AREA INCLUDES AN ADDITIONAL 25,000 PERSONS. THE ENTIRE AREA IS RURAL WITH AN AGING POPULATION AND RELATIVELY LOW INCOME LEVELS.
PART VI, LINE 5:VERNON MEMORIAL HEALTHCARE PROVIDES A FULL RANGE OF INPATIENT AND OUTPATIENT SERVICES TO THE PEOPLE IN THE COMMUNITIES IT SERVICES. SERVICES ARE PROVIDED WITHOUT REGARD TO RACE, COLOR, CREED, RELIGION, GENDER ORIENTATION, DISABILITY, AGE OR NATIONAL ORIGIN. VERNON MEMORIAL HEALTHCARE OPERATES A 24/7 EMERGENCY ROOM THAT IS OPEN TO SERVE ALL IN NEED, REGARDLESS OF ABILITY TO PAY. THE ORGANIZATION OWNS AND OPERATES FOUR RURAL HEALTH CLINICS LOCATED IN THE CITIES OF VIROQUA, WESTBY, SOLDIERS GROVE AND LAFARGE, AS WELL AS FOUR RETAIL PHARMACIES LOCATED IN VIROQUA, WESTBY, LAFARGE, AND SOLDIERS GROVE. HOME HEALTH AND HOSPICE SERVICES (INPATIENT AND OUTPATIENT) ARE ALSO PROVIDED. VERNON MEMORIAL HEALTHCARE COLLABORATES WITH COMMUNITIES, CHURCHES, BUSINESSES AND OTHER HEALTH CARE ORGANIZATIONS IN THE REGION TO FACILITATE AND STRENGTHEN ACCESSIBILITY OF QUALITY COMPREHENSIVE HEALTHCARE SERVICES. THE ORGANIZATION SUPPORTS THE LOCAL COMMUNITIES BY PROVIDING CONVENIENT LOCATIONS FOR PRIMARY CARE AND PHARMACY SERVICES. THE BOARD OF DIRECTORS IS COMPRISED OF INDEPENDENT COMMUNITY MEMBERS WHO REPRESENT THE MAKE-UP OF THE AREAS SERVED BY THE ORGANIZATION. VERNON MEMORIAL HEALTHCARE HAS AN OPEN MEDICAL STAFF MADE UP OF QUALIFIED PHYSICIANS WHO WORK WITH THE HOSPITAL TO PROVIDE CARE TO THE COMMUNITIES SERVED. ALL QUALIFIED PHYSICIANS AND AFFILIATED STAFF WHO ARE GRANTED PRIVILEGES UNDERGO A THOROUGH AND COMPREHENSIVE CREDENTIALING AND ORIENTATION PROCESS. ANY SURPLUS FUNDS GENERATED THROUGH OPERATIONS ARE USED TO CONTINUE TO MEET THE NEEDS OF THE PEOPLE THAT ARE SERVED THROUGH THE ADDITION OF NEW FACILITIES AND EQUIPMENT, OR THE ADDITION OR EXPANSION OF NEEDED SERVICES.
PART VI, LINE 7, REPORTS FILED WITH STATESWI

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (10 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
YOUTH INITIATIVE HIGH SCHOOL
500 EAST JEFFERSON STVIROQUAWI54665391906073501(C)(3)$10,000MATCHING FUNDS, STUDENT FUNDRAISING
VERNON COUNTY TREASURER
400 COURTHOUSE SQUAREVIROQUAWI54665396005749GOV'T ORGANIZATION$7,200COON PRAIRIE TRAIL CONSTRUCTION, TRAIL MAINTENANCE
WESTERN TECHNICAL COLLEGE
400 7TH ST NLA CROSSEWI54602396002842GOV'T ORGANIZATION$17,500PARTIAL COMPENSATION NURSING CLINICAL INSTRUCTOR - VIROQUA CAMPUS
VERNON COUNTY HISTORICAL SOCIETY
410 S CENTER AVEVIROQUAWI54665391429799501(C)(3)$10,000CAPITAL CAMPAIGN FOR ELEVATOR PROJECT
PLEASANT RIDGE WALDORF SCHOOL
431 EAST COURT STREETVIROQUAWI54665391357578GOV'T ORGANIZATION$10,000EARLY CHILDHOOD PROGRAM AND GARDENING EDUCATION
FINE ARTS FOUNDATION OF THE WESTBY AREA
PO BOX 8WESTBYWI54667392018130501(C)(3)$75,000PERFORMING ARTS CENTER PLEDGE
LA CROSSE SYMPHONY ORCHESTRA
201 MAIN STREET STE 230LA CROSSEWI54601391024330501(C)(3)$5,000CHAMBER CONCERTS
LA FARGE SCHOOL DISTRICT
301 W ADAMS STREETLA FARGEWI54639396002844GOV'T ORGANIZATION$5,000SCOREBOARD
WDRT DRIFTLESS COMMUNITY RADIO
311 S MAIN STREETVIROQUAWI54665743090618501(C)(3)$5,000SIGNAL INCREASE
CITY OF PRAIRIE DU CHIEN
PO BOX 324 214 E BLACKHAWK DRIVEPRAIRIE DU CHIENWI53821396005577GOV'T ORGANIZATION$5,000SMART BUS CONTRIBUTION
FieldValueIRS element (for citing)
Total501c3 Org10Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationALL DONEES ARE REQUIRED TO SUBMIT THEIR DONATION REQUESTS TO THE CEO OR MARKETING MANAGER OF VERNON MEMORIAL HEALTHCARE, INC. REQUESTS SUBMITTED TO THE MARKETING MANAGER ARE FORWARDED TO THE CEO FOR FINAL APPROVAL. THE REQUESTS MUST INCLUDE A DETAILED DESCRIPTION OF WHAT THE FUNDS WILL BE USED FOR AND HOW THEY WILL BENEFIT THE COMMUNITY. DONEES ARE ASKED TO PROVIDE CONFIRMATION OF RECEIPT AND AN EXPLANATION OF HOW THE FUNDS WERE USED, EITHER VERBALLY OR IN WRITING, TO THE CEO. IF THE REQUESTS ARE DEEMED BENEFICIAL TO THE NEEDS OF THE COMMUNITY, THE FUNDS ARE AWARDED TO THE APPLYING ORGANIZATION.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractYes (X)WrittenEmploymentContractInd
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 Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 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
MARY KOENIG
CFO$236,834$0$0$0$0$0$13,028$0$34,674$0$284,536$0$0$0
KYLE BAKKUM
CEO$278,990$0$0$0$0$0$16,131$0$17,992$0$313,113$0$0$0
DR ANTHONY MACASAET
PHYSICIAN$416,997$0$0$0$0$0$17,833$0$35,371$0$470,201$0$0$0
ARNOLD NOMANN
CRNA$373,506$0$0$0$0$0$12,980$0$16,674$0$403,160$0$0$0
BRIAN MILLER
CRNA$405,287$0$0$0$0$0$15,755$0$41,518$0$462,560$0$0$0
GREGORY SAUER
CRNA$416,699$0$0$0$0$0$11,488$0$42,359$0$470,546$0$0$0
DR PATRICK SCOTT
PHYSICIAN$365,965$0$0$0$0$0$17,928$0$7,174$0$391,067$0$0$0

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN391337855BondIssuerEIN
CUSIP97712DGX8CUSIPNum
Bond Issued2014-12-09BondIssuedDt
Issue Price$19,445,225IssuePriceAmt
PurposeREFINANCE 2005 BONDSPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$1,320,000RetiredAmt
Total Proceeds$19,445,225TotalProceedsAmt
Issuance Costs From Proceeds$286,481IssuanceCostsFromProceedsAmt
Other Spent Proceeds$19,158,744OtherSpentProceedsAmt
Current RefundingYes (1)CurrentRefundingInd
Advance Refunding0AdvanceRefundingInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Private Bus Concerning UBI0.03770PrivateBusConcerningUBIPct
Total Private Business Use0.03770TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond Remdtd0ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due Yet0RebateNotDueYetInd
Exception To Rebate0ExceptionToRebateInd
No Rebate DueYes (1)NoRebateDueInd
Variable Rate Issue0VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor Reqs0WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective Action0ProceduresCorrectiveActionInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6ANY PERSON WHO IS EIGHTEEN YEARS OF AGE OR OLDER AND A BONA FIDE RESIDENT OF VERNON COUNTY, WISCONSIN, OR THE AREA WITHIN A RADIUS OF TWENTY-FIVE MILES OF THE CITY OF VIROQUA, WISCONSIN, AND WHO HAS HERETOFORE OR MAY HEREAFTER CONTRIBUTE TEN DOLLARS OR MORE TO VERNON MEMORIAL HEALTHCARE, INC. (THE ORGANIZATION") SHALL BE A MEMBER THEREOF. ALL MEMBERS OF THE ORGANIZATION SHALL BE VOTING MEMBERS. EACH MEMBER SHALL HAVE ONE VOTE ON ANY MATTER SUBMITTED TO A VOTE OF THE MEMBERS OF THE ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7ATHE DUTIES OF THE MEMBERS OF THE ORGANIZATION SHALL BE: THE ELECTION OF MEMBERS OF THE BOARD OF DIRECTORS OF THE ORGANIZATION, THE REMOVAL OF MEMBERS OF THE BOARD OF DIRECTORS OF THE ORGANIZATION, AND THE CHANGING OF THE NUMBER OF DIRECTORS CONSTITUTING THE BOARD OF DIRECTORS OF THE ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7BTHE DUTIES OF THE MEMBERS OF THE VERNON ORGANIZATION SHALL ALSO INCLUDE: THE AMENDMENT, RESTATEMENT, OR MODIFICATION OF THE ARTICLES OF INCORPORATION OR BYLAWS OF THE ORGANIZATION; AND THE APPROVAL OF THE SALE, LEASE, OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL OF THE ASSETS AND PROPERTY OF THE ORGANIZATION, THE DISSOLUTION OF THE ORGANIZATION, OR ITS MERGER WITH ANOTHER CORPORATION.
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 IS DISTRIBUTED TO THE BOARD OF DIRECTORS OF VERNON MEMORIAL HEALTHCARE, INC. FOR REVIEW PRIOR TO FILING THE RETURN.
FORM 990, PART VI, SECTION B, LINE 12CALL BOARD MEMBERS OF VERNON MEMORIAL HEALTHCARE, INC. ARE REQUIRED TO DISCLOSE ALL POSSIBLE CONFLICTS OF INTEREST WHEN FIRST ELECTED TO THE BOARD OF DIRECTORS. DURING THEIR TERMS, IF ANY BUSINESS RELATIONSHIPS ARE ENTERED INTO WHICH MAY AFFECT THEIR INDEPENDENCE AS A MEMBER, THE MEMBER MUST IMMEDIATELY DISCLOSE THESE RELATIONSHIPS. THE COMPLIANCE DEPARTMENT PROVIDES EDUCATION ANNUALLY WHEN BOARD MEMBERS ARE REQUIRED TO UPDATE AND SIGN A CONFLICT OF INTEREST STATEMENT EACH YEAR.
FORM 990, PART VI, SECTION B, LINE 15TO DETERMINE APPROPRIATE SALARY RANGES FOR UPPER MANAGEMENT POSITIONS, VERNON MEMORIAL HEALTHCARE, INC. UTILIZES BENCHMARK DATA FROM SURVEYS CONDUCTED BY RELEVANT TRADE ORGANIZATIONS. THE CEO HAS THE RIGHT TO AMEND THE DETERMINED AMOUNT FOR THE CFO AND COO. THE BOARD HAS THE RIGHT TO AMEND THE AMOUNT FOR THE CEO. THE EXECUTIVE COMMITTEE OF THE BOARD REVIEWS THE DATA FOR THE CEO ANNUALLY TO DETERMINE THE AMOUNT OF HIS COMPENSATION AND ANY CHANGES IN COMPENSATION ARE MAINTAINED IN THE PERSONNEL FILE. THE CEO REVIEWS THE DATA FOR THE CFO AND COO ANNUALLY TO DETERMINE THE AMOUNT OF COMPENSATION AND ANY CHANGES ARE MAINTAINED IN THE PERSONNEL FILE.
FORM 990, PART VI, SECTION C, LINE 19VERNON MEMORIAL HEALTHCARE, INC. MAKES ITS FINANCIAL STATEMENTS AND GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC ON A PER REQUEST BASIS. THE FORM 990 IS ALSO AVAILABLE TO THE PUBLIC ON A THIRD PARTY WEBSITE CALLED GUIDESTAR.
FORM 990, PART XI, LINE 2C:OVERSIGHT OF AUDIT: VERNON MEMORIAL HEALTHCARE, INC. DOES NOT HAVE A SPECIFIC COMMITTEE WHICH ASSUMES THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT. THE ENTIRE BOARD OF DIRECTORS IS RESPONSIBLE FOR SELECTION OF THE INDEPENDENT ACCOUNTANT. NO CHANGES HAVE BEEN MADE IN THE PAST YEAR REGARDING THIS OVERSIGHT FUNCTION OF THE GOVERNING BODY.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1VERNON MEMORIAL HEALTHCARE FOUNDATION INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1507 SOUTH MAIN STREETAddressLine1Txt
CityVIROQUACityNm
State AbbreviationWIStateAbbreviationCd
ZIP54665ZIPCd
FieldValueIRS element (for citing)
EIN391515716EIN
Primary ActivitiesFUNDRAISINGPrimaryActivitiesTxt
Legal Domicile StateWILegalDomicileStateCd
Exempt Code Section501(C)3ExemptCodeSectionTxt
Public Charity StatusLINE 7PublicCharityStatusTxt
Direct Controlling NAN/ADirectControllingNACd
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd