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PROHEALTH WAUKESHA MEMORIAL HOSPITAL INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
PROHEALTH WAUKESHA MEMORIAL HOSPITAL INC (EIN 39-0910727)
Tax period
2012-10-01 to 2013-09-30
Filed
2014-08-14
IRS object ID
201412269349303476
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-08-14T14:20:42-05:00Timestamp
Tax Period End Date2013-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN381357951EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PLANTE & MORAN PLLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 307AddressLine1
CitySOUTHFIELDCity
StateMIState
ZIP Code480370307ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN390910727EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1WAUKESHA MEMORIAL HOSPITAL INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlWAUKNameControl
Phone2629282496Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1725 AMERICAN AVENUEAddressLine1
CityWAUKESHACity
StateWIState
ZIP Code53188ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameRONALD FARRName
TitleCHIEF FINANCIAL OFFICERTitle
Phone2629282496Phone
Date Signed2014-08-12DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameDAVID LOWENTHALName
PTINP00378651PTIN
Phone2483522500Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonSUSAN EDWARDSNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1725 AMERICAN AVENUEAddressLine1
CityWAUKESHACity
StateWIState
ZIP Code53188ZIPCode
FieldValueIRS element (for citing)
Gross Receipts467956145GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.PROHEALTHCARE.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1956YearFormation
State Legal DomicileWIStateLegalDomicile
Activity Or Mission DescriptionPROVIDER OF INPATIENT AND OUTPATIENT HOSPITAL SERVICES.ActivityOrMissionDescription
Nbr Voting Members Governing Body12NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees2914TotalNbrEmployees
Total Nbr Volunteers430TotalNbrVolunteers
Total Gross UBI2823723TotalGrossUBI
Net Unrelated Business Txbl Income-344326NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year4208350ContributionsGrantsPriorYear
Contributions Grants Current Year1424641ContributionsGrantsCurrentYear
Program Service Revenue Prior Year437502571ProgramServiceRevenuePriorYear
Program Service Revenue CY431462556ProgramServiceRevenueCY
Investment Income Prior Year13144261InvestmentIncomePriorYear
Investment Income Current Year33254390InvestmentIncomeCurrentYear
Other Revenue Prior Year5532710OtherRevenuePriorYear
Other Revenue Current Year1787006OtherRevenueCurrentYear
Total Revenue Prior Year460387892TotalRevenuePriorYear
Total Revenue Current Year467928593TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year27193336GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY20374573GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year135368239SalariesEtcPriorYear
Salaries Etc Current Year139172445SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year259795822OtherExpensePriorYear
Other Expenses Current Year257795231OtherExpensesCurrentYear
Total Expenses Prior Year422357397TotalExpensesPriorYear
Total Expenses Current Year417342249TotalExpensesCurrentYear
Revenues Less Expenses Prior Year38030495RevenuesLessExpensesPriorYear
Revenues Less Expenses CY50586344RevenuesLessExpensesCY
Total Assets BOY750447287TotalAssetsBOY
Total Assets EOY805868769TotalAssetsEOY
Total Liabilities BOY361000320TotalLiabilitiesBOY
Total Liabilities EOY316340282TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY389446967NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY489528487NetAssetsOrFundBalancesEOY
Mission DescriptionCONTINUOUSLY IMPROVING THE HEALTH OF OUR COMMUNITY.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense392877709Expense
Grants20374573Grants
Revenue428613305Revenue
DescriptionWAUKESHA MEMORIAL HOSPITAL FULFILLS ITS EXEMPT PURPOSE BY PROVIDING CARE AND SERVICES TO ALL PATIENTS REGARDLESS OF INSURANCE OR ABILITY TO PAY. WAUKESHA MEMORIAL HOSPITAL ALSO USES ITS RESOURCES TO ADDRESS VARIOUS COMMUNITY NEEDS. WAUKESHA MEMORIAL HOSPITAL PROVIDED APPROXIMATELY 58,666 DAYS OF INPATIENT CARE AND APPROXIMATELY 274,238 OUTPATIENT VISITS DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2013. SEE SCHEDULE H FOR ILLUSTRATION OF ITS PROGRAM SERVICE ACCOMPLISHMENTS.Description
Total Program Service Expense392877709TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096296NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees2914NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members12NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure0WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledWIStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonRONALD FARRNamePerson
Telephone Number2629284740TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1N17 W24100 RIVERWOOD DRIVE SUITEAddressLine1
CityWAUKESHACity
StateWIState
ZIP Code531881131ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (24 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
GARY BEYER MD
CHAIRMAN2.004.00XX2400000
SUSAN EDWARDS
CEO - PHC2.0050.00XX01062296748997
TED GARVEY
VICE CHAIRPERSON2.004.00XX000
EILEEN GILLESPIE
SECRETARY2.004.00XX000
ED LUMP
TREASURER2.004.00XX000
JOHN ROBERTSTAD
PRESIDENT - PHC HOSPITAL DIVISION32.0012.00XX6177850272942
MIKE BARRY
DIRECTOR - PART YEAR2.004.00X000
PAUL BOSTROM
DIRECTOR2.004.00X000
CLIFF BROOKS
DIRECTOR2.004.00X000
CHARLOTTE HALL
DIRECTOR2.004.00X000
RICHARD NEILS
DIRECTOR2.004.00X000
ARCH PEQUET
DIRECTOR2.004.00X000
TIM WESTLAKE
DIRECTOR2.004.00X000
DAVID EBEL
INTERIM CFO2.0050.00X000
NANINE NELSON
CFO - PHC - PART YEAR2.0050.00X0478402208280
JAMES GARDNER
VP MEDICAL AFFAIRS40.000.00464280063030X
KENNETH PRICE
PRESIDENT - PHC40.000.00328976055048X
CATHERINE RAPP
VP OF NURSING - PART YEAR40.000.00282934038209X
MARY JO O'MALLEY
VP SUPPORT & DIAGNOSTICS - PART YEAR40.000.00255221034956X
DEAN REIN
EXECUTIVE VP - PHCF - PART YEAR40.000.001187469268137659X
ERIC HENDEE
CHIEF PHYSICIST - RADIOLOGY ONCOLOGY40.000.00206553043505X
MOHAMMAD KHARBAT
DIRECTOR PHARMACY40.000.00184647031329X
MARY CASEY
VP & CHIEF NURSING EXECUTIVE40.000.00152039043655X
DEBRA ENDEAN
DIRECTOR LABORATORY - PART YEAR40.000.00151641035770X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2786822TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1633379TotalReportableCompFrmRltdOrgs
Total Other Compensation1613380TotalOtherCompensation
Number Individuals GT100 K66NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
RILEY CONSTRUCTION CO INC
5301-99TH AVEKENOSHAWI53144CONSTRUCTION SERVICES12678184
FINDORFF INC
PO BOX 575MADISONWI53701CONSTRUCTION SERVICES6254183
MEDICAL COLLEGE OF WI
PO BOX 13308MILWAUKEEWI53213MEDICAL SERVICES3595197
EPIC SYSTEMS CORP
PO BOX 88314MILWAUKEEWI53288MAINTENANCE CONTRACTS3521400
ADVANCED ICU CARE INC
PO BOX 671773DALLASTX75267HEALTHCARE SERVICES1569692
FieldValueIRS element (for citing)
Number Of Contractors GT100 K66NumberOfContractorsGT100K
Related Organizations1266320RelatedOrganizations
All Other Contributions158321AllOtherContributions
Total Contributions1424641TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
NET PATIENT REV.622110416904577416904577
MEANINGFUL USE90009936348683634868
MEDICAL SERVICE LAB62150028492512849251
HOSPITAL JOINT VENTURE62231021288402128840
SURGERY CENTER62140015663331566333

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column4378687TotalRevenueColumn
Related Or Exempt Function Income4378687RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue431462556TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column33200123TotalRevenueColumn
Exclusion$33,200,123ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Personal45773Personal

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Personal9975Personal

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Personal35798Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column35798TotalRevenueColumn
Unrelated Business Revenue24778UnrelatedBusinessRevenue
Exclusion$11,020ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other71844Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other17577Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other54267Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column54267TotalRevenueColumn
Exclusion$54,267ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountUnrelated Business RevenueUnrelatedBusinessRevenue
CAFETERIA7222101762735$1,762,735
GIFT SHOP45322038779$38,779
PASS-THROUGH INCOME900099-50306-50306
FieldValueIRS element (for citing)
Total Other Revenue1751208TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column467928593TotalRevenueColumn
Related Or Exempt Function Income428613305RelatedOrExemptFunctionIncome
Unrelated Business Revenue2823723UnrelatedBusinessRevenue
Exclusion$35,066,924ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total20374573Total
Program Services20374573ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1139823Total
Management And General1139823ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total105768202Total
Program Services104091285ProgramServices
Management And General1676917ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total7955211Total
Program Services7745613ProgramServices
Management And General209598ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total16728446Total
Program Services16287696ProgramServices
Management And General440750ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total7580763Total
Program Services7457876ProgramServices
Management And General122887ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total104562632Total
Program Services86026902ProgramServices
Management And General18535730ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total16175294Total
Program Services16166799ProgramServices
Management And General8495ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total4769023Total
Program Services4382762ProgramServices
Management And General386261ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total12252342Total
Program Services12252342ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total32530607Total
Program Services32530607ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL SUPPLIES344860253448598540
DRUGS & PHARMACEUTICALS2088785720887857
MEDICAID PROVIDER TAXES1377599513775995
BAD DEBTS1301560313015603

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total5339853Total
Program Services3395814ProgramServices
Management And General1944039ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total417342249Total
Program Services392877709ProgramServices
Management And General24464540ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY516365BOY
EOY512250EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY12792321BOY
EOY10461182EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY56245729BOY
EOY56552150EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY6289663BOY
EOY8036858EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY4938143BOY
EOY5489553EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis686720307LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec407895887LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY258329039BOY
EOY278824420EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY273261901BOY
EOY310964639EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY8925389BOY
EOY9278045EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY129148737BOY
EOY125749672EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY750447287BOY
EOY805868769EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY46265248BOY
EOY42391690EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY201704893BOY
EOY195427377EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY34008321BOY
EOY33441881EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY79021858BOY
EOY45079334EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY361000320BOY
EOY316340282EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY388628994BOY
EOY488784731EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY817973BOY
EOY743756EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY389446967BOY
EOY489528487EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY750447287BOY
EOY805868769EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses50586344ReconcilationRevenueExpenses
Reconciliation Unrealized Invest16674576ReconciliationUnrealizedInvest
Reconcilation Other Changes32820600ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance6710388BeginningOfYearBalance
Other Expenditures6710388OtherExpenditures

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance6625195BeginningOfYearBalance
Contributions88002Contributions
Investment Earnings Or Losses-2809InvestmentEarningsOrLosses
End Of Year Balance6710388EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance6542035BeginningOfYearBalance
Contributions84926Contributions
Investment Earnings Or Losses-1766InvestmentEarningsOrLosses
End Of Year Balance6625195EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance5498739BeginningOfYearBalance
Contributions1045116Contributions
Investment Earnings Or Losses-1820InvestmentEarningsOrLosses
End Of Year Balance6542035EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance5293708BeginningOfYearBalance
Contributions236781Contributions
Investment Earnings Or Losses-31750InvestmentEarningsOrLosses
End Of Year Balance5498739EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs1EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R1AreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis22617283OtherCostOrOtherBasis
Book Value22617283BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis310865386OtherCostOrOtherBasis
Depreciation147231357Depreciation
Book Value163634029BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis2697048OtherCostOrOtherBasis
Depreciation2487273Depreciation
Book Value209775BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis339575191OtherCostOrOtherBasis
Depreciation258177257Depreciation
Book Value81397934BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis10965399OtherCostOrOtherBasis
Book Value10965399BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings278824420TotalOfBookValueLandBuildings

Other Assets OtherAssets (7 entries)

DescriptionDescriptionBook ValueBookValue
DEFERRED FINANCING1256730
DEBT SERVICE RESERVE FUND-628202
ACCRUED INTEREST RECEIVABLE595097
DUE FROM AFFILIATES11265663
OTHER ASSETS4206467
DEPRECIATION RESERVE108362555
INSURANCE RECOVERY691362
FieldValueIRS element (for citing)
Total Book Value Other Assets125749672TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (6 entries)

DescriptionDescriptionAmountAmount
ACCRUED POSTRETIREMENT MEDICAL$108,513
FAIR VALUE-INTEREST RATE SWAP$18,090,231
ASSET RETIREMENT OBLIGATION$282,335
ACCUMULATED MIN PENSION LIABILITY$24,892,940
INSURANCE LIABILITY$716,362
OTHER LONG TERM LIABILITIES$988,953
FieldValueIRS element (for citing)
Total Of Amounts45079334TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:TO SUPPORT WAUKESHA MEMORIAL HOSPITAL IN ITS CHARITABLE MISSION.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X, LINE 2:FIN48 DISCLOSURE: PHC, WMH, OMH, NATIONAL REGENCY, PHCMA, PHCF, AND PHHC ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND ARE EXEMPT FROM FEDERAL INCOME TAXES PURSUANT TO SECTION 501(A) OF THE CODE. ALL OF THESE ENTITIES ARE, HOWEVER, SUBJECT TO FEDERAL AND STATE INCOME TAXES ON ANY UNRELATED BUSINESS INCOME UNDER THE PROVISIONS OF SECTION 511 OF THE CODE. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE CORPORATION AND RECOGNIZE A TAX LIABILITY IF THE CORPORATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE CORPORATION AND HAS CONCLUDED THAT AS OF SEPTEMBER 30, 2013, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE CORPORATION IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO SEPTEMBER 30, 2010.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically Indigent0FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense6025728TotalCommunityBenefitExpense
Net Community Benefit Expense6025728NetCommunityBenefitExpense
Percent Of Total Expense0.01490PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense36811467TotalCommunityBenefitExpense
Direct Offsetting Revenue20565383DirectOffsettingRevenue
Net Community Benefit Expense16246084NetCommunityBenefitExpense
Percent Of Total Expense0.04020PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense42837195TotalCommunityBenefitExpense
Direct Offsetting Revenue20565383DirectOffsettingRevenue
Net Community Benefit Expense22271812NetCommunityBenefitExpense
Percent Of Total Expense0.05510PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs30NumberOfActivitiesOrPrograms
Persons Served63387PersonsServed
Total Community Benefit Expense6706464TotalCommunityBenefitExpense
Direct Offsetting Revenue4047DirectOffsettingRevenue
Net Community Benefit Expense6702417NetCommunityBenefitExpense
Percent Of Total Expense0.01660PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs8NumberOfActivitiesOrPrograms
Persons Served2937PersonsServed
Total Community Benefit Expense5437829TotalCommunityBenefitExpense
Direct Offsetting Revenue4078049DirectOffsettingRevenue
Net Community Benefit Expense1359780NetCommunityBenefitExpense
Percent Of Total Expense0.00340PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense6877081TotalCommunityBenefitExpense
Direct Offsetting Revenue2162010DirectOffsettingRevenue
Net Community Benefit Expense4715071NetCommunityBenefitExpense
Percent Of Total Expense0.01170PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served100PersonsServed
Total Community Benefit Expense336159TotalCommunityBenefitExpense
Net Community Benefit Expense336159NetCommunityBenefitExpense
Percent Of Total Expense0.00080PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs9NumberOfActivitiesOrPrograms
Persons Served7110PersonsServed
Total Community Benefit Expense1464181TotalCommunityBenefitExpense
Direct Offsetting Revenue120338DirectOffsettingRevenue
Net Community Benefit Expense1343843NetCommunityBenefitExpense
Percent Of Total Expense0.00330PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs50NumberOfActivitiesOrPrograms
Persons Served73534PersonsServed
Total Community Benefit Expense20821714TotalCommunityBenefitExpense
Direct Offsetting Revenue6364444DirectOffsettingRevenue
Net Community Benefit Expense14457270NetCommunityBenefitExpense
Percent Of Total Expense0.03580PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs50NumberOfActivitiesOrPrograms
Persons Served73534PersonsServed
Total Community Benefit Expense63658909TotalCommunityBenefitExpense
Direct Offsetting Revenue26929827DirectOffsettingRevenue
Net Community Benefit Expense36729082NetCommunityBenefitExpense
Percent Of Total Expense0.09090PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served80PersonsServed
Total Community Building Expense26232TotalCommunityBuildingExpense
Net Community Building Expense26232NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served925PersonsServed
Total Community Building Expense57254TotalCommunityBuildingExpense
Direct Offsetting Revenue8106DirectOffsettingRevenue
Net Community Building Expense49148NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Leadership Development LeadershipDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Building Expense4200TotalCommunityBuildingExpense
Net Community Building Expense4200NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served34PersonsServed
Total Community Building Expense882TotalCommunityBuildingExpense
Net Community Building Expense882NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served129PersonsServed
Total Community Building Expense6025TotalCommunityBuildingExpense
Net Community Building Expense6025NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served24PersonsServed
Total Community Building Expense10068TotalCommunityBuildingExpense
Net Community Building Expense10068NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs6NumberOfActivitiesOrPrograms
Persons Served1192PersonsServed
Total Community Building Expense104661TotalCommunityBuildingExpense
Direct Offsetting Revenue8106DirectOffsettingRevenue
Net Community Building Expense96555NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$13,059,331BadDebtExpenseAmount
Amount Attributable To1332953AmountAttributableTo
Amount Reimbursed By Medicare90641340AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare139565186CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-48923846MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (2 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivityOrganization Profit Or OwnershipOrganizationProfitOrOwnershipPhysicans Profit Or OwnershipPhysicansProfitOrOwnership
1 PROHEALTH ALIGNED LLC
AMBULATORY SURGERY CENTER0.510000.49000
2 THE ORTHOPEDIC SURGERY CENTER LLC
ORTHOPEDIC SURGICAL SERVICES0.300000.70000
FieldValueIRS element (for citing)
Number Of Hospital Facilities2NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalTeaching HospitalTeachingHospitalEr OtherErOtherOtherOther
WAUKESHA MEMORIAL HOSPITAL INC
1725 AMERICAN AVENUEWAUKESHAWI53188XXXX
REHABILITATION HOSPITAL OF WISCONSIN LLC
21625 COLDWATER CREEK DRIVEWAUKESHAWI53188XINPATIENT REHABILITATION

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (2 entries)

Hospital Facility NumberHospitalFacilityNumberCHNA ConductedCHNAConductedCommunity DefinitionCommunityDefinitionCommunity DemographicsCommunityDemographicsExisting ResourcesExistingResourcesHow Data ObtainedHowDataObtainedCommunity Health NeedsCommunityHealthNeedsIdentifying ProcessIdentifyingProcessConsulting ProcessConsultingProcessOtherOtherNeeds Assessment ConductedNeedsAssessmentConductedTake Into AccountTakeIntoAccountOther FacilitiesOtherFacilitiesCHNA Widely AvailableCHNAWidelyAvailableOwn WebsiteOwnWebsiteOn RequestOnRequestOther MethodOtherMethodAdopt Implement StrategyAdoptImplementStrategyExecute Implement StrategyExecuteImplementStrategyDevelop Community PlanDevelopCommunityPlanParticipate Community PlanParticipateCommunityPlanInclude Operational PlansIncludeOperationalPlansAdopt BudgetAdoptBudgetPrioritize Health NeedsPrioritizeHealthNeedsPrioritize ServicesPrioritizeServicesAll Needs AddressedAllNeedsAddressedOrganization Incur Excise TaxOrganizationIncurExciseTaxEligibility Criteria ExplainedEligibilityCriteriaExplainedUses FPG FreeUsesFPGFreeFPG Free PercentFPGFreePercentUses FPG DiscountedUsesFPGDiscountedFPG Discount PercentFPGDiscountPercentExplains BasisExplainsBasisIncome LevelIncomeLevelAsset LevelAssetLevelUninsured DiscountUninsuredDiscountExplains Application MethodExplainsApplicationMethodIncludes Publicity MeasuresIncludesPublicityMeasuresPosted On WebsitePostedOnWebsiteAttached To InvoicesAttachedToInvoicesPosted In Emergency RoomPostedInEmergencyRoomPosted In Admission OfficePostedInAdmissionOfficeProvided On AdmissionProvidedOnAdmissionAvailable On RequestAvailableOnRequestOther PublicityOtherPublicityActions On NonpaymentActionsOnNonpaymentCollection ActivitiesCollectionActivitiesReport To Credit AgencyReportToCreditAgencyLawsuitLawsuitLien On ResidenceLienOnResidenceNotified All PatientsNotifiedAllPatientsDocumented DeterminationDocumentedDeterminationNondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicyAverage Negotiated RatesAverageNegotiatedRatesAmounts Generally BilledAmountsGenerallyBilledGross ChargesGrossChargesMedical IndigencyMedicalIndigencyPermit Report To Credit AgencyPermitReportToCreditAgencyPermit Other ActionsPermitOtherActionsUsed Other MethodUsedOtherMethod
WAUKESHA MEMORIAL HOSPITAL INC
11XXXXXXXX12111XXXXXXXXXXX0011200.0000000000001400.0000000000001XXX11XXXXXXX11XXXXX1X00
REHABILITATION HOSPITAL OF WISCONSIN LLC
2011150.0000000000001250.0000000000001XX11X10XX000XXXX

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities3NumberOfOtherFacilities

Other Facilities OtherFacilities (3 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
REHAB HOSPITAL OF WI OUTPATIENT CLINIC
1625 COLDWATER CREEK DRIVEWAUKESHAWI53188OUTPATIENT REHABILATION CLINIC
PROHEALTH ALIGNED LLC
1111 DELAFIELD ST SUITE 100WAUKESHAWI53188AMBULATORY SURGERY CENTER
THE ORTHOPEDIC SURGERY CENTER LLC
W238 N 1610 BUSSE ROAD SUITE 100WAUKESHAWI53188ORTHOPEDIC SURGERY CENTER

Form990 Schedule H Part VI Form990ScheduleHPartVI (20 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
PART I, LINE 3C: N/A
PART I, LINE 6A: PROHEALTH CARE, INC.
PART I, LINE 7: THE COST-TO-CHARGE RATIO WAS USED TO CALCULATE AMOUNTS ON LINES 7A-7D. THIS WAS CALCULATED BY USING WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS. THE HOSPITAL'S FINANCIAL COST REPORTING SYSTEM WAS USED TO CALCULATE THE AMOUNTS ON LINES 7E-7I
PART I, LINE 7G: N/A
PART I, L7 COL(F): $13,015,603 OF BAD DEBT EXPENSES FROM WAUKESHA MEMORIAL HOSPITAL, INC. WAS INCLUDED ON FORM 990, PART, IX, LINE 25. ADDITIONALLY, THERE WAS BAD DEBT EXPENSE OF $43,728 RELATED TO REHABILITATION HOSPITAL OF WISCONSIN, LLC. BOTH AMOUNTS WERE SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE.
PART II: WAUKESHA/OCONOMOWOC MEMORIAL HOSPITALS HAVE PARTNERSHIPS WITH VARIOUS ORGANIZATIONS THROUGHOUT THE COMMUNITIES WE SERVE. ONE EXAMPLE IS THE PARTNERSHIPS WE HAVE WITH THE LOCAL CHAMBERS OF COMMERCE WITHIN OUR SERVICE AREA BY PROVIDING LEADERSHIP AND HEALTH RELATED OUTREACH TOWARDS STRENGTHENING COMMUNITY DEVELOPMENT. WE ARE THE MAJOR SPONSOR FOR "LEADERSHIP WAUKESHA", A PROGRAM THAT FOCUSES ON THE DEVELOPMENT OF EMERGING LEADERS IN OUR COUNTY. ADDITIONALLY, WE PROVIDE LAND, RESOURCES AND EXPERTISE FOR LOCAL COMMUNITY GARDENS. WE PROVIDE DELIVERY OF EMERGENCY CARE IN THE COMMUNITY AND OFFER/SUPPORT NUMEROUS SERVICES AIMED AT OUR YOUTH INCLUDING SPONSORSHIP OF SAFE "AFTER PROM" ACTIVITIES. WE SUPPORT AREA HOMELESS SHELTERS AND ARE ACTIVE MEMBERS OF THE HOUSING ACTION COALITION AND HISPANIC COLLABORATIVE NETWORK.
PART III, LINE 4: BAD DEBT EXPENSE FOOTNOTE FOR WAUKESHA MEMORIAL HOSPITAL, INC: AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS ESTABLISHED ON AN AGGREGATE BASIS BY USING HISTORICAL WRITE-OFF RATE FACTORS APPLIED TO UNPAID ACCOUNTS BASED ON AGING. LOSS RATE FACTORS ARE BASED ON HISTORICAL LOSS EXPERIENCE AND ARE ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE HOSPITAL'S ABILITY TO COLLECT OUTSTANDING AMOUNTS. UNCOLLECTIBLE AMOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE. THE BAD DEBT COST WAS REVIEWED BY THE HOSPITAL'S REVENUE CYCLE TEAM AND THE AMOUNT OF BAD DEBT ESTIMATED TO BE ATTRIBUTABLE TO PATIENTS WHO WOULD HAVE QUALIFIED UNDER OUR FINANCIAL ASSISTANCE PROGRAM IS 30% OF TOTAL BAD DEBTS.THE AMOUNT OF BAD DEBT EXPENSE REPORTED ON PART III LINE 2 IS THE BAD DEBT EXPENSE REPORTED ON FORM 990 PART IX FOR WAUKESHA MEMORIAL HOSPITAL PLUS ITS SHARE OF THE BAD DEBT EXPENSE OF REHABILITATION HOSPITAL OF WISCONSIN LLC.BAD DEBT EXPENSE FOOTNOTE FOR REHABILITATION HOSPITAL OF WISCONSIN LLC:ACCOUNTS RECEIVABLE PRIMARILY CONSIST OF AMOUNTS DUE FROM THIRD-PARTY PAYORS AND PATIENTS. THE HOSPITAL'S ABILITY TO COLLECT OUTSTANDING RECEIVABLES IS CRITICAL TO ITS RESULTS OF OPERATIONS AND CASH FLOWS. TO PROVIDE FOR ACCOUNTS RECEIVABLE THAT COULD BECOME UNCOLLECTIBLE IN THE FUTURE, THE HOSPITAL ESTABLISHES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS TO REDUCE THE CARRYING VALUE OF SUCH RECEIVABLES TO THEIR ESTIMATED NET REALIZABLE VALUE. THE PRIMARY UNCERTAINTY OF SUCH ALLOWANCES LIES WITH UNINSURED PATIENT RECEIVABLES AND DEDUCTIBLES, CO-PAYMENTS OR OTHER AMOUNTS DUE FROM INDIVIDUAL PATIENTS. THE HOSPITAL'S POLICY TO RECORD AN ALLOWANCE FOR DOUBTFUL ACCOUNTS IS BASED UPON A PERCENTAGE OF NET RECEIVABLES BY AGE OF BALANCE AFTER DISCHARGE DATE.THE HOSPITAL HAS AN ESTABLISHED PROCESS TO DETERMINE THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS THAT RELIES ON A NUMBER OF ANALYTICAL TOOLS AND BENCHMARKS TO ARRIVE AT A REASONABLE ALLOWANCE. NO SINGLE STATISTIC OR MEASUREMENT DETERMINES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. SOME OF THE ANALYTICAL TOOLS THAT THE HOSPITAL UTILIZES INCLUDE, BUT ARE NOT LIMITED TO, HISTORICAL CASH COLLECTION EXPERIENCE, REVENUE TRENDS BY PAYOR CLASSIFICATION AND REVENUE DAYS IN ACCOUNTS RECEIVABLE. INDIVIDUAL PATIENT ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE HOSPITAL'S POLICIES.BAD DEBT EXPENSE IS RECORDED FOR FINANCIAL STATEMENT PURPOSES BASED ON UNCOLLECTED REVENUE, BUT THE RELATED COST COULD BE DETERMINED BY APPLYING COST TO CHARGE RATIOS FROM THE MEDICARE COST REPORT. DISCOUNTS ARE RECORDED TO AN APPROPRIATE CONTRA REVENUE ACCOUNT INCLUDING CHARITY CARE WHEN APPLICABLE; PAYMENTS RECEIVED AFTER AN ACCOUNT HAS BEEN WRITTEN OFF WOULD DECREASE BAD DEBT EXPENSE. MOST OF THE PATIENTS FOR WHICH BAD DEBT EXPENSE IS RECORDED WOULD PROBABLY QUALIFY FOR SOME LEVEL OF FINANCIAL ASSISTANCE ACCORDING TO HOSPITAL POLICIES, BUT MANY CHOOSE NOT TO COMPLETE THE NECESSARY FINANCIAL ASSISTANCE APPLICATION SO THAT THIS CAN BE PROPERLY DETERMINED.
PART III, LINE 8: THE SHORTFALL ON LINE 7 SHOULD NOT BE TREATED AS COMMUNITY BENEFIT. COSTING METHODOLOGY USED IS THE COST TO CHARGE RATIO AS REPORTED ON THE MEDICARE COST REPORT.
PART III, LINE 9B: PATIENTS THAT QUALIFY FOR FINANCIAL ASSISTANCE WILL HAVE A CHARITY DISCOUNT APPLIED TO THEIR BALANCES AT THE TIME OF BILLING. IF THIS RESULTS IN NO BALANCE DUE FORM THE PATIENT, THEN THE PATIENT WILL NOT RECEIVE A STATEMENT. IF A BALANCE REMAINS AFTER THE DISCOUNT PERCENTAGE IS APPLIED, THE PATIENT WILL RECEIVE A STATEMENT FOR THE BALANCE DUE. THE STATEMENT CYCLE IS CONSISTENT FOR ALL PATIENTS.
PART V, SECTION B, LINE 1J: WAUKESHA MEMORIAL HOSPITAL'S CHNA ALSO INCLUDES INFORMATION ABOUT ITS ACTIVE PARTICIPATION AND PARTNERSHIP IN THE WAUKESHA COUNTY HEALTH AND HUMAN SERVICES CHIPP (COMMUNITY HEALTH IMPROVEMENT PLAN AND PROCESS).WAUKESHA MEMORIAL HOSPITAL, INC
PART V, SECTION B, LINE 7: ADDITIONAL COMMUNITY NEEDS IDENTIFIED INCLUDED MENTAL HEALTH, AODA AND ACCESS TO CARE. AS THESE ARE THE NEEDS CHOSEN BY THE WAUKESHA COUNTY HHS, WE CHOSE NOT TO DUPLICATE. RATHER, WE ARE ACTIVELY PARTNERING WITH THE COUNTY TO ADDRESS THESE NEEDS IN ADDITION TO OTHER NEEDS WE IDENTIFIED AS A PART OF OUR CHNA.WAUKESHA MEMORIAL HOSPITAL, INC
PART V, SECTION B, LINE 14G: THE POLICY IS AVAILABLE UPON REQUEST OR ON OUR WEBSITE. A PHONE NUMBER IS PROVIDED ON OUR BILLING STATEMENTS, AND IN THE EMERGENCY DEPARTMENT AND ADMITTING AREAS FOR A PATIENT TO CALL IF THEY HAVE A FINANCIAL NEED.WAUKESHA MEMORIAL HOSPITAL, INC
PART V, SECTION B, LINE 16E: ASSIGNMENT OF ACCOUNTS TO COLLECTION AGENCY.REHABILITATION HOSPITAL OF WISCONSIN LLC
PART V, SECTION B, LINE 20D: THE HOSPITAL HAS NEVER HAD AN EMERGENCY CARE SITUATION REQUIRING THE DETERMINATION OF AN AMOUNT TO BE BILLED FOR SERVICES TO A PATIENT IN THESE CIRCUMSTANCES. IF SUCH A CASE ARISES, THE HOSPITAL WILL CONSULT WITH WAUKESHA MEMORIAL HOSPITAL TO DETERMINE APPROPRIATE EMERGENCY CARE CHARGES AND THEN APPLY PROCEDURES ACCORDING TO CHARITY CARE AND PRIVATE PAY DISCOUNT POLICIES IF THE PATIENT IS ELIGIBLE.REHABILITATION HOSPITAL OF WISCONSIN LLC
PART VI, LINE 2: COMMUNITY NEEDS ARE IDENTIFIED BASED UPON A REVIEW OF STATE, COUNTY AND COMMUNITY HEALTH DATA AND ASSESSMENTS. THIS INCLUDES SUCH DOCUMENTS AS: THE STATE HEALTH PLAN, THE COUNTY HEALTH REPORT CARD, THE WAUKESHA COMMUNITY HEALTH SURVEY, THE HEALTHY PEOPLE 2020 PLAN AND VARIOUS OTHER NEEDS ASSESSMENTS, SUCH AS THE UNITED WAY/UNIVERSITY OF WISCONSIN SURVEY OF WAUKESHA COUNTY. ADDITIONALLY, WE HAVE ACTIVELY PARTNERED WITH OUR COUNTY HEALTH DEPARTMENT IN THEIR COMMUNITY HEALTH IMPROVEMENT PLAN AND PROCESS (CHIPP) ASSESSMENT. TO COMPLEMENT ALL OF THESE DATA SOURCES, WE ALSO PERIODICALLY PERFORM A SERVICE GAP ANALYSIS WITH OUR EMPLOYED COMMUNITY OUTREACH NURSES AS WELL AS LOCAL NON-PROFIT AGENCIES WITH WHICH WE PARTNER. WE THEN ANALYZE THE DATA, IDENTIFY THE PRESSING NEEDS, AND PROACTIVELY PLAN AND IMPLEMENT COMMUNITY BENEFIT INITIATIVES TO ADDRESS THESE NEEDS. WE ARE CURRENTLY COLLECTING AND ANALYZING PRIMARY DATA FOR OUR FORMAL CHNA AS REQUIRED BY THE AFFORDABLE CARE ACT.
PART VI, LINE 3: EVERY PATIENT WITH A SELF PAY BALANCE RECEIVES A STATEMENT WHICH CONVEYS THE AVAILABILITY OF COMMUNITY (CHARITY) CARE AND A CONTACT NUMBER FOR FURTHER INFORMATION. PATIENTS THAT ARE UNINSURED RECEIVE AN UNINSURED DISCOUNT WHICH IS LISTED ON THE FIRST STATEMENT THAT THEY RECEIVE. PATIENTS RECEIVE A TOTAL OF FOUR STATEMENTS. EACH STATEMENT CONTAINS VERBIAGE REFERENCING THE HOSPITAL'S COMMUNITY CARE PROGRAM AND A CONTACT NUMBER FOR FURTHER INFORMATION. IF SOMEONE HAS BEEN FOUND ELIGIBLE FOR SOME LEVEL OF CHARITY CARE, THE ELIGIBILITY PERIOD IS THREE MONTHS SO ANY SUBSEQUENT ACCOUNTS DURING THAT TIMEFRAME WOULD BE DISCOUNTED AT WHATEVER LEVEL OF CHARITY CARE THE PATIENT IS DEEMED ELIGIBLE. PATIENTS MAY REAPPLY FOR COMMUNITY CARE WHEN THEIR ELIGIBILITY PERIOD HAS EXPIRED. SELF PAY PATIENTS MAY ALSO BE INFORMED OF THE HOSPITAL'S COMMUNITY CARE PROGRAM WHILE THEY ARE INPATIENTS. SOCIAL WORK AND/OR THE BUSINESS OFFICE MAY MAKE CONTACT WITH THESE PATIENTS DURING THEIR STAY TO INFORM THEM OF THE COMMUNITY CARE PROGRAM AND ASSIST THEM WITH COMPLETION OF THE APPLICATION.INFORMATION IS AVAILABLE AT REGISTRATION AREAS RELATED TO OUR COMMUNITY CARE PROGRAM. THIS INFORMATION CONTAINS CONTACT INFORMATION FOR THE HOSPITAL'S CENTRAL BUSINESS OFFICE WHERE PATIENTS CAN RECEIVE ASSISTANCE IN OBTAINING AND COMPLETING APPLICATIONS.
PART VI, LINE 4: PROHEALTH CARE SERVES ABOUT 285,000 PEOPLE EACH YEAR IN WAUKESHA COUNTY AND PORTIONS OF SURROUNDING COUNTIES. IN EVERY FEDERAL POPULATION CENSUS, WAUKESHA COUNTY HAS RECORDED AN INCREASE IN POPULATION. SINCE 1960, THE POPULATION OF THE COUNTY HAS MORE THAN DOUBLED. WAUKESHA COUNTY HAS AN AGING POPULATION WITH 14.7% OVER THE AGE OF 65 AND A MEDIAN AGE OF 42.0 YEARS. THE RATE OF RETIREMENT IS LIKELY TO SURPASS THE RATE OF ENTRY INTO THE WORKFORCE BETWEEN 2015 AND 2020. THE RACIAL MAKEUP OF THE WAUKESHA COUNTY COMMUNITY IS AS FOLLOWS: CAUCASIAN (NON-HISPANIC) 94.1%, HISPANIC OR LATINO 4.4%, ASIAN 3.0%, BLACK 1.4%. MEDIAN HOUSEHOLD INCOME IS $75,689, WITH 5.0% OF PEOPLE LIVING BELOW THE POVERTY LEVEL. UNEMPLOYMENT IN WAUKESHA COUNTY STOOD AT 5.4% IN AUGUST 2013. THE PRESENCE OF SOME HIGH INCOME COMMUNITIES IN WAUKESHA COUNTY OFTEN GIVES A MISTAKEN IMPRESSION. OFTEN OVERLOOKED IS A GROWING POPULATION OF LOW INCOME, NON-ENGLISH SPEAKING, VULNERABLE AND MARGINALIZED CITIZENS WHO FACE ENORMOUS ODDS IN ACCESSING HEALTH CARE. THE WAUKESHA COUNTY MEDICAID POPULATION HAS NEARLY TRIPLED IN 10 YEARS, FROM ABOUT 9,451 PEOPLE IN 2000 TO MORE THAN 30,000 IN 2011. THE HISPANIC POPULATION HAS SEEN A 42% INCREASE IN THE PAST 8 YEARS. DOWNTOWN WAUKESHA WAS DECLARED A "MEDICALLY UNDERSERVED" AREA AND A "HEALTH-PROFESSIONAL SHORTAGE AREA" BY THE FEDERAL GOVERNMENT IN 2008. AS AN UNDERSERVED AREA, MEDICAL OPTIONS FOR INDIVIDUALS, PARTICULARLY THOSE WITHOUT HEALTH INSURANCE OR WITH PUBLIC INSURANCE, ARE SEVERELY LIMITED BECAUSE PRIVATE SERVICE PROVIDERS OFTEN REFUSE TO CARE FOR THESE INDIVIDUALS. CONSEQUENTLY, PROHEALTH CARE EMBARKED ON A FUND-RAISING INITIATIVE TO SUPPORT THE FORMATION OF AN FEDERALLY QUALIFIED HEALTH CENTER (FQHC) IN DOWNTOWN WAUKESHA.
PART VI, LINE 5: OCONOMOWOC/WAUKESHA MEMORIAL HOSPITAL HAS PARTNERSHIPS WITH VARIOUS NON-PROFIT ORGANIZATIONS AIMED AT IMPROVING THE HEALTH OF OUR COMMUNITY. WE ARE ACTIVELY INVOLVED WITH PROGRAMMING AND ONGOING FINANCIAL SUPPORT OF THE WAUKESHA COMMUNITY HEALTH CENTER, THE NEW AND ONLY FEDERALLY-QUALIFIED HEALTH CENTER SERVING OUR AREA. WE PROVIDE ONGOING FINANCIAL AND IN-KIND SUPPORT TO THE AREA FREE CLINICS. SEVERAL OF OUR STAFF ARE ACTIVITY INVOLVED WITH THE HEALTH DEPARTMENT'S CHIPP AND SERVE ON A VARIETY OF COMMITTEES FOR THE DEPARTMENT OF HEALTH AND HUMAN SERVICES. OUR OUTREACH NURSING PROGRAM SUPPORTS MORE THAN 70 AREA PARTNER AGENCIES. FROM COMMUNITY-WIDE HEALTH FAIRS OFFERING A WIDE VARIETY OF FREE SCREENINGS TO OUR ONGOING PROVISION OF OPERATIONAL SPACE FOR THE WAUKESHA COUNTY COMMUNITY DENTAL CLINIC AND MULTIPLE OTHER NON-PROFITS, WE PROVIDE BROAD SUPPORT TO SAFETY NET ORGANIZATIONS IN OUR AREA. WE ALSO PROVIDE OTHER, DIVERSE SUPPORT IN THE COMMUNITY SUCH AS NUMEROUS SERVICES AIMED AT OUR YOUTH INCLUDING SPONSORSHIP OF SAFE "AFTER PROM" ACTIVITIES. WE SUPPORT AREA HOMELESS SHELTERS AND ARE ACTIVE MEMBERS OF THE HOUSING ACTION COALITION AND HISPANIC COLLABORATIVE NETWORK.
PART VI, LINE 6: OUR HOSPITAL IS A MEMBER OF THE PROHEALTH CARE HEALTH SYSTEM WHICH SERVES AS OUR PARENT COMPANY. WHILE COMMUNITY BENEFIT RESPONSIBILITIES RESIDE WITH OUR HOSPITAL BOARD, THE PARENT COMPANY PLAYS A KEY ROLE IN COORDINATING COMMUNITY NEEDS ASSESSMENTS, COMMUNITY BENEFIT PROGRAM PLANNING, AND EVALUATION.A DESCRIPTION OF EACH AFFILIATES ROLE IN PROMOTING HEALTH WITHIN THE COMMUNITIES SERVED IS AS FOLLOWS:PROHEALTH CARE, INC. - HELPS TO MANAGE THE HOSPITALS TO ENSURE THEY CAN PROMOTE HEALTH AND WELLNESS WITHIN THE COMMUNITY.NATIONAL REGENCY OF NEW BERLIN, INC. - OWNS AND OPERATES SENIOR LIVING CENTERS AS A MEANS TO PROMOTE HEALTH WITHIN THE COMMUNITY.PROHEALTH HOME CARE, INC. - PROVIDES HOSPICE AND HOME HEALTH CARE SERVICES AS A MEANS TO PROMOTE HEALTH WITHIN THE COMMUNITY.PROHEALTH CARE FOUNDATION, INC. - SUPPORTS THE CHARITABLE MISSION OF WAUKESHA MEMORIAL HOSPITAL AND OCONOMOWOC MEMORIAL HOSPITAL SO THAT IT MAY PROVIDE HEALTH SERVICES WITHIN THE COMMUNITY.PROHEALTH CARE MEDICAL ASSOCIATES, INC. - OPERATES 18 CLINIC AND URGENT CARE LOCATIONS THROUGHOUT WAUKESHA COUNTY AND THE SURROUNDING COMMUNITIES. PROHEALTH CARE MEDICAL ASSOCIATES FULFILLS ITS EXEMPT PURPOSE BY PROVIDING CARE AND SERVICES TO ALL PATIENTS REGARDLESS OF INSURANCE OR ABILITY TO PAY. PROHEALTH CARE MEDICAL ASSOCIATES PROVIDED 393,313 CLINIC VISITS DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2013.OCONOMOWOC MEMORIAL HOSPITAL, INC. - PROVIDES CARE AND SERVICES TO ALL PATIENTS REGARDLESS OF INSURANCE OR ABILITY TO PAY. OCONOMOWOC MEMORIAL HOSPITAL ALSO USES ITS RESOURCES TO ADDRESS VARIOUS COMMUNITY NEEDS. OCONOMOWOC MEMORIAL HOSPITAL PROVIDED APPROXIMATELY 9,926 DAYS OF INPATIENT CARE AND APPROXIMATELY 66,602 OUTPATIENT VISITS DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2013.
WIREPORTS FILED WITH STATESPART VI, LINE 7

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1PROHEALTH CARE INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1N17 W24100 RIVERWOOD DR STE 200AddressLine1
CityWAUKESHACity
StateWIState
ZIP Code531881131ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient391486873EINOfRecipient
IRC Section501(C)(3)IRCSection
Amount Of Cash Grant20374573AmountOfCashGrant
Method Of ValuationN/AMethodOfValuation
Description Of Non Cash AssistanceN/ADescriptionOfNonCashAssistance
Purpose Of GrantTO ASSIST PROHEALTH CARE, INC. IN ITS CHARITABLE MISSION.PurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: ALL GRANTS ARE APPROVED AND PROCESSED BY THE ORGANIZATION'S MANAGEMENT.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org1CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs1CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (12 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
SUSAN EDWARDS
CEO - PHC07108750348385030360731425017572018112930313385
JOHN ROBERTSTAD
PRESIDENT - PHC HOSPITAL DIVISION4359680176743050740241099031843089072701767430
NANINE NELSON
CFO - PHC - PART YEAR0352255012498401163017759203068806866820124984
JAMES GARDNER
VP MEDICAL AFFAIRS3389400107788017552034504028526052731001077880
KENNETH PRICE
PRESIDENT - PHC24023607747901126102620802884003840240774790
CATHERINE RAPP
VP OF NURSING - PART YEAR208071065151097120358330237603211430651510
MARY JO O'MALLEY
VP SUPPORT & DIAGNOSTICS - PART YEAR18510405902301109401943101552502901770590230
DEAN REIN
EXECUTIVE VP - PHCF - PART YEAR1181223585705032262465024225175326477520414944899638050322
ERIC HENDEE
CHIEF PHYSICIST - RADIOLOGY ONCOLOGY20360902944000179530255520250058029440
MOHAMMAD KHARBAT
DIRECTOR PHARMACY16572101874601800680202452702159760187460
MARY CASEY
VP & CHIEF NURSING EXECUTIVE135508015541099001323303042201956940155410
DEBRA ENDEAN
DIRECTOR LABORATORY - PART YEAR13515401590605810577102999901874110159060

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
PART I, LINE 4BPART I, LINE 4B: NAMES: JAMES GARDNER KENNETH PRICE CATHERINE RAPP MARY JO O'MALLEY DEAN REIN SUSAN EDWARDS NANINE NELSON PROHEALTH CARE INC. (PHC) MAINTAINS A SUPPLEMENTAL RETIREMENT PLAN (SERP) FOR A SELECT GROUP OF EXECUTIVES OF PHC AND ITS AFFILIATED ENTITIES. THE SERP IS AN UNFUNDED, NONQUALIFIED DEFERRED COMPENSATION PLAN THAT IS INTENDED TO COMPLY WITH SECTION 457(F) OF THE INTERNAL REVENUE CODE. BENEFITS UNDER THE SERP ARE TAXABLE TO THE PARTICIPATING EXECUTIVES WHEN SUCH AMOUNTS ARE VESTED.
PART I, LINE 6PRO HEALTH CARE HAS A LEADERSHIP INCENTIVE PROGRAM FOR LEADERS OF THE CORPORATION AND RELATED ORGANIZATIONS (COLLECTIVELY THE "SYSTEM"). THE PLAN RELATES FINANCIAL REWARD TO THE SYSTEM'S ACHIEVEMENT OF CERTAIN FINANCIAL AND NON-FINANCIAL OBJECTIVES. THE PRIMARY PURPOSE OF THE PLAN IS TO SUPPORT THE SYSTEM'S MISSION TO ACHIEVE CONTINUED GROWTH AND DEMONSTRATE VALUE THROUGH: (1) A SEAMLESS CONTINUUM OF PATIENT CENTERED CARE; (2) NATIONALLY RECOGNIZED OUTCOMES; (3) RESPONSIBLE AND EFFICIENT USE OF HEALTH CARE RESOURCES; AND (4) A FOCUS ON THE HEALTH OF OUR COMMUNITY.
PART IIISCHEDULE J, PART I THIS ENTITY RELIED ON A RELATED ORGANIZATION THAT USED THE FOLLOWING METHODS TO ESTABLISH COMPENSATION FOR OFFICERS AND DIRECTORS: 1. COMPENSATION COMMITTEE 2. COMPENSATION STUDY 3. APPROVAL OF THE BOARD ANNUALLY APPROVING COMPENSATION AMOUNTS 4. INDEPENDENT COMPENSATION CONSULTANT 5. WRITTEN EMPLOYEMENT CONTRACTSUPPLEMENTAL INFORMATION

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)

Bond ReferenceBondReferenceCdIssuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
WISCONSIN HEALTH & EDUCATIONAL FACILITIES
A39133785597710BDJ82008-08-14107960000CURRENT REFUND BONDS ISSUED 4/25/01 & CURRENT REFUND BONDS ISSUED 6/9/04.000
WISCONSIN HEALTH & EDUCATIONAL FACILITIES
B39133785597710BGZ92009-04-3066126415RENOVATION TO HOSPITAL FACILITY & CONSTRUCTION OF PARKING STRUCTURE.000
WISCONSIN HEALTH & EDUCATIONAL FACILITIES
C39133785597710BB502011-02-1632039358CURRENT REFUND BONDS ISSUED 11/14/95 & CURRENT REFUND BONDS ISSUED 5/13/99.000

Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)

Bond ReferenceBondReferenceCdAmount RetiredAmountRetiredTotal ProceedsTotalProceedsIssuance Costs From ProceedsIssuanceCostsFromProceedsCredit EnhancementCreditEnhancementOther Spent ProceedsOtherSpentProceedsYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindAmount In Reserve FundAmountInReserveFundCapital ExpendituresCapitalExpenditures
A704382310844347586598965905710691842920071011
B59926555951574986077420100011602942258654976
C10295000320393585971863144217320011011

Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyEngage Bond Counsel ContractsEngageBondCounselContractsAny Research AgreementsAnyResearchAgreementsPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUseBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestChange In Use Bond Financed PropChangeInUseBondFinancedPropNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
A001100.000000.000000.00000000
B001100.000000.000000.00000000
C001100.000000.000000.00000000

Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledRebate Not Due YetRebateNotDueYetException To RebateExceptionToRebateNo Rebate DueNoRebateDueVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedWritten Proc To Monitor ReqsWrittenProcToMonitorReqs
A001010000
B001000000
C001000000

Form990 Schedule K Part V Form990ScheduleKPartV (3 entries)

Bond ReferenceBondReferenceCdProc To Undertk Corrective ActionProcToUndertkCorrectiveAction
A0
B0
C0

Form990 Schedule K Part VI Form990ScheduleKPartVI (15 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
PART I, A - COL. CCUSIP #:THE CUSIP # OF 97710BDH2 ON FORM 8038 WAS NOT THE NUMBER ON THE BOND OF THE LATEST MATURITY. THE NUMBER FOR THE LATEST MATURITY IS CORRECTLY REPORTED ON SCHEDULE K.
PART I, A - COL. EISSUE PRICE:THE TOTAL ISSUE PRICE ON FORM 8038 IS $122,535,000. THE AMOUNT REPORTED ON SCHEDULE K IS ONLY THE AMOUNT OF THE ISSUE BENEFITING THE REPORTING ORGANIZATION.
PART I, B - COL. CCUSIP #:THE CUSIP # OF 97710BGW6 ON FORM 8038 WAS NOT THE NUMBER ON THE BOND OF THE LATEST MATURITY. THE NUMBER FOR THE LATEST MATURITY IS CORRECTLY REPORTED ON SCHEDULE K.
PART I, B - COL. EISSUE PRICE:THE TOTAL ISSUE PRICE ON FORM 8038 IS $134,951,867.50. THE AMOUNT REPORTED ON SCHEDULE K IS ONLY THE AMOUNT OF THE ISSUE BENEFITING THE REPORTING ORGANIZATION.
PART I, C - COL. CCUSIP #:THE CUSIP # OF 97710BB50 ON FORM 8038 WAS NOT THE NUMBER ON THE BOND OF THE LATEST MATURITY. THE NUMBER FOR THE LATEST MATURITY IS CORRECTLY REPORTED ON SCHEDULE K.
PART I, C - COL. EISSUE PRICE:THE TOTAL ISSUE PRICE ON FORM 8038 IS $35,678,572.65. THE AMOUNT REPORTED ON SCHEDULE K IS ONLY THE AMOUNT OF THE ISSUE BENEFITING THE REPORTING ORGANIZATION.
PART II, A - LINE 3TOTAL PROCEEDS OF ISSUE:SALE PROCEEDS OF ISSUE IN AMOUNT OF $108,443,475.00 ALLOCABLE TO REPORTING ORGANIZATION PLUS ZERO INVESTMENT PROCEEDS.
PART II, A - LINE 6PROCEEDS IN REFUNDING ESCROWS:PROCEEDS IN THE AMOUNT OF $106,918,428.56 ALLOCABLE TO REPORTING ORGANIZATION DEPOSITED IN REFUNDING ESCROWS ON 8/14/08; BALANCE ON 9/30/13 IS ZERO.
PART II, A - LINE 7ISSUANCE COSTS FROM PROCEEDS:$865,989.17 OF PROCEEDS ALLOCABLE TO REPORTING ORGANIZATION USED FOR ISSUANCE COSTS; $659,057.27 USED FOR CREDIT ENHANCEMENT.
PART II, A - LINE 13YEAR OF SUBSTANTIAL COMPLETION:YEAR OF SUBSTANTIAL COMPLETION OF PROJECTS FINANCED WITH REFUNDED PRIOR BONDS ISSUED 4/25/01 WAS 2003 AND YEAR OF SUBSTANTIAL COMPLETION OF PROJECTS FINANCED WITH REFUNDED PRIOR BONDS ISSUED 6/09/04 WAS 2007.
PART II, B - LINE 3TOTAL PROCEEDS OF ISSUE:SALE PROCEEDS OF ISSUE IN AMOUNT OF $66,126,415.08 ALLOCABLE TO REPORTING ORGANIZATION PLUS $1,975.67 OF INVESTMENT PROCEEDS ALLOCABLE TO REPORTING ORGANIZATION LESS SALE PROCEEDS IN THE AMOUNT OF $6,612,641.51 DEPOSITED IN REASONABLY REQUIRED RESERVE FUND ALLOCABLE TO REPORTING ORGANIZATION.
PART II, C - LINE 3TOTAL PROCEEDS OF ISSUE:SALE PROCEEDS OF ISSUE IN AMOUNT OF $32,039,358 PLUS ZERO INVESTMENT PROCEEDS.
PART II, C - LINE 6PROCEEDS IN REFUNDING ESCROWS:PROCEEDS IN THE AMOUNT OF $31,442,172.63 ALLOCABLE TO REPORTING ORGANIZATION DEPOSITED IN REFUNDING ESCROWS ON 2/16/11; BALANCE ON 9/30/13 IS ZERO.
PART II, C - LINE 13YEAR OF SUBSTANTIAL COMPLETION:YEAR OF SUBSTANTIAL COMPLETION OF PROJECTS FINANCED WITH REFUNDED PRIOR BONDS ISSUED 11/14/95 WAS 1995 AND YEAR OF SUBSTANTIAL COMPLETION OF PROJECTS FINANCED WITH REFUNDED PRIOR BONDS ISSUED 5/13/99 WAS 2001.
IN 2012, PHC REFUNDED A PORTION OF THE 2009 BOND ISSUE, THE WMH PORTION IS INCLUDED IN THE BONDS RETIRED. ASSOCIATED WITH THE REFUNDING THE 2009 DEBT SERVICE RESERVE FUND WAS REDUCED BY $1,190,243.80 OF WHICH $583,219.46 IS WMH'S ALLOCATED REDUCTION.

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (5 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
WAUKESHA HEALTH SYSTEM INC
BOARD MEMBER, JOHN ROBERTSTAD, IS AN OFFICER OF WAUKESHA HEALTH SYSTEM4951446WAUKESHA HEALTH SYSTEM PROVIDES RENT AND REIMBURSEMENT OF EXPENSES TO WMH.0
THE ORTHOPEDIC SURGERY CENTER
BOARD MEMBER JOHN ROBERTSTAD IS AN OFFICER OF THE ORTHOPEDIC SURGERY CENTER1096832INVESTMENT DISTRIBUTIONS0
PROHEALTH ALIGNED LLC (DBA MSC)
JOHN ROBERTSTAD AND KENNETH PRICE ARE DIRECTORS OF PROHEALTH ALIGNED1678665INVESTMENT DISTRIBUTIONS0
PROHEALTH SOLUTIONS
ARCH PEQUET AND JOHN ROBERTSTAD ARE BOARD MEMBERS OF PROHEALTH SOLUTIONS535500PROHEALTH SOLUTIONS PROVIDES PHYSICIAN SERVICES TO WAUKESHA MEMORIAL HOSPITAL.0
WAUKESHA SURGICAL SPECIALISTS
BOARD MEMBER ARCH PEQUET, IS THE PRESIDENT OF WAUKESHA SURGICAL SPECIALISTS236860WAUKESHA SURGICAL SPECIALISTS PROVIDES MEDICAL SERVICES TO WAUKESHA MEMORIAL HOSPITAL.0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 3DAVID EBEL WAS COMPENSATED BY WARBIRD CONSULTING, A MANAGEMENT COMPANY, FOR SERVICES AS INTERIM CFO FOR WAUKESHA MEMORIAL HOSPITAL, INC. AND RELATED ORGANIZATIONS. WARBIRD CONSULTING WAS NOT PAID ANY COMPENSATION IN CALENDAR YEAR 2012, AS SERVICES DID NOT COMMENCE UNTIL 2013. BEGINNING IN MAY 2013, COMPENSATION WAS PAID TO WARBIRD CONSULTING BY PROHEALTH CARE, INC., THE PARENT ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 6PROHEALTH CARE, INC. IS THE SOLE CORPORATE MEMBER.
FORM 990, PART VI, SECTION A, LINE 7BPROHEALTH CARE, INC. HOLDS CERTAIN RESERVED POWERS OVER THE (NON-STOCK) CORPORATION, INCLUDING APPROVAL OF STRATEGIC PLANNING, ANNUAL OPERATING AND CAPITAL BUDGETS, BORROWING, TRANSFER, LEASE, PLEDGE OR SALE OF ASSETS.
FORM 990, PART VI, SECTION B, LINE 11AFTER THE FORM 990 WAS PREPARED BY THE ORGANIZATION'S TAX PREPARERS AND PRIOR TO FILING THE FORM 990, SELECT EXECUTIVE MEMBERS OF THE ORGANIZATION AND THE AUDIT & COMPLIANCE COMMITEE PERFORMED A REVIEW. THEN THE ORGANIZATION'S TAX PREPARERS MADE A PRESENTATION TO THE AUDIT COMMITTEE, AND THE BOARD OF DIRECTORS WAS PROVIDED A COPY OF THE RETURN, WHICH WAS SUBSEQUENTLY FILED BY THE ORGANIZATION.
FORM 990, PART VI, SECTION B, LINE 12CALL OFFICERS, VICE-PRESIDENTS, MANAGERS AND ABOVE, AS WELL AS BOARD MEMBERS ARE REQUIRED TO ANNUALLY COMPLETE A CONFLICT OF INTEREST FORM. ALL REPORTED POTENTIAL CONFLICTS OF INTEREST ARE TRACKED IN THE CORPORATE COMPLIANCE DEPARTMENT. THEY ARE REVIEWED AND ANY PERSON IDENTIFIED AS HAVING A POTENTIAL CONFLICT OF INTEREST IS GIVEN DIRECTION AS TO WHAT STEPS SHOULD BE TAKEN TO MITIGATE THE CONCERN. ALL EMPLOYEES ARE EDUCATED ANNUALLY. THE STEPS TAKEN WHEN A CONFLICT ARISES ARE AS FOLLOWS: FOR THE BOARD OF DIRECTORS, THE RESTRICTION IS NOT BEING ALLOWED TO PARTICIPATE IN DISCUSSION OR VOTING RELATED TO ANY DECISION WHERE THE BOARD MEMBER HAS BEEN DETERMINED TO HAVE A CONFLICT OF INTEREST. FOR LEADERS, RESEARCHERS, AND EMPLOYEES, RECOMMENDATIONS ARE MADE FROM COMPLIANCE MANAGER TO LEADERSHIP AND/OR HUMAN RESOURCES. RESTRICTIONS CAN RANGE FROM ANY OF THE FOLLOWING: DISCLOSING POTENTIAL CONFLICTS OF INTEREST TO PATIENTS; NOT BEING ABLE TO BE INVOLVED IN DISCUSSION OR DECISION MAKING ON SPECIFIC TOPICS; AND NOT BEING ABLE TO WORK AT PROHEALTH IN THE SPECIFIC ROLE WHERE THE REPORTED CONFLICT EXISTS. IF THE RECOMMENDATION IS CHALLENGED, THE MATTER GOES TO THE SENIOR EXECUTIVE TEAM FOR A DECISION.
FORM 990, PART VI, SECTION B, LINE 15AN INDEPENDENT, EXTERNAL COMPENSATION REVIEW IS CONDUCTED FOR THE POSITIONS OF CEO/PRESIDENT, EXECUTIVE DIRECTOR, VICE-PRESIDENT, SENIOR VICE-PRESIDENT AND ABOVE. THE RESULTS OF THE COMPENSATION REVIEW ARE PRESENTED TO THE BOARD'S EXECUTIVE COMMITTEE FOR APPROVAL. ANY MEMBER OF THE EXECUTIVE COMMITTEE WHOSE SALARY IS INCLUDED IN THE SALARY REVIEW IS RECUSED FROM THE APPROVAL PROCESS FOR HIS/HER SALARY APPROVAL. THIS PROCESS WAS LAST DONE IN 2013.
FORM 990, PART VI, SECTION C, LINE 19FINANCIAL STATEMENTS, GOVERNING DOCUMENTS & CONFLICT OF INTEREST POLICY ARE AVAILABLE UPON REQUEST.
FORM 990, PART VI, SECTION B, LINE 16B:THE PROCESS IS TO HAVE ALL JOINT VENTURE ARRANGEMENTS REVIEWED BY THE LEGAL DEPARTMENT TO ENSURE IT MEETS ALL LEGAL REQUIREMENTS AND TO ENSURE THAT WAUKESHA MEMORIAL HOSPITAL, INC. MAY RETAIN ITS EXEMPT STATUS.
FORM 990, PART IX, LINE 11GPHYSICIAN FEES: PROGRAM SERVICE EXPENSES 5,983,517. MANAGEMENT AND GENERAL EXPENSES 143,103. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,126,620. PHCMA SUBSIDIES: PROGRAM SERVICE EXPENSES 4,747,098. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,747,098. LINEN SERVICES: PROGRAM SERVICE EXPENSES 1,171,051. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,171,051. OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 6,915,746. MANAGEMENT AND GENERAL EXPENSES 2,047,418. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,963,164. PHC SERVICES: PROGRAM SERVICE EXPENSES 66,242,386. MANAGEMENT AND GENERAL EXPENSES 7,278,575. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 73,520,961. MAINTENANCE CONTRACTS: PROGRAM SERVICE EXPENSES 967,104. MANAGEMENT AND GENERAL EXPENSES 9,066,634. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,033,738.OTHER FEES
FORM 990, PART XI, LINE 9:CHANGE IN FAIR VALUE OF INTEREST RATE SWAPS 8,585,153. CHANGE IN MINIMUM PENSION LIABILITY 24,235,447.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XII, LINE 2CTHE AUDIT PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
OCONOMOWOC MEMORIAL HOSPITAL INC
791 SUMMIT AVENUEOCONOMOWOCWI53066390794174HOSPITALWI501(C)(3)LINE 3PROHEALTH CARE INC1
PROHEALTH CARE FOUNDATION INC
725 AMERICAN AVENUEWAUKESHAWI53188391314542FUNDRAISINGWI501(C)(3)LINE 7PROHEALTH CARE INC1
PROHEALTH HOME CARE INC
N17 W24100 RIVERWOOD DR SUITE 200WAUKESHAWI53188200067392HEALTHCAREWI501(C)(3)LINE 3PROHEALTH CARE INC1
NATIONAL REGENCY OF NEW BERLIN INC
N17 W24100 RIVERWOOD DR SUITE 200WAUKESHAWI53188391077992HEALTHCAREWI501(C)(3)LINE 9PROHEALTH CARE INC1
PROHEALTH CARE INC
N17 W24100 RIVERWOOD DR SUITE 200WAUKESHAWI53188391786873MANAGEMENTWI501(C)(3)LINE 11C, III-FI0N/A
PROHEALTH CARE MEDICAL ASSOCIATES INC
N17 W24100 RIVERWOOD DR SUITE 200WAUKESHAWI53188391083015HEALTHCAREWI501(C)(3)LINE 3PROHEALTH CARE INC1

Form990 Schedule R Part III Form990ScheduleRPartIII (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnershipDirect Controlling Entity NADirectControllingEntityNA
PROHEALTH ALIGNED LLC (DBA MSC)
1111 DELAFIELD STREET STE 100WAUKESHAWI53188263324572SURGERY CENTERWIWAUKESHA MEMORIAL HOSPITAL INCRELATED17562974721654010.51000
REHABILITATION HOSPITAL OF WISCONSIN LLC
1625 COLDWATER CREEK DRIVEWAUKESHAWI53188262332250INPATIENT REHABILITATIONWIWAUKESHA MEMORIAL HOSPITAL INCRELATED77741023325959010.49000
THE ORTHOPEDIC SURGERY CENTER LLC
W238 N1610 BUSSE ROADWAUKESHAWI53188208356016ORTHOPEDIC SURGICAL SERVICESWIWAUKESHA MEMORIAL HOSPITAL INCRELATED11809142241309010.30000
PROHEALTH SOLUTIONS LLC
2000 PEWAUKEE RD SUITE CWAUKESHAWI53188273863494ACCOUNTABLE CARE ORGANIZATIONWIN/A
LAKE COUNTRY ENDOSCOPY CENTER
1185 CORPORATE CENTER DROCONOMOWOCWI53066261572986ENDOSCOPY SERVICESWIN/A

Form990 Schedule R Part IV Form990ScheduleRPartIV (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityControlled OrgControlledOrg
WAUKESHA HEALTH SYSTEM INC
N17 W24100 RIVERWOOD DRIVE SUITE 20WAUKESHAWI53188391507910HEALTHCAREWIN/AC0
EMPATHIA PACIFIC INC
31416 AGOURA RD STE 180WESTLAKE VILLAGECA91361953070501HEALTHCARECAN/AC0
NATIONAL AVENUE DEVELOPMENT CORPORATION
N17 W24100 RIVERWOOD DRIVE SUITE 20WAUKESHAWI53188391417226HEALTHCAREWIN/AC0
EMPATHIA INC
N17 W24100 RIVERWOOD DRIVE SUITE 20WAUKESHAWI53188391567366HEALTHCAREWIN/AC0
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties1ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (23 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
PROHEALTH CARE FOUNDATION INC
C1266320ACTUAL AMOUNT RECEIVED
PROHEALTH CARE MEDICAL ASSOCIATES INC
A976466ACTUAL AMOUNT RECEIVED
REHABILITATION HOSPITAL OF WISCONSIN
A1173025ACTUAL AMOUNT RECEIVED
WAUKESHA HEALTH SYSTEM INC
A27712ACTUAL AMOUNT RECEIVED
WAUKESHA HEALTH SYSTEM INC
K84000ACTUAL COSTS INCURRED
PROHEALTH CARE MEDICAL ASSOCIATES INC
K484548ACTUAL COSTS INCURRED
NATIONAL REGENCY OF NEW BERLIN INC
K639731ACTUAL COSTS INCURRED
PROHEALTH ALIGNED LLC
K395453ACTUAL COSTS INCURRED
PROHEALTH CARE INC
M73520961ACTUAL COSTS INCURRED
PROHEALTH SOLUTIONS
M577500ACTUAL COSTS INCURRED
REHABILITATION HOSPITAL OF WISCONSIN
L140305ACTUAL AMOUNT RECEIVED
OCONOMOWOC MEMORIAL HOSPITAL INC
P117210ACTUAL COSTS INCURRED
PROHEALTH CARE MEDICAL ASSOCIATES INC
P4667903ACTUAL COSTS INCURRED
OCONOMOWOC MEMORIAL HOSPITAL INC
Q14361301ACTUAL AMOUNT RECEIVED
PROHEALTH CARE INC
Q4347039ACTUAL AMOUNT RECEIVED
WAUKESHA HEALTH SYSTEM INC
Q4830352ACTUAL AMOUNT RECEIVED
PROHEALTH CARE MEDICAL ASSOCIATES INC
Q23432261ACTUAL AMOUNT RECEIVED
PROHEALTH HOME CARE INC
Q1112097ACTUAL AMOUNT RECEIVED
EMPATHIA PACIFIC INC
Q1434630ACTUAL AMOUNT RECEIVED
PROHEALTH CARE INC
B20374573ACTUAL COSTS INCURRED
PROHEALTH ALIGNED LLC
S1678665ACTUAL AMOUNT RECEIVED
ORTHOPEDIC SURGERY CENTER
S1096832ACTUAL AMOUNT RECEIVED
REHABILITATION HOSPITAL OF WISCONSIN
S955815ACTUAL AMOUNT RECEIVED