COMMUNITY MEMORIAL HOSPITAL OF MENOMONEE FALLS INC: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY MEMORIAL HOSPITAL OF MENOMONEE FALLS INC (EIN 39-0987025)
- Tax period
- 2009-07-01 to 2010-06-30
- Filed
- 2011-05-11
- IRS object ID
- 201101319349302805
- Schema version
- 2009v1.3
- 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 G
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-05-11T14:09:03-07:00 | Timestamp |
| Tax Period End Date | 2010-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 191 W Nationwide Blvd Suite 500 | AddressLine1 |
| City | Columbus | City |
| State | OH | State |
| ZIP Code | 43215 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390987025 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Community Memorial Hospital of Menomonee | BusinessNameLine1 |
| Business Name Line2 | Falls Inc | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | COMM | NameControl |
| Phone | 4147770960 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | W180 N8085 Town Hall Road | AddressLine1 |
| City | Menomonee Falls | City |
| State | WI | State |
| ZIP Code | 53051 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Jeff Van De Kreeke | Name |
| Title | Senior VP of Finance | Title |
| Date Signed | 2011-05-11 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | William D Petasnick | NameOfPrincipalOfficerPerson |
| Gross Receipts | 323297635 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| All Affiliates Included | false | AllAffiliatesIncluded |
| Organization501c | X | Organization501c |
| Web Site | www.communitymemorial.com | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1959 | YearFormation |
| State Legal Domicile | WI | StateLegalDomicile |
| Activity Or Mission Description | To improve quality of life and meet the comprehensive needs of the community by providing high-quality, safe, cost-effective health services while serving our patients with compassionate, dignified and state-of-the art care. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1681 | TotalNbrEmployees |
| Total Nbr Volunteers | 226 | TotalNbrVolunteers |
| Total Gross UBI | 414194 | TotalGrossUBI |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 171927411 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 175412913 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -4655714 | InvestmentIncomePriorYear |
| Investment Income Current Year | 5461085 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 2700570 | OtherRevenuePriorYear |
| Other Revenue Current Year | 2891106 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 169972267 | TotalRevenuePriorYear |
| Total Revenue Current Year | 183765104 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 48474 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 50000 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 83130264 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 64859051 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 239618 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 101482167 | OtherExpensePriorYear |
| Other Expenses Current Year | 110210162 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 184660905 | TotalExpensesPriorYear |
| Total Expenses Current Year | 175119213 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -14688638 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 8645891 | RevenuesLessExpensesCY |
| Total Assets BOY | 264948156 | TotalAssetsBOY |
| Total Assets EOY | 305532900 | TotalAssetsEOY |
| Total Liabilities BOY | 135959927 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 178937983 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 128988229 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 126594917 | NetAssetsOrFundBalancesEOY |
| Mission Description | To improve quality of life and meet the comprehensive needs of the community by providing high-quality, safe, cost-effective health services. Our exceptional employees, volunteers and dedicated medical staff work collaboratively to serve our patients with compassionate, dignified and state-of-the art care. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 97769035 | Expense |
| Revenue | 115656102 | Revenue |
| Description | Inpatient Services:Community Memorial Hospital was founded in 1964 by citizens of the community it serves and specializes in cardiovascular services, women's health, cancer care, and advanced surgical procedures. Combining next-generation technology with personalized care, Community Memorial strives to enhance and improve the quality of life in Waukesha, Washington, Milwaukee and Ozaukee counties.Community Memorial Hospital is approved for 237 beds of which 202 are staffed - and had 9,845 patient admissions and 45,455 patient days related to a wide range of inpatient services, including orthopedics, internal medicine, general surgery, cardiology, intensive care services, obstetrics and maternity care, and other specialty care for the twelve months ended June 30, 2010.Community Memorial's heart surgery program is the third largest in southeastern Wisconsin. The Heart and Vascular Center is staffed with experienced cardiac professionals utilizing the state-of-the-art technology to treat patients. In 2008, surgeons began using the da Vinci Robotic Surgery system to perform minimally invasive procedures. The growing demand for robotic-assisted laparoscopic surgery has been driven by improved outcomes such as less pain, shorter recovery time and fewer complications. During fiscal year 2010, Community Memorial had 16,558 cardiac procedures.In 2008, the Cancer Care Center at Community Memorial received the prestigious American College of Surgeons Commission on Cancer Outstanding Achievement Award, affirming its commitment to high-quality cancer care. The award recognizes cancer programs that provide the highest quality care to cancer patients and is received by only 66 programs in the US annually. During fiscal year 2010, Community Memorial had 505 cancer registry cases.The Birthing Center at Community Memorial includes 13 specialty equipped rooms and provides the full spectrum of prenatal services for both normal and high-risk pregnancies. Staffing is provided by leading obstetricians and board-certified neonatologists from the Medical College of Wisconsin. During fiscal year 2010, Community Memorial had 975 births.In addition to the cardiac, cancer care and birthing services noted above, the Hospital provided a variety of inpatient ancillary treatments and procedures during the fiscal year including but not limited to the following: - Surgeries: 3,759 - CT Scans: 5,047 - MRI's: 893 - Medical Imaging Exams: 16,942 - Ultrasounds: 2,940 - Laboratory Tests: 410,103 - Nuclear Medicine Scans: 597 - EKG's: 10,150 - Dialysis: 749 | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 46802720 | Expense |
| Revenue | 55365384 | Revenue |
| Description | Outpatient Services:Community Memorial had 87,249 outpatient visits in the twelve months ended June 30, 2010. Community offers a wide variety of ancillary, specialty and subspecialty services including but not limited to the following: - Allergy/Immunology - Cardiology - Clinical Genetics - Dermatology - Electrophysiology - Endocrinology - Family Practice - Gastroenterology - Gerontology - Gynecologic Oncology - Gynecology - Hand Surgery - Hematology - Infectious Disease - Internal Medicine - Interventional Radiology - Magnetic Resonance Imaging - Neonatology - Nephrology - Neurosurgery - Nuclear Medicine - Occupational Medicine - Oncology - Ophthalmology - Oral Surgery - Otolaryngology - Pathology - Pediatrics - Pedodontics - Perinatology - Periodontics - Physical Medicine and Rehabilitation - Plastic/Reconstructive Surgery - Podiatry - Psychiatry - Psychology - Pulmonary Medicine - Radiology - Radiation Oncology - Rheumatology - Thoracic Surgery - Urology - Vascular Surgery - Thoracic Surgery | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 3712261 | Expense |
| Revenue | 4391427 | Revenue |
| Description | Emergency Services:The Emergency Department at Community Memorial Hospital provides expert care 24/7 for adults and children throughout northern Waukesha, Milwaukee, and Washington counties. The facility is a Level III Trauma Center, and is staffed by board-certified emergency physicians, as well as specialists in trauma, neurosurgery, cardiology and orthopedics. During fiscal year 2010, the emergency department had 19,597 emergency visits. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 148284016 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | true | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | true | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | true | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | true | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | true | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | true | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 296 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 1681 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Form8886 T Filed | false | Form8886TFiled |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Non Deductible Disclosure | false | NonDeductibleDisclosure |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Quid Pro Quo Disclosure | false | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Number Of8282 Filed | 0 | NumberOf8282Filed |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Form8899 Filed | false | Form8899Filed |
| Form1098 C Filed | false | Form1098CFiled |
| Excess Business Holdings | false | ExcessBusinessHoldings |
| Taxable Distributions | false | TaxableDistributions |
| Distribution To Donor | false | DistributionToDonor |
| Filed Lieu1041 | false | FiledLieu1041 |
| Nbr Voting Governing Body Members | 14 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Policies Reference Chapters | false | PoliciesReferenceChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | true | InvestmentInJointVenture |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | WI | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | David Dirksmeyer | NamePerson |
| Telephone Number | 4147770960 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | N74W127501 Leatherwood Ct | AddressLine1 |
| City | Menomonee Falls | City |
| State | WI | State |
| ZIP Code | 530514490 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (22 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | FormerFormer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Highest Compensated EmployeeHighestCompensatedEmployee | OfficerOfficer |
|---|---|---|---|---|---|---|---|---|
| Zorbini John | ||||||||
| Sr VP HR F&CH | 0. | X | 0 | 361597 | 35025 | |||
| White MD Michael G | ||||||||
| Director | 1.00 | 0 | 0 | 0 | X | |||
| Unger Michael J | ||||||||
| VP Medical Affairs | 40.00 | 276267 | 0 | 28875 | X | |||
| Turtenwald Robyn | ||||||||
| Director | 1.00 | 0 | 0 | 0 | X | |||
| Templin Susan | ||||||||
| Director | 1.00 | 0 | 0 | 0 | X | |||
| Stadelmann Douglas J | ||||||||
| Dir & Secretary | 1.00 | 0 | 0 | 0 | X | X | ||
| Specht Christine | ||||||||
| Director | 1.00 | 0 | 0 | 0 | X | |||
| Sanders Paul A | ||||||||
| VP Clinical Srvcs | 0. | X | 209367 | 0 | 32745 | |||
| Pollard Dennis | ||||||||
| Director | 40.00 | 0 | 434855 | 40951 | X | X | ||
| Pieters Robert B | ||||||||
| Director | 1.00 | 0 | 0 | 0 | X | |||
| Petasnick William D | ||||||||
| Director | 5.00 | 0 | 2998008 | 667247 | X | |||
| O'Connell Blaine J | ||||||||
| FCH CFO | 1.00 | 0 | 470157 | 32759 | X | |||
| Nelson Karen J | ||||||||
| Director | 1.00 | 0 | 0 | 0 | X | |||
| McClure Debra | ||||||||
| Nurse Anesthetist | 0. | 279452 | 0 | 22153 | X | |||
| Hart Daniel | ||||||||
| Dir & Treasurer | 1.00 | 0 | 0 | 0 | X | X | ||
| Freiberg Kerry J | ||||||||
| VP Extrnl Affairs | 40.00 | 213710 | 0 | 19570 | X | |||
| Evenson Rock E | ||||||||
| VP Pln & Prg Dvlp | 40.00 | 222110 | 0 | 31558 | X | |||
| Ellis Sharon Q | ||||||||
| Director | 1.00 | 0 | 0 | 0 | X | |||
| Dittmar Clarence H | ||||||||
| Director | 1.00 | 0 | 0 | 0 | X | |||
| Bestor William E | ||||||||
| Former Pres/CEO | 40.00 | 873073 | 0 | 21786 | X | |||
| Becker Richard C | ||||||||
| Dir & Chair | 1.00 | 0 | 0 | 0 | X | X | ||
| Bast Ronald R | ||||||||
| Dir & Vice Chr | 1.00 | 0 | 0 | 0 | X | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2073979 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 4264617 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 932669 | TotalOtherCompensation |
| Number Individuals GT100 K | 45 | NumberIndividualsGT100K |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Transolutions Inc | |||||
| 5019 Paysphere Circle | Chicago | IL | 60674 | Transcription | 1093612 |
| Siemens Medical Solutions | |||||
| 51 Valley Stream Parkway | Malvern | PA | 19355 | Equipment Servicing | 580924 |
| Pyramid Healthcare Solutions | |||||
| PO BOx 17389 | Clearwater | FL | 33762 | HIM Outsourcing | 635923 |
| Medical College of WI | |||||
| 8701 Watertown Plank Rd | Milwaukee | WI | 53206 | Physicians | 973126 |
| Columbia St Marys | |||||
| 4425 N Port Washington Rd | Glendale | WI | 53212 | Physicians | 1352394 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 26 | NumberOfContractorsGT100K |
| Total Contributions | 0 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Outpatient Revenue | 900099 | 55365384 | 55365384 |
| Inpatient Revenue | 900099 | 115656102 | 115656102 |
| Emergency/Trauma Revenue | 900099 | 4391427 | 4391427 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 175412913 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 4688555 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1584706 | RelatedOrExemptFunctionIncome |
| Exclusion | $3,103,849 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 13334 | TotalRevenueColumn |
| Exclusion | $13,334 | ExclusionAmount |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1205120 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 633660 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 571460 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 571460 | TotalRevenueColumn |
| Unrelated Business Revenue | 332519 | UnrelatedBusinessRevenue |
| Exclusion | $238,941 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 139620402 | Securities |
| Other | 3300 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 138747650 | Securities |
| Other | 116856 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 872752 | Securities |
| Other | -113556 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 759196 | TotalRevenueColumn |
| Exclusion | $759,196 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 66762 | GrossIncomeFundraisingEvents |
| Fundraising Direct Expenses | 34365 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 32397 | TotalRevenueColumn |
| Exclusion | $32,397 | ExclusionAmount |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| Other Dept Operating Rev | 561499 | 699988 | 618313 | 81675 | |
| Dietary Revenue | 561499 | 701944 | $701,944 | ||
| Corporate Allocated Rev | 561000 | 728502 | 728502 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 156815 | TotalRevenueColumn |
| Exclusion | $156,815 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 2287249 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 183765104 | TotalRevenueColumn |
| Related Or Exempt Function Income | 178344434 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 414194 | UnrelatedBusinessRevenue |
| Exclusion | $5,006,476 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 50000 | Total |
| Program Services | 50000 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 60341928 | Total |
| Program Services | 56736136 | ProgramServices |
| Management And General | 3460726 | ManagementAndGeneral |
| Fundraising | 145066 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 208845 | Total |
| Program Services | 196356 | ProgramServices |
| Management And General | 11988 | ManagementAndGeneral |
| Fundraising | 501 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4308278 | Total |
| Program Services | 4050643 | ProgramServices |
| Management And General | 247295 | ManagementAndGeneral |
| Fundraising | 10340 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 269590 | Total |
| Program Services | 269590 | ProgramServices |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 505881 | Total |
| Program Services | 374129 | ProgramServices |
| Management And General | 131752 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12632429 | Total |
| Program Services | 11337995 | ProgramServices |
| Management And General | 1293819 | ManagementAndGeneral |
| Fundraising | 615 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 107280 | Total |
| Program Services | 901 | ProgramServices |
| Management And General | 106379 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34022924 | Total |
| Program Services | 33336339 | ProgramServices |
| Management And General | 675642 | ManagementAndGeneral |
| Fundraising | 10943 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 418337 | Total |
| Program Services | 80239 | ProgramServices |
| Management And General | 338098 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4312762 | Total |
| Program Services | 3517489 | ProgramServices |
| Management And General | 784060 | ManagementAndGeneral |
| Fundraising | 11213 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 55440 | Total |
| Program Services | 20500 | ProgramServices |
| Management And General | 34598 | ManagementAndGeneral |
| Fundraising | 342 | Fundraising |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 72940 | Total |
| Program Services | 57599 | ProgramServices |
| Management And General | 15216 | ManagementAndGeneral |
| Fundraising | 125 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2613143 | Total |
| Program Services | 2131280 | ProgramServices |
| Management And General | 475069 | ManagementAndGeneral |
| Fundraising | 6794 | Fundraising |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8084099 | Total |
| Program Services | 6593391 | ProgramServices |
| Management And General | 1469689 | ManagementAndGeneral |
| Fundraising | 21019 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3630 | Total |
| Program Services | 3630 | ProgramServices |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| State Hospital Assessment | 5206073 | 5206073 | ||
| Provision for Uncollectable | 3152000 | 3152000 | ||
| Dues & Subscriptions | 311275 | 94187 | 215771 | 1317 |
| Corporate Allocations | 31843309 | 14500231 | 17311735 | 31343 |
| Clinic Practice Fee | 6504735 | 6504735 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 94315 | Total |
| Program Services | 70573 | ProgramServices |
| Management And General | 23742 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 175119213 | Total |
| Program Services | 148284016 | ProgramServices |
| Management And General | 26595579 | ManagementAndGeneral |
| Fundraising | 239618 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 866444 | BOY |
| EOY | 539468 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4968487 | BOY |
| EOY | 7199533 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20539627 | BOY |
| EOY | 20690343 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2249584 | BOY |
| EOY | 1675089 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1484406 | BOY |
| EOY | 3726241 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3365285 | BOY |
| EOY | 3131291 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 168610475 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 82968289 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 91749630 | BOY |
| EOY | 85642186 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 97300440 | BOY |
| EOY | 134375008 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 42424253 | BOY |
| EOY | 48553741 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 264948156 | BOY |
| EOY | 305532900 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23627086 | BOY |
| EOY | 12113961 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 6955 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 51484652 | BOY |
| EOY | 69223820 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2074804 | BOY |
| EOY | 549764 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 58773385 | BOY |
| EOY | 97043483 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 135959927 | BOY |
| EOY | 178937983 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 128442230 | BOY |
| EOY | 125905277 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 545999 | BOY |
| EOY | 689640 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 128988229 | BOY |
| EOY | 126594917 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 264948156 | BOY |
| EOY | 305532900 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
| Federal Grant Audit Performed | false | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3166213 | BeginningOfYearBalance |
| Contributions | 353474 | Contributions |
| Investment Earnings Or Losses | 384524 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | -189853 | GrantsOrScholarships |
| End Of Year Balance | 4094064 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3670185 | BeginningOfYearBalance |
| Contributions | 505082 | Contributions |
| Investment Earnings Or Losses | -466268 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 542781 | GrantsOrScholarships |
| End Of Year Balance | 3166218 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 1.00000 | BoardDesignatedEOYBalance |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | true | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | true | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2455851 | OtherCostOrOtherBasis |
| Book Value | 2455851 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 100885133 | OtherCostOrOtherBasis |
| Depreciation | 35239575 | Depreciation |
| Book Value | 65645558 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2384844 | OtherCostOrOtherBasis |
| Depreciation | 1796379 | Depreciation |
| Book Value | 588465 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 31685497 | OtherCostOrOtherBasis |
| Depreciation | 25012726 | Depreciation |
| Book Value | 6672771 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 31199150 | OtherCostOrOtherBasis |
| Depreciation | 20919609 | Depreciation |
| Book Value | 10279541 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 85642186 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (5 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Senior Management Deferred Compensation | 5748 |
| M&I Collateral Sec Loan | 36727265 |
| Executive Deferred Compensation | 1737122 |
| Due from Employee | 36 |
| Due from Affiliates | 380356 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 48553741 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Pension Liability | $36,608,831 |
| Payable under securties lending agreemen | $37,343,867 |
| Market Adjustment - Swaps | $4,256,915 |
| Due to Affiliates | $18,833,870 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 97043483 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Part X | Part X : FIN48 Footnote | Effective January 1, 2007, F&CH adopted ASC No. 740, Income Taxes (formerly FIN 48), 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 will be evaluated for recognition, derecognition, and measurement using consistent criteria and will provide more information about the uncertainty in income tax assets and liabilities. At the date of adoption and as of June 30, 2010 and 2009, F&CH does not have an asset or liability recorded. |
| Part V, Line 4 | Part V, Line 4: Intended uses of the endowment fund. | The funds are held by Community Memorial Foundation of Menomonee Falls (CMF), a related organization. The board designated endowment was created to support long range financial needs of Community Memorial Hospital of Menomonee Falls, Inc and its affiliates. |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agreement Ref Fundraising | false | AgreementRefFundraising |
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | Cheery Cherry Fall Fair | NameOfEvent1 |
| Gross Receipts Event1 | 53279 | GrossReceiptsEvent1 |
| Gross Revenue Event1 | 53279 | GrossRevenueEvent1 |
| Rent Facility Costs Event1 | 6262 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 4065 | FoodAndBeverageEvent1 |
| Other Direct Expenses Event1 | 10532 | OtherDirectExpensesEvent1 |
| Name Of Event2 | Holiday Nuts & Candy | NameOfEvent2 |
| Gross Receipts Event2 | 8212 | GrossReceiptsEvent2 |
| Gross Revenue Event2 | 8212 | GrossRevenueEvent2 |
| Other Direct Expenses Event2 | 6817 | OtherDirectExpensesEvent2 |
| Gross Receipts Total | 61491 | GrossReceiptsTotal |
| Gross Revenue Total Events | 61491 | GrossRevenueTotalEvents |
| Rent Facility Costs Total Events | 6262 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 4065 | FoodAndBeverageTotalEvents |
| Other Direct Expenses Total Events | 17349 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 27676 | DirectExpenseSummaryEvents |
| Net Income Summary | 33815 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | false | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1365144 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 1365144 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00780 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7371484 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4428927 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2942557 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01680 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 8736628 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4428927 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4307701 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02460 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 73 | NumberOfActivitiesOrPrograms |
| Persons Served | 24242 | PersonsServed |
| Total Community Benefit Expense | 2442484 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 78627 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2363857 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01350 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 7 | NumberOfActivitiesOrPrograms |
| Persons Served | 730 | PersonsServed |
| Total Community Benefit Expense | 1054502 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 11500 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1043002 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00600 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 32 | NumberOfActivitiesOrPrograms |
| Persons Served | 4975 | PersonsServed |
| Total Community Benefit Expense | 448935 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 22987 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 425948 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00240 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 112 | NumberOfActivitiesOrPrograms |
| Persons Served | 29947 | PersonsServed |
| Total Community Benefit Expense | 3945921 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 113114 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3832807 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02190 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 112 | NumberOfActivitiesOrPrograms |
| Persons Served | 29947 | PersonsServed |
| Total Community Benefit Expense | 12682549 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4542041 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 8140508 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04650 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 80975 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 80975 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00050 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 80975 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 80975 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00050 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReported |
| Bad Debt Expense | $1,502,732 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 48448676 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 58245425 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -9796749 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | X | CostAccountingSystem |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
Form990 Schedule H Part V Form990ScheduleHPartV
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Community Memorial Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | W180 N8085 Town Hall Road | AddressLine1 |
| City | Menomonee Falls | City |
| State | WI | State |
| ZIP Code | 53051 | 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 VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Income Based Criteria | Financial Assistance and Billing HighlightsPolicy: Community Memorial Hospital (CMH) is committed to providing the community with quality healthcare without regard to economic status, race, color, sex, faith or national origin of the recipient. Patients with insufficient resources to meet their financial responsibilities may be given a Financial Assistance discount to relieve all or a portion of the obligation to make payment for services rendered at CMH.CommunicationCMH will communicate to patients the availability of Financial Assistance. They will provide uninsured patients information to ensure each patient understands the financial obligations he/she is incurring by receiving healthcare services. Brochures, available to all patients at registration, explain the hospital policy for billing and payment of services. Also information is available on each hospital's website. Patients also have the opportunity to speak with a financial counselor and the hospital will assist patients in identifying and applying for government assistance programs for which the patient may be eligible.EligibilityCMH reserves the right to review each application for financial assistance on its own merits and to consider other extenuating circumstances in the decision to approve or deny a patient's application for financial assistance. The applicant's gross family income will be compared to the annual Federal Poverty guidelines set forth by the U.S. Department of Health and Human Services. Applicants whose gross family income is equal to or less than 400% of the current year's poverty guidelines will not pay for more than 15% of their annual gross income on any single account during the approved eligibility time frame.DiscountsCMH recognizes that patients without any insurance coverage are billed at full charges, and as the hospitals offer discounts to other payers, several options for discounted billing are in place for these self pay patients. Total charges to self pay patients will be discounted 20% before any bill is submitted for payment. This discount will be noted on each patient's bill. An additional 20% discount will be extended to self pay patients if estimated charges are paid in advance of service. Self pay patients who have not prepaid, will receive a 10% prompt pay discount if the bill is paid in full within 15 days of receipt. | IncomeBasedCriteria |
| Costing Method Used | Charity Care and certain other community benefits costs were determined by using internal information to reduce the various activities to cost. We try to present cost information consistently in the different venues that it appears. | CostingMethodUsed |
| Bad Debt Footnote | Community Memorial Hospital reports accounts receivable for services rendered at net realizable amounts from third-party payers, patients, and others. Community Memorial 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. As a not-for-profit, patient care is provided to all, regardless of ability to pay for that care. Making quality patient care available to all in our community, regardless of their economic means, qualifies bad debts as a community benefit. | BadDebtFootnote |
| Shortfall As Community Benefit | The total revenues and costs associated with Medicare services are respectively $50,105,000 and $68,266,000. This results in a total Medicare shortfall of $18,161,000. Community Memorial Hospital believes that all of the $18,161,000 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. | ShortfallAsCommunityBenefit |
| Debt Collection Policy | Collection policies are the same for all patients. Patients are screened for eligibility for financial assistance before collection procedures begin. If at any point in the collection process, documentation is received that indicates the patient is potentially eligible for financial assistance but has not applied for it, the account is referred back for a financial assistance review. | DebtCollectionPolicy |
| Number Of Facility Type Expln | Community Memorial Hospital is the only facility listed under this reporting of the IRS Form 990, Schedule H. | NumberOfFacilityTypeExpln |
| Needs Assessment | In August 2007, the Community Outreach Steering Committee of Community Memorial Hospital (CMH) wanted to again explore how it can measurably improve the health and wellness of people who live in the hospital's service area. A review was conducted of research reports and data provided by various state, county and local agencies regarding health related issues of the area's population. This assessment indicated that the optimal goal of the community outreach efforts would be to help alleviate obesity, alcohol and tobacco addiction, and the mismanagement of diabetes and asthma among at risk populations in the area.Focus group discussions were conducted with professionals who work with at risk populations in regard to obesity, addiction and/or chronic disease management in the CHM service area. The discussions explored the causes of these problems and possible ways to reduce them. Methodology was: 1.Four focus group sessions were conducted with professionals who work with at risk populations in regard to obesity, addiction, chronic disease management or related fields in the CMH service area. 2.Qualified participants were identified and recruited by the Community Outreach department at CMH. 3.CMH contracted with a professional research group to develop the discussion topic outline and moderate sessions. 4.The research group analyzed the discussions and the findings are reported.Specific objectives of the focus group discussions included: 1.The causes, influences and factors that contribute to obesity, alcohol and tobacco addiction, and the mismanagement of diabetes and asthma. 2.What has been done and what is being done now to help reduce these problems, and the level of success to these efforts. 3.Possible solutions to alleviate obesity, alcohol and tobacco addiction, and the mismanagement of diabetes and asthma. Solutions are to be collaborative efforts among community groups/agencies/organizations, supported by the public, aimed at at risk populations, and provide measurable results. 4.The need and effectiveness of a possible central listing of resources in the community for help with these problems. 5.Work site programs to help alleviate obesity, alcohol and tobacco addiction, and the mismanagement of diabetes and asthma. | NeedsAssessment |
| Patient Education Assistance | Community Memorial Hospital (CMH) has a Financial Counselor who performs outreach to all self pay patients. Contact may be in person or via phone call to patient. The patient is screened for eligibility for state/local programs and/or CMH's Financial Assistance program. Information regarding our financial assistance program is also available in our registration areas, in our ED, and is noted on our billing statements. In addition, during our billing call cycle, if a patient indicates they are unable to pay, they are screened for eligibility for Financial Assistance. | PatientEducationAssistance |
| Community Information | Since its founding in 1964 by the citizens of the community it serves, Community Memorial Hospital (CMH) has focused on the emerging healthcare and wellness needs of over half a million people in the four county region of Waukesha, Washington, northwest Milwaukee, and Ozaukee Counties. Our growth has been guided by listening carefully to people we serve, and designing and expanding our services to meet their changing needs. The population served by CMH is 88% Caucasian, 5.5% African American, 3.5% Asian American, 1.5% Hispanic/Latino, 0.5% Asian American, and 1% other. Today, CMH ranks as one of the top hospitals nationally based on surveys by the Joint Commission on Accreditation of Healthcare Organizations, which reviews all hospitals for safety and quality healthcare practices. The Hospital has 202 staffed beds and a medical staff of 657 physicians in 49 specialties, over 1,400 employees and 320 volunteers caring for 9,845 inpatients, 87,249 outpatients and 19,597 emergency visits in fiscal 2010. Based on demographic and community needs assessments, CMH has led area community based hospitals by establishing programs in hospital based day surgery, cardiac rehabilitation, and the "Right from the Start" birthing program which matches a personal obstetrics case manager with first time expectant mothers. CMH is accredited by Joint Commission, the Commission on Accreditation of Rehabilitation Facilities (CARF), the American Association of Cardiovascular & Pulmonary Rehabilitation, the American College of Radiology (ACR), the Intersocietal Commission for Accreditation of Echocardiography, the College of American Pathologists (CAP), the American College of Surgeons (ACS), and is licensed by the State of Wisconsin. Eight area institutions of higher learning send students to CMH for clinical experiences in health care. CMH is more than a healthcare facility; it is a true community partner, joining forces with other organizations who share our vision and values. Our collaborative initiatives include outreach to youth, elderly and the underserved; satellite rehabilitation clinics offering outpatient therapy; community education in parenting and wellness topics; health screenings and support groups; a program for lab house calls to the homebound; and serving as the medical control center for five area Emergency Medical Service units. In July 2009, the American Diabetes Association acknowledged Community Memorial as having a Recognized Diabetes Self Management Education Program for outpatients. In January 2010, Community Memorial received the Gold Recognition as a Wellness Council of America Well Workplace organization, an award that recognizes quality and excellence in worksite health promotion. Also in 2010, the Cancer Care Center received Accreditation with Commendation from the American College of Surgeons - Commission on Cancer. Community Memorial was also recognized as a Quality Respiratory Care Recognition Hospital in 2010. Only 700 hospitals in the U.S. have been named a QRCR institution. The hospital received certification as a Level III Trauma Center in January 2010 and was awarded certification for its Stroke program from the Joint Commission in February 2010.The Community Outreach Health Clinic (COHC) was established by CMH in 2000 to provide quality, affordable health care to the uninsured and underinsured in our service area. COHC's rapid growth since its opening has demonstrated the need for such a service in CMH's service area. | CommunityInformation |
| Community Building Activities | In order to promote the health of the community we serve, our hospital participates in community building activities which are not a part of Part I Charity Care and Other Community Benefits, and are not included elsewhere on Schedule H. Workforces development: Our hospital has a diversity recruiting officer who trains and recruits health professionals needed in our traditionally underserved community. | CommunityBuildingActivities |
| Other Information | The Community Outreach Steering Committee (COSC) actualizes the mission of Community Memorial Hospital (CMH) through community benefit activities that improve the quality of life and enhance wellness resources which meet identified comprehensive health needs of the communities served. The Community Outreach Steering Committee is appointed annually by the hospital president and is advisory to the CMH Board and Administration. Membership appointments are made each June with members serving one year terms. The COSC meets quarterly and is composed of hospital and board representatives plus community members representing the various constituencies of the total service area. Functions include: - Provide a leadership role in advocating community wide responses to health care needs in the community. - Facilitate and support community and health care partnerships. - Envision, assess and guide new community benefit opportunities. - Identify and describe unmet health needs. - Promote universal access to health care. - Determine allocation of the Community Outreach Services Fund. - Annually submit a community benefit report, which describes the scope of community benefit provided directly and in collaboration with others. | OtherInformation |
| Affiliated Health Care System | Every year, the Froedtert & Community Health partners engage in a variety of outreach activities in collaboration with key leaders and organizations in their communities that help improve health and quality of life. Much more than the provision of charity care, the American Hospital Association defines community benefit as "promoting and protecting the health and well being of the entire community through responsive programs and services." Froedtert & Community Health strategies are based on the unique needs of each of the communities that we serve. By conducting regular community needs assessments that monitor critical public health issues, and actively seeking community input, the F&CH partners have built important relationships with their local communities, and are committed to providing meaningful outreach programs that link each hospital to their neighbors and patients.In FY2010, Froedtert, Community Memorial and St. Joseph's Hospitals made significant investments in the health of their communities. Patients who couldn't pay for their medical care received more than $36 million in uncompensated services. Beyond providing care for the poor, we contributed $54 million to improve access to care, teach future healthcare professionals, develop new medical therapies and participate in local partnerships aimed at reducing health disparities. Froedtert & Community Health members develop, and are held accountable for achieving community benefit goals, and strategies are based on the unique needs of each of their communities. By conducting regular community needs assessments that monitor critical public health issues, and actively seeking community input, the member partners have built important local relationships and are committed to providing meaningful outreach programs that link each hospital to their neighbors and patients. As a not-for-profit health system, Froedtert & Community Health reinvests its surplus funds back into the community through programs to serve the poor and uninsured, teach future healthcare professionals, develop new medical therapies, manage chronic conditions like diabetes, health education and promotion initiatives, and participate in local partnerships aimed at reducing health disparities. For more information about Froedtert & Community Health, visit www.froedterthealth.org. | AffiliatedHealthCareSystem |
| Reports Filed With States | WI | ReportsFiledWithStates |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Amount Of Non Cash AssistanceAmountOfNonCashAssistance | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|---|
| Community Outreach Health Clinic | ||||||||
| W180 N8085 Town Hall Road | Menomonee Falls | WI | 53051 | 391743056 | 501(c)(3) | 28500 | 0 | Support the operations of the clinic |
| All other grants 5000 | ||||||||
| 501(c)(3) | 21500 | 0 | Various | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 10 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Grantmaker's Description of How Grants are Used | Identifier |
| Explanation | Organizations submit grant requests to the Community Outreach Steering Committee (the Committee). On a quarterly basis the fund allocations are determined. Each organization selected for funds receives an award letter detailing the expectations and conditions of the grant money. In order to comply with applicable tax laws, regulations and the Community Outreach Services Fund policy, the Community Outreach Services Fund provides grant support to organizations with the understanding that:1) Grant funds distributed will be used only for the purposes designated in the award letter.2) No funds will be used for any political campaign or to support attempts to influence legislation of any governmental body. 3) If the organization loses exempt status, any unexpended funds will be returned to the Community Outreach Steering Committee.4) Adequate accounting records of the expenditures of funds will be maintained by the organization.5) This is a one time-only support distribution. In addition, the Committee includes a "Final Report Form" with each organization's award letter. The form requires the organization to provide a brief description of the activity and measurable outcomes/benefits, an expenditure report, and future plans. The Committee requests that each organization submit the "Final Report Form" to the Committee within thirty days after the completion of the project for which the funds were intended or within a maximum of one year from the receipt of funds. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | false | WrittenPolicyReTAndEExpenses |
| Substantiation Required | true | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | true | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
| Rebuttable Presumption Procedure | false | RebuttablePresumptionProcedure |
Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)
| Comp Based On Related OrgsCompBasedOnRelatedOrgs | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs | Base Compensation Filing OrgBaseCompensationFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Zorbini John | |||||||||||
| 237657 | 123940 | 15906 | 19119 | 396622 | 105075 | ||||||
| Unger Michael J | |||||||||||
| 149561 | 126706 | 12650 | 16225 | 305142 | 111400 | ||||||
| Sanders Paul A | |||||||||||
| 176351 | 33016 | 11361 | 21384 | 242112 | 25360 | ||||||
| Pollard Dennis | |||||||||||
| 282703 | 152152 | 11875 | 29076 | 475806 | 82062 | ||||||
| Petasnick William D | |||||||||||
| 1131447 | 1866561 | 610010 | 57237 | 3665255 | 1846999 | ||||||
| O'Connell Blaine J | |||||||||||
| 393660 | 76497 | 13800 | 18959 | 502916 | 746647 | ||||||
| McClure Debra | |||||||||||
| 279030 | 422 | 12382 | 9771 | 301605 | |||||||
| Freiberg Kerry J | |||||||||||
| 142771 | 70939 | 9190 | 10380 | 233280 | 54653 | ||||||
| Evenson Rock E | |||||||||||
| 141957 | 80153 | 9571 | 21987 | 253668 | 61971 | ||||||
| Bestor William E | |||||||||||
| 400951 | 472122 | 5750 | 16036 | 894859 | 221078 | ||||||
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Sch J, Part I, Line 7 | Part I, Line 7: Non-Fixed payments not listed above | Certain management employees participate in an incentive compensation plan that includes some non-fixed elements. Upon the attainment of a certain financial threshold, incentive compensation is available for meeting identified goals in the areas of financial performance, operational efficiencies, quality improvements, customer satisfaction, strategic growth and partnership initiatives. In some cases the determination of whether a goal is met is absolute while others require a certain amount of discretion to determine if goal is met. In addition, the incentive compensation includes a purely discretionary component. |
| Sch J, Part I, Line 1b | Part I, Line 1b: Reason for not following policy regarding payment provisions for expenses | Health club membership subsidy/discount is a benefits program applicable to all employees and is documented in the benefit program documents. Dining club membership is specified in the written employment contract which was approved by the Compensation Committee. |
| Sch J, Part I, Line 1a | Part I, Line 1a: Relevant information in regards to selections on 1a. | Discounted or subsidized health club membership is available to all employees. |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| Riteway Bus Services | |||
| See Sch O | 110807 | Shuttle Bus Services | false |
| Stacy Werner | |||
| See Sch O | 23606 | Employment | false |
| Carrie Fitzgerald Hart | |||
| See Sch O | 117822 | Employment | false |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Form 990, Part VI, Line 19 | Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | Financial Information: The Health Systems quarterly financial information is made available to the public through Digital Assurance Corporation, Inc. website.Governing Documents and COI Policy: Documents are available to the public through the corporate office upon request. |
| Form 990, Part VI, Line 15b | Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | In establishing the compensation of the organizations CEO/Directors/Top Management, independent compensation consultants are utilized, compensation studies are completed to gather comparative data, and amounts are reviewed and approved by the Compensation Committee of the Board of Directors. |
| Form 990, Part VI, Line 12c | Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | On an annual basis all officers, directors, trustees, key employees are required to complete a conflict of interest disclosure document. The data is compiled, and the Vice President - Chief Compliance Officer (CCO), the Vice President - General Counsel and/or delegate will review all forms and notifications to determine if any conflicts of interests exist 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 an F&CH affiliate 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 Finance Committee of the Board of Directors. |
| Form 990, Part VI, Line 11 | Form 990, Part VI, Line 11: Form 990 Review Process | Froedtert & Community Health accounting staff prepare form 990 which is reviewed by the Corporation's financial leaders and legal counsel. The 990 is then reviewed by KPMG, the Corporation's outside accounting firm. Next, the 990 is reviewed by the Corporation's Board of Directors. Finally, the 990 is filed as required. |
| Form 990, Part VI, Line 7a | Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body | Froedtert & Community Health, as the member of Community Memorial Hospital of Menomonee Falls, has the final approval of election of all board members. |
| Form 990, Part VI, Line 6 | Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder | Froedtert & Community Health is the member of Community Memorial Hospital of Menomonee Falls. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Total IncomeTotalIncome | EOY AssetsEOYAssets |
|---|---|---|---|---|---|---|---|---|---|
| West Bend Surgery Center LLC | |||||||||
| 1710 Vogt Drive | West Bend | WI | 53095 | 391954169 | Surgical Services | WI | West Bend Clinic Inc | ||
| F&CH Heart Institute LLC | |||||||||
| 9220 West Wisconsin Ave | Milwaukee | WI | 532263596 | Inactive | WI | Froedtert & Community Health Inc | |||
| Horizon Ventures Limited LLC | |||||||||
| W180 N8085 Town Hall Road | Menomonee Falls | WI | 53051 | 391855822 | Lessor of Medical Office Building | WI | NA | 916000 | 7879000 |
Form990 Schedule R Part II Form990ScheduleRPartII (10 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| Froedtert Physician Partners Inc | |||||||||
| 9200 W Wisconsin Ave | Milwaukee | WI | 53226 | 272042610 | Health Care Services | WI | 501(c)(3) | 3 | Froedtert & Community Health Inc |
| Quality Health Solutions Inc | |||||||||
| N74 W12501 Leatherwood Court | Menomonee Falls | WI | 530514480 | 202636686 | Health Care Services | WI | 501(c)(3) | Ln 11, Type 1 | Froedtert & Community Health Inc |
| Froedtert Hospital Foundation Inc | |||||||||
| 9200 West Wisconsin Avenue | Milwaukee | WI | 532263596 | 391431192 | Health, Welfare, Research and Education Promotion | WI | 501(c)(3) | Ln 11, Type 1 | Froedtert Memorial Lutheran Hospital |
| St Josephs Community Foundation Inc | |||||||||
| 3200 Pleasant Valley Road | West Bend | WI | 530953686 | 392034296 | Health and Welfare Promotion | WI | 510(c)(3) | Ln 11, Type 1 | St Josephs Community Hospital Inc |
| West Bend Clinic Inc | |||||||||
| 1700 W Paradise Drive | West Bend | WI | 53095 | 392034294 | Health Care Services | WI | 501(c)(3) | 3 | Froedtert & Community Health Inc |
| St Josephs Community Hospital Inc | |||||||||
| 3200 Pleasant Valley Road | West Bend | WI | 530953868 | 390806302 | Hospital Care Services | WI | 501(c)(3) | 3 | Froedtert & Community Health Inc |
| Froedtert Memorial Lutheran Hospital Inc | |||||||||
| 9200 West Wisconsin Avenue | Milwuakee | WI | 532263522 | 396105970 | Hospital | WI | 501(c)(3) | 3 | Froedtert & Community Health Inc |
| Community Memorial Foundation | |||||||||
| W180 N8085 Town Hall Road | Menomonee Falls | WI | 53051 | 391635057 | Health and Welfare promotion | WI | 501(c)(3) | Ln 11, Type 1 | NA |
| Community Outpatient Health Services | |||||||||
| W180 N8085 Town Hall Road | Menomonee Falls | WI | 53051 | 391743056 | Outpatient Medical and Dental Services | WI | 501(c)(3) | 3 | NA |
| Froedtert & Community Health Inc | |||||||||
| 9200 West Wisconsin Avenue | Milwaukee | WI | 532263596 | 392014409 | Management Services | WI | 501(c)(3) | Ln 11, Type 1 | NA |
Form990 Schedule R Part III Form990ScheduleRPartIII (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner |
|---|---|---|---|---|---|---|---|---|---|
| Fitness Development Associates LLC | |||||||||
| 9200 W Wisconsin Avenue | Milwaukee | WI | 53226 | 391936497 | Real Estate | WI | NA | false | false |
| Milwaukee Center of Diagnostic Imaging | |||||||||
| 5775 Wayzata Boulevard Suite 400 | St Louis Park | MN | 55416 | 411748361 | Health Care | WI | NA | false | false |
| FMLH MCW Real Estate Ventures LLC | |||||||||
| 9200 W Wisconsin Avenue | Milwaukee | WI | 53226 | 260629591 | Real Estate | WI | na | false | false |
Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|
| Progressive Physician Network Inc | |||||||||
| 9200 W Wisconsin Ave | Milwaukee | WI | 53226 | 270367127 | Management Services | WI | Froedtert & Community Health Inc | C | |
| Kettle Moraine Anesthesiology Inc | |||||||||
| PO Box 8031 | Appleton | WI | 54912 | 141842439 | Health Care | WI | West Bend Clinic Inc | C | |
| Community Ventures of Menomonee Falls | |||||||||
| W180N8085 Town Hall Road | Menomonee Falls | WI | 53051 | 391635059 | Inactive | WI | NA | C | 1.00000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | true | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | true | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | true | OtherTransferToOtherOrg |
| Other Transfer From Other Org | true | OtherTransferFromOtherOrg |