SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
Medium right arrow 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
ThedaCare Regional Medical Center - Neenah Inc
 
Employer identification number

39-0830664
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
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.
3
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.
a
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:
3a
Yes
 
%
b
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: . . . . . . . .
3b
Yes
 
%
c
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.
4
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"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

 

No
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
 
c
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? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
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) . . . 		    1,786,779   1,786,779 0.77 %
b Medicaid (from Worksheet 3, column a) . . . . .   14,304 35,285,754 32,397,700 2,888,054 1.25 %
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 14,304 37,072,533 32,397,700 4,674,833 2.03 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4). 10 859,288 1,425,726   1,425,726 0.62 %
f Health professions education (from Worksheet 5) . . . 3 392 850,857   850,857 0.37 %
g Subsidized health services (from Worksheet 6) . . . . 3   901,504   901,504 0.39 %
h Research (from Worksheet 7) .         0 0 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . . 5 49,571 3,424,394   3,424,394 1.48 %
j Total. Other Benefits . . 21 909,251 6,602,481 0 6,602,481 2.86 %
k Total. Add lines 7d and 7j . 21 923,555 43,675,014 32,397,700 11,277,314 4.89 %
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   33,260   33,260 0.01 %
3 Community support 1 86,985 1,042,185   1,042,185 0.45 %
4 Environmental improvements         0 0 %
5 Leadership development and
training for community members		         0 0 %
6 Coalition building         0 0 %
7 Community health improvement advocacy         0 0 %
8 Workforce development         0 0 %
9 Other         0 0 %
10 Total 2 86,985 1,075,445 0 1,075,445 0.47 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
5,962,258
3
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. ......
3
5,313,052
4
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
5
Enter total revenue received from Medicare (including DSH and IME).....
5
21,915,154
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
23,495,686
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-1,580,532
8
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:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
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 .........................

9b

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
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) 		Licensed Hospital General Medical and Surgical Children's Hospital Teaching Hospital Critical Access Hospital Research Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 THEDACARE REGIONAL MEDICAL CENTER - NEENAH
120 SECOND STREET
NEENAH,WI54956
WWW.THEDACARE.ORG
32 		X X         X      
Schedule H (Form 990) 2023
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Schedule H (Form 990) 2023
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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)
THEDACARE REGIONAL MEDICAL CENTER - NEENAH
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): 		1
Yes No
Community Health Needs Assessment
1 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?........................ 1   No
2 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............... 2   No
3 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...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 22
5 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 ................. 5 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.................................. 6a   No
b 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. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 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. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 23
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): HTTPS://THEDACARE.ORG/ABOUT-US/COMMUNITY-HEALTH/NEEDS-ASSESSMENT-PLANS/
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 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   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c 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
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Schedule H (Form 990) 2023
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
THEDACARE REGIONAL MEDICAL CENTER - NEENAH
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 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):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
HTTPS://THEDACARE.ORG/PATIENTS-AND-VISITORS/BILLING-AND-PAYMENT/PAYMENT-OPTIONS/
b
HTTPS://THEDACARE.ORG/PATIENTS-AND-VISITORS/BILLING-AND-PAYMENT/PAYMENT-OPTIONS/
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2023
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Schedule H (Form 990) 2023
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Part VFacility Information (continued)

Billing and Collections
THEDACARE REGIONAL MEDICAL CENTER - NEENAH
Name of hospital facility or letter of facility reporting group  
Yes No
17 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?.................................. 17 Yes  
18 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:
a
b
c
d
e
f
19 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 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):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2023
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Schedule H (Form 990) 2023
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
THEDACARE REGIONAL MEDICAL CENTER - NEENAH
Name of hospital facility or letter of facility reporting group  
Yes No
22 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.
a
b
c
d
23 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? ............................... 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2023
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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 3E THE HOSPITAL FACILITY ANALYZED SEVERAL HEALTH NEEDS OF THE COMMUNITY AND HAS PRIORITIZED THOSE OF MOST CONCERN. THE PRIORITIZATION OF THE TOP SIGNIFICANT COMMUNITY HEALTH NEEDS IS DESCRIBED IN THE CHNA.
Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - THEDACARE REGIONAL MEDICAL CENTER - NEENAH. As part of the Needs Assessment Advisory Team, ThedaCare consulted with the Public Health Departments of Outagamie County, Winnebago County, Calumet County, Shawano, Green Lake, Marquette, Waushara, Waupaca and the City of Appleton: * Chuck Sepers, City of Appleton, Public Health Officer * Bonnie Thelen RN, Calumet County, Public Health Officer * Natalie Vandeveld, MS, REHS / WI RS * Doug Gieryn, Winnebago County, Public Health Officer * Director Terri Harmala, MSN, RN, Shawano County, Health Officer * Rachel Prellwitz, Green Lake County, Public Health Officer * Jayme Sophe, Marquette County, Public Health Officer * Stefanie Eldredge, BSN, RN, Health Officer/Director * Jed Woldt, Waupaca County, Public Health Officer In addition, over the course of a one-year period, secondary data was collected, key informant interviews were conducted, ThedaCare CHAT Teams (Community Health Action Team) provided input and patient health data was studied. Vulnerable populations included low income, rural farm families, older adults, veterans, Hispanic/Latino population, Lesbian, Gay, Bisexual, Transgender (LGBT), Hmong and African American populations. ThedaCare Chat (Community Health Action Team) of the Fox Cities Members: Amy Putzer, Oshkosh Area Community Foundation Barb Tangesdahl, Executive Director, First Five, Fox Velley Becky Bartoszek, President/CEO Fox Cities Chamber of Commerce Ben Vogel, Appleton Area School District Beth Clay, Executive Director, New Mental Health Connection Bridget Clementi, Wi Children's Hospital Chris Matheny, Fox Valley Technical College Chuck Sepers, Health Officer, City of Appleton Dale Gisi, VP, Central Region, ThedaCare Doug Gieryn, Health Officer, Winnebago County Greg Lemke-Rochon, Boys and Girls Club, Fox Valley Jesse Smith, Lawrence University Joe Mauthe, Community Volunteer Martin Rudd, Assistant Chan., Access Computer Montgomery Elmer, Chief Medical Officer Ambulatory Care, ThedaCare Oliver Zorrow, Executive Director, Building for Kids Peter Granopoulos, President/CEO UW Fox Cities Peter Lee, Behavioral Health Diversity and Inclusion Consultant Rayor Brown, Behavioral Health Diversity and Inclusion Consultant Reiko Ramos, Diversity and Resilience Director Shane Kohl, ThedaCare Family of Foundations Tammy Geenen, Community Foundation for the Fox Valley Region Tim Galloway, Galloway Company Timber Smith, City of Appleton, City of Appleton Diversity, Inclusion, Special Assistant to the Mayor
Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - HOW HOSPITAL FACILITY IS ADDRESSING NEEDS IDENTIFIED IN CHNA. THE THEDACARE COMMUNITY HEALTH IMPLEMENTATION STRATEGY WAS APPROVED BY THE THEDACARE BOARD OF TRUSTEES IN 2022. THE FOLLOWING PRIORITIES WERE IDENTIFIED AS THE TOP COMMUNITY HEALTH NEEDS FOR THE 2023-2025 CHNA CYCLE: MENTAL AND BEHAVIORAL HEALTH CHALLENGES CONTINUE WITH THE MENTAL AND BEHAVIORAL HEALTH OF OUR COMMUNITY. ACCESS TO MENTAL HEALTH SERVICES IS NOT KEEPING UP WITH DEMAND, AND THERAPISTS AND HEALTH PROFESSIONALS ARE LACKING IN RURAL AREAS. ADDITIONALLY, ANXIETY AND DEPRESSION HAVE RISEN 20-30% IN RECENT YEARS WHILE SELF-MEDICATION AND SUBSTANCE ABUSE, INCLUDING ALCOHOL, METHAMPHETAMINE, AND VAPING ARE ON THE RISE. TO ADDRESS THIS HEALTH NEED, THE HOSPITAL FACILITY HAS IMPLEMENTED THE FOLLOWING TO ENSURE THAT PEOPLE HAVE THE SUPPORT NEEDED TO LEAD MENTALLY HEALTHY LIVES, FREE OF RELIANCE ON HARMFUL SUBSTANCES AND TO SUPPORT UPSTREAM EFFORTS THAT FOSTER MENTAL HEALTH: 1) PARTNER TO ESTABLISH REGIONAL DETOXIFICATION CAPACITY. 2) EXPAND ED2RECOVERY+ COACHING CAPACITY 3) ADDRESS MENTAL HEALTH NEEDS OF LGBTQ+ COMMUNITY 4) PARTNER TO SUPPORT SOCIAL CONNECTION AND BELONGING WORK 5) SUPPORT CATALPA HEALTH AND CATALPA HEALTH "SEEDLINGS" PROGRAM ADDRESSING EARLY CHILDHOOD SOCIAL EMOTIONAL LEARNING. SOCIAL NEEDS AS THEDACARE SHIFTS ITS FOCUS UPSTREAM TO POPULATION HEALTH, IT IS IMPORTANT TO UNDERSTAND HOW VITAL CONDITIONS, SUCH AS CLEAN AIR, FAIR PAY, HOUSING, EDUCATION AND OTHER BASIC NECESSITIES CAN IMPACT AN INDIVIDUAL'S WELL-BEING. ADDITIONALLY, RELIABLE TRANSPORTATION, BELONGING AND CIVIC MUSCLE, AND PURPOSE ALL INFLUENCE HEALTH. TO ADDRESS THIS IDENTIFIED NEED, THE HOSPITAL FACILITY HAS IMPLEMENTED THE FOLLOWING TO ENSURE THAT THE BASIC NEEDS OF PATIENTS ARE MET: 1) ADDRESS SOCIAL NEEDS THROUGH EMPLOYEE VOLUNTEERING/GIVING EFFORTS. 2) IMPLEMENT CULTURAL COMPETENCY TRAINING OF THEDACARE TEAM MEMBERS. 3) SUPPORT EXPANSION OF STAR PROGRAM ADDRESSING "OPPORTUNITY GAP" BETWEEN BLACK AND WHITE HIGH SCHOOL STUDENTS. 4) SUPPORT BE WELL FOX VALLEY AND EAT WELL FOR LIFE INITIATIVES ADDRESSING DIABETES MANAGEMENT AMONG LOW-INCOME POPULATIONS. 5) SUPPORT BASIC NEEDS GIVING PARTNERSHIP AND US VENTURE GOLF OUTING TO END POVERTY. STRONG START TO LIFE GROWING UP HEALTHY AND STRONG STARTS AT THE BEGINNING OF AN INDIVIDUAL'S LIFE. IN PARTNERSHIP WITH CHILDREN'S WISCONSIN, THEDACARE SEEKS TO ADDRESS SOCIAL DETERMINANTS OF HEALTH, MENTAL, BEHAVIORAL AND INFANT HEALTH, AND SAFETY AND VIOLENCE IN CHILDREN THROUGH THE FOLLOWING: 1) SUPPORT REGIONAL FIRST 5 FOX VALLEY EARLY CHILDHOOD COALITION AND HELP ME GROW CENTRALIZED FAMILY SUPPORT ACCESS POINT. 2) ESTABLISH THEDACARE PEDIATRIC SDOH COMMUNITY RESOURCE NAVIGATION ASSISTANCE IN RURAL MARKETS THROUGH ADVANCING A HEALTHIER WISCONSIN GRANT AND EXPAND TO ENTIRE SERVICE AREA. 3) PARTNER TO ESTABLISH COMMUNITY RESOURCE NAVIGATION SUPPORT WITHIN CATALPA. 4) EXPLORE EXPANSION OF WELCOME BABY COMMUNITY MODEL IN RURAL MARKETS. 5) FACILITATE COLLABORATIVE REGIONAL ASSESSMENT OF AVAILABILITY AND ACCESSIBILITY OF PARENTING PROGRAMS AND SUPPORTS: REGIONAL ALIGNMENT IN ORDER TO POSITIVELY AFFECT COMMUNITY HEALTH, HEALTH SYSTEMS, NOT-FOR-PROFIT ORGANIZATIONS, AND THE PUBLIC SECTOR MUST BE UNITED ON THEIR PRIORITIES AND COMMITMENTS. THEDACARE WILL WORK WITH PARTNERS TO ESTABLISH COMMON INFRASTRUCTURE NEEDED TO IMPROVE ALIGNMENT OF HEALTH PRIORITIES AND ACTIONS THROUGH THE FOLLOWING: 1) ESTABLISH COMMON COMMUNITY HEALTH NEEDS ASSESSMENT AND ALIGNED IMPROVEMENT PLANS ACROSS HEALTH SYSTEMS AND PUBLIC HEALTH PARTNERS. 2) DEVELOP COLLABORATIVE REGIONAL NETWORK AND INFRASTRUCTURE FOR ADDRESSING SOCIAL NEEDS. 3) DEVELOP ALIGNMENT AND SYNERGY ACROSS CHAT TEAMS. 4) SUPPORT IMAGINE FOX CITIES REGIONAL VISIONING INITIATIVE. 5) DEVELOP RELIABLE TRANSPORTATION ACROSS THE REGION. SIGNIFICANT NEEDS IDENTIFIED THROUGH THE MOST RECENTLY CONDUCTED CHNA THAT WILL NOT BE ADDRESS IN THE CURRENT THREE-YEAR PLAN ARE: 1) HIGH PAYING JOBS/ECONOMIC OPPORTUNITY - LIMITED RESOURCES TO ADDRESS 2) INTERNET - BEING ADDRESSED BY OTHERS 3) FOOD INSECURITY - BEING ADDRESS BY OTHERS 4) MOTOR VEHICLE CRASH DEATHS - LIMITED RESOURCES TO ADDRESS 5) EXERCISE OPPORTUNITIES - LIMITED RESOURCES TO ADDRESS. WORK ON THESE NEEDS CONTINUES AS THEDACARE ADDRESSES PRIORITY ISSUES IN THE COMMUNITY HEALTH IMPROVEMENT PLAN.
Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - THEDACARE REGIONAL MEDICAL CENTER - NEENAH. PATIENTS ARE SENT AN OVERVIEW LETTER EXPLAINING THE PROCESS FOR APPLYING FOR OUR ASSISTANCE PROGRAM OR OUR STAFF WALKS THEM THROUGH THE PROCESS. THEY ARE ASKED TO COMPLETE AN APPLICATION THAT INCLUDES REQUESTS FOR INFORMATION. THIS INFORMATION IS NEEDED IN ORDER TO MAKE A DECISION AS TO WHETHER THE PATIENT MEETS THE CRITERIA FOR ACCEPTANCE, AND IF ACCEPTED, WHAT LEVEL OF ASSISTANCE WILL BE PROVIDED. ONCE THE DECISION IS MADE, WE WILL NOTIFY THE PATIENT AND IF ACCEPTABLE, WRITE OFF THE BALANCE AS DETERMINED.
Schedule H, Part V, Section B, Line 15 Facility , 1 Facility , 1 - THEDACARE REGIONAL MEDICAL CENTER - NEENAH. CONTRACTED WITH ELIGIBILITY VENDOR (CARDON) TO WORK DIRECTLY WITH THE UNINSURED PATIENT TO ASSIST THEM WITH INSURANCE ENROLLMENT AND EDUCATION.
Schedule H, Part V, Section B, Line 16 Facility , 1 Facility , 1 - THEDACARE REGIONAL MEDICAL CENTER - NEENAH. THE FAP AND APPLICATION WERE AVAILABLE AT HOSPITAL CASHIER OFFICES, ON OUR WEB SITE AND OFFERED TO ALL PATIENTS THAT EXPRESSED A FINANCIAL HARDSHIP WHEN CALLING THE BILLING OFFICE. THE PLS WAS PRINTED ON EVERY STATEMENT AND A FOOTER WAS ADDED TO THE FRONT OF THE STATEMENT ADVISING PATIENT TO SEE REVERSE SIDE OF STATEMENT FOR FINANCIAL ASSISTANCE AND PAYMENT OPTIONS. NOTIFICATION OF FINANCIAL ASSISTANCE AVAILABILITY WAS ADDED TO THE INITIAL LETTER SENT BY THE THIRD PARTY COLLECTION AGENCY.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2023
Page 9
Schedule H (Form 990) 2023
Page 9
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?6
Name and address Type of Facility (describe)
1 AYLWARD SURGERY CENTER
120 SECOND STREET
NEENAH,WI54956 		OUTPATIENT SURGERY CENTER
2 RENAISSANCE SURGERY CENTER
2400 WITZEL AVENUE
OSHKOSH,WI54904 		OUTPATIENT SURGERY CENTER
3 THEDACARE PHYSICAL THERAPY
1516 S COMMERCIAL ST
NEENAH,WI54956 		REHAB CLINIC
4 THEDACARE PHYSICAL THERAPY
600 N WESTHAVEN DR
OSHKOSH,WI54904 		REHAB CLINIC
5 NEUROSPINE CENTER OF WISCONSIN
5320 W MICHAELS DR
APPLETON,WI54913 		SPECIALTY CLINIC
6 THEDACARE BEHAVIORAL HEALTH
1095 MIDWAY RD
MENASHA,WI54952 		BEHAVIORAL HEALTH CLINIC
7
8
9
10
Schedule H (Form 990) 2023
Page 10
Schedule H (Form 990) 2023
Page 10
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 I, Line 3c DISCOUNTED CARE EXCEPTIONS SEE PART V, SECTION B, LINE 13 FOR THE LIST OF FACTORS USED IN THE ELIGIBILITY CRITERIA EXPLAINED IN THE FAP FOR PROVIDING FREE AND DISCOUNT CARE.
Schedule H, Part I, Line 7 COLUMN F The bad debt expense is not considered a community benefit expense and is not included in Schedule H, Part I, Line 7. The amount excluded is $5,962,258.
Schedule H, Part I, Line 6a Community benefit report prepared by related organization THEDACARE, INC. 39-1509362
Schedule H, Part I, Line 7g Subsidized Health Services NO PHYSICIAN CLINIC COSTS ARE INCLUDED IN THE COMMUNITY BENEFIT EXPENSES.
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS IN THE TABLE IS A COMBINATION OF AVERAGE COSTS AND ACTUAL COSTS PERTAINING TO SUPPLIES, WAGES, AND BENEFITS. FOR SUPPLIES, THE ACTUAL COST OF ITEMS USED FOR EACH EVENT IS APPLIED. IF NO ACTUAL COST IS AVAILABLE, WE THEN USE AN ESTIMATE. WAGES ARE CALCULATED BY MULTIPLYING THE AVERAGE WAGE RATE TIMES ACTUAL HOURS WORKED. THE BENEFIT RATE USED INCLUDEDS A FRINGE RATIO OF ALL BENEFITS RELATED TO THE ABOVE WAGE CALCULATION. THE COST ACCOUNTING SYSTEM DOES NOT DIFFERENTIATE BETWEEN DIFFERENT PAYER TYPES AND NO COST-TO-CHARGE RATIO IS USED.
Schedule H, Part II Community Building Activities THE HOSPITAL FACILITY PARTICIPATES IN NUMEROUS COMMUNITY BUILDING EFFORTS THROUGHOUT THE YEAR. SPECIFIC ACTIVITIES REPORTED ON SCHEDULE H, PART II INCLUDE: Economic Development - The primary aim of the chamber is to protect the interest of the business community as a whole. Strong employment is a social determinant of health, reducing poverty and providing individual and family sustainability. ThedaCare works together with local Chambers of Commerce in all of the communities it serves. Community Support - Caring Hearts is a financial assistance program designed for patients who are unable to pay for medically necessary services provided by all divisions within ThedaCare. The Caring Hearts Program covers services which are deemed to be medically necessary as determined by their physician. This cost is for time and expense needed to support Caring Hearts. The Caring Hearts financial assistance program is in effect at all ThedaCare facilities - ThedaCare Regional Medical Centers in Appleton and Neenah, ThedaCare Medical Center- Berlin, ThedaCare Medical Center-New London, ThedaCare Medical Center-Shawano, ThedaCare Medical Center-Waupaca and ThedaCare Medical Center-Wild Rose.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount PATIENT ACCOUNTS RECEIVABLE ARE UNCOLLATERALIZED PATIENT OBLIGATIONS THAT ARE STATED AT THE AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH THEDACARE EXPECTS TO BE ENTITLED IN EXCHANGE FOR PROVIDING PATIENT CARE. THESE OBLIGATIONS ARE PRIMARILY FROM LOCAL RESIDENTS, MOST OF WHOM ARE INSURED UNDER THIRD-PARTY PAYOR AGREEMENTS. THEDACARE BILLS THIRD-PARTY PAYORS ON THE PATIENTS' BEHALF, OR IF A PATIENT IS UNINSURED, THE PATIENT IS BILLED DIRECTLY. ONCE CLAIMS ARE SETTLED WITH THE PRIMARY PAYOR, ANY SECONDARY INSURANCE IS BILLED, AND PATIENTS ARE BILLED FOR COPAY AND DEDUCTIBLE AMOUNTS THAT ARE THE PATIENTS' RESPONSIBILITY. PAYMENTS ON ACCOUNTS RECEIVABLE ARE APPLIED TO THE SPECIFIC CLAIM IDENTIFIED ON THE REMITTANCE ADVICE OR STATEMENTS. THEDACARE DOES NOT HAVE A POLICY TO CHARGE INTEREST ON PAST DUE ACCOUNTS. PATIENT ACCOUNTS RECEIVABLE ARE RECORDED AT NET REALIZABLE VALUE BASED ON CERTAIN ASSUMPTIONS. FOR THIRD-PARTY PAYORS, INCLUDING MEDICARE, MEDICAID, MANAGED CARE AND COMMERCIAL PAYORS, THE NET REALIZABLE VALUE IS BASED ON THE ESTIMATED CONTRACTUAL REIMBURSEMENT PERCENTAGE, WHICH IS BASED ON CURRENT CONTRACT PRICES OR HISTORICAL PAID CLAIMS DATA BY PAYOR. FOR UNINSURED PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR A PORTION OF THE BILL), THE NET REALIZABLE VALUE IS DETERMINED USING ESTIMATES OF HISTORICAL COLLECTION EXPERIENCE. THESE ESTIMATES ARE ADJUSTED FOR EXPECTED RECOVERIES AND ANY ANTICIPATED CHANGES IN TRENDS, INCLUDING SIGNIFICANT CHANGES IN PAYOR MIX, ECONOMIC CONDITIONS OR TRENDS IN FEDERAL AND STATE GOVERNMENTAL HEALTH CARE COVERAGE.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology THE HOSPITAL USES ACCOUNTING DATA, INCLUDING ACCOUNTS AND COST CENTERS, TO ESTIMATE THE PORTION OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. AS THIS IS A COST OF PROVIDING HEALTH CARE SERVICES TO THOSE IN THE COMMUNITY WHO FALL UNDER THE FAP, THE AMOUNT IS CONSIDERED COMMUNITY BENEFIT.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote SEE "PATIENT ACCOUNTS RECEIVABLE AND ALLOWANCE FOR CREDIT LOSSES" OF NOTE 1 ON PAGE 11 IN THE ATTACHED FINANCIAL STATEMENTS.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs MEDICARE ALLOWABLE COSTS WERE CALCULATED USING A COST-TO-CHARGE RATIO. SHORTFALLS ARISE FROM PAYMENTS THAT ARE LESS THAN THE COSTS TO PROVIDE THE SERVICES. THE SHORTFALLS SHOULD BE CONSIDERED COMMUNITY BENEFIT AS THEY MUST BE ABSORBED IN ORDER TO CONTINUE PROVIDING CARE TO OUR COMMUNITY. IT IS ALSO IMPLIED IN INTERNAL REVENUE SERVICE RULING 69-545 WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR TAX-EXEMPT HOSPITALS AND INDICATES THAT PARTICIPATION IN PUBLICLY-FINANCED PROGRAMS, SUCH AS MEDICARE, IS EVIDENCE THAT A HOSPITAL MEETS THE COMMUNITY BENEFIT STANDARD.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance OUR POLICY IS NOT TO PURSUE PATIENT ACCOUNTS TO THE EXTENT ANY CHARGES ARE ELIGIBLE AND WRITTEN OFF THROUGH OUR CHARITY CARE/FINANCIAL ASSISTANCE PROGRAM. IF ONLY A PORTION OF THE CHARGES ARE ELIGIBLE AND WRITTEN OFF THROUGH OUR CHARITY CARE/FINANCIAL ASSISTANCE PROGRAM, THE REMAINING BALANCE WILL BE BILLED TO THE PATIENT AND COLLECTED IN ACCORDANCE WITH OUR NORMAL COLLECTION POLICY.
Schedule H, Part V, Section B, Line 16a FAP website - THEDACARE REGIONAL MEDICAL CENTER - NEENAH: Line 16a URL: HTTPS://THEDACARE.ORG/PATIENTS-AND-VISITORS/BILLING-AND-PAYMENT/PAYMENT-OPTIONS/;
Schedule H, Part V, Section B, Line 16b FAP Application website - THEDACARE REGIONAL MEDICAL CENTER - NEENAH: Line 16b URL: HTTPS://THEDACARE.ORG/PATIENTS-AND-VISITORS/BILLING-AND-PAYMENT/PAYMENT-OPTIONS/;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website - THEDACARE REGIONAL MEDICAL CENTER - NEENAH: Line 16c URL: HTTPS://THEDACARE.ORG/PATIENTS-AND-VISITORS/BILLING-AND-PAYMENT/PAYMENT-OPTIONS/;
Schedule H, Part VI, Line 2 Needs assessment THEDACARE COVERS A 9-COUNTY PRIMARY SERVICE AREA SERVED BY 7 HOSPITALS. THEDACARE CONDUCTS A COMMUNITY NEEDS ASSESSMENT EVERY THREE YEARS FOR EACH HOSPITAL GATHERING DATA PERTINENT TO THAT COMMUNITY AND THE SURROUNDING AREAS. INFORMATION COLLECTED INCLUDES DATA FROM THE WISCONSIN COUNTY HEALTH RANKINGS, FOX CITIES LIFE STUDY (LOCAL INDICATORS FOR EXCELLENCE), THE BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY, INSIGHTS FROM INTERVIEWS OF PUBLIC HEALTH OFFICIALS, INSIGHTS FROM INTERVIEWS WITH REPRESENTATIVES OF VULNERABLE POPULATIONS, EMERGENCY DEPARTMENT PATIENT DATA AND INSIGHTS GATHERED FROM MONTHLY MEETINGS OF THE THEDACARE-LED CHAT TEAM (COMMUNITY HEALTH ACTION TEAM) COMPRISED OF COMMUNITY LEADERS IN BUSINESS, NON-PROFIT, CLERGY, EDUCATION, DIVERSE POPULATION GROUPS, HEALTHCARE, UNITED WAY, PUBLIC HEALTH AND THE LOCAL COMMUNITY FOUNDATIONS.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance PATIENT EDUCATION BEGINS WHEN A PATIENT IS ADMITTED TO A THEDACARE HOSPITAL. ADMISSION SPECIALISTS MEET WITH EACH PERSON INDIVIDUALLY TO ASSESS INSURANCE STATUS AND FINANCIAL NEED. IF NECESSARY, SPECIALISTS REFER PATIENTS TO CARE MANAGEMENT SPECIALISTS WHO ASSIST WITH THE ENROLLMENT OF PATIENTS IN AN APPLICABLE PROGRAM. THE HOSPITAL PATIENT HANDBOOK IS PROVIDED TO ALL IN-PATIENTS. INTERNAL POLICIES SUCH AS DISCOUNTED SERVICES POLICY, CARING HEARTS POLICY AND PAYMENT FOR SERVICE POLICY FOR SELF-PAY BALANCES PROVIDE GUIDANCE. THE THEDACARE WEBSITE, WWW.THEDACARE.ORG, PROVIDES EDUCATION REGARDING THE AFFORDABLE CARE ACT IN EASY-TO-UNDERSTAND LANGUAGE. IT DISCUSSES OPTIONS AND WHERE TO GO FOR ASSISTANCE.
Schedule H, Part VI, Line 4 Community information ThedaCare Regional Medical Center-Neenah service area consists of Winnebago County and is located in east-central Wisconsin. The two-county area hosts a population of over 238,000 combined with concentration in the Fox Cities urban area. OVER ONE-THIRD OF HOUSEHOLDS ARE LIVING BELOW THE ALICE THRESHOLD, WHICH INDICATES A HOUSEHOLD EITHER ABOVE OR BELOW THE FEDERAL POVERTY LEVEL BUT STILL NOT EARNING ENOUGH TO AFFORD BASIC NECESSITIES. * Between 2010 and 2021, the share of the population that is Hispanic/Latino in Winnebago County grew the most, increasing 1.2 percentage points. The white (non-Hispanic) population had the largest decrease dropping 3.8 percentage points. * Among six age groups in Winnebago County - 0 to 4, 5 to 19, 20 to 34, 35 to 49, 50 to 64, and 65 and older - the 65+ group was the fastest growing between 2010 and 2021. * The 35 to 49 age group in Winnebago County declined the most between 2010 and 2021, dropping 8.7 percentage points. * In Winnebago County 12% of the children live below 100% of the Federal Poverty Level. * Winnebago County has 6% of residents who are uninsured. * Winnebago County high school graduation rate is 94%. * In comparison to more rural counties in the ThedaCare service area, Winnebago County continues to have a higher percentage of children.
Schedule H, Part VI, Line 5 Promotion of community health THE FOUNDATION OF COMMUNITY HEALTH WITHIN THEDACARE IS COMMUNITY HEALTH IMPROVEMENT. THEDACARE COMMUNITY HEALTH IMPROVEMENT IS FUNDED THROUGH OPERATING BUDGET, GRANTS, AND THE THEDACARE FAMILY OF FOUNDATION SUPPORT. THEDACARE PROVIDES FUNDING AND DEDICATED STAFF TO MAKE CHAT COMMUNITY HEALTH EFFORTS POSSIBLE. THE COMMUNITY HEALTH TEAM WORKS WITH LOCAL COMMUNITY HEALTH ACTION TEAM (CHAT), GROUPS OF COMMUNITY LEADERS WHO STUDY SYSTEMIC HEALTH ISSUES OUTSIDE THE WALLS OF OUR HOSPITALS. CHAT IS THE FOUNDATION OF INNOVATIVE, COLLABORATIVE SOLUTIONS FOR COMMUNITY ISSUES THAT DRAW UPON THE WIDE ARRAY OF RESOURCES AND STRENGTHS OF OUR COMMUNITY. THERE ARE THEDACARE LED CHAT'S IN THE FOX CITIES OF APPLETON/MENASHA/NEENAH, BERLIN, NEW LONDON, SHAWANO, WAUPACA AND WILD ROSE.
Schedule H, Part VI, Line 6 Affiliated health care system THEDACARE, INC., THE PARENT ORGANIZATION, PROVIDES DIRECTION RELATED TO COMMUNITY HEALTH NEEDS ASSESSMENT FOR EACH HOSPITAL AND SURROUNDING COMMUNITIES WITHIN ITS SERVICE AREA. PLANS ARE APPROVED BY LOCAL HOSPITAL BOARDS. EACH THEDACARE HOSPITAL, ALONG WITH CHI STAFF AND COMMUNITY MEMBERS DETERMINE HOW BEST TO MEET LOCAL NEEDS. IMPLEMENTATION OF COMMUNITY PROGRAMMING OCCURS AT THE LOCAL LEVEL.
Schedule H, Part VI, Line 7 State filing of community benefit report WI
Schedule H (Form 990) 2023
Additional Data


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