2018-05-14T20:02:34-05:00 2017-06-30 990 2016-07-01 391834639 Columbia St Mary's Inc COLU 3147338000 400 West River Woods Parkway Glendale WI 53212 Tonya Mershon Tax Officer 2017-10-23 2016 2022-09-23 18:48:47Z X Bernard Sherry Sr VP 400 West River Woods Parkway Glendale WI 53212 206582248 false X columbia-stmarys.org X 2001 WI To improve the health and well-being of all people in the communities we serve. X 9 8 683 1 64000 4333 541763 330533 144265947 205817467 631720 -66525 1272942 425159 146712372 206506634 650500 644384 0 26844327 57357346 0 0 0 99632399 150346169 127127226 208347899 19585146 -1841265 220506061 214869341 198401807 493501387 22104254 -278632046 Our Mission as part of a Catholic health care system is to further the healing ministry of Jesus by continually improving the health and well-being of all people, especially the poor, in the communities we serve. false false 154602101 644384 205753467 Columbia St. Mary's, Inc. EXISTS AS THE PARENT CORPORATION IN THE Columbia St. Mary's sYSTEM, WHICH IS COMPRISED OF THREE HOSPITALS, (COLUMBIA ST. MARY'S HOSPITAL MILWAUKEE INC, COLUMBIA ST. MARY'S HOSPITAL OZAUKEE INC, AND SACRED HEART REHABILITATION INSTITUTE INC.), 61 COMMUNITY CLINICS, THE COLUMBIA COLLEGE OF NURSING, A PARTNERSHIP WITH THE ORTHOPAEDIC HOSPITAL OF WISCONSIN, A PARTNERSHIP WITH THE SLEEP WELLNESS INSTITUTE, AND FIVE URGENT CARE CENTERS. 154602101 true true false true false false false false false false true false true true true true false true false false false false false false false false true true true false true false false false false false false false false false false false true false true true true false false true 89 0 true 683 true true true false false false false false false false false false X 9 8 false false false false true true true true true false false false true true true true true false true false X David Mannes Controller 4144654589 400 W River Woods Pkwy Glendale WI 53212 WILLIAM C WERNER CHAIR (START 9/2016) 0.2 1.9 X X 0 0 101 ROBERT J VENABLE VICE CHAIR 0.2 1.9 X X 0 0 101 RANDALL PERRY Secretary 0.2 1.9 X X 0 0 101 KURT D VELDHUIZEN CPA TREASURER (START 9/2016) 0.2 1.9 X X 0 0 101 BERNARD J SHERRY SR VP - ASCENSION WI (START 9/2016) 7.0 44.0 X X 0 1559311 45520 SISTER M THERESE GOTTSCHALK DIRECTOR (START 9/2016) 0.2 7.6 X 0 0 0 JOHN BYKOWSKI DIRECTOR (START 9/2016) 0.3 2.5 X 0 0 101 JOHN SPLUDE DIRECTOR (START 9/2016) 0.2 1.9 X 0 0 101 PATRICIA DOLHUN MD Director 0.2 1.9 X 0 0 101 JONATHAN SOHN CFO - ASCENSION, WI 7.0 39.0 X 0 707247 95164 TIMOTHY WALDOCH INTERIM CFO (END 12/2016) 10.0 36.0 X 252913 0 18219 Vincent Gallucci Chief Marketing Officer - Ascension WI 13.0 27.0 X 0 504634 8231 Sarah Herzog Chief Legal Officer - Ascension WI 10.0 30.0 X 0 571731 46286 Douglas Reding MD Chief Medical Officer - Ascension WI (START 10/2016) 14.0 33.0 X 0 616522 34486 Tracy A Rogers Chief Operating Officer - Ascension WI 9.0 32.0 X 0 1380803 41883 Celia Shaughnessy Chief HR Officer - Ascension WI 10.0 30.0 X 0 430073 29945 TRAVIS D ANDERSEN Regional President - South Market 17.0 27.0 X 1214959 0 43221 Timothy Belec Chief Information Officer - Ascension WI (start 11/2016) 20.0 20.0 X 0 303004 25930 Lisa Benson MD Chief Quality Officer - Ascension WI (start 10/2016) 20.0 20.0 X 0 283090 12058 KEVIN KLUESNER Chief Admin Officer, AW South 36.0 31.0 X 261820 0 40319 Therese Rocole Chief Ministry Officer - Ascension WI 13.0 27.0 X 0 303861 32805 Lynn Schuster Regional Risk Officer - Ascension WI (start 8/2016) 20.0 20.0 X 0 233288 43790 CLARISSA COX VP QUALITY & CLINICAL INTEGRATION 10.0 35.0 X 246644 0 14379 WILLIAM HART VP/Chief Operating Officer 5.0 45.0 X 335740 0 21829 GERRI LIETZ-STAFFILENO VP/Chief Nursing Officer 5.0 45.3 X 283666 0 37124 BRUCE MCCARTHY MD PRESIDENT PHYSICIAN DIVISION (END 1/2017) 5.0 45.0 X 703503 0 38015 SUZANNE SANICOLA VP PHYSICIAN SVCS 5.0 35.0 X 234696 0 41525 RICHARD SHIMP MD CHIEF MEDICAL OFFICER 5.0 35.0 X 432536 0 41640 DAVID H SHAPIRO MD Pres, Clinical AMG WI Mkt 40.0 0 X 540938 0 0 BRIAN J CRAMER Chief Executive Officer OHOW 40.0 0 X 323577 0 21357 JEFFREY C SQUIER Reg Leader-VB Contr&Mgd Care 40.0 0 X 260569 0 42780 JOY TAPPER Executive Director MHCP 40.0 0 X 252322 0 15756 RICHARD P THIEDE MD Physician 40.0 0 X 232296 0 34608 MICHAEL SANDERL FORMER KEY EMPLOYEE (END 12/2015) 0.0 0.0 X 159745 0 11943 ALLAN SPOONER FORMER KEY EMPLOYEE (END 8/2015) 0.0 0.0 X 357603 0 10586 MARK TAYLOR FORMER OFFICER (END 6/2014) 0.0 0.0 X 409715 0 0 6503242 6893564 850106 44 true true false ACCENTURE LLP 111 E KILBOURNE AVE SUITE 1200 MILWAUKEE WI 53202 CONSULTING SERVICES 2015960 MEDSPEED LLC 11260 W LINCOLN AVE WEST ALLIS WI 53227 COURIER SERVICES 704880 LEIDOS HEALTH HOLDINGS LLC 705 E MAIN STREET WESTFIELD IN 46074 CONSULTING SERVICES 410687 HOUSER AND COMPANY LLC 3967 PARKER HILL ROAD SANTA ROSA CA 95404 HEALTHCARE MANAGEMENT CONSULTING 264000 WIPFLI LLP PO BOX 8010 MADISON WI 53708 ACCOUNTING SERVICES 198159 9 69746 260787 330533 Management Fees 561000 189783381 189719381 64000 Income From Joint Ventures 622110 14567000 14567000 Interest Income from Affiliates 900099 1172228 1172228 Research Sponsor Fees 900099 294858 294858 0 0 0 0 205817467 9089 9089 129454 129454 0 129454 129454 75614 0 -75614 -75614 -75614 Medical Staff Dues 561499 193700 193700 Laundry Revenue 812300 32710 32710 Other Miscellaneous Revenue 900099 69295 69295 0 0 0 0 295705 206506634 205753467 64000 358634 644384 644384 4262748 4262748 50378263 42342076 8036187 -283093 -237690 -45403 -617991 -512206 -105785 3617419 2815780 801639 118987 95169 23818 -20020 -20020 339601 339601 49040 49040 1200702 1153577 47125 0 1046879 143564 903315 2044218 1036892 1007326 497266 291082 206184 4365731 4355973 9758 501803 200148 301655 231912 94384 137528 10682251 10682251 9887609 9796726 90883 479530 477332 2198 PURCHASED SERVICES 91458518 86580865 4877653 Corporate Overhead Allocation 13216624 13216624 Charitable Expenses 2421483 2421483 Symphony Transition Expenses 1485887 1485887 10338148 2902562 7435586 0 208347899 154602101 53745798 0 2108757 2010513 2781118 0 0 292751 8704915 257215 0 0 0 52151 52151 664991 1669772 63338116 37838210 10940443 25499906 0 40116027 30850434 25379281 27013753 129758378 127222846 220506061 214869341 8338075 24912469 0 21548 0 190063732 468567370 198401807 493501387 X 6430960 -294295458 10447723 11139233 5225571 4524179 22104254 -278632046 220506061 214869341 X -1841265 -298895035 X false true X true false X X X 4 COLUMBIA ST MARY'S HOSPITAL MILWAUKEE INC 390806315 3 true 0 0 COLUMBIA ST MARY'S HOSPITAL OZAUKEE INC 390807063 3 true 0 0 SACRED HEART REHABILITATION INSTITUTE INC 390902199 3 true 0 0 COLUMBIA COLLEGE OF NURSING INC 391596986 2 true 0 0 4 0 0 true false false false false false false false false false false false false false false true RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false false false false true 39718 true 437 true 8885 49040 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY ASCENSION WISCONSIN WAS PART OF A CONTROLLED GROUP OF HEALTHCARE ORGANIZATIONS RELATED THROUGH A COMMON PARENT ORGANIZATION. CERTAIN ENTITIES WITHIN THIS CONTROLLED GROUP ENGAGED IN LIMITED LOBBYING ACTIVITIES THAT BENEFITED EACH ORGANIZATION COLLECTIVELY. FOR CALENDAR YEAR 2016, TWO INDIVIDUALS WERE EMPLOYED WHOSE RESPONSIBILITIES INCLUDED OVERSIGHT AND MANAGEMENT OF LOBBYING ACTIVITIES FOR THESE ORGANIZATIONS - THE SENIOR VICE PRESIDENT OF STRATEGIC INITIATIVES (THROUGH 06/30/2016) AND THE DIRECTOR OF GOVERNMENT RELATIONS AND ADVOCACY. THE SENIOR VICE PRESIDENT PROVIDED STRATEGIC OVERSIGHT FOR THE DEPARTMENT AND PARTICIPATED IN VISITS WITH KEY ELECTED OFFICIALS WHEN APPROPRIATE. THE DIRECTOR PROVIDED ON-THE-GROUND SUPPORT, SERVED AS THE FIRST POINT OF CONTACT FOR ELECTED OFFICIALS, AND EXECUTED ON LEGISLATIVE LOBBYING ACTIVITIES THAT SUPPORTED THE STRATEGIC INTERESTS OF THE ORGANIZATION. WE ESTIMATE THESE LOBBYING ACTIVITIES APPROXIMATED 50% OF TOTAL ANNUAL SALARY FOR THE DIRECTOR AND 15% FOR THE SENIOR VICE PRESIDENT. A BENEFITS FACTOR OF 25% WAS ADDED, AND THE TOTAL WAS ALLOCATED AMONGST THE ORGANIZATIONS THAT RECEIVED THE BENEFIT OF THESE SERVICES. THE LOBBYING ACTIVITIES INCLUDED ADVOCACY EFFORTS RELATED TO PUBLIC POLICY PROPOSALS SUCH AS: CHANGES TO MEDICARE AND MEDICAID FUNDING; FEDERAL OR STATE LEGISLATION THAT MAY IMPACT THE ORGANIZATIONS IN WISCONSIN; PARTICIPATING IN AND COORDINATING VISITS WITH ELECTED OFFICIALS AT ALL LEVELS OF GOVERNMENT (LOCAL, STATE AND FEDERAL); MOBILIZING GRASSROOTS EFFORTS ON BEHALF OF THE ORGANIZATION ON ISSUES OF IMPORTANCE; COORDINATING ADVOCACY ACTIVITIES IN CONJUNCTION WITH RELEVANT TRADE ASSOCIATIONS; AND PROVIDING INTERNAL AWARENESS ON SPECIFIC STATE-RELATED LEGISLATIVE ISSUES WHEN THE NEED ARISES. THE PORTION OF DIRECT EXPENSES RELATED TO ANNUAL EMPLOYEE BUSINESS TRAVEL TO WASHINGTON DC, MADISON WI, OR OTHER LOCATIONS, IN ORDER TO LOBBY FOR ISSUES IMPORTANT TO HEALTHCARE PROVIDERS AND PATIENTS, HAVE BEEN INCLUDED IF APPLICABLE. FINALLY, ANY TRADE ASSOCIATION DUES CONTAINING A PERCENTAGE PORTION ALLOCABLE TO LOBBYING ACTIVITIES, HAS BEEN IDENTIFIED, AND INCLUDED WHERE APPROPRIATE. Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY ASCENSION WISCONSIN WAS PART OF A CONTROLLED GROUP OF HEALTHCARE ORGANIZATIONS RELATED THROUGH A COMMON PARENT ORGANIZATION. CERTAIN ENTITIES WITHIN THIS CONTROLLED GROUP ENGAGED IN LIMITED LOBBYING ACTIVITIES THAT BENEFITED EACH ORGANIZATION COLLECTIVELY. FOR CALENDAR YEAR 2016, TWO INDIVIDUALS WERE EMPLOYED WHOSE RESPONSIBILITIES INCLUDED OVERSIGHT AND MANAGEMENT OF LOBBYING ACTIVITIES FOR THESE ORGANIZATIONS - THE SENIOR VICE PRESIDENT OF STRATEGIC INITIATIVES (THROUGH 06/30/2016) AND THE DIRECTOR OF GOVERNMENT RELATIONS AND ADVOCACY. THE SENIOR VICE PRESIDENT PROVIDED STRATEGIC OVERSIGHT FOR THE DEPARTMENT AND PARTICIPATED IN VISITS WITH KEY ELECTED OFFICIALS WHEN APPROPRIATE. THE DIRECTOR PROVIDED ON-THE-GROUND SUPPORT, SERVED AS THE FIRST POINT OF CONTACT FOR ELECTED OFFICIALS, AND EXECUTED ON LEGISLATIVE LOBBYING ACTIVITIES THAT SUPPORTED THE STRATEGIC INTERESTS OF THE ORGANIZATION. WE ESTIMATE THESE LOBBYING ACTIVITIES APPROXIMATED 50% OF TOTAL ANNUAL SALARY FOR THE DIRECTOR AND 15% FOR THE SENIOR VICE PRESIDENT. A BENEFITS FACTOR OF 25% WAS ADDED, AND THE TOTAL WAS ALLOCATED AMONGST THE ORGANIZATIONS THAT RECEIVED THE BENEFIT OF THESE SERVICES. THE LOBBYING ACTIVITIES INCLUDED ADVOCACY EFFORTS RELATED TO PUBLIC POLICY PROPOSALS SUCH AS: CHANGES TO MEDICARE AND MEDICAID FUNDING; FEDERAL OR STATE LEGISLATION THAT MAY IMPACT THE ORGANIZATIONS IN WISCONSIN; PARTICIPATING IN AND COORDINATING VISITS WITH ELECTED OFFICIALS AT ALL LEVELS OF GOVERNMENT (LOCAL, STATE AND FEDERAL); MOBILIZING GRASSROOTS EFFORTS ON BEHALF OF THE ORGANIZATION ON ISSUES OF IMPORTANCE; COORDINATING ADVOCACY ACTIVITIES IN CONJUNCTION WITH RELEVANT TRADE ASSOCIATIONS; AND PROVIDING INTERNAL AWARENESS ON SPECIFIC STATE-RELATED LEGISLATIVE ISSUES WHEN THE NEED ARISES. THE PORTION OF DIRECT EXPENSES RELATED TO ANNUAL EMPLOYEE BUSINESS TRAVEL TO WASHINGTON DC, MADISON WI, OR OTHER LOCATIONS, IN ORDER TO LOBBY FOR ISSUES IMPORTANT TO HEALTHCARE PROVIDERS AND PATIENTS, HAVE BEEN INCLUDED IF APPLICABLE. FINALLY, ANY TRADE ASSOCIATION DUES CONTAINING A PERCENTAGE PORTION ALLOCABLE TO LOBBYING ACTIVITIES, HAS BEEN IDENTIFIED, AND INCLUDED WHERE APPROPRIATE. 764011 764011 19313539 15792008 3521531 1536898 949767 587131 30672636 21096435 9576201 11051032 11051032 25499906 Investment in Unconsolidated Entities 30850434 C Investments in CSM Foundation - Perm Rest Investments in CSM Foundation - Temp Rest 30850434 Interest in Investments held by Ascension Health Alliance Deferred Compensation 148658 Due From Affiliates 109630009 Other Receivables 1739024 Miscellaneous Assets 41743 Interest in Net Assets of Columbia St. Mary's Foundation 15663412 127222846 Misc Noncurrent Liabilities Debt with Ascension Health Alliance 304141922 At Risk Liability 1976290 Deferred Compensation Liability 148658 Liability from Discontinued OPerations 3478332 Due to Affiliates 122753481 Lease LIability 1946788 Other Miscellaneous LIabilities 72504 Pension Liability 29512648 Savings Plan Liability 4536747 468567370 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote THE SYSTEM ACCOUNTS FOR UNCERTAINTY IN INCOME TAX PROVISIONS BY APPLYING A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE SYSTEM HAS DETERMINED THAT NO MATERIAL UNRECOGNIZED TAX BENEFITS OR LIABILITIES EXIST AS OF JUNE 30, 2017. true true X true X 250 true X true true true false true true 164000 164000 0.0007 6086052 714688 5371364 0.0236 0 0.0 0 0 6250052 714688 5535364 0.0244 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 0 0 6250052 714688 5535364 0.0244 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 false 175097 13288 6313902 17180715 -10866813 X true true ORTHOPAEDIC HOSPITAL OF WISCONSIN LLC ORTHOPEDIC SURGERIES 0.5 0.5 1 1 ORTHOPAEDIC HOSPITAL OF WISCONSIN 475 WEST RIVER WOODS PARKWAY GLENDALE WI 53212 WWW.OHOW.COM 1006 X Specialty Orthopedic Hospital ORTHOPAEDIC HOSPITAL OF WISCONSIN 1 false false true X X X X X X X X X 15 true true false true X http://www.columbia-stmarys.org/doc/Page.asp?PageID=DOC103013 X X true 15 true http://www.columbia-stmarys.org/doc/Page.asp?PageID=DOC103013 false true X 250.0 400.0 X X X X true true X X X true X http://www.ohow.com/financial-assistance.html X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - Orthopaedic Hospital of Wisconsin. The CHNA was conducted to include three levels of information: a community telephone survey of residents to gather their input on community health needs; a secondary data report commissioned from a consultant proficient in gathering and interpreting of data from public health departments, state organizations and non-profit organizations working in the field of health; and interviews with key stakeholders in the field of health.T Denotes this organization represents low-income populations. TT Denotes this organization represents medically underserved populations. TTT Denotes this organization represents minority populations. * AIDS Resource Center of Wisconsin T,TT, * Apostle Presbyterian Church T,TT, * Black Health Coalition of Wisconsin, Inc. T,TT,TTT * Boys & Girls Club T,TT, * Center for Veterans Issues T,TT, * Centro Hispano T,TT,TTT * Children's Hospital of Wisconsin T,TT, * Children's Health Alliance of Wisconsin/ Milwaukee County Oral Health Task Force T,TT, * City of Milwaukee Health Department T,TT, * City of West Allis T,TT, * Community Advocates T,TT, * CORE/El Cento T,TT,TTT * Cudahy Health Department T,TT, * Franklin Health Department T,TT, * Gerald E. Ignace Indian Health Center T,TT,TTT * Greenfield Health Department T,TT, * Hmong American Women's Association T,TT,TTT * IMPACT Planning Council T,TT, * Medical College of Wisconsin Institute for Health and Society T,TT, * Mental Health America of Wisconsin T,TT, * Milwaukee Center for Independence T,TT,TTT * Milwaukee County Behavioral Health Division * Milwaukee County Department of Health & Human Services T,TT, * Milwaukee County Department on Aging T,TT, * Milwaukee Police Department T,TT, * Milwaukee Public Schools T,TT, * MP3 Health Group; T,TT, * Next Door Foundation T,TT, * North Shore Health Department T,TT, * Oak Creek Health Department T,TT, * South Milwaukee Health Department T,TT, * Tri-City National Bank T, * United Way of Greater Milwaukee and Waukesha County T,TT, * UW-Milwaukee Joseph J. Zilber School of Public Health (2012-2015) T,TT, * Wauwatosa Health Department T,TT, * West Allis & West Milwaukee Health Department T,TT, * West Allis Fire Department T,TT, * West Allis Fire Department T,TT, * West Allis/West Milwaukee Chamber of Commerce T,TT, * West Allis/West Milwaukee School District T,TT, * YMCA of Metro Milwaukee T,TT, * YWCA Southeast Wisconsin T,TT, Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - Orthopaedic Hospital of WIsconsin. Aurora Health Care, Children's Hospital of Wisconsin, Froedtert Hospital, and Wheaton Franciscan Health Care. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - Orthopaedic Hospital of Wisconsin. Using the CHNA completed in June 2016, the hospital developed, adopted, and worked on executing a three-year Implementation Strategy to address priority community health needs. In Fiscal Year 2017 (Tax Year 2016), the hospital implemented the following plan to address the priority needs: Violence and Injury -- Reduce Falls and Injury -- Developed a risk assessment to be shared with community partners -- Offered fall prevention education at community resource center -- Provided preventative strategies to reduce falls to community Chronic Disease -- Support Diabetic Friendly Food Pantry -- Offered nutrition education to pantry participants. -- Increased the number of healthy food options at the pantry. -- Expanded food pantry offerings and services Explanation on needs identified in CHNA that are not being addressed: SEXUAL HEALTH This is an area in which CSM will not participate directly. United Way of Greater Milwaukee and Waukesha County has led a task force to reduce teen pregnancy and significantly reduced pregnancy rates. CSM has not participated in this activity and this collaboration. Our resources are well used in other areas of community leadership. Schedule H, Part V, Section B, Line 16 Facility , 1 Facility , 1 - Orthopaedic Hospital of Wisconsin. The filing organization takes several proactive approaches to make patients aware of our financial assistance policy. In addition to our policy being posted on our website and available to anyone who requests one, there is abundant signage throughout our facility explaining our financial assistance policy and how to obtain the actual policy, if desired. Notices regarding the availability of financial assistance are displayed in highly visible locations where there is a significant volume of inpatient or outpatient traffic such as in inpatient and outpatient admitting and registration areas, physician offices, and emergency departments. Brochures describing the policy are available in the same locations, and the policy is discussed at the time of registration or pre-registration, admission, discharge, and with billing for those identified with a need. Patients who call and express a financial hardship with paying their bill will be assisted by a customer service representative, who will assist the patient in setting up an appointment to meet with a financial advocate who will go over the financial assistance policy in detail, get the financial assistance application process started, and educate the patient regarding any questions they may have. Lastly, our patient statements also include notifications about the availability of financial assistance and a phone number to call for more information. Additionally, our Financial Assistance Policy is available on our website at http://www.ohow.com/financial-assistance.html, and has been translated into 7 languages: English, Spanish, Hmong, Laotian, Arabic, Russian, and Serbian/Croatian. 0 Schedule H, Part VI, Line 7 Community Benefit Report COMMUNITY BENEFIT AMOUNTS ARE COMPILED USING TOTAL ACTUAL COSTS PER THE HOSPITAL'S MANAGERIAL ACCOUNTING SYSTEM IN USE, WHICH INCLUDES ALL PATIENT SEGMENTS INCLUDING INPATIENT, OUTPATIENT, EMERGENCY ROOM, PRIVATE INSURANCE, MEDICAID, MEDICARE, MEDICARE HMO, UNINSURED, AND SELF-PAY PATIENTS. MEDICARE IS REPORTED USING THE MOST RECENTLY FILED COST REPORT AT THE TIME THE ANNUAL REPORT AND RELATED COMMUNITY BENEFIT INFORMATION IS PUBLISHED. COMMUNITY BENEFIT AMOUNTS WERE DETERMINED FOR EXTERNAL REPORTING PURPOSES, AND AMOUNTS ARE SUMMARIZED USING A SOFTWARE APPLICATION RECOMMENDED BY THE CATHOLIC HEALTH ASSOCIATION BECAUSE IT HAS THE ABILITY TO PROVIDE THE INFORMATION IN A FORMAT SUITABLE FOR SCHEDULE H PRESENTATION. Although community benefit reporting is not required in the state of Wisconsin, the organization VOLUNTARILY REPORTS COMMUNITY BENEFIT INFORMATION IN WISCONSIN BY REPORTING THE INFORMATION TO THE WISCONSIN HOSPITAL ASSOCIATION. Schedule H, Part V, Section B, Line 17 Billing and Collection Policy During tax year 2017, the organization learned via verbal comments of IRS agents at public events that the IRS intends that the "readily obtainable" standard in the 501(r) regulations for the AGB calculation and billing and collection policy is only met if those items are posted to the organization's web site. The organization had interpreted that web posting standard to be a safe harbor after consulting with external counsel and tax advisors, and timely took other steps to make the information readily obtainable. Consequently, the organization does not believe its decision to not post these documents to its web site rises to the level of a failure, nor does it believe the circumstances were either willful or egregious, having otherwise timely taken the steps necessary to attain and continue to maintain compliance with the other requirements related to the billing and collection policy and the AGB, as part of its policies and procedures for ensuring compliance with all aspects of 501(r). However, the organization is making this voluntary disclosure in order to communicate to the IRS the changes it is undertaking in response to the recent IRS informal guidance on this specific point concerning the "readily obtainable" standard, and the fact that the organization has started the work necessary to post its AGB information and billing and collection policy to its web site and will complete those additional postings as soon as reasonably possible. The other web postings required under 501(r) (i.e., those related to the community health needs assessment and the financial assistance policy) were timely completed and continue to remain in place as required. The organization believes its safeguards worked as intended in this case (i.e., the organization has regular communications with a number of external law firms and tax consultants and the timely attention to the recent guidance was supported by the framework of regular access to subject matter experts). These changes are in the process of being incorporated into corporate policies and procedures that apply to the organization. Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance The cost of providing charity care, means-tested government programs, and other community benefit programs is estimated using internal cost data, and is calculated in compliance with Catholic Health Association ("CHA") guidelines. The organization uses a cost accounting system that addresses all patient segments (for example, inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, or self pay). The best available data was used to calculate the amounts reported in the table. For the information in the table, a cost-to-charge ratio was calculated and applied. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Corporation follows established guidelines for placing certain past-due patient balances within collection agencies, subject to the terms of certain restrictions on collection efforts as determined by Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with the Corporation's policies. After applying the cost-to-charge ratio, the share of the bad debt expense in fiscal year 2017 was $664,406 at charges, ($175,097 at cost). Schedule H, Part III, Line 3 Bad Debt Expense Methodology The provision for doubtful accounts is based upon management's assessment of expected net collections considering historical experience, economic conditions, trends in healthcare coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for doubtful accounts to establish an appropriate allowance for doubtful accounts. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote The organization is part of the Ascension Health Alliance's consolidated audit in which the footnote that discusses the bad debt expense begins on page 19. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs A cost to charge ratio is applied to the organization's Medicare Expense to determine the Medicare allowable costs reported in the organization's Medicare Cost Report. Ascension Health and its related health ministries follow the Catholic Health Association (CHA) guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as community benefit. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance COLUMBIA ST. MARY'S, INC. FOLLOWS THE ASCENSION GUIDELINES FOR COLLECTION PRACTICES RELATED TO PATIENTS QUALIFYING FOR CHARITY OR FINANCIAL ASSISTANCE. A PATIENT CAN APPLY FOR CHARITY OR FINANCIAL ASSISTANCE AT ANY TIME DURING THE COLLECTION CYCLE. ONCE QUALIFYING DOCUMENTATION IS RECEIVED, THE PATIENT'S ACCOUNT IS ADJUSTED. PATIENT ACCOUNTS FOR THE QUALIFYING PATIENT IN THE PREVIOUS SIX MONTHS MAY ALSO BE CONSIDERED FOR CHARITY OR FINANCIAL ASSISTANCE. ONCE A PATIENT QUALIFIES FOR CHARITY OR FINANCIAL ASSISTANCE, ALL COLLECTION ACTIVITY IS SUSPENDED. Schedule H, Part V, Section B, Line 16a FAP website - ORTHOPAEDIC HOSPITAL OF WISCONSIN: Line 16a URL: http://www.ohow.com/financial-assistance.html; Schedule H, Part VI, Line 2 Needs assessment In addition to the CHNA reported in Part V, Section B, Orthopaedic Hospital of Wisconin uses both hospital data and reliable, third party reports, including data from government sources, to assess the health needs of the community it serves. These reports provide information about key health, socioeconomic, and demographic indicators that point to areas of need. Orthopaedic Hospital of Wisconin utilizes this information to determine develop programs and services to be provided for the community. These needs and initiatives are presented to senior leadership and board members to ensure the findings are considered in developing the organization's strategy, policy development, and internal financial and operational decisions. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance The filing organization iS COMMITTED TO DELIVERING EFFECTIVE, SAFE, PERSON-CENTRIC, HEALTH CARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. AS A NONPROFIT HOSPITAL (OR HEALTH SYSTEM), IT IS OUR MISSION AND PRIVILEGE TO PLAY THIS IMPORTANT ROLE IN OUR COMMUNITY. STAFF SCREEN UNINSURED PATIENTS AND IF FOUND POTENTIALLY ELIGIBLE FOR A GOVERNMENT FUNDING SOURCE, PROVIDE ASSISTANCE AND/OR RESOURCES TO THE PATIENT AND THEIR FAMILY. IF A PATIENT IS NOT ELIGIBLE FOR A PAYMENT SOURCE, our FINANCIAL ASSISTANCE POLICY COVERS PATIENTS WHO LACK THE FINANCIAL RESOURCES TO PAY FOR ALL OR PART OF THEIR BILLS. ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED UPON THE ANNUAL FEDERAL POVERTY GUIDELINES and is provided for tHOSE WHO EARN UP TO 400% OF THE FEDERAL POVERTY LEVEL. The following documents are widELY PUBLICIZEd on the organization's website at: http://www.ohow.com/financial-assistance.html - FINANCIAL ASSISTANCE POLICY - The organization also MAKES PAPER COPIES OF the following DOCUMENTS AVAILABLE UPON REQUEST: - FINANCIAL ASSISTANCE POLICY - FINANCIAL ASSISTANCE APPLICATION - FINANCIAL ASSISTANCE POLICY SUMMARY - LIST OF PROVIDERS COVERED BY THE FINANCIAL ASSISTANCE POLICY - AMOUNT GENERALLY BILLED CALCULATION PAPER COPIES ARE MADE READILY AVAILABLE AS PART OF THE INTAKE, DISCHARGE, AND CUSTOMER SERVICE PROCESSES. UPON REQUEST, PAPER COPIES CAN ALSO BE OBTAINED BY MAIL. The organization INFORMS ITS PATIENTS OF THE FINANCIAL ASSISTANCE POLICY VIA A NOTICE ON PATIENT BILLING STATEMENTS, INCLUDING THE PHONE NUMBER AND WEB ADDRESS WHERE MORE INFORMATION CAN BE OBTAINED. Signage displayed in the emergency room and admission area also INFORMS PATIENTS OF THE FINANCIAL ASSISTANCE POLICY. Schedule H, Part VI, Line 4 Community information Please see detailed information provided at Schedule H Part V Section B Lines 1-12 and Part VI Line 5. Schedule H, Part VI, Line 5 Promotion of community health The organization's GOVERNING BODY IS COMPRISED OF PERSONS REPRESENTING DIVERSE ASPECTS AND INTERESTS OF THE COMMUNITY. MANY MEMBERS OF the GOVERNING BODY RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA; WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS OR SPECIALTIES. SURPLUS FUNDS are provided TO FUND IMPROVEMENTS IN PATIENT CARE, MEDICAL EDUCATION, and RESEARCH through DONATIONS from supporting organizations. Please also see Part III for community activities undertaken by this organization, as well as a compilation of regional charity care information. Schedule H, Part VI, Line 6 Affiliated health care system The filing organization IS AN AFFILIATE OF Columbia St. Mary's, Inc. and ASCENSION HEALTH. The hospital's aFFILIATES ARE LARGE MULTI-FACETED, INTEGRATED, NOT-FOR-PROFIT MINISTRIES INCLUDING HOSPITAL AND NON-HOSPITAL MINISTRIES (PHYSICIAN GROUP PRACTICES, HOSPITAL ORGANIZATIONS, RESEARCH, HOME HEALTH, DURABLE MEDICAL EQUIPMENT AND SENIOR FACILITIES). THESE MINISTRIES WORK TOGETHER TO CARE FOR PATIENTS, JOINED BY COMMON SYSTEMS AND A PHILOSOPHY OF SERVING AS A HEALING PRESENCE WITH SPECIAL CONCERN FOR OUR NEIGHBORS ESPECIALLY THOSE WHO ARE poor or VULNERABLE. THIS COMMUNITY BENEFIT HAPPENS THROUGH ITS FOCUS ON PATIENT CARE, EDUCATION AND RESEARCH. THE ORGANIZATIONS WORK TOGETHER TO SERVE THEIR COMMUNITIES AT THE LOCAL, REGIONAL, STATE AND NATIONAL LEVEL. ASCENSION HEALTH ALLIANCE, D/B/A ASCENSION (ASCENSION), IS A MISSOURI NONPROFIT CORPORATION FORMED ON SEPTEMBER 13, 2011. ASCENSION IS THE SOLE CORPORATE MEMBER AND PARENT ORGANIZATION OF ASCENSION HEALTH, A CATHOLIC NATIONAL HEALTH SYSTEM CONSISTING PRIMARILY OF NONPROFIT CORPORATIONS THAT OWN AND OPERATE LOCAL HEALTHCARE FACILITIES, OR HEALTH MINISTRIES, LOCATED IN 23 OF THE UNITED STATES AND THE DISTRICT OF COLUMBIA. ASCENSION IS SPONSORED BY ASCENSION SPONSOR, A PUBLIC JURIDIC PERSON. THE PARTICIPATING ORGANIZATIONS/ENTITIES OF ASCENSION SPONSOR ARE THE DAUGHTERS OF CHARITY OF ST. VINCENT DE PAUL, ST. LOUISE PROVINCE; THE CONGREGATION OF ST. JOSEPH; THE CONGREGATION OF THE SISTERS OF ST. JOSEPH OF CARONDELET; THE CONGREGATION OF ALEXIAN BROTHERS OF THE IMMACULATE CONCEPTION PROVINCE, INC. - AMERICAN PROVINCE; AND THE SISTERS OF THE SORROWFUL MOTHER OF THE THIRD ORDER OF ST. FRANCIS OF ASSISI - US/CARIBBEAN PROVINCE. The organization PROMOTES THE HEALTH OF THE COMMUNITY BY providing healthcare services in the Southeast Wisconsin area, regardless of the person's ability to pay, because it is our mission to improve the lives of those in the communities we serve. true UNITED WAY OF GREATER MILWAUKEE 225 W Vine Street Milwaukee WI 53212 390806190 501(c)(3) 464000 OPERATING SUPPORT Concordia University Wisconsin Foundation 12800 North Lake Shore Dr Mequon WI 53097 396077337 501(c)(3) 100000 OPERATING SUPPORT EBENEZER MINISTRY & FAMILY WORSHIP CENTER 3132 N MARTIN LUTHER KING DRIVE MILWAUKEE WI 53216 391287366 501(c)(3) 6089 OPERATING SUPPORT INROADS INC 10 S BROADWAY ST LOUIS MO 63102 620967197 501(c)(3) 15000 OPERATING SUPPORT MILWAUKEE AFFILIATE OF THE SUSAN G KOMEN 2025 W OAKLAHOMA AVE Milwaukee WI 53215 752844639 501(c)(3) 7500 OPERATING SUPPORT OSHKOSH AREA UNITED WAY 36 BOARD STREET OSHKOSH WI 54901 391017908 501(c)(3) 40000 OPERATING SUPPORT 6 0 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. CONTRIBUTIONS TO GOVERNMENTS AND ORGANIZATIONS IN THE UNITED STATES ARE APPROVED BY THE BOARD OF DIRECTORS AND/OR THE PRESIDENT & CEO. ALL RECORDS OF OUTGOING CONTRIBUTIONS ARE RETAINED FOR A PERIOD OF 10 YEARS, PLUS THE CURRENT FISCAL YEAR, AND CAN BE LOCATED AT THE OFFICE CENTER AT 400 W River Woods Parkway, GlENDALE, WI 53212. true true false false false false false true false BERNARD J SHERRY SR VP - ASCENSION WI (START 9/2016) 0 745387 0 575928 0 237996 0 17226 0 28294 0 1604831 0 0 MARK TAYLOR FORMER OFFICER (END 6/2014) 0 0 0 0 409715 0 0 0 0 0 409715 0 360637 0 JONATHAN SOHN CFO - ASCENSION, WI 0 487399 0 206003 0 13845 0 67575 0 27589 0 802411 0 0 TIMOTHY WALDOCH INTERIM CFO (END 12/2016) 231469 0 20233 0 1211 0 12290 0 5929 0 271132 0 0 0 MICHAEL SANDERL FORMER KEY EMPLOYEE (END 12/2015) 0 0 0 0 159745 0 0 0 11943 0 171688 0 0 0 ALLAN SPOONER FORMER KEY EMPLOYEE (END 8/2015) 0 0 0 0 357603 0 0 0 10586 0 368189 0 0 0 Vincent Gallucci Chief Marketing Officer - Ascension WI 0 358698 0 142628 0 3308 0 7950 0 281 0 512865 0 0 Sarah Herzog Chief Legal Officer - Ascension WI 0 425348 0 123200 0 23183 0 20734 0 25552 0 618017 0 0 Douglas Reding MD Chief Medical Officer - Ascension WI (START 10/2016) 0 517958 0 86443 0 12121 0 13250 0 21236 0 651008 0 0 Tracy A Rogers Chief Operating Officer - Ascension WI 0 717307 0 547153 0 116343 0 15900 0 25983 0 1422686 0 0 Celia Shaughnessy Chief HR Officer - Ascension WI 0 295713 0 103994 0 30366 0 7950 0 21995 0 460018 0 0 TRAVIS D ANDERSEN Regional President - South Market 564396 0 517513 0 133050 0 13250 0 29971 0 1258180 0 0 0 Timothy Belec Chief Information Officer - Ascension WI (start 11/2016) 0 255845 0 46220 0 939 0 24913 0 1017 0 328934 0 0 Lisa Benson MD Chief Quality Officer - Ascension WI (start 10/2016) 0 280654 0 0 0 2436 0 11509 0 549 0 295148 0 0 KEVIN KLUESNER Chief Admin Officer, AW South 232817 0 20208 0 8795 0 13238 0 27081 0 302139 0 0 0 Therese Rocole Chief Ministry Officer - Ascension WI 0 230061 0 63300 0 10500 0 27996 0 4809 0 336666 0 0 Lynn Schuster Regional Risk Officer - Ascension WI (start 8/2016) 0 190436 0 40520 0 2332 0 21035 0 22755 0 277078 0 0 CLARISSA COX VP QUALITY & CLINICAL INTEGRATION 188127 0 16334 0 42183 0 11086 0 3293 0 261023 0 0 0 WILLIAM HART VP/Chief Operating Officer 303200 0 25293 0 7247 0 15900 0 5929 0 357569 0 0 0 GERRI LIETZ-STAFFILENO VP/Chief Nursing Officer 243022 0 20963 0 19681 0 17041 0 20083 0 320790 0 0 0 BRUCE MCCARTHY MD PRESIDENT PHYSICIAN DIVISION (END 1/2017) 548057 0 60724 0 94722 0 14575 0 23440 0 741518 0 0 0 SUZANNE SANICOLA VP PHYSICIAN SVCS 211973 0 18060 0 4663 0 14674 0 26851 0 276221 0 0 0 RICHARD SHIMP MD CHIEF MEDICAL OFFICER 364753 0 56107 0 11676 0 13250 0 28390 0 474176 0 0 0 DAVID H SHAPIRO MD Pres, Clinical AMG WI Mkt 0 0 0 0 540938 0 0 0 0 0 540938 0 260049 0 BRIAN J CRAMER Chief Executive Officer OHOW 251889 0 66584 0 5104 0 15780 0 5577 0 344934 0 0 0 JEFFREY C SQUIER Reg Leader-VB Contr&Mgd Care 238666 0 20661 0 1242 0 14199 0 28581 0 303349 0 0 0 JOY TAPPER Executive Director MHCP 250000 0 0 0 2322 0 12212 0 3544 0 268078 0 0 0 RICHARD P THIEDE MD Physician 228870 0 0 0 3426 0 11750 0 22858 0 266904 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation ASCENSION HEALTH, A RELATED ORGANIZATION OF COLUMBIA ST. MARY'S, INC. USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OF COMPENSATION COMMITTEE Schedule J, Part I, Line 4a Severance or change-of-control payment The following individual(s) received severance payments from the organization or a related organization during calendar year 2016: Allan Spooner - $344,725 Michael Sanderl - $159,745 Clarissa Cox - $26,606 Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. The following individuals received payment from the supplemental nonqualified retirement plan in the amount as noted during calendar year 2016: Jonathan Sohn - $9,620 Mark Taylor - $360,637 David Shapiro - $260,049 Schedule J, Part I, Line 7 Non-fixed payments BOARD MEMBERS, OFFICERS, KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES WHO ARE EMPLOYED BY THE CSM ORGANIZATIONS AND ARE MEDICAL DOCTORS ARE ELIGIBLE TO RECEIVE A PERCENTAGE OF THE REVENUE GENERATED FROM PATIENTS THEY SERVED, BASED ON ESTABLISHED GUIDELINES. CASH ACCOUNT TRANSFERRED TO SYSTEM OFFICE 2016-07-01 130952220 ACTUAL COST (CASH) 453358926 ASCENSION HEALTH ALLIANCE PO BOX 45998 ST LOUIS MO 63145 501(C)(3) false false false false Form 990, Part VI, Line 15a PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL In determining the compensation of the Organization's President, the process performed by Ascension Health, a related organization of Columbia St. Mary's Inc., included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Compensation Committee reviewed and approved the compensation. In the review of the compensation, the President was compared to individuals at other organizations in the area who hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the Committee minutes. The individual was not present when his compensation was decided. Form 990, Part VI, Line 6 Classes of members or stockholders Columbia St. Mary's, Inc. has two corporate members, Ascension Health and Columbia Health System. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body ONE OF Columbia St. Mary's Inc. (CSM) CORPORATE MEMBERS, ASCENSION HEALTH, HAS THE ABILITY TO ELECT MEMBERS TO THE GOVERNING BODY OF CSM. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders All decisions that have a material impact to Columbia St. Mary's, Inc. financial information or corporation as a whole are subject to approval by one of its corporate members, Ascension Health. COLUMBIA HEALTH SYSTEM HAS THE AUTHORITY TO APPROVE ANY CHANGES TO THE GOVERNING DOCUMENTS WHICH WOULD AFFECT ITS INTEREST OR RIGHTS IN CSM, THE MISSION AND VISION STATEMENTS OF CSM, AND ANY MAJOR CORPORATE STRUCTURAL TRANSACTIONS OF CSM. Form 990, Part VI, Line 11b Review of form 990 by governing body DURING THE RETURN PREPARATION PROCESS, THE TAX DEPARTMENT WORKS WITH OTHER FUNCTIONAL AREAS INCLUDING FINANCE, ACCOUNTING, TREASURY, LEGAL, HUMAN RESOURCES, AND CORPORATE COMPLIANCE FOR ADVICE, INFORMATION AND ASSISTANCE IN ORDER TO PREPARE A COMPLETE AND ACCURATE RETURN. UPON COMPLETION, THE FORM 990 IS REVIEWED BY THE ORGANIZATION'S INTERNAL TAX DEPARTMENT WHICH CONSISTS OF ATTORNEYS AND CPAS. A COMPLETE FINAL COPY OF THE RETURN IS PROVIDED TO THE ORGANIZATION'S PRESIDENT, FINANCIAL OFFICER, AND/OR OTHER KEY OFFICERS IN LIEU OF THE FULL BOARD. Form 990, Part VI, Line 12c Conflict of interest policy The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflicts of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose. Form 990, Part VI, Line 15b Process to establish compensation of other employees IN DETERMINING COMPENSATION OF THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES, THE PROCESS INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE EXECUTIVE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE OFFICERS' SALARIES WERE COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE MINUTES. INDIVIDUALS WERE NOT PRESENT WHEN THEIR COMPENSATION WAS DECIDED. Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION WILL PROVIDE ANY DOCUMENTS OPEN TO PUBLIC INSPECTION UPON REQUEST. Form 990, Part XI, Line 9 Other changes in net assets or fund balances FAS 158 PENSION LIABILITY ADJUSTEMENT - -19012774; Change in Interest of Net Assets of Columbia St. Mary's Foundation - -209882; Equity Transfer to Columbia Health System - -320016; Interest in Investment of AScension Health Alliance Transferred Back to AHA - -XXX-XX-XXXX; Transfers with ALpha FUnd - -XXX-XX-XXXX; Form 990, Part XII, Line 2b AUDITED FINANCIAL STATEMENTS The activity of COLUMBIA ST. MARY'S, INC. is reported in the consolidated financial statements of Ascension Health Alliance. No individual audit of COLUMBIA ST. MARY'S, INC. is completed. Therefore, the attached audited financial statements are of Ascension Health Alliance and Affiliates, which include the activity of COLUMBIA ST. MARY'S, INC. Form 990, Part XII, Line 2c AUDIT COMMITTEE COLUMBIA ST. MARY'S, INC. is included in the consolidated financial statements of Ascension Health Alliance. The Finance and Audit committee of Ascension Health Alliance's Board assumes responsibility for the consolidated organization as a whole. ASCENSION HEALTH ALLIANCE PO BOX 45998 ST LOUIS MO 63145 453358926 NATIONAL HEALTH MO 501(c)(3) Type I NA false ASCENSION HEALTH PO BOX 45998 ST LOUIS MO 63145 311662309 NATIONAL HEALTH MO 501(c)(3) Type I ASCENSION HEALTH ALLIANCE false MINISTRY HEALTH CARE INC 10925 W LAKE PARK DR STE 100 MILWAUKEE WI 53224 391490371 PARENT CORPORATION WI 501(c)(3) Type II ASCENSION HEALTH true WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN INC 400 WEST RIVER WOODS PARKWAY GLENDALE WI 53212 391568865 PARENT CORPORATION IL 501(c)(3) Type III-FI ASCENSION HEALTH true COLUMBIA ST MARY'S HOSPITAL MILWAUKEE INC 4425 NORTH PORT WASHINGTON ROAD GLENDALE WI 53212 390806315 HOSPITAL WI 501(c)(3) 3 COLUMBIA ST MARY'S INC true COLUMBIA ST MARY'S HOSPITAL OZAUKEE INC 4425 NORTH PORT WASHINGTON ROAD GLENDALE WI 53212 390807063 HOSPITAL WI 501(c)(3) 3 COLUMBIA ST MARY'S INC true SACRED HEART REHABILITATION INSTITUTE INC 4425 NORTH PORT WASHINGTON ROAD GLENDALE WI 53212 390902199 REHAB SERVICES WI 501(c)(3) 3 COLUMBIA ST MARY'S INC true AFFINITY HEALTH SYSTEM 1570 MIDWAY PLACE MENASHA WI 54952 391568866 HEALTH SYSTEM IL 501(c)(3) Type II MINISTRY HEALTH CARE INC true AGAPE COMMUNITY CENTER OF MILWAUKEE INC 6100 NORTH 42ND STREET MILWAUKEE WI 53209 391461846 COMMUNITY CENTER WI 501(c)(3) 7 MINISTRY HEALTH CARE INC true ASCENSION EAGLE RIVER MEMORIAL HOSPITAL INC FKA EAGLE RIVER MEMORIAL HOSPIT AL INC 201 HOSPITAL ROAD EAGLE RIVER WI 54521 390985690 HOSPITAL WI 501(c)(3) 3 MINISTRY HEALTH CARE INC true ASCENSION GOOD SAMARITAN HOSPITAL INC FKA GOOD SAMARITAN HEALTH CENTER OF M ERRILL WI INC 601 SOUTH CENTER AVENUE MERRILL WI 54452 390808503 HOSPITAL WI 501(c)(3) 3 MINISTRY HEALTH CARE INC true ASCENSION OUR LADY OF VICTORY HOSPITAL INC FKA OUR LADY OF VICTORY HOSPITAL INC 1120 PINE STREET STANLEY WI 54768 390807065 HOSPITAL WI 501(c)(3) 3 MINISTRY HEALTH CARE INC true ASCENSION SACRED HEART-STMARY'S HOSPITALS INC FKA SACRED HEART-SAINT MARY'S HOSPITALS INC PO BOX 347 STEVENS POINT WI 54481 391390638 HOSPITAL WI 501(c)(3) 3 MINISTRY HEALTH CARE INC true ASCENSION ST CLARE'S HOSPITAL INC FKA SAINT CLARE'S HOSPITAL OF WESTON INC 3400 MINISTRY PARKWAY WESTON WI 54476 721531917 HOSPITAL WI 501(c)(3) 3 MINISTRY HEALTH CARE INC true ASCENSION ST MICHAEL'S HOSPITAL INC FKA SAINT MICHAEL'S HOSPITAL OF STEVENS POINT INC 900 ILLINOIS AVENUE STEVENS POINT WI 54481 390808443 HOSPITAL WI 501(c)(3) 3 MINISTRY HEALTH CARE INC true HOWARD YOUNG HEALTH CARE INC 240 MAPLE STREET WOODRUFF WI 54568 391499115 HOME OFFICE WI 501(c)(3) Type II MINISTRY HEALTH CARE INC true MERCY MEDICAL CENTER OF OSHKOSH INC 500 S OAKWOOD ROAD OSHKOSH WI 54904 390806268 HOSPITAL WI 501(c)(3) 3 MINISTRY HEALTH CARE INC true MINISTRY MEDICAL GROUP INC 824 ILLINOIS AVENUE STEVENS POINT WI 54481 391965593 MEDICAL GROUP WI 501(c)(3) Type III-FI MINISTRY HEALTH CARE INC true SAINT ELIZABETH'S HOSPITAL OF WABASHA INC 1200 GRANT BLVD WEST WABASHA WI 55981 410693877 HOSPITAL WI 501(c)(3) 3 MINISTRY HEALTH CARE INC true ST JOSEPH'S HOSPITAL OF MARSHFIELD INC 611 SAINT JOSEPH AVENUE MARSHFIELD WI 54449 391847631 HOSPITAL WI 501(c)(3) 3 MINISTRY HEALTH CARE INC true ST ELIZABETH HOSPITAL INC 1506 S ONEIDA STREET APPLETON WI 54915 390816818 HOSPITAL WI 501(c)(3) 3 MINISTRY HEALTH CARE INC true THE HOWARD YOUNG MEDICAL CENTER INC 240 MAPLE STREET WOODRUFF WI 54568 390873606 HOSPITAL WI 501(c)(3) 3 MINISTRY HEALTH CARE INC true DOOR COUNTY MEMORIAL HOSPITAL INC 323 SOUTH 18TH AVENUE STURGEON BAY WI 54235 390806324 HOSPITAL (sold 11/2016) WI 501(c)(3) 3 MINISTRY HEALTH CARE INC true ASCENSION CALUMET HOSPITAL INC FKA CALUMET MEDICAL CENTER INC 614 MEMORIAL DRIVE CHILTON WI 53014 390905385 HOSPITAL WI 501(c)(3) 3 MINISTRY HEALTH CARE INC true WHEATON FRANCISCAN HEALTHCARE - 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SOUTHEAST WISCONSIN INC true WHEATON FRANCISCAN INC 5000 WEST CHAMBERS STREET MILWAUKEE WI 53210 390816857 HOSPITAL WI 501(c)(3) 3 WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN INC true WHEATON FRANCISCAN HOME HEALTH & HOSPICE INC 3070 North 51st Street Suite 406 MILWAUKEE WI 53210 391559428 HOME HEALTH WI 501(c)(3) 10 WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN INC true CATALPA HEALTH INC N4642 COUNTY N APPLETON WI 54914 454681563 BEHAVIORAL HEALTH SERVICES WI 501(c)(3) 3 AFFINITY HEALTH SYSTEM true MERCY HEALTH FOUNDATION INC PO BOX 3370 OSHKOSH WI 54903 237140261 FOUNDATION WI 501(c)(3) 10 AFFINITY HEALTH SYSTEM true NETWORK HEALTH SYSTEM INC 1570 APPLETON RD MENASHA WI 54952 391127163 CLINICAL HEALTHCARE SERVICES WI 501(c)(3) 3 AFFINITY HEALTH SYSTEM true ST ELIZABETH HOSPITAL FOUNDATION INC 1506 S ONEIDA STREET APPLETON WI 54915 391256677 FOUNDATION WI 501(c)(3) 7 AFFINITY HEALTH SYSTEM true GOOD SAMARITAN HEALTH CENTER FOUNDATION OF MERRILL WISCONSIN INC 601 SOUTH CENTER AVENUE MERRILL WI 54452 391627755 FOUNDATION WI 501(c)(3) Type I ASCENSION GOOD SAMARITAN HOSPITAL INC true MINISTRY WEIGHT MANAGEMENT INC 2251 NORTH SHORE DRIVE RHINELANDER WI 54501 391829015 SPECIALTY HEALTH SERVICES WI 501(c)(3) 3 ASCENSION SACRED HEART - 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