2026-05-12T16:07:48+00:00 2025-06-30 135565207 KPMG LLP 191 West Nationwide Blvd Suite 500 Columbus OH 432152568 990 2024-07-01 392034296 Froedtert West Bend Hospital Foundation Inc FROE 2623345533 3200 PLEASANT VALLEY RD WEST BEND WI 53095 Matt Partridge SVP - Finance 2026-05-12 true true Riley Kobrick P02401884 6142492300 2026-05-08 2024 2025-03-06 01:10:19Z ALLEN ERICSON 3200 PLEASANT VALLEY RD WEST BEND WI 53095 6902985 false X WWW.FROEDTERT.COM/WESTBENDFOUNDATION X 2002 WI TO ADVANCE THE HEALTH OF OUR COMMUNITIES THROUGH EXCELLENCE AND DISCOVERY, INSPIRING EACH PERSON TO LIVE THEIR UNIQUE, BEST LIFE. 13 10 0 40 0 248273 241272 0 0 1183817 1035714 6449 -2095 1438539 1274891 297644 302075 0 188334 198297 0 217173 67417 61142 553395 561514 885144 713377 25011797 27362713 355819 203018 24655978 27159695 TO ADVANCE THE HEALTH OF OUR COMMUNITIES THROUGH EXCELLENCE AND DISCOVERY, INSPIRING EACH PERSON TO LIVE THEIR UNIQUE, BEST LIFE. false false 257959 250200 FROEDTERT WEST BEND HOSPITAL FOUNDATION, INC., IS A NONSTOCK, NONPROFIT CORPORATION THAT RECEIVES GIFTS AND BEQUESTS, RAISES FUNDS FOR SPECIFIC PROJECTS OR NEEDS, ADMINISTERS AND INVESTS FUNDS, AND DISBURSES PAYMENTS TO FURTHER THE MISSION AND PURPOSES OF ST. JOSEPH'S COMMUNITY HOSPITAL OF WEST BEND. 51875 51875 FROEDTERT WEST BEND HOSPITAL FOUNDATION, INC. ISSUES SCHOLARSHIPS EACH YEAR FROM MONEY DONATED TO THE FOUNDATION FROM AN OUTSIDE DONOR. CURRENT YEAR SCHOLARSHIP EXPENSES TOTALED $51,875. 309834 true true false false false false false false false true true false false false true true false true false false false false false false true false false true true true false false false false false false false false false false false false false false false true false false false false true 0 0 0 false false false false false true true false false false false false false X 13 10 false false false false true true true true true false false false true true true true true true true true false false WI X X DAVE DIRKSMEYER 4148053000 N74 W12501 LEATHERWOOD CT MENOMONEE FALLS WI 53051 Allen Ericson Director & FWBH President 1.0 49.0 X X 0 1114216 180192 Chad Feltz Director & BOD V.Chair (eff 7/1/24) 1.0 0 X X 0 0 0 Dan Miller Director & BOD Chair 1.0 0 X X 0 0 0 Nooriya Farheen Director & Treasurer 1.0 49.0 X X 0 210117 43299 Troy Hanson Director & BOD Secr (eff 1/23/25) 1.0 0 X X 0 0 0 Ann Johnson Director & Executive Director 1.0 49.0 X 0 176530 41980 Austin Smith Director 1.0 0 X 0 0 0 Bryce Gartland MD Director (eff 5/1/25) 1.0 4.0 X 0 0 0 Chris Chlupp Director 1.0 0 X 0 0 0 Imran Andrabi MD Director & FTCH President/CEO (eff 7/1/24; term 5/1/25) 1.0 40.0 X 0 4591338 647039 Jacci Gambucci Director 1.0 0 X 0 0 0 John Breuer Director 1.0 0 X 0 0 0 Peter Rettler Director 1.0 1.0 X 0 0 0 Tom Zuern Director 1.0 0 X 0 0 0 0 6092201 912510 0 false true false 0 142396 98876 8679 241272 0 0 0 0 0 701939 701939 0 0 5935147 5601372 333775 0 333775 333775 24627 142396 26722 -2095 -2095 0 0 0 0 0 1274891 0 0 1033619 250200 250200 51875 51875 185195 18519 166676 13102 1310 11792 2581 2581 0 0 0 0 4080 408 3672 HOSPITAL SUPPORT 27225 7082 20143 ALL OTHER EXPENSES 10712 7759 2953 PRINTING & PUBLICATIONS 9423 942 8481 MINOR EQUIPMENT 4950 495 4455 2171 0 217 1954 561514 309834 34507 217173 256183 172478 20766 1458 0 0 0 0 0 0 27248 27248 0 0 24734848 27188777 0 0 0 0 25011797 27362713 0 0 355819 203018 355819 203018 X 24235501 26739218 420477 420477 24655978 27159695 25011797 27362713 X 713377 1418307 372033 X false true true false X 221662 266842 193752 248273 241272 1171801 0 0 221662 266842 193752 248273 241272 1171801 79732 1092069 902082 466968 638633 682167 701939 3391789 0 -22079 -15984 33517 6449 -2095 -192 4563398 0 0.23931 0.21603 X 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0 0 0.0 X 0 0 0 0 0 0 Schedule A, Part II, Line 17a PART II, SECTION C, LINE 17A, FACTS AND CIRCUMSTANCES TEST: THERE ARE TWO REQUIREMENTS THAT FROEDTERT WEST BEND HOSPITAL FOUNDATION MUST FULFILL IN ORDER TO SATISFY THE FACTS-AND-CIRCUMSTANCES TEST SET FORTH IN TREAS. REG. 1.170A-9 (F) (3) (II). FIRST, THEY MUST DERIVE AT LEAST 10% OF ITS SUPPORT FROM GOVERNMENTAL UNITS OR FROM DIRECT OR INDIRECT CONTRIBUTIONS FROM THE GENERAL PUBLIC, OR A COMBINATION OF BOTH. FROEDTERT WEST BEND HOSPITAL FOUNDATION RECEIVED 23.93% OF ITS TOTAL SUPPORT FROM GOVERNMENT UNITS AND THE PUBLIC AND THEREFORE, FROEDTERT WEST BEND HOSPITAL FOUNDATION HAS SATISFIED THIS FIRST REQUIREMENT. SECOND, FROEDTERT WEST BEND HOSPITAL FOUNDATION MUST MAINTAIN A CONTINUOUS AND BONAFIDE FUNDRAISING PROGRAM OR CARRY ON PROGRAMS DESIGNED TO ATTRACT SUPPORT FROM GOVERNMENTAL UNITS OR OTHER PUBLIC CHARITIES DESCRIBED IN IRC 170 (B) (1) (A) (I) THROUGH (VI). FROEDTERT WEST BEND HOSPITAL FOUNDATION MAINTAINS SEVERAL FUNDRAISING PROGRAMS AND INITIATIVES, EACH OF WHICH IS DESIGNED TO ATTRACT SUPPORT FROM THE PUBLIC. FROEDTERT WEST BEND HOSPITAL FOUNDATION CONDUCTS A MID-YEAR AND YEAR-END DIRECT MAIL CONTRIBUTIONS SOLICITATION PROGRAM, AN ANNUAL STAFF GIVING CAMPAIGN, A GRATEFUL PATIENT PROGRAM WHICH INVOLVES WORKING WITH INDIVIDUALS WHO HAVE BENEFITTED FROM THE CARE THEY RECEIVED AT ST. JOSEPH'S COMMUNITY HOSPITAL, AND A MEMORIAL DONATION PROGRAM FOR WORKING WITH FAMILIES WHO HAVE LOST A LOVED ONE. FROEDTERT WEST BEND HOSPITAL FOUNDATION ALSO CONDUCTS VARIOUS FUNDRAISING EVENTS EACH YEAR TO BENEFIT SPECIFIC CARE PROGRAMS OF ST. JOSEPH'S COMMUNITY HOSPITAL. FROEDTERT WEST BEND HOSPITAL FOUNDATION MAINTAINS A VERY CLOSE RELATIONSHIP WITH ST. JOSEPH'S COMMUNITY HOSPITAL, AN EXEMPT CHARITABLE ORGANIZATION UNDER IRC 501 (A) AS DESCRIBED IN IRC 501 (C) (3), AND CLASSIFIED AS A PUBLICLY SUPPORTED PUBLIC CHARITY UNDER IRC 509 (A) (1) AND DESCRIBED IN IRC 170 (B) (1) (A) (III). ST. JOSEPH'S COMMUNITY HOSPITAL PROVIDES A SIGNIFICANT PORTION OF FROEDTERT WEST BEND HOSPITAL FOUNDATION'S SUPPORT IN RECOGNITION OF THE NEED TO PROVIDE HEALTH CARE SERVICES TO THE COMMUNITIES SERVED BY ST. JOSEPH'S COMMUNITY HOSPITAL AND FROEDTERT WEST BEND HOSPITAL FOUNDATION. FROEDTERT WEST BEND HOSPITAL FOUNDATION IS ACCOUNTABLE TO ST. JOSEPH'S COMMUNITY HOSPITAL FOR HOW THE FOUNDATION EXPENDS ITS FUNDS BY VIRTUE OF THE FACT THAT ST. JOSEPH'S COMMUNITY HOSPITAL APPOINTS AND APPROVES A MAJORITY OF FROEDTERT WEST BEND HOSPITAL FOUNDATION'S BOARD OF DIRECTORS AND RETAINS OTHER APPROVAL RIGHTS OVER THE FOUNDATION'S OPERATIONS. IN ADDITION TO SATISFYING THE TWO REQUIREMENTS SET FORTH ABOVE, THERE ARE ADDITIONAL RELEVANT FACTS AND CIRCUMSTANCES WHICH DEMONSTRATE THAT FROEDTERT WEST BEND HOSPITAL FOUNDATION QUALIFIES AS A "PUBLICLY SUPPORTED" PUBLIC CHARITY UNDER IRC 509 (A) (1) AND 170 (B) (1) (A) (VI). 1. FROEDTERT WEST BEND HOSPITAL FOUNDATION'S TOTAL SUPPORT EXCEEDS THE MINIMUM 10% "THRESHOLD" BY A SUBSTANTIAL PORTION. MOREOVER, HISTORICALLY THE TOTAL SUPPORT RECEIVED BY FROEDTERT WEST BEND HOSPITAL FOUNDATION IS FROM A CONSIDERABLE AND REPRESENTATIVE NUMBER OF DONORS LOCATED THROUGHOUT THE VARIOUS COMMUNITIES SERVED BY FROEDTERT WEST BEND HOSPITAL FOUNDATION. 2. FROEDTERT WEST BEND HOSPITAL FOUNDATION'S BOARD OF DIRECTORS IS COMPRISED OF INDIVIDUALS WHO INCLUDE COMMUNITY AND CIVIC LEADERS, COMMUNITY BUSINESS EXECUTIVES, PHYSICIANS AND OTHER INDIVIDUALS WHO REPRESENT THE BROAD INTERESTS OF THE PUBLIC. 3. FROEDTERT WEST BEND HOSPITAL FOUNDATION PROVIDES CONTINUING SUPPORT TO ST. JOSEPH'S COMMUNITY HOSPITAL, AND OTHER HEALTH CARE FACILITIES AND ORGANIZATIONS WHICH MAKE THEIR HEALTH CARE SERVICES AVAILABLE TO THE GENERAL PUBLIC WITH THE MISSION OF IMPROVING THE HEALTH OF THE COMMUNITIES SERVED BY SUCH ORGANIZATIONS. 4. FROEDTERT WEST BEND HOSPITAL FOUNDATION HAS VOLUNTEERS COMPRISED OF INDIVIDUALS FROM THE GENERAL PUBLIC WHO VOLUNTEER THEIR TIME AND SKILLS IN CARRYING OUT VARIOUS ACTIVITIES AND FUNCTIONS OF THE FOUNDATION. 5. IN ADDITION TO RECEIVING FUNDS FROM THE GENERAL PUBLIC, FROEDTERT WEST BEND HOSPITAL FOUNDATION RECEIVES A SIGNIFICANT AMOUNT OF SUPPORT FROM ITS "PARENTGANIZATION, ST. JOSEPH'S COMMUNITY HOSPITAL OF WEST BEND. Schedule A, Part II, Line 10 Other Income DESCRIPTION - FUNDRAISING, COLUMN A - -22079.0, COLUMN B - -15984.0, COLUMN C - 33517.0, COLUMN D - 6449.0, COLUMN E - -2095.0, COLUMN F - -192.0; RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2100 2100 2100 2100 2100 2100 2100 2100 2100 2100 1.0 false true true 27248 27248 0 0 Federal Income Taxes DUE TO AFFILIATES 203018 203018 X 0 0 0 0 0 0 0 0 0 0 0 0 Schedule D, Part V, Line 4 Intended uses of endowment funds FOR PERMANENTLY RESTRICTED ENDOWMENT FUNDS, THE INTENT OF THE FUNDS DEPENDS ON THE RESTRICTION THAT APPLIES TO THAT PARTICULAR ENDOWMENT, AS PRESCRIBED BY THE DONOR. DEPENDING ON THE PARTICULAR ENDOWMENT, THE INTENDED USE INCLUDES FELLOWSHIPS, RESEARCH AND EDUCATIONAL RESOURCES FOR THE COMMUNITY. Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote FROEDTERT THEDACARE HEALTH, INC., THE PARENT ENTITY INTO WHICH FROEDTERT WEST BEND HOSPITAL FOUNDATION INC.'S FINANCIAL RESULTS ARE CONSOLIDATED, APPLIES ASC NO. 740, INCOME TAXES, WHICH CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN A COMPANY'S FINANCIAL STATEMENTS. ASC NO. 740 PRESCRIBES A MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN. UNDER ASC NO. 740, TAX POSITIONS ARE EVALUATED FOR RECOGNITION, DERECOGNITION, AND MEASUREMENT USING CONSISTENT CRITERIA AND PROVIDE MORE INFORMATION ABOUT THE UNCERTAINTY IN INCOME TAX ASSETS AND LIABILITIES. AS OF JUNE 30, 2025 AND 2024, FROEDTERT WEST BEND HOSPITAL FOUNDATION, INC. DOES NOT HAVE AN ASSET OR LIABILITY RECORDED FOR UNRECOGNIZED TAX POSITIONS. ABOVE & BEYOND 167023 142396 24627 26722 0 0 167023 142396 24627 26722 26722 -2095 true INTERFAITH CAREGIVERS OF WASHINGTON COUNTY 2374A W WASHINGTON ST WEST BEND WI 53095 020657722 501(C)(3) 30000 HEALTHY AGING IN PLACE-SENIOR TRANSPORTATION ELEVATE INC N169W21005 MEADOW LN JACKSON WI 53037 391256286 501(C)(3) 32000 INDIVIDUALIZED INTERVENTION PROGRAMS (AODA) LAKESHORE COMMUNITY HEALTH CENTER 908 W WASHINGTON ST WEST BEND WI 53095 264321839 501(C)(3) 50000 EXPANDING WASHINGTON COUNTY'S HEALTH SAFETY NET (MENTAL HEALTH, CHRONIC DISEASE, ACCESS TO HEALTH CARE) COMMUNITY SMILES DENTAL 210 NW BARSTOW ST SUITE 305 WAUKESHA WI 53188 300436162 501(C)(3) 25000 DENTAL CARE ACCESS FOR LOW-INCOME WASHINGTON COUNTY FAMILIES (ACCESS-DENTAL) THE YOUTH AND FAMILY PROJECT INC 630 ELM STREET WEST BEND WI 53095 510149160 501(C)(3) 23000 CROSSROADS YOUTH PROGRAM OUTREACH (MENTAL HEALTH) BOYS & GIRLS CLUBS OF WASHINGTON COUNTY 925 N SILVERBROOK DRIVE WEST BEND WI 53095 391773689 501(C)(3) 25000 HEALTHCARE CAREER EXPLORATION PROGRAM (CHRONIC DISEASE, ACCESS TO HEALTHCARE) FAMILY PROMISE 450 E WATER ST WEST BEND WI 53095 270740203 501(C)(3) 28500 HEALTH SERVICES AND HOUSING FOR HOMELESS (HOUSING) CASA GUADALUPE EDUCATION CENTER 479 N MAIN STREET WEST BEND WI 53090 204483105 501(C)(3) 25000 HEALTHY LATINOS, HEALTHY FUTURES (CHRONIC DISEASE) SEED OF HOPE 206 N 6TH AVE WEST BEND WI 53095 391775712 501(C)(3) 11700 SAFE SLEEP PLUS (ACCESS TO HEALTHCARE) 9 SCHOLARSHIPS 13 51875 0 FMV N/A Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds APPLICATIONS FOR FUNDING ARE AVAILABLE VIA AN INDEPENDENT WEBSITE ON AN ANNUAL BASIS FOR 501(C)(3) NON-PROFIT ORGANIZATIONS. REQUESTS ARE LIMITED TO PROJECTS THAT WILL SIGNIFICANTLY IMPROVE THE HEALTH AND WELL-BEING OF PEOPLE LIVING IN WASHINGTON COUNTY AND MAY INCLUDE CAPITAL PROJECTS. APPLICANTS ARE GIVEN APPROXIMATELY ONE MONTH TO SUBMIT THEIR APPLICATION AND SUPPORTING DOCUMENTATION. THE APPLICATIONS THEN GO TO A COMMITTEE OF INDIVIDUALS FROM LOCAL COMMUNITIES, AS WELL AS INDIVIDUALS FROM THE FROEDTERT THEDACARE HEALTH, INC. SYSTEM. THE HEALTHY COMMUNITY FUND COMMITTEE WILL REVIEW APPROPRIATE APPLICATION REQUESTS AND DETERMINE IF THE PROGRAM/PROJECT MEETS REQUIREMENTS. AFTER A FORMAL RANKING PROCESS, IT WILL BE DETERMINED IF SUPPORT WILL BE GRANTED, AND AT WHAT LEVEL, GIVEN THE AVAILABLE RESOURCES AND COMMITTEE'S CURRENT PRIORITIES. THE RECOMMENDATION OF THE HEALTHY COMMUNITY FUND COMMITTEE THEN GOES TO THE FROEDTERT WEST BEND HOSPITAL FOUNDATION, INC. BOARD AND THE FROEDTERT THEDACARE HEALTH, INC. PRESIDENT FOR APPROVAL. ONCE THE ORGANIZATIONS ARE NOTIFIED OF FUNDING AND GIVEN THE MONEY, THEY ARE ASKED TO SUBMIT A REPORT TO THE FROEDTERT WEST BEND HOSPITAL FOUNDATION, INC.'S BOARD SHOWING THE PROGRESS OF THEIR PROJECT. false true false false false false false false false Nooriya Farheen Director & Treasurer 0 174888 0 34888 0 341 0 9882 0 33417 0 253416 0 0 Allen Ericson Director & FWBH President 0 570318 0 365694 0 178204 0 140575 0 39617 0 1294408 0 150044 Imran Andrabi MD Director & FTCH President/CEO (eff 7/1/24; term 5/1/25) 0 1794100 0 2564672 0 232566 0 620140 0 26899 0 5238377 0 216027 Ann Johnson Director & Executive Director 0 146304 0 29035 0 1191 0 9969 0 32011 0 218510 0 0 Schedule J, Part I, Line 3 THE PRESIDENT/CEO'S PERFORMANCE IS REVIEWED BY THE BOARD CHAIR ANNUALLY. THE BOARD OF ST. JOSEPH'S COMMUNITY HOSPITAL OF WEST BEND, INC. APPROVES ANY SALARY AND/OR BENEFIT CHANGES. SALARIES ARE REVIEWED AND APPROVED BY THE TALENT STRATEGY AND COMPENSATION COMMITTEE OF THE FROEDTERT THEDACARE HEALTH, INC. (A RELATED ORGANIZATION) BOARD OF DIRECTORS, UTILIZING VARIOUS COMPENSATION STUDIES AND COMPARATIVE DATA. Schedule J, Part I, Line 4b SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN 457(f) distributions: Andrabi, Imran - $216,027 Ericson, Allen - $150,044 457(f) plan participants: Andrabi, Imran Ericson, Allen Schedule J, Part I, Line 7 BONUS COMPENSATION IS PAID BASED UPON ATTAINMENT OF SPECIFIC GOALS RELATED TO THE ORGANIZATION'S STRATEGY, SERVICE, QUALITY, AND FINANCIAL STRENGTH. THE AMOUNT OF COMPENSATION IS CALCULATED USING SPECIFIED PERCENTAGES OF BASE SALARY FOR ACHIEVEMENT OF PARTICULAR GOAL LEVELS. HOWEVER, THE FROEDTERT THEDACARE HEALTH SYSTEM BOARD COMMITTEE WHICH ADMINISTERS THE BONUS COMPENSATION PROGRAM HAS DISCRETION OVER WHETHER TO PAY THE BONUS IN ANY GIVEN YEAR OR TO AMEND, CHANGE, OR TERMINATE THE PROGRAM AT ANY TIME. Schedule J, Part II, Column (B)(ii) BONUS AND INCENTIVE COMPENSATION AMOUNTS INCLUDE INCENTIVE COMPENSATION PAID. Schedule J, Part II, Column (B)(iii) OTHER REPORTABLE COMPENSATION INCLUDES 457(F) DEFERRED COMPENSATION PLAN DISTRIBUTIONS PAID TO INDIVIDUALS, AMOUNTS PAID IN LIEU OF 457(F) DEFERRED COMPENSATION PLAN CONTRIBUTIONS, AND OTHER MISCELLANEOUS COMPENSATION. Schedule J, Part II, Column (F) ON JANUARY 1, 2024, THE FROEDTERT HEALTH SYSTEM MERGED WITH THE THEDACARE HEALTH SYSTEM. AS OF THIS DATE, FROEDTERT HEALTH, INC. WAS RENAMED TO FROEDTERT THEDACARE HEALTH, INC. ("FTCH") AND BECAME THE SOLE CORPORATE MEMBER OF THEDACARE, INC. ("TC"). IN DOING SO, FTCH BECAME THE COMMON LAW EMPLOYER WITH RESPECT TO TC EMPLOYEES. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE LEGACY TC SECTION 457(F) DEFERRED COMPENSATION PLAN ("THEDACARE PLAN"). AS SUCH, ANY DEFERRED AMOUNTS IN PRIOR TAX YEARS UNDER THE THEDACARE PLAN WERE REPORTED ON THE RESPECTIVE TC FORM 990. NOW, AS COMMON LAW EMPLOYER OF THE TC EMPLOYEES, FTCH HAS INCLUDED ANY CURRENT YEAR COMPENSATION RELATED TO THESE PREVIOUSLY DEFERRED AMOUNTS IN COLUMN (B). THEREFORE, THESE AMOUNTS ARE ALSO APPROPRIATELY REPORTED IN COLUMN (F). ANDRABI, IMRAN Form 990, Part III, Line 4a DURING FY 2025, FROEDTERT WEST BEND HOSPITAL FOUNDATION, INC. PAID THE FOLLOWING AMOUNTS TO AREA ORGANIZATIONS: - $30,000 TO INTERFAITH CAREGIVERS OF WASHINGTON COUNTY FOR HEALTHY AGING IN PLACE (ACCESS TO HEALTHCARE/COMMUNITY SERVICES/TRANSPORTATION) - $32,000 TO ELEVATE, INC. FOR INDIVIDUALIZED INTERVENTION PROGRAMS (AODA) - $50,000 TO LAKESHORE COMMUNITY HEALTH CENTER FOR EXPANDING WASHINGTON COUNTY'S HEALTH SAFETY NET (MENTAL HEALTH, CHRONIC DISEASE, ACCESS TO HEALTHCARE) - $25,000 TO COMMUNITY SMILES DENTAL FOR DENTAL CARE ACCESS FOR LOW-INCOME WASHINGTON COUNTY FAMILIES (ACCESS-DENTAL) - $23,000 TO THE YOUTH AND FAMILY PROJECT INC. FOR CROSSROADS YOUTH PROGRAM OUTREACH (MENTAL HEALTH) - $25,000 TO BOYS & GIRLS CLUBS OF WASHINGTON COUNTY FOR HEALTHCARE CAREER EXPLORATION PROGRAM (CHRONIC DISEASE, ACCESS TO HEALTHCARE) - $28,500 TO FAMILY PROMISE FOR HEALTH SERVICES AND HOUSING FOR HOMELESS (HOUSING) - $25,000 TO CASA GUADALUPE EDUCATION CENTER FOR HEALTHY LATINOS, HEALTHY FUTURES (CHRONIC DISEASE) - $11,700 TO SEED OF HOPE FOR SAFE SLEEP PLUS (ACCESS TO HEALTHCARE) ADDITIONALLY, FROEDTERT WEST BEND HOSPITAL FOUNDATION, INC. PAID THE FOLLOWING AMOUNT TO INTERNAL PROGRAMS: - $5,000 TO THE ABOVE & BEYOND CANCER CENTER FUNDRAISER EVENT (CANCER CENTER) - $2,759 TO STAFF SCHOLARSHIPS Form 990, Part VI, Line 6 Classes of members or stockholders ST. JOSEPH'S COMMUNITY HOSPITAL OF WEST BEND, INC. IS THE SOLE CORPORATE MEMBER OF FROEDTERT WEST BEND HOSPITAL FOUNDATION, INC. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body ST. JOSEPH'S COMMUNITY HOSPITAL OF WEST BEND, INC., AS THE SOLE CORPORATE MEMBER OF FROEDTERT WEST BEND HOSPITAL FOUNDATION, INC., HAS THE FINAL APPROVAL OF ELECTION OF ALL BOARD MEMBERS. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders FROEDTERT THEDACARE HEALTH, INC., AS THE SOLE CORPORATE MEMBER OF ST. JOSEPH'S COMMUNITY HOSPITAL., AND ST. JOSEPH'S COMMUNITY HOSPITAL, AS THE SOLE MEMBER OF FROEDTERT WEST BEND HOSPITAL FOUNDATION, INC., EACH RETAIN AUTHORITIES AS DEFINED IN CORPORATE BYLAWS. Form 990, Part VI, Line 11b Review of form 990 by governing body FROEDTERT THEDACARE HEALTH, INC. ACCOUNTING STAFF PREPARE FORM 990 WHICH IS REVIEWED BY THE FROEDTERT THEDACARE HEALTH FINANCIAL LEADERS. THE 990 IS THEN REVIEWED BY KPMG, FROEDTERT THEDACARE HEALTH'S OUTSIDE ACCOUNTING FIRM. NEXT, THE 990 IS PROVIDED TO THE FROEDTERT THEDACARE HEALTH AUDIT COMMITTEE AND BOARD OF DIRECTORS. FINALLY, THE 990 IS FILED AS REQUIRED. Form 990, Part VI, Line 12c Conflict of interest policy ALL DIRECTORS, OFFICERS, KEY EMPLOYEES, AND OTHER COVERED INDIVIDUALS ARE REQUIRED TO COMPLETE AND SIGN AN ANNUAL CONFLICT OF INTEREST DISCLOSURE FORM. THESE FORMS REQUIRE INDIVIDUALS TO IDENTIFY ANY ACTUAL, POTENTIAL, OR PERCEIVED CONFLICTS. SUBMITTED DISCLOSURES ARE REVIEWED BY THE COMPLIANCE/OGC, AND BOARD GOVERNANCE COMMITTEE. THROUGHOUT THE YEAR, INDIVIDUALS ARE REQUIRED TO UPDATE DISCLOSURES WHENEVER NEW CONFLICTS ARISE. THIS IS REENFORCED IN ANNUAL COMPLIANCE EDUCATION. IN ADDITION, BOARD COMMITTEE MEETINGS AND PROCUREMENT COMMITTEE MEETINGS HAVE CONFLICT OF INTEREST DISCLOSURES AS AN AGENDA ITEM. THE ORGANIZATION ENFORCES COI POLICY THROUGH PUTTING MANAGEMENT PLANS IN PLACE TO MITIGATE A POTENTIAL CONFLICT WHEN APPROPRIATE. ALL DISCLOSURES, EVALUATIONS, AND MITIGATION ACTIONS ARE DOCUMENTED AND RETAINED BY THE COMPLIANCE DEPARTMENT. Form 990, Part VI, Line 15a Process to establish compensation of top management official THE PRESIDENT/CEO'S PERFORMANCE IS REVIEWED BY THE BOARD CHAIR ANNUALLY. THE BOARD OF ST. JOSEPH'S COMMUNITY HOSPITAL OF WEST BEND, INC. APPROVES ANY SALARY AND/OR BENEFIT CHANGES. THE INITIAL SALARY WAS DETERMINED BY THE SYSTEM CEO AND OUTSIDE CONSULTANT, USING COMPARATIVE DATA. Form 990, Part VI, Line 19 Required documents available to the public FINANCIAL INFORMATION: THE FROEDTERT THEDACARE HEALTH, INC. QUARTERLY FINANCIAL INFORMATION IS MADE AVAILABLE TO THE PUBLIC THROUGH THE DIGITAL ASSURANCE CORPORATION, INC. WEBSITE. ANYONE CAN REGISTER TO RECEIVE ONGOING ACCESS TO AND NOTIFICATIONS REGARDING FINANCIAL STATEMENTS AT THE ONLINE WEBSITE. GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY: DOCUMENTS ARE AVAILABLE TO THE PUBLIC THROUGH THE CORPORATE OFFICE UPON REQUEST. Form 990, Part IX, Line 9 BENEFIT COSTS FOR FROEDTERT WEST BEND HOSPITAL FOUNDATION, INC. ARE RECORDED AT THE CORPORATE LEVEL OF FROEDTERT THEDACARE HEALTH, INC. AND GET ABSORBED BY ST. JOSEPH'S COMMUNITY HOSPITAL OF WEST BEND, INC. Form 990, Part XI, Line 9 Other changes in net assets or fund balances FORGIVENESS OF RECEIVABLE FROM FOUNDATION - 216084; TRANSFER FROM AFFILIATES - 155949; Total - 372033; FROEDTERT THEDACARE HEALTH INC 9200 WEST WISCONSIN AVENUE MILWAUKEE WI 532263596 392014409 MGMT SERVICES WI 501(c)(3) Type III-FI NA false ST JOSEPH'S COMMUNITY HOSPITAL-WEST BEND 3200 PLEASANT VALLEY ROAD WEST BEND WI 53095 390806302 HOSPITAL WI 501(c)(3) 3 FTCH INC false FROEDTERT HOSPITAL FOUNDATION INC 9200 WEST WISCONSIN AVENUE MILWAUKEE WI 53226 391431192 HEALTH PROMO WI 501(c)(3) 7 FMLH false FROEDTERT MENOMONEE FALLS HOSPITAL FOUNDATION INC W180 N8085 TOWN HALL ROAD MENOMONEE FALLS WI 53051 391635057 HEALTH PROMO WI 501(c)(3) 10 CMH false FROEDTERT MEMORIAL LUTHERAN HOSPITAL 9200 WEST WISCONSIN AVENUE MILWAUKEE WI 53226 396105970 HOSPITAL WI 501(c)(3) 3 FTCH INC false COMMUNITY MEMORIAL HOSPITAL OF MF INC W180 N8085 TOWN HALL ROAD MENOMONEE FALLS WI 53051 390987025 HOSPITAL WI 501(c)(3) 3 FTCH INC false COMMUNITY OUTPATIENT HEALTH SERVICES W180 N8085 TOWN HALL RD MENOMONEE FALLS WI 53051 391743056 O/P SERVICES WI 501(c)(3) 3 CMH false FH ENTERPRISE SERVICES HOLDINGS INC 9200 W WISCONSIN AVENUE MILWAUKEE WI 53226 202636686 HLTHCARE SRVS WI 501(c)(3) Type I FTCH INC false HOLY FAMILY MEMORIAL INC 2300 WESTERN AVENUE MANITOWOC WI 54221 390806395 HOSPITAL WI 501(c)(3) 3 FTCH INC false THEDACARE REGIONAL MEDICAL CENTER - NEENAH INC PO BOX 8025 APPLETON WI 549128025 390830664 HOSPITAL WI 501(c)(3) 3 THEDACARE INC false THEDACARE MEDICAL CENTER - NEW LONDON INC PO BOX 8025 APPLETON WI 549128025 390869788 HOSPITAL WI 501(c)(3) 3 THEDACARE INC false THEDACARE MEDICAL CENTER - WAUPACA INC PO BOX 8025 APPLETON WI 549128025 390871113 HOSPITAL WI 501(c)(3) 3 THEDACARE INC false THEDACARE REGIONAL MEDICAL CENTER - APPLETON INC PO BOX 8025 APPLETON WI 549128025 390824015 HOSPITAL WI 501(c)(3) 3 THEDACARE INC false THEDACARE MEDICAL CENTER - SHAWANO INC PO BOX 8025 APPLETON WI 549128025 390807068 HOSPITAL WI 501(c)(3) 3 THEDACARE INC false THEDACARE MEDICAL CENTER - BERLIN INC PO BOX 8025 APPLETON WI 549128025 390806359 HOSPITAL WI 501(c)(3) 3 THEDACARE INC false THEDACARE MEDICAL CENTER - WILD ROSE INC PO BOX 8025 APPLETON WI 549128025 396089134 HOSPITAL WI 501(c)(3) 3 THEDACARE INC false THEDACARE FAMILY OF FOUNDATIONS INC PO BOX 8025 APPLETON WI 549128025 464112255 FOUNDATION WI 501(c)(3) 7 THEDACARE INC false THEDACARE INC PO BOX 8025 APPLETON WI 549128025 391509362 HEALTHCARE WI 501(c)(3) 10 FTCH INC false false true true false false false false false false false false false false true true true false true true