2024-05-07T11:12:14-05:00 2023-06-30 135565207 KPMG LLP 191 WEST NATIONWIDE BLVD SUITE 500 COLUMBUS OH 432152568 990 2022-07-01 391743056 COMMUNITY OUTPATIENT HEALTH SERVICES OF MENOMONEE FALLS INC COMM 2622511000 W180 N8085 TOWN HALL ROAD MENOMONEE FALLS WI 53051 ALICIA M MAITLAND SVP - FINANCE 2622511000 2024-05-07 1 ALICIA MAITLAND XXX-XX-XXXX 0 MOLLIE P LONGHOUSE P00294881 6142492300 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z DIANE EHN W180 N8085 TOWN HALL ROAD MENOMONEE FALLS WI 53051 562758 0 X WWW.FROEDTERT.COM X 1993 WI COMMUNITY OUTPATIENT HEALTH SERVICES IS COMMITTED TO PROVIDING OUTPATIENT MEDICAL SERVICES TO THE INDIGENT IN THE MENOMONEE FALLS AREA THROUGH ITS FREE CLINIC, COMMUNITY OUTREACH HEALTH CLINIC. 8 6 0 41 0 0 540609 562758 0 0 0 0 0 0 540609 562758 0 0 0 0 197109 203620 0 0 0 260980 316689 458089 520309 82520 42449 434648 477097 0 0 434648 477097 COMMUNITY OUTPATIENT HEALTH SERVICES IS COMMITTED TO PROVIDING OUTPATIENT MEDICAL SERVICES TO THE INDIGENT IN MENOMONEE FALLS AREA THROUGH ITS FREE CLINIC, COMMUNITY OUTREACH HEALTH CLINIC. 0 0 520309 0 0 COMMUNITY OUTREACH HEALTH CLINIC PROVIDED 835 PATIENT VISITS TO THE INDIGENT IN THE MENOMONEE FALLS AREA DURING FISCAL YEAR 2023. IN ADDITION, THE CLINIC DISPENSED 2,078 PRESCRIPTIONS, PROVIDED 957 LABORATORY TESTS, 45 RADIOLOGY PROCEDURES, 11 REHABILITATION PROCEDURES, AND 15 CARDIAC DIAGNOSTIC TESTS. CLINIC STAFF REFERRED 36 PATIENTS INTO PHARMACEUTICAL COMPANY PROGRAMS FOR A TOTAL OF 59 PRESCRIPTIONS. 520309 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 8 6 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X DAVID DIRKSMEYER 4148053000 N74 W12501 LEATHERWOOD CT MENOMONEE FALLS WI 53051 EHN DIANE L DIRECTOR & VP/COO & CHAIR 1.00 49.00 X X 0 381446 59476 FREIBERG KERRY TERM AUG22 DIRECTOR & BOD CHAIR/PRESIDENT 1.00 49.00 X X 0 414064 23055 MALZEWSKI MICHAEL TERM JUN23 DIRECTOR & BOD TREASURER 1.00 49.00 X X 0 352212 43529 DRESANG ANDREW DIRECTOR (START AUG22) 1.00 49.00 X 0 218457 42036 CARRAN MATT DIRECTOR 1.00 0.00 X 0 0 0 LEVINE BRAD DIRECTOR 1.00 0.00 X 0 0 0 MENKVELD SHARON MD DIRECTOR 1.00 0.00 X 0 0 0 MILLER MICHAEL MD DIRECTOR 1.00 0.00 X 0 0 0 ZAMBON CHAD DDS DIRECTOR 1.00 0.00 X 0 0 0 PARKER PAMELA DIRECTOR & BOD SECRETARY 1.00 0.00 X X 0 0 0 0 1366179 168096 0 0 1 0 0 269962 292796 290743 562758 562758 0 0 0 203620 203620 1858 1858 1400 1400 MEDICAL SUPPLIES 295010 295010 DUES & LICENSES 18421 18421 520309 520309 0 0 0 0 0 0 434393 477097 255 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 434648 477097 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 434648 477097 0 0 434648 477097 434648 477097 42449 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 X PART X, LINE 2: FROEDTERT HEALTH, INC. (FH), THE ENTITY INTO WHICH THE FINANCIALS OF COMMUNITY OUTPATIENT HEALTH SERVICES ARE CONSOLIDATED, APPLIES ASC TOPIC 740, INCOME TAXES, WHICH CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN A COMPANY'S FINANCIAL STATEMENTS. ASC TOPIC 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 TOPIC 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, 2023 AND 2022, COMMUNITY OUTPATIENT HEALTH SERVICES DOES NOT HAVE AN ASSET OR LIABILITY RECORDED FOR UNRECOGNIZED INCOME TAX POSITIONS. 0 1 0 0 0 0 0 0 0 EHN DIANE L DIRECTOR & VP/COO & CHAIR 0 251418 0 101446 0 28582 0 35760 0 23716 0 440922 0 25135 FREIBERG KERRY TERM AUG22 DIRECTOR & BOD CHAIR/PRESIDENT 0 173348 0 103176 0 137540 0 14045 0 9010 0 437119 0 121111 MALZEWSKI MICHAEL TERM JUN23 DIRECTOR & BOD TREASURER 0 256759 0 67118 0 28335 0 20750 0 22779 0 395741 0 0 DRESANG ANDREW DIRECTOR (START AUG22) 0 174958 0 34852 0 8647 0 12792 0 29244 0 260493 0 0 PART-I LINE-4B 457(F) DISTRIBUTIONS: EHN, DIANE - $25,135 FREIBERG, KERRY - $121,111 NON-QUALIFIED DISTRIBUTIONS: FREIBERG, KERRY - $12,897 (OF WHICH $0 WAS REPORTED AS DEFERRED ON A PRIOR FORM 990) 457(F) PLAN PARTICIPANTS: EHN, DIANE FREIBERG, KERRY NON-QUALIFIED PARTICIPANTS: FREIBERG, KERRY PART II, COLUMN (B)(II): BONUS AND INCENTIVE COMPENSATION AMOUNTS INCLUDE INCENTIVE COMPENSATION PAID. 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. X 262 290743 FMV 0 0 0 0 PART I, COLUMN (B): REPORTED THE NUMBER OF CONTRIBUTIONS, NOT THE NUMBER OF ITEMS CONTRIBUTED. FORM 990, PART VI, SECTION A, LINE 6 COMMUNITY MEMORIAL HOSPITAL OF MENOMONEE FALLS, INC. IS THE SOLE CORPORATE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A COMMUNITY MEMORIAL HOSPITAL OF MENOMONEE FALLS, INC., AS THE SOLE CORPORATE MEMBER OF COHS, HAS THE RIGHT TO RATIFY ALL DIRECTORS NOMINATED AND ELECTED BY THE COHS BOARD. FORM 990, PART VI, SECTION A, LINE 7B COMMUNITY MEMORIAL HOSPITAL OF MENOMONEE FALLS, INC., AS THE SOLE CORPORATE MEMBER OF COHS, HAS CERTAIN RESERVED POWERS AND AUTHORITIES WITH RESPECT TO THE OPERATIONS AND MANAGEMENT OF COHS, AS SET FORTH IN COHS'S BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B FH ACCOUNTING STAFF PREPARE FORM 990 WHICH IS REVIEWED BY FH'S FINANCIAL LEADERS. THE 990 IS THEN REVIEWED BY KPMG, FH'S OUTSIDE ACCOUNTING FIRM. NEXT, THE 990 IS PROVIDED TO FH'S AUDIT COMMITTEE AND BOARD OF DIRECTORS. FINALLY THE 990 IS FILED AS REQUIRED. FORM 990, PART VI, SECTION B, LINE 12C ON AN ANNUAL BASIS ALL OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT. THE DATA IS COMPILED, AND THE FH VICE PRESIDENT - CHIEF COMPLIANCE OFFICER (CCO), THE SENIOR VICE PRESIDENT - GENERAL COUNSEL AND/OR DELEGATE WILL REVIEW ALL FORMS AND NOTIFICATIONS TO DETERMINE IF ANY CONFLICTS OF INTERESTS EXIST IN THE DISCLOSURE DOCUMENTS. IF IT IS DETERMINED THAT A CONFLICT OF INTEREST EXISTS, THEN THE PERSON MAKING THE DISCLOSURE SHALL BE RELIEVED OF HIS/HER OBLIGATIONS ON BEHALF OF COMMUNITY OUTPATIENT HEALTH SERVICES, WITH RESPECT TO THE TRANSACTION OR ARRANGEMENT THAT CREATES THE CONFLICT OF INTEREST. A REPORT OF ALL CONFLICTS OF INTEREST WILL BE MADE BY THE CCO AT LEAST ANNUALLY TO THE FH FINANCE COMMITTEE OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 LINE 15A - COMPENSATION REVIEW & APPROVAL PROCESS - CEO & TOP MANAGEMENT COMPENSATION OF TOP MANAGEMENT IS PAID BY A RELATED ORGANIZATION BUT A REVIEW IS PERFORMED. IN ESTABLISHING THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT, INDEPENDENT COMPENSATION CONSULTANTS ARE UTILIZED, COMPENSATION STUDIES ARE COMPLETED TO GATHER COMPARATIVE DATA, PERSONS WITH A CONFLICT OF INTEREST REGARDING THE COMPENSATION ARRANGEMENTS AT ISSUE ARE NOT INVOLVED IN THE DECISION MAKING PROCESS, AND AMOUNTS ARE REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF THE FH (THE RELATED ORGANIZATION) BOARD OF DIRECTORS. IN ADDITION, THERE IS CONTEMPORANEOUS DOCUMENTATION AND RECORDKEEPING FOR DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENTS. LINE 15B - COMPENSATION REVIEW & APPROVAL PROCESS - OFFICERS & KEY EMPLOYEES COMPENSATION OF OFFICERS AND KEY EMPLOYEES IS PAID BY A RELATED ORGANIZATION BUT A REVIEW IS PERFORMED. IN ESTABLISHING THE COMPENSATION OF THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES, INDEPENDENT COMPENSATION CONSULTANTS ARE UTILIZED, COMPENSATION STUDIES ARE COMPLETED TO GATHER COMPARATIVE DATA, PERSONS WITH A CONFLICT OF INTEREST REGARDING THE COMPENSATION ARRANGEMENTS AT ISSUE ARE NOT INVOLVED IN THE DECISION MAKING PROCESS, AND AMOUNTS ARE REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF THE FH (THE RELATED ORGANIZATION) BOARD OF DIRECTORS. IN ADDITION, THERE IS CONTEMPORANEOUS DOCUMENTATION AND RECORDKEEPING FOR DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENTS. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL INFORMATION: FH'S QUARTERLY FINANCIAL INFORMATION IS MADE AVAILABLE TO THE PUBLIC ONLINE THROUGH THE DIGITAL ASSURANCE CORPORATION, INC. WEBSITE. ANYONE CAN REGISTER TO RECEIVE ONGOING ACCESS TO AND NOTIFICATIONS REGARDING FINANCIAL STATEMENTS AT THE ONLINE WEBSITE. ADDITIONALLY, GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE TO THE PUBLIC THROUGH THE CORPORATE OFFICE UPON REQUEST. FROEDTERT HEALTH INC 9200 W WISCONSIN AVE MILWAUKEE WI 532263596 392014409 MGMT SERVICES WI 501(C)(3) LN 12, III N/A 0 COMMUNITY MEMORIAL HOSPITAL OF MF W180 N8085 TOWN HALL ROAD MENOMONEE FALLS WI 53051 390987025 HOSPITAL WI 501(C)(3) 3 FH INC 0 COMMUNITY MEMORIAL FOUNDATION OF MF W180 N8085 TOWN HALL ROAD MENOMONEE FALLS WI 53051 391635057 HEALTH PROMO WI 501(C)(3) 10 CMH INC 0 ST JOSEPH'S COMMUNITY FOUNDATION 3200 PLEASANT VALLEY ROAD WEST BEND WI 530953868 392034296 HEALTH PROMO WI 501(C)(3) LINE 7 SJH INC 0 FROEDTERT HOSPITAL FOUNDATION INC 9200 W WISCONSIN AVE MILWAUKEE WI 532263596 391431192 HEALTH PROMO WI 501(C)(3) LINE 7 FMLH INC 0 FROEDTERT MEMORIAL LUTHERAN HOSPITAL 9200 W WISCONSIN AVE MILWAUKEE WI 532263596 396105970 HOSPITAL WI 501(C)(3) 3 FH INC 0 ST JOSEPH'S COMMUNITY HOSPITAL INC 3200 PLEASANT VALLEY ROAD WEST BEND WI 530953868 390806302 HOSPITAL WI 501(C)(3) 3 FH INC 0 HOLY FAMILY MEMORIAL INC 2300 WESTERN AVE PO BOX 1450 MANITOWOC WI 542211450 390806395 HOSPITAL WI 501(C)(3) 3 FH INC 0 QHS 1 INC 9200 W WISCONSIN AVE MILWAUKEE WI 532263596 202636686 HLTHCARE SRVS WI 501(C)(3) LN 12, 1 FH INC 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0