TY 2023 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(1) Carrie Booher...................................................................... Director & BOD Chair	1.0 ................. 0	X	X	0	0
(2) Cindy Simons...................................................................... Director & BOD V.Chair	1.0 ................. 0	X	X	0	0
(3) Teresa Lux...................................................................... Director & CMH President	44.0 ................. 6.0	X	X	688,727	132,026
(4) Brad Christianson...................................................................... Director	1.0 ................. 0	X		0	0
(5) Christopher Rechlicz...................................................................... Director	1.0 ................. 1.0	X		0	0
(6) Cristino Canga MD...................................................................... Director	1.0 ................. 0	X		0	0
(7) David Woloszyk...................................................................... Director	1.0 ................. 0	X		0	0
(8) Edna Abernathy...................................................................... Director	1.0 ................. 0	X		0	0
(9) Eric Conley...................................................................... Director & FMLH President (Start Jul23; Term Apr24)	1.0 ................. 49.0	X		1,403,238	212,976
(10) Jennifer Jo Berrall JJ Barnes...................................................................... Director	1.0 ................. 0	X		0	0
(11) Mary Benedum...................................................................... Director	1.0 ................. 0	X		0	0
(12) Michael DeGere DPM...................................................................... Chief Medical Officer (Start Jul23)	1.0 ................. 49.0	X		472,454	94,185
(13) Payal Shah...................................................................... Director	1.0 ................. 0	X		0	0
(14) Rick Rosser...................................................................... Director (Start Jul23)	1.0 ................. 0	X		0	0
(15) Ryan Burch DO...................................................................... Director	1.0 ................. 0	X		0	0
(16) Sam Sova...................................................................... Director	1.0 ................. 0	X		0	0
(17) Sandhya Padala...................................................................... Director (Term Nov23)	1.0 ................. 0	X		0	0

- TIN:

SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

Community Memorial Hospital of Menomonee Falls Inc

Employer identification number

39-0987025

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990) 2023

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf ....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) ..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

Gross receipts from related activities, etc. (see instructions) ..................

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2023 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2022 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2023. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2022. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2023. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

10%-facts-and-circumstances test—2022. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990) 2023

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here................................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2023 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2022 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2023 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2022 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2023. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3 % support tests—2022. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990) 2023

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990) 2023

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990) 2023

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by 0.035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1	0
2	Enter 85% of line 1	2	0
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3	0
4	Enter greater of line 2 or line 3	4	0
5	Income tax imposed in prior year	5	0
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6	0

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990) 2023

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2023 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2023	(iii) Distributable Amount for 2023
1 Distributable amount for 2023 from Section C, line 6
2 Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2023:
a From 2018.......
b From 2019.......
c From 2020.......
d From 2021.......
e From 2022.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2023 distributable amount
i Carryover from 2018 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2023 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2023 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2023, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2023. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2024. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2019.....
b Excess from 2020.....
c Excess from 2021.....
d Excess from 2022.....
e Excess from 2023.....

Schedule A (Form 990) (2023)

Schedule A (Form 990) 2023

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Name of the organization

Community Memorial Hospital of Menomonee Falls Inc

Employer identification number

39-0987025

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990) (2023)

Schedule B (Form 990) (2023) Page 2

Name of organization Community Memorial Hospital of Menomonee Falls Inc

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2023)

Schedule B (Form 990) (2023)

Page 3

Name of organization Community Memorial Hospital of Menomonee Falls Inc		Employer identification number 39-0987025

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990) (2023)

Schedule B (Form 990) (2023)

Page 4


Name of organization Community Memorial Hospital of Menomonee Falls Inc			Employer identification number 39-0987025
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990) (2023)

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
right arrow

Attach to Form 990.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

Community Memorial Hospital of Menomonee Falls Inc

Employer identification number

39-0987025

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after July 25, 2006, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year right arrow

Number of states where property subject to conservation easement is located right arrow

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... right arrow

(ii)

Assets included in Form 990, Part X ............................... right arrow

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... right arrow

Assets included in Form 990, Part X ............................... right arrow

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2022

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....	9,345,996	8,614,155	8,973,060	7,598,551	7,585,233
b	Contributions ...	886,361	605,522	1,365,028	774,955	703,700
c	Net investment earnings, gains, and losses	1,025,826	856,382	-1,049,030	1,396,032	62,097
d	Grants or scholarships ...	536,028	467,680	526,326	410,861	402,620
e	Other expenditures for facilities and programs ...	500,384	261,426	148,577	384,001	333,816
f	Administrative expenses ....	0	957	0	1,616	16,043
g	End of year balance ......	10,221,771	9,345,996	8,614,155	8,973,060	7,598,551

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment right arrow

100 %

Permanent endowment right arrow

0 %

Term endowment right arrow

0 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

Yes

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Yes

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	80,711		80,711
b	Buildings ....	159,573,365	93,115,980	66,457,385
c	Leasehold improvements	7,249,108	4,636,861	2,612,247
d	Equipment ....	68,648,075	54,025,522	14,622,553
e	Other .....	38,253,898	34,039,035	4,214,863
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				87,987,759

Schedule D (Form 990) 2022

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
EST. SETTLEMENTS-MEDICARE/3RD PARTY PAYORS	3,640,000
PENSION LIABILITY
LONG TERM - CAPITAL LEASE OBLIGATION	236,017
SHORT TERM - CAPITAL LEASE OBLIGATION	297,772
DUE TO AFFILIATES - TOTAL	4,158,243




Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	8,332,032
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2022

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ...........	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ...........	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference

Explanation

Schedule D, Part V, Line 4 Intended uses of endowment funds

THE FUNDS ARE HELD BY FROEDTERT MENOMONEE FALLS HOSPITAL FOUNDATION, INC. (FMFHF), A RELATED ORGANIZATION. THE BOARD DESIGNATED ENDOWMENT WAS CREATED TO SUPPORT LONG RANGE FINANCIAL NEEDS OF FMFH AND ITS PROGRAMS.

Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote

FROEDTERT THEDACARE HEALTH, INC. (FTCH), THE PARENT ENTITY INTO WHICH FMFH'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, 2024 AND 2023, FTCH DOES NOT HAVE AN ASSET OR LIABILITY RECORDED FOR UNRECOGNIZED TAX POSITIONS.

Schedule D (Form 990) 2022

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- TIN:

SCHEDULE G (Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" on Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization
Community Memorial Hospital of Menomonee Falls Inc

Employer identification number

39-0987025

Part I

Fundraising Activities.Complete if the organization answered "Yes" on Form 990, Part IV, line 17.

Form 990-EZ filers are not required to complete this part.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

YesNo

If "Yes," list the 10 highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

(i) Name and address of individual or entity (fundraiser)	(iii) Did fundraiser have custody or control of contributions?
	Yes	No










Total . . . . . . . . . . . . . . . . . . . .

List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50083H

Schedule G (Form 990) 2023

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.

		(a) Event #1 COOKIES (event type)	(b) Event #2 NUTMAN SALES (event type)	(c) Other events 5 (total number)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	27,660	24,314	17,154	69,128
2	Less: Contributions . . . .
3	Gross income (line 1 minus line 2) . . . . . .	27,660	24,314	17,154	69,128

4	Cash prizes . . . . .
5	Noncash prizes . . . .
6	Rent/facility costs . . . .
7	Food and beverages . . .
8	Entertainment . . . .
9	Other direct expenses . . .	10,241	18,740	7,314	36,295
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .				36,295
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .				32,833

Part III

Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

		(a) Bingo	(b) Pull tabs/Instant bingo/progressive bingo	(c) Other gaming	(d) Total gaming (add col.(a) through col.(c))
1	Gross revenue . . . . .

2	Cash prizes . . . . .
3	Noncash prizes . . . .
4	Rent/facility costs . . . .
5	Other direct expenses . . .

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow

Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow

Enter the state(s) in which the organization conducts gaming activities:

Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .

YesNo

If "No," explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .

YesNo

If "Yes," explain:

Schedule G (Form 990) 2023

Page 3

Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? . . . . . . . . . . . . . . . . .

YesNo

Indicate the percentage of gaming activity conducted in:

The organization's facility . . . . . . . . . . . . . . . . . .

13a

An outside facility . . . . . . . . . . . . . . . . . . . .

13b

Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? . . . . . . . . . . . . . . . . . . . . . . . .

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? . . . . . . . . . . . . . . . . . . .

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also provide any additional information. See instructions.

Return Reference	Explanation

Schedule G (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
Medium right arrow

Attach to Form 990.
Medium right arrow

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

Community Memorial Hospital of Menomonee Falls Inc

Employer identification number

39-0987025

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other 25000 %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .			1,257,991		1,257,991	0.44 %
b	Medicaid (from Worksheet 3, column a) . . . . .			27,565,741	11,740,118	15,825,623	5.56 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .					0	0 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	0	0	28,823,732	11,740,118	17,083,614	6.00 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	25	96,568	1,015,015	4,622	1,010,393	0.36 %
f	Health professions education (from Worksheet 5) . . .	5	14,955	6,086,366	1,073,352	5,013,014	1.76 %
g	Subsidized health services (from Worksheet 6) . . . .	1	840	550,738		550,738	0.19 %
h	Research (from Worksheet 7) .					0	0 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	14	39,220	1,297,656		1,297,656	0.46 %
j	Total. Other Benefits . .	45	151,583	8,949,775	1,077,974	7,871,801	2.77 %
k	Total. Add lines 7d and 7j .	45	151,583	37,773,507	12,818,092	24,955,415	8.77 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2023

Schedule H (Form 990) 2023

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing					0	0 %
2	Economic development	1		29,332		29,332	0.01 %
3	Community support	1	50	4,605		4,605	0 %
4	Environmental improvements					0	0 %
5	Leadership development and training for community members					0	0 %
6	Coalition building	1		43,916		43,916	0.02 %
7	Community health improvement advocacy					0	0 %
8	Workforce development	3	1,310	158,194		158,194	0.06 %
9	Other					0	0 %
10	Total	6	1,360	236,047	0	236,047	0.08 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

7,887,707

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

42,965,279

Enter Medicare allowable costs of care relating to payments on line 5.....

62,657,349

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-19,692,070

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2023

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	COMMUNITY MEMORIAL HOSPITAL DBA FROEDTERT MENOMONEE FALLS W180 N8085 TOWN HALL ROAD MENOMONEE FALLS,WI53051 WWW.FROEDTERT.COM 28	X	X	X

Schedule H (Form 990) 2023

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	COMMUNITY MEMORIAL HOSPITAL DBA FROEDTERT MENOMONEE FALLS
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 23

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): WWW.FROEDTERT.COM/COMMUNITY-ENGAGEMENT

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 24

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): WWW.FROEDTERT.COM/COMMUNITY-ENGAGEMENT

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2023

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	COMMUNITY MEMORIAL HOSPITAL DBA FROEDTERT MENOMONEE FALLS
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 250.0%
and FPG family income limit for eligibility for discounted care of 400.0%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

www.froedtert.com/financial-services

The FAP application form was widely available on a website (list url):

www.froedtert.com/financial-services

A plain language summary of the FAP was widely available on a website (list url):
www.froedtert.com/financial-services

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 6

Part VFacility Information (continued)

Billing and Collections

	COMMUNITY MEMORIAL HOSPITAL DBA FROEDTERT MENOMONEE FALLS
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	COMMUNITY MEMORIAL HOSPITAL DBA FROEDTERT MENOMONEE FALLS
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2023

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - DBA FROEDTERT MENOMONEE FALLS. IN 2020, A CHNA WAS CONDUCTED TO 1) DETERMINE CURRENT COMMUNITY HEALTH NEEDS IN WAUKESHA COUNTY, 2) GATHER INPUT FROM PERSONS WHO REPRESENT THE BROAD INTEREST OF THE COMMUNITY AND IDENTIFY COMMUNITY ASSETS, 3) IDENTIFY AND PRIORITIZE SIGNIFICANT HEALTH NEEDS, AND 4) DEVELOP IMPLEMENTATION STRATEGIES TO ADDRESS THE PRIORITIZED HEALTH NEEDS. FROEDTERT MENOMONEE FALLS HOSPITAL ASSESSES THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES THROUGH A COMPREHENSIVE DATA COLLECTION PROCESS FROM A NUMBER OF KEY SOURCES. DATA AND RESEARCH INCLUDED INFORMATION FROM COMMUNITY MEMBERS, PUBLIC HEALTH OFFICIALS, COMMUNITY LEADERS/EXPERTS, AND NON-PROFIT ORGANIZATIONS REPRESENTING VULNERABLE POPULATIONS IN OUR SERVICE AREA. THE FOLLOWING INFORMATION/DATA SOURCES WAS COLLECTED AND TAKEN INTO CONSIDERATION FOR ASSESSING AND ADDRESSING COMMUNITY HEALTH NEEDS: COMMUNITY HEALTH SURVEY: USING THE CENTER FOR DISEASE CONTROL'S BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS), A TELEPHONE-BASED SURVEY OF 400 RESIDENTS WAS CONDUCTED BY FROEDTERT MENOMONEE FALLS HOSPITAL IN COLLABORATION WITH THE MILWAUKEE HEALTH CARE PARTNERSHIP. THE FULL REPORT OF THIS SURVEY CAN BE FOUND AT HTTPS://WWW.FROEDTERT.COM/COMMUNITY-ENGAGEMENT. KEY INFORMANT INTERVIEWS: FROEDTERT MENOMONEE FALLS HOSPITAL COMMUNITY ENGAGEMENT TEAM AND LEADERS CONDUCTED 47 INTERVIEWS WITH COMMUNITY LEADERS OF VARIOUS SCHOOL DISTRICTS, NON-PROFIT ORGANIZATIONS, HEALTH & HUMAN SERVICE DEPARTMENT AND BUSINESS LEADERS. THE FULL KEY INFORMANT RESULTS CAN BE FOUND AT HTTPS://WWW.FROEDTERT.COM/COMMUNITY-ENGAGEMENT. COMMUNITY PARTNER/AGENCY REPORTS: TO BETTER UNDERSTAND THE NEEDS OF OUR UNDERSERVED POPULATIONS; FROEDTERT MENOMONEE FALLS HOSPITAL OBTAINED IMPORTANT DATA AND TRENDS FROM PARTNER ORGANIZATIONS SUCH AS COMMUNITY OUTREACH HEALTH CLINIC, UNITED WAY OF GREATER MILWAUKEE & WAUKESHA COUNTY ALICE REPORT, AND IMPACT 211 DATA SPECIFIC TO FROEDTERT MENOMONEE FALLS HOSPITAL'S PRIMARY SERVICE AREA TO SEEK IMPORTANT TRENDS, DEMOGRAPHIC DATA AND SERVICES TO PROVIDE AN INCLUSIVE VIEWPOINT OF COMMUNITY NEEDS FOR THESE UNREPRESENTED POPULATIONS. SECONDARY DATA REPORTS: UTILIZING MULTIPLE COUNTY AND COMMUNITY-BASED PUBLICLY AVAILABLE REPORTS, INFORMATION WAS GATHERED REGARDING: MORTALITY/MORBIDITY DATA, INJURY HOSPITALIZATIONS, EMERGENCY DEPARTMENT VISITS, WAUKESHA COUNTY HEALTH RANKINGS, PUBLIC SAFETY/CRIME REPORTS AND SOCIO-ECONOMIC DATA. A FULL SUMMARY OF SECONDARY DATA INFORMATION CAN BE FOUND AT HTTPS://WWW.FROEDTERT.COM/COMMUNITY-ENGAGEMENT. FROEDTERT MENOMONEE FALLS HOSPITAL IS COMMITTED TO ADDRESSING COMMUNITY HEALTH NEEDS COLLABORATIVELY WITH LOCAL PARTNERS. FROEDTERT MENOMONEE FALLS HOSPITAL USED THE FOLLOWING METHODS TO GAIN COMMUNITY INPUT FROM JUNE-SEPTEMBER 2020 ON THE SIGNIFICANT HEALTH NEEDS OF THE FROEDTERT MENOMONEE FALLS HOSPITAL'S COMMUNITY. THESE METHODS PROVIDED ADDITIONAL PERSPECTIVES ON HOW TO SELECT AND ADDRESS TOP HEALTH ISSUES FACING FROEDTERT MENOMONEE FALLS HOSPITAL'S COMMUNITY. INPUT FROM COMMUNITY MEMBERS KEY INFORMANT INTERVIEWS: KEY ORGANIZATIONS WITH SPECIFIC KNOWLEDGE AND INFORMATION RELEVANT TO THE SCOPE OF THE IDENTIFIED SIGNIFICANT HEALTH NEEDS ("INFORMANTS") IN FROEDTERT MENOMONEE FALLS HOSPITAL'S COMMUNITY, INCLUDING WAUKESHA COUNTY, WERE IDENTIFIED BY ORGANIZATIONS AND PROFESSIONALS THAT REPRESENT THE BROAD NEEDS OF THE COMMUNITY AS WELL AS ORGANIZATIONS THAT SERVE LOW-INCOME AND UNDERSERVED POPULATIONS. THESE LOCAL PARTNERING ORGANIZATIONS ALSO INVITED THE INFORMANTS TO PARTICIPATE IN AND CONDUCT THE INTERVIEWS. THE INTERVIEWERS USED A STANDARD INTERVIEW SCRIPT THAT INCLUDED THE FOLLOWING ELEMENTS: - RANKING OF UP TO FIVE PUBLIC HEALTH ISSUES, BASED ON THE FOCUS AREAS PRESENTED IN WISCONSIN'S STATE HEALTH PLAN, THAT ARE THE MOST IMPORTANT ISSUES FOR WAUKESHA COUNTY; AND - FOR THOSE FIVE PUBLIC HEALTH ISSUES: - EXISTING STRATEGIES TO ADDRESS THE ISSUE - BARRIERS/CHALLENGES TO ADDRESSING THE ISSUE - ADDITIONAL STRATEGIES NEEDED - KEY GROUPS IN THE COMMUNITY THAT HOSPITALS SHOULD PARTNER WITH TO IMPROVE COMMUNITY HEALTH - IDENTIFICATION OF SUBGROUPS OR SUBPOPULATIONS WHERE EFFORTS COULD BE TARGETED - WAYS EFFORTS CAN BE TARGETED TOWARD EACH SUBGROUP OR SUBPOPULATION - TO BE RESPONSIVE TO THE CURRENT CONDITIONS DURING THE COVID-19 PANDEMIC, THE FOLLOWING ADDITIONAL QUESTIONS WERE ADDED TO THE INTERVIEW GUIDE: - WHAT COMMUNITY NEEDS OR GAPS HAVE DEVELOPED SINCE THE CORONAVIRUS PANDEMIC BEGAN? - HOW CAN HEALTH CARE ORGANIZATIONS SUPPORT THE COMMUNITY DURING THIS PANDEMIC? - WHAT METHODS OF COMMUNICATION AND OUTREACH HAVE BEEN SUCCESSFUL TO REACH PARTNERS AND COMMUNITY MEMBERS DURING THE PANDEMIC? - HOW WOULD YOU SUGGEST HEALTH CARE ORGANIZATIONS OUTREACH TO COMMUNITY PARTNERS AND MEMBERS TO IMPLEMENT HEALTH INITIATIVES? UNDERSERVED POPULATION INPUT: FROEDTERT MENOMONEE FALLS HOSPITAL IS DEDICATED TO REDUCING HEALTH DISPARITIES AND INPUT FROM COMMUNITY MEMBERS WHO ARE MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS AND/OR ORGANIZATIONS THAT REPRESENT THOSE POPULATIONS ARE IMPORTANT IN ADDRESSING COMMUNITY HEALTH NEEDS. WITH THAT IN MIND, FROEDTERT MENOMONEE FALLS HOSPITAL TOOK THE FOLLOWING STEPS TO GAIN INPUT: - COMMUNITY HEALTH SURVEY: WHEN APPROPRIATE, DATA WAS STRATIFIED BY GENDER, AGE, EDUCATION HOUSEHOLD INCOME LEVEL AND MARITAL STATUS. - KEY INFORMANT INTERVIEWS: THE KEY INFORMANT INTERVIEWS INCLUDED INPUT FROM MEMBERS OF ORGANIZATIONS REPRESENTING MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS. SUMMARY OF COMMUNITY MEMBER INPUT TOP FIVE HEALTH ISSUES RANKED MOST CONSISTENTLY OR MOST OFTEN CITED FOR WAUKESHA COUNTY WERE: KEY INFORMANT INTERVIEWS: - MENTAL HEALTH - SUBSTANCE USE AND ABUSE - ACCESS TO HEALTH CARE - CHRONIC DISEASE - NUTRITION COMMUNITY HEALTH SURVEY: - CORONAVIRUS/COVID-19 - ILLEGAL DRUG USE - OVERWEIGHT OR OBESITY - CHRONIC DISEASES - MENTAL HEALTH OR DEPRESSION AFTER ADOPTION OF THE CHNA REPORT AND IMPLEMENTATION STRATEGY, FROEDTERT MENOMONEE FALLS HOSPITAL PUBLICLY SHARES BOTH DOCUMENTS WITH COMMUNITY PARTNERS, KEY INFORMANTS, HOSPITAL BOARD MEMBERS, PUBLIC SCHOOLS, NON-PROFITS, HOSPITAL COALITION MEMBERS, THE WAUKESHA COUNTY PUBLIC HEALTH DIVISION, AND THE GENERAL PUBLIC. DOCUMENTS ARE MADE AVAILABLE VIA EMAIL, HARD COPIES ARE MADE AVAILABLE AT APPLICABLE MEETINGS, AND ELECTRONIC COPIES ARE MADE AVAILABLE BY PDF FOR DOWNLOAD ON HTTPS://WWW.FROEDTERT.COM/COMMUNITY-ENGAGEMENT. FEEDBACK AND PUBLIC COMMENTS ARE ALWAYS WELCOMED AND ENCOURAGED, AND CAN BE PROVIDED THROUGH THE CONTACT FORM ON THE FROEDTERT THEDACARE HEALTH WEBSITE AT HTTPS://WWW.FROEDTERT.COM/CONTACT, OR CONTACTING FROEDTERT THEDACARE HEALTH, INC.'S COMMUNITY ENGAGEMENT LEADERSHIP/STAFF WITH QUESTIONS AND CONCERNS BY CALLING 414-777-1926. FROEDTERT MENOMONEE FALLS HOSPITAL RECEIVED NO COMMENTS OR ISSUES WITH THE PREVIOUS COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND/IMPLEMENTATION STRATEGY. WAUKESHA COUNTY KEY INFORMANT INTERVIEW ORGANIZATIONS: - ADDICTION RESOURCE COUNCIL, INC. - NONPROFIT PROVIDING ADDICTION RESOURCES AND EDUCATION - AGING AND DISABILITY RESOURCE CENTER OF WAUKESHA COUNTY - PROVIDES INFORMATION, ASSISTANCE, COUNSELING AND SUPPORTIVE SERVICES FOR OLDER ADULTS, CAREGIVERS, PEOPLE WITH DISABILITIES AND ADULTS WITH MENTAL HEALTH OR SUBSTANCE USE CONCERNS - COMMUNITY OUTREACH HEALTH CLINIC - FREE MEDICAL CLINIC FOR UNINSURED - EASTERSEALS SOUTHEAST WISCONSIN - NONPROFIT SERVING PEOPLE WITH DISABILITIES AND AT-RISK FAMILIES - ELMBROOK CHURCH - SERVING PEOPLE WHO ARE HOMELESS, DISFRANCHISED, MENTALLY ILL, AND JOBLESS - ERAS SENIOR NETWORK, INC. - NONPROFIT SERVING SENIORS, ADULTS WITH DISABILITIES, AND FAMILY CAREGIVERS - FAMILY SERVICE OF WAUKESHA - NONPROFIT COUNSELING CENTER - HAMILTON SCHOOL DISTRICT - PROVIDES EDUCATION TO YOUTH - HEBRON HOUSE OF HOSPITALITY - NONPROFIT DEDICATED TO ENDING HOMELESSNESS - HOPE NETWORK FOR SINGLE MOTHERS - NONPROFIT SERVING SINGLE MOTHERS - KETTLE MORAINE SCHOOL DISTRICT - PROVIDES EDUCATION TO YOUTH - LAKE AREA FREE CLINIC - FREE MEDICAL CLINIC FOR UNINSURED - LINDENGROVE COMMUNITIES - PROVIDES ASSISTED LIVING, MEMORY CARE, SHORT-TERM REHABILITATION & SKILLED NURSING HOUSING - MENOMONEE FALLS AREA FOOD PANTRY - PROVIDES FOOD FOR LOW INCOME INDIVIDUALS & FAMILIES - MENOMONEE FALLS POLICE DEPARTMENT - EMERGENCY RESPONSE - MENOMONEE FALLS SCHOOLS - PROVIDES EDUCATION TO YOUTH - MUKWONAGO AREA SCHOOL DISTRICT - PROVIDES EDUCATION TO YOUTH - MUKWONAGO FOOD PANTRY - PROVIDES FOOD FOR LOW INCOME INDIVIDUALS AND FAMILIES - NATIONAL ALLIANCE ON MENTAL ILLNESS (NAMI) WAUKESHA, INC. - NONPROFIT PROVIDES SUPPORT FOR MENTAL HEALTH - NEW BERLIN FOOD PANTRY - PROVIDES FOOD FOR LOW INCOME INDIVIDUALS & FAMILIES - NEW BERLIN POLICE DEPARTMENT - EMERGENCY RESPONSE
Schedule H, Part V, Section B, Line 5 Facility , 2	Facility , 2 - DBA FROEDTERT MENOMONEE FALLS. FACILITIES POLICIES (H6), PART V, LN5 (CONTINUED) - OCONOMOWOC AREA CHAMBER OF COMMERCE - NONPROFIT SUPPORTING LOCAL BUSINESSES - OCONOMOWOC AREA SCHOOL DISTRICT - PROVIDES EDUCATION TO YOUTH - SCHOOL DISTRICT OF NEW BERLIN - PROVIDES EDUCATION TO YOUTH - SCHOOL DISTRICT OF WAUKESHA - PROVIDES EDUCATION TO YOUTH - SIXTEENTH STREET COMMUNITY HEALTH CENTERS - FREE MEDICAL CLINIC FOR UNINSURED - SUSSEX AREA OUTREACH SERVICES - PROVIDES FOOD FOR LOW INCOME INDIVIDUALS AND FAMILIES - THE FOOD PANTRY SERVING WAUKESHA COUNTY - PROVIDES FOOD FOR LOW INCOME INDIVIDUALS AND FAMILIES - THE WOMEN'S CENTER - NONPROFIT PROVIDING SAFETY, SHELTER AND SUPPORT FOR INDIVIDUALS AFFECTED BY DOMESTIC AND SEXUAL VIOLENCE - UNITED WAY OF GREATER MILWAUKEE & WAUKESHA COUNTY - ENGAGES, CONVENES, AND MOBILIZES COMMUNITY RESOURCES TO ADDRESS ROOT CAUSES OF LOCAL HEALTH AND HUMAN SERVICES NEEDS - UNIVERSITY OF WISCONSIN-EXTENSION WAUKESHA COUNTY - SHARES, DEVELOPS AND DELIVERS RESOURCES AND PROGRAMS TO RESPOND TO COMMUNITY ISSUES - WAUKESHA COUNTY - LOCAL GOVERNMENT - WAUKESHA COUNTY BUSINESS ALLIANCE - NONPROFIT SUPPORTING LOCAL BUSINESSES IN WAUKESHA COUNTY - WAUKESHA COUNTY COMMUNITY DENTAL CLINIC - NONPROFIT PROVING ORAL HEALTH SERVICES - WAUKESHA COUNTY FIRE CHIEFS' ASSOCIATION - EMERGENCY RESPONSE - WAUKESHA COUNTY HEALTH AND HUMAN SERVICES - GOVERNMENT DEPARTMENT THAT PROVIDES COMMUNITY PROGRAMS TO INDIVIDUALS & FAMILIES CHALLENGED BY DISABILITIES, ECONOMIC HARDSHIP AND SAFETY CONCERNS - WAUKESHA COUNTY MEDICAL EXAMINER'S OFFICE - GOVERNMENT DEPARTMENT THAT INVESTIGATES DEATHS - WAUKESHA COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES, PUBLIC HEALTH DIVISION - GOVERNMENT DEPARTMENT THAT PREVENTS DISEASE AND PROMOTES HEALTH - WAUKESHA FREE CLINIC - FREE MEDICAL CLINIC FOR UNINSURED - YMCA AT PABST FARMS - NONPROFIT PROVIDING SERVICES THAT HELP PEOPLE IMPROVE THEIR HEALTH AND WELL-BEING IN 2023, THE MOST RECENT CHNA WAS COMPLETED WITH THE DEVELOPMENT OF THE 2025-2027 IMPLEMENTATION STRATEGY/COMMUNITY HEALTH IMPROVEMENT PLAN. HOWEVER, THIS NARRATIVE IS A THREE YEAR SUMMARY OF INITIATIVES AND OUTCOMES OF THE 2020 CHNA AND 2022-2024 IMPLEMENTATION STRATEGY/COMMUNITY HEALTH IMPROVEMENT PLAN.
Schedule H, Part V, Section B, Line 6a Facility , 1	Facility , 1 - DBA FROEDTERT MENOMONEE FALLS. FROEDTERT MENOMONEE FALLS HOSPITAL COLLABORATES WITH THE OTHER HOSPITAL SYSTEMS AND ORGANIZATIONS TO ASSESS THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES THROUGH A COMPREHENSIVE DATA COLLECTION PROCESS FROM A NUMBER OF KEY SOURCES. THIS SHARED CHNA SERVES AS THE FOUNDATION FOR FROEDTERT MENOMONEE FALLS HOSPITAL AND IS THE BASIS FOR CREATION OF AN IMPLEMENTATION STRATEGY TO IMPROVE HEALTH OUTCOMES AND REDUCED DISPARITIES IN WAUKESHA COUNTY AND THE HOSPITAL'S PRIMARY SERVICE AREA. WAUKESHA COUNTY COLLABORATIVE PARTNERS: FROEDTERT & THE MEDICAL COLLEGE OF WISCONSIN AURORA HEALTH CARE (HOSPITAL/HEALTH SYSTEM) CHILDREN'S WISCONSIN (HOSPITAL/HEALTH SYSTEM) PROHEALTH CARE (HOSPITAL/HEALTH SYSTEM) ASCENSION (HOSPITAL/HEALTH SYSTEM) AFTER COMPLETION OF THE SHARED CHNA, THE DATA WAS TAKEN INTO CONSIDERATION IN ORDER FOR FROEDTERT MENOMONEE FALLS HOSPITAL TO CREATE AN INDEPENDENT CHNA AND IMPLEMENTATION STRATEGY SPECIFIC TO THE HOSPITALS SERVICE AREA AND COMMUNITY HEALTH NEEDS.
Schedule H, Part V, Section B, Line 6b Facility , 1	Facility , 1 - DBA FROEDTERT MENOMONEE FALLS. FROEDTERT MENOMONEE FALLS HOSPITAL COLLABORATES WITH THE OTHER HOSPITAL SYSTEMS AND ORGANIZATIONS TO ASSESS THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES THROUGH A COMPREHENSIVE DATA COLLECTION PROCESS FROM A NUMBER OF KEY SOURCES. THIS SHARED CHNA SERVES AS THE FOUNDATION FOR FROEDTERT MENOMONEE FALLS HOSPITAL AND IS THE BASIS FOR CREATION OF AN IMPLEMENTATION STRATEGY TO IMPROVE HEALTH OUTCOMES AND REDUCE DISPARITIES IN WAUKESHA COUNTY AND THE HOSPITAL'S PRIMARY SERVICE AREA. WAUKESHA COUNTY ORGANIZATIONS: CENTER FOR URBAN POPULATION HEALTH WAUKESHA COUNTY PUBLIC HEALTH DIVISION AFTER COMPLETION OF THE SHARED CHNA, THE DATA WAS TAKEN INTO CONSIDERATION IN ORDER FOR FROEDTERT MENOMONEE FALLS HOSPITAL TO CREATE AN INDEPENDENT CHNA AND IMPLEMENTATION STRATEGY SPECIFIC TO THE HOSPITALS SERVICE AREA AND COMMUNITY HEALTH NEEDS.
Schedule H, Part V, Section B, Line 7 Facility , 1	Facility , 1 - DBA FROEDTERT MENOMONEE FALLS. THE FULL VERSION OF THE MOST RECENT AND PAST CHNA SUMMARIES, REPORTS AND OTHER SUPPORTING DOCUMENTS CAN BE FOUND ON FROEDTERT THEDACARE HEALTH'S WEBSITE: HTTPS://WWW.FROEDTERT.COM/COMMUNITY-ENGAGEMENT ADDITIONALLY, THE WAUKESHA COUNTY NEEDS ASSESSMENT AND COUNTY HEALTH IMPROVEMENT PLAN CAN BE FOUND AT THE FOLLOWING WEBSITE: WAUKESHA COUNTY PUBLIC HEALTH DEPARTMENT: HTTPS://WWW.WAUKESHACOUNTY.GOV/HEALTHANDHUMANSERVICES/PUBLICHEALTH/CHIPP/ FROEDTERT MENOMONEE FALLS HOSPITAL'S IMPLEMENTATION STRATEGY IS POSTED ON OUR INTRANET SITE FOR STAFF, PHYSICIANS AND LEADERS AS WELL AS THE GENERAL PUBLIC THROUGH OUR EXTERNAL WEBSITE FROEDTERT.COM. TO ACCESS THE IMPLEMENTATION STRATEGY, PLEASE GO TO: HTTPS://WWW.FROEDTERT.COM/COMMUNITY-ENGAGEMENT
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - DBA FROEDTERT MENOMONEE FALLS. COMMUNITY HEALTH IMPROVEMENT PLAN FOR FROEDTERT MENOMONEE FALLS HOSPITAL IS AVAILABLE ONLINE AT: HTTPS://WWW.FROEDTERT.COM/COMMUNITY-ENGAGEMENT THE FISCAL YEAR 2022-2024 IMPLEMENTATION STRATEGY WAS REVIEWED AND ADOPTED BY THE FROEDTERT MENOMONEE FALLS HOSPITAL BOARD OF DIRECTORS ON 08/26/2021. FROEDTERT MENOMONEE FALLS HOSPITAL'S COMMUNITY ENGAGEMENT STRATEGIES ARE GUIDED BY THE COMMUNITY OUTREACH STEERING COMMITTEE (COSC) WHICH IS A SUBCOMMITTEE OF THE HOSPITAL'S BOARD OF DIRECTORS. THE COSC ACTUALIZES THE MISSION OF FROEDTERT MENOMONEE FALLS HOSPITAL THROUGH COMMUNITY ENGAGEMENT ACTIVITIES THAT IMPROVE THE QUALITY OF LIFE AND ENHANCE WELLNESS RESOURCES WHICH MEET IDENTIFIED COMPREHENSIVE HEALTH NEEDS OF THE COMMUNITIES SERVED. THE COMMUNITY OUTREACH STEERING COMMITTEE IS APPOINTED ANNUALLY BY THE HOSPITAL PRESIDENT AND IS ADVISORY TO THE FROEDTERT MENOMONEE FALLS HOSPITAL BOARD AND ADMINISTRATION. MEMBERSHIP APPOINTMENTS ARE MADE EACH JUNE WITH MEMBERS SERVING ONE YEAR TERMS. THE COSC MEETS QUARTERLY AND IS COMPOSED OF HOSPITAL AND BOARD REPRESENTATIVES PLUS COMMUNITY MEMBERS REPRESENTING THE VARIOUS CONSTITUENCIES OF THE TOTAL SERVICE AREA. FUNCTIONS INCLUDE: - PROVIDE A LEADERSHIP ROLE IN ADVOCATING COMMUNITY WIDE RESPONSES TO HEALTH CARE NEEDS IN THE COMMUNITY - FACILITATE AND SUPPORT COMMUNITY AND HEALTH CARE PARTNERSHIPS - ENVISION, ASSESS AND GUIDE NEW COMMUNITY BENEFIT OPPORTUNITIES - IDENTIFY AND DESCRIBE UNMET HEALTH NEEDS - PROMOTE UNIVERSAL ACCESS TO HEALTH CARE UNDER THE DIRECTION OF THE COMMUNITY ENGAGEMENT LEADERSHIP TEAM AND TRAINED MEETING FACILITATOR; THE CHNA PLANNING PROCESS INCLUDED SIX STEPS IN DEVELOPING THE IMPLEMENTATION PLAN: - REVIEWED THE 2020 COMMUNITY HEALTH NEEDS ASSESSMENT RESULTS FOR IDENTIFICATION AND PRIORITIZATION OF COMMUNITY HEALTH NEEDS - REVIEWED IMPACT 211 DATA, COMMUNITY OUTREACH HEALTH CLINIC DATA, UNITED WAY ALICE REPORT FOR WAUKESHA COUNTY - REVIEWED PREVIOUS IMPLEMENTATION STRATEGY PRIORITIES, PROGRAMS AND RESULTS - REVIEWED CURRENT HOSPITAL AND COMMUNITY HEALTH IMPROVEMENT INITIATIVES AND STRATEGIES - RANKED AND SELECTED PRIORITY AREAS - SELECTED EVIDENCE-BASED STRATEGIES, PARTNERSHIPS AND PROGRAMS TO ADDRESS COMMUNITY HEALTH NEEDS BASED ON THE INFORMATION FROM ALL THE CHNA DATA COLLECTION SOURCES, THE MOST SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED AS: - INFECTIOUS DISEASE; - MENTAL HEALTH; - SUBSTANCE USE & ABUSE (ALCOHOL, TOBACCO AND OTHER DRUGS); - ACCESS TO HEALTH CARE; - CHRONIC DISEASE; - NUTRITION; - WORKFORCE DEVELOPMENT (HEALTHCARE CAREER EXPLORATION); - TRANSPORTATION; - FOOD INSECURITY; - HOUSING/HOMELESSNESS; AND - SAFETY/VIOLENCE BEFORE THE FACILITATED WORKOUT SESSION IN FEBRUARY 2021, MEMBERS OF THE CHNA/IMPLEMENTATION STRATEGY ADVISORY COMMITTEE WERE ASKED TO RATE EACH HEALTH NEED BASED ON THE FOLLOWING CRITERIA: IMPACT OF HEALTH NEED, FEASIBILITY OF FROEDTERT MENOMONEE FALLS HOSPITAL TO ADDRESS THE NEED (DIRECT PROGRAMS, CLINICAL STRENGTHS AND DEDICATED RESOURCES), ALIGNMENT WITH FROEDTERT THEDACARE HEALTH'S STRATEGIC PRIORITIES, CURRENT OR POTENTIAL COMMUNITY PARTNERS/COALITIONS; ENSURING DISPARITIES ARE ADDRESSED AND EACH NEED HAS ACHIEVABLE AND MEASURABLE OUTCOMES. BASED ON THIS CRITERIA, THE TOP RANKED SIGNIFICANT HEALTH NEEDS INCLUDED: - MENTAL HEALTH; - WORKFORCE DEVELOPMENT; - FOOD INSECURITY; - INFECTIOUS DISEASE; - TRANSPORTATION; AND - SUBSTANCE USE & ABUSE DURING FEBRUARY 2021 WORKOUT SESSION, MEMBERS OF THE COMMUNITY OUTREACH STEERING COMMITTEE WERE ASKED TO PRIORITIZE THE TOP RANKED SIGNIFICANT HEALTH NEEDS. OF THOSE SIGNIFICANT HEALTH NEEDS CATEGORIES, FOUR OVERARCHING THEMES WERE IDENTIFIED AS THE FOCUS FOR FROEDTERT MENOMONEE FALLS HOSPITAL'S IMPLEMENTATION STRATEGY FOR FISCAL 2022-2024: - POPULATION HEALTH AND HEALTH EQUITY; - BEHAVIORAL HEALTH; - WORKFORCE DEVELOPMENT (HEALTH CARE CAREER EXPLORATION); AND - INFECTIOUS DISEASE SIGNIFICANT HEALTH NEEDS NOT ADDRESSED - TOBACCO USE: FROEDTERT MENOMONEE FALLS HOSPITAL SUPPORTS THE MULTI-JURISDICTIONAL COALITION OF TOBACCO FREE COMMUNITY PARTNERSHIP DODGE, JEFFERSON AND WAUKESHA COUNTIES. - NUTRITION: FROEDTERT MENOMONEE FALLS HOSPITAL SUPPORTS THE WAUKESHA COUNTY CHIPP BY ACTIVELY PARTICIPATING ON THE COUNTY-WIDE NUTRITION COMMITTEE. - FOOD INSECURITY: FROEDTERT MENOMONEE FALLS HOSPITAL ACTIVELY PARTICIPATES ON THE WAUKESHA COUNTY CHIPP COALITION BY SUPPORTING INITIATIVES THROUGH THE COUNTY-WIDE NUTRITION COMMITTEE. IN ADDITION, THE HOSPITAL SUPPORTS INITIATIVES THROUGH THE LOCAL FOOD PANTRIES. - HOUSING/HOMELESSNESS: FROEDTERT MENOMONEE FALLS HOSPITAL SUPPORTS THE MILWAUKEE HEALTHCARE PARTNERSHIP THROUGH THE HOUSING NAVIGATION PROGRAM. - SAFETY/VIOLENCE: FROEDTERT MENOMONEE FALLS HOSPITAL SUPPORTS THE WOMEN'S CENTER, VIOLENCE INTERRUPTER PROGRAM AND A CULTURE OF SEE SOMETHING SAY SOMETHING. FROEDTERT MENOMONEE FALLS HOSPITAL SUMMARY OF IMPLEMENTATION STRATEGY FROEDTERT MENOMONEE FALLS HOSPITAL HAS COMPLETED A SEPARATE IMPLEMENTATION STRATEGY THAT ADDRESSES THE HOSPITAL'S IMPLEMENTATION STRATEGY TO MEET THE COMMUNITY HEALTH NEEDS IDENTIFIED IN THIS CHNA. THE FOLLOWING IS A SUMMARY OF THAT SEPARATE, MORE COMPREHENSIVE IMPLEMENTATION STRATEGY REPORT. THE KEY PROGRAMS, STRATEGIES AND DEDICATED HOSPITAL RESOURCES INTENDED TO ADDRESS IDENTIFIED SIGNIFICANT COMMUNITY HEALTH NEEDS ARE ADDRESSED BELOW. COMMUNITY ENGAGEMENT AND FROEDTERT MENOMONEE FALLS HOSPITAL HAVE DEDICATED FULL TIME EMPLOYEES AND BUDGETED FUNDS TOWARD SERVING THE NEEDS OF THE FROEDTERT MENOMONEE FALLS HOSPITAL COMMUNITIES. TO ACCESS A COPY OF THE FULL IMPLEMENTATION STRATEGY, PLEASE GO TO HTTPS://WWW.FROEDTERT.COM/COMMUNITY-ENGAGEMENT. HEALTHCARE ACCESS FOR PRIORITY POPULATIONS & NAVIGATION OF COMMUNITY RESOURCES, HEALTH EQUITY, PATIENT ACCESS TO AFFORDABLE TRANSPORTATION AND CHRONIC DISEASE PREVENTION AND MANAGEMENT CHNA SIGNIFICANT HEALTH NEED: POPULATION HEALTH & HEALTH EQUITY CHNA COMMUNITY HEALTH NEED/ RATIONALE: - 4% OF WAUKESHA COUNTY RESIDENTS UNINSURED - 13% OF WAUKESHA COUNTY RESIDENTS DID NOT SEEK MEDICAL CARE DUE TO COST - 9% OF WAUKESHA COUNTY RESIDENTS REPORTED HAVING UNMET MEDICAL CARE IN THEIR HOUSEHOLD - 5% OF WAUKESHA COUNTY RESIDENTS RESPONDED THAT A HOUSEHOLD MEMBER DID NOT TAKE PRESCRIPTION MEDICATION DUE TO COST GOAL: IMPROVE EQUITABLE ACCESS TO PRIMARY, COMPREHENSIVE, QUALITY HEALTH AND DENTAL CARE SERVICES. OBJECTIVES: 1. ENSURE A STRONG SAFETY NET OF SERVICES THAT IMPROVE ACCESS TO CARE AMONG PRIORITY POPULATIONS. 2. DECREASE THE PERCENT OF RESIDENTS WHO REPORTED UNMET MEDICAL AND DENTAL CARE (IN HOUSEHOLD). 3. PROVIDE INCLUSIVE, CULTURALLY AND LINGUISTICALLY COMPETENT CARE TO ALL PATIENTS, INFORMATION TO COMMUNITY MEMBERS AND EDUCATION TO STAFF. 4. PROVIDE AND ASSIST ELIGIBLE PATIENTS WITH AFFORDABLE TRANSPORTATION OPTIONS. 5. INCREASE NUMBER OF COMMUNITY CHRONIC DISEASE AND CANCER SCREENINGS, ACCESS TO SUPPORT SERVICES AND PREVENTION OPPORTUNITIES. FROEDTERT MENOMONEE FALLS HOSPITAL AVAILABLE RESOURCES: - COMMUNITY ENGAGEMENT LEADERSHIP/STAFF - FROEDTERT THEDACARE & MCW COMMUNITY PHYSICIANS - FINANCIAL SUPPORT THROUGH THE COMMUNITY OUTREACH STEERING COMMITTEE GIFTS - DEPARTMENT OF DIVERSITY AND INCLUSION - FROEDTERT MENOMONEE FALLS HOSPITAL FOUNDATION DEPARTMENT FROEDTERT MENOMONEE FALLS HOSPITAL COLLABORATIVE PARTNERS: - COMMUNITY OUTREACH HEALTH CLINIC-PARTNER ON PROVIDING HEALTHCARE AND BEHAVIORAL SERVICES TO UNDERSERVED POPULATIONS - COMMUNITY SMILES DENTAL-PARTNER ON PROVIDING DENTAL CARE TO UNDERSERVED POPULATIONS - FMFH FAMILY MEDICINE RESIDENCY PROGRAM-PARTNER ON PROVIDING HEALTHCARE SERVICES TO UNDERSERVED POPULATIONS - COMMUNITY COALITIONS (COLLECTIVE IMPACT & WAUKESHA COUNTY CHIPP)-PARTNER TO PROMOTE HEALTH AND WELLNESS IN THE COMMUNITY - WAUKESHA COUNTY SCHOOL DISTRICTS-PARTNER TO PROMOTE SERVICES - MENOMONEE FALLS AND SUSSEX FOOD PANTRIES-PARTNER TO PROMOTE SERVICES - FAITH-BASED ORGANIZATIONS-PARTNER TO PROMOTE SERVICES - UNITED WAY OF GREATER MILWAUKEE & WAUKESHA COUNTY-PROVIDES FUNDING TO ADDRESS PRIORITY HEALTH NEEDS - AREA COMMUNITY EDUCATION AND RECREATION DEPARTMENTS-PROMOTES COMMUNITY EDUCATION AND WELLNESS CLASSES - AMERICAN CANCER SOCIETY-PARTNER TO GAIN RESOURCES TO IMPLEMENT SERVICES - BOBBIE NICK VOSS CHARITABLE FUNDS-PARTNER TO PROMOTE AND ACCESS CANCER CARE SERVICES TO UNDERSERVED POPULATIONS - ERAS SENIOR PROGRAMS WAUKESHA COUNTY-PROMOTES COMMUNITY EDUCATION AND WELLNESS CLASSES - MEDICAL COLLEGE OF WISCONSIN-PARTNER ON FACULTY
Schedule H, Part V, Section B, Line 11 Facility , 2	Facility , 2 - DBA FROEDTERT MENOMONEE FALLS. PART V, LINE 11 (CONT) COMMUNITY OUTREACH HEALTH CLINIC The Community Outreach Health Clinic is a facility where uninsured populations at or below 250% federal poverty level can seek free medical care. The clinic serves people who do not have medical insurance or the ability to pay for medical care. The clinic provides quality medical care with dignity and confidentiality using the services of two Nurse Practitioners, RN Care Coordinator, and volunteers including, physicians, nurses, pharmacists, technicians and other professional staff. This clinic is open Tuesday and Thursday evenings from 5 - 9pm. FY 2022 Outcomes/Progress: Patient Referral Statistics/Outcomes for FY22: - Free or reduced pharmaceuticals dispensed: 2,610 - Laboratory Tests (Donated by Hospital): 841 - Cardiology Procedures (Donated by Hospital): 6 - Radiology Procedures (Donated by Hospital): 23 - Referrals to Specialty Care (Donated by F&MCW Community Physicians): 42 - Clinic served 809 individuals FY 2023 Outcomes/Progress: Patient Referral Statistics/Outcomes for FY23: - Free or reduced pharmaceuticals dispensed: 2,078 - Laboratory Tests (Donated by Hospital): 957 - Cardiology Procedures (Donated by Hospital): 15 - Radiology Procedures (Donated by Hospital): 45 - Referrals to Specialty Care (Donated by F&MCW Community Physicians): 49 - Clinic served 766 individuals FY 2024 Outcomes/Progress: Patient Referral Statistics/Outcomes for FY24: - Free or reduced pharmaceuticals dispensed: 2,449 - Laboratory Tests (Donated by Hospital): 971 - Cardiology Procedures (Donated by Hospital): 13 - Radiology Procedures (Donated by Hospital): 43 - Referrals to Specialty Care (Donated by F&MCW Community Physicians): 50 - Clinic served 840 individuals Family Medicine Residency Program The Froedtert Menomonee Falls Hospital Family Medicine Residency program in Menomonee Falls opened in July 2017 and offers specialty and inpatient rotations at Froedtert Menomonee Falls Hospital, the primary training site, while also featuring an outpatient clinic across the street at Town Hall Health Center, to new Medical College of Wisconsin residents. The six residents took advantage of learning in both a clinic location and a community hospital setting with access to an academic medical center. The Patient-Centered Medical Home model added to the optimal learning environment. In addition to providing exceptional training to new residents, the program also helps to address family medicine physician shortages and expands access to quality health care. FY 2022 Outcomes/Progress: - 16,588 patient visits - Menomonee Falls Senior Enrichment Fair Breakout session on COVID: Truth vs. Myth with 37 attendees. - Panel presenter on virtual webinar entitled Guarding Seniors from Drug Misuse in Partnership with the Heroin task Force with 27 people that attended live event. - Presenter at the Waukesha County Aging & Disability Resource Center's Cup of Health entitled Wellbeing in Turbulent Times with 7 people in attendance. - Attended Safety Town to present on bike safety to three sessions of preschool age students with a total attendance of 69 kids. FY 2023 Outcomes/Progress: - 14,816 patient visits - Menomonee Falls Senior Enrichment Fair Breakout session on vaccinations called Vaccines for the Elderly with 7 attendees. FY 2024 Outcomes/Progress: - 14,458 patient visits - Presented at Wisconsin's Independent Living program, locally operated by Forward Careers. This program is designed to empower young adults aging out of foster care to live independently and participate fully in their communities. 4 students in attendance learned about health screenings and insurance. Community Smiles Dental Community Smiles Dental and Froedtert Menomonee Falls Hospital developed a partnership to expand dental services to Menomonee Falls for uninsured/underinsured children and adults. Froedtert ThedaCare Health allocated a $1.65 million grant which is paid out over a five year span which began in FY 2018 and ended in FY 2022. The dental clinic is owned and operated by Community Smiles Dental in Menomonee Falls and provides preventative, routine and emergent dental care for the hospital's overall service area. Through the terms developed through the grant, Froedtert ThedaCare Health will provide restricted financial support for the rent, construction, equipment and operations for Menomonee Falls Clinic. FY 2022 Outcomes/Progress: - Provided $250,000 restricted grant to cover construction costs and first year operational costs - Continue to network with community partners on children and adult dental needs and services - 5,457 dental appointments - 21,068 dental procedures - 227 emergency exams - Total unique patients - 1,990 - Total value of care: $1,704,660 FY 2023 Outcomes/Progress: - Provided $100,000 restricted grant to cover construction costs and first year operational costs - Continue to network with community partners on children and adult dental needs and services - 5,027 dental appointments - 20,464 dental procedures - 128 emergency exams - Total unique patients - 1,762 (1,392 children, 370 adults) - Total value of care: $1,355,523 FY 2024 Outcomes/Progress: - Provided $600,000 restricted grant to cover construction costs and operational costs - Continue to network with community partners on children and adult dental needs and services - 5,071 dental appointments - 22,765 dental procedures - 167 emergency exams - Total unique patients - 1,855 (1,510 children, 345 adults) - Total value of care: $1,488,958 Chronic Disease and Cancer Preventative Screenings and Management FY2022 Outcomes/Progress: - Froedtert Menomonee Falls Hospital partners with the Bobbie Nick Voss Charitable Funds to provide free colonoscopies to patients (age 50 and above) in the Community Outreach Health Clinic that show signs or symptoms of colorectal related health conditions. 3 uninsured patients received a colonoscopy at no cost. - Monthly blood pressure screenings completed at the Menomonee Falls Senior Center. 75 blood pressure screenings were completed on 28 unique individuals. Results are tracked and basic education and coaching is done with participants. - Cancer Education Classes and Attendance (all classes were virtual) - Eating Well to Prevent Cancer - 7 attendance - Ovarian Cancer Awareness - 3 attendance - Advance Care Planning - 13 attendance - Navigation results from Lisa Lamontagne, Oncology Social Worker and Cancer Navigator include 45 patients that were screened and referred to community resources/assistance. Referrals include insurance resources, government assistance programs, transportation, food pantries and community based outpatient behavioral health services. FY2023 Outcomes/Progress: - Froedtert Menomonee Falls Hospital partners with the Bobbie Nick Voss Charitable Funds to provide free colonoscopies to patients (age 50 and above) in the Community Outreach Health Clinic that show signs or symptoms of colorectal related health conditions. Three uninsured patients received a colonoscopy at no cost. - Monthly blood pressure screenings completed at the Menomonee Falls Senior Center and Sussex Food Pantry. 112 blood pressure screenings were completed on 60 unique individuals. Results are tracked and basic education and coaching is done with participants. - Navigation results from Kelly Russel, Oncology Social Worker and Cancer Navigator include 56 patients that were screened and referred to community resources/assistance. Referrals include insurance resources, government assistance programs, transportation, food pantries and community based outpatient behavioral health services.
Schedule H, Part V, Section B, Line 11 Facility , 3	Facility , 3 - DBA FROEDTERT MENOMONEE FALLS. PART V, LINE 11 (CONT) FY2024 Outcomes/Progress: - Froedtert Menomonee Falls Hospital partners with the Bobbie Nick Voss Charitable Funds to provide free colonoscopies to patients (age 50 and above) in the Community Outreach Health Clinic that show signs or symptoms of colorectal related health conditions. Seven uninsured patients received a colonoscopy at no cost. In addition, we are working to increase the number of residents in Southeast Wisconsin who participate in colorectal screenings with in-home testing kits. In 2024, a second round of mailings of the Fecal Immunochemical Tests (FIT) Kits through the United States Postal Service to 800 Froedtert ThedaCare & the Medical College of Wisconsin patients who are overdue for colonoscopy screenings. The at-home testing kits are designed to address gaps in colorectal cancer screening between Non-BIPOC+A /BIPOC+A populations (black, indigenous, people of color). FIT Kits are an excellent first step for patients hesitant to undergo a colonoscopy. - Monthly blood pressure screenings at the Menomonee Falls Senior Center screened 65 people. Bimonthly blood pressure screenings at Sussex Area Outreach Services screened 34 people. Participants receive basic education and coaching based on their results. - Navigation results from Kelly Russel, Oncology Social Worker and Cancer Navigator include 115 patients that were screened, and 26 referrals were provided to community resources/assistance. Referrals include insurance resources, government assistance programs, transportation, food pantries and community based outpatient behavioral health services. Subsidized Transportation The Subsidized Medical Transportation Program at Froedtert Menomonee Falls contracts with local transportation organizations in order to provide transportation to and from the hospital service locations for ambulatory/non-ambulatory eligible patients (200% federal poverty level or below) who have difficulty arranging their own transportation and lack the financial resources to purchase transportation. FY2022 Outcomes/Progress: - Froedtert Menomonee Falls provided 496 subsidized rides to 467 patients with a total cost of $26,378. - Added an additional non-ambulatory transportation provider to increase capacity. FY2023 Outcomes/Progress: - Froedtert Menomonee Falls Hospital provided 128 subsidized rides to 113 patients with a total cost of $11,502. - Added an additional non-ambulatory transportation provider to increase capacity. FY2024 Outcomes/Progress: - Froedtert Menomonee Falls Hospital provided 248 subsidized rides with a total cost of $7,405. - Added an additional non-ambulatory transportation provider to increase capacity. Bias & Institutional Racism FY2022 Outcomes/Progress: - Exploration of programs and partnerships FY2023 Outcomes/Progress: - Exploration of programs and partnerships. FY2024 Outcomes/Progress: - Froedtert ThedaCare Health hosted an unconscious bias webinar with Judge Derek Mosley on September 28th. - Microaggression Learning Center module were incorporated into yearly staff learning bundle. - Staff badge extenders made available to add pronouns. Grants and In-Kind Contributions FY2022 Outcomes/Progress: - Provided $60,000 to improve population health/health equity in Waukesha County through the Community Outreach Steering Committee grants. - HOPE Inc- Healthy Moms and Birth Outcomes Project- $2,000 - Friends of Germantown Parks- Fit in the Parks - $1,000 - Hebron House of Hospitality- Jeremy House Safe Haven- $5,000 - Youth Choice to Live Inc.- Summer Webinar Series- $5,000 - Family Promise Waukesha County- Their Future Begins at Home Housing Project- $5,000 - Community Outreach Health Clinic- Clinic Operations- $42,000 - Staff volunteered 291.5 hours for the flu clinics that reached 1,089 individuals FY2023 Outcomes/Progress: - Provided $45,000 to improve population health/health equity in Waukesha County through the Community Outreach Steering Committee grants. - Friends of Germantown Parks- Fit in the Parks - $1,000 - Hebron Housing Services- Operational Cost for Emergency Shelters- $10,000 - Family Promise Waukesha County- Family Homelessness Prevention Project- $7,500 - Community Outreach Health Clinic- Clinic Operations- $25,000 - School District of Waukesha County - SDW Wake Up Call - $1,500 - Staff volunteered 154.5 hours for the flu clinics that reached 455 individuals FY2024 Outcomes/Progress: - Provided $75,000 to improve population health/health equity in Waukesha County through the Community Outreach Steering Committee grants. - Elevate - Community Project and Peers 4 Peers - $12,500 - The YMCA of Greater Waukesha County - Cardiac Rehab Maintenance Program - $5,000 - Sussex Area Outreach Services - Cooler repair and enhancements - $10,000 - CV Academics Foundation - Supporting students interested in a career in health care - $8,700 - Family Promise of Waukesha County - Homeless Prevention Project - $7,500 - Menomonee Falls Food Pantry - Food and hygiene items - $3,000 - Germantown Fit in the Park - Free health and exercise activities - $1,000 - Community Outreach Health Clinic - Clinic operations - $27,300 - Staff volunteered 179 hours for the flu clinics that reached 430 individuals Social Engagement, Support Groups, Prescription Drug Prevention, Treatment, Screenings and Referrals Services CNHA Significant Health Need: Behavioral Health (Mental Health and Substance Use & Abuse) CHNA Community Health Need/ Rationale: - 32% of Waukesha County residents reported binge drinking - 19% of Waukesha County residents reported having a Mental Health Condition - 4% of Waukesha County residents reporting having unmet mental health care in household - 3% of Waukesha County residents reporting considering suicide in past year Goals: 1. Support behavioral health outreach, education, and prevention programs. 2. Improve access to behavioral health treatment, services and navigation of community resources. Objectives: 1. Increase opportunities for social engagement to reduce isolation, depression and addiction. 2. Increase opportunities for the safe removal of prescription drugs from households. 3. Increase number of behavioral health treatment services, screenings and referrals targeted at underinsured populations through the Community Outreach Health Clinic. 4. Decrease the percent of residents who reported unmet mental health care (in household). Froedtert Menomonee Falls Hospital Available Resources: - Community Engagement leadership/staff - Grant support through the Community Outreach Steering Committee - Froedtert ThedaCare Health Behavioral Health Services - Froedtert ThedaCare & MCW Community Physicians Froedtert Menomonee Falls Hospital Collaborative Partners: - Waukesha County Health & Human Services-Partner to promote and implement behavioral health efforts. - Elevate, Inc-Partner on substance abuse prevention efforts - NAMI Southeast Wisconsin-Partner to promote mental wellness efforts - Community Outreach Health Clinic-Partner to promote and provide behavioral health services - Menomonee Falls Police Department-Partner for Drug Collection - Aging & Disability Resource Center-Community partner addressing opiate and alcohol use among older adults - UW-Extension -Waukesha County-Community partner working on programming with older adults and social engagement - Addiction Resource Council-Partner to promote and access alcohol and drug abuse services to underserved populations - Waukesha County School Districts-Partner to promote opportunities to students - Eras Senior Programs Waukesha County-Promotes community education and wellness classes Behavioral Health Support Groups and Programs FY 2022 Outcomes/Progress: - Participating member in the Waukesha County Criminal Justice Collaborative - Guarding seniors from Drug Misuse webinar in partnership with the Heroin Task Force. FY 2023 Outcomes/Progress: - Participating on the mental health community health action team through the Waukesha County Public Health Department. - Behavioral Health Peer Support Group with 60 participants FY 2024 Outcomes/Progress: - Participating on the mental health community health action team through the Waukesha County Public Health Department. - Focus areas include: - Youth Mental Health Navigation - Youth Mental Health Days - Promoting 988 and other hotlines/warmlines - Ending the Silence - Behavioral Health Peer Support Group with 406 participants
Schedule H, Part V, Section B, Line 13 Facility , 1	Facility , 1 - DBA FROEDTERT MENOMONEE FALLS. Froedtert ThedaCare Health reserves the right to review each Financial Assistance application on its own merits and to consider other extenuating circumstances in the decision to approve a patient's application for Financial Assistance. The applicant's gross family income will be determined using Modified Adjusted Gross Income (MAGI). Modified Adjusted Gross Income includes both earned income and passive income received. A patient who has an annual gross income equal to or less than 400% of the current year's poverty guidelines will not pay more than 15% of his/her annual gross income on any single account during the approved Financial Assistance eligibility timeframe. Patients who meet the requirements and have a gross income equal or less than 250% of the FPL may qualify for a 100% discount. Patients who meet the requirements and have a gross income between 250% and 400% of the FPL may qualify for a discount on a sliding scale. In addition to income, Froedtert ThedaCare Health also takes certain assets into consideration. Assets protected from financial evaluation include a household's retirement assets, home equity, and a portion of cash and savings assets.
Schedule H, Part V, Section B, Line 13 Facility , 1	Facility , 1 - DBA FROEDTERT MENOMONEE FALLS. OUT OF POCKET MAXIMUM DISCOUNT.
Schedule H, Part V, Section B, Line 20 Facility , 1	Facility , 1 - DBA FROEDTERT MENOMONEE FALLS. WE REQUEST ADDITIONAL DOCUMENTATION WHEN AN INDIVIDUAL HAS SUBMITTED AN INCOMPLETE FINANCIAL ASSISTANCE APPLICATION.

Schedule H (Form 990) 2023

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Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?0
Name and address		Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2023

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Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
Schedule H, Part VI, Line 7	COMMUNITY BENEFIT DATA IS REPORTED ANNUALLY TO THE WISCONSIN HOSPITAL ASSOCIATION.
Schedule H, Part I, Line 6a	Every year, Froedtert ThedaCare Health produces an annual report to the community highlighting community outreach programs, patient impact stories and investments in the communities we serve. The report is mailed to over 150 area non-profits, chambers of commerce, hospital partners, Froedtert Menomonee Falls Hospital Board of Directors, Froedtert Menomonee Falls Hospital leaders and staff, government officials, business leaders and other community members. A copy of the most recent report can be found at https://www.froedtert.com/about/annual-reports
Schedule H, Part V, Section C Facilities Policies, Line 11 (continued)	Grants and In-Kind Contributions FY2022 Outcomes/Progress: - Provided $15,000 to improve behavioral health in Waukesha County through the Community Outreach Steering Committee grants. - Addiction Resource Council- Outreach and Ind/Family Support Programs- $15,000 - Coalition work- Heroin Task Force of Waukesha County & Prevention sub-committee FY2023 Outcomes/Progress: - Provided $30,000 to improve behavioral health in Waukesha County through the Community Outreach Steering Committee grants. - Addiction Resource Council- Outreach and Ind/Family Support Programs- $20,000 - Family Services - Supporting Student Mental Health in Schools - $10,000 - Coalition work - Heroin Task Force of Waukesha County & Prevention sub-committee and Mental Health Community Health Action Team FY2024 Outcomes/Progress: - Provided $12,500 to improve behavioral health in Waukesha County through the Community Outreach Steering Committee grants. - Elevate Inc. - Elevate Community Project and Peers 4 Peers- $12,500 - Coalition work - Heroin Task Force of Waukesha County & Prevention sub-committee and Mental Health Community Health Action Team Drug Collection (AODA/Mental Health) As part of our commitment to improve the quality of life in our community and address drug/heroin addiction in our communities, Froedtert Menomonee Falls Hospital partners with the Menomonee Falls Police Department to host drug collections. FY 2022 Outcomes/Progress: At the collections, area residents dropped off 633pounds of prescription and over-the-counter medications and 330 area households participated in the collection. This year it took 35 staff and 103 hours to make the collections possible FY 2023 Outcomes/Progress: At the collections, area residents dropped off 543 pounds of prescription and over-the-counter medications and 350 area households participated in the collection. This year it took 26 staff and 116 hours to make the collections possible. FY 2024 Outcomes/Progress: At the collection, area residents dropped off 466 pounds of prescription and over-the-counter medications and 279 area households participated in the collection. This year it took 23 staff and 64 hours to make the collections possible. Community Outreach Health Clinic FY 2022 Outcomes/Progress: - Behavioral health screenings: 160 - Counseling/Case Management: 80 - Medically Assisted Treatment (MAT): 40 FY 2023 Outcomes/Progress: - Behavioral health screenings: 140 - Counseling/Case Management: 68 - Medically Assisted Treatment (MAT): 48 FY 2024 Outcomes/Progress: - Behavioral health screenings: 112 - Counseling/Case Management: 118 - Medically Assisted Treatment (MAT): 37 CNHA Significant Health Need: Workforce Development (health care career exploration) CHNA Community Health Need/ Rationale: - 2.2% unemployment rate - 4.8% of Waukesha County residents live in poverty - Froedtert Menomonee Falls Hospital provides yearly scholarships to high school students - Froedtert Menomonee Falls Hospital serves over 5,000 students through workforce development programs per year Goals: Increase student's exposure to health care careers. Objectives: Increase opportunities for students to gain exposure to all health care careers including medical, dental and behavioral health. Froedtert Menomonee Falls Hospital Available Resources: - Community Engagement leadership/staff - Froedtert ThedaCare Health Workforce Development - Froedtert ThedaCare Health Human Resources - Froedtert ThedaCare Health Organizations Development - Froedtert Menomonee Falls Hospital Foundation Department Froedtert Menomonee Falls Hospital Collaborative Partners: - Waukesha County School Districts-Partner to promote opportunities to students - Waukesha County Business Alliance -Partner to promote opportunities to students - Waukesha County Community Organizations-Partner to promote workforce development opportunities Community Engagement Workforce Development Program FY 2022 Outcomes/Progress: - Evaluate current partnerships and resources - Create effectiveness criteria - Develop and implement a coordinated plan - Develop a tracking tool FY 2023 Outcomes/Progress: - Developed a core working group to determine Community Engagement Workforce Development structure and staffing - Determined workforce development programs that align with Community Engagement scope and outreach - Developed a proposal that outlined programs, health system leads and future recommendations for approval FY 2024 Outcomes/Progress: - Held internal meetings with a core working group to determine and align Community Engagement Workforce Development structure and staffing - Held external meetings with three school districts to discuss partnership opportunities - Waukesha, Pewaukee and Sussex Hamilton. - Determined workforce development programs that align with Community Engagement scope and outreach to include health care career presentations, career exploration booths and special project partnerships. Froedtert Menomonee Falls Hospital Foundation Scholarship Program FY2022 Outcomes/Progress: - 33 students received a scholarship through the Froedtert Menomonee Falls Hospital Foundation with a total dollar amount of $81,000 FY2023 Outcomes/Progress: - 32 students received a scholarship through the Froedtert Menomonee Falls Hospital Foundation with a total dollar amount of $91,100 FY2024 Outcomes/Progress: - 27 students received a scholarship through the Froedtert Menomonee Falls Hospital Foundation with a total dollar amount of $100,100
Schedule H, Part V, Section C Facilities Policies, Line 11 (Continued)	Promote Mission Critical Health Care Careers Health care exploration programs are offered to showcase healthcare careers to middle and high school students. Students have the opportunity to participate in job shadows, get department tours and have small group or one-on-one time with health care professionals to discuss career pathways along with answering their questions. FY 2022 Outcomes/Progress: - Froedtert Menomonee Falls Hospital partnered with LAUNCH for two multi-week sessions with health care mentors. There were 42 students served. Eight staff supported the LAUNCH mock interviews for 42 students. Eight classroom presentations were done in a Biomedical Solutions Health Care classroom. - Presentations on careers and health topics at Waukesha North, Germantown & Sussex Hamilton High Schools. - A multi-week virtual job shadow took place with the Menomonee Falls High School Capstone classroom that included 12 students. - Supported Junior Achievement's Career Day at Muskego High School with 10 staff presenting to 560 students. - Provided job shadows for one student. - Provided clinical and nursing preceptor hours to 573 students. - Provided non-clinical preceptor hours to 77 students. FY 2023 Outcomes/Progress: - Froedtert Menomonee Falls Hospital partnered with LAUNCH for two multi-week sessions with health care mentors. There were 72 students served and 24 staff mentors. - 6 staff supported 9 different LAUNCH mock interview slots for 39 students. - 15 classroom presentations were done in a Biomedical Solutions Health Care classroom. - Presentations on careers and health topics at Brookfield East High School, Waukesha North, and Germantown High School. - Participated on a story telling panel where 13 staff served as an authentic audience with 130 students. - Waukesha Business Alliance Health Care Career Expo: 475 students attended with 9 Froedtert ThedaCare Health booths staffed by 19 staff and one comfort dog and handler. - Participated in a virtual Junior Achievement presentation where 645 students participated. - Junior Achievement presentation at Muskego High School (144 students). A total of 5 Froedtert ThedaCare Health speakers serving 18 hours. - Provided job shadows for 13 students. - Provided clinical and nursing preceptor hours to 304 students. - Provided non-clinical preceptor hours to 91students. FY 2024 Outcomes/Progress: - Froedtert Menomonee Falls Hospital partnered with LAUNCH for two multi-week sessions with health care mentors. There were 78 students served and 24 staff mentors. In addition, 3 staff served at judges at the spring showcase event. - 7 staff supported 10 different LAUNCH mock interview slots for 55 students. - Presentation on suturing at Germantown High School. - Participated in Mukwonago High School Healthcare Symposium - Capstone Project Gallery Walk where 6 staff attended impacting 31 students. - Waukesha Business Alliance Health Care Career Expo: 650 students attended with 7 Froedtert ThedaCare Health booths staffed by 13 staff and one comfort dog and handler. - Participated in a virtual Junior Achievement Career Panel on careers in Mental Health providing 3 speakers and a moderator. - Created a new partnership with AMP Honors where staff participated in short career interviews. Coordinated 6 staff interviews. - Participated in Pewaukee School District's Academic and Career Advisory Board. - Provided job shadows for 30 students. - Provided clinical and nursing preceptor hours to 288 students. - Provided non-clinical preceptor hours to 137 students. Health Disparities, Immunizations and Preparedness CNHA Significant Health Need: Infectious Disease CHNA Community Health Need/ Rationale: - 49.8% of Waukesha County residents have received at least one COVID-19 vaccine dose - 43.2% of Waukesha County residents have completed the COVID-19 vaccine series - Over 500 total COVID-19 deaths Goals: Support infectious disease outreach, education and prevention initiatives Objectives: 1. Increase outreach to priority populations to reduce health disparities related to access to care, language, historical trauma and other barriers. 2. Improve access to infectious disease immunizations. 3. Enhance collaborations with community partners on emergency preparedness efforts. 4. Achieve a low COVID-19 case activity level in Waukesha County by June, 2024.* Froedtert Menomonee Falls Hospital Available Resources: - Community Engagement leadership/staff - Froedtert ThedaCare Health Emergency Preparedness Department - Froedtert ThedaCare Health Infectious Disease and Clinical Experts Froedtert Menomonee Falls Hospital Collaborative Partners: - Waukesha County Health Department-Partner to promote and implement infectious disease efforts - Community Outreach Health Clinic-Partner to promote infectious disease services - United Way of Greater Milwaukee & Waukesha County-Provides funding to address priority health needs - Eras Senior Programs Waukesha County -Promotes community education and wellness classes Outreach and Prevention FY 2022 Outcomes/Progress: - Presentation at Menomonee Falls Senior Enrichment Fair titled COVID: Myths & Facts. FY 2023 Outcomes/Progress: - Presentation at Menomonee Falls Senior Enrichment Fair titled Vaccines for the Elderly with 7 attendees. FY 2024 Outcomes/Progress: - Shared information about the RSV vaccine at the Menomonee Falls Senior Center before Bingo with 41 attendees. Immunization Clinics FY 2022 Outcomes/Progress: - During the fall of FY22, provided 1,032 flu vaccines at THHC drive thru drives, 57 free flu vaccines at various community partner sites. 1,365 at all Froedtert ThedaCare Health system drive-thru drives. People were immunized at various locations as well as through drive through flu clinics. Each of the clinics was staffed by hospital pharmacists and support staff who were certified by the state to administer immunizations. - 69.1% of Waukesha County residents have received at least one dose of the COVID-19 vaccine - 66.4% of Waukesha County residents have completed the COVID-19 vaccine series - 38.6% of Waukesha County residents have received a booster dose FY 2023 Outcomes/Progress: - During the fall of FY23, provided 354 flu vaccines at THHC drive thru drives, 97 free flu vaccines at various community partner sites. 512 at all Froedtert ThedaCare Health system drive-thru drives. People were immunized at various locations as well as through drive through flu clinics. Each of the clinics was staffed by hospital pharmacists and support staff who were certified by the state to administer immunizations. FY 2024 Outcomes/Progress: - During the fall of FY24, provided 340 flu vaccines at THHC drive thru drives, 90 free flu vaccines at various community partner sites. 477 at all Froedtert ThedaCare Health system drive-thru drives. People were immunized at various locations as well as through drive through flu clinics. Each of the clinics was staffed by hospital pharmacists and support staff who were certified by the state to administer immunizations. Emergency Preparedness Plan FY2022 Outcomes/Progress: - Explored opportunities to strengthen partnership with health department. FY2023 Outcomes/Progress: - Explored opportunities to strengthen partnership with health department. FY2024 Outcomes/Progress: - The Froedtert ThedaCare Health Emergency Management Department has collaborative plans with the health department.
Schedule H, Part V, Section C Significant Health Needs Not Addressed, Line 11	Significant Health Needs Not Addressed - Tobacco Use: Froedtert Menomonee Falls Hospital supports the Multi-Jurisdictional Coalition of Tobacco Free Community Partnership Dodge, Jefferson and Waukesha Counties. - Nutrition: Froedtert Menomonee Falls Hospital supports the Waukesha County CHIPP by actively participating on the county-wide nutrition committee. - Food Insecurity: Froedtert Menomonee Falls Hospital actively participates on the Waukesha County CHIPP Coalition by supporting initiatives through the county-wide nutrition committee. In addition, the hospital supports initiatives through the local food pantries. - Housing/Homelessness: Froedtert Menomonee Falls Hospital supports the Milwaukee HealthCare Partnership through the Housing Navigation Program. - Safety/Violence: Froedtert Menomonee Falls Hospital supports The Women's Center, Violence Interrupter Program and a culture of see something say something.
Schedule H, Part II Community Building Activities	To promote the health of our communities, Froedtert Menomonee Falls Hospital participates in numerous community building activities, which are not included elsewhere on Schedule H. These activities include: 1. Economic Development: 3 leaders participate in local chamber of commerce boards focused on economic development to improve the local economy and local job opportunities. 2. Community Support: 25 hours were dedicated to supporting youth focused coalitions to improve the community environment for youth to set them up for greater success. 3. Community Health Improvement Advocacy: Participation in completing the Community Health Improvement Plan initiatives with the local health departments to increase collaborative work in our communities. 4. Workforce Development: Diversity training and minority internship programs that recruit health professionals in our traditionally underserved communities to diversify our workforce population to better serve our communities. Work with high school students to increase their interest in health care careers and includes things such as HealthCare Career Academy, hospital tours, career events and observation experiences.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	THE HOSPITAL PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION, AND EXISTING ECONOMIC CONDITIONS AND TRENDS. THE RATIO OF PATIENT CARE COST TO CHARGES IS APPLIED TO THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS TO CALCULATE THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS THAT IS REPORTED ON LINE 2. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS AN ADJUSTMENT TO REVENUE, NOT BAD DEBT EXPENSE.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology	THE FINANCIAL ASSISTANCE POLICY ALLOWS FOR ACCOUNTS IN BAD DEBT TO BE APPROVED FOR FINANCIAL ASSISTANCE IF THE PATIENT MEETS THE CRITERIA. THERE ARE POSSIBLE FINANCIAL ASSISTANCE ACCOUNTS IN BAD DEBT, ALTHOUGH THE EXACT PERCENTAGE IS UNKNOWN AS WE DO NOT HAVE THE APPROPRIATE TOOLS TO DETERMINE THIS PERCENTAGE ACCURATELY.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	PATIENTS' ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF PATIENTS' ACCOUNTS RECEIVABLE, FROEDTERT THEDACARE HEALTH, INC.(FTCH) ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD PARTY COVERAGE, FTCH ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD PARTY COVERAGE EXISTS FOR PART OF THE BILL), FROEDTERT THEDACARE HEALTH, INC. RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FTCH RECOGNIZES PATIENT SERVICE REVENUE ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD PARTY PAYOR COVERAGE ON THE BASIS OF CONTRACTUAL RATES FOR THE SERVICES RENDERED. FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, FROEDTERT THEDACARE HEALTH, INC. RECOGNIZES REVENUE ON THE BASIS OF ITS STANDARD RATES FOR SERVICES PROVIDED (OR ON THE BASIS OF DISCOUNTED RATES, IF NEGOTIATED OR PROVIDED BY POLICY). ON THE BASIS OF HISTORICAL EXPERIENCE, A SIGNIFICANT PORTION OF FTCH'S UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, FTCH RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. SEE ALSO PAGES 29-31 ON THE ATTACHED AUDITED FINANCIAL STATEMENTS.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	FMFH BELIEVES THAT ALL OF THE SHORTFALL SHOULD BE CONSIDERED AS COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. THE HOSPITAL PROVIDES EMERGENCY MEDICAL CARE OR OTHER MEDICALLY NECESSARY CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVES THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES. THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS IS BASED ON A CALCULATION DEVELOPED BY THE AMERICAN HOSPITAL ASSOCIATION IN WHICH THE DATA IS DERIVED FROM THE ANNUAL FILED MEDICARE COST REPORT.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	IN ALIGNMENT WITH THE FTCH FINANCIAL ASSISTANCE POLICY AND CREDIT AND COLLECTION POLICY REGARDING THE BILLING, COLLECTION AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS, FMFH MAKES EVERY EFFORT TO ADHERE TO THE POLICY AND IS COMMITTED TO IMPLEMENTING AND APPLYING THE POLICIES FOR ASSISTING THOSE PATIENTS WHO MAY QUALIFY FOR FINANCIAL ASSISTANCE IN A PROFESSIONAL AND CONSISTENT MANNER. STAFF MEMBERS WHO WORK CLOSELY WITH PATIENTS SUCH AS PATIENT FINANCIAL SERVICES CUSTOMER SERVICE AND FINANCIAL COUNSELING STAFF, AS WELL AS THOSE INVOLVED IN BILLING AND COLLECTIONS ARE TRAINED ABOUT THESE POLICIES WITH AN EMPHASIS ON TREATING ALL PATIENTS WITH DIGNITY AND RESPECT REGARDLESS OF THEIR INSURANCE OR THEIR ABILITY TO PAY FOR SERVICES. OTHER STAFF WHO MAY HAVE INTERACTIONS WITH PATIENTS, SUCH AS ADMITTING STAFF ARE ALSO AWARE OF THE POLICY, AND ABLE TO PROVIDE PATIENTS A COPY OF AN APPLICATION UPON REQUEST AND ALSO ARE COMMITTED TO TREATING PATIENTS WITH DIGNITY AND RESPECT REGARDLESS OF THEIR INSURANCE OR THEIR ABILITY TO PAY FOR SERVICES.
Schedule H, Part V, Section B, Line 16a FAP website	- COMMUNITY MEMORIAL HOSPITAL DBA FROEDTERT MENOMONEE FALLS: Line 16a URL: www.froedtert.com/financial-services;
Schedule H, Part V, Section B, Line 16b FAP Application website	- COMMUNITY MEMORIAL HOSPITAL DBA FROEDTERT MENOMONEE FALLS: Line 16b URL: www.froedtert.com/financial-services;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- COMMUNITY MEMORIAL HOSPITAL DBA FROEDTERT MENOMONEE FALLS: Line 16c URL: www.froedtert.com/financial-services;
Schedule H, Part VI, Line 2 Needs assessment	In 2020, a CHNA was conducted to 1) determine current community health needs in Waukesha County, 2) gather input from persons who represent the broad interest of the community and identify community assets, 3) identify and prioritize significant health needs, and 4) develop implementation strategies to address the prioritized health needs. Froedtert Menomonee Falls Hospital assesses the health needs of the communities it serves through a comprehensive data collection process from a number of key sources. Data and research included information from community members, public health officials, community leaders/experts, and non-profit organizations representing vulnerable populations in our service area. The following information/data sources was collected and taken into consideration for assessing and addressing community health needs: Community Health Survey: Using the Center for Disease Control's Behavioral Risk Factor Surveillance System (BRFSS), a telephone-based survey of 400 residents was conducted by Froedtert Menomonee Falls Hospital in collaboration with the Milwaukee Health Care Partnership. The full report of this survey can be found at https://www.froedtert.com/community-engagement. Key Informant Interviews: Froedtert Menomonee Falls Hospital Community Engagement team and leaders conducted 47 interviews with community leaders of various school districts, non-profit organizations, health & human service department and business leaders. The full Key Informant Results can be found at https://www.froedtert.com/community-engagement. Community Partner/Agency Reports: To better understand the needs of our underserved populations; Froedtert Menomonee Falls Hospital obtained important data and trends from partner organizations such as Community Outreach Health Clinic, United Way of Greater Milwaukee & Waukesha County ALICE Report, and Impact 211 data specific to FMFH's primary service area to seek important trends, demographic data and services to provide an inclusive viewpoint of community needs for these unrepresented populations. Secondary Data Reports: Utilizing multiple county and community-based publicly available reports, information was gathered regarding: Mortality/Morbidity data, Injury Hospitalizations, Emergency Department visits, Waukesha County Health Rankings, Public Safety/Crime Reports and Socio-economic data. A full summary of Secondary Data information can be found at https://www.froedtert.com/community-engagement. Froedtert Menomonee Falls Hospital is committed to addressing community health needs collaboratively with local partners. Froedtert Menomonee Falls Hospital used the following methods to gain community input from June-September 2020 on the significant health needs of the Froedtert Menomonee Falls Hospital's community. These methods provided additional perspectives on how to select and address top health issues facing Froedtert Menomonee Falls Hospital's community. Input from Community Members Key Informant Interviews: Key organizations with specific knowledge and information relevant to the scope of the identified significant health needs ("informants") in Froedtert Menomonee Falls Hospital's community, including Waukesha County, were identified by organizations and professionals that represent the broad needs of the community as well as organizations that serve low-income and underserved populations. These local partnering organizations also invited the informants to participate in and conduct the interviews. The interviewers used a standard interview script that included the following elements: - Ranking of up to five public health issues, based on the focus areas presented in Wisconsin's State Health Plan, that are the most important issues for Waukesha County; and - For those five public health issues: - Existing strategies to address the issue - Barriers/challenges to addressing the issue - Additional strategies needed - Key groups in the community that hospitals should partner with to improve community health - Identification of subgroups or subpopulations where efforts could be targeted - Ways efforts can be targeted toward each subgroup or subpopulation - To be responsive to the current conditions during the COVID-19 pandemic, the following additional questions were added to the interview guide: - What community needs or gaps have developed since the coronavirus pandemic began? - How can health care organizations support the community during this pandemic? - What methods of communication and outreach have been successful to reach partners and community members during the pandemic? - How would you suggest health care organizations outreach to community partners and members to implement health initiatives? Underserved Population Input: Froedtert Menomonee Falls Hospital is dedicated to reducing health disparities and input from community members who are medically underserved, low-income and minority populations and/or organizations that represent those populations are important in addressing community health needs. With that in mind, Froedtert Menomonee Falls Hospital took the following steps to gain input: - Community Health Survey: When appropriate, data was stratified by gender, age, education household income level and marital status. - Key Informant Interviews: The key informant interviews included input from members of organizations representing medically underserved, low-income and minority populations. Summary of Community Member Input Top five health issues ranked most consistently or most often cited for Waukesha County were: Key Informant Interviews: - Mental Health - Substance Use and Abuse - Access to Health Care - Chronic Disease - Nutrition Community Health Survey: - Coronavirus/COVID-19 - Illegal Drug Use - Overweight or Obesity - Chronic Diseases - Mental Health or Depression After adoption of the CHNA Report and Implementation Strategy, Froedtert Menomonee Falls Hospital publicly shares both documents with community partners, key informants, hospital board members, public schools, non-profits, hospital coalition members, the Waukesha County Public Health Division, and the general public. Documents are made available via email, hard copies are made available at applicable meetings, and electronic copies are made available by PDF for download on https://www.froedtert.com/community-engagement. Feedback and public comments are always welcomed and encouraged, and can be provided through the contact form on the Froedtert ThedaCare Health website at https://www.froedtert.com/contact, or contacting Froedtert ThedaCare Health, Inc.'s Community Engagement leadership/staff with questions and concerns by calling 414-777-1926. Froedtert Menomonee Falls Hospital received no comments or issues with the previous Community Health Needs Assessment Report and/Implementation Strategy. IN 2023, THE MOST RECENT CHNA WAS COMPLETED WITH THE DEVELOPMENT OF THE 2025-2027 IMPLEMENTATION STRATEGY/COMMUNITY HEALTH IMPROVEMENT PLAN. HOWEVER, THIS NARRATIVE IS A THREE YEAR SUMMARY OF INITIATIVES AND OUTCOMES OF THE 2020 CHNA AND 2022-2024 IMPLEMENTATION STRATEGY/COMMUNITY HEALTH IMPROVEMENT PLAN.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	Froedtert ThedaCare Health informs and educates patients regarding financial assistance and government program eligibility in a number of ways. Its communication efforts also address special needs of patients and their families, such as hearing or visual impairment or language interpretation. Information on hospital-based financial support policies and government programs are made available to patients during the pre-registration and registration processes through brochures, signage and direct contact with financial counselors, social workers / case managers and registration staff. Patient billing statements also inform patients that financial assistance is available. The FTCH website contains information regarding pricing, how to understand your hospital bill, and how to apply for Financial Assistance. Froedtert ThedaCare Health has made financial assistance forms and information available in Spanish, Arabic, Russian, and Hmong. Financial counselors screen uninsured patients for government program eligibility and social services staff are available to assist patients with enrollment processes. Patients who are uninsured, those covered by government programs and those with limited financial means may also be eligible for charity care or discounts through the Froedtert ThedaCare Health financial assistance program. Financial counselors make every effort to determine a patient's eligibility prior to or at the time of admission or service. However, determination for financial assistance can be made during any stage of the patient's stay after stabilization, or the collection cycle.
Schedule H, Part VI, Line 4 Community information	Community Information Overview Froedtert Menomonee Falls Hospital, founded in 1964 by the citizens of Menomonee Falls and surrounding communities and originally named Community Memorial Hospital, is a full-service hospital that specializes in cancer care, heart and vascular care, orthopaedics, women's health and advanced surgical procedures. Froedtert Menomonee Falls Hospital is part of the Froedtert ThedaCare & MCW health care network, which includes Froedtert Hospital in Milwaukee, eastern Wisconsin's only academic medical center; hospitals in Kenosha, Manitowoc, New Berlin, Pewaukee, Pleasant Prairie and West Bend; and more than 45 primary and specialty care health centers and clinics. Mission Statement Froedtert Menomonee Falls Hospital advances the health of the people of the diverse communities we serve through exceptional care enhanced by innovation and discovery. Service Area and Demographics For the purpose of the Community Health Needs Assessment, the community is defined as Northeast Waukesha County and Germantown because we derive 73% of discharges occur from this geography. All programs, activities, and partnerships under the CHNA will be delivered in Waukesha County. However, Froedtert Menomonee Falls Hospital's total service area consists of Waukesha County as well as zip codes in southern Washington County and western Milwaukee County. Froedtert Menomonee Falls Hospital determines its primary and secondary service areas by completing an annual review and analysis of hospital discharges and market share according to various determinants. The map reflects the 25 zip codes - 53005 (Brookfield), 53007 (Butler), 53012 (Cedarburg), 53017 (Colgate), 53022 (Germantown), 53027 (Hartford), 53029 (Hartland), 53033 (Hubertus), 53037 (Jackson), 53040 (Kewaskum), 53045 (Brookfield), 53046 (Lannon), 53051 (Menomonee Falls), 53072 (Pewaukee), 53076 (Richfield), 53086 (Slinger), 53089 (Sussex), 53090 (West Bend), 53095 (West Bend), 53122 (Elm Grove), 53218 (Milwaukee), 53222 (Milwaukee), 53223 (Milwaukee), 53224 (Milwaukee), and 53225 (Milwaukee). HOUSEHOLD INCOME CY24 - PRIMARY SERVICE AREA AND SECONDARY SERVICE AREA UNDER $24,999 - 15.01% AND 9.18% $25,000 - $49,999 - 17.02% AND 12.28% $50,000 - $99,999 - 29.19% AND 24.77% $100,000 AND UP - 38.78% AND 53.78% TOTAL HOUSEHOLDS - 122,201 AND 63,169 SOURCE: ESRI BAO PAYER SOURCE FY23 - PRIMARY SERVICE AREA AND SECONDARY SERVICE AREA COMMERCIAL/MANAGED CARE - 22.5% AND 30.7% MEDICAID - 21.8% AND 9.5% MEDICARE - 52.7% AND 58.2% OTHER GOVERNMENT - 1.1% AND 0.8% OTHER SELF PAY - 1.9% AND 0.8% SOURCE: WHA RACE CY24 - PRIMARY SERVICE AREA AND SECONDARY SERVICE AREA WHITE - 63.06% AND 80.95% AFRICAN AMERICAN - 24.22% AND 6.09% ASIAN/HAWAIIAN/PACIFIC ISLANDER - 5.57% AND 5.95% NATIVE AMERICAN - 0.32% AND 0.24% TWO OR MORE RACES - 5.14% AND 5.67% OTHER - 1.69% AND 1.10% HISPANIC - 4.60% AND 3.98% TOTAL POPULATION - 301,863 AND 154,869 SOURCE: ESRI BAO PAYER SOURCE FY24 Q3 - PRIMARY SERVICE AREA AND SECONDARY SERVICE AREA COMMERCIAL/MANAGED CARE - 21.9% AND 29.8% MEDICAID - 20.9% AND 9.4% MEDICARE - 54.0% AND 59.1% OTHER GOVERNMENT - 1.0% AND 0.8% OTHER SELF PAY - 2.1% AND 0.8% SOURCE: WHA
Schedule H, Part VI, Line 5 Promotion of community health	Promotion of Community Health: Other Community Engagement Programs and Initiatives: Community Engagement proactively addresses the social, cultural and economic determinants that underpin health and seeks to build partnerships with others to find solutions. Froedtert & the Medical College of Wisconsin are committed to making a positive, sustained difference in our community. Community Engagement will strengthen the economic vitality and quality of life of those communities we serve. Froedtert Menomonee Falls Hospital's Community Engagement programming and health improvement activities are supported through staff resources, budgeted dollars for programming and community partnerships. United Way Employee Giving Campaign (Community Development) Froedtert Menomonee Falls Hospital collaborates with United Way of Greater Milwaukee and Waukesha County to address community needs in the areas of meeting basic needs, developing self-reliance, strengthening communities and community support. Community Memorial Hospital hosts an annual workplace giving campaign to support all local United Ways. FY 2022 Outcomes/Progress: - The implementation of the campaign took 305 hours of staff time to coordinate. As a health system, Froedtert ThedaCare staff, physicians, and leaders raised $1,207,919.51. FY 2023 Outcomes/Progress: - The implementation of the campaign took 137 hours of staff time to coordinate. As a health system, Froedtert ThedaCare staff, physicians, and leaders raised $1,257,932.20 FY 2024 Outcomes/Progress: - The implementation of the campaign took 137 hours of staff time to coordinate. As a health system, Froedtert ThedaCare staff, physicians, and leaders raised $1,220,269.21 Distracted Driving Programs (AODA) Speeding, recklessness and drug or alcohol use are common risk factors among children and teens killed in motor vehicle and transport crashes, according to the Wisconsin Child Death Review Council. Changes in behavior can help prevent death and injury from vehicle crashes, one of the top five causes of preventable death in Wisconsin children. To drive home a powerful message about the consequences of drinking and driving and to help prevent death from drunk driving crashes, Froedtert Menomonee Falls Hospital collaborates with local high schools in the "Every 15 Minutes" program. The program involves not only a mock crash, but multiple scenarios that are videotaped by high school students and presented at a moving and emotional assembly at school the next day. The hospital has been part of the "Every 15 Minutes" program since 2010, as the receiving hospital for mock crash victims arriving by local EMS ambulance and Flight for Life. The Emergency Care Center provides staffing to treat the mock victims in a realistic way. Physicians, nurses, EMTs, technicians and other staff are involved. Hospital staffs are also involved in the planning and communications. In a safe and caring way, the program confronts high school students with the real-life consequences of drug and/or alcohol use while driving and has been positively received by students and community. FY 2022 Outcomes/Progress: - Did not participate in FY22 due to COVID-19 FY 2023 Outcomes/Progress: - This program has not continued due to COVID-19 FY 2024 Outcomes/Progress: - This program has not returned. Financial Assistance & Affordable Care Financial Counseling (Access to Care) Froedtert ThedaCare Health (parent company of Froedtert Menomonee Falls Hospital) recognized the need to help individuals navigate financial resources including the new choices available to them through the Affordable Care Act's Insurance Marketplace and Medicaid reforms. Our overall health network of certified application counselors screened and enrolled over 6,000 community members in Public Assistance and Marketplace Insurance Plans. These certified application counselors answer thousands of phone calls and assisted with questions. Froedtert ThedaCare Health also partnered with the Milwaukee Enrollment Network which represented health systems, free clinics, health departments and other non-profit organizations to reach out to people throughout Milwaukee, Washington and Waukesha Counties in securing adequate and affordable health insurance. FY 2022 Outcomes/Progress: - Our network of certified application counselors assisted a total of 5,821 individuals with approximately 396 for Froedtert Menomonee Falls Hospital. FY 2023 Outcomes/Progress: - Our network of certified application counselors assisted a total of 6,759 individuals with approximately 527 for Froedtert Menomonee Falls Hospital. FY 2024 Outcomes/Progress: - Our network of certified application counselors assisted a total of 5,857 individuals with approximately 421 for Froedtert Menomonee Falls Hospital. Leadership Volunteerism/Community Support (Community Development) As an indication of Froedtert Menomonee Falls Hospital's executive team's commitment to the community, hospital leaders provided support to local initiatives, not-for-profit organizations, community boards and community events that align with the hospital's mission and directly support identified community needs. FY 2022 Outcomes/Progress: - 74 FMFH leaders provided 861 hours to community organizations and coalitions FY 2023 Outcomes/Progress: - 78 FMFH leaders provided 1,198 hours to community organizations and coalitions FY 2024 Outcomes/Progress: - 52 FMFH leaders provided 1,122 hours to community organizations and coalitions Sexual Assault Nurse Examiner (SANE) Available 24 Hours a Day (Access to Care and Navigation) When emergencies take on the even more traumatic element of sexual assault, the specially trained SANE program staff has created a safe haven at Froedtert Menomonee Falls Hospital for comprehensive, compassionate care. SANE staff are registered nurses with advanced training in medical-forensic examination and in the psychological and emotional trauma patient's experience. They care for victims of all ages, races and populations to provide timely emotional support. SANE nurses are available to speak to groups and organizations. They are also able to serve as expert witnesses if called to testify at a trial. Services provided: - Physical examination and wellness check - Collection of medical-forensic evidence - Assistance with reporting the crime to police, when requested (mandatory reporting for children) - Assistance with concerns about sexually transmitted infection and pregnancy - Assistance with safety planning - Development of a medical follow-up plan FY2022 Outcomes/Progress: - SANE nurses screened 14 patients and provided referrals and case management after initial consultation. FY2023 Outcomes/Progress: - SANE nurses screened 25 patients and provided referrals and case management after initial consultation. FY2024 Outcomes/Progress: - SANE nurses screened 16 patients and provided referrals and case management after initial consultation. SDOH Screening/UniteUs FY2024 Outcomes/Progress: Of those screened at Froedtert Menomonee Falls Hospital, 3,746 were patients who identified as underserved and 40 were referred. Drives FY2024 Outcomes/Progress: - Holiday Drive: 1,110 items collected by Froedtert Menomonee Falls Hospital with 48 total volunteer hours. - Healthy Shelves: 1,500 pounds of food was collected across the health network with 16 total volunteer hours from Froedtert Menomonee Falls Hospital staff.
Schedule H, Part VI, Line 6 Affiliated health care system	Affiliated Health Care Systems Froedtert Menomonee Falls Hospital located in Southeast Wisconsin, founded in 1964 by the citizens of Menomonee Falls and surrounding communities, is a full-service hospital that specializes in cancer care, heart and vascular care, orthopaedics, women's health and advanced surgical procedures. Froedtert Menomonee Falls Hospital is part of the Froedtert ThedaCare & MCW health care network, which includes Froedtert Hospital in Milwaukee, eastern Wisconsin's only academic medical center; hospitals in Kenosha, Pleasant Prairie and West Bend; and more than 40 primary and specialty care health centers and clinics. In the Southeast region, Froedtert Hospital, Froedtert Menomonee Falls Hospital, Froedtert West Bend Hospital, Froedtert Health Neighborhood Hospital, LLC, and Froedtert Holy Family Memorial Hospital made significant investments in the health of their communities. Patients who couldn't pay for their medical care received more than $188 million in uncompensated services. Beyond providing care for the uninsured/underinsured patients, we contributed $178 million to improve access to care, teach future healthcare professionals, develop new medical therapies and participate in local partnerships aimed at reducing health disparities. Our health network members develop community benefit strategies and goals based on the unique needs of each of their communities. By conducting regular community needs assessments that monitor critical public health issues, and actively seeking community input, the hospitals have built important local relationships that provide meaningful outreach programs that link each hospital to their neighbors and patients. As a not-for-profit health system, Froedtert ThedaCare Health reinvests its surplus funds back into the community through programs to serve the poor and uninsured, teach future healthcare professionals, develop new medical therapies, manage chronic conditions like diabetes, health education and promotion initiatives, and participate in local partnerships aimed at reducing health disparities. For more information about Froedtert ThedaCare Health, visit www.froedtert.com Promotion Of Community Health: The Community Outreach Steering Committee (COSC), which is a subcommittee of the hospital's Board of Directors, actualizes the mission of Froedtert Menomonee Falls Hospital through community benefit activities that improve the quality of life and enhance wellness resources, which meet identified comprehensive health needs of the communities served. The COSC is appointed annually by the hospital president and is advisory to the Community Memorial Hospital Board and Administration. Membership appointments are made each June with members serving one year terms. The COSC meets quarterly and is composed of hospital and board representatives, plus community members representing the various constituencies of the total service area. Functions include: - Provide a leadership role in advocating community wide responses to health care needs in the community. - Facilitate and support community and health care partnerships. - Envision, assess and guide new community benefit opportunities. - Identify and describe unmet health needs. - Promote universal access to health care. - Determine allocation of the Community Outreach Services Fund, which awards $50,000 annually towards area non-profits efforts to improve health disparities focused on Access to Care/Navigation, Mental Health/AODA and Chronic Disease Management in the communities Froedtert Menomonee Falls Hospital serves. Addressing Needs Through Targeted Outreach: Froedtert Menomonee Falls Hospital develops and executes community outreach programming and activities based on identified community health needs. Since 1990 Froedtert Menomonee Falls Hospital conducts needs assessments every three years in order to determine priorities and strategies in addressing community health disparities. Every needs assessment cycle, Froedtert Menomonee Falls Hospital Community Engagement staff along with the hospital's COSC develops a Community Health Improvement Plan that is incorporated into the hospital's overall strategic plan to address the most critical needs in the communities we serve. The plan is reviewed annually by the COSC. Froedtert Menomonee Falls Hospital Community Outreach staff, leaders and external community partners work collaboratively to develop key goals and strategies to address community health needs. Progress towards community outreach programs/activities and goals are reported quarterly through the COSC, Physician Advisory Council, Leadership Meetings and the Board of Directors. Based on the results from the 2020 Community Health Needs Assessment, programs and activities are focused around the following identified health needs: - Population Health and Health Equity; - Behavioral Health; - Workforce Development (health care career exploration); and - Infectious Disease For more information on specific community outreach efforts, Implementation Strategy and Community Health Needs Assessments, please go to Froedtert ThedaCare Health's website at www.froedtert.com.
Schedule H, Part VI, Line 7 State filing of community benefit report	WI

Schedule H (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization
Community Memorial Hospital of Menomonee Falls Inc

Employer identification number
39-0987025

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) WAUKESHA COUNTY COMMUNITY DENTAL CLINIC 2010 NW BARSTOW ST SUITE 305 WAUKESHA,WI53188	30-0436162	501(c)(3)	100,000	SUPPORT OPERATIONS
(2) OPTIMIST CLUB OF MENOMONEE FALLS INC PO BOX 671 MENOMONEE FALLS,WI53052	23-7297960	501(c) (3)	50,000	SUPPORT OPERATIONS
(3) FROEDTERT MENOMONEE FALLS HOSPITAL FOUNDATION INC W180 N8085 TOWN HALL ROAD MENOMONEE FALLS,WI53052	39-1635057	501(c) (3)	27,300	SUPPORT OPERATIONS
(4) ELEVATE INC N169 W21005 MEADOW LANE JACKSON,WI53037	39-1256286	501(c) (3)	12,500	SUPPORT OPERATIONS
(5) HEBRON HOUSE OF HOSPITATLITY INC 1166 QUAIL CT SUITE 400 PEWAUKEE,WI53072	39-1414365	501(c) (3)	10,000	SUPPORT OPERATIONS
(6) SUSSEX OUTREACH SERVICES N64 W23760 MAIN STREET SUSSEX,WI53089	39-1746231	501(c) (3)	10,000	SUPPORT OPERATIONS
(7) CV ACADEMICS FOUNDATION INC N37 W23800 BROKEN Hill CIRS PEWAUKEE,WI53072	84-4761897	501(c) (3)	8,700	SUPPORT OPERATIONS
(8) FAMILY PROMISE OF WAUKESHA COUNTY INC 139 E NORTH STREET WAUKESHA,WI53188	45-5502675	501(c) (3)	7,500	SUPPORT OPERATIONS

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2023

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference

Explanation

Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds.

ORGANIZATIONS SUBMIT GRANT REQUESTS TO THE COMMUNITY OUTREACH STEERING COMMITTEE (THE COMMITTEE). ON A QUARTERLY BASIS THE FUND ALLOCATIONS ARE DETERMINED. EACH ORGANIZATION SELECTED FOR FUNDS RECEIVES AN AWARD LETTER DETAILING THE EXPECTATIONS AND CONDITIONS OF THE GRANT MONEY. IN ORDER TO COMPLY WITH APPLICABLE TAX LAWS, REGULATIONS AND THE COMMUNITY OUTREACH SERVICES FUND POLICY, THE COMMUNITY OUTREACH SERVICES FUND WILL PROVIDE GRANT SUPPORT TO ORGANIZATIONS WITH THE UNDERSTANDING THAT: 1) GRANT FUNDS DISTRIBUTED WILL BE USED ONLY FOR THE PURPOSES DESIGNATED IN THE AWARD LETTER. 2) NO FUNDS WILL BE USED FOR ANY POLITICAL CAMPAIGN OR TO SUPPORT ATTEMPTS TO INFLUENCE LEGISLATION OF ANY GOVERNMENTAL BODY. 3) IF THE ORGANIZATION LOSES EXEMPT STATUS, ANY UNEXPENDED FUNDS WILL BE RETURNED TO THE COMMUNITY OUTREACH STEERING COMMITTEE. 4) ADEQUATE ACCOUNTING RECORDS OF THE EXPENDITURES OF FUNDS WILL BE MAINTAINED BY THE ORGANIZATION. 5) THIS IS A ONE TIME GRANT DISTRIBUTION. FUTURE FUNDING REQUESTS WILL BE CONSIDERED ON A CASE BY CASE BASIS. IN ADDITION, THE COMMITTEE INCLUDES A "FINAL REPORT FORM" WITH EACH ORGANIZATION'S AWARD LETTER. THE FORM REQUIRES THE ORGANIZATION TO PROVIDE A BRIEF DESCRIPTION OF THE ACTIVITY AND MEASURABLE OUTCOMES/BENEFITS, AN EXPENDITURE REPORT, FOLLOW UP ACTIONS TO THE COMMITTEE'S RECOMMENDATIONS, AND FUTURE PLANS. THE COMMITTEE REQUESTS THAT EACH ORGANIZATION SUBMIT THE "FINAL REPORT FORM" TO THE COMMITTEE WITHIN THIRTY DAYS AFTER THE COMPLETION OF THE PROJECT FOR WHICH THE FUNDS WERE INTENDED OR WITHIN A MAXIMUM OF ONE YEAR FROM THE RECEIPT OF FUNDS.

Schedule I (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
medium right arrow graphic

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
medium right arrow graphic

Attach to Form 990.
medium right arrow graphic

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

Community Memorial Hospital of Menomonee Falls Inc

Employer identification number

39-0987025

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2023

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2, 1099-MISC compensation, and/or 1099-NEC			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1Teresa Lux Director & CMH President	(i) (ii)	0 ------------- 448,266	0 ------------- 113,523	0 ------------- 126,938	0 ------------- 116,644	0 ------------- 15,382	0 ------------- 820,753	0 ------------- 101,318
2Eric Conley Director & FMLH President (Start Jul23; Term Apr24)	(i) (ii)	0 ------------- 766,153	0 ------------- 494,021	0 ------------- 143,064	0 ------------- 176,458	0 ------------- 36,518	0 ------------- 1,616,214	0 ------------- 115,894
3Michael DeGere DPM Chief Medical Officer (Start Jul23)	(i) (ii)	0 ------------- 363,118	0 ------------- 84,153	0 ------------- 25,183	0 ------------- 57,290	0 ------------- 36,895	0 ------------- 566,639	0 ------------- 0
4Shelly Waala Director & VP Patient Care Svc	(i) (ii)	0 ------------- 283,270	0 ------------- 62,474	0 ------------- 34,610	0 ------------- 37,518	0 ------------- 35,290	0 ------------- 453,162	0 ------------- 31,460
5Jeffrey Van De Kreeke Former - Officer (Treas)	(i) (ii)	0 ------------- 0	0 ------------- 0	0 ------------- 196,046	0 ------------- 12,200	0 ------------- 0	0 ------------- 208,246	0 ------------- 0
6Linda McPike Secretary	(i) (ii)	0 ------------- 293,069	0 ------------- 30,750	0 ------------- 44,508	0 ------------- 20,575	0 ------------- 6,289	0 ------------- 395,191	0 ------------- 0
7Adam Smith Treasurer	(i) (ii)	0 ------------- 314,773	0 ------------- 101,071	0 ------------- 1,112	0 ------------- 49,435	0 ------------- 22,554	0 ------------- 488,945	0 ------------- 0

Schedule J (Form 990) 2023

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
Schedule J, Part I, Line 3	COMPENSATION OF CEO/EXECUTIVE DIRECTOR ESTABLISHED BY RELATED ORGANIZATION, FROEDTERT THEDACARE HEALTH, THROUGH USE OF COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
Schedule J, Part I, Line 4a SEVERANCE OR CHANGE-OF-CONTROL PAYMENT	SEVERANCE: VAN DE KREEKE, JEFFREY - $196,046
Schedule J, Part I, Line 4b SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN	457(F) DISTRIBUTIONS: CONLEY, ERIC - $115,894 LUX, TERESA - $101,318 WAALA, SHELLY - $31,460 457(F) PLAN PARTICIPANTS: CONLEY, ERIC DEGERE, MICHAEL LUX, TERESA SMITH, ADAM WAALA, SHELLY
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, AND OTHER MISCELLANEOUS COMPENSATION.

Schedule J (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- TIN:

SCHEDULE O
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

Community Memorial Hospital of Menomonee Falls Inc

Employer identification number

39-0987025

Return Reference	Explanation
Form 990, Part III, Line 4a Outpatient Services - (Continued)	- GASTROENTEROLOGY - GERONTOLOGY - GYNECOLOGIC ONCOLOGY - GYNECOLOGY - HAND SURGERY - HEMATOLOGY - HEMATOLOGY/ONCOLOGY - INFECTIOUS DISEASE - INTERNAL MEDICINE - INTERVENTIONAL RADIOLOGY - IMAGING, INCLUDING MRI - NEONATOLOGY - NEPHROLOGY - NEUROSURGERY - NUCLEAR MEDICINE - OCCUPATIONAL MEDICINE - ONCOLOGY - OPHTHALMOLOGY - ORAL SURGERY - ORTHOPAEDICS - OTOLARYNGOLOGY - PATHOLOGY - PEDIATRICS - PEDODONTICS - PERINATOLOGY - PERIODONTICS - PHYSICAL MEDICINE AND REHABILITATION - PLASTIC/RECONSTRUCTIVE SURGERY - PODIATRY - PSYCHIATRY - PSYCHOLOGY - PULMONARY MEDICINE - RADIOLOGY - RADIATION ONCOLOGY - RHEUMATOLOGY - THORACIC SURGERY - UROLOGY - UROLOGIC ONCOLOGY - VASCULAR SURGERY
Form 990, Part III, Line 4b Inpatient Services - (Continued)	SERVICES, INCLUDING HOSPITALIST SERVICES, PSYCHIATRY, OBSTETRICS AND MATERNITY CARE, CRITICAL CARE MEDICINE, ORTHOPEDICS, INTERNAL MEDICINE, GENERAL SURGERY, AND OTHER SPECIALTY CARE. DURING FISCAL YEAR 2024 THE HOSPITAL HAD 780 CANCER REGISTRY CASES. Awards, Accreditations and Recognitions Froedtert Menomonee Falls Hospital (FMFH) was named a "LGBTQ+ Equality Leader" in the Human Rights Campaign Foundation's 2024 Healthcare Equality Index (HEI), earning a perfect score of 100. Earning a "LGBTQ+ Equality Leader" designation shows our commitment to having strong LGBTQ+ policies that help ensure our patients, visitors and workforce feel valued, safe and heard. HEI award criteria includes non-discrimination and staff training, patient services and support, employee benefits and policies, patient and community engagement and responsible citizenship. Froedtert ThedaCare Health, parent organization to FMFH, was named a Best Place to Work for Disability Inclusion, earning a top score on the 2024 Disability Equality Index (DEI) for outstanding commitment to disability inclusion practices. The DEI assessment measures an organization's culture and leadership, accessibility, employment practices (including benefits, education and accommodations), community engagement and supplier diversity. U.S. News and World Report. Froedtert Menomonee Falls Hospital is recognized by U.S. News & World Report as high performing in four adult procedures and conditions - hip replacement, knee replacement, chronic obstructive pulmonary disease (COPD), and heart failure. - The Joint Commission. All Froedtert ThedaCare & the Medical College of Wisconsin health network hospitals are accredited by The Joint Commission, an independent nonprofit organization. The Joint Commission accreditation is recognized nationwide as a symbol of quality, reflecting an organization's commitment to meeting standards of patient safety and care. The Joint Commission conducts extensive on-site visits of health care providers every three years and evaluates every aspect of patient care delivery. The Joint Commission - Stroke Care. Froedtert Menomonee Falls Hospital is a Certified Advanced Primary Stroke Center, recognized by The Joint Commission, demonstrating its ability to provide care from a multidisciplinary team of neurologists, neurosurgeons, emergency medicine specialists, radiologists, nurses, therapists, pharmacists, technicians and more, all working in a coordinated, collaborative system. The Joint Commission - Orthopaedic Care. Froedtert Menomonee Falls Hospital is also certified by The Joint Commission for Advanced Total Hip and Knee Replacement. Froedtert Menomonee Falls Hospital is among "America's 100 Best Hospitals," according to a list released by Healthgrades in 2023. This recognition places our hospital among the top 2% of hospitals nationally, according to Healthgrades. Healthgrades America's Best Hospitals achievements are based on an objective review of clinical outcomes across multiple conditions and procedures, analyzing the performance of nearly 4,500 hospitals nationwide. America's Best Hospitals deliver better outcomes than 95% of hospitals in the nation. In its 2023 Specialty Excellence Awards, Healthgrades recognized Froedtert Menomonee Falls Hospital for various specialty achievements. - American College of Radiology. Froedtert Menomonee Falls Hospital Imaging Services is recognized as a Diagnostic Imaging Center of Excellence (DICOE) by the American College of Radiology (ACR). At a DICOE facility, patients receive the highest levels of imaging quality, safety and care. The DICOE program is an achievement that goes beyond accreditation to recognize the best in quality imaging practices and diagnostic care. This includes a comprehensive assessment of the entire medical imaging enterprise, including structure, operations, quality, safety and outcomes. This award formally recognizes our ongoing commitment to provide the highest quality medical imaging. Additionally, the American College of Radiology grants accreditation in 10 forms of imaging. Accreditation is given to facilities demonstrating the highest standards of care and compliance with Medicare and other mandates. Froedtert Menomonee Falls Hospital has earned accreditation in the following areas: - Computerized tomography (CT) - Magnetic resonance imaging (MRI) - Nuclear medicine - Positron emission tomography (PET) - General ultrasound - Breast Imaging Center of Excellence, including: - Mammography - Breast ultrasound - Breast MRI - Stereotactic breast biopsy - Ultrasound-guided breast biopsy - National Accreditation Program for Breast Centers. The Breast Care Center at Froedtert Menomonee Falls Hospital is accredited by the National Accreditation Program for Breast Centers (NAPBC), a program of the American College of Surgeons. Accreditation by the NAPBC involves extensive review of performance, including on-site review, to ensure compliance with NAPBC standards for quality care. American Heart Association. The American Heart Association recognized Froedtert Menomonee Falls Hospital with its Get With the Guidelines Heart Failure Gold Plus Award. In addition, the hospital was recognized on the AHA's Target: Heart Failure (SM) Honor Roll and received the AHA's Target: Type 2 Diabetes Honor Roll award. The American Heart Association recognized Froedtert Menomonee Falls Hospital with its Get With The Guidelines-Coronary Artery Disease STEMI and NSTEMI Receiving Gold with Target: Type 2 Diabetes. These awards demonstrate our commitment to improving care by adhering to the latest treatment guidelines and streamlining processes to ensure timely and proper care for heart attacks. The Stroke Program at Froedtert Menomonee Falls Hospital earned the Get With The Guidelines - Stroke GOLD Plus, Target: Stroke Elite Honor Roll and Target: Type 2 Diabetes Honor Roll, from the American Heart Association Get With the Guidelines Program. The award recognizes commitment and success in implementing the highest standard of stroke care. - Press Ganey. The Froedtert ThedaCare & MCW Cancer Network, which includes the Cancer Center at Froedtert Menomonee Falls Hospital, is a 2022 Press Ganey Guardian of Excellence Award winner. This award honors organizations that have reached the 95th percentile for patient experience, engagement or clinical quality performance. In 2023, Froedtert Menomonee Falls Hospital and Froedtert Hospital were designated as American College of Surgeons Surgical Quality Partners. This designation means we are dedicated to maintaining the highest standards in surgical care. Radiation Oncology at Froedtert Menomonee Falls Hospital is accredited by the American Society of Therapeutic Radiology and Oncology Accreditation Program for Excellence. This accreditation program evaluates radiation oncology practices by objectively assessing care teams, policies and procedures and the facility, while focusing on the highest level of quality and patient safety.
Form 990, Part III, Line 4b Inpatient Services - (Continued)	Cancer Care As a Froedtert ThedaCare & the Medical College of Wisconsin Cancer Network location, the Cancer Center at Froedtert Menomonee Falls Hospital* provides advanced cancer care, while offering access to the vast resources of eastern Wisconsin's only academic medical center at Froedtert Hospital campus. Through the Cancer Network, patients at Froedtert Menomonee Falls Hospital have access to expanded services: nationally and internationally known specialists who focus on specific cancers, advanced treatments and technologies, and more options through the largest cancer clinical trials treatment program in Wisconsin. Medical College of Wisconsin cancer specialists are joined by radiation therapists, oncology nurses, genetic counselors, registered dietitians, psycho-oncology specialists, and support service specialists - all of whom are keenly attuned to the needs, hopes and fears of cancer patients. Each patient's care is coordinated with teams from many areas of Froedtert Menomonee Falls Hospital, who help and support patients and their families through the physical, emotional and economic phases of treatment. Applying clinical research that translates into the most advanced treatments, our doctors are battling cancer from every angle possible. Heart and Vascular Care At the Heart and Vascular Center, dedicated physicians work as a team with cardiovascular nurses and other specialized staff to provide the full spectrum of heart and vascular care, from diagnostic tests to surgical procedures. An extensive network of heart and vascular specialists collaborates to ensure our patients receive comprehensive, high-quality care. During fiscal year 2024, Froedtert Menomonee Falls Hospital had 11,237 cardiology patient encounters. Women's Services At the FMFH Birth Center, we are committed to relationship-centered birthing care. The Birth Center includes 13 specialty equipped suites and provides the full spectrum of prenatal services for women with normal and high-risk pregnancies. The Level II Neonatal Intensive Care Unit (NICU) has the technology needed to provide long-term care for babies. During fiscal year 2024, 406 women gave birth at Froedtert Menomonee Falls Hospital. Orthopaedics - Joint Care FMFH is the Froedtert ThedaCare & MCW Center of Excellence for elective joint replacements. The hospital also provided a variety of inpatient ancillary treatments, tests and procedures during fiscal year 2024, including but not limited to the following: - Surgeries: 2,069 - Laboratory tests: 319,232 - CT scans: 7,331 - Magnetic resonance (MR) I scans: 1,349 - Nuclear Medicine/PET scans: 349 - Ultrasounds: 1,734
Form 990, Part III, Line 4d Description of other program services	(Expenses $ 11,526,649 including grants of $ 240,000)(Revenue $ 13,035,519) OTHER PROGRAM SERVICES: AS PART OF OPERATING AN ACUTE CARE HOSPITAL AND PROVIDING HEALTH CARE SERVICES TO THE COMMUNITY, OTHER REVENUE IS DERIVED IN THE FOLLOWING AREAS: OTHER DEPARTMENT OPERATING REVENUE - REVENUE DERIVED FROM DIFFERENT SERVICES THROUGH THE PROCESS OF PROVIDING PATIENT CARE AND IN THE NORMAL OPERATION OF A MEDICAL FACILITY. INCLUDED IN THIS CATEGORY ARE ITEMS SUCH AS MEANINGFUL USE REVENUE, CANCER CARE/ONCOLOGY REVENUE, RENTAL REVENUE, GIFT SHOP REVENUE, CLINICAL DIETETICS, AND OTHER WELLNESS SERVICES. DIETARY REVENUE - REVENUE DERIVED FROM CAFETERIA SALES, VENDING MACHINE SALES, GUEST TRAY SALES AND EMPLOYEE MEALS. DIETARY SERVICES ARE NECESSARY TO SUPPORT SERVICES TO PATIENT FAMILIES WHILE THEIR LOVED ONE IS RECEIVING CARE IN THE HOSPITAL. THE REVENUE FROM EMPLOYEE MEALS IS A BENEFIT PROVIDED BY THE HOSPITAL AS AN EMPLOYER AND IT ALLOWS OUR STAFF TO REMAIN ON SITE FOR PATIENT CARE. CORPORATE ALLOCATED REVENUE - REVENUE PASSED THROUGH FROM FROEDTERT THEDACARE HEALTH (FTCH), A RELATED PARTY. INTERCOMPANY REVENUE CONSISTS OF REVENUE DERIVED FROM MEDICAL AND ADMINISTRATIVE SERVICES PROVIDED TO THE OTHER FTCH ENTITIES. ALL OF THESE SERVICES SUPPORT THE DELIVERY OF HEALTHCARE TO THE COMMUNITY. MISCELLANEOUS REVENUE - REVENUE DERIVED FROM DIFFERENT SERVICES THROUGH THE PROCESS OF PROVIDING PATIENT CARE IN THE NORMAL OPERATION OF A MEDICAL FACILITY. SPECIAL EVENT ACTIVITY REVENUE, AND TAXABLE SALES.
Form 990, Part VI, Line 6 Classes of members or stockholders	FROEDTERT THEDACARE HEALTH, INC, (FTCH) IS THE SOLE CORPORATE MEMBER OF FMFH.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	FTCH, AS THE SOLE CORPORATE MEMBER OF FMFH, HAS FINAL APPROVAL OF ELECTION OF FULL BOARD MEMBERS.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	FTCH, AS THE SOLE CORPORATE MEMBER OF FMFH, RETAINS CERTAIN RESERVED POWERS AND AUTHORITIES WITH RESPECT TO SPECIFIC GOVERNANCE MATTERS, AND STRATEGIC AND MISSION-RELATED INITIATIVES OF FMFH.
Form 990, Part VI, Line 11b Review of form 990 by governing body	FTCH ACCOUNTING STAFF PREPARE FORM 990 WHICH IS REVIEWED BY FTCH FINANCIAL LEADERS. THE 990 IS THEN REVIEWED BY KPMG, FTCH'S OUTSIDE ACCOUNTING FIRM. NEXT, THE 990 IS PROVIDED TO THE FTCH AUDIT COMMITTEE AND BOARD OF DIRECTORS. FINALLY, THE 990 IS FILED AS REQUIRED.
Form 990, Part VI, Line 12c Conflict of interest policy	ON AN ANNUAL BASIS ALL OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT. THE DATA IS COMPILED, AND THE FTCH 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 INTEREST EXIST IN THE DISCLOSURE DOCUMENTS. IF IT IS DETERMINED THAT A CONFLICTS OF INTEREST EXISTS, THEN THE PERSON MAKING THE DISCLOSURE SHALL BE RELIEVED OF HIS/HER OBLIGATIONS ON BEHALF OF FMFH 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 FTCH FINANCE COMMITTEE OF THE FTCH BOARD OF DIRECTORS.
Form 990, Part VI, Line 15a Process to establish compensation of top management official	COMPENSATION OF TOP MANAGEMENT IS PAID BY FTCH, 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 FTCH (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, Line 15b Process to establish compensation of other 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 FTCH (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, Line 19 Required documents available to the public	FTCH'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.
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue	ALL OTHER REVENUE - Total Revenue: 1030661, Related or Exempt Function Revenue: 1030661, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part IX, Line 24b CORPORATE ALLOCATIONS	FTCH ALLOCATES CERTAIN REVENUES AND EXPENSES TO FMLH, FMFH, FWBH, HFMH & CP. THE ALLOCATION IS CALCULATED BY APPLYING AN ALLOCATION METRIC TO EACH ACCOUNTING UNIT AT FTCH. EACH ENTITY THEN RECEIVES ITS PORTION OF THE FTCH ALLOCATION ON A MONTHLY BASIS.
Form 990, Part IX, Line 11g Other Fees	FEES FOR SVCS- OTHER - Total Expense: 30669951, Program Service Expense: 23709871, Management and General Expenses: 6942111, Fundraising Expenses: 17969;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	PENSION ADJUSTMENT - 3597687; CHANGE IN RESTRICTED ASSETS - -790102; TRANSFER FROM AFFILIATES - 8182673;

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

Community Memorial Hospital of Menomonee Falls Inc

Employer identification number

39-0987025

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)FROEDTERT THEDACARE HEALTH INC 9200 WEST WISCONSIN AVENUE MILWAUKEE,WI532263596 39-2014409	MGMNT SVCS	WI	501(c)(3)	Type III-FI	NA		No
(2)FROEDTERT MENOMONEE FALLS HOSPITAL FOUNDATIONINC W180 N8085 TOWN HALL ROAD MENOMONEE FALLS,WI53051 39-1635057	HLTH & WLFR	WI	501(c)(3)	10	CMH INC	Yes
(3)COMMUNITY OUTPATIENT HEALTH SERVICES OF MENOMONEE FALLS INC W180 N8085 TOWN HALL ROAD MENOMONEE FALLS,WI53051 39-1743056	OP MED & DNTL	WI	501(c)(3)	3	CMH INC	Yes
(4)FROEDTERT MEMORIAL LUTHERAN HOSPITAL INC 9200 WEST WISCONSIN AVENUE MILWAUKEE,WI532263522 39-6105970	HOSPITAL	WI	501(c)(3)	3	FTCH INC		No
(5)ST JOSEPH'S COMMUNITY HOSPITAL INC 3200 PLEASANT VALLEY ROAD WEST BEND,WI530953868 39-0806302	HOSPITAL	WI	501(c)(3)	3	FTCH INC		No
(6)FH ENTERPRISE SERVICES HOLDINGS INC 9200 WEST WISCONSIN AVENUE MILWAUKEE,WI53226 20-2636686	HEALTHCARE SVCS	WI	501(c)(3)	Type I	FTCH INC		No
(7)FROEDTERT WEST BEND HOSPITAL FOUNDATION INC 3200 PLEASANT VALLEY ROAD WEST BEND,WI530953868 39-2034296	HLTH & WLFR	WI	501(c)(3)	7	SJH INC		No
(8)FROEDTERT HOSPITAL FOUNDATION INC 9200 WEST WISCONSIN AVENUE MILWAUKEE,WI532263596 39-1431192	HLTH & WLFR	WI	501(c)(3)	7	FMLHINC		No
(9)HOLY FAMILY MEMORIAL INC 2300 WESTERN AVE MANITOWOC,WI542211450 39-0806395	HOSPITAL	WI	501(c)(3)	3	FTCH INC		No
(10)THEDACARE REGIONAL MEDICAL CENTER - NEENAH INC PO BOX 8025 APPLETON,WI549128025 39-0830664	HOSPITAL	WI	501(c)(3)	3	THEDACARE INC		No
(11)THEDACARE MEDICAL CENTER - NEW LONDON INC PO BOX 8025 APPLETON,WI549128025 39-0869788	HOSPITAL	WI	501(c)(3)	3	THEDACARE INC		No
(12)THEDACARE MEDICAL CENTER - WAUPACA INC PO BOX 8025 APPLETON,WI549128025 39-0871113	HOSPITAL	WI	501(c)(3)	3	THEDACARE INC		No
(13)THEDACARE REGIONAL MEDICAL CENTER - APPLETON INC PO BOX 8025 APPLETON,WI549128025 39-0824015	HOSPITAL	WI	501(c)(3)	3	THEDACARE INC		No
(14)THEDACARE MEDICAL CENTER - SHAWANO INC PO BOX 8025 APPLETON,WI549128025 39-0807068	HOSPITAL	WI	501(c)(3)	3	THEDACARE INC		No
(15)THEDACARE MEDICAL CENTER - BERLIN INC PO BOX 8025 APPLETON,WI549128025 39-0806359	HOSPITAL	WI	501(c)(3)	3	THEDACARE INC		No
(16)THEDACARE MEDICAL CENTER - WILD ROSE INC PO BOX 8025 APPLETON,WI549128025 39-6089134	HOSPITAL	WI	501(c)(3)	3	THEDACARE INC		No
(17)THEDACARE FAMILY OF FOUNDATIONS INC PO BOX 8025 APPLETON,WI549128025 46-4112255	FOUNDATION	WI	501(c)(3)	7	THEDACARE INC		No
(18)THEDACARE INC PO BOX 8025 APPLETON,WI549128025 39-1509362	HEALTHCARE	WI	501(c)(3)	10	FTCH INC		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2023

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership
(1) FMLH MCW REAL ESTATE VENTURES LLC 9200 W WISCONSIN AVENUE MILWAUKEE,WI53226 26-0629591	REAL ESTATE	WI	N/A					No			No
(2) WISCONSIN DIAGNOSTIC LABORATORIES LLC 9200 W WISCONSIN AVENUE MILWAUKEE,WI53226 39-1896819	LABORATORY SVCS	WI	N/A					No			No
(3) D1 SPORTS TRAINING OF MILWAUKEE LLC 9200 W WISCONSIN AVENUE MILWAUKEE,WI53226 47-3322294	SPORTS THERAPY	WI	N/A					No			No
(4) DREXEL TOWN SQUARE SURGERY CENTER LLC 7901 S 6TH STREET SECOND FLOOR OAK CREEK,WI53154 81-4904300	SURGICAL SERVICES	WI	N/A					No			No
(5) MENOMONEE FALLS AMBULATORY SURGERY LLP W180 N8045 TOWN HALL ROAD MENOMONEE FALLS,WI53051 39-1745697	SURGICAL SERVICES	WI	CMH INC	Related	369,644	9,677,504		No		Yes
(6) THP-FROEDTERT HEALTH VENTURE LLC 1415 LOUISIANA ST FL 27TH HOUSTON,TX77002 82-3559342	HEALTH CARE SVCS	TX	N/A					No			No
(7) F&MCW NETWORK LLC 9200 W WISCONSIN AVENUE MILWAUKEE,WI53226 81-4382585	HEALTH CARE SVCS	WI	N/A					No			No
(8) FROEDERT & MEDICAL COLLEGE OF WI ACOLLC 8710 WATERTOWN PLANK RD MILWAUKEE,WI53226 83-3159534	HEALTH CARE SVCS	WI	N/A					No			No
(9) FROEDTERT SURGERY CENTER LLC 9200 W WISCONSIN AVENUE MILWAUKEE,WI53226 20-1499345	HEALTH CARE SVCS	WI	N/A					No			No
(10) WEST BEND SURGERY CENTER LLC 3212 PLEASANT VALLEY ROAD WEST BEND,WI53095 39-1954169	HEALTH CARE SVCS	WI	N/A					No			No
(11) NATIONAL LABORATORY NETWORK LLC 9200 W WISCONSIN AVENUE MILWAUKEE,WI53226 88-3305667	LABORATORY SVCS	WI	N/A					No			No
(12) N APPLETON AMBULATORY CARE CENTER BUILDING COMPANY LLC 2500 E CAPITOL DR APPLETON,WI54911 26-2497187	RENTAL	WI	N/A					No			No
(13) ENCIRCLE REALCO LLC 65 HIDDEN RAVINES DRIVE SUITE 100 POWELL,OH43065 85-3472736	PROPERTY HOLDING	OH	N/A					No			No

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	Yes	No
(1) HART'S MILLS INSURANCE COMPANY SPC 62 FORUM LANE 3RD FL CAMANA BAY GRAND CAYMANKY11203 CJ 98-1311808	SELF - INSURANCE	CJ	N/A	C Corporation					No
(2) NETWORK HEALTH INC 1570 MIDWAY PLACE MENASHA,WI54952 46-2966177	HEALTH INSURANCE	WI	N/A	C Corporation					No
(3) NETWORK HEALTH INSURANCE CORPORATION 1570 MIDWAY PLACE MENASHA,WI54952 39-2020474	HEALTH INSURANCE	WI	N/A	C Corporation					No
(4) NETWORK HEALTH PLAN 1570 MIDWAY PLACE MENASHA,WI54952 39-1442058	HEALTH INSURANCE	WI	N/A	C Corporation					No
(5) FH INVESTMENT HOLDINGS INC 9200 W WISCONSIN AVENUE MILWAUKEE,WI53226 99-1422017	HEALTH SERVICES	WI	N/A	C Corporation					No
(6) HOLY FAMILY HEALTH SERVICES INC 1650 SOUTH 41ST STREET MANITOWOC,WI54220 39-1572253	HEALTH SERVICES	WI	N/A	C Corporation					No

Schedule R (Form 990) 2023

Page 3

Part V

Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

Yes

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

Yes

h Purchase of assets from related organization(s) ............................

Yes

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

Yes

k Lease of facilities, equipment, or other assets from related organization(s) ......................

Yes

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

Yes

s Other transfer of cash or property from related organization(s) ............................

Yes

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) FROEDTERT MENOMONEE FALLS HOSPITAL FOUNDATION INC	Q	1,196,059	CASH TRANSFER
(2) COMMUNITY OUTPATIENT HEALTH SERVICES	Q	128,582	CASH TRANSFER
(3) FROEDTERT MENOMONEE FALLS HOSPITAL FOUNDATION INC	C	64,473	FMV

Schedule R (Form 990) 2023

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Schedule R (Form 990) 2023

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. See instructions.

Return Reference	Explanation

Schedule R (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v6.0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	45,763	64,473
9	Program service revenue (Part VIII, line 2g) .........	245,317,792	265,639,587
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	-128,811	-3,340
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	12,454,419	13,068,352
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	257,689,163	278,769,072
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	215,000	240,000
14	Benefits paid to or for members (Part IX, column (A), line 4).....		0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	109,945,949	100,021,174
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 596,786
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	173,515,923	184,325,466
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	283,676,872	284,586,640
19	Revenue less expenses. Subtract line 18 from line 12.......	-25,987,709	-5,817,568
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	121,589,519	129,708,445
21	Total liabilities (Part X, line 26).............	11,514,312	14,460,548
22	Net assets or fund balances. Subtract line 21 from line 20.....	110,075,207	115,247,897

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 109,113,236 including grants of $ ) (Revenue $ 123,396,459 )
	OUTPATIENT SERVICES: FROEDTERT MENOMONEE FALLS HOSPITAL HAD 103,807 OUTPATIENT VISITS IN THE 12 MONTHS ENDING JUNE 30, 2024. THE HOSPITAL OFFERS A WIDE VARIETY OF ANCILLARY, SPECIALTY SERVICES, INCLUDING BUT NOT LIMITED TO THE FOLLOWING: - ALLERGY/IMMUNOLOGY - CARDIOLOGY - CLINICAL GENETICS - DERMATOLOGY - ELECTROPHYSIOLOGY - ENDOCRINOLOGY - FAMILY PRACTICE

4b	(Code: ) (Expenses $ 103,093,115 including grants of $ ) (Revenue $ 116,588,288 )
	INPATIENT SERVICES: FROEDTERT MENOMONEE FALLS HOSPITAL (FMFH) FOUNDED IN 1964 BY THE CITIZENS OF THE COMMUNITY IT SERVES, IS A FULL-SERVICE HOSPITAL THAT SPECIALIZES IN CANCER CARE, HEART AND VASCULAR CARE, ORTHOPAEDICS, WOMEN'S HEALTH AND ADVANCED SURGICAL PROCEDURES. THE HOSPITAL IS ACCREDITED BY THE JOINT COMMISSION, ENJOYS A NATIONAL REPUTATION OF EXCELLENCE AS A PROVIDER OF TOP QUALITY HEALTH CARE SERVICES AND HAS RECEIVED MANY AWARDS FOR INNOVATIONS. COMBINING NEXT-GENERATION TECHNOLOGY WITH PERSONALIZED CARE, THE HOSPITAL STRIVES TO ENHANCE AND IMPROVE THE QUALITY OF LIFE IN WAUKESHA COUNTY, AS WELL AS WASHINGTON, MILWAUKEE AND OZAUKEE COUNTIES. FMFH IS APPROVED FOR 237 BEDS OF WHICH 131 ARE STAFFED. FOR THE 12 MONTHS ENDED JUNE 30 2024, FMFH HAD 7,945 PATIENT ADMISSIONS AND 31,759 PATIENT DAYS RELATED TO A WIDE RANGE OF INPATIENT

4c	(Code: ) (Expenses $ 22,685,274 including grants of $ ) (Revenue $ 25,654,840 )
	EMERGENCY SERVICES: THE EMERGENCY DEPARTMENT AT FROEDTERT MENOMONEE FALLS HOSPITAL IS ALSO A LEVEL III TRAUMA CENTER AND PROVIDES CARE FOR INDIVIDUALS WITH EMERGENT AND URGENT PROBLEMS. DURING FISCAL YEAR 2024, THE EMERGENCY DEPARTMENT HAD 27,874 EMERGENCY VISITS, WITH PATIENTS RECEIVING EXPERT CARE FROM BOARD-CERTIFIED EMERGENCY MEDICINE PHYSICIANS AND NURSES CERTIFIED IN ADVANCED CARDIAC LIFE SUPPORT, STROKE AND TRAUMA CARE. THE EMERGENCY DEPARTMENT INCLUDES 23 EXAM ROOMS AND AN ADDITIONAL 4,000 SQUARE FEET TO MEET THE NEEDS OF CRITICALLY ILL PATIENTS, AS WELL AS EXPANDED CAPACITY TO TREAT PATIENTS WITH TRAUMATIC INJURIES. OUR EMERGENCY DEPARTMENT IS STRENGTHENED BY THE AVAILABILITY OF AND ACCESS TO HIGHLY TRAINED SPECIALISTS IN TRAUMA, NEUROSURGERY, CARDIOLOGY, CARDIOTHORACIC SURGERY, INCLUDING ROBOTIC SURGERY, ORTHOPAEDICS, RESPIRATORY, OBSTETRICS, GYNECOLOGY, IMAGING, PSYCHIATRY AND OTHER SPECIALTIES WHEN THE NEED ARISES.

	(Code: ) (Expenses $ 11,526,649 including grants of $ 240,000 ) (Revenue $ 13,035,519 )
	OTHER PROGRAM SERVICES: AS PART OF OPERATING AN ACUTE CARE HOSPITAL AND PROVIDING HEALTH CARE SERVICES TO THE COMMUNITY, OTHER REVENUE IS DERIVED IN THE FOLLOWING AREAS: OTHER DEPARTMENT OPERATING REVENUE - REVENUE DERIVED FROM DIFFERENT SERVICES THROUGH THE PROCESS OF PROVIDING PATIENT CARE AND IN THE NORMAL OPERATION OF A MEDICAL FACILITY. INCLUDED IN THIS CATEGORY ARE ITEMS SUCH AS MEANINGFUL USE REVENUE, CANCER CARE/ONCOLOGY REVENUE, RENTAL REVENUE, GIFT SHOP REVENUE, CLINICAL DIETETICS, AND OTHER WELLNESS SERVICES. DIETARY REVENUE - REVENUE DERIVED FROM CAFETERIA SALES, VENDING MACHINE SALES, GUEST TRAY SALES AND EMPLOYEE MEALS. DIETARY SERVICES ARE NECESSARY TO SUPPORT SERVICES TO PATIENT FAMILIES WHILE THEIR LOVED ONE IS RECEIVING CARE IN THE HOSPITAL. THE REVENUE FROM EMPLOYEE MEALS IS A BENEFIT PROVIDED BY THE HOSPITAL AS AN EMPLOYER AND IT ALLOWS OUR STAFF TO REMAIN ON SITE FOR PATIENT CARE. CORPORATE ALLOCATED REVENUE - REVENUE PASSED THROUGH FROM FROEDTERT THEDACARE HEALTH (FTCH), A RELATED PARTY. INTERCOMPANY REVENUE CONSISTS OF REVENUE DERIVED FROM MEDICAL AND ADMINISTRATIVE SERVICES PROVIDED TO THE OTHER FTCH ENTITIES. ALL OF THESE SERVICES SUPPORT THE DELIVERY OF HEALTHCARE TO THE COMMUNITY. MISCELLANEOUS REVENUE - REVENUE DERIVED FROM DIFFERENT SERVICES THROUGH THE PROCESS OF PROVIDING PATIENT CARE IN THE NORMAL OPERATION OF A MEDICAL FACILITY. SPECIAL EVENT ACTIVITY REVENUE, AND TAXABLE SALES.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 11,526,649 including grants of $ 240,000 ) (Revenue $ 13,035,519 )
4e	Total program service expenses246,418,274

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)			(D) Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(18) Shelly Waala........................................................................ Director & VP Patient Care Svc	49.0 .......................1.0	X			0	380,354	72,808
(19) Travis Fisher MD........................................................................ Director	1.0 .......................0	X			0	0	0
(20) Adam Smith........................................................................ Treasurer	1.0 .......................49.0		X		0	416,956	71,989
(21) Linda McPike........................................................................ Secretary	1.0 .......................49.0		X		0	368,327	26,864
(22) Jeffrey Van De Kreeke........................................................................ Former - Officer (Treas)	0.0 .......................50.0			X	0	196,046	12,200

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	0	3,926,102	623,048

1	Briefly describe the organization’s mission or most significant activities: COMMUNITY MEMORIAL HOSPITAL OF MENOMONEE FALLS, INC. DBA FROEDTERT MENOMONEE FALLS HOSPITAL (FMFH) ADVANCES THE HEALTH OF THE PEOPLE OF THE DIVERSE COMMUNITIES WE SERVE THROUGH EXCEPTIONAL CARE ENHANCED BY INNOVATION AND DISCOVERY.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	17
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	14
5	Total number of individuals employed in calendar year 2023 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6	212
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

(A) Name and business address	(B) Description of services	(C) Compensation





2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 0

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	64,473
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f

g	Noncash contributions included in lines 1a - 1f:$		1g	1,164

h Total. Add lines 1a-1f.......		64,473

		Business Code
2a	OUTPATIENT REVENUE	900099	123,396,459	123,396,459
b	INPATIENT REVENUE	900099	116,588,288	116,588,288
c	EMERGENCY/TRAUMA REVENUE	900099	25,654,840	25,654,840
d
e
f	All other program service revenue.		0	0	0	0
g	Total. Add lines 2a–2f .....		265,639,587

3 Investment income (including dividends, interest, and othersimilar amounts) ......			16,937			16,937
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
			(i) Real	(ii) Personal
6a	Gross rents	6a
b	Less: rental expenses	6b
c	Rental income or (loss)	6c	0	0
d	Net rental income or (loss).......
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a
b	Less: cost or other basis and sales expenses	7b		20,277
c	Gain or (loss)	7c	0	-20,277
d	Net gain or (loss).........			-20,277			-20,277
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a	69,128
b	Less: direct expenses ...		8b	36,295
c	Net income or (loss) from fundraising events..			32,833			32,833
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..

Business Code
11a	INTERCOMPANY REVENUE		900099	6,394,329	6,394,329
b	CORPORATE ALLOCATED REVENUE		561000	3,417,149	3,417,149
c	OTHER DEPARTMENT REVENUE		561499	2,193,380	2,193,380
d	All other revenue ....			1,030,661	1,030,661	0	0
e	Total. Add lines 11a–11d ......			13,035,519
12	Total revenue. See instructions.....			278,769,072	278,675,106	0	29,493

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	240,000	240,000
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	93,735,513	88,835,469	4,499,308	400,736
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....
9	Other employee benefits .......	10,844	10,277	521	46
10	Payroll taxes ...........	6,274,817	5,946,800	301,191	26,826
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	37,576		37,576
c	Accounting ...........
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	30,669,951	23,709,871	6,942,111	17,969
12	Advertising and promotion ....
13	Office expenses .......	758,923	709,450	46,633	2,840
14	Information technology ......	282,730	112,995	150,383	19,352
15	Royalties ..
16	Occupancy ...........	2,518,578	2,118,842	396,340	3,396
17	Travel ............	48,402	41,444	4,688	2,270
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	91,673	79,711	10,967	995
20	Interest ...........	1,780,150	1,497,613	280,136	2,401
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	9,823,910	8,264,708	1,545,955	13,247
23	Insurance ...
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	SUPPLIES - MEDICAL & OT	53,052,062	52,935,550	111,022	5,490
b	CORPORATE ALLOCATED EXP	43,145,921	25,996,600	17,049,703	99,618
c	AFFILIATE SUPPORT - CP	32,886,747	27,039,756	5,846,991
d	STATE HOSPITAL ASSESSME	5,283,986	5,283,986
e	All other expenses	3,944,857	3,595,202	348,055	1,600
25	Total functional expenses. Add lines 1 through 24e	284,586,640	246,418,274	37,571,580	596,786
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			5,975	1	5,025
2	Savings and temporary cash investments .........			5,340	2	11,889
3	Pledges and grants receivable, net ......				3	0
4	Accounts receivable, net .............			27,119,419	4	32,720,003
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
				0	6	0
7	Notes and loans receivable, net ...........				7	0
8	Inventories for sale or use ............			2,999,920	8	2,497,239
9	Prepaid expenses and deferred charges ......			550,416	9	993,527
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	273,805,157
b	Less: accumulated depreciation	10b	185,817,398	82,966,776	10c	87,987,759
11	Investments—publicly traded securities .				11	0
12	Investments—other securities. See Part IV, line 11 .....			0	12
13	Investments—program-related. See Part IV, line 11 ..			0	13
14	Intangible assets ...............				14	0
15	Other assets. See Part IV, line 11 ...........			7,941,673	15	5,493,003
16	Total assets. Add lines 1 through 15 (must equal line 33)...			121,589,519	16	129,708,445

17	Accounts payable and accrued expenses .....	6,243,636	17	6,128,516
18	Grants payable ...		18	0
19	Deferred revenue .........	120	19	0
20	Tax-exempt bond liabilities .........		20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
		0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..		23	0
24	Unsecured notes and loans payable to unrelated third parties ..		24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	5,270,556	25	8,332,032
26	Total liabilities. Add lines 17 through 25..	11,514,312	26	14,460,548

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	109,285,106	27	115,247,897
28	Net assets with donor restrictions ...........	790,101	28	0
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29	0
30	Paid-in or capital surplus, or land, building or equipment fund ...		30	0
31	Retained earnings, endowment, accumulated income, or other funds		31	0
32	Total net assets or fund balances ...........	110,075,207	32	115,247,897
33	Total liabilities and net assets/fund balances ........	121,589,519	33	129,708,445