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Nonprofiteer
← THEDACARE MEDICAL CENTER-WILD ROSE INC

Form 990 for tax year 2023

Filed by THEDACARE MEDICAL CENTER-WILD ROSE INC.

Totals

Total revenue
$13,976,851
Total expenses
$13,087,272
Contributions and grants received
$11,528
Grants paid
$0
Program service revenue
$13,936,455
Investment income
$0
Other revenue
$28,868
Total assets, end of year
$9,999,655
Total liabilities, end of year
$4,361,672
Net assets or fund balances, end of year
$5,637,983
Program services expenses (Part IX)
$10,700,658
Management and general expenses
$2,386,614
Fundraising expenses
$0
Program service expenses (Part III)
$10,700,658

Program services were 81.8% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1d · Related organizations

    $6,892

  • 1e · Government grants (contributions)

    $4,636

  • 2a · Program service revenue: Net Patient Service Revenue

    total $13,936,455 · related or exempt $13,936,455

  • 2f · All other program service revenue

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 6c · Rental income or loss

    real property $0 · personal property $0

  • 7c · Gain or loss

    securities $0 · other assets $0

  • 11a · Other revenue: Cafeteria Revenue

    total $25,159 · excluded $25,159

  • 11b · Other revenue: Other Operating Revenue

    total $3,709 · excluded $3,709

  • 11d · All other revenue

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 11e · Other revenue, total

    $28,868

Functional expenses

Part IX, the statement of functional expenses.

  • 4 · Benefits paid to or for members

    total $0 · program services $0

  • 7 · Other salaries and wages

    total $7,244,751 · program services $6,524,972 · management and general $719,779

  • 8 · Pension plan contributions

    total $152,612 · program services $137,450 · management and general $15,162

  • 9 · Other employee benefits

    total $843,043 · program services $708,556 · management and general $134,487

  • 10 · Payroll taxes

    total $363,861 · program services $327,711 · management and general $36,150

  • 11a · Fees: management

    total $256,354 · management and general $256,354

  • 11d · Fees: lobbying

    total $1,228 · management and general $1,228

  • 11g · Fees: other

    total $2,156,579 · program services $1,064,849 · management and general $1,091,730 · fundraising $0

  • 12 · Advertising and promotion

    total $2,587 · program services $2,587

  • 13 · Office expenses

    total $162,431 · program services $162,431

  • 16 · Occupancy

    total $258,048 · program services $258,048

  • 17 · Travel

    total $21,383 · program services $21,383

  • 19 · Conferences, conventions and meetings

    total $33,841 · program services $33,841

  • 22 · Depreciation, depletion and amortization

    total $446,993 · program services $315,269 · management and general $131,724

  • 23 · Insurance

    total $41,096 · program services $41,096

  • 24a · Other expenses: Medical Supplies

    total $614,024 · program services $614,024

  • 24b · Other expenses: Equipment and Maintenance

    total $365,490 · program services $365,490

  • 24c · Other expenses: Food and Nutrition

    total $90,089 · program services $90,089

  • 24d · Other expenses: Medicaid Assessment

    total $32,862 · program services $32,862

  • 24e · All other expenses

    total $0 · program services $0 · management and general $0 · fundraising $0

Balance sheet

Part X, book values.

  • 2 · Savings and temporary cash investments

    beginning of year $1,865,586 · end of year $2,886,610

  • 4 · Accounts receivable

    beginning of year $1,802,690 · end of year $1,884,341

  • 5 · Loans and receivables from officers and key people

    beginning of year $0 · end of year $0

  • 6 · Loans and receivables from disqualified persons

    beginning of year $0 · end of year $0

  • 8 · Inventories for sale or use

    beginning of year $143,226 · end of year $196,138

  • 9 · Prepaid expenses and deferred charges

    beginning of year $4,334 · end of year $12,274

  • 10a · Land, buildings and equipment: cost or other basis

    $6,979,696

  • 10b · Land, buildings and equipment: accumulated depreciation

    $3,337,049

  • 10c · Land, buildings and equipment, net

    beginning of year $3,689,481 · end of year $3,642,647

  • 12 · Investments: other securities

    beginning of year $0

  • 13 · Investments: program-related

    beginning of year $0

  • 15 · Other assets

    beginning of year $2,105,882 · end of year $1,377,645

  • 17 · Accounts payable and accrued expenses

    beginning of year $121,983 · end of year $106,382

  • 22 · Loans and payables to officers and key people

    beginning of year $0 · end of year $0

  • 25 · Other liabilities

    beginning of year $4,740,812 · end of year $4,255,290

  • 27 · Net assets without donor restrictions

    beginning of year $4,748,404 · end of year $5,637,983

Mission and programs · 2023

Mission

TO PROVIDE THE HIGHEST QUALITY HEALTH CARE, DELIVERED IN THE MOST EFFICIENT AND COST-EFFECTIVE WAYS, AND ACCESSIBLE TO ALL MEMBERS OF THE COMMUNITY.

Activities or mission (Part I)

IMPROVING THE HEALTH OF OUR COMMUNITY.

  • THEDACARE IS A TAX-EXEMPT, NON-PROFIT CORPORATION, AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THEDACARE MEDICAL CENTER-WILD ROSE IS A 25-BED CRITICAL ACCESS HOSPITAL SERVING WILD ROSE AND NEARBY COMMUNITIES. THERE ARE MORE THAN 90 TEAM MEMBERS LOCATED AT THE WILD ROSE LOCATION. THEDACARE MEDICAL CENTER-WILD ROSE PROVIDES PATIENT CARE AND SUPPORT SERVICES INCLUDING DIAGNOSTIC SERVICES SUCH AS X-RAY, ULTRASOUND, MRI, CT SCAN, MAMMOGRAPHY AND MEDICAL LABORATORY TESTING AND SPECIALTY SERVICES SUCH AS CANCER CARE, CARDIOVASCULAR CARE, ORTHOPEDIC CARE, SPINE, NEUROLOGY, FAMILY BIRTH CARE, INTERNAL MEDICINE, EMERGENCY, OCCUPATIONAL HEALTH, PULMONOLOGY, UROLOGY, WOMEN'S CARE, OUTPATIENT SURGERY AND THERAPY SERVICES. AS PART OF THE THEDACARE SYSTEM, WE OFFER PUBLIC AWARENESS CAMPAIGNS, CHARITY CARE, SUPPORT GROUPS AND EDUCATION PROGRAMS TARGETED TO LOCAL COMMUNITY NEEDS. THEDACARE IS COMMITTED TO COMMUNITY FOCUSED EFFORTS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT IN COUNTIES (WAUSHARA) WHERE SERVICES ARE PROVIDED. EFFORTS INCLUDE PARTNERSHIPS WITH LOCAL GOVERNMENTS, COMMUNITY PARTNERS, AND AREA HEALTH ORGANIZATIONS TO ADDRESS THE TOP HEALTH PRIORITIES IDENTIFIED IN ITS MOST RECENT CHNA. THEDACARE OPERATES ON A NON-DISCRIMINATORY BASIS REGARDLESS OF RACE, COLOR, SEX, RELIGION, OR NATIONAL ORIGIN. THEDACARE PROVIDES A VARIETY OF FINANCIAL ASSISTANCE OPTIONS TO PATIENTS WHO MEET ESTABLISHED CRITERIA. SERVICES ARE ALSO PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS AT SUBSTANTIAL DISCOUNTS FROM STANDARD FEES.

    Expenses $10,700,658 · Revenue $13,936,455

As filed on the 2023 return.

Listed in Part VII

  • Carol Williams

    SECRETARY/TREASURER, BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • Dan Mielke

    CHAIR, BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • Mark Kjentvet

    VICE CHAIR, BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • Chandler Caves MD

    Physician, Board Member

    Total calculated
    $646,378
    From this org
    $0
    From related orgs
    $586,620
    Other
    $59,758
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $559,083 related
    Bonus
    $0 + $25,743 related
    Other
    $0 + $1,794 related
    Deferred
    $0 + $44,143 related
    Nontaxable benefits
    $0 + $15,615 related
    Filer's total
    $0 + $646,378 related

  • James Erdman

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • Karen West

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • Lynn Detterman

    SVP, TC-South Region, Board Member

    Total calculated
    $740,254
    From this org
    $0
    From related orgs
    $624,166
    Other
    $116,088
    Hours/week
    1 + 39 related

    Schedule J breakdown matched by us

    Base
    $0 + $475,803 related
    Bonus
    $0 + $140,534 related
    Other
    $0 + $7,829 related
    Deferred
    $0 + $90,273 related
    Nontaxable benefits
    $0 + $25,815 related
    Filer's total
    $0 + $740,254 related

  • Paul Smith

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • Sherry Brownlow

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • Tammy Bending

    Vice President, Critical Access Hospitals, Board Member

    Total calculated
    $302,550
    From this org
    $0
    From related orgs
    $271,204
    Other
    $31,346
    Hours/week
    20 + 20 related

    Schedule J breakdown matched by us

    Base
    $0 + $225,708 related
    Bonus
    $0 + $44,722 related
    Other
    $0 + $774 related
    Deferred
    $0 + $22,500 related
    Nontaxable benefits
    $0 + $8,846 related
    Filer's total
    $0 + $302,550 related

  • Terry Martz

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1

  • Brian Sterns

    Chief Digital Health Officer

    Total calculated
    $489,221
    From this org
    $0
    From related orgs
    $376,030
    Other
    $113,191
    Hours/week
    4 + 36 related

    Schedule J breakdown matched by us

    Base
    $0 + $301,872 related
    Bonus
    $0 + $70,805 related
    Other
    $0 + $3,353 related
    Deferred
    $0 + $87,376 related
    Nontaxable benefits
    $0 + $25,815 related
    Filer's total
    $0 + $489,221 related

  • Imran Andrabi MD

    President & CEO - System

    Total calculated
    $2,028,869
    From this org
    $0
    From related orgs
    $1,785,548
    Other
    $243,321
    Hours/week
    4 + 36 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,124,684 related
    Bonus
    $0 + $447,428 related
    Other
    $0 + $213,436 related
    Deferred
    $0 + $221,443 related
    Nontaxable benefits
    $0 + $21,878 related
    Filer's total
    $0 + $2,028,869 related

  • Maggie Lund

    Chief Culture and Integration Officer

    Total calculated
    $733,470
    From this org
    $0
    From related orgs
    $672,124
    Other
    $61,346
    Hours/week
    4 + 36 related

    Schedule J breakdown matched by us

    Base
    $0 + $543,254 related
    Bonus
    $0 + $110,401 related
    Other
    $0 + $18,469 related
    Deferred
    $0 + $52,500 related
    Nontaxable benefits
    $0 + $8,846 related
    Filer's total
    $0 + $733,470 related

  • Mark Thompson

    Pt Yr CFO, Chief Transformational Investments/Value Integration Officer

    Total calculated
    $1,383,936
    From this org
    $0
    From related orgs
    $1,305,621
    Other
    $78,315
    Hours/week
    4 + 36 related

    Schedule J breakdown matched by us

    Base
    $0 + $884,917 related
    Bonus
    $0 + $241,697 related
    Other
    $0 + $179,007 related
    Deferred
    $0 + $52,500 related
    Nontaxable benefits
    $0 + $25,815 related
    Filer's total
    $0 + $1,383,936 related

  • William Flett

    Chief Financial Officer

    Total calculated
    $180,467
    From this org
    $0
    From related orgs
    $153,343
    Other
    $27,124
    Hours/week
    4 + 36 related

    Schedule J breakdown matched by us

    Base
    $0 + $112,384 related
    Bonus
    $0 + $40,000 related
    Other
    $0 + $959 related
    Deferred
    $0 + $20,670 related
    Nontaxable benefits
    $0 + $6,454 related
    Filer's total
    $0 + $180,467 related

  • Thomas Arquilla

    Chief Growth Officer

    Total calculated
    $807,344
    From this org
    $0
    From related orgs
    $735,799
    Other
    $71,545
    Hours/week
    4 + 37 related

    Schedule J breakdown matched by us

    Base
    $0 + $496,464 related
    Bonus
    $0 + $125,813 related
    Other
    $0 + $113,522 related
    Deferred
    $0 + $52,500 related
    Nontaxable benefits
    $0 + $19,045 related
    Filer's total
    $0 + $807,344 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 4b · Supplemental nonqualified retirement plan
  • 7 · Other non-fixed payments

Answered no

  • 4a · Severance or change-of-control payment
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation
THE PRESIDENT & CEO OF THE ORGANIZATION IS COMPENSATED BY A RELATED ORGANIZATION. THE RELATED ORGANIZATION USES THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE PRESIDENT: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
SENIOR LEVEL EXECUTIVES OF THE COMPANY ARE ENTITLED TO AN ANNUAL FLEXIBLE BENEFIT EQUAL TO 20% OF THE MIDPOINT OF THEIR SALARY RANGE. THIS 457(F) SUPPLEMENTAL BENEFIT PLAN COMPLIES WITH THE FINAL REGULATIONS UNDER SECTION 409(A) AND 457(F) OF THE INTERNAL REVENUE CODE. PARTICIPANTS MAY ELECT THE BENEFIT TO BE USED TO PURCHASE PARTICULAR INSURANCE BENEFITS, INVEST IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN, OR A COMBINATION OF THE TWO. BENEFITS ARE ACCRUED ON A MONTHLY BASIS AND ARE SUBJECT TO THE SUBSTANTIAL RISK OF FORFEITURE AGREEMENT SIGNED BY THE PARTICIPANTS. PLAN CONTRIBUTIONS ARE MADE ON A QUARTERLY BASIS. DURING THE YEAR, THE FOLLOWING INDIVIDUALS PARTICIPATED IN AND RECEIVED PAYMENT FROM THE PLAN: IMRAN ANDRABI, MD $202,750 THOMAS ARQUILLA $97,329 MARK THOMPSON $162,970 DURING THE YEAR, THE FOLLOWING INDIVIDUALS ACCRUED AN AMOUNT FROM THE PLAN, WHICH IS INCLUDED IN DEFERRED COMPENSATION: BRIAN STERNS $34,876 IMRAN ANDRABI, MD $175,103 LYNN DETTERMAN $52,275 WILLIAM FLETT $12,775
Schedule J, Part I, Line 7 Non-fixed payments
EXECUTIVE AT-RISK COMPENSATION PLAN: THE PLAN OBJECTIVES ARE TO ENHANCE THEDACARE, INC'S ABILITY TO ACHIEVE ITS GOALS BY PROVIDING A TOOL FOR STIMULATING AND REWARDING SUPERIOR LEVELS OF PERFORMANCE AMONG LEADERS AND TO WORK TOGETHER AS A COHESIVE GROUP TOWARD COMMON GOALS. LEADERS FROM MANAGEMENT LEVEL TO THE PRESIDENT AND CEO ARE ELIGIBLE TO PARTICIPATE IN THIS PLAN. THE PERCENTAGE FOR WHICH AN INDIVIDUAL IS ELIGIBLE IS DETERMINED BY THE PARAMETERS LISTED FOR THE LEADERSHIP POSITION AND IN THE PLAN DOCUMENT ON FILE. LEADERS MAKE RECOMMENDATIONS FOR THEIR MANAGEMENT LEVEL DIRECT REPORTS TO THEIR EXECUTIVE LEADER BASED ON PERFORMANCE RESULTS. THE PRESIDENT AND CEO ALSO REVIEWS AND APPROVES. FOR SENIOR VICE PRESIDENTS, THE EXECUTIVE LEADERSHIP TEAM, AND THE PRESIDENT AND CEO, THE RECOMMENDATIONS ARE REVIEWED AND APPROVED BY THE HUMAN RESOURCES AND GOVERNANCE COMMITTEE OF THE BOARD AND THE EXECUTIVE COMMITTEE OF THE BOARD. THESE COMMITTEES ALSO REVIEW THE TOTAL SPEND FOR THE INCENTIVE PLANS. THESE LEADERS MUST BE IN ACTIVE REGULAR SERVICE OF THEDACARE, INC. FOR THE ENTIRE PLAN YEAR (JANUARY 1, 2023, TO DECEMBER 31, 2023) TO RECEIVE A 2024 BONUS. CARING FOR SUCCESS: THE PLAN OBJECTIVES ARE TO PROVIDE INCENTIVE TO FOCUS THE ORGANIZATION'S RESOURCES, ENERGY AND ATTENTION ON THE FULFILLMENT OF THEDACARE'S MISSION. EMPLOYEE ELIGIBILITY IS BASED ON THE NUMBER OF HOURS WORKED. ALL ELIGIBLE EMPLOYEES SHARE IN THE PAYOUT. THE PAYOUT AMOUNT IS A FLAT DOLLAR AMOUNT, DETERMINED BASED ON BOTH FINANCIAL AND QUALITY THRESHOLDS. THE AMOUNT PER EMPLOYEE IS DETERMINED BY DIVIDING THE TOTAL GAIN REALIZED (THE EMPLOYEE SHARE) BY HOURS PAID TO ALL ELIGIBLE EMPLOYEES. THE THEDACARE BOARD OF TRUSTEES APPROVES THE SPEND FOR THE PLAN.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

  • N APPLETON AMBULATORY CARE CENTER BUILDING COMPANY LLC

    N/A · RENTAL · WI

    Directly controlled by NA

  • ENCIRCLE REALCO LLC

    Excluded · PROPERTY HOLDING · OH

    Directly controlled by THEDACARE REGIONAL MEDICAL CENTER - APPLETON INC

Provenance

Return type
form_990
Tax year
2023
Filed
13 November 2024
IRS schema version
2023v5.1
Source object
202443189349308844

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