FLAMBEAU HOSPITAL INC: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- FLAMBEAU HOSPITAL INC (EIN 39-0973724)
- Tax period
- 2014-07-01 to 2015-06-30
- Filed
- 2016-05-13
- IRS object ID
- 201611349349302411
- Schema version
- 2014v6.0
- 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 G
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-05-13T09:44:31-05:00 | ReturnTs |
| Tax Period End | 2015-06-30 | 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 8010 | AddressLine1Txt |
| City | WAUSAU | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 544028010 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390973724 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FLAMBEAU HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FLAM | BusinessNameControlTxt |
| Phone | 7157622484 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 98 SHERRY AVENUE | AddressLine1Txt |
| City | PARK FALLS | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54552 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JAMES BRAUN | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 7157622484 | PhoneNum |
| Signature | 2016-05-05 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KATHLEEN J LABRAKE CPA | PreparerPersonNm |
| PTIN | P00164006 | PTIN |
| Phone | 7158453111 | PhoneNum |
| Preparation | 2016-05-05 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-08-17 19:52:53Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JAMES BRAUN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 98 SHERRY AVENUE | AddressLine1Txt |
| City | PARK FALLS | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54552 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $22,045,454 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTP://MINISTRYHEALTH.ORG/FH/HOME.NWS | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1961 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | TO CREATE HEALTHIER COMMUNITIES WHILE IMPROVING THE HEALTH AND WELL BEING OF THE PEOPLE IN THE RURAL SETTINGS SERVED. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 264 | TotalEmployeeCnt |
| Total Volunteers | 14 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $242,534 | PYContributionsGrantsAmt |
| CY Contributions Grants | $154,432 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $20,741,763 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $21,861,419 | CYProgramServiceRevenueAmt |
| PY Investment Income | $28,012 | PYInvestmentIncomeAmt |
| CY Investment Income | $26,359 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $21,012,309 | PYTotalRevenueAmt |
| CY Total Revenue | $22,042,210 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $11,202,414 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $11,657,274 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $9,068,675 | PYOtherExpensesAmt |
| CY Other Expenses | $9,131,097 | CYOtherExpensesAmt |
| PY Total Expenses | $20,271,089 | PYTotalExpensesAmt |
| CY Total Expenses | $20,788,371 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $741,220 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,253,839 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $14,974,437 | TotalAssetsBOYAmt |
| Total Assets EOY | $16,030,789 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,922,806 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $5,358,974 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $9,051,631 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $10,671,815 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE FOLLOWING OBJECTIVES PROVIDE THE DIRECTION FOR FLAMBEAU HOSPITAL IN FULFILLING ITS VISION:- TO CONTINUOUSLY IMPROVE QUALITY SERVICES TO CUSTOMERS BY BUILDING EXCELLENCE INTO EVERY ASPECT AND PROCESS OF THE HOSPITAL. CUSTOMERS INCLUDE PATIENTS AND STAFF MEMBERS. THIS EXCELLENCE DEVELOPS FROM TOTAL QUALITY IMPROVEMENT, AN ENVIRONMENT THAT ENCOURAGES EVERYONE TO CONTRIBUTE TO THE HOSPITAL'S MISSION.- TO ENCOURAGE HEALTH PROMOTION AND WELLNESS THROUGH EDUCATIONAL ACTIVITIES. WHEN FEASIBLE, THESE ACTIVITIES WILL BE PURSUED IN CONJUNCTION WITH AREA HEALTH CARE PROVIDERS.- TO COLLABORATE WITH AND PROVIDE REFERRALS TO AGENCIES PROVIDING SERVICES NOT DIRECTLY AVAILABLE AT THE HOSPITAL.- TO MAINTAIN AN OPEN RELATIONSHIP WITH THE MEDICAL AND HOSPITAL STAFF TO ENSURE EFFICIENT AND EFFECTIVE UTILIZATION OF HOSPITAL RESOURCES.- TO PROVIDE IN-SERVICE AND CONTINUING EDUCATIONAL OPPORTUNITIES FOR HEALTH CARE PERSONNEL AS A MEANS OF PROVIDING QUALITY PATIENT CARE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $16,190,681 | ExpenseAmt |
| Revenue | $21,766,779 | RevenueAmt |
| Desc | FLAMBEAU HOSPITAL PROVIDES WELLNESS ACTIVITIES, EDUCATION AND PRIMARY HEALTHCARE SERVICES TO APPROXIMATELY 17,000 RESIDENTS IN OUR SERVICE AREA. HEALTHCARE SERVICE INCLUDES INPATIENT CARE AND SWING BED SERVICES ALONG WITH LABORATORY, RADIOLOGY, PHARMACY, REHABILITATION, SURGERY, AND OTHER OUTPATIENT SERVICES. SERVICES FOR THE YEAR ENDED JUNE 30, 2015 INCLUDED 1,620 INPATIENT DAYS, 128 SWING BED DAYS AND 27,963 OUTPATIENT REGISTRATIONS.FLAMBEAU HOME HEALTH PROVIDES HEALTH CARE SERVICES FOR HOMEBOUND PATIENTS INCLUDING PRIMARY CARE, WOUND AND INFECTION SERVICES, PERSONAL CARE SERVICES, PAIN MANAGEMENT AND OTHER MEDICAL SERVICES THAT CAN BE PROVIDED IN THE HOME. THESE SERVICES ARE PROVIDED TO THE SAME SERVICE AREA AND INCLUDED UNDUPLICATED PATIENT DAYS AND SERVICES TO PATIENTS.FLAMBEAU HOSPICE PROVIDES END OF LIFE CARE TO PATIENTS AND THEIR FAMILIES IN THEIR HOMES OR OTHER APPROPRIATE FACILITIES. ALSO PROVIDED ARE CHAPLAIN, VOLUNTEER AND BEREAVEMENT SERVICES. BEREAVEMENT SERVICES CONTINUE AFTER A PATIENT'S DEATH FOR ONE YEAR OR MORE. THESE SERVICES ARE PROVIDED TO THE SAME SERVICE AREA AND INCLUDED UNDUPLICATED PATIENT DAYS AND SERVICES TO PATIENTS. | Desc |
| Total Program Service Expenses | $16,190,681 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 57 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 264 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JAMES BRAUN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7157622484 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 98 SHERRY AVE | AddressLine1Txt |
| City | PARK FALLS | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54552 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| TOM OLSON | |||||||
| CHAIRPERSON | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DOUG MOQUIN | |||||||
| VICE CHAIRPERSON | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| RICK SVEHLA | |||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| BOBBI DAMROW | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LOUAY DANIAL MD | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DAVE DEDA | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JOANN IDES | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| BRIAN KIEF | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| TIMOTHY LINDGREN MD | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CAROL MADER | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| NARAYANA MURALI MD | |||||||
| DIRECTOR (TERM 1/31/15) | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| BOB SCHIENEBECK | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| GAYLE STANGLE | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MATTHEW THOMAS MD | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JOE WOLF | |||||||
| DIRECTOR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DAVID GRUNDSTROM | |||||||
| CAO | 40.00 | Yes (X) | $0 | $190,375 | $45,881 | ||
| JAMES BRAUN | |||||||
| CFO | 40.00 | Yes (X) | $157,783 | $0 | $35,388 | ||
| JANE EATON-NYMN | |||||||
| DIRECTOR OF ORGANIZATIONAL | 40.00 | $119,685 | $0 | $34,148 | Yes (X) | ||
| SARA HILGART | |||||||
| PHARMACIST | 40.00 | $128,656 | $0 | $15,317 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $406,124 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $190,375 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $130,734 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 3 | 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 |
|---|---|---|---|---|---|
| MARSHFIELD CLINIC | |||||
| 1000 N OAK AVENUE | MARSHFIELD | WI | 54449 | EKG, ADMIN, ER DOCS, LAB SVCS, MRI | $1,899,220 |
| SIEMENS MEDICAL SOLUTIONS USA | |||||
| 40 LIBERTY BOULEVARD | MALVERN | PA | 19355 | EQUIPMENT & SUPPLIES | $566,126 |
| ALEXANDER KORITTNIG | |||||
| 442 S 3RD AVE | PARK FALLS | WI | 54552 | ANESTHESIA | $475,232 |
| SHARED MEDICAL TECHNOLOGY | |||||
| 202 WEST NEWTON ST | RIB LAKE | WI | 54868 | MRI AND NUCLEAR MED SERVICES | $382,439 |
| TRIMEDX LLC | |||||
| 5451 LAKEVIEW PARKWAY S DRIVE | INDIANAPOLIS | IN | 46268 | EQUIPMENT MAINTENANCE | $295,847 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 8 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $24,014 | FundraisingAmt |
| Related Organizations | $38,948 | RelatedOrganizationsAmt |
| Government Grants | $24,640 | GovernmentGrantsAmt |
| All Other Contributions | $66,830 | AllOtherContributionsAmt |
| Total Contributions | $154,432 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621110 | $21,309,783 | $21,309,783 | |
| AFFILIATED ORG RENT | 900099 | $247,577 | $247,577 | |
| OTHER OPERATING REVENUE | 621110 | $209,419 | $209,419 | |
| CAFETERIA REVENUE | 900099 | $94,640 | $94,640 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $21,861,419 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $26,359 | TotalRevenueColumnAmt |
| Exclusion | $26,359 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $3,244 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $15,109 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $3,244 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $22,042,210 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $21,766,779 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $120,999 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $193,170 | TotalAmt |
| Management And General | $193,170 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,369,826 | TotalAmt |
| Program Services | $6,674,228 | ProgramServicesAmt |
| Management And General | $1,695,598 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $238,944 | TotalAmt |
| Program Services | $192,152 | ProgramServicesAmt |
| Management And General | $46,792 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,278,750 | TotalAmt |
| Program Services | $1,806,045 | ProgramServicesAmt |
| Management And General | $472,705 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $576,584 | TotalAmt |
| Program Services | $476,416 | ProgramServicesAmt |
| Management And General | $100,168 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,017 | TotalAmt |
| Management And General | $69,017 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,109,190 | TotalAmt |
| Program Services | $225,620 | ProgramServicesAmt |
| Management And General | $883,570 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,262 | TotalAmt |
| Management And General | $69,262 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,573,513 | TotalAmt |
| Program Services | $1,525,880 | ProgramServicesAmt |
| Management And General | $47,633 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $523,855 | TotalAmt |
| Program Services | $420,562 | ProgramServicesAmt |
| Management And General | $103,293 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $241,955 | TotalAmt |
| Program Services | $188,447 | ProgramServicesAmt |
| Management And General | $53,508 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,129,208 | TotalAmt |
| Program Services | $1,061,639 | ProgramServicesAmt |
| Management And General | $67,569 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $147,586 | TotalAmt |
| Management And General | $147,586 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SERVICES | $2,736,479 | $2,700,522 | $35,957 |
| EQUIPMENT RENTAL | $654,329 | $605,862 | $48,467 |
| BAD DEBT | $437,961 | $437,961 | |
| COMMUNICATION | $121,514 | $121,514 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $317,228 | TotalAmt |
| Program Services | $191,794 | ProgramServicesAmt |
| Management And General | $125,434 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,788,371 | TotalAmt |
| Program Services | $16,190,681 | ProgramServicesAmt |
| Management And General | $4,597,690 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $149,440 | BOYAmt |
| EOY | $6,056 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,373,763 | BOYAmt |
| EOY | $4,897,867 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,145,217 | BOYAmt |
| EOY | $2,779,797 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $221,641 | BOYAmt |
| EOY | $210,637 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,119 | BOYAmt |
| EOY | $80,776 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $23,663,288 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $16,112,195 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,431,466 | BOYAmt |
| EOY | $7,551,093 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $609,791 | BOYAmt |
| EOY | $504,563 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,974,437 | BOYAmt |
| EOY | $16,030,789 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,468,050 | BOYAmt |
| EOY | $1,461,987 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,185,592 | BOYAmt |
| EOY | $3,695,774 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $67,951 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $201,213 | BOYAmt |
| EOY | $201,213 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,922,806 | BOYAmt |
| EOY | $5,358,974 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,386,646 | BOYAmt |
| EOY | $9,886,238 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $664,985 | BOYAmt |
| EOY | $785,577 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,051,631 | BOYAmt |
| EOY | $10,671,815 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,974,437 | BOYAmt |
| EOY | $16,030,789 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,253,839 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $366,345 | 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| 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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $3,468 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $3,468 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | FLAMBEAU HOSPITAL PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THESE DUES ARE PRIMARILY FOR ACCESS TO EDUCATIONAL MATERIALS AND STAFF TRAINING AND DEVELOPMENT. THE AHA AND WHA HAVE NOTIFIED FLAMBEAU HOSPITAL THAT $3,468 OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $73,128 | OtherCostOrOtherBasisAmt |
| Book Value | $73,128 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,060,002 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,985,002 | DepreciationAmt |
| Book Value | $5,075,000 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $446,144 | OtherCostOrOtherBasisAmt |
| Depreciation | $323,483 | DepreciationAmt |
| Book Value | $122,661 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,076,014 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,803,710 | DepreciationAmt |
| Book Value | $2,272,304 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,000 | OtherCostOrOtherBasisAmt |
| Book Value | $8,000 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $7,551,093 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ASBESTOS ABATEMENT LIABILITY | Desc |
| Amt | $201,213 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $201,213 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $21,604,249 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $21,604,249 | RevenueSubtotalAmt |
| Other Revenues Not Included | $437,961 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $437,961 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $22,042,210 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $20,350,410 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $20,350,410 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $437,961 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $437,961 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $20,788,371 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE HOSPITAL IS A NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND IS EXEMPT FROM FEDERAL INCOME TAX ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE HOSPITAL IS ALSO EXEMPT FROM STATE INCOME TAX ON RELATED INCOME. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT NET AGAINST REVENUE 437,961. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT NET AGAINST REVENUE 437,961. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GOLF OUTING | Event1Nm |
| Gross Receipts Event1 | $18,353 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $15,109 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $3,244 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $3,244 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $18,353 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $15,109 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $3,244 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $3,244 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $3,244 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $0 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| 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 | $95,940 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $95,940 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00470 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,351,759 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,851,997 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $499,762 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02460 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,447,699 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,851,997 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $595,702 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02930 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $83,314 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $83,314 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00410 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $28,536 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $28,536 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,858,519 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,130,539 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,727,980 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08490 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $112,724 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $112,724 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00550 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,083,093 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,130,539 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,952,554 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09590 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,530,792 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,982,536 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,548,256 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12520 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,431 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,431 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,446 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $18,446 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00090 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,588 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,588 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $16,286 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $16,286 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,089 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,089 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $21,816 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $21,816 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $62,656 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $62,656 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00310 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $235,630 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $6,523,873 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $6,459,281 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $64,592 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FLAMBEAU HOSPITAL INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 98 SHERRY AVENUE | AddressLine1Txt |
| City | PARK FALLS | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54552 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FLAMBEAU HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTP://MINISTRYHEALTH.ORG/FLAMBEAUHOSPITAL/FLAMBEAU_COMMUNITY_ASSESSMENT_5. | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 12 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTP://MINISTRYHEALTH.ORG/FLAMBEAUHOSPITAL/FLAMBEAU_BENEFIT_IMPLEMENTATION_ | StrategyWebsiteURLTxt |
| Strategy Attached | Yes (1) | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FLAMBEAU HOSPITAL, INC. | PART V, SECTION B, LINE 5: FLAMBEAU HOSPITAL CHAIRED SEVERAL MEETINGS WITH COMMUNITY MEMBERS OVER AN 8-MONTH PERIOD TO DISCUSS, TABULATE AND FORM THE TOP PRIORITY NEEDS IN THE COMMUNITY. THE HOSPITAL WORKED WITH THE PRICE COUNTY PUBLIC HEALTH DEPARTMENT TO CO-CHAIR THESE MEETINGS. ALSO, FLAMBEAU HOSPITAL AND PRICE COUNTY PUBLIC HEALTH DEPARTMENT SENT INVITATIONS TO NUMEROUS GROUPS INCLUDING LOCAL BUSINESSES, GOVERNMENT AGENCIES, CHURCHES, CLINICS, HOSPITALS, SCHOOL DISTRICTS, COUNSELING CENTERS, ADVOCACY GROUPS, PUBLIC CITIZENS, AND CITY AND COUNTY LAW ENFORCEMENT FOR PARTICIPATION IN THE MEETINGS. |
| FLAMBEAU HOSPITAL, INC. | PART V, SECTION B, LINE 11: THERE WERE ITEMS IDENTIFIED IN THE CHNA WHICH WERE NOT ADDRESSED BY FLAMBEAU HOSPITAL; HOWEVER, ALL ITEMS WERE CONSIDERED IF A NEED WAS BROUGHT TO THE ATTENTION OF THE GROUP DURING THE INFORMATION GATHERING PHASE OF THE CHNA PROCESS. SEVERAL OF THE ITEMS NOT ADDRESSED PRIMARILY WERE DUE TO THE FINANCIAL CONSTRAINT OF PROVIDING THE SERVICE FOR A LIMITED POPULATION OF PEOPLE WITHIN THE PRIMARY SERVICE AREA. FLAMBEAU HOSPITAL ALSO CONSIDERED STAFFING RESOURCES IN ADDITION TO FINANCIAL CONSIDERATIONS TO ENSURE THAT THERE ARE ENOUGH PERSONNEL RESOURCES AVAILABLE FOR ANY PROGRAMS THAT MAY NOT CURRENTLY BE OFFERED BY THE HOSPITAL. DUE TO THE FINANCIAL AND STAFFING CONSTRAINTS, THE HOSPITAL HAS DETERMINED THE TOP FIVE PRIORITIES THAT THEY WILL FOCUS THEIR ATTENTION ON, AS THESE ISSUES WERE THE MOST CRITICAL AND SIGNIFICANT WORK NEEDS TO BE DONE IN THESE AREAS. OVER THE NEXT THREE YEARS AS THE IMPLEMENTATION STRATEGY IS IMPLEMENTED, THE HOSPITAL PLANS TO CONTINUALLY EVALUATE THE BENEFITS PROVIDED TO THE COMMUNITY MEMBERS TO ENSURE THAT HEATH NEEDS ARE MET WHENEVER POSSIBLE. |
| FLAMBEAU HOSPITAL, INC. | PART V, SECTION B, LINE 16I: IN ADDITION TO POSTING THE POLICY IN THE ADMISSIONS OFFICE AND WAITING ROOMS, ALL PATIENTS WHO REGISTER AS SELF-PAY ARE CONTACTED AND GIVEN INFORMATION ABOUT THE HOSPITAL'S CHARITY CARE POLICY. |
| FLAMBEAU HOSPITAL, INC. | PART V, SECTION B, LINE 22D: GROSS CHARGES ARE APPLIED TO ALL BILLED SERVICES OF THE HOSPITAL. UPON THE INDIVIDUAL MEETING THE FAP-ELIGIBILITY REQUIREMENTS DISCOUNTS AND ASSISTANCE FOR THOSE NOT ABLE TO PAY ARE THEN APPLIED. FREE CARE IS PROVIDED TO ANY INDIVIDUAL THAT FALLS BELOW 100% OF THE FPG FAMILY INCOME LIMIT. DISCOUNTED CARE IS OFFERED TO ANY INDIVIDUAL THAT FALLS BELOW 200% OF THE FPG FAMILY INCOME LIMIT. FLAMBEAU HOSPITAL, INC. PROVIDES DISCOUNTS ON A SLIDING SCALE METHOD. A 10% DISCOUNT IS GIVEN FOR EVERY 10TH PERCENTILE AN INDIVIUAL IS BELOW THE 200% FPG FAMILY INCOME LIMIT. AN INDIVIDUAL THAT FALLS IN THE 190% OF THE FPG FAMILY INCOME LIMIT WOULD BE GIVEN A 10% DISCOUNT ON GROSS CHARGES AND AN INDIVIDUAL THAT FALLS IN THE 110% OF THE FPG FAMILY INCOME LIMIT WOULD BE GIVEN A 90% DISCOUNT ON GROSS CHARGES. |
| FLAMBEAU HOSPITAL, INC. | PART V, SECTION B, LINE 24: GROSS CHARGES ARE APPLIED TO ALL BILLED SERVICES OF THE HOSPITAL. UPON THE INDIVIDUAL MEETING THE FAP-ELIGIBILITY REQUIREMENTS DISCOUNTS AND ASSISTANCE FOR THOSE NOT ABLE TO PAY ARE THEN APPLIED. FREE CARE IS PROVIDED TO ANY INDIVIDUAL THAT FALLS BELOW 100% OF THE FPG FAMILY INCOME LIMIT. DISCOUNTED CARE IS OFFERED TO ANY INDIVIDUAL THAT FALLS BELOW 200% OF THE FPG FAMILY INCOME LIMIT. FLAMBEAU HOSPITAL, INC. PROVIDES DISCOUNTS ON A SLIDING SCALE METHOD. A 10% DISCOUNT IS GIVEN FOR EVERY 10TH PERCENTILE AN INDIVIUAL IS BELOW THE 200% FPG FAMILY INCOME LIMIT. AN INDIVIDUAL THAT FALLS IN THE 190% OF THE FPG FAMILY INCOME LIMIT WOULD BE GIVEN A 10% DISCOUNT ON GROSS CHARGES AND AN INDIVIDUAL THAT FALLS IN THE 110% OF THE FPG FAMILY INCOME LIMIT WOULD BE GIVEN A 90% DISCOUNT ON GROSS CHARGES. |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | THE COSTING METHODOLOGY USED ON FORM 990 IS BASED ON A COST TO CHARGE RATIO WHICH IS DEVELOPED BASED ON THE HOSPITALS TOTAL OPERATING EXPENSES, EXCLUDING THE PROVISION FOR BAD DEBTS DIVIDED BY GROSS PATIENT SERVICE REVENUES. THIS COST TO CHARGE RATIO IS APPLIED AGAINST VARIOUS REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER IRS SUGGESTED COSTING METHODS FOR THE FORM 990. |
| PART I, LINE 7G: | SUBSIDIZED HEALTH SERVICES AT FLAMBEAU HOSPITAL INCLUDE THE OPERATION OF THE EMERGENCY ROOM DEPARTMENT, AND THE COMMUNITY BASED HOSPICE AND HOMECARE PROGRAMS. THE HOSPITAL EMERGENCY DEPARTMENT OPERATES 24 HOURS PER DAY, SEVEN DAYS PER WEEK AND IS STAFFED BY A GROUP OF HIGHLY TRAINED NURSING STAFF INCLUDING REGISTERED NURSES, LICENSED PRACTICED NURSES, AND OTHER SUPPORT STAFF. MANY OF THE ADMISSIONS TO THE HOSPITAL EMERGENCY DEPARTMENT COME FROM THE COMMUNITY AND SURROUNDING AREAS. THE HOSPICE AND HOMECARE PROGRAMS ARE PROVIDED AS COMMUNITY SUPPORT SERVICES TO THE AREA OF PRICE COUNTY, WISCONSIN. ALL OF THESE SUBSIDIZED HEALTH SERVICES WORK IN SUPPORT AND COOPERATION WITH THE COMBINED EFFORTS OF FLAMBEAU HOSPITAL AND SHARE MANY SUPPORT FUNCTIONS OF THE HOSPITAL IN AN EFFORT TO PROVIDE EXCELLENT LOW COST CARE TO PATIENTS IN THEIR LOCAL COMMUNITY AND AREA. A SIGNIFICANT PAYOR FOR THESE PROGRAMS IS THE MEDICARE PROGRAM WHICH DOES NOT REIMBURSE THE HOSPITAL FOR THESE SERVICES IN ALL CASES BASED ON COST SO A SIGNIFICANT LOSS IS ABSORBED BY THE HOSPITAL TO PROVIDE THESE SERVICES TO MEMBERS OF THE COMMUNITY. IT IS THE GOAL OF FLAMBEAU HOSPITAL, INC. TO PROVIDE THESE SERVICES TO THE COMMUNITY REGARDLESS OF A PATIENTS ABILITY TO PAY. THE COSTING METHODOLOGY FOR SUBSIDIZED HEALTH SERVICES IS BASED ON THE COSTING METHODS USED ON THE HOSPITALS MEDICARE COST REPORT. THIS METHODOLOGY PROVIDES FOR A DIRECT ALLOCATION OF EXPENSES AS WELL AS PROVIDING THE SAME DATA TO THE MEDICARE PROGRAM AS WELL AS TO THE IRS FOR THE FORM 990 PURPOSES. |
| PART I, LN 7 COL(F): | BAD DEBT EXPENSE IN THE AMOUNT OF $437,961 INCLUDED ON FORM 990, PART IX, LINE 25 WAS NOT INCLUDED IN TOTAL EXPENSES FOR PURPOSES OF CALCULATING COMMUNITY BENEFIT PERCENTAGES. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | WHILE THERE IS A GROWING AGREEMENT IN THE UNITED STATES ABOUT WHAT CONSTITUTES A NON-PROFIT HOSPITALS "COMMUNITY BENEFIT," THESE EFFORTS CONTINUE TO BE A WORK IN PROGRESS. FLAMBEAU HOSPITAL, INC. PROVIDES SIGNIFICANT CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS AND IN ADDITION, THE HOSPITAL BELIEVES THAT IT PROVIDES A CRITICALLY IMPORTANT COMMUNITY BENEFIT WHICH IS NOT QUANTIFIED. FLAMBEAU HOSPITAL, INC., LIKE MOST RURAL HOSPITALS, WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE CARE LOCALLY WHICH WITHOUT THE HOSPITAL, WOULD NOT BE AVAILABLE LOCALLY. BEYOND INPATIENT HOSPITALIZATIONS, THE HOSPITAL PROVIDES LOCAL ACCESS TO MANY HEALTH SERVICES INCLUDING: BIRTHING SERVICES, DIAGNOSTICS, EMERGENCY SERVICES & URGENT CARE, HOME CARE, HOSPICE, SWING BED SERVICES, LABORATORY SERVICES, OCCUPATIONAL HEALTH, REHABILITATION SERVICES, SLEEP CENTER, SURGICAL SERVICES, AND WOMENS SERVICES, TO NAME SOME OF THE MAJOR SERVICES PROVIDED. |
| PART III, LINE 4: | THE CARRYING AMOUNTS OF PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY ALLOWANCES THAT REFLECT MANAGEMENT'S BEST ESTIMATE OF THE AMOUNTS THAT WILL NOT BE COLLECTED. MANAGEMENT PROVIDES FOR CONTRACTUAL ADJUSTMENTS UNDER TERMS OF THIRD-PARTY REIMBURSEMENT AGREEMENTS THROUGH A REDUCTION OF GROSS REVENUE AND A CREDIT TO PATIENT ACCOUNTS RECEIVABLE. IN ADDITION, MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY FROM 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 LIKELIHOOD 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.THE COST TO CHARGE RATIO WAS USED TO DETERMINE THE AMOUNTS REPORTED ABOVE. |
| PART III, LINE 8: | THE TOTAL MEDICARE REVENUE SHOWN IN SCHEDULE H OF THE FORM 990 IS BASED ON THE IRS 990 INSTRUCTIONS AND INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE OF THE ORGANIZATION AND ALSO DOES NOT CONSIDER CONTRACTUAL ADJUSTMENTS FOR THE REIMBURSEMENT THAT IS ACTUALLY RECEIVED FROM THE MEDICARE PROGRAM. AMOUNTS LISTED FOR MEDICARE REVENUES DO NOT INCLUDE SIGNIFICANT PORTIONS OF LABORATORY, RADIOLOGY, AMBULANCE AND REHABILITATION SERVICES PROVIDED TO MEDICARE BENEFICIARIES AS WELL AS PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT, ANETHESIA PROFESSIONAL SERVICES, CLINICAL PHYSICIAN PROFESSIONAL SERVICES, SURGICAL PHYSICIAN PROFESSIONAL SERVICES AND REVENUES FOR ANY PATIENTS COVERED UNDER MEDICARE ADVANTAGE PLAN PROGRAMS. PHYSICIAN SERVICES ARE REIMBURSED PRIMARILY ON FEE SCHEDULE REIMBURSEMENT AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY, SURGICAL, AND CLINICAL SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND AS SUCH THESE COSTS AND SHORTFALLS SHOULD BE CONSIDERED AS AN ADDITIONAL BENEFIT THAT FLAMBEAU HOSPITAL PROVIDES TO THE COMMUNITY AND SURROUNDING AREASS. THE COSTING METHOD USED ABOVE FOR IRS 990 COMPLIANCE REPORTING IS ALSO BASED ON THE FILED MEDICARE COST REPORT FOR THE YEAR ENDED JUNE 30, 2014 AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICE REVENUES (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE.)WHETHER THERE IS A SHORTFALL OR SURPLUS ON SERVICES PROVIDED TO MEDICARE BENEFICIARES, THESE PEOPLE, WHICH ARE TYPICALLY ELDERLY OR DISABLED MEMBERS OF THE COMMUNITY, ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE PATIENT SERVICES, THE CENTERS FOR MEDICARE AND MEDICAID (CMS) WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING THE SERVICES TO THE ELDERLY AND DISABLES MEMBERS OF THE COMMUNITY. |
| PART III, LINE 9B: | ONCE A PERSON IS KNOWN TO QUALIFY FOR CHARITY CARE, THE HOSPITAL WILL KEEP THAT INFORMATION ON FILE AND AUTOMATICALLY GRANT CHARITY CARE FOR UP TO A YEAR. AT THAT POINT, THE PATIENT WOULD NEED TO REAPPLY OR VERIFY THAT THEIR SITUATION HAS NOT CHANGED SIGNIFICANTLY SINCE THEIR LAST APPLICATION. CHARITY CARE IS APPLIED FIRST BEFORE ANY COLLECTION EFFORTS ARE PURSUED. |
| PART VI, LINE 2: | THE HOSPITAL COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT REPORT IN FISCAL YEAR 2013 AND USED THE DATA AND FINDINGS OF THIS REPORT TO GUIDE THE ORGANIZATION IN THE FUTURE TO BE ABLE TO RESPOND TO THOSE NEEDS.IN ADDITION, THE HOSPITAL IS PARTICIPATING WITH PRICE COUNTY ON THE COUNTY HEALTH ASSESSMENT AND HEALTH PLAN. |
| PART VI, LINE 3: | INFORMATION IS POSTED IN THE FACILITY AND ALL PATIENTS WHO REGISTER AS SELF-PAY ARE CONTACTED FOR ANY ASSISTANCE NEEDS THEY MAY HAVE. |
| PART VI, LINE 4: | FLAMBEAU HOSPITAL, INC. PROVIDES SERVICES TO RESIDENTS OF PRICE COUNTY, WI AND PORTIONS OF THREE OTHER COUNTIES. THE NEXT CLOSEST HOSPITAL IS 45 MILES AWAY, AND FLAMBEAU HOSPITAL IS DESIGNATED AS UNDERSERVED. THE HOSPITAL PROVIDES A SIGNIFICANT PORTION OF ITS PATIENT CARE SERVICES TO BENEFICIARIES OF THE MEDICARE AND MEDICAID PROGRAMS ESPECIALLY THOSE BENEFICIARIES WHO RECEIVE HOME HEALTH SERVICES FROM THE ORGANIZATION. IN THE SHORT PERIOD ENDING JUNE 30, 2015, THESE MEDICARE AND MEDICAID PATIENTS ACCOUNTED FOR APPROXIMATELY 73 PERCENT OF THE PATIENT SERVICES PROVIDED BY THE ORGANIZATION DURING THE YEAR. |
| PART VI, LINE 5: | FLAMBEAU HOSPITAL PROVIDES EDUCATION, NEEDED SUBSIDIZED SERVICES AND SUPPORT TO THE COMMUNITY THROUGH SERVICES IT PROVIDES AND COLLABORATION WITH OTHER GROUPS TO IMPROVE THE HEALTH STATUS OF THE COMMUNITY. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | WI |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DAVID GRUNDSTROM | ||||||||||||||
| CAO | $0 | $187,217 | $0 | $0 | $0 | $3,158 | $0 | $26,406 | $0 | $19,475 | $0 | $236,256 | $0 | $0 |
| JAMES BRAUN | ||||||||||||||
| CFO | $157,783 | $0 | $0 | $0 | $0 | $0 | $6,567 | $0 | $28,820 | $0 | $193,170 | $0 | $0 | $0 |
| JANE EATON-NYMN | ||||||||||||||
| DIRECTOR OF ORGANIZATIONAL | $119,685 | $0 | $0 | $0 | $0 | $0 | $4,768 | $0 | $29,380 | $0 | $153,833 | $0 | $0 | $0 |
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 | CITY OF PARK FALLS WISCONSIN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 396005566 | BondIssuerEIN |
| Bond Issued | 2012-02-10 | BondIssuedDt |
| Issue Price | $4,523,750 | IssuePriceAmt |
| Purpose | REFINANCE 1994, 1997, 2007, AND 2009 LOAN AND FINANCE ER DEPARTMENT REMODEL | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $827,976 | RetiredAmt |
| Total Proceeds | $4,523,750 | TotalProceedsAmt |
| Credit Enhancement | $90,475 | CreditEnhancementAmt |
| Capital Expenditures | $3,475,615 | CapitalExpendituresAmt |
| Other Spent Proceeds | $957,660 | OtherSpentProceedsAmt |
| Substantial Completion | 2012 | SubstantialCompletionYr |
| Current Refunding | 0 | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | MARSHFIELD CLINIC AND MINISTRY HEALTH CARE, INC. ("MINISTRY"), BOTH WISCONSIN TAX-EXEMPT CORPORATIONS, ARE JOINT CORPORATE MEMBERS OF THE HOSPITAL. MINISTRY ALSO, VIA CONTRACT, SHARES CERTAIN GOVERNANCE AUTHORITIES WITH MARSHFIELD CLINIC WITH RESPECT TO THE PARK FALLS AND PHILLIPS ("PRICE COUNTY CLINICS") CLINIC OPERATIONS OF MARSHFIELD CLINIC, WITH MARSHFIELD CLINIC RETAINING THE REMAINING AUTHORITIES. MARSHFIELD CLINIC HAS CONTRACTED TO PROVIDE OPERATING MANAGEMENT TO THE HOSPITAL AND PRICE COUNTY CLINICS. THE GOAL OF THE MEMBERSHIP ARRANGEMENTS IS TO PROVIDE FOR THE EFFECTIVE, ECONOMICAL, AND COORDINATED MANAGEMENT AND OPERATION OF HEALTH CARE SERVICES IN PRICE COUNTY. COLLECTIVELY, THE PARTIES HAVE ESTABLISHED AN INTEGRATED HEALTH CARE DELIVERY SYSTEM FOR PRICE COUNTY. |
| FORM 990, PART VI, SECTION A, LINE 7A | CORPORATE MEMBERS HAVE APPROVED RIGHT FOR DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7B | APPROVAL OF BUDGET, ADMINISTRATOR, PROPERTY PURCHASED, AND DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 8B | NOT APPLICABLE AS THERE ARE NO SUB-COMMITTEES. |
| FORM 990, PART VI, SECTION B, LINE 11 | A COPY OF THE FORM 990 WAS PROVIDED TO ALL MEMBERS OF THE BOARD PRIOR TO FILING. IF THE BOARD MEMBERS WOULD LIKE ANY EXPLANATION OR CHANGES, THEY WOULD HAVE AN OPPORTUNITY TO COMMENT ON THE RETURN BEFORE ITS FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE BOARD OF DIRECTORS AND KEY EMPLOYEES OF THE HOSPITAL ANNUALLY SIGN TO ADHERE TO THE CONFLICT OF INTEREST POLICY AT FLAMBEAU HOSPITAL, INC. IT IS ASSUMED THAT THE BOARD OF DIRECTORS AND KEY EMPLOYEES WILL RECOGNIZE CONFLICTS OF INTEREST WITH ANY PERSONS OR FIRMS MENTIONED IN THE POLICY. IT IS THE POLICY OF THE BOARD THAT THE EXISTENCE OF ANY INTEREST DESCRIBED IN THE POLICY SHALL BE DISCLOSED BEFORE ANY TRANSACTION IS CONSUMMATED. IT IS THE BOARD OF DIRECTORS AND KEY EMPLOYEES RESPONSIBILITY TO REVIEW POTENTIAL CONFLICTS OF INTEREST AND IF A CONFLICT EXISTS THE INDIVIDUAL IS PROHIBITED TO VOTE ON TRANSACTIONS WHERE THE POTENTIAL CONFLICT EXISTS. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE MARSHFIELD CLINIC PREPARES A COMPENSATION SCHEDULE THAT IS USED TO DETERMINE TOP MANAGEMENT AND KEY EMPLOYEE COMPENSATION. COMPENSATION STUDIES ARE ALSO USED TO PROVIDE COMPARABILITY DATA. THIS DATA IS REVIEWED AND APPROVED BY INDEPENDENT PERSONS AND ALL DECISIONS ARE SUBSTANTIATED. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE HOSPITAL DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. |
| FORM 990, PART XI, LINE 9: | ADMINISTRATION NON-OP OTHER 366,345. |
| FORM 990, PART XI, LINE 2C | THE PROCESS IS CONSISTENT WITH PRIOR YEARS. |
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 | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| FLAMBEAU HOSPITAL FOUNDATION INC | |||||||||||
| PO BOX 310 | PARK FALLS | WI | 54552 | 205957150 | SUPPORT OF FLAMBEAU HOSPITAL | WI | 501 (C) 3 | 11, I | FLAMBEAU HOSPITAL INC | Yes (1) | |
| FLAMBEAU HOSPITAL AUXILIARY INC | |||||||||||
| PO BOX 310 | PARK FALLS | WI | 54552 | 510211754 | SUPPORT OF FLAMBEAU HOSPITAL | WI | 501 (C) 3 | LINE 11D, III-O | 0 | N/A | |
| 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 | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |