LAKEVIEW MEDICAL CENTER INC OF RICE LAKE: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- LAKEVIEW MEDICAL CENTER INC OF RICE LAKE (EIN 39-0837206)
- Tax period
- 2009-10-01 to 2010-09-30
- Filed
- 2011-08-15
- IRS object ID
- 201112279349303396
- Schema version
- 2009v1.7
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-08-15T14:26:30-05:00 | Timestamp |
| Tax Period End Date | 2010-09-30 | 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 | 303 EAST WACKER DRIVE | AddressLine1 |
| City | CHICAGO | City |
| State | IL | State |
| ZIP Code | 606015212 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390837206 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAKEVIEW MEDICAL CENTER INC OF RICE LAKE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | LAKE | NameControl |
| Phone | 7152341515 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1700 west stout street | AddressLine1 |
| City | RICE LAKE | City |
| State | WI | State |
| ZIP Code | 54868 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Jackie Klein | Name |
| Title | Chief Financial Officer | Title |
| Date Signed | 2011-08-11 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3126651000 | Phone |
| 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) |
|---|---|---|
| Address Change | X | AddressChange |
| Name Of Principal Officer Person | EDWARD H WOLF | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1700 west stout street | AddressLine1 |
| City | RICE LAKE | City |
| State | WI | State |
| ZIP Code | 54868 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 60313888 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | www.lakeviewmedical.com | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1919 | YearFormation |
| State Legal Domicile | WI | StateLegalDomicile |
| Activity Or Mission Description | Lakeview Medical Center serves the community by providing services intended to enhance the health of the people in the surrounding region. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 6 | NbrIndependentVotingMembers |
| Total Nbr Employees | 512 | TotalNbrEmployees |
| Total Nbr Volunteers | 203 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 63293 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 121749 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 59242842 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 59608642 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 892130 | InvestmentIncomePriorYear |
| Investment Income Current Year | 483224 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 2193453 | OtherRevenuePriorYear |
| Other Revenue Current Year | -21557 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 62391718 | TotalRevenuePriorYear |
| Total Revenue Current Year | 60192058 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 221807 | 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 | 26993201 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 28654289 | 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 | 25486815 | OtherExpensePriorYear |
| Other Expenses Current Year | 25783132 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 52701823 | TotalExpensesPriorYear |
| Total Expenses Current Year | 54437421 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 9689895 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 5754637 | RevenuesLessExpensesCY |
| Total Assets BOY | 97278419 | TotalAssetsBOY |
| Total Assets EOY | 104956226 | TotalAssetsEOY |
| Total Liabilities BOY | 36013213 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 37936383 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 61265206 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 67019843 | NetAssetsOrFundBalancesEOY |
| Mission Description | LAKEVIEW MEDICAL CENTER PROVIDES MEDICAL, SURGICAL, EMERGENCY, OUTPATIENT, DIALYSIS, AMBULANCE, HOSPICE, AND HOME HEALTH SERVICES. IT ALSO SERVES THE COMMUNITY BY PROVIDING SERVICES INTENDED TO ENHANCE THE HEALTH OF THE PEOPLE IN THE SURROUNDING REGION. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 7318076 | Expense |
| Revenue | 25078379 | Revenue |
| Description | LAKEVIEW MEDICAL CENTER PROVIDES INPATIENT AND OUTPATIENT SURGICAL SERVICES FOR ORTHOPEDIC, UROLOGY, WOMEN'S HEALTH, ENT AND GENERAL SURGERY. FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2010 THERE WERE 3,582 SURGICAL CASES. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 4484208 | Expense |
| Revenue | 8183847 | Revenue |
| Description | LAKEVIEW MEDICAL CENTER PROVIDES INPATIENT ROOM, BOARD AND CARE TO MEDICAL AND SURGICAL PATIENTS. FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2010 THIS UNIT HAD 2,030 DISCHARGES AND 6,289 PATIENT DAYS. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 2567632 | Expense |
| Revenue | 7627782 | Revenue |
| Description | LAKEVIEW MEDICAL CENTER PHARMACY SUPPLIES PHARMACEUTICALS TO THE VARIOUS DEPARTMENTS, BOTH INPATIENT AND OUTPATIENT, OF LAKEVIEW MEDICAL CENTER. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 30100196 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Rev | 18718634 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 44470112 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | 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 | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| 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 | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | 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 | false | 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 | 31 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 512 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 6 | 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 |
| 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 | false | InvestmentInJointVenture |
| 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 | JACQUELINE KLEIN | NamePerson |
| Telephone Number | 7152366129 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1700 W STOUT STREET | AddressLine1 |
| City | RICE LAKE | City |
| State | WI | State |
| ZIP Code | 54868 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (19 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| SUE ZAHRBOCK | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| MARY BITZ | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| JAMES DORRANCE | |||||||
| VICE CHAIRMAN | 1.0 | X | 0 | 0 | 0 | X | |
| SANDY BONNEVILLE | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| DR BRAD BEKKUM | |||||||
| CHAIRMAN | 1.0 | X | 0 | 305448 | 20818 | X | |
| PAUL CHASE | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| DAVID HILDEBRAND | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| DAN DEGROOT | |||||||
| DIRECTOR | 1.0 | X | 0 | 209308 | 36600 | ||
| DR PAUL LISS | |||||||
| DIRECTOR | 1.0 | X | 0 | 401603 | 73399 | ||
| Dr Douglas Reding | |||||||
| Director | 1.0 | X | 0 | 565295 | 72902 | ||
| Dr Peter Neal | |||||||
| Director | 1.0 | X | 0 | 433517 | 89573 | ||
| EDWARD WOLF | |||||||
| PRESIDENT | 40.0 | 236846 | 0 | 37634 | X | ||
| CYNTHIA ARTS-STRENKE | |||||||
| VP - COO | 40.0 | 158558 | 0 | 31040 | X | ||
| JACQUELINE KLEIN | |||||||
| VP-CFO | 40.0 | 151447 | 0 | 24193 | X | ||
| Ken Engel | |||||||
| Pharmacy Director | 40.0 | 132158 | 0 | 3950 | X | ||
| Sherry Johnson | |||||||
| Inpatient Services Director | 40.0 | 109259 | 0 | 3344 | X | ||
| Andrew Daigle | |||||||
| CRNA | 40.0 | 188754 | 0 | 20304 | X | ||
| Daniel O'Connell | |||||||
| CRNA | 40.0 | 186358 | 0 | 14509 | X | ||
| James Kiffmeyer | |||||||
| CRNA | 40.0 | 198482 | 0 | 18744 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1361862 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1915171 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 447010 | TotalOtherCompensation |
| Number Individuals GT100 K | 12 | NumberIndividualsGT100K |
| Formers Listed | false | 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 |
|---|---|---|---|---|---|
| Cerner Corporation | |||||
| PO Box 412702 | KANSAS CITY | MO | 64141 | computer consulting | 708170 |
| The revere group | |||||
| 3266 paysphere circle | CHICAGO | IL | 60674 | computer consulting | 363430 |
| aramark management | |||||
| 22506 network place | CHICAGO | IL | 606731225 | management services | 309139 |
| sartori consulting | |||||
| po box 1265 | WAUSAU | WI | 544021265 | advertising agency | 161403 |
| aureus radiology | |||||
| po box 3037 | OMAHA | NE | 681030037 | contracted employees | 145339 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 5 | NumberOfContractorsGT100K |
| Federated Campaigns | 5162 | FederatedCampaigns |
| Fundraising Events | 5521 | FundraisingEvents |
| Government Grants | 24936 | GovernmentGrants |
| All Other Contributions | 86130 | AllOtherContributions |
| Total Contributions | 121749 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 624100 | 56502281 | 56502281 | |
| LEASING REVENUE | 624100 | 2715810 | 2715810 | |
| LIFELINE PROGRAM | 624100 | 119470 | 119470 | |
| OCCUPATIONAL/INDUSTRIAL HEALTH | 624100 | 67258 | 67258 | |
| EMPLOYEE MEALS | 624100 | 92705 | $92,705 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 111118 | TotalRevenueColumn |
| Related Or Exempt Function Income | 85006 | RelatedOrExemptFunctionIncome |
| Exclusion | $26,112 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 59608642 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 477715 | TotalRevenueColumn |
| Exclusion | $469,998 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 78060 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 112163 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -34103 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -34103 | TotalRevenueColumn |
| Exclusion | -$34,103 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 5509 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 0 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 5509 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5509 | TotalRevenueColumn |
| Exclusion | $5,509 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 11063 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 5521 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 9667 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1396 | TotalRevenueColumn |
| Exclusion | $1,396 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Gaming | 11150 | GrossIncomeGaming |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 11150 | TotalRevenueColumn |
| Exclusion | $11,150 | ExclusionAmount |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 0 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 60192058 | TotalRevenueColumn |
| Related Or Exempt Function Income | 59489825 | RelatedOrExemptFunctionIncome |
| Exclusion | $572,767 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
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 | 745878 | Total |
| Management And General | 745878 | ManagementAndGeneral |
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 | 20979376 | Total |
| Program Services | 18309430 | ProgramServices |
| Management And General | 2669946 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1065304 | Total |
| Program Services | 926569 | ProgramServices |
| Management And General | 138735 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4339294 | Total |
| Program Services | 3659990 | ProgramServices |
| Management And General | 679304 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1524437 | Total |
| Program Services | 1325909 | ProgramServices |
| Management And General | 198528 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 331509 | Total |
| Program Services | 331509 | ProgramServices |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 235838 | Total |
| Management And General | 235838 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 58186 | Total |
| Management And General | 58186 | ManagementAndGeneral |
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 | 4856266 | Total |
| Program Services | 2253232 | ProgramServices |
| Management And General | 2603034 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 152493 | Total |
| Management And General | 152493 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8710475 | Total |
| Program Services | 8277024 | ProgramServices |
| Management And General | 433451 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3659471 | Total |
| Program Services | 1821238 | ProgramServices |
| Management And General | 1838233 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 117736 | Total |
| Program Services | 117736 | ProgramServices |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 167660 | Total |
| Program Services | 167660 | ProgramServices |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5128779 | Total |
| Program Services | 5128779 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 152619 | Total |
| Management And General | 152619 | ManagementAndGeneral |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| PROVISION FOR BAD DEBTS | 1861245 | 1861245 | |
| FOOD AND PROVISIONS | 253334 | 253334 | |
| DUES AND SUBSCRIPTIONS | 97521 | 36457 | 61064 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 54437421 | Total |
| Program Services | 44470112 | ProgramServices |
| Management And General | 9967309 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1530 | BOY |
| EOY | 2530 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 46267836 | BOY |
| EOY | 42345712 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6822267 | BOY |
| EOY | 8033403 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 684095 | BOY |
| EOY | 666791 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 300568 | BOY |
| EOY | 366855 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 84692746 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 32144189 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 41933425 | BOY |
| EOY | 52548557 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1268698 | BOY |
| EOY | 992378 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 97278419 | BOY |
| EOY | 104956226 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4287997 | BOY |
| EOY | 5928616 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 716000 | BOY |
| EOY | 500000 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30565810 | BOY |
| EOY | 30814091 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 443406 | BOY |
| EOY | 693676 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 36013213 | BOY |
| EOY | 37936383 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 60522020 | BOY |
| EOY | 66267615 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 743186 | BOY |
| EOY | 752228 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 61265206 | BOY |
| EOY | 67019843 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 97278419 | BOY |
| EOY | 104956226 | 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 |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
| Contrib By Controlling Individual | false | ContribByControllingIndividual |
| Contribution By Related Party | false | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | false | ContribBy35ControlledEntity |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5471594 | OtherCostOrOtherBasis |
| Book Value | 5471594 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 37110069 | OtherCostOrOtherBasis |
| Depreciation | 10413373 | Depreciation |
| Book Value | 26696696 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 0 | OtherCostOrOtherBasis |
| Depreciation | 0 | Depreciation |
| Book Value | 0 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 29274428 | OtherCostOrOtherBasis |
| Depreciation | 21392888 | Depreciation |
| Book Value | 7881540 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 12836655 | OtherCostOrOtherBasis |
| Depreciation | 337928 | Depreciation |
| Book Value | 12498727 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 52548557 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DEFERRED COMPENSATION | $478,480 |
| PAYABLE TO THIRD PARTY REIMBURSEMENT PROGRAM | $215,196 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 693676 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | FASB ASC 740 FOOTNOTE | Identifier |
| Explanation | Effective October 1, 2007, the Organization adopted Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC) 740, Income Taxes, which clarifies the accounting for uncertainty in income taxes recognized in a company's financial statements. ASC 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 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. Based on an analysis prepared by the Organization, it was determined that the application of ASC 740 had no material effect on the Organization at September 30, 2010 or 2009. | Explanation |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | Voices/Hospice | NameOfEvent1 |
| Gross Receipts Event1 | 16584 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 5521 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 11063 | GrossRevenueEvent1 |
| Other Direct Expenses Event1 | 9667 | OtherDirectExpensesEvent1 |
| Total Number Of Other Events | 0 | TotalNumberOfOtherEvents |
| Gross Receipts Total | 16584 | GrossReceiptsTotal |
| Charitable Contributions Total | 5521 | CharitableContributionsTotal |
| Gross Revenue Total Events | 11063 | GrossRevenueTotalEvents |
| Other Direct Expenses Total Events | 9667 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 9667 | DirectExpenseSummaryEvents |
| Net Income Summary | 1396 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCare |
| Free Disc Care Medically Indigent | false | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | false | ExpensesExceededBudget |
| 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 | 274624 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 274624 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00520 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 9338249 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6900000 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2438249 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04640 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 9612873 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6900000 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2712873 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05160 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 371675 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 37500 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 334175 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00640 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 69304 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 69304 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00130 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2092481 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2004413 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 88068 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00170 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4451 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4451 | NetCommunityBenefitExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2537911 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2041913 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 495998 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00940 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 12150784 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8941913 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3208871 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06100 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $979,201 | BadDebtExpenseAmount |
| Amount Attributable To | 171300 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 14670880 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 16506211 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -1835331 | 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 | false | WrittenDebtCollectionPolicy |
Form990 Schedule H Part V Form990ScheduleHPartV
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAKEVIEW MEDICAL CENTER INC OF RICE LAKE | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1700 W Stout Street | AddressLine1 |
| City | RICE LAKE | City |
| State | WI | State |
| ZIP Code | 54868 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Income Based Criteria | Lakeview Medical Center, Inc. of Rice Lake uses the federal poverty guidelines at 200% to determine eligibility for providing free care as stated in line 3a. For self-pay individuals who don't qualify for free care per our policy, we offer a 6% discount (our highest commercial discount). We also offer an interest free payment plan, with the approval of the credit supervisor based on the patient's circumstances and ability to pay. The guidelines for a payment plan include: * Maximum of 60 months * Level payments or a front-end-loaded arrangement is acceptable * Lower initial payments with a balloon payment is not appropriate * Minimum of $25 per month (ie: $5 per month on a $25 balance is not appropriate) | IncomeBasedCriteria |
| Costing Method Used | The costing method used on form 990 is based on a cost to charge ratio which is developed based on the hospital's total operating expenses less the provision for bad debts divided by gross patient services revenues. This cost to charge ratio is applied against various revenue and expense categories to compute the estimated community benefit expense under IRS suggested costing methods for the form 990. | CostingMethodUsed |
| Subsidized Health Services Expln | Subsidized health services at Lakeview Medical Center, Inc. of Rice Lake include the operation of the Home Care and Hospice. These services are operated to provide support to the community and the surrounding areas, which would otherwise be underserved. It is the goal of Lakeview Medical Center, Inc. of Rice Lake to provide these services to the community regardless of a patient's ability to pay. | SubsidizedHealthServicesExpln |
| Percent Of Total Expense Expln | The amount of Provision for Bad Debts that was removed from total expenses reported on Form 990, Part IX, Line 24 was $1,861,245. The reduced total expense amount of $52,576,176 was used to calculate the percentages reported on Schedule H, Part I, line 7, column (f). | PercentOfTotalExpenseExpln |
| Bad Debt Footnote | Management provides for probable uncollectible amounts, primarily uninsured patients and amounts patients are personally responsible for, through a charge to operations and a credit to a valuation allowance based on its assessment of historical collection likelihood and the current status of individual accounts. Balances that are still outstanding after the organization has used reasonable collection efforts are written off through a charge to the valuation allowance and a credit to accounts receivable. Many times patients do not complete the required charity care application and are transferred to collection services even though the organization provides this this information to all patients and assistance with the applications. Due to no responses from some patients a significant amount of bad debts could be considered as charity care. | BadDebtFootnote |
| Shortfall As Community Benefit | The total Medicare revenue shown in Schedule H to the form 990 is based on the IRS 990 instructions and includes only a portion of the gross Medicare revenue of the organization and also does not consider all contractual adjustments for services reimbursed by the Medicare program. Amounts listed for Medicare revenues do not include lab and therapy services reimbursed on fee schedule reimbursements at rates that are often below the costs of caring for patients. The costing method used above for IRS compliance reporting is also based on the filed Medicare cost report for the year ended September 30, 2010, and does not consider Medicare non-allowable expenses, as it is based on total hospital patient service revenues (ignoring contractual adjustments on fee schedule reimbursed items and non-allowable Medicare expenses as noted above). Whether there is a shortfall or surplus on services provided to Medicare beneficiaries, these people, which are typically elderly or disabled members of the community, are an underserved population who experience issues with access to healthcare services. Without tax-exempt hospitals providing Medicare patient services, the Centers for Medicare and Medicaid (CMS) would bear the burden of directly providing services to the elderly and disabled members of the community. | ShortfallAsCommunityBenefit |
| Debt Collection Policy | Under the organization's collection and charity care policies, Lakeview Medical Center, Inc. of Rice Lake, makes every attempt to identify and promote charity care to patients. Included in the organization's charity care policy it is noted that patients may qualify for charity care either prior to admission or following discharge. All inpatient self-pay admissions are screened by the hospital's patient financial counselor or social workers to allow these patients the ability to complete their application during their stay at the hospital. Depending upon the patient's condition, the patient or the patient's responsible party may be contacted to complete and return the forms at a later time when their care allows this completion. During the patient account collection process, self-pay patients are also informed of the hospital's collection policies as well as the charity care program to allow patients the opportunity to complete the appropriate forms and qualify under the program. The organization also publishes information regarding its charity care program on its website. A description of the charity care program is included in the "Welcome" booklet that patients receive upon admission. | DebtCollectionPolicy |
| Needs Assessment | Lakeview Medical Center, Inc. of Rice Lake assesses the health care needs of the communities and areas it serves by reviewing local demographics and trends in patient service utilization to determine which services could and should be made available to the community in a cost-effective manner to be consistent with Lakeview Medical Center's mission in the community. Lakeview Medical Center joined with Barron County in the Barron County Community Health Improvement Process to identify local health concerns and address local health priorities linked to state and national priorities. The information gathered from this process was used to identify and prioritize community health issues and needs. | NeedsAssessment |
| Patient Education Assistance | Uninsured and under insured patients are asked to meet with the hospital's patient financial counselor either at the time service is provided or when the patient's bill is generated. The financial counselor explains the various payment options available to the patient as well as the hospital's charity care program and offers the charity care application when appropriate. If other programs are available to the patient, such as the Wisconsin Medical Assistance or Badgercare programs, these patients are referred to the appropriate government agency for further assistance. | PatientEducationAssistance |
| Community Information | The primary service area for Lakeview Medical Center encompasses all persons living within a 30 to 40 mile radius of the Hospital. Some of the communities included in this area are Rice Lake, Cameron, Barron, Birchwood, Ladysmith, Cumberland, Chetek and Spooner, Wisconsin, among many others. The hospital provides a significant portion of its patient services to beneficiaries of the Medicare and Medical Assistance programs. These Medicare and Medical Assistance patients accounted for approximately 65% of the hospital's gross patient service revenue for the year. | CommunityInformation |
| Community Building Activities | Gerry Lisi, Director of Ambulatory Care for Lakeview Medical Center received the 2010 Wisconsin Victim Witness Professional Service Award for his years of service on behalf of sexual assault victims. Lisi received this award in recognition of his efforts toward creating, maintaining and expanding the Sexual Assault Nurse Examiner (SANE) program at Lakeview Medical Center. The SANE program supports community efforts to address the crime of sexual assault by establishing a process for accurate evidence collection and support for sexual assault survivors. Lakeview Medical Center joined the Safe and Stable Family Coalition and led the effort to secure a grant from the Rice Lake Area Health Foundation to reduce the tobacco use in the greater Rice Lake Area. Through the grant the Not on Tobacco (NOT) program was implemented in Barron High School and the Restorative Justice Program adopted the NOT Program as a sanctioned workshop for rehabilitation. A Worksite Wellness Committee was formed at Lakeview Medical Center to share best evidenced based practices for employee health improvements with local employers. A Community Outreach Series is offered which brings physicians and patients together in a casual environment to answer questions about specific health needs. 50 Plus 50 Plus is a free wellness event for those over 50. The event offers a variety of health screenings, community resources, educational presentations and entertainment. This event is coordinated by a coalition of community agencies led by Lakeview Medical Center. United Way Board Member A hospital representative is a member of the Rice Lake United Way Coalition serving the community by issuing community improvement grants. Sharps Containers The organization has a long standing commitment to being environmentally sensitive. There are many examples of how this is demonstrated, one of which is our participation in the Sharps Program. The hospital serves as a drop-off site for Sharps, such as needles to inject insulin. This provides the opportunity for community members and businesses to dispose of their used hazardous medical supplies free of charge keeping them out of landfills. Rice Lake Free Clinic The hospital offers free radiology and lab services to the free clinic serving the underserved population in the area. Health and Wellness Center The Health and Wellness Center is the only one in the area offering community members the opportunity to exercise while being supervised by medically trained staff. Athletic Trainer Lakeview Medical Center offered an athletic trainer to student athletes free of charge to minimize injuries and expedite healing. Radiology Student Education & WITC Nursing Orientation Lakeview Medical Center is committed to support the training of future medical professionals to impact projected medical staff shortfalls. Worksite Weight loss Challenge In light of rising obesity issues in the county this program was developed. 408 participants from 20 area businesses lost a total of 3,848 pounds during this 12 week challenge. Throughout the 12 weeks fitness classes and nutritional education was offered free of charge or at a nominal fee. | CommunityBuildingActivities |
| Other Information | Lakeview Medical Center Inc. of Rice Lake provides significant charity care and other community benefits as defined by the IRS. In addition, the organization believes that it provides a critically important benefit which is not quantified. Lakeview Medical Center, like most community hospitals, was created and is maintained in order to provide care locally which without the hospital, would not be available locally. Beyond inpatient hospitalizations, the hospital provides local access to many services including: birthing center, diagnostics, emergency services, hospice, home care, dialysis, infusion services, health and wellness services, laboratory services, occupational health, rehabilitation services, sleep center, speech pathology, surgical services and womens' services, to name some of the major services provided. Lakeview Medical Center is governed by an eleven member Board of Directors, including six community members. | OtherInformation |
| Affiliated Health Care System | Marshfield Clinic is the sole corporate member of Lakeview Medical Center. Marshfield Clinic is a multi-specialty physician and healthcare organization comprised of over 40 sites, including a site in Rice Lake, Wisconsin. The integration of Lakeview Medical Center and Marshfield Clinic has enhanced the access and quality of health care throughout Rice Lake and the surrounding communities while achieving economic efficiencies. | AffiliatedHealthCareSystem |
| Reports Filed With States | WI | ReportsFiledWithStates |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | 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 | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (11 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DR BRAD BEKKUM | |||||||||||||
| 0 | 289332 | 0 | 15450 | 0 | 666 | 0 | 20818 | 0 | 0 | 0 | 326266 | 0 | 0 |
| DAN DEGROOT | |||||||||||||
| 0 | 207996 | 0 | 100 | 0 | 1212 | 0 | 28648 | 0 | 7952 | 0 | 245908 | 0 | 0 |
| DR PAUL LISS | |||||||||||||
| 0 | 399797 | 0 | 0 | 0 | 1806 | 0 | 52728 | 0 | 20671 | 0 | 475002 | 0 | 0 |
| EDWARD WOLF | |||||||||||||
| 199493 | 0 | 101 | 0 | 37252 | 0 | 27000 | 0 | 10634 | 0 | 274480 | 0 | 0 | 0 |
| CYNTHIA ARTS-STRENKE | |||||||||||||
| 136949 | 0 | 101 | 0 | 21508 | 0 | 20406 | 0 | 10634 | 0 | 189598 | 0 | 0 | 0 |
| JACQUELINE KLEIN | |||||||||||||
| 135152 | 0 | 101 | 0 | 16194 | 0 | 18393 | 0 | 5800 | 0 | 175640 | 0 | 0 | 0 |
| Andrew Daigle | |||||||||||||
| 164321 | 0 | 101 | 0 | 24332 | 0 | 9670 | 0 | 10634 | 0 | 209058 | 0 | 0 | 0 |
| Daniel O'Connell | |||||||||||||
| 166757 | 0 | 101 | 0 | 19500 | 0 | 9390 | 0 | 5119 | 0 | 200867 | 0 | 0 | 0 |
| James Kiffmeyer | |||||||||||||
| 182500 | 0 | 101 | 0 | 15881 | 0 | 8110 | 0 | 10634 | 0 | 217226 | 0 | 0 | 0 |
| Dr Douglas Reding | |||||||||||||
| 0 | 552077 | 0 | 11166 | 0 | 2052 | 0 | 52728 | 0 | 20174 | 0 | 638197 | 0 | 0 |
| Dr Peter Neal | |||||||||||||
| 0 | 431577 | 0 | 0 | 0 | 1940 | 0 | 69228 | 0 | 20345 | 0 | 523090 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (3 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| Supplemental Information to Form 990 | The Lakeview Medical Center Home Health Care Program announced that it has been named to the 2010 Homecare Elite(TM), a compilation of the top-performing home health agencies in the united states. This annual review identifies the top 500 agencies overall. Winners are ranked by an analysis of performance measures in quality outcomes, quality improvement, and financial performance. The 2010 Homecare Elite is the only performance recognition of its kind in the Home Health industry. The 2010 Homecare Elite is brought to the industry by OCS Homecare, the leading provider of homecare information, and Decisionhealth, publisher of Homecare's most respected independent newsletter Home Health Line. The data used for this analysis was compiled from publicly available information. the entire list of the 2009 homecare elite agencies can be viewed by visiting the OCS web site at www.ocshomecare.com. Part III, Line 4d - Other Program Services The other program services of Lakeview medical center include imaging, women's inpatient and outpatient care, and all indirect expenses associated with furthering the exempt purpose. | |
| Supplemental Information to Form 990 | Part VI, Section A, Line 6 Marshfield Clinic is the sole corporate member of Lakeview Medical center. Part Vi, Section A, Line 7a Marshfield clinic is the sole corporate member of Lakeview Medical Center and has the authority to elect board members. Part VI, Section A, Line 7b Marshfield clinic is the sole corporate member of lakeview Medical Center and the decisions of the governing body are subject to the approval of Marshfield Clinic. Part VI, Section A, Line 11 The Form 990 is compiled by the accounting department and then prepared and signed by KPMG LLP. The completed 990, including required schedules is emailed to and reviewed by the board members before filing. Part VI, Section B, Line 12 On an annual basis, board members, top management and employees who have contact with suppliers sign a statement acknowledging their understanding and adherence to the conflict of interest policy. In addition to the requirement of an annual completed disclosure form, it is the continuing responsibility of the disclosing individuals to scrutinize their transactions and outside business interests and relationships for potential conflicts of interest and to immediately make such disclosures. The individuals required to complete the disclosure form include: Board members, Administration (President, COO and CFO), and Managers of Materials Management, Information Technology, Lab, Imaging, Community Relations/Marketing and Plant Operations. Part VI, Section B, Line 15a & b The board of directors determines and approves the CEO's salary based on survey's comparability data and an outside consulting firm has been used at times. Salaries of other management employees are based on market surveys analyzed by the Human Resources department and approved by the adminstrative team and/or the CEO. Part VI, Section C, line 19 The organizations governing documents, conflict of interest policy and financial statements are available upon request. | Form 990, Part VI |
| Supplemental Information to Form 990 | Form 990, Part X, Line 2 includes $25,524,076. held in cash accounts to be used at a later date for program purposes, such as the construction of the new hospital and purchase of equipment. This amount consists of: health insurance trust $ 40,680. board designated 7,373,653. restricted building fund 16,759,304. lifeline 443,544. gifts, grants, bequests 521,684. hospice 375,867. home health care 9,344. ------------ total $25,524,076. ============ | Form 990, Part X |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (5 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 |
|---|---|---|---|---|---|---|---|---|---|
| Marshfield Clinic | |||||||||
| 1000 North Oak Avenue | Marshfield | WI | 54449 | 390452970 | Medical Care | WI | 501(C)(3) | 3 | NA |
| Volunteer Partners of Lakeview Medical C | |||||||||
| 1100 N Main Street | Rice Lake | WI | 54868 | 391329084 | Support Org. | WI | 501(C)(3) | 11, iii-o | NA |
| Security health plan of wisconsin inc | |||||||||
| 1515 N St Josephs Ave | Marshfield | WI | 54449 | 391572880 | HMO | WI | 501(C)(4) | N/A | NA |
| The heritage foundation | |||||||||
| 1000 N Oak Ave | Marshfield | WI | 54449 | 391865942 | Honor Individ | WI | 501(C)(3) | 11-Type 1 | NA |
| Flambeau Hospital Inc | |||||||||
| 98 Sherry Ave | Park Falls | WI | 54552 | 390973724 | Hospital | WI | 501(C)(3) | 3 | NA |
Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)
| EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner |
|---|---|---|---|---|---|---|---|---|
| marshfield food safety | ||||||||
| 201056380 | food testing | WI | NA | RELATED | 0 | 0 | false | false |
| diagnostic treatment ctr | ||||||||
| 200691634 | medical svcs | WI | NA | RELATED | 0 | 0 | false | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | 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 | true | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | true | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |