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ASPIRUS EAGLE RIVER HOSPITAL INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
ASPIRUS EAGLE RIVER HOSPITAL INC (EIN 39-0985690)
Tax period
2009-10-01 to 2010-09-30
Filed
2011-08-12
IRS object ID
201142249349300344
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-08-12T07:11:03-07:00Timestamp
Tax Period End Date2010-09-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2009-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN390985690EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1EAGLE RIVER MEMORIAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlEAGLNameControl
Phone7153568109Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1201 HOSPITAL RDAddressLine1
CityEAGLE RIVERCity
StateWIState
ZIP Code54521ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameCATHY BUKOWSKIName
TitleREGIONAL CFOTitle
Date Signed2011-08-12DateSigned
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts14928987GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Group Exemption Number0928GroupExemptionNumber
Organization501cXOrganization501c
Web SiteWWW.MINISTRYHEALTH.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1941YearFormation
State Legal DomicileWIStateLegalDomicile
Activity Or Mission DescriptionEAGLE RIVER MEMORIAL HOSPITAL'S MISSION AS A CATHOLIC HOSPITAL IS TO FURTHER THE HEALING MINISTRY OF JESUS BY IMPROVING THE HEALTH/WELL-BEING OF ALL PEOPLE, ESPECIALLY THE POOR. WE PROVIDE ACUTE HEALTH CARE SRVCS TO THE COMMUNITY REGARDLESS OF THEIR ABILITY TO PAY.ActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees140TotalNbrEmployees
Total Nbr Volunteers150TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year67890ContributionsGrantsPriorYear
Contributions Grants Current Year117405ContributionsGrantsCurrentYear
Program Service Revenue Prior Year15700908ProgramServiceRevenuePriorYear
Program Service Revenue CY14691417ProgramServiceRevenueCY
Investment Income Prior Year119685InvestmentIncomePriorYear
Investment Income Current Year81796InvestmentIncomeCurrentYear
Other Revenue Prior Year24342OtherRevenuePriorYear
Other Revenue Current Year30654OtherRevenueCurrentYear
Total Revenue Prior Year15912825TotalRevenuePriorYear
Total Revenue Current Year14921272TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year7325801SalariesEtcPriorYear
Salaries Etc Current Year7679962SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year7867654OtherExpensePriorYear
Other Expenses Current Year7269110OtherExpensesCurrentYear
Total Expenses Prior Year15193455TotalExpensesPriorYear
Total Expenses Current Year14949072TotalExpensesCurrentYear
Revenues Less Expenses Prior Year719370RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-27800RevenuesLessExpensesCY
Total Assets BOY32117110TotalAssetsBOY
Total Assets EOY30229958TotalAssetsEOY
Total Liabilities BOY11972952TotalLiabilitiesBOY
Total Liabilities EOY10084169TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY20144158NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY20145789NetAssetsOrFundBalancesEOY
Mission DescriptionEAGLE RIVER MEMORIAL HOSPITAL'S MISSION AS A CATHOLIC HOSPITAL IS TO FURTHER THE HEALING MINISTRY OF JESUS BY IMPROVING THE HEALTH/WELL-BEING OF ALL PEOPLE, ESPECIALLY THE POOR. WE PROVIDE ACUTE HEALTH CARE SRVCS TO THE COMMUNITY REGARDLESS OF THEIR ABILITY TO PAY.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense13093866Expense
Revenue14698009Revenue
DescriptionEAGLE RIVER MEMORIAL HOSPITAL PROVIDES INPATIENT, OUTPATIENT, EMERGENCY ROOM AND ANCILLARY SERVICES REGARDLESS OF AN INDIVIDUAL'S ABILITY TO PAY OR METHOD OF PAYMENT. THE HOSPITAL ALSO PROVIDES EDUCATIONAL PROGRAMS AND SERVICES ON HEALTH CARE ISSUES TO THE COMMUNITY IT SERVES. SEE SCHEDULE H FOR FURTHER DETAILS.Description
Total Program Service Expense13093866TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Balance Sheet Amounts ReportedtrueBalanceSheetAmountsReported
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10966NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees140NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Form8886 T FiledfalseForm8886TFiled
Non Deductible ContributionsfalseNonDeductibleContributions
Non Deductible DisclosurefalseNonDeductibleDisclosure
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Quid Pro Quo DisclosurefalseQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Policies Reference ChaptersfalsePoliciesReferenceChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledWIStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonCATHY BUKOWSKINamePerson
Telephone Number7153568109TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 470AddressLine1
CityWOODRUFFCity
StateWIState
ZIP Code54568ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (19 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
WILLIAM ARVOLD III
Director1.00X000
SHEILA CLOUGH
President40.00X019518933391X
REBECCA MORIN
VP-PATIENT CARE40.0001493088685X
PHIL JENSEN
VICE CHAIR1.00X000X
NANCY SCHULLER
Director1.00X000
MONICA HILT
REGIONAL CEO20.00029499246690X
LEE GUENTHER
Director1.00X000
LAURIE OUNGST
VP-OPERATIONS40.00014258714406X
KURT VELDUIZEN
Chairman1.00X000X
KAREN GEIER
Director1.00X000
JOHN LUND
VP-GEN COUNSEL40.00012049922676X
JACK BERGINZ
PHARMACIST-MNGR40.00135679016086X
G H BRISTER
Treasurer1.00X000X
DAWN GAPKO
DIR-PATIENT CARE40.00112774018914X
CATHY BUKOWSKI
REGIONAL CFO20.00018669822101X
BRIAN KIEF
REGIONAL CEO20.00050963356305X
BRIAN ELIASON
Director1.00X000
ADRIENNE LAVERDURE MD
Director1.00X000
A WOODSON HAGGE
Secretary1.00X000X
FieldValueIRS element (for citing)
Total Reportable Comp From Org248453TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1598906TotalReportableCompFrmRltdOrgs
Total Other Compensation239254TotalOtherCompensation
Number Individuals GT100 K2NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (3 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
MARSHFIELD CLINIC
1000 NORTH OAKMARSHFIELDWI54449EMER ROOM PHYS/SERVC102998
CROSS COUNTRY STAFFING
6551 PARK OF COMMERCE BLVD NWBOCA RATONFL33487PHYS/NURSING COVRAGE222045
ADVANCED CARE PROVIDERS
9900 KAWAGA ROADMINOCQUAWI54548MID LEVEL ED COVERAG101577
FieldValueIRS element (for citing)
Number Of Contractors GT100 K3NumberOfContractorsGT100K
Related Organizations93680RelatedOrganizations
Government Grants23725GovernmentGrants
Total Contributions117405TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
PROGRAM SVC REV-AMBULANCE6219109717197171
PROGRAM SERVICE REV-RENT5311901764817648
PROGRAM SERVICE REVENUE9000991457659814576598
FieldValueIRS element (for citing)
Total Program Service Revenue14691417TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column89503TotalRevenueColumn
Exclusion$89,503ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column8TotalRevenueColumn
Exclusion$8ExclusionAmount

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other7715Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-7715Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-7715TotalRevenueColumn
Exclusion-$7,715ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
MISC PROGRAM SERVICE REV90009960096009
MISC INTEREST5230005427$5,427
CAFETERIA/VENDING INCOME72221018635$18,635

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column583TotalRevenueColumn
Related Or Exempt Function Income583RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue30654TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column14921272TotalRevenueColumn
Related Or Exempt Function Income14698009RelatedOrExemptFunctionIncome
Exclusion$105,858ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total5918542Total
Program Services5786401ProgramServices
Management And General132141ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total349816Total
Program Services347088ProgramServices
Management And General2728ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1035747Total
Program Services1017220ProgramServices
Management And General18527ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total375857Total
Program Services365714ProgramServices
Management And General10143ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total16149Total
Management And General16149ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total5582Total
Management And General5582ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total397413Total
Program Services353403ProgramServices
Management And General44010ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total558656Total
Program Services538952ProgramServices
Management And General19704ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total9892Total
Program Services9892ProgramServices

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total287309Total
Program Services271714ProgramServices
Management And General15595ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total21606Total
Program Services19881ProgramServices
Management And General1725ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total11617Total
Program Services11617ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total580149Total
Program Services580149ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total796946Total
Program Services796674ProgramServices
Management And General272ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total62925Total
Program Services14060ProgramServices
Management And General48865ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
PURCHASE SERVICES1131249962112169137
MHC EXECUTIVE SERVICES225066225066
MANAGEMENT FEE FROM AFFLIATE17836826594531124229
DRUGS326818326818
BAD DEBT944622944622

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total109429Total
Program Services88096ProgramServices
Management And General21333ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total14949072Total
Program Services13093866ProgramServices
Management And General1855206ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY10553618BOY
EOY9067043EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2675026BOY
EOY2345120EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY129014BOY
EOY125552EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY12829BOY
EOY80251EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis19003472LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec9675726LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY9740273BOY
EOY9327746EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY8335263BOY
EOY8560243EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY671087BOY
EOY724003EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY32117110BOY
EOY30229958EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY946341BOY
EOY954244EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY55247BOY
EOY6246EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY9786754BOY
EOY9541809EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1184610BOY
EOY-418130EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY11972952BOY
EOY10084169EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY19956216BOY
EOY19907398EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY187942BOY
EOY238391EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY20144158BOY
EOY20145789EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY32117110BOY
EOY30229958EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Form4720 Filed4955 TaxfalseForm4720Filed4955Tax
Correction MadefalseCorrectionMade
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$2,591OtherActivitiesAmount
Total Lobbying Expenditures IIB2591TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3
Form4720 Filed4912 TaxfalseForm4720Filed4912Tax

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierPart II-B, Line 1iIdentifier
Return ReferencePart II-B, Line 1i - Other Activities DescriptionReturnReference
ExplanationEAGLE RIVER MEMORIAL HOSPITAL BELONGS TO A NUMBER OF TRADE ASSOCIATIONS (WHA, CHA, AHA). THESE ASSOCIATIONS ARE PAID ANNUAL DUES AND A PERCENTAGE OF THE DUES ARE RELATED TO LOBBYING DONE BY THE TRADE ASSOCIATION. LOBBY PERCENTAGES RANGE BETWEEN 5-24% OF THE ANNUAL AMOUNTS. THE AMOUNT REPORTED ON (1i) REPRESENTS THE SUM OF ALL TRADE ASSOCIATION DUES RELATED TO LOBBYING EXPENSE.Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis300919OtherCostOrOtherBasis
Book Value300919BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis11077795OtherCostOrOtherBasis
Depreciation3940525Depreciation
Book Value7137270BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis130188OtherCostOrOtherBasis
Depreciation110554Depreciation
Book Value19634BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis7494570OtherCostOrOtherBasis
Depreciation5624647Depreciation
Book Value1869923BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings9327746TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
DUE TO THIRD PARTY PAYORS-$472,739
ASSET RETIREMENT OBLIGATION$54,609
FieldValueIRS element (for citing)
Total Of Amounts-418130TotalOfAmounts
Total Revenue14921272TotalRevenue
Total Expenses14949072TotalExpenses
Excess Or Deficit For Year-27800ExcessOrDeficitForYear
Net Unrealized GL On Investments7663NetUnrealizedGLOnInvestments
Other$21,768OtherAmount
Total Adjustments29431TotalAdjustments
Excess Or Deficit Per FS1631ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt14921272TotRevenueEtcAuditedFinclStmt
Revenue Subtotal14921272RevenueSubtotal
Total Revenue Per Form99014921272TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt14949072TotExpensesEtcAuditedFinclStmt
Expenses Subtotal14949072ExpensesSubtotal
Total Expenses Per Form99014949072TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierPart XI, Line 8Identifier
Return ReferencePart XI, Line 8: Other Changes in Net Assets or Fund BalancesReturnReference
ExplanationCHANGE IN TEMP RESTRICTED FUNDS $50448 DONATED CAPITAL $65000 FOUNDATION CONTRIBUTION $ -93680Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent150XPcent150
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgetfalseExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Persons Served90PersonsServed
Total Community Benefit Expense208000TotalCommunityBenefitExpense
Net Community Benefit Expense208000NetCommunityBenefitExpense
Percent Of Total Expense0.01490PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Persons Served1266PersonsServed
Total Community Benefit Expense1820000TotalCommunityBenefitExpense
Direct Offsetting Revenue1104000DirectOffsettingRevenue
Net Community Benefit Expense716000NetCommunityBenefitExpense
Percent Of Total Expense0.05110PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Persons Served1356PersonsServed
Total Community Benefit Expense2028000TotalCommunityBenefitExpense
Direct Offsetting Revenue1104000DirectOffsettingRevenue
Net Community Benefit Expense924000NetCommunityBenefitExpense
Percent Of Total Expense0.06180PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs3NumberOfActivitiesOrPrograms
Persons Served25PersonsServed
Total Community Benefit Expense296TotalCommunityBenefitExpense
Net Community Benefit Expense296NetCommunityBenefitExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served1PersonsServed
Total Community Benefit Expense4797TotalCommunityBenefitExpense
Net Community Benefit Expense4797NetCommunityBenefitExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Benefit Expense24860TotalCommunityBenefitExpense
Net Community Benefit Expense24860NetCommunityBenefitExpense
Percent Of Total Expense0.00180PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs3NumberOfActivitiesOrPrograms
Total Community Benefit Expense392TotalCommunityBenefitExpense
Net Community Benefit Expense392NetCommunityBenefitExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs8NumberOfActivitiesOrPrograms
Persons Served26PersonsServed
Total Community Benefit Expense30345TotalCommunityBenefitExpense
Net Community Benefit Expense30345NetCommunityBenefitExpense
Percent Of Total Expense0.00200PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs8NumberOfActivitiesOrPrograms
Persons Served1382PersonsServed
Total Community Benefit Expense2058345TotalCommunityBenefitExpense
Direct Offsetting Revenue1104000DirectOffsettingRevenue
Net Community Benefit Expense954345NetCommunityBenefitExpense
Percent Of Total Expense0.06380PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$491,061BadDebtExpenseAmount
Amount Reimbursed By Medicare6409000AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare7626767CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-1217767MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare

Form990 Schedule H Part V Form990ScheduleHPartV

Name Name

FieldValueIRS element (for citing)
Business Name Line1EAGLE RIVER MEMORIAL HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1201 HOSPITAL RDAddressLine1
CityEAGLE RIVERCity
StateWIState
ZIP Code54521ZIPCode
FieldValueIRS element (for citing)
Critical Access HospitalXCriticalAccessHospital

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Annual Community Benefit ExplnMINISTRY HEALTH CARE PUBLISHES AN ANNUAL COMMUNITY BENEFIT REPORT FOR ALL WHOLLY OWNED ENTITIES. EAGLE RIVER MEMORIAL HOSPITAL IS WHOLLY OWNED BY MINISTRY HEALTH CARE AND THUS INCLUDED WITHIN THE REPORT.AnnualCommunityBenefitExpln
Costing Method UsedAmounts calculated in Part I, Line 7 are determined both on a cost accounting system and a cost-to-charge ratio. Other Benefits are determined based on the direct and indirect costs (where allocated) associated with a program net of earned revenue. Detail for each program/activity is maintained and determined at the department level. Charity care and means-tested programs are determined based on a cost-to-charge ratio consistent with Worksheet 2, Ratio of Patient Care Cost to Charges. Prior year cost report settlements are excluded from the shortfall calculation in order to get a true fiscal year shortfall amount.CostingMethodUsed
Percent Of Total Expense ExplnBAD DEBT EXPENSE OF $944,622 SHOULD EXCLUDED FROM TOTAL OPERATING EXPENSES OF $14,949,072 WHEN CALCULATING PERCENTAGE OF TOTAL EXPENSE IN PART I, LINE 7, COL. F.HOWEVER, DUE TO AN ISSUE WITH THE SOFTWARE, THE AMOUNT INCORRECTLY INCLUDED WHEN CALCULATING THE PERCENTAGE OF THE TOTAL LINES 7D, 7J, AND 7K. THE CORRECT PERCENTAGES REPORTED SHOULD BE 6.60, 0.21 AND 6.81 RESPECTIVELY.PercentOfTotalExpenseExpln
Bad Debt FootnoteNo footnote exists in the organization's financials statements that describe bad debt expense. Bad debt expense is recorded in a consistent manner with the organization's collection policies. Bad debt expense includes accounts which are written off and estimates made on live accounts based on historical payment trends and account modeling.A number of patients are truly unable to pay their out-of-pocket liability, but do not complete the process required to apply for financial assistance under the hospital's charity care policy. These patients would qualify for charity care if they completed the charity application, so the bad debt expense associated with treating them should be treated as community benefit. The organization does have a presumptive eligibility program in place to help identify indigent patients and minimize the instances of when they become a bad debt. The administrative requirements to determine whether patients who do not cooperate with the financial assistance process would have qualified for charity can be burdensome, particularly for small balances. The organization continues serving patients even after the patients have generated significant bad debt which is evidence that the care is given for community benefit motivations.BadDebtFootnote
Shortfall As Community BenefitThe shortfall associated with Medicare should be considered a community benefit for several reasons. First, IRS Rev. Rul. 69-545, which established the community benefit standard for non-profit hospitals, states that if a hospital serves patients with government health benefits, including Medicare, then this is an indication that the hospital operates to promote the health of the community. This implies that treating Medicare patients is a community benefit. Second, for-profit specialty hospitals have been carving out certain high-margin services (i.e. cardiac, orthopedics, and oncology), leaving general acute care hospitals with lower-margin Medicare services. This indicates that Medicare losses can be a result of rendering these lower-margin services (which benefit the community) rather than inefficient operations. Lastly, the community which the organization serves has Medicare as the largest payer. The organization must accept these patients regardless of whether they make a surplus or deficit from providing such services. If the Medicare participation is premised on this fact, then providing Medicare services promotes access to healthcare services which is a community benefit. The demographic of the community is also an aging and underserved population who experience issues with access to healthcare services. Without tax-exempt hospitals providing Medicare services, CMS would bear the burden of directly providing services to the elderly.ShortfallAsCommunityBenefit
Debt Collection PolicyThe organization has a debt collection policy which sets forth collection practices for patients who are known to qualify or may qualify for financial assistance under the charity care program. Sufficient financial counseling support is made available to patients so they can easily access patient financial service representatives and have their questions answered, and gain an understanding of the reasons why they owe a balance. Accounts are designated as charity care in the business offices so no additional time is spent on collection efforts.DebtCollectionPolicy
General ExplanationAs part of Ministry Health Care, Inc., the organization files an annual community benefit report on its webpage. The report can be viewed by visiting www.ministryhealth.org/MinistryHealth/Community.nws.GeneralExplanation
Needs AssessmentThe organization performs community needs assessments as needed. Planning workgroups consisting of community partners are formed to define the community and its needs through review of Health People Initiatives, census documents, and local government health and welfare agencies. Considering other community resources/assets, data collection methods are used to identify particular problems or subgroups and areas known to have high poverty rates and to be underserved. The data is analyzed and priorities are set based on trending information which may target a specific need. When a need is identified, the hospital develops a plan to implement a program either through community collaboration or individually. Outcomes from the programs are measured and considered in subsequent community needs assessments. Community benefit plans are presented to senior leadership and board members to ensure the findings are incorporated into the organization's strategy and policy development. For example, senior leaders are required to provide direct service to the poor hours as part of their performance goals.NeedsAssessment
Patient Education AssistanceThe organization goes to great lengths in order to inform and educate patients/persons who may be billed for patient care about their eligibility for assistance under federal, state or local government programs and under the organization's charity care policy. The charity care policy and application is posted on the organization's website. Admissions and other key areas contain summary information of the charity care policy. As part of the intake/discharge process, patients are provided with a copy of the policy and other information for financial assistance. If during the course of the patient registration process, care encounter, treatment, or upon discharge it becomes evident that a patient may need financial assistance, the patient shall be referred to the organization's community care program. Patients may be identified as needing financial assistance at any time during the course of an encounter. A referral for consideration of community care financial assistance can be initiated by any member of the hospital's workforce, including medical staff members, who become aware of the patient's potential need for community care financial assistance. The charity care policy was also translated into dialects prevalent in the community in order to reach out to those that may speak another language (Spanish and Hmong). Patient Registration staff and Financial Counselors are provided with scripts to follow when interacting with patients. As part of the charity care process, patients must register with the county public assistance to see if they may qualify under any other federal or state programs.PatientEducationAssistance
Community InformationWhile there is growing agreement in the United States about what constitutes a non-profit hospital's 'community benefit', this is a work in progress. The organization provided significant charity care and other community benefits as defined by the IRS. But in addition, we believe that we provide a critically important community benefit, which is not quantified. Our hospital, like most rural hospitals, was created and is maintained in order to provide care locally-care that without our hospital, would not be available locally.Certain specialized services available include: Diabetes education and management,; Speech Therapy; Wound care and management; Palliative Care services; Pain Management services; Inpatient and Outpatient services.EAGLE RIVER MEMORIAL HOSPITAL IS LOCATED IN EAGLE RIVER, WISCONSIN AND SERVES THE SURROUNDING COMMUNITIES. ACCORDING TO THE 2000 CENSUS, EAGLE RIVER HAD A POPULATION OF 1,443 PEOPLE, WITH 19.4% UNDER THE AGE OF 18, 8.2% FOR 18-24 YEARS OF AGE, 25.4% FROM 25-44 YEARS OF AGE, 20.6% FROM 45-64 YEARS OF AGE, AND 26.5% OVER THE AGE OF 65. THE MEDIAN INCOME IN 2000 FOR A HOUSEHOLD WAS $23,611, WHICH DECREASED TO $22,276 IN 2009. THE PER CAPITA INCOME OF THE CITY IN 2000 WAS $15,876. ABOUT 11.8% OF THE POPULATION WERE BELOW THE POVERTY LINE. THE TOWN HAS A TOTAL AREA OF 2.7 SQUARE MILES. THE MEDIAN AGE IS 42.5 YEARS. THE UNEMPLOYMENT RATE FOR DEC 2010 WAS 11% COMPARED TO THE STATE UNEMPLOYMENT RATE OF 7.0%EAGLE RIVER IS LOCATED IN VILAS COUNTY WISCONSIN. ACCORDING TO THE 2000 CENSUS, VILAS COUNTY HAD A POPULATION OF 21,033 PEOPLE, WITH 17.2% UNDER THE AGE OF 18 AND 26% OVER THE AGE OF 65. THE MEDIAN AGE IN 45.8 YEARS. THE MEDIAN HOUSEHOLD INCOMES IN 2008 WAS $41,022. ABOUT 11.5% OF THE POPULATION WAS BELOW THE POVERTY LEVEL.CommunityInformation
Community Building ActivitiesCommunity-building activities include programs that, while not directly related to health care, provide opportunities to address the root causes of health problems, such as poverty, homelessness, and environmental problems. These activities support community assets by offering the expertise and resources of the organization. Costs for these activities include cash, in-kind donations, and expenditures for the development of a variety of community health programs and partnerships.CommunityBuildingActivities
Other InformationThe organization strives to further its exempt purposes by the following: (1) The organization's governing board consists primarily of persons who reside within the primary service area. They are not employees of the organization. (2) As mentioned, the organization provides several services which are not otherwise available being in a rural setting. (3) Based on the organization's mission, emergency rooms are made available to all patients regardless of the ability to pay. (4) The organization also participates in the education and training of healthcare professionals through internship programs.EAGLE RIVER MEMORIAL HOSPITAL IS ALSO INVOLVED IN THE FOLLOWING EFFORTS WHICH FURTHER ITS TAX EXEMPT STATUS: THE HOSPITAL PARTICIPATES IN GOVERNMENT SPONSORED HEALTH PROGRAMS (MEDICARE, MEDICAID, CHAMPUS, TRICARE). THE FACILITY STRIVES TO BE A LOW-COST/LOW-CHARGE PROVIDER BY UTILIZING THE LEAN SIX SIGMA APPROACH TO IMPROVE PATIENT SAFETY, PATIENT QUALITY OF SERVICES AND PATIENT SATISFACTION. THE EAGLE RIVER MEMORIAL HOSPITAL EMERGENCY ROOM SERVES ALL PEOPLE REGARDLESS OF THEIR ABILITY TO PAY. CHARITY CARE IS AVAILABLE TO ALL IN THE COMMUNITY BASED ON NEED AND IS SUBJECT TO SLIDING SCALE DISCOUNTS. EAGLE RIVER MEMORIAL HOSPITAL HAS A VOLUNTEER SERVICES PROGRAM WHERE COMMUNITY MEMBERS UTILIZE THE HOSPITAL AS A VECHILE TO CONNECT WITH AND CONTRIBUTE TO INDIVIDUALS AND THE OVERALL COMMUNITY THROUGH VOLUNTEERING. EAGLE RIVER MEMORIAL HOSPITAL ENCOURAGES STAFF TO WORK WITH THE VILAS COUNTY FOOD PANTRY BY SERVING DINNERS AND PLACING FOOD DONATION CONTAINERS IN THE HOSPITAL LOBBY. ONE EMPLOYEE HAS HELPED HER ENTIRE DEPARTMENT STEP UP BY SETTING UP A SERIES OF FUNDRAISERS TO PROVIDE MONETARY GIFTS, FOOD GIFTS AND SERVICES TO THE PANTRY. THEY ALSO WORKED WITH LOCAL GROCERS TO SET UP A FREST FRUIT PROGRAM. EAGLE RIVER MEMORIAL HOSPITAL LAB STAFF ARE ALSO PROVIDING FREE SCREENINGS INCLUDING NON-FASTING CHOLESTEROL AND GLUCOSE TESTING AT THE PANTRY, WHICH HAS INSPIRED OTHER HOSPITAL EMPLOYEES TO OFFER BLOOD PRESSURE TESTS, NUTRITION SERVICES, AND WELLNESS INFORMATION.OtherInformation
Affiliated Health Care SystemThe organization is part of an affiliated health care system called Ministry Health Care, Inc. The mission of Ministry as a Catholic health care system is to further the healing ministry of Jesus by continually improving the health and well being of all people, especially the poor, in the communities served. Ministry supports such non-hospital facilities as the Agape Community Center. As a community center, it has the unique advantage of welcoming youth, adults, families and seniors into the facility through a broad range of educational, social, recreational, cultural, health and life-long learning opportunities in an impoverished portion of Milwaukee. Our Catholic Identity expects leaders to initiate and support efforts to reach out to the poor and vulnerable people, especially where no one else wants to go. Health care can become very bureaucratic and burdened with oversight of finances, regulatory requirements and strategic planning. Our focus on these issues may cause us to lose touch with those for whom we have a primary responsibility-those who are poor and vulnerable. Tithing of time allows us to look into the face of the poor, hear the voice of the poor, and help us better understand the daily challenges and barriers they face. As an affiliated health system, all leaders with direct reports are required to provide service to the poor. This also includes physician leaders and hourly supervisory staff. The organization also participates in the Ministry Health Care Fund which provides monies for special projects within the communities we serve. All organizations sponsored or co-sponsored by Ministry Health Care, Inc. set aside monies each year to assist with the needs of the community and the poor. As the Ministry Health Care Fund, these dollars are funneled back into our communities for a variety of programs and services through a community assets and needs assessment process.The organization has a foundation which is affliated with the hospital, but reported separately for 990 purposes. The foundation provides programs and cash donations which help support the mission of the organization and the affiliated health care system.AffiliatedHealthCareSystem
Reports Filed With StatesWIReportsFiledWithStates

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsBase Compensation Filing OrgBaseCompensationFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrg
SHEILA CLOUGH
16769412748147471617417217228580
REBECCA MORIN
1280102129840364649157993
MONICA HILT
24750930818166652947317217341682
LAURIE OUNGST
122645633313609125771829156993
JACK BERGINZ
11561320066231213774151765
CATHY BUKOWSKI
1369981030139399152316870208799
BRIAN KIEF
382940110302163913908717218565938

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Line 19Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableThe Ministry Web Page is available to the public for inspection with a good deal of information regarding who Ministry Health Care is and the entities included along with our mission. The Articles of Incorporation, Bylaws, conflicts policy, and financial statements are not included on any web page. However if an inquiry is made for any documents they are shared as appropriate.
Form 990, Part VI, Line 15bForm 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesTHE MINISTRY BOARD OF DIRECTORS HAS A COMPENSATION COMMITTEE THAT IS ASSISTED BY AN INDEPENDENT OUTSIDE CONSULTING FIRM, SULLIVAN COTTER. SULLIVAN COTTER, IN PARTNERSHIP WITH THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS, REVIEWS MARKET DATA FOR COMPENSATION AND BENEFITS AND COMPARABILITY DATA ON EVERY MINISTRY HEALTH CARE EXECUTIVE.
Form 990, Part VI, Line 12cForm 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsThe Board members complete each year a Board of Directors Conflict of Interest & Insider Transaction Policy questionnaire. A standard annual refresher is completed each year in the fall. Any significant reported items are corrected promptly through the Ministry Corporate Compliance Officer and local administrator.
Form 990, Part VI, Line 11Form 990, Part VI, Line 11: Form 990 Review ProcessCompleted through joint efforts of shared finance function with review and guidance of legal counsel and corporate oversight, Form 990 is presented to our governing body at the most recent board committee meeting. The President/CFO presents and briefly explains the form and its purpose.
Form 990, Part VI, Line 7aForm 990, Part VI, Line 7a: How Members or Shareholders Elect Governing BodyMinistry Health Care Inc has certain reserves and influential powers over all of its wholly owned healthcare facilities. Eagle River Memorial Hospital is wholly owned by Howard Young Health Care, who is wholly owned by Ministry Health Care.
Form 990, Part VI, Line 6Form 990, Part VI, Line 6: Explanation of Classes of Members or ShareholderMinistry Health Care Inc has certain reserves and influential powers over all of its wholly owned healthcare facilities. Eagle River Memorial Hospital is wholly owned by Howard Young Health Care, who is wholly owned by Ministry Health Care.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
DR KATE CONVALESCENT CENTER
240 MAPLE STWOODRUFFWI54568391357365PROMOTE HEALTH AND WELLNESSWI501(C)39NA
HOWARD YOUNG MEDICAL CENTER
240 MAPLE STWOODRUFFWI54568390873606HEALTH CARE SERVICESWI501(C)33NA
HOWARD YOUNG FOUNDATION
240 MAPLE STWOODRUFFWI54568391521169SUPPORT FOR HEALTH CARE ORGANIZATIONS TO PROMOTE WELLNESSWI501(C)37NA
MINISTRY HEALTH CARE
11925 W LAKE PARK DR SUITE 100MILWAUKEEWI53224391490371MANAGEMENT SUPPORT FOR INTEGRATED HEALTHCARE SYSTEMWI501(C)311, TYPE III-FINA
HOWARD YOUNG HEALTH CARE
240 MAPLE STWOODRUFFWI54568391499115HEALTH CARE MANAGEMENT SERVICESWI501(c)311, TYPE IINA
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
MINISTRY HEALTH CARE
o262710
MINISTRY HEALTH CARE
n53124
HOWARD YOUNG HEALTH CARE
o577273
HOWARD YOUNG HEALTH CARE
n942744