2015-05-15T15:14:06-05:00 2014-06-30 861065772 Deloitte Tax LLP 555 East Wells Street Suite 1400 Milwaukee WI 53202 990 2013-07-01 721531917 Saint Clare's Hospital of Weston Inc STCL 7153933000 3400 Ministry Parkway Weston WI 54476 Jeffrey Francis Ministry Health Care CAFO 7153933000 2015-05-15 1 Rachel Becker P00966076 4142713000 2015-05-07 2013 2016-02-25 16:41:14Z Mary T Krueger 3400 Ministry Parkway Weston WI 54476 104640723 0 0928 X www.ministryhealth.org X 2002 WI To further the healing ministry of Jesus by improving the health/well-being of all people. 10 9 617 162 25505 -44565 40663 128354 76455863 103497950 -3106 -2474 -3872936 997003 72620484 104620833 0 0 0 0 30043191 42702762 0 0 0 43567878 57621673 73611069 100324435 -990585 4296398 97642245 94985084 190043387 184174198 -92401142 -89189114 Saint Clare's Hospital of Weston, Inc.'s mission as a Catholic hospital is to further the healing ministry of Jesus by continually improving the health and well-being of all people, especially the poor. 0 0 85657292 103605011 Saint Clare's Hospital of Weston, Inc. provides inpatient, outpatient, emergency room and ancillary services regardless of an individual's ability pay or method of payment. The Hospital also provides education programs and services on health care issues to the community it serves. During fiscal 2014, the Hospital counted 17,193 total patient days and 5,338 total admissions and its Emergency Department received 14,199 visits. See Schedule H for further details regarding the community benefits that Saint Clare's Hospital of Weston, Inc. provides. 85657292 1 1 0 1 0 0 0 0 0 0 1 0 1 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 71 0 1 617 1 1 1 0 0 0 0 0 0 0 0 0 X 10 9 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 WI X Jeffrey Francis 4143593145 222 W College Avenue 3rd Floor Appleton WI 54911 X Kevin Noel Chairman 0.20 0.00 X X 0 0 0 Kristine Gilmore end 1113 Chairman 0.30 0.00 X X 0 0 0 Thomas Felch Vice Chairman 0.20 0.00 X X 0 0 0 Tim Bodette end 913 Vice Chairman 0.30 0.00 X X 0 0 0 Tee Daly Secretary/Treasurer 0.20 0.00 X X 0 0 0 Michael Kryda MD end 913 Secretary/Treasurer 0.30 10.00 X X 0 82704 7436 David Eisenreich start 1013 Board Member 0.20 0.00 X 0 0 0 Jim Frings Board Member 0.20 0.00 X 0 0 0 Mary Jo Johnson end 913 Board Member 0.30 0.00 X 0 0 0 Kevin Kraft start 1013 Board Member 0.20 0.00 X 0 0 0 Joanne Leonard Board Member 0.20 0.00 X 0 0 0 Jamie Schaefer start 1013 Board Member 0.20 0.00 X 0 0 0 Sister Maria Vinton Board Member 0.20 1.00 X 0 0 0 Mary T Krueger President 27.00 13.80 X X 308415 0 60218 Jeffrey L Martin President at SMH 6.00 34.80 X 0 561639 136783 Nicholas Desien Ministry Health Care CEO 0.30 56.00 X 0 2061606 41974 Jeffrey Francis Ministry Health Care CAFO 0.30 65.60 X 0 522252 124025 Larry T Hegland MD Chief Medical Officer 7.00 13.00 X 312819 0 42802 Kristine McGarigle VP of Patient Care 27.00 13.10 X 205206 0 29210 Robert K Middleton Director Pharmacy 40.00 0.00 X 156047 0 51487 Paul W Daubner Clinical Staff Pharmacist 40.00 0.00 X 135802 0 20248 Jason M Rominski Clinical Staff Pharmacist 40.00 0.00 X 134461 0 31295 Maria Hegland Clinical Staff Pharmacist 40.00 0.00 X 131052 0 26322 Maher M Salem Clinical Staff Pharmacist 40.00 0.00 X 133678 0 31582 Jeff Badger Former Officer 1.00 51.00 X 0 497813 62987 1517480 3726014 666369 16 1 1 0 Mathy Construction DBA American Asphalt PO Box 98 Mosinee WI 544550098 Constuction Services (Sch O) 1349370 Medical Staffing Solutions Inc PO Box 101 3 South Main St Rice Lake WI 54868 Agency Staffing 1053846 Advance ICU Care PO Box 790379 St Louis MO 63179 Medical Services 646881 Marshfield Clinic 1000 North Oak Ave Marshfield WI 544495779 Medical Services 503624 Johnson Controls Inc 6767 N Green Bay Ave Milwaukee WI 53209 Equip. Install./Maintenance 466462 13 49624 78730 128354 Net Patient Revenue 622110 96845178 96845178 Rent from Exempt Org 531190 3342329 3342329 Ancillary - DTC Income 621500 3310443 3310443 103497950 127 127 41510 14863 26647 26647 26647 2426 5027 -2601 -2601 -2601 Cafeteria 722210 744017 25505 718512 Gift Shop 453220 119278 119278 Rebates/Discounts 900099 107061 107061 970356 104620833 103605011 25505 861963 1186570 1186570 32671976 28482717 4189259 1353885 1330441 23444 5696445 4149064 1547381 1793886 1764478 29408 8005 8005 1500 1500 2825341 1365382 1459959 14651683 14142313 509370 360351 360351 1921359 1567410 353949 78534 25896 52638 368065 139147 228918 8479163 8479163 6631400 5572372 1059028 288262 278335 9927 Underarrangements 8302233 8302233 Purchased Services 6777801 4203648 2574153 Pharmaceuticals 2732037 2722172 9865 Anesthesia Services 2409664 2409664 1786275 361006 1425269 100324435 85657292 14667143 0 1700 1700 9508826 3570700 9958394 12382234 2082547 2098839 407026 408454 70670995 6190126 65220847 64480869 6680398 6866472 1895168 1935588 1887339 3240228 97642245 94985084 34386549 29902577 7373 155649465 154271621 190043387 184174198 X -92401142 -89332273 143159 -92401142 -89189114 97642245 94985084 X 4296398 -1084370 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 5026 5026 0 Part II-B, Line 1: Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. Saint Clare's Hospital of Weston, 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. 5736650 5736650 47102276 2046755 45055521 1590497 135250 1455247 13490625 3299096 10191529 2750947 709025 2041922 64480869 Equity Investment in DTC 6866472 C 6866472 Note Payable to MHC (Related Party) 150090181 Other Liabilities Long-Term 2458031 Estimated Due to Third Party Payors 1723409 154271621 X Part X, Line 2: From the consolidated audited financial statements of Ministry Health Care, Inc. which includes the activity of Saint Clare's Hospital of Weston, 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 taken or expected to be taken in a tax return. 1 1 X 1 X 1 X 1 1 1 0 1 1 1361184 2636 1358548 0.01350 10849541 10964522 -114981 0.00000 12210725 10967158 1243567 0.01350 11 230158 230158 0.00230 7 105952 105952 0.00110 2 25048 6537 18511 0.00020 16 224936 224936 0.00220 36 586094 6537 579557 0.00580 36 12796819 10973695 1823124 0.01930 1 771 771 0.00000 4 26962 26962 0.00030 2 5807 5807 0.00010 3 69923 69923 0.00070 10 103463 103463 0.00110 0 4869958 42585640 50427760 -7842120 X 1 1 1 Diagnostic Treatment Center Outpatient/Diagnostic Services 0.50000 0.00000 0.00000 1 1 Saint Clare's Hospital of Weston Inc 3400 Ministry Parkway Weston WI 54476 www.ministryhealth.org 310 X X X Saint Clare's Hospital of Weston Inc 1 1 X X X X X X X X X 12 1 0 1 X http://ministryhealth.org/SCH/home.nws X X X X X X 0 0 1 1 200.000000000000 1 300.000000000000 1 X X X X X X 1 1 X X 1 0 X X X X 1 X 0 0 Saint Clare's Hospital of Weston, Inc. Part V, Section B, Line 3: In the past decade, representatives from health care, business and other community resources have been actively engaged in the Marathon County LIFE report and Healthy Marathon County Board structures in an effort to positively impact the quality of life in this county. These committees regularly analyze and publicly report progress made on the key priorities that were identified through the assessment process. They also review updated data and reprioritize the key issues impacting health and quality of life, in an effort to continually realign resources to take action on those priorities. Ministry Saint Clare's leadership participates on The Marathon County LIFE Report Steering Committee. United Way of Marathon County serves as the lead agent for this committee of community partners who collaboratively seeks to maximize opportunities to analyze, strategize and ultimately implement plans to address community health care needs. The four major health care systems of the region are active leaders on this committee and include Ministry Health Care, Aspirus, Marshfield Clinic and Marathon County Public Health. Participants also include governmental and business representatives, as well as other community organizations and volunteer community representatives. The Healthy Marathon County Board of Directors is comprised of diverse organizations working together to make a healthier community. Healthy Marathon County serves as the oversight board for Marathon County's Community Health Improvement Plan to ensure the success of the Action Teams tasked with addressing identified health priorities. Ministry Saint Clare's Hospital leadership also serves on this Board. Detailed analysis of health issues was conducted by the Health and Wellness Sub-Committee, a collaborative team comprised of membership from the LIFE steering committee, the Healthy Marathon County Board, and representation from the community. Six representatives of Ministry Saint Clare's Hospital were liaisons to the subcommittee. Appendix 3 includes the names of the individuals, and their corresponding organizations, whom are representing the organizations described above.- Joan Theuer, Health Officer, Marathon County Public Health, RN, MSN. Ms. Theuer has served for nearly four years as the health officer for Marathon County. Prior to this role, she worked as public health nurse consultant for the State of Wisconsin - Division of Public Health for 12 years of which the majority was in the Northern Region. Ms. Theurer cites many successes that include combining the Community Health Needs Assessment with the Life Report; the development of new health coalitions including the Early Age Initiative and the AODA Coalition; and an increased awareness and strengthening of Healthy Marathon County. Ms. Theuer's proudest accomplishment to date is an approved 2012 resolution to make Marathon County the healthiest one in the state.- Roger Lucas LIFE Project Chair, Aspirus Wausau Hospital, Inc.- Rita Straub LIFE Project Vice Chair Retired, Professor Emeriti-UW- Rachel Yaron Ministry Saint Clare's Hospital- Joan Theurer, RN, MSN, Marathon County Health Officer- Ann Lucas, Marshfield Clinic- Dr. Tom Peterson, Retired Physician- Andy Napgezek, Aspirus Wausau Hospital, Inc.- Paula Brabec Aspirus Wausau Hospital, Inc.- Ken, Day American Society for Laser Medicine & Surgery, Inc/Marathon County Board- Sandi Cihlar, Rural Health Care Advocate- Rick Nevers, Aspirus Wausau Hospital, Inc.- Deb Hager, Marathon County Administration- Julie Burmesch Wausau School District- Michael Beck, Wausau Daily Herald- JoAnn Janikowski, United Way of Marathon County- Karen Katz EO Johnson Office Technologies- James McCluskey University of Wisconsin-Marathon County- Hugh Jones, M&I Bank & Wealth Management- Jeff Sargent, North Central Community Action Program- Diane Wessel, Marathon County-Conservation, Planning and Zoning- Jeff Zriny, Wausau Region Chamber of Commerce- Jeff Hardel, Wausau Police Department- Joel VerDuin, Wausau School District- Joanne Kelly, United Way of Marathon County- Mary Radke, LIFE Project Manager- Zachary Heit, LIFE Project Associate Saint Clare's Hospital of Weston, Inc. Part V, Section B, Line 7: Although Oral Health Care was identified as a priority in the CHNA, another organization in the community, Bridge Community Health Clinic, currently has a daily emergency dental walk-in clinic. Due to their mission statement, "that everyone, regardless of their income or insurance coverage, deserves access to the best in dental care," the community's oral health needs are being well-served. While Ministry Saint Clare's Hospital does have staff that participates in local Alcohol and Other Drug Abuse (AODA) councils, it is not directly involved in providing alcohol and drug treatment. North Central Health Care provides a six-week structured AODA Treatment. Program for teens and adults in our community. An inpatient hospital unit is available for those with more severe detoxification needs. North Central Health Care has a network of highly trained on-site professionals who improve chances for recovery by providing education, counseling sessions and support groups for their patients, as well as for the patient's family and friends. The Central Wisconsin Tobacco Free Coalition, a multi-jurisdictional association, strives to reduce tobacco/nicotine related death and disability through education and advocacy, creating a community environment that encourages tobacco free living. The coalition accomplishes this by increasing knowledge and application of evidence-based practices such as advocating for clean indoor and workplace air policies, advocating for increases in the unit price of products, media campaigns, quit lines, and reducing commercial availability of tobacco products to youth. The coalition provides resources to educate people about the health risks associated with smoking, connects the public with tobacco cessation resources, and lobbies at the state level to end targeted tobacco advertising. Ministry Saint Clare's staff participates in the coalitional and advocates for a tobacco free community through these auspices.Ministry Saint Clare's Hospital of Weston, Inc. has a number of internal programs which help to support the care and treatment of people with chronic illness. These include a Palliative Care Program which helps to ensure that patients living with chronic disease have the highest quality of life possible. Additionally, it proactively engages patients and their families in making life decisions which will support their physical, emotional and spiritual well-being. Saint Clare's Hospital of Weston, Inc. works with their pharmacists to verify the accuracy of patients' current medication lists upon admission. Select patients, such as those with chronic illnesses, receive detailed discharge counseling to improve understanding and management of their medications with the goal of improving compliance with their treatment plans. Saint Clare's Hospital of Weston, Inc. also provides necessary medications to those patients whom are unable to afford them while working to get them enrolled in sustainable medication programs. Saint Clare's Hospital of Weston, Inc. actively works to prevent readmissions due to chronic conditions by calling patients after discharge to ensure that they understand their follow-up directives, including future appointments, pain management, and medication instructions. At this time, however, Saint Clare's Hospital of Weston, Inc. staff does not have the resources to extend this care to the general public, although information regarding ways to access healthcare for chronic conditions is diligently provided to all whom inquire. Saint Clare's Hospital of Weston, 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. 1 The Diagnostic & Treatment Center 3401 Cranberry Blvd Weston WI 54476 Outpatient/ Diagnostic Services Part I, Line 6a: Saint Clare's Hospital of Weston, 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.Bad Debt expense of $4,869,958 is excluded from total operating expenses when calculating percentage of total expense in Part I, line 7, Column F. Part II, Community Building Activities: Community building activities include that, while not directly related to health care, provide oppurtunities 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 docations, and expenditures for the development of a variety of community health programs and partnerships.Saint Clare's Hospital of Weston, Inc. in collaboration with the community, help to identify various health problems affecting the surrounding area, causes leading to these health problems, and actions taken to communicate these issues. these are being done with various health fairs and education related to those at-risk population.The Organization in conjuction with its foundation have a fund set up for patients who may need assistance with food, medication, clothing, transportation or basic needs when they leave the hospital. 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: Saint Clare's Hospital of Weston, 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 Saint Clare's Hospital of Weston, Inc.):The provision for doubtful accounts is based upon management's assessment of expected net collections considering economic conditions, historical experience, trends in health care coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for doubtful accounts to establish an appropriate allowance for doubtful accounts. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Health Ministry follows established guidelines for placing certain past-due patient balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with the Health Ministry's policies.The methodology for determining the allowance for doubtful accounts and related write-offs on uninsured patient accounts has remained consistent with the prior year. 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: The organization has a debt collection policy which sets forth collection practices for patients who are known to qualify or may qualify for financial assistance under the charity care program. Sufficient financial counseling support is made available to patients so they can easily access patient financial service representatives and have their questions answered, and gain an understanding of the reasons why they owe a balance. Accounts are designated as charity care in the business offices so no additional time is spent on collection efforts. Part VI, Line 2: The Organization performs community needs assessments as needed. Planning workgroups consisting of community partners are formed to define the community and its needs through review of Health People Initiatives, census documents, and local government health and welfare agencies. Considering other community resources/assets, data collection methods are used to identify particular problems or subgroups and areas known to have high poverty rates and to be underserved. The data is analyzed and priorities are set based on trending information which may target a specific need. When a need is identified, the Hospital develops a plan to implement a program either through community collaboration or individually. Outcomes from the programs are measured and considered in subsequent community health needs assessments. Community benefit plans are presented to senior leadership and board members to ensure the findings are incorporated into the organization's strategy and policy development. For example, senior leaders required to provide direct service to the poor in their communities, and hours are included as part of their performance goals. Part VI, Line 3: The organization has financial counselors located at every hospital. If a patient indicates they are unable to pay their bill at any point during pre-service, adamission, discharge or billing process, the financial counselors will assist the patient in either securing a funding source (grants, COBRA coverage, Disability benefits, Medicaid, VA etc.) if eligible or assist them in completing a financial assistance application. 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. The organization 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. Our hospital, like most rural 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: emergency services, surgical services, inpatient medical services & obstetrics.Saint Clare's Hospital of Weston, WI and the surrounding areas include Schofield, Rothschild, Rib Mountain & Wausau.The 2013 estimated population for Weston, WI is 14,934. Based on the 2010 census, the racial make-up was 87.7% white, 0.8% African American, 0.4% Native American, 8.7% Asian, 2.0% Hispanic, and 0.4% of other races. 11.5% of the population were over 65 year old and 29.7% under 18. The median household income for the last five years was $52,290 and 8.9% of the population was below the poverty line. 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 an urban 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 professional through internship programs.Saint Clare's Hospital of Weston, Inc. is also involved int he following efforts to further its tax exempt status. Examples include:- The Hospital participates in government-sponsored health programs (Medicare, Medicaid, Champus, Tricare).- The role of the emergency department and urgent care units in serving all persons regardless of ability to pay.- Availability of financial assistance and sliding scale discounts and changes to financial assistance or collection policies that would be viewed as constructive.- The Hospital offers volunteer service program where community members utilize the hospital as a vehicle to connect with and contribute to individuals and the overall community through volunteering. 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. Part VI, Line 7, Reports Filed With States WI 0 1 0 0 0 0 0 0 0 Mary T Krueger President 242465 0 38261 0 27689 0 43259 0 16959 0 368633 0 0 0 Jeffrey L Martin President at SMH 0 428700 0 69766 0 63173 0 113532 0 23251 0 698422 0 0 Nicholas Desien Ministry Health Care CEO 0 1004953 0 329299 0 727354 0 15000 0 26974 0 2103580 0 0 Jeffrey Francis Ministry Health Care CAFO 0 427032 0 63804 0 31416 0 101523 0 22502 0 646277 0 0 Larry T Hegland MD Chief Medical Officer 265898 0 24091 0 22830 0 29175 0 13627 0 355621 0 0 0 Kristine McGarigle VP of Patient Care 155427 0 13643 0 36136 0 11029 0 18181 0 234416 0 0 0 Robert K Middleton Director Pharmacy 132984 0 0 0 23063 0 18108 0 33379 0 207534 0 0 0 Paul W Daubner Clinical Staff Pharmacist 109924 0 16779 0 9099 0 8135 0 12113 0 156050 0 0 0 Jason M Rominski Clinical Staff Pharmacist 98280 0 16779 0 19402 0 18972 0 12323 0 165756 0 0 0 Maria Hegland Clinical Staff Pharmacist 105509 0 0 0 25543 0 25106 0 1216 0 157374 0 0 0 Maher M Salem Clinical Staff Pharmacist 125939 0 0 0 7739 0 0 0 31582 0 165260 0 0 0 Jeff Badger Former Officer 0 405962 0 56934 0 34917 0 44888 0 18099 0 560800 0 0 Part I, Line 3 Ministry Health Care, Inc., a related organization of Saint Clare's Hospital of Weston, 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 These executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. The following individual received payout from Ministry Health Care's nonqualified retirement plan in the amount as noted: Kristine McGarigle - $18,080 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 Saint Clare's Hospital of Weston, Inc. has a single corporate member, Ministry Health Care, Inc. Form 990, Part VI, Section A, line 7a Saint Clare's Hospital of Weston, Inc. has a single corporate member, Ministry Health Care, Inc., who has the ability to elect members to the governing body of the Saint Clare's Hospital of Weston, Inc. Form 990, Part VI, Section A, line 7b All decisions that have a material impact to Saint Clare's Hospital of Weston, Inc. financial information or corporation as a whole are subject to approval by its sole corporate member, Ministry Health Care, Inc. Form 990, Part VI, 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 Saint Clare's Hospital of Weston, 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, Executive Director, and top management 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. Individuals were not present when their 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 Saint Clare's Hospital of Weston, 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 employees 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 who Ministry Health Care is and the entities included along with our mission. The Articles of Incorporation, Bylaws, Conflict of Interest Policy and financial statements are not included on any web page. However, if any inquiry is made for any documents they are shared as appropriate. Form 990, Part VII, Section B: Compensation paid to Mathy Construction: Payments made to Mathy Construction constitute payments for both materials and services. These amounts cannot be separated. Form 990, Part XI, line 9: Equity Transfer to Foundation of Saint Clare's Hospital of Weston, Inc. -117,180. Equity Transfer to Ministry Health Care, Inc. 904,199. Pension Acturial Adjustments 203,837. SJH Outreach -2,199,996. Temporarily Restricted Increase in Fund Balance 143,159. Final D&T Fixed Asset Reconciliation Adjustment -18,389. 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 Ascension Health Alliance 0 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 Ascension Health 0 Affinity Health System 1570 Midway Place Menasha WI 54952 391568866 Support Related Healthcare Organziations IL Section 501(c)(3) Schedule A, Line 11b Ministry Health Care Inc 1 Agape Community Center of Milwaukee Inc 6100 North 42nd Street Milwaukee WI 532093560 391461846 Community Center WI Section 501(c)(3) Schedule A, Line 7 Ministry Health Care Inc 1 Calumet Medical Center Inc 614 Memorial Drive Chilton WI 53014 390905385 Hospital WI Section 501(c)(3) Schedule A, Line 3 Affinity Health System 1 Catalpa Health Inc N4642 County N Appleton WI 54914 454681563 Mental Health Facility WI Section 501(c)(3) Schedule A, Line 3 St Elizabeth Hospital Inc 1 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 Saint Michael's Hospital of Stevens Point Inc 1 Door County Memorial Hospital 323 South 18th Avenue Sturgeon Bay WI 54235 390806324 Hospital WI Section 501(c)(3) Schedule A, Line 3 Ministry Health Care Inc 1 Dr Kate Newcomb Convalescent Center Inc PO Box 829 Woodruff WI 54568 391357365 LTC Facility WI Section 501(c)(3) Schedule A, Line 9 Howard Young Health Care Inc 1 Eagle River Memorial Hospital Incorporated 201 Hospital Road Eagle River WI 54521 390985690 Hospital WI Section 501(c)(3) Schedule A, Line 3 The Howard Young Medical Center Inc 1 Foundation of Saint Clare's Hospital of Weston Inc 3400 Ministry Parkway Weston WI 54476 753193633 Charitable Foundation WI Section 501(c)(3) Schedule A, Line 11a Ministry Health Care Inc 1 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 Saint Joseph's Hospital of Marshfield Inc 1 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 Ministry Health Care Inc 1 Good Samaritan Health Center Foundation of Merrill Wisconsin Inc 601 South Center Avenue Merrill WI 54452 391627755 Charitable Foundation WI Section 501(c)(3) Schedule A, Line 11a Good Samaritan Health Center of Merrill Wisconsin Inc 1 Howard Young Foundation Inc 240 Maple Street Woodruff WI 54568 391521169 Charitable Foundation WI Section 501(c)(3) Schedule A, Line 7 Howard Young Health Care Inc 1 Howard Young Health Care Inc 240 Maple Street Woodruff WI 54568 391499115 Home Office WI Section 501(c)(3) Schedule A, Line 11b Ministry Health Care Inc 1 The Howard Young Medical Center Inc 240 Maple Street Woodruff WI 54568 390873606 Hospital WI Section 501(c)(3) Schedule A, Line 3 Howard Young Health Care Inc 1 Mercy Health Foundation Inc PO Box 3370 Oshkosh WI 54903 237140261 Charitable Foundation WI Section 501(c)(3) Schedule A, Line 9 Affinity Health System 1 Mercy Medical Center of Oshkosh Inc 500 S Oakwood Road Oshkosh WI 54904 390806268 Hospital WI Section 501(c)(3) Schedule A, Line 3 Ministry Health Care Inc 1 Ministry Home Care Inc 611 St Joseph Avenue 4S Marshfield WI 54449 391936201 Home Care/Hospice WI Section 501(c)(3) Schedule A, Line 9 Ministry Health Care Inc 1 Ministry Medical Group Inc 824 Illinois Avenue Stevens Point WI 54481 391965593 Clinics WI Section 501(c)(3) Schedule A, Line 11c Ministry Health Care Inc 1 Ministry Weight Management Inc 2251 North Shore Drive Rhinelander WI 54501 391829015 Health Services WI Section 501(c)(3) Schedule A, Line 3 Sacred Heart-St Mary's Hospitals Inc 1 Network Health System Inc 1570 Appleton Rd Menasha WI 54952 391127163 Clinical Healthcare Services WI Section 501(c)(3) Schedule A, Line 3 Affinity Health System 1 Our Lady of Victory Hospital Inc 1120 Pine Street Stanley WI 54768 390807065 Hospital WI Section 501(c)(3) Schedule A, Line 3 Ministry Health Care Inc 1 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 Ministry Health Care Inc 1 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 Ministry Health Care Inc 1 St Elizabeth Hospital Foundation Inc 1506 S Oneida Street Appleton WI 54915 391256677 Charitable Foundation WI Section 501(c)(3) Schedule A, Line 7 Affinity Health System 1 St Elizabeth Hospital Inc 1506 S Oneida Street Appleton WI 54915 390816818 Hospital WI Section 501(c)(3) Schedule A, Line 3 Ministry Health Care Inc 1 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 Ministry Health Care Inc 1 Saint Michael's Hospital of Stevens Point Inc 900 Illinois Avenue Stevens Point WI 54481 390808443 Hospital WI Section 501(c)(3) Schedule A, Line 3 Ministry Health Care Inc 1 Twin Med LLP PO Box 8005 Menasha WI 54952 391180341 Rental Property WI N/A Diagnostic & Treatment Center 3401 Cranberry Blvd Weston WI 54476 200691634 Outpatient Services WI Saint Clare's Hospital of Weston Inc Related 7013975 6849873 0 0 0.50000 Network Health Plan Inc 1570 Midway Place Menasha WI 54952 391442058 Insurance WI N/A C 0 Network Health Insurance Corporation 1570 Midway Place Menasha WI 54952 392020474 Insurance WI N/A C 0 Ministry Holdings Inc 1570 Midway Place Menasha WI 54952 422966177 Insurance Holding Company WI N/A C 0 1 0 1 0 1 0 0 0 0 0 0 1 1 1 1 1 1 1 0 Ministry Medical Group Inc A 246684 FMV Diagnostic & Treatment Center A 2804969 FMV Ministry Health Care Inc E 150090181 FMV Ministry Medical Group Inc L 2409664 FMV Foundation of Saint Clare's Hospital of Weston Inc O 101188 FMV Ministry Health Care Inc O 8019670 FMV Saint Joseph's Hospital of Marshfield Inc O 454909 FMV Good Samaritan Health Center of Merrill Wisconsin Inc O 280722 FMV Ministry Medical Group Inc O 8743630 FMV Ministry Health Care Inc P 12539263 FMV Foundation of Saint Clare's Hospital of Weston Inc Q 76341 FMV Foundation of Saint Clare's Hospital of Weston Inc R 117180 FMV Ministry Health Care Inc R 8316529 FMV