ST MARYS HOSPITAL MEDICAL CENTER OF GREEN BAY INC: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization: ST MARYS HOSPITAL MEDICAL CENTER OF GREEN BAY INC (EIN 39-0818682)
Tax period: 2015-07-01 to 2016-06-30
Filed: 2017-05-12
IRS object ID: 201731329349300313
Schema version: 2015v3.0
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 L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2017-05-12T07:03:51-05:00	ReturnTs
Tax Period End	2016-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	350921680	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

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

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	225 West Wacker Drive	AddressLine1Txt
Address Line2	Suite 2600	AddressLine2Txt
City	Chicago	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	606061224	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2015-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	390818682	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	St Mary's Hospital Medical Center of Green Bay Inc - Hospital Sisters	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	STMA	BusinessNameControlTxt
Phone	9204984200	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1726 SHAWANO AVENUE	AddressLine1Txt
City	Green Bay	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54303	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	THERESE PANDL	PersonNm
Person Title	CHIEF EXECUTIVE OFFICER	PersonTitleTxt
Signature	2017-05-11	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	John V Woodhull	PreparerPersonNm
PTIN	P01305268	PTIN
Phone	3128997000	PhoneNum

Field	Value	IRS element (for citing)
Tax	2015	TaxYr
Build TS	2021-01-29 14:40:06Z	BuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	THERESE PANDL	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1726 SHAWANO AVENUE	AddressLine1Txt
City	Green Bay	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54303	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$133,258,264	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Group Exemption	0928	GroupExemptionNum
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.STMGB.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1900	FormationYr
Legal Domicile State	WI	LegalDomicileStateCd
Activity Or Mission	TO CONTINUE CHRIST'S HEALING LOVE THROUGH DELIVERY OF COMPETENT & COMPASSIONATE HEALTHCARE IN AN ENVIRONMENT SENSITIVE TO THE NEEDS OF ALL PEOPLE.	ActivityOrMissionDesc
Voting Members Governing Body	11	VotingMembersGoverningBodyCnt
Voting Members Independent	8	VotingMembersIndependentCnt
Total Employee	798	TotalEmployeeCnt
Total Volunteers	100	TotalVolunteersCnt
Total Gross UBI	$753,400	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	-$1,114,503	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$567,879	PYContributionsGrantsAmt
CY Contributions Grants	$184,300	CYContributionsGrantsAmt
PY Program Service Revenue	$122,800,388	PYProgramServiceRevenueAmt
CY Program Service Revenue	$125,549,707	CYProgramServiceRevenueAmt
PY Investment Income	$680,925	PYInvestmentIncomeAmt
CY Investment Income	$1,440,582	CYInvestmentIncomeAmt
PY Other Revenue	$2,709,122	PYOtherRevenueAmt
CY Other Revenue	$1,666,797	CYOtherRevenueAmt
PY Total Revenue	$126,758,314	PYTotalRevenueAmt
CY Total Revenue	$128,841,386	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	$47,899,833	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$48,408,981	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$69,721,517	PYOtherExpensesAmt
CY Other Expenses	$73,685,366	CYOtherExpensesAmt
PY Total Expenses	$117,621,350	PYTotalExpensesAmt
CY Total Expenses	$122,094,347	CYTotalExpensesAmt
PY Revenues Less Expenses	$9,136,964	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$6,747,039	CYRevenuesLessExpensesAmt
Total Assets BOY	$198,257,345	TotalAssetsBOYAmt
Total Assets EOY	$194,660,407	TotalAssetsEOYAmt
Total Liabilities BOY	$60,605,804	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$68,444,806	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$137,651,541	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$126,215,601	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	TO CONTINUE CHRIST'S HEALING LOVE THROUGH DELIVERY OF COMPETENT & COMPASSIONATE HEALTHCARE IN AN ENVIRONMENT SENSITIVE TO THE NEEDS OF ALL PEOPLE. THE HOSPITAL IS COMMITTED TO PROVIDING A BROAD RANGE OF QUALITY INPATIENT AND OUTPATIENT SERVICES WITHOUT REGARD TO THE INDIVIDUAL'S RACE, CREED, HANDICAPS, OR FINANCIAL STATUS.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$14,543,601	ExpenseAmt
Revenue	$27,234,553	RevenueAmt
Desc	SURGERY - SEE SCHEDULE O	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$7,621,255	ExpenseAmt
Revenue	$17,434,369	RevenueAmt
Desc	HEART & VASCULAR CENTER - SEE SCHEDULE O	Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

Field	Value	IRS element (for citing)
Expense	$5,621,700	ExpenseAmt
Revenue	$19,680,744	RevenueAmt
Desc	RADIOLOGY SERVICES - SEE SCHEDULE O	Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

Field	Value	IRS element (for citing)
Expense	$63,384,678	ExpenseAmt
Revenue	$60,891,274	RevenueAmt
Desc	ST. MARY'S HOSPITAL MEDICAL CENTER OTHER PROGRAM SERVICES AT ST. MARY'S HOSPITAL MEDICAL CENTER IS COMPRISED OF FAMILY BIRTHING CENTER, INTENSIVE CARE, EMERGENCY, CENTER FOR DIGESTIVE HEALTH, PHARMACY, LABORATORY, RESPIRATORY THERAPY AND OTHER SERVICES. IN FY2016 THE HOSPITAL HAD OVER 103,600 OUTPATIENT VISITS, NEARLY 4,400 ADMISSIONS, OVER 13,100 PATIENT DAYS, OVER 550 BIRTHS AND OVER 31,100 EMERGENCY ROOM VISITS.	Desc

Field	Value	IRS element (for citing)
Total Other Prog Srvc Expense	$63,384,678	TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue	$60,891,274	TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses	$91,171,234	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	false	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (true)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	Yes (true)	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	Yes (true)	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	false	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	42	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	798	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	11	GoverningBodyVotingMembersCnt
Independent Voting Member	8	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (true)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (true)	WrittenPolicyOrProcedureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Joanne Horvath	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	9204313211	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	835 S Van Buren St	AddressLine1Txt
City	GREEN BAY	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54301	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Highest Compensated EmployeeHighestCompensatedEmployeeInd
JOHN HAGER
SECRETARY	1.0	1.0	Yes (X)	Yes (X)	$0	$0	$0
DJ LONG JR
CHAIR PERSON	1.0	1.0	Yes (X)	Yes (X)	$0	$0	$0
JUDY NAGEL
2015 VICE CHAIR	1.0	1.0	Yes (X)	Yes (X)	$0	$0	$0
THERESE B PANDL
PRESIDENT/Divisional CEO	20.0	40.0	Yes (X)	Yes (X)	$0	$1,047,858	$231,464
DANIEL J PLATKOWSKI
2016 VICE CHAIR	1.0	1.0	Yes (X)	Yes (X)	$0	$0	$0
JULES BLANK MD
DIRECTOR	1.0	1.0	Yes (X)		$0	$0	$0
ROBERT BURNS
DIRECTOR	1.0	1.0	Yes (X)		$0	$0	$0
MICHAEL W COTTRELL
DIRECTOR	1.0	64.0	Yes (X)		$0	$959,964	$215,686
SR BERNADINE GUTOWSKI OSF
DIRECTOR	1.0	2.0	Yes (X)		$0	$0	$0
KENNETH HUJET MD
DIRECTOR	1.0	1.0	Yes (X)		$0	$0	$0
BETSY MITCHELL
DIRECTOR	1.0	1.0	Yes (X)		$0	$0	$0
ANN M CARR
TREASURER	0.3	59.8		Yes (X)	$0	$354,305	$222,661
LAWRENCE J CONNORS
COO	20.0	20.0		Yes (X)	$361,521	$0	$157,276
GREG SIMIA
DIVISION CFO	5.0	35.0		Yes (X)	$0	$803,634	$165,408
JAMIE BABBITTS
EXECUTIVE DIRECTOR	20.0	0			$150,244	$0	$87,412	Yes (X)
THOMAS BERG
PHARMACIST	40.0	0			$149,094	$0	$54,530	Yes (X)
JAYNE BLEUEL
PHARMACIST	40.0	0			$146,829	$0	$98,062	Yes (X)
GREGORY LAEHN
PHARMACIST	40.0	0			$154,726	$0	$81,356	Yes (X)
KAREN WENZEL
PHARMACIST	40.0	0			$155,448	$0	$54,363	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,117,862	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$3,165,761	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,368,218	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	14	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
ST VINCENT HOSPITAL
835 S VAN BUREN STREET	GREEN BAY	WI	54303	SHARED SERVICES	$18,951,990
PREVEA CLINIC
PO BOX 19070	GREEN BAY	WI	54307	SHARED LABOR & SERVICES	$4,208,865
SODEXO INC
4880 PAYSPHERE CIRCLE	CHICAGO	IL	60674	FOOD & HOUSEKEEPING SERVICES	$945,867
IEI GENERAL CONTRACTORS
PO BOX 5067	DE PERE	WI	54115	CONTRACTOR	$853,144
SUPERIOR HEALTH LINENS
2150 MAPLE DRIVE	PLOVER	WI	54467	LAUNDRY & LINEN	$393,314

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	12	CntrctRcvdGreaterThan100KCnt
Related Organizations	$184,300	RelatedOrganizationsAmt
Total Contributions	$184,300	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT SERVICES	900099	$125,236,057	$125,236,057
LABORATORY SERVICES	621500	$308,767		$308,767
PREVEA INVESTMENT GAIN/LOSS	900099	$4,883	$4,883

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$125,549,707	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$276,561	TotalRevenueColumnAmt
Exclusion	$276,561	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$3,459,869	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$3,588,147	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	-$128,278	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$128,278	TotalRevenueColumnAmt
Exclusion	-$128,278	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$1,187,704	SecuritiesAmt
Other	$805,048	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Other	$828,731	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$1,187,704	SecuritiesAmt
Other	-$23,683	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,164,021	TotalRevenueColumnAmt
Exclusion	$1,164,021	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
OTHER OPERATING REVENUE	900099	$815,253	$815,253
CHILDCARE REVENUE	624410	$979,822	$535,189	$444,633

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$1,795,075	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$128,841,386	TotalRevenueColumnAmt
Related Or Exempt Func Income	$125,240,940	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$753,400	UnrelatedBusinessRevenueAmt
Exclusion	$2,662,746	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$518,797	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$518,797	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$35,981,804	TotalAmt
Program Services	$25,550,421	ProgramServicesAmt
Management And General	$10,431,383	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$1,033,390	TotalAmt
Program Services	$723,373	ProgramServicesAmt
Management And General	$310,017	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$8,710,598	TotalAmt
Program Services	$6,097,419	ProgramServicesAmt
Management And General	$2,613,179	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$2,164,392	TotalAmt
Program Services	$1,515,074	ProgramServicesAmt
Management And General	$649,318	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$10,080,564	TotalAmt
Program Services	$7,056,395	ProgramServicesAmt
Management And General	$3,024,169	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$22,077	TotalAmt
Program Services	$15,454	ProgramServicesAmt
Management And General	$6,623	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Fundraising	$0	FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$11,468,433	TotalAmt
Program Services	$8,027,903	ProgramServicesAmt
Management And General	$3,440,530	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$139,402	TotalAmt
Program Services	$97,581	ProgramServicesAmt
Management And General	$41,821	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$1,521,669	TotalAmt
Program Services	$1,065,168	ProgramServicesAmt
Management And General	$456,501	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$59,527	TotalAmt
Program Services	$41,669	ProgramServicesAmt
Management And General	$17,858	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$107,469	TotalAmt
Program Services	$75,228	ProgramServicesAmt
Management And General	$32,241	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$142,963	TotalAmt
Program Services	$100,074	ProgramServicesAmt
Management And General	$42,889	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$5,164,903	TotalAmt
Program Services	$3,615,432	ProgramServicesAmt
Management And General	$1,549,471	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$372,793	TotalAmt
Program Services	$260,955	ProgramServicesAmt
Management And General	$111,838	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
SUPPLIES - MED/SURG/O2/DRUGS	$21,394,987	$14,976,491	$6,418,496	$0
PREVEA INVESTMENT AND LEASE	$13,055,115	$13,055,115	$0	$0
BAD DEBT EXPENSE	$2,369,206	$2,369,206	$0	$0
MEDICAID TAX ASSESSMENT	$3,592,984	$3,592,984	$0	$0

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$4,193,274	TotalAmt
Program Services	$2,935,292	ProgramServicesAmt
Management And General	$1,257,982	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$122,094,347	TotalAmt
Program Services	$91,171,234	ProgramServicesAmt
Management And General	$30,923,113	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$2,007	BOYAmt
EOY	$3,077	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$2,729,510	BOYAmt
EOY	-$691,720	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$13,504,993	BOYAmt
EOY	$13,294,848	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$428,540	BOYAmt
EOY	$415,371	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$2,618,333	BOYAmt
EOY	$2,452,311	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$145,008	BOYAmt
EOY	$306,776	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$165,223,043	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$85,656,667	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$82,654,211	BOYAmt
EOY	$79,566,376	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$85,026,970	BOYAmt
EOY	$89,077,513	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$9,234,116	BOYAmt
EOY	$9,044,174	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$1,913,657	BOYAmt
EOY	$1,191,681	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$198,257,345	BOYAmt
EOY	$194,660,407	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$9,808,638	BOYAmt
EOY	$9,231,038	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$162,629	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$31,555,884	BOYAmt
EOY	$30,132,572	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$19,241,282	BOYAmt
EOY	$28,918,567	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$60,605,804	BOYAmt
EOY	$68,444,806	EOYAmt

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

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$130,840,623	BOYAmt
EOY	$119,298,786	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$4,512,348	BOYAmt
EOY	$4,618,245	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$2,298,570	BOYAmt
EOY	$2,298,570	EOYAmt

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$137,651,541	BOYAmt
EOY	$126,215,601	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$198,257,345	BOYAmt
EOY	$194,660,407	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$6,747,039	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$3,356,232	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$14,826,747	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	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 (true)	AuditCommitteeInd
Federal Grant Audit Required	Yes (true)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (true)	FederalGrantAuditPerformedInd

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	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$10,842	OtherActivitiesAmt
Total Lobbying Expenditures	$10,842	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY

ST. MARY'S HOSPITAL MEDICAL CENTER OF GREEN BAY, INC. ("THE HOSPITAL") IS A MEMBER OF THE CATHOLIC HEALTH ASSOCIATION ("CHA"), THE WISCONSIN HEALTH ASSOCIATION ("WHA"), THE NATIONAL ASSOCIATION FOR HOME CARE AND HOSPICE, AND THE AMERICAN HEALTH ASSOCIATION ("AHA"). AS A MEMBER OF THESE ORGANIZATIONS, THE HOSPITAL PAYS DUES, WITH PART OF THESE DUES BEING ATTRIBUTABLE TO LOBBYING FEES PAID BY THE ORGANIZATIONS. THE AMOUNT LISTED IS THE AMOUNT ATTRIBUTABLE TO THE HOSPITAL FROM ITS DUES PAID.

Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$2,276,732	OtherCostOrOtherBasisAmt
Book Value	$2,276,732	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$74,053,586	OtherCostOrOtherBasisAmt
Depreciation	$29,907,069	DepreciationAmt
Book Value	$44,146,517	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$682,229	OtherCostOrOtherBasisAmt
Depreciation	$385,974	DepreciationAmt
Book Value	$296,255	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$35,321,405	OtherCostOrOtherBasisAmt
Depreciation	$24,557,655	DepreciationAmt
Book Value	$10,763,750	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$52,889,091	OtherCostOrOtherBasisAmt
Depreciation	$30,805,969	DepreciationAmt
Book Value	$22,083,122	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$79,566,376	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDesc	AmtAmt
ACCRUED PENSION LIABILITY	$28,686,671
RETIREMENT OBLIGATION ASBESTOS	$231,896

Field	Value	IRS element (for citing)
Total Liability	$28,918,567	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote	FormAndLineReferenceDesc
Explanation	HSHS and the Foundation are Illinois not-for-profit organizations as described in Section 501(c)(3) of the Internal Revenue Code (the Code} and are exempt from federal income taxes on related income pursuant to Section 501 (a) of the Code. Kiara, Inc. is an Illinois for-profit corporation that recognizes income taxes under the asset- and-liability method. Deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the consolidated financial statement carrying amounts of existing assets-and-liabilities and their respective tax basis and operating loss and tax credit carryforwards. Deferred tax assets and liabilities are measured using the enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. In assessing the realizability of deferred tax assets, management considers whether it is more likely than not that some portion or all of the deferred tax assets will not be realized. The ultimate realization of deferred tax assets is dependent upon the generation of future taxable income during the periods in which those temporary differences become deductible. Management considers projected future taxable income and tax planning strategies in making this assessment. Based upon the level of historical taxable losses and projections for future taxable losses over the periods for which the deferred tax assets are deductible, management believes it is more likely than not Kiara, Inc. will not realize the majority of the benefits of these deductible differences. Full valuation allowances have been applied against the deferred tax assets attributable to the net operating loss carryforwards not realized as of June 30, 2016 and 2015 in the accompanying consolidated financial statements due to the uncertainty of realization. HSHS recognizes the tax benefit from an uncertain tax position only if it is more likely than not the tax position will be sustained on examination by the taxing authorities, based on the technical merits of the position. As of June 30, 2016 and 2015, HSHS does not have any liabilities for unrecognized tax benefits.	ExplanationTxt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Discounted Care Other	600	DiscountedCareOtherPct

Field	Value	IRS element (for citing)
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	false	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	2182	PersonsServedCnt
Total Community Benefit Expns	$4,990,577	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,927,710	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,062,867	NetCommunityBenefitExpnsAmt
Total Expense	0.0172	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	19979	PersonsServedCnt
Total Community Benefit Expns	$21,605,284	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$10,941,622	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$10,663,662	NetCommunityBenefitExpnsAmt
Total Expense	0.0891	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	620	PersonsServedCnt
Total Community Benefit Expns	$1,003,456	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$683,642	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$319,814	NetCommunityBenefitExpnsAmt
Total Expense	0.0027	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Activities Or Programs	3	ActivitiesOrProgramsCnt
Persons Served	22781	PersonsServedCnt
Total Community Benefit Expns	$27,599,317	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$14,552,974	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$13,046,343	NetCommunityBenefitExpnsAmt
Total Expense	0.1090	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	54	ActivitiesOrProgramsCnt
Persons Served	6619	PersonsServedCnt
Total Community Benefit Expns	$316,602	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$10,375	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$306,227	NetCommunityBenefitExpnsAmt
Total Expense	0.0026	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Activities Or Programs	10	ActivitiesOrProgramsCnt
Persons Served	13	PersonsServedCnt
Total Community Benefit Expns	$311,157	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$311,157	NetCommunityBenefitExpnsAmt
Total Expense	0.0026	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$3,463,205	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,375,092	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,088,113	NetCommunityBenefitExpnsAmt
Total Expense	0.0091	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	8	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$166,734	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$166,734	NetCommunityBenefitExpnsAmt
Total Expense	0.0014	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	73	ActivitiesOrProgramsCnt
Persons Served	6632	PersonsServedCnt
Total Community Benefit Expns	$4,257,698	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,385,467	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,872,231	NetCommunityBenefitExpnsAmt
Total Expense	0.0156	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	76	ActivitiesOrProgramsCnt
Persons Served	29413	PersonsServedCnt
Total Community Benefit Expns	$31,857,015	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$16,938,441	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$14,918,574	NetCommunityBenefitExpnsAmt
Total Expense	0.1246	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$2,000	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,000	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$2,000	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,000	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$2,369,206	BadDebtExpenseAmt
Bad Debt Expense Attributable	$258,306	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$34,113,598	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$50,940,612	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$16,827,014	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 (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (3 entries)

Primary ActivitiesPrimaryActivitiesTxt	Org Profit Or OwnershipOrgProfitOrOwnershipPct
PREVEA CLINIC INC
HEALTHCARE	0.25
PREVEA HEALTH SERVICES
HEALTHCARE	0.25
UNITY LIMITED PARTNERSHIP
HEALTHCARE	0.1

Field	Value	IRS element (for citing)
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 MARY'S HOSPITAL MEDICAL CENTER	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1726 SHAWANO AVENUE	AddressLine1Txt
City	GREEN BAY	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54303	ZIPCd

Field	Value	IRS element (for citing)
Website Address	www.stmgb.org	WebsiteAddressTxt
State License	18	StateLicenseNum
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 MARY'S HOSPITAL MEDICAL CENTER	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	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
Information Gaps	Yes (X)	InformationGapsInd
CHNA Conducted	14	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (true)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	www.stvincenthospital.org/Hospital-Information	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	14	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	www.stvincenthospital.org/Hospital-Information/About/Community-Health-Needs.aspx	StrategyWebsiteURLTxt
Strategy Attached	false	StrategyAttachedInd
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.0	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	600.0	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	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 (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	http://www.stmgb.org/Patients-Guests/Patient-Financial-Services	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	http://www.stmgb.org/Patients-Guests/Patient-Financial-Services	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	http://www.stmgb.org/Patients-Guests/Patient-Financial-Services	FAPSummaryOnWebsiteURLTxt
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
FAP Notice Displayed	Yes (X)	FAPNoticeDisplayedInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
FAP Notified Upon Admission	Yes (X)	FAPNotifiedUponAdmissionInd
FAP Notified Before Discharge	Yes (X)	FAPNotifiedBeforeDischargeInd
FAP Notified All Patients	Yes (X)	FAPNotifiedAllPatientsInd
Documented Elig Determination	Yes (X)	DocumentedEligDeterminationInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Average Negotiated Rates	Yes (X)	AverageNegotiatedRatesInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - HSHS St. Mary's Hospital Medical Center. Quantitative data for each of the potential health focus areas was assembled from a wide variety of public sources. The quantitative data was then reviewed to help validate the selection of health priorities. In alignment with IRS Treasury Notice 2011-52,2 data was reviewed by individuals who represented 1) the broad interests of the community, and 2) the voice of community members who were medically underserved, minorities, low-income, and/or those persons with chronic illnesses. These people attended the community health improvement project summit in November 2014. Scott Anderson, Northeast Wisconsin Technical College, Associate Dean, Allied Health Sciences Deborah Armbruster, Brown County Health Department, MCH Nurse Manager Sandy Atkins, Greater Green Bay YMCA, Director of Center Operations Sharla Baenen, Bellin Psychiatric Center, President Donna Boehm, St. Vincent Hospital, Director, Regional Cancer Services Erin Bongers, De Pere Health Department, Public Health Nurse Jamie Campbell, N.E.W. Community Clinic - WIC, Project Nutritionist, RD Tina Cazzola, Brown County Community Treatment Center, Substance Abuse Counselor In Training Barbara Coniff, Libertas, Director Laura Cormier, Bellin Health Oconto Hospital, Vice President Operations Kathie DeMuth, Bellin College, Assistant Professor Mike Donovan, City of De Pere Board of Health Chair/Council President Elaine Doxtator, HSHS St. Mary's Hospital Medical Center, Director Emergency Dept/Nursing Resource Grant Dvorak, Greater Green Bay Chamber Health Educator John Dye, Live 54218, Chairman, Executive Committee Christopher Elfner, Bellin Health, Team Leader Howard Endow, Brown County United Way, Community Impact Manager Thomas Erdman, University of Wisconsin Green Bay, Academic Curator Richter Museum of Natural History Patricia Finder-Stone, De Pere Board of Health/LWVGGB/BACC, Volunteer/BOD Judy Friederichs, Brown County Health Department, Director Caroline Glander, St. Vincent Hospital, RN-Patient Navigator (Cancer Center) Patti Glaser-Martin, Hospital Sisters Health System/Prevea Health, Sr. Manager, Internal Communication and Community Rob Gollman, Brown County Health Department, Environmental and Laboratory Division Manager Meredith Hansen, Aging & Disability Resource Center, Resource Specialist Adam Hardy, Achieve Brown County, Executive Director Margie Hempel, Unified School District of De Pere, Health Services Coordinator Kimberly Hess, Center for Childhood Safety Executive Director Laura Hieb, Bellin Health Sarah Himmelheber, University of Wisconsin-Green Bay Sarah Inman, Brown County United Way, VP of Community Investment & Strategic Impact Amy Jerdee, Aurora Baycare Medical Center, Vice President of Clinical Operations Elizabeth Kostichka, ElizK Insurance, Independent Insurance Agent Bonnie Kuhr, N.E.W. Community Clinic CEO Celia LaTour, Catholic Charities Greg Maass, Brown County United Way , Pres/CEO Steve McCarthy, N.E.W. Curative Rehabilitation, President and CEO Mary Miceli-Wink, Brown County Human Services, AODA Counselor Seth Moore, N.E.W. Community Clinic - Outreach Healthcare, Nurse Practitioner / Program Coordinator Melinda Morella, Live54218 , Assistant Director Mary Paluchniak, St. Nicholas Hospital, Facilitator - Outreach Angela Raleigh, Prevea Health, Marketing Associate John Rocheleau, Bellin Health, System V.P. Business Support and I.T. Stacy Ross, Brown County Health Department Dawn Schaefer, West De Pere School District, School Nurse Elizabeth Scheelk, State of Wisconsin - Division of Public Health, Public Health Educator Christine Schneider, Schneider National, Health and Wellness Manager Heidi Selberg, Hospital Sisters Health System, VP Advocacy and Community Benefit Patti Smeester, Brown County Health Department Rose Smits, Community Volunteer Jill Sobieck, Brown County United Way, Community Partnership for Children Coordinator Carrie Stempski, Brown County Oral Health Partnership Executive Director Troy Streckenbach, Brown County Brown County Executive Kaitlin Swanson, St. Vincent and St. Mary's Hospitals, Director of Planning & Strategic Support Dan Teaters, BC Planning & Land Services Dept./Green Bay MPO, Transportation Planner/GIS Catherine Therrien, N.E.W. Community Clinic, N.E.W. Dental Clinic Coordinator Ashley VandenBoomen, Brown County United Way, Research and Initiatives Manager Jen Van Den Elzen, Live54218, Director Christine Vandenhouten, University of Wisconsin Green Bay, Associate Professor Janelle Walton Aging & Disability Resource Center of Brown County, Disability Benefit Specialist Jody Wilmet, Bellin Health VP Bob Woessner, Bob, Inc. CEO Chrystal Woller, De Pere Health Department, Director Chua Xiong, Brown County Health Department, Nurse Manager Leanne Zhu, University of Wisconsin - Green Bay, Assistant Professor in Nutritional Sciences By holding the summit and by sharing the priorities and implementation plans with the hospital community advisory committee, the hospital took into account input from persons who represent the broad interests of the community served by the hospital, including those with special knowledge of, or expertise in public health (local, regional, state and/or tribal). Members of medically underserved, low-income and minority populations served by the hospital or individuals or organizations representing the interests of such populations also provided input. The medically underserved are members of a population who experience health disparities, are at risk of not receiving adequate medical care as a result of being uninsured or underinsured, and/or experiencing barriers to health care due to geographic, language, financial or other barriers.
Schedule H, Part V, Section B, Line 6a Facility , 1	Facility , 1 - HSHS St. Mary's Hospital Medical Center. Yes, we conducted the CHNA with Bellin Health and with Aurora BayCare Medical Center, as well as with our sister hospital HSHS St. Vincent Hospital.
Schedule H, Part V, Section B, Line 6b Facility , 1	Facility , 1 - HSHS St. Mary's Hospital Medical Center. A community wide CHNA steering committee was developed to guide the structure of the process to ensure that the requirements of all parties were met. Members of the CHNA Steering Committee represented organizations that have a legal or regulatory requirement to conduct a CHNA. The CHNA Steering Committee members included: Judy Friedrichs, Brown County Public Health Chrystal Woller, City of DePere Public Health Heidi Selberg, Hospital Sisters Health System John Rocheleau, Bellin Health Jodi Wilmet, Bellin Health Laura Heib, Bellin Health Mark Huber, Aurora Health Howard Endow , United Way Christopher Colletta, WI Department of Health Northeast Region
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - HSHS St. Mary's Hospital Medical Center. HSHS St. Mary's Hospital will partner with the community wide action planning teams to develop, implement, monitor and evaluate both new and ongoing initiatives that address the identified priority community health needs. The implementation strategies and interventions will include, but are not limited to, the following initiatives categories. 1. Oral Health -HSHS St. Mary's Hospital is involved in the implementation and/or continuation of the following efforts to improve access to care. a. Lead the activities of the community Oral Health Task Force, which has its own three year plan with goals and outcome measures (work plan will be attached to this report upon completion). b. Support Public Health's efforts to retain fluoridation in public health water supplies via testimony when requested 2. Mental Health, AODA, Physical Activity and Nutrition - St. Mary's Hospital is engaged in the development, implementation and/or continuation of the following efforts to improve services. a. Support the activities of the community action planning teams, which have their own three year plan with goals and outcome measures (work plans will be attached to this report upon completion). b. Work with Public Health and our community partners to identify and implement at least one new evidence-based community program that addresses one of the identified health priorities. 3. Identify and implement programs to provide appropriate care to poor and needy. a. Develop strategies to reduce ED visits for dental conditions b. Develop strategies to reduce ED visits by Medicaid patients and provide them with care in settings appropriate to their needs. c. Provide assistance to community members to enroll in insurance products through the market place or to enroll in BadgerCare, as appropriate for their situation. HSHS ST. MARY'S HOSPITAL WAS A KEY PART OF A COLLABORATIVE APPROACH IN CONDUCTING ITS CHNA AND ADOPTING AN IMPLEMENTATION PLAN IN FY2015 (JULY 1, 2014 THROUGH JUNE 30, 2015) IN PARTNERSHIP WITH REPRESENTATIVES FROM THE COMMUNITY. UPON COMPLETION OF THE CHNA, THE HOSPITAL DEVELOPED A SET OF IMPLEMENTATION STRATEGIES AND ADOPTED AN IMPLEMENTATION PLAN TO ADDRESS PRIORITY COMMUNITY HEALTH NEEDS. THE POPULATION ASSESSED WAS BROWN COUNTY, WISCONSIN. DATA COLLECTED THROUGHOUT THE ASSESSMENT PROCESS WAS SUPPLEMENTED WITH THE RESULTS OF A BEHAVIORAL RISK FACTOR COMMUNITY SURVEY AND THE OPINIONS OF COMMUNITY LEADERS OBTAINED VIA A COMMUNITY HEALTH NEEDS ASSESSMENT "SUMMIT" HELD IN NOVEMBER, 2014. THE FOLLOWING HEALTH NEEDS WERE IDENTIFIED BASED ON THE PERCEIVED MAGNITUDE AND SERIOUSNESS OF THE PROBLEM AND THE FEASIBILITY OF ADDRESSING IT, AS DETERMINED AT A HEALTH NEEDS SUMMIT ATTENDED BY A GROUP BROADLY REPRESENTATIVE OF THE COMMUNITY: ALCOHOL AND OTHER DRUG ABUSE, MENTAL HEALTH, PHYSICAL ACTIVITY AND NUTRITION, AND ORAL HEALTH. THESE NEEDS WERE IDENTIFIED BY USING THE WISCONSIN DEPARTMENT OF PUBLIC HEALTH'S CHIP INFRASTRUCTURE IMPROVEMENT PROJECT'S RECOMMENDED LIST OF HEALTH FOCUS AREAS, IDENTIFYING EXISTING DATA THAT OUTLINES THE MAGNITUDE AND SERIOUSNESS OF THE HEALTH FOCUS AREAS, AND THEN CONVENING A HEALTH SUMMIT WITH ATTENDANCE BROADLY REPRESENTATIVE OF THE COMMUNITY TO SELECT THE HEALTH FOCUS AREA FOR INTENSIVE FOCUS OVER THE NEXT THREE YEARS. AS PART OF THE ENGAGEMENT PROCESS WITH KEY STAKEHOLDERS, ATTENTION HAS BEEN GIVEN TO NATURAL PARTNERSHIPS AND COLLABORATIONS THAT WILL BE USED TO OPERATIONALIZE THE IMPLEMENTATION PLAN. THE IMPLEMENTATION PLAN IS CONSIDERED A "LIVING DOCUMENT" - A SET OF STRATEGIES THAT CAN BE ADAPTED TO THE LESSONS LEARNED WHILE IMPLEMENTING COMMUNITY BENEFIT PROGRAMS AND SERVICES RELEVANT TO THE PRIORITY NEEDS. THE BROADER SET OF COMMUNITY HEALTH NEEDS WILL CONTINUE TO BE MONITORED FOR CONSIDERATION AS FUTURE FOCUS AREAS.

Field	Value	IRS element (for citing)
Facility	0	FacilityNum

Supplemental Information Detail SupplementalInformationDetail (20 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part VI, Line 6 Description of Affiliated Group (Continued A)	In southwest Illinois, HSHS St. Joseph's Hospital in Highland enhanced their offerings to their senior population based on their CHNA. "Senior Renewal" is an outpatient counseling program for senior adults who may be facing emotional and physical problems unique to the aging process such as feelings of loneliness, isolation and anxiety. Clients receive a comprehensive level of treatment without inpatient hospitalization through counseling strategies and education. In addition, St. Joseph's Hospital in collaboration with the Illinois Department of Insurance participates in the Senior Health Insurance Program (SHIP), a free health insurance counseling service for Medicare beneficiaries and their caregivers. In addition to programs designed to increase access to care, HSHS makes sure that those who need financial assistance receive it. HSHS's Financial Assistance (Charity Care) policy was modified effective January 1, 2014 to offer a 25 percent self-pay discount to all patients who register without insurance. HSHS Financial Assistance programs have a sliding scale, in some instances providing up to a 55 percent reduction off billed charges if an uninsured patient's family income level is determined to be above 500 percent but equal to our less than 600 percent of the current Federal Poverty Guidelines. HSHS hospitals waive all charges for patients below 200 percent of the Federal Poverty Levels. Counselors are available in our hospitals to explain our financial assistance policy to patients, provide them with assistance in filling out a simple application form, or help them enroll in publicly funded health care programs. Enhance community health As part of our mission to embody Christ's healing love for all people, we understand that we have a responsibility to improve the overall quality of life in our communities by supporting initiatives that promote health and wellness. We recognize we are most successful when we work together with a wide array of public and private organizations that share our commitment to improving lives. By doing so, we maximize our efforts and reduce the duplication of services. To ensure the health care needs of all are being met, HSHS hospitals also understand we need to listen closely to the residents of the communities we serve. In turn, 13 of our 15 hospitals completed Community Health Needs Assessments (CHNAs) in FY2015. HSHS St. Clare Memorial Hospital in Oconto Falls, Wisconsin, who affiliated with HSHS in September 2015, and HSHS Holy Family Hospital in Greenville, Illinois, who affiliated with HSHS in May 2016, both completed their CHNAs in FY2014. HSHS hospitals are using the information gathered from their most recent CHNAs to develop new, and enhance existing, programs and services that best address the needs of the community. Several priority areas were identified in the FY2015 CHNAs including access to health care services; alcohol, tobacco, and other drug abuse; chronic disease prevention and management; nutrition/wellness; mental health; and oral health. HSHS hospitals are addressing these and other needs by proactively offering educational opportunities, preventative screenings, and new or enhanced clinical services. In many cases, the hospitals collaborate with other hospital facilities, local departments of public health and community organizations to address identified needs. In western Wisconsin, HSHS Sacred Heart Hospital in Eau Claire and HSHS St. Joseph's Hospital in Chippewa Falls are taking the lead on programming to educate the public about mental health issues and treatment, the stigma associated with mental health, and the recognition of mental health issues. To combat the rising rate of suicides in the area, both hospitals under the umbrella of 3D Community Health are providing community education on QPR (Question, Persuade and Refer), an evidence-based suicide prevention program. In FY2016, 3D Community Health provided 37 adult QPR programs for 1,046 persons and 44 youth QPR programs for 1,161 high school students. In addition, 3D Community Health hosted a community forum to discuss the CHNA results and introduce QPR to 192 community members. HSHS St. Vincent Hospital in Green Bay collaborated with Prevea Health to implement the TIPS program, a program for non-violent opioid abusers that provides treatment and deferred/dismissed prosecution upon successful completion of the treatment program. St. Vincent Hospital also subsidized scholarships for a residential treatment program and arranged to have the first dose of Vivitrol donated; Vivitrol prevents relapse to opioid dependence after opioid detox by attaching to opioid receptors and blocking feelings of pain relief and wellbeing. HSHS St. Mary's Hospital in Decatur, Illinois joined the Macon County Mental Health Board to collaborate on existing programs and to provide resources to meet identified gaps. While other communities are cutting back on mental health services, St. Mary's Hospital remains committed to providing a full spectrum of behavioral health services for adolescents, adults and senior. For example, the hospital collaborates with the Decatur Public School District to provide school teachers for two hours per day for children in the adolescent behavioral health unit. The partnership limits the amount of schoolwork missed during hospitalization. The hospital also has substance abuse counselors who provide educational programs on alcohol and other drug abuse in county schools for students and faculty. HSHS St. Nicholas Hospital in Sheboygan identified nutrition and physical activity as a priority health need in its FY2015 CHNA. In response, St. Nicholas Hospital coordinated and supported the development of the "Double Your Bucks" program at the Sheboygan Farmers Market in FY2016 to enable EBT recipients to double the amount of fresh fruits and vegetables they can purchase. The hospital is also a sponsor of the Sheboygan Farmers Market to promote healthy eating in the community. Additionally, St. Nicholas subsidized the cost of additional bike helmets at the Early Learning Center to increase the physical activity levels of Head Start students and purchased culinary equipment for South High School nutrition and fitness classes to increase opportunities for students to learn how to prepare healthy food. HSHS St. Mary's Hospital in Streator, Illinois collaborated with two local schools to establish community gardens on each of their campuses to address childhood obesity in addition to the community garden on the hospital campus. Students, their families, and hospital colleagues planted, tended and harvested the gardens. Math and science teachers incorporated the gardens into their curricula. Neither school offered Home Economics classes, so St. Mary's Hospital provided the produce and colleagues to offer cooking demonstrations in the classrooms to encourage students to prepare fresh fruit and vegetables snacks. The three gardens produced more than 1,713 pounds of produce in three years, which was donated to the local food pantry, Salvation Army, students and local churches providing healthy food to the poor and vulnerable. Advance medical knowledge HSHS works to advance medical knowledge by supporting research initiatives and educational opportunities. In FY2016, HSHS hospitals and affiliated physician groups contributed more than $19.1 million toward research and education. Highlights of this commitment include subsidizing medical school residency programs, offering ongoing medical education to physicians and clinicians, and providing job shadowing programs for high school students. In southern Illinois, HSHS St. Joseph's Hospital in Breese, hosted members of the Health Occupations Students of America onsite to learn about job opportunities in health care from health care professionals. St. Joseph's also provided clinical experience for Kaskaskia College students enrolled in nursing, physical therapy and radiology programs. Pharmacy students have also completed their clinical training at St. Joseph's Hospital. In FY2016, the program served more than 100 students. In FY2016, HSHS St. Mary's Hospital Medical Center and HSHS St. Vincent Hospital in Green Bay invested more than $311,000 to provide onsite training and education of nurses and allied health professionals. In addition, the hospitals have been collaborating with the Medical College of Wisconsin to establish a community medical education program in Green Bay and to provide financial support to offset operating costs in FY2016. Also in eastern Wisconsin, HSHS St. Clare Memorial Hospital in Oconto Falls provided training for local paramedics and emergency response personnel through the hospital's EMS liaison program.
Schedule H, Part VI, Line 6 Description of Affiliated Group (Continued B)	Mission-driven and strategically implemented Community Benefit is an integral part of Hospital Sisters Health System's Mission. Our commitment to Community Benefit arises from our Catholic identity, Mission and Core Values shared by 14,000 colleagues across Illinois and Wisconsin. Through our work to improve access to health care services, enhance community health, advance medical knowledge, and relieve or reduce the burden of government, we believe we have made a positive difference in the quality of lives of tens of thousands of people in Illinois and Wisconsin in FY2016. As a Catholic health care ministry, HSHS is concerned with the dignity of all persons, the common good, and the stewardship of resources. We advocate for health care for all and work to improve social conditions that lead to improved health and well-being. We engage partners in our communities to improve health and quality of life and to reduce duplication. Working side by side with many faith communities, HSHS remains dedicated to our common purpose of compassionate care for all people.
Schedule H, Part VI, Line 5 Promotion of Community Health (Continued A)	Double your bucks: Adequate food and nutrition was identified as one of the major health needs facing our community. The community wide food and nutrition action planning group has been actively working with local farmers market to encourage customers using EBT (Electronic benefit transfer, formerly known as food stamps) to purchase fruits and vegetables. They worked to enable vendors to accept EBT, and, using a planning grant from a local foundation, trialed a "double your bucks" initiative to double the purchasing power of EBT when used for fruits and vegetables up to a maximum of $10. A trial of this program showed that that the programs increased purchases of fruits and vegetables by those receiving EBT benefits. HSHS St. Vincent and St Mary's has stepped forward to provided funding so that the "double your bucks" program could continue. Without this agreement, the trial program would have been discontinued despite demonstrated success. Here are some of the outcomes from the 2015 season: 95% of participants say that as a result of the program they eat more fruits and vegetables; 84% say they purchase fewer high fat low nutrition snacks, and 94% say they now purchase more fruits and vegetables year round. And, to have this program have even greater impact, a condition of our support has been that the patient focused literature developed by the oral health group be distributed to participants along with toothbrushes. Reports are the participants are delighted by this extra added bonus! Other community benefit activities: * Provided free and discounted laboratory and radiology services to NEW Community Clinic, an FQHC. More than 70 percent of patients indicate the clinic's care prevented a trip to the emergency department. * Provided more than $100,000 to support acute care clinic operations NEW Community Clinic's Northeast Wisconsin Technical College location, as well as funds to help support operating costs associated with the oral surgeon's services at the dental clinic. * Assisted in excess of 2800 people by screening and applying for the appropriate assistance, such as SSDI or medical assistance, including providing certified application counselors to assist patients in understanding and using the new health insurance marketplace. * Spent over $311,000 to provide onsite training and education of nursing and allied health professionals within its facilities. * Collaborate with Medical College of Wisconsin in offering a community medical education program in Green Bay, and have provided financial support to offset operating costs and staff to assist in training physicians. * Through A Woman's Place, provide health and wellness education, health screenings, resources and referral services, facilitated by a Hispanic health outreach facilitator. * A Woman's Place served nearly 4800 women through its resource center and consumer lending library; screenings for cardiovascular disease, osteoporosis and reproductive cancer; and educational events and classes on a variety of health topics. * Hospital employees provide information at educational and public forums. Many underserved and uninsured of our community attend these events. * A loan closet located at A Woman's Place provides wigs, scarves, turbans, hats and breast prostheses for women living with the side effects of cancer treatments. * Additionally, the Look Good, Feel Better Program offers information and guidance to cancer patients looking to enhance their appearance. This gives patients a sense of control over physical changes they may experience. * St. Mary's Hospital donated more than $44,000 in diagnostic services supplies to the missions. * St. Mary's Hospital, along with St. Vincent Hospital and Bellin Health, supports Unity Hospice, a provider of appropriate and compassionate care for the terminally ill.
Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation	2369206
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance	Charity care is calculated by determining the total amount from patient billing that is written off to charity care charge codes or allowances. This amount matches the number that is reported on our fiscal year ending 2016 audited financial statements. The total charity care dollar amount is then reduced to cost by applying the hospital's cost to charge ratio as calculated on IRS Schedule H-Worksheet J.
Schedule H, Part II Community Building Activities	THE COMMUNITY BUILDING ACTIVITIES THAT WE HAVE TRACKED AND REPORTED IN OUR COMMUNITY BENEFIT REPORT ARE A MINOR PORTION OF OUR TOTAL COMMUNITY BENEFIT EFFORTS. THEY CONSIST PRIMARILY OF ACTIVELY PARTICIPATING IN AND SUPPORTING THE WORK OF COMMUNITY GROUPS TO ADVANCE COMMUNITY AWARENESS ABOUT HEALTH ISSUES SUCH AS LEADING THE ORAL HEALTH COMMUNITY TASK FORCE AND SERVING ON THE NEW COMMUNITY CLINIC BOARD.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	Self-pay patients are screened for verification of no insurance coverage. Once verification of no coverage has been completed, the guarantors will be screened for charity or uninsured discounts based on income levels. Those guarantors that do not qualify for charity through the screening process will be asked to provide proof of income in the form of a recent pay stub and/or recent tax return to determine the level of uninsured discounting. If no proof of income is provided or a guarantor's income is greater than 201% of the federal poverty level, the appropriate discount according to the established criteria will be applied. The amount of money not collected from those self-pay patients who are not eligible for charity care is reported as bad debt. Allowances for doubtful accounts have been recorded based on an historical matrix, using collectability percentages by payor and aging category in accordance with HSHS Executive Policy #F-23, Valuation of Net Accounts Receivable. Percentages are based on historical experience at the hospital and adjusted for known limitations. HSHS St. Mary's Hospital reports bad debt in accordance with healthcare financial management association statement 15, as modified and consistent with Generally Accepted Accounting Principles (GAAP).
Schedule H, Part III, Line 3 Bad Debt Expense Methodology	The hospital strongly believes that its charity care, and the related community benefit obtained from such care, is understated because of those patients who potentially qualify for charity care but do not wish to apply for it. In addition, some care is not classified as charity because of missing documentation on patient resources. Thus, the hospital's bad debt includes a portion that could be classified as charity care if application for such care was sought and/or completed. Currently, the hospital is implementing processes, procedures and systems to more effectively determine charity care that will reduce a patient's documentation requirements and ease the patient's emotional burden in applying for charity care. This will provide a more accurate reporting of charity care services provided by the hospital.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	The text of the footnote to the organization's financial statements that describes bad debt expense can be found on page 21 in the HSHS Consolidated Audit Report.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	The hospital continually strives to provide excellent patient care in the most cost effective fashion. Nonetheless, the Medicare program, in many cases, does not provide payment that covers the full cost of the care provided. Since it is the mission of the hospital to respond to community need, hospital management continually advocates for improved Medicare payment so that the cost of quality care to those patients who are not able to afford it is not compromised and is fairly subsidized by all payers. While this shortfall in Medicare payments is not classified as community benefit by the IRS, we nonetheless believe it is an important contribution made by the hospital to the health and well-being of the community. If the Medicare program did not exist, many Medicare patients would be eligible for charity care or other means-tested government programs. Further, by absorbing this payment shortfall and providing care below cost to these individuals, HSHS St. Mary's Hospital is relieving the burden of the government. Accordingly, this shortfall restricts HSHS St. Mary's Hospital's ability to make funds available to provide charity care and other community benefit. The hospital computes the unpaid costs of providing care to Medicare patients by comparing the cost of the services to the reimbursement received from Medicare during the year. The cost of Medicare services is calculated by applying the ratio of patient care cost to charges to the annual Medicare charges. The patient care cost is determined by reducing the total annual operating expense by bad debt expenses, Medicaid provider taxes and community benefit expense. The difference between the reimbursement received and the calculated cost of the services is reported as the Medicare shortfall. The hospital's Medicare shortfall at cost for fiscal year 2016 was nearly $16,827,014.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	Every effort is made prior to, during, and after provision of medical services to determine whether a patient is eligible for charity/community care and to assist the patient in completing the application and providing adequate documentation. If the patient qualifies for charity/community care for the full balance of their account, the entire amount is written off to charity/community care and hence no debt collection is pursued. If the patient qualifies for charity/community care for a portion of their account balance, that portion is written off to charity/community care, with the patient being responsible for the remainder of the balance. Additionally, reasonable effort will be made to obtain third-party or government payer reimbursement on behalf of the patient. If those efforts are not fruitful, an offer will be extended to the patient to make installment payments on their balance. Only at such point that the patient defaults on installment payments or refuses to cooperate with the hospital's efforts to be reimbursed will the account be sent to collections.
Schedule H, Part V, Section B, Line 16a FAP website	- ST. MARY'S HOSPITAL MEDICAL CENTER: Line 16a URL: http://www.stmgb.org/Patients-Guests/Patient-Financial-Services;
Schedule H, Part V, Section B, Line 16b FAP Application website	- ST. MARY'S HOSPITAL MEDICAL CENTER: Line 16b URL: http://www.stmgb.org/Patients-Guests/Patient-Financial-Services;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- ST. MARY'S HOSPITAL MEDICAL CENTER: Line 16c URL: http://www.stmgb.org/Patients-Guests/Patient-Financial-Services;
Schedule H, Part VI, Line 2 Needs assessment	As indicated in Part V, Section C, HSHS St. Mary's Hospital conducted a community health needs assessment in FY2015 (July 1, 2014 through June 30, 2015). The previous community health needs assessment was completed in fiscal year 2012, using a community-wide collaborative process similar to the one used in FY2015. Prior to that, the hospital used a variety of means to assess community needs. These included forming a community advisory committee broadly representative of the community, having executive leaders serve on the boards of community agencies, visiting with agencies serving the poor and needy to learn what their needs are, and reviewing the health care needs of the Medicaid and uninsured patients who visited our emergency departments. Provisions in the Affordable Care Act require charitable hospitals to conduct a CHNA and adopt implementation strategies to meet the needs identified. To comply with these requirements, St. Mary's Hospital led a collaborative approach to conduct its CHNA and adopt an implementation plan in FY2015 (July 1, 2014 through June 30, 2015), a process we undertake every three years.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	Our hospital posts our charity care brochure and application on our website. In addition, charity care applications are available and prominently displayed in our waiting and registration areas. Our financial counselors are available to meet with patients on site before or at the time of service to assist them in identifying whether they are eligible for government aid or financial assistance, and to assist them in applying for programs for which they may be eligible. After patients receive service, our customer service representatives are also trained to assist them to apply for various government programs or for our charity care program. Our collectors are trained to provide this assistance as well. We also have contracted with an outside firm to do active outreach with patients who may need additional assistance or advocacy to apply for benefits, appeal denials, or who need transportation to government agencies to apply for benefits. One-on-one conversations to educate patients about financial assistance often stem from patients receiving a statement or a pre- collection letter. At that point, the customer service representative or cashier, or other qualified staff, will inform/educate the caller about financial assistance options. The first pre-collection letter reminds the patient their account is in delinquent status. It also informs them they may be eligible for financial assistance through the organization's charity care program. The letter provides direct contact information to begin the application process for charity care and lists the internet address where the policy can be obtained. A system called Search America is now being utilized after failed attempts made by the hospital and our law firm to work out payment arrangements. That system reviews credit and other publicly available financial information to discern the probability of a patient being able to pay their bill. After assessing that information, the hospital makes a determination whether to grant charity care or continue collection efforts.
Schedule H, Part VI, Line 4 Community information	Brown County, Wisconsin is a primarily urban county, one of 72 Wisconsin counties, and is located in the northeastern part of the state. Brown County's population is predominantly Caucasian (86%), with a small proportion of people who are Native American) or Black (about 2%). There is a sizeable Hispanic population, just over 7% of the population. There are approximately 260,000 residents, of which nearly 34,000 are covered by Medicaid/BadgerCare . About 12% of Brown County residents live at or below the federal poverty level (sources: County Health Rankings). According to the 2016 County Health Rankings, 11% of Brown County's population is uninsured. Brown County contains a dental care HPSA (health professional shortage area) and the metro area is a MUA (medically underserved area), per HRSA. There are three not-for-profit general medical surgical hospitals and one for-profit general medical surgical hospital serving brown county and the surrounding area. In addition, there is one not-for-profit psychiatric hospital and one county operated psychiatric hospital operating, and one for-profit psychiatric hospital scheduled to open summer of 2016. Since most of the population resides in the Green Bay metro area, plans and services focus on this area.
Schedule H, Part VI, Line 5 Promotion of community health	HSHS St. Mary's Hospital is committed to delivering high quality, compassionate, and cost-effective health care services to all. The hospital was founded more than 125 years ago to bring a healing presence and improve the health of our community, especially for those persons who are sick, poor, and disadvantaged. Because of the hospital's purpose and tradition, it is organized to promote the health of Brown County, Wisconsin and surrounding areas. The hospital is governed by a Board of Directors, at least a majority of whom reside in the hospital's primary service area and who are neither employees nor independent contractors of the hospital (nor family members thereof). The Board ensures that HSHS St Mary's Hospital is responding to community need. During FY2012 and FY2015, for example, the board reviewed the community health needs assessment and approved an implementation strategy for addressing selected needs. Our hospital advisory council and the Friends of St. St. Mary's Foundation, provide the hospital with additional connections to and insights into the larger community and its health care needs. Also consistent with its exempt purpose, HSHS St. Mary's Hospital has an open medical staff with privileges available to all qualified physicians in the area. The hospital also operates an emergency department that is open 24 hours to all persons regardless of their ability to pay. As a not-for-profit hospital, HSHS St. Mary's Hospital reinvests surplus funds to support the mission of the organization and health of the community rather than distributing surplus funds as profits to shareholders or individuals. Funds not committed to ongoing operations are generally used to upgrade facilities, secure new technologies, improve patient care, and support initiatives designed to promote health and ensure access for all. HSHS St. Mary's Hospital also serves as a site for health professions education HSHS St. Mary's Hospital also devotes significant resources to access for patients who cannot afford care, along with other community benefits. In FY 2016, HSHS St. Mary's Hospital provided nearly $15 million in Community Benefit services, including charity care at cost, unpaid costs of Medicaid and other public programs, and a range of diverse programs designed to enhance access and improve community health. Additionally, in FY2016, HSHS St. Mary's Hospital provided nearly $17 million (at cost) in excess of Medicare payment for health care services. HSHS St. Mary's Hospital provides a range of Community Benefit activities and programs that furthers our mission and long-standing commitment to our community. In many cases, these Community Benefit initiatives would not exist without the leadership role played by HSHS St. Mary's Hospital and they often relieve a burden that would otherwise be carried by government. Since HSHS St. Vincent Hospital and HSHS St Mary's Hospital are in the same market, only a few miles apart, they jointly conduct the CHNA along with community partners. They work together on their CHNA implementation strategy. Indeed, the cost of most proactive community benefit projects are shared two thirds by St. Vincent and one third by St. Mary's. Following are the top identified health needs and examples of related implementation strategies in FY2016: 1. Oral Health a. Continued to lead the activities of the community Oral Health Task Force, which has its own three year plan with goals and outcome measures. Extensive summary of this work is available. Prevention, intervention, and policy modification strategies are included in the committee's action plan. b. Helped to expand services at NEW Community Clinic dental clinic by i. Supporting the effort to gain a HRSA grant for expansion through subsidizing the rent guarantee necessary and assisting with the design cost for the center ii. Supporting the efforts of the oral surgeons to provide their services free of charge at NEW Clinic by subsidizing the cost of a staff person to gain the necessary medical clearances and consent forms for patients-many of whom are elderly and/or disabled and need consent from guardians c. Helped to expand oral health services to children in other school districts by paying for a dental hygienist employed by the Brown County Oral Health Partnership to offer services in the Ashwaubenon school district. d. Served on the boards for NEW Community Clinic and Oral Health Partnership, playing significant roles in their governance (e.g., Vice President on NEW Clinic board; search committee member for OHP and lead the announcement process for the new executive director) 2. Mental Health, AODA, Physical Activity and Nutrition a. Actively participated in the development of the Greater Green Bay Mental Health Connection, which is a collaboration of agencies and organizations designed to reform the mental health delivery system in our community. Led the strategic planning process, wrote portions of the grant application that resulted in a major seven year grant from Medical College of Wisconsin, and served on the steering committee. b. Partnered with Prevea Health to implement the TIPS program, a program for non-violent opioid abusers that provides treatment and deferred/dismissed prosecution upon successful completion of the treatment process. Actions included subsidizing scholarships for a residential treatment program and arranging to have the first dose of Vivitrol donated. c. Started the "Plant a Row" program to address "food and nutrition," a health focus area in all of our markets. d. Supported the "double your bucks" program at farmers markets in Green Bay, DePere and Oneida to enable EBT recipients to by double the amount of fresh fruits and vegetables. e. Supported the Boy Scout "Scouting for Food" food drive. This food drive is using the materials developed by the local food and nutrition group that provides guidelines and suggestions for donors that encourages them to contribute healthy foods. 3. Identify and implement programs to provide appropriate care to poor and needy. a. Provided assistance to community members to enroll in insurance products through the market place or to enroll in BadgerCare with the assistance of certified application counselors and educational sessions. b. Through an agreement with Brown County, subsidized the cost of an income maintenance worker to assist with immediate enrollment in BadgerCare. Assistance). The following are two examples of the impact these efforts have had on our community: Oral Health Partnership: The Oral Health Partnership has made tremendous inroads in the Green Bay schools to address these issues, but has not had the capacity to reach out to other local school districts-there are 9 in Brown County. Based on their assessment of where the greatest need resides and using a donation from HSHS St Vincent and HSHS St Mary's, OHP was able to begin services to the Ashwaubenon school district. OHP shared the following story: "Due to our opportunity to expand our school based services to Ashwaubenon, a young middle school student was able to receive much needed dental services. Her only access to dental care has been provided through OHP. During her school appointment for an exam, sealants and a cleaning 6 teeth were identified with decay. One of these molars was deeply decayed down to the gum line and the infection had spread through the roof of the mouth. This situation is especially dangerous in that the infection can spread to other parts of the body, including the brain. This patient received chair-side oral hygiene education and then through case management was appointed for follow up treatment at the Howe Resource Center Dental Clinic. The mother of this patient was unaware of the severity of her child's dental disease and our clinical staff was able to relay the importance of receiving oral care and education to aid in prevention of further disease and maintenance of oral health." The school nurse writes, "I am so appreciative of the relationship that the Brown County Oral Health Partnership has forged with our district. Through this alliance 79 students received oral health care that otherwise would have been difficult to obtain. Some of these students were identified with significant dental issues, including dental caries and abscesses. What a relief to know that these students can now receive the proper dental care, which in turn helps them to be healthy and ready to learn. I am hoping we can continue this partnership in the future!"
Schedule H, Part VI, Line 6 Affiliated health care system	HSHS St. Mary's Hospital Medical Center in Green Bay is an affiliate of Hospital Sisters Health System (HSHS), a health care ministry that includes 15 hospitals, numerous community-based health centers and clinics, and hundreds of physician partners across Illinois and Wisconsin. The mission of HSHS is "to reveal and embody Christ's healing love for all people through our high quality Franciscan health care ministry." We live our mission by providing holistic healing to all who seek our care, as well as through Community Benefit. In tandem with others in the communities we serve, our Community Benefit initiatives are strategically increasing access to care, improving the health status of residents, and increasing medical education and knowledge. In FY2016, our hospitals responded to the top needs identified in each of their most recent Community Health Needs Assessments (CHNAs). The information gathered from these assessments was used to develop or enhance Community Benefit programs and services to best address community health needs. Among the priority needs identified in the most recent CHNA process were access to care; alcohol, tobacco, and other drug abuse; chronic disease prevention and management; nutrition/wellness; mental health; and oral health. HSHS hospitals are proactively addressing these and other needs through patient, provider and community education, preventative screenings, self-management classes, and new or enhanced clinical services. In FY2016, HSHS collectively provided $203.8 million in Community Benefit (10.0% of total hospital expenses). This amount included $28.1 million provided for Financial Assistance (i.e. Charity Care) and $134.3 million for unreimbursed care provided as part of the Medicaid program. In addition, HSHS hospitals committed significant resources to treat Medicare patients. The cost of providing services to primarily elderly beneficiaries of the Medicare program - in excess of governmental and managed care contract payments - was $221.3 million. HSHS hospitals also recorded $31.4 million in uncollectible accounts. While HSHS does not count the latter two amounts as Community Benefit, they nonetheless reflect our commitment to serving all persons in need of care. In addition to the dollars invested in our Community Benefit programs, HSHS continues to reinvest any surplus revenue from operations and investments into new medical technology, facility infrastructure and health care services in our communities. By doing so, we ensure our ability to meet the ongoing demand for high quality, efficient and easily accessible health care. Improve access to health services As a Franciscan health care ministry, HSHS is deeply committed to serving those who are most in need with a special focus on the poor and vulnerable. We not only provide care to every patient who walks through our doors, but also reach out beyond the walls of our hospitals and clinics to care for those in our communities. Our efforts to ensure residents in the communities we serve receive the right care, at the right time, and in the right setting involve collaborating with others to achieve this goal. Across our two-state System, there are numerous examples of partnerships with departments of public health, other health care facilities and community and social service organizations to enhance access to care for those in need. In FY2016, HSHS and our 15 hospitals invested Community Benefit resources to educate the uninsured about new enrollment opportunities in affordable health care coverage and to facilitate the process. Studies have shown that people without insurance are more likely to postpone care and develop more severe and expensive conditions than their insured counterparts. It is for this reason that the Catholic Church, Catholic health care and HSHS have long promoted "coverage and access for all." HSHS and our 15 hospitals in partnership with local health departments, social service agencies and other health care providers played a vital role in educating eligible people in their local communities, by referring people to Certified Application Counselors and/or in enrolling them in the health insurance exchanges, or in securing coverage through Medicaid expansion. In southern Illinois, HSHS St. Elizabeth's Hospital in Belleville identified an education gap among newly insured patients. Although these patients now had health insurance, they did not know how to use insurance nor did they understand the many benefits that come with different plans. To bridge the gap, St. Elizabeth's Hospital hosted quarterly resource fairs in collaboration with other social service agencies in the community to not only educate the public about their health insurance benefits but also about other resources in the community that can improve their overall health and quality of life. More than 100 persons participated in the resource fairs and each received a healthy snack or hygiene kit. In response to its FY2015 CHNA, HSHS St. John's Hospital in Springfield, Illinois established a community health worker program to increase access to health care and coordination of care for residents of the Enos Park Neighborhood. The hospital also helped establish an Enos Park Neighborhood Advisory Council and Providers Alliance as part of the access collaborative to drive behavior changes and improve health outcomes. In the first year of the program, 103 clients were 100% engaged. Services provided included basic needs (70%) and health care access (30%). The access collaborative also placed 12 homeless individuals or families in affordable, safe housing in Enos Park. Of the 27 parolees we worked with, we realized an 18% recidivism rate compared to the national rate of 60% due to lack of housing or employment. One hundred percent of our clients visited a primary care provider and 84% connected to a medical home. Due to the program's initial success, it is being replicated in Sangamon County's eastside where our most poor and vulnerable populations live. HSHS St. Mary's Hospital Medical Center in Green Bay led the activities of the community Oral Health Task Force, which focuses on prevention, intervention and policy modification strategies to improve oral health in Brown County. In FY2016, St. Mary's Hospital helped to expand the services at NEW Community Clinic dental clinic by supporting their efforts to secure a HRSA grant for expansion by subsidizing the rent guarantee necessary and by assisting with the design cost for the center. The hospital also subsidized the cost of a staff person to obtain the necessary medical clearances and consent forms for patients, many of whom are elderly and/or disabled and need consent from guardians - thus supporting the oral surgeons who are providing their services free of charge. St. Mary's Hospital expanded oral health services for children by covering the costs of a dental hygienist employed by the Brown County Oral Health Partnership to offer oral health services in the Ashwaubenon school district. Through this new alliance, 79 students received oral health care that otherwise would have been difficult to obtain, including care for dental caries and abscesses. HSHS St. Francis Hospital in Litchfield, Illinois collaborated with Lewis & Clark Community College and local dental providers to bring the College's mobile dental health unit to the Litchfield area; the unit provides free or low cost dental exams and screenings, x-rays and hygiene services. In addition, three local dental providers also participated by opening their offices and donating time, staff and supplies to provide either a free filling, extraction or hygiene services. Beginning in 2015, the hospital collaborated with Catholic Charities to launch a dental voucher program. Five dentists in Macoupin and Montgomery counties participate in the program, which covers an initial exam and x-rays, one tooth extraction and up to three fillings per year per individual. The percentage of total emergency department visits related to dental issues decreased from 2.2 percent in 2011 to 1.27 percent in 2014 because of this collaboration. In southeast Illinois, area residents can get help filling a prescription through the long-term collaboration between HSHS St. Anthony's Memorial Hospital in Effingham and Catholic Charities. In FY2016, St. Anthony's Memorial Hospital helped to underwrite the cost of prescription medications for 518 residents. St. Anthony's Memorial Hospital and Catholic Charities believe no one should be without prescriptions because of the inability to pay.
Schedule H, Part VI, Line 7 State filing of community benefit report	WI

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Form990 Of Other Organizations	Yes (X)	Form990OfOtherOrganizationsInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 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
THERESE B PANDL
PRESIDENT/Divisional CEO	$0	$663,621	$0	$145,946	$0	$238,291	$0	$200,088	$0	$31,376	$0	$1,279,322	$0	$217,428
MICHAEL W COTTRELL
DIRECTOR	$0	$608,295	$0	$125,031	$0	$226,638	$0	$185,294	$0	$30,392	$0	$1,175,650	$0	$189,961
ANN M CARR
TREASURER	$0	$253,980	$0	$36,527	$0	$63,798	$0	$201,780	$0	$20,881	$0	$576,966	$0	$29,789
LAWRENCE J CONNORS
COO	$302,422	$0	$40,127	$0	$18,972	$0	$136,198	$0	$21,078	$0	$518,797	$0	$0	$0
GREG SIMIA
DIVISION CFO	$0	$760,565	$0	$41,509	$0	$1,560	$0	$112,100	$0	$53,308	$0	$969,042	$0	$0
JAMIE BABBITTS
EXECUTIVE DIRECTOR	$149,464	$0	$0	$0	$780	$0	$59,974	$0	$27,438	$0	$237,656	$0	$0	$0
THOMAS BERG
PHARMACIST	$144,787	$0	$4,307	$0	$0	$0	$53,312	$0	$1,218	$0	$203,624	$0	$0	$0
JAYNE BLEUEL
PHARMACIST	$138,929	$0	$4,323	$0	$3,577	$0	$81,607	$0	$16,455	$0	$244,891	$0	$0	$0
GREGORY LAEHN
PHARMACIST	$149,764	$0	$4,572	$0	$390	$0	$72,174	$0	$9,182	$0	$236,082	$0	$0	$0
KAREN WENZEL
PHARMACIST	$148,106	$0	$4,615	$0	$2,727	$0	$52,067	$0	$2,296	$0	$209,811	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation

PLEASE SEE RESPONSE TO FORM 990, PART VI, LINE 15A IN SCHEDULE O.

Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan

HSHS EXECUTIVES ELIGIBLE TO PARTICIPATE IN SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) ARE DEFINED IN THE SERP PLAN DOCUMENTS. THE SERP WAS ESTABLISHED TO PROVIDE ADDITIONAL RETIREMENT BENEFITS TO ENSURE REASONABLE MARKET COMPETITIVE BENEFITS IN ACCORDANCE WITH THE HSHS EXECUTIVE COMPENSATION PHILOSOPHY ESTABLISHED BY THE HSHS COMPENSATION COMMITTEE. THE PLAN PROVIDES A DEFINED RETIREMENT CONTRIBUTION TO PARTICIPANTS COMMENCING ON JANUARY 1, 2008, EQUAL TO A PERCENTAGE OF COMPENSATION AS DEFINED IN THE SERP PLAN DOCUENTS FOR THE PLAN YEAR. PARTICIPANTS CONSTRUCTIVELY RECEIVE A DISTRIBUTION FROM THE PLAN NO LATER THAN MARCH 15TH OF THE CALENDAR YEAR FOLLOWING THE CALENDAR YEAR IN WHICH AN AMOUNT IS VESTED AND TAXABLE PURSUANT TO A VESTING SCHEDULE AS SPECIFIED IN THE PLAN DOCUMENT. THE ACTUAL DISTRIBUTION OF THE VESTED BENEFIT UNDER THE PLAN IS PAID IN A SINGLE LUMP SUM TO THE PARTICIPANT OR THE PARTICIPANT'S BENEFICIARY UPON THE EARLIER OF THE PARTICIPANT'S TERMINATION OF EMPLOYMENT, DEATH, OR TOTAL AND PERMANENT DISABILITY. THE FOLLOWING INTERESTED PERSONS CONSTRUCTIVELY RECEIVED DEFERRALS TO THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2015; THESE DEFERRALS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C). Ann Carr -- $31,485 Michael Cottrell --$76,064 Therese Pandl -- $81,687 THE FOLLOWING INTERESTED PERSONS RECEIVED DISTRIBUTIONS FROM THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2015; THESE PAYMENTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III) AND SCHEDULE J, PART II, COLUMN (F), AS APPLICABLE. Ann Carr -- $29,789 Michael Cottrell -- $189,961 Theresa Pandl -- $217,428

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	PREVEA CLINIC INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Relationship Description	SVGB OFFICER IS PREVEA CLINIC BOARD MEMBER (SEE PART V)	RelationshipDescriptionTxt
Transaction	$4,208,865	TransactionAmt
Transaction	PHYSICIAN SERVICES	TransactionDesc
Sharing Of Revenues	false	SharingOfRevenuesInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule L, Part IV BUSINESS TRANSACTIONS WITH INTERESTED PERSONS	FormAndLineReferenceDesc
Explanation	THERESE PANDL, PRESIDENT OF SVGB, IS A BOARD MEMBER OF PREVEA CLINIC. ALL TRANSACTIONS INVOLVING INTERESTED PERSONS ARE DETERMINED TO BE CONSISTENT WITH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. ANY TRANSACTIONS REQUIRING BOARD APPROVAL ARE APPROVED BY AN INDEPENDENT BOARD PRIOR TO OCCURRING.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (16 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part III, Line 4a PROGRAM SERVICE REVENUE - SURGERY	ST. MARY'S HOSPITAL MEDICAL CENTER SURGICAL SERVICES: SURGICAL SERVICES AT ST. MARY'S HOSPITAL MEDICAL CENTER ARE COMPRISED OF CENTRAL PROCESSING, ANESTHESIA, SURGERY AND RECOVERY. THIS INCLUDES EIGHT OR SUITES, A C-SECTION ROOM AND TWO MINOR TREATMENT ROOMS. SERVICES ARE AVAILABLE 24/7 AND INCLUDE BOTH INPATIENT AND OUTPATIENT PROCEDURES. IN FY2016, NEARLY 6,100 SURGICAL PROCEDURES WERE PERFORMED. SURGICAL PROCEDURES INCLUDE GENERAL, ORTHOPEDIC, UROLOGY, GYNECOLOGY, ORAL - MAXILLOFACIAL, AND ORGAN PROCUREMENT. ANESTHESIA AND CENTRAL PROCESSING ALSO PROVIDE HOSPITAL-WIDE SERVICES TO INPATIENT NURSING, LABOR AND DELIVERY AND THE EMERGENCY DEPARTMENT.
Form 990, Part III, Line 4c PROGRAM SERVICE REVENUE - RADIOLOGY SERVICES	ST. MARY'S HOSPITAL MEDICAL CENTER IMAGING SERVICES: THE IMAGING SERVICES DEPARTMENT AT ST. MARY'S HOSPITAL MEDICAL CENTER PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE. OVERALL, THE DEPARTMENT PERFORMED NEARLY 54,700 INPATIENT AND OUTPATIENT EXAMS AND PROCEDURES DURING FY16. PATIENTS HAVE ACCESS TO THE LATEST TECHNOLOGY IN DIGITAL MAMMOGRAPHY, COMPUTED TOMOGRAPHY, MRI, NUCLEAR MEDICINE, AND ULTRASOUND. FOUR INTERVENTIONAL RADIOLOGISTS PROVIDE MINIMALLY INVASIVE PROCEDURES USING IMAGE GUIDANCE. THE STAFF CONSISTS OF BOARD CERTIFIED RADIOLOGISTS AS WELL AS LICENSED AND CERTIFIED TECHNOLOGISTS, NURSES, AND SONOGRAPHERS. THE MODALITIES ARE ACCREDITED AND UTILIZE STATE-OF-THE-ART EQUIPMENT TO AFFORD THE RADIOLOGISTS OPTIMAL IMAGES FOR INTERPRETATION. THE DEPARTMENT AND HOSPITAL ARE ACCREDITED BY THE JOINT COMMISSION. THE DEPARTMENT USES A STATE OF THE ART MRI WIDE BORE SCANNER.
Form 990, Part III, Line 4b PROGRAM SERVICE REVENUE - HEART & VASCULAR CENTER	ST. MARY'S HOSPITAL MEDICAL CENTER CATH LAB: THE CATH LAB OFFERS A COMPLETE ARRAY OF CATHETERIZATION LABORATORY PROCEDURES AND NONINVASIVE CARDIOVASCULAR DIAGNOSTIC PROCEDURES, DOING NEARLY 2,000 CARDIAC CATHETERIZATIONS IN FY2016. IF NEEDED, A STATE-OF-THE-ART CARDIOVASCULAR OPERATING CENTER (CVOR) IS AVAILABLE NEARBY AT OUR SISTER FACILITY, ST. VINCENT HOSPITAL, FOR CUTTING-EDGE OPEN HEART PROCEDURES BY OUR HIGHLY-SKILLED CARDIOTHORACIC SURGEONS. CVICU SUITES ARE ALSO OFFERED THERE. FOR THOSE PATIENTS WHO NEED FOLLOW-UP, A CARDIO-PULMONARY REHABILITATION PROGRAM IS OFFERED ON SITE AT ST. MARY'S. ELECTROPHYSIOLOGY HAS BEEN AVAILABLE AT ST. MARY'S HOSPITAL SINCE FY13.
Form 990, Part III, Line 4d Description of other program services	(Expenses $ 63,384,678 including grants of $)(Revenue $ 60,891,274) ST. MARY'S HOSPITAL MEDICAL CENTER OTHER PROGRAM SERVICES AT ST. MARY'S HOSPITAL MEDICAL CENTER IS COMPRISED OF FAMILY BIRTHING CENTER, INTENSIVE CARE, EMERGENCY, CENTER FOR DIGESTIVE HEALTH, PHARMACY, LABORATORY, RESPIRATORY THERAPY AND OTHER SERVICES. IN FY2016 THE HOSPITAL HAD OVER 103,600 OUTPATIENT VISITS, NEARLY 4,400 ADMISSIONS, OVER 13,100 PATIENT DAYS, OVER 550 BIRTHS AND OVER 31,100 EMERGENCY ROOM VISITS.
Form 990, Part IV, Line 24a TAX EXEMPT BONDS	ST MARY'S HOSPITAL MEDICAL CENTER OF GREEN BAY, INC. HOLDS A LIABILITY ON ITS BOOKS FOR TAX-EXEMPT BONDS, WHICH IS AN ALLOCATION FROM ITS SOLE CORPORATE MEMBER, HOSPITAL SISTERS SERVICES, INC. AS A RESULT, THIS QUESTION WAS ANSWERED NO, AND SCHEDULE K WILL BE COMPLETED ON THE HOSPITAL SISTERS SERVICES, INC. FORM 990.
Form 990, Part VI, Line 13 WHISTLEBLOWER POLICY	PROVISIONS WITHIN THE CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY PROVIDE PROTECTIONS FOR WHISTLEBLOWER TYPE ACTIVITIES.
Form 990, Part VI, Line 6 Classes of members or stockholders	THE SENIOR GOVERNING BODY OF ST. MARY'S HOSPITAL MEDICAL CENTER OF GREEN BAY INC (THE "CORPORATION") IS THE MEMBER OF THE CORPORATION, WHICH IS HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	PURSUANT TO SECTION 2.3 OF THE CORPORATION'S BYLAWS, THE ORGANIZATION'S MEMBER, HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, HAS THE RIGHT TO APPOINT AND REMOVE THE CORPORATION'S BOARD OF DIRECTORS, CHAIRPERSON OF THE BOARD, AND PRESIDENT.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	RESPONSIBILITY FOR THE POLICY AND OPERATIONS OF ST. MARY'S HOSPITAL MEDICAL CENTER OF GREEN BAY INC. (THE "CORPORATION") IS VESTED IN ITS BOARD OF DIRECTORS, EXCEPT WITH RESPECT TO SPECIFIC POWERS RESERVED IN THE CORPORATION'S BYLAWS TO THE CORPORATION'S MEMBER, HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE MEMBER OF HSSI IS HOSPITAL SISTERS HEALTH SYSTEM ("HSHS"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE MEMBERS OF HSHS ARE THE INDIVIDUAL SISTERS WHO, FROM TIME TO TIME, ARE THE DULY ELECTED PROVINCIAL SUPERIOR AND PROVINCIAL COUNCILORS, RESPECTIVELY OF THE AMERICAN PROVINCE OF THE HOSPITAL SISTERS OF ST. FRANCIS ("AMERICAN PROVINCE"). THE AMERICAN PROVINCE IS THE UNITED STATES ORGANIZATION OF THE CONGREGATION OF THE HOSPITAL SISTERS OF THE THIRD ORDER REGULAR OF ST. FRANCIS, A RELIGIOUS INSTITUTE OF THE ROMAN CATHOLIC CHURCH. THE GOVERNANCE AND OPERATIONS OF THE CORPORATION ARE SUBJECT TO HSSI'S RIGHT TO EXERCISE THESE RESERVED POWERS WITH RESPECT TO THE CORPORATION AND ORGANIZATIONS OF WHICH THE CORPORATION IS EITHER, DIRECTLY OR INDIRECTLY, A CONTROLLING MEMBER OR A CONTROLLING SHAREHOLDER ("AFFILIATES"). HSSI'S RIGHT TO EXERCISE CERTAIN OF THESE RESERVED POWERS IS, IN TURN, SUBJECT TO THE APPROVAL OF HSHS AND HSHS' MEMBERS. THE RESERVED POWERS INCLUDE ALL RIGHTS GRANTED TO HSSI BY LAW AND THE RIGHT TO: (A) ADOPT, APPROVE AMENDMENTS TO, OR AMEND ANY STATEMENT OF PHILOSOPHY, MISSION, MISSION INTEGRATION OR VALUES, OR ANY NAME, LOGO, OR MARK OF THE CORPORATION OR OF ANY AFFILIATE; (B) ADOPT, APPROVE AMENDMENTS TO, OR AMEND THE ARTICLES OF INCORPORATION OF THE CORPORATION OR OF ANY AFFILIATE; (C) ADOPT, APPROVE AMENDMENTS TO, OR AMEND THE BYLAWS OF THE CORPORATION OR OF ANY AFFILIATE; (D) APPOINT AND REMOVE THE BOARD OF DIRECTORS, ANY ONE OR MORE OF THE DIRECTORS OF THE CORPORATION OR OF ANY AFFILIATE, AND THE CHAIRPERSON AND PRESIDENT OF THE CORPORATION OR OF ANY AFFILIATE; (E) APPROVE THE RECOMMENDATION OF THE BOARD OF DIRECTORS TO APPOINT OR REMOVE THE BOARD OF DIRECTORS, ANY ONE OR MORE DIRECTORS OF THE CORPORATION OR OF ANY AFFILIATE, OR THE CHAIRPERSON AND PRESIDENT OF THE CORPORATION OR OF ANY AFFILIATE. (F) WITH RESPECT TO THE CORPORATION OR ANY AFFILIATE, APPROVE THE PURCHASE, SALE, ALIENATION, EXCHANGE, LEASE, OR ENCUMBRANCE OF ANY REAL PROPERTY OF THE CORPORATION OR OF ANY AFFILIATE, WHICH PROPERTY HAS A VALUE IN EXCESS OF LIMITS SET FROM TIME TO TIME BY HSSI; (G) APPROVE THE OPERATING AND CAPITAL BUDGETS OF THE CORPORATION OR OF ANY AFFILIATE, AND ANY DEVIATIONS BY THE CORPORATION OR OF ANY AFFILIATE FROM SUCH BUDGETS IN AN AMOUNT OR PERCENTAGE SPECIFIED BY HSSI FROM TIME TO TIME; (H) APPROVE THE STRATEGIC PLAN AND GOALS OF THE CORPORATION OR OF ANY AFFILIATE; (I) APPROVE THE SALE OF SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION OR OF ANY AFFILIATE; (J) APPROVE THE MERGER OR DISSOLUTION OF THE CORPORATION OR OF ANY AFFILIATE; (K) ADOPT OR AMEND THE PLAN FOR MINISTRY EDUCATION AND GOVERNANCE FOR THE CORPORATION AND ITS AFFILIATES; (L) APPROVE THE CORPORATION'S MISSION ACCOUNTABILITY REPORTS AND THOSE OF ANY AFFILIATE; (M) APPROVE THE FINANCIAL POLICIES AND PROCEDURES OF THE CORPORATION OR OF ANY AFFILIATE, AND APPROVE ANY DEVIATIONS FROM SUCH POLICIES AND PROCEDURES BY THE CORPORATION OR ANY AFFILIATE; AND (N) ADOPT POLICIES TO IMPLEMENT THE RESERVED POWERS OF HSSI.
Form 990, Part VI, Line 11b Review of form 990 by governing body	THE HOSPITAL EMPLOYS CROWE HORWATH TO ASSIST IN THE OVERALL REVIEW AND ELECTRONIC SUBMISSION OF ITS FORM 990. CROWE HORWATH PROVIDES GUIDANCE IN IDENTIFYING CRITICAL ERRORS IN THE RETURN SUBMISSION, AND FEEDBACK ON QUANTITATIVE AND QUALITATIVE RESPONSES. ADDITIONALLY, THE HOSPITAL CFO PERFORMS A THOROUGH REVIEW OF THE RETURN AND REVIEWS IT WITH THE HOSPITAL CEO AND/OR SENIOR LEADERS BEFORE PRESENTING IT IN ITS ENTIRETY TO THE HOSPITAL BOARD FOR QUESTIONING AND REVIEW PRIOR TO THE RETURN'S SIGNING AND SUBMISSION TO THE IRS.
Form 990, Part VI, Line 12c Conflict of interest policy	THE ORGANIZATION IS SUBJECT TO THE CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY ("POLICY") OF HOSPITAL SISTERS HEALTH SYSTEM, AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. A REVISED CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY HAVE BEEN IMPLEMENTED SINCE JANUARY, 2009 TO MANAGE CONFLICTS OF INTEREST USING A SYSTEM-WIDE PROTOCOL FOR DISCLOSURE STATEMENTS. IN ACCORDANCE WITH THE ORGANIZATON'S CONFLICT OF INTEREST POLICY, ALL COVERED PERSONS HAVE A DUTY TO COMPLY WITH THE CONFLICT OF INTEREST POLICY FOR ANY CONTRACT, TRANSACTION, RELATIONSHIP, OR ACTIVITY CONTEMPLATED, ENTERED INTO, OR CONDUCTED AT HSHS OR ITS AFFILIATES. THE POLICY DEFINES COVERED PERSONS AS BOARD MEMBERS, BOARD COMMITTEE MEMBERS, OFFICERS, BOARD DESIGNEES, SENIOR MANAGEMENT, MEMBERS OF ANY COMMITTEE THAT OVERSEES THE APPROVAL OF PHARMACEUTICALS AND MEDICAL DEVICES, AND ANY OTHER INDIVIDUAL WHO HOLDS A POSITION OF TRUST. ON AN ANNUAL BASIS, HSHS DISCLOSES A COPY OF THE CONFLICT OF INTEREST POLICY (AND ALL CORRESPONDING PROCEDURES, GUIDELINES, FORMS, AND TOOLS) TO ALL COVERED PERSONS AND ADVISES ALL COVERED PERSONS IN WRITING OF ANY SUBSTANTIVE CHANGES TO THIS POLICY AND SUCH RELATED MATERIALS. COVERED PERSONS ARE REQUIRED TO REVIEW AND COMPLETE THE CORRESPONDING CONFLICT OF INTEREST STATEMENT. THE SYSTEM OFFICE VICE PRESIDENT - SYSTEM RESPONSIBILITY, VICE PRESIDENT - RISK & COMPLIANCE, OR MEMBERS OF THE AUDIT AND INTEGRITY COMMITTEE ("COMMITTEE") ARE AVAILABLE TO ANSWER ANY QUESTIONS A COVERED PERSON MAY HAVE. IN ADDITION, IF, AT ANY TIME AFTER SUBMITTING AN ANNUAL CONFLICT OF INTEREST STATEMENT, A COVERED PERSON BECOMES AWARE OF AN INTEREST THAT HE OR SHE WOULD HAVE HAD TO DISCLOSE AT THE ANNUAL INTERVAL, THE COVERED PERSON IS REQUIRED PROMPTLY TO DISCLOSE THE INTEREST TO THE COMMITTEE USING THE HSHS CONFLICT OF INTEREST DISCLOSURE STATEMENT. COMPLETED CONFLICT OF INTEREST STATEMENTS ARE SUBMITTED TO THE COMMITTEE, WHICH IS RESPONSIBLE FOR IDENTIFYING, ASSESSING, AND MANAGING CONFLICTS OF INTEREST THAT ARISE IN THE COURSE OF CONDUCTING THE AFFAIRS OF HSHS AND ITS AFFILIATES. IF THE COMMITTEE DETERMINES THAT A CONFLICT OF INTEREST EXISTS, THE CONFLICT OF INTEREST POLICY REQUIRES HSHS NOT TO ENGAGE IN, OR ENTER INTO A PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY UNLESS THE COMMITTEE OR, WHERE NECESSARY, THE BOARD OF DIRECTORS (ACTING THROUGH ITS DISINTERESTED MEMBERS), HAS INVESTIGATED ALTERNATIVES TO THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY AND, IN THE ABSENCE OF ALTERNATIVES THAT ARE IN THE BEST INTERESTS OF HSHS, HAS DETERMINED: 1. THAT, REGARDLESS OF WHETHER THE COVERED PERSON PARTICIPATES IN THE IMPLEMENTATION OF THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY; 2. THE CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY IS IN THE BEST INTERESTS OF HSHS; 3. THE CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY IS FAIR AND REASONABLE FROM THE PERSPECTIVE OF HSHS; AND 4. HSHS CANNOT OBTAIN A MORE ADVANTAGEOUS CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES. IN DETERMINING WHETHER A CONTRACT, TRANSACTION OR ARRANGEMENT IS FAIR AND REASONABLE TO HSHS, THE COMMITTEE SHALL CONSIDER, WHERE APPLICABLE: 1. APPRAISALS OR OTHER INDEPENDENT VALUATIONS OF THE FAIR MARKET VALUE OF THE CONTRACT, TRANSACTION, OR ARRANGEMENT; 2. INFORMATION REGARDING COMPARABLE CONTRACTS, TRANSACTIONS, OR ARRANGEMENTS BETWEEN UNRELATED PARTIES; 3. OFFERS FROM COMPARABLE COMPETING ENTITIES; AND/OR 4. STUDIES OF COMPARABLE COMPENSATION ARRANGEMENTS. IN ANY CASE IN WHICH THE COMMITTEE FINDS, AFTER TAKING THE STEPS DESCRIBED ABOVE, THAT HSHS SHOULD PARTICIPATE IN A PROPOSED TRANSACTION OR ARRANGEMENT DESPITE THE EXISTENCE OF A CONFLICT OF INTEREST, THE COMMITTEE SHALL DEVELOP, IMPLEMENT, MONITOR, AND ENFORCE COMPLIANCE WITH A CONFLICT MANAGEMENT PLAN FOR MANAGING THE CONFLICT OF INTEREST AS IT CONSIDERS NECESSARY FOR SUCH FINDINGS TO REMAIN VALID THROUGHOUT THE LIFE OF THE CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY. ALL CONFLICT MANAGEMENT PLANS SHALL: 1. STATE THAT THE COMMITTEE WILL OVERSEE, MONITOR, AND ENFORCE COMPLIANCE WITH THE PLAN THROUGHOUT THE COURSE OF THE STUDY AND SPECIFY MEANS FOR DOING SO, INCLUDING, WITHOUT LIMITATION, THAT THE APPROPRIATE INDIVIDUALS MUST PROVIDE THE COMMITTEE WITH WRITTEN REPORTS PERTAINING TO COMPLIANCE WITH THE CONFLICT MANAGEMENT PLAN, THAT THE COMMITTEE SHALL HAVE THE RIGHT TO AUDIT THE STUDY FOR SUCH COMPLIANCE AND THE RIGHT TO IMPOSE SANCTIONS FOR NON-COMPLIANCE; 2. STATE THAT THE PLAN MUST BE SHARED WITH COVERED PERSON WHOSE INTERESTS IT WAS DEVELOPED TO MANAGE; 3. STATE THAT THE PLAN MUST BE SHARED WITH, AND PERIODIC REPORTS ON COMPLIANCE WITH THE PLAN MUST BE PROVIDED TO, THE BOARD, SENIOR MANAGEMENT, AND/OR GOVERNMENT AGENCIES; AND 4. PROVIDE FOR SUCH OTHER MANAGEMENT STEPS AND MECHANISMS THE COMMITTEE CONSIDERS NECESSARY AND APPROPRIATE. IN ADDITION TO THE COMMITTEE, THE SYSTEM OFFICE VICE PRESIDENTS OF SYSTEM RESPONSIBILITY AND RISK & COMPLIANCE MAY RETAIN SUCH INDEPENDENT ADVISORS OR EXPERTS AS DEEMED NECESSARY TO ASSIST IN MAKING ITS DETERMINATIONS AND DECISIONS. IF THE COMMITTEE DETERMINES THAT THE CONTEMPLATED TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY CANNOT PROCEED DUE TO A CONFLICT OF INTEREST, THE COMMITTEE SHALL INFORM THE APPLICABLE COVERED PERSON OR DECISION-MAKING BODY OF SUCH DETERMINATION WITHIN ONE WEEK OF THE COMMITTEE MEETING AT WHICH THE CONTEMPLATED TRANSACTION WAS DISCUSSED. THE COMMITTEE SHALL DOCUMENT ITS REJECTION OF THE CONTEMPLATED TRANSACTION IN THE COMMITTEE'S MEETING MINUTES.
Form 990, Part VI, Line 15a Process to establish compensation of top management official	THE COMPENSATION COMMITTEE (COMMITTEE) IS COMPRISED OF INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS. THE COMMITTEE DEVELOPS A COMPENSATION PHILOSOPHY FOR THE SYSTEM AND ALL AFFILIATES. THE COMMITTEE SELECTS AND HIRES THE INDEPENDENT COMPENSATION CONSULTANT TO DEVELOP COMPARABILITY DATA AND ADVISE THE COMMITTEE DURING ITS DELIBERATIONS REGARDING ALL ELEMENTS OF TOTAL COMPENSATION FOR ALL DISQUALIFIED INDIVIDUALS. INTEGRATED HEALTHCARE STRATEGIES ("IHS"), THE CONSULTANTS UTILIZED BY THE COMMITTEE, USE DATA FROM MULTIPLE TAX-EXEMPT PEER GROUP SOURCES TO DETERMINE SALARY RANGES, INCENTIVE OPPORTUNITY RANGES, AND BENEFITS FOR THE DISQUALIFIED INDIVIDUALS. IHS THEN ASSISTS THE COMMITTEE IN PREPARING CONTEMPORANEOUS DOCUMENTATION OF ALL ACTIONS. EACH COMMITTEE MEETING IS CONDUCTED WITH THE INTENT TO CREATE A REBUTTABLE PRESUMPTION OF REASONABLENESS FOR ALL ELEMENTS OF EXECUTIVE TOTAL COMPENSATION FOR THE DISQUALIFIED INDIVIDUALS. THE CHAIRMAN MAKES THIS DECLARATION AND ALSO INQUIRES IF THERE ARE ANY CONFLICTS OF INTEREST BY ANY ATTENDEES. ANY CONFLICTS ARE DISCLOSED AND THE COMMITTEE THEN ACTS IN A MANNER TO AVOID ANY CONFLICTED INDIVIDUAL PARTICIPATING IN ANY MANNER WHERE A CONFLICT MIGHT EXIST. AT THE END OF THE MEETING, THE COMMITTEE PREPARES CONTEMPORANEOUS MINUTES THAT RECORD ALL ACTIONS TAKEN DURING THE MEETING.
Form 990, Part VI, Line 15b Process to establish compensation of other employees	PLEASE SEE RESPONSE TO FORM 990, PART VI, LINE 15A.
Form 990, Part VI, Line 19 Required documents available to the public	BOARD-APPROVED FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE GENERAL PUBLIC AT THIS TIME
Form 990, Part X, Line 11 POOLED INVESTMENT ACCOUNT	THE HOSPITAL'S CASH RESERVES ARE INVESTED IN A POOLED INVESTMENT ACCOUNT MAINTAINED BY HOSPITAL SISTERS HEALTH SYSTEM ("HSHS"). PARTICIPATION IN THE POOLED FUND IS LIMITED TO THE 501(C)(3) HOSPITALS AND HEALTH SERVICES ORGANIZATIONS SPONSORED BY HSHS. THE POOLED ACCOUNT CONSISTS OF CASH, EQUITY, AND DEBT SECURITIES THAT ARE PUBLICLY TRADED. IN ACCORDANCE WITH THE PROVISIONS OF STATEMENT OF FINANCIAL ACCOUNTING STANDARDS ("SFAS") NO. 124 "ACCOUNTING FOR CERTAIN INVESTMENTS HELD BY NOT-FOR-PROFIT ORGANIZATIONS", INVESTMENTS IN EQUITY SECURITIES WITH READILY DETERMINABLE FAIR VALUES, AND ALL INVESTMENTS IN DEBT SECURITIES, ARE REPORTED AT FAIR VALUE ON THE BALANCE SHEET. INCOME, REALIZED AND UNREALIZED GAINS AND LOSSES ARE POOLED AND ALLOCATED TO THE PARTICIPANTS. INDIVIDUAL COMPONENTS OF ASSETS AND REVENUE ARE NOT IDENTIFIED TO THE INDIVIDUAL HOSPITAL PARTICIPANTS.
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	TRANSFER TO AFFILIATES - -757765; CHANGE IN PENSION - -13060928; CHANGE IN TEMPORARILY RESTRICTED NET ASSETS - 572753; CHANGE IN FAIR VALUE OF INTEREST RATE SWAPS - -1285086; SWAP PAYMENTS - -295721;

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (3 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
KIARA CLINICAL INTEGRATION NETWORK LLC
4936 LAVERNA ROAD	SPRINGFIELD	IL	62707	261417684	HEALTHCARE	IL	-$3,126,361	$6,209,010	HSSI
PHYSICIAN CLINICAL INTEGRATION NETWORK LLC
4936 LAVERNA ROAD	SPRINGFIELD	IL	62707	371668647	HEALTHCARE	IL	-$127,884	$6,099,730	KCIN
HSHS ACO LLC
4937 LAVERNA ROAD	SPRINGFIELD	IL	62707	320465666	HEALTHCARE & SOCIAL ASSISTANCE	IL	-$35	$0	KCIN

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (27 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
HOSPITAL SISTERS HEALTH SYSTEM
4936 LAVERNA ROAD	SPRINGFIELD	IL	62707	371058692	HEALTHCARE	IL	501(c)(3	Type III-FI	NA	false
HOSPITAL SISTERS OF ST FRANCIS FOUNDATION
4936 LAVERNA ROAD	SPRINGFIELD	IL	62707	371186514	HEALTHCARE	IL	501(c)(3	7	HSHS	Yes (true)
HSHS HEALTHCARE PLAN TRUST FUND
4936 LAVERNA ROAD	SPRINGFIELD	IL	62707	371137724	HEALTHCARE	IL	501(c)(9		HSHS	Yes (true)
HSHS SELF INSURANCE TRUST
4936 LAVERNA ROAD	SPRINGFIELD	IL	62707	371120626	INSURANCE	IL	501(c)(3	Type I	HSHS	Yes (true)
HOSPITAL SISTERS HEALTHCARE WEST INC
2661 COUNTY HIGHWAY 1	CHIPPEWA FALLS	WI	54729	510157933	HEALTHCARE	WI	501(c)(3	Type III-FI	HSSI	Yes (true)
SACRED HEART HOSPITAL
990 WEST CLAIREMONT AVENUE	EAU CLAIRE	WI	54701	390807060	HEALTHCARE	WI	501(c)(3	3	HSSI	Yes (true)
ST ANTHONY'S HOSPITAL
503 N MAPLE STREET	EFFINGHAM	IL	62401	370661233	HEALTHCARE	IL	501(c)(3	3	HSSI	Yes (true)
ST ELIZABETH'S HOSPITAL
211 SOUTH THIRD STREET	BELLEVILLE	IL	62220	370663567	HEALTHCARE	IL	501(c)(3	3	HSSI	Yes (true)
ST NICHOLAS HOSPITAL
3100 SUPERIOR AVENUE	SHEBOYGAN	WI	53081	390808480	HEALTHCARE	WI	501(c)(3	3	HSSI	Yes (true)
ST JOHN'S HOSPITAL
800 EAST CARPENTER STREET	SPRINGFIELD	IL	62769	370661238	HEALTHCARE	IL	501(c)(3	3	HSSI	Yes (true)
ST JOSEPH'S HOSPITAL
9515 HOLY CROSS LANE	BREESE	IL	62230	371208459	HEALTHCARE	IL	501(c)(3	3	HSSI	Yes (true)
ST JOSEPH'S HOSPITAL
2661 COUNTY HIGHWAY 1	CHIPPEWA FALLS	WI	54729	390810545	HEALTHCARE	WI	501(c)(3	3	HSSI	Yes (true)
ST MARY'S HOSPITAL
1800 E LAKE SHORE DRIVE	DECATUR	IL	62521	370661244	HEALTHCARE	IL	501(c)(3	3	HSSI	Yes (true)
ST MARY'S HOSPITAL
111 Spring Street	Streator	IL	61364	362169181	HEALTHCARE	IL	501(c)(3	3	HSSI	Yes (true)
ST VINCENT HOSPITAL
835 S VAN BUREN	GREEN BAY	WI	51301	390817529	HEALTHCARE	WI	501(c)(3	3	HSSI	Yes (true)
ST JOSEPH'S HOSPITAL
12866 TROXLER AVENUE	HIGHLAND	IL	62249	370663568	HEALTHCARE	IL	501(c)(3	3	HSSI	Yes (true)
ST FRANCIS HOSPITAL
1215 FRANCISCAN DRIVE	LITCHFIELD	IL	62056	370661236	HEALTHCARE	IL	501(c)(3	3	HSSI	Yes (true)
HOSPITAL SISTERS SERVICES INC
4936 LAVERNA ROAD	SPRINGFIELD	IL	62707	371163402	HEALTHCARE	IL	501(c)(3	Type III-FI	HSHS	Yes (true)
HSHS MEDICAL GROUP INC
3215 EXECUTIVE PARK DRIVE	SPRINGFIELD	IL	62703	263956318	HEALTHCARE	IL	501(c)(3	Type III-FI	HSSI	Yes (true)
HSHS WISCONSIN MEDICAL GROUP INC
3215 EXECUTIVE PARK DRIVE	SPRINGFIELD	IL	62703	264515959	HEALTHCARE	WI	501(c)(3	Type III-FI	HSSI	Yes (true)
ORANGE CROSS AMBULANCE INC
919 ASHLAND AVENUE	SHEBOYGAN	WI	53081	391860942	HEALTHCARE	WI	501(c)(3	9	ST NICHOLAS	Yes (true)
UNITY LIMITED PARTNERSHIP
2366 OAK RIDGE CIRCLE	DE PERE	WI	54115	391750729	HEALTHCARE	WI	501(c)(3	9	HSSI	Yes (true)
PRAIRIE EDUCATION & RESEARCH COOPERATIVE
317 NORTH 5TH STREET	SPRINGFIELD	IL	62701	371157915	HEALTHCARE	IL	501(c)(3	4	HSSI	Yes (true)
ST CLARE MEMORIAL HOSPITAL
855 S MAIN STREET	OCONTO FALLS	WI	54154	390848401	HEALTHCARE	WI	501(c)(3	3	HSSI	Yes (true)
HSHS HOLY FAMILY HOSPITAL
200 HEALTHCARE DRIVE	GREENVILLE	IL	62246	370792770	HEALTHCARE	IL	501(c)(3	3	HSSI	Yes (true)
UTLAUT MEMORIAL FOUNDATION
200 HEALTHCARE DRIVE	GREENVILLE	IL	62246	371140166	FUNDRAISING	IL	501(c)(3	Type II	HSSI	Yes (true)
GREENVILLE REGIONAL HEALTHCARE
200 HEALTHCARE DRIVE	GREENVILLE	IL	62246	371139987	HEALTHCARE	IL	501(c)(3	Type II	HSSI	Yes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (7 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd	OwnershipOwnershipPct
MEMORIAL AND ST ELIZABETH'S HEALTHCARE CANCER TREATMENT CENTER
4000 NORTH ILLINOIS STREET	SWANSEA	IL	62226	371312961	HEALTHCARE	IL	ST ELIZABETH'S	Related	$848,922	$4,789,579	false	false	0.5
PRAIRIE HEART INSTITUTE ST JOHN'S
800 EAST CARPENTER STREET	SPRINGFIELD	IL	62769	371321197	HEALTHCARE	IL	HSHS	Related	-$596	$8,000	false	false	1.0
PAIN CENTER OF WISCONSIN
4131 W LOOMIS ROAD SUITE 300	GREENFIELD	WI	53221	263155343	HEALTHCARE	WI	ST VINCENT	Related	$606,068	$807,898	false	false	0.5
PAIN CENTER OF WISCONSIN - OCONTO FALLS LLC
4131 W LOOMIS ROAD SUITE 300	GREENFIELD	WI	53221	364717036	HEALTHCARE	WI	ST CLARE	Related	-$79,535	$206,472	false	false	0.5
CARPENTER STREET HOTEL LLC
525 NORTH SIXTH STREET	SPRINGFIELD	IL	62702	364128127	HOTEL	IL	LASANTE INC	N/A					0
SPRINGFIELD URGENT CARE REAL ESTATE LLC
PO BOX 19456	SPRINGFIELD	IL	727949456	030413258	RENTAL REAL ESTATE	IL	LASANTE INC	N/A					0
PRAIRIE HEART INSTITUTE MANAGEMENT COMPANY LLC
4936 LAVERNA ROAD	SPRINGFIELD	IL	62707	261479945	MEDICAL	IL	HSHS	Related	-$7,435	$17,725	false	Yes (true)	1.0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	OwnershipOwnershipPct	Controlled OrganizationControlledOrganizationInd	Address Line1ForeignAddress/AddressLine1Txt	Province Or StateForeignAddress/ProvinceOrStateNm	CountryForeignAddress/CountryCd	Foreign PostalForeignAddress/ForeignPostalCd	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd
KIARA INC
4936 LAVERNA ROAD	SPRINGFIELD	IL	62707	371163401	HEALTHCARE	IL	HSHS	C Corporation	-$36,664,461	$46,374,438	0.01	Yes (true)
LASANTE WISCONSIN INC
4936 LAVERNA ROAD	SPRINGFIELD	IL	62707	391572196	HEALTHCARE	IL	KIARA INC	C Corporation				Yes (true)
LASANTE INC
4936 LAVERNA ROAD	SPRINGFIELD	IL	62707	371163400	HEALTHCARE	IL	KIARA INC	C Corporation				Yes (true)
PRAIRIE CARDIOVASCULAR
619 EAST MASON SUITE 4P57	SPRINGFIELD	IL	62701	371071858	HEALTHCARE	IL	KIARA INC	C Corporation				Yes (true)
PREVEA HEALTH SERVICES INC
2710 EXECUTIVE DRIVE	GREEN BAY	WI	54304	391839351	HEALTHCARE	WI	HSSI	C Corporation	$174,464	$47,208,492	0.005	Yes (true)
PREVEA CLINIC INC
2710 EXECUTVE DRIVE	GREEN BAY	WI	54304	391839349	HEALTHCARE	WI	PHSI	C Corporation				Yes (true)
RENAISSANCE QUALITY INSURANCE LTD
				980669953	INSURANCE		HSSI	C Corporation	$0	$105,014,533	0.01	Yes (true)	PO BOX 1159	GRAND CAYMAN	CJ	KY11102	CJ
OJV INC
4936 LAVERNA ROAD	SPRINGFIELD	IL	62707	460873384	HEALTHCARE	IL	LASANTE INC	C Corporation				Yes (true)

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

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule R, Part V, Line 2 TRANSACTIONS WITH RELATED ORGANIZATIONS	FormAndLineReferenceDesc
Explanation	ANY TRANSACTIONS LISTED ON SCHEDULE R, PART V, LINE 1 AND NOT ON SCHEDULE R, PART V, LINE 2 ARE BETWEEN RELATED 501(C)(3) AND DO NOT REQUIRE REPORTING ON THIS SECTION.	ExplanationTxt