2020-05-11T11:08:09-05:00 2019-06-30 390758449 WIPFLI LLP PO BOX 12237 GREEN BAY WI 543072237 990 2018-07-01 390816845 FROEDTERT SOUTH INC FROE 2625778113 6308 8TH AVENUE KENOSHA WI 531435082 THOMAS J KELLEY VP & CFO 2625778113 2020-05-06 1 TERRI REXRODE CPA MST P00096513 9206620016 2020-05-06 184.100.226.141 2020-05-06 14:36:52 CD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 7D2FE2EA17AC540A2D29D4112E82844D375299C1 2018 2020-09-23 17:36:50Z THOMAS J KELLEY 6308 8TH AVENUE KENOSHA WI 531435082 650176663 0 X WWW.FROEDTERTSOUTH.COM X 1910 WI FROEDTERT SOUTH, INC. IS COMMITTED TO LIVING OUT THE HEALING MINISTRIES OF THE JUDEO-CHRISTIAN FAITHS BY PROVIDING EXCEPTIONAL AND COMPASSIONATE HEALTHCARE SERVICES THAT PROMOTES THE DIGNITY AND WELL-BEING OF THE PEOPLE WE SERVE. THIS IS OUR MISSION AND OUR REASON FOR BEING. WE STRIVE TO RECRUIT AND RETAIN THE BEST PHYSICIANS AND STAFF AND PURCHASE THE BEST DIAGNOSTIC AND CURATIVE MEDICAL EQUIPMENT THAT OUR FINANCIAL RESOURCES WILL PERMIT. WE ALSO STRIVE TO BE ACCESSIBLE TO ALL MEMBERS OF OUR COMMUNITY WITH EMERGENT AND URGENT HEALTHCARE NEEDS, IRRESPECTIVE OF THEIR ABILITY TO PAY. THIS IS OUR COMMITTMENT TO THE QUALITY, ACCESSIBILITY AND AFFORDABILITY FUNDAMENTALS AFFECTING THE DELIVERY OF HEALTHCARE. 14 11 2775 106 155835 0 317475 561278 326290984 338796713 6409875 3891012 3180 -17099 333021514 343231904 11800 3125 0 0 169316855 171936148 0 0 0 147012725 156466444 316341380 328405717 16680134 14826187 528977325 533648652 87853025 94289723 441124300 439358929 X FROEDTERT SOUTH, INC. IS A COMPREHENSIVE REGIONAL HEALTHCARE SYSTEM THAT HAS SERVED SOUTHEASTERN WISCONSIN AND NORTHERN ILLINOIS COMMUNITIES FOR MORE THAN 100 YEARS. FROEDTERT SOUTH PROVIDES SERVICES PRIMARILY THROUGH THE FROEDTERT KENOSHA HOSPITAL AND THE FROEDTERT PLEASANT PRAIRIE HOSPITAL AND SEVERAL OTHER CLINIC LOCATIONS.WE, AT FROEDTERT SOUTH, ARE COMMITTED TO LIVING OUT THE HEALING MINISTRIES OF THE JUDEO-CHRISTIAN FAITHS BY PROVIDING EXCEPTIONAL AND COMPASSIONATE HEALTHCARE SERVICES THAT PROMOTES THE DIGNITY AND WELL BEING OF THE PEOPLE WE SERVE. THIS IS OUR MISSION AND OUR REASON FOR BEING. 0 0 279747940 3125 338640878 ACUTE CARE HOSPITAL THAT PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES TO ITS COMMUNITY. 2019 CHARITY CARE $3,304,254. CHARITY CARE IS DEFINED AS FREE OR DISCOUNTED HEALTH SERVICES PROVIDED TO THOSE WHO CANNOT AFFORD TO PAY AND WHO MEET ALL CRITERIA FOR FINANCIAL ASSISTANCE. CHARITY CARE IS BASED ON ACTUAL COSTS, NOT CHARGES, AND DOES NOT INCLUDE BAD DEBT. UNREIMBURSED COST OF PUBLIC PROGRAMS $23,134,092. UNREIMBURSED COST OF PUBLIC PROGRAMS IS DEFINED AS THE SHORTFALL EXPERIENCED WHEN PAYMENTS RECEIVED ARE BELOW THE COST OF TREATING PUBLIC BENEFICIARIES THROUGH MEDICAID AND OTHER LOCAL PUBLIC PROGRAMS. COMMUNITY HEALTH IMPROVEMENT SERVICES $947,522. COMMUNITY HEALTH IMPROVEMENT SERVICES ARE DEFINED AS CLINICAL AND NON-CLINICAL SERVICES DESIGNED TO IMPROVE COMMUNITY HEALTH, WHICH ARE PROVIDED TO THE COMMUNITY FOR FREE OR FOR FEES THAT DID NOT COVER COSTS. FINANCIAL CONTRIBUTIONS $280,754. FINANCIAL CONTRIBUTIONS ARE DEFINED AS CONTRIBUTIONS, INCLUDING CASH, NON-CASH ITEMS SUCH AS FOOD, FURNITURE, EQUIPMENT, SUPPLIES, AND LOANED STAFF FOR VOLUNTEER AND CHARITABLE PURPOSES, MADE TO INDIVIDUALS, COMMUNITY GROUPS, OR NONPROFIT ORGANIZATIONS FOR CHARITABLE PURPOSES. HEALTH PROFESSIONS EDUCATION $3,232. HEALTH PROFESSIONS EDUCATION IS DEFINED AS DIRECT COSTS INCURRED FOR ACCREDITED TRAINING AND EDUCATION PROGRAMS FOR PHYSICIANS, NURSES, ALLIED HEALTH PROFESSIONALS AND TECHNICIANS (DOES NOT INCLUDE ONGOING EDUCATION FOR STAFF). COMMUNITY BUILDING ACTIVITIES $416,371. COMMUNITY BUILDING ACTIVITIES ARE DEFINED AS PROGRAMS THAT, WHILE NOT DIRECTLY RELATED TO HEALTH CARE, PROVIDE OPPORTUNITIES TO ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS, SUCH AS POVERTY, HOMELESSNESS, AND ENVIRONMENTAL ISSUES. COSTS FOR THESE ACTIVITIES INCLUDE CASH AND IN-KIND DONATIONS. COMMUNITY BENEFIT OPERATIONS $6,465. COMMUNITY BENEFIT OPERATIONS ARE DEFINED AS COSTS ASSOCIATED WITH DEDICATED STAFF AND COMMUNITY HEALTH NEEDS AND/OR ASSETS ASSESSMENT, AS WELL AS, OTHER COSTS ASSOCIATED WITH COMMUNITY BENEFIT STRATEGY AND OPERATIONS. TOTAL BENEFIT TO THE COMMUNITY FOR 2019 $34,528,843. 279747940 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 1 1 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 0 0 0 1 76 0 2775 1 1 1 0 0 0 0 1 1 0 0 0 0 1 0 X 14 11 0 0 0 0 0 0 1 1 1 0 0 0 1 1 1 1 1 1 1 0 WI X JENS EMERSON 2625778113 6308 8TH AVENUE KENOSHA WI 531435082 THOMAS AMBRO MD DIRECTOR/PHYSICIAN 40.00 X 392489 0 45582 TODD BATTLE DIRECTOR 2.00 X X 0 0 0 A JAMES CICCHINI DIRECTOR (THRU 7/18) 2.00 X 0 0 0 MARIO GARRETTO MD DIRECTOR/PHYSICIAN 40.00 X 2050047 0 32338 MIKE GENTILE DIRECTOR 2.00 X 0 0 0 CATHERINE JACOBSON DIRECTOR 2.00 2.00 X 0 0 0 ROBERT LEE JR DIRECTOR 2.00 X X 0 0 0 THOMAS P MAHONEY DIRECTOR 2.00 X X 0 0 0 HAROLD W MAYER DIRECTOR 2.00 X X 0 0 0 MICHAEL PITTS DIRECTOR 2.00 X 0 0 0 DAVID R RILEY DIRECTOR 2.00 X X 0 0 0 DEAN THOMAS DIRECTOR 2.00 2.00 X 0 0 0 GARY ZAID MD DIRECTOR/PHYSICIAN 2.00 X 0 0 0 DR F GREGORY CAMPBELL CHAIRMAN 2.00 2.00 X X 0 0 0 ROBERT A CORNOG VICE-CHAIR/SEC./TREAS. (THRU 10/18) 2.00 2.00 X X 0 0 0 RICHARD O SCHMIDT JR PRESIDENT/CEO/DIRECTOR 45.00 2.00 X X 1367844 0 140928 THOMAS KELLEY ASST TREASURER/VP-CFO 45.00 X 542165 0 66168 LINDA WOHLGEMUTH ASST SECRETARY/SVP-COO 45.00 X 586261 0 49511 SUSAN VENTURA SVP/COO 45.00 X 591418 0 49917 KEVIN FULLIN PHYSICIAN 40.00 X 648254 0 32591 DAVID KNIGHT PHYSICIAN 40.00 X 1211376 0 17405 ASHWANI SETHI MD PHYSICIAN 40.00 X 658243 0 15967 NEIL SHEPLER PHYSICIAN 40.00 X 1177595 0 37435 W HARLEY SOBIN PHYSICIAN 40.00 X 695791 0 20688 9921483 0 508530 158 0 1 0 RILEY CONSTRUCTION COMPANY INC 5301 99TH AVENUE KENOSHA WI 53144 CONSTRUCTION SERVICES 44618511 AEROTEK COMMERCIAL STAFFING PO BOX 198531 ATLANTA GA 30384 ENVIRONMENTAL SERVICES STAFFING 2686502 ALLSCRIPTS HEALTHCARE LLC 24630 NETWORK PLACE CHICAGO IL 60673 IS SERVICES 2664031 INFINITY HEALTHCARE PHYSICIAN SC 7032 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 MEDICAL SERVICES 1636783 STATE COLLECTION SERVICE INC 2509 S STOUGHTON ROAD MADISON WI 53716 BILLING SERVICES 1357313 45 74893 486385 561278 NET PATIENT SERVICE REVENUE 623000 334056561 334056561 OTHER OPERATING REVENUE 623990 4587779 4431944 155835 MEDICAL OFFICE RENTAL 900099 152373 152373 338796713 3615381 3615381 307149924 500 306874793 0 275131 500 275631 275631 39432 74893 68153 -28721 -28721 13435 1813 11622 11622 343231904 338640878 155835 3873913 3125 3125 4936976 4082412 854564 133236112 111716750 21519362 8853205 6083367 2769838 15755165 9484426 6270739 9154690 7632065 1522625 57838 57838 72800 72800 25343473 24397957 945516 324290 90821 233469 1691981 929527 762454 8748430 2380838 6367592 6140065 5977191 162874 604146 225109 379037 23095965 20786369 2309596 857778 209562 648216 SUPPLIES 34728800 33639646 1089154 DRUGS 25050374 25050374 BAD DEBTS 13841494 13841494 PROVIDER TAX ASSESSMENT 6868596 6868596 9040414 6348311 2692103 328405717 279747940 48657777 0 X 55846713 24083525 51842291 52259843 15000000 10000000 4915473 5867944 4759163 6400325 537837853 288069308 173110821 249768545 166091231 168268124 57411633 17000346 528977325 533648652 29699782 29592420 15000000 10000000 43153243 54697303 87853025 94289723 X 438763618 436933535 842205 905546 1518477 1519848 441124300 439358929 528977325 533648652 X 14826187 3605627 -20197185 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2360682 67837 3125 2425394 2296413 76069 11800 2360682 2168810 136903 9300 2296413 2050490 125683 7363 2168810 2037824 17291 4625 2050490 0.00000 0.62660 0.37340 0 0 17598877 17598877 328823716 180266708 148557008 135740983 107802600 27938383 55674277 55674277 249768545 DEFERRED COMPENSATION 20062945 PENSION LIABILITY 34634358 54697303 312795727 3605627 -34041804 -30436177 343231904 0 343231904 314561098 0 314561098 13844619 13844619 328405717 PART V, LINE 4: TEMPORARILY RESTRICTED NET ASSETS ARE RESTRICTED FOR EDUCATION SCHOLARSHIP GRANTS AND VARIOUS HEALTH CARE PROGRAMS. PERMANENTLY RESTRICTED NET ASSETS ARE TO BE HELD IN PERPETUITY, THE INCOME FROM WHICH IS EXPENDABLE FOR HOSPITAL DEVELOPMENT. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN PENSION OBLIGATION OTHER THAN PENSION EXPENSE -20,197,185. SCHOLARSHIPS INCLUDED IN INCOME -3,125. BAD DEBT EXPENSE -13,841,494. PART XII, LINE 4B - OTHER ADJUSTMENTS: SCHOLARSHIPS INCLUDED IN INCOME 3,125. BAD DEBT EXPENSE 13,841,494. GOLF OUTING 114325 74893 39432 4728 43680 19745 114325 74893 39432 4728 43680 19745 68153 -28721 1 1 X 1 X 250.000000000000 1 X 1 1 1 0 1 1 3271849 3271849 0.01040 53926873 24324223 29602650 0.09410 57198722 24324223 32874499 0.10450 38689 953987 953987 0.00300 1 8 3232 3232 0.00000 22 0 280754 280754 0.00090 23 38697 1237973 1237973 0.00390 23 38697 58436695 24324223 34112472 0.10840 13232 0 13232 0.00000 1 201 183124 0 183124 0.00060 217025 0 217025 0.00070 5 2990 0 2990 0.00000 6 201 416371 416371 0.00130 1 3320632 0 52300272 75970079 -23669807 X 1 1 2 1 KENOSHA MEDICAL CENTER 6308 8TH AVENUE KENOSHA WI 53143 WWW.FROEDTERTSOUTH.COM 22 X X X 2 SAINT CATHERINE'S MEDICAL CENTER 9555 76TH STREET PLEASANT PRAIRIE WI 53158 WWW.FROEDTERTSOUTH.COM 305 X X X KENOSHA MEDICAL CENTER 1 0 0 1 X X X X X X X X X 16 1 1 1 1 X HTTP://WWW.FROEDTERTSOUTH.COM/ABOUT/COMMUNITY-BENEFITS/ X 1 16 1 HTTP://WWW.FROEDTERTSOUTH.COM/ABOUT/COMMUNITY-BENEFITS/ 0 1 X 250.000000000000 400.000000000000 X X X X X 1 1 X X X 1 X HTTP://WWW.FROEDTERTSOUTH.COM/PATIENTS-VISITORS/BILLING/ X HTTP://WWW.FROEDTERTSOUTH.COM/PATIENTS-VISITORS/BILLING/ X HTTP://WWW.FROEDTERTSOUTH.COM/PATIENTS-VISITORS/BILLING/ X X X X X X 1 X 0 X X X X 1 X 0 0 SAINT CATHERINE'S MEDICAL CENTER 2 0 0 1 X X X X X X X X X 16 1 1 1 1 X HTTP://WWW.FROEDTERTSOUTH.COM/ABOUT/COMMUNITY-BENEFITS/ X 1 16 1 HTTP://WWW.FROEDTERTSOUTH.COM/ABOUT/COMMUNITY-BENEFITS/ 0 1 X 250.000000000000 400.000000000000 X X X X X 1 1 X X X 1 X HTTP://WWW.FROEDTERTSOUTH.COM/PATIENTS-VISITORS/BILLING/ X HTTP://WWW.FROEDTERTSOUTH.COM/PATIENTS-VISITORS/BILLING/ X HTTP://WWW.FROEDTERTSOUTH.COM/PATIENTS-VISITORS/BILLING/ X X X X X X 1 X 0 X X X X 1 X 0 0 KENOSHA MEDICAL CENTER PART V, SECTION B, LINE 5: AS PART OF THE CHNA PROCESS, 32 PERSONS WHO REPRESENT THE COMMUNITY SERVED BY FROEDTERT SOUTH PROVIDED VALUABLE FEEDBACK REGARDING THEIR VIEWS OF THE HEALTHCARE CHALLENGES FACING OUR COMMUNITY. THIRTY-TWO PEOPLE PARTICIPATED REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY INCLUDING LOW-INCOME, RACIAL AND ETHNIC MINORITIES, THE ELDERLY, YOUTH, VETERANS, FAITH COMMUNITIES, INDIVIDUALS WITH DISABILITIES, RURAL COMMUNITIES, SURVIVORS OF DOMESTIC AND SEXUAL VIOLENCE, AND THOSE LIVING WITH MENTAL ILLNESS AND SUBSTANCE ABUSE. THE INFORMATION/FEEDBACK PROVIDED BY THESE PERSONS WHO REPRESENT THE COMMUNITY SERVED BY FROEDTERT SOUTH WAS INCORPORATED INTO THE COMMUNITY HEALTH NEEDS ASSESSMENT, IDENTIFICATION, PRIORITIZATION AND IMPLEMENTATION PLANNING SUMMARY. KEY INFORMANTS RANKED UP TO FIVE PUBLIC HEALTH ISSUES AND PROVIDED EXISTING STRATEGIES TO ADDRESS THESE ISSUES, ALONG WITH BARRIERS/CHALLENGES TO ADDRESSING THESE ISSUES AND ADDITIONAL STRATEGIES NEEDED. SAINT CATHERINE'S MEDICAL CENTER PART V, SECTION B, LINE 5: AS PART OF THE CHNA PROCESS, 32 PERSONS WHO REPRESENT THE COMMUNITY SERVED BY FROEDTERT SOUTH PROVIDED VALUABLE FEEDBACK REGARDING THEIR VIEWS OF THE HEALTHCARE CHALLENGES FACING OUR COMMUNITY. THIRTY-TWO PEOPLE PARTICIPATED REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY INCLUDING LOW-INCOME, RACIAL AND ETHNIC MINORITIES, THE ELDERLY, YOUTH, VETERANS, FAITH COMMUNITIES, INDIVIDUALS WITH DISABILITIES, RURAL COMMUNITIES, SURVIVORS OF DOMESTIC AND SEXUAL VIOLENCE, AND THOSE LIVING WITH MENTAL ILLNESS AND SUBSTANCE ABUSE. THE INFORMATION/FEEDBACK PROVIDED BY THESE PERSONS WHO REPRESENT THE COMMUNITY SERVED BY FROEDTERT SOUTH WAS INCORPORATED INTO THE COMMUNITY HEALTH NEEDS ASSESSMENT, IDENTIFICATION, PRIORITIZATION AND IMPLEMENTATION PLANNING SUMMARY. KEY INFORMANTS RANKED UP TO FIVE PUBLIC HEALTH ISSUES AND PROVIDED EXISTING STRATEGIES TO ADDRESS THESE ISSUES, ALONG WITH BARRIERS/CHALLENGES TO ADDRESSING THESE ISSUES AND ADDITIONAL STRATEGIES NEEDED. KENOSHA MEDICAL CENTER PART V, SECTION B, LINE 6A: AURORA HEALTHCARE, CHILDREN'S HOSPITAL OF WISCONSIN AND SAINT CATHERINE'S MEDICAL CENTER SAINT CATHERINE'S MEDICAL CENTER PART V, SECTION B, LINE 6A: AURORA HEALTHCARE, CHILDREN'S HOSPITAL OF WISCONSIN AND KENOSHA MEDICAL CENTER KENOSHA MEDICAL CENTER PART V, SECTION B, LINE 6B: KENOSHA COUNTY DIVISION OF HEALTH, KENOSHA COMMUNITY HEALTH CENTER AND UNITED WAY OF KENOSHA COUNTY SAINT CATHERINE'S MEDICAL CENTER PART V, SECTION B, LINE 6B: KENOSHA COUNTY DIVISION OF HEALTH, KENOSHA COMMUNITY HEALTH CENTER AND UNITED WAY OF KENOSHA COUNTY KENOSHA MEDICAL CENTER PART V, SECTION B, LINE 11: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED DURING THE FISCAL YEAR ENDED 2017. AS PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, A THREE (3) YEAR ACTION PLAN WAS DEVELOPED IN AN EFFORT TO ADDRESS THE NEEDS IDENTIFIED WITHIN THE COMMUNITY HEALTH NEEDS ASSESSMENT. FROEDTERT SOUTH IS ACTIVELY WORKING ON THE ACTION ITEMS ESTABLISHED FOR YEAR THREE:MENTAL HEALTH AWARENESS - WE HAVE NOW EXTENDED OUR SOCIAL WORK HOURS IN THE EMERGENCY ROOM TO HELP ADDRESS SUPPORTING THE NEEDS OF MENTAL HEALTH.ACCESS TO HEALTHCARE - WE HAVE UPDATED PHYSICIAN SCHEDULING TO INCREASE AVAILABILITY AND DECREASE WAIT TIMES.SUBSTANCE ABUSE EDUCATION AND PREVENTION - ALCOHOL AND OTHER DRUG ADDICTIONS IS A CONSISTENT TOP FINDING. THERE HAS BEEN AN OPIOID TASK FORCE AND A SUBSTANCE ABUSE COMMITTEE WHICH MEETS MONTHLY. THERE ARE HOSPITAL REPRESENTATIVES AT THE TABLE WITH THE GOAL TO IDENTIFY COMMUNITY RESOURCES, WORK WITH PHYSICIANS TO ADMINISTER SUBOXONE IN THE EMERGENCY DEPARTMENT AND STREAMLINE THEM INTO A COMMUNITY TREATMENT PLAN AND EXPLORE GRANT OPTIONS FOR THE USE OF NARCAN. CURRENTLY WE ARE PROVIDING A "THIS COULD SAVE YOUR LIFE" PACKET TO ALL PATIENTS WHO HAVE EXPERIENCED AN OVERDOSE IN THE EMERGENCY DEPARTMENT. THIS PACKET WAS DRIVEN BY COMMUNITY COLLABORATIONSELF-CARE AWARENESS - WE WILL SUPPORT HEALTHY NUTRITION AS WE PARTICIPATE IN THE COMMUNITY INITIATIVE OF HEALTHY PEOPLE KENOSHA. WE WILL PROMOTE PROPER NUTRITION THROUGHOUT THE HOSPITAL SYSTEM WITH INPATIENTS AND OUTPATIENTS IN OUR HOSPITAL AND CLINIC SETTINGS THROUGH INDIVIDUALIZING OUR NUTRITIONAL COUNSELING. WE ALSO OFFER THE "LIVING WELL PROGRAM" IN OUR HOSPITAL CAFETERIAS WHICH PROVIDES ALTERNATIVES FOR HEALTHY FOOD CHOICES TO OUR EMPLOYEES AND THE PUBLIC. CHRONIC DISEASE AWARENESS AND PREVENTION - WE ARE CURRENTLY FOCUSED IN ON OUR PATIENT POPULATION WITH A DIAGNOSIS OF CHF, COPD, PNEUMONIA AND DIABETES TO HELP AVOID READMISSIONS AND PROMOTE CONTINUITY OF CARE. SOME INITIATIVES THAT WE ARE WORKING ON: IDENTIFY A PATIENT WITH A 30-DAY ADMISSION IN THE EMERGENCY DEPARTMENT, COMPLETE A SOCIAL WORK SCREEN FOR COMMUNITY RESOURCES, ENSURE A TIMELY FOLLOW UP APPOINTMENT IS SCHEDULED WITH THE PHYSICIAN AND CONSIDER A CASE MANAGEMENT MODEL FOR CARE POST DISCHARGE PLANNING WHILE WORKING WITH OUR COMMUNITY PARTNERS. WE ARE AT THE TABLE WITH THE KENOSHA COUNTY DIVISION OF AGING AND DISABILITY RESOURCE CENTER TO FOCUS ON COMMUNITY COLLABORATIONS TO SUPPORT EDUCATION ON OUR PATIENTS WITH A CHRONIC DISEASE AND OVERALL REDUCE OUR READMISSION RATE. SAINT CATHERINE'S MEDICAL CENTER PART V, SECTION B, LINE 11: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED DURING THE FISCAL YEAR ENDED 2017. AS PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, A THREE (3) YEAR ACTION PLAN WAS DEVELOPED IN AN EFFORT TO ADDRESS THE NEEDS IDENTIFIED WITHIN THE COMMUNITY HEALTH NEEDS ASSESSMENT. FROEDTERT SOUTH IS ACTIVELY WORKING ON THE ACTION ITEMS ESTABLISHED FOR YEAR THREE:MENTAL HEALTH AWARENESS - WE HAVE NOW EXTENDED OUR SOCIAL WORK HOURS IN THE EMERGENCY ROOM TO HELP ADDRESS SUPPORTING THE NEEDS OF MENTAL HEALTH.ACCESS TO HEALTHCARE - WE HAVE UPDATED PHYSICIAN SCHEDULING TO INCREASE AVAILABILITY AND DECREASE WAIT TIMES.SUBSTANCE ABUSE EDUCATION AND PREVENTION - ALCOHOL AND OTHER DRUG ADDICTIONS IS A CONSISTENT TOP FINDING. THERE HAS BEEN AN OPIOID TASK FORCE AND A SUBSTANCE ABUSE COMMITTEE WHICH MEETS MONTHLY. THERE ARE HOSPITAL REPRESENTATIVES AT THE TABLE WITH THE GOAL TO IDENTIFY COMMUNITY RESOURCES, WORK WITH PHYSICIANS TO ADMINISTER SUBOXONE IN THE EMERGENCY DEPARTMENT AND STREAMLINE THEM INTO A COMMUNITY TREATMENT PLAN AND EXPLORE GRANT OPTIONS FOR THE USE OF NARCAN. CURRENTLY WE ARE PROVIDING A "THIS COULD SAVE YOUR LIFE" PACKET TO ALL PATIENTS WHO HAVE EXPERIENCED AN OVERDOSE IN THE EMERGENCY DEPARTMENT. THIS PACKET WAS DRIVEN BY COMMUNITY COLLABORATIONSELF-CARE AWARENESS - WE WILL SUPPORT HEALTHY NUTRITION AS WE PARTICIPATE IN THE COMMUNITY INITIATIVE OF HEALTHY PEOPLE KENOSHA. WE WILL PROMOTE PROPER NUTRITION THROUGHOUT THE HOSPITAL SYSTEM WITH INPATIENTS AND OUTPATIENTS IN OUR HOSPITAL AND CLINIC SETTINGS THROUGH INDIVIDUALIZING OUR NUTRITIONAL COUNSELING. WE ALSO OFFER THE "LIVING WELL PROGRAM" IN OUR HOSPITAL CAFETERIAS WHICH PROVIDES ALTERNATIVES FOR HEALTHY FOOD CHOICES TO OUR EMPLOYEES AND THE PUBLIC. CHRONIC DISEASE AWARENESS AND PREVENTION - WE ARE CURRENTLY FOCUSED IN ON OUR PATIENT POPULATION WITH A DIAGNOSIS OF CHF, COPD, PNEUMONIA AND DIABETES TO HELP AVOID READMISSIONS AND PROMOTE CONTINUITY OF CARE. SOME INITIATIVES THAT WE ARE WORKING ON: IDENTIFY A PATIENT WITH A 30-DAY ADMISSION IN THE EMERGENCY DEPARTMENT, COMPLETE A SOCIAL WORK SCREEN FOR COMMUNITY RESOURCES, ENSURE A TIMELY FOLLOW UP APPOINTMENT IS SCHEDULED WITH THE PHYSICIAN AND CONSIDER A CASE MANAGEMENT MODEL FOR CARE POST DISCHARGE PLANNING WHILE WORKING WITH OUR COMMUNITY PARTNERS. WE ARE AT THE TABLE WITH THE KENOSHA COUNTY DIVISION OF AGING AND DISABILITY RESOURCE CENTER TO FOCUS ON COMMUNITY COLLABORATIONS TO SUPPORT EDUCATION ON OUR PATIENTS WITH A CHRONIC DISEASE AND OVERALL REDUCE OUR READMISSION RATE. KENOSHA MEDICAL CENTER CAMPUS: PART V, SECTION B, LINE 22B: PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THIS POLICY WILL NOT BE CHARGED INDIVIDUALLY MORE FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE THAN THE AMOUNT GENERALLY BILLED TO INDIVIDUALS WHO HAVE INSURANCE COVERAGE FOR SUCH CARE ("AGB"). FURTHERMORE, CHARGES FOR ANY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE PROVIDED TO INDIVIDUALS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THIS POLICY WILL BE LESS THAN THE GROSS CHARGES FOR SUCH SERVICES. THE ORGANIZATION CALCULATES ONE OR MORE AGB PERCENTAGES USING THE "LOOK-BACK METHOD AND INCLUDING MEDICARE FEE-FOR-SERVICE AND ALL PRIVATE HEALTH INSURERS THAT PAY CLAIMS TO THE ORGANIZATION, ALL INACCORDANCE WITH 501(R). THESE CALCULATIONS ARE MADE AS FOLLOWS:1. THE ORGANIZATION DETERMINES AGB BY MULTIPLYING THE GROSS CHARGES FOR THE APPLICABLE MEDICAL CARE BY THE AGB PERCENTAGE, WHICH IS DETERMINED ANNUALLY BY DIVIDING (A) THE SUM OF THE AMOUNTS FOR ALL OF ITS CLAIMS FOR EMERGENCY AND OTHER MEDICALLY NECESSARY CARE THAT HAVE BEEN ALLOWED DURING THE AGB PERIOD BY MEDICARE FEE-FOR-SERVICE AND ALL PRIVATE HEALTH INSURERS AS PRIMARY PAYORS, TOGETHER WITH ANY ASSOCIATED PORTIONS OF THESE CLAIMS PAID BY MEDICARE BENEFICIARIES OR INSURED INDIVIDUALS IN THE FORM OF CO-PAYS, CO-INSURANCE OR DEDUCTIBLES BY (B) THE SUM OF THE ASSOCIATED GROSS CHARGES FOR THOSE CLAIMS.2. "GROSS CHARGES" MEANS THE ORGANIZATION'S FULL, ESTABLISHED PRICE FOR MEDICAL CARE THAT THE ORGANIZATION CONSISTENTLY AND UNIFORMLY CHARGES PATIENTS BEFORE APPLYING ANY CONTRACTUAL ALLOWANCES, DISCOUNTS, OR DEDUCTIONS.3. THE "AGB PERIOD" MEANS EACH PRIOR 12-MONTH PERIOD ENDING ON DECEMBER 31ST.4. THE ORGANIZATION WILL BEGIN TO APPLY THE ANNUALLY DETERMINED AGB PERCENTAGE WITHIN 120 DAYS FOLLOWING THE END OF THE AGB PERIOD THAT WAS USED IN CALCULATION THE AGB PERCENTAGE.5. ANY CAPITALIZED TERMS NOT DEFINED IN THIS DOCUMENT WILL HAVE THE MEANING ASSIGNED TO SUCH TERM IN THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY.THESE LIMITATIONS ON CHARGES FOR MEDICAL SERVICES SHALL NOT APPLY IF AN INDIVIDUAL HAS NOT SUBMITTED A COMPLETE FINANCIAL ASSISTANCE APPLICATION AS OF THE TIME THE CHARGES ARE BILLED TO SUCH INDIVIDUAL; PROVIDED, HOWEVER, THAT ADJUSTMENTS WILL BE MADE IF AMOUNTS ARE CHARGED IN EXCESS OF THESE LIMITATIONS AND THE INDIVIDUAL IS SUBSEQUENTLY DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE. SAINT CATHERINE'S MEDICAL CENTER CAMPUS: PART V, SECTION B, LINE 22B: PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THIS POLICY WILL NOT BE CHARGED INDIVIDUALLY MORE FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE THAN THE AMOUNT GENERALLY BILLED TO INDIVIDUALS WHO HAVE INSURANCE COVERAGE FOR SUCH CARE ("AGB"). FURTHERMORE, CHARGES FOR ANY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE PROVIDED TO INDIVIDUALS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THIS POLICY WILL BE LESS THAN THE GROSS CHARGES FOR SUCH SERVICES. THE ORGANIZATION CALCULATES ONE OR MORE AGB PERCENTAGES USING THE "LOOK-BACK METHOD AND INCLUDING MEDICARE FEE-FOR-SERVICE AND ALL PRIVATE HEALTH INSURERS THAT PAY CLAIMS TO THE ORGANIZATION, ALL INACCORDANCE WITH 501(R). THESE CALCULATIONS ARE MADE AS FOLLOWS:1. THE ORGANIZATION DETERMINES AGB BY MULTIPLYING THE GROSS CHARGES FOR THE APPLICABLE MEDICAL CARE BY THE AGB PERCENTAGE, WHICH IS DETERMINED ANNUALLY BY DIVIDING (A) THE SUM OF THE AMOUNTS FOR ALL OF ITS CLAIMS FOR EMERGENCY AND OTHER MEDICALLY NECESSARY CARE THAT HAVE BEEN ALLOWED DURING THE AGB PERIOD BY MEDICARE FEE-FOR-SERVICE AND ALL PRIVATE HEALTH INSURERS AS PRIMARY PAYORS, TOGETHER WITH ANY ASSOCIATED PORTIONS OF THESE CLAIMS PAID BY MEDICARE BENEFICIARIES OR INSURED INDIVIDUALS IN THE FORM OF CO-PAYS, CO-INSURANCE OR DEDUCTIBLES BY (B) THE SUM OF THE ASSOCIATED GROSS CHARGES FOR THOSE CLAIMS.2. "GROSS CHARGES" MEANS THE ORGANIZATION'S FULL, ESTABLISHED PRICE FOR MEDICAL CARE THAT THE ORGANIZATION CONSISTENTLY AND UNIFORMLY CHARGES PATIENTS BEFORE APPLYING ANY CONTRACTUAL ALLOWANCES, DISCOUNTS, OR DEDUCTIONS.3. THE "AGB PERIOD" MEANS EACH PRIOR 12-MONTH PERIOD ENDING ON DECEMBER 31ST.4. THE ORGANIZATION WILL BEGIN TO APPLY THE ANNUALLY DETERMINED AGB PERCENTAGE WITHIN 120 DAYS FOLLOWING THE END OF THE AGB PERIOD THAT WAS USED IN CALCULATION THE AGB PERCENTAGE.5. ANY CAPITALIZED TERMS NOT DEFINED IN THIS DOCUMENT WILL HAVE THE MEANING ASSIGNED TO SUCH TERM IN THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY.THESE LIMITATIONS ON CHARGES FOR MEDICAL SERVICES SHALL NOT APPLY IF AN INDIVIDUAL HAS NOT SUBMITTED A COMPLETE FINANCIAL ASSISTANCE APPLICATION AS OF THE TIME THE CHARGES ARE BILLED TO SUCH INDIVIDUAL; PROVIDED, HOWEVER, THAT ADJUSTMENTS WILL BE MADE IF AMOUNTS ARE CHARGED IN EXCESS OF THESE LIMITATIONS AND THE INDIVIDUAL IS SUBSEQUENTLY DETERMINED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE. 6 1 - FROEDTERT SOMERS CLINIC 3400 MARKET LANE KENOSHA WI 53144 OUTPATIENT PHYSICIAN CLINIC 2 - FROEDTERT PRAIRIE RIDGE 9697 ST CATHERINES DRIVE PLEASANT PRAIRIE WI 53158 OUTPATIENT PHYSICIAN CLINIC 3 - FROEDTERT PADDOCK LAKE CLINIC 7322 236TH AVENUE SALEM WI 53168 OUTPATIENT PHYSICIAN CLINIC 4 - LAKEVIEW RECPLEX 9900 TERWALL TERRACE PLEASANT PRAIRIE WI 53158 REHABILITATION CLINIC 5 - YMCA PHYSICAL THERAPY 7101 53RD STREET KENOSHA WI 53144 REHABILITATION CLINIC 6 - RCW ADMINISTRATIVE BUILDING 5000 68TH AVE KENOSHA WI 53144 ADMINISTRATIVE BUILDING PART I, LINE 7: THE COST METHOD USED TO CALCULATE THE COST OF THE COMMUNITY BENEFIT PROGRAMS WAS THE COST-TO-CHARGE RATIO. WORKSHEET 2 WAS USED TO CALCULATE THE RATIO OF PATIENT CARE COST TO CHARGES. PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $13,841,484. PART II, COMMUNITY BUILDING ACTIVITIES: MANY STAFF MEMBERS ARE UTILIZED TO PROMOTE THE HEALTH OF THE COMMUNITY AND THE GENERAL WELL-BEING OF THE COMMUNITY WE SERVE. THROUGH OUR EMERGENCY PREPAREDNESS COMMITTEE, STAFF ARE ALWAYS PLANNING AND PREPARING TO BE READY TO MEET THE NEEDS OF THE COMMUNITY AS EVENTS OCCUR. ADDITIONALLY, A VARIETY OF STAFF WORK WITH LOCAL SCHOOLS AND OTHER ORGANIZATIONS TO GIVE TALKS PROMOTING HEALTH AND CAREERS IN HEALTHCARE. A NUMBER OF STAFF MEMBERS ARE INVOLVED IN MENTORING PROGRAMS WITHIN THE LOCAL SCHOOLS. RECOGNIZING THE IMPORTANCE OF SUSTAINING AND GROWING OUR ECONOMY, WE PARTICIPATE IN OUR LOCAL BUSINESS ALLIANCE. PART III, LINE 2: THE ORGANIZATIONS UTILIZED THE HMFA #15 METHODOLOGY FOR DETERMINING BAD DEBT EXPENSE. PART III, LINE 3: SINCE THE ORGANIZATION UTILIZES HMFA #15, THERE IS NO PORTION OF THE BAD DEBT THAT WOULD BE CONSIDERED CHARITY CARE. PART III, LINE 4: IN EVALUATING THE COLLECTIBILITY OF PATIENT ACCOUNTS RECEIVABLE, THE CORPORATION ANALYZES PAST RESULTS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL 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. SPECIFICALLY, FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE CORPORATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL AMOUNTS 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 A PORTION OF THE BILL), THE CORPORATION 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 AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. PART III, LINE 8: SCHEDULE H PART III SECTION B LINE 6 REPORTS "ALLOWABLE COSTS OF CARE" AS TAKEN FROM THE MOST RECENTLY FILED MEDICARE COST REPORT AVAILABLE AT THE TIME THE COMMUNITY BENEFIT REPORT IS PUBLISHED. THE MEDICARE COST REPORT CALCULATES ITS ALLOWABLE TOTAL COSTS BASED ON APPLICABLE MEDICARE REGULATIONS. MEDICARE AND MEDICAID COST IS DETERMINED USING INDIVIDUAL COST CENTER COST-TO-CHARGE RATIOS. THIS COST TO CHARGE RATIO IS DETERMINED USING ALL PAYER COST AND ALL PAYER CHARGES. THE COST TO CHARGE RATIO IS APPLIED TO THE ACTUAL MEDICARE AND MEDICAID CHARGES TO DETERMINE THE MEDICARE AND MEDICAID COST. THIS ORGANIZATION HAS ADOPTED THE COST AND CHARGE PRACTICES AS RECOMMENDED BY THE CATHOLIC HEALTH ASSOCIATION AND THE WISCONSIN, IOWA, OR ILLINOIS HOSPITAL ASSOCIATION AS APPLICABLE, AND THEREFORE, DOES NOT COUNT ANY MEDICARE SHORTFALL NUMBERS IN ITS ANNUAL REPORTING OF COMMUNITY BENEFIT AMOUNTS. PART III, LINE 9B: OUR COLLECTION PROCESS IS THE SAME FOR ALL PATIENTS. IF A PATIENT EXPRESSES A NEED FOR FINANCIAL ASSISTANCE WE OFFER THE FINANCIAL ASSISTANCE APPLICATION. WE BILL ALL INSURANCES. PATIENT DOES NOT RECEIVE A COPY OF THE BILL UNTIL IT IS THEIR BALANCE. OUR EXTENDED BUSINESS OFFICE SENDS THREE STATEMENTS AND OUR REQUIRED FINAL REQUEST STATEMENT. FROM THIS POINT THE OUTSTANDING BALANCE IS HANDLED BY THE COLLECTION AGENCY. THE ACCOUNT DOES STAY ACTIVE ON OUR FINANCIAL SYSTEM FOR ONE YEAR. AT THAT TIME THE OUTSTANDING BALANCE IS MOVED OVER TO A BAD DEBT STATUS. PART VI, LINE 2: IN AN EFFORT TO UNDERSTAND AND ASSIST IN ADDRESSING THE NEEDS OF THE COMMUNITY WE SERVE, FROEDTERT SOUTH HAS INVOLVEMENT IN A VARIETY OF COMMUNITY COMMITTEES. FROEDTERT SOUTH HAS MULTIPLE STAFF, MANAGEMENT AND ADMINISTRATIVE LEVEL EMPLOYEES PARTICIPATE IN COMMITTEES THAT ARE SET UP TO ASSESS AND ADDRESS NEEDS IN THE COMMUNITY SUCH AS A HEALTHY LIFESTYLE COMMITTEE, MENTAL HEALTH COMMITTEE, INJURY PREVENTION COMMITTEE, SUICIDE PREVENTION COMMITTEE, INFANT MORTALITY COMMITTEE. THROUGH OUR PARTICIPATION IN COMMUNITY COMMITTEES WE GAIN AN UNDERSTANDING ABOUT THE NEEDS OF THE COMMUNITY AS WELL AS THE OPPORTUNITY TO WORK TOGETHER TO ADDRESS THE NEEDS. PART VI, LINE 3: WHEN STATEMENTS ARE SENT FROM OUR EXTENDED BUSINESS OFFICE, THERE IS A PHONE NUMBER FOR THE PATIENT TO CALL FOR ASSISTANCE WITH THEIR BALANCES. PATIENTS CALL AND THEY WORK WITH THEM TO SET UP PAYMENT ARRANGEMENTS. IF THEY EXPRESS ANY CONCERNS FOR FINANCIAL NEEDS THEY OFFER TO SEND THEM A COMMUNITY CARE APPLICATION. PART VI, LINE 4: KENOSHA COUNTY IS A FAST GROWING LAKESHORE COUMMUNITY IN SOUTHEASTERN WISCONSIN. LOCATED BETWEEN CHICAGO AND MILWAUKEE, KENOSHA COUNTY BOASTS A DIVERSE ECONOMY. KENOSHA IS THE FOURTH LARGEST CITY IN THE STATE OF WISCONSIN WITH 100,164 RESIDENTS REPORTED BY THE UNITED STATES CENSUS BUREAU IN THE 2018 POPULATION ESTIMATES. KENOSHA IS NOW THE EIGHTH LARGEST COUNTY IN WISCONSIN IN TERMS OF POPULATION WITH 169,290 RESIDENTS. FROEDTERT SOUTH SERVES PEOPLE IN SOUTHEASTERN WISCONSIN AND NORTHERN ILLINOIS THROUGH ITS TWO HOSPITAL LOCATIONS, FROEDTERT PLEASANT PRAIRIE HOSPITAL AND FROEDTERT KENOSHA HOSPITAL. ADVOCATE AURORA MEDICAL CENTER ALSO HAS A HOSPITAL CAMPUS IN KENOSHA. PART VI, LINE 5: FROEDTERT SOUTH IS COMMITTED TO IMPROVING THE HEALTH OF OUR PATIENTS AND NEIGHBORS. WE OFFER A VARIETY OF COMMUNITY OUTREACH PROGRAMS TO HELP THE GENERAL PUBLIC MAINTAIN GOOD HEALTH. THESE INCLUDE FREE COMMUNITY EDUCATION SEMINARS, HEALTH SCREENINGS, AND VARIOUS SUPPORT GROUPS. PART VI, LINE 7, REPORTS FILED WITH STATES WI X X 0 1 0 0 0 0 0 0 0 THOMAS AMBRO MD DIRECTOR/PHYSICIAN 391737 0 0 0 752 0 15785 0 29797 0 438071 0 0 0 MARIO GARRETTO MD DIRECTOR/PHYSICIAN 1663449 0 383667 0 2931 0 15785 0 16553 0 2082385 0 0 0 RICHARD O SCHMIDT JR PRESIDENT/CEO/DIRECTOR 933857 0 411819 0 22168 0 115785 0 25143 0 1508772 0 0 0 THOMAS KELLEY ASST TREASURER/VP-CFO 484065 0 57560 0 540 0 40785 0 25383 0 608333 0 0 0 LINDA WOHLGEMUTH ASST SECRETARY/SVP-COO 487919 0 96560 0 1782 0 40785 0 8726 0 635772 0 0 0 SUSAN VENTURA SVP/COO 488000 0 96560 0 6858 0 40785 0 9132 0 641335 0 0 0 KEVIN FULLIN PHYSICIAN 648254 0 0 0 0 0 15785 0 16806 0 680845 0 0 0 DAVID KNIGHT PHYSICIAN 567159 0 643871 0 346 0 15785 0 1620 0 1228781 0 0 0 ASHWANI SETHI MD PHYSICIAN 267115 0 390551 0 577 0 7892 0 8075 0 674210 0 0 0 NEIL SHEPLER PHYSICIAN 256179 0 919893 0 1523 0 15785 0 21650 0 1215030 0 0 0 W HARLEY SOBIN PHYSICIAN 150415 0 543735 0 1641 0 7892 0 12796 0 716479 0 0 0 PART I, LINE 4B INDIVIDUAL ELIGIBLE EMPLOYEES MAY PARTICIPATE IN A 457F PLAN. THE ORGANIZATION DOES NOT CONTRIBUTE TO THIS PLAN. THE FOLLOWING INDIVIDUALS PARTICIPATE IN THE PLAN: RICHARD SCHMIDT, MARIO GARRETTO, THOMAS AMBRO, ASHWANI SETHI, W. HARLEY SOBIN, DAVID KNIGHT, KEVIN FULLIN, LINDA WOHLGEMUTH, THOMAS KELLEY, AND SUSAN VENTURA. ROBERT LEE DIRECTOR 216502 SERVICES PROVIDED BY LEE PLUMBING MECHANICAL CONTRACTOR, INC. ROBERT LEE OWNS LEE PLUMBING MECHANICAL CONTRACTOR, INC. 0 DAVID RILEY DIRECTOR 37979672 SERVICES PROVIDED BY RILEY CONSTRUCTION COMPANY, INC. DAVID RILEY OWNS RILEY CONSTRUCTION COMPANY, INC. 0 ROBERT LEE DIRECTOR 425185 SERVICES PROVIDED BY LEE ELECTRICAL, INC. ROBERT LEE OWNS LEE ELECTRICAL, INC. 0 FORM 990, PART VI, SECTION A, LINE 7B EACH CLASS A MEMBER OF FROEDTERT SOUTH, INC. SHALL HAVE THE FOLLOWING RIGHTS TO BE EXECUTED ONLY UPON THE MUTUAL AGREEMENT OF BOTH CLASS A MEMBERS: - TO INITIATE, ADOPT AND APPROVE AND AMEND FROEDTERT SOUTH, INC.'S GOVERNING DOCUMENTS; - TO ADOPT, AMEND AND APPROVE THE MISSION, VISION, VALUES, PHILOSOPHY AND OBJECTS OF FROEDTERT SOUTH, INC. - TO APPROVE THE SALE (WHETHER BY DIRECT SALE, LEASE, LEASE FINANCING, PLEDGE OR OTHERWISE) OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF FROEDTERT SOUTH, INC. AND ANY OTHER CONTROLLED CORPORATION, THE PURCHASE (WHETHER BY DIRECT PURCHASE, LEASE, LEASE FINANCING OR OTHERWISE), SALE OR OTHER DISPOSITION OF PROPERTY INVOLVING A MATERIAL DOLLAR AMOUNT, AND ANY LONG-TERM BORROWING (FOR A TERM OF MORE THAN ONE YEAR) BY FROEDTERT SOUTH, INC. OR ANY OTHER CONTROLLED CORPORATION INVOLVING A MATERIAL DOLLAR AMOUNT; - TO APPROVE THE DISSOLUTION, MERGER, CONSOLIDATION, AFFILIATION OR INTEGRATION (OR TRANSACTION OF SIMILAR IMPORT) OF FROEDTERT SOUTH, INC. WITH OR INTO ANY OTHER PERSON, OR TRANSFER OF ANY MEMBERSHIP INTEREST BY ANY CLASS A MEMBER; - TO APPROVE THE FORMATION AND GOVERNANCE OF ANY NEW CORPORATIONS, PARTNERSHIPS, OR JOINT VENTURES (INVOLVING CAPITALIZATION INVOLVING A MATERIAL DOLLAR AMOUNT) IN WHICH FROEDTERT SOUTH, INC. OR ANY OTHER CONTROLLED CORPORATION HAS AN INTEREST THROUGH MEMBERSHIP, VOTING STOCK OR OTHER EQUITY PARTICIPATION. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS REVIEWED BY THE ORGANIZATION'S CFO AND CONTROLLER PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C FROEDTERT SOUTH'S WRITTEN CONFLICT OF INTEREST POLICY FOR THE BOARD IS REVIEWED ANNUALLY BY EACH BOARD MEMBER, AND ANY POTENTIAL CONFLICTS OF INTEREST ARE DISCLOSED AT THAT TIME. THE WRITTEN CONFLICT OF INTEREST POLICY FOR EMPLOYEES IS REVIEWED DURING ORIENTATION AND PERIODICALLY AT ORGANIZATION MEETINGS, AND IS INCORPORATED INTO THE PERFORMANCE STANDARDS OF THEIR ANNUAL EVALUATIONS. IF A CONFLICT ARISES, DEPENDING UPON THE NATURE OF THE FINANCIAL INTEREST AND WORK DONE BY THE BOARD, SEVERAL ACTIONS MAY BE CONSIDERED: THE BOARD MEMBER WITH A FINANCIAL INTEREST WOULD NEED TO VOLUNTARILY EXCUSE HIM OR HERSELF FROM THE DELIBERATIONS OR VOTING ON SUCH A MATTER; OR, IF NECESSARY, THE BOARD WOULD DETERMINE THAT THE SUBJECT'S FINANCIAL INTEREST WAS AN ACTUAL CONFLICT OF INTEREST, IN WHICH CASE THE BOARD MEMBER WOULD BE INFORMED BY THE BOARD CHAIRPERSON THAT HE OR SHE WOULD NOT BE ALLOWED TO VOTE IN ANY SUCH MATTERS DUE TO THIS REAL OR PERCEIVED CONFLICT OF INTEREST. MINUTES OF THE BOARD MEETING WOULD DOCUMENT THIS DECISION PROCESS, AND REFLECT WHATEVER ACTION(S) ARE ULTIMATELY TAKEN. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION FOR THE PRESIDENT, CEO AND GENERAL COUNSEL AND THE COMPENSATION FOR THE VICE PRESIDENTS REPORTING DIRECTLY TO THE PRESIDENT, CEO AND GENERAL COUNSEL ARE DETERMINED BY THE BOARD EXECUTIVE COMMITTEE WHICH SERVES AS THE BOARD COMPENSATION COMMITTEE. THE BOARD COMPENSATION COMMITTEE CONTRACTS WITH THE HEALTHCARE COMPENSATION FIRM NAMED THE GROVES GROUP, LLC, AND HAS UTILIZED THE PRESIDENT OF THE GROVES GROUP, LLC AS THE COMPENSATION CONSULTANT SINCE 2005. THE COMPENSATION CONSULTANT UTILIZES A METHODOLOGY THAT EVALUATES INTERNAL AND EXTERNAL EQUITY AFTER EVALUATING THE RESPONSIBILITIES OF EACH POSITION AND MAKES A RECOMMENDATION TO THE BOARD COMPENSATION COMMITTEE. THE BOARD COMPENSATION COMMITTEE HAS FOLLOWED THE DETAILED RECOMMENDATIONS OF THE COMPENSATION CONSULTANT ANNUALLY SINCE 2005 AND THE COMPENSATION CONSULTANT HAS BEEN RETAINED THROUGH 2019. FORM 990, PART VI, SECTION C, LINE 19 THESE DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART X: THE BEGINNING OF THE YEAR BALANCE SHEET CLASSIFICATIONS HAVE BEEN ADJUSTED. FORM 990, PART XI, LINE 9: CHANGE IN MINIMUM PENSION OBLIGATION -20,197,185. FORM 990, PART XII, LINE 2C: THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. FSINC INC 6308 8TH AVENUE KENOSHA WI 53143 391956749 HEALTHCARE WI 501(C)(3) LINE 12B, II FROEDTERT SOUTH INC 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0