ASPIRUS MERRILL HOSPITAL & CLINICS INC: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization: ASPIRUS MERRILL HOSPITAL & CLINICS INC (EIN 39-0808503)
Tax period: 2014-07-01 to 2015-06-30
Filed: 2016-05-16
IRS object ID: 201611379349310231
Schema version: 2014v6.0
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 C
Schedule D
Schedule H
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2016-05-16T18:06:42-05:00	ReturnTs
Tax Period End	2015-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	861065772	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

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

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	555 East Wells Street Suite 1400	AddressLine1Txt
City	Milwaukee	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	53202	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2014-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	390808503	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Good Samaritan Health Center of Merrill Wisconsin Inc	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	GOOD	BusinessNameControlTxt
Phone	7155365511	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	601 South Center Avenue	AddressLine1Txt
City	Merrill	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54452	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Brian Regan	PersonNm
Person Title	Interim CFO	PersonTitleTxt
Signature	2016-05-16	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Rachel Becker	PreparerPersonNm
PTIN	P00966076	PTIN
Phone	4142713000	PhoneNum

Field	Value	IRS element (for citing)
Tax	2014	TaxYr
Build TS	2016-08-17 19:52:53Z	BuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Mary T Krueger	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	601 South Center Avenue	AddressLine1Txt
City	Merrill	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54452	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$22,859,045	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Group Exemption	0928	GroupExemptionNum
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	www.ministryhealth.org/gshc/home.nws	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1950	FormationYr
Legal Domicile State	WI	LegalDomicileStateCd
Activity Or Mission	To improve the health and well-being of all people in the communities we serve.	ActivityOrMissionDesc
Voting Members Governing Body	12	VotingMembersGoverningBodyCnt
Voting Members Independent	10	VotingMembersIndependentCnt
Total Employee	178	TotalEmployeeCnt
Total Volunteers	116	TotalVolunteersCnt
Total Gross UBI	$16,039	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	-$11,280	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$0	PYContributionsGrantsAmt
CY Contributions Grants	$0	CYContributionsGrantsAmt
PY Program Service Revenue	$21,376,088	PYProgramServiceRevenueAmt
CY Program Service Revenue	$21,949,105	CYProgramServiceRevenueAmt
PY Investment Income	$987,223	PYInvestmentIncomeAmt
CY Investment Income	$758,160	CYInvestmentIncomeAmt
PY Other Revenue	$190,951	PYOtherRevenueAmt
CY Other Revenue	$150,712	CYOtherRevenueAmt
PY Total Revenue	$22,554,262	PYTotalRevenueAmt
CY Total Revenue	$22,857,977	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	$14,343,249	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$13,720,781	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$8,358,878	PYOtherExpensesAmt
CY Other Expenses	$8,679,040	CYOtherExpensesAmt
PY Total Expenses	$22,702,127	PYTotalExpensesAmt
CY Total Expenses	$22,399,821	CYTotalExpensesAmt
PY Revenues Less Expenses	-$147,865	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$458,156	CYRevenuesLessExpensesAmt
Total Assets BOY	$40,286,118	TotalAssetsBOYAmt
Total Assets EOY	$40,911,637	TotalAssetsEOYAmt
Total Liabilities BOY	$2,990,299	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$4,171,446	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$37,295,819	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$36,740,191	NetAssetsOrFundBalancesEOYAmt
Mission	Good Samaritan Health Center of Merrill, Wisconsin, Inc.'s mission as a Catholic hospital is to further the healing ministry of Jesus by continually improving the health and well-being of all people, especially the poor.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$16,502,195	ExpenseAmt
Revenue	$21,993,072	RevenueAmt
Desc	GOOD SAMARITAN HEALTH CENTER OF MERRILL, WISCONSIN, INC. PROVIDES INPATIENT, OUTPATIENT, EMERGENCY ROOM, AND ANCILLARY SERVICES REGARDLESS OF AN INDIVIDUAL'S ABILITY TO PAY OR METHOD OF PAYMENT. THE HOSPITAL ALSO PROVIDES EDUCATIONAL PROGRAMS AND SERVICES ON HEALTH CARE ISSUES TO THE COMMUNITY IT SERVES. SEE SCHEDULE H FOR FURTHER DETAILS REGARDING THE COMMUNITY BENEFITS THAT GOOD SAMARITAN HEALTH CENTER OF MERRILL, WISCONSIN, INC. PROVIDES.	Desc
Total Program Service Expenses	$16,502,195	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	false	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	Yes (true)	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	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	41	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	178	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	12	GoverningBodyVotingMembersCnt
Independent Voting Member	10	IndependentVotingMemberCnt
Family Or Business Rln	Yes (true)	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	false	CompensationProcessCEOInd
Compensation Process Other	false	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	WI	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Craig Aittama	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	7153465161	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	5700 Lands End Way 2nd Floor	AddressLine1Txt
City	Stevens Point	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54482	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (23 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	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
MARY T KRUEGER
HOSPITAL PRESIDENT	13.00	27.90	Yes (X)	Yes (X)	$0	$487,564	$17,534
VAL MINDAK
VICE CHAIRPERSON	1.00	0	Yes (X)	Yes (X)	$0	$0	$0
SHANNON MURRAY
SECRETARY/TREASURER	1.00	0	Yes (X)	Yes (X)	$0	$0	$0
MICHAEL RAVN
CHAIRPERSON	1.00	0	Yes (X)	Yes (X)	$0	$0	$0
JANE DEAU
BOARD MEMBER	1.00	0	Yes (X)		$0	$0	$0
KAREN KAROW
BOARD MEMBER	1.00	0	Yes (X)		$0	$0	$0
DENIS MCCARTHY
BOARD MEMBER	1.00	0	Yes (X)		$0	$0	$0
SUSAN RYMAN
BOARD MEMBER	1.00	0	Yes (X)		$0	$0	$0
ROBYN SCHERTZ MD
BOARD MEMBER	1.00	40.20	Yes (X)		$0	$403,878	$41,956
SISTER MARIA VINTON SSM
BOARD MEMBER	0.00	0.20	Yes (X)		$0	$0	$0
TRINA JOHNSON
BOARD MEMBER	1.00	0	Yes (X)		$0	$0	$0
TIM ZIMMERMAN
BOARD MEMBER	1.00	0	Yes (X)		$0	$0	$0
NICHOLAS DESIEN
MINISTRY HEALTH CARE CEO	1.00	54.60		Yes (X)	$0	$2,134,343	$18,803
JEFFREY FRANCIS
MINISTRY HEALTH CARE CAFO	1.00	53.80		Yes (X)	$0	$1,021,840	$19,803
LARRY T HEGLAND MD
CHIEF MEDICAL OFFICER	3.00	37.00		Yes (X)	$0	$427,650	$17,897
DANIEL NEUFELDER
SVP, HOSPITAL OPERATIONS & PRESIDENT, AHS	1.00	62.30		Yes (X)	$0	$1,071,649	$17,365
JEFFREY L MARTIN
VICE PRESIDENT MINISTRY HEALTH CARE	4.00	36.50		Yes (X)	$0	$1,023,508	$18,196
RACHEL YARON
VP - PATIENT CARE	6.00	34.00			$0	$237,518	$3,690	Yes (X)
KATHRYN S HORST
CLINICAL STAFF PHARMACIST	35.00	0			$120,081	$0	$9,363		Yes (X)
CHERYL JAHNS
DIRECTOR PATIENT CARE SERVICES	40.00	0			$109,385	$0	$2,719		Yes (X)
CRAIG SPANGLER
CLINICAL STAFF PHARMACIST	35.00	0			$108,262	$0	$13,999		Yes (X)
MARY WITTE
DIRECTOR DIAGNOSTIC & THERAPUTIC SERVICES	20.00	0			$100,728	$0	$15,055		Yes (X)
JEFF BADGER
FORMER OFFICER	0.00	0.00			$0	$659,840	$13,832			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$438,456	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$7,467,789	TotReportableCompRltdOrgAmt
Total Other Compensation	$210,212	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	4	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	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
ELLIS STONE CONSTRUCTION CO INC
PO BOX 366	STEVENS POINT	WI	544810366	CONSTRUCTION SERVICES	$506,480
Weatherby Locums Inc
PO Box 972633	Dallas	TX	753972633	Medical Staff	$206,252
Boldt Company
Lock Box 285	Milwaukee	WI	532880285	Contruction Services	$178,744
Shared Medical Services
209 Limestone Pass	Cottage Grove	WI	535270330	Medical Services	$175,075
Snow Tracks Plowing & Snow Removal
1505 Delmore Dr	Merrill	WI	54452	Snow Removal and Lawn Care	$114,349

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	5	CntrctRcvdGreaterThan100KCnt
Info In Schedule O Part VIII	Yes (X)	InfoInScheduleOPartVIIIInd
Federated Campaigns	$0	FederatedCampaignsAmt
Membership Dues	$0	MembershipDuesAmt
Fundraising	$0	FundraisingAmt
Related Organizations	$0	RelatedOrganizationsAmt
Government Grants	$0	GovernmentGrantsAmt
All Other Contributions	$0	AllOtherContributionsAmt
Noncash Contributions	$0	NoncashContributionsAmt
Total Contributions	$0	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net Patient Revenue	622110	$21,805,564	$21,805,564
Rent from Exempt Org.	531190	$90,681	$90,681
Intercompany Lab	541380	$31,141	$31,141
Physical Therapy	900099	$21,719	$21,719

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	$21,949,105	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$754,217	TotalRevenueColumnAmt
Exclusion	$754,217	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$8,345	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$8,345	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$8,345	TotalRevenueColumnAmt
Exclusion	$8,345	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$5,011	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt
Other	$1,068	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt
Other	$3,943	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$3,943	TotalRevenueColumnAmt
Exclusion	$3,943	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Cafeteria	722210	$85,500	$3,139	$82,361
Housekeeping	900099	$11,537	$11,537
PCARD Rebates	900099	$3,457			$3,457

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$41,873	TotalRevenueColumnAmt
Related Or Exempt Func Income	$40,510	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$1,363	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$142,367	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$22,857,977	TotalRevenueColumnAmt
Related Or Exempt Func Income	$21,993,072	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$16,039	UnrelatedBusinessRevenueAmt
Exclusion	$848,866	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	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$10,807,506	TotalAmt
Program Services	$9,025,303	ProgramServicesAmt
Management And General	$1,782,203	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$375,069	TotalAmt
Program Services	$319,309	ProgramServicesAmt
Management And General	$55,760	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$1,999,165	TotalAmt
Program Services	$1,278,859	ProgramServicesAmt
Management And General	$720,306	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$539,041	TotalAmt
Program Services	$458,903	ProgramServicesAmt
Management And General	$80,138	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

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

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	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	$1,050,859	TotalAmt
Program Services	$740,222	ProgramServicesAmt
Management And General	$310,637	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	$1,190,156	TotalAmt
Program Services	$1,010,188	ProgramServicesAmt
Management And General	$179,968	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$81,657	TotalAmt
Program Services	$81,657	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	$662,946	TotalAmt
Program Services	$504,219	ProgramServicesAmt
Management And General	$158,727	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$22,633	TotalAmt
Program Services	$17,861	ProgramServicesAmt
Management And General	$4,772	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	$101,711	TotalAmt
Program Services	$39,736	ProgramServicesAmt
Management And General	$61,975	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	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	$1,602,794	TotalAmt
Program Services	$612,575	ProgramServicesAmt
Management And General	$990,219	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$37,533	TotalAmt
Program Services	$9,249	ProgramServicesAmt
Management And General	$28,284	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
Purchased Services	$2,322,022	$1,334,620	$987,402	$0
Pharmaceuticals	$572,575	$572,575	$0	$0
Anesthesia Service	$394,659	$394,659	$0	$0
MHC Executive Salaries	$263,804	$0	$263,804	$0

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$375,691	TotalAmt
Program Services	$102,260	ProgramServicesAmt
Management And General	$273,431	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$22,399,821	TotalAmt
Program Services	$16,502,195	ProgramServicesAmt
Management And General	$5,897,626	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Joint Costs TotalJointCostsGrp

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

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$685	BOYAmt
EOY	$880	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$644,190	BOYAmt
EOY	$3,336,795	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

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

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$3,368,028	BOYAmt
EOY	$2,526,328	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)
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$411,806	BOYAmt
EOY	$411,731	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$47,030	BOYAmt
EOY	$40,190	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$10,324,684	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$2,621,645	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$8,449,240	BOYAmt
EOY	$7,703,039	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

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

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$982,709	BOYAmt
EOY	$673,499	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$26,382,430	BOYAmt
EOY	$26,219,175	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$40,286,118	BOYAmt
EOY	$40,911,637	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$2,315,873	BOYAmt
EOY	$3,387,020	EOYAmt

Grants Payable GrantsPayableGrp

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

Deferred Revenue DeferredRevenueGrp

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

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

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

Escrow Account Liability EscrowAccountLiabilityGrp

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

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

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

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$674,426	BOYAmt
EOY	$784,426	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$2,990,299	BOYAmt
EOY	$4,171,446	EOYAmt

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

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$37,273,722	BOYAmt
EOY	$36,724,487	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$22,097	BOYAmt
EOY	$15,704	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

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

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

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

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

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

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

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

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$37,295,819	BOYAmt
EOY	$36,740,191	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$40,286,118	BOYAmt
EOY	$40,911,637	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$458,156	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$998,081	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$15,703	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 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	$3,773	OtherActivitiesAmt
Total Lobbying Expenditures	$3,773	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	FormAndLineReferenceDesc
Explanation	Lobbying Activities: Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. Good Samaritan Health Center of Merrill, Wisconsin, Inc. does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office.	ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,250,000	OtherCostOrOtherBasisAmt
Book Value	$1,250,000	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$5,939,221	OtherCostOrOtherBasisAmt
Depreciation	$1,385,626	DepreciationAmt
Book Value	$4,553,595	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$201,111	OtherCostOrOtherBasisAmt
Depreciation	$62,282	DepreciationAmt
Book Value	$138,829	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,934,352	OtherCostOrOtherBasisAmt
Depreciation	$1,173,737	DepreciationAmt
Book Value	$1,760,615	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$0	OtherCostOrOtherBasisAmt
Depreciation	$0	DepreciationAmt
Book Value	$0	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$7,703,039	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDesc	Book ValueBookValueAmt
Interest in Investments Held by Ascension Health Alliance	$24,919,540
Due From Other Funds	$101,386
Pension Reserve	$1,198,249

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$26,219,175	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDesc	AmtAmt
Accretion Amortization	$177,428
Asset Retirement Obligation	$149,998
Unspecified Reserve	$457,000

Field	Value	IRS element (for citing)
Total Liability	$784,426	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	From the consolidated audited financial statements of Ministry Health Care, Inc., which includes the activity of Good Samaritan Health Center of Merrill, Wisconsin, Inc.: The Health Ministry accounts for uncertainty in income tax positions by applying a recognition threshold and measurement attribute for financial statement recognition and measurement of tax position taken or expected to be taken in a tax return.	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
Percent400	Yes (X)	Percent400Ind
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	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$73,168	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$73,168	NetCommunityBenefitExpnsAmt
Total Expense	0.0033	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$3,377,044	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,084,926	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,292,118	NetCommunityBenefitExpnsAmt
Total Expense	0.0577	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$3,450,212	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,084,926	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,365,286	NetCommunityBenefitExpnsAmt
Total Expense	0.0610	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	13	ActivitiesOrProgramsCnt
Persons Served	7689	PersonsServedCnt
Total Community Benefit Expns	$134,886	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$134,886	NetCommunityBenefitExpnsAmt
Total Expense	0.0060	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Activities Or Programs	5	ActivitiesOrProgramsCnt
Persons Served	141	PersonsServedCnt
Total Community Benefit Expns	$46,951	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$46,951	NetCommunityBenefitExpnsAmt
Total Expense	0.0021	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	3	ActivitiesOrProgramsCnt
Persons Served	121	PersonsServedCnt
Total Community Benefit Expns	$28,358	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$8,332	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$20,026	NetCommunityBenefitExpnsAmt
Total Expense	0.0009	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
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	13	ActivitiesOrProgramsCnt
Persons Served	21	PersonsServedCnt
Total Community Benefit Expns	$190,368	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$190,368	NetCommunityBenefitExpnsAmt
Total Expense	0.0085	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	34	ActivitiesOrProgramsCnt
Persons Served	7972	PersonsServedCnt
Total Community Benefit Expns	$400,563	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$8,332	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$392,231	NetCommunityBenefitExpnsAmt
Total Expense	0.0175	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	34	ActivitiesOrProgramsCnt
Persons Served	7972	PersonsServedCnt
Total Community Benefit Expns	$3,850,775	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,093,258	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,757,517	NetCommunityBenefitExpnsAmt
Total Expense	0.0785	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$42	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$42	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$2,592	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,592	NetCommunityBenefitExpnsAmt
Total Expense	0.0001	TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	150	PersonsServedCnt
Total Community Benefit Expns	$1,976	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,976	NetCommunityBenefitExpnsAmt
Total Expense	0.0001	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$504	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$504	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$84	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$84	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$157	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$157	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Persons Served	56	PersonsServedCnt
Total Community Benefit Expns	$3,373	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,373	NetCommunityBenefitExpnsAmt
Total Expense	0.0002	TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
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	9	ActivitiesOrProgramsCnt
Persons Served	206	PersonsServedCnt
Total Community Benefit Expns	$8,728	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$8,728	NetCommunityBenefitExpnsAmt
Total Expense	0.0004	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	false	BadDebtExpenseReportedInd
Bad Debt Expense	$1,265,049	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$10,505,601	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$11,190,973	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$685,372	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
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	Good Samaritan Health Center	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	601 South Center	AddressLine1Txt
City	Merrill	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54452	ZIPCd

Field	Value	IRS element (for citing)
Website Address	http://ministryhealth.org/gshc/home.nw	WebsiteAddressTxt
State License	1043	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Critical Access Hospital	Yes (X)	CriticalAccessHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	Good Samaritan Health 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	12	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	http://ministryhealth.org/GoodSamaritan/Ministry_Good_Samaritan_Health_Center_CHNA_2013_2_13FINAL3.p	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	12	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	http://ministryhealth.org/CommunityBenefits/MGSHC_Implementation_Plan_2013_3_28_FINAL.pdf	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	2.0	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	4.0	FPGFamilyIncmLmtDscntCarePct
Income Level Criteria	Yes (X)	IncomeLevelCriteriaInd
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
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
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	http://ministryhealth.org/Ministry_Health_Care/Financial_Assistance_Program_RC08.pdf	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	http://ministryhealth.org/Ministry_Health_Care/MHC_FinancialAid_Application_REV4.pdf	FAPAppAvailableOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
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
Medicare Rates	Yes (X)	MedicareRatesInd
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 - Good Samaritan Health Center. The assessment team comprised of private and public Lincoln County organization members include: hospital nurses and administrators; clinic personnel; public health nurses and educators; behavioral health therapists and leaders; elementary, high school and post high school educators, nurses and administrators; police and emergency personnel; child, women's, family and senior social services; as well as interested community members in the health needs assessment process. Community members received an invitation by mail and follow-up email. Jim Lawrence, Health Educator Consultant, and Angela Nimsgern, Regional Director from the Division of Public Health Northern Region Office, and Art Lersch, Community Resource Development Educator at UW Extension Lincoln County, were consultants. A representative from Ministry Good Samaritan Health of Merrill, Wisconsin, Inc. ("MGSHC") joined the Lincoln County Community Health Improvement Plan Steering Team as a community partner to obtain further data for each of the priorities. This team created the community health survey and MGSHC assisted with data compilation and analysis. Additionally, MGSHC conducted a focus group with physicians and case managers practicing in the facility. Those attending included: Dr. Robyn Schertz (Medical Director of Good Samaritan Emergency Department), Dr. Mark Gaulke (Internal Medicine/Pediatrics, Ministry Medical Group, Inc.), Dr. Robert Sedlacek (Family Practice, Ministry Medical Group, Inc.), Dr. Dionna Pendleton (Family Practice, Ministry Medical Group, Inc.), Dr. Ken Anuligo (Family Practice, Ministry Medical Group, Inc.) and Mark Moser (LSW Case Management, Ministry Good Samaritan Health Center of Merrill, Wisconsin, Inc.). Appendix 2 lists the individuals who participated in the community needs assessment process. Public Health Experts: - Shelley Hersil, Director and Health Officer Lincoln County Health Department Master in Public Health Administration, UW-Lacrosse Certified Health Education Specialist (CHES). Lincoln County Health Officer for seven years and more than 10 years experience with tobacco control and prevention. - Jim Lawrence, Health Educator Consultant Wisconsin Division of Public Health - Northern Regional office. More than 20 years of experience in public health consulting. - Art Lersch, Associate Professor, Community Resources Development Educator, UW Extension Lincoln County Master in Public Health Administration, Kent State University. Focus areas are organizational, leadership and business development. - Angela Nimsgern, Regional Director, Wisconsin Division of Public Health-Northern Regional Office Master in Public Health Administration, CHP more than 12 years of experience with community health assessments. - Angela Nimsgern, WI Division of Public Health Northern Region - Brenda Jones, Ministry Good Samaritan Health Center of Merrill, Wisconsin, Inc. - Susan Cronick, Ministry Sacred Heart-St. Mary's Hospitals, Inc. - Bill Zeitz, Lincoln County Board of Health - Bob Odegard, Merrill Fire Department - Bonnie Rudie, UW Extension - Lincoln County - Brigid Flood, Lincoln County Health Department - Carmen A. Viegut, Ministry Sacred Heart-St. Mary's Hospitals, Inc. - Cindy Lezotte, Ministry Good Samaritan Health Center of Merrill, Wisconsin, Inc. - Connie Kuczmarski, Community Care of Central Wisconsin - Dan Wendorf, City of Merrill - Parks & Recreation Department - Debbie Moellendorf, UW Extension - Lincoln County - Debi McGregor, Children's Service Society of Wisconsin - Dee Olsen, Merrill Area United Way - Erin Zastrow, Aging & Disability Resource Center - Evelyn Lee, Anderson Associates - Jane Deau, Merrill Area Community Enrichment - Jesse Borchardt, Community Care of Central Wisconsin - Jessica DeJong, Aspirus Clinics - Jim Lawrence, WI Division of Public Health Northern Region - John Sample, Merrill Area Public Schools - Julie Thompson, Tomahawk Senior Community Center - Kathy Graham, Citizen - Ken Neff, City of Merrill Police Department - Lori Decker, Ministry Medical Group, Inc. - Tomahawk - Pam Melander, Church Mutual Insurance Company - Paula Gebauer, Ministry Sacred Heart-St. Mary's Hospitals, Inc. - Peggy McDowell, Northern WI Tobacco Free Coalition - Robin Lane, Marshfield Clinic - Merrill Center - Sarah Jaeger, Bridge Community Health Clinic - Sharon Anderson, Citizen - Shelley Hersil, Lincoln County Health Department - Stacy Bolder, Tomahawk School District - Tammi Boers, Lincoln County Health Department - Tammy Hansen, UW Extension Lincoln County - William Erickson, COO Ministry Sacred Heart-St. Mary's Hospitals, Inc. - Amanda Kostman, UW Extension Lincoln County.
Schedule H, Part V, Section B, Line 6a Facility , 1	Facility , 1 - Good Samaritan Health Center:. The CHNA was conducted with Ministry Sacred Heart Hospital.
Schedule H, Part V, Section B, Line 6b Facility , 1	Facility , 1 - Good Samaritan Health Center. The CHNA was conducted with Lincoln County Public Health.
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - Good Samaritan Health Center of Merrill, Wisconsin, Inc.. Using the CHNA completed in Fiscal Year 2013 (Tax Year 2012), the hospital developed, adopted, and worked on executing a 2012 Implementation Strategy to address priority community health needs. In 2014, the hospital implemented the following plan to address the priority needs: 1. Nutrition: Increase access to healthy foods and increase youth with healthy weights. - Increase distribution of non-processed meat and produce at the food pantry. - Implement use of EBT machines at three farmers markets. - Participate in Lincoln County Nutrition Coalition. - Provide healthy cooking classes at local food pantry. - Work with local schools toward implementation of a healthy snack policy. 2. Oral Health: Increase access to oral health services. - Provide Sugar Out Day to area schools. - Distribute Dental Kits - Participate in Lincoln County Oral Health Coalition - Provide funding for MGHC ED patients without Dental Insurance to receive Urgent Dental Care through the Tooth Fairy Fund. - Provide healthy snack education at Kids Safety Day. 3. Mental Health: Increase access to mental health services. - Provide AODA counselor for med/surg patients as needed. - Work to identity a psychologist to provide formal capacity assessments - Investigate the use of telehealth for mental health. - Provide monthly grief support groups. - Provide QPR training in the community - Participate in Lincoln County Mental Health Coalition The needs below are not being addressed directly by the organization in its current year as part of its implementation strategy, for the following reasons: Sexual Health: Although sexual health has been identified, MGSHC, being a Catholic health organization, is guided by ethical and religious directives. These directives do not align with public health and the public school programs available in the community. Domestic Violence: MGSHC currently provides Sexual Assault Nurse Examiners (SANE) when an incident occurs. The Health Center works very closely with HAVEN a domestic abuse shelter by providing funding. The Health Center Chaplain serves on the HAVEN Board of Directors. Alcohol and Drug Abuse: The Lincoln County Drug Free Coalition is very active in the Merrill community providing multiple agencies to decrease alcohol and drug use.

Field	Value	IRS element (for citing)
Facility	0	FacilityNum

Supplemental Information Detail SupplementalInformationDetail (16 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part I, Line 6a Community benefit report prepared by related organization	Good Samaritan Health Center of Merrill, Wisconsin, Inc. is included in the annual community benefit report which is published by Ministry Health Care, Inc. (EIN: 39-1490371) and available to the public on its website, www.ministryhealth.org. This report includes all of the related entities within the Ministry Health Care, Inc. network of hospitals, clinics and other health-related organizations.
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance	Amounts calculated in Part 1, Line 7 are determined both on a cost accounting system and a cost-to-charge ratio. Other benefits are determined based on the direct and indirect costs (where allocated) associated with a program net of earned revenue. Detail for each program/activity is maintained and determined at the department level. Charity care and means-tested programs are determined based on a cost-to-charge ratio consistent with Worksheet 2, Ratio of Patient Care Cost to Charges.
Schedule H, Part II Community Building Activities	Community building activities include that, while not directly related to health care, provide opportunities to address the root causes of health problems, such as poverty, homelessness, and environmental problems. These activities support community assets by offering the expertise and resources of the organization. Costs for these activities include cash, in-kind donations, and expenditures for the development of a variety of community health programs and partnerships. Good Samaritan Health Center of Merrill, Inc. in collaboration with the community, help to identify various health problems affecting the surrounding area, causes leading to these health problems, and actions taken to communicate these issues. these are being done with various health fairs and education related to those at-risk population. The Organization in conjunction with its foundation have a fund set up for patients who may need assistance with food, medication, clothing, transportation or basic needs when they leave the hospital.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	Accounts are written off to bad debt after all internal collection efforts have been exhausted. Attempts to resolve these outstanding balances can include, but are not limited to statements being sent, phone calls and letters being sent. Account follow up protocol is based on personal pay balance size owed.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology	Good Samaritan Health Center of Merrill, Wisconsin, Inc. has a very robust financial assistance program; therefore, no estimate is made for bad debt attributed to financial assistance eligible patients.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	From the consolidated audited financial statements of Ministry Health Care, Inc. (which includes the activity of Good Samaritan Health Center of Merrill, Inc.): The provision for doubtful accounts is based upon management's assessment of expected net collections considering historical experience, economic conditions, trends in health care coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for doubtful accounts to establish an appropriate allowance for doubtful accounts. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Health Ministry follows established guidelines for placing certain past-due patient balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with the Health Ministry's policies. The methodology for determining the allowance for doubtful accounts and related write offs on uninsured patient accounts has remained consistent with the prior year.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	Ascension Health and related Health Ministries follow the Catholic Health Association ("CHA") guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as community benefit.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	The Organization has a debt collection policy which sets forth collection practices for patients who are known to qualify or may qualify for financial assistance under the Charity Care Program. Sufficient financial counseling support is made available to patients so they can easily access patient financial service representatives and have their questions answered, and gain an understanding of the reasons why they owe a balance. Accounts are designated as Charity Care in the business offices so no additional time is spent on collection efforts.
Schedule H, Part V, Section B, Line 16a FAP website	- Good Samaritan Health Center: Line 16a URL: http://ministryhealth.org/Ministry_Health_Care/Financial_Assistance_Program_RC08.pdf;
Schedule H, Part V, Section B, Line 16b FAP Application website	- Good Samaritan Health Center: Line 16b URL: http://ministryhealth.org/Ministry_Health_Care/MHC_FinancialAid_Application_REV4.pdf;
Schedule H, Part VI, Line 2 Needs assessment	The Organization performs community needs assessments as needed. Planning workgroups consisting of community partners are formed to define the community and its needs through review of Health People Initiatives, census documents, and local government health and welfare agencies. Considering other community resources/assets, data collection methods are used to identify particular problems or subgroups and areas known to have high poverty rates and to be underserved. The data is analyzed and priorities are set based on trending information which may target a specific need. When a need is identified, the Hospital develops a plan to implement a program either through community collaboration or individually. Outcomes from the programs are measured and considered in subsequent community health needs assessments. Community benefit plans are presented to senior leadership and board members to ensure the findings are incorporated into the organization's strategy and policy development. For example, senior leaders required to provide direct service to the poor in their communities, and hours are included as part of their performance goals.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	Ministry Health Care, Inc. ("MHC") has financial counselors located at every hospital. If a patient indicates they are unable to pay their bill at any point during pre-service, admission, discharge or billing process, the financial counselors will assist the patient in either securing a funding source (grants, COBRA coverage, disability benefits, Medicaid, VA, etc.) if eligible or assist them in completing a financial assistance application.
Schedule H, Part VI, Line 4 Community information	The city of Merrill is located in Southern Lincoln County located in the Northern portion of Wisconsin. Merrill serves as the county seat and is the largest city in the county. The 2015 population of Merrill is 9,915. According to the 2010 census data the population of Merrill was 9,661. The racial make-up consisted of 96.3% White, 2.00% Hispanic, 0.50% African American, 0.40% Native American, 0.60% Asian, and 0.20% other. 23.9% were under 18 and 19.40% were over 65. The median income for a household in Lincoln County over the last five years is $49,021 and 11.1% of the population was below the poverty line.
Schedule H, Part VI, Line 5 Promotion of community health	The Organization strives to further its exempt purposes by the following: - The Organization's governing board consists primarily of persons who reside within the primary service area who are not employees of the Organization. - As mentioned, the Organization provides several services which are not otherwise available being in a rural setting. - Based on the Organization's mission, emergency rooms are made available to all patients regardless of the ability to pay. - The Organization also participates in the education and training of healthcare professional through internship programs. The Hospital participates in government-sponsored health programs (Medicare, Medicaid, Champus, Tricare). The Hospital offers volunteer opportunities to the community. There are 359 volunteers that serve the Hospital as needed. Various financial programs are available to patients of Good Samaritan Health Center of Merrill, Wisconsin, Inc. They include discounted and/or free care depending on individual circumstances. The facility also offers payment plans for those self pay patients. Good Samaritan Health Center of Merrill, Wisconsin, Inc. is a critical access hospital that has inpatient and swing beds. They also provide emergency and walk-in services. As a critical access hospital, the Organization serves as a critical point in stabilizing patients for transport to other facilities.
Schedule H, Part VI, Line 6 Affiliated health care system	Ministry Health Care, Inc. (Ministry or the Health Ministry) is a member of Ascension Health. In December 2011, Ascension Health Alliance, doing business as Ascension, became the sole corporate member and parent organization of Ascension Health, a Catholic national health system consisting primarily of nonprofit corporations that own and operate local health care facilities, or Health Ministries, located in 23 states and the District of Columbia. In addition to serving as the sole corporate member of Ascension Health, Ascension serves as the member or shareholder of various other subsidiaries. Ascension, its subsidiaries, and the Health Ministries are referred to collectively from time to time hereafter as the System. Ascension is sponsored by Ascension Sponsor, a Public Juridic Person. The Participating Entities of Ascension Sponsor are the Daughters of Charity of St. Vincent de Paul, St. Louise Province, the Congregation of St. Joseph, the Congregation of the Sisters of St. Joseph of Carondelet, the Congregation of Alexian Brothers of the Immaculate Conception Province, Inc. - American Province, and the Sisters of the Sorrowful Mother of the Third Order of St. Francis of Assisi-US/Caribbean Province. The Health Ministry is a Wisconsin non-stock, tax-exempt corporation that manages, promotes, and supports health care and related ministries in Wisconsin and Minnesota. The Health Ministry provides inpatient, outpatient, and emergency care services for the residents of Wisconsin and Minnesota. Admitting physicians are primarily practitioners in the local area. The Health Ministry is related to Ascension Health's other sponsored organizations through common control. Substantially all expenses of the Health Ministry are related to providing health care services. Effective November 1, 2014, the Health Ministry sold 50% of its ownership in Network Health, Inc. to an unrelated health system (see Note 3). On February 1, 2015, the Health Ministry transferred its ownership in Ministry Home Care, Inc. to Ascension Health. The consolidated financial statements include the following affiliates located primarily in Wisconsin, in which Ministry has a controlling interest and/or is the sole sponsor. Affinity Health System, Inc. (Affinity): Calumet Medical Center, Inc. (CMC): Affinity Medical Group (AMG) Twin Med, LLC Mercy Medical Center, Inc. Mercy Health Foundation St. Elizabeth Hospital Catalpa Health: St. Elizabeth Foundation Agape Community Center of Milwaukee, Inc. Door County Memorial Hospital (Door County) Good Samaritan Health Center of Merrill Good Samaritan Health Center Foundation Howard Young Health Care, Inc. (Howard Young): Dr. Kate Newcomb Convalescent Center Howard Young Medical Center, Inc. Dr. Howard Young Foundation Eagle River Memorial Hospital, Inc. Ministry Medical Group, Inc. Ministry Holdings, Inc. (through November 1, 2014): Network Health (NH) (through November 1, 2014) Network Health Insurance Corporation (NHIC) (thru November 1, 2014) Our Lady of Victory Hospital Sacred Heart Hospital-St. Mary's Hospital, Inc. St. Clare's Hospital of Weston, Inc. Foundation of St. Clare's Hospital of Weston, Inc. St. Elizabeth's Hospital of Wabasha, Inc. St. Joseph's Hospital of Marshfield, Inc. Foundation of St. Joseph's Hospital of Marshfield, Inc. St. Michael's Hospital of Stevens Point, Inc. St. Michael's Foundation of Stevens Point, Inc. The System directs its governance and management activities toward strong, vibrant, Catholic Health Ministries united in service and healing and dedicates its resources to spiritually centered care that sustains and improves the health of the individuals and communities it serves. In accordance with the System's mission of service to those persons living in poverty and to other vulnerable persons, each Health Ministry accepts patients regardless of their ability to pay. The System uses four categories to identify the resources utilized for the care of persons living in poverty and for community benefit programs: 1. Traditional charity care includes the cost of services provided to persons who cannot afford health care because of inadequate resources and/or who are uninsured or underinsured. 2. Unpaid cost of public programs, excluding Medicare, represents the unpaid cost of services provided to persons covered by public programs for persons living in poverty and for other vulnerable persons. 3. Cost of other programs for persons living in poverty and for other vulnerable persons includes unreimbursed costs of programs intentionally designed to serve the persons living in poverty and the other vulnerable persons of the community, including substance abusers, the homeless, victims of child abuse, and persons with acquired immune deficiency syndrome. 4. Community benefit consists of the unreimbursed costs of community benefit programs and services for the general community, not solely for the persons living in poverty, including health promotion and education, health clinics and screenings, and medical research. Discounts are provided to all uninsured patients, including those with the means to pay. Discounts provided to those patients who did not qualify for assistance under charity care guidelines are not included in the cost of providing care to persons living in poverty or in the cost of other community benefit programs. The cost of providing care to persons living in poverty and of other community benefit programs is estimated using internal cost data and is estimated by reducing charges forgone by a factor derived from the ratio of total operating expenses to billed charges for patient care. The amount of traditional charity care provided, determined on the basis of cost, was approximately $12,600 and $18,400 for the years ended June 30, 2015 and 2014, respectively. The amount of unpaid cost of public programs, cost of other programs for persons living in poverty and for other vulnerable persons, and cost of community benefit programs are reported in the accompanying supplementary information.
Schedule H, Part VI, Line 7 State filing of community benefit report	WI

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
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 (9 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
MARY T KRUEGER
HOSPITAL PRESIDENT	$0	$248,235	$0	$88,927	$0	$150,402	$0	$0	$0	$17,534	$0	$505,097	$0	$0
ROBYN SCHERTZ MD
BOARD MEMBER	$0	$391,687	$0	$350	$0	$11,841	$0	$17,500	$0	$24,456	$0	$445,834	$0	$0
JEFF BADGER
FORMER OFFICER	$0	$264,031	$0	$374,899	$0	$20,910	$0	$0	$0	$13,832	$0	$673,672	$0	$0
NICHOLAS DESIEN
MINISTRY HEALTH CARE CEO	$0	$1,009,502	$0	$1,079,643	$0	$45,198	$0	$0	$0	$18,803	$0	$2,153,146	$0	$0
JEFFREY FRANCIS
MINISTRY HEALTH CARE CAFO	$0	$438,327	$0	$141,768	$0	$441,745	$0	$0	$0	$19,803	$0	$1,041,644	$0	$0
LARRY T HEGLAND MD
CHIEF MEDICAL OFFICER	$0	$268,295	$0	$69,095	$0	$90,260	$0	$0	$0	$17,897	$0	$445,547	$0	$0
DANIEL NEUFELDER
SVP, HOSPITAL OPERATIONS & PRESIDENT, AHS	$0	$791,344	$0	$259,379	$0	$20,926	$0	$0	$0	$17,365	$0	$1,089,014	$0	$0
JEFFREY L MARTIN
VICE PRESIDENT MINISTRY HEALTH CARE	$0	$428,700	$0	$166,683	$0	$428,125	$0	$0	$0	$18,196	$0	$1,041,703	$0	$0
RACHEL YARON
VP - PATIENT CARE	$0	$140,124	$0	$38,758	$0	$58,636	$0	$0	$0	$3,690	$0	$241,208	$0	$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

Schedule J, Part I, Line 3 EXPLANATION

MINISTRY HEALTH CARE, INC., A RELATED ORGANIZATION OF GOOD SAMARITAN HEALTH CENTER OF MERRILL, WISCONSIN, INC., USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE

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

Executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. The following received current year distributions of: Mary Krueger - $71,310 Rachel Yaron - $18,357 JEFF MARTIN - $200,949 JEFFREY FRANCIS - $260,079 LARRY HEGLAND - $36,834

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part VI, Line 15 EXPLANATION	IN DETERMINING COMPENSATION OF THE ORGANIZATION'S CEO, THE PROCESS PERFORMED BY MINISTRY HEALTH CARE, INC., A RELATED ORGANIZATION OF GOOD SAMARITAN HEALTH CENTER OF MERRILL, WISCONSIN, INC., INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE COMPENSATION COMMITTEE, WHICH IS ASSISTED BY AN INDEPENDENT CONSULTING FIRM, REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE CEO WAS COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE BOARD MINUTES. THE INDIVIDUAL WAS NOT PRESENT WHEN HIS COMPENSATION WAS DECIDED. IN DETERMINING COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION, THE PROCESS PERFORMED BY MINISTRY HEALTH CARE, INC., A RELATED ORGANIZATION OF GOOD SAMARITAN HEALTH CENTER OF MERRILL, WISCONSIN, INC., INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE COMPENSATION COMMITTEE, ASSISTED BY AN INDEPENDENT CONSULTING FIRM, REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION WERE COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE BOARD MINUTES.
Form 990, Part VI, Line 2 Family/business relationships amongst interested persons	Many of the persons listed on Part VII have a "business relationship" with each other by virtue of employment by Ministry Health Care, Inc. related entities. - Business relationship
Form 990, Part VI, Line 6 Classes of members or stockholders	Good Samaritan Health Center of Merrill Wisconsin, Inc. has a single corporate member, Ministry Health Care, Inc.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	Good Samaritan Health Center of Merrill, Wisconsin, Inc. has a single corporate member, Ministry Health Care, Inc., who has the ability to elect members to the governing body of Good Samaritan Health Center of Merrill, Wisconsin, Inc.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	All decisions that have a material impact to Good Samaritan Health Center of Merrill, Wisconsin, Inc. financial information or corporation as a whole are subject to approval by its sole corporate member, Ministry Health Care, Inc.
Form 990, Part VI, Line 11b Review of form 990 by governing body	Management, including certain officers, works diligently to complete the Form 990 and attached schedules in a thorough manner. Prior to filing the return, all board members are provided the Form 990 and management team members are available to answer any Board Members' questions
Form 990, Part VI, Line 12c Conflict of interest policy	The organization regularly and consistently monitors and enforces compliance with the Conflict of Interest Policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs statement which affirms such person has received a copy of the Conflicts of Interest Policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose.
Form 990, Part VI, Line 19 Required documents available to the public	The Ministry web page is available to the public for inspection with a good deal of information regarding who Ministry Health Care, Inc. is and the entities included along with our mission. The Articles of Incorporation, Bylaws, Conflicts of Interest Policy, and financial statements are not included on any web page. However, if any inquiry is made for any documents they are shared as appropriate.
Form 990, Part VII, Section B, Line 1 Explanation	Amounts paid to Ellis Stone Construction Co., Inc. represent payments for both services and goods. These amounts cannot be separated. Amounts paid to Boldt Company represent payments for both services and goods. These amounts cannot be separated.
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue	Other - Total Revenue: 40510, Related or Exempt Function Revenue: 40510, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Radiology - Other Income - Total Revenue: 1363, Related or Exempt Function Revenue: , Unrelated Business Revenue: 1363, Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	Beg Bal -Temp Restricted Funds held by Foundation - -15703;

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (31 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	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
ASCENSION HEALTH ALLIANCE
PO BOX 45998	STLOUIS	MO	63145	453358926	NATIONAL HEALTH SYSTEM	MO	501(c)(3	Type I	N/A	false
ASCENSION HEALTH
PO BOX 45998	STLOUIS	MO	63145	311662309	NATIONAL HEALTH SYSTEM	MO	501(c)(3	Type I		false	ASCENSION HEALTH ALLIANCE
MINISTRY HEALTH CARE INC
10925 W LAKE PARK DR STE 100	MILWAUKEE	WI	53224	391490371	PARENT CORPORATION	WI	501(c)(3	Type II		false	ASCENSION HEALTH
AFFINITY HEALTH SYSTEM
1570 MIDWAY PLACE	MENASHA	WI	54952	391568866	SUPPORT RELATED HEALTHCARE ORGANZIATIONS	IL	501(c)(3	Type II		Yes (true)	MINISTRY HEALTH CARE INC
AGAPE COMMUNITY CENTER OF MILWAUKEE INC
6100 NORTH 42ND STREET	MILWAUKEE	WI	53209	391461846	COMMUNITY CENTER	WI	501(c)(3	7		Yes (true)	MINISTRY HEALTH CARE INC
CALUMET MEDICAL CENTER INC
614 MEMORIAL DRIVE	CHILTON	WI	53014	390905385	HOSPITAL	WI	501(c)(3	3		Yes (true)	AFFINITY HEALTH SYSTEM
CATALPA HEALTH INC
N4642 COUNTY N	APPLETON	WI	54914	454681563	MENTAL HEALTH FACILITY	WI	501(c)(3	3		Yes (true)	ST ELIZABETH HOSPITAL INC
SAINT MICHAEL'S FOUNDATION OF STEVENS POINT INC
900 ILLINOIS AVENUE	STEVENS POINT	WI	54481	391657410	CHARITABLE FOUNDATION	WI	501(c)(3	Type I		Yes (true)	SAINT MICHAEL'S HOSPITAL OF STEVENS POINT
DOOR COUNTY MEMORIAL HOSPITAL
323 SOUTH 18TH AVENUE	STURGEON BAY	WI	54235	390806324	HOSPITAL	WI	501(c)(3	3		Yes (true)	MINISTRY HEALTH CAREINC
DR KATE NEWCOMB CONVALESCENT CENTER INC
PO BOX 829	WOODRUFF	WI	54568	391357365	NURSING/ASSISTED LIVING SERVICES	WI	501(c)(3	9		Yes (true)	HOWARD YOUNG HEALTH CARE INC
EAGLE RIVER MEMORIAL HOSPTIAL INCORPORATED
201 HOSPITAL ROAD	EAGLE RIVER	WI	54521	390985690	HOSPITAL	WI	501(c)(3	3		Yes (true)	THE HOWARD YOUNG MEDICAL CENTER INC
FOUNDATION OF SAINT CLARE''S HOSPITAL OF WESTON INC
3400 MINISTRY PARKWAY	WESTON	WI	54476	753193633	CHARITABLE FOUNDATION	WI	501(c)(3	Type I		Yes (true)	MINISTRY HEALTH CARE INC
FOUNDATION OF SAINT JOSEPH'S HOSPITAL OF MARSHFIELD
611 SAINT JOSEPH AVENUE	MARSHFIELD	WI	54449	391684957	CHARITABLE FOUNDATION	WI	501(c)(3	Type I		Yes (true)	SAINT JOSEPH''S HOSPITAL OF MARSHFIELD INC
GOOD SAMARITAN HEALTH CENTER FOUNDATION OF MERRILL WISCONSIN INC
601 SOUTH CENTER AVENUE	MERRILL	WI	54452	391627755	CHARITABLE FOUNDATION	WI	501(c)(3	Type I		Yes (true)	GOOD SAMARITAN HEALTH CENTER OF MERRILL
HOWARD YOUNG FOUNDATION INC
240 MAPLE STREET	WOODRUFF	WI	54568	391521169	CHARITABLE FOUNDATION	WI	501(c)(3	7		Yes (true)	HOWARD YOUNG HEALTH CARE INC
HOWARD YOUNG HEALTH CARE INC
240 MAPLE STREET	WOODRUFF	WI	54568	391499115	HOME OFFICE	WI	501(c)(3	Type II		Yes (true)	MINISTRY HEALTH CARE INC
THE HOWARD YOUNG MEDICAL CENTER INC
240 MAPLE STREET	WOODRUFF	WI	54568	390873606	HOSPITAL	WI	501(c)(3	3		Yes (true)	HOWARD YOUNG HEALTH CARE INC
MERCY HEALTH FOUNDATION INC
PO BOX 3370	OSHKOSH	WI	54903	237140261	CHARITABLE FOUNDATION	WI	501(c)(3	9		Yes (true)	AFFINITY HEALTH SYSTEM
MERCY MEDICAL CENTER OF OSHKOSH INC
500 S OAKWOOD ROAD	OSHKOSH	WI	54904	390806268	HOSPITAL	WI	501(c)(3	3		Yes (true)	MINISTRY HEALTH CARE INC
MINISTRY HOMECARE INC
611 STJOSEPH AVENUE 4S	MARSHFIELD	WI	54449	391936201	HOME CARE/ HOSPICE	WI	501(c)(3	9		Yes (true)	MINISTRY HEALTH CARE INC
MINISTRY MEDICAL GROUP INC
824 ILLINOIS AVENUE	STEVENS POINT	WI	54481	391965593	CLINICS	WI	501(c)(3	Type III-FI		Yes (true)	MINISTRY HEALTH CARE INC
MINISTRY WEIGHT MANAGEMENT INC
2251 NORTH SHORE DRIVE	RHINELANDER	WI	54501	391829015	HEALTH SERVICES	WI	501(c)(3	3		Yes (true)	SACRED HEART - STMARY''S HOSPITALS INC
OUR LADY OF VICTORY HOSPITAL
1120 PINE STREET	STANLEY	WI	54768	390807065	HOSPITAL	WI	501(c)(3	3		Yes (true)	MINISTRY HEALTH CARE INC
SACRED HEART-STMARY'S HOSPITALS INC
PO BOX 347	STEVENS POINT	WI	54481	391390638	HOSPITAL	WI	501(c)(3	3		Yes (true)	MINISTRY HEALTH CARE INC
SAINT CLARE'S HOSPITAL OF WESTON INC
3400 MINISTRY PARKWAY	WESTON	WI	54476	721531917	HOSPITAL	WI	501(c)(3	3		Yes (true)	MINISTRY HEALTH CARE INC
SAINT ELIZABETH'S HOSPITAL OF WABASHA INC
1200 GRANT BLVD WEST	WABASHA	MN	55981	410693877	HOSPITAL	MN	501(c)(3	3		Yes (true)	MINISTRY HEALTH CARE INC
ST ELIZABETH'S HOSPITAL FOUNDATION INC
1506 S ONEIDA STREET	APPLETON	WI	54915	391256677	CHARITABLE FOUNDATION	WI	501(c)(3	7		Yes (true)	AFFINITY HEALTH SYSTEM
ST ELIZABETH HOSPITAL INC
1506 S ONEIDA STREET	APPLETON	WI	54915	390816818	HOSPITAL	WI	501(c)(3	3		Yes (true)	MINISTRY HEALTH CARE INC
SAINT JOSEPH'S HOSPITAL OF MARSHFIELD INC
611 SAINT JOSEPH AVENUE	MARSHFIELD	WI	54449	391847631	HOSPITAL	WI	501(c)(3	3		Yes (true)	MINISTRY HEALTH CARE INC
SAINT MICHAEL'S HOSPTIAL OF STEVENS POINT INC
900 ILLINOIS AVENUE	STEVENS POINT	WI	54481	390808443	HOSPITAL	WI	501(c)(3	3		Yes (true)	MINISTRY HEALTH CARE INC
NETWORK HEALTH SYSTEM INC
1570 APPLETON RD	MENASHA	WI	54952	391127163	CLINICAL HEALTHCARE SERVICES	WI	501(c)(3	3		Yes (true)	AFFINITY HEALTH SYSTEM

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

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

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 8005	AddressLine1Txt
City	MENASHA	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54952	ZIPCd

Field	Value	IRS element (for citing)
EIN	391180341	EIN
Primary Activities	RENTAL PROPERTY	PrimaryActivitiesTxt
Legal Domicile State	WI	LegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

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

Field	Value	IRS element (for citing)
Predominant Income Type	N/A	PredominantIncomeTypeTxt

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt
NETWORK HEALTH PLAN INC
1570 MIDWAY PLACE	MENASHA	WI	54952	391442058	INSURANCE	WI	NA	C Corporation
NETWORK HEALTH INSURANCE CORPORATION
1570 MIDWAY PLACE	MENASHA	WI	54952	392020474	INSURANCE	WI	NA	C Corporation
MINISTRY HOLDINGS INC
1570 MIDWAY PLACE	MENASHA	WI	54952	422966177	INSURANCE HOLDING COMPANY	WI	NA	C Corporation

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	false	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	false	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (true)	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (6 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
Ministry Health Care Inc
O	$201,735	FMV
St Claire's Hospital of Weston Inc
O	$475,607	FMV
Ministry Medical Group Inc
O	$3,311,297	FMV
Ministry Health Care Inc
P	$4,070,248	FMV
Ministry Medical Group Inc
R	$394,659	FMV
Ministry Medical Group Inc
M	$209,784	FMV