STRATEGY STUDIO / PUBLIC DATA EXPLORER

ST JOSEPHS COMMUNITY HOSPITAL OF WEST BEND INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
ST JOSEPHS COMMUNITY HOSPITAL OF WEST BEND INC (EIN 39-0806302)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-05-08
IRS object ID
201421289349301352
Schema version
2012v2.0
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-05-08T09:13:19-07:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1191 W Nationwide Blvd Suite 500AddressLine1
CityColumbusCity
StateOHState
ZIP Code43215ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN390806302EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1St Josephs Community HospitalBusinessNameLine1
Business Name Line2of West Bend IncBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlSTJONameControl
Phone2623345533Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line13200 Pleasant Valley RoadAddressLine1
CityWest BendCity
StateWIState
ZIP Code53095ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameScott R HawigName
TitleCFOTitle
Date Signed2014-05-08DateSigned
Authorize Third PartyfalseAuthorizeThirdParty
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJacobson CatherineNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line13200 Pleasant Valley RoadAddressLine1
CityWest BendCity
StateWIState
ZIP Code53095ZIPCode
FieldValueIRS element (for citing)
Gross Receipts121465201GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501c3XOrganization501c3
Web Sitewww.froedtert.comWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1930YearFormation
State Legal DomicileWIStateLegalDomicile
Activity Or Mission DescriptionSt. Joseph's Community Hospital of West Bend, Inc is a health care organization serving residents of West Bend and Washington County. Our mission is to advance the health of communities we serve through exceptional care enhanced by innovation and discovery.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees651TotalNbrEmployees
Total Nbr Volunteers169TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year14202ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year84875970ProgramServiceRevenuePriorYear
Program Service Revenue CY92990948ProgramServiceRevenueCY
Investment Income Prior Year987125InvestmentIncomePriorYear
Investment Income Current Year1140406InvestmentIncomeCurrentYear
Other Revenue Prior Year3659257OtherRevenuePriorYear
Other Revenue Current Year4319228OtherRevenueCurrentYear
Total Revenue Prior Year89536554TotalRevenuePriorYear
Total Revenue Current Year98450582TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year29341296SalariesEtcPriorYear
Salaries Etc Current Year29584404SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year56577617OtherExpensePriorYear
Other Expenses Current Year62337118OtherExpensesCurrentYear
Total Expenses Prior Year85918913TotalExpensesPriorYear
Total Expenses Current Year91921522TotalExpensesCurrentYear
Revenues Less Expenses Prior Year3617641RevenuesLessExpensesPriorYear
Revenues Less Expenses CY6529060RevenuesLessExpensesCY
Total Assets BOY126472402TotalAssetsBOY
Total Assets EOY132974592TotalAssetsEOY
Total Liabilities BOY67008680TotalLiabilitiesBOY
Total Liabilities EOY68762606TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY59463722NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY64211986NetAssetsOrFundBalancesEOY
Mission DescriptionSt. Joseph's Community Hospital of West Bend, Inc is a health care organization serving residents of West Bend and Washington County. Our mission is to advance the health of communities we serve through exceptional care enhanced by innovation and discovery.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense39119120Expense
Revenue52085389Revenue
DescriptionIn addition to being a 70-bed hospital, St. Joseph's Hospital offers a wide variety of outpatient services to the community, including cancer care services, various diagnostic and therapeutic treatments, outpatient and ambulatory surgeries, and rehab treatments.In 2010, St. Joseph's Hospital's Alyce and Elmore Kraemer Cancer Care Center joined the Froedtert & The Medical College Cancer Network, bringing more cancer expertise to the community. The new St. Joseph's Hospital's 16,000-square-foot Kraemer Cancer Center opened July 9, 2012. Care is conveniently provided close to home, with Medical College specialists working with community physicians to provide advanced, coordinated care, and if needed, access to specialized treatment at Froedtert & The Medical College Clinical Cancer Center in Milwaukee. Cancer network physicians in West Bend include specialists in radiation oncology, urologic oncology, gynecologic oncology and plastic and reconstructive surgery. During the fiscal year, radiation oncology and medical oncology visits totaled 5,736 and 4,987, respectively.Recently, more medical specialties became locally available as the Froedtert & The Medical College Specialty Clinics at St. Joseph's Hospital expanded to include urology, urogynecology, infectious diseases, electrophysiology and cardiology, in addition to the cancer specialties, all of which provide access to leading-edge care to the residents of West Bend and Washington County. In addition to the specialty clinics and cancer care services, St. Joseph's Hospital provided a variety of outpatient treatments and procedures during the fiscal year including:Operations: 2,359CT Scans: 5,006MRIs: 1,956Radiological Diagnostic Exams: 10,534Ultrasounds: 3,484Laboratory Tests: 156,293Nuclear Medicine Scans: 1,768Rehabilitation Treatments: 12,257Ambulatory Surgery Visits: 4,191GI Visits: 695Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense26992420Expense
Revenue35939221Revenue
DescriptionSt. Joseph's Hospital is a health care organization dedicated to improving the health status of residents of West Bend and neighboring communities regardless of ability to pay. The hospital has been serving residents of Washington County for more than 80 years and today offers a wide range of inpatient services. In 2005 St. Joseph's opened a new 70-bed hospital that earned national recognition for a design emphasizing patient safety and quality. The 143-acre hospital campus also includes the Kathy Hospice, Froedtert Health West Bend Clinic-South and the Froedtert & The Medical College of Wisconsin Specialty Clinics.St. Joseph's Hospital is an acute care general hospital with 70 licensed and staffed beds, providing a wide range of inpatient services, including general and orthopedic surgery, general medicine, intensive care services, obstetrics and maternity care, and inpatient hospice care.The New Life Center at St. Joseph's Hospital is Washington County's leading birth center, with 723 deliveries and 1,883 patient days during fiscal year 2013. Convenient and comfortable, the center offers experienced nurses, tastefully appointed labor, delivery, recovery and postpartum rooms, a special care nursery and a dedicated C-section suite. The inpatient hospice care unit, the Kathy Hospice, is a separate 8-bed building located on the campus of St. Joseph's Hospital, and provides a peaceful and comfortable environment for individuals in need of end-of-life care. The home-like hospice was the first of its kind in Washington County, and experienced 151 admissions and 2,482 patient days during the fiscal year.In addition to the newborn and hospice services, St. Joseph's Hospital had 2,738 admissions and 10,871 patient days related to medical, surgical and intensive care inpatient services. In conjunction with inpatient stays, the hospital provided a variety of inpatient ancillary treatments and procedures during the fiscal year including, but not limited, to:Operations: 808CT Scans: 1,653MRIs: 233Radiological Diagnostic Exams: 7,243Ultrasounds: 1,302Laboratory Tests: 127,291Nuclear Medicine Scans: 234Rehabilitation Treatments: 24,480Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense3730005Expense
Revenue4966338Revenue
DescriptionThe Emergency Care Center at St. Joseph's Hospital provides high-quality care for all types of emergencies, 24 hours a day, augmented by its close ties to Froedtert & the Medical College Level I Trauma Center. Staffed by board-certified emergency medicine physicians and emergency certified RNs, the center served more than 16,500 patients in FY 2013. Its designation as a Level III Trauma Center means prompt availability of surgeons and on-call physicians in multiple specialties.Description
FieldValueIRS element (for citing)
Total Program Service Expense69841545TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096139NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees651NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocstrueChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledWIStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonDavid DirksmeyerNamePerson
Telephone Number4147770960TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1N74 W12501 Leatherwood CtAddressLine1
CityMenomonee FallsCity
StateWIState
ZIP Code53051ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (26 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Zwygart Christopher
Dir&Chair1.001.00XX000
Olson David
Dir&President1.0052.00XX036092866767
Komas Ron
Dir&Secretary1.001.00XX000
Ericson Allen
Dir&Pres45.006.00XX10970308147
Wolter Brian MD
Dir&Doctor1.0041.00X044151633717
O'Meara Charles
Director1.000.00X000
Neitzke Ted
Director1.000.00X000
Martin Mary
Dir&CNO1.0040.00X01434149909
Lux Theresa M
Dir&CNO1.0050.00X024766839985
Leitheiser Richard
Director1.001.00X000
Johnston Brenda
Director1.000.00X000
Jacobson Catherine
Dir&FH CEO1.0050.00X01001826179860
Herdrich Gary MD
Dir&Chief Staff1.0061.00X062552334295
Gardner Patrick MD
Director1.000.00X000
Bloedorn Michael
Director1.000.00X000
Bast Ronald
Director1.002.00X000
Knoll Thomas
Treasurer1.0041.00X015236135101
Van De Kreeke Jeffrey
FH CFO1.0050.00X042872585514
Hawig Scott
FH CFO1.0050.00X022959710354
Bangalore Nitish S
Pharmacy Manager40.000.00136037010340X
Herdeman Charles
Pharmacist40.000.00144560025790X
Juech Thomas
Pharmacist40.000.00136617017251X
Laird Michael
Past President40.000.00281200013475X
Less Timothy
Medical Physicist40.000.00191889028897X
Malzewski Michael
Former - Officer (AVP Finance)0.000.00024304039534X
Lauenstein Debra
Former - Key (Dir HR)0.000.00015424518073X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1000006TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs4028843TotalReportableCompFrmRltdOrgs
Total Other Compensation657009TotalOtherCompensation
Number Individuals GT100 K12NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Pearson Engineering LLC
14 Ellis Potter CtMadisonWI53711Engineering services107897
Medical Solutions Incorporated
9101 Western Avenue Suite 101OmahaNE68114Staffing services111324
Medical College of WI
8701 Watertown Plank RdMilwaukeeWI53226Physician Services3070468
C&A Industries
PO Box 3037OmahaNE681370037Staffing services105884
Advanced HRO Solutions Inc
10 E College Avenue Suite 300AppletonWI549115759Staffing services143456
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Outpatient Revenue6214005208538952085389
Inpatient Revenue6219903593922135939221
Emergency Dept Revenue62199049663384966338
FieldValueIRS element (for citing)
Total Program Service Revenue92990948TotalProgramServiceRevenue

Investment Income InvestmentIncome

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Total Revenue Column712809TotalRevenueColumn
Exclusion$712,809ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

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Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

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Total Revenue Column0TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

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Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities23402516Securities
Other39700Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities22972647Securities
Other41972Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities429869Securities
Other-2272Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column427597TotalRevenueColumn
Exclusion$427,597ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Medical Office Building621110819431819431
Corporate Allocated Rev900099702002702002
Clinic Revenue62111016504211650421

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column1147374TotalRevenueColumn
Related Or Exempt Function Income1147374RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue4319228TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column98450582TotalRevenueColumn
Related Or Exempt Function Income97310176RelatedOrExemptFunctionIncome
Exclusion$1,140,406ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Grants To Domestic Orgs GrantsToDomesticOrgs

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Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total321594Total
Management And General321594ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total27212601Total
Program Services25459439ProgramServices
Management And General1753162ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total67765Total
Management And General67765ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total0Total

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1982444Total
Program Services1845062ProgramServices
Management And General137382ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total90416Total
Management And General90416ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total9663460Total
Program Services8797610ProgramServices
Management And General865850ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total6832Total
Management And General6832ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total338170Total
Program Services224242ProgramServices
Management And General113928ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total67112Total
Program Services65444ProgramServices
Management And General1668ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2146162Total
Program Services1246276ProgramServices
Management And General899886ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total66115Total
Program Services38736ProgramServices
Management And General27379ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total51348Total
Program Services29914ProgramServices
Management And General21434ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total2855464Total
Program Services1658168ProgramServices
Management And General1197296ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total5445631Total
Program Services3535062ProgramServices
Management And General1910569ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total6752Total
Management And General6752ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
State Hospital Assessment21032762103276
Loss on Refinancing35144533514453
Medical Supplies169730761693618436892
Corporate Allocated Expense18063706765953610404170

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total945145Total
Program Services242596ProgramServices
Management And General702549ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total91921522Total
Program Services69841545ProgramServices
Management And General22079977ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY2019BOY
EOY1920EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY5237304BOY
EOY9909805EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY9398418BOY
EOY12244108EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY250000BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1873009BOY
EOY2008435EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1386522BOY
EOY682113EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis131561417LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec52361126LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY77327798BOY
EOY79200291EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

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BOY30780247BOY
EOY27426934EOY

Investments Other Securities InvestmentsOtherSecurities

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EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

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EOY0EOY

Other Assets Total OtherAssetsTotal

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BOY217085BOY
EOY1500986EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY126472402BOY
EOY132974592EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

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BOY6476931BOY
EOY8532063EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY115000BOY
EOY115000EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY55822923BOY
EOY58426605EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY4593826BOY
EOY1688938EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY67008680BOY
EOY68762606EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY59315827BOY
EOY64068318EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY147895BOY
EOY143668EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY59463722BOY
EOY64211986EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY126472402BOY
EOY132974592EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses6529060ReconcilationRevenueExpenses
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Reconcilation Other Changes-2840783ReconcilationOtherChanges
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ExplanationFroedtert Health, Inc. applies ASC No. 740, Income Taxes, which clarifies the accounting for uncertainty in income taxes recognized in a company's financial statements. ASC No. 740 prescribes a more-likely-than-not recognition threshold and measurement attribute for the financial statement recognition and measurement of a tax position taken or expected to be taken. Under ASC No. 740, tax positions are evaluated for recogniton, derecogniton, and measurement using consistent criteria and provide more information about the uncertainty in income tax assets and liabilities. As of June 30, 2013 and 2012, Froedtert Health does not have an asset or liability recorded for unrecognized tax positions.Explanation

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Form990 Schedule H Part VI Form990ScheduleHPartVI (21 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part VI - Additional InformationPart VI - States Where Community Benefit Report FiledCommunity Benefit Data is reported annually to the Wisconsin Hospital Association.
Part V - Explanation of Number of Facility TypeSt. Joseph's Community Hospital of West Bend is the only facility listed under this reporting of the IRS Form 990, Schedule H.
Part VI - States Where Community Benefit Report FiledWI
Part VI - Affilated Health Care System Roles and PromotionPromotion of Community HealthThe Board of Directors at St. Josephs Hospital is made up of medical and business professionals, all of whom reside in the hospitals primary service area. They are dedicated to leveraging the benefits of our community through our hospitals mission. They value the unique character and needs of the patients and communities we serve and the physicians who provide specialty care. St. Josephs Hospitals community board demonstrates our commitment to quality and service. Annually, the board reviews and approves the hospitals Community Health Improvement Plan.Additionally, SJH supports the Healthy Community Fund, administered through St. Josephs Community Foundation, was created in 2008 to support community programs or projects throughout Washington County that positively affect the health and wellness of those living and working within the area. The fund awarded $220,000 in grants to nine area non-profit organizations in fiscal year 2013.SJH has an open Medical Staff with the exception of some departments having contracted exclusivity services. As a hospital, SJH does not search outside of our system, however, if a physician comes to us wishing to have privileges they are put through the credentialing process.As a not-for-profit health system, Froedtert Health reinvests its surplus funds back to the community through programs to serve the poor and uninsured, teach future healthcare professionals, develop new medical therapies, manage chronic conditions like diabetes, provide health education and promotion initiatives, and participating in local partnerships aimed at reducing health disparities.In fiscal year 2013, Froedtert Memorial Lutheran Hospital, Community Memorial Hospital of Menomonee Falls and St. Josephs Hospital made significant investments in the health of their communities. Patients who couldnt pay for their medical care received more than $80.3 million in uncompensated services. Beyond providing care for the poor, we contributed $74.5 million to improve access to care, teach future healthcare professionals, develop new medical therapies and participate in local partnerships aimed at reducing health disparities.Addressing Needs Through Targeted Outreach:St. Josephs Hospital develops and executes community outreach programming and activities based on identified community health needs. Every needs assessment cycle, SJH Community Outreach staff along with the hospitals community partners and other leaders develops a community health improvement plan which is incorporated into the hospitals overall strategic plan to address the most critical needs in the communities we serve. The plan is reviewed annually by the Community Outreach Steering Committee. SJH Community Outreach staff, leaders and external community partners work collaboratively to develop key goals and strategies to address community health needs. Progress towards community outreach programs/activities and goals are reported annually to the SJH Board of Directors, Physician Advisory Council, Leadership Council, Foundation and Healthy Community Fund Boards. Based on the results from the 2012 Community Health Needs Assessment, programs and activities are focused around the following identified health needs:- Access to Primary and Specialty Care- AODA- Chronic Disease Management- Obesity and Physical ActivityFor more information on specific community outreach efforts, please refer to the 2013 Community Benefit Report by going to www.froedterthealth.org/community-memorial-benefit-report.Affiliated Health Care SystemFroedtert & the Medical College of Wisconsin St. Josephs Hospital, founded in 1930 by local doctors, community leaders and the Sisters of the Divine Savior, is a full-service hospital serving residents of West Bend and Washington County. St. Josephs Hospital, specializing in birthing services, cancer care, emergency care, orthopaedics, surgical services and womens health, is part of the Froedtert & The Medical College of Wisconsin health care network, which also includes Froedtert Memorial Lutheran Hospital, Milwaukee; Community Memorial Hospital, Menomonee Falls; and more than 30 primary and specialty care health centers and clinics.For more information about Froedtert Health, visit www.froedtert.com.
Part VI - Explanation Of How Organization Furthers Its Exempt PurposeSt. Josephs Hospital provides healthy community initiatives that support the community. These initiatives include but not limited to, community education classes, complimentary fitness classes, community volunteering, speakers bureau opportunities and community health fairs.Community Health Education ProgramsSt. Josephs Hospital regularly schedules educational classes for the community. The services offered are readily accessible to the general public and are free of charge. These programs provide information on a wide variety of health concerns including chronic disease prevention / management. In addition, St. Josephs Hospital offers a speakers bureau that is a free service to the community. Our knowledgeable health professionals provide credible, up-to-date information on a variety of healthcare topics for groups and organizations. Every 15 MinutesSpeeding, recklessness and drug or alcohol use are common risk factors among children and teens killed in motor vehicle and transport crashes, according to the Wisconsin Child Death Review Council. Changes in behavior can help prevent death and injury from vehicle crashes, one of the top five causes of preventable death in Wisconsin children.To drive home a powerful message about the consequences of drinking and driving and to help prevent death from drunk driving crashes, St. Josephs Hospital collaborates with the Washington County Injury Prevention Coalition in the Every 15 Minutes program. The program involves not only a mock crash but multiple scenarios that are videotaped by high school students and presented at a moving and emotional assembly at school the next day. The hospital has been part of the Every 15 Minutes program since 2006, as the receiving hospital for mock crash victims arriving by local EMS ambulance and Flight for Life. The Emergency Care Center provides staffing to treat the mock victims in a realistic way. Physicians, nurses, EMTs, technicians and other staff are involved. Hospital staff are also involved in the planning and communications. In a safe and caring way, the program confronts high school students with the real-life consequences of drunk driving and has been positively received by students and community. United Way Employee CampaignSt. Josephs Hospital collaborates with the United Way of Washington County to address community needs in the areas of health, education and quality of life. St. Josephs Hospital hosts an annual workplace giving campaign to support United Way and its affiliated organizations. Over 200 hours were spent coordinating the FY13 campaign. In addition to an employee campaign, St. Josephs Hospital matches donations up to $8,000.Healthy People Project of Washington CountySt. Josephs Hospital, through leadership representation on the Healthy People Project of Washington County and the committees dedication, are successfully impacting the health of many in our community. These efforts are being done through collaborative partners, such as Washington County Planning and Parks, Washington County Injury Prevention Coalition, and various local municipalities. The Healthy People Project of Washington County is one of only 118 communities throughout the country (and one of five in Wisconsin) selected as a Pioneering Healthier Communities coalition. Albrecht Free ClinicThe Albrecht Free Clinic provides free medical care to uninsured and underinsured residents of Washington County. Through the support of St. Josephs Hospital, the clinic is able to serve patients for chronic illness and acute care issues. Services provided by St. Josephs Hospital at no cost to the patient would be: x-rays, labs, MRI and CT Scans. On an average, over 3,300 patients seek medical services per year. In addition to services related to the patients direct care, St. Josephs Hospital provides assistance in providing medical supplies, IT services, and rental space at a cost of $93,009 (4,896 sq ft). Sexual Assault Nurse Examiner (SANE) Available 24 Hours a Day When emergencies take on the even more traumatic element of sexual assault, the specially trained SANE program staff has created a safe haven at St. Josephs for comprehensive, compassionate care SANE staff are registered nurses with advanced training in medical-forensic examination and in the psychological and emotional trauma patients experience. They care for victims of all ages, races and populations to provide timely:- Emotional support - Physical examination and wellness check - Collection of medical-forensic evidence - Assistance with reporting the crime to police, when requested (mandatory reporting for children) - Assistance with concerns about sexually transmitted infection and pregnancy - Assistance with safety planning - Development of a medical follow-up plan SANE nurses are available to speak to groups and organizations. They are also able to serve as expert witnesses if called to testify at a trial.In Fiscal Year 2013, St. Josephs Hospital SANE program served 15 people. Subsidized Transportation Program:The Subsidized Medical Transportation Program at St. Josephs Hospital provides transportation to and from the hospital service locations for eligible persons (200% federal poverty level or below) who have difficulty arranging their own transportation and lack the financial resources to purchase transportation. In 2013, St. Josephs provided over 900 subsidized rides to 500 people who needed transportation to receive their health care. Leadership Quality Indicator:As an indication of the St. Joseph's executive teams commitment to the community, 15 hospital leaders provided more than 100 hours of support to local initiatives, not-for-profit organizations and community events. Job Shadow Program:St. Josephs Hospital recognizes the value of preparing tomorrows health care providers, giving dozens of aspiring care-givers the valuable opportunity to serve as job shadows or preceptors every year. In FY 2013, 40 students participated in the program at St. Joseph's Hospital.Project Lead the WayExperts from St. Josephs Hospital partnered with teachers at Hartford Union High School this year by sharing their knowledge and passion for their professions with high school students interested in biomedical sciences.This was the third year of an ongoing, innovative program called Project Lead the Way, a national STEM (science, technology, engineering and math) education curricular program that provides hands-on classroom experiences for students, who may earn college credit for their work.A total of 4 professionals delivered 4 classroom presentations to 125 students in the 2012-2013 school year. Presenters included an advanced practice nurse with a PHD, lab technician, cardiologist and infectious disease physician. Community Health ScreeningsSt. Josephs Hospital offered free blood pressure and skin cancer screenings. With the goal to empower people and the community to make better decisions and take actions to improve and maintain their health, our community health screenings provide much needed access to services for many of our community members. In Fiscal Year 2013, St. Joseoh's Hospital conducted health screenings for 125 people.For more information on St. Joseph's Hospital Community Benefit programs, please visit www.froedtert.com or see the Community Benefit report.
Part VI - Community Building ActivitiesTo promote the health of our communities, St. Joseph's Hospital participates in numerous community building activities that are recognized in the community, which are included elsewhere on Schedule H. These activities include:1. Physical Improvements and Housing: contributions toward neighborhood housing improvement for the underserved.2. Coalition Building: collaboration with county service agencies includes work with the Washington County Injury Prevention Coalition on the Every 15 Minutes anti-drunk driving program for teens. St. Joseph's Hospital's SANE (Sexual Assault Nurse Examiner Program) works closely with volunteers from the area Women's Shelter to care for victims of sexual assault and SANE nurses collaborate with a county coalition to promote awareness, education and prevention of sexual assaults. 3. Economic Development: Leadership participates in local chamber of commerce boards focusing on economic development.4. Diversity: training that recruits health professionals in our traditionally underserved community. 5. Other: Contributions to local organization of equipment, lease space and supplies.
Part VI - Community InformationSt. Josephs Hospital has been dedicated to serving residents of West Bend and Washington County since 1930 when it was established through the efforts of visionary community leaders and volunteers. As an important part of the community fabric, the hospital continues to meet the changing health and wellness of people who live in and around Washington County. To better serve those needs in a modern, accessible, safe and efficient setting, the hospital built a new replacement facility on US 45 and Hwy PV in August 2005. The area served has a large population between the ages of 18 and 34 years old. 39% of the residents are a high school graduate or less and 34% are in the bottom 40 percent of the income bracket.Aurora Hartford Hospital is the only other hospital located in Washington county. There are no FQHC's located Washington County. Albrecht Free Clinic is a free clinic serving residents throughout Washington County.
Part VI - Patient Education of Eligibility for AssistanceSt. Joseph's Community Hospital of West Bend informs and educates patients regarding financial assistance and government program eligibility in a number of ways. Its communication efforts also address special needs of patients and their families, such as hearing or visual impairment or language interpretation.Information on hospital-based financial support policies and government programs are made available to patients during the pre-registration and registration processes through brochures, signage and direct contact with financial counselors, social workers / case managers and registration staff. Patient billing statements also inform patients that financial assistance is available. The Hospital website contains information regarding pricing, how to understand your hospital bill, and how to apply for Financial Assistance. The Hospital has made financial assistance forms and information available in Spanish. Financial counselors screen uninsured patients for government program eligibility and social services staff are available to assist patients with enrollment processes. Patients who are uninsured, those covered by government programs and those with limited financial means may also be eligible for charity care or discounts through the Hospital's financial assistance program. Financial counselors make every effort to determine a patient's eligibility prior to or at the time of admission or service. However, determination for financial assistance can be made during any stage of the patient's stay after stabilization, or the collection cycle.
Part VI - Needs AssessmentIn December, 2011 St. Josephs Hospital West Bend collaborated with JKV Research, LLC along with Aurora Health Care, Childrens Hospital of Wisconsin, Columbia St. Marys Health System and Washington County Health Department to conduct a Community Health Needs Assessment in Washington County. The research from the needs assessment provides valuable behavioral data, lifestyle habits, and the prevalence of risk factors and disease conditions of Washington County residents. CHNA Overview/Objectives: Gather data on behavioral and lifestyle habits of the adult population and household-level data. Gather data on the prevalence of risk factors and disease conditions of the adult population. Compare health data of residents to previous health studies. Compare health data to national and state measurements.CHNA Methodology: 18 minute telephone survey of area residents 400 completions from November 29 through December 19, 2011 Two-fold sampling1) RDD landline sample of listed & unlisted #s (n=300)- Respondents randomly selected based on number of adults in household - Weighting based on number of adults and number of residential phone numbers in HH 2) Cell phone only sample (n=100) Adult answering the phone designated as the respondent - All data post-stratified by age and gender of adult residents as of 2010 Census proportions. Margin of error: 5%In addition to the Washington County Community Health Needs Assessment, St. Josephs Hospital conducted key informant interviews with 26 individuals representing school district representatives, public health officials, non-profit health and human service professionals, churches, police/fire departments, free clinics and business professionals throughout Washington County. Following extensive interviews with key community stakeholders, findings from the assessment were categorized into eight areas: Access to Primary and Specialty Care, Chronic Disease Management, Mental Health Services, Prevention and Wellness, Alcohol, Drug, Tobacco, Abuse, Dental Services, Transportation and Other. Of those eight health needs categories, four were identified as the focus for community outreach activities in 2012 through 2016 based on select criteria: Community Health Priorities, Disproportionate Unmet Needs, Public Health Concerns and Scope of Services. The most critically documented health needs were identified:- Access to Care- Obesity/Nutrition- Lack of Physical Exercise- Chronic Disease Management- AODAWashington County Health Department Community Health Improvement Plan 2012 2016St. Josephs Hospital is a partner with Washington County Public Health Departments Community Health Improvement Plan. The plan which was adopted by the county board in 2012 focuses on the following community health needs:- Improve Dietary Quality- Increase Breastfeeding- Increase Physical Activity- Obesity (Healthy People Project of Washington County)- Enhance state and community capacity to improve population level health.St. Josephs hospital is very active in the Healthy People Project of Washington Countys strategic plan with goals to improve access to fruit and vegetable consumption and increase physical activity as a means to decrease obesity. For more information on this initiative please go to www.getmovingwashingtoncounty.com.
Part V, Line 12h - Other Factors Used in Determing Amounts Charged PatientsOut of pocket maximum discount.Number of Hospital Faciltiy - 1
Part V, Line 7 - Explanation of Needs Not Addressed and Reasons WhySt. Josephs Hospitals community health improvement initiatives are targeted for the broad community, especially vulnerable populations (uninsured/underinsured) in the hospitals primary and secondary service areas. St. Josephs Hospitals mission is to advance the health of the communities we serve through exceptional care enhanced by innovation and discovery. The hospitals Board of Directors and Community Engagement staff prioritized community health improvement programs, activities and services that reflect the hospitals mission and scope of care: Access to Primary and Specialty Care, AODA, Chronic Disease Management and Obesity/Physical Activity.The following needs are not being addressed by St. Joseph's Hospital:1. Oral and Dental Health ServicesExplanation: We do not have the dedicated resources. There are other local organizations dedicated to improve access to dental care.2. Teen PregnancyExplanation: United Way, Public Health, Safe Babies Healthy Families, the Hope Network and a number of other community organizations are working on this health issue.3. Health Literacy and NavigationExplanation: Other community organizations are working to increase awareness of health services and health seeking behaviors among low income individuals.4. Cigarette UseExplanation: We support the Multi-Jurisdictional Coalitions of Tobacco Free Community Partnership Dodge Jefferson Waukesha County and Washington County.5. Mental HealthExplanation: We do not have the dedicated resources. There are other local health and human service agencies and organizations dedicated to this issue.Number of Hospital Faciltiy - 1
Part V, Line 6i - Describe Other Needs IdentifiedEffective May 14, 2013, St. Josephs's Hospital adopted a Community Health Improvement Plan.OverviewThis Implementation Strategy serves as the community health improvement component of St. Josephs Hospital community benefit strategy, focusing on Access to Primary/Specialty Care, Chronic Disease Management, Alcohol and Other Drug Abuse and Obesity/Physical Activity. St. Josephs Hospital community benefit framework is to improve the quality of life in the communities we serve through health care programs and services that are measurable, accessible, and culturally appropriate.Community Health Needs AssessmentFroedtert Health is a member of the Milwaukee Health Care Partnership www.mkehcp.org, a public private consortium dedicated to improving care for underserved populations in Milwaukee County. Through the Partnership, Milwaukees five health systems and the Milwaukee Health Department aligned resources to complete a shared community health needs assessment (CHNA) in 2011 - 2012. Supported by additional analysis from the Center for Urban Population Health, this robust community-wide CHNA includes findings from a community health survey of over 400 adults, significant key informant interviews and a secondary source data analysis. This shared CHNA serves as the foundation for St. Josephs Hospitals implementation strategy to improve health outcomes and reduce disparities in Washington County.The CHNA summary and full reports can be found on St. Josephs website.Identified Community Needs in Washington County:- Access to Health Care Services: includes behavioral, oral health and prenatal services- Health Insurance Coverage- Mental Health: includes Alcohol and Other Drug Abuse (AODA)- Obesity, Nutrition and Physical Activity- Chronic Disease- Transportation- Health Literacy and NavigationSt. Josephs Hospitals Implementation Strategy PrioritiesReflecting St. Josephs Hospital clinical strengths and community partnerships, the CHNA identified priorities of Access, AODA, Obesity and Physical Activity and Chronic Disease as focus areas for its Implementation Strategy. Implementation Strategy 20131. Program: Subsidized TransportationHealth Need: Affordable and Accessible TransportationInternal Resources: Community Outreach; Discharge Planning and Case Management; Nursing Administration; Emergency Department Community Resources: Washington County Shared Ride TaxiObjective: Provide affordable and accessible medical transportation to SJH patients at or below 200% Federal Poverty Level2. Program: Albrecht Free ClinicHealth Need: 8% of Washington County Residents Uninsured; Unmet Medical Care; Routine Procedures; Access to Specialty Care Internal Resources: F&MCW Community Physicians; SJH Leadership and Physician Involvement on AFC Board; SJH & CP Lab and Radiology Depts; SJH Case Managers; SJH Emergency Dept Community Resources: Albrecht Free Clinic; Washington County Healthy Community Fund; Washington County Public Health DepartmentObjective: Referral process for uninsured populations from SJH Emergency Department to Albrecht Free Clinic; Provide vouchers for ancillary services for AFC patients; Provide vouchers for specialty care to clinic patients; Recruitment and support F&MCW Community physicians that donate time to AFC3. Program: Prostate Screening ProgramHealth Need: Decrease in percentage of men having prostate cancer screenings in Washington County the past two years. Internal Resources: Kraemer Cancer Center; F&MCW Community Physicians; Community Outreach; SJH Community Foundation; Marketing Community Resources: ZERO; Albrecht Free Clinic; Washington County Public Health Dept; American Cancer Society; Casa GuadalupeObjective: Increase the amount of men having PSA and Digital Exam every two years4. Program: Colorectal Screening ProgramHealth Need: Decrease in blood stool test in past year; 69% of population age 50 and older had a colonoscopy in the past 10 yearsInternal Resources: Kraemer Cancer Center; F&MCW Community Physicians; Community Outreach; SJH Community Foundation; MarketingCommunity Resources: American Cancer Society; Albrecht Free Clinic; Casa Guadalupe; Bobbie Nick Voss Charitable FundsObjective: Increase the number of populations reporting having a colonoscopy age 50 and above; Provide care navigation and facilitate access for vulnerable populations through health education and colonoscopy screenings 5. Program: Sexual Assault Nurse Examiner Program (SANE)Health Need: 4% of population reported being afraid for their safetyInternal Resources: Emergency Department; Trained SANE Nurse; St. Joesph's Community Foundation; SJH PartnersCommunity Resources: Friends of Abused Families; Washington County EMS/Police DepartmentsObjective: Provide forensic evaluations, assessments and emotional support to victims; Track and facilitate referrals to medical and other non-profit agencies6. Program: Every 15 Minutes ProgramHealth Need: Increase in binge drinking - higher than state and national average; 3% of population reported driving while under the influence or was a passengerInternal Resources: Emergency Department; Community Outreach; Emergency Preparedness Coordinator; Marketing; Nursing StaffCommunity Resources: West Bend School District; Kewaskum School District; Washington County Sheriffs Department; West Bend Fire/EMS; Flight for LifeObjective: Reduce youth underage drinking and driving; Reduce traffic related impairment accidents and deaths; Program runs approximately every three years7. Program: Health People Project of Washington CountyHealth Need: Increase in populations reporting they are overweight- higher than the national average; Decrease in the number of populations reported getting recommended moderate and vigorous physical activity; Decrease in recommended fruit and vegetable intakeInternal Resources: Community Outreach; MarketingCommunity Resources: Washington County Healthy Community Fund; Full Shelf Food Pantry; Albrecht Free Clinic; Aurora Health Care; Kettle Moraine YMCA; UW-Extension Washington County; Washington County Public Health DeptObjective: Increase the number of individuals reporting moderate to vigorous physical activity; Increase the daily amount of fruit and vegetable intake; Decrease the number of individuals reporting being overweight or obese 8. Program: Living Well with Chronic ConditionsHealth Need: Adults in Washington County with Chronic disease: 28% with high blood pressure; 21% with high cholesterol; 9% with diabetesInternal Resources: Community Education Dept; F&MCW trained facilitators; Wellness Works; Community Outreach; F&MCW Community PhysiciansCommunity Resources: Wisconsin Institute for Health Aging; Washington County ADRC; Albrecht Free Clinic; Kettle Moraine YMCA; Casa GuadalupeObjective: Increase patient engagement in self-management of chronic disease; Decrease ED utilization for chronic disease management; Increase in self-management as measured by pre and post surveyNumber of Hospital Faciltiy - 1
Part V, Line 5c - Description of Making Needs Assessment Widely AvailableThe full version of the report and other supporting documents can be found on Froedtert Healths website - http://www.froedterthealth.org/upload/docs/community-memorial/community-giving/Benefit/washington-county-community-health-survey-report.pdfAdditional Websites:Washington County Public Health Department - http://www.co.washington.wi.us/uploads/docs/washington-county-community-health-survey-report-march-2012.pdfNumber of Hospital Faciltiy - 1
Part V, Line 4 - List Other Hospital Facilities that Jointly Conducted Needs AssessmentWashington County Health Needs Assessment Collaboration:JKV ResearchFroedtert Health Froedtert Health St. Josephs HospitalAurora Health CareColumbia St. Marys Health SystemChildrens Hospital of WisconsinWashington County Public Health DepartmentJKV Research was hired by the participating Health Care Systems and Washington County Public Health Department to lead the CHNA process for Washington County. The total cost of the CHNA conducted was divided up by each of the participating health systems and health departments. Each health system and health department was assigned to conduct key informant interviews within their service area.Number of Hospital Faciltiy - 1
Part V, Line 3 - Account Input from Person Who Represent the CommunityIn fiscal year 2012, St. Josephs Hospital Community Outreach Staff conducted key informant interviews with the following non-profit health and human service agencies:Albrecht Free Clinic Hartford Jt 1 School DistrictHartford Parks and Recreation DepartmentInterfaith Caregivers of Washington CountyUniversity of Wisconsin Extension Washington CountyWashington County Mental Health DepartmentWashington County Public Health DepartmentThe Council on AODAVolunteer Center of Washington CountyEconomic Development of Washington CountySt. Gabriel ChurchSt. Marys Catholic Parish Holy HillWashington County WICKettle Moraine YMCAAging and Disability Resource CenterFriends of Abused FamiliesCasa Guadalupe Education CenterHabitat for Humanity Washington CountyWest Bend Police DepartmentWashington County Sheriffs DepartmentWest Bend Chamber of CommerceHartford Area Chamber of CommerceNumber of Hospital Faciltiy - 1
Part III, Line 9b - Provisions On Collection Practices For Qualified PatientsIn alignment with the Froedtert Health, Inc. financial assistance policy regarding the billing, collection and support for patients with payment obligations, St. Joseph's Community Hospital of West Bend makes every effort to adhere to the policy and is committed to implementing and applying the policy for assisting patients with limited means in a professional, consistent manner. Staff members who work closely with patients (including those working in patient registration and admitting, financial assistance, customer service, billing and collections) are trained regularly about these policies with an emphasis on treating all patients with dignity and respect regardless of their insurance or their ability to pay for services.
Part III, Line 8 - Explanation Of Shortfall As Community BenefitSt. Joseph's Community Hospital of West Bend believes that all of the $6,520,797 shortfall should be considered as community benefit. The IRS Community Benefit Standard includes the provision of care to the elderly and Medicare patients. Medicare shortfalls must be absorbed by the hospital in order to continue treating the elderly in our community. The hospital provides care regardless of this shortfall and thereby relieves the federal government of the burden of paying the full cost for Medicare beneficiaries.The costing methodology used to determine the Medicare allowable costs is based on a calculation developed by the American Hospital Association in which the data is derived from the annual filed Medicare cost report.
Part III, Line 4 - Bad Debt ExpensePatients accounts receivable are reduced by an allowance for uncollectible accounts. In evaluating the collectability of patients accounts receivable, Froedtert Health, Inc. (FH) analyzes its past history and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for uncollectible accounts and provision for bad debts. Management regularly reviews data about these major payor sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, FH analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for bad debts, if necessary (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payor has not yet paid, or for payors who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), FH records a significant provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts.FH recognizes patient service revenue associated with services provided to patients who have third-party payor coverage on the basis of contractual rates for the services rendered. For uninsured patients that do not qualify for charity care, FH recognizes revenue on the basis of its standard rates for services provided (or on the basis of discounted rates, if negotiated or provided by policy). On the basis of historical experience, a significant portion of FHs uninsured patients will be unable or unwilling to pay for the services provided. Thus, FH records a significant provision for bad debts related to uninsured patients in the period the services are provided.See also page 26 and 27 of attached financial statements.
Part III, Line 2 - Methodology Used To Estimate Bad Debt ExpenseThe Hospital provides an allowance for uncollectible accounts based upon a review of outstanding receivables, historical collection information, and existing economic conditions and trends. The ratio of patient care cost to charges is applied to the bad debt attributable to patient accounts to calculate the estimated cost of bad debt attributable to patient accounts that is reported on line 2. Discounts and payments on patient accounts are recorded as an adjustment to revenue, not bad debt expense.
Part I, Line 7, Column F - Explanation of Bad Debt ExpenseOur total expense from Form 990, Part IX, line 25, column (A) was $91,921,522. Bad debt expense is included in Form 990, Part VIII, Statement of Revenue, lines 2a-2c as required by ASU 2011-07, Presentation and Disclosure of Patient Service Revenue, Provision for Bad Debts, and the Allowance for Doubtful Accounts for Certain Health Care Entities. Therefore, bad debt expense is not included on Part IX, Statement of Functional Expenses, Line 25, column (A).
Part I, Line 7 - Explanation of Costing MethodologyCharity Care and certain other community benefits costs were determined by using internal information to reduce the various activities to cost. The costing methodology follows the instructions from the IRS.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (15 entries)

TitleTitleComp Based On Related OrgsCompBasedOnRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsBonus Related OrgsBonusRelatedOrgsBase Compensation Filing OrgBaseCompensationFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrg
Wolter Brian MD
Dir&Doctor43330282141347520242475233
Van De Kreeke Jeffrey
FH CFO291459272577347512039514239110009
Olson David
Dir&President2830652208373332943442769575655
Martin Mary
Dir&CNO14303238268433066153323
Malzewski Michael
Former - Officer (AVP Finance)24018928511294526589282574
Lux Theresa M
Dir&CNO18014417299299011008428765350225
Less Timothy
Medical Physicist1909978921092417973220786
Lauenstein Debra
Former - Key (Dir HR)15352172481179956172318
Laird Michael
Past President28120013475294675
Knoll Thomas
Treasurer151668693831026791187462
Juech Thomas
Pharmacist135467115093657886153868
Jacobson Catherine
Dir&FH CEO6983734782150975288851181686298671
Herdrich Gary MD
Dir&Chief Staff604933205901715017145659818
Herdeman Charles
Pharmacist143961599964116149170350
Hawig Scott
FH CFO2141505846103542399519601

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Sch J, Part III, Additional InformationPart III, Additional InformationPart II, Column (B)(ii): Bonus and incentive compensation amounts include incentive compensation and amounts paid to individuals in lieu of participation in 457(f) deferred compensation plan for the purchase of benefits.
Sch J, Part I, Line 1aPart I, Line 1a: Relevant information in regards to selections on 1a.Health club membership subsidy/discount is a benefits program applicable to all employees and is outlined in the benefit program documents. Country Club memberships for Executives are for business purposes only, with all expenses substantiated by receipts and approvals. All amounts are included in taxable compensation as required.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part IV, Line 24aEven though the liability is on the books of St. Joseph's Community Hospital of West Bend, Inc.,this question was answered no, as Schedule K will be completed on the Form 990 of the parent corporation, Froedtert Health, Inc.
Other Changes In Net Assets Or Fund Balances - Other DecreasesTransfer to affiliates = -$2836555Form 990, Part XI, Line 9
Other Changes In Net Assets Or Fund Balances - Other DecreasesReleased from restriction = -$8997Form 990, Part XI, Line 9
Other Changes In Net Assets Or Fund Balances - Other IncreasesContributions = $4769Form 990, Part XI, Line 9
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableFroedtert Health, Inc.'s quarterly financial information, which includes St. Joseph's Community Hospital of West Bend, Inc., is made available to the public through the Digital Assurance Corporation, Inc. website. Anyone can register to receive ongoing access to and notifications regarding financial statements at the online website. St. Joseph's Community Hospital of West Bend, Inc. governing documents and conflict of interest policy is made available to the public through the corporate office upon request.Form 990, Part VI, Line 19
Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top ManagementIn establishing the compensation of the organization's Top Management, independent compensation consultants are utilized, compensation studies are completed to gather comparative data, persons with a conflict of interest regarding the compensation arrangements at issue are not involved in the decision making process, and amounts are reviewed and approved by the Compensation Committee of the Board of Directors of Froedtert Health, the parent organization.In addition, there is contemporaneous documentation and recordkeeping for deliberations and decisions regarding the compensation arrangements.Form 990, Part VI, Line 15a
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsOn an annual basis all officers, directors, trustees, and key employees are required to complete a conflict of interest disclosure document. The data is compiled, and the Froedtert Health Vice President-Chief Compliance Officer (CCO), the Senior Vice President-General Counsel and/or delegate review all forms and notifications to determine if any conflicts of interest exists in the disclosure documents. If it is determined that a conflict of interest exists, then the person making the disclosure shall be relieved of his/her obligations on behalf of St. Joseph's Hospital with respect to the transaction or arrangement that creates the conflict of interest. A report of all conflicts of interest will be made by the CCO at least once annually to the Froedtert Health Finance Committee of the Board of Directors.Form 990, Part VI, Line 12c
Form 990, Part VI, Line 11b: Form 990 Review ProcessFroedtert Health, Inc. accounting staff prepare Form 990 which is reviewed by the Froedtert Health financial leaders and legal counsel. The 990 is then reviewed by KPMG, Froedtert Health's outside accounting firm. Next, the 990 is provided to the Froedtert Health Finance Committee and Board of Directors. Finally, the 990 is filed as required.Form 990, Part VI, Line 11b
Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or ShareholdersFroedtert Health, Inc., as the sole member of St. Joseph's Community Hospital, has certain reserved powers and authorities with respect to the operations and management of St. Joseph's Hospital, as set forth in St. Joseph's bylaws.Form 990, Part VI, Line 7b
Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing BodyFroedtert Health, Inc. as the member of St. Joseph's Community Hospital of West Bend, Inc. has the final approval of election of all board members.Form 990, Part VI, Line 7a
Form 990, Part VI, Line 6: Explanation of Classes of Members or ShareholderFroedtert Health, Inc. is the sole member of St. Joseph's Community Hospital of West Bend, Inc.Form 990, Part VI, Line 6
Form 990, Part VI, Line 4: Description of Significant Changes to Organizational DocumentsArticles of Incorporation and Bylaws were amended and restated to reflect termination of definitive agreement that created original health care system.Form 990, Part VI, Line 4

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
Community Memorial Foundation of MF Inc
W180 N8085 Town Hall RoadMenomonee FallsWI53051391635057Health and welfare promotionWI501(c)(3)Ln 11, Type 1Community Memorial Hospital of MF Incfalse
Froedtert Hospital Foundation Inc
9200 West Wisconsin AvenueMilwaukeeWI532263596391431192Health, welfare, research & educ promoWI501(c)(3)Ln 11, Type 1Froedtert Memorial Lutheran Hospital Incfalse
Froedtert Physician Partners Inc
9200 W Wisconsin AveMilwaukeeWI53226272042610Healthcare ServicesWI501(c)(3)3Froedtert Health Incfalse
Froedtert Health Inc
9200 W Wisconsin AveMilwaukeeWI53226392014409Management ServicesWI501(c)(3)Ln 11, type 111NAfalse
West Bend Clinic Inc
1700 W Paradise DriveWest BendWI53095392034294Health Care ServicesWI501(c)(3)3Froedtert Health Incfalse
St Josephs Community Foundation Inc
3200 Pleasant Valley RoadWest BendWI530953868392034296Health and welfare promotionWI501(c)(3)Ln 11, type 1St Josephs Hospitaltrue
Community Memorial Hospital of MF Inc
W180 N8085 Town Hall RoadMenomonee FallsWI53051390987025HospitalWI501(c)(3)3Froedtert Health Incfalse
Froedtert Memorial Lutheran Hosp Inc
9200 W Wisconsin AveMilwaukeeWI53226396105970HospitalWI501(c)(3)3Froedtert Health Incfalse

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1Progressive Physician Network IncBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line19200 West Wisconsin AvenueAddressLine1
CityMilwaukeeCity
StateWIState
ZIP Code53226ZIPCode
FieldValueIRS element (for citing)
EIN270367127EIN
Primary ActivityManagement ServicesPrimaryActivity
Legal Domicile StateWILegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Froedtert Health IncBusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityCTypeOfEntity
Controlled OrgfalseControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
IdentifierSchedule R, Part V, Line 2Identifier
ExplanationAny transactions listed on Schedule R, Part V, Line 1 and not on Schedule R, Part V, Line 2 are between related 501(c)(3) organizations and therefore, are not reported in this section.Explanation