ASCENSION NE WISCONSIN INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- ASCENSION NE WISCONSIN INC (EIN 39-0816818)
- Tax period
- 2013-07-01 to 2014-06-30
- Filed
- 2015-05-14
- IRS object ID
- 201501349349302910
- Schema version
- 2013v4.0
- 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 I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-05-14T10:46:13-05:00 | ReturnTs |
| Tax Period End | 2014-06-30 | 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 | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 555 East Wells Street Suite 1400 | AddressLine1 |
| City | Milwaukee | City |
| State | WI | State |
| ZIP Code | 53202 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390816818 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Elizabeth Hospital Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STEL | BusinessNameControlTxt |
| Phone | 9207382000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1506 South Onedia Street | AddressLine1 |
| City | Appleton | City |
| State | WI | State |
| ZIP Code | 549151397 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Jeffrey Francis | PersonNm |
| Person Title | Ministry Health Care CAFO | PersonTitleTxt |
| Phone | 9207382000 | PhoneNum |
| Signature | 2015-05-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Rachel Becker | PreparerPersonNm |
| PTIN | P00966076 | PTIN |
| Phone | 4142703000 | PhoneNum |
| Preparation | 2015-05-07 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Jeffrey Francis | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1506 South Onedia Street | AddressLine1 |
| City | Appleton | City |
| State | WI | State |
| ZIP Code | 549151397 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $191,724,614 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.affinityhealth.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1899 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | To further the healing ministry of Jesus by improving the health and well-being of all people. | ActivityOrMissionDesc |
| Voting Members Governing Body | 18 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 1354 | TotalEmployeeCnt |
| Total Volunteers | 412 | TotalVolunteersCnt |
| Total Gross UBI | $172,652 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$49,396 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,887,720 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,469,503 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $134,504,858 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $184,284,906 | CYProgramServiceRevenueAmt |
| PY Investment Income | $39,454 | PYInvestmentIncomeAmt |
| CY Investment Income | $235,141 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,379,149 | PYOtherRevenueAmt |
| CY Other Revenue | $4,584,388 | CYOtherRevenueAmt |
| PY Total Revenue | $137,811,181 | PYTotalRevenueAmt |
| CY Total Revenue | $190,573,938 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $58,500 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $613,381 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $56,762,320 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $78,437,985 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $56,461,378 | PYOtherExpensesAmt |
| CY Other Expenses | $74,601,315 | CYOtherExpensesAmt |
| PY Total Expenses | $113,282,198 | PYTotalExpensesAmt |
| CY Total Expenses | $153,652,681 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $24,528,983 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $36,921,257 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $147,885,810 | TotalAssetsBOYAmt |
| Total Assets EOY | $195,528,987 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $118,972,312 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $126,076,497 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $28,913,498 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $69,452,490 | NetAssetsOrFundBalancesEOYAmt |
| Mission | The mission of St. Elizabeth Hospital, Inc. is to live out the healing ministry of Christ by providing services that promote the health and well-being of the communities we serve, especially the poor. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $122,523,300 | ExpenseAmt |
| Grant | $613,381 | GrantAmt |
| Revenue | $186,133,500 | RevenueAmt |
| Desc | St. Elizabeth Hospital, Inc. provides inpatient, outpatient, emergency room, and ancillary services regardless of an individual's ability to pay. The Hospital also provides educational programs and services on health care issues to the community it serves. See Schedule H for further details. | Desc |
| Total Program Service Expenses | $122,523,300 | 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 | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | 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 | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| 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 | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 71 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1354 | 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 | 0 | ForeignFinancialAccountInd |
| 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 | 18 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | 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 | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Jeffrey Francis | PersonNm |
| Phone | 4143593145 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 222 W College Avenue 3rd Floor | AddressLine1 |
| City | Appleton | City |
| State | WI | State |
| ZIP Code | 54911 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (29 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| William Calhoun | ||||||||||
| President at MMC | 10.00 | 31.60 | Yes (X) | Yes (X) | $0 | $392,457 | $47,205 | |||
| Stephen C Morton | ||||||||||
| Chairman | 0.30 | 1.20 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| Daniel Neufelder | ||||||||||
| Sr. VP Hosp Ops/Vice Chair | 10.00 | 46.10 | Yes (X) | Yes (X) | $0 | $896,266 | $89,267 | |||
| John Russo end 1213 | ||||||||||
| Vice Chairman | 0.30 | 1.20 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| Wayne Trembly | ||||||||||
| Secretary | 0.30 | 1.20 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| Kathryn Sieman | ||||||||||
| Treasurer | 0.30 | 1.20 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| Lane Earns | ||||||||||
| Board Member | 0.30 | 1.20 | Yes (X) | $0 | $0 | $0 | ||||
| Mark Faustich MD | ||||||||||
| Board Member | 0.30 | 40.80 | Yes (X) | $0 | $409,546 | $24,567 | ||||
| Mary Harp-Jirschele | ||||||||||
| Board Member | 0.30 | 1.20 | Yes (X) | $0 | $0 | $0 | ||||
| Frederick Klein MD | ||||||||||
| Board Member | 0.30 | 1.20 | Yes (X) | $0 | $0 | $0 | ||||
| Joseph McCormick MD | ||||||||||
| Board Member | 0.30 | 40.80 | Yes (X) | $0 | $906,132 | $54,733 | ||||
| Kevin Ralofsky start 114 | ||||||||||
| Board Member | 0.30 | 1.50 | Yes (X) | $0 | $0 | $0 | ||||
| Jay Sauter | ||||||||||
| Board Member | 0.30 | 1.20 | Yes (X) | $0 | $0 | $0 | ||||
| Stacey Sensor DO | ||||||||||
| Board Member | 0.30 | 41.10 | Yes (X) | $0 | $582,436 | $36,897 | ||||
| Sudeep Sodhi MD | ||||||||||
| Board Member | 0.30 | 40.80 | Yes (X) | $0 | $851,724 | $54,749 | ||||
| Barbara J Strand MD | ||||||||||
| Board Member | 0.30 | 40.80 | Yes (X) | $0 | $313,912 | $29,366 | ||||
| Catherine Tierney | ||||||||||
| Board Member | 0.30 | 1.20 | Yes (X) | $0 | $0 | $0 | ||||
| Monica Vomastic | ||||||||||
| Board Member | 0.30 | 1.20 | Yes (X) | $0 | $0 | $0 | ||||
| Nicholas Desien | ||||||||||
| Ministry Health Care CEO | 1.00 | 55.30 | Yes (X) | $0 | $2,061,606 | $41,974 | ||||
| Jeffrey Francis | ||||||||||
| Ministry Health Care CAFO | 1.00 | 64.90 | Yes (X) | $0 | $522,252 | $124,025 | ||||
| Travis Andersen | ||||||||||
| Hospital Pres - STE App | 40.00 | 1.30 | Yes (X) | $0 | $355,671 | $48,793 | ||||
| Mark Kehrberg | ||||||||||
| Chief Medical Officer AHS | 10.00 | 30.60 | $0 | $394,415 | $54,779 | Yes (X) | ||||
| Lawrence Donatelle | ||||||||||
| Vice President of Medical Affairs | 40.00 | 0.00 | $308,458 | $0 | $46,816 | Yes (X) | ||||
| Jennie Rebecca Gaurkee | ||||||||||
| Pharmacy Director | 40.00 | 0.00 | $170,491 | $0 | $33,346 | Yes (X) | ||||
| Debra Lastofka | ||||||||||
| Pharmacist | 40.00 | 0.00 | $149,291 | $0 | $30,772 | Yes (X) | ||||
| Annette Siedschlag | ||||||||||
| Pharmacist | 40.00 | 0.00 | $139,884 | $0 | $25,518 | Yes (X) | ||||
| Brian G Humphrey | ||||||||||
| Senior Ultrasound Technologist | 40.00 | 0.00 | $139,993 | $0 | $12,903 | Yes (X) | ||||
| Jeanne Maurer | ||||||||||
| Pharmacist | 40.00 | 0.00 | $138,825 | $0 | $38,831 | Yes (X) | ||||
| Jeff Badger | ||||||||||
| Former Officer | 0.00 | 52.00 | $0 | $497,813 | $62,987 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,046,942 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $8,184,230 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $857,528 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 35 | 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/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| The Boldt Company | |||||
| 2525 N Roemer Rd PO Box 419 | Appleton | WI | 54912 | Purchased Services | $21,242,873 |
| Boldt Procurement LLC | |||||
| 2525 N Roemer Rd PO Box 419 | Appleton | WI | 54912 | Purchased Services | $7,985,017 |
| Hammel Green & Abrahamson Inc | |||||
| 333 East Erie Street | Milwaukee | WI | 53202 | Consulting & Design Services | $3,051,068 |
| GE Healthcare | |||||
| PO Box 96483 | Chicago | IL | 60693 | Equipment Repairs | $963,231 |
| Outagamie Department of Solid Waste | |||||
| 1419 Holland Road | Appleton | WI | 54911 | Construction Bed Tower | $881,817 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 36 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $1,469,503 | RelatedOrganizationsAmt |
| Total Contributions | $1,469,503 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| Net Patient Revenue | 622110 | $184,315,801 | $184,315,801 | |
| Misc. Hospital Revenue | 622000 | $1,054,842 | $1,054,842 | |
| Outpatient Lab Revenue | 621500 | $168,702 | $168,702 | |
| Genetic Services | 900099 | $3,950 | $3,950 | |
| Equity Int. in Catalpa | 621500 | -$1,258,389 | -$1,258,389 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $184,284,906 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $188,868 | TotalRevenueColumnAmt |
| Exclusion | $188,868 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $2,637,046 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,092,625 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,544,421 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,544,421 | TotalRevenueColumnAmt |
| Exclusion | $1,544,421 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $104,324 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $58,051 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $46,273 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $46,273 | TotalRevenueColumnAmt |
| Exclusion | $46,273 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| EHR Incentive Pymnt | 900099 | $1,902,077 | $1,902,077 | |
| Cafeteria Income | 722210 | $1,018,721 | $1,018,721 | |
| Other Non-Op. Revenue | 900099 | $119,169 | $119,169 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $3,039,967 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $190,573,938 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $186,133,500 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $172,652 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,798,283 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $613,381 | TotalAmt |
| Program Services | $613,381 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,422,653 | TotalAmt |
| Program Services | $51,852,955 | ProgramServicesAmt |
| Management And General | $10,569,698 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,530,409 | TotalAmt |
| Program Services | $1,530,409 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,579,402 | TotalAmt |
| Program Services | $7,571,425 | ProgramServicesAmt |
| Management And General | $3,007,977 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,905,521 | TotalAmt |
| Program Services | $3,905,521 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,989,172 | TotalAmt |
| Program Services | $1,128,315 | ProgramServicesAmt |
| Management And General | $3,860,857 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,824,848 | TotalAmt |
| Program Services | $24,937,811 | ProgramServicesAmt |
| Management And General | $887,037 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,126,976 | TotalAmt |
| Program Services | $3,424,844 | ProgramServicesAmt |
| Management And General | $702,132 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $443,251 | TotalAmt |
| Program Services | $36,213 | ProgramServicesAmt |
| Management And General | $407,038 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,926,656 | TotalAmt |
| Program Services | $2,926,656 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,421,765 | TotalAmt |
| Program Services | $5,788,273 | ProgramServicesAmt |
| Management And General | $633,492 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $632,017 | TotalAmt |
| Program Services | $617,461 | ProgramServicesAmt |
| Management And General | $14,556 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Purchased Services | $15,003,704 | $9,411,042 | $5,592,662 |
| Pharmaceuticals | $7,348,003 | $7,329,235 | $18,768 |
| Food | $1,120,198 | $1,033,018 | $87,180 |
| Dues | $203,432 | $27,935 | $175,497 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,561,293 | TotalAmt |
| Program Services | $388,806 | ProgramServicesAmt |
| Management And General | $5,172,487 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $153,652,681 | TotalAmt |
| Program Services | $122,523,300 | ProgramServicesAmt |
| Management And General | $31,129,381 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,212,352 | BOYAmt |
| EOY | $3,280,970 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $864,442 | BOYAmt |
| EOY | $660,107 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,780,846 | BOYAmt |
| EOY | $27,070,582 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,892,284 | BOYAmt |
| EOY | $3,145,705 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $459,390 | BOYAmt |
| EOY | $169,831 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $161,289,910 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $7,632,800 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100,453,087 | BOYAmt |
| EOY | $153,657,110 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,223,409 | BOYAmt |
| EOY | $7,544,682 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $147,885,810 | BOYAmt |
| EOY | $195,528,987 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,777,492 | BOYAmt |
| EOY | $36,770,693 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $79,640,825 | BOYAmt |
| EOY | $79,236,726 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,553,995 | BOYAmt |
| EOY | $10,069,078 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $118,972,312 | BOYAmt |
| EOY | $126,076,497 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,865,122 | BOYAmt |
| EOY | $68,434,029 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,376 | BOYAmt |
| EOY | $1,018,461 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,913,498 | BOYAmt |
| EOY | $69,452,490 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $147,885,810 | BOYAmt |
| EOY | $195,528,987 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $36,921,257 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $47,122 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $3,570,613 | 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 | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 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 | $10,845 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $10,845 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part II-B, Line 1: | FormAndLineReferenceDesc |
| Explanation | Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. St. Elizabeth Hospital, 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 | $4,117,424 | OtherCostOrOtherBasisAmt |
| Book Value | $4,117,424 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $56,899,329 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,427,080 | DepreciationAmt |
| Book Value | $53,472,249 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $415,308 | OtherCostOrOtherBasisAmt |
| Depreciation | $66,895 | DepreciationAmt |
| Book Value | $348,413 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $29,841,760 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,091,700 | DepreciationAmt |
| Book Value | $25,750,060 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $70,016,089 | OtherCostOrOtherBasisAmt |
| Depreciation | $47,125 | DepreciationAmt |
| Book Value | $69,968,964 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $153,657,110 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| Pension Liability | $7,809,592 |
| Due to Third Party Payors | $753,950 |
| 457(b) Plan | $581,198 |
| Unspecified Revenue | $520,000 |
| Deferred Tax Liability | $404,338 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $10,069,078 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X, Line 2: | FormAndLineReferenceDesc |
| Explanation | From the consolidated audited financial statements of Ministry Health Care, Inc. which include the activity of St. Elizabeth Hospital, 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 a tax position or expected to be taken in a tax returns. | 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 |
| Percent200 | Yes (X) | Percent200Ind |
| 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 | $2,115,640 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,115,640 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01380 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,458,733 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,458,733 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02250 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $86,153 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $86,153 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,660,526 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,660,526 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03690 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 15 | ActivitiesOrProgramsCnt |
| Persons Served | 2959 | PersonsServedCnt |
| Total Community Benefit Expns | $523,716 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $838 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $522,878 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00340 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Persons Served | 43 | PersonsServedCnt |
| Total Community Benefit Expns | $1,023,770 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $167,765 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $856,005 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00560 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $4,700,933 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,149,610 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $551,323 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00360 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 11 | ActivitiesOrProgramsCnt |
| Persons Served | 5351 | PersonsServedCnt |
| Total Community Benefit Expns | $667,886 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $667,886 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00430 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 31 | ActivitiesOrProgramsCnt |
| Persons Served | 8353 | PersonsServedCnt |
| Total Community Benefit Expns | $6,916,305 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,318,213 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,598,092 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01690 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 31 | ActivitiesOrProgramsCnt |
| Persons Served | 8353 | PersonsServedCnt |
| Total Community Benefit Expns | $12,576,831 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,318,213 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,258,618 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05380 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 170 | PersonsServedCnt |
| Total Community Benefit Expns | $569 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $569 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $15,966 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $15,966 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 44 | PersonsServedCnt |
| Total Community Benefit Expns | $983 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $983 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Persons Served | 87 | PersonsServedCnt |
| Total Community Benefit Expns | $1,214 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,214 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 8 | ActivitiesOrProgramsCnt |
| Persons Served | 301 | PersonsServedCnt |
| Total Community Benefit Expns | $18,732 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $18,732 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $7,898,641 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $65,953,283 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $63,403,017 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $2,550,266 | 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 Elizabeth Hospital Inc | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1506 South Oneida Street | AddressLine1 |
| City | Appleton | City |
| State | WI | State |
| ZIP Code | 54915 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.affinityhealth.org | WebsiteAddressTxt |
| State License | 88 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Teaching Hospital | Yes (X) | TeachingHospitalInd |
| 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 Elizabeth Hospital Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| 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 | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | See Part v, Section B | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Exec Community Wide Plan | Yes (X) | ExecCommunityWidePlanInd |
| Include Operational Plan | Yes (X) | IncludeOperationalPlanInd |
| Adopt Budget | Yes (X) | AdoptBudgetInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | Yes (1) | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Asset Level | Yes (X) | AssetLevelInd |
| Medical Indigency | Yes (X) | MedicalIndigencyInd |
| Insurance Status | Yes (X) | InsuranceStatusInd |
| Uninsured Discount | Yes (X) | UninsuredDiscountInd |
| Medicaid Medicare | Yes (X) | MedicaidMedicareInd |
| State Regulation | Yes (X) | StateRegulationInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| 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 |
| Lowest Negotiated Rates | Yes (X) | LowestNegotiatedRatesInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| St. Elizabeth Hospital, Inc. | Part V, Section B, Line 3: St. Elizabeth Hospital, Inc. participated in the assessment processes that gathered input from both private and public Outagamie, Calumet and Winnebago County organization members including: medical staff, nurses and administrators; clinic personnel; public health nurses and educators; behavioral health staff and leaders; health insurance-health management staff, 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 community members interested in the health needs assessment process. Several Affinity representatives participated as a member of the Fox Valley L.I.F.E. Study and/or Fox Valley Regional Community Health Coalition throughout the assessment process. Ernesto Gonzalez, CASA Hispana was consulted about the Latino community health needs. As part of the Fox Cities L.I.F.E. Study, Kristene Stacker, Fox Cities Community Health Clinic was consulted about the medically underserved community health needs.Outagamie County Public Health Experts:- Mary Dorn, Public Health Manager of Outagamie County, Department of Health and Human Services, Division of Public Health BSN and Master's in Public Health (MPH).- Fifteen years of public health experience in tribal and local health department settings focusing on population based health.- Sue Kamien, Health Officer/Maternal Child Health Supervisor of Outagamie County Health and Human Services.- More than 30 years of public health experience with a focus on nutrition, maternal and child health.- Ellen Koski, Community Health Educator of Outagamie County, Department of Health and Human Services, Division of Public Health, Master's in Public Health (MPH).- Nine years of academic and community programming through the University of Minnesota School of Public Health.- City of Appleton Health Experts:Kurt Eggebrecht, Public Health Officer, Appleton Health Department, Master's in Education (M.Ed).- Thirteen years of experience as City of Appleton Health Officer conducting and overseeing community health needs assessments; has more than 34 years health promotion/disease prevention experience.City of Menasha Health Experts:- Sue Nett, Public Health Director, City of Menasha Health Department BSN and Master in Public Administration.- About 28 years of experience as City of Menasha Public Health Director overseeing the health of the community with 10 years of experience conducting and overseeing community needs assessments (as part of the Fox Cities L.I.F.E. Study). |
| St. Elizabeth Hospital, Inc. | Part V, Section B, Line 4: Conducted with Calumet Medical Center, Mercy Medical Center, Thedacare, and Aurora Health. |
| St. Elizabeth Hospital, Inc. | Part V, Section B, Line 5d: http://www.affinityhealth.org/Affinity-Files/Community- Health-Needs-Assessments/FY2013-STE-CHNA_FINAL4.pdf |
| St. Elizabeth Hospital, Inc. | Part V, Section B, Line 7: Three other broad health categories were identified by the Community Health Needs Assessment process. While individual segments within our system are addressing specific health needs within these broad categories (i.e. COPD, hypertension, palliative care, etc.), the following will not be a priority of St. Elizabeth Hospital, Inc.:- Chronic Disease Management - already being addressed by others in the community and system (with the exception of obesity, which is a priority need for St. Elizabeth Hospital, Inc.);- Sexual Activity, Pregnancy and Parenting - already being addressed by others in the community;- Preventive Care Services - already being addressed by others in the community;Fourteen other health issues were identified by the Community Health Needs Assessment process. Given the reasons indicated below, St. Elizabeth Hospital, Inc. will not be focusing on these health needs at this time.- Access to dental care - already being addressed by others in the community- Low birth weights - already being addressed by others in the community.- Teen birth rate up - already being addressed by others in the community.- High cost of child care - Hospital does not have the expertise to effectively address the need.- Increased gaps in care management for people with disabilities of all ages - already being addressed by others in the community.- Increase in low income students - Hospital does not have the expertise to effectively address the need.- Decreased water quality - Hospital does not have the expertise to effectively address the need.- Increased elder abuse - already being addressed by others in the community.- Increase in violent crime esp. drug-related - Hospital does not have the expertise to effectively address the need.- Increased homelessness related to unemployment (more children) - insufficient resources (financial and personnel) to address the need.- Increased FoodShare recipients - insufficient resources (financial and personnel) to address the need.- Increased food insecurity and hunger - Hospital does not have the expertise to effectively address the need.- Transportation challenges - Hospital does not have the expertise to effectively address the need.- Availability of jobs with health care benefits - insufficient resources (financial and personnel) to address the need. |
| St. Elizabeth Hospital, Inc. | Part V, Section B, Line 14g: A plain language summary of the financial assistance policy is available in the following locations:- The Hospital facility's website- Attachment to billing invoices- Posted to the Hospital facility's emergency rooms and waiting rooms- Posted in the Hospital facility's admission offices- Provided, in writing, to patients on admission to the Hospital facility. |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3c: | It is the policy of St. Elizabeth Hospital, Inc. to provide medically necessary health care services to people in the communities it serves, regardless of their ability to pay. Affinity Care financial assistance is granted based upon the patient's inability to pay and to individuals who are uninsured, underinsured or medically indigent. Affinity Care works in collaboration with other financial (both public and private) assistance programs. This is to ensure holistic wellness of patients by facilitating knowledge of available services and programs for health while practicing good stewardship of funds. Key criteria utilized to determine eligibility for Affinity Care financial assistance includes family size, federal poverty income guidelines and available assets. The available asset test includes consideration of the amount of equity in a home, automobiles, and savings accounts which are considered part of total allowable income when assessing against the federal poverty income guidelines. |
| Part I, Line 6a: | St. Elizabeth's Hospital, Inc. is included in the annual community benefit report which is published by Ministry Health Care (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 network of hospitals, clinics and other health-related organizations. |
| Part I, Line 7: | Amounts calculated in Part I, 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. Prior year cost report settlements are excluded from the shortfall calculation in order to get a true fiscal year shortfall amount. |
| Part II, Community Building Activities: | Community-building activities include programs 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.Some examples include: Rebuilding Together in which managers from St. Elizabeth Hospital went out to help low-income elderly members of the community with remodeling projects to improve safety or condition of their homes. Another example is the Health Career Experience Day in which professionals from St. Elizabeth Hospital, Inc. highlighted a variety of healthcare careers and talk about their professions (i.e. nursing, surgery, laboratory and radiology). |
| Part III, Line 2: | 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. |
| Part III, Line 3: | St. Elizabeth Hospital, Inc. has a very robust financial assistance program; therefore, no estimate is made for bad debt attributed to financial assistance eligible patients. |
| Part III, Line 4: | From the consolidated audited financial statements of Ministry Health Care, Inc. (which includes the activity of St. Elizabeth Hospital, Inc.):The provision for doubtful accounts is based upon management's assessment of expected net collections considering economic conditions, historical experience, trends in healthcare coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for doubtful accounts to establish an appropriate allowance for doubtful accounts. 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. The Health Ministry has not experienced material changes in write-off trends and has not materially changed its charity care policy in the current year. |
| Part III, Line 8: | 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. |
| Part III, Line 9b: | St. Elizabeth Hospital, Inc. 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. |
| Part VI, Line 2: | St. Elizabeth Hospital, Inc. performs community health needs assessments as needed. Planning workgroups consisting of community partners are formed to define the community and its health needs through review of United Way Life Study results, Healthy 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. The leadership at Affinity takes their commitment to the health and well-bring of the community it serves very seriously. In fact, it is core to the Organization's mission, "to live out the healing ministry of Christ by providing services that promote the health and well-being of the communities we serve, especially the poor." Senior leaders and management are also highly encouraged to provide direct service to the poor in their communities. St. Elizabeth and the leadership also subscribe to publications like the Advisory Board to compare national trends to local trends to ensure the hospital is resourcing areas to meet patient needs. |
| Part VI, Line 3: | St. Elizabeth Hospital, Inc. goes to great lengths in order to inform and educate patients/persons who may be billed for patient care about their eligibility for assistance under federal, state or local government programs and under the organizations Affinity Care Policy. The Affinity Care Policy and application is posted on the Organization's website. Admissions and other key areas contain summary information of the Affinity Care Policy. As part of the intake/discharge process, patients are provided with a copy of the policy and other information for financial assistance. If during the course of the patient registration process, care encounter, treatment, or upon discharge it becomes evident that a patient may need financial assistance, the patient shall be referred to the organizations Affinity Care Program. Patients may be identified as needing financial assistance at any time during the course of an encounter. A referral for consideration of Affinity Care financial assistance can be initiated by any member of the Hospital's workforce, including medical staff members, who become aware of the patients potential need for Affinity Care financial assistance. The Affinity Care brochure was also translated into dialects prevalent in the community in order to reach out to those that may speak another language (Spanish and Hmong). Patient registration staff and financial counselors are provided with guidelines to follow when interacting with patients. As part of the Affinity Care process, patients must register with the county public assistance to see if they may qualify under any other federal or state programs. |
| Part VI, Line 4: | While there is growing agreement in the United States about what constitutes a non-profit hospitals "community benefit," this is a work in progress. St. Elizabeth Hospital, Inc. provided significant charity care and other community benefits as defined by the IRS. But in addition, we believe that we provide a critically important community benefit, which is not quantified. St. Elizabeth Hospital, Inc., like most community hospitals, was created and is maintained in order to provide care locally, care that without our hospital, may not be available locally.Certain specialized services available include: I/P adult behavioral health services, I/P adolescent behavioral health services and neonatal intensive care services.The City of Appleton is located in Outagamie, Calumet, and Winnebago counties. According to the 2008-2012 American Community Survey 5-Year Estimates, there were 72,575 people living in Appleton, consisting of 28,428 households and 18,074 families. The population density of Appleton was 2,984.9 people per square mile. The population consisted of 86.0% White, 4.7% Hispanic, 1.6% African American, 0.5% Native American, 5.3% Asian, and 1.9% Other.Of the 28,428 households in Appleton, 32.8% of those had children under the age of 18, living at home. The 28,428 households are categorized as 49% married couples living together, 4.1% had a male head of household with no wife present, 10.5% had a female head of household with no husband present, and 47% were non-families. 29.6% of the households consisted of individuals and 10.1% had someone 65 and older living alone.The age population is widely spread. 28.9% were under 18, 6.5% were 19-24, 26.8% were 25-44, 26.3% were 45-64, and 11.5% were 65+. The median income for a household was $52,605 and the median income for a family was $66,781. The per capita income for the city was $27,106. The largest industry in Appleton is educational, health and social services (21.5%). Manufacturing (20.4%) and retail trade (11.4%) are the next largest industries in Appleton.Roughly 8% of families and 10.5% of the population were below the poverty line. That includes 13.5% of those under 18 years old and 7.4% of those 65 and older.The unadjusted seasonal unemployment rate for Outagamie, Calumet, and Winnebago Counties was 4.0%, 3.7%, and 4.3%, respectively, compared to a state unemployment rate of 5.1% and a national unemployment rate of 7.9%. |
| Part VI, Line 5: | The Organization strives to further its exempt purposes by the following:(1) The Organization's governing board consists primarily of persons who reside within the primary service area who are not employees of the Organization.(2) As mentioned, the Organization provides several services which are not otherwise available being in a rural setting.(3) Based on the Organization's mission, emergency rooms are made available to all patients regardless of the ability to pay.(4) The Organization also participates in the education and training of healthcare professionals through internship programs.Certain specialized services available include: dental services to primarily the indegent, fertility clinic services and WIC home visits to new mothers and infants. |
| Part VI, Line 6: | Ministry Health Care, Inc. ("Ministry" or "the Health Ministry") is a member of Ascension Health. Ascension Health Alliance, d/b/a Ascension (Ascension), is a Missouri nonprofit corporation formed on September 13, 2011. Ascension is the sole corporate member and parent organization of Ascension Health, a Catholic national health system consisting primarily of nonprofit corporations that own and operate local healthcare facilities, or Health Ministries, located in 23 of the United States and the District of Columbia. Ascension and its member organizations are hereafter referred to collectively 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. As more fully described in the Organizational Changes note, Marian Health System, which was previously sponsored by the Sisters of the Sorrowful Mother of the Third Order of St. Francis of Assisi US/Caribbean Province, became part of Ascension Health on April 1, 2013.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.The consolidated financial statements include the following affiliates in which Ministry has a controlling interest or is the sole sponsor.Affiliate Organization LocationAffinity Health System, Inc. (Affinity)Calumet Medical Center, Inc. (CMC) Chilton, WINetwork Health System, Inc. (NHS)Affinity Medical Group (AMG) Fox Valley of WisconsinTwin Med, LLC Fox Valley of WisconsinMercy Medical Center, Inc. Oshkosh, WIMercy Health Foundation Oshkosh, WISt. Elizabeth Hospital Appleton, WICatalpa Health Appleton, WISt. Elizabeth Foundation Appleton, WIAgape Community Center of Milwaukee, Inc. Milwaukee, WIDoor County Memorial Hospital (Door County) Sturgeon Bay, WIGood Samaritan Health Center of Merrill Merrill, WIGood Samaritan Health Center Foundation Merrill, WIHoward Young Health Care, Inc. (Howard Young)Dr. Kate Newcomb Convalescent Center Woodruff, WIHoward Young Medical Center, Inc. Woodruff, WIHoward Young Foundation Woodruff, WIEagle River Memorial Hospital, Inc. Eagle River, WIMinistry Holdings, Inc.Network Health (NH) Fox Valley of WisconsinNetwork Health Insurance Corporation (NHIC) Fox Valley of WisconsinMinistry Home Care, Inc.Ministry Home Care Services Various in WisconsinMinistry Medical Group, Inc.Our Lady of Victory Hospital Stanley, WISacred Heart Hospital- Tomahawk, WI/Rhine-St. Mary's Hospital, Inc. -lander, WISaint Clare's Hospital of Weston, Inc. Weston, WIFoundation of St. Clare's Hospital of Weston, Inc. Weston, WISt. Elizabeth's Hospital of Wabasha, Inc. Wabasha, MNSt. Joseph's Hospital of Marshfield, Inc. Marshfield, WIFoundation of St. Joseph's Hospital of Marshfield, Inc. Marshfield, WISt. Michael's Hospital of Stevens Point, Inc. Stevens Point, WISt. Michael's Foundation of Stevens Point, Inc. Stevens Point, WIMission: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 which 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 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 community benefit programs:- Traditional charity care includes the cost of services provided to persons who cannot afford healthcare because of inadequate resources and/or who are uninsured or underinsured.- 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 other vulnerable persons.- Cost of other programs for persons living in poverty and other vulnerable persons includes unreimbursed costs of programs intentionally designed to serve the persons living in poverty and other vulnerable persons of the community, including substance abusers, the homeless, victims of child abuse, and persons with acquired immune deficiency syndrome.- 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 of persons living in poverty and other community benefit programs. The cost of providing care to persons living in poverty and other community benefit programs is estimated by reducing charges forgone by a factor derived from the ratio of each entity's total operating expenses to the entity's billed charges for patient care.The amount of traditional charity care provided, determined on the basis of cost, was approximately $18,380,000 for the year ended June 30, 2014. The amount of unpaid cost of public programs, cost of other programs for persons living in poverty and other vulnerable persons, and community benefit cost are reported in the accompanying supplementary information. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Partnership Community Health Center Inc | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5337 Grande Market Drive | AddressLine1 |
| City | Appleton | City |
| State | WI | State |
| ZIP Code | 54913 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 202090446 | RecipientEIN |
| IRC Section | Section 501(c)(3) | IRCSectionDesc |
| Cash Grant | $613,381 | CashGrantAmt |
| Purpose Of Grant | Provide Medical Care For the Uninsured In Our Community | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | Each year St. Elizabeth Hospital provides a grant based on an integration agreement. The integration agreement substantiates the amount and the recipient of the grant. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | 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 (18 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| William Calhoun | ||||||||||||||
| President at MMC | $0 | $330,620 | $0 | $44,429 | $0 | $17,408 | $0 | $29,514 | $0 | $17,691 | $0 | $439,662 | $0 | $0 |
| Daniel Neufelder | ||||||||||||||
| Sr. VP Hosp Ops/Vice Chair | $0 | $770,217 | $0 | $95,952 | $0 | $30,097 | $0 | $70,286 | $0 | $18,981 | $0 | $985,533 | $0 | $0 |
| Mark Faustich MD | ||||||||||||||
| Board Member | $0 | $387,296 | $0 | $0 | $0 | $22,250 | $0 | $20,384 | $0 | $4,183 | $0 | $434,113 | $0 | $0 |
| Joseph McCormick MD | ||||||||||||||
| Board Member | $0 | $891,235 | $0 | $0 | $0 | $14,897 | $0 | $35,000 | $0 | $19,733 | $0 | $960,865 | $0 | $0 |
| Stacey Sensor DO | ||||||||||||||
| Board Member | $0 | $567,140 | $0 | $0 | $0 | $15,296 | $0 | $17,500 | $0 | $19,397 | $0 | $619,333 | $0 | $0 |
| Sudeep Sodhi MD | ||||||||||||||
| Board Member | $0 | $834,731 | $0 | $0 | $0 | $16,993 | $0 | $35,000 | $0 | $19,749 | $0 | $906,473 | $0 | $0 |
| Barbara J Strand MD | ||||||||||||||
| Board Member | $0 | $246,953 | $0 | $40,532 | $0 | $26,427 | $0 | $21,723 | $0 | $7,643 | $0 | $343,278 | $0 | $0 |
| Nicholas Desien | ||||||||||||||
| Ministry Health Care CEO | $0 | $1,004,953 | $0 | $329,299 | $0 | $727,354 | $0 | $15,000 | $0 | $26,974 | $0 | $2,103,580 | $0 | $0 |
| Jeffrey Francis | ||||||||||||||
| Ministry Health Care CAFO | $0 | $427,032 | $0 | $63,804 | $0 | $31,416 | $0 | $101,523 | $0 | $22,502 | $0 | $646,277 | $0 | $0 |
| Travis Andersen | ||||||||||||||
| Hospital Pres - STE App | $0 | $281,005 | $0 | $45,452 | $0 | $29,214 | $0 | $31,388 | $0 | $17,405 | $0 | $404,464 | $0 | $0 |
| Mark Kehrberg | ||||||||||||||
| Chief Medical Officer AHS | $0 | $333,905 | $0 | $25,071 | $0 | $35,439 | $0 | $39,160 | $0 | $15,619 | $0 | $449,194 | $0 | $0 |
| Lawrence Donatelle | ||||||||||||||
| Vice President of Medical Affairs | $257,910 | $0 | $24,454 | $0 | $26,094 | $0 | $29,525 | $0 | $17,291 | $0 | $355,274 | $0 | $0 | $0 |
| Jennie Rebecca Gaurkee | ||||||||||||||
| Pharmacy Director | $160,656 | $0 | $0 | $0 | $9,835 | $0 | $17,275 | $0 | $16,071 | $0 | $203,837 | $0 | $0 | $0 |
| Debra Lastofka | ||||||||||||||
| Pharmacist | $126,959 | $0 | $0 | $0 | $22,332 | $0 | $22,405 | $0 | $8,367 | $0 | $180,063 | $0 | $0 | $0 |
| Annette Siedschlag | ||||||||||||||
| Pharmacist | $122,283 | $0 | $0 | $0 | $17,601 | $0 | $23,000 | $0 | $2,518 | $0 | $165,402 | $0 | $0 | $0 |
| Brian G Humphrey | ||||||||||||||
| Senior Ultrasound Technologist | $133,518 | $0 | $0 | $0 | $6,475 | $0 | $6,686 | $0 | $6,217 | $0 | $152,896 | $0 | $0 | $0 |
| Jeanne Maurer | ||||||||||||||
| Pharmacist | $117,818 | $0 | $0 | $0 | $21,007 | $0 | $23,000 | $0 | $15,831 | $0 | $177,656 | $0 | $0 | $0 |
| Jeff Badger | ||||||||||||||
| Former Officer | $0 | $405,962 | $0 | $56,934 | $0 | $34,917 | $0 | $44,888 | $0 | $18,099 | $0 | $560,800 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3 | Ministry Health Care, Inc., a related organization of St. Elizabeth Hospital, 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. |
| Part I, Line 4b | Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. No distributions were made from the plan during the year. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 2 | Many of the persons listed on Part VII have a "business relationship" with each other by virtue of employment by Ministry Healthcare, Inc. related entities. |
| Form 990, Part VI, Section A, line 6 | St. Elizabeth Hospital, Inc. has a two corporate members, Ministry Healthcare, Inc. and Affinity Health System. |
| Form 990, Part VI, Section A, line 7a | St. Elizabeth Hospital, Inc. has a two corporate members, Ministry Healthcare, Inc. and Affinity Health System, who has the ability to elect members to the governing body of St. Elizabeth Hospital Inc. |
| Form 990, Part VI, Section A, line 7b | All decisions that have a material impact to St. Elizabeth Hospital, Inc. financial information or corporation as a whole are subject to approval by its two corporate members, Ministry Healthcare, Inc. and Affinity Health System. |
| Form 990, Part VI, Section B, line 11 | 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, Section B, line 12c | The Organization regularly and consistently monitors and enforces compliance with the Conflict of Interest Policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the Conflict 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, Section B, line 15 | In determining compensation of the organization's CEO, the process, performed by Ministry Health Care, Inc., a related organization of St. Elizabeth Hospital, Inc., included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Compensation Committee reviewed and approved the compensation. In the review of the compensation, the 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 St. Elizabeth Hospital, Inc., included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Compensation Committee reviewed and approved the compensation. In the review of the compensation, the 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, Section C, line 19 | The Ministry web page is available to the public for inspection with a good deal of information regarding whom Ministry Health Care 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 an inquiry is made for any documents, they are shared as appropriate. |
| Form 990, Part XI, line 9: | FASB 136 Elimination - St. Elizabeth Hospital Foundation 970,085. Pension Adjustment 2,600,528. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (31 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Ascension Health Alliance | |||||||||||
| PO Box 45998 | St Louis | MO | 631455998 | 453358926 | National Health System | MO | Section 501(c)(3) | Schedule A, Line 11a | N/A | 0 | |
| Ascension Health | |||||||||||
| PO Box 45998 | St Louis | MO | 631453806 | 311662309 | National Health System | MO | Section 501(c)(3) | Schedule A, Line 11a | 0 | Ascension Health Alliance | |
| Ministry Health Care Inc | |||||||||||
| 10925 W Lake Park Dr Ste 100 | Milwaukee | WI | 53224 | 391490371 | Parent Corporation | WI | Section 501(c)(3) | Schedule A, Line 11b | 0 | Ascension Health | |
| Affinity Health System Inc | |||||||||||
| 1570 Midway Place | Menasha | WI | 54952 | 391568866 | Support related healthcare organziations | IL | Section 501(c)(3) | Schedule A, Line 3 | 0 | Ministry Health Care Inc | |
| Agape Community Center of Milwaukee Inc | |||||||||||
| 6100 North 42nd Street | Milwaukee | WI | 532093560 | 391461846 | Community Center | WI | Section 501(c)(3) | Schedule A, Line 1 | Yes (1) | Ministry Health Care Inc | |
| Calumet Medical Center Inc | |||||||||||
| 614 Memorial Drive | Chilton | WI | 53014 | 390905385 | Hospital | WI | Section 501(c)(3) | Schedule A, Line 3 | Yes (1) | Affinity Health System Inc | |
| Catalpa Health Inc | |||||||||||
| N4642 County N | Appleton | WI | 54914 | 454681563 | Mental Health Facility | WI | Section 501(c)(3) | Schedule A, Line 3 | Yes (1) | St Elizabeth Hospital Inc | |
| Saint Michael's Foundation of Stevens Point Inc | |||||||||||
| 900 Illinois Avenue | Stevens Point | WI | 54481 | 391657410 | Charitable Foundation | WI | Section 501(c)(3) | Schedule A, Line 11a | Yes (1) | St Michael's Hospital of Stevens Point Inc | |
| Door County Memorial Hospital | |||||||||||
| 323 South 18th Avenue | Sturgeon Bay | WI | 54235 | 390806324 | Hospital | WI | Section 501(c)(3) | Schedule A, Line 3 | Yes (1) | Ministry Health Care Inc | |
| Dr Kate Newcomb Convalescent Center Inc | |||||||||||
| PO Box 829 | Woodruff | WI | 54568 | 391357365 | LTC Facility | WI | Section 501(c)(3) | Schedule A, Line 3 | Yes (1) | Howard Young Health Care Inc | |
| Eagle River Memorial Hospital Incorporated | |||||||||||
| 201 Hospital Road | Eagle River | WI | 54521 | 390985690 | Hospital | WI | Section 501(c)(3) | Schedule A, Line 3 | Yes (1) | Howard Young Medical Center | |
| Foundation of Saint Clare's Hospital of Weston Inc | |||||||||||
| 3400 Ministry Parkway | Weston | WI | 54476 | 733193633 | Charitable Foundation | WI | Section 501(c)(3) | Schedule A, Line 11a | Yes (1) | St Clare's Hospital of Weston Inc | |
| Foundation of Saint Joseph's Hospital of Marshfield Inc | |||||||||||
| 611 Saint Joseph Avenue | Marshfield | WI | 54449 | 391684957 | Charitable Foundation | WI | Section 501(c)(3) | Schedule A, Line 11a | Yes (1) | St Joseph's Hospital of Marshfield Inc | |
| Good Samaritan Health Center of Merrill Wisconsin Inc | |||||||||||
| 601 South Center Avenue | Merrill | WI | 54452 | 390808503 | Hospital | WI | Section 501(c)(3) | Schedule A, Line 3 | Yes (1) | Ministry Health Care Inc | |
| Good Samaritan Hlth Cntr Foundation of Merrill Wisconsin Inc | |||||||||||
| 601 South Center Avenue | Merrill | WI | 54452 | 391627755 | Charitable Foundation | WI | Section 501(c)(3) | Schedule A, Line 11a | Yes (1) | Ministry Health Care Inc | |
| Howard Young Foundation Inc | |||||||||||
| 240 Maple Street | Woodruff | WI | 54568 | 391521169 | Charitable Foundation | WI | Section 501(c)(3) | Schedule A, Line 7 | Yes (1) | Ministry Health Care Inc | |
| Howard Young Health Care Inc | |||||||||||
| 240 Maple Street | Woodruff | WI | 54568 | 391499115 | Home Office | WI | Section 501(c)(3) | Schedule A, Line 3 | Yes (1) | Ministry Health Care Inc | |
| Howard Young Medical Center Inc | |||||||||||
| 240 Maple Street | Woodruff | WI | 54568 | 390873606 | Hospital | WI | Section 501(c)(3) | Schedule A, Line 3 | Yes (1) | Howard Young Health Care Inc | |
| Mercy Health Foundation Inc | |||||||||||
| PO Box 3370 | Oshkosh | WI | 54903 | 237140261 | Charitable Foundation | WI | Section 501(c)(3) | Schedule A, Line 9 | Yes (1) | Affinity Health System Inc | |
| Mercy Medical Center of Oshkosh Inc | |||||||||||
| 500 S Oakwood Road | Oshkosh | WI | 54904 | 390806268 | Hospital | WI | Section 501(c)(3) | Schedule A, Line 3 | Yes (1) | Ministry Health Care Inc | |
| Ministry Home Care Inc | |||||||||||
| 611 St Joseph Avenue 4S | Marshfield | WI | 54449 | 391936201 | Home Care/Hospice | WI | Section 501(c)(3) | Schedule A, Line 3 | Yes (1) | Ministry Health Care Inc | |
| Ministry Medical Group Inc | |||||||||||
| 824 Illinois Avenue | Stevens Point | WI | 54481 | 391965593 | Clinics | WI | Section 501(c)(3) | Schedule A, Line 3 | Yes (1) | Ministry Health Care Inc | |
| Ministry Weight Management Inc | |||||||||||
| 2251 North Shore Drive | Rhinelander | WI | 54501 | 391829015 | Health Services | WI | Section 501(c)(3) | Schedule A, Line 3 | Yes (1) | Sacred Heart-St Mary's Hospital Inc | |
| Network Health System Inc | |||||||||||
| 1570 Appleton Rd | Menasha | WI | 54952 | 391127163 | Clinical Healthcare Services | WI | Section 501(c)(3) | Schedule A, Line 3 | Yes (1) | Affinity Health System Inc | |
| Our Lady of Victory Hospital Inc | |||||||||||
| 1120 Pine Street | Stanley | WI | 54768 | 390807065 | Hospital | WI | Section 501(c)(3) | Schedule A, Line 3 | Yes (1) | Ministry Health Care Inc | |
| Sacred Heart-St Mary's Hospitals Inc | |||||||||||
| PO Box 347 | Stevens Point | WI | 54481 | 391390638 | Hospital | WI | Section 501(c)(3) | Schedule A, Line 3 | Yes (1) | Ministry Health Care Inc | |
| Saint Clare's Hospital of Weston Inc | |||||||||||
| 3400 Ministry Parkway | Weston | WI | 54476 | 721531917 | Hospital | WI | Section 501(c)(3) | Schedule A, Line 3 | Yes (1) | Ministry Health Care Inc | |
| Saint Elizabeth's Hospital of Wabasha Inc | |||||||||||
| 1200 Grant Blvd West | Wabasha | MN | 55981 | 410693877 | Hospital | MN | Section 501(c)(3) | Schedule A, Line 3 | Yes (1) | Ministry Health Care Inc | |
| St Elizabeth Hospital Foundation Inc | |||||||||||
| 1506 S Oneida Street | Appleton | WI | 54915 | 391256677 | Charitable Foundation | WI | Section 501(c)(3) | Schedule A, Line 7 | Yes (1) | Affinity Health System Inc | |
| Saint Joseph's Hospital of Marshfield Inc | |||||||||||
| 611 Saint Joseph Avenue | Marshfield | WI | 54449 | 390847631 | Hospital | WI | Section 501(c)(3) | Schedule A, Line 3 | Yes (1) | Ministry Health Care Inc | |
| Saint Michael's Hospital of Stevens Points Inc | |||||||||||
| 900 Illinois Avenue | Stevens Point | WI | 54481 | 390808443 | Hospital | WI | Section 501(c)(3) | Schedule A, Line 3 | Yes (1) | Ministry Health Care Inc | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Twin Med LLP | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 8005 | AddressLine1 |
| City | Menasha | City |
| State | WI | State |
| ZIP Code | 54952 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391180341 | EIN |
| Primary Activities | Rental Property | PrimaryActivitiesTxt |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| Network Health Plan Inc | |||||||||
| 1570 Midway Place | Menasha | WI | 54952 | 391442058 | Insurance | WI | N/A | C | 0 |
| Ministry Holdings Inc | |||||||||
| 1570 Midway Place | Menasha | WI | 54952 | 422966177 | Insurance Holding Company | WI | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | 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 | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | 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 | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | 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 | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (16 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Network Health System Inc | ||
| A | $2,476,612 | FMV |
| Network Health System Inc | ||
| A | $161,609 | FMV |
| St Elizabeth Hospital Foundation Inc | ||
| C | $1,469,497 | FMV |
| Ministry Health Care Inc | ||
| E | $86,609,853 | FMV |
| Mercy Medical Center of Oshkosh Inc | ||
| L | $448,350 | FMV |
| Mercy Medical Center of Oshkosh Inc | ||
| M | $324,316 | FMV |
| Network Health System Inc | ||
| O | $231,896 | FMV |
| Affinity Health System Inc | ||
| O | $133,518 | FMV |
| Ministry Health Care Inc | ||
| O | $13,455,445 | FMV |
| Network Health Plan Inc | ||
| O | $58,170 | FMV |
| Calumet Medical Center Inc | ||
| O | $187,803 | FMV |
| Mercy Medical Center of Oshkosh Inc | ||
| O | $761,270 | FMV |
| Ministry Health Care Inc | ||
| P | $10,769,605 | FMV |
| Network Health Systems Inc | ||
| Q | $890,747 | FMV |
| Ministry Health Care Inc | ||
| R | $4,270,893 | FMV |
| Network Health System Inc | ||
| S | $167,750 | FMV |