BELOIT HEALTH SYSTEM INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- BELOIT HEALTH SYSTEM INC (EIN 39-1028081)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-14
- IRS object ID
- 201233199349306563
- Schema version
- 2011v1.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-14T16:44:28-07:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391028081 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BELOIT HEALTH SYSTEM INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | BELO | NameControl |
| Phone | 6083645011 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1969 West Hart Road | AddressLine1 |
| City | Beloit | City |
| State | WI | State |
| ZIP Code | 53511 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | William Groeper | Name |
| Title | VP of Financial Services | Title |
| Phone | 6083645281 | Phone |
| Date Signed | 2012-11-14 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Gregory K Britton | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1969 West Hart Road | AddressLine1 |
| City | Beloit | City |
| State | WI | State |
| ZIP Code | 53511 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 188333798 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.beloithealthsystem.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1965 | YearFormation |
| State Legal Domicile | WI | StateLegalDomicile |
| Activity Or Mission Description | The mission of Beloit Health System is to be the leader in regional health and wellness services that delivers high quality, value, and satisfaction to our patients and communities we serve. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 13 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 5 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1649 | TotalNbrEmployees |
| Total Nbr Volunteers | 425 | TotalNbrVolunteers |
| Total Gross UBI | 301209 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 177222838 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 182496310 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 817049 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1207498 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 4496063 | OtherRevenuePriorYear |
| Other Revenue Current Year | 4629990 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 182535950 | TotalRevenuePriorYear |
| Total Revenue Current Year | 188333798 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 107711789 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 110980222 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 67559452 | OtherExpensePriorYear |
| Other Expenses Current Year | 68378983 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 175271241 | TotalExpensesPriorYear |
| Total Expenses Current Year | 179359205 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 7264709 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 8974593 | RevenuesLessExpensesCY |
| Total Assets BOY | 191593671 | TotalAssetsBOY |
| Total Assets EOY | 203439891 | TotalAssetsEOY |
| Total Liabilities BOY | 113912312 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 127310310 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 77681359 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 76129581 | NetAssetsOrFundBalancesEOY |
| Mission Description | Beloit Health System provides quality medical health care regardless of race, creed, sex, national origin, disability, age or ability to pay. During 2011, the System's Hospital served over 4,400 inpatients and provided more than 726,000 outpatient services, the NorthPointe facility provided more than 74,000 outpatient services and the Clinics had over 220,000 encounters. The System is equipped to serve the greater Beloit areas entire spectrum of health needs and strives to continue the long-standing tradition of providing excellent general acute care and to better serve the greater Beloit area. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 43504517 | Expense |
| Revenue | 56591202 | Revenue |
| Description | Inpatient Revenue: Total admissions of 4,404 with an average daily census of 47. This was a slight 1% decrease from 2010 mainly due to continued economic uncertainty as well as the fact that more and more services are transitioning to an outpatient type setting. Total patient days were 17,139 | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 101510536 | Expense |
| Grants | 0 | Grants |
| Revenue | 125603899 | Revenue |
| Description | Outpatient Revenue: Beloit Memorial Hospital successfully integrated with the Beloit Clinic in 2010 to create the Beloit Health System. Outpatient revenue has shown continued growth with the addition of physicians in certain specialties. Total Hospital and NorthPointe outpatient procedures for 2011 were 800,539. Total Clinic encouters were 220,275. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 0 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Grnt | 0 | TotalOfOtherProgramServiceGrnt |
| Total Of Other Program Service Rev | 0 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 145015053 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 1 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1649 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 13 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 5 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 0 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Beloit Health System Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 6083645102 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1969 West Hart Road | AddressLine1 |
| City | Beloit | City |
| State | WI | State |
| ZIP Code | 53511 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (23 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| G Curtis Lansbery | ||||||||
| Board Chair | 0 | X | X | 0 | 0 | 0 | ||
| Bonnie D Wetter | ||||||||
| Board Vice Chair | 0 | X | X | 0 | 0 | 0 | ||
| Steven M Eldred | ||||||||
| Board Treasurer | 0 | X | X | 0 | 0 | 0 | ||
| Russel Albert MD | ||||||||
| Board Secretary & Physician | 40 | X | X | 376369 | 0 | 15925 | ||
| Gregory K Britton | ||||||||
| Board Member & System President & CEO | 40 | X | 567782 | 0 | 540273 | X | ||
| Suzanne Anderson | ||||||||
| Board Member | 0 | X | 0 | 0 | 0 | |||
| Leo Egbujiobi MD | ||||||||
| Board Member & Physician | 40 | X | 1041992 | 0 | 15925 | |||
| James B Fisher | ||||||||
| Board Member | 0 | X | 0 | 0 | 0 | |||
| Mark Gliebe | ||||||||
| Board Member | 0 | X | 0 | 0 | 0 | |||
| James L Packard | ||||||||
| Board Member | 0 | X | 0 | 0 | 0 | |||
| Tejesh Patel MD | ||||||||
| Board Member & Physician | 40 | X | 344073 | 0 | 15925 | |||
| Mario Rojas MD | ||||||||
| Board Member & Physician | 40 | X | 567843 | 0 | 15925 | |||
| Bill Sullivan | ||||||||
| Board Member & Clinic Division CEO | 40 | X | 311973 | 0 | 15925 | X | ||
| Timothy M McKevett | ||||||||
| Executive Vice President | 40 | 295738 | 0 | 91049 | X | |||
| William Groeper | ||||||||
| Vice President of Financial Services | 40 | 250585 | 0 | 14557 | X | |||
| Leland From MD | ||||||||
| Vice President of Medical Affairs | 40 | 256649 | 0 | 20206 | X | |||
| Doris Mulder | ||||||||
| Vice President of Nursing Services | 40 | 217442 | 0 | 80390 | X | |||
| Kristinn Armann | ||||||||
| Vice President of Human Relations | 40 | 154724 | 0 | 17028 | X | |||
| Paul Segal MD | ||||||||
| Physician | 40 | 793449 | 0 | 15925 | X | |||
| Emmy Ho MD | ||||||||
| Physician | 40 | 734980 | 0 | 15925 | X | |||
| Tsu-Hon Wang MD | ||||||||
| Physician | 40 | 709877 | 0 | 15925 | X | |||
| Glenn Tan MD | ||||||||
| Physician | 40 | 663239 | 0 | 15925 | X | |||
| John Johanson MD | ||||||||
| Physician | 40 | 648437 | 0 | 15925 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 7935152 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 922753 | TotalOtherCompensation |
| Number Individuals GT100 K | 93 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation | Address Line2AddressOfContractor/AddressUS/AddressLine2 |
|---|---|---|---|---|---|---|
| North American Mechanical | ||||||
| 330 E Delavan Drive | Janesville | WI | 53546 | Construction Contractors | 902796 | |
| Power Wellness Management LLC | ||||||
| 2055 W Army Trail Road | Addison | IL | 60101 | Wellness Operations Contractor | 998013 | Suite 124 |
| Clear Choice Transcription LLC | ||||||
| PO Box 643455 | Cincinnati | OH | 452643455 | Transcription Services | 738369 | |
| Southern WI Emergency Association | ||||||
| 1664 N Randall | Janesville | WI | 53545 | Trauma Physicians | 502676 | |
| Guenther Electric Inc | ||||||
| 220 Liberty Avenue | Beloit | WI | 53511 | Electrical Contractors | 447590 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 15 | NumberOfContractorsGT100K |
| Total Contributions | 0 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| Outpatient Service Revenue | 622000 | 125603899 | 125603899 | 0 | $0 |
| Inpatient Service Revenue | 622000 | 56591202 | 56591202 | 0 | $0 |
| Third Party Adminstration | 524292 | 301209 | 0 | 301209 | $0 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 182496310 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1207498 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $1,207,498 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 292881 | Real |
| Personal | 0 | Personal |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
| Personal | 0 | Personal |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 292881 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 292881 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $292,881 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | 0 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 0 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 0 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 0 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Gaming | 0 | GrossIncomeGaming |
| Gaming Direct Expenses | 0 | GamingDirectExpenses |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | 0 | GrossSalesOfInventory |
| Cost Of Goods Sold | 0 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| Wellness Center & Spa Revenue | 622000 | 2937435 | 0 | 0 | $2,937,435 |
| Cafeteria & Snack Shop Revenue | 622000 | 608487 | 0 | 0 | $608,487 |
| Physician Billing | 622000 | 138350 | 0 | 0 | $138,350 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 652837 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $652,837 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 4337109 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 188333798 | TotalRevenueColumn |
| Related Or Exempt Function Income | 182195101 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 301209 | UnrelatedBusinessRevenue |
| Exclusion | $5,837,488 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 79072248 | Total |
| Program Services | 65026670 | ProgramServices |
| Management And General | 14045578 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4321583 | Total |
| Program Services | 3543698 | ProgramServices |
| Management And General | 777885 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 22514245 | Total |
| Program Services | 18461681 | ProgramServices |
| Management And General | 4052564 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5072146 | Total |
| Program Services | 4159160 | ProgramServices |
| Management And General | 912986 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12174 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 12174 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 80100 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 80100 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Fundraising | 0 | Fundraising |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5403585 | Total |
| Program Services | 4392625 | ProgramServices |
| Management And General | 1010960 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1464452 | Total |
| Program Services | 1200851 | ProgramServices |
| Management And General | 263601 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25368930 | Total |
| Program Services | 22697758 | ProgramServices |
| Management And General | 2671172 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1420516 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 1420516 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6012019 | Total |
| Program Services | 4929856 | ProgramServices |
| Management And General | 1082163 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 507826 | Total |
| Program Services | 252056 | ProgramServices |
| Management And General | 255770 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27604 | Total |
| Program Services | 5810 | ProgramServices |
| Management And General | 21794 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3653150 | Total |
| Program Services | 2995583 | ProgramServices |
| Management And General | 657567 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9699138 | Total |
| Program Services | 7953293 | ProgramServices |
| Management And General | 1745845 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1302670 | Total |
| Program Services | 1302670 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Equipment Rental & Maintenance | 5637628 | 2484778 | 3152850 |
| WI Provider Tax | 4602457 | 4602457 | 0 |
| Other Purchased Services | 2618866 | 866189 | 1752677 |
| Professional Memberships | 220831 | 139918 | 80913 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 347037 | Total |
| Management And General | 347037 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 179359205 | Total |
| Program Services | 145015053 | ProgramServices |
| Management And General | 34344152 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9035 | BOY |
| EOY | 9035 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15808573 | BOY |
| EOY | 25022490 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25058445 | BOY |
| EOY | 24403307 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 812752 | BOY |
| EOY | 493011 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2432468 | BOY |
| EOY | 2219638 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2113888 | BOY |
| EOY | 3702970 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 186138978 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 86087285 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 101717940 | BOY |
| EOY | 100051693 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32884646 | BOY |
| EOY | 36711033 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3580000 | BOY |
| EOY | 3510000 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7175924 | BOY |
| EOY | 7316714 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 191593671 | BOY |
| EOY | 203439891 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19770232 | BOY |
| EOY | 22657559 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3245545 | BOY |
| EOY | 3895631 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 70365000 | BOY |
| EOY | 70080000 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2387255 | BOY |
| EOY | 2119240 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18144280 | BOY |
| EOY | 28557880 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 113912312 | BOY |
| EOY | 127310310 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 77681359 | BOY |
| EOY | 76129581 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 77681359 | BOY |
| EOY | 76129581 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 191593671 | BOY |
| EOY | 203439891 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 8974593 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -10526371 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Both | X | FinancialStatementBoth |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 1700000 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 5865455 | OtherCostOrOtherBasis |
| Book Value | 7565455 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 105217733 | OtherCostOrOtherBasis |
| Depreciation | 34125506 | Depreciation |
| Book Value | 71092227 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 5920816 | OtherCostOrOtherBasis |
| Depreciation | 2832115 | Depreciation |
| Book Value | 3088701 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 67376727 | OtherCostOrOtherBasis |
| Depreciation | 49129664 | Depreciation |
| Book Value | 18247063 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 58247 | OtherCostOrOtherBasis |
| Depreciation | 0 | Depreciation |
| Book Value | 58247 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 100051693 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Pension Liability | $16,754,275 |
| Interest Rate Swap Agreements | $11,731,493 |
| Capitalized Leases | $72,112 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 28557880 | TotalOfAmounts |
| Total Revenue | 188333798 | TotalRevenue |
| Total Expenses | 179359205 | TotalExpenses |
| Excess Or Deficit For Year | 8974593 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 0 | NetUnrealizedGLOnInvestments |
| Donated Services And Facilities | 0 | DonatedServicesAndFacilities |
| Investment Expenses | 0 | InvestmentExpenses |
| Prior Period Adjustments | 0 | PriorPeriodAdjustments |
| Other | -$419,965 | OtherAmount |
| Total Adjustments | -419965 | TotalAdjustments |
| Excess Or Deficit Per FS | 8554628 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 188333798 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 0 | NetUnrealizedGainsInvestments |
| Donated Srvc And Use Of Facilities | 0 | DonatedSrvcAndUseOfFacilities |
| Recoveries Of Prior Year Grants | 0 | RecoveriesOfPriorYearGrants |
| Other Revenues | 0 | OtherRevenues |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 188333798 | RevenueSubtotal |
| Investment Expenses Not Included | 0 | InvestmentExpensesNotIncluded |
| Other Revenues Not Included | 0 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 188333798 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 179359205 | TotExpensesEtcAuditedFinclStmt |
| Donated Services Use Of Facilities | 0 | DonatedServicesUseOfFacilities |
| Prior Year Adjustments | 0 | PriorYearAdjustments |
| Losses Reported | 0 | LossesReported |
| Other Expenses Included | 0 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 179359205 | ExpensesSubtotal |
| Investment Expenses Not Included2 | 0 | InvestmentExpensesNotIncluded2 |
| Other Expenses Not Included | 0 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 179359205 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SchD_P10_S00_L02 | Schedule D, Part X, Line 2 | The Health System is a nonprofit corporation as described in Section 501(c)(3) of the Internal Revenue Code (the "Code") and is exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. The System is also exempt from state income taxes on related income. In order to account for any uncertain tax positions, The Corporation determines whether it is more likely than not that a tax position will be sustained upon examination on the technical merits of the positon, assuming the taxing authority has full knowledge of all information. If the tax position does not meet the more likely than not recognition threshold, the benefit of that position is not recognized in the financial statements. The Corporation recorded no assest or liabilities related to uncertain tax positions in 2011 and 2010. Tax returns for the years ended 2008 and beyond remain subject to examination by the Internal Revenue Service. |
| SchD_P11_S00_L08 | Schedule D, Part XI, Line 8 | Total is derived from the change in market value on Pension Restoration Asset for $(113,686) plus the change in market value of the Interest Rate Swap Agreements $(306,279). All nonoperating items are not included on Form 990 Statement of revenue and Functional Expenses. Total other is $(419,965). |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent150 | X | Pcent150 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expense | 11303128 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.063 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 32761305 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 19297376 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 13463929 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.075 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 32761305 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 19297376 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 24767057 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.138 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 17120 | PersonsServed |
| Total Community Benefit Expense | 185926 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 9062 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 176864 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.001 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 192 | PersonsServed |
| Total Community Benefit Expense | 196641 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 196641 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.001 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 16536 | PersonsServed |
| Total Community Benefit Expense | 88251 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 88251 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 33848 | PersonsServed |
| Total Community Benefit Expense | 470818 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 9062 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 461756 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.002 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 33848 | PersonsServed |
| Total Community Benefit Expense | 33232123 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 19306438 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 25228813 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.140 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $3,398,679 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 27900789 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 121417412 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -93516623 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Beloit Memorial Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1969 West Hart Road | AddressLine1 |
| City | Beloit | City |
| State | WI | State |
| ZIP Code | 53511 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Teaching Hospital | X | TeachingHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Beloit Memorial Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 10 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (11 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| Beloit Clinic | ||||
| 1905 E Huebbe Parkway | Beloit | WI | 53511 | Ourpatient Physician Clinic |
| Northpointe Health and Wellness | ||||
| 5605 E Rockton Road | Roscoe | IL | 61073 | Other Outpatient Physcian Clinic and Diagnostic Center |
| Beloit At-Home Healthcare | ||||
| 1904 E Huebbe Parkway | Beloit | WI | 53511 | At Home Healthcare Practice |
| Riverside Terrace | ||||
| 3055 S Riverside Drive | Beloit | WI | 53511 | Assisted Living Center |
| Northpointe Terrace | ||||
| 5601 Rockton Road | Roscoe | IL | 61073 | Assisted Living Center |
| Occupational Health Sports and Family Medicine | ||||
| 1650 Lee Lane | Beloit | WI | 53511 | Outpatient Physician Clinic |
| West Side Clinic | ||||
| 1735 Madison Ave | Beloit | WI | 53511 | Outpatient Physician Clinic |
| Clinton Clinic | ||||
| 307 Ogden Ave | Clinton | WI | 53525 | Outpatient Physician Clinic |
| Darien Clinic | ||||
| 300 N Walworth | Darien | WI | 53114 | Ourpatient Physician Clinic |
| Janesville Clinic | ||||
| 1321 Creston Park | Janesville | WI | 53545 | Outpatient Physician Clinic |
| South Beloit Facility | ||||
| 1655 Blackhawk Blvd | South Beloit | IL | 61080 | Unoccupied |
Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SchH_P01_S00_L06a | Schedule H, Part I, Line 6a | Each year the Beloit Health System prepares a community benefit report using the guidelines of the Wisconsin Hospital Association (WHA). It is then submitted to WHA foir data tracking and reporting purposes. |
| SchH_P01_S00_L07 | Schedule H, Part I, Line 7 | Costing methodology used was the Ratio of Patient Care Cost to Charges with guidance from the IRS worksheets in the instructions. |
| SchH_P01_S00_L072f | Schedule H, Part I, Line 7, Column f | Not applicable |
| SchH_P01_S00_L07g | Schedule H, Part I, Line 7g | Not applicable |
| SchH_P03_S0A_L04 | Schedule H, Part III, Section A, Line 4 | Patient accounts receivable are recorded net of contractual adjustments and allowance for doubtful accounts which reflects management's best estimate of the amounts that won't be collected. Management provides for contractual adjustments under terms of third-party reimbursement agreements through a reduction of gross revenue and a credit to patient accounts receivable. In evaluating the collectibility of patient accounts receivable,the System analyzes historical loss experience on revenue from non-governmental payors. The loss experience rate is applied to current year non-governmental revenue as a basis for the allowance for doubtful accounts. The System also considers receivables from non-governmental payors aged over 151 days. Based on these factors, the System eliminates the appropriate allowance for doubtful accounts and provision for bad debts. 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. |
| SchH_P03_S0B_L08 | Schedule H, Part III, Section B, Line 8 | Costing methodology used for Medicare allowable costs came directly off the 2011 Medicare Cost Report on Worksheet B per the IRS instructions. |
| SchH_P03_S0C_L09b | Schedule H, Part III, Section C, Line 9b | The Health System's collection policy states that patient accounts that have aged 100 days are to be reviewed for possible collection and pre-collection activity by a Credit Consultant. For accounts over $100, if it has been determined that no payment is forthcoming from a third-party payor and the patient had made no attempts to satisfy the balance of the account, a pre-collection letter shall be sent to the patient by a collection agency. If satisfactory payment arrangements are not made within 15 days of the letter, the account status shall be changed to bad debt. For account balances under $100, if it has been determined that no payment is forthcoming from a third-party payor and the patient has made no attempts to satisfy the balance of the account, the account status shall be changed to bad debt. No pre-collection letter will be sent. All accounts in a Bad Debt status are transferred to a collection agency on the 15th and 30th of each month. Pre-collection accounts are transferred on the same dates. Accounts for services rendered for Hospital physicians or members of the Board shall not be transferred to bad debt or pre-collection without the approval of the Patient Accounts Advisor. The Health System will not force the sale or foreclosure of a patient's primary residence to pay an outstanding medical bill. |
| SchH_P06_S00_L02 | Schedule H, Part VI, Line 2 | There are primarily three ways the Health System assesses health care needs of the community. 1) A marketing group is used and their service is to measure through phone interviews, etc. what the needed medical services are, how our services are perceived, and are there any disconnects between these community needs, our actual services, and the community perception. 2) The Health System also looks at out migration data. Often limited to CMS data, this is what services (by CPT codes) were billed for residents of a particular zip code and where they go to get that service. If the volume of people going to our facilities is large, the Health System will review the costs, etc. of providing that service within the Health System. 3) The Health Systems corporate culture strongly supports due diligence for any request we receive from patients, family members, and their agents. Another way the Health System attempts to assess the health needs of the community is through Rock County Health Needs Assessment Task Force which has been established for this purpose and meets on a monthly basis. Beloit Health System has two representatives on the task force as well as representation from all other area hospitals and major health providers within the County. Primary purpose of this task force is to compile county-wide data as well as Beloit specific data on major health parameters to address through a perception of needs survey. Action plans are then developed to meet gaps between services provided and the needs of the community. |
| SchH_P06_S00_L03 | Schedule H, Part VI, Line 3 | Information about the Health System's charity care benefits are available on the Health System's website as well as in all patient rooms. In addition, admissions staff are trained to offer financial assistance applications to all uninsured patients who inquire at the time of registration. Finally, every patient billing statement includes contact information for the System's charity care benefits. |
| SchH_P06_S00_L04 | Schedule H, Part VI, Line 4 | Beloit, Wisconsin is a community of approximately 38,000 residents and located just north of the Wisonsin-Illinois border. One of the most ethnically diverse communities in the Midwest, the population is 67% Caucasian, 15% African American, 9% Hispanic/Latino, and 1% Asian American, with another 8% from other ethnic backgrounds. The Health System monitors market share based on service areas identified through the use of zip codes. The primary and secondary service area represent a market population of approximately 250,000 people. 93% of the System's patients are from Beloit, Janesville, Clinton (all Rock County, WI) South Beloit and Rockton (in Winnebago County, IL). The remaining 7% are from other Wisconsin and Illinois communities. Median household income for Rock County, WI is $50,373 and for Winnebago County, IL is $47,859. Unemployment is the area remains high for 2011 but much better than in 2010. Rock County, WI had an unemployment rate of 9.2% in 2011 compared to 11.4% in 2010. Winnebago County, IL had an unemployment rate of 12.0% in 2011 compared to 16.1% in 2010. Sources of Beloit Health System's gross patient revenue are 45.6% Medicare, 16.2% Medicaid, 5.1% Self Pays, and 33.1% Other Insurances. |
| SchH_P06_S00_L05 | Schedule H, Part VI, Line 5 | The Health System actively provided or participated in the following community based activities and programs. 1) General health education services such as health fairs, cancer education, health heart education, family planning, and mental health education. 2) Provided health information on the System's website and through health-related publications distributed at no charge. 3) Support groups such as AIDS/HIV, diabetes, substance abuse, and weight management. 4) Self help and wellness programs such as nutrition and weight management and sports injury prevention. 5) Blood pressure screenings, cholesterol testing, and hearing testing. 6) Crisis intervention counseling. 7) Guidance, referral, and enrollment assistance for public medical programs and other family support assistance. 8) Provided discounted or free medical supplies and equipment to those unable to pay. 9) Delivered hot in-home meals. 10) Provided emergency bus tokens for the indigent to access health care services. 11) Promoted participation in blood drives by employees. 12) Contributed to the education of student nurses and other health care professionals. Also, the Beloit Area Community Health Center has approached the Health System as to provide specialty physician care to indigent patients. This is a project above and beyond the Health System's current charity care process in that physicians are volunteering their time. |
| SchH_P06_S00_L06 | Schedule H, Part VI, Line 6 | Not applicable |
| SchH_P06_S00_L07 | Schedule H, Part VI, Line 7 | Wisconsin |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (16 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Gregory K Britton | |||||||||||||
| 414182 | 0 | 153600 | 0 | 0 | 0 | 540273 | 0 | 0 | 0 | 1108055 | 0 | 986485 | 0 |
| Leo Egbujiobi MD | |||||||||||||
| 1041992 | 0 | 0 | 0 | 0 | 0 | 15925 | 0 | 0 | 0 | 1057917 | 0 | 993850 | 0 |
| Paul Segal MD | |||||||||||||
| 793449 | 0 | 0 | 0 | 0 | 0 | 15925 | 0 | 0 | 0 | 809374 | 0 | 804966 | 0 |
| Emmy Ho MD | |||||||||||||
| 734980 | 0 | 0 | 0 | 0 | 0 | 15925 | 0 | 0 | 0 | 750905 | 0 | 862513 | 0 |
| Tsu-Hon Wang MD | |||||||||||||
| 709877 | 0 | 0 | 0 | 0 | 0 | 15925 | 0 | 0 | 0 | 725802 | 0 | 724600 | 0 |
| Glenn Tan MD | |||||||||||||
| 663239 | 0 | 0 | 0 | 0 | 0 | 15925 | 0 | 0 | 0 | 679164 | 0 | 572015 | 0 |
| John Johanson MD | |||||||||||||
| 648437 | 0 | 0 | 0 | 0 | 0 | 15925 | 0 | 0 | 0 | 664362 | 0 | 0 | 0 |
| Mario Rojas MD | |||||||||||||
| 567843 | 0 | 0 | 0 | 0 | 0 | 15925 | 0 | 0 | 0 | 583768 | 0 | 527457 | 0 |
| Russel Albert MD | |||||||||||||
| 376370 | 0 | 0 | 0 | 0 | 0 | 15925 | 0 | 0 | 0 | 392295 | 0 | 377416 | 0 |
| Timothy M McKevett | |||||||||||||
| 248737 | 0 | 47004 | 0 | 0 | 0 | 91049 | 0 | 0 | 0 | 386790 | 0 | 367069 | 0 |
| Tejesh Patel MD | |||||||||||||
| 344073 | 0 | 0 | 0 | 0 | 0 | 15925 | 0 | 0 | 0 | 359998 | 0 | 370621 | 0 |
| Bill Sullivan | |||||||||||||
| 265173 | 0 | 46800 | 0 | 0 | 0 | 15925 | 0 | 0 | 0 | 327898 | 0 | 267271 | 0 |
| Doris Mulder | |||||||||||||
| 182350 | 0 | 35092 | 0 | 0 | 0 | 80390 | 0 | 0 | 0 | 297832 | 0 | 304912 | 0 |
| Leland From MD | |||||||||||||
| 244049 | 0 | 12600 | 0 | 0 | 0 | 20206 | 0 | 0 | 0 | 276855 | 0 | 0 | |
| William Groeper | |||||||||||||
| 212785 | 0 | 37800 | 0 | 0 | 0 | 14557 | 0 | 0 | 0 | 265142 | 0 | 222988 | 0 |
| Kristinn Armann | |||||||||||||
| 131724 | 0 | 23000 | 0 | 0 | 0 | 20206 | 0 | 0 | 0 | 174930 | 0 | 185100 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SchJ_P01_S00_L04 | Identifier |
| Return Reference | Schedule J, Part I, Line 4 | ReturnReference |
| Explanation | 457(f) Plan Participants: Gregory K. Britton and Doris Mulder - no payments received to date. | Explanation |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)
| Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing | CUSIP NumberCUSIPNumber |
|---|---|---|---|---|---|---|
| Illinois Finance Authority | ||||||
| 2010-10-21 | 37895000 | Proceeds along with existing balances in the 2006A funds were used to refund the Series 2006A Bonds | 0 | 0 | 0 | |
| Wisconsin Health and Educational Facilities Authority | ||||||
| 2010-10-21 | 32470000 | Refund Series 2006B and refinance loans used for the acquisition of Beloit Clinic and ER renovations | 0 | 0 | 0 | 97710BYF3 |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Amount RetiredAmountRetired | Amount Bond DefeasedAmountBondDefeased | Total ProceedsTotalProceeds | Amount In Reserve FundAmountInReserveFund | Capitalized InterestCapitalizedInterest | Refunding EscrowRefundingEscrow | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Credit EnhancementCreditEnhancement | Working Capital ExpendituresWorkingCapitalExpenditures | Capital ExpendituresCapitalExpenditures | Other Spent ProceedsOtherSpentProceeds | Amount UnspentAmountUnspent | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 285000 | 0 | 37895000 | 0 | 0 | 0 | 255032 | 0 | 0 | 0 | 0 | 0 | 2007 | 1 | 0 | 1 | 1 |
| 0 | 0 | 32470000 | 2764200 | 0 | 0 | 510859 | 0 | 0 | 0 | 0 | 14450 | 2010 | 1 | 0 | 1 | 1 |
Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers | Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI | Total Private Business UseTotalPrivateBusinessUse | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs |
|---|---|---|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 |
| 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Term Of HedgeTermOfHedge | Superintegrated HedgeSuperintegratedHedge | Hedge TerminatedHedgeTerminated | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|---|---|---|
| Piper Jaffray | ||||||||
| 0 | 1 | 1 | 25.5 | 0 | 0 | 0 | 0 | 0 |
| (no name) | ||||||||
| 0 | 0 | 0 | 0 | 0 | 0 | |||
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| First National Bank & Trust Co | |||
| An entity with System Board Conections | 0 | Bank accounts and normal business | 0 |
| Marshall & Ilsley Trust Co | |||
| An entity with a System Board connection | 0 | Trustee fior Hospital Pension Plans | 0 |
| Regal Beloit Corp | |||
| An entity with a System board connection | 0 | Medical clains paid to Health System | 0 |
Form990 Schedule L Part V Form990ScheduleLPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SchL_P04_S00_L00 | Identifier |
| Return Reference | Schedule L, Part IV | ReturnReference |
| Explanation | An amount of $0 was entered in column c due to the inability to quantify an accurate total amount for the year. However, all transaction are considered to be in the normal course of business. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| F990_P06_S0A_L02 | Form 990, Part VI, Section A, Line 2 | There are several business relationships on the Board as there are two board members currently key employees of local banks: First National Bank and Trust Company and Marshall and Ilsley Trust Company. All relationships are considered normal banking relationships and all transactions are within the normal course of business. |
| F990_P06_S0B_L11b | Form 990, Part VI, Section B, Line 11b | Form 990 is prepared by an employee of the Health System's accounting staff and is reviewed by the VP of Financial Services, where it is signed and filed. After filing the return, the VP will present Form 990 to the Board. |
| F990_P06_S0B_L12c | Form 990, Part VI, Section B, Line 12c | It is the policy of the Health System that any leadership staff who believes he or she may be acting in contrary to the conflict of interest policy to promptly disclose the conflict to his or her supervisor. Employees should immediately report all known, observed or potential conflict of interests to their immediate supervisour or Human Resources. It is the responsiblilty of the President to enforce and interpret this policy on all related matters. |
| F990_P06_S0B_L15 | Form 990, Part VI, Section B, Line 15 | The Hospital Board of Directors has established a CEO Evaluation Committee to evaluate the CEO's performance based on criteria and links performance evaluation to compensation. This committee meets at least three times per year to establish and review measurable goals. Outside directors establish performance criteria, compensation, and benefit programs for the CEO. |
| F990_P06_S0C_L19 | Form 990, Part VI, Section C, Line 19 | Beloit Health System makes its financial statements available to the public via summary in the annual financial report which is posted on the Health System's website (www.beloithealthsystem.org). Also available on the website is the Board of Trustees Principle Based Governance Policy. It has been adopted by the Trustees and applies to all aspects of the governance to create a consistent, effective, and continously improving governance system. The principles are divided into three major categories: 1) Board Independence and Leadership 2) Board Processes and Evaluation and 3) Board structure. |
| F990_P11_S00_L05 | Form 990, Part XI, Line 5 | Change in pension obligation: $(4,901,997). Net assets released from restrictions and contributions for capital improvements: $520,193. Change in net unrealized gains and losses on investments other than trading securities: $(885,303). Foundation receivable write-down: ($77,956). Change in fair value of effective portion Interest rate swap agreements: $(4,761,343). Change in market valuation of Swap Agreements: $(306,279). Change in market valuation of Retirement Supplement Agreement: $(113,686). |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|
| Beloit Health System Foundation Inc | |||||||||
| 1969 West Hart Road | Beloit | WI | 53511 | 391477854 | Support Beloit Health System | WI | 501(c)(3) | 3 | N/A |
| Beloit Memorial Hospital Auxiliary Inc | |||||||||
| 1969 West Hart Road | Beloit | WI | 53511 | 390928583 | Support Beloit Health System | WI | 501(c)(3) | 3 | N/A |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| Beloit Health System Foundation Inc | ||
| c | 530765 | Actual cash received fron Beloit Health System Foundation |
| Beloit Health System Foundation Inc | ||
| o | 77956 | Actual expenses incurred by Beloit Health System Foundation and paid by Beloit Health System. |
| Beloit Health System Foundation Inc | ||
| m | 0 | Beloit Health System Foundation uses office space at Beloit Health System. No amount of consideration is received |
| Beloit Memorial Hospital Auxiliary Inc | ||
| m | 0 | Beloit Memorial Hospital Auxiliary uses office space of Beloit Health System. No amount of consideration is received |