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ST VINCENT HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
ST VINCENT HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST (EIN 39-0817529)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-05-12
IRS object ID
201401329349302785
Schema version
2012v2.3
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-05-12T14:07:21-05:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1191 West Nationwide Blvd Ste 500AddressLine1
CityColumbusCity
StateOHState
ZIP Code432152568ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN390817529EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1ST VINCENT HOSPITAL OF THE HOSPITALBusinessNameLine1
Business Name Line2SISTERS OF THE THIRD ORDER OF ST FRANCISBusinessNameLine2
FieldValueIRS element (for citing)
In Care Of Name% KELLY GIGOTInCareOfName
Name ControlSTVINameControl
Phone9204330111Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1835 S VAN BURENAddressLine1
Address Line2SuiteAddressLine2
CityGREEN BAYCity
StateWIState
ZIP Code543013256ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameKELLY GIGOTName
TitleV.P.-FINANCETitle
Phone9204330111Phone
Date Signed2014-05-07DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone6142492300Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonTherese PandlNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12710 Executive Drive PO Box 19AddressLine1
CityGreen BayCity
StateWIState
ZIP Code54307ZIPCode
FieldValueIRS element (for citing)
Gross Receipts435862302GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web SiteWWW.STVINCENTHOSPITAL.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1888YearFormation
State Legal DomicileWIStateLegalDomicile
Activity Or Mission DescriptionST. VINCENT HOSPITAL'S MISSION IS TO CARRY OUT THE HEALING MINISTRY OF THE CATHOLIC CHURCH BY PROVIDING HIGH-QUALITY HOSPITAL SERVICES TO THE PEOPLE OF GREEN BAY, NORTHEAST WISCONSIN, AND NEARBY UPPER MICHIGAN.ActivityOrMissionDescription
Nbr Voting Members Governing Body12NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees2253TotalNbrEmployees
Total Nbr Volunteers500TotalNbrVolunteers
Total Gross UBI3899079TotalGrossUBI
Net Unrelated Business Txbl Income-2177673NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1834503ContributionsGrantsPriorYear
Contributions Grants Current Year3907101ContributionsGrantsCurrentYear
Program Service Revenue Prior Year410199647ProgramServiceRevenuePriorYear
Program Service Revenue CY417632154ProgramServiceRevenueCY
Investment Income Prior Year2470350InvestmentIncomePriorYear
Investment Income Current Year12012568InvestmentIncomeCurrentYear
Other Revenue Prior Year852316OtherRevenuePriorYear
Other Revenue Current Year1808219OtherRevenueCurrentYear
Total Revenue Prior Year415356816TotalRevenuePriorYear
Total Revenue Current Year435360042TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year112196539SalariesEtcPriorYear
Salaries Etc Current Year108512345SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year289501907OtherExpensePriorYear
Other Expenses Current Year300767087OtherExpensesCurrentYear
Total Expenses Prior Year401698446TotalExpensesPriorYear
Total Expenses Current Year409279432TotalExpensesCurrentYear
Revenues Less Expenses Prior Year13658370RevenuesLessExpensesPriorYear
Revenues Less Expenses CY26080610RevenuesLessExpensesCY
Total Assets BOY552025079TotalAssetsBOY
Total Assets EOY593393031TotalAssetsEOY
Total Liabilities BOY201244752TotalLiabilitiesBOY
Total Liabilities EOY181262138TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY350780327NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY412130893NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionSt. Vincent Hospital's mission is to reveal and embody Christ's healing love for all people through our high quality Franciscan health care ministry.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense24694216Expense
Revenue52788216Revenue
DescriptionSURGICAL SERVICES - SEE SCHEDULE O "PROGRAM SERVICE ACCOMPLISHMENTS"Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense10017009Expense
Revenue42307551Revenue
DescriptionRADIOLOGY SERVICES - SEE SCHEDULE O "PROGRAM SERVICE ACCOMPLISHMENTS"Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense8109253Expense
Revenue21215563Revenue
DescriptionHEART AND VASCULAR CENTER - SEE SCHEDULE O "PROGRAM SERVICE ACCOMPLISHMENTS"Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp304895685TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev297685111TotalOfOtherProgramServiceRev
Total Program Service Expense347716163TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvesttrueReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPtrueLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntitytrueDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096100NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees2253NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members12NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturetrueInvestmentInJointVenture
Written Policy Or ProceduretrueWrittenPolicyOrProcedure
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonKELLY GIGOTNamePerson
Telephone Number9204338287TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1835 S VAN BURENAddressLine1
CityGREEN BAYCity
StateWIState
ZIP Code54301ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (25 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerAverage Hours Per Week RelatedAverageHoursPerWeekRelatedHighest Compensated EmployeeHighestCompensatedEmployee
KENNETH HUJET MD
DIRECTOR1.0X000
JOHN HAGER
SECRETARY1.0X000X
ROBERT BURNS
DIRECTOR1.0X000
DANIEL PLATKOWSKI
DIRECTOR1.0X000
JULES BLANK MD
DIRECTOR1.0X000
KENNETH JOHNSON
DIRECTOR26.0X069215419514.0
FRANK MIKELL MD
DIRECTOR1.0X084193013214059.0
BETSY MITCHELL
DIRECTOR1.0X000
JUDY NAGEL
VICE CHAIR1.0X000X
THERESE PANDL
President20.0X0663886124666X40.0
D J LONG Jr
CHAIRPERSON1.0X000X0.0
Sr Bernadine Gutowski OSF
DIRECTOR1.0X0000.0
TIMOTHY JAHN MD
CHIEF MEDICAL OFFICER1.0175538010190X
PAULA HAFEMAN
CNO40.0221084016261X
TANYA TOWNSEND
CIO50.0148144011442X
ANN M CARR
TREASURER0.250272146138031X59.75
THOMAS R BAYER
SR VP - REGIONAL DEVELOPMENT40.0221541025088X
KELLY GIGOT
VP FINANCE40.0206013025572X
CHRISTINE JENSEMA
CHIEF PEOPLE OFFICER50.0151360025775X
GREGORY SIMIA
DIVISION CFO20.0339812024098X
CURTIS WATSON
ANESTHESIA MANAGER40.0286731021957X
BRADLEY LYONS
CRNA50.0193518025449X
TIFFANY SHAVE
CRNA40.0202321021782X
SARAH LULLOFF MD
PHYSICIAN50.0210128022098X
CHERYL BURKEL-EMMERS
CRNA50.0190938025826X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2547128TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1847177TotalReportableCompFrmRltdOrgs
Total Other Compensation654570TotalOtherCompensation
Number Individuals GT100 K99NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
EPIC SYSTEMS CORPORATION
1979 MILKY WAYVERONAWI59593MAINENANCE2361158
CARDINAL HEALTH - PHARMACY
2901 ENLOE STREETHUDSONWI54016PHARMACY SERVICES1802024
SODEXO INC AFFILIATES
4880 PAYSHERE CIRCHICAGOIL60674FOODSERVICE1595236
BAYCARE CLINIC LLP
164 S BROADWAYGREEN BAYWI54303NEUROSURGICAL SERV.1073500
GENERAL VASCULAR CONSULT LLC
720 S VAN BUREN ST SUITE 101GREEN BAYWI54301TRAUMA SERVICES802241
FieldValueIRS element (for citing)
Number Of Contractors GT100 K45NumberOfContractorsGT100K
Related Organizations554886RelatedOrganizations
Government Grants3342535GovernmentGrants
All Other Contributions9680AllOtherContributions
Total Contributions3907101TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
PATIENT SERVICE REVENUE900099413996441413996441
OTHER OPERATING REVENUE90009918880321888032
REFERENCE LAB62150017476811747681
FieldValueIRS element (for citing)
Total Program Service Revenue417632154TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column4458394TotalRevenueColumn
Exclusion$4,458,394ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real496082Real
Personal1572Personal

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real304242Real
Personal2620Personal

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real191840Real
Personal-1048Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column190792TotalRevenueColumn
Unrelated Business Revenue-1048UnrelatedBusinessRevenue
Exclusion$191,840ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other135690Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other195398Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities7613882Securities
Other-59708Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column7554174TotalRevenueColumn
Exclusion$7,554,174ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
PRINT SHOP323100350035213326$136,709
OTHER REVENUE9000991201528$1,201,528
CATERING7223206586451088$14,776
FieldValueIRS element (for citing)
Total Other Revenue1617427TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column435360042TotalRevenueColumn
Related Or Exempt Function Income413996441RelatedOrExemptFunctionIncome
Unrelated Business Revenue3899079UnrelatedBusinessRevenue
Exclusion$13,557,421ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1717749Total
Management And General1717749ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total76295093Total
Program Services67578875ProgramServices
Management And General8716218ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total10851120Total
Program Services9399818ProgramServices
Management And General1451302ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total12960775Total
Program Services11227313ProgramServices
Management And General1733462ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total6687608Total
Program Services5793162ProgramServices
Management And General894446ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total503803Total
Program Services-592047ProgramServices
Management And General1095850ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total21571Total
Program Services378ProgramServices
Management And General21193ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total175942900Total
Program Services149600003ProgramServices
Management And General26342897ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total2013797Total
Program Services2038920ProgramServices
Management And General-25123ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total3493860Total
Program Services1186488ProgramServices
Management And General2307372ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total1461295Total
Program Services1135690ProgramServices
Management And General325605ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total13319310Total
Program Services11226246ProgramServices
Management And General2093064ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total272355Total
Program Services195117ProgramServices
Management And General77238ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total2154741Total
Program Services1849543ProgramServices
Management And General305198ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total1182972Total
Management And General1182972ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total15957494Total
Program Services11753967ProgramServices
Management And General4203527ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total2086918Total
Program Services1394085ProgramServices
Management And General692833ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
SUPPLIES5547124354760940710303
EQUIPMENT RENTAL & MAINT.1074852110748521
BAD DEBT EXPENSES97434019743401
MISCELLANEOUS6392906-132425777171630

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total409279432Total
Program Services347716163ProgramServices
Management And General61563269ManagementAndGeneral
Fundraising0Fundraising
FieldValueIRS element (for citing)
Info In Schedule O Part XXInfoInScheduleOPartX

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY9685900BOY
EOY12300177EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY10114543BOY
EOY6903469EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY81097240BOY
EOY66739818EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY464785BOY
EOY5450100EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY5196821BOY
EOY5267347EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY2650148BOY
EOY2305014EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis331256374LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec199337422LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY120931492BOY
EOY131918952EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY283363561BOY
EOY326413509EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY37514443BOY
EOY35438890EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1006146BOY
EOY655755EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY552025079BOY
EOY593393031EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY43343005BOY
EOY49450937EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY77388398BOY
EOY77739461EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY80513349BOY
EOY54071740EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY201244752BOY
EOY181262138EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY344108890BOY
EOY404059142EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY3867496BOY
EOY5239697EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2803941BOY
EOY2832054EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY350780327BOY
EOY412130893EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY552025079BOY
EOY593393031EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses26080610ReconcilationRevenueExpenses
Reconciliation Unrealized Invest13005928ReconciliationUnrealizedInvest
Reconcilation Other Changes22264028ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$21,571OtherActivitiesAmount
Total Lobbying Expenditures IIB21571TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3
Form4720 Filed4912 TaxfalseForm4720Filed4912Tax

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF OTHER LOBBYING ACTIVITIESIdentifier
Return ReferenceSCHEDULE C, PART II B, QUESTION 1iReturnReference
ExplanationST. Vincent HOSPITAL (THE HOSPITAL) IS A MEMBER OF THE CATHOLIC HEALTH ASSOCIATION ("CHA"), THE WISCONSIN HEALTH ASSOCIATION ("WHA"),THE NATIONAL ASSOCIATION FOR HOME CARE AND HOSPICE, AND THE AMERICAN HEALTH ASSOCIATION ("AHA"). AS A MEMBER OF THESE ORGANIZATIONS, THE HOSPITAL PAYS DUES, With PART OF THESE DUES being ATTRIBUTABLE TO LOBBYING FEES PAID BY THE ORGANIZATIONS. THE AMOUNT LISTED ABOVE IS THE AMOUNT ATTRIBUTABLE TO THE HOSPITAL FROM ITS DUES PAID.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Current Year Minus3 YearsCurrentYearMinus3Years
Current Year Minus4 YearsCurrentYearMinus4Years

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis9558500OtherCostOrOtherBasis
Book Value9558500BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis141465746OtherCostOrOtherBasis
Depreciation85108327Depreciation
Book Value56357419BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1553355OtherCostOrOtherBasis
Depreciation1322334Depreciation
Book Value231021BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis166667082OtherCostOrOtherBasis
Depreciation112906761Depreciation
Book Value53760321BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis12011691OtherCostOrOtherBasis
Book Value12011691BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings131918952TotalOfBookValueLandBuildings

Investments Program Related InvestmentsProgramRelated (8 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
INV - PREVEA PREF.18238627C
INVESTMENT - UNITY6241591C
INV - COMM MEMORIAL2837804C
INVESTMENT - WUPOMS2068445C
INV - PREVEA - COMMON3076470C
INV - PAIN CENTER WI1183047C
ONCOLOGY JOINT VENTURE302467C
INV-HOLY FAMILY GOODWILL1490439C
FieldValueIRS element (for citing)
Total Of Book Value Program Related35438890TotalOfBookValueProgramRelated
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionAmountAmount
ACCRUED BENEFIT LIABILITY$47,024,578
RETIREMENT OBLIGATION - ASBESTOS$654,874
WORKERS COMPENSATION$351,873
DUE TO MEDICARE$620,076
CAP LEASE PAY-PREVEA$5,420,339
FieldValueIRS element (for citing)
Total Of Amounts54071740TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierSCHEDULE D, ASC SUBTOPIC 740-10Identifier
ExplanationHSHS HAS ADOPTED ASC SUBTOPIC 740-10, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES - AN INTERPRETATION OF FASB STATEMENT NO.109. ASC SUBTOPIC 740-10 ADDRESSES THE DETERMINATION OF HOW TAX BENEFITS CLAIMED OR EXPECTED TO BE CLAIMED ON A TAX RETURN SHOULD BE RECORDED IN THE CONSOLIDATED FINANCIAL STATEMENTS. UNDER ASC SUBTOPIC 740-10, HSHS MUST RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFITS RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. ASC SUBTOPIC 740-10 ALSO PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES ON INCOME TAXES, ACCOUNTING IN INTERIM PERIODS, AND REQUIRES INCREASED DISCLOSURES. AS OF JUNE 30, 2013 AND 2012, HSHS DOES NOT HAVE AN ASSET OR LIABILITY FOR UNRECOGNIZED TAX BENEFITS.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage225.FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgetfalseExpensesExceededBudget
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense7258775TotalCommunityBenefitExpense
Net Community Benefit Expense7258775NetCommunityBenefitExpense
Percent Of Total Expense0.01820PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense27283235TotalCommunityBenefitExpense
Net Community Benefit Expense27283235NetCommunityBenefitExpense
Percent Of Total Expense0.06830PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense4121417TotalCommunityBenefitExpense
Direct Offsetting Revenue1645941DirectOffsettingRevenue
Net Community Benefit Expense2475476NetCommunityBenefitExpense
Percent Of Total Expense0.00620PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense38663427TotalCommunityBenefitExpense
Direct Offsetting Revenue1645941DirectOffsettingRevenue
Net Community Benefit Expense37017486NetCommunityBenefitExpense
Percent Of Total Expense0.09270PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Persons Served1870PersonsServed
Total Community Benefit Expense1343695TotalCommunityBenefitExpense
Direct Offsetting Revenue3100DirectOffsettingRevenue
Net Community Benefit Expense1340595NetCommunityBenefitExpense
Percent Of Total Expense0.00340PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Persons Served1136PersonsServed
Total Community Benefit Expense706838TotalCommunityBenefitExpense
Net Community Benefit Expense706838NetCommunityBenefitExpense
Percent Of Total Expense0.00180PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Persons Served536PersonsServed
Total Community Benefit Expense173322TotalCommunityBenefitExpense
Net Community Benefit Expense173322NetCommunityBenefitExpense
Percent Of Total Expense0.00050PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Persons Served127980PersonsServed
Total Community Benefit Expense86973TotalCommunityBenefitExpense
Net Community Benefit Expense86973NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Persons Served131522PersonsServed
Total Community Benefit Expense2310828TotalCommunityBenefitExpense
Direct Offsetting Revenue3100DirectOffsettingRevenue
Net Community Benefit Expense2307728NetCommunityBenefitExpense
Percent Of Total Expense0.00590PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Persons Served131522PersonsServed
Total Community Benefit Expense40974255TotalCommunityBenefitExpense
Direct Offsetting Revenue1649041DirectOffsettingRevenue
Net Community Benefit Expense39325214NetCommunityBenefitExpense
Percent Of Total Expense0.09860PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Persons Served1400PersonsServed
Total Community Building Expense2057TotalCommunityBuildingExpense
Net Community Building Expense2057NetCommunityBuildingExpense

Total Total

FieldValueIRS element (for citing)
Persons Served1400PersonsServed
Total Community Building Expense2057TotalCommunityBuildingExpense
Net Community Building Expense2057NetCommunityBuildingExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$4,781,494BadDebtExpenseAmount
Amount Attributable To1821908AmountAttributableTo
Amount Reimbursed By Medicare116967092AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare171721692CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-54754600MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (9 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivityOrganization Profit Or OwnershipOrganizationProfitOrOwnershipPhysicans Profit Or OwnershipPhysicansProfitOrOwnership
Unity Ltd Ptnrshp
Healthcare0.45000
NE Wisc Radiation
Healthcare0.250000.50000
Therapy Serv LLC
Healthcare
Pain Ctr of WI LLC
Healthcare0.500000.50000
WI UPPER PENINSULA
HOSPITAL - HEALTHCARE
SERVICES INC
HEALTHCARE0.50000
PREVEA HLTH SERV INC
HEALTHCARE0.250000.50000
COMMUNITY MEMORIAL
HEALTHCARE0.17000
HOLY FAMILY ONCOLOGY
Healthcare0.50000
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1St Vincent HospitalBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1835 S Van BurenAddressLine1
CityGreen BayCity
StateWIState
ZIP Code54301ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1St Vincent HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA ConductedtrueCHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
Needs Assessment Conducted11NeedsAssessmentConducted
Take Into AccounttrueTakeIntoAccount
Other FacilitiestrueOtherFacilities
CHNA Widely AvailabletrueCHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Adopt Implement StrategyXAdoptImplementStrategy
Develop Community PlanXDevelopCommunityPlan
Participate Community PlanXParticipateCommunityPlan
Include Operational PlansXIncludeOperationalPlans
Adopt BudgetXAdoptBudget
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
All Needs AddressedfalseAllNeedsAddressed
Organization Incur Excise TaxfalseOrganizationIncurExciseTax
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent225.FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent300.FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Attached To InvoicesXAttachedToInvoices
Available On RequestXAvailableOnRequest
Other PublicityXOtherPublicity
Actions On NonpaymenttrueActionsOnNonpayment
Collection ActivitiesfalseCollectionActivities
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (17 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
Part I, Line 3cNOT APPLICABLE AS THE ORGANIZATION DOES FOLLOW FPG TO DETERMINE ELIGIBILITY FOR PROVIDING CHARITY AND DISCOUNTED CARE TO LOW-INCOME UNINSURED AND UNDERINSURED INDIVIDUALS.
Part I, Line 6aYes, The hospitals community benefit report can be accessed at www.stvincenthospital.org. Part I, Line 7, Column (F) The percentage of charity care and certain other benefits at cost as a percent of total expenses less bad debt is 9.86%. The amount of bad debt removed when calculating Part I, Line 7, Column (F) was $9,743,401.
Part I, Line 7Charity care is calculated by determining the total amount from patient billing that is written off to charity care charge codes or allowances. This amount matches the number that is reported on our fiscal year ending 2013 audited financial statements. The total charity care dollar amount is then reduced to cost by applying the hospital's cost to charge ratio as calculated on IRS Schedule H-Worksheet J. PART I, LINE 7G The hospital uses Lyons Software (CBISA) to determine subsidized services. Physician clinics were not included in the subsidized health services.
Part IIThe community building activities that we have tracked and reported in our community benefit report are a minor potion of our total community benefit efforts. They consist primarily of actively participating in and supporting the work of community groups to advance community awareness about health issues such as leading the Oral Health Community Task Force and serving on the NEW Community Clinic Board.
Part III, Line 4The hospital strongly believes that its charity care, and the related community benefit obtained from such care, is understated because of those patients who potentially qualify for charity care but do not wish to apply for it. In addition, some care is not classified as charity because of missing documentation on patient resources. Thus, the hospital's bad debt includes a portion that could be classified as charity care if application for such care was sought and/or completed. Currently, the hospital is implementing processes, procedures and systems to more effectively determine charity care that will reduce a patient's documentation requirements and ease the patient's emotional burden in applying for charity care. This will provide a more accurate reporting of charity care services provided by the hospital. The hospital computes the cost of bad debt by applying the ratio of patient care cost to charges to the total charges written off as bad debt expense. The patient care cost is determined by reducing the total annual operating expense by non-patient care expenses, Medicaid provider taxes and community benefit expense. The adjusted operating cost is then divided by the total gross patient charges to calculate the ratio of patient care cost to charges.
Part III, Line 8The hospital continually strives to provide excellent patient care in the most cost effective fashion. Nonetheless, the Medicare program, in many cases, does not provide payment that covers the full cost of the care provided. Since it is the mission of the hospital to respond to community need, hospital management continually advocates for improved Medicare payment so that the cost of quality care to those patients that are not able to afford it is not compromised and is fairly subsidized by all payers. While this shortfall in Medicare payments is not classified as community benefit by the IRS, we nonetheless believe it is an important contribution made by the hospital to the health and well being of the community. Our mission calls us to serve all patients with the highest possible quality and efficiency, even if we are not paid fully for doing so. The hospital computes the unpaid costs of providing care to Medicare patients by comparing the cost of the services to the reimbursement received from Medicare during the year. The cost of Medicare services is calculated by applying the ratio of patient care cost to charges to the annual Medicare charges. The patient care cost is determined by reducing the total annual operating expense by bad debt expenses, Medicaid provider taxes and community benefit expense. The difference between the reimbursement received and the calculated cost of the services is reported as the Medicare shortfall.The hospital Medicare shortfall at cost for FY2013 is $54,754,600.
Part III, Line 9bEvery effort is made prior to, during, and after provision of medical services to determine whether a patient is eligible for charity/community care and to assist the patient in completing the application and providing adequate documentation. If the patient qualifies for charity/community care for the full balance of their account, the entire amount is written off to charity/community care and hence no debt collection is pursued. If the patient qualifies for charity/community care for a portion of their account balance, that portion is written off to charity/community care, with the patient being responsible for the remainder of the balance. Additionally, reasonable effort will be made to obtain third-party or government payer reimbursement on behalf of the patient. If those efforts are not fruitful, an offer will be extended to the patient to make installment payments on their balance. Only at such point that the patient defaults on installment payments or refuses to cooperate with the hospital's efforts to be reimbursed will the account be sent to collections.
Part V, Section B, Line 3The Community Health Needs Assessment was truly a collaborative effort. In Wisconsin, public health departments conduct community health needs assessments every five years. The Brown County and City of DePere Public Health Departments collaborate on the one for Brown County, the county in which Green Bay is located. When a leader from St. Vincent approached the health departments about possible opportunities to collaborate, they not only willingly agreed to find ways to do so, they also agreed to modify their every-five-year process to meet the hospitals' every- three-year time frame and to begin to conduct the local needs assessment immediately. In the past, the Brown County/City of DePere health departments would themselves convene the community wide planning team and the subsequent action planning teams. Once contacted about opportunities to collaborate, they instead convened a community health needs assessment steering committee that included representatives of St. Vincent and its sister hospital St. Mary's, the local United Way, the other not for profit hospital in Green Bay, and representatives of the regional office of Wisconsin's Department of Health. This steering committee then worked to identify representatives who could broadly represent the community in actually conducting the needs assessment and setting priorities. These individuals were referred to as our community "partners". All steering committee members were assigned people to contact to invite them into the process as partners. This resulted in a community partner group that was broadly representative of the community: many community service agencies, educational institutions, government, health care, low income and minority population representatives, public health experts, and others (see partner listing at the end of this report). The steering committee also decided the format for each meeting, evaluated the effectiveness of each meeting after it occurred, developed the prioritization process, and evaluated the effectiveness of the entire process. Steering committee members all assumed responsibilities for tasks related to the process during the course of the needs assessment. The report entitled Healthy Wisconsin 2020 and the health focus areas contained within served as the basis for the health needs assessment. An epidemiologist from the Wisconsin Department of Health gathered data from secondary sources (such as public health statistics) on how Brown County and the City of DePere compares with the state-wide data. St. Vincent Hospital also provided additional data when available. Meetings of all the partners were held once a month for over six months. A profile of each health needs area was developed, and the "partners" reviewed the data at these meeting where the information was presented. They discussed key data points and assessed what is currently being done. Before the meeting concluded, they then rated the health focus area on 3 criteria-magnitude (number of people impacted), seriousness (level of impact of the problem), and feasibility (whether there are known interventions to address the problem). These ratings were combined, and based on this the health focus areas were narrowed to the top eight. At a final meeting of the partners group, a multi-vote approach was used to narrow the top eight to the top three. The top three needs were: o oral health o adequate and appropriate food and nutrition, and o alcohol and other drug abuse (AODA) Throughout this process, St. Vincent's leadership was actively engaged. The progress of the needs assessment was regularly reviewed by an internal community benefit committee. The findings of the needs assessment were also shared with our hospital's community advisory committee for their reaction and comment. The community advisory committee is a group of over 25 community members representing business, education, not for profit agencies, low income and minority populations, clergy, and others who serve as advisors to the hospital. The internal Community Benefit Committee and the Community Advisory Committee serve both St. Mary's and St. Vincent because the two hospitals provide coordinated services to the Green Bay area as part of the Hospital Sisters Health System Eastern Wisconsin Division. Brown Community Health Needs Assessment Partner Listing: - Aging & Disability Resource Center, Sunny Archambault - Aurora Health System, Julie Pomasl - Bay Area Community Council, Pat Finder-Stone - Bellin College, Kathie DeMuth - Bellin Health, Jody Wilmet - Bellin Health, Linda Roethle - Boys & Girls Club, John Benberg - Brown County Board , Mike Fleck - Brown County Board of Health (board member), Audrey Murphy - Brown County Community Treatment Center, Mary Johnson - Brown County Cooperative Extension, Judy Knudsen - Brown County Health Department, Judy Friederichs (Director, Brown County Health Department) - Brown County Human Services, Kevin Lunog - Brown County Planning, Chuck Lamine - Brown County United Way, Stephanie Foley - Center for Childhood Safety/ Safe Kids Greater Green Bay, Justine Lodl - City of De Pere Board of Health (board member), Pat Finder- Stone - City of De Pere Health Department, Mary Dorn, Health Director - De Pere Area Chamber of Commerce, Cheryl Detrick - Division of Public Health Northeast Regional Office, Rebecca Hovarter, Regional Public Health Nursing Consultant - Division of Public Health Northeast Regional Office, Lynn Hrabik, Epidemiologist - Family Services-Crisis Center, Tana Koss - Greater Green Bay Community Foundation, Martha Ahrendt - Greater Green Bay YMCA, Sandy Atkins - Green Bay Chamber of Commerce, Nan Nelson, CCE - Homeless Population Representative, Seth Moore - N.E.W. Community Clinic, Bonnie Kuhr - NWTC Health Science, Kay Tupala, Dean - Oneida Tribe of Indians, Michelle Myers - Parish Nurse, Katie Dykes - Brown County Sheriff Representation-Chief's group, Randy Schultz - Prevea Health, Dr. Ashok Rai - St. Mary's Hospital Medical Center, Heidi Selberg - St Vincent Hospital, Heidi Selberg - St Willebroad Catholic Parish, Maria Plascencia - School Representation-Superintendent's group, Barb Natelle - The Salvation Army, Rebecca Lesperance - United Hmong and Asian American Community Center, Staryoung Thao - UWGB-Environmental Sciences, Thomas Erdman - UW-Green Bay Nursing Program, Chris Vandenhouten - Women, Infant and Children (WIC), Bonnie Kuhr Part V, Section B, Line 4 Bellin Health was actively involved in the community health needs assessment.
Part V, Section B, Line 7The St. Vincents board of directors approved an implementation strategy based on the CHNA from the prior reporting year. Based on the CHNA, three priority needs for the community were identified in FY2013: oral health; alcohol and other drug abuse (AODA); and adequate and appropriate food and nutrition. Oral Health In partnership with sister hospital St. Marys, St. Vincent Hospital supported the NEW Dental Clinic on the campus of Northeast Wisconsin Technical College (NWTC) to expand its services to accommodate up to 6,000 patients. St. Vincent actively supported the efforts of the NEW Community Clinic to apply for FQHC (federally qualified health center) status allowing the clinic to provide dental services more easily and effectively than had been the case in the past; they were awarded this status at the end of June 2012. St. Vincent Hospitals support of NEW Clinics application included donations to the current clinic location that were cited as part of the required matching funds, providing grant writing expertise and providing access to data to support the application. Most importantly, St. Vincent Hospital provided funds to purchase the capital equipment needed to open a dental clinic for low income uninsured and Medicaid patients at NEW Community Clinics location at Northeast Wisconsin Technical College; this enabled them to open a six-chair operatory in spring 2013. The NEW Community Clinics FQHC status also enabled them to be reimbursed for Medicaid patients dental care. This new program provides a viable alternative other than the ED for Medicaid and uninsured patients. Alcohol and Other Drug Abuse (AODA) Work began to address the AODA needs by initiating discussions with local agencies on how medical clearance for alcohol intoxication is currently working. These discussions led to efforts to develop a telemedicine approach for medical clearance for patients needing psychiatric clearance; these collaborative discussions continue. Adequate and Appropriate Food and Nutrition St. Vincent Hospital did not address this identified need as the other health system that participated in the community health needs assessment took the lead on addressing this need. St. Vincent Hospital focused its efforts on oral health and AODA. Part V, Section B, Line 12h Yes, the Financial Assistance Policy contains a detailed description of the Purpose, Definitions and Guidelines for financial assistance.
Part V, Section B, Line 14GSt. Vincent Hospital posts its charity care policy and application on our website. In addition, charity care applications are available and prominently displayed in our waiting and registration areas. Our financial counselors are available to meet with patients on site before or at the time of service to assist them in identifying whether they are eligible for government aid or financial assistance, and to assist them in applying for programs for which they may be eligible. After patients receive service, our customer service representatives are also trained to assist them to apply for various government programs or for our charity care program. Our collectors are trained to provide this assistance as well. Last but not least, we have contracted with an outside firm to do active outreach with patients who may need additional assistance or advocacy to apply for benefits, appeal denials, or who need transportation to government agencies to apply for benefits. Yes, section I of the Financial Assistance Policy describes the Communication of the Financial Assistance Program to Patients in detail.
Part V, Section B, Line 20DThe hospital sets the rate for billing individuals without insurance covering emergency or other medically necessary care at the hospitals lowest commercial rate.
2, NEED ASSESSMENTAs indicated in Part V, Section B, St. Vincent Hospital conducted a Community Health Needs Assessment in our FY2012. Prior to completing the CHNA with our community partners, we employed a number of methods to assess health care needs: 1) we have a community advisory committee broadly representative of the community, which meets regularly to discuss hospital services and advise the hospital on how well we are meeting community needs. As terms expire, committee members assist in identifying new members. We include representatives from the neighboring communities we serve, as well as some potentially underserved groups such as Hmong and Native American leaders. 2) Hospital leadership meets with individual committee members each year to learn more about their opinions about community needs. 3) We examine the reasons that self-pay and medical assistance patients come to our ED for care. 4) Hospital leaders serve on local social service agency boards, such as NEW Community Clinic. 5) Our Hispanic health educator/cultural liaisons assist in identifying the needs of special subgroups of patients.
3, Patient education of eligibility for assistanceOur hospital posts our charity care policy and application on our website. In addition, charity care applications are available and prominently displayed in our waiting and registration areas. Our financial counselors are available to meet with patients on site before or at the time of service to assist them in identifying whether they are eligible for government aid or financial assistance, and to assist them in applying for programs for which they may be eligible. After patients receive service, our customer service representatives are also trained to assist them to apply for various government programs or for our charity care program. Our collectors are trained to provide this assistance as well. Last but not least, we have contracted with an outside firm to do active outreach with patients who may need additional assistance or advocacy to apply for benefits, appeal denials, or who need transportation to government agencies to apply for benefits.
4, COMMUNITY INFORMATIONBrown County, Wisconsin is a primarily urban county, one of 72 Wisconsin counties, and is located in the northeastern part of the state. Brown Countys population is predominantly Caucasian (85%), but there is a sizeable Hispanic population comprising about 7% of the population. The balance is made up almost equally of Asian, Native American and African Americans. There are approximately 250,000 residents, of which about 41,000 are covered by Medicaid/Badger Care Plus. About 11% of Brown County Residents live at or below the federal poverty level, (Source: WI DHS Public Health Profiles). According to the Wisconsin Department of Health Services, 6% of Brown Countys population is uninsured. Brown County contains a dental care HPSA (health professional shortage area) and the metro area is a MUA (medically underserved area), per maps on the Wisconsin DHS website. There are three not-for-profit general medical surgical hospitals and one for-profit general medical surgical hospital serving Brown County and the surrounding area. In addition, there is one not-for-profit psychiatric hospital and one county operated psychiatric hospital. Since most of the population resides in the Green Bay metro area, plans and services focus on this area.
5, PROMOTION OF COMMUNITY HEALTHSt. Vincent Hospital offers hope to our community in the tradition of the Hospital Sisters of St. Francis. As a healing ministry of the Catholic Church and an affiliate of the Hospital Sisters Health System (HSHS), St. Vincent is committed to delivering high quality, compassionate, and cost-effective health care services to all. The hospital was founded over 125 years ago to bring a healing presence and improve the health of our community, especially for people who are sick, poor, and disadvantaged. Because of the hospital's purpose and tradition, it is organized to promote the health of Brown County, Wisconsin, and surrounding areas. The hospital is governed by a Board of Directors, the majority of whom who reside in the organization's primary service area and who are neither employees nor contractors of the hospital (nor family members thereof). The Board ensures that St. Vincent is responding to community need. During FY2012, for example, the Board reviewed the Community Health Needs Assessment and approved an implementation strategy for addressing selected needs. In addition our hospital Advisory Council, Friends of St. Vincent Foundation, Cancer Research Institute Board, and the St. Vincent Auxiliary, whose members assist in many areas of the hospital, provide the hospital with additional connections to and insights into the larger community and its health care needs. Also consistent with its exempt purpose, St. Vincent has an open medical staff with privileges available to all qualified physicians in the area. In addition, the hospital operates an emergency department that is open 24 hours to all persons regardless of their ability to pay. As a not-for-profit hospital, St. Vincent reinvests surplus funds into the mission of the organization and health of the community rather than distributing them as profits to shareholders or individuals. Funds not committed to ongoing operations are generally used to upgrade facilities, secure new technologies, improve patient care, and support initiatives designed to promote health and ensure access for all. For example, St. Vincent is currently working with its parent organization, Hospital Sisters Health System, to continuously enhance quality and improve coordination of care both inside the hospital and with a growing number of physician partners. Supported by investments in information technology, this "care integration" strategy is designed to better coordinate care, improve health outcomes, create new efficiencies, and help ensure that patients (especially those with chronic conditions) get well and stay well. For example, the Epic electronic medical record system enables providers to connect with their patients' medical records from wherever they are and allows emergency physicians access to patient medical records from any facility that has Epic. This reduces duplicate testing, puts critical health information at providers' fingertips, helps better manage chronic conditions, and improves patient safety. A Heart Failure Clinic has been established to assist heart failure patients to maintain good health and stay out of the hospital by incorporating diet, exercise and other wellness information into the long-term care plan. This growing program has shown success in reducing readmissions, something that is also especially helpful for those with limited financial resources. St. Vincent Hospital devotes significant resources to provide access for patients who cannot afford care, along with other community benefits. In Fiscal Year 2013, St. Vincent provided over $39 million in community benefit services, including charity care at cost, unpaid costs of Medicaid and other public programs, and a range of diverse programs designed to enhance access and improve community health. Additionally, during this period, St. Vincent provided over $54 million (at cost) in excess of Medicare payment for health care services. Responding to Community Need An example of our community benefit initiatives is the support we also provide to patients of the NEW Community Clinic. St. Vincent covers the cost of a school nurse employed by the NEW Community Clinic to serve high risk children. We also supply the clinic with free and discounted laboratory and radiology services. More than 70% of patients say the clinic's care prevented a trip to the Emergency Department. This year, St. Vincent Hospital, along with sister hospital St. Mary's Hospital Medical Center, provided funds to purchase the equipment necessary to operate a 6-chair dental operatory at the NEW Clinic's Northeast Wisconsin Technical College site. This donation will provide the facilities for as many as 6,000 additional patient visits annually for basic restorative and hygiene care for uninsured and Medicaid patients. St. Vincent Hospital has developed the Sexual Assault Nurse Examiner program to provide care and assistance for anyone who has been sexually assaulted; 12 nurses comprise the Sexual Assault Nurse Examiner (SANE) Program at St. Vincent Hospital. SANE operates in a specially designed room in the Emergency Center, one that is available around the clock to the victims of sexual assault, male or female, infant to elderly. The SANE staff greets them all with gentle words and compassionate medical care. The program, which began in 1992, is the regional site for such care, one where all the hospitals in Green Bay and the surrounding communities send sexual assault victims because only our SANE nurses have been properly trained to conduct the detailed medical examination, collect evidence, repair injury and later provide courtroom testimony that will be a key factor in getting convictions of the perpetrators of these crimes. Special tools, such as a picture book, have been developed to assist with examination and evidence gathering with some of our most tender victims-children. SANE reached over 170 patients this last year at a most vulnerable and devastating time of their lives and truly demonstrates the compassion and mission that is St. Vincent Hospital. SANE works closely with the police force and investigators in the area. In Fiscal Year 2013, St. Vincent spent over $706,000 in services by providing onsite training and education of nursing and allied health professionals within its facilities. We also provided training/education programs at schools such as the University of Wisconsin-Green Bay, Bellin College of Nursing, Northeast Wisconsin Technical College and others around the state. St. Vincent Hospital provided $659,538 in family support services. Professionals at the hospital assisted in excess of 5000 people to apply for the appropriate assistance, such as Social Security or Medical Assistance when they came to the hospital in a time of medical need. The cost included the salary of a cancer care coordinator as well as guidance, referrals, and aid in enrolling in public assistance and HRS Erase, a debt reduction program. When patients can't get to St. Vincent Hospital, or get to their doctor appointments from the hospital, St. Vincent finds a way to help. In the past year, we paid for over $2,500 in uncompensated ambulance and other vehicle rides for patients, either to or from the hospital or to help them get to their doctor appointments elsewhere. The following is a listing of some of the other services St. Vincent Hospital provided in FY2013: - Cash donations, used equipment, furnishings and printing services to local churches, organizations and schools; - Free support programs including cancer survivor and grief care; - Eagle III - transportation for critically ill and injured patients; provided over 4 FTE's and more than $88,000 in financial assistance to Eagle III for patients they served who were unable to pay their bill; - EnCare program - Emergency Room nurses give presentations at area schools and organizations and provide training on the dangers of drinking and driving; - "Every 15 Minutes" program, an in-depth program about the dangers and consequences of drinking and driving provided to teens around homecoming and prom times. - Hospital colleagues spoke at health fairs, schools, technical colleges, and a wide variety of organizations as well as providing logo items for prizes for the various functions; - Training for county health nurses, local paramedics and home health agencies; - Student intern programs with local colleges and universities, and a residency program; - Hospital colleagues serve on local health organization boards and donate their time and expertise during and after business hours; - Free translator service to those patients who do not speak English; - Training to regional staff in how to prepare patients for transport and other topics. - Laundry service for the local Altrusa House free of charge. - St. Vincent Hospital along with St. Mary's Hospital and Bellin Health supports Unity Hospice, a provider of appropriate and compassionate care for the terminally ill. - St. Vincent, along with St. Mary's H
6, AFFILIATED HEALTH CARE SYSTEMSt. Vincent Hospital in Green Bay, Wisconsin is an affiliate of Hospital Sisters Health System (HSHS), a health care ministry that includes 13 hospitals, scores of community-based health centers and clinics, and hundreds of physician partners across Illinois and Wisconsin. The Mission of HSHS is to reveal and embody Christs healing love for all people through our high quality Franciscan health care ministry. We live our Mission by providing holistic healing to all who seek our care, as well as through Community Benefit. Working collaboratively with others in the communities we serve, our Community Benefit initiatives are strategically and successfully expanding access to care, improving the health status of residents, and furthering medical education and knowledge. In FY2013, our 13 hospitals responded to needs identified in each of their Community Health Needs Assessments (CHNAs) completed in FY2012. The information gathered from these assessments was used to develop new and enhance existing Community Benefit programs and services that best addressed community needs. Included among the many priority needs identified in our CHNAs were chronic disease prevention and management, obesity, adequate food and nutrition, mental health, and access to health care services. HSHS hospitals are proactively addressing these and other needs through patient, provider and community education, preventative screenings, self-management classes, and new or enhanced clinical services. Across HSHS, we collectively provided $185.6 million in Community Benefit (or 10.2% of total hospital expenses) in FY2013. Included in this amount was $45.9 million provided for Financial Assistance (i.e. Charity Care) and $104.2 million for unreimbursed care provided under the Medicaid program. In addition, HSHS hospitals committed significant resources to care for Medicare patients. The cost of providing services to primarily elderly beneficiaries of the Medicare program - in excess of governmental and managed care contract payments - was $152.3 million. HSHS hospitals also recorded $107.1 million in uncollectible accounts. In addition to the dollars invested in our Community Benefit programs, HSHS also continues to reinvest any surplus revenue from operations and investments into new medical technology, facility infrastructure and health care services in our communities. By doing so, we ensure we are able to meet the ongoing demand for high quality, efficient and easily accessible health care. Recognizing that the health care delivery model in the United States is evolving, HSHS remains focused on implementing our Care Integration strategy. Care Integration coordinates the delivery of care around the needs of each patient. During FY2013, we made significant progresswith this strategy as we further implemented interoperable health information technologies, expanded the number of Medical Homes, and strengthened our alignment with physicians. Greater access to care As a Franciscan health care ministry, HSHS is deeply committed to serving those who are most in need. We not only provide care to every patient who walks through our doors, but also reach out beyond the walls of our hospitals and clinics to care for those in our communities. Our efforts to ensure residents in the communities we serve receive the right care at the right time in the right setting often involve partnering with others to achieve this goal. Across our two-state System, there are numerous examples of HSHS collaborating with other organizations to enhance access to care for those in need. From 2006 to 2009, the United States saw a 16% increase in individuals seeking dental care at hospital emergency rooms. With the support of St. Marys Hospital Medical Center and St. Vincent Hospital in Green Bay, Wisconsin, the NEW Dental Clinic on the campus of Northeast Wisconsin Technical College expanded in FY2013 and was able to accommodate up to 6,000 visits. The clinic provides dental services to low-income and uninsured persons including the homeless in Brown County. St. Francis Hospital in Litchfield, Illinois partnered with Lewis & Clark Community College to bring their mobile health unit to the Litchfield area; the unit provides dental exams and screenings, x-rays and dental hygiene to those in need. In western Wisconsin, St. Josephs Hospital in Chippewa Falls works closely with the Chippewa Health Improvement Partnership (CHIP) to support the Open Door Clinic. The free medical clinic provides health care for those without insurance coverage. This past year, the clinic received a total of 2,672 patient visits, an 11% increase from the prior year. With more than 166 individuals volunteering, the clinic provided more than 6,751 hours (including 753 provider hours and 675 nursing hours) of service to individuals. The Open Door Clinic is an example of HSHS providing leadership and support to a community-based program designed to meet the needs of those less fortunate. In southeast Illinois, area residents can get help filling a prescription through the long-term collaboration between St. Anthonys Memorial Hospital in Effingham and Catholic Charities. Last year, St. Anthonys helped underwrite the cost of prescription medications for more than 280 residents. In southwest Illinois, St. Joseph's Hospital in Highland enhanced their offerings to their senior population based on their CHNA. Senior Renewal is an outpatient counseling program for senior adults who may be facing emotional and physical problems unique to the aging process such as feelings of loneliness, isolation and anxiety. Clients receive an intensive level of treatment without inpatient hospitalization through counseling strategies and education. In addition, in collaboration with the Illinois Department of Insurance, St. Josephs Hospital participates in the Senior Health Insurance Program (SHIP), a free health insurance counseling service for Medicare beneficiaries and their caregivers. In addition to programs such as these, HSHS makes sure that those who need financial assistance for care receive it. Our Financial Assistance (i.e. Charity Care) program covers 100% of hospital charges for individuals and families who earn less than 200% of the federal poverty level. HSHS Financial Assistance programs have a sliding scale, in some instances providing up to a 60% discount on charges for those earning up to 600% of the federal poverty level. Counselors are available in our hospitals to explain our financial assistance policies to patients, provide them with assistance in filling out a simple application form, or help them enroll in publicly funded health care programs. Better community health As part of our Mission to embody Christs healing love, we understand that we have a responsibility to improve the overall quality of life in our communities by supporting initiatives that promote health and wellness. We recognize we are most successful when we work together with a wide array of public and private organizations that share our commitment to improving lives. By doing so, we maximize our efforts and reduce the duplication of services. HSHS hospitals also understand we need to listen closely to the residents of the communities we serve to ensure the health care needs of all are being met. To that end, each of our 13 hospitals completed Community Health Needs Assessments (CHNA) during FY2012. The information gathered from these assessments is being used to help us develop new, and enhance existing, programs and services that best address the needs of the community. Among the many priority needs identified from the CHNAs include metabolic and cardiovascular disease management, adequate food and nutrition, and mental health. HSHS hospitals are addressing these and other needs by proactively offering educational opportunities, preventative screenings, and new or enhanced clinical services. In partnership with the Sangamon County Health Department (SCDH) and local farmers, St. Johns Hospital in Springfield, Illinois took a lead role in bringing a Farmers Market to the east side of Springfield. The East Side Farmers Market addresses three community needs: childhood obesity, childhood poverty (26% of children in Sangamon County live in poverty vs. 18% in the state) and providing fresh produce to persons living in a known food desert. WIC Cooking Classes are also offered in tandem with the East Side Farmers Market to teach participants how to prepare fresh produce. The Farmers Market and cooking classes are hosted at the SCDH. St. Marys Hospital in Streator, Illinois teamed up with the Streator YMCA to offer a 12 week weight loss program Healthy You to motivate 282 participants (nearly double the participants from last year) to lose weight and maintain a healthy lifestyle. The program included aerobics classes, cooking classes, and a maintenance program to encourage participants to weigh in monthly. A total of 191 participants completed the program, losing
STATE FILING OF COMMUNITY BENEFIT REPORTWI,990 SCHEDULE H, PART VI

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (15 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
TIMOTHY JAHN MD
CHIEF MEDICAL OFFICER1755380000000105660186104000
FRANK MIKELL MD
DIRECTOR06027580110977012819501129630200700974963059328
PAULA HAFEMAN
CNO2210840000000171390238223000
THERESE PANDL
President05652880779680206300100815028586079328700
TANYA TOWNSEND
CIO1481440000000121580160302000
ANN M CARR
TREASURER019345402944004925201211700176860411002018215
THOMAS R BAYER
SR VP - REGIONAL DEVELOPMENT2215410000000259910247532000
KELLY GIGOT
VP FINANCE2060130000000264740232487000
CHRISTINE JENSEMA
CHIEF PEOPLE OFFICER1513600000000265610177921000
GREGORY SIMIA
DIVISION CFO3398120000000250430364855000
CURTIS WATSON
ANESTHESIA MANAGER2867310000000227920309523000
BRADLEY LYONS
CRNA1935180000000263300219848000
TIFFANY SHAVE
CRNA2023210000000225930224914000
SARAH LULLOFF MD
PHYSICIAN2101280000000229740233102000
CHERYL BURKEL-EMMERS
CRNA1909380000000266370217575000

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
SCHEDULE J, PART I, LINE 1ASOCIAL DUES WERE PROVIDED TO THERESE PANDL. THIS BENEFIT WAS TREATED AS TAXABLE COMPENSATION TO THE RECIPIENT. ANN M. CARR SCHEDULE J, PART I, LINE 4B ANN M. CARR PARTICIPATED IN A SERP PLAN DURING THE YEAR IN THE AMOUNT OF $42,817.
THERESE PANDLSCHEDULE J, PART I, LINE 4B THERESE PANDL PARTICPIATED IN A SERP DURING THE YEAR IN THE AMOUNT OF $64,900.
FRANK MIKELLFRANK MIKELL PARTICIPATED IN A SERP DURING THE YEAR IN THE AMOUNT OF $133,006.SCHEDULE J, PART I, LINE 4B

Schedule L IRS990ScheduleL

Loan Table LoanTable (2 entries)

Relationship With OrganizationRelationshipWithOrganizationPurpose Of LoanPurposeOfLoanLoan From OrganizationLoanFromOrganizationOriginal PrincipalOriginalPrincipalAmountBalance DueBalanceDueDefaultDefaultApproved By BoardApprovedByBoardWritten AgreementWrittenAgreement
THERESE PANDL
DIR/OFFICERMortgage extX$250,000251973falsetruetrue
THERESE PANDL
DIR/OFFICERStock purchX$4,1254125falsetruetrue
FieldValueIRS element (for citing)
Total Balance Due256098TotalBalanceDue

Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransaction
WI UPPER PENINSULA ONCOLOGY
OFFICER2541821LEASED FACILITIES/EMPLOYEES
MANAGEMENT SERVICES INC
PREVEA Clinics
Officer1180411LEASED FACILITiES/EQUIP

Form990 Schedule L Part V Form990ScheduleLPartV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
LOANS TO/FROM INTERESTED PERSONSSchedule L, Part IIALL TRANSACTIONS WITH INTERESTED PERSONS ARE COMPLIANT WITH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. ANY TRANSACTIONS REQUIRING BOARD APPROVAL ARE REVIEWED BY AN INDEPENDENT BOARD PRIOR TO OCCURRING.
BUSINESS TRANSACTIONS WITH INTERESTED PERSONSschedule l, part ivKelly Gigot and Tom Bayer, both officers of SVGB, are board members of WUPOMS. Therese Pandl, President of SVGB, is a board member of Prevea Clinic. ALL TRANSACTIONS WITH INTERESTED PERSONS ARE COMPLIANT WITH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. ANY TRANSACTIONS REQUIRING BOARD APPROVAL ARE REVIEWED BY AN INDEPENDENT BOARD PRIOR TO OCCURRING.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
PROGRAM SERVICE ACCOMPLISHMENTSFORM 990, PART III, LINE 4ASURGERY St. Vincent Hospital Surgical Services Surgical Services is comprised of Pre-Operative Services (Preadmission Testing/AM Admit/Short Stay), 16 functional OR Suites and 2 Open Heart OR Suites, Central Processing/Distribution, Anesthesia, and Recovery. The 24/7 operations are conducted on 4th and 5th floor with the direct report of 167 employees. In FY2013, 9,120 surgical procedures were performed and patients cared for both on an inpatient and outpatient basis. The surgical procedures performed are General, Orthopedic, Neurosurgery, Urology, Gynecology, Ophthalmology, Oral Maxillofacial, Trauma, Cardiac surgery, and Organ procurement. Surgical Services collaborates and provides services in the Heart Center, Cancer Center, Women's and Children, Orthopedic Center, Trauma Center. Anesthesia and Central Processing/Distribution also provides Hospital wide services to Inpatient Nursing, Labor and Delivery and the Emergency Department. The Anesthesia department is comprised of 13 employed Nurse Anesthetists and 14 contracted Anesthesiologists. FORM 990, PART III, LINE 4B RADIOLOGY St. Vincent Hospital Imaging Services The Imaging services department at St. Vincent Hospital provides Inpatient, Outpatient, Emergency and Trauma care. Overall, the department performs more 100,000 exams and procedures annually. Patients have access to the latest technology in Computed Tomography, MRI, Nuclear Medicine, and Ultrasound. Five Interventional Radiologists provide minimally invasive procedures using image guidance. Through the departments fixed site PET/CT, patients have greater access to a technology which provides unique images for early diagnosis. The staff consists of Board Certified radiologists as well as licensed and certified technologists, nurses, and sonographers. The modalities utilize state-of-the-art equipment to afford the radiologists optimal images for interpretation. The department and hospital are accredited by the Joint Commission. Additionally, many of the modalities maintain separate accreditation to ensure quality in the work performed. FORM 990, PART III, LINE 4C HEART & VASCULAR CENTER St. Vincent Heart and Vascular Center The Cath Lab offers a complete array of catheterization laboratory procedures and noninvasive cardiovascular diagnostic procedures doing 1,773 cardiac catheterizations in FY2013. Just steps away, the state-of-the-art Cardiovascular operating center (CVOR) is available for cutting-edge open heart procedures by our highly-skilled cardiothoracic surgeons where 229 open heart surgeries were performed this year. In the same complex, CVICU suites are outfitted with up-to-the-minute monitoring devices that allow staff and physicians to keep careful watch over their patients while delivering hands-on care immediately after procedures. For those patients who need follow-up, a Cardio-Pulmonary Rehabilitation Program is offered. FORM 990, PART III, LINE 4d - Other Program Services St Vincent Hospital provides a wide array of services. Besides the programs listed above, we have a Regional Cancer Center that includes Peds Hematology/Oncology, Gyn Oncology, a Cancer Research Institute and Radiation Oncology on site as well as in two satellite offices in Marinette, WI and Sturgeon Bay, WI. We also have Orthopedic Services that includes Joint Care, Physical Therapy & Occupational Therapy. Our Women's Services Department provides Labor & Delivery Services, OB Clinic, Nurse Educators and Lactation Specialist. We provide Neonatal, Pediatric and General ICU as well as Intermediate Care Units. We have a 24 hour Emergency Department/Trauma Center with SANE nurses available. Our Pharmacy is also open 24 hours to meet patient needs. Our Pulmonary Functions Area includes a Bronchial Lab, Respiratory Care and a Sleep Center. We provide Dialysis for both inpatient and Outpatients. Our Home Health Care Department provides Care for patients that no longer require hospitalization but who continue care in some way. We provide a Wound Care Center that includes Hyperbaric treatments. We also have programs to increase patient care and satisfaction such as Case Management, Palliative Care, Infection Prevention, Spiritual Services, Continuous Process Improvement and Risk Management.
RIGHTS OF MEMBERS TO ELECT GOVERNING BODYFORM 990 PART VI, LINES 6 & 7ATHE SENIOR GOVERNING BODY OF ST. VINCENT HOSPITAL (THE CORPORATION) IS THE MEMBER OF THE CORPORATION, WHICH IS HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. PURSUANT TO SECTION 2.3 OF THE CORPORATION'S BYLAWS, HSSI HAS THE RIGHT TO APPOINT AND REMOVE THE CORPORATION'S BOARD OF DIRECTORS, CHAIRPERSON OF THE BOARD, AND PRESIDENT.
MEMBER RESERVED POWERSFORM 990 PART VI, LINE 7BRESPONSIBILITY FOR THE POLICY AND OPERATIONS OF ST. VINCENT HOSPITAL (THE "CORPORATION") IS VESTED IN ITS BOARD OF DIRECTORS, EXCEPT WITH RESPECT TO SPECIFIC POWERS RESERVED IN THE CORPORATION'S BYLAWS TO THE CORPORATION'S MEMBER, HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE MEMBER OF HSSI IS HOSPITAL SISTERS HEALTH SYSTEM ("HSHS"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE MEMBERS OF HSHS ARE THE INDIVIDUAL SISTERS WHO, FROM TIME TO TIME, ARE THE DULY ELECTED PROVINCIAL SUPERIOR AND PROVINCIAL COUNCILORS, RESPECTIVELY, OF THE AMERICAN PROVINCE OF THE HOSPITAL SISTERS OF ST. FRANCIS ("AMERICAN PROVINCE"). THE AMERICAN PROVINCE IS THE UNITED STATES ORGANIZATION OF THE CONGREGATION OF THE HOSPITAL SISTERS OF THE THIRD ORDER REGULAR OF ST. FRANCIS, A RELIGIOUS INSTITUTE OF THE ROMAN CATHOLIC CHURCH. THE GOVERNANCE AND OPERATIONS OF THE CORPORATION ARE SUBJECT TO HSSI'S RIGHT TO EXERCISE THESE RESERVED POWERS WITH RESPECT TO THE CORPORATION AND ORGANIZATIONS OF WHICH THE CORPORATION IS EITHER, DIRECTLY OR INDIRECTLY, A CONTROLLING MEMBER OR A CONTROLLING SHAREHOLDER ("AFFILIATES"). HSSI'S RIGHT TO EXERCISE CERTAIN OF THESE RESERVED POWERS IS, IN TURN, SUBJECT TO THE APPROVAL OF HSHS AND HSHS' MEMBERS. THE RESERVED POWERS INCLUDE ALL RIGHTS GRANTED TO HSSI BY LAW AND THE RIGHT TO: (A) ADOPT, APPROVE AMENDMENTS TO, OR AMEND ANY STATEMENT OF PHILOSOPHY, MISSION, MISSION INTEGRATION OR VALUES, OR ANY NAME, LOGO, OR MARK OF THE CORPORATION OR OF ANY AFFILIATE; (B) ADOPT, APPROVE AMENDMENTS TO, OR AMEND THE ARTICLES OF INCORPORATION OF THE CORPORATION OR OF ANY AFFILIATE; (C) ADOPT, APPROVE AMENDMENTS TO, OR AMEND THE BYLAWS OF THE CORPORATION OR OF ANY AFFILIATE; (D) APPOINT AND REMOVE THE BOARD OF DIRECTORS, ANY ONE OR MORE OF THE DIRECTORS OF THE CORPORATION OR OF ANY AFFILIATE, AND THE CHAIRPERSON AND PRESIDENT OF THE CORPORATION OR OF ANY AFFILIATE; (E) APPROVE THE RECOMMENDATION OF THE BOARD OF DIRECTORS TO APPOINT OR REMOVE THE BOARD OF DIRECTORS, ANY ONE OR MORE DIRECTORS OF THE CORPORATION OR OF ANY AFFILIATE, OR THE CHAIRPERSON AND PRESIDENT OF THE CORPORATION OR OF ANY AFFILIATE. (F) WITH RESPECT TO THE CORPORATION OR ANY AFFILIATE, APPROVE THE PURCHASE, SALE, ALIENATION, EXCHANGE, LEASE, OR ENCUMBRANCE OF ANY REAL PROPERTY OF THE CORPORATION OR OF ANY AFFILIATE, WHICH PROPERTY HAS A VALUE IN EXCESS OF LIMITS SET FROM TIME TO TIME BY HSSI; (G) APPROVE THE OPERATING AND CAPITAL BUDGETS OF THE CORPORATION OR OF ANY AFFILIATE, AND ANY DEVIATIONS BY THE CORPORATION OR OF ANY AFFILIATE FROM SUCH BUDGETS IN AN AMOUNT OR PERCENTAGE SPECIFIED BY HSSI FROM TIME TO TIME; (H) APPROVE THE STRATEGIC PLAN AND GOALS OF THE CORPORATION OR OF ANY AFFILIATE; (I) APPROVE THE SALE OF SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION OR OF ANY AFFILIATE; (J) APPROVE THE MERGER OR DISSOLUTION OF THE CORPORATION OR OF ANY AFFILIATE; (K) ADOPT OR AMEND THE PLAN FOR MINISTRY EDUCATION AND GOVERNANCE FOR THE CORPORATION AND ITS AFFILIATES; (L) APPROVE THE CORPORATION'S MISSION ACCOUNTABILITY REPORTS AND THOSE OF ANY AFFILIATE; (M) APPROVE THE FINANCIAL POLICIES AND PROCEDURES OF THE CORPORATION OR OF ANY AFFILIATE, AND APPROVE ANY DEVIATIONS FROM SUCH POLICIES AND PROCEDURES BY THE CORPORATION OR ANY AFFILIATE; AND (N) ADOPT POLICIES TO IMPLEMENT THE RESERVED POWERS OF HSSI.
FORM 990 REVIEW PROCESSFORM 990 PART VI, LINE 11bTHE HOSPITAL EMPLOYS KPMG TO ASSIST IN THE OVERALL PREPARATION, REVIEW AND ELECTRONIC SUBMISSION OF ITS FORM 990. KPMG PROVIDES GUIDANCE IN IDENTIFYING CRITICAL ERRORS IN THE RETURN SUBMISSION, AND FEEDBACK ON QUANTITATIVE AND QUALITATIVE RESPONSES. ADDITIONALLY, THE HOSPITAL CFO PERFORMS A THOROUGH REVIEW OF THE RETURN, AND REVIEWS IT WITH THE HOSPITAL CEO AND/OR SENIOR LEADERS BEFORE PRESENTING IT IN ITS ENTIRETY TO THE HOSPITAL BOARD FOR QUESTIONING AND REVIEW PRIOR TO THE RETURN'S SIGNING AND SUBMISSION TO THE IRS.
CONFLICT OF INTEREST POLICYFORM 990 PART VI, LINE 12CTHE ORGANIZATION IS SUBJECT TO THE CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY ("POLICY") OF HOSPITAL SISTERS HEALTH SYSTEM, AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. A REVISED CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY HAVE BEEN IMPLEMENTED SINCE JANUARY 2009 TO MANAGE CONFLICTS OF INTEREST USING A SYSTEM-WIDE PROTOCOL FOR DISCLOSURE STATEMENTS. IN ACCORDANCE WITH THE ORGANIZATON'S CONFLICT OF INTEREST POLICY, ALL COVERED PERSONS HAVE A DUTY TO COMPLY WITH THE CONFLICT OF INTEREST POLICY FOR ANY CONTRACT, TRANSACTION, RELATIONSHIP, OR ACTIVITY CONTEMPLATED, ENTERED INTO, OR CONDUCTED AT HSHS OR ITS AFFILIATES. THE POLICY DEFINES COVERED PERSONS AS BOARD MEMBERS, BOARD COMMITTEE MEMBERS, OFFICERS, BOARD DESIGNEES, SENIOR MANAGEMENT, MEMBERS OF ANY COMMITTEE THAT OVERSEES THE APPROVAL OF PHARMACEUTICALS AND MEDICAL DEVICES, AND ANY OTHER INDIVIDUAL WHO HOLDS A POSITION OF TRUST. ON AN ANNUAL BASIS, HSHS DISCLOSES A COPY OF THE CONFLICT OF INTEREST POLICY (AND ALL CORRESPONDING PROCEDURES, GUIDELINES, FORMS, AND TOOLS) TO ALL COVERED PERSONS AND ADVISES ALL COVERED PERSONS IN WRITING OF ANY SUBSTANTIVE CHANGES TO THIS POLICY AND SUCH RELATED MATERIALS. COVERED PERSONS ARE REQUIRED TO REVIEW AND COMPLETE THE CORRESPONDING CONFLICT OF INTEREST STATEMENT. THE SYSTEM OFFICE VICE PRESIDENT - SYSTEM RESPONSIBILITY, VICE PRESIDENT - RISK & COMPLIANCE, OR MEMBERS OF THE AUDIT AND INTEGRITY COMMITTEE ("COMMITTEE") ARE AVAILABLE TO ANSWER ANY QUESTIONS A COVERED PERSON MAY HAVE. IN ADDITION, IF, AT ANY TIME AFTER SUBMITTING AN ANNUAL CONFLICT OF INTEREST STATEMENT, A COVERED PERSON BECOMES AWARE OF AN INTEREST THAT HE OR SHE WOULD HAVE HAD TO DISCLOSE AT THE ANNUAL INTERVAL, THE COVERED PERSON IS REQUIRED PROMPTLY TO DISCLOSE THE INTEREST TO THE COMMITTEE USING THE HSHS CONFLICT OF INTEREST DISCLOSURE STATEMENT. COMPLETED CONFLICT OF INTEREST STATEMENTS ARE SUBMITTED TO THE COMMITTEE, WHICH IS RESPONSIBLE FOR IDENTIFYING, ASSESSING, AND MANAGING CONFLICTS OF INTEREST THAT ARISE IN THE COURSE OF CONDUCTING THE AFFAIRS OF HSHS AND ITS AFFILIATES. IF THE COMMITTEE DETERMINES THAT A CONFLICT OF INTEREST EXISTS, THE CONFLICT OF INTEREST POLICY REQUIRES HSHS NOT TO ENGAGE IN, OR ENTER INTO, A PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY UNLESS THE COMMITTEE OR, WHERE NECESSARY, THE BOARD OF DIRECTORS (ACTING THROUGH ITS DISINTERESTED MEMBERS), HAS INVESTIGATED ALTERNATIVES TO THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY AND, IN THE ABSENCE OF ALTERNATIVES THAT ARE IN THE BEST INTERESTS OF HSHS, HAS DETERMINED: 1. THAT, REGARDLESS OF WHETHER THE COVERED PERSON PARTICIPATES IN THE IMPLEMENTATION OF THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY; 2. THE CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY IS IN THE BEST INTERESTS OF HSHS; 3. THE CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY IS FAIR AND REASONABLE FROM THE PERSPECTIVE OF HSHS; AND 4. HSHS CANNOT OBTAIN A MORE ADVANTAGEOUS CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES. IN DETERMINING WHETHER A CONTRACT, TRANSACTION OR ARRANGEMENT IS FAIR AND REASONABLE TO HSHS, THE COMMITTEE SHALL CONSIDER, WHERE APPLICABLE: 1. APPRAISALS OR OTHER INDEPENDENT VALUATIONS OF THE FAIR MARKET VALUE OF THE CONTRACT, TRANSACTION, OR ARRANGEMENT; 2. INFORMATION REGARDING COMPARABLE CONTRACTS, TRANSACTIONS, OR ARRANGEMENTS BETWEEN UNRELATED PARTIES; 3. OFFERS FROM COMPARABLE COMPETING ENTITIES; AND/OR 4. STUDIES OF COMPARABLE COMPENSATION ARRANGEMENTS. IN ANY CASE IN WHICH THE COMMITTEE FINDS, AFTER TAKING THE STEPS DESCRIBED ABOVE, THAT HSHS SHOULD PARTICIPATE IN A PROPOSED TRANSACTION OR ARRANGEMENT DESPITE THE EXISTENCE OF A CONFLICT OF INTEREST, THE COMMITTEE SHALL DEVELOP, IMPLEMENT, MONITOR, AND ENFORCE COMPLIANCE WITH, A CONFLICT MANAGEMENT PLAN FOR MANAGING THE CONFLICT OF INTEREST AS IT CONSIDERS NECESSARY FOR SUCH FINDINGS TO REMAIN VALID THROUGHOUT THE LIFE OF THE CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY. ALL CONFLICT MANAGEMENT PLANS SHALL: 1. STATE THAT THE COMMITTEE WILL OVERSEE, MONITOR, AND ENFORCE COMPLIANCE WITH THE PLAN THROUGHOUT THE COURSE OF THE STUDY AND SPECIFY MEANS FOR DOING SO, INCLUDING, WITHOUT LIMITATION, THAT THE APPROPRIATE INDIVIDUALS MUST PROVIDE THE COMMITTEE WITH WRITTEN REPORTS PERTAINING TO COMPLIANCE WITH THE CONFLICT MANAGEMENT PLAN, THAT THE COMMITTEE SHALL HAVE THE RIGHT TO AUDIT THE STUDY FOR SUCH COMPLIANCE AND THE RIGHT TO IMPOSE SANCTIONS FOR NON-COMPLIANCE; 2. STATE THAT THE PLAN MUST BE SHARED WITH COVERED PERSON WHOSE INTERESTS IT WAS DEVELOPED TO MANAGE; 3. STATE THAT THE PLAN MUST BE SHARED WITH, AND PERIODIC REPORTS ON COMPLIANCE WITH THE PLAN MUST BE PROVIDED TO, THE BOARD, SENIOR MANAGEMENT, AND/OR GOVERNMENT AGENCIES; AND 4. PROVIDE FOR SUCH OTHER MANAGEMENT STEPS AND MECHANISMS THE COMMITTEE CONSIDERS NECESSARY AND APPROPRIATE. IN ADDITION TO THE COMMITTEE, THE SYSTEM OFFICE VICE PRESIDENTS OF SYSTEM RESPONSIBILITY AND RISK & COMPLIANCE MAY RETAIN SUCH INDEPENDENT ADVISORS OR EXPERTS AS DEEMED NECESSARY TO ASSIST IN MAKING ITS DETERMINATIONS AND DECISIONS. IF THE COMMITTEE DETERMINES THAT THE CONTEMPLATED TRANSACTION, RELATIONSHIP ARRANGEMENT, OR ACTIVITY CANNOT PROCEED DUE TO A CONFLICT OF INTEREST, THE COMMITTEE SHALL INFORM THE APPLICABLE COVERED PERSON OR DECISION-MAKING BODY OF SUCH DETERMINATION WITHIN ONE WEEK OF THE COMMITTEE MEETING AT WHICH THE CONTEMPLATED TRANSACTION WAS DISCUSSED. THE COMMITTEE SHALL DOCUMENT ITS REJECTION OF THE CONTEMPLATED TRANSACTION IN THE COMMITTEE'S MEETING MINUTES.
WHISTLEBLOWER POLICYFORM 990 PART VI, LINE 13PROVISIONS WITHIN THE CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY PROVIDE PROTECTIONS FOR WHISTLEBLOWER TYPE ACTIVITIES.
COMPENSATION PROCESSFORM 990 PART VI, LINE 15THE COMPENSATION COMMITTEE (COMMITTEE) IS COMPRISED OF INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS. THE COMMITTEE DEVELOPS A COMPENSATION PHILOSOPHY FOR THE SYSTEM AND ALL AFFILIATES. THE COMMITTEE SELECTS AND HIRES THE INDEPENDENT COMPENSATION CONSULTANT TO DEVELOP COMPARABILITY DATA, AND ADVISE THE COMMITTEE DURING ITS DELIBERATIONS REGARDING ALL ELEMENTS OF TOTAL COMPENSATION FOR ALL DISQUALIFIED INDIVIDUALS. INTEGRATED HEALTHCARE STRATEGIES ("IHS"), THE CONSULTANTS UTILIZED BY THE COMMITTEE, USE DATA FROM MULTIPLE TAX-EXEMPT PEER GROUP SOURCES TO DETERMINE SALARY RANGES, INCENTIVE OPPORTUNITY RANGES, AND BENEFITS FOR THE DISQUALIFIED INDIVIDUALS. IHS THEN ASSISTS THE COMMITTEE IN PREPARING CONTEMPORANEOUS DOCUMENTATION OF ALL ACTIONS. EACH COMMITTEE MEETING IS CONDUCTED WITH THE INTENT TO CREATE A REBUTTABLE PRESUMPTION OF REASONABLENESS FOR ALL ELEMENTS OF EXECUTIVE TOTAL COMPENSATION FOR THE DISQUALIFIED INDIVIDUALS. THE CHAIRMAN MAKES THIS DECLARATION AND ALSO INQUIRES IF THERE ARE ANY CONFLICTS OF INTEREST BY ANY ATTENDEES. ANY CONFLICTS ARE DISCLOSED AND THE COMMITTEE THEN ACTS IN A MANNER TO AVOID ANY CONFLICTED INDIVIDUAL PARTICIPATING IN ANY MANNER WHERE A CONFLICT MIGHT EXIST. AT THE END OF THE MEETING, THE COMMITTEE PREPARES CONTEMPORANEOUS MINUTES THAT RECORD ALL ACTIONS TAKEN DURING THE MEETING. THE FOLLOWING DESCRIPTIONS PRESENT ST. VINCENT'S PROCESS FOR DETERMINATION OF COMPENSATION FOR VARIOUS INDIVIDUALS: OFFICER: PROCESS IS DONE AT THE HSHS SYSTEM OFFICE WITH INPUT FROM THE PRESIDENT AND CEO OF THE EASTERN WISCONSIN DIVISION. KEY EMPLOYEE: IF THE POSITION IS FOR A SENIOR LEADERSHIP MEMBER, THE PROCESS IS DONE AT THE HSHS SYSTEM OFFICE WITH INPUT FROM THE PRESIDENT AND CEO OF THE EASTERN WISCONSIN DIVISION. THIS PROCESS APPLIES TO TIMOTHY JAHN. IF THE POSITION IS A DIRECTOR POSITION AT ST. VINCENT HOSPITAL, ON AN ANNUAL BASIS AN OUTSIDE ORGANIZATION, CURRENTLY INTEGRATED HEALTHCARE STRATEGIES ("IHS"), COMPILES MARKET DATA FOR EACH POSITION AND PROVIDES RECOMMENDATIONS FOR THE SALARY RANGE FOR THESE POSITIONS. THE MANAGER OF PEOPLE SERVICES PROVIDES A RECOMMENDATION FOR ADJUSTMENT BASED UPON THE RECOMMENDED RANGE INFORMATION FROM IHS. THE WAGE AND SALARY COMMITTEE AT ST. VINCENT HOSPITAL, WHICH CONSISTS OF THE SENIOR LEADERSHIP TEAM AND MANAGER OF PEOPLE SERVICES, REVIEWS THE SALARY RANGE AND ADJUSTMENT RECOMMENDATIONS; DOCUMENTATION IS KEPT REGARDING ANY DEVIATIONS FROM THE RECOMMENDATIONS. HIGHEST PAID: ON AN ANNUAL BASIS SALARY RANGE RECOMMENDATIONS ARE MADE UTILIZING MARKET DATA THAT IS EXTRACTED FROM SALARY SURVEYS AND AGED TO ALIGN WITH THE COMPENSATION PROGRAM PHILOSOPHY. THE RECOMMENDATIONS FOR SALARY RANGE AND INDIVIDUAL PAY ADJUSTMENTS BY POSITION ARE THEN REVIEWED AND DISCUSSED DURING A MEETING OF THE WAGE AND SALARY COMMITTEE, WHICH CONSISTS OF THE SENIOR LEADERSHIP TEAM AND MANAGER OF PEOPLE SERVICES. DOCUMENTATION IS KEPT REGARDING APPROVAL AND/OR DEVIATIONS FROM THE RECOMMENDATIONS. JOINT VENTURES FORM 990 PART VI, LINE 16B HOSPITAL SISTERS HEALTH SYSTEM ADOPTED A JOINT VENTURE COMPLIANCE PROGRAM POLICY EFFECTIVE ON JANUARY 1, 2012 FOR ALL SYSTEM HOSPITALS, INCLUDING ST. VINCENT HOSPITAL. THE OVERALL PURPOSE OF THE POLICY IS TO PROVIDE PRACTICAL GUIDELINES FOR ETHICAL BUSINESS CONDUCT, TO ACHIEVE COMPLIANCE, AND TO DETECT AND PREVENT VIOLATIONS OF APPLICABLE LAWS. THE POLICY REQUIRES ST. VINCENT HOSPITAL, AND ALL HSHS HOSPITALS, TO EVALUATE THEIR PARTICIPATION IN JOINT VENTURE ARRANGEMENTS, INCLUDING UNDER APPLICABLE FEDERAL TAX LAWS, AND TO SAFEGUARD ST. VINCENT HOSPITAL'S TAX EXEMPT STATUS WITH RESPECT TO ANY JOINT VENTURE ARRANGEMENTS.
DISCLOSURE DOCUMENTS AVAILABLE TO PUBLICFORM 990 PART VI, LINE 19BOARD-APPROVED FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE GENERAL PUBLIC AT THIS TIME.
PUBLICLY TRADED SECURITIESFORM 990 PART X, LINE 11INVESTMENTS IN SECURITIES AND RELATED INVESTMENT INCOME: THE HOSPITAL'S CASH RESERVES ARE INVESTED IN A POOLED INVESTMENT ACCOUNT. PARTICIPATION IN THE POOLED FUND IS LIMITED TO THE 501(C)(3) HOSPITALS AND RELATED HEALTH SERVICES ORGANIZATIONS SPONSORED BY HOSPITAL SISTERS HEALTH SYSTEM. THE POOLED ACCOUNT CONSISTS OF CASH, EQUITY, AND DEBT SECURITIES THAT ARE PUBLICLY TRADED. IN ACCORDANCE WITH THE PROVISIONS OF SFAS NO. 124 "ACCOUNTING FOR CERTAIN INVESTMENTS HELD BY NOT-FOR-PROFIT ORGANIZATIONS" INVESTMENTS IN EQUITY SECURITIES WITH READILY DETERMINABLE VALUES, AND ALL INVESTMENTS IN DEBT SECURITIES, ARE REPORTED AT FAIR VALUE ON THE BALANCE SHEET. INCOME, REALIZED AND UNREALIZED GAINS AND LOSSES ARE POOLED AND ALLOCATED TO THE PARTICIPANTS. INDIVIDUAL COMPONENTS OF ASSETS AND REVENUE ARE NOT IDENTIFIED TO THE INDIVIDUAL HOSPITAL PARTICIPANTS.
Reconciliation of Change in Net AssetsForm 990, Part XI, Line 5TRANSFER TO/FROM AFFILIATES (3,645,084) RECOGNITION OF CHANGE IN PENSION FUNDED STATUS 26,284,030 TEMPORARILY RESTRICTED NET ASSETS 900,000 PERM RESTRICTED NET ASSETS - CONTRIBUTIONS 28,113 CHANGE IN FAIR VALUE OF INTEREST RATE SWAPS 764,877 SWAP PAYMENTS (1,048,161) LOSS ON EARLY EXTINGUISHMENT OF DEBT (957,353) OTHER (62,394) ---------- TOTAL 22,264,028 ==========

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateEOY AssetsEOYAssetsBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Kiara Clinical Integration Network LLC
4936 Laverna RoadSPRINGFIELDIL62707261417684Health CareIL0HSSI
Physician Clinical Integration Network
4936 Laverna RoadSPRINGFIELDIL62707371668647HEALTH CAREIL0KCIN
SPRINGFIELD HEALTH PARTNERS LLC
4936 LAVERNA ROADSPRINGFIELDIL62707371364419HEALTHCAREIL0HSHS MG

Form990 Schedule R Part II Form990ScheduleRPartII (23 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
HOSPITAL SISTERS HEALTH SYSTEM
4936 LAVERNA ROADSPRINGFIELDIL62707371058692HEALTHCAREIL501(c)(3)11AHSHSfalse
HOSPITAL SISTERS SERVICES INC
4936 LAVERNA ROADSPRINGFIELDIL62707371163402HEALTHCAREIL501(c)(3)11ANAfalse
HOSPITAL SISTERS OF ST FRANCIS FDTN
4936 LAVERNA RAODSPRINGFIELDIL62707371186514HEALTHCAREIL501(c)(3)11AHSHSfalse
HSHS SELF INSURANCE TRUST FUND
4936 LAVERNA ROADSPRINGFIELDIL62707371120626INSURANCEIL501(c)(3)11AHSHSfalse
HSHS HEALTH CARE PLAN TRUST FUND
4936 LAVERNA ROADSPRINGFIELDIL62707371137724HEALTHCAREIL501(c)(9)N/AHSHSfalse
HOSPITAL SISTERS HEALTHCARE WEST INC
2661 COUNTY HIGHWAY ICHIPPEWA FALLSWI54729510157933HEALTHCAREWI501(c)(3)11AHSSIfalse
SACRED HEART HOSPITAL
900 WEST CLAIREMONT AVENUEEAU CLAIREWI54701390807060HEALTHCAREWI501(c)(3)3HSSIfalse
ST ANTHONY'S HOSPITAL
503 N MAPLE STREETEFFINGHAMIL62401370661233HEALTHCAREIL501(c)(3)3HSSIfalse
ST ELIZABETH'S HOSPITAL
211 SOUTH THIRD STREETBELLEVILLEIL62220370663567HEALTHCAREIL501(c)(3)3HSSIfalse
ST NICHOLAS HOSPITAL
3100 SUPERIOR AVENUESHEBOYGANWI53081390808480HEALTHCAREWI501(c)(3)3HSSIfalse
ST JOHN'S HOSPITAL
800 EAST CARPENTER STREETSPRINGFIELDIL62769370661238HEALTHCAREIL501(c)(3)3HSSIfalse
ST JOSEPH'S HOSPITAL
9515 HOLY CROSS LANE PO BOX 9BREESEIL62230371208459HEALTHCAREIL501(c)(3)3HSSIfalse
ST JOSEPH'S HOSPITAL
2661 COUNTY HIGHWAY 1CHIPPEWA FALLSWI54729390810545HEALTHCAREWI501(c)(3)3HSSIfalse
ST MARY'S HOSPITAL
1800 E LAKE SHORE DRIVEDECATURIL62521370661244HEALTHCAREIL501(c)(3)3HSSIfalse
ST MARY'S HOSPITAL
111 SPRING STREETSTREATORIL61364362169181HEALTHCAREIL501(c)(3)3HSSIfalse
ST MARY'S MEDICAL CENTER
1726 SHAWANO AVENUEGREEN BAYWI54303390818682HEALTHCAREWI501(c)(3)3HSSIfalse
ST FRANCIS HOSPITAL
1215 FRANCISCAN DRIVELITCHFIELDIL62056370661236HEALTHCAREIL501(c)(3)3HSSIfalse
St Joseph's Hospital
1515 MAIN STREETHIGHLANDIL62249370663568HEALTHCAREIL501(c)(3)3HSSIfalse
HSHS MEDICAL GROUP INC
3215 EXECUTIVE PARK DRIVESPRINGFIELDIL62703263956318HEALTHCAREIL501(c)(3)11AHSSIfalse
HSHS WISCONSIN MEDICAL GROUP INC
3215 EXECUTIVE PARK DRIVESPRINGFIELDIL62703264515959HEALTHCAREIL501(c)(3)11AHSSIfalse
ORANGE CROSS AMBULANCE INC
919 ASHLAND AVESHEBOYGANWI53081391860942HEALTHCAREWI501(c)(3)9ST NICHOLASfalse
WISCONSIN UPPER PEN OCN MNGMT SERVICES
835 S VAN BURENGREEN BAYWI54301391677100HEALTHCAREWI501(c)(3)3ST VINCENTtrue
UNITY LIMITED PARTNERSHIP
2366 OAK RIDGE CIRCLEDE PEREWI54115391750729HEALTHCAREWI501(c)(3)11AHSSIfalse

Form990 Schedule R Part III Form990ScheduleRPartIII (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodePrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeDisproportionate AllocationsDisproportionateAllocationsCode VCodeVAmountGeneral Or Managing PartnerGeneralOrManagingPartnerShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipEINEIN
MEMORIAL AND ST ELIZABETH'S HOSPITAL
4000 NORTH ILLINOIS STREETSpringfieldIL62769HEALTHCAREILST ELIZABETH'SRELATEDfalse$0false
PRAIRIE HEART INSTITUTE-CARB
800 EAST CARPENTER STREETSPRINGFIELDIL62769HEALTHCAREILST JOHN'SRELATEDfalse$0false
NORTHEAST WISCONSIN RADIATION
1821 S WEBSTER AVENUE STE 30GREEN BAYWI54301HEALTHCAREWIHSSIRELATEDfalse$0false948524765070.50000
PAIN CENTER OF WISCONSIN
4131 W LOOMIS ROAD STE 300MILWAUKEEWI53221HEALTHCAREWIST VINCENTRELATEDfalse$0false182730311830470.50000
SURGERY CENTER OF SHEBOYGAN
3141 SAEMANN AVESHEBOYGANWI53081HEALTHCAREWIST NICHOLASRELATEDfalse$0false
PREVEA VENTURES LLC
2710 EXECUTIVE DRGREEN BAYWI54304HEALTHCAREWIHSSIRELATEDfalse$0false203775127
CARPENTER STREET HOTEL LLC
525 NORTH SIXTH STREETSPRINGFIELDIL62707HOTELILLASANTE INCRELATEDfalse$0false
SPRINGFIELD URGENT CARE REAL ESTATE
PO BOX 19456SPRINGFIELDIL62794RENT. REAL ESILLASANTE INCRELATEDfalse$0false

Form990 Schedule R Part IV Form990ScheduleRPartIV (9 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsControlled OrgControlledOrg
Kiara Inc
4936 Laverna ROAdSpringfieldIL62707371163401HealthCareILHSHSC Corp
LaSante WISCONSIN INC
4936 Laverna ROAdSpringfieldIL62707391572196HEALTHCAREILKiara IncC Corp
LaSante INC
4936 Laverna ROAdSpringfieldIL62707371163400HealthCareILKiara IncC Corp
Prairie Cardiovascular
619 East Mason Suite 4P57SpringfieldIL62701371071858HEALTHCAREILKiara IncC Corp
PREVEA HEALTH SERVICES
2710 EXECUTIVE DRGREEN BAYWI54304391839351HEALTHCAREWIHSSIC CORP
PREVEA CLINIC INC
2710 EXECUTIVE DRGREEN BAYWI54304391839349HEALTHCAREWIHSSIC CORP
PREVEA HEALTH NETWORK
2710 EXECUTIVE DRGREEN BAYWI54304392000537HEALTHCAREWIHSSIC CORP
RENAISSANCE QUALITY INSURANCE
980669953INSURANCECAHSSIC CORP00false
OJV INC
4936 LAVERNA RDSPRINGFIELDIL62707460873384HEALTHCAREILLASANTE INCC CORP00false
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiestrueReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgtrueLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgtrueSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgtruePurchaseOfAssetsFromOtherOrg
Exchange Of AssetstrueExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
IdentifierTRANSACTIONS WITH RELATED ENTITIESIdentifier
Return ReferenceFORM 990, SCHEDULE R, PART V, LINE 2ReturnReference
ExplanationTRANSACTIONS ARE BETWEEN RELATED 501(C)(3) AND DO NOT REQUIRE REPORTING ON THIS SECTION.Explanation