AGNESIAN HEALTHCARE INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization: AGNESIAN HEALTHCARE INC (EIN 39-0807236)
Tax period: 2016-07-01 to 2017-06-30
Filed: 2018-05-10
IRS object ID: 201831309349301768
Schema version: 2016v3.0
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule J
Schedule K
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2018-05-10T10:32:26-05:00	ReturnTs
Tax Period End	2017-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	390758449	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	Wipfli LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	PO Box 12237	AddressLine1Txt
City	Green Bay	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	543072237	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2016-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	390807236	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Agnesian Healthcare Inc	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	AGNE	BusinessNameControlTxt
Phone	9209265519	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	430 East Division St	AddressLine1Txt
City	Fond du Lac	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	53935	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	BONNIE SCHMITZ	PersonNm
Person Title	VP and CFO	PersonTitleTxt
Phone	9209265519	PhoneNum
Signature	2018-05-09	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Terri Rexrode CPA MST	PreparerPersonNm
PTIN	P00096513	PTIN
Phone	9206620016	PhoneNum
Preparation	2018-05-09	PreparationDt

Field	Value	IRS element (for citing)
Tax	2016	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	STEVEN LITTLE CEO	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	430 East Division St	AddressLine1Txt
City	Fond du Lac	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	53935	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$488,786,133	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Group Exemption	0928	GroupExemptionNum
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.AGNESIAN.COM	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1892	FormationYr
Legal Domicile State	WI	LegalDomicileStateCd
Activity Or Mission	THE MISSION OF AGNESIAN HEALTHCARE IS TO PROVIDE COMPASSIONATE CARE THAT BRINGS HOPE, HEALTH AND WHOLENESS TO THOSE WE SERVE BY HONORING THE SACREDNESS AND DIGNITY OF ALL PERSONS AT EVERY STAGE OF LIFE. WE CONTINUE THE MISSION OF THE CATHOLIC CONGREGATION OF SISTERS OF ST. AGNES.	ActivityOrMissionDesc
Voting Members Governing Body	15	VotingMembersGoverningBodyCnt
Voting Members Independent	12	VotingMembersIndependentCnt
Total Employee	4313	TotalEmployeeCnt
Total Volunteers	567	TotalVolunteersCnt
Total Gross UBI	$4,658,207	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	-$548,634	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$848,003	PYContributionsGrantsAmt
CY Contributions Grants	$985,901	CYContributionsGrantsAmt
PY Program Service Revenue	$345,488,864	PYProgramServiceRevenueAmt
CY Program Service Revenue	$353,753,153	CYProgramServiceRevenueAmt
PY Investment Income	$8,886,890	PYInvestmentIncomeAmt
CY Investment Income	$9,341,789	CYInvestmentIncomeAmt
PY Other Revenue	$16,174,531	PYOtherRevenueAmt
CY Other Revenue	$16,571,485	CYOtherRevenueAmt
PY Total Revenue	$371,398,288	PYTotalRevenueAmt
CY Total Revenue	$380,652,328	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$156,598,769	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$165,819,796	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$198,902,309	PYOtherExpensesAmt
CY Other Expenses	$208,046,706	CYOtherExpensesAmt
PY Total Expenses	$355,501,078	PYTotalExpensesAmt
CY Total Expenses	$373,866,502	CYTotalExpensesAmt
PY Revenues Less Expenses	$15,897,210	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$6,785,826	CYRevenuesLessExpensesAmt
Total Assets BOY	$533,058,855	TotalAssetsBOYAmt
Total Assets EOY	$587,595,135	TotalAssetsEOYAmt
Total Liabilities BOY	$216,873,372	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$253,246,914	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$316,185,483	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$334,348,221	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	THE MISSION OF AGNESIAN HEALTHCARE IS TO PROVIDE COMPASSIONATE CARE THAT BRINGS HOPE, HEALTH AND WHOLENESS TO THOSE WE SERVE BY HONORING THE SACREDNESS AND DIGNITY OF ALL PERSONS AT EVERY STAGE OF LIFE. WE CONTINUE THE MISSION OF THE CATHOLIC CONGREGATION OF SISTERS OF ST. AGNES.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$256,201,247	ExpenseAmt
Revenue	$346,253,487	RevenueAmt
Desc	Agnesian healthcare operates St. Agnes hospital, a 163-licensed bed general/surgical acute care hospital which provides inpatient and outpatient services to residents of fond du lac and the surrounding counties. During fiscal year 2017, St. Agnes hospital had 6,806 inpatient admissions, with total patient days of 26,997. There was a total of 30,480 emergency room visits and 14,276 surgeries performed in FY17. In addition, St. Agnes Hospital provided 436,023 physician clinic visits, 80,904 medical imaging procedures, and 35,154 physical, occupational and speech therapy units. There were 1,881 cardiac cath lab visits and 47,496 hospice days. The hospital also operates Samaritan clinic, a free clinic offering medical services to qualified individuals. Samaritan clinic provided 740 visits to patients, at a cost of $173,999 for FY17. The hospital maintains records to identify and monitor the level of charity it provides to its patients. The cost of services and supplies furnished under the hospital's charity care policy was $1,105,071. In addition to quality health care services, St. Agnes hospital provides its communities with education, support groups and other community benefits. The net cost of these community benefits was $4,238,674.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$8,485,795	ExpenseAmt
Revenue	$3,405,987	RevenueAmt
Desc	AGNESIAN HEALTHCARE OPERATES AGNESIAN ENTERPRISES, WHICH IS COMPRISED OF PHARMACIES SERVING FOND DU LAC AND SURROUNDING TOWNS, AS WELL AS AGNESIAN HEALTH SHOPPE, WHICH SERVES THE POPULATION WITH HOSPITAL (INPATIENT AND OUTPATIENT), CLINIC AND HOME HEALTH EQUIPMENT. AGNESIAN ENTERPRISES FILLED 503,182 PRESCRIPTIONS DURING FY17. AGNESIAN HEALTH SHOPEE PROVIDES RETAIL SALES OF DURABLE MEDICAL EQUIPMENT, AS WELL AS TELECARE AND HOME OXYGEN SERVICES. THE COST OF SERVICES AND SUPPLIES FURNISHED UNDER AHE'S CHARITY CARE POLICY WAS $4,534. AGNESIAN HEALTHCARE ENTERPRISES CONTRIBUTES TO COMMUNITY BENEFIT WITH SEVERAL SUPPORT GROUPS. THE COST OF THE COMMUNITY BENEFIT WAS $6,143.	Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

Field	Value	IRS element (for citing)
Expense	$949,845	ExpenseAmt
Revenue	$14,596,104	RevenueAmt
Desc	AGNESIAN HEALTHCARE OPERATES CONSULTANTS LABORATORY OF WISCONSIN, AN INDEPENDENT REFERENCE LAB SERVING FOND DU LAC, DODGE, OUTAGAMIE, WINNEBAGO AND COLUMBIA COUNTIES. CLW PROVIDED 1,100,128 TESTS DURING FISCAL YEAR 2017. THE LABORATORY ALSO PROVIDES THE COMMUNITY WITH CAREER EDUCATION, CONTRIBUTIONS AND SERVICES TO SAMARITAN CLINIC. THE NET COST OF THESE COMMUNITY BENEFITS WAS $43,476. THE COST OF SERVICES AND SUPPLIES FURNISHED UNDER THE CHARITY CARE POLICY WAS $29,858.	Desc

Field	Value	IRS element (for citing)
Total Program Service Expenses	$265,636,887	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Temp Or Permanent Endowments	Yes (1)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	Yes (1)	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	0	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	0	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (1)	TaxExemptBondsInd
Invest Tax Exempt Bonds	0	InvestTaxExemptBondsInd
Escrow Account	0	EscrowAccountInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (1)	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	Yes (1)	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	Yes (1)	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	0	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	340	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	4313	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	Yes (1)	ForeignFinancialAccountInd
Foreign Country	CJ	ForeignCountryCd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	15	GoverningBodyVotingMembersCnt
Independent Voting Member	12	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (1)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (1)	WrittenPolicyOrProcedureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Audra Hoffmann	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	9209265519	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	430 EAST DIVISION STREET	AddressLine1Txt
City	FOND DU LAC	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54935	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (31 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
STEVEN N LITTLE
PRESIDENT AND CEO	50.00	Yes (X)	Yes (X)	$908,932	$0	$39,382
SR MARY NOEL BROWN
EX-OFFICIO	1.00	Yes (X)		$0	$0	$0
JAMES R CHATTERTON
Chairperson	1.00	Yes (X)	Yes (X)	$0	$0	$0
JOAN KARSTEN
DIRECTOR	1.00	Yes (X)		$0	$0	$0
SR RHEA EMMER
EX-OFFICIO	1.00	Yes (X)		$0	$0	$0
SR HERTHA LONGO
TreasuRER	1.00	Yes (X)	Yes (X)	$0	$0	$0
thor h gilbertson
DIRECTOR	1.00	Yes (X)		$0	$0	$0
wayne e matzke
VICE CHAIRPERSON	1.00	Yes (X)	Yes (X)	$0	$0	$0
JAMES B SIMON
SECRETARY	1.00	Yes (X)	Yes (X)	$0	$0	$0
dr JEFFERY STRONG
DIRECTOR	1.00	Yes (X)		$0	$0	$0
DR JUDITH WESTPHAL
DIRECTOR	1.00	Yes (X)		$0	$0	$0
MarySue Michels
direCTOR	1.00	Yes (X)		$0	$0	$0
DR richard schaefer
direCTOR	1.00	Yes (X)		$0	$0	$0
thomas schuessler
direCTOR	1.00	Yes (X)		$0	$0	$0
Dr Toni Stanley
direcTOR	1.00	Yes (X)		$0	$0	$0
JAMES P MUGAN
SR VP CLINICAL SERVICES	50.00			$332,020	$0	$41,281	Yes (X)
BONNIE R SCHMITZ
CHIEF FINANCIAL OFFICER	50.00			$488,547	$0	$27,858	Yes (X)
SUSAN L EDMINSTER
VP - HUMAN RESOURCES	50.00			$315,385	$0	$43,710	Yes (X)
NANCY A BIRSCHBACH
VP - CIO	50.00			$338,309	$0	$43,166	Yes (X)
Barbara L Knutzen
Pres and ceo-ahe and perfo	50.00			$268,433	$0	$33,479	Yes (X)
Holly brenner
vp strategic development/m	50.00			$293,402	$0	$14,489	Yes (X)
Michael Degere
VP population health manag	50.00			$387,276	$0	$40,306	Yes (X)
Michael Drees
chief operating officer fd	50.00			$281,672	$0	$44,753	Yes (X)
Katherine Vergos
Chief Nursing Officer	50.00			$258,959	$0	$16,134	Yes (X)
JOHN CHOI MD
ANESTHESIOLOGIST - PAIN RE	50.00			$755,269	$0	$38,079		Yes (X)
YASIR HATAHET MD
INTENSIVIST/pulmonologist	50.00			$955,386	$0	$45,978		Yes (X)
MICHAEL VANDER KOOY MD
RADIATION ONCOLOGIST	50.00			$672,183	$0	$46,760		Yes (X)
michael freeland MD
intensivist	50.00			$628,719	$0	$37,567		Yes (X)
allen foster md
physician - sleep medicine	50.00			$653,489	$0	$43,118		Yes (X)
MARY j MOLLISON
FORMER VP SPIRITUALITY AND CARE	50.00			$227,999	$0	$8,714			Yes (X)
JILL A STENSON
FORMER vp NURSING	50.00			$259,096	$0	$24,107			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$8,025,076	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$588,881	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	193	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (1)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
FOND DU LAC REGIONAL CLINIC
420 E DIVISION ST	FOND DU LAC	WI	54935	PHYSICIAN SERVICES	$54,043,230
CERNER CORP
2800 ROCKCREEK PKWY	KANSAS CITY	MO	64141	COMPUTER SERVICES	$11,070,817
CD SMITH CONSTRUCTION
PO BOX 1066	FOND DU LAC	WI	54935	CONSTRUCTION	$4,553,034
Medical College of WI
8701 watertown Plank Rd po box 26	Wauwatosa	WI	53226	physician serVICES	$1,720,436
MI-HEALTH HOLDINGS
PO BOX 128	BROWNSVILLE	WI	530060128	ComPUTER SERVICES	$1,169,282

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	65	CntrctRcvdGreaterThan100KCnt
Related Organizations	$985,901	RelatedOrganizationsAmt
Total Contributions	$985,901	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
NET PATIENT SERVICE REVENUE	621400	$220,542,583	$219,547,226	$995,357
MEDICARE/MEDICAID REVENUE	621400	$133,210,570	$133,210,570

Field	Value	IRS element (for citing)
Total Program Service Revenue	$353,753,153	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$5,844,596	TotalRevenueColumnAmt
Exclusion	$5,844,596	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$78,177	TotalRevenueColumnAmt
Exclusion	$78,177	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$82,500,699	SecuritiesAmt
Other	$4,403	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$79,038,025	SecuritiesAmt
Other	$48,061	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$3,462,674	SecuritiesAmt
Other	-$43,658	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$3,419,016	TotalRevenueColumnAmt
Exclusion	$3,419,016	ExclusionAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$39,497,882	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$29,047,719	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$10,450,163	TotalRevenueColumnAmt
Related Or Exempt Func Income	$6,833,608	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$3,616,555	UnrelatedBusinessRevenueAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
WORK INJURY/OCC HEALTH	621990	$1,922,057	$1,922,057
CAFETERIA SALES	900099	$1,457,148		$46,295	$1,410,853
MEDICARE EHR	900099	$940,203	$940,203

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,801,914	TotalRevenueColumnAmt
Related Or Exempt Func Income	$1,801,914	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$6,121,322	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$380,652,328	TotalRevenueColumnAmt
Related Or Exempt Func Income	$364,255,578	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$4,658,207	UnrelatedBusinessRevenueAmt
Exclusion	$10,752,642	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$4,970,088	TotalAmt
Management And General	$4,970,088	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$139,682,374	TotalAmt
Program Services	$109,462,202	ProgramServicesAmt
Management And General	$30,220,172	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$6,140,589	TotalAmt
Program Services	$4,616,131	ProgramServicesAmt
Management And General	$1,524,458	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$5,474,142	TotalAmt
Program Services	$3,503,878	ProgramServicesAmt
Management And General	$1,970,264	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$9,552,603	TotalAmt
Program Services	$6,978,273	ProgramServicesAmt
Management And General	$2,574,330	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$692,830	TotalAmt
Program Services	$59,039	ProgramServicesAmt
Management And General	$633,791	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$128,365	TotalAmt
Management And General	$128,365	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$74,744,877	TotalAmt
Program Services	$69,946,832	ProgramServicesAmt
Management And General	$4,798,045	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$998,705	TotalAmt
Program Services	$85,404	ProgramServicesAmt
Management And General	$913,301	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$57,624,471	TotalAmt
Program Services	$55,253,406	ProgramServicesAmt
Management And General	$2,371,065	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$28,307,469	TotalAmt
Program Services	$1,848,560	ProgramServicesAmt
Management And General	$26,458,909	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$13,685,578	TotalAmt
Program Services	$5,094,451	ProgramServicesAmt
Management And General	$8,591,127	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$729,474	TotalAmt
Program Services	$606,330	ProgramServicesAmt
Management And General	$123,144	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$799,001	TotalAmt
Program Services	$469,398	ProgramServicesAmt
Management And General	$329,603	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$4,877,594	TotalAmt
Management And General	$4,877,594	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$15,298,212	TotalAmt
Program Services	$887,134	ProgramServicesAmt
Management And General	$14,411,078	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$1,819,348	TotalAmt
Program Services	$1,083,004	ProgramServicesAmt
Management And General	$736,344	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
HOSPITAL ASSESSMENT	$5,044,397	$5,044,397
Miscellaneous	$2,007,883	$433,012	$1,574,871
DUES, SUBSCRIPTIONS, LI	$661,565	$265,436	$396,129
INVESTMENT FEES	$656,464		$656,464

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	-$29,527	TotalAmt
Management And General	-$29,527	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$373,866,502	TotalAmt
Program Services	$265,636,887	ProgramServicesAmt
Management And General	$108,229,615	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$4,976,303	BOYAmt
EOY	$4,371,979	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$19,075,426	BOYAmt
EOY	$6,584,344	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$57,815,091	BOYAmt
EOY	$57,466,984	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$5,584,360	BOYAmt
EOY	$5,347,100	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$3,746,011	BOYAmt
EOY	$3,765,809	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$395,976,101	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$223,575,229	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$170,382,278	BOYAmt
EOY	$172,400,872	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$206,669,832	BOYAmt
EOY	$227,296,330	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$64,809,554	BOYAmt
EOY	$110,361,717	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$533,058,855	BOYAmt
EOY	$587,595,135	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$43,689,233	BOYAmt
EOY	$43,689,173	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$134,013,484	BOYAmt
EOY	$165,518,041	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$39,170,655	BOYAmt
EOY	$44,039,700	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$216,873,372	BOYAmt
EOY	$253,246,914	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$302,538,252	BOYAmt
EOY	$320,651,021	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$11,481,683	BOYAmt
EOY	$12,530,403	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$2,165,548	BOYAmt
EOY	$1,166,797	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$316,185,483	BOYAmt
EOY	$334,348,221	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$533,058,855	BOYAmt
EOY	$587,595,135	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$6,785,826	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$12,897,926	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$1,521,014	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$19,407	OtherActivitiesAmt
Total Lobbying Expenditures	$19,407	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part II-B, Line 1:	FormAndLineReferenceDesc
Explanation	LOBBYING PORTION OF WISCONSIN HOSPITAL ASSOCIATION, AMERICAN HOSPITAL ASSOCIATION and AMERICAN COLLEGE OF RADIOLOGY ASSOCIATION DUES.	ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,032,857	BeginningYearBalanceAmt
Contributions	-$1,000,000	ContributionsAmt
Investment Earnings Or Losses	-$29,891	InvestmentEarningsOrLossesAmt
Other Expenditures	$2,785	OtherExpendituresAmt
Administrative Expenses	$181	AdministrativeExpensesAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,049,591	BeginningYearBalanceAmt
Investment Earnings Or Losses	$36,713	InvestmentEarningsOrLossesAmt
Other Expenditures	$50,000	OtherExpendituresAmt
Administrative Expenses	$3,447	AdministrativeExpensesAmt
End Year Balance	$1,032,857	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,039,915	BeginningYearBalanceAmt
Investment Earnings Or Losses	$13,223	InvestmentEarningsOrLossesAmt
Administrative Expenses	$3,547	AdministrativeExpensesAmt
End Year Balance	$1,049,591	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,019,387	BeginningYearBalanceAmt
Investment Earnings Or Losses	$73,707	InvestmentEarningsOrLossesAmt
Other Expenditures	$50,000	OtherExpendituresAmt
Administrative Expenses	$3,179	AdministrativeExpensesAmt
End Year Balance	$1,039,915	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,004,976	BeginningYearBalanceAmt
Investment Earnings Or Losses	$57,144	InvestmentEarningsOrLossesAmt
Other Expenditures	$40,000	OtherExpendituresAmt
Administrative Expenses	$2,733	AdministrativeExpensesAmt
End Year Balance	$1,019,387	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (1)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (1)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$6,716,640	OtherCostOrOtherBasisAmt
Book Value	$6,716,640	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$194,692,541	OtherCostOrOtherBasisAmt
Depreciation	$90,237,251	DepreciationAmt
Book Value	$104,455,290	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$4,002,469	OtherCostOrOtherBasisAmt
Depreciation	$1,989,992	DepreciationAmt
Book Value	$2,012,477	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$174,989,058	OtherCostOrOtherBasisAmt
Depreciation	$131,347,986	DepreciationAmt
Book Value	$43,641,072	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$15,575,393	OtherCostOrOtherBasisAmt
Book Value	$15,575,393	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$172,400,872	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (9 entries)

DescDesc	Book ValueBookValueAmt
DUE FROM AFFILIATED ENTITIES	$4,574,435
LONG TERM DEBT FROM AFFILIATED ENTITY	$5,000,000
INVESTMENT - MERCURY CLINIC	$3,005,130
INVESTMENT - SAH FOUNDATION	$12,952,060
Limited Use Assets - BOND FUNDS	$4,720,746
Limited Use Assets - PHYSICIAN SUPPLEMENTAL BENEFIT PLAN	$40,437,228
OTHER RECEIVABLES	$2,718,212
MISCELLANEOUS	$1,321,628
RECEIVABLE FROM RIPON MEDICAL CENTER	$35,632,278

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$110,361,717	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)

DescDesc	AmtAmt
CAPITAL LEASE PAYABLE	$1,315,046
PHYSICIANS SUPPLEMENTAL BENEFIT PLAN	$39,561,061
FUND BALance SWAP MarKeT ADJUSTMENT	$1,977,264
DUE TO MEDICARE/MEDICAID	$183,196
Executive Deferred Comp PLAN	$876,168
Land Contract - Family Foot Clinic	$126,965

Field	Value	IRS element (for citing)
Total Liability	$44,039,700	TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part V, Line 4:	FormAndLineReferenceDesc
Explanation	AGNESIAN HEALTHCARE, INC. NO LONGER HOLDS AN ENDOWMENT FROM THE CONGREGATION OF THE SISTERS OF ST. AGNES. THE ORIGINAL ENDOWMENT OF $1,000,000 WAS PERMANENTLY RESTRICTED. INCOME GENERATED FROM THE ENDOWMENT WAS UNRESRICTED AND TO BE USED AT THE DISCRETION OF THE CHIEF EXECUTIVE OFFICER TO FUND PROGRAMS SUCH AS DOMESTIC VIOLENCE, CHARITY CARE, ETC.	ExplanationTxt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Free Care Other	165.000000000000	FreeCareOtherPct

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent300	Yes (X)	Percent300Ind
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (1)	ExpensesExceedBudgetInd
Unable To Provide Care	0	UnableToProvideCareInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,139,463	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,139,463	NetCommunityBenefitExpnsAmt
Total Expense	0.00300	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$25,551,208	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$25,551,208	NetCommunityBenefitExpnsAmt
Total Expense	0.06830	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$26,690,671	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$26,690,671	NetCommunityBenefitExpnsAmt
Total Expense	0.07130	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,749,662	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$227,747	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,521,915	NetCommunityBenefitExpnsAmt
Total Expense	0.00410	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$661,540	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$661,540	NetCommunityBenefitExpnsAmt
Total Expense	0.00180	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$693,387	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$22,126	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$671,261	NetCommunityBenefitExpnsAmt
Total Expense	0.00180	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$7,030	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$7,030	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,426,545	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,426,545	NetCommunityBenefitExpnsAmt
Total Expense	0.00380	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,538,164	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$249,873	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,288,291	NetCommunityBenefitExpnsAmt
Total Expense	0.01150	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$31,228,835	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$249,873	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$30,978,962	NetCommunityBenefitExpnsAmt
Total Expense	0.08280	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$16,685	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$16,685	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$17,128	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$17,128	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$101,971	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$101,971	NetCommunityBenefitExpnsAmt
Total Expense	0.00300	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$135,784	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$135,784	NetCommunityBenefitExpnsAmt
Total Expense	0.00300	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$12,242,102	BadDebtExpenseAmt
Reimbursed By Medicare	$113,412,898	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$180,568,798	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$67,155,900	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ST AGNES HOSPITAL	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	430 E DIVISION STREET	AddressLine1Txt
City	FOND DU LAC	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54935	ZIPCd

Field	Value	IRS element (for citing)
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	ST AGNES HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	14	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (1)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	www.agnesian.com	OwnWebsiteURLTxt
Other Website	Yes (X)	OtherWebsiteInd
Other Website URL	www.fdlco.wi.gov/home/showdocument?id=7260	OtherWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Rpt Available Thru Other Method	Yes (X)	RptAvailableThruOtherMethodInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	14	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	www.fdlco.wi.gov/home/showdocument?id=7260	StrategyWebsiteURLTxt
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	165.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	300.000000000000	FPGFamilyIncmLmtDscntCarePct
Income Level Criteria	Yes (X)	IncomeLevelCriteriaInd
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	WWW.AGNESIAN.COM/PAGE/FINANCIAL-ASSISTANCE	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	WWW.AGNESIAN.COM/PAGE/FINANCIAL-ASSISTANCE	FAPAppAvailableOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr Prvt	Yes (X)	LookBackMedicaidMedcrPrvtInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (8 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
ST. AGNES HOSPITAL	Part V, Section B, Line 5: THE CHNA WAS COMMISSIONED BY AGNESIAN HEALTHCARE (ST. AGNES HOSPITAL, WAUPUN MEMORIAL HOSPITAL, AND RIPON MEDICAL CENTER), FOND DU LAC AREA UNITED WAY, FOND DU LAC COUNTY HEALTH DEPARTMENT, FOND DU LAC FAMILY YMCA, AND FOND DU LAC SCHOOL DISTRICT. THE TASK FORCE REVIEWED COUNTY AND STATE SPECIFIC DISEASE INCIDENCE AND DEATH DATA, AS WELL AS ECONOMIC, DEMOGRAPHIC, AND HEALTH STATUS DATA. TO SUPPLEMENT THIS DATA, COMMUNITY AND STAKEHOLDER OPINION SURVEYS WERE CONDUCTED TO DETERMINE WHAT PEOPLE IN FDL COUNTY PERCEIVED AS THE MAJOR HEALTH PROBLEMS IN THE COUNTY. COMMUNITY MEMBERS WERE SCIENTIFICALLY SELECTED SO THAT THE SURVEY WOULD BE REPRESENTATIVE OF ALL ADULTS 18 YEARS OLD AND OLDER. A TOTAL OF 400 TELEPHONE INTERVIEWS WERE COMPLETED WITH COMMUNITY MEMBERS. IN ADDITION, ALL STUDENTS IN 8TH, 10TH, AND 11TH GRADES WERE ASKED TO PARTICIPATE IN AN ANONYMOUS AND CONFIDENTIAL SURVEY. THE 124-QUESTION SURVEY WAS ADMINSTERED BY TRAINED VOLUNTEERS AND STAFF. THE SCHOOL DISTRICTS OF CAMPBELLSPORT, FOND DU LAC, NORTH FOND DU LAC, ST. MARY'S SPRINGS ACADEMY, AND WINNEBAGO LUTHERAN ACADEMY PARTNERED TOGETHER TO CONDUCT THE IDENTICAL STUDENT HEALTH SURVEY. THE FOND DU LAC HEALTH 2020 COALITION, WHICH WAS FORMED AFTER THE PREVIOUS SURVEY, RESPONDED TO THE NEEDS IDENTIFIED IN THE CHNA. THE HEALTHY 2020 STEERING COMMITTEE INCLUDES THE FOLLOWING MEMBERS: DR. MATT DOLL, AGNESIAN HEALTHCARE PSYCHOLOGIST; ERIN GERRED, FOND DU LAC COUNTY; GREG GILES, YMCA; BILL LAMB, FOND DU LAC COUNTY POLICE DEPARTMENT; SR. MARY MOLLISON, AGNESIAN HEALTHCARE; LALITHA RAMAMOORTHY, MARIAN UNIVERSITY; LARRY RICHARDSON, FABOH; SANDI ROEHRIG, FOND DU LAC AREA FOUNDATION; MARTY RYAN, ROTARY; HEATHER SCHMIDT, DO, AGNESIAN HEALTHCARE; MARIAN SHERIDAN, FOND DU LAC SCHOOL DISTRICT; MICHELLE TIDEMANN, UW EXTENSION; DEANN THURMER, AGNESIAN HEALTHCARE; KATHERINE VERGOS, AGNESIAN HEALTHCARE; JENNIFER WALTERS, AURORA HEALTHCARE; GREG BREWER, AURORA HEALTHCARE; ALAN HATHAWAY, BROWN BOOTS INTERACTIVE; AMBER KILAWEE, FOND DU LAC AREA UNITED WAY; ERIC TONEY, FOND DU LAC COUNTY, KIM MUELLER, FOND DU LAC COUNTY HEALTH DEPARTMENT; KELLY NORTON, ST. MARY'S SPRINGS ACADEMY; TERI MATTEK, UW FOND DU LAC.THE HEALTHY 2020 COALITION HAS TAKEN THE LEAD ON DISTRIBUTION OF INFORMATION TO THE PUBLIC, AS WELL AS CONTINUING COMMUNITY UPDATES AND ASSESSMENT OF PROGRESS.
ST. AGNES HOSPITAL	Part V, Section B, Line 6a: HOSPITAlS INClUDED IN THE CHNA WERE AGNESIAN HEALTHCARE (ST. AGNES HOSPITAL), WAUPUN MEMORIAL HOSPITAL AND RIPON MEDICAl CENTER.
ST. AGNES HOSPITAL	Part V, Section B, Line 6b: THE CHNA WAS COMMISSIONED BY AGNESIAN HEALTHCARE, FOND DU LAC AREA UNITED WAY, FOND DU LAC COUNTY HEALTH DEPARTMENT, FOND DU LAC COUNTY YMCA, AND FOND DU LAC SCHOOL DISTRICT.
ST. AGNES HOSPITAL	Part V, Section B, Line 7d: THE HEALTHY 2020 COALITION MADE THE RESULTS OF THE CHNA WIDELY AVAILABLE THROUGH A SERIES OF COMMUNITY MEETINGS, DISTRIBUTION OF COMMUNITY HEALTH IMPROVEMENT PLAN FLYERS, NEWSPAPER ARTICLES, AND THE HEALTHY 2020 WEBSITE, WWW.LIVINGWELLFDL.ORG. IN ADDITION, THE FULL REPORT IS AVAILABLE ON THE FOND DU LAC COUNTY WEBSITE.
ST. AGNES HOSPITAL	Part V, Section B, Line 11: AS A RESULT OF THE CHNA CONDUCTED IN 2012 AND 2014, FOUR MAJOR AREAS OF CONCERN WERE DETERMINED, AND A STRATEGIC ACTION PLAN HAS BEEN DEVELOPED FOR EACH AREA.1) INCREASE THE NUMBER OF FDL COUNTY RESIDENTS WHO ARE AT A HEALTHY WEIGHT - AGNESIAN HEALTHCARE HAS COLLABORATED WITH THE YMCA BY HIRING AND PROVIDING FUNDING FOR A WELLNESS COORDINATOR FOR OUTREACH INTO THE COMMUNITY. THE WELLNESS COORDINATOR IS DEVELOPING AND IMPLEMENTING A COMMUNITY EDUCATION CAMPAIGN ON HEALTHY EATING AND ACTIVE LIVING, INCLUDING THE 5,2,1,0 CAMPAIGN IN THE SCHOOL DISTRICT.2) INCREASE DENTAL CARE ACCESS FOR CHILDREN AND ADULTS WITH MEDICAID - AGNESIAN HEALTHCARE HAS PROVIDED FUNDING TO FOND DU LAC COUNTY TO EXTEND THEIR PROGRAM TO PROVIDE DENTAL CARE TO ADuLTS WHO DO NOT CURRENTLY HAVE ACCESS TO DENTAL CARE. IN ADDITION, AGNESIAN HEALTHCARE HAS PROVIDED FUNDING TO THE SAVE A SMILE INITIATIVE, WHICH PROVIDES ACCESS TO DENTAL CARE FOR CHILDREN UTILIZING THE MEDICAID PROGRAM.3) IMPROVE MENTAL HEALTH ACCESS - AGNESIAN HEALTHCARE ASSOCIATES ARE PARTICIPATING ON A COMMUNITY-WIDE TASK FORCE TO PROVIDE EDUCATIONAL PROGRAMS TO DECREASE THE STIGMA SURROUNDING MENTAL HEALTH ISSUES. AGNESIAN HEALTHCARE IS PARTNERING WITH THE YMCA TO PROVIDE CITY AND COUNTY EVENTS AND EDUCATION. FUNDING HAS ALSO BEEN PROVIDED TO SHARDS, A MENTAL HEALTH PROVIDER WHICH PROVIDES MENTAL HEALTH COUNSELING TO THOSE WITHOUT INSURANCE.4) DECREASE BINGE DRINKING AND DRUG AbUSE/MISUSE AMOUNG YOUNG AND ADULTS - THE TASK FORCE IS WORKING WITH COMMUNITIES TO IMPLEMENT BEST PRACTICES AS DESCRIBED IN THE COMMUNITY EVENTS TOOLKIT. ITS STRATEGIES INCLUDE IMPLEMENTING AN APPROACH TO ADDRESS HEROIN/OPIOD ABUSE AND IS also UTILIZING A MEDIA/MARKETING CAMPAIGN TO RAISE AWARENESS, AND ACTIVELY DISCOURAGE BINGE DRINKING AND OVER-CONSUMPTION.THE HOSPITAL IS PARTICIPATING IN THE INITIATIVES NOTED ABOVE TO ADDRESS THE NEEDS IDENTIFIED IN CHNA. OUR INITIATIVES ARE ALREADY SHOWING POSITIVE RESULTS. THE UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE PRODUCES A WELL-KNOWN DOCUMENT TITLED "COUNTY HEALTH RANKINGS AND ROADMAPS". THE MOST CURRENT REPORT SHOWS THAT FOND DU LAC COUNTY HAS IMPROVED FROM THE HEALTH FACTORS RANK OF 20 TO RANK OF 16 IN THE STATE. IN ORDER TO FURTHER HELP COMMUNITY MEMBERS TAKE POSITIVE STEPS IN IMPROVING THEIR HEALTH, AGNESIAN HEALThCARE DISTRIBUTED 2017 WELLNESS CALENDARS TO 75,000 RESIDENTS.
ST. AGNES HOSPITAL	Part V, Section B, Line 13b: PATIENTS AND THEIR GURANTOR'S INCOME IS USED IN DETERMINING INCOME LEVEL FOR FREE OR DISCOUNTED CARE.
ST. AGNES HOSPITAL	Part V, Section B, Line 18e: COLLECTION AGENCIES ARE ENGAGED TO COLLECT UNPAID BALANCES. THESE AGENCIES ARE AUTHORIZED TO REPORT TO CREDIT AGENCIES. COLLECTION AGENCIES ARE AUTHORIZED BY THE HOSPITAL TO ESTABLISH GARNISHMENT AGAINST WAGES ON UNPAID BALANCES THEY ARE ATTEMPTING TO COLLECT. THESE ACTIONS ARE NOT UNDERTAKEN UNTIL REASONABLE EFFORTS TO DETERMINE THE PATIENT'S ELIGIBILITY UNDER THE GAP HAVE BEEN MADE.Agnesian healthcare does not take any of the actions against an individual that are listed in 18a - 18d.
Part V, Line 22	UNINSURED PATIENTS RECEIVE A DISCOUNT AT THE TIME THE UNDISCOUNTED CHARGES ARE RENDERED. THIS APPLIES TO PATIENTS WITH NO COVERAGE FOR PAYMENT FROM HEALTH CARE INSURANCE AND/OR OTHER THIRD PARTY PAYORS.

Field	Value	IRS element (for citing)
Facility	3	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
1 - AGNESIAN HEALTHCARE ENTERPRISES LLC
430 E DIVISION STREET	FOND DU LAC	WI	54935	PHARMACEUTICALS, HOME HEALTH, MEDICAL SUPPLIES
2 - CONSULTANTS LAB OF WISCONSIN LLC
430 E DIVISION STREET	FOND DU LAC	WI	54935	LABORATORY AND TESTING
3 - FOND DU LAC REGIONAL CLINIC
420 E DIVISION STREET	FOND DU LAC	WI	54935	OUTPATIENT PHYSICIAN CLINIC

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part I, Line 3c:	Agnesian healthcare does not use any other factors than federal poverty guidelines to determine eligibility.
Part I, Line 6a:	An annual community benefit report is completed by the finance department and distributed to the public through the public relations office of agnesian healthcare, inc.
Part I, Line 7:	A COST-TO-CHARGE RATIO WAS USED TO COMPUTE COST OF COMMUNITY BENEFIT SERVICES. OVERALL COSTS LESS TAXES WERE DIVISIBLE BY TOTAL CHARGES.
Part I, Line 7g:	Agnesian healthcare subsidizes a samaritan clinc and palliative care for those that qualify.
Part I, Ln 7 Col(f):	The bad debt expense that was included on Form 990, Part VIII and therefore not considered in the percentage calculation for purposes of Part I, line 7, col(f) is 12,242,102.
Part II, Community Building Activities:	Agnesian healthcare provides community support, leadership development and training for community members, coalition building and workforce development through their community benefit activities.
Part III, Line 4:	THE CARRYING AMOUNTS OF ACCOUNTS RECEIVABLE ARE REDUCED BY ALLOWANCES THAT REFLECT MANAGEMENT'S BEST ESTIMATE OF THE AMOUNTS THAT WILL NOT BE COLLECTED. MANAGEMENT PROVIDES FOR CONTRACTUAL ADJUSTMENTS UNDER TERMS OF THIRD-PARTY REIMBURSEMENT AGREEMENTS THROUGH A CHARGE TO CONTRACTUAL ADJUSTMENTS AND A CREDIT TO THE ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS. IN ADDITION, MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY FROM UNINSURED PATIENTS AND AMOUNTS PATIENTS ARE PERSONALLY RESPONSIBLE FOR, THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO A VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF HISTORICAL COLLECTION LIKELIHOOD AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUTSTANDING AFTER MANAGEMENT HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO ACCOUNTS RECEIVABLE. THE COSTING METHODOLOGY FOR DETERMINING BAD DEBTS IS A COST TO CHARGE RATIO.
Part III, Line 8:	MEDICARE SHORTFALL IS NOT TREATED AS A COMMUNITY BENEFIT. TO ARRIVE AT COST OF MEDICARE SERVICES, THE TOTAL EXPENSE LESS OTHER OPERATING REVENUE IS MULTIPLIED BY THE RATIO OF MEDICARE REVENUE TO TOTAL REVENUE.ALTHOUGH MEDICARE SHORTFALL HAS NOT BEEN REPORTED AS A COMMUNITY BENEFIT, IT SHOULD BE TREATED AS A COMMUNITY BENEFIT BECAUSE IT PROMOTES ACCESS TO HEALTHCARE TO THE UNDERSERVED ELDERLY POPULATION, WHO WOULD NOT HAVE ACCESS TO LOCAL CARE IF WE WERE NOT ABLE TO SERVE THEM. ALTHOUGH OUR HOSPITAl IS EFFICIENTLY OPERATED, THE CAlCUlATIONS USED FOR MEDICARE REIMBURSEMENT DO NOT ALLOW FOR PAYMENTS THAT COVER COSTS OF NECESSARY SERVICES.
Part III, Line 9B	ST. AGNES HOSPITAL HAS A WRITTEN DEBT COLLECTION POLICY. PAYMENT IS DUE WITHIN 30 DAYS OF RECEIPT OF A STATEMENT. IF PATIENTS DO NOT SET UP ACCEPTABLE PAYMENT ARRANGEMENTS, BILLS WILL BE REFERRED TO AN OUTSIDE COLLECTION AGENCY. FINANCIAL COUNSELORS WORK WITH ALL PATIENTS ON AN INDIVIDUAL BASIS AND MAY OFFER EXTENDED MONTHLY PAYMENTS WITHOUT INTEREST BASED ON DOLLAR AMOUNT, PRIVATE PAY DISCOUNTS (INDIVIDUALS WHO DO NOT HAVE INSURANCE COVERING EMERGANCY OR OTHER MEDICALLY NECESSARY CARE ARE BILLED AT A REDUCED RATE), OR GUARANTEED BANK LOANS.A ZERO DOLLAR AMOUNT WAS ESTIMATED FOR THE AMOUNT OF BAD DEBTS ATTRIBUTABLE TO PATIENTS WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE. IF PATIENTS QUALIFY, THEIR EXPENSES ARE RECLASSIFIED AS CHARITY CARE. PATIENTS WHO RECEIVED A COLLECTION NOTICE COULD APPLY FOR CHARITY CARE. IF THEIR APPLICATION IS APPROVED, THIS WOULD TRIGGER A TRANSFER OF EXPENSES FROM BAD DEBT TO CHARITY CARE.
Part VI, Line 2:	IN ADDITION TO THE CHNA NOTED ABOVE, THE HOSPITAL'S SENIOR LEADERS MEET REGULARLY WITH COMMUNITY LEADERS TO GATHER INPUT FROM AND RESPOND TO PATIENT AND CUSTOMER NEEDS. SENIOR LEADERS AND MEMBERS OF THE WORKFORCE PARTICIPATE IN A VARIETY OF ORGANIZATIONS IN SUPPORT OF St. Agnes Hospital's kEY COMMUNITIES. THROUGH THE HOSPITAL'S PARTICIPATION IN THESE ACTIVITIES, COMMUNITY MEMBERS LEARN OF THE HOSPITAL'S COMMITTMENT TO COMMUNITY-WIDE HEALTHCARE AND PROVIDE ST. AGNES HOSPITAL WITH INSIGHTS INTO COMMMUNITY HEALTH NEEDS AND DESIRES.
Part VI, Line 3:	FINANCIAL COUNSELORS AT ST. AGNES HOSPITAL ASSIST PATIENTS WITH APPLICATION FOR COMMUNITY CARE. PATIENTS CAN BE REFERRED TO COMMUNITY CARE BY CLERGY, DEPARTMENTS OF ST. AGNES HOSPITAL, SISTERS OF ST. AGNES, PHYSICIANS, AREA SOCIAL AND HEALTH AGENCIES, FAMILY OR SELF. THE APPLICATION IS COMPLETED BY THE PATIENT WITH ASSISTANCE FROM THE FINANCIAL COUNSELOR IF NEEDED. THE FINANCIAL COUNSELOR WILL COMMUNICATE TO THE PATIENT WHAT PROGRAMS THEY WILL BE ELIGIBLE FOR, AS WELL AS PROVIDE NOTIFICATION OF APPROVAL OR DENIAL OF THEIR APPLICATION IN A TIMELY MANNER.
Part VI, Line 4:	COMMUNITY CARE APPLICATIONS ARE ACCEPTED ONLY FROM PATIENTS OF ST. AGNES HOSPITAL WHO RESIDE IN THE COUNTIES OF DODGE, FOND DU LAC OR GREEN LAKE IN THE STATE OF WISCONSIN. INDIVIDUALS MUST BE A RESIDENT OF ONE OF THESE AREAS FOR A MINIMUM OF THREE MONTHS AND PROVIDE SUPPORTING DOCUMENTATION. ON OCCASION, INDIVIDUALS ARE NOT COMMUNITY MEMBERS BUT MAY NEED ASSISTANCE; THOSE APPLICATIONS ARE CONSIDERED ON A CASE-BY-CASE BASIS.
Part VI, Line 5:	WHILE THERE IS GROWING AGREEMENT IN THE UNITED STATES ABOUT WHAT CONSTITUTES A NON-PROFIT HOSPITAL'S "COMMUNITY BENEFIT", THIS IS A WORK IN PROGRESS. OUR HOSPITAL PROVIDES SIGNIFICANT CHARITY CARE AND OTHER COMMUNITY BENEFIT AS DEFINED BY THE IRS. BUT IN ADDITION, WE BELIEVE THAT WE PROVIDE A CRITICALLY IMPORTANT COMMUNITY BENEFIT WHICH IS NOT QUANTIFIED. OUR HOSPITAL, LIkE MOST HOSPITALS, WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE CARE LOCALLY - CARE THAT, WITHOUT OUR HOSPITAL, WOULD NOT BE AVAILABLE LOCALLY, BEYOND INPATIENT HOSPITALIZATIONS, WE PROVIDE LOCAL ACCESS TO MANY HEALTH SERVICES: DIALYSIS CENTER, DIAGNOSTICS, EMERGENCY SERVICES & URGENT CARE, EXTENDED CARE, INFUSION SERVICES, INPATIENT CARE, LABORATORY SERVICES, OCCUPATIONAL HEALTH REHABILITATION SERVICES, SPECIALTY MEDICINE, SPEECH AND AUDIOLOGY, SURGICAL SERVICES, AND WOMEN'S SERVICES.
Part VI, Line 6:	ST. AGNES HOSPITAL IS PART OF AGNESIAN HEALTHCARE, AN INTEGRATED, COMPREHENSIVE NOT-FOR-PROFIT HEALTHCARE DELIVERY SYSTEM COMPRISED OF TEN MINISTRIES: AGNESIAN HEALTHCARE ENTERPRISES, LLC, CONSULTANTS LAB OF WI, LLC, FOND DU LAC REGIONAL CLINIC, ST. AGNES HOSPITAL, ST. FRANCIS HOME, SISTER SERVANTS OF CHRIST THE KING VILLA LORETTO NURSING HOME, VILLA ROSA, INC, CHRISTIAN HOME, WAUPUN MEMORIAL HOSPITAL AND RIPON MEDICAL CENTER. AGNESIAN PROVIDES A CONTINUUM OF HEALTHCARE FROM BIRTH TO END OF LIFE, PREVENTIVE CARE, DIAGNOSIS, TREATMENT AND FOLLOWUP, ASSISTED LIVING, AND INDEPENDENT AND SKILLED CARE SERVICES. AGNESIAN HEALTHCARE IS COMMITTED TO ENSURING THAT INDIVIDUALS NEEDING VITAL HEALTHCARE SERVICES GET THE HELP THEY NEED AND DESERVE.
Part VI, Line 7, Reports Filed With States	WI

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Idemnification Gross Up Pmts	Yes (X)	IdemnificationGrossUpPmtsInd
Club Dues Or Fees	Yes (X)	ClubDuesOrFeesInd
Written Policy Ref T And E Expnss	Yes (1)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (1)	SubstantiationRequiredInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	Yes (1)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (1)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	Yes (1)	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (17 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
STEVEN N LITTLE
PRESIDENT AND CEO	$681,981	$0	$168,050	$0	$58,901	$0	$13,861	$0	$25,521	$0	$948,314	$0	$0	$0
JAMES P MUGAN
SR VP CLINICAL SERVICES	$280,554	$0	$36,934	$0	$14,532	$0	$15,847	$0	$25,434	$0	$373,301	$0	$0	$0
BONNIE R SCHMITZ
CHIEF FINANCIAL OFFICER	$409,577	$0	$55,849	$0	$23,121	$0	$18,040	$0	$9,818	$0	$516,405	$0	$0	$0
SUSAN L EDMINSTER
VP - HUMAN RESOURCES	$277,979	$0	$36,164	$0	$1,242	$0	$15,467	$0	$28,243	$0	$359,095	$0	$0	$0
NANCY A BIRSCHBACH
VP - CIO	$298,544	$0	$38,775	$0	$990	$0	$13,861	$0	$29,305	$0	$381,475	$0	$0	$0
Barbara L Knutzen
Pres and ceo-ahe and perfo	$234,758	$0	$30,607	$0	$3,068	$0	$12,553	$0	$20,926	$0	$301,912	$0	$0	$0
Holly brenner
vp strategic development/m	$249,156	$0	$30,387	$0	$13,859	$0	$13,146	$0	$1,343	$0	$307,891	$0	$0	$0
Michael Degere
VP population health manag	$310,877	$0	$40,732	$0	$35,667	$0	$15,900	$0	$24,406	$0	$427,582	$0	$0	$0
Michael Drees
chief operating officer fd	$241,062	$0	$32,004	$0	$8,606	$0	$14,736	$0	$30,017	$0	$326,425	$0	$0	$0
Katherine Vergos
Chief Nursing Officer	$222,910	$0	$29,610	$0	$6,439	$0	$12,072	$0	$4,062	$0	$275,093	$0	$0	$0
JOHN CHOI MD
ANESTHESIOLOGIST - PAIN RE	$609,011	$0	$143,936	$0	$2,322	$0	$15,900	$0	$22,179	$0	$793,348	$0	$0	$0
YASIR HATAHET MD
INTENSIVIST/pulmonologist	$482,971	$0	$377,801	$0	$94,614	$0	$14,571	$0	$31,407	$0	$1,001,364	$0	$0	$0
MICHAEL VANDER KOOY MD
RADIATION ONCOLOGIST	$620,647	$0	$0	$0	$51,536	$0	$15,900	$0	$30,860	$0	$718,943	$0	$0	$0
michael freeland MD
intensivist	$421,547	$0	$7,200	$0	$199,972	$0	$15,390	$0	$22,177	$0	$666,286	$0	$0	$0
allen foster md
physician - sleep medicine	$328,006	$0	$324,241	$0	$1,242	$0	$15,390	$0	$27,728	$0	$696,607	$0	$0	$0
MARY j MOLLISON
FORMER VP SPIRITUALITY AND CARE	$189,984	$0	$32,964	$0	$5,051	$0	$0	$0	$8,714	$0	$236,713	$0	$0	$0
JILL A STENSON
FORMER vp NURSING	$222,383	$0	$29,835	$0	$6,878	$0	$11,516	$0	$12,591	$0	$283,203	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part I, Line 1a	ALL GROSSUP PAYMENTS AND SOCIAL CLUB DUES ARE INCLUDED ON FORM 1099. These payments are made for a current and former member of the board of directors.
Part I, Lines 4a-b	ALL EXECUTIVES PARTICIPATE IN A 457(B) SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. JILL STENSON WAS PAID SEVERANCE PAY OF $71,739. THIS PAYMENT WAS COMPLETED IN THIS FISCAL YEAR; NO FURTHER RESTRICTIONS EXIST.
Part I, Line 5	COMPENSATION FOR SOME EMPLOYED PHYSICIANS IS BASED ON A PERCENTAGE OF GROSS BILLINGS.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
WI HEALTH AND EDUC FACILITIES AUTHORITY
A	391337855	97710Bgg1	2008-12-11	$49,330,000	REFUNDING OF 2001 ISSUE, PRIVATE ROOM PROJECT	0	0	0
WI HEALTH AND EDUC FACILITIES AUTHORITY
B	391337855	97710BYW6	2010-12-01	$57,260,000	REFUNDING OF 2001 ISSUE, PRIVATE ROOM PROJECT	0	0	0
WI HEALTH AND EDUC FACILITIES AUTHORITY
C	391337855	NONEAVAIL	2011-12-15	$10,020,000	PARTIAL REFUNDING OF 1998 ISSUE	0	0	0
WI HEALTH AND EDUC FACILITIES AUTHORITY
D	391337855	97710B7C0	2013-03-14	$5,705,000	CONSTRUCTION AND EXPANSION OF FACILITIES	0	0	0

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Total ProceedsTotalProceedsAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Working Capital ExpendituresWorkingCapitalExpendituresAmt	Substantial CompletionSubstantialCompletionYr	Current RefundingCurrentRefundingInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd	In Reserve FundInReserveFundAmt	Refunding EscrowRefundingEscrowAmt	Capital ExpendituresCapitalExpendituresAmt	Capitalized InterestCapitalizedInterestAmt
A	$5,625,000	$49,330,000	$430,000	$48,900,000	2005	Yes (1)	Yes (1)	Yes (1)
B	$8,015,000	$57,260,000	$767,686		2014	Yes (1)	Yes (1)	Yes (1)	$4,518,399	$31,465,565	$20,498,350
C	$6,186,000	$10,020,000	$90,000		2011	Yes (1)	Yes (1)	Yes (1)		$9,930,000
D	$210,000	$5,705,000	$32,111		2015	0	Yes (1)	Yes (1)			$5,672,889	$61,653

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCd	Private Bus Use By OthersPrivateBusUseByOthersPct	Total Private Business UseTotalPrivateBusinessUsePct	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	0.01470	0.01470	Yes (1)	Yes (1)
B			Yes (1)	Yes (1)
C			Yes (1)	Yes (1)
D			Yes (1)	Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Term Of HedgeTermOfHedgePct	Superintegrated HedgeSuperintegratedHedgeInd	Hedge TerminatedHedgeTerminatedInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
Piper jaffray
A	Yes (1)	Yes (1)	Yes (1)	28.000000000000	0	0	0	0	Yes (1)
(no name)
B	Yes (1)	0	0				0	0	Yes (1)
(no name)
C	Yes (1)	0	0				0	0	Yes (1)
(no name)
D	Yes (1)	0	0				0	0	Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (1)
B	Yes (1)
C	Yes (1)
D	Yes (1)

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	WI HEALTH AND EDUC FACILITIES AUTHORITY	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Bond Issuer EIN	391337855	BondIssuerEIN
CUSIP	97710B7C0	CUSIPNum
Bond Issued	2013-03-14	BondIssuedDt
Issue Price	$53,276,496	IssuePriceAmt
Purpose	conSTRUCTION AND EXPANSION OF FACILITIES	PurposeDesc
Defeased	0	DefeasedInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Pool Financing	0	PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Total Proceeds	$53,276,496	TotalProceedsAmt
Capitalized Interest	$569,394	CapitalizedInterestAmt
Issuance Costs From Proceeds	$296,559	IssuanceCostsFromProceedsAmt
Capital Expenditures	$52,979,937	CapitalExpendituresAmt
Substantial Completion	2015	SubstantialCompletionYr
Current Refunding	0	CurrentRefundingInd
Advance Refunding	0	AdvanceRefundingInd
Final Allocation Made	Yes (1)	FinalAllocationMadeInd
Adequate Books And Rec Maint	Yes (1)	AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Owning Bond Financed Property	0	OwningBondFinancedPropertyInd
Any Lease Arrangements	0	AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop	0	MgmtContractBondFincdPropInd
Any Research Agreements	0	AnyResearchAgreementsInd
Bond Iss Meet Prvt Sec Pymt Test	Yes (1)	BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop	0	ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond Remdtd	Yes (1)	ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	Yes (1)	Form8038TFiledInd
Variable Rate Issue	0	VariableRateIssueInd
Hedge Identified In Bks And Rec	0	HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC	0	GrossProceedsInvestedInGICInd
Gross Proceeds Invested	0	GrossProceedsInvestedInd
Written Proc To Monitor Reqs	Yes (1)	WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Procedures Corrective Action	Yes (1)	ProceduresCorrectiveActionInd

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
Richard Schaefer md
director	$84,928	richard schaefer's wife, evelyn schaefer, is employed as a psychologist at agnesian healthcare, earning an annual salary of $84,928.	0
WAYNE MATZKE
VICE CHAIRPERSON	$2,632,790	WAYNE MATZKE WAS THE PRESIDENT OF GRANDE CHEESE AND RETIRED IN FEBRUARY 2017. AGNESIAN HEALTHCARE, INC PROVIDES A HEALTH CARE CLINIC TO GRANDE CHEESe, BILLING $2,632,790 OF THESE SERVICES IN FISCAL YEAR 2017.	0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part VI	AN ANNUAL SURVEY IS PERFORMED BY AN OUTSIDE COMPANY.
Form 990, Part VI, Section A, line 6	The organization has two classes of members - Class a members WHO ARE MEMBERS of the Congregation of the Sisters of St. Agnes and Class B members who constitute the Board of Directors.
Form 990, Part VI, Section A, line 7a	The Class A members, who are THE GENERAL COUNCIL OF THE CONGREGATION OF SISTERS OF ST. AGNES, HAVE THE POWER TO ELECT OR APPOINT THE CLASS B MEMBERS. THE CLASS B MEMBERS CONSTITUTE THE BOARD OF DIRECTORS. THE CLASS B MEMBERS HAVE THE POWER, UPON THE RECOMMENDATION OF THE BOARD OF DIRECTORS, TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, THE PRESIDENT/CHIEF EXECUTIVE OFFICER OF THE CORPORATION.
Form 990, Part VI, Section A, line 7b	THE CONGREGATION OF THE SISTERS OF ST. AGNES SPONSORSHIP MINISTRIES IS THE CLASS B MEMBER WHO IS RESPONSIBLE FOR APPROVING CERTAIN RESERVED POWERS OF THE CORPORATION DELEGATED TO THEM BY CLASS A. THE GENERAL COUNCIL OF THE CONGREGATION OF SISTERS OF ST. AGNES IS THE CLASS A MEMBER WHO IS RESPONSIBLE FOR APPROVING CERTAIN RESERVED POWERS OF THE CORPORATION.
Form 990, Part VI, Section B, line 11b	THE FINANCE DEPARTMENT PREPARES THE FORM 990 AND THE RETURN IS REVIEWED BY THE DIRECTOR OF FINANCE AND CFO. A FINAL COPY OF THE 2016 FORM 990 IS PROVIDED TO THE BOARD EXECUTIVE COMMITTEE FOR REVIEW AND APPROVAL TO THE AGNESIAN HEALTHCARE BOARD BEFORE THE RETURN IS FILED WITH THE IRS.
Form 990, Part VI, Section B, line 12c	A WRITTEN CONFLICT OF INTEREST AND INSIDER TRANSACTION POLICY EXISTS WHICH REQUIRES EACH DIRECTOR, PRINCIPAL OFFICER, TRUSTEE OR COMMITTEE MEMBER TO DISCLOSE ON AN ANNUAL BASIS TO THE DeSIGNATED AUTHORITY A CONFLICT OF INTEREST DISCLOSURE STATEMENT. THE DESIGNATED AUTHORITY ENSURES THAT ALL STATEMENTS ARE COMPLETED, REVIEWS THEM FOR CONFLICTS, AND SUBMITS TO THE BOARD FOR REVIEW ANY CONFLICT OF INTEREST DISCLOSURE STATEMENTS THAT DISCLOSE ACTUAL OR POTENTIAL CONFLICTS.
Form 990, Part VI, Section B, line 15	DETERMINATION OF COMPENSATION OF THE CEO AND OFFICERS INCLUDES ANALYSIS OF COMPARABLE COMPENSATION SURVEYS BY AN INDEPENDENT COMPENSATION CONSULTANT, WHO RECOMMENDS RANGES OF APPROPRIATE COMPENSATION TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS APPROVES THE COMPENSATION PACKAGE FOR OFFICERS, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATIONS AND DECISION IS INCLUDED IN THE BOARD MINUTES. THE FINAL AGREEMENT IS DOCUMENTED WITH A WRITTEN CONTRACT, WHICH IS SIGNED BY BOTH PARTIES.
Form 990, Part VI, Section C, line 19	AGNESIAN HEALTHCARE'S POLICY AND PROCEDURE FIN1069 DEFINES THE PROCEDURE FOR MAKING ANNUAL INFORMATION RETURNS AVAILABLE FOR PUBLIC INSPECTION. INDIVIDUALS REQUESTING INSPECTION ARE REFERRED TO THE ADMINISTRATION OFFICE, WHERE THEY ARE PROVIDED WITH THE DOCUMENTS AND A CONFERENCE ROOM FOR INSPECTING DOCUMENTS. PHOTOCOPIES WILL BE PROVIDED TO THE REQUESTOR. ANYONE MAY INSPECT THE RETURNS UPON DEMAND, WITHOUT AN APPOINTMENT OR ANY FOREWARNING, DURING AGNESIAN HEALTHCARE INC'S NORMAL BUSINESS HOURS. GOVERNING DOCUMENTS AND CONFLICT OF INTEREST STATEMENTS ARE NOT AVAILABLE FOR PUBLIC INSPECTION, BUT CAN BE MADE AVAILABLE IF THE REQUESTING PARTY HAS A BONAFIDE REASON. ALL FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC THROUGH A POSTING ON A PUBLIC WEBSITE.
Form 990, Part IX, line 11g	Purchased Services - Physician services: Program service expenses 7,118,764. Management and general expenses 0. Fundraising expenses 0. Total expenses 7,118,764. Purchased Services - Laboratory: Program service expenses 211,861. Management and general expenses 6,346. Fundraising expenses 0. Total expenses 218,207. Purchased Services - Elevator: Program service expenses 3,515. Management and general expenses 138,641. Fundraising expenses 0. Total expenses 142,156. Purchased Services - Miscellaneous: Program service expenses 59,813,109. Management and general expenses 2,505,935. Fundraising expenses 0. Total expenses 62,319,044. PURCHASED SERVICEs - TEMPORARY STAFF: Program service expenses 793,974. Management and general expenses 7,765. Fundraising expenses 0. Total expenses 801,739. Purchased Services - Reference Tests: Program service expenses 1,095,647. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,095,647. Purchased Services - Housekeeping: Program service expenses 76,960. Management and general expenses 0. Fundraising expenses 0. Total expenses 76,960. Professional Fees: Program service expenses 579,693. Management and general expenses 179,734. Fundraising expenses 0. Total expenses 759,427. Professional Fees - Medical Director: Program service expenses 248,426. Management and general expenses 14,000. Fundraising expenses 0. Total expenses 262,426. Professional Fees - Collection: Program service expenses 4,883. Management and general expenses 971,480. Fundraising expenses 0. Total expenses 976,363. Purchased Services - Laundry: Program service expenses 0. Management and general expenses 752,328. Fundraising expenses 0. Total expenses 752,328. Purchased Services - Transcription: Program service expenses 0. Management and general expenses 221,816. Fundraising expenses 0. Total expenses 221,816.
Form 990, Part XI, line 9:	capital contributions from affiliates change in swap fund balance 949,684. change in fund balance - sah foundation 1,081,728. capital contributions - foundation 1,447,574. CSA Legacy Contributions -5,000,000.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Total IncomeTotalIncomeAmt	End Of Year AssetsEndOfYearAssetsAmt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
CONSULTANTS LABORATORY OF WISCONSIN LLC
430 E DIVISION STREET	FOND DU LAC	WI	54935	391528550	LAB SERVICES	WI	$28,477,190	$30,974,097	agnesian healthcare INC
AGNESIAN HEALTHCARE ENTERPRISES LLC
430 E DIVISION STREET	FOND DU LAC	WI	54935	392038757	RETAIL PHARMACY	WI	$10,436,655	$8,999,250	agnesian healthcare INC

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd	Direct Controlling NADirectControllingNACd
ST FRANCIS HOME OF FOND DU LAC
33 EVERETT STREET	FOND DU LAC	WI	54935	391029998	NURSING HOME	WI	501(C)(3)	Line 10	agnesian healthcare INC	Yes (1)
CONGREGATION OF SISTERS OF ST AGNES
320 COUNTY ROAD K	FOND DU LAC	WI	54935	390806217	CONVENT	WI	501(C)(3)	Line 1		0	N/A
AGNESIAN HEALTHCARE FOUNDATION
430 E DIVISION STREET	FOND DU LAC	WI	54935	391684956	FOUNDATION	WI	501(C)(3)	PF		0	N/A
WAUPUN MEMORIAL HOSPITAL
620 WEST BROWN STREET	WAUPUN	WI	53963	390806265	HOSPITAL	WI	501(C)(3)	Line 3	agnesian healthcare INC	Yes (1)
RIPON MEDICAL CENTER
845 PARKSIDE STREET	RIPON	WI	54971	391101287	HOSPITAL	WI	501(C)(3)	Line 3	AGNESIAN HEALTHCARE INC	Yes (1)
villa rosa inc
N8120 county ww	mount calvary	WI	53057	421670962	nursING HOME	WI	501(c)(3)	Line 10	agnesian healthcare INC	Yes (1)
Sister servants of christ the king
n8114 county ww	mount calvary	WI	53057	391022770	nurSING HOME	WI	501(c)(3)	Line 10	AGNESIAN HEALTHCARE INC	Yes (1)
THE CHRISTIAN HOME & REHABILITATION CENTER
331 BLY STREET	WAUPUN	WI	53963	390884514	NURSING HOME	WI	501(c)(3)	Line 10	AGnesian healthcare INC	Yes (1)

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	0	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (1)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	Yes (1)	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	0	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (1)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	0	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (1)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	0	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	0	TransferToOtherOrgInd
Transfer From Other Org	Yes (1)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (6 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
AGNESIAN HEALTHCARE FOUNDATION INC
C	$985,901	CASH RECEIPTS
ST FRANCIS HOME
D	$5,000,000	BOND VALUE
ST FRANCIS HOME
M	$71,047	CASH PAYMENTS
WAUPUN MEMORIAL HOSPITAL
P	$440,702	CASH TRANSFER
ripon medical center
P	$81,913	cash tRANSFER
THE CHRISTIAN HOME & REHABILITATION CENTER
M	$102,167	CASH PAYMENTS