2023-11-13T18:47:38+00:00 2022-12-31 440160260 FORVIS LLP 211 N Broadway Suite 600 St Louis MO 631022733 990 2022-01-01 390830664 ThedaCare Regional Medical Center - Neenah Inc THED 9207355560 PO BOX 8025 APPLETON WI 549128025 IMRAN ANDRABI MD PRESIDENT/CEO 9207355560 2023-11-14 true WILLIAM FLETT 999009999 KRISTEN M HANKINS P01256574 3142315544 2023-11-15 2022 2023-04-26 12:10:37Z IMRAN ANDRABI MD PO BOX 8025 APPLETON WI 549128025 267905701 false X WWW.THEDACARE.ORG X 1909 WI IMPROVING THE HEALTH OF OUR COMMUNITY. 14 12 0 114 1330812 0 50573254 16446861 267969024 246988909 6980 43969 2494880 4425962 321044138 267905701 0 0 0 0 96370598 91674834 0 0 0 141400137 142974935 237770735 234649769 83273403 33255932 635603266 736153610 15064026 82358438 620539240 653795172 TO PROVIDE THE HIGHEST QUALITY HEALTH CARE, DELIVERED IN THE MOST EFFICIENT AND COST-EFFECTIVE WAYS, AND ACCESSIBLE TO ALL MEMBERS OF THE COMMUNITY. false false 184094415 246988909 THEDACARE IS A TAX-EXEMPT, NON-PROFIT CORPORATION, AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THEDACARE REGIONAL MEDICAL CENTER-NEENAH IS A 151-BED ACUTE CARE HOSPITAL, EMPLOYING MORE THAN 1,000 TEAM MEMBERS. THE CAMPUS OFFERS DIAGNOSTIC SERVICES SUCH AS X-RAY, ULTRASOUND, MRI, CAT SCAN, MAMMOGRAPHY AND MEDICAL LABORATORY TESTING. SPECIALTY PATIENT CARE SERVICES OFFERED INCLUDE CANCER, CARDIOVASCULAR, ORTHOPEDIC, SPINE, FAMILY BIRTH CARE, BARIATRIC WEIGHT LOSS, DIABETES, INTERNAL MEDICINE, EMERGENCY, OCCUPATIONAL HEALTH, PULMONOLOGY, UROLOGY, WOMEN'S CARE, NEPHROLOGY, THERAPY SERVICES, LEVEL II TRAUMA CENTER, NEUROLOGY, OUTPATIENT SURGERY CENTERS AND WELLNESS PROGRAM. A SIGNIFICANT FEATURE OF THE THEDACARE TRAUMA PROGRAM IS THEDASTAR. THE AIR MEDICAL PROGRAM PROVIDES IMMEDIATE MEDICAL CARE, HELICOPTER TRANSPORTS AND TRANSFERS FOR TRAUMA PATIENTS AND CRITICALLY ILL PATIENTS, INCLUDING TRANSPORT FROM OUR RURAL HOSPITALS. THIS COLLABORATION ALLOWS FOR OUR TEAMS, ACROSS THE ENTIRE REGION, TO WORK IN CONCERT WITH EACH OTHER. THERE ARE 17 COUNTIES SERVED WITHIN THE PRIMARY AND SECONDARY SERVICE AREAS. CHILDREN'S HOSPITAL OF WISCONSIN-FOX VALLEY OPENED IN 2011 AND IS LOCATED WITHIN THEDACARE REGIONAL MEDICAL CENTER-NEENAH. THEDACARE AND CHW PARTNER TO ENSURE THE COMMUNITY HAS ACCESS TO HIGH LEVELS OF CARE. 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 NEEDS HEALTH ASSESSMENT IN COUNTIES (WINNEBAGO) 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 PROVIDES SCHOLARSHIPS, CHARITY CARE, INTERPRETING AND EDUCATIONAL SERVICES AND VARIOUS OTHER COMMUNITY BENEFITS. 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. HOSPITAL INPATIENT DAYS TOTALED 32,917 WITH 2,665 ADDITIONAL DAYS FOR NEWBORN CARE. AS PART OF THEDACARE, EMERGENCY MEDICAL HELICOPTER SERVICE IS PROVIDED THROUGHOUT THE 20 COUNTIES SERVED. THE HELICOPTER PROVIDES RAPID PATIENT TRANSPORT TO THE APPROPRIATE HEALTH CARE FACILITY ALONG WITH DELIVERING HIGH-LEVEL CRITICAL CARE. 184094415 true true false true false false false false false true false false true true false false true false false false false false false false false true true false false true false false false false false false false false false false false false false true true true false false true X 0 0 0 true true false false false false false false false false false false false X 14 12 true true false false true true true true true false false true true true true true true true true false X CHRIS SANBORN 9204544184 PO BOX 8025 APPLETON WI 549128025 Imran Andrabi MD President & CEO - System 4.0 36.0 X X 0 1808832 654639 Jim Kotek Chair, Board Member 1.0 3.0 X X 0 0 0 Kim Underhill Vice Chair, Board Member 1.0 3.0 X X 0 0 0 Anitha Rao MD Board Member 1.0 3.0 X 0 0 0 Chuck Dallas Board Member 1.0 3.0 X 0 0 0 David Koeper MD Board Member 1.0 3.0 X 0 0 0 Jim Meyer Board Member 1.0 3.0 X 0 0 0 John Bere' Board Member 1.0 3.0 X 0 0 0 Laurie Carter Board Member 1.0 3.0 X 0 0 0 Mary Goggans Board Member 1.0 3.0 X 0 0 0 Norma Turk MD Board Member/Physician 1.0 39.0 X 0 249788 53594 Patrick Brennan MD Board Member 1.0 3.0 X 0 0 0 Terry Timm Past Chair, Board Member 1.0 3.0 X 0 0 0 Tim Bergstrom Board Member 1.0 3.0 X 0 0 0 James Albin Chief Information Officer 4.0 36.0 X 0 494205 49169 Maggie Lund Chief Human Resource Officer 4.0 36.0 X 0 534688 165995 Mark Thompson Senior VP, CFO & COO - System, Treasurer 4.0 36.0 X 0 1160821 311108 Paul Van Den Heuvel Secretary, Chief Legal Strategist 1.0 39.0 X 0 370852 152744 Brian Sterns Chief Digital Health Officer 4.0 36.0 X 0 266613 135716 Thomas Arquilla Chief Strategy Officer 4.0 36.0 X 0 738065 188954 0 5623863 1711919 0 false true false TOTAL MSP LLC 221 W COLLEGE AVE 2ND FLOOR APPLETON WI 54911 MEDICAL STAFFING 4243788 PHI AIR MEDICAL 2800 N 44TH STREET SUITE 800 PHOENIX AZ 85008 AIR TRANSPORT 1824949 NEUOSCIENCE GROUP OF NE WI 1305 W AMERICAN DRIVE NEENAH WI 54956 MEDICAL STAFFING 1491110 MEDSPEED LLC 140 INDUSTRIAL DRIVE ELMHURST IL 60126 MEDICAL COURIER SERVICE 1283058 WISC STATE DEPT OF HEALTH SERVICES PO BOX 1668 MADISON WI 53701 MEDICAL STAFFING 1262525 31 3531379 12912972 2510 16446861 NET PATIENT SERVICE REVENUE 622110 246988909 246988909 0 0 0 0 246988909 43969 43969 2702352 2702352 0 2702352 2702352 0 0 LABORATORY REVENUE 621500 1318011 1318011 CAFETERIA REVENUE 722210 392798 392798 PHARMACY REVENUE 446110 12801 12801 0 0 0 0 1723610 267905701 246988909 1330812 3139119 X 71648453 57005800 14642653 1583059 1206546 376513 14353691 10939827 3413864 4089631 3116958 972673 5058088 5058088 35943447 24287863 11655584 0 52030 52030 273113 177481 95632 23351 23351 4196007 4196007 45102 45102 403962 403962 11283596 8380268 2903328 366168 366168 MEDICAL SUPPLIES 76120593 64683574 11437019 EQUIPMENT MAINTENANCE 4520797 4520797 MEDICAID ASSESSMENT 4022438 4022438 FOOD/NUTRITION 666243 666243 0 0 0 0 234649769 184094415 50555354 0 348528536 372654380 39986928 34031609 0 0 0 0 3768181 4172938 -4533 267059 217056540 118733322 65229704 98323218 0 0 178094450 226704406 635603266 736153610 1686087 80719871 12890472 0 0 487467 0 1638567 15064026 82358438 X 620539240 653795172 620539240 653795172 635603266 736153610 33255932 0 0 0 0 0 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false true 18838 false false false 18838 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY A PORTION OF THE AHA AND WHA DUES REPRESENT LOBBYING PERFORMED IN REGARD TO HEALTHCARE ISSUES. TOTAL DUES PAID IN 2022 FOR BOTH AHA AND WHA WERE $105,736. 7306282 7306282 108266873 68258783 40008090 66165540 50474539 15691001 35317845 35317845 98323218 DUE FROM AFFILIATES OTHER ASSETS 533864 DUE FROM AFFILIATE 226170542 226704406 ESTIMATED THIRD-PARTY SETTLEMENTS 75000 OTHER LIABILITIES 1563567 1638567 Schedule D, Part X, Line 2 EVALUATION OF UNCERTAIN TAX POSITIONS MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. true true X true X true X true false true true 1950956 1950956 0.0083 14740 35675808 31406418 4269390 0.0182 0 0.0 0 14740 37626764 31406418 6220346 0.0265 9 307468 1613370 1613370 0.0069 2 377 1311999 1311999 0.0056 3 2 842661 842661 0.0036 0 0.0 5 219590 1168672 1168672 0.0050 19 527437 4936702 0 4936702 0.0210 19 542177 42563466 31406418 11157048 0.0475 0 0.0 1 15800 15800 0.0001 1 26615 466919 466919 0.0020 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 26615 482719 0 482719 0.0021 false 7843890 23797549 23792783 4766 X true true 1 1 THEDACARE REGIONAL MEDICAL CENTER - NEENAH 120 SECOND STREET NEENAH WI 54956 WWW.THEDACARE.ORG 32 X X X THEDACARE REGIONAL MEDICAL CENTER - NEENAH 1 false false true X X X X X X X X X 22 true false false true X HTTPS://THEDACARE.ORG/ABOUT-US/COMMUNITY-HEALTH/NEEDS-ASSESSMENT-PLANS/ X true 23 true HTTPS://THEDACARE.ORG/ABOUT-US/COMMUNITY-HEALTH/NEEDS-ASSESSMENT-PLANS/ false true X 200.0 400.0 X X X X X true true X X X X X true X https://thedacare.org/patients-and-visitors/billing-and-payment/payment-options/ X https://thedacare.org/patients-and-visitors/billing-and-payment/payment-options/ X https://thedacare.org/patients-and-visitors/billing-and-payment/payment-options/ X X X X X X X true X false X X X true X false false Schedule H, Part V, Section B, Line 3E THE HOSPITAL FACILITY ANALYZED SEVERAL HEALTH NEEDS OF THE COMMUNITY AND HAS PRIORITIZED THOSE OF MOST CONCERN. THE PRIORITIZATION OF THE TOP SIGNIFICANT COMMUNITY HEALTH NEEDS IS DESCRIBED IN THE CHNA. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - THEDACARE REGIONAL MEDICAL CENTER - NEENAH. As part of the Needs Assessment Advisory Team, ThedaCare consulted with the Public Health Departments of Outagamie County, Winnebago County, Calumet County, Shawano, Green Lake, Marquette, Waushara, Waupaca and the City of Appleton: * Chuck Sepers, City of Appleton Public Health Officer * Bonnie Thelen RN, Calumet County Public Health Officer * Natalie Vandeveld, MS, REHS / WI RS * Doug Gieryn, Winnebago County Public Health Officer * Director Terri Harmala, MSN, RN, Shawano County Health Officer * Rachel Prellwitz, Green Lake County Public Health Officer * Jayme Sophe, Marquette County, Public Health Officer * Stefanie Eldredge, BSN, RN, Health Officer/Director * Jed Woldt, Waupaca County, Public Health Officer In addition, over the course of a one-year period, secondary data was collected, key informant interviews were conducted, ThedaCare CHAT Teams (Community Health Action Team) provided input and patient health data was studied. Vulnerable populations included low income, rural farm families, older adults, veterans, Hispanic/Latino population, Lesbian, Gay, Bisexual, Transgender (LGBT), Hmong population and African American population. * ThedaCare CHAT (Community Health Action Team) of the Fox Cities members: Amy Putzer, Oshkosh Area Community Foundation Barb Tangesdahl, Executive Director, First Five, Fox Velley Becky Bartoszek, President/CEO Fox Cities Chamber of Commerce Ben Vogel, Appleton Area School District Beth Clay, Executive Director, New Mental Health Connection Bridget Clementi, Wi Children's Hospital Chris Matheny, Fox Valley Technical College Chuck Sepers, Health Officer, City of Appleton Dale Gisi, VP, Central Region, ThedaCare Doug Gieryn, Health Officer, Winnebago County Greg Lemke-Rochon , Boys and Girls Club, Fox Valley Jesse Smith, Lawrence University Joe Mauthe, Community Volunteer Martin Rudd, Assistant Chan., Access Computer Montgomery Elmer, Chief Medical Officer Ambulatory Care, ThedaCare Oliver Zorrow, Executive Director, Building for Kids Peter Granopoulos, President/CEO UW Fox Cities Peter Lee, Behavioral Health Diversity and Inclusion Consultant Rayor Brown, Behavioral Health Diversity and Inclusion Consultant Reiko Ramos, Diversity and Resilient Director Shane Kohl, ThedaCare Family of Foundations Tammy Geenen, Community Foundation for the Fox Valley Region Tim Galloway, Galloway Company Timber Smith, City of Appleton, City of Appleton Diversity, Inclusion, Special Assistant to the Mayor Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - THEDACARE REGIONAL MEDICAL CENTER - NEENAH. THE THEDACARE COMMUNITY HEALTH IMPLEMENTATION STRATEGY WAS APPROVED BY THE THEDACARE BOARD OF TRUSTEES IN 2022. THE FOLLOWING PRIORITIES WERE IDENTIFIED AS THE TOP COMMUNITY HEALTH NEEDS FOR THE 2023-2025 CHNA CYCLE: MENTAL AND BEHAVIORAL HEALTH CHALLENGES CONTINUE WITH THE MENTAL AND BEHAVIORAL HEALTH OF OUR COMMUNITY. ACCESS TO MENTAL HEALTH SERVICES IS NOT KEEPING UP WITH DEMAND, AND THERAPISTS AND HEALTH PROFESSIONALS ARE LACKING IN RURAL AREAS. ADDITIONALLY, ANXIETY AND DEPRESSION HAVE RISEN 20-30% IN RECENT YEARS WHILE SELF-MEDICATION AND SUBSTANCE ABUSE, INCLUDING ALCOHOL, METHAMPHETAMINE, AND VAPING ARE ON THE RISE. TO ADDRESS THIS HEALTH NEED, THE HOSPITAL FACILITY HAS IMPLEMENTED THE FOLLOWING TO ENSURE THAT PEOPLE HAVE THE SUPPORT NEEDED TO LEAD MENTALLY HEALTHY LIVES, FREE OF RELIANCE ON HARMFUL SUBSTANCES AND TO SUPPORT UPSTREAM EFFORTS THAT FOSTER MENTAL HEALTH: 1) EXPAND THEDACARE BEHAVIORAL HEALTH TREATMENT CAPACITY a. EXPAND UTILIZATION OF/SERVICES OFFERED AT BEHAVIORAL HEALTH WALK-IN CARE CLINIC. ESTABLISH SAME-DAY ACCESS. b. EXPAND BEHAVIORAL HEALTH COLLABORATIVE CARE PROGRAM TO ALL PRIMARY CARE CLINICS BY 2026. c. INCREASE NUMBER OF MAT PROVIDERS. d. OPEN NEW BEHAVIORAL HEALTH CLINIC IN WAUPACA. e. ENHANCE RESOURCES OF PEDIATRIC PRIMARY CARE PROVIDERS TO ADDRESS COMMON BEHAVIORAL HEALTH NEEDS. 2) PARTNER TO ESTABLISH REGIONAL DETOXIFICATION CAPACITY, WORKING WITH COUNTY GOVERNMENTS, HEALTH SYSTEMS, PUBLIC HEALTH, LOCAL SUBSTANCE USE AGENCIES, AND LAW ENFORCEMENT. 3) STRENGTHEN, EXPAND AND DIVERSIFY BEHAVIORAL HEALTH WORKFORCE THROUGH: a. A REGIONAL TRAINING CENTER FOR NEW MENTAL HEALTH PRACTITIONERS NEEDING SUPERVISED CLINICAL HOURS. b. "JUST FOR ME" EMOTIONAL WELLNESS PROGRAMMING FOR MENTAL HEALTH PRACTITIONERS. 4) EXPAND ED2RECOVERY+ COACHING CAPACITY a. EXPAND TO INCLUDE REFERRALS FROM PRIMARY CARE AND COMMUNITY PARTNERS. b. ADDRESS ALL SUBSTANCES. 5) SUPPORT THE NEW MENTAL HEALTH CONNECTION 6) ADDRESS MENTAL HEALTH NEEDS OF LGBTQ+ COMMUNITY a. SPONSOR LGBTQ+ MENTAL HEALTH SUMMIT. b. LGBTQ+ FRIENDLY MENTAL HEALTH RESOURCE DIRECTORY THROUGH NEW MENTAL HEALTH CONNECTION. c. PROVIDER LGBTQ+ CULTURAL COMPETENCY TRAINING. 7) PARTNER TO SUPPORT SOCIAL CONNECTION AND BELONGING WORK 8) SUPPORT CATALPA HEALTH AND CATALPA HEALTH "SEEDLINGS" PROGRAM ADDRESSING EARLY CHILDHOOD SOCIAL EMOTIONAL LEARNING. SOCIAL NEEDS AS THEDACARE SHIFTS ITS FOCUS UPSTREAM TO POPULATION HEALTH, IT IS IMPORTANT TO UNDERSTAND HOW VITAL CONDITIONS, SUCH AS CLEAN AIR, FAIR PAY, HOUSING, EDUCATION AND OTHER BASIC NECESSITIES CAN IMPACT AN INDIVIDUAL'S WELL-BEING. ADDITIONALLY, RELIABLE TRANSPORTATION, BELONGING AND CIVIC MUSCLE, AND PURPOSE ALL INFLUENCE HEALTH. TO ADDRESS THIS IDENTIFIED NEED, THE HOSPITAL FACILITY HAS IMPLEMENTED THE FOLLOWING TO ENSURE THAT THE BASIC NEEDS OF PATIENTS ARE MET: 1) ESTABLISH SYSTEMATIC SOCIAL NEEDS "CLOSED-LOOP" SCREENING AND REFERRAL OF THEDACARE PATIENTS. a. ACROSS INPATIENT, ED, AND PRIMARY CARE. b. PEDIATRICS. 2) IMPROVE ACCESS TO EMPLOYMENT TRANSPORTATION THROUGH WORKFORCE INNOVATION GRANT COLLABORATION. 3) ADDRESS SOCIAL NEEDS THROUGH EMPLOYEE VOLUNTEERING/GIVING EFFORTS THROUGH: a. HOUSING - HABITAT FOR HUMANITY b. FOOD INSECURITY - FEEDING AMERICA c. UNITED WAY CAMPAIGN 4) IMPLEMENT CULTURAL COMPETENCY TRAINING OF THEDACARE TEAM MEMBERS. 5) SUPPORT EXPANSION OF STAR PROGRAM ADDRESSING "OPPORTUNITY GAP" BETWEEN BLACK AND WHITE HIGH SCHOOL STUDENTS. 6) SUPPORT BE WELL FOX VALLEY AND EAT WELL FOR LIFE INITIATIVES ADDRESSING DIABETES MANAGEMENT AMONG LOW-INCOME POPULATIONS. 7) SUPPORT BASIC NEEDS GIVING PARTNERSHIP AND US VENTURE GOLF OUTING TO END POVERTY. STRONG START TO LIFE GROWING UP HEALTHY AND STRONG STARTS AT THE BEGINNING OF AN INDIVIDUAL'S LIFE. IN PARTNERSHIP WITH CHILDREN'S WISCONSIN, THEDACARE SEEKS TO ADDRESS SOCIAL DETERMINANTS OF HEALTH, MENTAL, BEHAVIORAL AND INFANT HEALTH, AND SAFETY AND VIOLENCE IN CHILDREN THROUGH THE FOLLOWING: 1) SUPPORT REGIONAL FIRST 5 FOX VALLEY EARLY CHILDHOOD COALITION AND HELP ME GROW CENTRALIZED FAMILY SUPPORT ACCESS POINT. 2) SUPPORT REGIONAL COLLEGE SAVINGS ACCOUNT INITIATIVE FOR LOW-INCOME FAMILIES. 3) ESTABLISH THEDACARE PEDIATRIC SDOH COMMUNITY RESOURCE NAVIGATION ASSISTANCE IN RURAL MARKETS THROUGH ADVANCING A HEALTHIER WISCONSIN GRANT AND EXPAND TO ENTIRE SERVICE AREA. 4) PARTNER TO ESTABLISH COMMUNITY RESOURCE NAVIGATION SUPPORT WITHIN CATALPA. 5) EXPLORE EXPANSION OF WELCOME BABY COMMUNITY MODEL IN RURAL MARKETS. 6) FACILITATE COLLABORATIVE REGIONAL ASSESSMENT OF AVAILABILITY AND ACCESSIBILITY OF PARENTING PROGRAMS AND SUPPORTS: a. COLLABORATE TO ADDRESS GAPS AND IMPROVE ACCESSIBILITY TO OFFERINGS. b. ADDRESS BASIC PARENTING AND GROWING OBESITY AND MENTAL HEALTH CONCERNS ACROSS INFANT TO TEEN SPECTRUM. REGIONAL ALIGNMENT IN ORDER TO POSITIVELY AFFECT COMMUNITY HEALTH, HEALTH SYSTEMS, NOT-FOR-PROFIT ORGANIZATIONS, AND THE PUBLIC SECTOR MUST BE UNITED ON THEIR PRIORITIES AND COMMITMENTS. THEDACARE WILL WORK WITH PARTNERS TO ESTABLISH COMMON INFRASTRUCTURE NEEDED TO IMPROVE ALIGNMENT OF HEALTH PRIORITIES AND ACTIONS THROUGH THE FOLLOWING: 1) ESTABLISH COMMON COMMUNITY HEALTH NEEDS ASSESSMENT AND ALIGNED IMPROVEMENT PLANS ACROSS HEALTH SYSTEMS AND PUBLIC HEALTH PARTNERS. 2) DEVELOP COLLABORATIVE REGIONAL NETWORK AND INFRASTRUCTURE FOR ADDRESSING SOCIAL NEEDS. 3) DEVELOP ALIGNMENT AND SYNERGY ACROSS CHAT TEAMS THROUGH IMPLEMENTATION OF CHAT 2.0 MODEL. 4) SUPPORT IMAGINE FOX CITIES REGIONAL VISIONING INITIATIVE. SIGNIFICANT NEEDS IDENTIFIED THROUGH THE MOST RECENTLY CONDUCTED CHNA THAT WILL NOT BE ADDRESS IN THE CURRENT THREE-YEAR PLAN ARE: 1) HIGH PAYING JOBS/ECONOMIC OPPORTUNITY - LIMITED RESOURCES TO ADDRESS 2) INTERNET - BEING ADDRESSED BY OTHERS 3) FOOD INSECURITY - BEING ADDRESS BY OTHERS 4) MOTOR VEHICLE CRASH DEATHS - LIMITED RESOURCES TO ADDRESS 5) EXERCISE OPPORTUNITIES - LIMITED RESOURCES TO ADDRESS. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - THEDACARE REGIONAL MEDICAL CENTER - NEENAH. PATIENTS ARE SENT AN OVERVIEW LETTER EXPLAINING THE PROCESS FOR APPLYING FOR OUR ASSISTANCE PROGRAM OR OUR STAFF WALKS THEM THROUGH THE PROCESS. THEY ARE ASKED TO COMPLETE AN APPLICATION THAT INCLUDES REQUESTS FOR INFORMATION. THIS INFORMATION IS NEEDED IN ORDER TO MAKE A DECISION AS TO WHETHER THE PATIENT MEETS THE CRITERIA FOR ACCEPTANCE, AND IF ACCEPTED, WHAT LEVEL OF ASSISTANCE WILL BE PROVIDED. ONCE THE DECISION IS MADE, WE WILL NOTIFY THE PATIENT AND IF ACCEPTABLE, WRITE OFF THE BALANCE AS DETERMINED. Schedule H, Part V, Section B, Line 15 Facility , 1 Facility , 1 - THEDACARE REGIONAL MEDICAL CENTER - NEENAH. CONTRACTED WITH ELIGIBILITY VENDOR (CARDON) TO WORK DIRECTLY WITH THE UNINSURED PATIENT TO ASSIST THEM WITH INSURANCE ENROLLMENT AND EDUCATION. Schedule H, Part V, Section B, Line 16 Facility , 1 Facility , 1 - THEDACARE REGIONAL MEDICAL CENTER - NEENAH. THE FAP AND APPLICATION WERE AVAILABLE AT HOSPITAL CASHIER OFFICES, ON OUR WEB SITE AND OFFERED TO ALL PATIENTS THAT EXPRESSED A FINANCIAL HARDSHIP WHEN CALLING THE BILLING OFFICE. THE PLS WAS PRINTED ON EVERY STATEMENT AND A FOOTER WAS ADDED TO THE FRONT OF THE STATEMENT ADVISING PATIENT TO SEE REVERSE SIDE OF STATEMENT FOR FINANCIAL ASSISTANCE AND PAYMENT OPTIONS. NOTIFICATION OF FINANCIAL ASSISTANCE AVAILABILITY WAS ADDED TO THE INITIAL LETTER SENT BY THE THIRD PARTY COLLECTION AGENCY. 6 AYLWARD SURGERY CENTER 120 SECOND STREET NEENAH WI 54956 OUTPATIENT SURGERY CENTER RENAISSANCE SURGERY CENTER 2400 WITZEL AVENUE OSHKOSH WI 54904 OUTPATIENT SURGERY CENTER ThedaCare Physical Therapy 1516 S Commercial St Neenah WI 54956 Rehab clinic ThedaCare Physical Therapy 600 N Westhaven Dr Oshkosh WI 54904 Rehab clinic NeuroSpine Center of Wisconsin 5320 W Michaels Dr Appleton WI 54913 Specialty clinic ThedaCare Behavioral Health 1095 Midway Rd Menasha WI 54952 Behavioral health clinic Schedule H, Part I, Line 3c DISCOUNTED CARE EXCEPTIONS SEE PART V, SECTION B, LINE 13 FOR THE LIST OF FACTORS USED IN THE ELIGIBILITY CRITERIA EXPLAINED IN THE FAP FOR PROVIDING FREE AND DISCOUNT CARE. Schedule H, Part I, Line 7 COLUMN F The bad debt expense is not considered a community benefit expense and is not included in Schedule H, Part I, Line 7. The amount excluded is $7,843,890. Schedule H, Part I, Line 7g No physician clinic costs are included in the Community Benefit expenses. Schedule H, Part I, Line 6a Community benefit report prepared by related organization THEDACARE, INC. 39-1509362 Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS IN THE TABLE IS A COMBINATION OF AVERAGE COSTS AND ACTUAL COSTS PERTAINING TO SUPPLIES, WAGES, AND BENEFITS. FOR SUPPLIES, THE ACTUAL COST OF ITEMS USED FOR EACH EVENT IS APPLIED. IF NO ACTUAL COST IS AVAILABLE, WE THEN USE AN ESTIMATE. WAGES ARE CALCULATED BY MULTIPLYING THE AVERAGE WAGE RATE TIMES ACTUAL HOURS WORKED. THE BENEFIT RATE USED INCLUDEDS A FRINGE RATIO OF ALL BENEFITS RELATED TO THE ABOVE WAGE CALCULATION. THE COST ACCOUNTING SYSTEM DOES NOT DIFFERENTIATE BETWEEN DIFFERENT PAYER TYPES AND NO COST-TO-CHARGE RATIO IS USED. Schedule H, Part II Community Building Activities THE HOSPITAL FACILITY PARTICIPATES IN NUMEROUS COMMUNITY BUILDING ACTIVITIES THROUGHOUT THE YEAR. SPECIFIC ACTIVITIES REPORTED ON SCHEDULE H, PART II INCLUDE: Economic Development - The primary aim of the chamber is to protect the interest of the business community as a whole. Strong employment is a social determinant of health, reducing poverty and providing individual and family sustainability. ThedaCare works together with local Chambers of Commerce in all of the communities it serves. Community Support - Caring Hearts is a financial assistance program designed for patients who are unable to pay for medically necessary services provided by all divisions within ThedaCare. The Caring Hearts Program covers services which are deemed to be medically necessary as determined by their physician. This cost is for time and expense needed to support Caring Hearts. The Caring Hearts financial assistance program is in effect at all ThedaCare facilities - ThedaCare Regional Medical Centers in Appleton and Neenah, ThedaCare Medical Center- Berlin, ThedaCare Medical Center-New London, ThedaCare Medical Center-Shawano, ThedaCare Medical Center-Waupaca and ThedaCare Medical Center-Wild Rose. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount PATIENT ACCOUNTS RECEIVABLE ARE UNCOLLATERALIZED PATIENT OBLIGATIONS THAT ARE STATED AT THE AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH THEDACARE EXPECTS TO BE ENTITLED IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE OBLIGATIONS ARE PRIMARILY FROM LOCAL RESIDENTS, MOST OF WHOM ARE INSURED UNDER THIRD-PARTY PAYOR AGREEMENTS. THEDACARE 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 STATEMENTS. THEDACARE DOES NOT HAVE A POLICY TO CHARGE INTEREST ON PAST DUE ACCOUNTS. PATIENT ACCOUNTS RECEIVABLE ARE RECORDED AT NET REALIZABLE VALUE BASED ON CERTAIN ASSUMPTIONS. FOR THIRD-PARTY PAYORS, INCLUDING MEDICARE, MEDICAID, MANAGED CARE AND COMMERCIAL PAYORS, THE NET REALIZABLE VALUE IS BASED ON THE ESTIMATED CONTRACTUAL REIMBURSEMENT PERCENTAGE, WHICH IS BASED ON CURRENT CONTRACT PRICES OR HISTORICAL PAID CLAIMS DATA BY PAYOR. FOR UNINSURED PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR A PORTION OF THE BILL), THE NET REALIZABLE VALUE IS DETERMINED USING ESTIMATES OF HISTORICAL COLLECTION EXPERIENCE. THESE ESTIMATES ARE ADJUSTED FOR EXPECTED RECOVERIES AND ANY ANTICIPATED CHANGES IN TRENDS, INCLUDING SIGNIFICANT CHANGES IN PAYOR MIX, ECONOMIC CONDITIONS OR TRENDS IN FEDERAL AND STATE GOVERNMENTAL HEALTH CARE COVERAGE. Schedule H, Part III, Line 3 Bad Debt Expense Methodology THE HOSPITAL IS REPORTING $0 BECAUSE IT DOES NOT HAVE A METHOD OF REASONABLY ESTIMATING THE PORTION OF ITS BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE BUT WHO DID NOT COMPLETE A FINANCIAL ASSISTANCE APPLICATION. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote SEE "PATIENT ACCOUNTS RECEIVABLE AND CREDIT POLICY" OF NOTE 1 ON PAGE 11 IN THE ATTACHED FINANCIAL STATEMENTS. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST-TO-CHARGE RATIO. SHORTFALLS ARISE FROM PAYMENTS THAT ARE LESS THAN THE COSTS TO PROVIDE THE SERVICES. THE SHORTFALLS SHOULD BE CONSIDERED COMMUNITY BENEFIT AS THEY MUST BE ABSORBED IN ORDER TO CONTINUE PROVIDING CARE TO OUR COMMUNITY. IT IS ALSO IMPLIED IN INTERNAL REVENUE SERVICE RULING 69-545 WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR TAX-EXEMPT HOSPITALS AND INDICATES THAT PARTICIPATION IN PUBLICLY-FINANCED PROGRAMS, SUCH AS MEDICARE, IS EVIDENCE THAT A HOSPITAL MEETS THE COMMUNITY BENEFIT STANDARD. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance OUR POLICY IS NOT TO PURSUE PATIENT ACCOUNTS TO THE EXTENT ANY CHARGES ARE ELIGIBLE AND WRITTEN OFF THROUGH OUR CHARITY CARE/FINANCIAL ASSISTANCE PROGRAM. IF ONLY A PORTION OF THE CHARGES ARE ELIGIBLE AND WRITTEN OFF THROUGH OUR CHARITY CARE/FINANCIAL ASSISTANCE PROGRAM, THE REMAINING BALANCE WILL BE BILLED TO THE PATIENT AND COLLECTED IN ACCORDANCE WITH OUR NORMAL COLLECTION POLICY. Schedule H, Part V, Section B, Line 16a FAP website - THEDACARE REGIONAL MEDICAL CENTER - NEENAH: Line 16a URL: https://thedacare.org/patients-and-visitors/billing-and-payment/payment-options/; Schedule H, Part V, Section B, Line 16b FAP Application website - THEDACARE REGIONAL MEDICAL CENTER - NEENAH: Line 16b URL: https://thedacare.org/patients-and-visitors/billing-and-payment/payment-options/; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - THEDACARE REGIONAL MEDICAL CENTER - NEENAH: Line 16c URL: https://thedacare.org/patients-and-visitors/billing-and-payment/payment-options/; Schedule H, Part VI, Line 2 Needs assessment THEDACARE COVERS A 9-COUNTY PRIMARY SERVICE AREA SERVED BY 7 HOSPITALS. THEDACARE CONDUCTS A COMMUNITY NEEDS ASSESSMENT EVERY THREE YEARS FOR EACH HOSPITAL GATHERING DATA PERTINENT TO THAT COMMUNITY AND THE SURROUNDING AREAS. INFORMATION COLLECTED INCLUDES DATA FROM THE WISCONSIN COUNTY HEALTH RANKINGS, FOX CITIES LIFE STUDY (LOCAL INDICATORS FOR EXCELLENCE), THE BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY, INSIGHTS FROM INTERVIEWS OF PUBLIC HEALTH OFFICIALS, INSIGHTS FROM INTERVIEWS WITH REPRESENTATIVES OF VULNERABLE POPULATIONS, EMERGENCY DEPARTMENT PATIENT DATA AND INSIGHTS GATHERED FROM MONTHLY MEETINGS OF THE THEDACARE-LED CHAT TEAM (COMMUNITY HEALTH ACTION TEAM) COMPRISED OF COMMUNITY LEADERS IN BUSINESS, NON-PROFIT, CLERGY, EDUCATION, DIVERSE POPULATION GROUPS, HEALTHCARE, UNITED WAY, PUBLIC HEALTH AND THE LOCAL COMMUNITY FOUNDATIONS. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance PATIENT EDUCATION BEGINS WHEN A PATIENT IS ADMITTED TO A THEDACARE HOSPITAL. ADMISSION SPECIALISTS MEET WITH EACH PERSON INDIVIDUALLY TO ASSESS INSURANCE STATUS AND FINANCIAL NEED. IF NECESSARY, SPECIALISTS REFER PATIENTS TO CARE MANAGEMENT SPECIALISTS WHO ASSIST WITH THE ENROLLMENT OF PATIENTS IN AN APPLICABLE PROGRAM. THE HOSPITAL PATIENT HANDBOOK IS PROVIDED TO ALL IN-PATIENTS. INTERNAL POLICIES SUCH AS DISCOUNTED SERVICES POLICY, CARING HEARTS POLICY AND PAYMENT FOR SERVICE POLICY FOR SELF-PAY BALANCES PROVIDE GUIDANCE. THE THEDACARE WEBSITE, WWW.THEDACARE.ORG, PROVIDES EDUCATION REGARDING THE AFFORDABLE CARE ACT IN EASY-TO-UNDERSTAND LANGUAGE. IT DISCUSSES OPTIONS AND WHERE TO GO FOR ASSISTANCE. Schedule H, Part VI, Line 4 Community information THEDACARE REGIONAL MEDICAL CENTER - NEENAH DEFINES ITS PRIMARY HOSPITAL SERVICE AREA (HSA) AS WINNEBAGO COUNTY IN WISCONSIN. THE TOTAL POPULATION FOR THE HSA WAS 171,631 ACCORDING TO THE MOST RECENT AVAILABLE DATA. THE HOSPITAL'S SERVICE AREA CONSISTS OF MOSTLY SUBURBAN REGIONS. SINCE 2010, THE 65 AND OLDER POPULATION SHOWED THE MOST GROWTH, AND THE 35 TO 49 AGE GROUP THE MOST DECLINE. WHILE STILL PREDOMINANTLY NON-HISPANIC WHITE, THE AREA SAW INCREASES IN POPULATION FOR HISPANICS. OVER ONE-THIRD OF HOUSEHOLDS ARE LIVING BELOW THE ALICE THRESHOLD, WHICH INDICATES A HOUSEHOLD EITHER ABOVE OR BELOW THE FEDERAL POVERTY LEVEL BUT STILL NOT EARNING ENOUGH TO AFFORD BASIC NECESSITIES. Schedule H, Part VI, Line 5 Promotion of community health THE FOUNDATION OF COMMUNITY HEALTH WITHIN THEDACARE IS COMMUNITY HEALTH IMPROVEMENT. THEDACARE COMMUNITY HEALTH IMPROVEMENT IS FUNDED THROUGH OPERATING BUDGET, GRANTS, AND THE THEDACARE FAMILY OF FOUNDATION SUPPORT. THEDACARE PROVIDES FUNDING AND DEDICATED STAFF TO MAKE CHAT COMMUNITY HEALTH EFFORTS POSSIBLE. THE COMMUNITY HEALTH TEAM WORKS WITH LOCAL COMMUNITY HEALTH ACTION TEAM (CHAT), GROUPS OF COMMUNITY LEADERS WHO STUDY SYSTEMIC HEALTH ISSUES OUTSIDE THE WALLS OF OUR HOSPITALS. CHAT IS THE FOUNDATION OF INNOVATIVE, COLLABORATIVE SOLUTIONS FOR COMMUNITY ISSUES THAT DRAW UPON THE WIDE ARRAY OF RESOURCES AND STRENGTHS OF OUR COMMUNITY. THERE ARE THEDACARE LED CHAT'S IN THE FOX CITIES OF APPLETON/MENASHA/NEENAH, BERLIN, NEW LONDON, SHAWANO, WAUPACA AND WILD ROSE. Schedule H, Part VI, Line 6 Affiliated health care system THEDACARE, INC., THE PARENT ORGANIZATION, PROVIDES DIRECTION RELATED TO COMMUNITY HEALTH NEEDS ASSESSMENT FOR EACH HOSPITAL AND SURROUNDING COMMUNITIES WITHIN ITS SERVICE AREA. PLANS ARE APPROVED BY LOCAL HOSPITAL BOARDS. EACH THEDACARE HOSPITAL, ALONG WITH CHI STAFF AND COMMUNITY MEMBERS DETERMINE HOW BEST TO MEET LOCAL NEEDS. IMPLEMENTATION OF COMMUNITY PROGRAMMING OCCURS AT THE LOCAL LEVEL. Schedule H, Part VI, Line 7 State filing of community benefit report WI X X X X false true false false false false false true false Imran Andrabi MD President & CEO - System 0 1069773 0 625104 0 113954 0 654639 0 0 0 2463471 0 0 Norma Turk MD Board Member/Physician 0 224088 0 20338 0 5362 0 45500 0 8094 0 303382 0 0 Maggie Lund Chief Human Resource Officer 0 370127 0 157543 0 7018 0 157901 0 8094 0 700683 0 0 Mark Thompson Senior VP, CFO & COO - System, Treasurer 0 823122 0 321783 0 15916 0 287197 0 23911 0 1471929 0 0 James Albin Chief Information Officer 0 219539 0 170014 0 104652 0 38878 0 10291 0 543374 0 0 Paul Van Den Heuvel Secretary, Chief Legal Strategist 0 302983 0 60750 0 7118 0 134811 0 17933 0 523596 0 0 Thomas Arquilla Chief Strategy Officer 0 479252 0 200574 0 58239 0 171313 0 17641 0 927019 0 0 Brian Sterns Chief Digital Health Officer 0 200386 0 59016 0 7210 0 111805 0 23911 0 402329 0 0 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 $102,463 THOMAS ARQUILLA $45,524 JAMES ALBIN $95,700 DURING THE YEAR, THE FOLLOWING INDIVIDUALS ACCRUED AN AMOUNT FROM THE PLAN, WHICH IS INCLUDED IN DEFERRED COMPENSATION: IMRAN ANDRABI, MD $162,871 PAUL VAN DEN HEUVEL $20,282 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 MANAGER 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, 2022, TO DECEMBER 31, 2022) TO RECEIVE A 2023 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. Form 990, Part V, Line 1a ALL APPLICABLE 1099 AND 1096 IRS TAX FORMS ARE REPORTED AND FILED BY THE PARENT ORGANIZATION, THEDACARE, INC., EIN 39-1509362. Form 990, Part V, Line 2a ALL APPLICABLE W-2 AND W-3 IRS TAX FORMS ARE REPORTED AND FILED BY THE PARENT ORGANIZATION, THEDACARE, INC., EIN 39-1509362. Form 990, Part VI, Line 1a Delegate broad authority to a committee THE BOARD OF TRUSTEES HAS AN EXECUTIVE COMMITTEE CONSISTING OF THE BOARD'S CHAIR, VICE CHAIR, PRESIDENT, SECRETARY AND TREASURER. THE EXECUTIVE COMMITTEE HAS AND MAY EXERCISE, WHEN THE BOARD OF TRUSTEES IS NOT IN SESSION, THE POWER OF THE BOARD OF TRUSTEES IN THE MANAGEMENT OF THE ORGANIZATION'S AFFAIRS, EXCEPT ACTION WITH RESPECT TO ELECTION OF OFFICERS OR TRUSTEES. Form 990, Part VI, Line 2 Family/business relationships amongst interested persons An employee/employer relationship exists for individuals on Part VII who are employees of ThedaCare, Inc. and individuals listed on Part VII who also serve as Directors or Officers of ThedaCare, Inc. - Business relationship Form 990, Part VI, Line 3 Delegation of management duties ALL MANAGEMENT AND ADMINISTRATIVE FUNCTIONS ARE PROVIDED BY EMPLOYEES OF THEDACARE, INC., THE SOLE MEMBER AND PARENT COMPANY OF THEDACARE REGIONAL MEDICAL CENTER - NEENAH, INC Form 990, Part VI, Line 6 Classes of members or stockholders THEDACARE REGIONAL MEDICAL CENTER - NEENAH, INC.'S SOLE MEMBER OF THE SINGLE CLASS OF VOTING MEMBERS IS THEDACARE, INC. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body THEDACARE, INC. HAS SOLE AUTHORITY IN THE CORPORATION TO VOTE AND TAKE ANY ACTION WITH RESPECT TO THE ELECTION OF DIRECTORS AND OFFICERS. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders THEDACARE, INC. HAS THE SOLE AUTHORITY WITH RESPECT TO THE FOLLOWING MATTERS: 1. AMENDMENT OF THE ARTICLES OF INCORPORATION; 2. ADOPTION AND AMENDMENT OF BYLAWS OF THE CORPORATION; 3. CONSOLIDATION, MERGER AND DISSOLUTION OF THE CORPORATION; 4. MONITORING COMPLIANCE WITH LAWS AND REGULATIONS; 5. SELECTION, APPOINTMENT, AND REMOVAL OF A CHIEF OPERATING OFFICER; 6. PROVISION FOR LONG-RANGE FINANCIAL STABILITY OF THE HOSPITAL AND PROVISION FOR THE CONTROL AND USE OF THE PHYSICAL AND FINANCIAL RESOURCES OF THE HOSPITAL; 7. ESTABLISHMENT OF A LONG-RANGE PLANNING MECHANISM; 8. APPROVAL OF A HOSPITAL ORGANIZATION AND MAJOR AUTHORITY DELEGATION PATTERNS; 9. APPROVAL OF FINANCIAL, CAPITAL, AND OTHER ITEMS; 10. APPROVAL OF DEBT OR LEASES; AND 11. CONSIDERATION AND ACTION UPON POLICIES CONCERNING RELATIONS WITH EXTERNAL GROUPS AND ORGANIZATIONS. Form 990, Part VI, Line 11b Review of form 990 by governing body A DRAFT OF THE FORM 990 IS PROVIDED TO THE ORGANIZATION'S DESIGNATED COMMITTEE OF THE BOARD OF DIRECTORS FOR REVIEW AND DISCUSSION AT A BOARD MEETING. THE FINAL VERSION OF THE FORM 990 IS EMAILED TO THE ENTIRE BOARD BEFORE THE RETURN IS FILED. Form 990, Part VI, Line 12c Conflict of interest policy QUESTIONNAIRES ARE SENT TO ALL MANAGERS, TRUSTEES, AND OFFICERS ANNUALLY. COMPLETED FORMS ARE RETURNED TO THE COMPLIANCE OFFICER. THE COMPLIANCE OFFICER REVIEWS THE QUESTIONNAIRES AND FOLLOWS UP WITH ANY QUESTIONS ABOUT THE MANAGERS' ANSWERS ON THE CONFLICT OF INTEREST FORMS. ALL EMPLOYEES AND BOARD MEMBERS ARE COVERED UNDER THE CONFLICT OF INTEREST POLICY. THE CORPORATE COMPLIANCE COMMITTEE REVIEWS THE POTENTIAL CONFLICT AND THE CFO/BOARD OF TRUSTEES REVIEW ALL CONFLICTS. AFTER DISCLOSURE OF THE CONFLICT, THE EMPLOYEE SHALL NOT PARTICIPATE IN THE DECISION WHETHER TO ENGAGE IN THE TRANSACTION IN WHICH THE EMPLOYEE HAS AN INTEREST. Form 990, Part VI, Line 15a Process to establish compensation of top management official THEDACARE HIRES AN OUTSIDE CONSULTING FIRM TO CONDUCT A THOROUGH MARKET REVIEW OF EXECUTIVE COMPENSATION EVERY OTHER YEAR. THE HUMAN RESOURCES AND GOVERNANCE COMMITTEE OF THE BOARD WAS FORMED IN DECEMBER 2018. THE OUTSIDE CONSULTANT PRESENTED HIS FINDINGS TO THE CHIEF HUMAN RESOURCES OFFICER, THE PRESIDENT AND CEO. THE INFORMATION WAS THEN PRESENTED TO THE HUMAN RESOURCES AND GOVERNANCE COMMITTEE OF THE BOARD AND THEN TO THE EXECUTIVE COMMITTEE OF THE BOARD. BOTH COMMITTEES WERE PROVIDED THE INFORMATION FOR REVIEW, EDUCATION AND ACCEPTANCE IN 2021. Form 990, Part VI, Line 19 Required documents available to the public THEDACARE REGIONAL MEDICAL CENTER - NEENAH, INC. DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND INTERNAL FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. Form 990, Part IX, Line 11g Other Fees Contract labor/agency - Total Expense: 9162049, Program Service Expense: 5427275, Management and General Expenses: 3734774, Fundraising Expenses: ; Physician/professional fees - Total Expense: 3126426, Program Service Expense: 1851984, Management and General Expenses: 1274442, Fundraising Expenses: ; Fees for other services - Total Expense: 23654972, Program Service Expense: 17008604, Management and General Expenses: 6646368, Fundraising Expenses: ; THEDACARE INC PO BOX 8025 APPLETON WI 549128025 391509362 HEALTHCARE WI 501(c)(3) 10 NA false THEDACARE MEDICAL CENTER - NEW LONDON INC PO BOX 8025 APPLETON WI 549128025 390869788 HOSPITAL WI 501(c)(3) 3 THEDACARE INC true THEDACARE MEDICAL CENTER - WAUPACA INC PO BOX 8025 APPLETON WI 549128025 398711113 HOSPITAL WI 501(c)(3) 3 THEDACARE INC true THEDACARE REGIONAL MEDICAL CENTER -APPLETON INC PO BOX 8025 APPLETON WI 549128025 390824015 HOSPITAL WI 501(c)(3) 3 THEDACARE INC true THEDACARE MEDICAL CENTER - SHAWANO INC PO BOX 8025 APPLETON WI 549128025 390807068 HOSPITAL WI 501(c)(3) 3 THEDACARE INC true THEDACARE MEDICAL CENTER - BERLIN INC PO BOX 8025 APPLETON WI 549128025 390806359 HOSPITAL WI 501(c)(3) 3 THEDACARE INC true THEDACARE REGIONAL MEDICAL CENTER - WILD ROSE INC PO BOX 8025 APPLETON WI 549128025 396089134 HOSPITAL WI 501(c)(3) 3 THEDACARE INC true THEDACARE FAMILY OF FOUNDATIONS INC PO BOX 8025 APPLETON WI 549128025 464112255 FOUNDATION WI 501(c)(3) 7 THEDACARE INC true NORTH APPLETON AMBULATORY CARE CENTER BUILDING COMPANY LLC 2500 E CAPITOL DR APPLETON WI 54911 262497187 RENTAL WI NA N/A ENCIRCLE REALCO LLC 65 HIDDEN RAVINES DRIVE SUITE 100 POWELL OH 43065 853472736 PROPERTY HOLDING OH THEDACARE REGIONAL MEDICAL CENTER - APPLETON INC N/A false false true false false false false false false false false false true true true false false false false THEDACARE FAMILY OF FOUNDATIONS INC C 3531379 BOOK