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ROGERS MEMORIAL HOSPITAL INCORPORATED: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
ROGERS MEMORIAL HOSPITAL INCORPORATED (EIN 39-1139101)
Tax period
2014-08-01 to 2015-07-31
Filed
2016-06-14
IRS object ID
201621669349300227
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 ReturnHeader

FieldValueIRS element (for citing)
Return2016-06-14T14:12:23-05:00ReturnTs
Tax Period End2015-07-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390758449PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1WIPFLI LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 8010AddressLine1Txt
CityWAUSAUCityNm
State AbbreviationWIStateAbbreviationCd
ZIP544028010ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-08-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN391139101EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ROGERS MEMORIAL HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlROGEBusinessNameControlTxt
Phone2626463526PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line134700 VALLEY ROADAddressLine1Txt
CityOCONOMOWOCCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53066ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKEITH DEGNERPersonNm
Person TitleEXECUTIVE VICE PRESIDENT AND CFOPersonTitleTxt
Phone2626463526PhoneNum
Signature2016-06-08SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKimberly Heller CPAPreparerPersonNm
PTINP00766668PTIN
Phone7158453111PhoneNum
Preparation2016-06-08PreparationDt
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-08-17 19:52:53ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerKEITH DEGNERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line134700 VALLEY ROADAddressLine1Txt
CityOCONOMOWOCCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53066ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$134,891,346GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.ROGERSHOSPITAL.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1907FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionROGERS MEMORIAL HOSPITAL, INC. OPERATES FACILITIES IN OCONOMOWOC, MILWAUKEE, KENOSHA, AND BROWN DEER, WISCONSIN TO PROVIDE INPATIENT AND OUTPATIENT PSYCHIATRIC SERVICES TO PATIENTS PRIMARILY FROM THE MIDWEST. SERVICES AVAILABLE AT THE HOSPITAL INCLUDE PROGRAMS RELATING TO THE RECOVERY FROM ADDICTIONS; TREATMENT FOR DISRUPTIVE BEHAVIOR OF CHILDREN AND ADOLESCENTS; GENERAL PSYCHIATRY FOR ADULTS; REGIONAL ADULT AND ADOLESCENT PARTIAL HOSPITALIZATION; AND CHILD AND ADOLESCENT EXTENDED CARE.ActivityOrMissionDesc
Voting Members Governing Body20VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee1505TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$516,197TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$52,260NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$155,307PYContributionsGrantsAmt
CY Contributions Grants$322,179CYContributionsGrantsAmt
PY Program Service Revenue$100,008,194PYProgramServiceRevenueAmt
CY Program Service Revenue$122,352,066CYProgramServiceRevenueAmt
PY Investment Income$1,055,401PYInvestmentIncomeAmt
CY Investment Income$998,518CYInvestmentIncomeAmt
PY Other Revenue-$975,530PYOtherRevenueAmt
CY Other Revenue$103,582CYOtherRevenueAmt
PY Total Revenue$100,243,372PYTotalRevenueAmt
CY Total Revenue$123,776,345CYTotalRevenueAmt
PY Grants And Similar Paid$1,978,365PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$2,115,713CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$60,325,067PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$78,703,166CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$26,672,646PYOtherExpensesAmt
CY Other Expenses$36,047,596CYOtherExpensesAmt
PY Total Expenses$88,976,078PYTotalExpensesAmt
CY Total Expenses$116,866,475CYTotalExpensesAmt
PY Revenues Less Expenses$11,267,294PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$6,909,870CYRevenuesLessExpensesAmt
Total Assets BOY$150,863,373TotalAssetsBOYAmt
Total Assets EOY$207,076,774TotalAssetsEOYAmt
Total Liabilities BOY$43,134,538TotalLiabilitiesBOYAmt
Total Liabilities EOY$93,446,134TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$107,728,835NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$113,630,640NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionWE EXIST TO OFFER EXEMPLARY BEHAVIORAL HEALTHCARE SERVICES, INCLUDING TREATMENT, RESEARCH, EDUCATION, TRAINING AND CONSULTATION BUILT ON OUR CENTURY-LONG HERITAGE. WE ARE DEDICATED TO THE DELIVERY OF QUALITY CARE USING A SKILLED TEAM APPROACH THAT RESPECTS THE DIGNITY OF EACH INDIVIDUAL. OUR SUCCESS IS DEMONSTRATED IN PREMIER QUALITY CARE, SUCCESSFUL OUTCOM, FINANCIAL INTEGRITY, PERSONAL AND ORGANIZATIONAL GROWTH, AND COMMUNITY WELL-BEING.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$92,356,015ExpenseAmt
Grant$2,115,713GrantAmt
Revenue$122,352,066RevenueAmt
DescROGERS MEMORIAL HOSPITAL, INC.PRIAMARY EXEMPT PURPOSE AND PROGRAM ACCOMPLISHMENTSROGERS MEMORIAL HOSPITAL, INC. (ROGERS) IS A TAX-EXEMPT HOSPITAL WHICH EXISTS TO OFFER EXEMPLARY BEHAVIORAL HEALTHCARE SERVICES, INCLUDING TREATMENT, RESEARCH, EDUCATION AND TRAINING, IN CONTINUATION OF A CENTURY LONG TRADITION. ROGERS IS DEDICATED TO A SKILLED, PROFESSIONAL, TEAM APPROACH OF INDIVIDUALIZED CARE WITHIN A TREATMENT COMMUNITY, RESPECTING THE DIGNITY OF EACH PERSON.ROGERS IS GOVERNED BY A VOLUNTEER CITIZEN BOARD OF DIRECTORS AND IS STAFFED BY HIGHLY QUALIFIED MENTAL HEALTH PROFESSIONALS INCLUDING TEAMS OF PHSICIANS, THERAPISTS, COUNSELORS, DIETICIANS, AND OTHER PROFESSIONAL STAFF. ROGERS HAS DEVELOPED COMMUNITY GOODWILL AND CONFIDENCE THROUGH STABLE OWNERSHIP AND GOVERNANCE STRUCTURES.TO MEET THE INDIVIDIAUL NEEDS OF PATIENTS, ROGERS OFFERS THE FOLLOWING THREE LEVELS OF CARE:INPATIENT CARE - THIS INTENSIVE, SHORT-TERM LEVEL OF CARE PROVIDES STABILIZATION FOR A VARIETY OF ACUTE PSYCHIATRIC SYMPTOMS AND DIAGNOSES. THE PRIMARY FOCUS IS ASSESSMENT, STABILIZATION AND TRANSITION INTO PARTIAL HOSPITALIZATION (DAY TREATEMENT) OR OUTPATIENT THERAPY.PARTIAL HOSPITALIZATION - PARTIAL HOSPITALIZATION PROGRAMS PROVIDE TRANSITION FROM INPATIENT CARE, AN ALTERNATIVE TO INPATIENT TREATMENT, OR A SUPPLEMENT TO OUTPATIENT THERAPY. THESE HALF-DAY OR PART-TIME STRUCTURED PROGRAMS ALLOW PATIENTS TO CONTINUE INVOLVEMENT AT HOME, WORK, OR SCHOOL.RESIDENTIAL TREATMENT - RESIDENTIAL TREATMENT CENTERS PROVIDE INTENSIVE EXTENDED CARE OPPORTUNITIES IN A HOME-LIKE SETTING FOR INDIVIDUALS SEEKING TO OVERCOME SEVERE EATHING DISORDERS, ALCOHOL AND OTHER ADDITIONS, AND OBSESSIVE-COMPULSIVE DISORDER. LOCATED AT OUR OCONOMOWOC SITE ON 80 ACRES OF WOODED LAKEFRONT PROPERTY, EACH CENTER PROVIDES A CALMING, CONFIDENTIAL ENVIRONMENT THAT ALLOWS PATIENTS TO FOCUS ON THEIR TREATMENT. OUR RESIDENTIAL PROGRAMS ARE TYPICALLY ONE-THIRD THE DAILY RATE OF INPATIENT CARE, WHILE PROVIDNG INPATIENT-INTENSIVE TREATMENT. IN 2015, ROGERS PATIENT CARE SERVICES INCLUDED 43,473 INPATIENT DAYS, 76,510 PARTIAL TREATMENT DAYS, AND 41,105 RESIDENTIAL PROGRAM DAYS.Desc
Total Program Service Expenses$92,356,015TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org MemYes (1)BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer EntYes (1)BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document116IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld Compliance0BackupWthldComplianceInd
Employee1505EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members20GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldWIStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1KEITH DEGNERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2626464605PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line134700 VALLEY ROADAddressLine1Txt
CityOCONOMOWOCCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53066ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (40 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Garry Anderson
Chair3.00Yes (X)Yes (X)$0$0$0
Calvin Schmidt
Vice Chair3.00Yes (X)Yes (X)$0$0$0
Mark Mohr
Treasurer3.00Yes (X)Yes (X)$0$0$0
Mary Panzer
Board Secretary3.00Yes (X)Yes (X)$0$0$0
Nick Bauer
Member3.00Yes (X)$0$0$0
Peter Gottsacker
Board Member1.00Yes (X)$0$0$0
Roger Jensen
Board Member1.00Yes (X)$0$0$0
John Curran
Board Member1.00Yes (X)$0$0$0
Gary Jorgensen
Board Member1.00Yes (X)$0$0$0
William Mulligan
Board Member1.00Yes (X)$0$0$0
Theodore Weltzin
Board Member1.00Yes (X)$0$0$0
Patrick Andritsch
Board Member1.00Yes (X)$0$0$0
Vineet Kulkarni
Board Member1.00Yes (X)$382,845$0$33,441
Daniel Bader
Board Member1.00Yes (X)$0$0$0
Martin Borell
Board Member1.00Yes (X)$0$0$0
Molly Kubly Fritz
Board Member1.00Yes (X)$0$0$0
Andrew Sawyer
Board Member1.00Yes (X)$0$0$0
Demond Means
Board Member1.00Yes (X)$0$0$0
Johnathan Wertz
Board Member1.00Yes (X)$0$0$0
Bradley Riemann
Board Member41.00Yes (X)$340,741$0$38,165
Paul Mueller
COO40.00Yes (X)$404,327$0$41,951
Keith Degner
CFO - RMH40.00Yes (X)$259,227$0$41,632
Patrick Hammer
CEO - RBHS10.00Yes (X)$0$656,975$35,40230.00
Michael Hedrick
CfO - RBHS1.00Yes (X)$0$304,697$37,15040.00
William Hendricks
VP Operations40.00Yes (X)$206,698$0$25,753
Renee Patterson
VP of Employment & Trainin40.00Yes (X)$243,816$0$37,681
Suzanne Harrison
VP of Operations - Ocon40.00Yes (X)$96,662$0$2,867
Teresa Schultz
VP Nursing40.00Yes (X)$231,221$0$9,352
James Kubicek
VP of Operations - BD40.00Yes (X)$570$0$0
Orvin Fillman
VP of Operations - MKE40.00Yes (X)$219,822$0$32,253
James Ledbetter
VP of Regional Partial Hospital Program40.00Yes (X)$70,619$0$5,794
Peter Lake
Medical Director40.00$479,404$0$41,951Yes (X)
Kambiz Pahlavan
Medical Director40.00$299,165$0$10,400Yes (X)
Ahmed Numaan
Physician40.00$450,249$0$9,620Yes (X)
Michael Miller
Physician40.00$330,526$0$33,655Yes (X)
Brad Smith
Physician40.00$388,437$0$38,165Yes (X)
Jerry Halverson
Physician40.00$344,427$0$41,951Yes (X)
Tracey Cornells-Carlson
Physician40.00$525,772$0$9,837Yes (X)
David Moulthrop
Former CEO1.00$133,571$0$29,022Yes (X)
Gerald Noll
FORMER CFO1.00$248,055$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$5,656,154TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$961,672TotReportableCompRltdOrgAmt
Total Other Compensation$556,042TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K94IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
VJS Construction Services Inc
W233N2847 Roundy Circle WPewaukeeWI53072Construction$16,266,376
Cerner Corporation
2800 Rockcreek Pkwy NKansas CityMO64117Health information technology$4,696,328
Bluemond Builders Supply LLC
W233N2847 Roundy Circle WPewaukeeWI53072Construction$2,970,172
Merit Solutions Inc
1749 S Naperville Rd Ste 200WheatonIL60189Consultants$1,833,711
Serve You
PO Box 2079MilwaukeeWI53201Pharmacy Services$1,788,495
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K69CntrctRcvdGreaterThan100KCnt
Related Organizations$322,179RelatedOrganizationsAmt
Total Contributions$322,179TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
NET PATIENT SVC REVENUE900099$121,456,748$121,456,748
MANAGEMENT SERVICES541610$476,130$476,130
CAFETERIA900099$187,556$187,556
RCRT Clinical Trials900099$136,924$136,924
Miscellaneous Revenue900099$54,641$54,641

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$40,067TotalRevenueColumnAmt
Unrelated Business Revenue$40,067UnrelatedBusinessRevenueAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$122,352,066TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$625,262TotalRevenueColumnAmt
Exclusion$625,262ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$103,582RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$103,582RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$103,582TotalRevenueColumnAmt
Exclusion$103,582ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$714,857SecuritiesAmt
Other$10,773,400OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$11,115,001OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$714,857SecuritiesAmt
Other-$341,601OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$373,256TotalRevenueColumnAmt
Exclusion$373,256ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$123,776,345TotalRevenueColumnAmt
Related Or Exempt Func Income$121,593,672RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$516,197UnrelatedBusinessRevenueAmt
Exclusion$1,344,297ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$2,115,713TotalAmt
Program Services$2,115,713ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$3,480,677TotalAmt
Program Services$1,479,015ProgramServicesAmt
Management And General$2,001,662ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$61,311,689TotalAmt
Program Services$51,453,871ProgramServicesAmt
Management And General$9,857,818ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,497,411TotalAmt
Program Services$1,212,454ProgramServicesAmt
Management And General$284,957ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$8,577,331TotalAmt
Program Services$6,909,428ProgramServicesAmt
Management And General$1,667,903ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$3,836,058TotalAmt
Program Services$3,051,636ProgramServicesAmt
Management And General$784,422ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$145,598TotalAmt
Management And General$145,598ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$7,886,637TotalAmt
Program Services$5,179,879ProgramServicesAmt
Management And General$2,706,758ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,978,335TotalAmt
Program Services$1,615,606ProgramServicesAmt
Management And General$362,729ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$1,320,389TotalAmt
Program Services$816,379ProgramServicesAmt
Management And General$504,010ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$1,074,156TotalAmt
Program Services$934,516ProgramServicesAmt
Management And General$139,640ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$5,985,858TotalAmt
Program Services$5,597,200ProgramServicesAmt
Management And General$388,658ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,274,350TotalAmt
Program Services$183,954ProgramServicesAmt
Management And General$1,090,396ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
PROFESSIONAL AND CONTRA$8,089,021$3,744,852$4,344,169
BAD DEBT EXPENSE$7,495,422$7,495,422
DUES AND FEES$497,630$265,890$231,740
PROPERTY TAXES$300,200$300,200

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$116,866,475TotalAmt
Program Services$92,356,015ProgramServicesAmt
Management And General$24,510,460ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$791,931BOYAmt
EOY-$2,141,671EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$15,027,967BOYAmt
EOY$30,478,674EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$15,271,401BOYAmt
EOY$22,213,592EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$276,855BOYAmt
EOY$397,800EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$151,894,007LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$27,835,998LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$91,366,286BOYAmt
EOY$124,058,009EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$25,379,958BOYAmt
EOY$27,858,418EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$2,748,975BOYAmt
EOY$4,211,952EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$150,863,373BOYAmt
EOY$207,076,774EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$10,448,890BOYAmt
EOY$12,584,866EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$30,390,000BOYAmt
EOY$50,745,000EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$585,000BOYAmt
EOY$27,707,533EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,710,648BOYAmt
EOY$2,408,735EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$43,134,538BOYAmt
EOY$93,446,134EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$105,122,379BOYAmt
EOY$109,560,104EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$889,477BOYAmt
EOY$2,102,270EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,716,979BOYAmt
EOY$1,968,266EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$107,728,835BOYAmt
EOY$113,630,640EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$150,863,373BOYAmt
EOY$207,076,774EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$6,909,870ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$171,644NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$836,421OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consol And Sep Basis Fincl StmtYes (X)ConsolAndSepBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$65,650OtherActivitiesAmt
Total Lobbying Expenditures$65,650TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationPORTIONS OF ASSOCIATION DUES ALLOCATED FOR LOBBYING EXPENSES OF WHA $33,225(15.5%) TOTALING $5,150. ROGERS MEMORIAL HOSPITAL, INC. EMPLOYS AN INDIVIDUAL FOR $60,500 WHO COMMUNICATED TO LEGISLATORS. THE INDIVIDUAL WORKED ON THE SPEAKERS BEHAVIORAL HEALTH TASK FORCE, AND THE DEVELOPMENT OF A PROPOSAL TO CREATE A PROFESSIONALS HEALTH PROGRAM.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,923,542BeginningYearBalanceAmt
Contributions$251,287ContributionsAmt
Investment Earnings Or Losses$42,097InvestmentEarningsOrLossesAmt
Other Expenditures$43,536OtherExpendituresAmt
End Year Balance$2,173,390EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,263,229BeginningYearBalanceAmt
Contributions$565,929ContributionsAmt
Investment Earnings Or Losses$94,384InvestmentEarningsOrLossesAmt
End Year Balance$1,923,542EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$578,612BeginningYearBalanceAmt
Contributions$596,745ContributionsAmt
Investment Earnings Or Losses$87,872InvestmentEarningsOrLossesAmt
End Year Balance$1,263,229EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,268,341BeginningYearBalanceAmt
Contributions$308,852ContributionsAmt
Investment Earnings Or Losses$1,419InvestmentEarningsOrLossesAmt
Other Expenditures$1,000,000OtherExpendituresAmt
End Year Balance$578,612EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,000,000BeginningYearBalanceAmt
Contributions$245,453ContributionsAmt
Investment Earnings Or Losses$22,888InvestmentEarningsOrLossesAmt
End Year Balance$1,268,341EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.90560PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.09440TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$7,969,141OtherCostOrOtherBasisAmt
Book Value$7,969,141BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$102,117,382OtherCostOrOtherBasisAmt
Depreciation$19,661,611DepreciationAmt
Book Value$82,455,771BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,358,510OtherCostOrOtherBasisAmt
Depreciation$1,751,502DepreciationAmt
Book Value$1,607,008BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$19,649,395OtherCostOrOtherBasisAmt
Depreciation$6,422,885DepreciationAmt
Book Value$13,226,510BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$18,799,579OtherCostOrOtherBasisAmt
Book Value$18,799,579BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$124,058,009TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
EST. THIRD PARTY SETTLEMENTS$728,811
DEFERRED COMPENSATION$1,096,691
DUE TO ROGERS BEHAVIORAL HEALTH SYSTEM, INC.$482,464
Due to Rogers InHealth, Inc.$100,769
FieldValueIRS element (for citing)
Total Liability$2,408,735TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$113,828,914TotalRevEtcAuditedFinclStmtAmt
Other Revenue-$9,947,431OtherRevenueAmt
Revenue Not Reported-$9,947,431RevenueNotReportedAmt
Revenue Subtotal$123,776,345RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$123,776,345TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$109,225,455TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$109,225,455ExpensesSubtotalAmt
Other Expenses Not Included$7,641,020OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$7,641,020ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$116,866,475TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Line 4:THE ENDOWMENT FUNDS ARE USED TO SUPPORT HOSPITAL CAPITAL PROJECTS, SPECIFIC PROGRAMS DESIGNATED BY THE DONOR, AND PATIENT CARE ASSISTANCE.
Part X, Line 2:THE HOSPITAL IS A TAX-EXEMPT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 509(A)(2) OF THE CODE. IT IS ALSO EXEMPT FROM STATE INCOME TAXES ON RELATED INCOME. THE HOSPITAL IS ALSO ENGAGED, TO A LIMITED EXTENT, IN CERTAIN ACTIVITIES SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME (UBI). INCOME TAXES ON UBI ARE NOT SIGNIFICANT. PBH IS A TAXABLE SINGLE MEMBER LIMITED LIABILITY CORPORATION. INCOME OR LOSS FOR PBH IS REQUIRED TO BE REPORTED BY THE HOSPITAL ON ITS TAX RETURN.
Part XI, Line 2d - Other Adjustments:BAD DEBT EXPENSE -7,495,422. Costs related to early extinguishment of debt -2,633,555. Net Assets Released from restrictions 327,144. Investment Mgmt Fees -145,598.
Part XII, Line 4b - Other Adjustments:BAD DEBT EXPENSE 7,495,422. Investment Mgmt Fees 145,598.

Schedule H IRS990ScheduleH

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

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other115.000000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Discounted Care Other115.000000000000DiscountedCareOtherPct
FieldValueIRS element (for citing)
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$872,288TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$872,288NetCommunityBenefitExpnsAmt
Total Expense0.00750TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$32,539,110TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$31,852,116DirectOffsettingRevenueAmt
Net Community Benefit Expns$686,994NetCommunityBenefitExpnsAmt
Total Expense0.00590TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$33,411,398TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$31,852,116DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,559,282NetCommunityBenefitExpnsAmt
Total Expense0.01340TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$219,883TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$75,622DirectOffsettingRevenueAmt
Net Community Benefit Expns$144,261NetCommunityBenefitExpnsAmt
Total Expense0.00120TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$104,315TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$104,315NetCommunityBenefitExpnsAmt
Total Expense0.00090TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$324,198TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$75,622DirectOffsettingRevenueAmt
Net Community Benefit Expns$248,576NetCommunityBenefitExpnsAmt
Total Expense0.00210TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$33,735,596TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$31,927,738DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,807,858NetCommunityBenefitExpnsAmt
Total Expense0.01550TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$3,767,051BadDebtExpenseAmt
Reimbursed By Medicare$2,416,022ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$3,302,139CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$886,117MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection Policy0WrittenDebtCollectionPolicyInd
Hospital Facilities3HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (3 entries)

FacilityFacilityNumAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdWebsite AddressWebsiteAddressTxtLicensed HospitalLicensedHospitalInd
ROGERS MEMORIAL HOSPITAL - OCONOMOWOC
134700 VALLEY ROADOCONOMOWOCWI53006WWW.ROGERSHOSPITAL.ORGYes (X)
ROGERS MEMORIAL HOSPITAL - WEST ALLIS
211101 W LINCOLN AVENUEMILWAUKEEWI53227WWW.ROGERSHOSPITAL.ORGYes (X)
ROGERS MEMORIAL HOSPITAL - BROWN DEER
34600 WEST SHROEDER DRIVE SUITE 2BROWN DEERWI53223WWW.ROGERSHOSPITAL.ORGYes (X)

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (3 entries)

FacilityFacilityNumFirst Licensed CY Or PYFirstLicensedCYOrPYIndTax Exempt Hospital CY Or PYTaxExemptHospitalCYOrPYIndCHNA ConductedCHNAConductedIndCommunity DefinitionCommunityDefinitionIndCommunity DemographicsCommunityDemographicsIndExisting ResourcesExistingResourcesIndHow Data ObtainedHowDataObtainedIndCommunity Health NeedsCommunityHealthNeedsIndOther Health IssuesOtherHealthIssuesIndCommunity Hlth Needs Id ProcessCommunityHlthNeedsIdProcessIndConsulting ProcessConsultingProcessIndInformation GapsInformationGapsIndCHNA ConductedCHNAConductedYrTake Into Account Others InputTakeIntoAccountOthersInputIndCHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsIndCHNA Conducted With Non FcltsCHNAConductedWithNonFcltsIndCHNA Report Widely AvailableCHNAReportWidelyAvailableIndRpt Available On Own WebsiteRptAvailableOnOwnWebsiteIndOwn Website URLOwnWebsiteURLTxtPaper Copy Public InspectionPaperCopyPublicInspectionIndRpt Available Thru Other MethodRptAvailableThruOtherMethodIndImplementation Strategy AdoptImplementationStrategyAdoptIndImplementation Strategy AdptImplementationStrategyAdptYrStrategy Posted WebsiteStrategyPostedWebsiteIndStrategy Website URLStrategyWebsiteURLTxtStrategy AttachedStrategyAttachedIndOrganization Incur Excise TaxOrganizationIncurExciseTaxIndElig Criteria ExplainedEligCriteriaExplainedIndFPG Family Incm Lmt Free DscntFPGFamilyIncmLmtFreeDscntIndFPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePctFPG Family Incm Lmt Dscnt CareFPGFamilyIncmLmtDscntCarePctIncome Level CriteriaIncomeLevelCriteriaIndAsset Level CriteriaAssetLevelCriteriaIndMedical Indigency CriteriaMedicalIndigencyCriteriaIndInsurance Status CriteriaInsuranceStatusCriteriaIndUnderinsurance Stat CriteriaUnderinsuranceStatCriteriaIndExplained BasisExplainedBasisIndApp Financial Asst ExplnAppFinancialAsstExplnIndDescribed InfoDescribedInfoIndDescribed Suprt DocDescribedSuprtDocIndProvided Hospital ContactProvidedHospitalContactIndProvided Nonprofit ContactProvidedNonprofitContactIndIncludes Publicity MeasuresIncludesPublicityMeasuresIndFAP Avlbl On Request No ChargeFAPAvlblOnRequestNoChargeIndFAP App Avlbl On Request No ChrgFAPAppAvlblOnRequestNoChrgIndCommuntity Notified FAPCommuntityNotifiedFAPIndOther PublicityOtherPublicityIndFAP Actions On NonpaymentFAPActionsOnNonpaymentIndPermit No ActionsPermitNoActionsIndCollection ActivitiesCollectionActivitiesIndFAP Notified Upon AdmissionFAPNotifiedUponAdmissionIndFAP Notified Before DischargeFAPNotifiedBeforeDischargeIndFAP Notified All PatientsFAPNotifiedAllPatientsIndDocumented Elig DeterminationDocumentedEligDeterminationIndNondis Emergency Care PolicyNondisEmergencyCarePolicyIndOther Method UsedOtherMethodUsedIndAmounts Generally BilledAmountsGenerallyBilledIndGross ChargesGrossChargesInd
ROGERS MEMORIAL HOSPITAL - OCONOMOWOC
100Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)13Yes (1)00Yes (1)Yes (X)SEE PART V, SECTION B, LINE 5DYes (X)Yes (X)Yes (1)13Yes (1)http://rogershospital.org/pdf/CHNA-2013.pdf00Yes (1)Yes (X)115.000000000000115.000000000000Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)0Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)00
ROGERS MEMORIAL HOSPITAL - WEST ALLIS
200Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)13Yes (1)00Yes (1)Yes (X)SEE PART V, SECTION B, LINE 5DYes (X)Yes (X)Yes (1)13Yes (1)http://rogershospital.org/pdf/CHNA-2013.pdf00Yes (1)Yes (X)115.000000000000115.000000000000Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (1)Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)0Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)00
ROGERS MEMORIAL HOSPITAL - BROWN DEER
3Yes (1)Yes (1)Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)13Yes (1)00Yes (1)Yes (X)SEE PART V, SECTION B, LINE 5DYes (X)Yes (X)Yes (1)13Yes (1)http://rogershospital.org/pdf/CHNA-2013.pdf00Yes (1)Yes (X)115.000000000000115.000000000000Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (1)Yes (1)Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)0Yes (X)Yes (X)Yes (X)Yes (X)Yes (1)Yes (X)00

Supplemental Information SupplementalInformationGrp (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
ROGERS MEMORIAL HOSPITAL - OCONOMOWOCPart V, Section B, Line 5: Yes, we surveyed community members and reviewed other hospital and governmental surveys conducted to assess the community need.
ROGERS MEMORIAL HOSPITAL - OCONOMOWOCPart V, Section B, Line 7d: http://rogershospital.org/pdf/CHNA-2013.pdf
ROGERS MEMORIAL HOSPITAL - WEST ALLISPart V, Section B, Line 7d: http://rogershospital.org/pdf/CHNA-2013.pdf
ROGERS MEMORIAL HOSPITAL - BROWN DEERPart V, Section B, Line 7d: http://rogershospital.org/pdf/CHNA-2013.pdf
ROGERS MEMORIAL HOSPITAL - OCONOMOWOCPart V, Section B, Line 11: The advisory committee made the decision not to address the following priorities:1. Community Support GroupsThe advisory committee felt that there are a wide variety of support groups for AODA and mental health disorders already located in each county in Southeastern Wisconsin. Several of them are handled through the county level. In order to prevent duplication RMH will not respond to this priority at this time.2. Knowing Where to go for HelpThere is currently a program in Waukesha called 211/First Call for Help that provides immediate support and connections to community resources for individuals and families of several South Eastern Wisconsin. This need has started being addressed at the county level therefore, Rogers will not respond to this priority at this time.
ROGERS MEMORIAL HOSPITAL - WEST ALLISPart V, Section B, Line 11: The advisory committee made the decision not to address the following priorities:1. Community Support GroupsThe advisory committee felt that there are a wide variety of support groups for AODA and mental health disorders already located in each county in Southeastern Wisconsin. Several of them are handled through the county level. In order to prevent duplication RMH will not respond to this priority at this time.2. Knowing Where to go for HelpThere is currently a program in Waukesha called 211/First Call for Help that provides immediate support and connections to community resources for individuals and families of several South Eastern Wisconsin. This need has started being addressed at the county level therefore, Rogers will not respond to this priority at this time.
ROGERS MEMORIAL HOSPITAL - BROWN DEERPart V, Section B, Line 11: The advisory committee made the decision not to address the following priorities:1. Community Support GroupsThe advisory committee felt that there are a wide variety of support groups for AODA and mental health disorders already located in each county in Southeastern Wisconsin. Several of them are handled through the county level. In order to prevent duplication RMH will not respond to this priority at this time.2. Knowing Where to go for HelpThere is currently a program in Waukesha called 211/First Call for Help that provides immediate support and connections to community resources for individuals and families of several South Eastern Wisconsin. This need has started being addressed at the county level therefore, Rogers will not respond to this priority at this time.
ROGERS MEMORIAL HOSPITAL - OCONOMOWOCPart V, Section B, Line 16i: NOTIFIED INDIVIDUALS IN COMMUNICATIONS REGARDING THEIR BILLS.
ROGERS MEMORIAL HOSPITAL - WEST ALLISPart V, Section B, Line 16i: NOTIFIED INDIVIDUALS IN COMMUNICATIONS REGARDING THEIR BILLS.
ROGERS MEMORIAL HOSPITAL - BROWN DEERPart V, Section B, Line 16i: NOTIFIED INDIVIDUALS IN COMMUNICATIONS REGARDING THEIR BILLS.
ROGERS MEMORIAL HOSPITAL - OCONOMOWOCPart V, Section B, Line 22d: THE HOSPITAL USES VARIOUS RATES DEPENDING ON EACH PATIENTS UNIQUE SITUATIONS, BASED ON THE CRITERIA FILLED OUT ON OUR FINANCIAL ASSISTANCE FORM.
ROGERS MEMORIAL HOSPITAL - WEST ALLISPart V, Section B, Line 22d: THE HOSPITAL USES VARIOUS RATES DEPENDING ON EACH PATIENTS UNIQUE SITUATIONS, BASED ON THE CRITERIA FILLED OUT ON OUR FINANCIAL ASSISTANCE FORM.
ROGERS MEMORIAL HOSPITAL - BROWN DEERPart V, Section B, Line 22d: THE HOSPITAL USES VARIOUS RATES DEPENDING ON EACH PATIENTS UNIQUE SITUATIONS, BASED ON THE CRITERIA FILLED OUT ON OUR FINANCIAL ASSISTANCE FORM.
FieldValueIRS element (for citing)
Facility6FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
ROGERS MEMORIAL HOSPITAL - MADISON
406 SCIENCE DRIVE SUITE 110MADISONWI53711CENTER FOR EATING AND ANXIETY DISORDERS, AND COGNITIVE-BEHAVIORAL THERAPY
ROGERS MEMORIAL HOSPITAL - BROWN DEER
4600 WEST SHROEDER DRIVE SUITE 2BROWN DEERWI53223TREATMENT CENTER FOR CHILDREN AND ADOLESCENTS
ROGERS MEMORIAL HOSPITAL - KENOSHA
9916 75TH STREETKENOSHAWI53142TREATMENT CENTER FOR CHILDREN AND ADOLESCENTS
ROGERS BEHAVIORAL HEALTH - TAMPA
2002 N LOIS AVE SUITE 400TAMPAFL33607CENTER FOR OCD, ANXIETY AND EATING DISORDERS
ROGERS BEHAVIORAL HEALTH - NASHVILLE
4230 HARDING ROAD SUITE 707NASHVILLETN37205CENTER FOR OCD, ANXIETY AND EATING DISORDERS
ROGERS BEHAVIORAL HEALTH - CHICAGO
4711 GOLF ROAD SUITE 600SKOKIEIL60076CENTER FOR OCD, ANXIETY, EATING, DEPRESSION, AND MOOD DISORDERS

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 6a:COMMUNITY BENEFIT WISCONSIN STATE ASSOCIATION SURVEY
Part I, Line 7:LINES A - E: CONSISTENT WITH THE MISSION OF THE HOSPITAL, CARE IS PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY, INCLUDING PROVIDING SERVICES TO THOSE PERSONS WHO ARE UNINSURED AND WHO CANNOT AFFORD HEALTH INSURANCE BECAUSE OF INADEQUATE RESOURCES. THE HOSPITAL PROVIDES DISCOUNTS FROM ESTABLISHED CHARGES TO SELF-PAY PATIENTS WITHOUT REGARD TO THE PATIENT'S ABILITY TO PAY AND CONSIDERS THESE DISCOUNTS A PART OF THEIR COMMUNITY BENEFIT. PATIENTS WHO MEET CERTAIN CRITERIA FOR COMMUNITY CARE, GENERALLY BASED ON FEDERAL POVERTY GUIDELINES, ARE PROVIDED CARE WITHOUT CHARGE OR AT A REDUCED RATE, DETERMINED BASED ON QUALIFYING CRITERIA AS DEFINED IN THE HOSPITAL'S COMMUNITY CARE POLICY AND FROM APPLICATIONS COMPLETED BY PATIENTS AND THEIR FAMILIES. LINE H: RESEARCH AND RELATED COSTS ARE DIRECTLY ASSIGNED BASED ON UTILIZATION OF RESOURCES.LINES E AND I: THESE ARE COSTS DEVELOPED BASED ON THE ESTIMATED TIME AND RESOUCES UTILIZED IN PROVIDING THESE COMMUNITY BENEFITS.
Part III, Line 4:ROGERS MEMORIAL HOSPITAL UTILIZED A COST TO CHARGE RATIO FOR DETERMINING COST OF BAD DEBT EXPENSE.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 CHARGE TO 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.CERTAIN AMOUNTS OF BAD DEBT EXPENSE COULD BE ATTRIBUTED TO CHARITY CARE AS ALL RELEVANT INFORMATION IS NOT READILY AVAILABLE FOR ALL PATIENTS. IF, AT THE TIME OF ADMISSION AND BEFORE BILLING, PATIENTS WHO KNEW THEY COULD NOT PAY FOR SERVICES REQUESTED ASSISTANCE UP FRONT OR THE HOSPITAL BECAME AWARE UPON ADMISSION THAT A PATIENT WOULD BE UNABLE TO PAY, THEY WOULD HAVE HAD THOSE PATIENTS APPLY FOR CHARITY CARE INSTEAD OF HAVING THE FACTS COME TO LIGHT AFTER THE PATIENT HAD BEEN BILLED AND NOT BEEN ABLE TO PAY.
Part III, Line 8:DATA REPORTED AS MEDICARE ALLOWABLE COSTS WERE TAKEN DIRECTLY FROM THE MEDICARE COST REPORT.THE MEDICARE SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT AS A HOSPITAL THAT SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS (INCLUDING MEDICARE) INDICATES THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY AND THEREFORE IMPLIES THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT.
Part III, Line 9b:ROGERS MEMORIAL HOSPITAL RECOGNIZES THE NEED FOR THE MEDICALLY INDIGENT TO RECEIVE NECESSARY SERVICES. PATIENT CARE IS NOT AFFECTED BY HIS/HER INABLILITY TO PAY REGARDLESS OF FINANCIAL STATUS, RACE, COLOR, CREED, SEXUAL ORIENTATION, HANDICAP, SEX OR NATIONAL ORIGIN. SERVICES ARE RENDERED IN A CARING, RESPECTFUL AND CONCERNED MANNER. TO ENSURE THAT THE PHILOSOPHY OF THE HOSPITAL IS UPHELD, A CONSISTENT METHOD OF DETERMINING ELIGIBILITY FOR COMMUNITY CARE HAS BEEN DEVELOPED. IT IS THE POLICY OF ROGERS MEMORIAL HOSPITAL TO WRITE-OFF ACCOUNTS THAT QUALIFY FOR CHARITY CARE, THUS THERE ARE NO COLLECTION EFFORTS RELATED TO THOSE THAT QUALIFY FOR CHARITY CARE. COMMUNITY CARE IS NOT TO BE USED AS A SUBSTITUTE FOR BAD DEBT. ONLY THOSE PATIENTS WHO MEET THE CRITERIA ARE ELIGIBLE FOR COMMUNITY CARE RELIEF. THOSE PATIENTS WHO DO NOT MEET THE CRITERIA AND REFUSE TO COOPERATE WITH COLLECTION EFFORTS WILL BE PURSUED TO THE EXTENT DEEMED NECESSARY BY MANAGEMENT FOR COLLECTION AND IF STILL UNCOLLECTIBLE, WILL BE WRITTEN OFF TO BAD DEBT.
Part VI, Line 2:WE COLLABORATE WITH OTHER PROVIDERS THROUGH PARTNERSHIPS AND CONSULTING RELATIONSHIPS WITH THE MEDICAL COLLEGE OF WISCONSIN, CHILDREN'S HOSPITAL OF WISCONSIN, FROEDTERT HEALTH, COMMUNITY MEMORIAL HOSPITAL AND COLUMBIA ST. MARY'S,IN ORDER TO BRING QUALITY BEHAVIORAL HEALTH SERVICES TO WISCONSIN RESIDENTS.
Part VI, Line 3:A PATIENT'S ABILITY TO PAY FOR SERVICES WILL BE DETERMINED UPON, OR AS SOON AS POSSIBLE AFTER, ADMISSION TO THE HOSPITAL. A.) IF, UPON ADMISSION (INPATIENT, OUTPATIENT), THE PATIENT AND/OR RESPONSIBLE PARTY REQUESTS FINANCIAL ASSISTANCE, HE/SHE WILL BE INFORMED THAT THE HOSPITAL HAS A COMMUNITY CARE POLICY AND WILL BE REFERRED TO THE MANAGER OF PATIENT ACCOUNTS BY THE ADMITTING SPECIALIST. B.) IF, AFTER ADMISSION, THE PATIENT IS DETERMINED TO BE POSSIBLY ELIGIBLE FOR COMMUNITY CARE AND REQUESTS ASSISTANCE, HE/SHE WILL BE REFERRED TO THE MANAGER OF PATIENT ACCOUNTS BY THE BILLING ASSISTANT.
Part VI, Line 4:ROGERS MEMORIAL HOSPITAL OPERATES FACILITIES IN THE WISCONSIN COMMUNITIES OF ONCONOMOWOC, WEST ALLIS, BROWN DEER, KENOSHA, AND DELAFIELD TO PROVIDE INPATIENT AND OUTPATIENT BEHAVIORAL HEALTH AND PSYCIATRIC SERVICES TO PATIENTS PRIMARILY FROM THE MIDWEST. THE HOSPITAL PROVIDES SERVICES RELATING TO RECOVERY FROM ADDICTIONS, ABUSE, DISRUPTIVE BEHAVIOR, EATING AND OBSESSIVE COMPULSIVE DISORDERS; GENERAL PSYCHIATRY FOR ADULTS, ADOLESCENTS, AND CHILDREN; AND ADOLESCENT EXTENDED CARE.IN 2014-2015, APPROXIMATELY 11,700 INDIVIDUALS WERE ADMITTED TO ROGERS. 90% of the individuals were Wisconsin residents, 54% coming from Milwaukee and Waukesha Counties. THIS SERVICES AREA SUGGESTS THAT ROGERS NOT ONLY PROVIDES A SIGNIFICANT SERVICE TO ITS SURROUNDING COMMUNITY, BUT ALSO TO THE GREATER WISCONSIN COMMUNITY AS A WHOLE.
Part VI, Line 5:SEE STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS ON PART III OF FORM 990.

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtNon Cash AssistanceNonCashAssistanceAmtValuation Method UsedValuationMethodUsedDescNon Cash AssistanceNonCashAssistanceDescPurpose Of GrantPurposeOfGrantTxt
ROGERS MEMORIAL HOSPITAL FOUNDATION INC
34700 VALLEY ROADOCONOMOWOCWI53066391363507501(C)3$1,000,000$619,913CostPROVIDES SUPPORT TO FOUNDATION TO ASSIST IN CARRYING OUT ITS EXEXPT PURPOSETHE HOSPITAL PROVIDES SUPPORT TO THE FOUNDATION TO ASSIST IN CARRYING OUT ITS EXEXPT PURPOSE
ROGERS INHEALTH INC
34700 VALLEY ROADOCONOMOWOCWI53066463960059501(C)3$495,800CostPROVIDES SUPPORT TO INHEALTH TO ASSIST IN CARRYING OUT ITS EXEXPT PURPOSETHE HOSPITAL PROVIDES SUPPORT TO INHEALTH TO ASSIST IN CARRYING OUT ITS EXEXPT PURPOSE
FieldValueIRS element (for citing)
Total501c3 Org2Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 2:FormAndLineReferenceDesc
ExplanationAS GRANTS ARE MADE PRIMARILY TO ROGERS MEMORIAL HOSPITAL FOUNDATION, MONITORING OF THESE TRANSACTIONS ARE PERFORMED BY OFFICERS OF THE HOSPITAL WITH OVERSIGNT BY THE BOARD OF DIRECTORS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (1)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (19 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Vineet Kulkarni
Board Member$380,714$0$0$0$2,131$0$10,400$0$23,041$0$416,286$0$0$0
Bradley Riemann
Board Member$339,924$0$0$0$817$0$10,400$0$27,765$0$378,906$0$0$0
Paul Mueller
COO$336,080$0$66,544$0$1,703$0$10,400$0$31,551$0$446,278$0$0$0
Keith Degner
CFO - RMH$221,424$0$32,109$0$5,694$0$9,867$0$31,765$0$300,859$0$0$0
Patrick Hammer
CEO - RBHS$0$526,910$0$120,517$0$9,548$0$10,400$0$25,002$0$692,377$0$0
Michael Hedrick
CfO - RBHS$0$261,848$0$31,731$0$11,118$0$5,385$0$31,765$0$341,847$0$0
William Hendricks
VP Operations$206,698$0$0$0$0$0$9,248$0$16,505$0$232,451$0$0$0
Renee Patterson
VP of Employment & Trainin$216,880$0$26,637$0$299$0$9,916$0$27,765$0$281,497$0$0$0
Teresa Schultz
VP Nursing$205,629$0$24,793$0$799$0$9,222$0$130$0$240,573$0$0$0
Orvin Fillman
VP of Operations - MKE$194,518$0$24,122$0$1,182$0$9,082$0$23,171$0$252,075$0$0$0
Peter Lake
Medical Director$466,741$0$0$0$12,663$0$10,400$0$31,551$0$521,355$0$0$0
Kambiz Pahlavan
Medical Director$293,875$0$0$0$5,290$0$10,400$0$0$0$309,565$0$0$0
Ahmed Numaan
Physician$449,734$0$0$0$515$0$9,620$0$0$0$459,869$0$0$0
Michael Miller
Physician$328,242$0$0$0$2,284$0$10,400$0$23,255$0$364,181$0$0$0
Brad Smith
Physician$387,306$0$0$0$1,131$0$10,400$0$27,765$0$426,602$0$0$0
Jerry Halverson
Physician$332,548$0$0$0$11,879$0$10,400$0$31,551$0$386,378$0$0$0
Tracey Cornells-Carlson
Physician$524,944$0$0$0$828$0$9,837$0$0$0$535,609$0$0$0
David Moulthrop
Former CEO$132,809$0$0$0$762$0$5,600$0$23,422$0$162,593$0$0$0
Gerald Noll
FORMER CFO$248,055$0$0$0$0$0$0$0$0$0$248,055$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 1aHEALTH AND SOCIAL MEMBERSHIPS FOR CERTAIN OFFICERS, KEY EMPLOYEES AND HIGHEST COMPENSATED INDIVIDUALS ARE INCLUDED IN TAXABLE COMPENSATION AS THESE FEES ARE PAID BY ROGERS MEMORIAL HOSPITAL. $3,470 PAUL MUELLER $3,470 PAT HAMMER
Part I, Line 4aGERALD NOLL AND WILLIAM HENDRICKS RECEIVED SEVERANCE PAYMENTS THAT WERE INCLUDED IN THE TOTAL COMPENSATION DISCLOSED IN PART II OF SCHEDULE J.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTHORITYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN391337855BondIssuerEIN
CUSIP97712DEV4CUSIPNum
Bond Issued2014-08-15BondIssuedDt
Issue Price$55,065,129IssuePriceAmt
PurposeBUILDING IMPROVEMENTS TO VARIOUS SITESPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$1,040,000RetiredAmt
Total Proceeds$55,065,129TotalProceedsAmt
Refunding Escrow$33,023,555RefundingEscrowAmt
Issuance Costs From Proceeds$757,709IssuanceCostsFromProceedsAmt
Capital Expenditures$18,709,734CapitalExpendituresAmt
Unspent$2,574,130UnspentAmt
Current RefundingYes (1)CurrentRefundingInd
Advance RefundingYes (1)AdvanceRefundingInd
Final Allocation Made0FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdYes (1)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due YetYes (1)RebateNotDueYetInd
Exception To Rebate0ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate Issue0VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor ReqsYes (1)WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (1)ProceduresCorrectiveActionInd

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (11 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
RW BAIRD
GARRY ANDERSON, BOARD CHAIRMAN, IS BAIRD'S SENIOR VP OF INVESTMENTS$66,123ROGER'S MEMORIAL HOSPITAL PAYS FEES TO BAIRD FOR INVESTMENT SERVICES.0
VJS CONSTRUCTION SERVICES
GARY JORGENSEN, A BOARD MEMBER, IS THE CHAIRMAN OF VJS CONSTRUCTION$19,236,548ROGER'S MEMORIAL HOSPITAL HAS CONTRACTED WITH VJS FOR CONSTRUCTION AND CONSTRUCTION MANAGEMENT SERVICES.0
TWP ARCHITECTURE
JOHN CURRAN, A BOARD MEMBER, IS THE SENIOR VP OF TWP ARCHITECTURE$713,121TWP ARCHITECTURE PROVIDES ARCHITECTURAL SERVICES TO ROGER'S MEMORIAL HOSPITAL.0
PANZER PUBLIC AFFAIRS
MARY PANZER, BOARD MEMBER$60,500PANZER PUBLIC AFFAIRS COMMUNICATES WITH LEGISLATORS, WORKS ON SPEAKERS BEHAVIORAL TASK FORCE, AND THE DEVELOPMENT OF A PROPOSAL TO CREATE A PROFESSIONALS HEALTH PROGRAM ON BEHALF OF THE HOSPITAL.0
DAVE MOULTHROP
FORMER OFFICER$1,638DAVE MOULTHROP, A FORMER OFFICER, PROVIDES CONSULTING SERVICES TO ROGERS MEMORIAL HOSPITAL.0
J PAHLAVAN
SPOUSE OF KAMBIZ PAHLAVAN$151,204J. PHALAVAN IS A PROGRAM MANAGER EMPLOYED BY ROGERS MEMORIAL HOSPITAL.0
C HENRICKS
SPOUSE OF WILLIAM HENRICKS$70,163C HENRICKS IS A PROGRAM MANAGER EMPLOYED BY ROGERS MEMORIAL HOSPITAL.0
MARTIN BORELL
BOARD MEMBER$1,098AIRFARE AND CAR RENTAL0
CHARLES E KUBLY FOUNDATION
MOLLY KUBLY FIRTA IS A BOARD MEMBER$2,740CHARITABLE CONTRIBUTION MADE TO THE CHARLES E. KUBLY FOUNDATION - BEYOND BLUES0
MEDICAL COLLEGE OF WISCONSIN
JOHNATHAN WERTZ$199,315PAYMENT FOR FELLOWSHIP.INTERN AND CONSULTING SERVICES0
NORTHWESTERN MUTUAL
CALVIN SCHMIDT IS THE VICE CHAIR OF THE BOARD$3,770PAYMENT FOR FINANCIAL PLANNING SERVICES0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 2BOARD MEMBER ANDRITSCH IS AN EMPLOYEE OF VJS CONSTRUCTION OF WHICH BOARD MEMBER JORGENSEN IS AN OWNER.
Form 990, Part VI, Section A, line 6ROGERS BEHAVIORAL HEALTH SYSTEM IS THE SOLE CORPORATE MEMBER.
Form 990, Part VI, Section A, line 7aPER THE BY-LAWS, ADDITIONAL MEMBERS OF THE BOARD OF DIRECTORS SHALL BE DETERMINED BY THE SOLE CORPORATE MEMBER FROM TIME TO TIME.
Form 990, Part VI, Section A, line 7bTHE FOLLOWING ACTIONS MUST BE APPROVED BY THE SOLE MEMBER OF THE ORGANIZATION, ROGERS BEHAVIORAL HEALTH SYSTEM: 1) SELLING OR DISPOSING OF A MATERIAL PART OF THE CORPORATION'S ASSETS, 2) LENDING OR BORROWING MONEY OTHER THAN PURSUANT TO AN APPROVED LINE OF CREDIT, 3) GRANTING A MORTGAGE OR SUBJECTING TO ANOTHER SECURITY INTEREST ANY MATERIAL PORTION OF THE CORPORATION'S ASSETS, 4) ENTERING INTO CONTRACTS OR AGREEMENTS WITH PERSONS WHICH, INDIVIDUALLY, OR AS TO THE SAME PARTY, IN AGGREGATE CALL FOR THE PAYMENT BY THE CORPORATION OF AMOUNTS WHICH ARE GREATER THAN SUCH AMOUNTS WHICH ARE APPROVED BY RESOLUTION OF THE MEMBER FROM TIME TO TIME. THE MEMBER MAY ESTABLISH LIMITATIONS OF DIFFERING SIZES FOR DIFFERENT TYPES OF EXPENDITURES AND AREAS TO WHICH THESE LIMITS ARE NOT APPLICABLE, 5) UNDERTAKING MAJOR CAPITAL IMPROVEMENTS TO OR OTHERWISE REHABILITATING THE CORPORATION'S PROPERTIES, 6) CONFESSING A JUDGEMENT AGAINST THE CORPORATION, 7) MAKING ANY CHANGES OR AMENDMENTS TO THE CORPORATION'S ARTICLES OF INCORPORATION OR BYLAWS.
Form 990, Part VI, Section B, line 11KEITH DEGNER, CFO, COMPLETES A DETAILED REVIEW OF THE 990 PRIOR TO MAKING THE 990 AVAILABLE TO THE BOARD MEMBERS. THE FORM 990 IS MADE AVAILABLE TO THE BOARD MEMBERS THROUGH THE BOARD'S WEBSITE SO THEY CAN REVIEW AND COMMENT ON IT PRIOR TO FILING.
Form 990, Part VI, Section B, line 12cRoger's Memorial Hospital's Directors and officers shall, should a conflict arise at any time, promptly disclose such conflict in writing to the chairperson of the board of directors; and in matters where a member has a conflict that requires a vote, abstain. Annually, the conflict of interest form will be submitted to the chairman of the board. In addition, each administrative staff member, medical staff officer, medical/administrative agent, and employee involved in purchasing supplies and equipment for the hospital shall have a conflict of interest statement on file in the president's office and those statements shall be updated annually and whenever there is a need for additions or deletions.
Form 990, Part VI, Section B, line 15THE CEO'S COMPENSATION IS DETERMINED BY INDUSTRY ANALYSIS AND IS SUPPORTED BY AN ANALYSIS BY AN EXTERNAL CONSULTANT. APPROVAL OF THE RESULTS IS BY THOSE BOARD MEMBERS WITHOUT CONFLICT OF INTEREST AND THE APPROVAL IS DOCUMENTED. OTHER KEY OFFICERS' COMPENSATION IS DETERMINED BY INDUSTRY ANALYSIS SIMILAR TO THE PROCESS USED TO DETERMINE THE CEO'S COMPENSATION.
Form 990, Part VI, Section C, line 19ROGER'S MEMORIAL HOSPITAL DOES NOT MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. THE FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC AS THEY ARE ATTACHED TO THE FILED IRS FORM 990 AND SUBSEQUENTLY PUBLISHED ONLINE BY THE IRS.
Form 990, Part XI, line 9:CHANGE IN INTEREST IN NET ASSETS OF ROGERS MEMORIAL HOSPITAL FOUNDATION, IN 1,797,134. Costs related to early extinguishment of debt -2,633,555.
Form 990, Part XII, Line 2c:The process has not changed from the prior year.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1Partners in Behavioral HealthBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line134700 Valley RoadAddressLine1Txt
CityOconomowocCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53066ZIPCd
FieldValueIRS element (for citing)
EIN391832142EIN
Primary ActivitiesTo assist its subsidiaries in providing behavioral health servicesPrimaryActivitiesTxt
Legal Domicile StateWILegalDomicileStateCd
Total Income$129,002TotalIncomeAmt
End Of Year Assets$213,355EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Rogers Memorial HospitalBusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
ROGERS BEHAVIORAL HEALTH SYSTEM INC
34700 VALLEY ROADOCONOMOWOCWI53066263902724TO ASSIST ITS SUBSIDIARIES IN PROVIDING BEHAVIORAL HEALTH SERVICESWI501(c)(3)Line 11b, IIN/A0
ROGERS MEMORIAL HOSPITAL FOUNDATION INC
34700 VALLEY ROADOCONOMOWOCWI53066391363507TO SUPPORT ALL ENTITIES OF ROGER'S BEHAVIORAL HEALTH SYSTEM, INC.WI501(c)(3)Line 9Yes (1)ROGERS BEHAVIORAL HEALTH SYSTEM INC
ROGERS INHEALTH INC
34700 VALLEY ROADOCONOMOWOCWI53066463960059IMPLEMENTS AND PROMOTES ACCESSIBLE EDUCATION AND ADVOCACY RESOURCESWI501(c)(3)Line 9Yes (1)ROGERS BEHAVIORAL HEALTH SYSTEM INC
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (1)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (4 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
Rogers Memorial Hospital Foundation
B$1,619,913FMV of Grants Paid and Serv Perf
Rogers Memorial Hospital Foundation
C$322,179FMV of Grants Paid
Rogers InHealth Inc
B$495,800FMV of Services Performed
Rogers Behavioral Health System Inc
M$1,498,000FMV of Services Performed