DOOR COUNTY MEMORIAL HOSPITAL: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- DOOR COUNTY MEMORIAL HOSPITAL (EIN 39-0806324)
- Tax period
- 2015-07-01 to 2016-06-30
- Filed
- 2017-05-10
- IRS object ID
- 201721309349302622
- Schema version
- 2015v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-05-10T14:02:50-05:00 | ReturnTs |
| Tax Period End | 2016-06-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390806324 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Door County Memorial Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | DOOR | BusinessNameControlTxt |
| Phone | 9207435566 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 323 South 18th Avenue | AddressLine1Txt |
| City | Sturgeon Bay | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54235 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Bill Hinner | PersonNm |
| Person Title | CFO Reg Health System,WI North | PersonTitleTxt |
| Signature | 2017-05-09 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Ministry Door County Medical Center | BusinessNameLine1Txt |
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Gerald Worrick | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 323 South 18th Avenue | AddressLine1Txt |
| City | Sturgeon Bay | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54235 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $80,968,730 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.ministryhealth.org/dcmh/home.nws | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1944 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | To improve the health and well-being of all people in the communities we serve. | ActivityOrMissionDesc |
| Voting Members Governing Body | 16 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 726 | TotalEmployeeCnt |
| Total Volunteers | 130 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $224,901 | PYContributionsGrantsAmt |
| CY Contributions Grants | $882,164 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $77,061,808 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $78,975,945 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$72,603 | PYInvestmentIncomeAmt |
| CY Investment Income | $325,699 | CYInvestmentIncomeAmt |
| PY Other Revenue | $534,631 | PYOtherRevenueAmt |
| CY Other Revenue | $552,339 | CYOtherRevenueAmt |
| PY Total Revenue | $77,748,737 | PYTotalRevenueAmt |
| CY Total Revenue | $80,736,147 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $12,000 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $601,850 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $44,487,849 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $47,060,985 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $24,371,962 | PYOtherExpensesAmt |
| CY Other Expenses | $27,710,781 | CYOtherExpensesAmt |
| PY Total Expenses | $68,871,811 | PYTotalExpensesAmt |
| CY Total Expenses | $75,373,616 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $8,876,926 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $5,362,531 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $92,782,314 | TotalAssetsBOYAmt |
| Total Assets EOY | $94,049,534 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $19,215,283 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $16,360,510 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $73,567,031 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $77,689,024 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Our mission as a Catholic health care system is to further the healing ministry of Jesus by continually improving the health and well-being of all people, especially the poor, in the communities we serve. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $50,769,246 | ExpenseAmt |
| Grant | $601,850 | GrantAmt |
| Revenue | $79,096,944 | RevenueAmt |
| Desc | DOOR COUNTY MEMORIAL HOSPITAL ("THE HOSPITAL") IS A FULLY ACCREDITED, ACUTE-CARE HOSPITAL AND OUTPATIENT MEDICAL CENTER, WITH 25 LICENSED BEDS. THE HOSPITAL OFFERS A FULL RANGE OF SERVICES AND SPECIALTIES, INCLUDING HOME HEALTH, A SKILLED NURSING FACILITY FOR LONG-TERM CARE AND REHABILITATION SERVICES, A REHAB SERVICES DEPARTMENT AND MINISTRY NORTH SHORE MEDICAL CLINIC. DURING FISCAL 2016, THE HOSPITAL COUNTED 3,985 INPATIENT DAYS, INCLUDING SWING BED. THE HOSPITAL'S OUTPATIENT FACILITIES, WHICH INCLUDE ITS REHABILITATION AGENCY AND 30 BED EXTENDED CARE FACILITY SERVED 103,479 VISITS, AND THE NORTH SHORE MEDICAL CLINIC, INCLUDING ITS URGENT CARE FACILITY, RECEIVED 67,642 VISITS. SEE SCHEDULE H FOR FURTHER DETAILS REGARDING THE COMMUNITY BENEFITS DOOR COUNTY MEMORIAL HOSPITAL PROVIDES. | Desc |
| Total Program Service Expenses | $50,769,246 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (true) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (true) | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 109 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 726 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 16 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Craig Aittama | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7153465161 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5700 Lands End Way 2nd Floor | AddressLine1Txt |
| City | Stevens Point | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54482 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| BARTH GUILETTE | ||||||||
| VICE CHAIR | 1.0 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JOSEPH MCMAHON | ||||||||
| TREASURER | 1.0 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| PATRICK O'HERN | ||||||||
| CHAIRMAN | 1.0 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| CATHY WIESE | ||||||||
| SECRETARY | 1.0 | 0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| GERALD WORRICK | ||||||||
| CORP PRESIDENT - CEO | 40.0 | 1.0 | Yes (X) | Yes (X) | $0 | $361,891 | $32,820 | |
| CORWIN DAHL | ||||||||
| BOARD MEMBER | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | ||
| RICHARD HOGAN MD | ||||||||
| BOARD MEMBER | 40.0 | 0 | Yes (X) | $0 | $0 | $0 | ||
| WILLIAM MUNDY | ||||||||
| BOARD MEMBER | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | ||
| ERIC PAULSEN | ||||||||
| BOARD MEMBER | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | ||
| SALLY PFEIFER | ||||||||
| MEMBER AT LARGE | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | ||
| JEFF RABAS | ||||||||
| BOARD MEMBER | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | ||
| KELTON REITZ MD | ||||||||
| BOARD MEMBER | 40.0 | 0 | Yes (X) | $0 | $0 | $0 | ||
| GRACE ROSSMAN | ||||||||
| BOARD MEMBER | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | ||
| DAVID WARD | ||||||||
| BOARD MEMBER | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | ||
| JAMES SARKIS | ||||||||
| BOARD MEMBER | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | ||
| SCOTT WEDERQUIST | ||||||||
| BOARD MEMBER | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | ||
| NICHOLAS DESIEN | ||||||||
| MINISTRY HEALTH CARE CEO (END 12/31/15) | 1.0 | 54.3 | Yes (X) | $0 | $2,799,737 | $271,786 | ||
| JEFFREY FRANCIS | ||||||||
| MINISTRY HEALTH CARE CAFO (END 9/9/15) | 1.0 | 53.8 | Yes (X) | $0 | $652,678 | $51,385 | ||
| DANIEL NEUFELDER | ||||||||
| SVP, HOSPITAL OPERATIONS & PRESIDENT, AHS | 0.5 | 63.4 | Yes (X) | $0 | $2,171,860 | $190,168 | ||
| MICHAEL S BRUNO MD | ||||||||
| PHYSICIAN | 40.0 | 0 | $497,396 | $0 | $36,964 | Yes (X) | ||
| DANIEL J TOMASZEWSKI MD | ||||||||
| PHYSICIAN | 40.0 | 0 | $877,302 | $0 | $36,878 | Yes (X) | ||
| MARC P BINARD MD | ||||||||
| PHYSICIAN | 40.0 | 0 | $512,901 | $0 | $17,902 | Yes (X) | ||
| STEVEN S DAVIS MD | ||||||||
| PHYSICIAN | 40.0 | 0 | $533,131 | $0 | $37,545 | Yes (X) | ||
| DR JAMES F HEISE | ||||||||
| PHYSICIAN | 40.0 | 0 | $504,024 | $0 | $35,447 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,924,754 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $5,986,165 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $710,895 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 55 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (true) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CDW Government | |||||
| 300 N Milwaukee Avenue | Vernon Hills | IL | 60061 | IT Services | $400,585 |
| Synthes | |||||
| 1302 Wrights Lane East | West Chester | PA | 19380 | Medical Devices | $174,898 |
| Navin Haffty & Associates LLC | |||||
| 200 Cordwainer Drive Suite 100 | Norwell | MA | 02061 | Software Consulting | $158,801 |
| NewPoint Healthcare Advisors LLC | |||||
| 200 Quebec St Suite 300-111 | Denver | CO | 80230 | Professional Services | $140,428 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Info In Schedule O Part VIII | Yes (X) | InfoInScheduleOPartVIIIInd |
| Federated Campaigns | $17,000 | FederatedCampaignsAmt |
| Membership Dues | $0 | MembershipDuesAmt |
| Fundraising | $0 | FundraisingAmt |
| Related Organizations | $660,000 | RelatedOrganizationsAmt |
| Government Grants | $48,230 | GovernmentGrantsAmt |
| All Other Contributions | $156,934 | AllOtherContributionsAmt |
| Total Contributions | $882,164 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| Net Patient Revenue | 622110 | $77,650,783 | $77,650,783 | $0 | $0 |
| Oncology Clinic Rev. | 621110 | $299,414 | $299,414 | $0 | $0 |
| Occupational Health | 622000 | $242,847 | $242,847 | $0 | $0 |
| 340B Pharmacy Rev. | 622110 | $116,226 | $116,226 | $0 | $0 |
| Wash Island Subsidy | 621110 | $135,000 | $135,000 | $0 | $0 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $531,675 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $531,675 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $78,975,945 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $325,699 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $325,699 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $417,221 | RealAmt |
| Personal | $0 | PersonalAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $232,583 | RealAmt |
| Personal | $0 | PersonalAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $184,638 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $184,638 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $184,638 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $0 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| Cafeteria Sales | 722514 | $246,702 | $0 | $0 | $246,702 |
| Lifeline Equipment | 900099 | $120,999 | $120,999 | $0 | $0 |
| $0 | $0 | $0 | $0 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $367,701 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $80,736,147 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $79,096,944 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $757,039 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $601,850 | TotalAmt |
| Program Services | $601,850 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,558,566 | TotalAmt |
| Program Services | $27,211,765 | ProgramServicesAmt |
| Management And General | $9,346,801 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,770,333 | TotalAmt |
| Program Services | $1,348,146 | ProgramServicesAmt |
| Management And General | $422,187 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,419,412 | TotalAmt |
| Program Services | $4,815,101 | ProgramServicesAmt |
| Management And General | $1,604,311 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,312,674 | TotalAmt |
| Program Services | $695,364 | ProgramServicesAmt |
| Management And General | $1,617,310 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,836 | TotalAmt |
| Program Services | $31,836 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $400,766 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $400,766 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,957 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $20,957 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,050 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $7,050 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,691,994 | TotalAmt |
| Program Services | $2,994,680 | ProgramServicesAmt |
| Management And General | $697,314 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $694,547 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $694,547 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,952,620 | TotalAmt |
| Program Services | $3,951,925 | ProgramServicesAmt |
| Management And General | $1,000,695 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,269,342 | TotalAmt |
| Program Services | $144,363 | ProgramServicesAmt |
| Management And General | $1,124,979 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,301,257 | TotalAmt |
| Program Services | $1,245,356 | ProgramServicesAmt |
| Management And General | $55,901 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $183,096 | TotalAmt |
| Program Services | $92,097 | ProgramServicesAmt |
| Management And General | $90,999 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $579,114 | TotalAmt |
| Program Services | $318,481 | ProgramServicesAmt |
| Management And General | $260,633 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $234,689 | TotalAmt |
| Program Services | $234,689 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,011,586 | TotalAmt |
| Program Services | $1,350,565 | ProgramServicesAmt |
| Management And General | $2,661,021 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $238,119 | TotalAmt |
| Program Services | $208,250 | ProgramServicesAmt |
| Management And General | $29,869 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| Purchased Services | $4,820,522 | $1,853,662 | $2,966,860 | $0 |
| Medical Supplies | $2,613,817 | $2,613,817 | $0 | $0 |
| Dues and Licenses | $264,627 | $157,159 | $107,468 | $0 |
| Food Supplies | $535,404 | $535,404 | $0 | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,859,438 | TotalAmt |
| Program Services | $364,736 | ProgramServicesAmt |
| Management And General | $1,494,702 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $75,373,616 | TotalAmt |
| Program Services | $50,769,246 | ProgramServicesAmt |
| Management And General | $24,604,370 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Joint Costs TotalJointCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,978 | BOYAmt |
| EOY | $3,278 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,033,689 | BOYAmt |
| EOY | $12,822,979 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $50,558 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,070,039 | BOYAmt |
| EOY | $12,452,383 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $108,053 | BOYAmt |
| EOY | $142,490 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $194,161 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $995,910 | BOYAmt |
| EOY | $916,418 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,785,399 | BOYAmt |
| EOY | $2,026,877 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $33,353,893 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $7,470,126 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,803,339 | BOYAmt |
| EOY | $25,883,767 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $725,282 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,982,907 | BOYAmt |
| EOY | $38,831,341 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $92,782,314 | BOYAmt |
| EOY | $94,049,534 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,458,248 | BOYAmt |
| EOY | $5,853,398 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,613,899 | BOYAmt |
| EOY | $8,111,969 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,084,651 | BOYAmt |
| EOY | $1,504,651 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,058,485 | BOYAmt |
| EOY | $890,492 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,215,283 | BOYAmt |
| EOY | $16,360,510 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $72,486,968 | BOYAmt |
| EOY | $77,210,429 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,080,063 | BOYAmt |
| EOY | $478,595 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $73,567,031 | BOYAmt |
| EOY | $77,689,024 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $92,782,314 | BOYAmt |
| EOY | $94,049,534 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $5,362,531 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$1,240,538 | NetUnrlzdGainsLossesInvstAmt |
| Donated Services And Use Fclts | $0 | DonatedServicesAndUseFcltsAmt |
| Investment Expense | $0 | InvestmentExpenseAmt |
| Prior Period Adjustments | $0 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $7,050 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $7,050 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY | Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. Door County Memorial Hospital does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office. |
| Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY | Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. Door County Memorial Hospital does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office. |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,203,539 | OtherCostOrOtherBasisAmt |
| Book Value | $4,203,539 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $17,588,858 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,254,133 | DepreciationAmt |
| Book Value | $15,334,725 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Depreciation | $0 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,260,644 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,119,201 | DepreciationAmt |
| Book Value | $5,141,443 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $1,300,852 | OtherCostOrOtherBasisAmt |
| Depreciation | $96,792 | DepreciationAmt |
| Book Value | $1,204,060 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $25,883,767 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (5 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Other Receivables | $547,098 |
| Foundation Receivables | $478,595 |
| Interest in Investments Held by Ascension Health Alliance | $36,134,488 |
| Due From Third Party Payers | $1,362,845 |
| Physician Receivable | $308,315 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $38,831,341 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Intercompany Debt with Ministry Health Care, Inc. | $345,147 |
| due to Third Party Payors | $545,345 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $890,492 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote | FormAndLineReferenceDesc |
| Explanation | From the consolidated audited financial statements of Ministry Health Care, Inc., which includes the activity of Door County Memorial Hospital: The Health Ministry accounts for uncertainty in income tax positions by applying a recognition threshold and measurement attribute for financial statement recognition and measurement of tax position taken or expected to be taken in a tax return. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 250 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $747,956 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $747,956 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0099 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $7,559,820 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,346,367 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,213,453 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0294 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $8,307,776 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,346,367 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,961,409 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0393 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 18 | ActivitiesOrProgramsCnt |
| Persons Served | 2100 | PersonsServedCnt |
| Total Community Benefit Expns | $1,042,449 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $123,259 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $919,190 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0122 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 7 | ActivitiesOrProgramsCnt |
| Persons Served | 226 | PersonsServedCnt |
| Total Community Benefit Expns | $217,582 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $217,582 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0029 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 3751 | PersonsServedCnt |
| Total Community Benefit Expns | $1,091,515 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $124,517 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $966,998 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0128 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 8 | ActivitiesOrProgramsCnt |
| Persons Served | 1058 | PersonsServedCnt |
| Total Community Benefit Expns | $529,981 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $529,981 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0070 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 35 | ActivitiesOrProgramsCnt |
| Persons Served | 7135 | PersonsServedCnt |
| Total Community Benefit Expns | $2,881,527 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $247,776 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,633,751 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0349 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 35 | ActivitiesOrProgramsCnt |
| Persons Served | 7135 | PersonsServedCnt |
| Total Community Benefit Expns | $11,189,303 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,594,143 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,595,160 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0742 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $1,450 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,450 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0000 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $1,218 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,218 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0000 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $18,891 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $18,891 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0003 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 346 | PersonsServedCnt |
| Total Community Benefit Expns | $33,422 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $33,422 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0004 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $8,513 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,513 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0001 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 30 | PersonsServedCnt |
| Total Community Benefit Expns | $152,842 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $152,842 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0020 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 9 | ActivitiesOrProgramsCnt |
| Persons Served | 376 | PersonsServedCnt |
| Total Community Benefit Expns | $216,336 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $216,336 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0029 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,035,798 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $35,380,035 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $37,986,145 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$2,606,110 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Door County Memorial Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 323 South 18th Avenue | AddressLine1Txt |
| City | Sturgeon Bay | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54235 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.ministryhealth.org/dcmh/home.nws | WebsiteAddressTxt |
| State License | 1064 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Door County Memorial Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | false | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | http://dcmedical.org/Hospital-Information/About/Community-Health-Needs | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | http://dcmedical.org/Hospital-Information/About/Community-Health-Needs | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 250.0 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.0 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTP://MINISTRYHEALTH.ORG/MINISTRY_HEALTH_CARE/FINANCIAL_ASSISTANCE_PROGRAM_RC08.PDF | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTP://MINISTRYHEALTH.ORG/MINISTRY_HEALTH_CARE/MHC_FINANCIALAID_APPLICATION_REV4.PDF | FAPAppAvailableOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Medicare Rates | Yes (X) | MedicareRatesInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part V, Section B, Line 5 Facility , 1 | Facility , 1 - door county memorial hospital. Door County Medical Center's CHNA process sought input from community members, including members of medically underserved, low-income and minority populations and from organizations that serve those populations. In January 2016, a community stakeholder meeting was held. Door County Medical Center intentionally invited organizations that represent members of medically underserved, low-income and minority populations. The stakeholder meeting attendees participated in a facilitated discussion about the community health data, progress on the previous priority areas, and any emerging needs. The list of organizations participating in the January 2016 stakeholder meeting is below. * Door County Department of Public Health Staff* * Ministry Door County Medical Center * United Way of Door County* * Door County Public Library * Ministry Dental Clinic* * UW-Extension, Door County * UW-Green Bay * Door County Public Schools* * Boys and Girls Club of Door County* * Door County YMCA * Senior Resource Center* * Ministry Home Care * Sturgeon Bay Fire Department * Northeast Wisconsin Technical College (NWTC) * Door County Board of Health * Bellin College * Good Samaritan- Scandia Village * Lakeshore CAP Food Pantry* * Door County Sheriff's Department* *Denotes organizations or programs representing medically underserved, low-income, and/or minority populations. |
| Schedule H, Part V, Section B, Line 6b Facility , 1 | Facility , 1 - door county memorial hospital. Door County Public Health Department |
| Schedule H, Part V, Section B, Line 11 Facility , 1 | Facility , 1 - door county memorial hospital. Using the CHNA completed in June 2013, the hospital developed, adopted, and worked on executing a three-year Implementation Strategy to address priority community health needs. In Fiscal Year 2016 (Tax Year 2015), the hospital implemented the following plan to address the priority needs: 1. Food, Nutrition and Exercise: Create awareness around the importance of adequate, appropriate and safe food and. * Encouraged restaurants' use of visual indicators of healthy options. * Supported in-school sampling of fruits and vegetables. 2. Mental Health and Well-Being: Create awareness of and access to mental health services in the community. * Participated in the Door County Mental Health Focus Group Committee. * Revised and redistributed the Mental Health Resource Guide to area residents. Electronic versions were made available to public on public websites. * Increased the number of mental health awareness events. 3. Oral Health: Increase access to oral health care or prevention for Door County residents and increase awareness of, or education about, oral health issues in Door County. * Conducted fluoride varnish clinics for children. * Initiated a program to provide dental care to underserved adults in the community. * Provided oral health educational presentations. Using the CHNA completed in June 2016, the hospital developed and adopted FY17-FY19 (tax years 2016-2018) Implementation Strategy. The following summarizes the strategies the hospital will implement during that time period to address the priority needs. Mental Health * Increase mental health awareness and education by conducting at least two annual mental health awareness events/activities/educational sessions. * Increase access to behavioral and mental health services through primary care screening and referral. * Create and distribute a mental health resource guide. * Promote local QPR (Question, Persuade, Refer) training. QPR is a research-based suicide prevention program that trains lay people on how to recognize the warning signs of a suicide crisis and how to question, persuade and refer someone for help. Oral Health * Increase access to dental care through the Door County Dental Clinic by continuing to provide a full range of dental services for low-income residents who have limited ability to purchase dental care services. * Assess opportunities for increased oral health-related programming in schools. * Increase awareness of oral health issues through public service announcements. Adequate, Appropriate and Safe Food and Nutrition * Incorporate visual indicators of healthy food at local eating establishments. * Increase healthy nutritional choices in schools. * Increase access to fresh produce and whole foods for low-income individuals by sponsoring a voucher program at the local farmer's market, enabling FoodShare recipients to double each FoodShare dollar. Healthy Growth & Development * Conduct research to identify key issues in the early childhood population and top family needs, and then develop an action plan. * Provide parenting information and support. The description below includes the needs not being addressed as well as the reason why the needs are not being addressed. In addition to the four health issues selected as top priorities, stakeholders identified two other significant health issues in Door County. These issues will be addressed by other organizations in the community. While these issues will not be addressed by Door County Medical Center as priority health needs, we will provide support to those community efforts whenever possible. Alcohol and Drug Use: The stakeholders identified alcohol misuse and drug use, particularly heroin and other opiates, as emerging issues in the community. Wisconsin has seen a 260 percent increase in opiate overdose death among 12-24 year olds in the past decade, with prescription opioids playing a role in more deaths than heroin and cocaine combined. Ministry will engage in increased educational efforts around this issue. The Door County AODA Coalition, of which Ministry is a part, and local law enforcement departments will be addressing these issues. Chronic Disease Prevention: Stakeholders identified chronic preventable disease as another health issue, in particular heart health, obesity and diabetes. Because diet plays a significant role in these conditions, this health issue is being addressed through the priority need of adequate, appropriate and safe food and nutrition. In addition, MDCMC's continued support of silent sporting events, athletic events, the Door County YMCA, youth sports, outdoor activities, nature preserves and other outdoor resources provides increased opportunities for exercise, which contributes to addressing this need. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 4 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| North Shore Medical Clinic | ||||
| 323 South 18th Avenue | Sturgeon Bay | WI | 54235 | OP Phys Clinic |
| North Shore Medical Clinic | ||||
| 3711 Highway 42 | Fish Creek | WI | 54212 | OP Phys Clinic |
| North Shore Medical Clinic | ||||
| 815 Jefferson Street | Algoma | WI | 54201 | OP Phys Clinic |
| North Shore Medical Clinic | ||||
| 910 Main Road | Washington Island | WI | 54201 | OP Phys Clinic |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part I, Line 6a Community benefit report prepared by related organization | Door County Memorial Hospital is inlcuded in Ministry Healthcare |
| Schedule H, Part II Community Building Activities | Door County Medical Center participates in community coalitions and other collaborative efforts with the community whose purpose is to improve the health of the community. These include Habitat for Humanity, Wisconsin Community Health Program, Southern Door Auditorium committee, Door county Elder and Adult-at-risk Interdisciplinary team, Door County Community Partnership for Children and Families, Mental Health Focus group and Door County United Way. By working together with other organizations in the community, we expect to have a greater impact on health. According to the County Health Rankings site, with a shared vision and commitment to improved health, working together can yield better results than working alone. Leadership from Door County Medical Center also attend Leadership Door County. Future community leaders who are knowledgeable about both the assets and challenges our community has will help us to positively address the health issues of the future. The Medical Center also is a community Sharps disposal site. By safely removing sharps from the environment, we make the community safer in terms of injury and infection. In addition, Door County Medical Center provides job shadowing for area youth. According to the County Health Rankings, employment provides income and, often, benefits that can support healthy lifestyle choices. Unemployment and under employment limit these choices, and negatively affect both quality of life and health overall. |
| Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount | Accounts are written off to bad debt after all internal collection efforts have been exhausted. Attempts to resolve these outstanding balances can include, but are not limited to statements being sent, phone calls and letters being sent. Account follow up protocol is based on personal pay balance size owed. |
| Schedule H, Part III, Line 3 Bad Debt Expense Methodology | Door County Memorial Hospital has a very robust financial assistance program; therefore, no estimate is made for bad debt attributed to financial assistance eligible patients. |
| Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote | From the footnote of the consolidated financial statements of Ministry Health Care, Inc., which includes the activity of Door County Memorial Hospital: The provision for doubtful accounts is based upon management's assessment of expected net collections considering historical experience, economic conditions, trends in health care coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for doubtful accounts to establish an appropriate allowance for doubtful accounts. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Health Ministry follows established guidelines for placing certain past-due patient balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with the Health Ministry's policies. The methodology for determining the allowance for doubtful accounts and related write-offs on uninsured patient accounts has remained consistent with the prior year. |
| Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs | Ascension Health and related health ministries follow the Catholic Health Association ("CHA") guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as community benefit. |
| Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance | Door County Memorial Hospital ("DCMH") has a debt collection policy which sets forth collection practices for patients who are known to qualify or may qualify for financial assistance under the charity care program. Sufficient financial counseling support is made available to patients so they can easily access patient financial service representatives and have their questions answered, and gain an understanding of the reasons why they owe a balance. Accounts are designated as charity care in the business offices so no additional time is spent on collection efforts. |
| Schedule H, Part V, Section B, Line 16a FAP website | - Door County Memorial Hospital: Line 16a URL: HTTP://MINISTRYHEALTH.ORG/MINISTRY_HEALTH_CARE/FINANCIAL_ASSISTANCE_PROGRAM_RC08.PDF; |
| Schedule H, Part V, Section B, Line 16b FAP Application website | - Door County Memorial Hospital: Line 16b URL: HTTP://MINISTRYHEALTH.ORG/MINISTRY_HEALTH_CARE/MHC_FINANCIALAID_APPLICATION_REV4.PDF; |
| Schedule H, Part VI, Line 2 Needs assessment | The Organization performs community needs assessments as needed. Planning workgroups consisting of community partners are formed to define the community and its needs through review of healthy people initiatives, census documents, and local government health and welfare agencies. Considering other community resources/assets, data collection methods are used to identify particular problems or subgroups and areas known to have high poverty rates and to be underserved. The data is analyzed and priorities are set based on trending information which may target a specific need. When a need is identified, the Hospital develops a plan to implement a program either through community collaboration or individually. Outcomes from the programs are measured and considered in subsequent community needs assessments. Community benefit plans are presented to senior leadership and board members to ensure the findings are incorporated into the Organization's strategy and policy development. For example, senior leaders are required to provide direct service hours to the poor as part of their performance goals. |
| Schedule H, Part VI, Line 3 Patient education of eligibility for assistance | The Organization goes to great lengths in order to inform and educate patients/persons who may be billed for patient care about their eligibility for assistance under federal, state or local government programs and under the Organization's Charity Care Policy. The Charity Care Policy and application is posted on the Organization's website. Admissions and other key areas contain summary information of the Charity Care Policy. As part of the intake/discharge process, patients are provided with a copy of the policy and other information for financial assistance. If during the course of the patient registration process, treatment, or upon discharge it becomes evident that a patient may need financial assistance, the patient shall be referred to the Organization's Community Care program. Patients may be identified as needing financial assistance at any time during the course of an encounter. A referral for consideration of Community Care Financial Assistance can be initiated by any member of the hospital's workforce, including medical staff members, who become aware of the patient's potential need for Community Care Financial Assistance. The Charity Care Policy was also translated into dialects prevalent in the community in order to reach out to those that may speak another language. Patient registration staff and financial counselors are provided with scripts to follow when interacting with patients. As part of the charity care process, patients must register with the county public assistance to see if they may qualify under any other federal or state programs. |
| Schedule H, Part VI, Line 4 Community information | While there is growing agreement in the United States about what constitutes a non-profit hospital's "community benefit", this is a work in progress. Door County Memorial Hospital ("DCMH") provided significant 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 care locally - care that without our Hospital, would not be available locally. The City of Sturgeon Bay is located in Door County. The population of Door County, as of the 2015 census data, is 24,038. The population consisted of 97% White, 2% Hispanic, 1% African American, and 1% Asian. Of the 24,038 population, 51% were female and 49% male. The age population is widely spread. 17% were under 18 and 24% were 65+. The largest industry in Door County is educational, health and social services (18.8%). Arts, entertainment and recreation (16.1%) and manufacturing (14.0%) are the next largest industries in Door County. Roughly 6.2% of families and 11.4% of the population were below the poverty line. That includes 20.7% of those under 18 years old and 7.9% of those 65 and older. |
| Schedule H, Part VI, Line 5 Promotion of community health | The local board for Door County Memorial Hospital is made up of community members that live in our primary service area. Door County Memorial Hospital partners with the local YMCA on various events promoting health and well-being in the community. Door County Memorial Hospital extends medical privileges to all qualified physicians in the community. Door County Memorial Hospital participates in Medicare, Medicaid, and other government sponsored programs. |
| Schedule H, Part VI, Line 6 Affiliated health care system | MINISTRY HEALTH CARE, INC. (MINISTRY OR THE HEALTH MINISTRY) IS A MEMBER OF ASCENSION HEALTH. IN DECEMBER 2011, ASCENSION HEALTH ALLIANCE, DOING BUSINESS AS ASCENSION, BECAME THE SOLE CORPORATE MEMBER AND PARENT ORGANIZATION OF ASCENSION HEALTH, A CATHOLIC NATIONAL HEALTH SYSTEM CONSISTING PRIMARILY OF NONPROFIT CORPORATIONS THAT OWN AND OPERATE LOCAL HEALTH CARE FACILITIES, OR HEALTH MINISTRIES, LOCATED IN 23 STATES AND THE DISTRICT OF COLUMBIA. IN ADDITION TO SERVING AS THE SOLE CORPORATE MEMBER OF ASCENSION HEALTH, ASCENSION SERVES AS THE MEMBER OR SHAREHOLDER OF VARIOUS OTHER SUBSIDIARIES. ASCENSION, ITS SUBSIDIARIES, AND THE HEALTH MINISTRIES ARE REFERRED TO COLLECTIVELY FROM TIME TO TIME HEREAFTER AS THE SYSTEM. ASCENSION IS SPONSORED BY ASCENSION SPONSOR, A PUBLIC JURIDIC PERSON. THE PARTICIPATING ENTITIES OF ASCENSION SPONSOR ARE THE DAUGHTERS OF CHARITY OF ST. VINCENT DE PAUL, ST. LOUISE PROVINCE, THE CONGREGATION OF ST. JOSEPH, THE CONGREGATION OF THE SISTERS OF ST. JOSEPH OF CARONDELET, THE CONGREGATION OF ALEXIAN BROTHERS OF THE IMMACULATE CONCEPTION PROVINCE, INC. - AMERICAN PROVINCE, AND THE SISTERS OF THE SORROWFUL MOTHER OF THE THIRD ORDER OF ST. FRANCIS OF ASSISI-US/CARIBBEAN PROVINCE. THE HEALTH MINISTRY IS A WISCONSIN NON-STOCK, TAX-EXEMPT CORPORATION THAT MANAGES, PROMOTES, AND SUPPORTS HEALTH CARE AND RELATED MINISTRIES IN WISCONSIN AND MINNESOTA. THE HEALTH MINISTRY PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES FOR THE RESIDENTS OF WISCONSIN AND MINNESOTA. ADMITTING PHYSICIANS ARE PRIMARILY PRACTITIONERS IN THE LOCAL AREA. THE HEALTH MINISTRY IS RELATED TO ASCENSION HEALTH'S OTHER SPONSORED ORGANIZATIONS THROUGH COMMON CONTROL. SUBSTANTIALLY ALL EXPENSES OF THE HEALTH MINISTRY ARE RELATED TO PROVIDING HEALTH CARE SERVICES. EFFECTIVE NOVEMBER 1, 2014, THE HEALTH MINISTRY SOLD 50% OF ITS OWNERSHIP IN NETWORK HEALTH, INC. TO AN UNRELATED HEALTH SYSTEM. ON FEBRUARY 1, 2015, THE HEALTH MINISTRY TRANSFERRED ITS OWNERSHIP IN MINISTRY HOME CARE, INC. TO ASCENSION HEALTH. THE CONSOLIDATED FINANCIAL STATEMENTS INCLUDE THE FOLLOWING AFFILIATES LOCATED PRIMARILY IN WISCONSIN, IN WHICH MINISTRY HAS A CONTROLLING INTEREST AND/OR IS THE SOLE SPONSOR. AFFINITY HEALTH SYSTEM, INC. (AFFINITY): CALUMET MEDICAL CENTER, INC. (CMC): AFFINITY MEDICAL GROUP (AMG) TWIN MED, LLC MERCY MEDICAL CENTER, INC. MERCY HEALTH FOUNDATION ST. ELIZABETH HOSPITAL CATALPA HEALTH: ST. ELIZABETH FOUNDATION AGAPE COMMUNITY CENTER OF MILWAUKEE, INC. DOOR COUNTY MEMORIAL HOSPITAL (DOOR COUNTY) GOOD SAMARITAN HEALTH CENTER OF MERRILL GOOD SAMARITAN HEALTH CENTER FOUNDATION HOWARD YOUNG HEALTH CARE, INC. (HOWARD YOUNG): DR. KATE NEWCOMB CONVALESCENT CENTER HOWARD YOUNG MEDICAL CENTER, INC. DR. HOWARD YOUNG FOUNDATION EAGLE RIVER MEMORIAL HOSPITAL, INC. MINISTRY MEDICAL GROUP, INC. MINISTRY HOLDINGS, INC. (THROUGH NOVEMBER 1, 2014): NETWORK HEALTH (NH) (THROUGH NOVEMBER 1, 2014) NETWORK HEALTH INSURANCE CORPORATION (NHIC) (THRU NOVEMBER 1, 2014) OUR LADY OF VICTORY HOSPITAL SACRED HEART HOSPITAL-ST. MARY'S HOSPITAL, INC. ST. CLARE'S HOSPITAL OF WESTON, INC. FOUNDATION OF ST. CLARE'S HOSPITAL OF WESTON, INC. ST. ELIZABETH'S HOSPITAL OF WABASHA, INC. ST. JOSEPH'S HOSPITAL OF MARSHFIELD, INC. FOUNDATION OF ST. JOSEPH'S HOSPITAL OF MARSHFIELD, INC. ST. MICHAEL'S HOSPITAL OF STEVENS POINT, INC. ST. MICHAEL'S FOUNDATION OF STEVENS POINT, INC. THE SYSTEM DIRECTS ITS GOVERNANCE AND MANAGEMENT ACTIVITIES TOWARD STRONG, VIBRANT, CATHOLIC HEALTH MINISTRIES UNITED IN SERVICE AND HEALING AND DEDICATES ITS RESOURCES TO SPIRITUALLY CENTERED CARE THAT SUSTAINS AND IMPROVES THE HEALTH OF THE INDIVIDUALS AND COMMUNITIES IT SERVES. IN ACCORDANCE WITH THE SYSTEM'S MISSION OF SERVICE TO THOSE PERSONS LIVING IN POVERTY AND TO OTHER VULNERABLE PERSONS, EACH HEALTH MINISTRY ACCEPTS PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE SYSTEM USES FOUR CATEGORIES TO IDENTIFY THE RESOURCES UTILIZED FOR THE CARE OF PERSONS LIVING IN POVERTY AND FOR COMMUNITY BENEFIT PROGRAMS: 1. TRADITIONAL CHARITY CARE INCLUDES THE COST OF SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD HEALTH CARE BECAUSE OF INADEQUATE RESOURCES AND/OR WHO ARE UNINSURED OR UNDERINSURED. 2. UNPAID COST OF PUBLIC PROGRAMS, EXCLUDING MEDICARE, REPRESENTS THE UNPAID COST OF SERVICES PROVIDED TO PERSONS COVERED BY PUBLIC PROGRAMS FOR PERSONS LIVING IN POVERTY AND FOR OTHER VULNERABLE PERSONS. 3. COST OF OTHER PROGRAMS FOR PERSONS LIVING IN POVERTY AND FOR OTHER VULNERABLE PERSONS INCLUDES UNREIMBURSED COSTS OF PROGRAMS INTENTIONALLY DESIGNED TO SERVE THE PERSONS LIVING IN POVERTY AND THE OTHER VULNERABLE PERSONS OF THE COMMUNITY, INCLUDING SUBSTANCE ABUSERS, THE HOMELESS, VICTIMS OF CHILD ABUSE, AND PERSONS WITH ACQUIRED IMMUNE DEFICIENCY SYNDROME. 4. COMMUNITY BENEFIT CONSISTS OF THE UNREIMBURSED COSTS OF COMMUNITY BENEFIT PROGRAMS AND SERVICES FOR THE GENERAL COMMUNITY, NOT SOLELY FOR THE PERSONS LIVING IN POVERTY, INCLUDING HEALTH PROMOTION AND EDUCATION, HEALTH CLINICS AND SCREENINGS, AND MEDICAL RESEARCH. DISCOUNTS ARE PROVIDED TO ALL UNINSURED PATIENTS, INCLUDING THOSE WITH THE MEANS TO PAY. DISCOUNTS PROVIDED TO THOSE PATIENTS WHO DID NOT QUALIFY FOR ASSISTANCE UNDER CHARITY CARE GUIDELINES ARE NOT INCLUDED IN THE COST OF PROVIDING CARE TO PERSONS LIVING IN POVERTY OR IN THE COST OF OTHER COMMUNITY BENEFIT PROGRAMS. THE COST OF PROVIDING CARE TO PERSONS LIVING IN POVERTY AND OF OTHER COMMUNITY BENEFIT PROGRAMS IS ESTIMATED USING INTERNAL COST DATA AND IS ESTIMATED BY REDUCING CHARGES FORGONE BY A FACTOR DERIVED FROM THE RATIO OF TOTAL OPERATING EXPENSES TO BILLED CHARGES FOR PATIENT CARE. THE AMOUNT OF TRADITIONAL CHARITY CARE PROVIDED, DETERMINED ON THE BASIS OF COST, WAS APPROXIMATELY $10,700 AND $12,600 FOR THE YEARS ENDED JUNE 30, 2016 AND 2015, RESPECTIVELY. THE AMOUNT OF UNPAID COST OF PUBLIC PROGRAMS, COST OF OTHER PROGRAMS FOR PERSONS LIVING IN POVERTY AND FOR OTHER VULNERABLE PERSONS, AND COST OF COMMUNITY BENEFIT PROGRAMS ARE REPORTED IN THE ACCOMPANYING SUPPLEMENTARY INFORMATION. |
| Schedule H, Part VI, Line 7 State filing of community benefit report | WI |
Schedule I IRS990ScheduleI
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Door County Memorial Hospital Foundation | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1843 Michigan Street | AddressLine1Txt |
| City | Sturgeon Bay | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54235 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 391649104 | RecipientEIN |
| IRC Section | 501(c)(3) | IRCSectionDesc |
| Cash Grant | $601,469 | CashGrantAmt |
| Valuation Method Used | Pledges Reported by Foundation due to Door County Memorial Hospital | ValuationMethodUsedDesc |
| Purpose Of Grant | Foundation raises money to support DCMH projects | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GERALD WORRICK | ||||||||||||||
| CORP PRESIDENT - CEO | $0 | $268,527 | $0 | $68,336 | $0 | $25,028 | $0 | $9,275 | $0 | $23,545 | $0 | $394,711 | $0 | $0 |
| NICHOLAS DESIEN | ||||||||||||||
| MINISTRY HEALTH CARE CEO (END 12/31/15) | $0 | $1,298,254 | $0 | $1,454,145 | $0 | $47,338 | $0 | $242,978 | $0 | $28,808 | $0 | $3,071,523 | $0 | $0 |
| JEFFREY FRANCIS | ||||||||||||||
| MINISTRY HEALTH CARE CAFO (END 9/9/15) | $0 | $382,625 | $0 | $40,711 | $0 | $229,342 | $0 | $27,845 | $0 | $23,540 | $0 | $704,063 | $0 | $0 |
| DANIEL NEUFELDER | ||||||||||||||
| SVP, HOSPITAL OPERATIONS & PRESIDENT, AHS | $0 | $1,009,083 | $0 | $1,146,884 | $0 | $15,893 | $0 | $162,663 | $0 | $27,505 | $0 | $2,362,028 | $0 | $0 |
| MICHAEL S BRUNO MD | ||||||||||||||
| PHYSICIAN | $497,396 | $0 | $0 | $0 | $0 | $0 | $15,900 | $0 | $21,064 | $0 | $534,360 | $0 | $0 | $0 |
| DANIEL J TOMASZEWSKI MD | ||||||||||||||
| PHYSICIAN | $877,302 | $0 | $0 | $0 | $0 | $0 | $15,473 | $0 | $21,405 | $0 | $914,180 | $0 | $0 | $0 |
| MARC P BINARD MD | ||||||||||||||
| PHYSICIAN | $512,901 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $17,902 | $0 | $530,803 | $0 | $0 | $0 |
| STEVEN S DAVIS MD | ||||||||||||||
| PHYSICIAN | $533,131 | $0 | $0 | $0 | $0 | $0 | $15,900 | $0 | $21,645 | $0 | $570,676 | $0 | $0 | $0 |
| DR JAMES F HEISE | ||||||||||||||
| PHYSICIAN | $504,024 | $0 | $0 | $0 | $0 | $0 | $15,900 | $0 | $19,547 | $0 | $539,471 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Line 3 EXPLANATION | MINISTRY HEALTH CARE, INC., A RELATED ORGANIZATION OF DOOR COUNTY MEMORIAL HOSPITAL, USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE |
| Schedule J, Part I, Line 4a Severance or change-of-control payment | The following individual(s) received severance payments from the organization or a related organization: Jeffrey Francis - $225,000 |
| Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan | Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment witht the organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part ll, Column B in the year paid. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Wisconsin Health & Education Facilities Authority | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 391337855 | BondIssuerEIN |
| Bond Issued | 2014-08-15 | BondIssuedDt |
| Issue Price | $10,000,000 | IssuePriceAmt |
| Purpose | Refund debt issued 10/21/2009 | PurposeDesc |
| Defeased | false | DefeasedInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Pool Financing | false | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $1,888,031 | RetiredAmt |
| Bond Defeased | $0 | BondDefeasedAmt |
| Total Proceeds | $10,000,000 | TotalProceedsAmt |
| In Reserve Fund | $0 | InReserveFundAmt |
| Capitalized Interest | $0 | CapitalizedInterestAmt |
| Refunding Escrow | $0 | RefundingEscrowAmt |
| Issuance Costs From Proceeds | $0 | IssuanceCostsFromProceedsAmt |
| Credit Enhancement | $0 | CreditEnhancementAmt |
| Working Capital Expenditures | $0 | WorkingCapitalExpendituresAmt |
| Capital Expenditures | $0 | CapitalExpendituresAmt |
| Other Spent Proceeds | $10,000,000 | OtherSpentProceedsAmt |
| Unspent | $0 | UnspentAmt |
| Current Refunding | Yes (true) | CurrentRefundingInd |
| Advance Refunding | false | AdvanceRefundingInd |
| Final Allocation Made | Yes (true) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (true) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | false | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | false | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | Yes (true) | MgmtContractBondFincdPropInd |
| Engage Bond Counsel Contracts | Yes (true) | EngageBondCounselContractsInd |
| Any Research Agreements | false | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.0 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.0 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.0 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | false | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | false | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (true) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | false | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (true) | RebateNotDueYetInd |
| Exception To Rebate | false | ExceptionToRebateInd |
| No Rebate Due | false | NoRebateDueInd |
| Variable Rate Issue | Yes (true) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | false | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | false | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (true) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (true) | ProceduresCorrectiveActionInd |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (4 entries)
| Relationship With OrgRelationshipWithOrgTxt | Loan PurposeLoanPurposeTxt | Loan From OrganizationLoanFromOrganizationInd | Original PrincipalOriginalPrincipalAmt | Balance DueBalanceDueAmt | DefaultDefaultInd | Board Or Committee ApprovalBoardOrCommitteeApprovalInd | Written AgreementWrittenAgreementInd |
|---|---|---|---|---|---|---|---|
| DR TOMASZEWSKI | |||||||
| HIGHEST COMPENSATED EMPLOYEE | EMPLOYEE RETENTION LOAN | Yes (X) | $150,000 | $29,149 | false | Yes (true) | Yes (true) |
| BRIAN MATYSIAK | |||||||
| HIGHEST COMPENSATED EMPLOYEE | RETENTION LOAN | Yes (X) | $85,000 | $61,952 | false | Yes (true) | Yes (true) |
| DR MARC BINNARD | |||||||
| HIGHEST COMPENSATED EMPLOYEE | EMPLOYEE RETENTION | Yes (X) | $50,000 | $26,389 | false | Yes (true) | Yes (true) |
| DR JAMES HEISE | |||||||
| HIGHEST COMPENSATED EMPLOYEE | EDUCATION LOAN | Yes (X) | $25,000 | $25,000 | false | Yes (true) | Yes (true) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $142,490 | TotalBalanceDueAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 15 ADDITIONAL INFORMATION | IN DETERMINING COMPENSATION OF THE ORGANIZATION'S CEO, THE PROCESS PERFORMED BY MINISTRY HEALTH CARE, INC., A RELATED ORGANIZATION OF DOOR COUNTY MEMORIAL HOSPITAL, INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE COMPENSATION COMMITTEE, WHICH IS ASSISTED BY AN INDEPENDENT CONSULTING FIRM, REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE CEO, WAS COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE BOARD MINUTES. INDIVIDUAL WAS NOT PRESENT WHEN HIS COMPENSATION WAS DECIDED. IN DETERMINING COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION, THE PROCESS PERFORMED BY MINISTRY HEALTH CARE, INC., A RELATED ORGANIZATION OF DOOR COUNTY MEMORIAL HOSPITAL, INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE COMPENSATION COMMITTEE, ASSISTED BY AN INDEPENDENT CONSULTING FIRM, REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION WERE COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE BOARD MINUTES. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | Door County Memorial Hospital has a single corporate member, Ministry Health Care, Inc. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | Door County Memorial Hospital has a single corporate member, Ministry Health Care, Inc., who has the ability to elect members to the governing body of Door County Memorial Hospital. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | All decisions that have a material impact to Door County Memorial Hospital financial information or corporation as a whole are subject to approval by its sole corporate member, Ministry Health Care, Inc. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | Management, including certain officers, works diligently to complete the Form 990 and attached schedules in a thorough manner. Prior to filing the return, all board members are provided the Form 990 and management team members are available to answer any Board Members' questions. |
| Form 990, Part VI, Line 12c Conflict of interest policy | The Organization regularly and consistently monitors and enforces compliance with the Conflict of Interest Policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the Conflict of Interest Policy, has read and understands the policy, has agreed to comply with the policy, and understands that the Organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose. |
| Form 990, Part VI, Line 19 Required documents available to the public | The Ministry web page is available to the public for inspection with a good deal of information regarding who Ministry Health Care, Inc. is and the entities included along with our mission. The Articles of Incorporation, Bylaws, Conflict of Interest Policy and financial statements are not included on any web page. However, if any inquiry is made for any documents they are shared as appropriate. |
| Form 990, Part VIII, Line 2f Other Program Service Revenue | Other Program Rev - Total Revenue: 99141, Related or Exempt Function Revenue: 99141, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Corp BSO Allocation - Total Revenue: 432534, Related or Exempt Function Revenue: 432534, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (30 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| ASCENSION HEALTH ALLIANCE | ||||||||||
| PO BOX 45998 | STLOUIS | MO | 63145 | 453358926 | NATIONAL HEALTH SYSTEM | MO | 501(c)(3 | Type I | NA | false |
| ASCENSION HEALTH | ||||||||||
| PO BOX 45998 | STLOUIS | MO | 63145 | 311662309 | NATIONAL HEALTH SYSTEM | MO | 501(c)(3 | Type I | ASCENSION HEALTH ALLIANCE | false |
| MINISTRY HEALTH CARE INC | ||||||||||
| 10925 W LAKE PARK DR STE 100 | MILWAUKEE | WI | 53224 | 391490371 | PARENT CORPORATION | WI | 501(c)(3 | Type II | ASCENSION HEALTH | false |
| AFFINITY HEALTH SYSTEM | ||||||||||
| 1570 MIDWAY PLACE | MENASHA | WI | 54952 | 391568866 | SUPPORT RELATED HEALTHCARE ORGANIZATIONS | IL | 501(c)(3 | Type II | MINISTRY HEALTH CARE INC | Yes (true) |
| AGAPE COMMUNITY CENTER OF MILWAUKEE INC | ||||||||||
| 6100 NORTH 42ND STREET | MILWAUKEE | WI | 53209 | 391461846 | COMMUNITY CENTER | WI | 501(c)(3 | 7 | MINISTRY HEALTH CARE INC | Yes (true) |
| CALUMET MEDICAL CENTER INC | ||||||||||
| 614 MEMORIAL DRIVE | CHILTON | WI | 53014 | 390905385 | HOSPITAL | WI | 501(c)(3 | 3 | AFFINITY HEALTH SYSTEM | Yes (true) |
| CATALPA HEALTH INC | ||||||||||
| N4642 COUNTY N | APPLETON | WI | 54914 | 454681563 | MENTAL HEALTH FACILITY | WI | 501(c)(3 | 3 | ST ELIZABETH HOSPITAL INC | Yes (true) |
| SAINT MICHAEL'S FOUNDATION OF STEVENS POINT INC | ||||||||||
| 900 ILLINOIS AVENUE | STEVENS POINT | WI | 54481 | 391657410 | CHARITABLE FOUNDATION | WI | 501(c)(3 | Type I | SAINT MICHAEL'S HOSPITAL OF STEVENS POINT | Yes (true) |
| DR KATE NEWCOMB CONVALESCENT CENTER INC | ||||||||||
| PO BOX 829 | WOODRUFF | WI | 54568 | 391357365 | NURSING/ASSISTED LIVING SERVICES | WI | 501(c)(3 | 9 | HOWARD YOUNG HEALTH CARE INC | Yes (true) |
| EAGLE RIVER MEMORIAL HOSPTIAL INCORPORATED | ||||||||||
| 201 HOSPITAL ROAD | EAGLE RIVER | WI | 54521 | 390985690 | HOSPITAL | WI | 501(c)(3 | 3 | THE HOWARD YOUNG MEDICAL CENTER INC | Yes (true) |
| FOUNDATION OF SAINT CLARE'S HOSPITAL OF WESTON INC | ||||||||||
| 3400 MINISTRY PARKWAY | WESTON | WI | 54476 | 753193633 | CHARITABLE FOUNDATION | WI | 501(c)(3 | Type I | MINISTRY HEALTH CARE INC | Yes (true) |
| FOUNDATION OF SAINT JOSEPH'S HOSPITAL OF MARSHFIELD | ||||||||||
| 611 SAINT JOSEPH AVENUE | MARSHFIELD | WI | 54449 | 391684957 | CHARITABLE FOUNDATION | WI | 501(c)(3 | Type I | SAINT JOSEPH'S HOSPITAL OF MARSHFIELD INC | Yes (true) |
| GOOD SAMARITAN HEALTH CENTER OF MERRILL WISCONSIN INC | ||||||||||
| 601 SOUTH CENTER AVENUE | MERRILL | WI | 54452 | 390808503 | HOSPITAL | WI | 501(c)(3 | 3 | MINISTRY HEALTH CARE INC | Yes (true) |
| GOOD SAMARITAN HEALTH CENTER FOUNDATION OF MERRILL WISCONSIN INC | ||||||||||
| 601 SOUTH CENTER AVENUE | MERRILL | WI | 54452 | 391627755 | CHARITABLE FOUNDATION | WI | 501(c)(3 | Type I | GOOD SAMARITAN HEALTH CENTER OF MERRILL | Yes (true) |
| HOWARD YOUNG FOUNDATION INC | ||||||||||
| 240 MAPLE STREET | WOODRUFF | WI | 54568 | 391521169 | CHARITABLE FOUNDATION | WI | 501(c)(3 | 7 | HOWARD YOUNG HEALTH CARE INC | Yes (true) |
| HOWARD YOUNG HEALTH CARE INC | ||||||||||
| 240 MAPLE STREET | WOODRUFF | WI | 54568 | 391499115 | HOME OFFICE | WI | 501(c)(3 | Type II | MINISTRY HEALTH CARE INC | Yes (true) |
| THE HOWARD YOUNG MEDICAL CENTER INC | ||||||||||
| 240 MAPLE STREET | WOODRUFF | WI | 54568 | 390873606 | HOSPITAL | WI | 501(c)(3 | 3 | HOWARD YOUNG HEALTH CARE INC | Yes (true) |
| MERCY HEALTH FOUNDATION INC | ||||||||||
| PO BOX 3370 | OSHKOSH | WI | 54903 | 237140261 | CHARITABLE FOUNDATION | WI | 501(c)(3 | 9 | AFFINITY HEALTH SYSTEM | Yes (true) |
| MERCY MEDICAL CENTER OF OSHKOSH INC | ||||||||||
| 500 S OAKWOOD ROAD | OSHKOSH | WI | 54904 | 390806268 | HOSPITAL | WI | 501(c)(3 | 3 | MINISTRY HEALTH CARE INC | Yes (true) |
| MINISTRY MEDICAL GROUP INC | ||||||||||
| 824 ILLINOIS AVENUE | STEVENS POINT | WI | 54481 | 391965593 | CLINICS | WI | 501(c)(3 | Type III-FI | MINISTRY HEALTH CARE INC | Yes (true) |
| MINISTRY WEIGHT MANAGEMENT INC | ||||||||||
| 2251 NORTH SHORE DRIVE | RHINELANDER | WI | 54501 | 391829015 | HEALTH SERVICES | WI | 501(c)(3 | 3 | SACRED HEART - ST MARY'S HOSPITALS INC | Yes (true) |
| OUR LADY OF VICTORY HOSPITAL | ||||||||||
| 1120 PINE STREET | STANLEY | WI | 54768 | 390807065 | HOSPITAL | WI | 501(c)(3 | 3 | MINISTRY HEALTH CARE INC | Yes (true) |
| SACRED HEART-ST MARY'S HOSPITALS INC | ||||||||||
| PO BOX 347 | STEVENS POINT | WI | 54481 | 391390638 | HOSPITAL | WI | 501(c)(3 | 3 | MINISTRY HEALTH CARE INC | Yes (true) |
| SAINT CLARE'S HOSPITAL OF WESTON INC | ||||||||||
| 3400 MINISTRY PARKWAY | WESTON | WI | 54476 | 721531917 | HOSPITAL | WI | 501(c)(3 | 3 | MINISTRY HEALTH CARE INC | Yes (true) |
| SAINT ELIZABETH'S HOSPITAL OF WABASHA INC | ||||||||||
| 1200 GRANT BLVD WEST | WABASHA | MN | 55981 | 410693877 | HOSPITAL | MN | 501(c)(3 | 3 | MINISTRY HEALTH CARE INC | Yes (true) |
| SAINT ELIZABETH'S HOSPITAL FOUNDATION INC | ||||||||||
| 1506 S ONEIDA STREET | APPLETON | WI | 54915 | 391256677 | CHARITABLE FOUNDATION | WI | 501(c)(3 | 7 | AFFINITY HEALTH SYSTEM | Yes (true) |
| ST ELIZABETH HOSPITAL INC | ||||||||||
| 1506 S ONEIDA STREET | APPLETON | WI | 54915 | 390816818 | HOSPITAL | WI | 501(c)(3 | 3 | MINISTRY HEALTH CARE INC | Yes (true) |
| SAINT JOSEPH'S HOSPITAL OF MARSHFIELD INC | ||||||||||
| 611 SAINT JOSEPH AVENUE | MARSHFIELD | WI | 54449 | 391847631 | HOSPITAL | WI | 501(c)(3 | 3 | MINISTRY HEALTH CARE INC | Yes (true) |
| SAINT MICHAEL'S HOSPITAL OF STEVENS POINT INC | ||||||||||
| 900 ILLINOIS AVENUE | STEVENS POINT | WI | 54481 | 390808443 | HOSPITAL | WI | 501(c)(3 | 3 | MINISTRY HEALTH CARE INC | Yes (true) |
| NETWORK HEALTH SYSTEM INC | ||||||||||
| 1570 APPLETON RD | MENASHA | WI | 54952 | 391127163 | CLINICAL HEALTHCARE SERVICES | WI | 501(c)(3 | 3 | AFFINITY HEALTH SYSTEM | Yes (true) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TWIN MED LLP | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 8005 | AddressLine1Txt |
| City | MENASHA | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54952 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391180341 | EIN |
| Primary Activities | RENTAL PROPERTY | PrimaryActivitiesTxt |
| Legal Domicile State | WI | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | N/A | PredominantIncomeTypeTxt |
| Ownership | 0 | OwnershipPct |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| NETWORK HEALTH PLAN INC | |||||||||
| 1570 MIDWAY PLACE | MENASHA | WI | 54952 | 391442058 | INSURANCE | WI | NA | C Corporation | false |
| MINISTRY HOLDINGS INC | |||||||||
| 1570 MIDWAY PLACE | MENASHA | WI | 54952 | 422966177 | INSURANCE HOLDING COMPANY | WI | NA | C Corporation | false |
| NETWORK HEALTH INSURANCE CORPORATION | |||||||||
| 1570 MIDWAY PLACE | MENASHA | WI | 54952 | 392020474 | INSURANCE | WI | NA | C Corporation | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY MEDICAL CENTER OF OSHKOSH INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | M | TransactionTypeTxt |
| Involved | $120,000 | InvolvedAmt |
| Method Of Amount Determination | FMV | MethodOfAmountDeterminationTxt |