AGNESIAN HEALTHCARE INC: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization: AGNESIAN HEALTHCARE INC (EIN 39-0807236)
Tax period: 2015-07-01 to 2016-06-30
Filed: 2017-05-12
IRS object ID: 201741329349301044
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 K
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2017-05-12T08:17:43-05:00	ReturnTs
Tax Period End	2016-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

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

Preparer Firm Name PreparerFirmName

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

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 12237	AddressLine1Txt
City	GREEN BAY	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	543072237	ZIPCd

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

Filer Filer

Field	Value	IRS element (for citing)
EIN	390807236	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	AGNESIAN HEALTHCARE INC	BusinessNameLine1Txt

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

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	430 EAST DIVISION ST	AddressLine1Txt
City	FOND DU LAC	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	53935	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	BONNIE SCHMITZ	PersonNm
Person Title	VP AND CFO	PersonTitleTxt
Phone	9209265519	PhoneNum
Signature	2017-05-11	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	TERRI REXRODE CPA MST	PreparerPersonNm
PTIN	P00096513	PTIN
Phone	9206620016	PhoneNum
Preparation	2017-05-11	PreparationDt

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

Form 990 IRS990

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

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	430 EAST DIVISION ST	AddressLine1Txt
City	FOND DU LAC	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	53935	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$445,050,424	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Group Exemption	0928	GroupExemptionNum
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.AGNESIAN.COM	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1892	FormationYr
Legal Domicile State	WI	LegalDomicileStateCd
Activity Or Mission	THE MISSION OF AGNESIAN HEALTHCARE IS TO PROVIDE COMPASSIONATE CARE THAT BRINGS HOPE, HEALTH AND WHOLENESS TO THOSE WE SERVE BY HONORING THE SACREDNESS AND DIGNITY OF ALL PERSONS AT EVERY STAGE OF LIFE. WE CONTINUE THE MISSION OF THE CATHOLIC CONGREGATION OF SISTERS OF ST. AGNES.	ActivityOrMissionDesc
Voting Members Governing Body	14	VotingMembersGoverningBodyCnt
Voting Members Independent	10	VotingMembersIndependentCnt
Total Employee	4120	TotalEmployeeCnt
Total Volunteers	532	TotalVolunteersCnt
Total Gross UBI	$4,212,865	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	-$964,765	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$620,042	PYContributionsGrantsAmt
CY Contributions Grants	$848,003	CYContributionsGrantsAmt
PY Program Service Revenue	$332,741,447	PYProgramServiceRevenueAmt
CY Program Service Revenue	$345,488,864	CYProgramServiceRevenueAmt
PY Investment Income	$11,492,881	PYInvestmentIncomeAmt
CY Investment Income	$8,886,890	CYInvestmentIncomeAmt
PY Other Revenue	$16,790,832	PYOtherRevenueAmt
CY Other Revenue	$16,174,531	CYOtherRevenueAmt
PY Total Revenue	$361,645,202	PYTotalRevenueAmt
CY Total Revenue	$371,398,288	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	$146,098,380	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$156,598,769	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$192,654,040	PYOtherExpensesAmt
CY Other Expenses	$198,902,309	CYOtherExpensesAmt
PY Total Expenses	$338,752,420	PYTotalExpensesAmt
CY Total Expenses	$355,501,078	CYTotalExpensesAmt
PY Revenues Less Expenses	$22,892,782	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$15,897,210	CYRevenuesLessExpensesAmt
Total Assets BOY	$534,790,023	TotalAssetsBOYAmt
Total Assets EOY	$533,058,855	TotalAssetsEOYAmt
Total Liabilities BOY	$211,346,231	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$216,873,372	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$323,443,792	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$316,185,483	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	THE MISSION OF AGNESIAN HEALTHCARE IS TO PROVIDE COMPASSIONATE CARE THAT BRINGS HOPE, HEALTH AND WHOLENESS TO THOSE WE SERVE BY HONORING THE SACREDNESS AND DIGNITY OF ALL PERSONS AT EVERY STAGE OF LIFE. WE CONTINUE THE MISSION OF THE CATHOLIC CONGREGATION OF SISTERS OF ST. AGNES.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$241,025,778	ExpenseAmt
Revenue	$337,389,521	RevenueAmt
Desc	AGNESIAN HEALTHCARE OPERATES ST. AGNES HOSPITAL, A 168-LICENSED BED GENERAL/SURGICAL ACUTE CARE HOSPITAL WHICH PROVIDES INPATIENT AND OUTPATIENT SERVICES TO RESIDENTS OF FOND DU LAC AND THE SURROUNDING COUNTIES. DURING FISCAL YEAR 2016, ST. AGNES HOSPITAL HAD 6,882 INPATIENT ADMISSIONS, WITH TOTAL PATIENT DAYS OF 27,405. THERE WAS A TOTAL OF 30,314 EMERGENCY ROOM VISITS AND 14,065 SURGERIES PERFORMED IN FY16. IN ADDITION, ST. AGNES HOSPITAL PROVIDED 433,423 PHYSICIAN CLINIC VISITS, 80,210 MEDICAL IMAGING PROCEDURES, AND 1,587,135 PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY UNITS. THERE WERE 1,797 CARDIAC CATH LAB VISITS AND 45,390 HOSPICE DAYS. THE HOSPITAL ALSO OPERATES SAMARITAN CLINIC, A FREE CLINIC OFFERING MEDICAL SERVICES TO QUALIFIED INDIVIDUALS. SAMARITAN CLINIC PROVIDED 738 VISITS TO PATIENTS, AT A COST OF $70,570 FOR FY16. THE HOSPITAL MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY IT PROVIDES TO ITS PATIENTS. THE COST OF SERVICES AND SUPPLIES FURNISHED UNDER THE HOSPITAL'S CHARITY CARE POLICY WAS $697,912. IN ADDITION TO QUALITY HEALTH CARE SERVICES, ST. AGNES HOSPITAL PROVIDES ITS COMMUNITIES WITH EDUCATION, SUPPORT GROUPS AND OTHER COMMUNITY BENEFITS. THE NET COST OF THESE COMMUNITY BENEFITS WAS $3,531,599.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$8,275,395	ExpenseAmt
Revenue	$4,363,434	RevenueAmt
Desc	AGNESIAN HEALTHCARE OPERATES AGNESIAN ENTERPRISES, WHICH IS COMPRISED OF EIGHT PHARMACIES SERVING FOND DU LAC AND SURROUNDING TOWNS, AS WELL AS AGNESIAN HEALTH SHOPPE, WHICH SERVES THE POPULATION WITH HOSPITAL (INPATIENT AND OUTPATIENT), CLINIC AND HOME HEALTH EQUIPMENT. AGNESIAN ENTERPRISES FILLED 470,149 PRESCRIPTIONS DURING FY16. AGNESIAN HEALTH SHOPEE PROVIDES RETAIL SALES OF DURABLE MEDICAL EQUIPMENT, AS WELL AS TELECARE AND HOME OXYGEN SERVICES. THE COST OF SERVICES AND SUPPLIES FURNISHED UNDER AHE'S CHARITY CARE POLICY WAS $3,862. AGNESIAN HEALTHCARE ENTERPRISES CONTRIBUTES TO COMMUNITY BENEFIT WITH SEVERAL SUPPORT GROUPS. THE COST OF THE COMMUNITY BENEFIT WAS $5,958.	Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

Field	Value	IRS element (for citing)
Expense	$1,097,673	ExpenseAmt
Revenue	$14,346,584	RevenueAmt
Desc	AGNESIAN HEALTHCARE OPERATES CONSULTANTS LABORATORY OF WISCONSIN, AN INDEPENDENT REFERENCE LAB SERVING FOND DU LAC, DODGE, OUTAGAMIE, WINNEBAGO AND COLUMBIA COUNTIES. CLW PROVIDED 1,083,639 TESTS DURING FISCAL YEAR 2016. THE LABORATORY ALSO PROVIDES THE COMMUNITY WITH CAREER EDUCATION, CONTRIBUTIONS AND SERVICES TO SAMARITAN CLINIC. THE NET COST OF THESE COMMUNITY BENEFITS WAS $74,169. THE COST OF SERVICES AND SUPPLIES FURNISHED UNDER THE CHARITY CARE POLICY WAS $24,694.	Desc

Field	Value	IRS element (for citing)
Total Program Service Expenses	$250,398,846	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Temp Or Permanent Endowments	Yes (1)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	Yes (1)	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	0	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	0	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (1)	TaxExemptBondsInd
Invest Tax Exempt Bonds	0	InvestTaxExemptBondsInd
Escrow Account	0	EscrowAccountInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (1)	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	Yes (1)	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	Yes (1)	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	0	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	362	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	4120	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	Yes (1)	ForeignFinancialAccountInd
Foreign Country	CJ	ForeignCountryCd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	14	GoverningBodyVotingMembersCnt
Independent Voting Member	10	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (1)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (1)	WrittenPolicyOrProcedureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	AUDRA HOFFMANN	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	9209265519	PhoneNum

US Address USAddress

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

Form990 Part VII Section A Form990PartVIISectionAGrp (32 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
STEVEN N LITTLE
PRESIDENT AND CEO	50.00	Yes (X)	Yes (X)	$821,140	$0	$40,806
SR MARY NOEL BROWN
EX-OFFICIO	1.00	Yes (X)		$0	$0	$0
JAMES R CHATTERTON
CHAIRPERSON	1.00	Yes (X)	Yes (X)	$0	$0	$0
JOAN KARSTEN
DIRECTOR	1.00	Yes (X)		$0	$0	$0
SR RHEA EMMER
EX-OFFICIO	1.00	Yes (X)		$0	$0	$0
SR HERTHA LONGO
TREASURER	1.00	Yes (X)	Yes (X)	$0	$0	$0
DR STEPHEN MASSICK
DIRECTOR	1.00	Yes (X)		$0	$0	$0
ROBERT MIKKELSEN
DIRECTOR	1.00	Yes (X)		$0	$0	$0
JAMES B SIMON
SECRETARY	1.00	Yes (X)	Yes (X)	$5,055	$0	$0
DR JEFFERY STRONG
DIRECTOR	1.00	Yes (X)		$0	$0	$0
DR JUDITH WESTPHAL
DIRECTOR	1.00	Yes (X)		$0	$0	$0
MARYSUE MICHELS
DIRECTOR	1.00	Yes (X)		$0	$0	$0
RICHARD SCHAEFER MD
DIRECTOR	1.00	Yes (X)		$0	$0	$0
THOMAS SCHUESSLER
DIRECTOR	1.00	Yes (X)		$0	$0	$0
JAMES P MUGAN
SR VP CLINICAL SERVICES	50.00			$321,789	$0	$40,587	Yes (X)
BONNIE R SCHMITZ
CHIEF FINANCIAL OFFICER	50.00			$473,353	$0	$27,234	Yes (X)
MARY J MOLLISON
VP SPIRITUALITY AND CARE	50.00			$202,885	$0	$8,662	Yes (X)
SUSAN L EDMINSTER
VP - HUMAN RESOURCES	50.00			$301,940	$0	$38,551	Yes (X)
NANCY A BIRSCHBACH
VP - CIO	50.00			$312,575	$0	$42,871	Yes (X)
JILL A STENSON
VP NURSING	50.00			$233,256	$0	$22,167	Yes (X)
BARBARA L KNUTZEN
PRES AND CEO-AHE AND PERFO	50.00			$253,396	$0	$32,369	Yes (X)
HOLLY BRENNER
VP STRATEGIC DEVELOPMENT/M	50.00			$237,923	$0	$12,381	Yes (X)
MICHAEL DEGERE
VP POPULATION HEALTH MANAGEMENT	50.00			$276,231	$0	$39,245	Yes (X)
MICHAEL DREES
CHIEF OPERATING OFFICER FDL REG	50.00			$269,692	$0	$28,501	Yes (X)
JOHN CHOI MD
ANESTHESIOLOGIST - PAIN RE	50.00			$815,101	$0	$38,795		Yes (X)
YASIR HATAHET MD
INTENSIVIST/PULMONOLOGIST	50.00			$931,158	$0	$45,476		Yes (X)
PONTUS OSTMAN MD
MEDICAL DIRECTOR - PAIN MG	50.00			$657,761	$0	$16,760		Yes (X)
MICHAEL VANDER KOOY MD
RADIATION ONCOLOGIST	50.00			$629,155	$0	$46,426		Yes (X)
STEVEN FLURRY MD
ANESTHESIOLOGIST	50.00			$613,984	$0	$43,291		Yes (X)
H JACK POLLEI
FORMER DIRECTOR	1.00			$11,316	$0	$0			Yes (X)
DENNIS C YUNK
FORMER SR VP CLINIC ADMINISTRATOR	50.00			$20,501	$0	$8,143			Yes (X)
CAROL B HYLAND
PRESIDENT AND CEO - CLW	50.00			$200,901	$0	$28,496			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$7,589,112	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$560,761	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	178	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (1)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
FOND DU LAC REGIONAL CLINIC
420 E DIVISION ST	FOND DU LAC	WI	54935	PHYSICIAN SERVICES	$51,065,497
CERNER CORP
2800 ROCKCREEK PKWY	KANSAS CITY	MO	64141	COMPUTER SERVICES	$13,517,815
CD SMITH CONSTRUCTION
PO BOX 1066	FOND DU LAC	WI	54935	CONSTRUCTION	$6,461,205
MEDICAL COLLEGE OF WI
8701 WATERTOWN PLANK RD PO BOX 26	WAUWATOSA	WI	53226	PHYSICIAN SERVICES	$2,143,140
LOGICALIS INC DEPT # 172301
PO BOX 67000	DETROIT	MI	48267	COMPUTER SERVICES	$1,588,311

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	69	CntrctRcvdGreaterThan100KCnt
Related Organizations	$848,003	RelatedOrganizationsAmt
Total Contributions	$848,003	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
NET PATIENT SERVICE REVENUE	621400	$218,167,086	$217,358,456	$808,630
MEDICARE/MEDICAID REVENUE	621400	$127,321,778	$127,321,778

Field	Value	IRS element (for citing)
Total Program Service Revenue	$345,488,864	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$5,728,903	TotalRevenueColumnAmt
Exclusion	$5,728,903	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$86,466	TotalRevenueColumnAmt
Exclusion	$86,466	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$49,767,036	SecuritiesAmt
Other	$132,706	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$46,589,107	SecuritiesAmt
Other	$239,114	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$3,177,929	SecuritiesAmt
Other	-$106,408	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$3,071,521	TotalRevenueColumnAmt
Exclusion	$3,071,521	ExclusionAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$36,657,950	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$26,823,915	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$9,834,035	TotalRevenueColumnAmt
Related Or Exempt Func Income	$6,465,713	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$3,368,322	UnrelatedBusinessRevenueAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
WORK INJURY/OCC HEALTH	621990	$1,695,000	$1,695,000
MEDICARE EHR	900099	$1,664,294	$1,664,294
CAFETERIA SALES	900099	$1,386,904		$35,913	$1,350,991

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,594,298	TotalRevenueColumnAmt
Related Or Exempt Func Income	$1,594,298	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$6,340,496	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$371,398,288	TotalRevenueColumnAmt
Related Or Exempt Func Income	$356,099,539	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$4,212,865	UnrelatedBusinessRevenueAmt
Exclusion	$10,237,881	ExclusionAmt

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

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$4,071,386	TotalAmt
Management And General	$4,071,386	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$131,722,683	TotalAmt
Program Services	$101,948,990	ProgramServicesAmt
Management And General	$29,773,693	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$6,780,595	TotalAmt
Program Services	$4,983,397	ProgramServicesAmt
Management And General	$1,797,198	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$5,087,951	TotalAmt
Program Services	$2,596,709	ProgramServicesAmt
Management And General	$2,491,242	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$8,936,154	TotalAmt
Program Services	$6,506,793	ProgramServicesAmt
Management And General	$2,429,361	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$504,799	TotalAmt
Management And General	$504,799	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$126,896	TotalAmt
Management And General	$126,896	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$72,209,521	TotalAmt
Program Services	$67,918,404	ProgramServicesAmt
Management And General	$4,291,117	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$1,133,013	TotalAmt
Program Services	$87,073	ProgramServicesAmt
Management And General	$1,045,940	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$53,350,769	TotalAmt
Program Services	$51,039,495	ProgramServicesAmt
Management And General	$2,311,274	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$26,316,242	TotalAmt
Program Services	$279,421	ProgramServicesAmt
Management And General	$26,036,821	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$13,593,270	TotalAmt
Program Services	$5,244,262	ProgramServicesAmt
Management And General	$8,349,008	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$705,875	TotalAmt
Program Services	$570,726	ProgramServicesAmt
Management And General	$135,149	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$734,412	TotalAmt
Program Services	$437,885	ProgramServicesAmt
Management And General	$296,527	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$4,868,009	TotalAmt
Management And General	$4,868,009	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$15,367,387	TotalAmt
Program Services	$1,857,939	ProgramServicesAmt
Management And General	$13,509,448	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$1,878,741	TotalAmt
Program Services	$1,217,974	ProgramServicesAmt
Management And General	$660,767	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
HOSPITAL ASSESSMENT	$5,031,792	$5,031,792
MISCELLANEOUS	$2,154,369	$431,398	$1,722,971
INVESTMENT FEES	$643,963		$643,963
DUES, SUBSCRIPTIONS, LI	$566,209	$246,588	$319,621

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	-$282,958	TotalAmt
Management And General	-$282,958	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$355,501,078	TotalAmt
Program Services	$250,398,846	ProgramServicesAmt
Management And General	$105,102,232	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$8,449,951	BOYAmt
EOY	$4,976,303	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$14,209,288	BOYAmt
EOY	$19,075,426	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$51,807,749	BOYAmt
EOY	$57,815,091	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$5,783,059	BOYAmt
EOY	$5,584,360	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$4,232,055	BOYAmt
EOY	$3,746,011	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$376,586,256	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$206,203,978	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$170,956,029	BOYAmt
EOY	$170,382,278	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$216,431,616	BOYAmt
EOY	$206,669,832	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$62,920,276	BOYAmt
EOY	$64,809,554	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$534,790,023	BOYAmt
EOY	$533,058,855	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$35,647,967	BOYAmt
EOY	$43,689,233	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$136,105,860	BOYAmt
EOY	$134,013,484	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$39,592,404	BOYAmt
EOY	$39,170,655	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$211,346,231	BOYAmt
EOY	$216,873,372	EOYAmt

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

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$310,945,702	BOYAmt
EOY	$302,538,252	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$10,333,000	BOYAmt
EOY	$11,481,683	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$2,165,090	BOYAmt
EOY	$2,165,548	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$323,443,792	BOYAmt
EOY	$316,185,483	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$534,790,023	BOYAmt
EOY	$533,058,855	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$15,897,210	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$17,801,786	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$5,353,733	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

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

Schedule A IRS990ScheduleA

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

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

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

Contributor US Address ContributorUSAddress

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

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

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$17,193	OtherActivitiesAmt
Total Lobbying Expenditures	$17,193	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

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

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

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

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

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

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

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

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

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

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$992,140	BeginningYearBalanceAmt
Investment Earnings Or Losses	$15,366	InvestmentEarningsOrLossesAmt
Administrative Expenses	$2,530	AdministrativeExpensesAmt
End Year Balance	$1,004,976	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Prmnnt Endowment Balance EOY	1.00000	PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (1)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (1)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$6,681,757	OtherCostOrOtherBasisAmt
Book Value	$6,681,757	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$188,566,502	OtherCostOrOtherBasisAmt
Depreciation	$81,614,584	DepreciationAmt
Book Value	$106,951,918	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$3,560,267	OtherCostOrOtherBasisAmt
Depreciation	$1,798,566	DepreciationAmt
Book Value	$1,761,701	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$161,196,888	OtherCostOrOtherBasisAmt
Depreciation	$122,790,828	DepreciationAmt
Book Value	$38,406,060	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$16,580,842	OtherCostOrOtherBasisAmt
Book Value	$16,580,842	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$170,382,278	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (8 entries)

DescDesc	Book ValueBookValueAmt
DUE FROM AFFILIATED ENTITIES	$433,478
LONG TERM DEBT FROM AFFILIATED ENTITY	$5,000,000
INVESTMENT - MERCURY CLINIC	$3,005,130
INVESTMENT - SAH FOUNDATION	$11,816,618
LIMITED USE ASSETS - BOND FUNDS	$4,853,766
LIMITED USE ASSETS - PHYSICIAN SUPPLEMENTAL BENEFIT PLAN	$33,416,460
OTHER RECEIVABLES	$5,000,609
MISCELLANEOUS	$1,283,493

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$64,809,554	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)

DescDesc	AmtAmt
CAPITAL LEASE PAYABLE	$1,993,347
PHYSICIANS SUPPLEMENTAL BENEFIT PLAN	$32,671,578
FUND BALANCE SWAP MARKET ADJUSTMENT	$2,926,948
DUE TO MEDICARE/MEDICAID	$461,400
EXECUTIVE DEFERRED COMP PLAN	$744,882
LAND CONTRACT - FAMILY FOOT CLINIC	$372,500

Field	Value	IRS element (for citing)
Total Liability	$39,170,655	TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART V, LINE 4:	FormAndLineReferenceDesc
Explanation	AGNESIAN HEALTHCARE, INC. HOLDS AN ENDOWMENT FROM THE CONGREGATION OF THE SISTERS OF ST. AGNES. THE ORIGINAL ENDOWMENT OF $1,000,000 IS PERMANENTLY RESTRICTED. INCOME GENERATED FROM THE ENDOWMENT IS UNRESRICTED AND TO BE USED AT THE DISCRETION OF THE CHIEF EXECUTIVE OFFICER TO FUND PROGRAMS SUCH AS DOMESTIC VIOLENCE, CHARITY CARE, ETC.	ExplanationTxt

Schedule H IRS990ScheduleH

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

Free Care Oth Percentage FreeCareOthPercentageGrp

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

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

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$726,468	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$726,468	NetCommunityBenefitExpnsAmt
Total Expense	0.00210	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$24,925,425	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$24,925,425	NetCommunityBenefitExpnsAmt
Total Expense	0.07290	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$25,651,893	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$25,651,893	NetCommunityBenefitExpnsAmt
Total Expense	0.07500	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,739,850	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$223,423	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,516,427	NetCommunityBenefitExpnsAmt
Total Expense	0.00440	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$600,486	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$600,486	NetCommunityBenefitExpnsAmt
Total Expense	0.00180	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$510,127	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$6,868	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$503,259	NetCommunityBenefitExpnsAmt
Total Expense	0.00150	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,033	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$4,033	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$980,653	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$980,653	NetCommunityBenefitExpnsAmt
Total Expense	0.00290	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,835,149	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$230,291	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,604,858	NetCommunityBenefitExpnsAmt
Total Expense	0.01060	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$29,487,042	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$230,291	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$29,256,751	NetCommunityBenefitExpnsAmt
Total Expense	0.08560	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$10,969	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$10,969	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$842	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$842	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$24,031	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$24,031	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$23,512	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$23,512	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$59,354	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$59,354	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$14,253,152	BadDebtExpenseAmt
Reimbursed By Medicare	$109,140,855	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$169,057,840	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$59,916,985	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

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

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

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

US Address USAddress

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

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

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

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

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Information Gaps	Yes (X)	InformationGapsInd
CHNA Conducted	14	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (1)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	WWW.AGNESIAN.COM	OwnWebsiteURLTxt
Other Website	Yes (X)	OtherWebsiteInd
Other Website URL	WWW.LIVINGWELLFDL.ORG	OtherWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Rpt Available Thru Other Method	Yes (X)	RptAvailableThruOtherMethodInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	14	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	WWW.LIVINGWELLFDL.ORG	StrategyWebsiteURLTxt
Strategy Attached	0	StrategyAttachedInd
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	165.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	300.000000000000	FPGFamilyIncmLmtDscntCarePct
Income Level Criteria	Yes (X)	IncomeLevelCriteriaInd
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	WWW.AGNESIAN.COM	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	WWW.AGNESIAN.COM	FAPAppAvailableOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Notice Displayed	Yes (X)	FAPNoticeDisplayedInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	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 (1)	NondisEmergencyCarePolicyInd
Other Method Used	Yes (X)	OtherMethodUsedInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (8 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
ST. AGNES HOSPITAL	PART V, SECTION B, LINE 5: THE CHNA WAS COMMISSIONED BY AGNESIAN HEALTHCARE (ST. AGNES HOSPITAL, WAUPUN MEMORIAL HOSPITAL, AND RIPON MEDICAL CENTER), FOND DU LAC AREA UNITED WAY, FOND DU LAC COUNTY HEALTH DEPARTMENT, FOND DU LAC FAMILY YMCA, AND FOND DU LAC SCHOOL DISTRICT. THE TASK FORCE REVIEWED COUNTY AND STATE DISEASE INCIDENCE AND DEATH DATA, AS WELL AS ECONOMIC, DEMOGRAPHIC, AND HEALTH STATUS DATA. TO SUPPLEMENT THIS DATA, COMMUNITY AND STAKEHOLDER OPINION SURVEYS WERE CONDUCTED TO DETERMINE WHAT PEOPLE IN FDL COUNTY PERCEIVED AS THE MAJOR HEALTH PROBLEMS IN THE COUNTY. COMMUNITY MEMBERS WERE SCIENTIFICALLY SELECTED SO THAT THE SURVEY WOULD BE REPRESENTATIVE OF ALL ADULTS 18 YEARS OLD AND OLDER. A TOTAL OF 400 TELEPHONE INTERVIEWS WERE COMPLETED WITH COMMUNITY MEMBERS. IN ADDITION, ALL STUDENTS IN 8TH, 10TH, AND 11TH GRADES WERE ASKED TO PARTICIPATE IN AN ANONYMOUS AND CONFIDENTIAL SURVEY. THE 124-QUESTION SURVEY WAS ADMINSTERED BY TRAINED VOLUNTEERS AND STAFF. THE SCHOOL DISTRICTS OF CAMPBELLSPORT, FOND DU LAC, NORTH FOND DU LAC, ST. MARY'S SPRINGS ACADEMY, AND WINNEBAGO LUTHERAN ACADEMY PARTNERED TOGETHER TO CONDUCT THE IDENTICAL STUDENT HEALTH SURVEY. THE FOND DU LAC HEALTH 2020 COALITION, WHICH WAS FORMED AFTER THE PREVIOUS SURVEY, RESPONDED TO THE NEEDS IDENTIFIED IN THE CHNA. THE HEALTHY 2020 STEERING COMMITTEE INCLUDES THE FOLLOWING MEMBERS: DR. MATT DOLL, AGNESIAN HEALTHCARE PSYCHOLOGIST; ERIN GERRED, FOND DU LAC COUNTY; GREG GILES, YMCA; BILL LAMB, FOND DU LAC COUNTY POLICE DEPARTMENT; SR. MARY MOLLISON, AGNESIAN HEALTHCARE; KIM MUELLER, FOND DU LAC COUNTY HEALTH DEPARTMENT; WARREN POST, MD, AGNESIAN HEALTHCARE; TINA POTTER, FOND DU LAC AREA UNITED WAY; LALITHA RAMAMOORTHY, MARIAN UNIVERSITY; LARRY RICHARDSON, FABOH; SANDI ROEHRIG, FOND DU LAC AREA FOUNDATION; MARTY RYAN, ROTARY; HEATHER SCHMIDT, DO, AGNESIAN HEALTHCARE; STEVE LITTLE, AGNESIAN HEALTHCARE; KEVIN SHAW, ST. MARY'S SPRINGS ACADEMY; MARIAN SHERIDAN, FOND DU LAC SCHOOL DISTRICT; JOHN SHORT, UW FOND DU LAC; MICHELLE TIDEMANN, UW EXTENSION; DEANN THURMER, AGNESIAN HEALTHCARE; KATHERINE VERGOS, AGNESIAN HEALTHCARE; JENNIFER WALTERS, AURORA HEALTHCARE.THE HEALTHY 2020 COALITION HAS TAKEN THE LEAD ON DISTRIBUTION OF INFORMATION TO THE PUBLIC, AS WELL AS CONTINUING COMMUNITY UPDATES AND ASSESSMENT OF PROGRESS.
ST. AGNES HOSPITAL	PART V, SECTION B, LINE 6A: HOSPITALS INCLUDED IN THE CHNA WERE AGNESIAN HEALTHCARE (ST. AGNES HOSPITAL), WAUPUN MEMORIAL HOSPITAL AND RIPON MEDICAL CENTER.
ST. AGNES HOSPITAL	PART V, SECTION B, LINE 6B: THE CHNA WAS COMMISSIONED BY AGNESIAN HEALTHCARE, FOND DU LAC AREA UNITED WAY, FOND DU LAC COUNTY HEALTH DEPARTMENT, FOND DU LAC COUNTY YMCA, AND FOND DU LAC SCHOOL DISTRICT.
ST. AGNES HOSPITAL	PART V, SECTION B, LINE 7D: THE HEALTHY 2020 COALITION MADE THE RESULTS OF THE CHNA WIDELY AVAILABLE THROUGH A SERIES OF COMMUNITY MEETINGS, DISTRIBUTION OF COMMUNITY HEALTH IMPROVEMENT PLAN FLYERS, NEWSPAPER ARTICLES, AND THE HEALTHY 2020 WEBSITE, WWW.LIVINGWELLFDL.ORG. IN ADDITION, THE FULL REPORT IS AVAILABLE ON THE FOND DU LAC COUNTY WEBSITE.
ST. AGNES HOSPITAL	PART V, SECTION B, LINE 11: AS A RESULT OF THE CHNA CONDUCTED IN 2012 AND 2014, FOUR MAJOR AREAS OF CONCERN WERE DETERMINED, AND A STRATEGIC ACTION PLAN HAS BEEN DEVELOPED FOR EACH AREA.1) INCREASE THE NUMBER OF FDL COUNTY RESIDENTS WHO ARE AT A HEALTHY WEIGHT - AGNESIAN HEALTHCARE HAS COLLABORATED WITH THE YMCA BY HIRING AND PROVIDING FUNDING FOR A WELLNESS COORDINATOR FOR OUTREACH INTO THE COMMUNITY. THE WELLNESS COORDINATOR IS DEVELOPING AND IMPLEMENTING A COMMUNITY EDUCATION CAMPAIGN ON HEALTHY EATING AND ACTIVE LIVING, INCLUDING THE 5,2,1,0 CAMPAIGN IN THE SCHOOL DISTRICT.2) INCREASE DENTAL CARE ACCESS FOR CHILDREN AND ADULTS WITH MEDICAID - AGNESIAN HEALTHCARE HAS PROVIDED FUNDING TO FOND DU LAC COUNTY TO EXTEND THEIR PROGRAM TO PROVIDE DENTAL CARE TO ADULTS WHO DO NOT CURRENTLY HAVE ACCESS TO DENTAL CARE. IN ADDITION, AGNESIAN HEALTHCARE HAS PROVIDED FUNDING TO THE SAVE A SMILE INITIATIVE, WHICH PROVIDES ACCESS TO DENTAL CARE FOR CHILDREN UTILIZING THE MEDICAID PROGRAM.3) IMPROVE MENTAL HEALTH ACCESS - AGNESIAN HEALTHCARE ASSOCIATES ARE PARTICIPATING ON A COMMUNITY-WIDE TASK FORCE TO PROVIDE EDUCATIONAL PROGRAMS TO DECREASE THE STIGMA SURROUNDING MENTAL HEALTH ISSUES. AGNESIAN HEALTHCARE IS PARTNERING WITH THE YMCA TO PROVIDE CITY AND COUNTY EVENTS AND EDUCATION. FUNDING HAS ALSO BEEN PROVIDED TO SHARDS, A MENTAL HEALTH PROVIDER WHICH PROVIDES MENTAL HEALTH COUNSELING TO THOSE WITHOUT INSURANCE.4) DECREASE BINGE DRINKING AND DRUG ABUSE/MISUSE AMOUNG YOUNG AND ADULTS - THE TASK FORCE IS WORKING WITH COMMUNITIES TO IMPLEMENT BEST PRACTICES AS DESCRIBED IN THE COMMUNITY EVENTS TOOLKIT. IT IS ALSO UTILIZING A MEDIA/MARKETING CAMPAIGN TO RAISE AWARENESS, AND ACTIVELY DISCOURAGE BINGE DRINKING AND OVER-CONSUMPTION.THE HOSPITAL IS PARTICIPATING IN THE INITIATIVES NOTED ABOVE TO ADDRESS THE NEEDS IDENTIFIED IN CHNA. OUR INITIATIVES ARE ALREADY SHOWING POSITIVE RESULTS. THE UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE PRODUCES A WELL-KNOWN DOCUMENT TITLED "COUNTY HEALTH RANKINGS AND ROADMAPS". THE MOST CURRENT REPORT SHOWS THAT FOND DU LAC COUNTY HAS IMPROVED FROM THE HEALTH FACTORS RANK OF 20 TO RANK OF 16 IN THE STATE. IN ORDER TO FURTHER HELP COMMUNITY MEMBERS TAKE POSITIVE STEPS IN IMPROVING THEIR HEALTH, AGNESIAN HEALTHCARE DISTRIBUTED 2016 WELLNESS CALENDARS TO 75,000 RESIDENTS.
ST. AGNES HOSPITAL	PART V, SECTION B, LINE 13H: UNINSURED PATIENTS ARE AUTOMATICALLY GIVEN A 15% DISCOUNT.
ST. AGNES HOSPITAL	PART V, SECTION B, LINE 18D: COLLECTION AGENCIES ARE ENGAGED TO COLLECT UNPAID BALANCES. THESE AGENCIES ARE AUTHORIZED TO REPORT TO CREDIT AGENCIES. COLLECTION AGENCIES ARE AUTHORIZED BY THE HOSPITAL TO ESTABLISH GARNISHMENT AGAINST WAGES ON UNPAID BALANCES THEY ARE ATTEMPTING TO COLLECT. THESE ACTIONS ARE NOT UNDERTAKEN UNTIL REASONABLE EFFORTS TO DETERMINE THE PATIENT'S ELIGIBILITY UNDER THE GAP HAVE BEEN MADE.AGNESIAN HEALTHCARE DOES NOT TAKE ANY OF THE ACTIONS AGAINST AN INDIVIDUAL THAT ARE LISTED IN 18A - 18D.
ST. AGNES HOSPITAL	PART V, SECTION B, LINE 22D: UNINSURED PATIENTS AUTOMATICALLY RECEIVE A 15% DISCOUNT OFF GROSS CHARGES.

Field	Value	IRS element (for citing)
Facility	3	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)

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

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 3C:	AGNESIAN HEALTHCARE DOES NOT USE ANY OTHER FACTORS THAN FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY.
PART I, LINE 6A:	AN ANNUAL COMMUNITY BENEFIT REPORT IS COMPLETED BY THE FINANCE DEPARTMENT AND DISTRIBUTED TO THE PUBLIC THROUGH THE PUBLIC RELATIONS OFFICE OF AGNESIAN HEALTHCARE, INC.
PART I, LINE 7:	A COST-TO-CHARGE RATIO WAS USED TO COMPUTE COST OF COMMUNITY BENEFIT SERVICES. OVERALL COSTS LESS TAXES WERE DIVISIBLE BY TOTAL CHARGES.
PART I, LINE 7G:	AGNESIAN HEALTHCARE SUBSIDIZES A SAMARITAN CLINC AND PALLIATIVE CARE FOR THOSE THAT QUALIFY.
PART I, LINE 7, COLUMN (F):	THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 14,253,152.
PART II, COMMUNITY BUILDING ACTIVITIES:	AGNESIAN HEALTHCARE PROVIDES COMMUNITY SUPPORT, LEADERSHIP DEVELOPMENT AND TRAINING FOR COMMUNITY MEMBERS, COALITION BUILDING AND WORKFORCE DEVELOPMENT THROUGH THEIR COMMUNITY BENEFIT ACTIVITIES.
PART III, LINE 4:	THE CARRYING AMOUNTS OF ACCOUNTS RECEIVABLE ARE REDUCED BY ALLOWANCES THAT REFLECT MANAGEMENT'S BEST ESTIMATE OF THE AMOUNTS THAT WILL NOT BE COLLECTED. MANAGEMENT PROVIDES FOR CONTRACTUAL ADJUSTMENTS UNDER TERMS OF THIRD-PARTY REIMBURSEMENT AGREEMENTS THROUGH A CHARGE TO CONTRACTUAL ADJUSTMENTS AND A CREDIT TO THE ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS. IN ADDITION, MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY FROM UNINSURED PATIENTS AND AMOUNTS PATIENTS ARE PERSONALLY RESPONSIBLE FOR, THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO A VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF HISTORICAL COLLECTION LIKELIHOOD AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUTSTANDING AFTER MANAGEMENT HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO ACCOUNTS RECEIVABLE. THE COSTING METHODOLOGY FOR DETERMINING BAD DEBTS IS A COST TO CHARGE RATIO.
PART III, LINE 8:	MEDICARE SHORTFALL IS NOT TREATED AS A COMMUNITY BENEFIT. TO ARRIVE AT COST OF MEDICARE SERVICES, THE TOTAL EXPENSE LESS OTHER OPERATING REVENUE IS MULTIPLIED BY THE RATIO OF MEDICARE REVENUE TO TOTAL REVENUE.ALTHOUGH MEDICARE SHORTFALL HAS NOT BEEN REPORTED AS A COMMUNITY BENEFIT, IT SHOULD BE TREATED AS A COMMUNITY BENEFIT BECAUSE IT PROMOTES ACCESS TO HEALTHCARE TO THE UNDERSERVED ELDERLY POPULATION, WHO WOULD NOT HAVE ACCESS TO LOCAL CARE IF WE WERE NOT ABLE TO SERVE THEM. ALTHOUGH OUR HOSPITAL IS EFFICIENTLY OPERATED, THE CALCULATIONS USED FOR MEDICARE REIMBURSEMENT DO NOT ALLOW FOR PAYMENTS THAT COVER COSTS OF NECESSARY SERVICES.
PART III, LINE 9B	ST. AGNES HOSPITAL HAS A WRITTEN DEBT COLLECTION POLICY. PAYMENT IS DUE WITHIN 30 DAYS OF RECEIPT OF A STATEMENT. IF PATIENTS DO NOT SET UP ACCEPTABLE PAYMENT ARRANGEMENTS, BILLS WILL BE REFERRED TO AN OUTSIDE COLLECTION AGENCY. FINANCIAL COUNSELORS WORK WITH ALL PATIENTS ON AN INDIVIDUAL BASIS AND MAY OFFER EXTENDED MONTHLY PAYMENTS WITHOUT INTEREST BASED ON DOLLAR AMOUNT, PRIVATE PAY DISCOUNTS (INDIVIDUALS WHO DO NOT HAVE INSURANCE COVERING EMERGENCY OR OTHER MEDICALLY NECESSARY CARE ARE BILLED AT A REDUCED RATE), OR GUARANTEED BANK LOANS.A ZERO DOLLAR AMOUNT WAS ESTIMATED FOR THE AMOUNT OF BAD DEBTS ATTRIBUTABLE TO PATIENTS WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE. IF PATIENTS QUALIFY, THEIR EXPENSES ARE RECLASSIFIED AS CHARITY CARE. PATIENTS WHO RECEIVED A COLLECTION NOTICE COULD APPLY FOR CHARITY CARE. IF THEIR APPLICATION IS APPROVED, THIS WOULD TRIGGER A TRANSFER OF EXPENSES FROM BAD DEBT TO CHARITY CARE.
PART VI, LINE 2:	IN ADDITION TO THE CHNA NOTED ABOVE, THE HOSPITAL'S SENIOR LEADERS MEET REGULARLY WITH COMMUNITY LEADERS TO GATHER INPUT FROM AND RESPOND TO PATIENT AND CUSTOMER NEEDS. SENIOR LEADERS AND MEMBERS OF THE WORKFORCE PARTICIPATE IN A VARIETY OF ORGANIZATIONS IN SUPPORT OF ST. AGNES HOSPITAL'S KEY COMMUNITIES. THROUGH THE HOSPITAL'S PARTICIPATION IN THESE ACTIVITIES, COMMUNITY MEMBERS LEARN OF THE HOSPITAL'S COMMITTMENT TO COMMUNITY-WIDE HEALTHCARE AND PROVIDE ST. AGNES HOSPITAL WITH INSIGHTS INTO COMMMUNITY HEALTH NEEDS AND DESIRES.
PART VI, LINE 3:	FINANCIAL COUNSELORS AT ST. AGNES HOSPITAL ASSIST PATIENTS WITH THE APPLICATION FOR COMMUNITY CARE. PATIENTS CAN BE REFERRED TO COMMUNITY CARE BY CLERGY, DEPARTMENTS OF ST. AGNES HOSPITAL, SISTERS OF ST. AGNES, PHYSICIANS, AREA SOCIAL AND HEALTH AGENCIES, FAMILY OR SELF. THE APPLICATION IS COMPLETED BY THE PATIENT WITH ASSISTANCE FROM THE FINANCIAL COUNSELOR IF NEEDED. THE FINANCIAL COUNSELOR WILL COMMUNICATE TO THE PATIENT WHAT PROGRAMS THEY WILL BE ELIGIBLE FOR, AS WELL AS PROVIDE NOTIFICATION OF APPROVAL OR DENIAL OF THEIR APPLICATION IN A TIMELY MANNER.
PART VI, LINE 4:	COMMUNITY CARE APPLICATIONS ARE ACCEPTED ONLY FROM PATIENTS OF ST. AGNES HOSPITAL WHO RESIDE IN THE COUNTIES OF CALUMET, COLUMBIA, DODGE, FOND DU LAC, GREEN LAKE, MARQUETTE, WASHINGTON, WAUSHARA OR WINNEBAGO. INDIVIDUALS MUST BE A RESIDENT OF ONE OF THOSE AREAS FOR A MINIMUM OF THREE MONTHS AND PROVIDE SUPPORTING DOCUMENTATION. ON OCCASION, INDIVIDUALS ARE NOT COMMUNITY MEMBERS BUT MAY NEED ASSISTANCE; THOSE APPLICATIONS ARE CONSIDERED ON A CASE-BY-CASE BASIS.
PART VI, LINE 5:	WHILE THERE IS GROWING AGREEMENT IN THE UNITED STATES ABOUT WHAT CONSTITUTES A NON-PROFIT HOSPITAL'S "COMMUNITY BENEFIT", THIS IS A WORK IN PROGRESS. OUR HOSPITAL PROVIDES SIGNIFICANT CHARITY CARE AND OTHER COMMUNITY BENEFIT AS DEFINED BY THE IRS. BUT IN ADDITION, WE BELIEVE THAT WE PROVIDE A CRITICALLY IMPORTANT COMMUNITY BENEFIT WHICH IS NOT QUANTIFIED. OUR HOSPITAL, LIKE MOST HOSPITALS, WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE CARE LOCALLY - CARE THAT, WITHOUT OUR HOSPITAL, WOULD NOT BE AVAILABLE LOCALLY. BEYOND INPATIENT HOSPITALIZATIONS, WE PROVIDE LOCAL ACCESS TO MANY HEALTH SERVICES: DIALYSIS CENTER, DIAGNOSTICS, EMERGENCY SERVICES & URGENT CARE, EXTENDED CARE, INFUSION SERVICES, INPATIENT CARE, LABORATORY SERVICES, OCCUPATIONAL HEALTH REHABILITATION SERVICES, SPECIALTY MEDICINE, SPEECH AND AUDIOLOGY, SURGICAL SERVICES, AND WOMENS SERVICES.
PART VI, LINE 6:	ST. AGNES HOSPITAL IS PART OF AGNESIAN HEALTHCARE, AN INTEGRATED, COMPREHENSIVE NOT-FOR-PROFIT HEALTHCARE DELIVERY SYSTEM COMPRISED OF NINE MINISTRIES: AGNESIAN HEALTHCARE ENTERPRISES, LLC, CONSULTANTS LAB OF WI, LLC, FOND DU LAC REGIONAL CLINIC, ST. AGNES HOSPITAL, ST. FRANCIS HOME, SISTER SERVANTS OF CHRIST THE KING VILLA LORETTO NURSING HOME, VILLA ROSA, INC, WAUPUN MEMORIAL HOSPITAL AND RIPON MEDICAL CENTER. AGNESIAN PROVIDES A CONTINUUM OF HEALTHCARE FROM BIRTH TO END OF LIFE, PREVENTIVE CARE, DIAGNOSIS, TREATMENT AND FOLLOWUP, ASSISTED LIVING, AND INDEPENDENT AND SKILLED CARE SERVICES. AGNESIAN HEALTHCARE IS COMMITTED TO ENSURING THAT INDIVIDUALS NEEDING VITAL HEALTHCARE SERVICES GET THE HELP THEY NEED AND DESERVE.
PART VI, LINE 7, REPORTS FILED WITH STATES	WI

Schedule J IRS990ScheduleJ

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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (19 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
STEVEN N LITTLE
PRESIDENT AND CEO	$642,271	$0	$152,021	$0	$26,848	$0	$14,600	$0	$26,206	$0	$861,946	$0	$0	$0
JAMES P MUGAN
SR VP CLINICAL SERVICES	$272,953	$0	$34,656	$0	$14,180	$0	$15,287	$0	$25,300	$0	$362,376	$0	$0	$0
BONNIE R SCHMITZ
CHIEF FINANCIAL OFFICER	$398,605	$0	$52,086	$0	$22,662	$0	$17,450	$0	$9,784	$0	$500,587	$0	$0	$0
MARY J MOLLISON
VP SPIRITUALITY AND CARE	$179,909	$0	$22,976	$0	$0	$0	$0	$0	$8,662	$0	$211,547	$0	$0	$0
SUSAN L EDMINSTER
VP - HUMAN RESOURCES	$267,275	$0	$33,443	$0	$1,222	$0	$11,069	$0	$27,482	$0	$340,491	$0	$0	$0
NANCY A BIRSCHBACH
VP - CIO	$276,675	$0	$34,910	$0	$990	$0	$13,840	$0	$29,031	$0	$355,446	$0	$0	$0
JILL A STENSON
VP NURSING	$202,634	$0	$25,288	$0	$5,334	$0	$10,543	$0	$11,624	$0	$255,423	$0	$0	$0
BARBARA L KNUTZEN
PRES AND CEO-AHE AND PERFO	$223,203	$0	$27,308	$0	$2,885	$0	$11,484	$0	$20,885	$0	$285,765	$0	$0	$0
HOLLY BRENNER
VP STRATEGIC DEVELOPMENT/M	$200,911	$0	$23,318	$0	$13,694	$0	$11,096	$0	$1,285	$0	$250,304	$0	$0	$0
MICHAEL DEGERE
VP POPULATION HEALTH MANAGEMENT	$231,803	$0	$26,163	$0	$18,265	$0	$15,480	$0	$23,765	$0	$315,476	$0	$0	$0
MICHAEL DREES
CHIEF OPERATING OFFICER FDL REG	$236,286	$0	$25,025	$0	$8,381	$0	$435	$0	$28,066	$0	$298,193	$0	$0	$0
JOHN CHOI MD
ANESTHESIOLOGIST - PAIN RE	$590,231	$0	$222,548	$0	$2,322	$0	$15,600	$0	$23,195	$0	$853,896	$0	$0	$0
YASIR HATAHET MD
INTENSIVIST/PULMONOLOGIST	$468,789	$0	$370,407	$0	$91,962	$0	$14,103	$0	$31,373	$0	$976,634	$0	$0	$0
PONTUS OSTMAN MD
MEDICAL DIRECTOR - PAIN MG	$401,962	$0	$252,235	$0	$3,564	$0	$15,600	$0	$1,160	$0	$674,521	$0	$0	$0
MICHAEL VANDER KOOY MD
RADIATION ONCOLOGIST	$602,504	$0	$0	$0	$26,651	$0	$15,600	$0	$30,826	$0	$675,581	$0	$0	$0
STEVEN FLURRY MD
ANESTHESIOLOGIST	$603,613	$0	$0	$0	$10,371	$0	$15,600	$0	$27,691	$0	$657,275	$0	$0	$0
H JACK POLLEI
FORMER DIRECTOR	$11,316	$0	$0	$0	$0	$0	$0	$0	$0	$0	$11,316	$0	$0	$0
DENNIS C YUNK
FORMER SR VP CLINIC ADMINISTRATOR	$0	$0	$0	$0	$20,501	$0	$8,143	$0	$0	$0	$28,644	$0	$0	$0
CAROL B HYLAND
PRESIDENT AND CEO - CLW	$124,744	$0	$28,555	$0	$47,602	$0	$16,377	$0	$12,119	$0	$229,397	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 1A	ALL GROSSUP PAYMENTS AND SOCIAL CLUB DUES ARE INCLUDED ON FORM 1099. THESE PAYMENTS ARE MADE FOR A CURRENT AND FORMER MEMBER OF THE BOARD OF DIRECTORS.
PART I, LINE 4B	ALL EXECUTIVES PARTICIPATE IN A 457(B) SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN.
PART I, LINE 5	COMPENSATION FOR SOME EMPLOYED PHYSICIANS IS BASED ON A PERCENTAGE OF GROSS BILLINGS.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
WI HEALTH AND EDUC FACILITIES AUTHORITY
A	391337855	97710BGG1	2008-12-11	$49,330,000	REFUNDING OF 2001 ISSUE, PRIVATE ROOM PROJECT	0	0	0
WI HEALTH AND EDUC FACILITIES AUTHORITY
B	391337855	97710BYW6	2010-12-01	$57,260,000	REFUNDING OF 2001 ISSUE, PRIVATE ROOM PROJECT	0	0	0
WI HEALTH AND EDUC FACILITIES AUTHORITY
C	391337855	NONEAVAIL	2011-12-15	$10,020,000	PARTIAL REFUNDING OF 1998 ISSUE	0	0	0
WI HEALTH AND EDUC FACILITIES AUTHORITY
D	391337855	97710B7C0	2013-03-14	$5,705,000	CONSTRUCTION AND EXPANSION OF FACILITIES	0	0	0

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Total ProceedsTotalProceedsAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Working Capital ExpendituresWorkingCapitalExpendituresAmt	Substantial CompletionSubstantialCompletionYr	Current RefundingCurrentRefundingInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd	In Reserve FundInReserveFundAmt	Refunding EscrowRefundingEscrowAmt	Capital ExpendituresCapitalExpendituresAmt	Capitalized InterestCapitalizedInterestAmt
A	$4,875,000	$49,330,000	$430,000	$48,900,000	2005	Yes (1)	Yes (1)	Yes (1)
B	$6,260,000	$57,260,000	$767,686		2014	Yes (1)	0	Yes (1)	$4,518,399	$31,465,565	$20,498,350
C	$5,025,000	$10,020,000	$90,000		2011	Yes (1)	Yes (1)	Yes (1)		$9,930,000
D		$5,705,000	$32,111		2015	0	Yes (1)	Yes (1)			$5,672,889	$61,653

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

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

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

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

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

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

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

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

Issuer Name IssuerName

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

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

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

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

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

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

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

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

Procedures Corrective Action ProceduresCorrectiveActionGrp

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

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
ROBERT MIKKELSEN MD
DIRECTOR	$44,903	ROBERT MIKKELSEN'S STEP-DAUGHTER, KAYLA AVILA, IS EMPLOYED AS AN RN AT AGNESIAN HEALTHCARE, EARNING AN ANNUAL SALARY OF $44,903.	0
JAMES CHATTERTON
DIRECTOR	$25,278	JIM CHATTERTON IS PRESIDENT OF AMERICAN BANK. AGNESIAN HEALTHCARE, INC PROVIDED OCCUPATIONAL HEALTH SERVICES TO AMERICAN BANK, BILLING $25,278 OF THESE SERVICES IN FISCAL YEAR 2016.	0
RICHARD SCHAEFER MD
DIRECTOR	$61,384	RICHARD SCHAEFER'S WIFE, EVELYN SCHAEFER, IS EMPLOYED AS A PSYCHOLOGIST AT AGNESIAN HEALTHCARE, EARNING AN ANNUAL SALARY OF $61,384.	0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6	THE ORGANIZATION HAS TWO CLASSES OF MEMBERS - CLASS A MEMBERS WHO ARE MEMBERS OF THE CONGREGATION OF THE SISTERS OF ST. AGNES AND CLASS B MEMBERS WHO CONSTITUTE THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7A	THE CLASS A MEMBERS, WHO ARE THE GENERAL COUNCIL OF THE CONGREGATION OF SISTERS OF ST. AGNES, HAVE THE POWER TO ELECT OR APPOINT THE CLASS B MEMBERS. THE CLASS B MEMBERS CONSTITUTE THE BOARD OF DIRECTORS. THE CLASS B MEMBERS HAVE THE POWER, UPON THE RECOMMENDATION OF THE BOARD OF DIRECTORS, TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, THE PRESIDENT/CHIEF EXECUTIVE OFFICER OF THE CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7B	THE CONGREGATION OF THE SISTERS OF ST. AGNES SPONSORSHIP MINISTRIES IS THE CLASS B MEMBER WHO IS RESPONSIBLE FOR APPROVING CERTAIN RESERVED POWERS OF THE CORPORATION DELEGATED TO THEM BY CLASS A. THE GENERAL COUNCIL OF THE CONGREGATION OF SISTERS OF ST. AGNES IS THE CLASS A MEMBER WHO IS RESPONSIBLE FOR APPROVING CERTAIN RESERVED POWERS OF THE CORPORATION.
FORM 990, PART VI, SECTION B, LINE 11	THE FINANCE DEPARTMENT PREPARES THE FORM 990 AND THE RETURN IS REVIEWED BY THE DIRECTOR OF FINANCE AND CFO. A FINAL COPY OF THE 2015 FORM 990 IS PROVIDED TO THE BOARD EXECUTIVE COMMITTEE FOR REVIEW AND APPROVAL TO THE AGNESIAN HEALTHCARE BOARD BEFORE THE RETURN IS FILED WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C	A WRITTEN CONFLICT OF INTEREST AND INSIDER TRANSACTION POLICY EXISTS WHICH REQUIRES EACH DIRECTOR, PRINCIPAL OFFICER, TRUSTEE OR COMMITTEE MEMBER TO DISCLOSE ON AN ANNUAL BASIS TO THE DESIGNATED AUTHORITY A CONFLICT OF INTEREST DISCLOSURE STATEMENT. THE DESIGNATED AUTHORITY ENSURES THAT ALL STATEMENTS ARE COMPLETED, REVIEWS THEM FOR CONFLICTS, AND SUBMITS TO THE BOARD FOR REVIEW ANY CONFLICT OF INTEREST DISCLOSURE STATEMENTS THAT DISCLOSE ACTUAL OR POTENTIAL CONFLICTS.
FORM 990, PART VI, SECTION B, LINE 15	DETERMINATION OF COMPENSATION OF THE CEO AND OFFICERS INCLUDES ANALYSIS OF COMPARABLE COMPENSATION SURVEYS BY AN INDEPENDENT COMPENSATION CONSULTANT, WHO RECOMMENDS RANGES OF APPROPRIATE COMPENSATION TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS APPROVES THE COMPENSATION PACKAGE FOR OFFICERS, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATIONS AND DECISION IS INCLUDED IN THE BOARD MINUTES. THE FINAL AGREEMENT IS DOCUMENTED WITH A WRITTEN CONTRACT, WHICH IS SIGNED BY BOTH PARTIES.
FORM 990, PART VI, SECTION C, LINE 19	AGNESIAN HEALTHCARE'S POLICY AND PROCEDURE FIN1069 DEFINES THE PROCEDURE FOR MAKING ANNUAL INFORMATION RETURNS AVAILABLE FOR PUBLIC INSPECTION. INDIVIDUALS REQUESTING INSPECTION ARE REFERRED TO THE ADMINISTRATION OFFICE, WHERE THEY ARE PROVIDED WITH THE DOCUMENTS AND A CONFERENCE ROOM FOR INSPECTING DOCUMENTS. PHOTOCOPIES WILL BE PROVIDED TO THE REQUESTOR. ANYONE MAY INSPECT THE RETURNS UPON DEMAND, WITHOUT AN APPOINTMENT OR ANY FOREWARNING, DURING AGNESIAN HEALTHCARE INC'S NORMAL BUSINESS HOURS. GOVERNING DOCUMENTS AND CONFLICT OF INTEREST STATEMENTS ARE NOT AVAILABLE FOR PUBLIC INSPECTION, BUT CAN BE MADE AVAILABLE IF THE REQUESTING PARTY HAS A BONAFIDE REASON. ALL FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC THROUGH A POSTING ON A PUBLIC WEBSITE.
FORM 990, PART VI, SECTION B, LINE 15B	AN ANNUAL SURVEY IS PERFORMED BY AN OUTSIDE COMPANY.
FORM 990, PART IX, LINE 11G	PURCHASED SERVICES - PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 7,151,956. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,151,956. PURCHASED SERVICES - LABORATORY: PROGRAM SERVICE EXPENSES 187,366. MANAGEMENT AND GENERAL EXPENSES 6,973. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 194,339. PURCHASED SERVICES - ELEVATOR: PROGRAM SERVICE EXPENSES 4,973. MANAGEMENT AND GENERAL EXPENSES 133,173. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 138,146. PURCHASED SERVICES - MISCELLANEOUS: PROGRAM SERVICE EXPENSES 57,727,436. MANAGEMENT AND GENERAL EXPENSES 1,749,894. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 59,477,330. PURCHASED SERVICES - TEMPORARY STAFF: PROGRAM SERVICE EXPENSES 768,442. MANAGEMENT AND GENERAL EXPENSES 107,362. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 875,804. PURCHASED SERVICES - REFERENCE TESTS: PROGRAM SERVICE EXPENSES 1,063,514. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,063,514. PURCHASED SERVICES - HOUSEKEEPING: PROGRAM SERVICE EXPENSES 79,883. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 79,883. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 661,534. MANAGEMENT AND GENERAL EXPENSES 331,000. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 992,534. PROFESSIONAL FEES - MEDICAL DIRECTOR: PROGRAM SERVICE EXPENSES 267,180. MANAGEMENT AND GENERAL EXPENSES 13,000. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 280,180. PROFESSIONAL FEES - COLLECTION: PROGRAM SERVICE EXPENSES 6,120. MANAGEMENT AND GENERAL EXPENSES 904,518. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 910,638. PURCHASED SERVICES - LAUNDRY: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 782,954. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 782,954. PURCHASED SERVICES - TRANSCRIPTION: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 262,243. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 262,243.
FORM 990, PART XI, LINE 9:	CAPITAL CONTRIBUTIONS FROM AFFILIATES -1,000,000. CHANGE IN SWAP FUND BALANCE -730,140. CHANGE IN FUND BALANCE - SAH FOUNDATION 1,054,498. CAPITAL CONTRIBUTIONS - FOUNDATION 298,357. CAPITAL CONTRIBUTIONS - OTHER 23,552. CSA LEGACY CONTRIBUTIONS -5,000,000.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Total IncomeTotalIncomeAmt	End Of Year AssetsEndOfYearAssetsAmt	Direct Controlling NADirectControllingNACd
CONSULTANTS LABORATORY OF WISCONSIN LLC
430 E DIVISION STREET	FOND DU LAC	WI	54935	391528550	LAB SERVICES	WI	$28,136,703	$23,014,321	N/A
AGNESIAN HEALTHCARE ENTERPRISES LLC
430 E DIVISION STREET	FOND DU LAC	WI	54935	392038757	RETAIL PHARMACY	WI	$9,927,784	$10,269,336	N/A

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Direct Controlling NADirectControllingNACd	Controlled OrganizationControlledOrganizationInd
ST FRANCIS HOME OF FOND DU LAC
33 EVERETT STREET	FOND DU LAC	WI	54935	391029998	NURSING HOME	WI	501(C)(3)	9	N/A	0
CONGREGATION OF SISTERS OF ST AGNES
320 COUNTY ROAD K	FOND DU LAC	WI	54935	390806217	CONVENT	WI	501(C)(3)	1	N/A	0
AGNESIAN HEALTHCARE FOUNDATION
430 E DIVISION STREET	FOND DU LAC	WI	54935	391684956	FOUNDATION	WI	501(C)(3)	PF	N/A	0
WAUPUN MEMORIAL HOSPITAL
620 WEST BROWN STREET	WAUPUN	WI	53963	390806265	HOSPITAL	WI	501(C)(3)	3	N/A	0
RIPON MEDICAL CENTER
845 PARKSIDE STREET	RIPON	WI	54971	391101287	HOSPITAL	WI	501(C)(3)	3	N/A	0
VILLA ROSA INC
N8120 COUNTY WW	MOUNT CALVARY	WI	53057	421670962	NURSING HOME	WI	501(C)(3)	9	N/A	0
SISTER SERVANTS OF CHRIST THE KING
N8114 COUNTY WW	MOUNT CALVARY	WI	53057	391022770	NURSING HOME	WI	501(C)(3)	9	N/A	0

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

Transactions Related Org TransactionsRelatedOrgGrp (8 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
AGNESIAN HEALTHCARE FOUNDATION INC
C	$848,003	CASH RECEIPTS
ST FRANCIS HOME
D	$5,000,000	BOND VALUE
ST FRANCIS HOME
M	$63,202	CASH PAYMENTS
CONGREGATION OF SISTERS OF ST AGNES
M	$5,327,039	CASH PAYMENTS
CONGREGATION OF SISTERS OF ST AGNES
O	$425,115	CASH PAYMENTS
WAUPUN MEMORIAL HOSPITAL
O	$531,186	CASH TRANSFER
RIPON MEDICAL CENTER
P	$80,625	CASH TRANSFER
VILLA LORETTO-SISTER SERVANT OF CHRIST
M	$2,000	CASH PAYMENTS