THEDACARE MEDICAL CENTER-WAUPACA INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- THEDACARE MEDICAL CENTER-WAUPACA INC (EIN 39-0871113)
- Tax period
- 2010-01-01 to 2010-12-31
- Filed
- 2011-11-08
- IRS object ID
- 201113129349302211
- Schema version
- 2010v3.4
- 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 C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-11-08T16:11:00-06:00 | Timestamp |
| Tax Period End Date | 2010-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 8010 | AddressLine1 |
| City | WAUSAU | City |
| State | WI | State |
| ZIP Code | 544028010 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390871113 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RIVERSIDE MEDICAL CENTER INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | RIVE | NameControl |
| Phone | 7152581000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 RIVERSIDE DRIVE | AddressLine1 |
| City | WAUPACA | City |
| State | WI | State |
| ZIP Code | 54981 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CRAIG KANTOS | Name |
| Title | CHIEF EXECUTIVE OFFICER | Title |
| Phone | 7152581000 | Phone |
| Date Signed | 2011-11-05 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | KATHLEEN J LABRAKE CPA | Name |
| Phone | 7158453111 | Phone |
| Date Prepared | 2011-11-05 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | CRAIG KANTOS | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 RIVERSIDE DRIVE | AddressLine1 |
| City | WAUPACA | City |
| State | WI | State |
| ZIP Code | 54981 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 37107162 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.THEDACARE.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1955 | YearFormation |
| State Legal Domicile | WI | StateLegalDomicile |
| Activity Or Mission Description | RIVERSIDE MEDICAL CENTER, IN PARTNERSHIP WITH THE MEDICAL STAFF AND OTHER HEALTH CARE PROVIDERS, SHALL PROVIDE ACCESS TO HEALTH CARE SERVICES FOR WAUPACA AND THE SURROUNDING AREAS THROUGH A STRATEGY EMPHASIZING THE VALUE OF HEALTH CARE ON THE WELLNESS CONTINUUM.RIVERSIDE MEDICAL CENTER SHALL PROVIDE QUALITY, CARING, AND COST EFFECTIVE SERVICES TO ADJUST OR IMPROVE THEIR HEALTH STATUS WHILE RECOGNIZING THE INDIVIDUAL PATIENT'S RIGHTS AND RESPONSIBILITIES.WAUPACA WILL HAVE A MEDICAL COMMUNITY THAT FUNCTIONS AS A RESOURCE FOR THE HEALTH CARE DELIVERY SYSTEM. RIVERSIDE MEDICAL CENTER WILL PROVIDE LEADERSHIP FOR THE HEALTH CARE DELIVERY SYSTEM IN OUR COMMUNITY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 6 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 186 | TotalNbrVolunteers |
| Total Gross UBI | 2112 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 80135 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 54606 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 36554360 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 36078948 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 358776 | InvestmentIncomePriorYear |
| Investment Income Current Year | 402759 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | -262083 | OtherRevenuePriorYear |
| Other Revenue Current Year | -213312 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 36731188 | TotalRevenuePriorYear |
| Total Revenue Current Year | 36323001 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 17788166 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 19317531 | 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 | 14699687 | OtherExpensePriorYear |
| Other Expenses Current Year | 13169704 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 32487853 | TotalExpensesPriorYear |
| Total Expenses Current Year | 32487235 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 4243335 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 3835766 | RevenuesLessExpensesCY |
| Total Assets BOY | 57744897 | TotalAssetsBOY |
| Total Assets EOY | 59633154 | TotalAssetsEOY |
| Total Liabilities BOY | 9924521 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 7977012 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 47820376 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 51656142 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | TO PROVIDE THE HIGHEST QUALITY HEALTH CARE, DELIVERED IN THE MOST EFFICIENT AND COST-EFFECTIVE WAYS, AND ACCESIBLE TO ALL MEMBERS OF THE COMMUNITY. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 30308320 | Expense |
| Revenue | 35957091 | Revenue |
| Description | RIVERSIDE MEDICAL CENTER PROVIDED MEDICAL CARE TO THE CITY OF WAUPACA AND ITS SURROUNDING COMMUNITIES AS A CRITICAL ACCESS FACILITY.INPATIENT ADMISSIONS WERE 1304 FOR THE PERIOD.THE AVERAGE LENGTH OF STAY (ALOS) WAS 3.0 DAYS PER STAY FOR THE PERIOD, COMPARED TO 3.1 DAYS PER STAY FOR THE PRIOR YEAR. THE MEDICAL CENTERS CASE MANAGEMENT PROGRAM CONTINUES TO PLAY A MAJOR ROLE IN KEEPING RMC'S ALOS BELOW INDUSTRY LEVELS.THE PERIOD AVERAGE DAILY CENSUS WAS 10.7, OR 1.3 PATIENT PER DAY LOWER THAN LAST YEAR. RIVERSIDE MEDICAL CENTERS FINANCIAL SUCCESS CONTINUES TO RELY HEAVILY ON ITS OUTPATIENT BUSINESS. OUTPATIENT VISITS FOR PERIOD TOTALED 49,754 VISITS. THIS IS AN AVERAGE OF 136.3 PER DAY, DOWN SLIGHTLY FROM 139.1 VISITS PER DAY LAST YEAR.THE OVERALL EMERGENCY ROOM/URGENT PATIENT VOLUMES TOTALED 11,884. THIS IS AN AVERAGE OF 32.6 PER DAY, COMPARED TO AN AVERAGE OF 32.1 LAST YEAR.TOTAL SURGERIES DURING THE PERIOD WERE 2,715. THIS IS AN AVERAGE OF 7.4 PER DAY COMPARED TO A TOTAL OF 2,531 DURING THE SAME PERIOD LAST YEAR.LABORATORY BILLED TESTS WERE 371,609 FOR THE PERIOD. THIS IS AN AVERAGE OF 1,018.1 PER DAY, COMPARED TO THE PREVIOUS YEARS DAILY AVERAGE OF 1003.1 PER DAY.RIVERSIDE MEDICAL CENTER ALSO CONTINUES TO PROVIDE X-RAY, NUCLEAR MEDICINE, MRI, CT SCAN, ULTRASOUND, CARDIO SERVICES, CARDIAC REHAB, BONE DENSITY, VASCULAR ULTRASOUND AND REHABILITATION SERVICES.THE MEDICAL CENTER CONTINUED TO OFFER A VARIETY OF EDUCATIONAL PROGRAMS TO THE COMMUNITY. | Description |
| Total Program Service Expense | 30308320 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 1 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 0 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 1 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 6 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | WI | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CRAIG KANTOS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7152581000 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 RIVERSIDE DRIVE | AddressLine1 |
| City | WAUPACA | City |
| State | WI | State |
| ZIP Code | 549811119 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (20 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| JIM LARSON | ||||||||
| VICE-CHAIR(TERM EXP 2011) | 2.00 | X | 0 | 0 | 0 | |||
| GARY JANSSEN | ||||||||
| CHAIRMAN (TERM EXP 2011) | 2.00 | X | 0 | 0 | 0 | |||
| ROSE CROW | ||||||||
| DIRECTOR (TERM EXP 2012) | 2.00 | X | 0 | 413196 | 64311 | |||
| DAVID POESCHL PHD | ||||||||
| DIRECTOR (TERM EXP 2012) | 2.00 | X | 0 | 0 | 0 | |||
| MARY ELLEN BOARIO | ||||||||
| TREASURER(TERM EXP 2011) | 2.00 | X | 0 | 0 | 0 | |||
| TOM JOHNSON | ||||||||
| SECRETARY(TERM EXP 2010) | 2.00 | X | 0 | 0 | 0 | |||
| ROBERT DENT MD | ||||||||
| DIRECTOR (TERM EXP 2012) | 2.00 | X | 0 | 170942 | 19531 | |||
| BRIAN BURMEISTER | ||||||||
| DIRECTOR (TERM EXP 2010) | 2.00 | X | 0 | 284915 | 61721 | |||
| DR JERRY SALAN | ||||||||
| DIRECTOR (TERM EXP 2011) | 2.00 | X | 0 | 0 | 0 | |||
| KERRY LEE BLANKE | ||||||||
| CFO, RMC | 40.00 | 142219 | 0 | 17320 | X | |||
| CRAIG KANTOS | ||||||||
| CEO, RMC | 40.00 | 254736 | 0 | 19828 | X | |||
| TIM OLSON | ||||||||
| CFO, SYSTEM | 0.00 | 0 | 412161 | 100566 | X | |||
| DEAN GRUNER | ||||||||
| CEO, SYSTEM | 0.00 | 0 | 872658 | 166257 | X | |||
| KEITH LIVINGSTON | ||||||||
| VP - CIO, SYSTEM | 0.00 | 0 | 372618 | 75731 | X | |||
| MAUREEN PISTONE | ||||||||
| VP - HR, SYSTEM | 0.00 | 0 | 299215 | 70644 | X | |||
| KATHRYN CORREIA | ||||||||
| VP - HOSP SERVICES, SYSTEM | 0.00 | 0 | 505245 | 96560 | X | |||
| GREGORY LONG | ||||||||
| CHIEF MEDICAL OFFICER, SYSTEM | 0.00 | 0 | 447920 | 98137 | X | |||
| JOHN POOLE | ||||||||
| VP - SR TIS, SYSTEM | 0.00 | 0 | 392123 | 78629 | X | |||
| WILLIAM HUNTER | ||||||||
| VP - PLANNING AND MARKETING | 0.00 | 0 | 396078 | 73945 | X | |||
| GREGORY DEVINE | ||||||||
| VP - BUS DEVELOP, SYSTEM | 0.00 | 0 | 472636 | 82239 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 396955 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 5039707 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 1025419 | TotalOtherCompensation |
| Number Individuals GT100 K | 17 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (2 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| RICHARD VEIGA MD SC | |||||
| E2409 PEBBLE RUN ROAD | WAUPACA | WI | 54981 | PATHOLOGY | 382213 |
| SHARED MEDICAL SERVICES | |||||
| PO BOX 330 | COTTAGE GROVE | IL | 53527 | PATIENT SCREENING SERVICES | 111685 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 2 | NumberOfContractorsGT100K |
| Related Organizations | 12222 | RelatedOrganizations |
| All Other Contributions | 42384 | AllOtherContributions |
| Total Contributions | 54606 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| MEDICAL CARE | 900099 | 35894883 | 35892771 | 2112 | |
| CAFETERIA | 900099 | 119745 | $119,745 | ||
| OTHER REVENUE | 900099 | 64320 | 64320 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 36078948 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 400351 | TotalRevenueColumn |
| Exclusion | $400,351 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 570849 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 784161 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -213312 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -213312 | TotalRevenueColumn |
| Exclusion | -$213,312 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 2408 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 2408 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2408 | TotalRevenueColumn |
| Exclusion | $2,408 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 36323001 | TotalRevenueColumn |
| Related Or Exempt Function Income | 35957091 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 2112 | UnrelatedBusinessRevenue |
| Exclusion | $309,192 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 434103 | Total |
| Program Services | 217052 | ProgramServices |
| Management And General | 217051 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15364654 | Total |
| Program Services | 14521376 | ProgramServices |
| Management And General | 843278 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3518774 | Total |
| Program Services | 3300488 | ProgramServices |
| Management And General | 218286 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 340025 | Total |
| Program Services | 170012 | ProgramServices |
| Management And General | 170013 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2402276 | Total |
| Program Services | 2402276 | ProgramServices |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| OTHER PROFESSIONAL SERV | 3828229 | 3828229 | |
| BAD DEBTS | 1910190 | 1910190 | |
| NURSING | 1882858 | 1882858 | |
| FISCAL & ADMINISTRATION | 1460575 | 730288 | 730287 |
| GENERAL SERVICES | 1345551 | 1345551 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32487235 | Total |
| Program Services | 30308320 | ProgramServices |
| Management And General | 2178915 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 820 | BOY |
| EOY | 920 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9245763 | BOY |
| EOY | 12187371 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4298208 | BOY |
| EOY | 3939353 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 169116 | BOY |
| EOY | 177907 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 89056 | BOY |
| EOY | 170665 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 53915869 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 20903146 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 34660681 | BOY |
| EOY | 33012723 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4634793 | BOY |
| EOY | 5332457 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4646460 | BOY |
| EOY | 4762001 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 49757 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 57744897 | BOY |
| EOY | 59633154 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1381608 | BOY |
| EOY | 636797 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8195450 | BOY |
| EOY | 7340215 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 347463 | BOY |
| EOY | 0 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9924521 | BOY |
| EOY | 7977012 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 47820376 | BOY |
| EOY | 51656142 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 47820376 | BOY |
| EOY | 51656142 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 57744897 | BOY |
| EOY | 59633154 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 3835766 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $4,152 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 4152 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF OTHER LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1I: | ReturnReference |
| Explanation | PORTION OF WHA DUES = 4,152 | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2102028 | OtherCostOrOtherBasis |
| Book Value | 2102028 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 37597104 | OtherCostOrOtherBasis |
| Depreciation | 12445876 | Depreciation |
| Book Value | 25151228 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 13191537 | OtherCostOrOtherBasis |
| Depreciation | 7903872 | Depreciation |
| Book Value | 5287665 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1025200 | OtherCostOrOtherBasis |
| Depreciation | 553398 | Depreciation |
| Book Value | 471802 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 33012723 | TotalOfBookValueLandBuildings |
Investments Program Related InvestmentsProgramRelated (9 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| INVEST-FARMERS STATE C.D. | 407203 | C |
| INVEST-FNB WAUPACA C.D. | 606095 | C |
| INVEST-FNB WAUPACA C.D. | 838524 | C |
| INVEST-FNB WAUPACA C.D | 761799 | C |
| INVEST-COMM FIRST C.D. | 133114 | C |
| INVEST-FNB WAUPACA C.D. | 689170 | C |
| INVEST-FNB WAUPACA C.D. | 680002 | C |
| ACCRUED INT ON INVEST | 32551 | C |
| INVEST-FNB WAUPACA C.D. | 613543 | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Program Related | 4762001 | TotalOfBookValueProgramRelated |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X: | ReturnReference |
| Explanation | FOOTNOTE FROM CONSOLIDATED FINANCIAL STATEMENTS: RIVERSIDE MEDICAL CENTER FOLLOWS FASB GUIDANCE ON INCOME TAXES, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, WHICH ADDRESSES THE DETERMINATION OF WHETHER TAX BENEFITS CLAIMED OR EXPECTED TO BE CLAIMED ON A TAX RETURN SHOULD BE RECORDED IN THE FINANCIAL STATEMENTS. UNDER THIS GUIDANCE, RIVERSIDE MEDICAL CENTER MAY RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. EXAMPLES OF TAX POSITIONS INCLUDE THE TAX-EXEMPT STATUS OF THEDACRE, AND VARIOUS POSITIONS RELATED TO THE POTENTIAL SOURCES OF UNRELATED BUSINESS TAXABLE INCOME (UBIT). THE TAX BENEFITS RECOGNIZED IN THE FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASES ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50 PERCENT LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. AT DECEMBER 31, 2010 AND 2009, THERE WERE NO UNRECOGNIZED TAX BENEFITS IDENTIFIED OR RECORDED AS LIABILITIES. RIVERSIDE MEDICAL CENTER FILES FORM 990 IN THE U.S. FEDERAL JURISDICITON. TAX RETURNS FILED BY RIVERSIDE MEDICAL CENTER ARE GENERALLY OPEN FOR EXAMINATION FOR THE YEARS 2007 THROUGH 2010. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 0 | AmountsBudgetedForCharityCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 330 | PersonsServed |
| Total Community Benefit Expense | 185453 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 185453 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00610 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 5736 | PersonsServed |
| Total Community Benefit Expense | 3755097 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2872247 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 882850 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02890 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 6066 | PersonsServed |
| Total Community Benefit Expense | 3940550 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2872247 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1068303 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03500 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 27 | NumberOfActivitiesOrPrograms |
| Persons Served | 549619 | PersonsServed |
| Total Community Benefit Expense | 736496 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 7287 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 729209 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02380 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 4 | NumberOfActivitiesOrPrograms |
| Persons Served | 635 | PersonsServed |
| Total Community Benefit Expense | 133383 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 500 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 132883 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00430 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 4 | NumberOfActivitiesOrPrograms |
| Persons Served | 2780 | PersonsServed |
| Total Community Benefit Expense | 2283886 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 699465 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1584421 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05180 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 88 | PersonsServed |
| Total Community Benefit Expense | 100104 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 100104 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00330 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 7 | NumberOfActivitiesOrPrograms |
| Persons Served | 12842 | PersonsServed |
| Total Community Benefit Expense | 455655 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 455655 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01490 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 43 | NumberOfActivitiesOrPrograms |
| Persons Served | 565964 | PersonsServed |
| Total Community Benefit Expense | 3709524 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 707252 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3002272 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.09810 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 43 | NumberOfActivitiesOrPrograms |
| Persons Served | 572030 | PersonsServed |
| Total Community Benefit Expense | 7650074 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3579499 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4070575 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.13310 | PercentOfTotalExpense |
Physical Improvements And Housing PhysicalImprovementsAndHousing
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 1 | PersonsServed |
| Total Community Building Expense | 1132 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 1132 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Building Expense | 509 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 509 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 89 | PersonsServed |
| Total Community Building Expense | 640 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 640 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Environmental Improvements EnvironmentalImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 0 | PersonsServed |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 437 | PersonsServed |
| Total Community Building Expense | 2801 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 2801 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 25 | PersonsServed |
| Total Community Building Expense | 3499 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 3499 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 137 | PersonsServed |
| Total Community Building Expense | 569 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 569 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Building Expense | 8481 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 8481 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Other Other
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 572 | PersonsServed |
| Total Community Building Expense | 28193 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 28193 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00090 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 8 | NumberOfActivitiesOrPrograms |
| Persons Served | 1261 | PersonsServed |
| Total Community Building Expense | 45824 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 45824 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00140 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $953,033 | BadDebtExpenseAmount |
| Amount Attributable To | 185453 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 14532862 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 14942046 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -409184 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RIVERSIDE MEDICAL CENTER INC | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 RIVERSIDE DRIVE | AddressLine1 |
| City | WAUPACA | City |
| State | WI | State |
| ZIP Code | 54981 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| Critical Access Hospital | X | CriticalAccessHospital |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NOT REQUIRED | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)
| ExplanationExplanation |
|---|
| PART I, LINE 7: THE COST TO CHARGE RATIO WAS USED IN DETERMINING THE AMOUNTS REPORTED ON PART I, LINE 7. |
| PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 1910190. |
| PART II: OUR COMMUNITY BUILDING ACTIVITIES CREATE AWARENESS OF HEALTHY LIFE STYLES BY LEADING BY EXAMPLE. IT HELPS THE COMMUNITY REALIZE THAT WE ARE MORE THAN A PACE TO GO WHEN YOU ARE SICK. WE ARE A RESOURCE AND PARTNER IN LIVING A HEALTHIER LIFE STYLE. |
| PART III, LINE 4: ACCOUNTS RECEIVABLE ARE UNCOLLATERALIZED PATIENT OBLIGATIONS THAT ARE STATED AT THE AMOUNT MANAGEMENT EXPECTS TO COLLECT FROM OUTSTANDING BALANCES. THESE OBLIGATIONS ARE PRIMARILY FROM LOCAL RESIDENTS, MOST OF WHOM ARE INSURED UNDER THIRD-PARTY PAYOR AGREEMENTS. THE CENTER BILLS THIRD-PARTY PAYORS ON THE PATIENTS' BEHALF, OR IF A PATIENT IS UNINSURED, THE PATIENT IS BILLED DIRECTLY. ONCE CLAIMS ARE SETTLED WITH THE PRIMARY PAYOR, ANY SECONDARY INSURANCE IS BILLED, AND PATIENTS ARE BILLED FOR COPAY AND DEDUCTIBLE AMOUNTS THAT ARE THE PATIENTS' RESPONSIBILITY. PAYMENTS ON ACCOUNTS RECEIVABLE ARE APPLIED TO THE SPECIFIC CLAIM IDENTIFIED ON THE REMITTANCE ADVICE OR STATEMENT. THE CENTER DOES NOT HAVE A POLICY TO CHARGE INTEREST ON PAST DUE ACCOUNTS.THE CARRYING AMOUNTS OF ACCOUNTS RECEIVABLE ARE REDUCED BY ALLOWANCES THAT REFLECT MANAGEMENT'S BEST ESTIMATE OF THE AMOUNTS THAT WILL NOT BE COLLECTED. MANAGEMENT PROVIDES FOR CONTRACTUAL ADJUSTMENTS UNDER TERMS OF THIRD-PARTY REIMBURSEMENT AGREEMENTS THROUGH A CHARGE TO GROSS REVENUE AND A CREDIT TO THE ACCOUNTS RECEIVABLE. IN ADDITION, MANANGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY FROM 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 MANAGEMENT HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO ACCOUNTS RECEIVABLE.THE COST OF RMC'S BAD DEBTS AND CHARITY CARE ARE CALCULATED BY MULTIPLYING THE GROSS CHARGES OF BAD DEBTS AND CHARITY CARE BY THE CURRENT YEARS COST TO CHARGE RATIO. |
| PART III, LINE 8: THE MEDICARE COST REPORT USES A COST TO CHARGE RATIO IN DETERMINING THE AMOUNTS LISTED ABOVE. |
| PART III, LINE 9B: RMC DOES NOT PERSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE. |
| PART VI, LINE 2: RMC'S BOARD OF DIRECTORS IS MADE UP OF COMMUNITY MEMBERS WHO PROVIDE US WITH DIRECT INPUT. WE USE A THIRD PARTY PATIENT QUESTIONNAIRE SYSTEM THAT GIVES US FEEDBACK FROM PATIENTS THAT WE SERVE. WE HOLD AN ANNUAL COMMUNITY REPORT OUT WHERE PARTICIPANTS HAVE AN OPEN FORUM TO PROVIDE INPUT ON COMMUNITY HEALTH CARE NEEDS. PERIODICALLY, WE PERFORM A COMMUNITY HEALTH NEEDS ASSESSMENT. |
| PART VI, LINE 3: BILLING STAFF CONTACT SELF PAY PATIENTS TO OBTAIN PAYMENT OR SET UP PAYMENT ARRANGEMENTS. THE POSSIBILITY OF ELIGIBILITY FOR ANY TYPE OF GOVERNMENT ASSISTANCE OR RMC'S CHARITY CARE PROGRAM IS DISCUSSED WITH PATIENTS AT THIS TIME IF THEY ARE UNABLE TO MAKE PAYMENTS. |
| PART VI, LINE 4: THEDACARE'S SERVICE AREA CONSISTS OF 7 COUNTIES INCLUDING OUTAGAMIE, WINNEBAGO, CALUMET, SHAWANO, WAUPACA, WAUSHARA, AND GREEN LAKE. RIVERSIDE MEDICAL CENTER PROVIDES SERVICES PRIMARILY TO PEOPLE IN WAUPACA COUNTY. HIGHLIGHTS REGARDING THE COMMUNITIES WE SERVE INCLUDE:- TOTAL POPULATION OF THE THEDACARE SERVICE AREA IS 518,000. RIVERSIDE MEDICAL CENTER'S SERVICE AREA TOTALS APPROXIMATELY 50,000. - POPULATION OF THE SERVICE AREA CONTINUES TO GROW BUT THE RATE OF GROWTH IS DECLINING- THE AVERAGE AGE OF THE POPULATION IS INCREASING; THE WORKING-AGE POPULATION IS DECLINING- THERE IS A TREND TOWARD SUBURBANIZATION; CORE CITIES AND TOWNS STAY FLAT WHILE CITIES SPRAWL INTO THE SUBURBS- THE NORTHEAST WISCONSIN WILL GROW SLIGHTLY SLOWER THAN THE FOX CITIES. - THE NUMBER OF UNINSURED IN RIVERSIDE'S SERVICE AREA IS SLIGHTLY HIGHER THAN THE FOX CITIES AT 10%- 98% OF SERVICE AREA IS CAUCASIAN WITH PRESENCE OF HISPANIC POPULATION. - THE POVERTY RATE IN RIVERSIDE MEDICAL CENTER'S SERVICE AREA IS APPROXIMATELY 9% |
| PART VI, LINE 6: EACH YEAR, RIVERSIDE MEDICAL CENTER'S PARENT ORGANIZATION THEDACARE SETS ASIDE A PERCENTAGE OF EXCESS NET BUDGETED INCOME TO FUND AN EFFORT CALLED CHAT (COMMUNITY HEALTH ACTION TEAM). CHAT IS A GROUP OF 25 COMMUNITY LEADERS WHO STUDY SYSTEMIC HEALTH ISSUES OUTSIDE THE WALLS OF OUR HOSPITALS AND CLINICS AND WORK TO IDENTIFY INNOVATIVE, COLLABORATIVE SOLUTIONS THAT DRAW UPON THE WIDE ARRAY OF RESOURCES AND STRENGTHS OF OUR COMMUNITY. THROUGH CHAT, SUCH EFFORTS AS THE SHAWANO COUNTY RURAL HEALTH INITIATIVE HAVE BEEN DEVELOPED. THIS INITIATIVE TAKES BASIC HEALTH CARE AND SCREENING SERVICES TO THE FARM. EACH YEAR HUNDREDS OF FARM FAMILIES LIVING WITHOUT INSURANCE OR ONLY CATASTROPHIC COVERAGE RECEIVE CRITICAL ASSISTANCE. ANOTHER INITIATIVE DEVELOPED THROUGH CHAT IS MAKING THE RIDE HAPPEN WHICH PROVIDES TRANSPORTATION TO OLDER ADULTS WHO OTHERWISE WOULD STAY COOPED UP IN APARTMENTS AND FIGHT DEPRESSION AND ISOLATION. PROJECT PROMISE IS A POVERTY INITIATIVE DEVELOPED THROUGH CHAT THAT BROUGHT TOGETHER MANY LOCAL AGENCIES AND BUSINESSES TO WORK TO ADDRESS POVERTY IN A COLLABORATIVE FASHION. VOICES OF MEN WAS LAUNCHED WITH SUPPORT FROM CHAT TO RAISE AWARENESS OF EVERYDAY BEHAVIORS OF MEN THAT CAN LEAD TO AN ACCEPTANCE OF VIOLENCE TOWARD WOMEN. THE PROJECTS ARISING FROM CHAT ARE NUMEROUS. THE LIVES TOUCHED ARE NUMEROUS. THEDACARE PROVIDES FUNDING AND STAFF SUPPORT TO MAKE CHAT AND THESE COMMUNITY HEALTH EFFORTS POSSIBLE.OTHER WAYS THAT THEDACARE HOSPITALS IMPROVE THE HEALTH OF THE COMMUNITY INCLUDE: - THEDACARE SHARED ITS CUTTING EDGE APPLICATION OF LEAN PRODUCTION IMPROVEMENTS WITH VISITORS ALMOST WEEKLY IN 2010. HUNDREDS OF HEALTHCARE AND NON-HEALTHCARE VISITORS CAME FROM AS FAR AWAY AS AUSTRALIA AND RUSSIA TO OBSERVE. MOST VISITORS WERE FROM HOSPITALS AND HEALTH SYSTEMS IN THE UNITED STATES LOOKING TO IMPROVE QUALITY AND REDUCE COSTS.- THEDACARE HOSPITALS PROVIDED FUNDING TO THE THEDACARE CENTER FOR HEALTHCARE VALUE WHICH IS COORDINATING EFFORTS ACROSS THE COUNTRY TO SHARE QUALITY IMPROVEMENT AND COST REDUCTION LEARNINGS. - THEDACARE PARTNERS WITH THE FOX CITIES/UW RESIDENCY CENTER TO PROVIDE HANDS ON EXPERIENCE FOR MEDICAL STUDENTS.- THEDACARE ALSO PARTNERS WITH AREA NURSING SCHOOLS SUCH AS UW OSHKOSH AND FOX VALLEY TECHNICAL COLLEGE TO PROVIDE TEACHERS FOR THEIR NURSING PROGRAMS AND PROVIDES VENUES FOR NURSING STUDENTS TO PRACTICE THEIR SKILLS. - THEDACARE HOSPITALS LEADERSHIP PROVIDED MORE THAN $40,000 WORTH OF STAFF TIME PROVIDING LEADERSHIP TO LOCAL NON-PROFIT ORGANIZATIONS.- THEDACARE HOSPITALS PROVIDED FINANCIAL AS WELL AS DIAGNOSTIC AND LAB SUPPORT TO TWO AREA CLINICS PROVIDING MEDICAL AND DENTAL CARE TO THE UNDERSERVED IN OUR SERVICE AREA.- THEDACARE HOSPITAL EMPLOYEES TAKE PART IN HELPING HEARTS, AN EMPLOYEE VOLUNTEERISM PROGRAM ENCOURAGING STAFF TO GIVE OF THEIR TIME IN THE COMMUNITY. THEDACARE PROVIDES PAID STAFF TO COORDINATE THE PROGRAM AND IDENTIFY AND PROMOTE VOLUNTEERISM OPPORTUNITIES.- ALL THEDACARE HOSPITALS PROVIDE HEALTH EDUCATION PROGRAMMING FOR THEIR RESPECTIVE COMMUNITIES FOCUSING ON SUCH CRITICAL TOPICS AS PROPER NUTRITION, DIABETES IDENTIFICATION, AND STRESS MANAGEMENT.- THEDACARE SPONSORS PARTY AT THE PAC FOR THOUSANDS OF AREA YOUTH TO EDUCATE YOUTH ON THE PERILS OF RISKY BEHAVIOR AND DRIVING. HOSTED AT OUR PERFORMING ARTS CENTER, LIVE DRAMATIZATIONS ALONG WITH STORIES OF YOUTH DISABLED DUE TO DRIVING OR TEXTING AND DRIVING.- RIVERSIDE MEDICAL CENTER STAFF ARE ENGAGED IN WAUPACA COUNTY NUACT COALITION, A COMMUNITY-WIDE MULTI-DISCIPLINARY TEAM ADDRESSING COMMUNITY HEALTH AND WELLNESS NEEDS.- RIVERSIDE MEDICAL CENTER STAFF WORK WITH THE AREA CHAMBER OF COMMERCE AND LOCAL HIGH SCHOOLS AND COLLEGES TO INFORM YOUTH ABOUT MEDICAL CAREER OPPORTUNITIES AND TO HELP PREPARE OUR EDUCATIONAL FACILITIES TO MEET THE HEALTHCARE STAFFING NEEDS FOR THE COMMUNITIES WE SERVE.- RIVERSIDE MEDICAL CENTER REACHES OUT TO THE COMMUNITY TO HOST SCREENINGS AND HEALTH FAIRS.- RIVERSIDE MEDICAL CENTER STAFF ARE INVOLVED IN STATEWIDE AND REGIONAL DISASTER READINESS PLANNING TO PREPARE OUR COMMUNITY FOR TIMES OF CRISIS.- RIVERSIDES MEDICAL CENTER STAFF PARTICIPATED IN THEDACARE-WIDE REBUILDING TOGETHER EVENT WHERE STAFF SPENT THE DAY FIXING UP THE HOME OF A LOCAL FAMILY IN NEED.- THEDACARE PRESIDENT AND CEO IS ENGAGED IN STATEWIDE WISCONSIN COLLABORATIVE FOR HEALTHCARE QUALITY MAKING QUALITY HEALTHCARE DATA TRANSPARENT. |
| PART VI, LINE 7: THEDACARE, THE PARENT ORGANIZATION, PROVIDES DIRECTION RELATED TO COMMUNITY NEEDS ASSESSMENT FOR ALL HOSPITALS AND MARKETS WITH ITS SERVICE AREA. EACH THEDACARE HOSPITAL DETERMINES HOW BEST TO MEET LOCAL NEEDS. IMPLEMENTATION OF COMMUNITY PROGRAMMING OCCURS AT THE HOSPITAL LEVEL. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (14 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROSE CROW | |||||||||||||
| 0 | 305672 | 0 | 68590 | 0 | 38934 | 0 | 57965 | 0 | 6346 | 0 | 477507 | 0 | 0 |
| ROBERT DENT MD | |||||||||||||
| 0 | 167424 | 0 | 979 | 0 | 2539 | 0 | 6646 | 0 | 12885 | 0 | 190473 | 0 | 0 |
| BRIAN BURMEISTER | |||||||||||||
| 0 | 219678 | 0 | 48120 | 0 | 17117 | 0 | 48147 | 0 | 13574 | 0 | 346636 | 0 | 0 |
| KERRY LEE BLANKE | |||||||||||||
| 137816 | 0 | 579 | 0 | 3824 | 0 | 4231 | 0 | 13089 | 0 | 159539 | 0 | 0 | 0 |
| CRAIG KANTOS | |||||||||||||
| 210397 | 0 | 23605 | 0 | 20734 | 0 | 7277 | 0 | 12551 | 0 | 274564 | 0 | 0 | 0 |
| TIM OLSON | |||||||||||||
| 0 | 322102 | 0 | 67349 | 0 | 22710 | 0 | 87350 | 0 | 13216 | 0 | 512727 | 0 | 0 |
| DEAN GRUNER | |||||||||||||
| 0 | 605880 | 0 | 253368 | 0 | 13410 | 0 | 151350 | 0 | 14907 | 0 | 1038915 | 0 | 0 |
| KEITH LIVINGSTON | |||||||||||||
| 0 | 288984 | 0 | 63436 | 0 | 20198 | 0 | 62750 | 0 | 12981 | 0 | 448349 | 0 | 0 |
| MAUREEN PISTONE | |||||||||||||
| 0 | 227179 | 0 | 49763 | 0 | 22273 | 0 | 57993 | 0 | 12651 | 0 | 369859 | 0 | 0 |
| KATHRYN CORREIA | |||||||||||||
| 0 | 373218 | 0 | 122629 | 0 | 9398 | 0 | 82071 | 0 | 14489 | 0 | 601805 | 0 | 0 |
| GREGORY LONG | |||||||||||||
| 0 | 350771 | 0 | 76836 | 0 | 20313 | 0 | 84750 | 0 | 13387 | 0 | 546057 | 0 | 0 |
| JOHN POOLE | |||||||||||||
| 0 | 299010 | 0 | 67095 | 0 | 26018 | 0 | 65550 | 0 | 13079 | 0 | 470752 | 0 | 0 |
| WILLIAM HUNTER | |||||||||||||
| 0 | 318550 | 0 | 71480 | 0 | 6048 | 0 | 60750 | 0 | 13195 | 0 | 470023 | 0 | 0 |
| GREGORY DEVINE | |||||||||||||
| 0 | 382611 | 0 | 83735 | 0 | 6290 | 0 | 67750 | 0 | 14489 | 0 | 554875 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE COMPLETE FORM 990 WAS MADE AVAILABLE TO THE BOARD MEMBERS AT A MONTHLY BOARD MEETING PRIOR TO ITS FILING. | |
| ON AN ANNUAL BASIS ALL RIVERSIDE MEDICAL CENTER EMPLOYEES ARE REQUIRED TO COMPLETE A COMPUTER BASED CORPORATE COMPLIANCE MODULE. WITHIN THIS MODULE, CONFLICT OF INTEREST IS ADDRESSED. AS PART OF COMPLETION OF THIS MODULE THE EMPLOYEE INDICATES THAT NO CONFLICT OF INTEREST EXISTS, OR DISCLOSES THE CONFLICT OF INTEREST. ANY DISCLOSURE OF A CONFLICT OF INTEREST IS INVESTIGATED. BOARD OF DIRECTORS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST STATEMENT ANNUALLY. AT THE TIME OF COMPLETION, THE BOARD MEMBER INDICATES IF NO CONFLICT OF INTEREST EXISTS, OR DISCLOSES THE CONFLICT OF INTEREST. ANY DISCLOSURE OF A CONFLICT OF INTEREST IS INVESTIGATED. IF INFORMATION IS RECEIVED AT ANY TIME DURING THE YEAR SUGGESTING THAT A CONFLICT OF INTEREST COULD POTENTIALLY EXIST WITH AN EMPLOYEE OR BOARD MEMBER, THIS IS IMMEDIATELY INVESTIGATED AND RESOLVED. | FORM 990, PART VI, SECTION B, LINE 12C | |
| COMPENSATION IS ESTABLISHED BASED UPON MARKET SALARY SURVEY DATA. ADJUSTMENTS TO SALARY ARE BASED UPON THE SAME DATA AND APPROVED BY THE BOARD OF DIRECTORS. | FORM 990, PART VI, SECTION B, LINE 15 | |
| GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC BY CONTACTING THE MEDICAL CENTER'S ADMINISTRATIVE ASSISTANT, CFO, OR CEO. | FORM 990, PART VI, SECTION C, LINE 19 | |
| ROSE CROW, ROBERT DENT, BRIAN BURMEISTER, TIM OLSON, DEAN GRUNER, KEITH LIVINGSTON, MAUREEN PISTONE, KATHRYN CORREIA, GREGORY LONG, JOHN POOLE, WILLIAM HUNTER, AND GREGORY DEVINE ARE COMPENSATED BY A RELATED ORGANIZATION. THEY EACH PROVIDE 40 HOURS OF SERVICE TO THE RELATED ORGANIZATION EACH WEEK. | FORM 990, PART VII, LINE 1A: | |
| NO CHANGE FROM PRIOR YEAR | FORM 990, PART XII, LINE 2C |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (13 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| THEDACARE INC | ||||||||||
| 122 E COLLEGE AVE | APPLETON | WI | 54912 | 391509362 | HEALTHCARE SERVICES | WI | 501 C (3) | LINE 3 | N/A | 0 |
| AUXILIARY OF RIVERSIDE MEDICAL CENTER | ||||||||||
| 800 RIVERSIDE DRIVE | WAUPACA | WI | 54981 | 900328881 | SUPPORT OF RIVERSIDE MEDICAL CENTER | WI | 501 C (3) | LINE 11A, I | N/A | 0 |
| APPLETON MEDICAL CENTER INC | ||||||||||
| 1818 NORTH MEADE STREET | APPLETON | WI | 54911 | 390824015 | HEALTHCARE SERVICES | WI | 501 C (3) | LINE 3 | N/A | 0 |
| WOLF RIVER AREA HEALTH CARE FOUNDATION | ||||||||||
| 1405 MILL STREET | NEW LONDON | WI | 54961 | 200049796 | CHARITABLE FOUNDATION | WI | 501 C (3) | LINE 7 | N/A | 0 |
| APPLETON MEDICAL CENTER FOUNDATION | ||||||||||
| 1818 N MEADE STREET | APPLETON | WI | 54911 | 391459276 | CHARITABLE FOUNDATION | WI | 501 C (3) | LINE 7 | N/A | 0 |
| THEDA CLARK MEDICAL CENTER | ||||||||||
| 130 SECOND STREET | NEENAH | WI | 54956 | 390830664 | HOSPITAL | WI | 501 C (3) | LINE 3 | N/A | 0 |
| THEDA CLARK MEDICAL CENTER FOUNDATION | ||||||||||
| PO BOX 8025 | APPLETON | WI | 54912 | 311550056 | CHARITABLE FOUNDATION | WI | 501 C (3) | LINE 7 | N/A | 0 |
| GEORGE P PEABODY FOUNDATION INC | ||||||||||
| PO BOX 2553 | APPLETON | WI | 54912 | 391702534 | CHARITABLE FOUNDATION | WI | 501 C (3) | LINE 7 | N/A | 0 |
| COMMUNITY HOSPICE FOUNDATION INC | ||||||||||
| 1818 N MEADE STREET | APPLETON | WI | 54911 | 391511977 | CHARITABLE FOUNDATION | WI | 501 C (3) | LINE 7 | N/A | 0 |
| GOLD CROSS AMBULANCE SERVICE INC | ||||||||||
| 1055 WITTMAN DRIVE | MENASHA | WI | 54952 | 391702433 | AMBULANCE | WI | 501 C (3) | LINE 7 | N/A | 0 |
| CRITICAL CARE SOLUTIONS LLC | ||||||||||
| 9200 WEST WISCONSIN AVE | MILWAUKEE | WI | 53226 | 202636740 | EICU | WI | 501 C (3) | LINE 3 | N/A | 0 |
| QUALITY HEALTH SOLUTIONS LLC | ||||||||||
| N74 WI2501 LEATHERWOOD COURT | MENOMINEE FALLS | WI | 53051 | 202636686 | HEALTHCARE SERVICES | WI | 501 C (3) | LINE 3 | N/A | 0 |
| NEW LONDON FAMILY MEDICAL INC | ||||||||||
| 1405 MILL STREET | NEW LONDON | WI | 54961 | 390869788 | HOSPITAL | WI | 501 C (3) | LINE 3 | N/A | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |