FROEDTERT SOUTH INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- FROEDTERT SOUTH INC (EIN 39-0816845)
- Tax period
- 2015-07-01 to 2016-06-30
- Filed
- 2017-05-11
- IRS object ID
- 201731319349301218
- 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 D
- Schedule G
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-05-11T08:56:32-05:00 | ReturnTs |
| Tax Period End | 2016-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 12237 | AddressLine1Txt |
| City | GREEN BAY | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 543072237 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390816845 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNITED HOSPITAL SYSTEM INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | UNIT | BusinessNameControlTxt |
| Phone | 2625778113 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6308 8TH AVENUE | AddressLine1Txt |
| City | KENOSHA | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 531435082 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | THOMAS J KELLEY | PersonNm |
| Person Title | VP & CFO | PersonTitleTxt |
| Phone | 2625778113 | PhoneNum |
| Signature | 2017-05-08 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TERRI REXRODE CPA MST | PreparerPersonNm |
| PTIN | P00096513 | PTIN |
| Phone | 9206620016 | PhoneNum |
| Preparation | 2017-05-08 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | THOMAS J KELLEY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6308 8TH AVENUE | AddressLine1Txt |
| City | KENOSHA | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 531435082 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $421,835,354 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.UNITEDHOSPITALSYSTEM.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1910 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | UNITED HOSPITAL SYSTEM, INC. IS COMMITTED TO LIVING OUT THE HEALING MINISTRIES OF THE JUDEO-CHRISTIAN FAITHS BY PROVIDING EXCEPTIONAL AND COMPASSIONATE HEALTHCARE SERVICES THAT PROMOTES THE DIGNITY AND WELL-BEING OF THE PEOPLE WE SERVE. THIS IS OUR MISSION AND OUR REASON FOR BEING. WE STRIVE TO RECRUIT AND RETAIN THE BEST PHYSICIANS AND STAFF AND PURCHASE THE BEST DIAGNOSTIC AND CURATIVE MEDICAL EQUIPMENT THAT OUR FINANCIAL RESOURCES WILL PERMIT. WE ALSO STRIVE TO BE ACCESSIBLE TO ALL MEMBERS OF OUR COMMUNITY WITH EMERGENT AND URGENT HEALTHCARE NEEDS, IRRESPECTIVE OF THEIR ABILITY TO PAY. THIS IS OUR COMMITTMENT TO THE QUALITY, ACCESSIBILITY AND AFFORDABILITY FUNDAMENTALS AFFECTING THE DELIVERY OF HEALTHCARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 2624 | TotalEmployeeCnt |
| Total Volunteers | 97 | TotalVolunteersCnt |
| Total Gross UBI | $195,246 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $91,950 | PYContributionsGrantsAmt |
| CY Contributions Grants | $232,988 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $315,781,773 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $324,436,848 | CYProgramServiceRevenueAmt |
| PY Investment Income | $3,528,454 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,340,154 | CYInvestmentIncomeAmt |
| PY Other Revenue | $546,691 | PYOtherRevenueAmt |
| CY Other Revenue | -$71,125 | CYOtherRevenueAmt |
| PY Total Revenue | $319,948,868 | PYTotalRevenueAmt |
| CY Total Revenue | $325,938,865 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $4,625 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $7,050 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $152,544,694 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $161,389,439 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $136,901,441 | PYOtherExpensesAmt |
| CY Other Expenses | $140,200,932 | CYOtherExpensesAmt |
| PY Total Expenses | $289,450,760 | PYTotalExpensesAmt |
| CY Total Expenses | $301,597,421 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $30,498,108 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $24,341,444 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $385,840,916 | TotalAssetsBOYAmt |
| Total Assets EOY | $392,516,348 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $98,836,292 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $134,378,118 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $287,004,624 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $258,138,230 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | UNITED HOSPITAL SYSTEM, INC. IS A COMPREHENSIVE REGIONAL HEALTHCARE SYSTEM THAT HAS SERVED SOUTHEASTERN WISCONSIN AND NORTHERN ILLINOIS COMMUNITIES FOR MORE THAN 100 YEARS. UNITED HOSPITAL SYSTEM PROVIDES SERVICES PRIMARILY THROUGH THE KENOSHA MEDICAL CENTER CAMPUS AND THE ST. CATHERINE'S MEDICAL CENTER CAMPUS AND SEVERAL OTHER CLINIC LOCATIONS.WE, AT UNITED, ARE COMMITTED TO LIVING OUT THE HEALING MINISTRIES OF THE JUDEO-CHRISTIAN FAITHS BY PROVIDING EXCEPTIONAL AND COMPASSIONATE HEALTHCARE SERVICES THAT PROMOTES THE DIGNITY AND WELL BEING OF THE PEOPLE WE SERVE. THIS IS OUR MISSION AND OUR REASON FOR BEING. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $248,109,897 | ExpenseAmt |
| Grant | $7,050 | GrantAmt |
| Revenue | $324,241,602 | RevenueAmt |
| Desc | ACUTE CARE HOSPITAL THAT PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES TO ITS COMMUNITY. | Desc |
| Total Program Service Expenses | $248,109,897 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 82 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 2624 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JENS EMERSON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2625778113 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6308 8TH AVENUE | AddressLine1Txt |
| City | KENOSHA | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 531435082 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| THOMAS AMBRO MD | ||||||||
| DIRECTOR/PHYSICIAN - START 1/1/16 | 2.00 | Yes (X) | $426,276 | $0 | $45,211 | |||
| TODD BATTLE | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| A JAMES CICCHINI | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| JAMES CONCANNON MD | ||||||||
| DIRECTOR - THRU 1/1/16 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| EDWARD C EMMA | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| MARIO GARRETTO MD | ||||||||
| PHYSICIAN/DIRECTOR - START 1/1/16 | 2.00 | Yes (X) | $725,156 | $0 | $95,154 | |||
| DON E KAELBER | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| RAYMOND KNIGHT MD | ||||||||
| DIRECTOR/PHYSICIAN - THRU 1/1/16 | 40.00 | Yes (X) | $393,915 | $0 | $45,154 | |||
| ROBERT LEE JR | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| THOMAS P MAHONEY | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| HAROLD W MAYER | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| LAWRENCE REIF MD | ||||||||
| DIRECTOR - THRU 1/1/16 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| DAVID R RILEY | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| GARY ZAID MD | ||||||||
| DIRECTOR - START 1/1/16 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| DR F GREGORY CAMPBELL | ||||||||
| CHAIRMAN | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| ROBERT A CORNOG | ||||||||
| VICE-CHAIRMAN/SECRETARY/TREASURER | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| RICHARD O SCHMIDT JR | ||||||||
| PRESIDENT/CEO/DIRECTOR | 45.00 | Yes (X) | $1,215,706 | $0 | $148,512 | Yes (X) | ||
| THOMAS KELLEY | ||||||||
| ASST TREASURER/VP-CFO | 45.00 | $422,672 | $0 | $68,043 | Yes (X) | |||
| LINDA WOHLGEMUTH | ||||||||
| ASST SECRETARY/VP-COO-SCMC | 45.00 | $522,977 | $0 | $55,704 | Yes (X) | |||
| SUSAN VENTURA | ||||||||
| SVP/COO-KMCC | 45.00 | $526,271 | $0 | $55,704 | Yes (X) | |||
| KATHERINE ABBO MD | ||||||||
| PHYSICIAN | 40.00 | $619,356 | $0 | $29,294 | Yes (X) | |||
| KEVIN FULLIN MD | ||||||||
| PHYSICIAN | 40.00 | $617,608 | $0 | $41,632 | Yes (X) | |||
| ASHWANI SETHI MD | ||||||||
| PHYSICIAN | 40.00 | $775,043 | $0 | $45,330 | Yes (X) | |||
| NEIL SHEPLER MD | ||||||||
| PHYSICIAN | 40.00 | $3,471,534 | $0 | $43,899 | Yes (X) | |||
| W HARLEY SOBIN MD | ||||||||
| DIRECTOR/PHYSICIAN - THRU 1/1/16 | 40.00 | $777,934 | $0 | $43,252 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $10,494,448 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $716,889 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 165 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| RILEY CONSTRUCTION | |||||
| 5301 99TH AVENUE | KENOSHA | WI | 53144 | BUILDING | $7,186,913 |
| ALLSCRIPTS HEALTHCARE LLC | |||||
| 24630 NETWORK PLACE | CHICAGO | IL | 60673 | IS SERVICES | $2,323,050 |
| INFINITY HEALTHCARE PHYSICIAN SC | |||||
| 111 E WISCONSIN AVENUE SUITE 2100 | MILWAUKEE | WI | 53202 | MEDICAL | $1,550,833 |
| AEROTEK COMMERCIAL STAFFING | |||||
| PO BOX 198531 | ATLANTA | GA | 30384 | ENVIRONMENTAL SERVICES STAFFING | $1,431,979 |
| STATE COLLECTION SERVICES | |||||
| 2509 S STOUGHTON ROAD | MADISON | WI | 53716 | BUSINESS OFFICE SERVICES | $1,028,340 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 38 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $73,981 | FundraisingAmt |
| All Other Contributions | $159,007 | AllOtherContributionsAmt |
| Total Contributions | $232,988 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 623000 | $317,759,725 | $317,759,725 | |
| OTHER OPERATING REVENUE | 623990 | $6,312,586 | $6,117,340 | $195,246 |
| MEDICAL OFFICE RENTAL | 900099 | $364,537 | $364,537 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $324,436,848 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,154,994 | TotalRevenueColumnAmt |
| Exclusion | $2,154,994 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $94,926,010 | SecuritiesAmt |
| Other | $44,150 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $95,764,065 | SecuritiesAmt |
| Other | $20,935 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$838,055 | SecuritiesAmt |
| Other | $23,215 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$814,840 | TotalRevenueColumnAmt |
| Exclusion | -$814,840 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $40,364 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $73,981 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $111,489 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$71,125 | TotalRevenueColumnAmt |
| Exclusion | -$71,125 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $325,938,865 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $324,241,602 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $195,246 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,269,029 | ExclusionAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,050 | TotalAmt |
| Program Services | $7,050 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,306,886 | TotalAmt |
| Program Services | $3,573,307 | ProgramServicesAmt |
| Management And General | $733,579 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $122,030,876 | TotalAmt |
| Program Services | $101,245,723 | ProgramServicesAmt |
| Management And General | $20,785,153 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,406,260 | TotalAmt |
| Program Services | $6,974,447 | ProgramServicesAmt |
| Management And General | $1,431,813 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,076,577 | TotalAmt |
| Program Services | $5,742,179 | ProgramServicesAmt |
| Management And General | $13,334,398 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,568,840 | TotalAmt |
| Program Services | $6,285,050 | ProgramServicesAmt |
| Management And General | $1,283,790 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $106,707 | TotalAmt |
| Management And General | $106,707 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $87,300 | TotalAmt |
| Management And General | $87,300 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,324,625 | TotalAmt |
| Program Services | $12,072,849 | ProgramServicesAmt |
| Management And General | $7,251,776 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $575,945 | TotalAmt |
| Program Services | $134,705 | ProgramServicesAmt |
| Management And General | $441,240 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,962,095 | TotalAmt |
| Program Services | $60,380,329 | ProgramServicesAmt |
| Management And General | $2,581,766 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,202,649 | TotalAmt |
| Program Services | $7,202,649 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,832,919 | TotalAmt |
| Program Services | $5,699,836 | ProgramServicesAmt |
| Management And General | $133,083 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $724,719 | TotalAmt |
| Program Services | $239,432 | ProgramServicesAmt |
| Management And General | $485,287 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,977,474 | TotalAmt |
| Program Services | $14,379,727 | ProgramServicesAmt |
| Management And General | $1,597,747 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,112,120 | TotalAmt |
| Program Services | $515,080 | ProgramServicesAmt |
| Management And General | $597,040 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBTS | $9,938,003 | $9,938,003 | |
| STATE HOSPITAL ASSESSME | $7,652,708 | $7,652,708 | |
| REPAIRS | $2,707,653 | $1,858,023 | $849,630 |
| SMALL EQUIPMENT | $1,836,186 | $1,634,059 | $202,127 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,159,829 | TotalAmt |
| Program Services | $2,574,741 | ProgramServicesAmt |
| Management And General | $1,585,088 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $301,597,421 | TotalAmt |
| Program Services | $248,109,897 | ProgramServicesAmt |
| Management And General | $53,487,524 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $88,917,336 | BOYAmt |
| EOY | $103,673,409 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,241,038 | BOYAmt |
| EOY | $55,620,666 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,346,838 | BOYAmt |
| EOY | $3,390,814 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,039,420 | BOYAmt |
| EOY | $3,869,886 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $313,018,554 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $222,082,145 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $80,881,153 | BOYAmt |
| EOY | $90,936,409 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $130,999,965 | BOYAmt |
| EOY | $128,245,220 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,415,166 | BOYAmt |
| EOY | $6,779,944 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $385,840,916 | BOYAmt |
| EOY | $392,516,348 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,914,875 | BOYAmt |
| EOY | $32,541,323 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $70,921,417 | BOYAmt |
| EOY | $101,836,795 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $98,836,292 | BOYAmt |
| EOY | $134,378,118 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $284,954,447 | BOYAmt |
| EOY | $255,969,420 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $532,841 | BOYAmt |
| EOY | $652,743 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,517,336 | BOYAmt |
| EOY | $1,516,067 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $287,004,624 | BOYAmt |
| EOY | $258,138,230 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $385,840,916 | BOYAmt |
| EOY | $392,516,348 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $24,341,444 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$2,081,350 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$51,126,488 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | 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 (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,050,490 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $125,683 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $7,363 | OtherExpendituresAmt |
| End Year Balance | $2,168,810 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,037,824 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $17,291 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $4,625 | OtherExpendituresAmt |
| End Year Balance | $2,050,490 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,030,556 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $19,058 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $11,790 | OtherExpendituresAmt |
| End Year Balance | $2,037,824 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,039,142 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $489 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $9,075 | OtherExpendituresAmt |
| End Year Balance | $2,030,556 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,012,126 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $38,761 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $11,745 | OtherExpendituresAmt |
| End Year Balance | $2,039,142 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.69900 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.30100 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,124,397 | OtherCostOrOtherBasisAmt |
| Book Value | $6,124,397 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $139,245,352 | OtherCostOrOtherBasisAmt |
| Depreciation | $94,434,591 | DepreciationAmt |
| Book Value | $44,810,761 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $164,016,215 | OtherCostOrOtherBasisAmt |
| Depreciation | $125,399,094 | DepreciationAmt |
| Book Value | $38,617,121 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,632,590 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,248,460 | DepreciationAmt |
| Book Value | $1,384,130 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $90,936,409 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (7 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| FIXED INCOME FUNDS | $31,351,442 | F |
| EQUITY MUTUAL FUNDS | $7,385,159 | F |
| EQUITY SECURITIES | $25,105,790 | F |
| CORPORATE BONDS | $31,983,747 | F |
| ETFS | $10,834,035 | F |
| INTERNATIONAL EQUITIES | $12,796,805 | F |
| US GOVERNMENT & AGENCY OBLIGATIONS | $8,788,242 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $128,245,220 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| DEFERRED COMPENSATION | $12,150,116 |
| PENSION LIABILITY | $86,468,804 |
| A/P TO THIRD-PARTY REIMBURSEMENT PROGRAMS | $3,217,875 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $101,836,795 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $272,721,595 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$2,081,350 | NetUnrealizedGainsInvstAmt |
| Other Revenue | -$51,133,538 | OtherRevenueAmt |
| Revenue Not Reported | -$53,214,888 | RevenueNotReportedAmt |
| Revenue Subtotal | $325,936,483 | RevenueSubtotalAmt |
| Other Revenues Not Included | $2,382 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $2,382 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $325,938,865 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $301,595,039 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $301,595,039 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $2,382 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $2,382 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $301,597,421 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | TEMPORARILY RESTRICTED NET ASSETS ARE RESTRICTED FOR EDUCATION SCHOLARSHIP GRANTS AND VARIOUS HEALTH CARE PROGRAMS. PERMANENTLY RESTRICTED NET ASSETS ARE TO BE HELD IN PERPETUITY, THE INCOME FROM WHICH IS EXPENDABLE FOR HOSPITAL DEVELOPMENT. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | CHANGE IN PENSION OBLIGATION OTHER THAN PENSION EXPENSE -42,428,478. REVENUE SHARING WITH AFFILIATE -8,698,010. SCHOLARSHIPS INCLUDED IN INCOME -7,050. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | FUNDRAISING INCOME 2,382. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | EMPLOYEE GIFTS 2,382. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GOLF OUTING | Event1Nm |
| Gross Receipts Event1 | $100,345 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $73,981 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $26,364 | GrossRevenueEvent1Amt |
| Non Cash Prizes Event1 | $12,814 | NonCashPrizesEvent1Amt |
| Food And Beverage Event1 | $39,220 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $9,879 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $7,549 | OtherDirectExpensesEvent1Amt |
| Event2 | HEART BALL | Event2Nm |
| Gross Receipts Event2 | $14,000 | GrossReceiptsEvent2Amt |
| Gross Revenue Event2 | $14,000 | GrossRevenueEvent2Amt |
| Non Cash Prizes Event2 | $1,400 | NonCashPrizesEvent2Amt |
| Food And Beverage Event2 | $31,983 | FoodAndBeverageEvent2Amt |
| Other Direct Expenses Event2 | $8,644 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $114,345 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $73,981 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $40,364 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $14,214 | NonCashPrizesTotalEventsAmt |
| Food And Beverage Total Events | $71,203 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $9,879 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $16,193 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $111,489 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$71,125 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,810,614 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,810,614 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01310 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $55,390,280 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $22,407,399 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $32,982,881 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11310 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $59,200,894 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $22,407,399 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $36,793,495 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12620 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 5240 | ActivitiesOrProgramsCnt |
| Persons Served | 54499 | PersonsServedCnt |
| Total Community Benefit Expns | $378,115 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $378,115 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 9 | PersonsServedCnt |
| Total Community Benefit Expns | $1,479 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,479 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 36 | ActivitiesOrProgramsCnt |
| Persons Served | 550 | PersonsServedCnt |
| Total Community Benefit Expns | $304,946 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $304,946 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 5277 | ActivitiesOrProgramsCnt |
| Persons Served | 55058 | PersonsServedCnt |
| Total Community Benefit Expns | $684,540 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $684,540 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00230 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 5277 | ActivitiesOrProgramsCnt |
| Persons Served | 55058 | PersonsServedCnt |
| Total Community Benefit Expns | $59,885,434 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $22,407,399 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $37,478,035 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12850 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $12,958 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $12,958 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 4 | ActivitiesOrProgramsCnt |
| Persons Served | 623 | PersonsServedCnt |
| Total Community Benefit Expns | $89,640 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $89,640 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 5 | ActivitiesOrProgramsCnt |
| Persons Served | 100 | PersonsServedCnt |
| Total Community Benefit Expns | $3,979 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,979 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 5 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $1,257 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,257 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 14 | ActivitiesOrProgramsCnt |
| Persons Served | 723 | PersonsServedCnt |
| Total Community Benefit Expns | $107,834 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $107,834 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,388,859 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $49,300,513 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $68,626,115 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$19,325,602 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 2 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp (2 entries)
| FacilityFacilityNum | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Website AddressWebsiteAddressTxt | State LicenseStateLicenseNum | Licensed HospitalLicensedHospitalInd | General Medical And SurgicalGeneralMedicalAndSurgicalInd | Emergency Room24 HrsEmergencyRoom24HrsInd |
|---|---|---|---|---|---|---|---|---|---|
| KENOSHA MEDICAL CENTER CAMPUS | |||||||||
| 1 | 6308 8TH AVENUE | KENOSHA | WI | 53143 | WWW.UNITEDHOSPITALSYSTEM.ORG | 22 | Yes (X) | Yes (X) | Yes (X) |
| SAINT CATHERINE'S MEDICAL CENTER CAMPUS | |||||||||
| 2 | 9555 76TH STREET | PLEASANT PRAIRIE | WI | 53158 | WWW.UNITEDHOSPITALSYSTEM.ORG | 305 | Yes (X) | Yes (X) | Yes (X) |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (2 entries)
| FacilityFacilityNum | First Licensed CY Or PYFirstLicensedCYOrPYInd | Tax Exempt Hospital CY Or PYTaxExemptHospitalCYOrPYInd | CHNA ConductedCHNAConductedInd | Community DefinitionCommunityDefinitionInd | Community DemographicsCommunityDemographicsInd | Existing ResourcesExistingResourcesInd | How Data ObtainedHowDataObtainedInd | Community Health NeedsCommunityHealthNeedsInd | Other Health IssuesOtherHealthIssuesInd | Community Hlth Needs Id ProcessCommunityHlthNeedsIdProcessInd | Consulting ProcessConsultingProcessInd | Information GapsInformationGapsInd | CHNA ConductedCHNAConductedYr | Take Into Account Others InputTakeIntoAccountOthersInputInd | CHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsInd | CHNA Conducted With Non FcltsCHNAConductedWithNonFcltsInd | CHNA Report Widely AvailableCHNAReportWidelyAvailableInd | Rpt Available On Own WebsiteRptAvailableOnOwnWebsiteInd | Own Website URLOwnWebsiteURLTxt | Paper Copy Public InspectionPaperCopyPublicInspectionInd | Implementation Strategy AdoptImplementationStrategyAdoptInd | Implementation Strategy AdptImplementationStrategyAdptYr | Strategy Posted WebsiteStrategyPostedWebsiteInd | Strategy Website URLStrategyWebsiteURLTxt | Strategy AttachedStrategyAttachedInd | Organization Incur Excise TaxOrganizationIncurExciseTaxInd | Elig Criteria ExplainedEligCriteriaExplainedInd | FPG Family Incm Lmt Free DscntFPGFamilyIncmLmtFreeDscntInd | FPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePct | FPG Family Incm Lmt Dscnt CareFPGFamilyIncmLmtDscntCarePct | Income Level CriteriaIncomeLevelCriteriaInd | Asset Level CriteriaAssetLevelCriteriaInd | Medical Indigency CriteriaMedicalIndigencyCriteriaInd | Insurance Status CriteriaInsuranceStatusCriteriaInd | Underinsurance Stat CriteriaUnderinsuranceStatCriteriaInd | Explained BasisExplainedBasisInd | App Financial Asst ExplnAppFinancialAsstExplnInd | Described InfoDescribedInfoInd | Described Suprt DocDescribedSuprtDocInd | Provided Hospital ContactProvidedHospitalContactInd | Includes Publicity MeasuresIncludesPublicityMeasuresInd | FAP Available On WebsiteFAPAvailableOnWebsiteInd | FAP Available On Website URLFAPAvailableOnWebsiteURLTxt | FAP App Available On WebsiteFAPAppAvailableOnWebsiteInd | FAP App Available On Website URLFAPAppAvailableOnWebsiteURLTxt | FAP Summary On WebsiteFAPSummaryOnWebsiteInd | FAP Summary On Website URLFAPSummaryOnWebsiteURLTxt | FAP Avlbl On Request No ChargeFAPAvlblOnRequestNoChargeInd | FAP App Avlbl On Request No ChrgFAPAppAvlblOnRequestNoChrgInd | FAP Sum Avlbl On Request No ChrgFAPSumAvlblOnRequestNoChrgInd | FAP Notice DisplayedFAPNoticeDisplayedInd | Communtity Notified FAPCommuntityNotifiedFAPInd | FAP Actions On NonpaymentFAPActionsOnNonpaymentInd | Permit No ActionsPermitNoActionsInd | Collection ActivitiesCollectionActivitiesInd | FAP Notified Upon AdmissionFAPNotifiedUponAdmissionInd | FAP Notified Before DischargeFAPNotifiedBeforeDischargeInd | FAP Notified All PatientsFAPNotifiedAllPatientsInd | Documented Elig DeterminationDocumentedEligDeterminationInd | Nondis Emergency Care PolicyNondisEmergencyCarePolicyInd | Other Method UsedOtherMethodUsedInd | Amounts Generally BilledAmountsGenerallyBilledInd | Gross ChargesGrossChargesInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KENOSHA MEDICAL CENTER CAMPUS | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 1 | 0 | 0 | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 13 | Yes (1) | Yes (1) | Yes (1) | Yes (1) | Yes (X) | HTTP://WWW.UHSI.ORG/ABOUT/COMMUNITY-BENEFITS/ | Yes (X) | Yes (1) | 13 | Yes (1) | HTTP://WWW.UHSI.ORG/ABOUT/COMMUNITY-BENEFITS/ | 0 | 0 | Yes (1) | Yes (X) | 100.000000000000 | 400.000000000000 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | HTTP://WWW.UNITEDHOSPITALSYSTEM.ORG/ | Yes (X) | HTTP://WWW.UNITEDHOSPITALSYSTEM.ORG/ | Yes (X) | HTTP://WWW.UNITEDHOSPITALSYSTEM.ORG/ | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | 0 |
| SAINT CATHERINE'S MEDICAL CENTER CAMPUS | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 2 | 0 | 0 | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 13 | Yes (1) | Yes (1) | Yes (1) | Yes (1) | Yes (X) | HTTP://WWW.UHSI.ORG/ABOUT/COMMUNITY-BENEFITS/ | Yes (X) | Yes (1) | 13 | Yes (1) | HTTP://WWW.UHSI.ORG/ABOUT/COMMUNITY-BENEFITS/ | 0 | 0 | Yes (1) | Yes (X) | 100.000000000000 | 400.000000000000 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | HTTP://WWW.UNITEDHOSPITALSYSTEM.ORG/ | Yes (X) | HTTP://WWW.UNITEDHOSPITALSYSTEM.ORG/ | Yes (X) | HTTP://WWW.UNITEDHOSPITALSYSTEM.ORG/ | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | 0 |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| KENOSHA MEDICAL CENTER CAMPUS | PART V, SECTION B, LINE 5: AS PART OF THE CHNA PROCESS, 32 PERSONS WHO REPRESENT THE COMMUNITY SERVED BY UNITED HOSPITAL SYSTEM PROVIDED VALUABLE FEEDBACK REGARDING THEIR VIEWS OF THE HEALTHCARE CHALLENGES FACING OUR COMMUNITY. THIRTY-TWO PEOPLE PARTICIPATED REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY INCLUDING LOW-INCOME, RACIAL AND ETHNIC MINORITIES, THE ELDERLY, YOUTH, VETERANS, FAITH COMMUNITIES, INDIVIDUALS WITH DISABILITIES, RURUAL COMMUNITIES, SURVIVORS OF DOMESTIC AND SEXUAL VIOLENCE, AND THOSE LIVING WITH MENTAL ILLNESS AND SUBSTANCE ABUSE. THE INFORMATION/FEEDBACK PROVIDED BY THESE PERSONS WHO REPRESENT THE COMMUNITY SERVED BY UNITED HOSPITAL SYSTEM WAS INCORPORATED INTO THE COMMUNITY HEALTH NEEDS ASSESSMENT, IDENTIFICATION, PRIORITIZATION AND IMPLEMENTATION PLANNING SUMMARY. KEY INFORMANTS RANKED UP TO FIVE PUBLIC HEALTH ISSUES AND PROVIDED EXISTING STRATEGIES TO ADDRESS THESE ISSUES, ALONG WITH BARRIERS/CHALLENGES TO ADDRESSING THESE ISSUES AND ADDITIONAL STRATEGIES NEEDED. |
| SAINT CATHERINE'S MEDICAL CENTER CAMPUS | PART V, SECTION B, LINE 5: AS PART OF THE CHNA PROCESS, 32 PERSONS WHO REPRESENT THE COMMUNITY SERVED BY UNITED HOSPITAL SYSTEM PROVIDED VALUABLE FEEDBACK REGARDING THEIR VIEWS OF THE HEALTHCARE CHALLENGES FACING OUR COMMUNITY. THIRTY-TWO PEOPLE PARTICIPATED REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY INCLUDING LOW-INCOME, RACIAL AND ETHNIC MINORITIES, THE ELDERLY, YOUTH, VETERANS, FAITH COMMUNITIES, INDIVIDUALS WITH DISABILITIES, RURUAL COMMUNITIES, SURVIVORS OF DOMESTIC AND SEXUAL VIOLENCE, AND THOSE LIVING WITH MENTAL ILLNESS AND SUBSTANCE ABUSE. THE INFORMATION/FEEDBACK PROVIDED BY THESE PERSONS WHO REPRESENT THE COMMUNITY SERVED BY UNITED HOSPITAL SYSTEM WAS INCORPORATED INTO THE COMMUNITY HEALTH NEEDS ASSESSMENT, IDENTIFICATION, PRIORITIZATION AND IMPLEMENTATION PLANNING SUMMARY. KEY INFORMANTS RANKED UP TO FIVE PUBLIC HEALTH ISSUES AND PROVIDED EXISTING STRATEGIES TO ADDRESS THESE ISSUES, ALONG WITH BARRIERS/CHALLENGES TO ADDRESSING THESE ISSUES AND ADDITIONAL STRATEGIES NEEDED. |
| KENOSHA MEDICAL CENTER CAMPUS | PART V, SECTION B, LINE 11: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED DURING THE FISCAL YEAR ENDED 2014. AS PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, A THREE (3) YEAR ACTION PLAN WAS DEVELOPED IN AN EFFORT TO ADDRESS THE NEEDS IDENTIFIED WITHIN THE COMMUNITY HEALTH NEEDS ASSESSMENT. UNITED HOSPITAL SYSTEM IS ACTIVELY WORKING ON THE ACTION ITEMS ESTABLISHED FOR YEAR THREE. |
| SAINT CATHERINE'S MEDICAL CENTER CAMPUS | PART V, SECTION B, LINE 11: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED DURING THE 2014 TAX YEAR. AS PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, A THREE (3) YEAR ACTION PLAN WAS DEVELOPED IN AN EFFORT TO ADDRESS THE NEEDS IDENTIFIED WITHIN THE COMMUNITY HEALTH NEEDS ASSESSMENT. UNITED HOSPITAL SYSTEM IS ACTIVELY WORKING ON THE ACTION ITEMS ESTABLISHED FOR YEAR TWO. |
| KENOSHA MEDICAL CENTER CAMPUS | PART V, SECTION B, LINE 22D: CHARGES FOR MEDICAL CARE PROVIDED TO INDIVIDUALS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE WILL BE CHARGED AT LESS THAN THEGROSS CHARGE FOR SUCH SERVICES. THESE LIMITATIONS ON CHARGES FOR MEDICAL SERVICES SHALL NOT APPLY IF AN INDIVIDUAL HAS NOT SUBMITTED A COMPLETE FINANCIAL ASSISTANCE APPLICATION AS OF THE TIME THE CHARGES ARE BILLED TO SUCH INDIVIDUAL; PROVIDED, HOWEVER, THAT ADJUSTMENTS WILL BE MADE IF AMOUNTS ARE CHARGED IN EXCESS OF THESE LIMITATIONS AND THE INDIVIDUAL IS SUBSEQUENTLY DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE. UNITED DETERMINES THE AGB BY MULTIPLYING THE GROSS CHARGES FOR THE APPLICABLE MEDICAL CARE BY THE AGB PERCENTAGE, WHICH IS DETERMINED ANNUALLY BY DIVIDING (1) THE SUM OF THE AMOUNTS FOR ALL OF ITS CLAIMS FOR EMERGENCY AND OTHER MEDICALLY NECESSARY CARE THAT HAVE BEEN ALLOWED DURING THE AGB PERIOD BY MEDICARE FEEFORSERVE AND ALL PRIVATE HEALTH INSURERS AS PRIMARY PAYORS, TOGETHER WITH ANY ASSOCIATED PORTIONS OF THESE CLAIMS PAID BY MEDICARE BENEFICIARIES OR INSURED INDIVIDUALS IN THE FORM OF COPAYS, COINSURANCE OR DEDUCTIBLES BY (2) THE SUM OF THE ASSOCIATED GROSS CHARGES FOR THOSE CLAIMS. THE CALCULATION OF THE AGB PERCENTAGE SHALL COMPLY WITH THE "LOOKBACK METHOD" DESCRIBED IN TREASURY REGULATION SECTION 1501B(B)(3). |
| SAINT CATHERINE'S MEDICAL CENTER CAMPUS | PART V, SECTION B, LINE 22D: CHARGES FOR MEDICAL CARE PROVIDED TO INDIVIDUALS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE WILL BE CHARGED AT LESS THAN THEGROSS CHARGE FOR SUCH SERVICES. THESE LIMITATIONS ON CHARGES FOR MEDICAL SERVICES SHALL NOT APPLY IF AN INDIVIDUAL HAS NOT SUBMITTED A COMPLETE FINANCIAL ASSISTANCE APPLICATION AS OF THE TIME THE CHARGES ARE BILLED TO SUCH INDIVIDUAL; PROVIDED, HOWEVER, THAT ADJUSTMENTS WILL BE MADE IF AMOUNTS ARE CHARGED IN EXCESS OF THESE LIMITATIONS AND THE INDIVIDUAL IS SUBSEQUENTLY DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE. UNITED DETERMINES THE AGB BY MULTIPLYING THE GROSS CHARGES FOR THE APPLICABLE MEDICAL CARE BY THE AGB PERCENTAGE, WHICH IS DETERMINED ANNUALLY BY DIVIDING (1) THE SUM OF THE AMOUNTS FOR ALL OF ITS CLAIMS FOR EMERGENCY AND OTHER MEDICALLY NECESSARY CARE THAT HAVE BEEN ALLOWED DURING THE AGB PERIOD BY MEDICARE FEEFORSERVE AND ALL PRIVATE HEALTH INSURERS AS PRIMARY PAYORS, TOGETHER WITH ANY ASSOCIATED PORTIONS OF THESE CLAIMS PAID BY MEDICARE BENEFICIARIES OR INSURED INDIVIDUALS IN THE FORM OF COPAYS, COINSURANCE OR DEDUCTIBLES BY (2) THE SUM OF THE ASSOCIATED GROSS CHARGES FOR THOSE CLAIMS. THE CALCULATION OF THE AGB PERCENTAGE SHALL COMPLY WITH THE "LOOKBACK METHOD" DESCRIBED IN TREASURY REGULATION SECTION 1501B(B)(3). |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 7 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - PADDOCK LAKE FAMILY MEDICINE CLINIC | ||||
| 7322 236TH AVENUE | SALEM | WI | 53168 | OUTPATIENT PHYSICIAN CLINIC |
| 2 - THE GURNEE CLINIC | ||||
| 1790 NATIONS DRIVE SUITE 106 | GURNEE | IL | 60031 | OUTPATIENT PHYSICIAN CLINIC |
| 3 - LAKEVIEW RECPLEX | ||||
| 9900 TERWALL TERRACE | PLEASANT PRAIRIE | WI | 53158 | REHABILITATION CLINIC |
| 4 - NORTH CENTRAL CLINIC | ||||
| 6127 GREEN BAY ROAD SUITE 200 | KENOSHA | WI | 53142 | OUTPATIENT PHYSICIAN CLINIC |
| 5 - SCMCC-MMB | ||||
| 9697 ST CATHERINES DRIVE | PLEASANT PRAIRIE | WI | 53158 | OUTPATIENT PHYSICIAN CLINIC |
| 6 - RCW ADMINISTRATIVE BUILDING | ||||
| 5000 68TH AVE | KENOSHA | WI | 53144 | ADMINISTRATIVE BUILDING |
| 7 - SOMERS NORTHSIDE CLINIC | ||||
| 3400 MARKET LANE | KENOSHA | WI | 53144 | OUTPATIENT PHYSICIAN CLINIC |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | THE COST METHOD USED TO CALCULATE THE COST OF THE COMMUNITY BENEFIT PROGRAMS WAS THE COST-TO-CHARGE RATIO. WORKSHEET 2 WAS USED TO CALCULTE THE RATIO OF PATIENT CARE COST TO CHARGES. |
| PART I, LN 7 COL(F): | THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $9,938,003. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | MANY STAFF MEMBERS ARE UTILIZED TO PROMOTE THE HEALTH OF THE COMMUNITY AND THE GENERAL WELL-BEING OF THE COMMUNITY WE SERVE. THROUGH OUR EMERGENCY PREPAREDNESS COMMITTEE, STAFF ARE ALWAYS PLANNING AND PREPARING TO BE READY TO MEET THE NEEDS OF THE COMMUNITY AS EVENTS OCCUR. ADDITIONALLY, A VARIETY OF STAFF WORK WITH LOCAL SCHOOLS AND OTHER ORGANIZATIONS TO GIVE TALKS PROMOTING HEALTH AND CAREERS IN HEALTHCARE. A NUMBER OF STAFF MEMBERS ARE INVOLVED IN MENTORING PROGRAMS WITHIN THE LOCAL SCHOOLS. RECOGNIZING THE IMPORTANCE OF SUSTAINING AND GROWING OUR ECONOMY, WE PARTICIPATE IN OUR LOCAL BUSINESS ALLIANCE. |
| PART III, LINE 2: | THE ORGANIZATIONS UTILIZED THE HMFA #15 METHODOLOGY FOR DETERMINING BAD DEBT EXPENSE. |
| PART III, LINE 3: | SINCE THE ORGANIZATION UTILIZES HMFA #15, THERE IS NO PORTION OF THE BAD DEBT THAT WOULD BE CONSIDERED CHARITY CARE. |
| PART III, LINE 4: | MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY UNINSURED PATIENTS AND AMOUNTS PATIENTS ARE PERSONALLY RESPONSIBLE FOR, THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO A VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF HISTORICAL COLLECTION EXPERIENCE AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUTSTANDING AFTER MANAGEMENT HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO PATIENT ACCOUNTS RECEIVABLE. WORKSHEET A IN THE INSTRUCTIONS WAS USED TO DETERMINE THE COSTING METHODOLOGY. |
| PART III, LINE 8: | SCHEDULE H PART III SECTION B LINE 6 REPORTS "ALLOWABLE COSTS OF CARE" AS TAKEN FROM THE MOST RECENTLY FILED MEDICARE COST REPORT AVAILABLE AT THE TIME THE COMMUNITY BENEFIT REPORT IS PUBLISHED. THE MEDICARE COST REPORT CALCULATES ITS ALLOWABLE TOTAL COSTS BASED ON APPLICABLE MEDICARE REGULATIONS. MEDICARE AND MEDICAID COST IS DETERMINED USING INDIVIDUAL COST CENTER COST-TO-CHARGE RATIOS. THIS COST TO CHARGE RATIO IS DETERMINED USING ALL PAYER COST AND ALL PAYER CHARGES. THE COST TO CHARGE RATIO IS APPLIED TO THE ACTUAL MEDICARE AND MEDICAID CHARGES TO DETERMINE THE MEDICARE AND MEDICAID COST. THIS ORGANIZATION HAS ADOPTED THE COST AND CHARGE PRACTICES AS RECOMMENDED BY THE CATHOLIC HEALTH ASSOCIATION AND THE WISCONSIN, IOWA, OR ILLINOIS HOSPITAL ASSOCIATION AS APPLICABLE, AND THEREFORE, DOES NOT COUNT ANY MEDICARE SHORTFALL NUMBERS IN ITS ANNUAL REPORTING OF COMMUNITY BENEFIT AMOUNTS. |
| PART III, LINE 9B: | OUR COLLECTION PROCESS IS THE SAME FOR ALL PATIENTS. IF A PATIENT EXPRESSES A NEED FOR FINANCIAL ASSISTANCE WE OFFER THE COMMUNITY CARE APPLICATION. WE BILL ALL INSURANCES. PATIENT DOES NOT RECEIVE A COPY OF THE BILL UNTIL IT IS THEIR BALANCE. OUR EXTENDED BUSINESS OFFICE SENDS THREE STATEMENTS AND OUR REQUIRED FINAL REQUEST STATEMENT. FROM THIS POINT THE OUTSTANDING BALANCE IS HANDLED BY THE COLLECTION AGENCY. THE ACCOUNT DOES STAY ACTIVE ON OUR FINANCIAL SYSTEM FOR ONE YEAR. AT THAT TIME THE OUTSTANDING BALANCE IS MOVED OVER TO A BAD DEBT STATUS. |
| PART VI, LINE 2: | IN AN EFFORT TO UNDERSTAND AND ASSIST IN ADDRESSING THE NEEDS OF THE COMMUNITY WE SERVE, UNITED HOSPITAL SYSTEM HAS INVOLVEMENT IN A VARIETY OF COMMUNITY COMMITTEES. UNITED HOSPITAL SYSTEM HAS MULTIPLE STAFF, MANAGEMENT AND ADMINISTRATIVE LEVEL EMPLOYEES PARTICIPATE IN COMMITTEES THAT ARE SET UP TO ASSESS AND ADDRESS NEEDS IN THE COMMUNITY SUCH AS A HEALTHY LIFESTYLE COMMITTEE, MENTAL HEALTH COMMITTEE, INJURY PREVENTION COMMITTEE, SUICIDE PREVENTION COMMITTEE, INFANT MORTALITY COMMITTEE. THROUGH OUR PARTICIPATION IN COMMUNITY COMMITTEES WE GAIN AN UNDERSTANDING ABOUT THE NEEDS OF THE COMMUNITY AS WELL AS THE OPPORTUNITY TO WORK TOGETHER TO ADDRESS THE NEEDS. |
| PART VI, LINE 3: | WHEN STATEMENTS ARE SENT FROM OUR EXTENDED BUSINESS OFFICE, THERE IS A PHONE NUMBER FOR THE PATIENT TO CALL FOR ASSISTANCE WITH THEIR BALANCES. PATIENTS CALL AND THEY WORK WITH THEM TO SET UP PAYMENT ARRANGEMENTS. IF THEY EXPRESS ANY CONCERNS FOR FINANCIAL NEEDS THEY OFFER TO SEND THEM A COMMUNITY CARE APPLICATION. |
| PART VI, LINE 4: | KENOSHA COUNTY IS A FAST GROWING LAKESHORE COUMMUNITY IN SOUTHEASTERN WISCONSIN. LOCATED BETWEEN CHICAGO AND MILWAUKEE, KENOSHA COUNTY BOASTS A DIVERSE ECONOMY. KENOSHA IS THE FOURTH LARGEST CITY IN THE STATE OF WISCONSIN WITH 99,218 RESIDENTS REPORTED IN THE 2010 CENSUS. KENOSHA IS NOW THE EIGHTH LARGEST COUNTY IN WISCONSIN IN TERMS OF POPULATION WITH 166,426 RESIDENTS. UNITED HOSPITAL SYSTEM SERVES PEOPLE IN SOUTHEASTERN WISCONSIN AND NORTHERN ILLINOIS THROUGH ITS TWO HOSPITAL CAMPUSES, ST CATHERINE'S MEDICAL CENTER AND KENOSHA MEDICAL CENTER. AURORA MEDICAL CENTER ALSO HAS A HOSPITAL CAMPUS IN KENOSHA. |
| PART VI, LINE 5: | UNITED HOSPITAL SYSTEM IS COMMITTED TO IMPROVING THE HEALTH OF OUR PATIENTS AND NEIGHBORS. WE OFFER A VARIETY OF COMMUNITY OUTREACH PROGRAMS TO HELP THE GENERAL PUBLIC MAINTAIN GOOD HEALTH. THESE INCLUDE FREE COMMUNITY EDUCATION SEMINARS, HEALTH SCREENINGS, AND VARIOUS SUPPORT GROUPS. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | WI |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | SCHOLARSHIPS | GrantTypeTxt |
| Recipient | 7 | RecipientCnt |
| Cash Grant | $7,050 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE MANAGER OF COMMUNITY RELATIONS EVALUATES APPLICANTS IN ACCORDANCE WITH SCHOLARSHIP PROGRAM REQUIREMENTS. RECIPIENTS ARE THEN MONITORED TO ENSURE COMPLIANCE REQUIREMENTS ARE MET, SUCH AS GPA. TRADITIONAL ACCOUNTING RECORDS ARE MAINTAINED FOR ANY DISBURSEMENTS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| THOMAS AMBRO MD | ||||||||||||||
| DIRECTOR/PHYSICIAN - START 1/1/16 | $425,724 | $0 | $0 | $0 | $552 | $0 | $23,612 | $0 | $21,599 | $0 | $471,487 | $0 | $0 | $0 |
| MARIO GARRETTO MD | ||||||||||||||
| PHYSICIAN/DIRECTOR - START 1/1/16 | $539,548 | $0 | $184,084 | $0 | $1,524 | $0 | $73,612 | $0 | $21,542 | $0 | $820,310 | $0 | $0 | $0 |
| RAYMOND KNIGHT MD | ||||||||||||||
| DIRECTOR/PHYSICIAN - THRU 1/1/16 | $388,971 | $0 | $0 | $0 | $4,944 | $0 | $23,612 | $0 | $21,542 | $0 | $439,069 | $0 | $0 | $0 |
| RICHARD O SCHMIDT JR | ||||||||||||||
| PRESIDENT/CEO/DIRECTOR | $830,002 | $0 | $366,106 | $0 | $19,598 | $0 | $123,612 | $0 | $24,900 | $0 | $1,364,218 | $0 | $0 | $0 |
| THOMAS KELLEY | ||||||||||||||
| ASST TREASURER/VP-CFO | $364,467 | $0 | $57,719 | $0 | $486 | $0 | $48,612 | $0 | $19,431 | $0 | $490,715 | $0 | $0 | $0 |
| LINDA WOHLGEMUTH | ||||||||||||||
| ASST SECRETARY/VP-COO-SCMC | $433,571 | $0 | $85,842 | $0 | $3,564 | $0 | $48,612 | $0 | $7,092 | $0 | $578,681 | $0 | $0 | $0 |
| SUSAN VENTURA | ||||||||||||||
| SVP/COO-KMCC | $433,571 | $0 | $85,842 | $0 | $6,858 | $0 | $48,612 | $0 | $7,092 | $0 | $581,975 | $0 | $0 | $0 |
| KATHERINE ABBO MD | ||||||||||||||
| PHYSICIAN | $619,356 | $0 | $0 | $0 | $0 | $0 | $23,612 | $0 | $5,682 | $0 | $648,650 | $0 | $0 | $0 |
| KEVIN FULLIN MD | ||||||||||||||
| PHYSICIAN | $617,608 | $0 | $0 | $0 | $0 | $0 | $23,612 | $0 | $18,020 | $0 | $659,240 | $0 | $0 | $0 |
| ASHWANI SETHI MD | ||||||||||||||
| PHYSICIAN | $467,182 | $0 | $306,829 | $0 | $1,032 | $0 | $23,612 | $0 | $21,718 | $0 | $820,373 | $0 | $0 | $0 |
| NEIL SHEPLER MD | ||||||||||||||
| PHYSICIAN | $268,634 | $0 | $3,201,868 | $0 | $1,032 | $0 | $23,612 | $0 | $20,287 | $0 | $3,515,433 | $0 | $0 | $0 |
| W HARLEY SOBIN MD | ||||||||||||||
| DIRECTOR/PHYSICIAN - THRU 1/1/16 | $277,663 | $0 | $498,687 | $0 | $1,584 | $0 | $23,612 | $0 | $19,640 | $0 | $821,186 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| ROBERT LEE | |||
| DIRECTOR | $326,617 | SERVICES PROVIDED BY LEE PLUMBING MECHANICAL CONTRACTOR, INC. ROBERT LEE OWNS LEE PLUMBING MECHANICAL CONTRACTOR, INC. | 0 |
| DAVID RILEY | |||
| DIRECTOR | $2,873,502 | SERVICES PROVIDED BY RILEY CONSTRUCTION COMPANY, INC. DAVID RILEY OWNS RILEY CONSTRUCTION COMPANY, INC. | 0 |
| ROBERT LEE | |||
| DIRECTOR | $549,271 | SERVICES PROVIDED BY LEE ELECTRICAL, INC. ROBERT LEE OWNS LEE ELECTRICAL, INC. | 0 |
| DAVID RILEY | |||
| DIRECTOR | $569,271 | SERVICES PROVIDED BY RILEY PURCHASING, LLC. DAVID RILEY OWNS RILEY PURCHASING, LLC. | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | FORM 990 IS REVIEWED BY THE ORGANIZATION'S CFO AND CONTROLLER PRIOR TO FILING. A COPY OF THE 990 IS PROVIDED TO THE GOVERNING BOARD PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | UNITED HOSPITAL SYSTEM'S WRITTEN CONFLICT OF INTEREST POLICY FOR THE BOARD IS REVIEWED ANNUALLY BY EACH BOARD MEMBER, AND ANY POTENTIAL CONFLICTS OF INTEREST ARE DISCLOSED AT THAT TIME. THE WRITTEN CONFLICT OF INTEREST POLICY FOR EMPLOYEES IS REVIEWED DURING ORIENTATION AND PERIODICALLY AT ORGANIZATION MEETINGS, AND IS INCORPORATED INTO THE PERFORMANCE STANDARDS OF THEIR ANNUAL EVALUATIONS. IF A CONFLICT ARISES, DEPENDING UPON THE NATURE OF THE FINANCIAL INTEREST AND WORK DONE BY THE BOARD, SEVERAL ACTIONS MAY BE CONSIDERED: THE BOARD MEMBER WITH A FINANCIAL INTEREST WOULD NEED TO VOLUNTARILY EXCUSE HIM OR HERSELF FROM THE DELIBERATIONS OR VOTING ON SUCH A MATTER; OR, IF NECESSARY, THE BOARD WOULD DETERMINE THAT THE SUBJECT'S FINANCIAL INTEREST WAS AN ACTUAL CONFLICT OF INTEREST, IN WHICH CASE THE BOARD MEMBER WOULD BE INFORMED BY THE BOARD CHAIRPERSON THAT HE OR SHE WOULD NOT BE ALLOWED TO VOTE IN ANY SUCH MATTERS DUE TO THIS REAL OR PERCEIVED CONFLICT OF INTEREST. MINUTES OF THE BOARD MEETING WOULD DOCUMENT THIS DECISION PROCESS, AND REFLECT WHATEVER ACTION(S) ARE ULTIMATELY TAKEN. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COMPENSATION FOR THE PRESIDENT, CEO AND GENERAL COUNSEL AND THE COMPENSATION FOR THE VICE PRESIDENTS REPORTING DIRECTLY TO THE PRESIDENT, CEO AND GENERAL COUNSEL ARE DETERMINED BY THE BOARD EXECUTIVE COMMITTEE WHICH SERVES AS THE BOARD COMPENSATION COMMITTEE. THE BOARD COMPENSATION COMMITTEE CONTRACTS WITH THE HEALTHCARE COMPENSATION FIRM NAMED THE GROVES GROUP, LLC, AND HAS UTILIZED THE PRESIDENT OF THE GROVES GROUP, LLC AS THE COMPENSATION CONSULTANT SINCE 2005. THE COMPENSATION CONSULTANT UTILIZES A METHODOLOGY THAT EVALUATES INTERNAL AND EXTERNAL EQUITY AFTER EVALUATING THE RESPONSIBILITIES OF EACH POSITION AND MAKES A RECOMMENDATION TO THE BOARD COMPENSATION COMMITTEE. THE BOARD COMPENSATION COMMITTEE HAS FOLLOWED THE DETAILED RECOMMENDATIONS OF THE COMPENSATION CONSULTANT ANNUALLY SINCE 2005 AND THE COMPENSATION CONSULTANT HAS BEEN RETAINED THROUGH 2016. |
| FORM 990, PART VI, SECTION C, LINE 19 | THESE DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | CHANGE IN MINIMUM PENSION OBLIGATION -42,428,478. REVENUE SHARING WITH AFFILIATE -8,698,010. |
| FORM 990, PART XII, LINE 2C: | THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| SAINT CATHERINE'S HOSPITAL INC | ||||||||||
| 6308 8TH AVENUE | KENOSHA | WI | 53143 | 390855075 | HEALTHCARE | WI | 501(C)(3) | LINE 11B, II | N/A | Yes (1) |
| UHS INC | ||||||||||
| 6308 8TH AVENUE | KENOSHA | WI | 53143 | 391956749 | HEALTHCARE | WI | 501(C)(3) | LINE 11A | N/A | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SAINT CATHERINE'S HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | K | TransactionTypeTxt |
| Method Of Amount Determination | FMV | MethodOfAmountDeterminationTxt |