ROGERS MEMORIAL HOSPITAL INCORPORATED: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- ROGERS MEMORIAL HOSPITAL INCORPORATED (EIN 39-1139101)
- Tax period
- 2013-08-01 to 2014-07-31
- Filed
- 2015-06-15
- IRS object ID
- 201541669349300224
- Schema version
- 2013v4.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-06-15T10:15:33-05:00 | ReturnTs |
| Tax Period End | 2014-07-31 | 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 | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 8010 | AddressLine1 |
| City | WAUSAU | City |
| State | WI | State |
| ZIP Code | 544028010 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-08-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391139101 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ROGERS MEMORIAL HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ROGE | BusinessNameControlTxt |
| Phone | 2626463526 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 34700 VALLEY ROAD | AddressLine1 |
| City | OCONOMOWOC | City |
| State | WI | State |
| ZIP Code | 53066 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KEITH DEGNER | PersonNm |
| Person Title | EXECUTIVE VICE PRESIDENT AND CFO | PersonTitleTxt |
| Phone | 2626463526 | PhoneNum |
| Signature | 2015-06-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Kimberly Heller CPA | PreparerPersonNm |
| PTIN | P00766668 | PTIN |
| Phone | 7158453111 | PhoneNum |
| Preparation | 2015-06-10 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KEITH DEGNER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 34700 VALLEY ROAD | AddressLine1 |
| City | OCONOMOWOC | City |
| State | WI | State |
| ZIP Code | 53066 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $103,976,152 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ROGERSHOSPITAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1907 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | ROGERS 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 Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 4 | VotingMembersIndependentCnt |
| Total Employee | 1229 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $1,264,481 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$298,402 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $779,699 | PYContributionsGrantsAmt |
| CY Contributions Grants | $155,307 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $92,355,717 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $100,008,194 | CYProgramServiceRevenueAmt |
| PY Investment Income | $682,142 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,055,401 | CYInvestmentIncomeAmt |
| PY Other Revenue | $10,150 | PYOtherRevenueAmt |
| CY Other Revenue | -$975,530 | CYOtherRevenueAmt |
| PY Total Revenue | $93,827,708 | PYTotalRevenueAmt |
| CY Total Revenue | $100,243,372 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $540,183 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,978,365 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $51,617,440 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $60,325,067 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $25,420,683 | PYOtherExpensesAmt |
| CY Other Expenses | $26,672,646 | CYOtherExpensesAmt |
| PY Total Expenses | $77,578,306 | PYTotalExpensesAmt |
| CY Total Expenses | $88,976,078 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $16,249,402 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $11,267,294 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $137,569,184 | TotalAssetsBOYAmt |
| Total Assets EOY | $150,863,373 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $42,687,241 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $43,134,538 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $94,881,943 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $107,728,835 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | WE 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 Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $69,605,170 | ExpenseAmt |
| Grant | $1,978,365 | GrantAmt |
| Revenue | $98,557,631 | RevenueAmt |
| Desc | ROGERS 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 2014, ROGERS PATIENT CARE SERVICES INCLUDED 42,577 INPATIENT DAYS, 57,782 PARTIAL TREATMENT DAYS, AND 34,083 RESIDENTIAL PROGRAM DAYS. | Desc |
| Total Program Service Expenses | $69,605,170 | 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 | Yes (1) | 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 | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | 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 | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 92 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | 0 | BackupWthldComplianceInd |
| Employee | 1229 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 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 | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 4 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | 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 | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | 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 | KEITH DEGNER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2626464605 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 34700 VALLEY ROAD | AddressLine1 |
| City | OCONOMOWOC | City |
| State | WI | State |
| ZIP Code | 53066 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Garry Anderson | ||||||||||
| Chair | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||||
| Peter Gottsacker | ||||||||||
| Board Member | 1.00 | Yes (X) | $0 | $0 | $0 | |||||
| Mark Mohr | ||||||||||
| Treasurer | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||||
| Roger Jensen | ||||||||||
| Board Member | 1.00 | Yes (X) | $0 | $0 | $0 | |||||
| Mary Panzer | ||||||||||
| Board Secretary | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||||
| John Curran | ||||||||||
| Board Member | 1.00 | Yes (X) | $0 | $0 | $0 | |||||
| Gary Jorgensen | ||||||||||
| Board Member | 1.00 | Yes (X) | $0 | $0 | $0 | |||||
| William Mulligan | ||||||||||
| Board Member | 1.00 | Yes (X) | $0 | $0 | $0 | |||||
| Theodore Weltzin | ||||||||||
| Board Member | 1.00 | Yes (X) | $403,680 | $0 | $33,961 | |||||
| Patrick Andritsch | ||||||||||
| Board Member | 1.00 | Yes (X) | $0 | $0 | $0 | |||||
| Ted Garvey | ||||||||||
| Board Member | 1.00 | Yes (X) | $0 | $0 | $0 | |||||
| Vineet Kulkarni | ||||||||||
| Board Member | 1.00 | Yes (X) | $305,421 | $0 | $27,095 | |||||
| Keith Degner | ||||||||||
| CFO | 40.00 | Yes (X) | $220,351 | $0 | $30,640 | |||||
| Patrick Hammer | ||||||||||
| CEO | 10.00 | Yes (X) | $0 | $607,015 | $43,659 | 30.00 | ||||
| Gerald Noll | ||||||||||
| EXECUTIVE VICE PRESIDENT | 10.00 | Yes (X) | $0 | $391,329 | $29,415 | 30.00 | ||||
| Paul Mueller | ||||||||||
| COO | 40.00 | Yes (X) | $357,819 | $0 | $39,586 | |||||
| William Hendricks | ||||||||||
| VP Operations | 40.00 | Yes (X) | $348,648 | $0 | $36,478 | |||||
| Renee Patterson | ||||||||||
| VP of Employment & Trainin | 40.00 | Yes (X) | $225,552 | $0 | $34,569 | |||||
| Teresa Schultz | ||||||||||
| VP Nursing | 40.00 | Yes (X) | $213,955 | $0 | $8,529 | |||||
| Peter Lake | ||||||||||
| Medical Director | 40.00 | $466,472 | $0 | $41,086 | Yes (X) | |||||
| Kambiz Pahlavan | ||||||||||
| Medical Director | 40.00 | $281,140 | $0 | $12,700 | Yes (X) | |||||
| Ahmed Numaan | ||||||||||
| Physician | 40.00 | $407,756 | $0 | $10,200 | Yes (X) | |||||
| Bradley Riemann | ||||||||||
| Physician | 40.00 | $328,511 | $0 | $35,765 | Yes (X) | |||||
| Michael Miller | ||||||||||
| Physician | 40.00 | $320,969 | $0 | $34,675 | Yes (X) | |||||
| Brad Smith | ||||||||||
| Physician | 40.00 | $358,844 | $0 | $35,765 | Yes (X) | |||||
| Roger Luhn | ||||||||||
| Physician | 40.00 | $324,535 | $0 | $39,586 | Yes (X) | |||||
| David Moulthrop | ||||||||||
| Former CEO | 1.00 | $230,526 | $0 | $27,612 | Yes (X) | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,794,179 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $998,344 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $521,321 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 64 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| WIPFLI LLP | |||||
| 11 SCOTT STREET | WAUSAU | WI | 54403 | ACCOUNTING | $565,419 |
| HALL RENDER KILLIAN HEATH & LYMAN P | |||||
| 39778 TREASURY CENTER | CHICAGO | IL | 60694 | ATTORNEY | $307,998 |
| TRAINING INSTITUTE FOR SUICIDE ASSESSMEN | |||||
| 104 STONEY BROOK ROAD | NEWBURY | NH | 03255 | CONSULTING | $146,468 |
| JERI DAVIS INTERNATIONAL LLC | |||||
| PO BOX 770534 | MEMPHIS | TN | 38177 | CONSULTING | $144,105 |
| THE JOXEL GROUP LLC | |||||
| 10555 N PORT WASHINGTON RD SUITE 20 | MEQUON | WI | 53092 | CONSULTING | $141,840 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 7 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $155,307 | RelatedOrganizationsAmt |
| Total Contributions | $155,307 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|---|
| NET PATIENT SVC REVENUE | 900099 | $98,638,486 | $98,515,025 | $123,461 | |
| MANAGEMENT SERVICES | 541610 | $1,264,481 | $1,264,481 | ||
| CAFETERIA | 900099 | $62,621 | $62,621 | ||
| PARTNERS IN BEHAVIORAL HEALTH | 900003 | $42,606 | $42,606 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $100,008,194 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $496,597 | TotalRevenueColumnAmt |
| Exclusion | $496,597 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $69,650 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $69,650 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $69,650 | TotalRevenueColumnAmt |
| Exclusion | $69,650 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $4,291,584 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,732,780 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $558,804 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $558,804 | TotalRevenueColumnAmt |
| Exclusion | $558,804 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | WRITE-OFF DEFERRED FINANCING COST | Desc |
| Business | 900000 | BusinessCd |
| Total Revenue Column | -$1,045,180 | TotalRevenueColumnAmt |
| Exclusion | -$1,045,180 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | -$1,045,180 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $100,243,372 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $98,557,631 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $1,264,481 | UnrelatedBusinessRevenueAmt |
| Exclusion | $265,953 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,978,365 | TotalAmt |
| Program Services | $1,978,365 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,334,389 | TotalAmt |
| Program Services | $1,023,882 | ProgramServicesAmt |
| Management And General | $1,310,507 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,411,769 | TotalAmt |
| Program Services | $39,266,046 | ProgramServicesAmt |
| Management And General | $8,145,723 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,301,440 | TotalAmt |
| Program Services | $1,081,451 | ProgramServicesAmt |
| Management And General | $219,989 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,082,343 | TotalAmt |
| Program Services | $4,990,302 | ProgramServicesAmt |
| Management And General | $1,092,041 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,195,126 | TotalAmt |
| Program Services | $2,580,908 | ProgramServicesAmt |
| Management And General | $614,218 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,099,004 | TotalAmt |
| Program Services | $3,708,949 | ProgramServicesAmt |
| Management And General | $2,390,055 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,710,159 | TotalAmt |
| Program Services | $1,355,185 | ProgramServicesAmt |
| Management And General | $354,974 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,211,463 | TotalAmt |
| Program Services | $699,311 | ProgramServicesAmt |
| Management And General | $512,152 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $668,057 | TotalAmt |
| Program Services | $581,210 | ProgramServicesAmt |
| Management And General | $86,847 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,611,777 | TotalAmt |
| Program Services | $4,012,246 | ProgramServicesAmt |
| Management And General | $599,531 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $964,467 | TotalAmt |
| Program Services | $839,086 | ProgramServicesAmt |
| Management And General | $125,381 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PROFESSIONAL AND CONTRA | $7,038,904 | $3,217,997 | $3,820,907 |
| BAD DEBT EXPENSE | $3,958,585 | $3,958,585 | |
| PROPERTY TAXES | $241,198 | $241,198 | |
| DUES AND FEES | $169,032 | $70,449 | $98,583 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,976,078 | TotalAmt |
| Program Services | $69,605,170 | ProgramServicesAmt |
| Management And General | $19,370,908 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,921,411 | BOYAmt |
| EOY | $791,931 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,886,144 | BOYAmt |
| EOY | $15,027,967 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,779,104 | BOYAmt |
| EOY | $15,271,401 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $711,065 | BOYAmt |
| EOY | $276,855 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $124,010,860 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $32,644,574 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $71,167,122 | BOYAmt |
| EOY | $91,366,286 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,423,776 | BOYAmt |
| EOY | $25,379,958 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,680,562 | BOYAmt |
| EOY | $2,748,975 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $137,569,184 | BOYAmt |
| EOY | $150,863,373 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,557,485 | BOYAmt |
| EOY | $10,448,890 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,901,668 | BOYAmt |
| EOY | $30,390,000 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $585,000 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,228,088 | BOYAmt |
| EOY | $1,710,648 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,687,241 | BOYAmt |
| EOY | $43,134,538 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $91,978,379 | BOYAmt |
| EOY | $105,122,379 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,752,514 | BOYAmt |
| EOY | $889,477 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,151,050 | BOYAmt |
| EOY | $1,716,979 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $94,881,943 | BOYAmt |
| EOY | $107,728,835 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $137,569,184 | BOYAmt |
| EOY | $150,863,373 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $11,267,294 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $583,537 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $996,061 | 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) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| 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 | $92,174 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $92,174 | 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 | PORTIONS OF ASSOCIATION DUES ALLOCATED FOR LOBBYING EXPENSES OF WHA $15,914(11.5%) AND AMA $16,260 (23.98%). WE HIRED AN INDIVIDUAL 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,263,229 | BeginningYearBalanceAmt |
| Contributions | $565,929 | ContributionsAmt |
| Investment Earnings Or Losses | $94,384 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $1,923,542 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $578,612 | BeginningYearBalanceAmt |
| Contributions | $596,745 | ContributionsAmt |
| Investment Earnings Or Losses | $87,872 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $1,263,229 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,268,341 | BeginningYearBalanceAmt |
| Contributions | $308,852 | ContributionsAmt |
| Investment Earnings Or Losses | $1,419 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,000,000 | OtherExpendituresAmt |
| End Year Balance | $578,612 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,000,000 | BeginningYearBalanceAmt |
| Contributions | $245,453 | ContributionsAmt |
| Investment Earnings Or Losses | $22,888 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $1,268,341 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,000,000 | BeginningYearBalanceAmt |
| End Year Balance | $1,000,000 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 0.89260 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.10740 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,070,341 | OtherCostOrOtherBasisAmt |
| Book Value | $5,070,341 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $86,493,214 | OtherCostOrOtherBasisAmt |
| Depreciation | $20,837,895 | DepreciationAmt |
| Book Value | $65,655,319 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,064,610 | OtherCostOrOtherBasisAmt |
| Depreciation | $339,592 | DepreciationAmt |
| Book Value | $2,725,018 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $17,741,094 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,810,004 | DepreciationAmt |
| Book Value | $8,931,090 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,641,601 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,657,083 | DepreciationAmt |
| Book Value | $8,984,518 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $91,366,286 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| EST. THIRD PARTY SETTLEMENTS | $596,813 |
| DEFERRED COMPENSATION | $771,281 |
| DUE TO ROGERS BEHAVIORAL HEALTH SYSTEM, INC. | $249,403 |
| Due to Rogers InHealth, Inc. | $93,151 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,710,648 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $96,284,787 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$3,958,585 | OtherRevenueAmt |
| Revenue Not Reported | -$3,958,585 | RevenueNotReportedAmt |
| Revenue Subtotal | $100,243,372 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $100,243,372 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $85,017,493 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $85,017,493 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $3,958,585 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $3,958,585 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $88,976,078 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 4: | ROGERS MEMORIAL HOSPITAL'S ENDOWMENT IS INTENDED TO PROVIDE FUNDS FOR FUTURE PROGRAMS AND CAPITAL IMPROVEMENTS. |
| Part X, Line 2: | IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE HOSPITAL DETERMINES WHETHER IT IS MORE-LIKELY-THAN-NOT THAT A TAX POSITION WITLL BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITIONS, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THE TAX POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. THE HOSPITAL HAS NOT RECORDED ANY ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS AS OF JULY 31, 2014 AND 2013. THE FEDERAL AND STATE RETURNS FOR TAX YEARS 2010 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE AND STATE AUTHORITIES. |
| Part XI, Line 2d - Other Adjustments: | BAD DEBT EXPENSE -3,958,585. |
| Part XII, Line 4b - Other Adjustments: | BAD DEBT EXPENSE 3,958,585. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 115.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 115.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | $506,026 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $506,026 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00570 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $25,155,710 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $22,596,086 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,559,624 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02880 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $25,661,736 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $22,596,086 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,065,650 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03450 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $180,711 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $107,393 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $73,318 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $192,367 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $192,367 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00220 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $373,078 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $107,393 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $265,685 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00300 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $26,034,814 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $22,703,479 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,331,335 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03750 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,901,133 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $2,733,956 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $3,107,322 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$373,366 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 0 | WrittenDebtCollectionPolicyInd |
| Hospital Facilities | 2 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp (2 entries)
| FacilityFacilityNum | Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | Licensed HospitalLicensedHospitalInd |
|---|---|---|---|---|---|
| ROGERS MEMORIAL HOSPITAL - OCONOMOWOC | |||||
| 1 | 34700 VALLEY ROAD | OCONOMOWOC | WI | 53006 | Yes (X) |
| ROGERS MEMORIAL HOSPITAL - WEST ALLIS | |||||
| 2 | 11101 W LINCOLN AVENUE | MILWAUKEE | WI | 53227 | Yes (X) |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (2 entries)
| FacilityFacilityNum | CHNA ConductedCHNAConductedInd | Community DefinitionCommunityDefinitionInd | Community DemographicsCommunityDemographicsInd | Existing ResourcesExistingResourcesInd | How Data ObtainedHowDataObtainedInd | Community Health NeedsCommunityHealthNeedsInd | Other Health IssuesOtherHealthIssuesInd | Community Hlth Needs Id ProcessCommunityHlthNeedsIdProcessInd | Consulting ProcessConsultingProcessInd | Information GapsInformationGapsInd | CHNA ConductedCHNAConductedYr | Take Into Account Others InputTakeIntoAccountOthersInputInd | CHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsInd | CHNA Report Widely AvailableCHNAReportWidelyAvailableInd | Rpt Available On Own WebsiteRptAvailableOnOwnWebsiteInd | Own Website URLOwnWebsiteURLTxt | Rpt Available Upon RequestRptAvailableUponRequestInd | Rpt Available Thru Other MethodRptAvailableThruOtherMethodInd | Adopt Implementation StrategyAdoptImplementationStrategyInd | Exec Implementation StrategyExecImplementationStrategyInd | Adopt BudgetAdoptBudgetInd | Prioritize Health NeedsPrioritizeHealthNeedsInd | Prioritize ServicesPrioritizeServicesInd | All Needs AddressedAllNeedsAddressedInd | Organization Incur Excise TaxOrganizationIncurExciseTaxInd | Elig Criteria ExplainedEligCriteriaExplainedInd | FPG Used Deter Elig Free CareFPGUsedDeterEligFreeCareInd | FPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePct | FPG Used Determ Elig Dscnt CareFPGUsedDetermEligDscntCareInd | FPG Family Incm Lmt Dscnt CareFPGFamilyIncmLmtDscntCarePct | Explained BasisExplainedBasisInd | Income LevelIncomeLevelInd | Asset LevelAssetLevelInd | Medical IndigencyMedicalIndigencyInd | Insurance StatusInsuranceStatusInd | Uninsured DiscountUninsuredDiscountInd | Medicaid MedicareMedicaidMedicareInd | State RegulationStateRegulationInd | App Financial Asst ExplnAppFinancialAsstExplnInd | Includes Publicity MeasuresIncludesPublicityMeasuresInd | Available On RequestAvailableOnRequestInd | Other PublicityOtherPublicityInd | FAP Actions On NonpaymentFAPActionsOnNonpaymentInd | Permit Report To Credit AgencyPermitReportToCreditAgencyInd | Collection ActivitiesCollectionActivitiesInd | Nondis Emergency Care PolicyNondisEmergencyCarePolicyInd | Other Method UsedOtherMethodUsedInd | Amounts Generally BilledAmountsGenerallyBilledInd | Gross ChargesGrossChargesInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROGERS MEMORIAL HOSPITAL - OCONOMOWOC | |||||||||||||||||||||||||||||||||||||||||||||||||
| 1 | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 13 | Yes (1) | 0 | Yes (1) | Yes (X) | SEE PART V, SECTION B, LINE 5D | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 0 | 0 | Yes (1) | Yes (1) | 115.000000000000 | Yes (1) | 115.000000000000 | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (1) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | Yes (1) | Yes (X) | 0 | 0 |
| ROGERS MEMORIAL HOSPITAL - WEST ALLIS | |||||||||||||||||||||||||||||||||||||||||||||||||
| 2 | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 13 | Yes (1) | 0 | Yes (1) | Yes (X) | SEE PART V, SECTION B, LINE 5D | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | 0 | 0 | Yes (1) | Yes (1) | 115.000000000000 | Yes (1) | 115.000000000000 | Yes (1) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (X) | Yes (1) | Yes (1) | Yes (X) | Yes (X) | Yes (1) | Yes (X) | 0 | Yes (1) | Yes (X) | 0 | 0 |
Supplemental Information SupplementalInformationGrp (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| ROGERS MEMORIAL HOSPITAL - OCONOMOWOC | Part V, Section B, Line 5d: http://rogershospital.org/pdf/CHNA-2013.pdf |
| ROGERS MEMORIAL HOSPITAL - WEST ALLIS | Part V, Section B, Line 5d: http://rogershospital.org/pdf/CHNA-2013.pdf |
| ROGERS MEMORIAL HOSPITAL - OCONOMOWOC | Part V, Section B, Line 7: 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 ALLIS | Part V, Section B, Line 7: 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 - OCONOMOWOC | Part V, Section B, Line 14g: NOTIFIED INDIVIDUALS IN COMMUNICATIONS REGARDING THEIR BILLS. |
| ROGERS MEMORIAL HOSPITAL - WEST ALLIS | Part V, Section B, Line 14g: NOTIFIED INDIVIDUALS IN COMMUNICATIONS REGARDING THEIR BILLS. |
| ROGERS MEMORIAL HOSPITAL - OCONOMOWOC | Part V, Section B, Line 20d: 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 ALLIS | Part V, Section B, Line 20d: THE HOSPITAL USES VARIOUS RATES DEPENDING ON EACH PATIENTS UNIQUE SITUATIONS, BASED ON THE CRITERIA FILLED OUT ON OUR FINANCIAL ASSISTANCE FORM. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 3 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt |
|---|---|---|---|---|
| ROGERS MEMORIAL HOSPITAL - MADISON | ||||
| 406 SCIENCE DRIVE SUITE 110 | MADISON | WI | 53711 | CENTER FOR EATING AND ANXIETY DISORDERS, AND COGNITIVE-BEHAVIORAL THERAPY |
| ROGERS MEMORIAL HOSPITAL - BROWN DEER | ||||
| 4600 WEST SHROEDER DRIVE SUITE 2 | BROWN DEER | WI | 53223 | TREATMENT CENTER FOR CHILDREN AND ADOLESCENTS |
| ROGERS MEMORIAL HOSPITAL - KENOSHA | ||||
| 9916 75TH STREET | KENOSHA | WI | 53142 | TREATMENT CENTER FOR CHILDREN AND ADOLESCENTS |
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 2010-2011, APPROXIMATELY 8,000 INDIVIDUALS WERE ADMITTED TO ROGERS. OF THE 72 WISCONSIN COUNTIES, RESIDENTS FROM 55 OF THESE COUNTIES RECEIVED SERVICES AT ROGERS. MILWAUKEE AND WAUKESHA COUNTY RESIDENTS CONSTITUTED OVER 60% OF THE POPULATION SERVED, WHILE 30% WERE FROM OTHER WISCONSIN 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Valuation Method UsedValuationMethodUsedDesc | Non Cash AssistanceNonCashAssistanceDesc | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|---|---|
| ROGERS MEMORIAL HOSPITAL FOUNDATION INC | ||||||||||
| 34700 VALLEY ROAD | OCONOMOWOC | WI | 53066 | 391363507 | 501(C)3 | $934,738 | $547,360 | Cost | PROVIDES SUPPORT TO FOUNDATION TO ASSIST IN CARRYING OUT IT'S EXEXPT PURPOSE | THE HOSPITAL PROVIDES SUPPORT TO THE FOUNDATION TO ASSIST IN CARRYING OUT IT'S EXEXPT PURPOSE |
| ROGERS INHEALTH INC | ||||||||||
| 34700 VALLEY ROAD | OCONOMOWOC | WI | 53066 | 463960059 | 501(C)3 | $496,267 | Cost | PROVIDES SUPPORT TO INHEALTH TO ASSIST IN CARRYING OUT IT'S EXEXPT PURPOSE | THE HOSPITAL PROVIDES SUPPORT TO INHEALTH TO ASSIST IN CARRYING OUT IT'S EXEXPT PURPOSE | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 2 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | AS 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| 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 (17 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Theodore Weltzin | ||||||||||||||
| Board Member | $402,132 | $0 | $0 | $0 | $1,548 | $0 | $10,200 | $0 | $23,761 | $0 | $437,641 | $0 | $0 | $0 |
| Vineet Kulkarni | ||||||||||||||
| Board Member | $303,363 | $0 | $0 | $0 | $2,058 | $0 | $10,200 | $0 | $16,895 | $0 | $332,516 | $0 | $0 | $0 |
| Keith Degner | ||||||||||||||
| CFO | $191,081 | $0 | $27,225 | $0 | $2,045 | $0 | $0 | $0 | $30,640 | $0 | $250,991 | $0 | $0 | $0 |
| Patrick Hammer | ||||||||||||||
| CEO | $0 | $510,683 | $0 | $87,504 | $0 | $8,828 | $0 | $10,200 | $0 | $33,459 | $0 | $650,674 | $0 | $0 |
| Gerald Noll | ||||||||||||||
| EXECUTIVE VICE PRESIDENT | $0 | $326,658 | $0 | $63,935 | $0 | $736 | $0 | $10,200 | $0 | $19,215 | $0 | $420,744 | $0 | $0 |
| Paul Mueller | ||||||||||||||
| COO | $310,144 | $0 | $44,752 | $0 | $2,923 | $0 | $10,200 | $0 | $29,386 | $0 | $397,405 | $0 | $0 | $0 |
| William Hendricks | ||||||||||||||
| VP Operations | $304,006 | $0 | $42,235 | $0 | $2,407 | $0 | $10,200 | $0 | $26,278 | $0 | $385,126 | $0 | $0 | $0 |
| Renee Patterson | ||||||||||||||
| VP of Employment & Trainin | $200,808 | $0 | $24,474 | $0 | $270 | $0 | $9,004 | $0 | $25,565 | $0 | $260,121 | $0 | $0 | $0 |
| Teresa Schultz | ||||||||||||||
| VP Nursing | $190,337 | $0 | $22,898 | $0 | $720 | $0 | $8,529 | $0 | $0 | $0 | $222,484 | $0 | $0 | $0 |
| Peter Lake | ||||||||||||||
| Medical Director | $460,819 | $0 | $0 | $0 | $5,653 | $0 | $10,200 | $0 | $30,886 | $0 | $507,558 | $0 | $0 | $0 |
| Kambiz Pahlavan | ||||||||||||||
| Medical Director | $275,850 | $0 | $0 | $0 | $5,290 | $0 | $10,200 | $0 | $2,500 | $0 | $293,840 | $0 | $0 | $0 |
| Ahmed Numaan | ||||||||||||||
| Physician | $407,293 | $0 | $0 | $0 | $463 | $0 | $10,200 | $0 | $0 | $0 | $417,956 | $0 | $0 | $0 |
| Bradley Riemann | ||||||||||||||
| Physician | $328,020 | $0 | $0 | $0 | $491 | $0 | $10,200 | $0 | $25,565 | $0 | $364,276 | $0 | $0 | $0 |
| Michael Miller | ||||||||||||||
| Physician | $318,762 | $0 | $0 | $0 | $2,207 | $0 | $10,200 | $0 | $24,475 | $0 | $355,644 | $0 | $0 | $0 |
| Brad Smith | ||||||||||||||
| Physician | $357,678 | $0 | $0 | $0 | $1,166 | $0 | $10,200 | $0 | $25,565 | $0 | $394,609 | $0 | $0 | $0 |
| Roger Luhn | ||||||||||||||
| Physician | $318,360 | $0 | $0 | $0 | $6,175 | $0 | $10,200 | $0 | $29,386 | $0 | $364,121 | $0 | $0 | $0 |
| David Moulthrop | ||||||||||||||
| Former CEO | $132,808 | $0 | $96,346 | $0 | $1,372 | $0 | $10,200 | $0 | $17,412 | $0 | $258,138 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 1a | FormAndLineReferenceDesc |
| Explanation | HEALTH 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 | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| WISCONSIN HEALTH AND EDUCATION FACILITIES AUTHORITY | ||||||||
| A | 391337855 | 97710VVT2 | 2004-09-23 | $5,135,000 | CONSTRUCTION OF AN ADDITION TO BORROWERS MENTAL HEALTH HOSPITAL FACILITY | 0 | 0 | 0 |
| COMMUNITY DEVELOPMENT AUTHORITY OF THE CITY OF WEST ALLIS | ||||||||
| B | 396005651 | 951175AA6 | 2008-07-01 | $10,000,000 | BUILDING IMPROVEMENTS TO THE BORROWER'S MENTAL HEALTH HOSPITAL FACILITY | 0 | 0 | 0 |
| COMMUNITY DEVELOPMENT AUTHORITY OF THE VILLIAGE OF SUMMIT | ||||||||
| C | 396006129 | 866334AA3 | 2011-05-31 | $15,000,000 | BUILDING IMPROVEMENTS TO THE OCONOMOWOC SITE | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Capital ExpendituresCapitalExpendituresAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|---|
| A | $760,000 | $5,135,000 | $102,701 | $5,096,488 | 2005 | 0 | 0 | Yes (1) | Yes (1) |
| B | $2,070,000 | $10,000,000 | $356,485 | $9,643,515 | 2009 | 0 | 0 | Yes (1) | Yes (1) |
| C | $1,390,000 | $15,000,000 | $302,624 | $14,697,376 | 2013 | 0 | 0 | Yes (1) | Yes (1) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| B | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| C | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 |
| B | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| C | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | 0 |
| B | 0 |
| C | 0 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (8 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| RW BAIRD | |||
| GARRY ANDERSON, BOARD CHAIRMAN, IS BAIRD'S SENIOR VP OF INVESTMENTS | $230,135 | ROGER'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 | $9,020,044 | ROGER'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 | $749,300 | TWP ARCHITECTURE PROVIDES ARCHITECTURAL SERVICES TO ROGER'S MEMORIAL HOSPITAL. | 0 |
| PANZER PUBLIC AFFAIRS | |||
| MARY PANZER, BOARD MEMBER | $60,000 | PANZER 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 | $207,526 | DAVE MOULTHROP, A FORMER OFFICER, PROVIDES CONSULTING SERVICES TO ROGERS MEMORIAL HOSPITAL. | 0 |
| TOWN BANK | |||
| ROGER JENSEN, BOARD MEMBER | $125,000 | TOWN BANK PROVIDES FINANCIAL SERVICES TO ROGERS MEMORIAL HOSPITAL. | 0 |
| J PAHLAVAN | |||
| SPOUSE OF KAMBIZ PAHLAVAN | $143,744 | J. PHALAVAN IS A PROGRAM MANAGER EMPLOYED BY ROGERS MEMORIAL HOSPITAL. | 0 |
| C HENRICKS | |||
| SPOUSE OF WILLIAM HENRICKS | $63,755 | C HENRICKS IS A PROGRAM MANAGER EMPLOYED BY ROGERS MEMORIAL HOSPITAL. | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 2 | BOARD MEMBER ANDRITSCH IS AN EMPLOYEE OF VJS CONSTRUCTION WHICH BOARD MEMBER JORGENSEN IS AN OWNER OF. |
| Form 990, Part VI, Section A, line 6 | ROGERS BEHAVIORAL HEALTH SYSTEM IS THE SOLE CORPORATE MEMBER. |
| Form 990, Part VI, Section A, line 7a | PER 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 7b | THE 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 11 | KEITH 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 12c | Roger'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 15 | THE 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 19 | ROGER'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 1,119,522. NET ASSETS RELEASED FROM RESTRICTION -123,461. |
| 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Partners in Behavioral Health | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 34700 Valley Road | AddressLine1 |
| City | Oconomowoc | City |
| State | WI | State |
| ZIP Code | 53066 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391832142 | EIN |
| Primary Activities | To assist its subsidiaries in providing behavioral health services | PrimaryActivitiesTxt |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Total Income | $228,368 | TotalIncomeAmt |
| End Of Year Assets | $74,226 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Rogers Memorial Hospital | BusinessNameLine1 |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ROGERS BEHAVIORAL HEALTH SYSTEM INC | |||||||||||
| 34700 VALLEY ROAD | OCONOMOWOC | WI | 53066 | 263902724 | TO ASSIST ITS SUBSIDIARIES IN PROVIDING BEHAVIORAL HEALTH SERVICES | WI | 501(c)(3) | Line 11b, II | N/A | 0 | |
| ROGERS MEMORIAL HOSPITAL FOUNDATION INC | |||||||||||
| 34700 VALLEY ROAD | OCONOMOWOC | WI | 53066 | 391363507 | TO SUPPORT ALL ENTITIES OF ROGER'S BEHAVIORAL HEALTH SYSTEM, INC. | WI | 501(c)(3) | Line 9 | Yes (1) | ROGERS BEHAVIORAL HEALTH SYSTEM INC | |
| ROGERS INHEALTH INC | |||||||||||
| 34700 VALLEY ROAD | OCONOMOWOC | WI | 53066 | 463960059 | IMPLEMENTS AND PROMOTES ACCESSIBLE EDUCATION AND ADVOCACY RESOURCES | WI | 501(c)(3) | Line 9 | Yes (1) | ROGERS BEHAVIORAL HEALTH SYSTEM INC | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | 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 | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (4 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Rogers Memorial Hospital Foundation | ||
| B | $1,482,098 | FMV of Grants Paid and Serv Perf |
| Rogers Memorial Hospital Foundation | ||
| C | $155,307 | FMV of Grants Paid |
| Rogers InHealth Inc | ||
| B | $496,267 | FMV of Services Performed |
| Rogers Behavioral Health System Inc | ||
| M | $1,295,000 | FMV of Services Performed |