THEDACARE REGIONAL MEDICAL CENTER- APPLETON INC: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization: THEDACARE REGIONAL MEDICAL CENTER- APPLETON INC (EIN 39-0824015)
Tax period: 2014-01-01 to 2014-12-31
Filed: 2015-11-12
IRS object ID: 201543169349302214
Schema version: 2014v5.0
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 J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2015-11-12T10:44:40-06:00	ReturnTs
Tax Period End	2014-12-31	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	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 12237	AddressLine1Txt
City	GREEN BAY	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	543072237	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2014-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	390824015	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	APPLETON MEDICAL CENTER INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	APPL	BusinessNameControlTxt
Phone	9207355560	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 8025	AddressLine1Txt
City	APPLETON	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54912	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	TIM A OLSON	PersonNm
Person Title	CHIEF FINANCIAL OFFICER	PersonTitleTxt
Phone	9207355560	PhoneNum
Signature	2015-10-26	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	TERRI REXRODE CPA MST	PreparerPersonNm
PTIN	P00096513	PTIN
Phone	9206620016	PhoneNum
Preparation	2015-10-26	PreparationDt

Field	Value	IRS element (for citing)
Tax	2014	TaxYr
Build TS	2016-04-25 22:37:26Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	TIM A OLSON	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 8025	AddressLine1Txt
City	APPLETON	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54912	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$252,114,280	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.THEDACARE.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1958	FormationYr
Legal Domicile State	WI	LegalDomicileStateCd
Activity Or Mission	TO IMPROVE THE HEALTH OF OUR COMMUNITY.	ActivityOrMissionDesc
Voting Members Governing Body	15	VotingMembersGoverningBodyCnt
Voting Members Independent	11	VotingMembersIndependentCnt
Total Employee	0	TotalEmployeeCnt
Total Volunteers	469	TotalVolunteersCnt
Total Gross UBI	$786,149	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	-$67,933	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$470,238	PYContributionsGrantsAmt
CY Contributions Grants	$168,503	CYContributionsGrantsAmt
PY Program Service Revenue	$236,362,664	PYProgramServiceRevenueAmt
CY Program Service Revenue	$251,778,383	CYProgramServiceRevenueAmt
PY Investment Income	$198,132	PYInvestmentIncomeAmt
CY Investment Income	-$35,105	CYInvestmentIncomeAmt
PY Other Revenue	$382,181	PYOtherRevenueAmt
CY Other Revenue	$150,405	CYOtherRevenueAmt
PY Total Revenue	$237,413,215	PYTotalRevenueAmt
CY Total Revenue	$252,062,186	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$113,055,200	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$116,601,921	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$110,374,179	PYOtherExpensesAmt
CY Other Expenses	$109,668,147	CYOtherExpensesAmt
PY Total Expenses	$223,429,379	PYTotalExpensesAmt
CY Total Expenses	$226,270,068	CYTotalExpensesAmt
PY Revenues Less Expenses	$13,983,836	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$25,792,118	CYRevenuesLessExpensesAmt
Total Assets BOY	$340,798,306	TotalAssetsBOYAmt
Total Assets EOY	$366,986,127	TotalAssetsEOYAmt
Total Liabilities BOY	$1,572,915	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$1,978,618	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$339,225,391	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$365,007,509	NetAssetsOrFundBalancesEOYAmt
Mission	TO PROVIDE THE HIGHEST QUALITY HEALTH CARE, DELIVERED IN THE MOST EFFICIENT AND COST-EFFECTIVE WAYS, AND ACCESSIBLE TO ALL MEMBERS OF THE COMMUNITY.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$195,238,709	ExpenseAmt
Revenue	$250,118,290	RevenueAmt
Desc	160-BED ACUTE CARE HOSPITAL, HEART, CANCER, AND OUTPATIENT SURGERY CENTERS, AND WELLNESS PROGRAMS. WITH CORPORATE PARENT THEDACARE, WE OFFER PUBLIC AWARENESS CAMPAIGNS, CHARITY CARE, SUPPORT GROUPS, AND EDUCATION PROGRAMS TARGETED TO LOCAL COMMUNITY NEEDS.	Desc
Total Program Service Expenses	$195,238,709	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Temp Or Permanent Endowments	0	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	Yes (1)	ReportOtherAssetsInd
Report Other Liabilities	0	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	0	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	0	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	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	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	0	EmployeeCnt
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	15	GoverningBodyVotingMembersCnt
Independent Voting Member	11	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	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	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	KRISTEN COGSWELL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	9207386471	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	122 EAST COLLEGE AVENUE	AddressLine1Txt
City	APPLETON	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54911	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
STELLMACHER JON
BOARD CHAIR	1.00	2.00	Yes (X)	Yes (X)	$0	$0	$0
WELLER MIKE
BOARD MEMBER	1.00	2.00	Yes (X)		$0	$0	$0
WHITESIDE JEFFREY MD
SECRETARY	1.00	2.00	Yes (X)	Yes (X)	$0	$0	$0
GRUNER DEAN
BOARD MEMBER/CEO - SYSTEM	5.00	38.00	Yes (X)	Yes (X)	$120,869	$1,087,821	$176,335
EDELMAN GARY MD
BOARD MEMBER/PHYSICIAN	1.00	42.00	Yes (X)		$0	$416,823	$28,643
TURK NORMA MD
BOARD MEMBER/PHYSICIAN	41.00	2.00	Yes (X)		$277,642	$0	$16,665
MOARD DOUGLAS MD
BOARD MEMBER/PHYSICIAN	1.00	42.00	Yes (X)		$0	$337,196	$32,121
JONES GINGER
BOARD MEMBER	1.00	2.00	Yes (X)		$0	$0	$0
LARSON JIM
BOARD MEMBER	1.00	3.00	Yes (X)		$0	$0	$0
DAVIS JOHN
BOARD MEMBER	1.00	2.00	Yes (X)		$0	$0	$0
BRENNAN PATRICK MD
BOARD MEMBER	1.00	2.00	Yes (X)		$0	$0	$0
TIMBERLAKE KAREN
BOARD MEMBER	1.00	2.00	Yes (X)		$0	$0	$0
WALSH CYRIL MD
BOARD MEMBER	1.00	3.00	Yes (X)		$0	$0	$0
KLISTER PAUL
BOARD MEMBER	1.00	2.00	Yes (X)		$0	$0	$0
DALEY-ULLEM BETH
BOARD MEMBER	1.00	2.00	Yes (X)		$0	$0	$0
OLSON TIM
VP CFO SYSTEM	4.00	38.00			$48,594	$437,352	$108,726	Yes (X)
LIVINGSTON KEITH
VP SR CIO	4.00	36.00			$47,685	$429,165	$89,435	Yes (X)
PISTONE MAUREEN
VP SR HR SERVICES	4.00	36.00			$44,020	$396,186	$83,053	Yes (X)
BARNAS KIM
VP SR AMC & TC	16.00	24.00			$276,890	$415,335	$23,158	Yes (X)
BURMEISTER BRIAN
VP SR AMC & TC	6.00	36.00			$65,942	$373,670	$73,139	Yes (X)
CORREIA KATHRYN
FORMER VP. SR. HOSPITAL SERVICES	0.00	0.00			$325,418	$0	$0		Yes (X)
FERRANTE ROBERT MD
PHYSICIAN	40.00	0.00			$788,294	$0	$30,875			Yes (X)
WILSON ROBERT MD
PHYSICIAN	40.00	0.00			$612,795	$0	$31,954			Yes (X)
MARIANO DIONISIO MD
PHYSICIAN	40.00	0.00			$612,696	$0	$32,728			Yes (X)
GUTTORMSEN BRIAN MD
PHYSICIAN	40.00	0.00			$615,967	$0	$31,303			Yes (X)
ACKELL PETER MD
PHYSICIAN	40.00	0.00			$610,712	$0	$34,424			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$4,447,524	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$3,893,548	TotReportableCompRltdOrgAmt
Total Other Compensation	$792,559	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	78	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/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
RADIOLOGY ASSOCIATES OF APPLETON
PO BOX 117	APPLETON	WI	54912	MEDICAL SERVICES	$662,899
CLEAN POWER LLC
PO BOX 88369	MILWAUKEE	WI	53288	ENVIRONMENTAL SERVICES	$340,877
FRESENIUS MANAGEMENT SVCS INC
16343 COLLECTION CENTER DR	CHICAGO	IL	60693	MANAGEMENT SERVICES	$318,825
DAILY CARE HOSPITALIST LLC
2919 SHELTER CREEK	GREEN BAY	WI	54313	MEDICAL SERVICES	$138,848
AUREUS RADIOLOGY LLC
PO BOX 3037	OMAHA	NE	68103	MEDICAL SERVICES	$113,516

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	5	CntrctRcvdGreaterThan100KCnt
Related Organizations	$168,503	RelatedOrganizationsAmt
Total Contributions	$168,503	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	ExclusionExclusionAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
OUTPATIENT REVENUE	621400	$140,809,342	$140,809,342
INPATIENT REVENUE	621990	$109,308,948	$109,308,948
CAFETERIA REVENUE	900099	$830,784		$830,784
LAB REFERRAL REVENUE	621500	$786,149			$786,149
OTHER MISC REVENUE	900099	$43,160		$43,160

Field	Value	IRS element (for citing)
Total Program Service Revenue	$251,778,383	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$14,181	TotalRevenueColumnAmt
Exclusion	$14,181	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$150,405	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	$150,405	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$150,405	TotalRevenueColumnAmt
Exclusion	$150,405	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$2,808	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Other	$52,094	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Other	-$49,286	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$49,286	TotalRevenueColumnAmt
Exclusion	-$49,286	ExclusionAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$252,062,186	TotalRevenueColumnAmt
Related Or Exempt Func Income	$250,118,290	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$786,149	UnrelatedBusinessRevenueAmt
Exclusion	$989,244	ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$964,295	TotalAmt
Program Services	$294,307	ProgramServicesAmt
Management And General	$669,988	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$89,590,225	TotalAmt
Program Services	$72,761,888	ProgramServicesAmt
Management And General	$16,828,337	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$3,160,087	TotalAmt
Program Services	$3,160,087	ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$17,310,081	TotalAmt
Program Services	$14,149,684	ProgramServicesAmt
Management And General	$3,160,397	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$5,577,233	TotalAmt
Program Services	$5,577,233	ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$21,733,246	TotalAmt
Program Services	$12,649,597	ProgramServicesAmt
Management And General	$9,083,649	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$163,270	TotalAmt
Program Services	$163,270	ProgramServicesAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,846,592	TotalAmt
Program Services	$866,591	ProgramServicesAmt
Management And General	$980,001	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$6,107,183	TotalAmt
Program Services	$5,798,196	ProgramServicesAmt
Management And General	$308,987	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$86,370	TotalAmt
Program Services	$86,370	ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$273,282	TotalAmt
Program Services	$273,282	ProgramServicesAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$5,207,884	TotalAmt
Program Services	$5,207,884	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$14,132,474	TotalAmt
Program Services	$14,132,474	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$736,973	TotalAmt
Program Services	$736,973	ProgramServicesAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt
CLIENT & PATIENT SERVIC	$50,649,276	$50,649,276
BAD DEBT EXPENSE	$4,921,042	$4,921,042
EQUIPMENT MAINTENANCE	$3,810,555	$3,810,555

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$226,270,068	TotalAmt
Program Services	$195,238,709	ProgramServicesAmt
Management And General	$31,031,359	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$3,500	BOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$29,048,936	BOYAmt
EOY	$31,978,239	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$1,306,927	BOYAmt
EOY	$1,844,978	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$227,945,744	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$130,867,532	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$103,172,109	BOYAmt
EOY	$97,078,212	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$207,266,834	BOYAmt
EOY	$236,084,698	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$340,798,306	BOYAmt
EOY	$366,986,127	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$1,572,915	BOYAmt
EOY	$1,978,618	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,572,915	BOYAmt
EOY	$1,978,618	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$339,225,391	BOYAmt
EOY	$365,007,509	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$339,225,391	BOYAmt
EOY	$365,007,509	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$340,798,306	BOYAmt
EOY	$366,986,127	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$25,792,118	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	-$10,000	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule 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	$11,329	OtherActivitiesAmt
Total Lobbying Expenditures	$11,329	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	PORTION OF WHA DUES = $11,329	ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,384,215	OtherCostOrOtherBasisAmt
Book Value	$2,384,215	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$146,276,678	OtherCostOrOtherBasisAmt
Depreciation	$66,195,385	DepreciationAmt
Book Value	$80,081,293	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,105,025	OtherCostOrOtherBasisAmt
Depreciation	$653,260	DepreciationAmt
Book Value	$451,765	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$78,179,826	OtherCostOrOtherBasisAmt
Depreciation	$64,018,887	DepreciationAmt
Book Value	$14,160,939	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$97,078,212	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

Field	Value	IRS element (for citing)
Desc	DUE FROM AFFILIATES	Desc
Book Value	$236,084,698	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$236,084,698	TotalBookValueOtherAssetsAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART X, LINE 2:	FormAndLineReferenceDesc
Explanation	IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THEDACARE DETERMINES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION, 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 THAT POSITION IS NOT RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS. THEDACARE RECORDED NO ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS IN 2014 AND 2013. TAX RETURNS FOR THE YEARS ENDED 2011 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE.	ExplanationTxt

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
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent300	Yes (X)	Percent300Ind
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	0	FinancialAssistanceBudgetInd
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	$1,736,648	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,736,648	NetCommunityBenefitExpnsAmt
Total Expense	0.00780	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$21,570,287	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$18,447,973	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,122,314	NetCommunityBenefitExpnsAmt
Total Expense	0.01410	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$23,306,935	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$18,447,973	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,858,962	NetCommunityBenefitExpnsAmt
Total Expense	0.02190	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	23	ActivitiesOrProgramsCnt
Persons Served	241714	PersonsServedCnt
Total Community Benefit Expns	$1,263,927	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,263,927	NetCommunityBenefitExpnsAmt
Total Expense	0.00570	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Activities Or Programs	3	ActivitiesOrProgramsCnt
Persons Served	586	PersonsServedCnt
Total Community Benefit Expns	$553,002	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$553,002	NetCommunityBenefitExpnsAmt
Total Expense	0.00250	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	4	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$4,427,630	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$4,427,630	NetCommunityBenefitExpnsAmt
Total Expense	0.02000	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Persons Served	64	PersonsServedCnt
Total Community Benefit Expns	$370,506	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$22,885	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$347,621	NetCommunityBenefitExpnsAmt
Total Expense	0.00160	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	6	ActivitiesOrProgramsCnt
Persons Served	406450	PersonsServedCnt
Total Community Benefit Expns	$810,430	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$810,430	NetCommunityBenefitExpnsAmt
Total Expense	0.00370	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	38	ActivitiesOrProgramsCnt
Persons Served	648814	PersonsServedCnt
Total Community Benefit Expns	$7,425,495	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$22,885	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$7,402,610	NetCommunityBenefitExpnsAmt
Total Expense	0.03350	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	38	ActivitiesOrProgramsCnt
Persons Served	648814	PersonsServedCnt
Total Community Benefit Expns	$30,732,430	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$18,470,858	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$12,261,572	NetCommunityBenefitExpnsAmt
Total Expense	0.05540	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	50	PersonsServedCnt
Total Community Benefit Expns	$17,535	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,944	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$12,591	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	100000	PersonsServedCnt
Total Community Benefit Expns	$4,670	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$4,670	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$1,683	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,683	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	8301	PersonsServedCnt
Total Community Benefit Expns	$7,689	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$7,689	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	198427	PersonsServedCnt
Total Community Benefit Expns	$670	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$670	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	25	PersonsServedCnt
Total Community Benefit Expns	$194	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$194	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	150	PersonsServedCnt
Total Community Benefit Expns	$4,887	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$4,887	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	7	ActivitiesOrProgramsCnt
Persons Served	306953	PersonsServedCnt
Total Community Benefit Expns	$37,328	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,944	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$32,384	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	0	BadDebtExpenseReportedInd
Bad Debt Expense	$2,160,492	BadDebtExpenseAmt
Bad Debt Expense Attributable	$1,728,896	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$41,894,768	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$43,843,126	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$1,948,358	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	APPLETON MEDICAL CENTER	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 8025	AddressLine1Txt
City	APPLETON	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54912	ZIPCd

Field	Value	IRS element (for citing)
Website Address	HTTPS://WWW.THEDACARE.ORG	WebsiteAddressTxt
State License	169	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	APPLETON MEDICAL CENTER	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Information Gaps	Yes (X)	InformationGapsInd
Other	Yes (X)	OtherInd
CHNA Conducted	13	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	0	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE 7D	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Rpt Available Thru Other Method	Yes (X)	RptAvailableThruOtherMethodInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	13	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	SEE 7D	StrategyWebsiteURLTxt
Strategy Attached	Yes (1)	StrategyAttachedInd
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	300.000000000000	FPGFamilyIncmLmtDscntCarePct
Income Level Criteria	Yes (X)	IncomeLevelCriteriaInd
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Other Method	Yes (X)	OtherMethodInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	0	FAPActionsOnNonpaymentInd
Collection Activities	0	CollectionActivitiesInd
FAP Notified All Patients	Yes (X)	FAPNotifiedAllPatientsInd
Documented Elig Determination	Yes (X)	DocumentedEligDeterminationInd
Other Actions Taken	Yes (X)	OtherActionsTakenInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Other Method Used	Yes (X)	OtherMethodUsedInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
APPLETON MEDICAL CENTER	PART V, SECTION B, LINE 3J: APPLETON MEDICAL CENTER'S CHNA ALSO IDENTIFIED OWNER EXPECTATIONS, MISSION/VALUES, KEY COMPONENTS OF OUR COMMITMENT, ORGANIZATIONAL SUPPORT, ADVISORY TEAM GUIDANCE AND THE HEALTH IMPROVEMENT MODEL.
APPLETON MEDICAL CENTER	PART V, SECTION B, LINE 5: PUBLIC HEALTHTHEDACARE WORKED CLOSELY WITH LOCAL OUTAGAMIE AND CALUMET COUNTY PUBLIC HEALTH DEPARTMENTS THROUGHOUT THE ENTIRE NEEDS ASSESSMENT PROCESS. THEDACARE HAS REPRESENTATION ON THE FOX VALLEY COMMUNITY HEALTH IMPROVEMENT COALITION WHICH MEETS MONTHLY WITH LOCAL HEALTH SYSTEM REPRESENTATIVES AND PUBLIC HEALTH OFFICIALS FROM THE COUNTIES OF OUTAGAMIE, CALUMET AND WINNEBAGO AND CITIES OF APPLETON AND MENASHA. PUBLIC HEALTH IS REPRESENTED ON THEDACARE'S NEEDS ASSESSMENT ADVISORY COMMITTEE AND ALSO ON THE THEDACARE-LED COMMUNITY HEALTH ACTION TEAM. IN ADDITION TO THESE FORMAL MEETINGS, ONE-ON-ONE INTERVIEWS WITH PUBLIC HEALTH OFFICIALS WERE CONDUCTED EITHER OVER THE PHONE OR IN PERSON. SOURCES: MARY DORN, OUTAGAMIE COUNTY PUBLIC HEALTH MANAGER; KURT EGGEBRECHT, CITY OF APPLETON PUBLIC HEALTH OFFICER; BONNIE KOLBE, CALUMET COUNTY PUBLIC HEALTH OFFICER.COMMUNITY HEALTH ACTION TEAMS (CHAT) ARE THE PRIMARY RESOURCES THEDACARE USES TO ENGAGE THE COMMUNITY IN BETTER UNDERSTANDING THE LOCAL HEALTH NEEDS AND DEVELOPING PLANS FOR ACTION. THEDACARE'S COMMUNITY HEALTH SPECIALISTS HELP FACILITATE THE CHAT EFFORTS FOR FOUR CHAT TEAMS IN THE FOX CITIES, NEW LONDON, SHAWANO AND WAUPACA AREAS. EACH CHAT TEAM IS COMPRISED OF LOCAL COMMUNITY LEADERS FROM BUSINESS, EDUCATION, PUBLIC HEALTH, AREA HEALTH SYSTEMS, FAITH COMMUNITIES, NON-PROFIT ORGANIZATIONS AND GOVERNMENT. THESE LEADERS SELECT ISSUES TO STUDY, ORGANIZE "PLUNGE" EXPERIENCES (DAY-LONG FIELD TRIPS) TO GAIN IN-DEPTH UNDERSTANDING AND COLLABORATE IN PROBLEM-SOLVING INITIATIVES. THIS RESULTS IN SUSTAINABLE, EFFECTIVE COMMUNITY-BASED SOLUTIONS TO SYSTEMIC HEALTH ISSUES. APPLETON MEDICAL CENTER PROVIDERS AND STAFF ARE INTEGRATED INTO A WIDE VARIETY OF THESE INITIATIVES. THE FOX CITIES CHAT INCLUDES LEADERS FROM PUBLIC HEALTH, UNITED WAY, COMMUNITY FOUNDATION, NON-PROFITS, EDUCATION, AND HEALTH ORGANIZATIONS WHICH COLLECTIVELY REPRESENT THE BROAD INTERESTS OF THE COMMUNITY. 2014 FOX CITIES COMMUNITY HEALTH ACTION TEAM ROSTERROGER BERTSCHAUSEN, FOX VALLEY UNITARIAN UNIVERSALIST FELLOWSHIPWILL BLOEDOW, RETIRED RAY DURKEE, APPLETON MEDICAL CENTER FOUNDATIONKURT EGGEBRECHT, CITY OF APPLETON HEALTH DEPARTMENTMICHAEL FROHNA, THEDACARE FOUNDATIONSJAY FULKERSON, HEALTH PAYMENT SYSTEMSTIM GALLOWAY, GALLOWAY COMPANYERNESTO GONZALES, CASA HISPANADEAN GRUNER, THEDACAREPAM HENSON, GANNETTMARTI HEMWALL, COMMUNITY FOUNDATION FOR THE FOX VALLEY REGIONCHAD HERSHNER, CHILDREN'S HOSPITAL OF WISCONSINPETER KELLY, UNITED WAY OF THE FOX CITIESSHANNON KENEVAN, HARMONY CAF /GOODWILL INDUSTRIESGREG LEMKE ROCHON, CPO BOYS & GIRLS CLUB OF THE FOX VALLEYCHRIS MATHENY, VP FOX VALLEY TECHNICAL COLLEGEJOHN MIELKE, MD, THEDACAREPAULA MORGEN, THEDACARECATHY MUTSCHLER, COMMUNITY FIRSTAMY PUTZER, OSHKOSH AREA COMMUNITY FOUNDATIONROLLIE STEPHENSON, FAITH TECHNOLOGIESLISA TRUMAN, MINISTRY HEALTH SYSTEMBEN VOGEL, APPLETON AREA SCHOOL DISTRICTDEBORAH WETTER, VALLEY TRANSITKEY INFORMANT INTERVIEWS WERE CONDUCTED WITH EXPERTS REPRESENTING VULNERABLE OR MARGINALIZED POPULATIONS IN OUR COMMUNITY INCLUDING FARM FAMILIES, LATINO POPULATION, LESBIAN, GAY, BISEXUAL TRANSGENDER (LGBT), LOW INCOME, HMONG. SOURCES: RHONDA STREBEL, RURAL HEALTH INITIATIVE; ERNESTO GONZALES, CASA HISPANA; DR. IRIS TORRES AND PATRICIA SARVALA, FOX CITIES COMMUNITY HEALTH CENTER; TONY GONZALES, THOMPSON COMMUNITY CENTER; TRICIA NELSON, THEDACARE MEDICAL HOME; LO LEE AND JENNIFER GAINES BATES, HMONG AMERICAN PARTNERSHIP; CHAT INCLUDE BREAKFAST, JAN & MAY 2013.
APPLETON MEDICAL CENTER	PART V, SECTION B, LINE 6A: AFFINITY HEALTH SYSTEM
APPLETON MEDICAL CENTER	PART V, SECTION B, LINE 7D: THE CHNA WAS MADE AVAILABLE TO LOCAL CHAT, THEDACARE BOARDS AND LEADERSHIP TEAMS.FULL CHNA AND IMPLEMENTATION STRATEGY WEBSITE: WWW.THEDACARE.ORG/HOSPITALS-AND-CLINICS/APPLETON-MEDICAL-CENTER.ASPX
APPLETON MEDICAL CENTER	PART V, SECTION B, LINE 11: NEEDS IDENTIFIED AND WORKING ON:OBESITY-ESTABLISHED WEIGHT OF THE FOX VALLEY - A FOUR HEALTHCARE SYSTEM APPROACH TO TACKLING OBESITY, IS IN THE PROCESS OF FORMING WORK GROUPS. THEDACARE SUPPORTS THIS WITH FINANCIAL CONTRIBUTIONS AND PARTICIPATION ON THE LEADERSHIP AND CORE TEAMS.-ESTABLISHED EAT SMART - A LOCAL RESTAURANT INITIATIVE PROMOTING HEALTHY EATING-PROVIDES FUNDING TO LOCAL FARMER'S MARKETS TO PROVIDE HEALTHY FOOD TO THE COMMUNITY -CONTRIBUTED FINANCIALLY TO THE CONSTRUCTION OF HOOP HOUSES AT THE COMMUNITY GARDEN -THEDACARE PARTNERS WITH LOCAL YMCA'S TO EDUCATE CHILDREN ABOUT EATING HEALTHY AND THE BENEFITS OF BEING ACTIVE-THEDACARE SPONSORS MULTIPLE FAMILY EVENTS THAT CONTRIBUTE TO EXERCISE AND FAMILY ACTIVITY AND SUPPORTS THE YMCA HEALTHY KIDS CAMPAIGN.-IN 2014, THEDACARE ESTABLISHED GOOD TO GO WEEK AN EMPLOYEE LED INITIATIVE THAT TOOK PLACE IN 6 SCHOOL DISTRICTS THROUGHOUT THE THEDACARE SYSTEM. ACTIVITIES WILL INCLUDE HEALTHY SNACKS, BUILD A SCHOOL GARDEN, FATS IN FOODS, MEASURE YOUR DRINK, LEADING GYM CLASSES. MENTAL HEALTH: -THEDACARE PROVIDES FINANCIAL AND IN-KIND SUPPORT FOR THE PRIMARY CARE/MENTAL HEALTH INITIATIVE AIMED AT IMPROVING PCP'S ABILITY TO TREAT BASIC MENTAL HEALTH ISSUES,-PROVIDES LEADERSHIP AND FINANCIAL SUPPORT FOR CATALPA HEALTH - HELPING CHILDREN AND FAMILIES OBTAIN MENTAL HEALTH AND WELLNESS-PROVIDES LEADERSHIP AND FUNDING FOR THE FOX VALLEY COMMUNITY CLINIC-PROVIDED OVER $1,000,000 IN SUBSIDIZED MENTAL HEALTH SERVICES, PROVIDED LEADERSHIP AND FINANCIAL SUPPORT FOR THE NEW MENTAL HEALTH CONNECTION-SUPPORTS THE NEW MENTAL HEALTH CONNECTION, A COALITION OF MENTAL HEALTH PROVIDERS-ESTABLISHED NO WRONG DOOR, A SAFETY NET SYSTEM TO DETECT KIDS IN CRISIS-PROVIDES LEADERSHIP TO THE SUICIDE PREVENTION TASK FORCESUBSTANCE ABUSE:-IS WORKING WITH LOCAL LEGISLATORS AND LOCAL COMMUNITIES TO CHANGE SOCIAL NORMS AND LAWS-CONTINUES TO HOST ANNUALLY PARTY AT THE PAC - EDUCATING TEENS ABOUT THE DANGERS OF DRIVING WHILE DRINKING OR TEXTING-USES STANDARD WORK PROCEDURES TO SCREEN PATIENTS FOR DOCTOR AND PRESCRIPTION SHOPPINGEND OF LIFE:-WITH THE GOAL OF INCREASING PEOPLE WHO HAVE WRITTEN END OF LIFE DIRECTIVES, THEDACARE IS WORKING WITH OTHER HEALTHCARE SYSTEMS TO DEVELOP A COMMON SYSTEM-THEDACARE PROVIDES FINANCIAL AND LEADERSHIP SUPPORT TO THE END OF LIFE COALITIONTEEN PREGNANCY:-PROVIDES FINANCIAL AND LEADERSHIP SUPPORT FOR CUIDATE - A CULTURALLY SENSITIVE DELAYED PREGNANCY PREVENTION INITIATIVEVIOLENCE:-PROVIDES FUNDING AND LEADERSHIP TO INCLUDE - CHANGING ATTITUDES ABOUT THE LGBT COMMUNITY IN THE FOX VALLEY BY EDUCATING BOTH YOUTH & ADULTS ON THE EFFECTS OF BULLYING AND OTHER BEHAVIORS.-PROVIDES FUNDING AND LEADERSHIP TO VOICES OF MEN - MAKING A POWERFUL STATEMENT THAT COMMITTING, CONDONING OR REMAINING SILENT ABOUT MEN'S VIOLENCE AGAINST WOMEN AND CHILDREN IS NOT ACCEPTABLE.-PROVIDES FUNDING AND LEADERSHIP TO WOMEN'S FUND - ADDRESSING LEADERSHIP IN YOUNG WOMENACCESS TO CARE:-PROVIDE FINANCIAL SUPPORT TO THE PARTNERSHIP COMMUNITY HEALTH CENTER-PROVIDE 24/7 ACCESS TO MEDICAL CALL ADVISE VIA TELEPHONE-PROVIDE LEADERSHIP AND FINANCIAL SUPPORT TO THE RURAL HEALTH INITIATIVE - AN INITIATIVE THAT TAKES HEALTHCARE RIGHT TO THE FARMER'S DOORIDENTIFIED BUT NOT ADDRESSED:1.NUMBER OF PRIMARY CARE PROVIDERS - THIS ISSUE IS LIMITED TO EASTERN CALUMET COUNTY WHICH IS SERVICED BY OTHER HEALTH SYSTEMS.2.POVERTY - BEYOND WHAT OUR RESOURCES CAN SUPPORT AT THIS TIME3.SMOKING - PROGRESS HAS ALREADY BEEN MADE ON THIS ISSUE4.DIABETES - ADDRESSED THROUGH THE OBESITY PRIORITY
APPLETON MEDICAL CENTER	PART V, SECTION B, LINE 15E: OFFERED TO WORK DIRECTLY WITH PATIENTS TO COMPLETE THE APPLICATION IF NEEDED AND PROVIDED ASSISTANCE BEYOND THEDACARE ASSISTANCE FOR UNINSURED PATIENTS BY ASSISTING WITH THE FUNDING OF STAFF AT "PARTNERSHIP COMMUNITY EDUCATION CENTER". THEY ARE A NOT FOR PROFIT AGENCY THAT ASSISTS ANY MEMBER OF ANY COMMUNITY WITH MARKETPLACE INSURANCE ENROLLMENT AS WELL AS ASSESSING THE NEED FOR ADDITIONAL COMMUNITY BENEFITS THAT MAY BENEFIT THE PATIENT.
APPLETON MEDICAL CENTER	PART V, SECTION B, LINE 16I: THE FAP AND APPLICATION WERE AVAILABLE AT HOSPITAL CASHIER OFFICES, ON WEB SITE AND OFFERED TO ALL PATIENTS THAT EXPRESSED A FINANCIAL HARDSHIP WHEN CALLING THE BILLING OFFICE. THE PLS WAS PRINTED ON EVERY STATEMENT AND A FOOTER WAS ADDED TO THE FRONT OF THE STATEMENT ADVISING PATIENT TO SEE REVERSE SIDE OF STATEMENT FOR FINANCIAL ASSISTANCE AND PAYMENT OPTIONS. NOTIFICATION OF FINANCIAL ASSISTANCE AVAILABILITY WAS ADDED TO THE INITIAL LETTER SENT BY THE THIRD PARTY COLLECTION AGENCY.
APPLETON MEDICAL CENTER	PART V, SECTION B, LINE 20E: THEDACARE AND/OR THIRD PARTY COLLECTION AGENCY ARE PLACING A MINIMUM OF ONE OUTBOUND CALL TO ADVISE CUSTOMER OF PAYMENT OPTIONS INCLUDING FA PRIOR TO CREDIT BUREAU REPORTING OR LEGAL JUDGEMENT. PROCESS ADJUSTED TO ENSURE NO ECA UNTIL CUSTOMER RECEIVES AT LEAST 4 BILLING STATEMENTS AFTER DATE OF DISCHARGE. NO ECA UNTIL AT LEAST 120 DAYS AFTER DISCHARGE.
APPLETON MEDICAL CENTER	PART V, SECTION B, LINE 22D: LOOKBACK METHOD: FOR ER PATIENTS, TAKE THE 3 LARGEST COMMERCIAL INSURERS PLUS MEDICARE. ADD ALL PAYMENTS AND ALL CHARGES TO ARRIVE AT A DEDUCTION PERCENTAGE. REDUCE THE PATIENT'S BILL BY THIS PERCENTAGE. FOR NON-ER PATIENTS, TAKE THE 3 LARGEST COMMERCIAL INSURERS. ADD ALL PAYMENTS AND ALL CHARGES TO ARRIVE AT A DEDUCTION PERCENTAGE.
PART V, LINE 13	PATIENTS ARE SENT AN OVERVIEW LETTER EXPLAINING THE PROCESS FOR APPLYING FOR OUR ASSISTANCE PROGRAM OR OUR STAFF WALKS THEM THROUGH THE PROCESS. THEY ARE ASKED TO COMPLETE AN APPLICATION THAT INCLUDES REQUESTS FOR INFORMATION. THIS INFORMATION IS NEEDED IN ORDER TO MAKE A DECISION AS TO WHETHER THE PATIENT MEETS THE CRITERIA FOR ACCEPTANCE, AND IF ACCEPTED, WHAT LEVEL OF ASSISTANCE WILL BE PROVIDED. ONCE THE DECISION IS MADE, WE WILL NOTIFY THE PATIENT AND IF ACCEPTABLE, WRITE OFF THE BALANCE AS DETERMINED.
PART V, SECTION B, LINE 16	FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY
APPLETON MEDICAL CENTER PART V, SECTION B, LINE 16A WEBSITE:	WWW.THEDACARE.ORG/~/LINK.ASPX?_ID=206478F0E2874D2EAD353B71BC978623&
APPLETON MEDICAL CENTER PART V, SECTION B, LINE 16B WEBSITE:	WWW.THEDACARE.ORG/~/LINK.ASPX?_ID=206478F0E2874D2EAD353B71BC978623&

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	GROTH SURGERY CENTER	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 8025	AddressLine1Txt
City	APPLETON	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54912	ZIPCd

Field	Value	IRS element (for citing)
Facility	OUTPATIENT SURGERY CENTER	FacilityTxt

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 3C:	IT IS THE ORGANIZATION'S POLICY THAT NO PATIENT SHOULD BE DENIED APPROPRIATE AND NECESSARY CARE ON THE BASIS OF INCOME. IN RESPONSE TO THIS POLICY, THE CARING HEARTS FINANCIAL ASSISTANCE PROGRAM WAS SET UP TO PROVIDE SHELTER TO THOSE PATIENTS WHO ARE UNABLE TO PAY FOR THEIR MEDICAL SERVICES. MEDICAL SERVICE FEES ARE WRITTEN OFF UNDER THE FINANCIAL ASSISTANCE PROGRAM THAT WOULD OTHERWISE HAVE BEEN SENT TO A COLLECTION AGENCY.
PART I, LINE 7:	THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS IN THE TABLE IS A COMBINATION OF AVERAGE COSTS AND ACTUAL COSTS PERTAINING TO SUPPLIES, WAGES, AND BENEFITS. FOR SUPPLIES, THE ACTUAL COST OF ITEMS USED FOR EACH EVENT IS APPLIED. IF NO ACTUAL COST IS AVAILABLE, WE THEN USE AN ESTIMATE. WAGES ARE CALCULATED BY MULTIPLYING THE AVERAGE WAGE RATE TIMES ACTUAL HOURS WORKED. THE BENEFIT RATE USED INCLUDES A FRINGE RATIO OF ALL BENEFITS RELATED TO THE ABOVE WAGE CALCULATION. THE COST ACCOUNTING SYSTEM DOES NOT DIFFERENTIATE BETWEEN DIFFERENT PAYER TYPES AND NO COST-TO-CHARGE RATIO IS USED.
PART I, LINE 7G:	NO PHYSICIAN CLINICS ARE INCLUDED IN SUBSIDIZED HEALTH SERVICES.
PART I, LN 7 COL(F):	THE BAD DEBT EXPENSE INCLUDED ON FORM 990 (PART IX, LINE 25, COLUMN A) BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $4,921,042.
PART II, COMMUNITY BUILDING ACTIVITIES:	THE HEALTH OF THE COMMUNITY APPLETON MEDICAL CENTER SERVES IS PROMOTED THROUGH SEVERAL COMMUNITY BUILDING ACTIVITIES AS DESCRIBED BELOW:WELL CITY INITIATIVE - PROMOTES DEVELOPMENT OF A HEALTHY WORKPLACE THROUGHOUT THE FOX CITIES.NEW MENTAL HEALTH CONNECTION - COALITION OF MENTAL HEALTH PROVIDERS MEETING TO IMPROVE ACCESS TO MENTAL HEALTH SERVICES THROUGHOUT FOX CITIES.CHAMBER OF COMMERCE SUPPORT - ENCOURAGES ECONOMIC DEVELOPMENT WHICH IN TURN PROVIDES JOBS AND INCOME, BOTH CONTRIBUTORS TO HEALTH.VOICES OF MEN - WORKS TO ADDRESS THE ROOT CAUSE OF VIOLENCE AGAINST WOMEN AND GIRLS WHICH INCLUDES DEVALUING AND OBJECTIFYING WOMEN AND TREATING WOMEN AS PROPERTY. NO WRONG DOOR - EFFORT TO DEVELOP COMMUNITY WIDE MENTAL HEALTH SAFETY NET.DISASTER READINESS - HELPS ENSURE THE ENTIRE COMMUNITY IS READY FOR POTENTIAL EMERGENCIES. COMMUNITY ACTION FOR HEALTHY LIVING - COALITION THAT ADVOCATES FOR HEALTHY LIFESTYLE CHANGE. THEDACARE NEIGHBORHOOD GARDEN/FARMER'S MARKETS - PROVIDES FRESH PRODUCE TO AREA FOOD PANTRIES AND THE COMMUNITY.FOX VALLEY END OF LIFE COALITION - A GRASSROOTS CONSORTIUM WITH A MISSION TO IMPROVE END-OF-LIFE CARE AND CHOICES FOR ALL PEOPLE, THEIR FAMILIES, AND THEIR PHYSICIANS IN THE FOX CITIES.EMERGING LEADERS - MAKING AN IMPACT IN OUR COMMUNITY THROUGH DEDICATION TO SERVICE AND PHILANTHROPY.SUMMIT FOR HOPE - AIMS TO RAISE AWARENESS ABOUT SUBSTANCE ABUSE AND THE GROWING HEROIN ISSUE. PARTY AT THE PAC - PUTS TEEN SAFETY INTO FOCUS.ELECTRONIC RECYCLING EVENT - WORKING TO TREAT THE EARTH WITH THE RESPECT THAT IT DESERVES.COMMUNITY SHARPS COLLECTION - REDUCING THE RISKS OF INFECTIOUS WASTE.WISCONSIN SUSTAINABLE BUSINESS COUNCIL - TAKING AN ACTIVE POSITION ON THE ROLE OF CLIMATE CHANGE AND BUILDING HEALTHY COMMUNITIES BY REDUCING OR ELIMINATING OUR ENERGY WASTE AND WATER FOOTPRINT. ORGAN/TISSUE DONATION - ADVANCING ORGAN DONATION EDUCATION.RURAL HEALTH INITIATIVE - ADDRESSING GROWING CONCERNS REGARDING THE HEALTH AND SAFETY ISSUES FACING TODAY'S FARM FAMILIES. YMCA STRONG KIDS - PROVIDING KIDS THE OPPORTUNITIES THEY NEED TO REACH THEIR FULL POTENTIAL, LIVE HEALTHIER, HAPPIER LIVES TODAY, AND GROW INTO PRODUCTIVE ADULTS IN THE FUTURE. FOX VALLEY FAMILY MEDICINE RESIDENCY PROGRAM - TEACHING THE ART AND HEART OF CARE.BUILDING FOR KIDS - BUILDING KIDS IMAGINATION, CREATIVITY AND CONFIDENCE. CHAT - COMMUNITY LEADERS WORKING TOGETHER TO EXPLORE LOCAL AND REGIONAL HEALTH ISSUES. THEDACARE CENTER FOR HEALTHCARE VALUE - OFFERS LEARNING EXPERIENCES THAT DEVELOP HEALTHCARE LEADERS WHO ARE CAPABLE OF CONFIDENTLY DRIVING THE LEAN TRANSFORMATION OF THEIR ORGANIZATIONS TO DELIVER MEASURABLY BETTER VALUE TO THE PATIENTS, FAMILIES AND COMMUNITIES THEY SERVE. TRAUMA SYMPOSIUM - FOCUSING ON EMERGENCY PREPAREDNESS. SEXUAL ASSAULT NURSE EXAMINER - WORKING TO END SEXUAL AND DOMESTIC VIOLENCE. UNITED WAY - WORKING EVERY DAY TO IMPROVE THE COMMUNITY.END OF LIFE COALITION - WORKING TOWARDS GETTING END OF LIFE DECISIONS COORDINATED AND DOCUMENTS SO THAT PEOPLE HAVE THEIR LAST WISHES RECOGNIZED.INSTITUTE FOR HEALTH CARE IMPROVEMENT - SUPPORT FOR COMMUNITY TRANSFORMATION EFFORTS
PART III, LINE 8:	HOSPITALS MUST ACCEPT MEDICARE PATIENTS REGARDLESS OF WHETHER THEY MAKE A SURPLUS OR DEFICIT FROM PROVIDING SERVICES TO THOSE PATIENTS. WE DID NOT REPORT ANY SHORTFALL AS A COMMUNITY BENEFIT. THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE ORGANIZATIONS MEDICARE COST REPORT IS STEP DOWN.
PART III, LINE 9B:	OUR POLICY IS NOT TO PURSUE PATIENT ACCOUNTS TO THE EXTENT ANY CHARGES ARE ELIGIBLE AND WRITTEN OFF THROUGH OUR CHARITY CARE/FINANCIAL ASSISTANCE PROGRAM. IF ONLY A PORTION OF THE CHARGES ARE ELIGIBLE AND WRITTEN OFF THROUGH OUR CHARITY CARE/FINANCIAL ASSISTANCE PROGRAM, THE REMAINING BALANCE WILL BE BILLED TO THE PATIENT AND COLLECTED IN ACCORDANCE WITH OUR NORMAL COLLECTION POLICY.
PART VI, LINE 2:	THEDACARE SERVES A 9 COUNTY PRIMARY SERVICE AREA. FIVE THEDACARE HOSPITALS PROVIDE SERVICE IN THIS AREA. THEDACARE CONDUCTS A COMMUNITY NEEDS ASSESSMENT EVERY THREE YEARS FOR THE ENTIRE SYSTEM GATHERING DATA PERTINENT TO EACH COMMUNITY. INFORMATION COLLECTED INCLUDES DATA FROM THE WISCONSIN COUNTY HEALTH RANKINGS, FOX CITIES LIFE STUDY (LOCAL INDICATORS FOR EXCELLENCE), THE BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY, INSIGHTS FROM INTERVIEWS OF PUBLIC HEALTH OFFICIALS, INSIGHTS FROM INTERVIEWS WITH REPRESENTATIVES OF VULNERABLE POPULATIONS, EMERGENCY DEPARTMENT PATIENT DATA AND INSIGHTS GATHERED FROM MONTHLY MEETINGS OF THE THEDACARE-LED CHAT TEAM (COMMUNITY HEALTH ACTION TEAM) COMPRISED OF 25 COMMUNITY LEADERS IN BUSINESS, NON-PROFIT, CLERGY, HEALTHCARE, UNITED WAY, PUBLIC HEALTH AND THE LOCAL COMMUNITY FOUNDATION.
PART VI, LINE 3:	PATIENT EDUCATION BEGINS WHEN A PATIENT IS ADMITTED TO A THEDACARE HOSPITAL. ADMISSION SPECIALISTS MEET WITH EACH PERSON INDIVIDUALLY TO ASSESS INSURANCE STATUS AND FINANCIAL NEED. IF NECESSARY, SPECIALISTS REFER PATIENTS TO CARE MANAGEMENT SPECIALISTS WHO ASSIST WITH THE ENROLLMENT OF PATIENTS IN AN APPLICABLE PROGRAM. THE HOSPITAL PATIENT HANDBOOK IS PROVIDED TO ALL IN-PATIENTS. INTERNAL POLICIES SUCH AS DISCOUNTED SERVICES POLICY, CARING HEARTS POLICY AND PAYMENT FOR SERVICE POLICY FOR SELF-PAY BALANCES PROVIDE GUIDANCE.THE THEDACARE WEBSITE, WWW.THEDACARE.ORG, PROVIDES EDUCATION REGARDING THE AFFORDABLE CARE ACT IN EASY TO UNDERSTAND LANGUAGE. IT DISCUSSES OPTIONS AND WHERE TO GO FOR ASSISTANCE.THE THEDACARE WEBSITE, WWW.THEDACARE.ORG, PROVIDES EDUCATION REGARDING THE AFFORDABLE CARE ACT IN EASY TO UNDERSTAND LANGUAGE. IT DISCUSSES OPTIONS AND WHERE TO GO FOR ASSISTANCE.
PART VI, LINE 4:	APPLETON MEDICAL CENTER'S SERVICE AREA CONSISTS OF OUTAGAMIE AND CALUMET COUNTIES AND IS LOCATED EAST-CENTRAL WISCONSIN. THE TWO-COUNTY AREA HOSTS A POPULATION OF 225,666 COMBINED WITH CONCENTRATION IN THE FOX CITIES URBAN AREA.OUTAGAMIE COUNTY:-OVER THE LAST DECADE, OUTAGAMIE COUNTY POPULATION HAS GROWN BY 9.77%. THIS WILL MAKE OUTAGAMIE THE 5TH MOST POPULOUS COUNTY IN WISCONSIN BY 2035. -OUTAGAMIE COUNTY HIGH SCHOOL GRADUATION RATE IS 90%.-TRADE/TRANSPORTATION/UTILITIES, ALONG WITH MANUFACTURING EMPLOY THE MOST PEOPLE IN THE TWO-COUNTY REGION FOLLOWED BY EDUCATION/HEALTH. THESE THREE SECTORS EMPLOY 40% OF THE AREA'S WORKFORCE.-IN COMPARISON TO MORE RURAL COUNTIES IN THE THEDACARE SERVICE AREA, OUTAGAMIE AND CALUMET COUNTIES CONTINUE TO HAVE A HIGHER PERCENTAGE OF CHILDREN.-IN OUTAGAMIE COUNTY 8% OF THE POPULATION LIVE BELOW 100% OF THE FEDERAL POVERTY LEVEL AND 9% OF THE POPULATION IS UNINSURED.-THE PERCENTAGE OF NON-CAUCASIAN POPULATION HAS GROWN FROM 6.2% TO 8.8%. NINETY SIX PERCENT OF THE SERVICE AREA IS CAUCASIAN WITH HISPANIC POPULATION OF 2% SEEING THE FASTEST GROWTH. HMONG ARE ARRIVING AS REFUGEES FOR SIMULATION. THE LARGEST MINORITY POPULATIONS ARE LATINO AND ASIAN. NATIVE AMERICANS ACCOUNT FOR APPROXIMATELY 1% OF THE POPULATION AND AFRICAN-AMERICANS REPRESENT LESS THAN 1%. THE MOST SIGNIFICANT GROWTH AMONG MINORITY POPULATIONS FROM 2000 TO 2010 OCCURRED AMONG LATINOS.CALUMET COUNTY:-OVER THE PAST DECADE, CALUMET COUNTY HAS GROWN IN POPULATION BY 20.53%.-THE CALUMET COUNTY HIGH SCHOOL GRADUATION RATE IS 94%-TRADE/TRANSPORTATION/UTILITIES ALONG WITH MANUFACTURING EMPLOY THE MOST PEOPLE IN THE TWO-COUNTY REGION FOLLOWED BY EDUCATION/HEALTH. THESE THREE SECTORS EMPLOY 40% OF THE AREA'S WORKFORCE.-IN COMPARISON TO MORE RURAL COUNTIES IN THE THEDACARE SERVICE AREA, OUTAGAMIE AND CALUMET COUNTIES CONTINUE TO HAVE A HIGHER PERCENTAGE OF CHILDREN-SIX PERCENT OF THE CALUMET COUNTY POPULATION LIVE BELOW 100% OF THE FEDERAL POVERTY LEVEL, 7% OF CALUMET COUNTY POPULATION ARE UNINSURED.-THE PERCENTAGE OF NON-CAUCASIAN POPULATION HAS GROWN FROM 6.2% TO 8.8%. NINETY SIX PERCENT OF SERVICE AREA IS CAUCASIAN WITH HISPANIC POPULATION OF 2% SEEING THE FASTEST GROWTH. HMONG ARE ARRIVING AS REFUGEES FOR SIMULATION. THE LARGEST MINORITY POPULATIONS ARE LATINO AND ASIAN. NATIVE AMERICANS ACCOUNT FOR APPROXIMATELY 1% OF THE POPULATION AND AFRICAN-AMERICANS REPRESENT LESS THAN 1%. THE MOST SIGNIFICANT GROWTH AMONG MINORITY POPULATIONS FROM 2000 TO 2010 OCCURRED AMONG LATINOS
PART VI, LINE 5:	EACH YEAR, APPLETON MEDICAL CENTER'S PARENT ORGANIZATION THEDACARE SETS ASIDE A PERCENTAGE OF EXCESS NET BUDGETED INCOME TO FUND AN EFFORT CALLED CHAT (COMMUNITY HEALTH ACTION TEAM). CHAT IS A GROUP OF 25 COMMUNITY LEADERS WHO STUDY SYSTEMIC HEALTH ISSUES OUTSIDE THE WALLS OF OUR HOSPITALS AND CLINICS AND WORK TO IDENTIFY INNOVATIVE, COLLABORATIVE SOLUTIONS THAT DRAW UPON THE WIDE ARRAY OF RESOURCES AND STRENGTHS OF OUR COMMUNITY. THROUGH CHAT, SUCH EFFORTS AS THE SHAWANO COUNTY RURAL HEALTH INITIATIVE HAVE BEEN DEVELOPED. THIS INITIATIVE TAKES BASIC HEALTH CARE AND SCREENING SERVICES TO THE FARM. EACH YEAR HUNDREDS OF FARM FAMILIES LIVING WITHOUT INSURANCE OR ONLY CATASTROPHIC COVERAGE RECEIVE CRITICAL ASSISTANCE. THIS INITIATIVE HAS NOW SPREAD TO OUTAGAMIE, WINNEBAGO AND WAUPACA COUNTIES. ANOTHER INITIATIVE IS THE THE NEW MENTAL HEALTH CONNECTION WHICH IS WORKING TO IMPROVE ACCESS TO MENTAL HEALTH SERVICES IN THE AREA. HIGH LATINO TEEN PREGNANCY RATES INSPIRED CHAT TO LAUNCH CUIDATE!, A CULTURALLY BASED TEEN PREGNANCY PREVENTION PROGRAM IN PARTNERSHIP WITH THE FOX CITIES COMMUNITY HEALTH CENTER. MAKING THE RIDE HAPPEN IS ANOTHER CHAT EFFORT THAT PROVIDES TRANSPORTATION TO OLDER ADULTS WHO OTHERWISE WOULD STAY COOPED UP IN APARTMENTS AND FIGHT DEPRESSION AND ISOLATION. PROJECT PROMISE IS A POVERTY INITIATIVE DEVELOPED THROUGH CHAT THAT BROUGHT TOGETHER MANY LOCAL AGENCIES AND BUSINESSES TO WORK TO ADDRESS POVERTY IN A COLLABORATIVE FASHION. VOICES OF MEN WAS LAUNCHED WITH SUPPORT FROM CHAT TO RAISE AWARENESS OF EVERYDAY BEHAVIORS OF MEN THAT CAN LEAD TO AN ACCEPTANCE OF VIOLENCE TOWARD WOMEN. ANOTHER RECENT INITIATIVE IS INCLUDE WHICH FOCUSES ON BUILDING INCLUSIVENESS AND TOLERANCE TO PREVENT SUICIDE AMONG THE GAY, LESBIAN, BISEXUAL, TRANSGENDER POPULATION. THEDACARE PROVIDES FUNDING AND STAFF SUPPORT TO MAKE CHAT AND COMMUNITY HEALTH EFFORTS POSSIBLE. OTHER WAYS THAT THEDACARE HOSPITALS IMPROVE THE HEALTH OF THE COMMUNITY INCLUDE:-IN 2014, THEDACARE SHARED ITS CUTTING EDGE APPLICATION OF LEAN PRODUCTION IMPROVEMENTS WITH HUNDREDS OF HEALTHCARE AND NON-HEALTHCARE VISITORS FROM AROUND THE WORLD. MOST WERE VISITORS WERE FROM HOSPITALS AND HEALTH SYSTEMS IN THE UNITED STATES LOOKING TO IMPROVE QUALITY AND REDUCE COSTS.-THEDACARE HOSPITALS PROVIDED SUPPORT TO THE THEDACARE CENTER FOR HEALTHCARE VALUE WHICH IS COORDINATING EFFORTS ACROSS THE COUNTRY TO SHARE QUALITY IMPROVEMENT AND COST REDUCTION LEARNINGS. -ALL THEDACARE HOSPITALS PROVIDE HEALTH EDUCATION PROGRAMMING FOR THEIR RESPECTIVE COMMUNITIES FOCUSING ON SUCH CRITICAL TOPICS AS PROPER NUTRITION, DIABETES IDENTIFICATION, AND CANCER PREVENTION.-THEDACARE PARTNERS WITH THE FOX CITIES/UW RESIDENCY CENTER TO PROVIDE HANDS ON EXPERIENCE FOR MEDICAL STUDENTS.-THEDACARE ALSO PARTNERS WITH AREA NURSING SCHOOLS SUCH AS UW OSHKOSH AND FOX VALLEY TECHNICAL COLLEGE TO PROVIDE PROFESSIONAL MENTORS FOR THEIR NURSING PROGRAMS AND VENUES FOR NURSING STUDENTS TO PRACTICE THEIR SKILLS.-THEDACARE HOSPITALS PROVIDED FINANCIAL AS WELL AS DIAGNOSTIC AND LAB SUPPORT TO TWO AREA CLINICS PROVIDING MEDICAL AND DENTAL CARE TO THE UNDERSERVED IN OUR SERVICE AREA.-THEDACARE HOSPITAL EMPLOYEES TAKE PART IN HELPING HEARTS, AN EMPLOYEE VOLUNTEERISM PROGRAM ENCOURAGING STAFF TO GIVE OF THEIR TIME IN THE COMMUNITY. THEDACARE PROVIDES PAID STAFF TO COORDINATE THE PROGRAM AND IDENTIFY AND PROMOTE VOLUNTEERISM OPPORTUNITIES. THEDACARE EMPLOYEES DONATED MORE THAN $1,434,000 IN UNPAID VOLUNTEER HOURS TO LOCAL NON-PROFITS IN 2014. -THEDACARE SPONSORS PARTY AT THE PAC FOR THOUSANDS OF AREA YOUTH TO EDUCATE YOUTH ON THE PERILS OF RISKY BEHAVIOR AND DRIVING. HOSTED AT OUR PERFORMING ARTS CENTER, LIVE DRAMATIZATIONS ALONG WITH STORIES OF YOUTH DISABLED DUE TO DRIVING AND RISKY BEHAVIOR ENCOURAGE TEENS TO THINK TWICE BEFORE DRINKING OR TEXTING AND DRIVING. -APPLETON MEDICAL CENTER STAFF WORK WITH THE AREA CHAMBER OF COMMERCE AND LOCAL HIGH SCHOOLS AND COLLEGES TO INFORM YOUTH ABOUT MEDICAL CAREER OPPORTUNITIES AND TO HELP PREPARE OUR EDUCATIONAL FACILITIES TO MEET THE HEALTHCARE STAFFING NEEDS FOR THE COMMUNITIES WE SERVE.-APPLETON MEDICAL CENTER SUPPORTS THE AMERICAN CANCER SOCIETY'S SOLE BURNER RUN AND THE AMERICAN HEART ASSOCIATION HEART WALK EVENTS TO HELP RAISE FUNDS FOR THE NON-PROFIT ORGANIZATIONS.-APPLETON MEDICAL CENTER STAFF SUPPORT THE THEDACARE NEIGHBORHOOD GARDEN WHICH SUPPLIES PRODUCE TO THE LOCAL EMERGENCY SHELTER. -APPLETON MEDICAL CENTER SUPPLIES ATHLETIC TRAINING SERVICES TO AREA HIGH SCHOOLS AT REDUCED COST.-APPLETON MEDICAL CENTER ORGANIZES SUPPORT GROUPS FOR CANCER AND DIABETES AND PROVIDES A TELEPHONE HOTLINE FOR NUTRITION COUNSELING.-APPLETON MEDICAL CENTER MAKES FINANCIAL AND IN-KIND DONATIONS TO NON-PROFIT ORGANIZATIONS INCLUDING UNITED WAY, AREA SCHOOLS, AMERICAN HEART ASSOCIATION, AMERICAN CANCER SOCIETY. -THEDA CARE STAFF PARTICIPATES IN LEADERSHIP FOX CITIES TO GROOM MIDDLE MANAGERS IN THE WORKINGS OF THE ENTIRE COMMUNITY, FROM EDUCATION SYSTEMS AND RECYCLING PROGRAMS TO GOVERNMENT AND JUSTICE SYSTEMS. -APPLETON MEDICAL CENTER STAFF ARE INVOLVED IN STATEWIDE AND REGIONAL DISASTER READINESS PLANNING TO PREPARE OUR COMMUNITY FOR TIMES OF CRISIS.-THEDA CARE PRESIDENT AND CEO IS ENGAGED IN STATEWIDE WISCONSIN COLLABORATIVE FOR HEALTHCARE QUALITY MAKING QUALITY HEALTHCARE DATA TRANSPARENT. -WITH INFORMATION GATHERS FROM A PLUNGE INTO THE END OF LIFE, THEDACARE IS WORKING IN PARTNERSHIP WITH THE AFFINITY AND MINISTRY HEALTH SYSTEMS TO DEVELOP A COMMON SET OF DOCUMENTS WITH WILL CAPTURE END OF LIFE WISHES FOR PEOPLE LIVING IN THE FOX VALLEY AND BEYOND.
PART VI, LINE 6:	THEDACARE, THE PARENT ORGANIZATION, PROVIDES DIRECTION RELATED TO COMMUNITY NEEDS ASSESSMENT FOR ALL HOSPITALS AND MARKETS WITHIN ITS SERVICE AREA. EACH THEDACARE HOSPITAL, ALONG WITH COMMUNITY HEALTH IMPROVEMENT (CHI) STAFF AND COMMUNITY MEMBERS DETERMINE HOW BEST TO MEET LOCAL NEEDS. IMPLEMENTATION OF COMMUNITY PROGRAMMING OCCURS AT THE LOCAL LEVEL.
PART VI, LINE 7, REPORTS FILED WITH STATES	WI

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Idemnification Gross Up Pmts	Yes (X)	IdemnificationGrossUpPmtsInd
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
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	Yes (1)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (1)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	Yes (1)	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (15 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
GRUNER DEAN
BOARD MEMBER/CEO - SYSTEM	$98,643	$887,783	$21,136	$190,227	$1,090	$9,811	$15,606	$140,459	$2,027	$18,243	$138,502	$1,246,523	$0	$0
EDELMAN GARY MD
BOARD MEMBER/PHYSICIAN	$0	$389,957	$0	$20,798	$0	$6,068	$0	$9,800	$0	$18,843	$0	$445,466	$0	$0
TURK NORMA MD
BOARD MEMBER/PHYSICIAN	$238,253	$0	$36,604	$0	$2,785	$0	$9,800	$0	$6,865	$0	$294,307	$0	$0	$0
MOARD DOUGLAS MD
BOARD MEMBER/PHYSICIAN	$0	$334,356	$0	$404	$0	$2,436	$0	$9,800	$0	$22,321	$0	$369,317	$0	$0
OLSON TIM
VP CFO SYSTEM	$40,976	$368,787	$5,500	$49,501	$2,118	$19,064	$9,040	$81,360	$1,833	$16,493	$59,467	$535,205	$0	$0
LIVINGSTON KEITH
VP SR CIO	$42,177	$379,589	$4,627	$41,643	$881	$7,933	$7,083	$63,746	$1,861	$16,745	$56,629	$509,656	$0	$0
PISTONE MAUREEN
VP SR HR SERVICES	$38,287	$344,585	$3,958	$35,623	$1,775	$15,978	$6,445	$58,009	$1,860	$16,739	$52,325	$470,934	$0	$0
BARNAS KIM
VP SR AMC & TC	$121,854	$182,782	$18,832	$28,247	$136,204	$204,306	$8,532	$12,799	$731	$1,096	$286,153	$429,230	$0	$0
BURMEISTER BRIAN
VP SR AMC & TC	$56,862	$322,219	$6,171	$34,967	$2,909	$16,484	$8,166	$46,273	$2,805	$15,895	$76,913	$435,838	$0	$0
CORREIA KATHRYN
FORMER VP. SR. HOSPITAL SERVICES	$325,418	$0	$0	$0	$0	$0	$0	$0	$0	$0	$325,418	$0	$0	$0
FERRANTE ROBERT MD
PHYSICIAN	$736,096	$0	$50,404	$0	$1,794	$0	$9,800	$0	$21,075	$0	$819,169	$0	$0	$0
WILSON ROBERT MD
PHYSICIAN	$581,668	$0	$24,779	$0	$6,348	$0	$9,800	$0	$22,154	$0	$644,749	$0	$0	$0
MARIANO DIONISIO MD
PHYSICIAN	$580,894	$0	$24,779	$0	$7,023	$0	$9,800	$0	$22,928	$0	$645,424	$0	$0	$0
GUTTORMSEN BRIAN MD
PHYSICIAN	$581,698	$0	$29,779	$0	$4,490	$0	$9,800	$0	$21,503	$0	$647,270	$0	$0	$0
ACKELL PETER MD
PHYSICIAN	$579,198	$0	$24,779	$0	$6,735	$0	$9,800	$0	$24,624	$0	$645,136	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 1A	EXECUTIVES RECEIVE REIMBURSEMENT FOR PERSONAL MEDICAL EXPENSES AT AN AMOUNT GROSSED-UP FOR TAXES. ALL EXECUTIVES IN THE SENIOR MANAGEMENT BENEFIT CATEGORY ARE ELIGIBLE TO HAVE HEALTH OR FITNESS CLUB FEES PAID DIRECTLY TO THE CLUB, OR REIMBURSED TO THEM ON EVIDENCE OF PAYMENT. SENIOR EXECUTIVES WHOSE DUTIES INCLUDE MEETING WITH PEOPLE OUTSIDE THE COMPANY FOR PURPOSES OF DEVELOPING BUSINESS RELATIONSHIPS HAVE COMPANY PAID MEMBERSHIPS AT A LOCAL COUNTRY CLUB. 6 EMPLOYEES RECEIVED TAXABLE MEDICAL EXPENSE REIMBURSEMENTS AND 4 EMPLOYEES RECEIVED CLUB DUES REIMBURSEMENTS.
PART I, LINE 3	SENIOR LEVEL EXECUTIVES OF THE COMPANY ARE ENTITLED TO AN ANNUAL FLEXIBLE BENEFIT EQUAL TO 20% OF THE MIDPOINT OF THEIR SALARY RANGE. THIS 457(F) SUPPLEMENTAL BENEFIT PLAN COMPLIES WITH THE FINAL REGULATIONS UNDER SECTION 409A AND 457(F) OF THE INTERNAL REVENUE CODE. PARTICIPANTS MAY ELECT THE BENEFIT TO BE USED TO PURCHASE PARTICULAR INSURANCE BENEFITS, INVESTED IN A CAPITAL ACCUMULATION ACCOUNT, OR A COMBINATION OF THE TWO. BENEFITS ARE ACCRUED ON A MONTHLY BASIS AND ARE SUBJECT TO THE SUBSTANTIAL RISK OF FORFEITURE AGREEMENT SIGNED BY THE PARTICIPANTS. PLAN CONTRIBUTIONS ARE MADE ON A QUARTERLY BASIS.
PART I, LINES 4A-B	EXECUTIVE AT RISK COMPENSATION PLAN THE PLAN OBJECTIVES ARE TO ENHANCE THEDACARE INC'S ABILITY TO ACHIEVE ITS GOALS BY PROVIDING A TOOL FOR STIMULATING AND REWARDING SUPERIOR LEVELS OF PERFORMANCE AMONG KEY EXECUTIVES, IMPROVE THEDACARE INC'S ABILITY TO COMPETE WITH OTHER EMPLOYERS FOR HIGH TALENT EXECUTIVES AND TO ENCOURAGE TOP-LEVEL EXECUTIVES TO WORK TOGETHER AS A COHESIVE GROUP TOWARD COMMON GOALS. THE PRESIDENT OF THEDACARE INC. DEVELOPS A LIST OF SENIOR LEVEL EXECUTIVES WHO ARE ELIGIBLE TO PARTICIPATE IN THIS PLAN, AS WELL AS THE PERFORMANCE LEVELS THE SENIOR EXECUTIVES MUST ACHIEVE AND THE BONUS AMOUNTS THAT THE EXECUTIVES WILL RECEIVE. THE PRESIDENT THEN SUBMITS THIS LIST TO THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES FOR FINAL APPROVAL. THESE EXECUTIVES MUST BE IN ACTIVE REGULAR SERVICE OF THEDACARE INC. FOR THE ENTIRE PLAN YEAR (JANUARY 1, 2013 TO DECEMBER 31, 2013) TO RECEIVE THEIR 2014 BONUSES. IF THE EMPLOYEE RETIRES, BECOMES DISABLED, MOVES TO A POSITION THAT IS ELIGIBLE UNDER THE BONUS PLAN OR MOVES TO A POSITION THAT IS NO LONGER ELIGIBLE FOR THE BONUS PLAN OR DIES, THE PLAN WILL BE PRORATED FOR THE AMOUNT OF TIME THEY SERVED THE COMPANY. IF AN ELIGIBLE EMPLOYEE IS FIRED OR LEAVES THE COMPANY FOR ANY OTHER REASON THE PLAN BONUS EARNED WILL BE FORFEITED. CARING FOR SUCCESS THE PLAN OBJECTIVES ARE TO PROVIDE INCENTIVE TO FOCUS THE ORGANIZATION'S RESOURCES, ENERGY AND ATTENTION ON THE FULFILLMENT OF THEDACARE'S MISSION. EMPLOYEE ELIGIBILITY IS BASED ON THE NUMBER OF HOURS WORKED, AND ALL ELIGIBLE EMPLOYEES SHARE IN THE PAYOUT. THE PAYOUT AMOUNT IS DETERMINED BASED ON BOTH FINANCIAL AND EMPLOYEE HEALTH AND SAFETY THRESHOLDS. THE AMOUNT PER EMPLOYEE IS DETERMINED BY DIVIDING THE TOTAL GAIN REALIZED (THE EMPLOYEE SHARE) BY HOURS PAID TO ALL ELIGIBLE EMPLOYEES. THE RESULTING DOLLAR UNIT PAYOUT IS MULTIPLIED BY AN INDIVIDUAL EMPLOYEE'S NUMBER OF HOURS PAID. THIS PLAN IS OVERSEEN BY AN ADMINISTRATIVE COMMITTEE. THE THEDACARE BOARD OF TRUSTEES MUST APPROVE THE PLAN. DURING 2014, KIM BARNAS RECEIVED A SEVERANCE PAYMENT OF $219,735.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART I, LINE 5	THEDACARE INC. CENTRALIZES PAYROLL AND TAX WITHHOLDING FUNCTIONS FOR A NUMBER OF AFFILIATED ENTITIES, WHILE ALL FILING UNDER THEDACARE'S FEDERAL IDENTIFICATION NUMBER. APPLETON MEDICAL CENTER (AMC) REPORTS "0" EMPLOYEES BECAUSE EMPLOYEES ARE PAID BY THEDACARE, INC., THEREFORE, AMC DOES NOT FILE ANY W-2 FORMS. THEDACARE INC. IS REIMBURSED BY AMC FOR SALARY EXPENSES FOR THE EMPLOYEES WHO ARE PERMANENTLY ASSIGNED TO AMC.
FORM 990, PART VI, SECTION A, LINE 6	APPLETON MEDICAL CENTER, INC.'S SOLE MEMBER OF THE SINGLE CLASS OF VOTING MEMBERS IS THEDACARE, INC.
FORM 990, PART VI, SECTION A, LINE 7A	THEDACARE, INC. HAS SOLE AUTHORITY IN THE CORPORATION TO VOTE AND TAKE ANY ACTION WITH RESPECT TO THE ELECTION OF DIRECTORS AND OFFICERS.
FORM 990, PART VI, SECTION A, LINE 7B	THEDACARE, INC. HAS THE SOLE AUTHORITY WITH RESPECT TO THE FOLLOWING MATTERS: 1. AMENDMENT OF THE ARTICLES OF INCORPORATION 2. ADOPTION AND AMENDMENT OF BYLAWS OF THE CORPORATION 3. CONSOLIDATION, MERGER AND DISSOLUTION OF THE CORPORATION 4. MONITORING COMPLIANCE WITH LAWS AND REGULATIONS 5. SELECTION, APPOINTMENT, AND REMOVAL OF A CHIEF OPERATING OFFICER 6. PROVISION FOR LONG-RANGE FINANCIAL STABILITY OF THE HOSPITAL AND PROVISION FOR THE CONTROL AND USE OF THE PHYSICAL AND FINANCIAL RESOURCES OF THE HOSPITAL 7. ESTABLISHMENT OF A LONG-RANGE PLANNING MECHANISM 8. APPROVAL OF A HOSPITAL ORGANIZATION AND MAJOR AUTHORITY DELEGATION PATTERNS 9. APPROVAL OF FINANCIAL, CAPITAL, AND OTHER ITEMS 10. APPROVAL OF DEBT OR LEASES 11. CONSIDERATION AND ACTION UPON POLICIES CONCERNING RELATIONS WITH EXTERNAL GROUPS AND ORGANIZATIONS
FORM 990, PART VI, SECTION B, LINE 11	A DRAFT OF THE FORM 990 IS PROVIDED TO THE ORGANIZATION'S DESIGNATED COMMITTEE OF THE BOARD OF DIRECTORS FOR REVIEW AND DISCUSSION AT A BOARD MEETING. THE FINAL VERSION OF THE FORM 990 IS EMAILED TO THE ENTIRE BOARD BEFORE THE RETURN IS FILED.
FORM 990, PART VI, SECTION B, LINE 12C	QUESTIONNAIRES ARE SENT TO ALL MANAGERS, TRUSTEES AND OFFICERS ANNUALLY. COMPLETED FORMS ARE RETURNED TO THE COMPLIANCE OFFICER. THE COMPLIANCE OFFICER REVIEWS THE QUESTIONNAIRES AND FOLLOWS UP WITH ANY QUESTIONS ABOUT THE MANAGERS' ANSWERS ON THE CONFLICT OF INTEREST FORMS. ALL EMPLOYEES AND BOARD MEMBERS ARE COVERED UNDER THE CONFLICT OF INTEREST POLICY. THE CORPORATE COMPLIANCE COMMITTEE REVIEWS THE POTENTIAL CONFLICT AND THE CFO/BOARD OF TRUSTEES REVIEW ALL CONFLICTS. AFTER DISCLOSURE OF THE CONFLICT, THE EMPLOYEE SHALL NOT PARTICIPATE IN THE DECISION WHETHER TO ENGAGE IN THE TRANSACTION IN WHICH THE EMPLOYEE HAS AN INTEREST.
FORM 990, PART VI, SECTION B, LINE 15	THEDACARE HIRES AN OUTSIDE CONSULTING FIRM TO CONDUCT A THOROUGH MARKET REVIEW OF EXECUTIVE COMPENSATION EVERY OTHER YEAR. INTERNALLY, A COMPENSATION COMMITTEE REAFFIRMS THE COMPENSATION POLICY, REVIEWS DATA FROM CONSULTANTS, AND WITH INPUT FROM THE SR VP OF HUMAN RESOURCES, ADVISES, VALIDATES, AND APPROVES A RANGE FOR CEO COMPENSATION. THE COMMITTEE ALSO RATIFIES THE BONUS PLAN.
FORM 990, PART VI, SECTION C, LINE 19	APPLETON MEDICAL CENTER INC. DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND INTERNAL FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.
FORM 990, PART XI, LINE 9:	EQUITY RECLASS -10,000.
FORM 990, PART XII, LINE 2C	THIS PROCESS DID NOT CHANGE DURING THE YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Direct Controlling NADirectControllingNACd	Controlled OrganizationControlledOrganizationInd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
THEDACARE INC
122 EAST COLLEGE AVENUE	APPLETON	WI	54911	391509362	HEALTHCARE	WI	501(C)(3)	LINE 11B, II	N/A	0
THEDA CLARK MEDICAL CENTER INC
PO BOX 8025	APPLETON	WI	54912	390830664	HOSPITAL	WI	501(C)(3)	LINE 3		Yes (1)	THEDACARE INC
THEDACARE MEDICAL CENTER - NEW LONDON INC
1405 MILL STREET	NEW LONDON	WI	54961	390869788	HOSPITAL	WI	501(C)(3)	LINE 3		Yes (1)	THEDACARE INC
RIVERSIDE MEDICAL CENTER INC
800 RIVERSIDE DRIVE	WAUPACA	WI	54981	390871113	HOSPITAL	WI	501(C)(3)	LINE 3		Yes (1)	THEDACARE INC
SHAWANO MEDICAL CENTER INC
309 N BARTLETTE STREET	SHAWANO	WI	54166	390807068	HOSPITAL	WI	501(C)(3)	LINE 3		Yes (1)	THEDACARE INC
COMMUNITY HEALTH NETWORK INC
225 MEMORIAL DRIVE	BERLIN	WI	54923	390806359	HOSPITAL	WI	501(C)(3)	LINE 3		Yes (1)	THEDACARE INC
WILD ROSE COMMUNITY MEMORIAL HOSPITAL INC
PO BOX 243	WILD ROSE	WI	54984	396089134	HOSPITAL	WI	501(C)(3)	LINE 3		Yes (1)	THEDACARE INC
APPLETON MEDICAL CENTER FOUNDATION INC
1818 NORTH MEADE STREET	APPLETON	WI	54911	391459276	FOUNDATION	WI	501(C)(3)	LINE 7		Yes (1)	THEDACARE INC
THEDACARE FAMILY OF FOUNDATIONS INC
1818 NORTH MEADE STREET	APPLETON	WI	54912	464112255	FOUNDATION	WI	501(C)(3)	LINE 7		Yes (1)	THEDACARE INC

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	NORTH APPLETON AMBULATORY CARE CENTER BUILDING COMPANY LLC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	122 E COLLEGE AVENUE	AddressLine1Txt
City	APPLETON	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54911	ZIPCd

Field	Value	IRS element (for citing)
EIN	262497187	EIN
Primary Activities	RENTAL	PrimaryActivitiesTxt
Legal Domicile State	WI	LegalDomicileStateCd
Direct Controlling NA	N/A	DirectControllingNACd

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	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	0	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	0	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	0	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (1)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	0	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	0	TransferToOtherOrgInd
Transfer From Other Org	0	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
THEDACARE INC
O	$116,601,922	ACTUAL
THEDACARE INC
N	$3,366,418	ACTUAL
THEDACARE FAMILY OF FOUNDATIONS INC
C	$110,140	ACTUAL