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FROEDTERT SOUTH INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
FROEDTERT SOUTH INC (EIN 39-0816845)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-05-14
IRS object ID
201401349349301310
Schema version
2012v2.1
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)
Timestamp2014-05-14T15:25:27-05:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN390758449EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1WIPFLI LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line110000 INNOVATION DRIVE SUITE 250AddressLine1
CityMILWAUKEECity
StateWIState
ZIP Code532264837ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN390816845EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1UNITED HOSPITAL SYSTEM INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlUNITNameControl
Phone2625778113Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line16308 8TH AVENUEAddressLine1
CityKENOSHACity
StateWIState
ZIP Code53143ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameTHOMAS J KELLEYName
TitleVP & CFOTitle
Phone2625778113Phone
Date Signed2014-05-14DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJAY ADKISSON CPAName
PTINP01360892PTIN
Phone4144319300Phone
Date Prepared2014-05-13DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonTHOMAS J KELLEYNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line16308 8TH AVENUEAddressLine1
CityKENOSHACity
StateWIState
ZIP Code53143ZIPCode
FieldValueIRS element (for citing)
Gross Receipts334710350GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.UNITEDHOSPITALSYSTEM.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1910YearFormation
State Legal DomicileWIStateLegalDomicile
Activity Or Mission DescriptionUNITED HOSPITAL SYSTEM, INC. IS COMMITTED TO LIVING OUT THE HEALING MINISTRIES OF THE JUDEO-CHRISTIAN FAITHS BY PROVIDING EXCEPTIONAL AND COMPASSIONATE HEALTHCARE SERVICES THAT PROMOTES THE DIGNITY AND WELL-BEING OF THE PEOPLE WE SERVE. THIS IS OUR MISSION AND OUR REASON FOR BEING. WE STRIVE TO RECRUIT AND RETAIN THE BEST PHYSICIANS AND STAFF AND PURCHASE THE BEST DIAGNOSTIC AND CURATIVE MEDICAL EQUIPMENT THAT OUR FINANCIAL RESOURCES WILL PERMIT. WE ALSO STRIVE TO BE ACCESSIBLE TO ALL MEMBERS OF OUR COMMUNITY WITH EMERGENT AND URGENT HEALTHCARE NEEDS, IRRESPECTIVE OF THEIR ABILITY TO PAY. THIS IS OUR COMMITTMENT TO THE QUALITY, ACCESSIBILITY AND AFFORDABILITY FUNDAMENTALS AFFECTING THE DELIVERY OF HEALTHCARE.ActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees2451TotalNbrEmployees
Total Nbr Volunteers136TotalNbrVolunteers
Total Gross UBI223803TotalGrossUBI
Net Unrelated Business Txbl Income-4389NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year100831ContributionsGrantsPriorYear
Contributions Grants Current Year162879ContributionsGrantsCurrentYear
Program Service Revenue Prior Year303624543ProgramServiceRevenuePriorYear
Program Service Revenue CY309098496ProgramServiceRevenueCY
Investment Income Prior Year1028282InvestmentIncomePriorYear
Investment Income Current Year2918538InvestmentIncomeCurrentYear
Other Revenue Prior Year628391OtherRevenuePriorYear
Other Revenue Current Year612515OtherRevenueCurrentYear
Total Revenue Prior Year305382047TotalRevenuePriorYear
Total Revenue Current Year312792428TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year11745GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY9075GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year144860983SalariesEtcPriorYear
Salaries Etc Current Year151482016SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year132539069OtherExpensePriorYear
Other Expenses Current Year133678103OtherExpensesCurrentYear
Total Expenses Prior Year277411797TotalExpensesPriorYear
Total Expenses Current Year285169194TotalExpensesCurrentYear
Revenues Less Expenses Prior Year27970250RevenuesLessExpensesPriorYear
Revenues Less Expenses CY27623234RevenuesLessExpensesCY
Total Assets BOY323780841TotalAssetsBOY
Total Assets EOY343768720TotalAssetsEOY
Total Liabilities BOY118963026TotalLiabilitiesBOY
Total Liabilities EOY84369260TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY204817815NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY259399460NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionUNITED HOSPITAL SYSTEM, INC. IS A COMPREHENSIVE REGIONAL HEALTHCARE SYSTEM THAT HAS SERVED SOUTHEASTERN WISCONSIN AND NORTHERN ILLINOIS COMMUNITIES FOR MORE THAN 100 YEARS. UNITED HOSPITAL SYSTEM PROVIDES SERVICES PRIMARILY THROUGH THE KENOSHA MEDICAL CENTER CAMPUS AND THE ST. CATHERINE'S MEDICAL CENTER CAMPUS AND SEVERAL OTHER CLINIC LOCATIONS.WE, AT UNITED, ARE COMMITTED TO LIVING OUT THE HEALING MINISTRIES OF THE JUDEO-CHRISTIAN FAITHS BY PROVIDING EXCEPTIONAL AND COMPASSIONATE HEALTHCARE SERVICES THAT PROMOTES THE DIGNITY AND WELL BEING OF THE PEOPLE WE SERVE. THIS IS OUR MISSION AND OUR REASON FOR BEING.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense235140686Expense
Grants9075Grants
Revenue309502590Revenue
DescriptionACUTE CARE HOSPITAL THAT PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES TO ITS COMMUNITY.Description
Total Program Service Expense235140686TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals1GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109661NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees2451NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy0WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledWIStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1THE ORGANIZATIONBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number2625778113TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line16308 8TH AVENUEAddressLine1
CityKENOSHACity
StateWIState
ZIP Code53143ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (22 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
DAVID R RILEY
DIRECTOR2.00X000
DR F GREGORY CAMPBELL
CHAIRMAN2.00X000X
ROBERT A CORNOG
VICE-CHAIRMAN/SECRETARY/TREASURER2.00X000X
RICHARD O SCHMIDT JR
PRESIDENT/CEO/DIRECTOR45.00X10744730144537X
EDWARD C EMMA
DIRECTOR2.00X000
HAROLD W MAYER
DIRECTOR2.00X000
A JAMES CICCHINI
DIRECTOR2.00X000
JAMES CONCANNON MD
DIRECTOR2.00X000
DON E KAELBER
DIRECTOR2.00X000
RAYMOND KNIGHT MD
DIRECTOR/PHYSICIAN2.00X376389039877
ROBERT LEE JR
DIRECTOR2.00X000
THOMAS P MAHONEY
DIRECTOR2.00X000
LAWRENCE REIF MD
DIRECTOR2.00X000
W HARLEY SOBIN MD
DIRECTOR/PHYSICIAN2.00X1011050039877
LINDA WOHLGEMUTH
ASST SECRETARY/VP-COO-SCMC45.00437412052000X
THOMAS KELLEY
ASST TREASURER/VP-CFO45.00303468064877X
SUSAN VENTURA
SVP/COO-KMCC45.00438654052000X
ASHWANI SETHI MD
PHYSICIAN40.001005478041716X
MARIO GARRETTO MD
PHYSICIAN40.00955313041525X
KATHERINE ABBO MD
PHYSICIAN40.00605292025014X
RAMANUJA MANDA MD
PHYSICIAN40.00601469037891X
JAMES SHAPIRO MD
PHYSICIAN40.00635494021525X
FieldValueIRS element (for citing)
Total Reportable Comp From Org7444492TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation560839TotalOtherCompensation
Number Individuals GT100 K119NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
ALLSCRIPTS HEALTHCARE LLC
PO BOX 8538-0133PHILADELPHIAPA19171IS SERVICES1834165
H M P OF KENOSHA COUNTY LTD
PO BOX 645037CINCINNATIOH45264MEDICAL1243893
RILEY CONSTRUCTION
5301 99TH AVENUEKENOSHAWI53144BUILDING1211173
QUEST DIAGNOSTICS
3924 COLLECTION CENTER DRCHICAGOIL60693MEDICAL964107
MARTIN PETERSEN CO INC
9800 55TH STREETKENOSHAWI53144BUILDING800531
FieldValueIRS element (for citing)
Number Of Contractors GT100 K41NumberOfContractorsGT100K
Fundraising Events30800FundraisingEvents
All Other Contributions132079AllOtherContributions
Total Contributions162879TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
NET PATIENT SERVICE REV623000301924037301924037
OTHER OPERATING REVENUE62399071744596950656223803
FieldValueIRS element (for citing)
Total Program Service Revenue309098496TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1389177TotalRevenueColumn
Exclusion$1,389,177ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real627897Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real627897Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column627897TotalRevenueColumn
Related Or Exempt Function Income627897RelatedOrExemptFunctionIncome

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities23338311Securities
Other51750Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities21840203Securities
Other20497Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities1498108Securities
Other31253Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column1529361TotalRevenueColumn
Exclusion$1,529,361ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events41840GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events30800CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses57222FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-15382TotalRevenueColumn
Exclusion-$15,382ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column312792428TotalRevenueColumn
Related Or Exempt Function Income309502590RelatedOrExemptFunctionIncome
Unrelated Business Revenue223803UnrelatedBusinessRevenue
Exclusion$2,903,156ExclusionAmount

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total9075Total
Program Services9075ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total7994831Total
Program Services6479976ProgramServices
Management And General1514855ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total107098638Total
Program Services89799489ProgramServices
Management And General17299149ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total8898724Total
Program Services7444075ProgramServices
Management And General1454649ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total20525683Total
Program Services4559788ProgramServices
Management And General15965895ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total6964140Total
Program Services5811507ProgramServices
Management And General1152633ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total13931665Total
Program Services9081616ProgramServices
Management And General4850049ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total281497Total
Program Services130223ProgramServices
Management And General151274ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total52838753Total
Program Services50281466ProgramServices
Management And General2557287ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total5324606Total
Program Services5324606ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total6001708Total
Program Services5882804ProgramServices
Management And General118904ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total571817Total
Program Services186083ProgramServices
Management And General385734ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total348994Total
Program Services314095ProgramServices
Management And General34899ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total14864254Total
Program Services13377829ProgramServices
Management And General1486425ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1012457Total
Program Services414233ProgramServices
Management And General598224ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBTS22674994226749940
STATE HOSPITAL ASSESSME79049727904972
REPAIRS25858081843983741825
BLOOD12122961212296

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total4124282Total
Program Services2407576ProgramServices
Management And General1716706ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total285169194Total
Program Services235140686ProgramServices
Management And General50028508ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY47819261BOY
EOY71107557EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY36239122BOY
EOY35183455EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY4213110BOY
EOY4162748EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY4212357BOY
EOY4086869EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis261943949LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec178817178LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY86152649BOY
EOY83126771EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY81786222BOY
EOY96506253EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY63358120BOY
EOY49595067EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY323780841BOY
EOY343768720EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY28493220BOY
EOY28809110EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY16378570BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY74091236BOY
EOY55560150EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY118963026BOY
EOY84369260EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY202778673BOY
EOY257368904EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY520158BOY
EOY513136EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1518984BOY
EOY1517420EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY204817815BOY
EOY259399460EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY323780841BOY
EOY343768720EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses27623234ReconcilationRevenueExpenses
Reconciliation Unrealized Invest3976066ReconciliationUnrealizedInvest
Reconcilation Other Changes22982345ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

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 D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance2039142BeginningOfYearBalance
Investment Earnings Or Losses489InvestmentEarningsOrLosses
Other Expenditures9075OtherExpenditures
End Of Year Balance2030556EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance2012126BeginningOfYearBalance
Investment Earnings Or Losses38761InvestmentEarningsOrLosses
Other Expenditures11745OtherExpenditures
End Of Year Balance2039142EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1998034BeginningOfYearBalance
Investment Earnings Or Losses23485InvestmentEarningsOrLosses
Other Expenditures9395OtherExpenditures
End Of Year Balance2012124EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1973518BeginningOfYearBalance
Investment Earnings Or Losses46211InvestmentEarningsOrLosses
Other Expenditures21695OtherExpenditures
End Of Year Balance1998034EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1955842BeginningOfYearBalance
Investment Earnings Or Losses33529InvestmentEarningsOrLosses
Other Expenditures15853OtherExpenditures
End Of Year Balance1973518EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.00000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.75000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.25000TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis6124397OtherCostOrOtherBasis
Book Value6124397BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis118340040OtherCostOrOtherBasis
Depreciation82048032Depreciation
Book Value36292008BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis131871906OtherCostOrOtherBasis
Depreciation95006398Depreciation
Book Value36865508BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis5607606OtherCostOrOtherBasis
Depreciation1762748Depreciation
Book Value3844858BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings83126771TotalOfBookValueLandBuildings

Other Securities OtherSecurities (6 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
CASH EQUIVLENTS5541161F
CERTIFICATE OF DEPOSIT19982946F
FIXED INCOME FUNDS21094493F
EQUITY MUTUAL FUNDS33679898F
EQUITY SECURITIES10965969F
CORPORATE BONDS5241786F
FieldValueIRS element (for citing)
Total Of Book Value Securities96506253TotalOfBookValueSecurities

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
DUE FROM AFFILIATE49526970
AMOUNTS RECEIVABLE FROM THIRD-PARTY REIMBURSEMENT PROGRAMS68097
FieldValueIRS element (for citing)
Total Book Value Other Assets49595067TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
DEFERRED COMPENSATION$10,908,216
PENSION LIABILITY$44,651,934
FieldValueIRS element (for citing)
Total Of Amounts55560150TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt340095434TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments3976066NetUnrealizedGainsInvestments
Other Revenues23326940OtherRevenues
Revenue Not Rptd F99027303006RevenueNotRptdF990
Revenue Subtotal312792428RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form990312792428TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt285513789TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal285513789ExpensesSubtotal
Other Expenses Not Included-344595OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt-344595ExpensesNotRptdOnFinStmt
Total Expenses Per Form990285169194TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:TEMPORARILY RESTRICTED NET ASSETS ARE RESTRICTED FOR EDUCATION SCHOLARSHIP GRANTS AND VARIOUS HEALTH CARE PROGRAMS. PERMANENTLY RESTRICTED NET ASSETS ARE TO BE HELD IN PERPETUITY, THE INCOME FROM WHICH IS EXPENDABLE FOR HOSPITAL DEVELOPMENT.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X, LINE 2:IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE CORPORATION DETERMINES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION ON THE TECHNICAL MERITS OF THE POSITION, ASSUMING THAT TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE LIKELY THAN NOT RECOGNITION THRESHOLD, THE BENEFIT OF THAT POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. THE CORPORATION RECORDED NO ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS IN 2013 AND 2012. TAX RETURNS FOR THE YEARS ENDED JUNE 30, 2009 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE.
PART XI, LINE 2D - OTHER ADJUSTMENTS:CHANGE IN PENSION OBLIGATION OTHER THAN PENSION EXPENSE 32,510,365. REVENUE SHARING WITH AFFILIATE -9,174,350. SCHOLARSHIPS INCLUDED IN INCOME -9,075.
PART XII, LINE 4B - OTHER ADJUSTMENTS:SCHOLARSHIPS INCLUDED IN INCOME 9,075. MACRS DEPRECIATION ADJUSTMENT -353,670.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1GOLF OUTINGNameOfEvent1
Gross Receipts Event172640GrossReceiptsEvent1
Charitable Contributions Event130800CharitableContributionsEvent1
Gross Revenue Event141840GrossRevenueEvent1
Cash Prizes Event11100CashPrizesEvent1
Non Cash Prizes Event18918NonCashPrizesEvent1
Food And Beverage Event132080FoodAndBeverageEvent1
Entertainment Event19760EntertainmentEvent1
Other Direct Expenses Event15364OtherDirectExpensesEvent1
Gross Receipts Total72640GrossReceiptsTotal
Charitable Contributions Total30800CharitableContributionsTotal
Gross Revenue Total Events41840GrossRevenueTotalEvents
Cash Prizes Total Events1100CashPrizesTotalEvents
Non Cash Prizes Total Events8918NonCashPrizesTotalEvents
Food And Beverage Total Events32080FoodAndBeverageTotalEvents
Entertainment Total Events9760EntertainmentTotalEvents
Other Direct Expenses Total Events5364OtherDirectExpensesTotalEvents
Direct Expense Summary Events57222DirectExpenseSummaryEvents
Net Income Summary-15382NetIncomeSummary

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense3757954TotalCommunityBenefitExpense
Net Community Benefit Expense3757954NetCommunityBenefitExpense
Percent Of Total Expense0.01430PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense42997320TotalCommunityBenefitExpense
Direct Offsetting Revenue24952912DirectOffsettingRevenue
Net Community Benefit Expense18044408NetCommunityBenefitExpense
Percent Of Total Expense0.06870PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense46755274TotalCommunityBenefitExpense
Direct Offsetting Revenue24952912DirectOffsettingRevenue
Net Community Benefit Expense21802362NetCommunityBenefitExpense
Percent Of Total Expense0.08300PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs306NumberOfActivitiesOrPrograms
Persons Served107382PersonsServed
Total Community Benefit Expense334830TotalCommunityBenefitExpense
Net Community Benefit Expense334830NetCommunityBenefitExpense
Percent Of Total Expense0.00130PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Persons Served71PersonsServed
Total Community Benefit Expense674403TotalCommunityBenefitExpense
Net Community Benefit Expense674403NetCommunityBenefitExpense
Percent Of Total Expense0.00260PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense60000TotalCommunityBenefitExpense
Net Community Benefit Expense60000NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs26NumberOfActivitiesOrPrograms
Persons Served550PersonsServed
Total Community Benefit Expense242981TotalCommunityBenefitExpense
Net Community Benefit Expense242981NetCommunityBenefitExpense
Percent Of Total Expense0.00090PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs332NumberOfActivitiesOrPrograms
Persons Served108003PersonsServed
Total Community Benefit Expense1312214TotalCommunityBenefitExpense
Net Community Benefit Expense1312214NetCommunityBenefitExpense
Percent Of Total Expense0.00500PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs332NumberOfActivitiesOrPrograms
Persons Served108003PersonsServed
Total Community Benefit Expense48067488TotalCommunityBenefitExpense
Direct Offsetting Revenue24952912DirectOffsettingRevenue
Net Community Benefit Expense23114576NetCommunityBenefitExpense
Percent Of Total Expense0.08800PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs11NumberOfActivitiesOrPrograms
Total Community Building Expense4061TotalCommunityBuildingExpense
Net Community Building Expense4061NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Persons Served37PersonsServed
Total Community Building Expense148918TotalCommunityBuildingExpense
Net Community Building Expense148918NetCommunityBuildingExpense
Percent Of Total Expense0.00060PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs10NumberOfActivitiesOrPrograms
Persons Served150PersonsServed
Total Community Building Expense1015TotalCommunityBuildingExpense
Net Community Building Expense1015NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs21NumberOfActivitiesOrPrograms
Persons Served187PersonsServed
Total Community Building Expense153994TotalCommunityBuildingExpense
Net Community Building Expense153994NetCommunityBuildingExpense
Percent Of Total Expense0.00060PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$7,913,573BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare49946344AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare63859558CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-13913214MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities2NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalEr24 HoursEr24Hours
KENOSHA MEDICAL CENTER CAMPUS
16308 8TH AVENUEKENOSHAWI53143XXX
SAINT CATHERINE'S MEDICAL CENTER CAMPUS
29555 76TH STREETPLEASANT PRAIRIEWI53158XXX

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (2 entries)

Hospital Facility NumberHospitalFacilityNumberCHNA ConductedCHNAConductedCommunity DefinitionCommunityDefinitionCommunity DemographicsCommunityDemographicsExisting ResourcesExistingResourcesHow Data ObtainedHowDataObtainedCommunity Health NeedsCommunityHealthNeedsOther Health IssuesOtherHealthIssuesIdentifying ProcessIdentifyingProcessConsulting ProcessConsultingProcessInformation GapsInformationGapsNeeds Assessment ConductedNeedsAssessmentConductedTake Into AccountTakeIntoAccountOther FacilitiesOtherFacilitiesCHNA Widely AvailableCHNAWidelyAvailableOwn WebsiteOwnWebsiteOn RequestOnRequestAdopt Implement StrategyAdoptImplementStrategyExecute Implement StrategyExecuteImplementStrategyDevelop Community PlanDevelopCommunityPlanParticipate Community PlanParticipateCommunityPlanAdopt BudgetAdoptBudgetPrioritize Health NeedsPrioritizeHealthNeedsPrioritize ServicesPrioritizeServicesAll Needs AddressedAllNeedsAddressedOrganization Incur Excise TaxOrganizationIncurExciseTaxEligibility Criteria ExplainedEligibilityCriteriaExplainedUses FPG FreeUsesFPGFreeFPG Free PercentFPGFreePercentUses FPG DiscountedUsesFPGDiscountedFPG Discount PercentFPGDiscountPercentExplains BasisExplainsBasisIncome LevelIncomeLevelAsset LevelAssetLevelMedical IndigencyMedicalIndigencyInsurance StatusInsuranceStatusUninsured DiscountUninsuredDiscountExplains Application MethodExplainsApplicationMethodIncludes Publicity MeasuresIncludesPublicityMeasuresAvailable On RequestAvailableOnRequestActions On NonpaymentActionsOnNonpaymentCollection ActivitiesCollectionActivitiesNotified All PatientsNotifiedAllPatientsDocumented DeterminationDocumentedDeterminationNondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicyUsed Other MethodUsedOtherMethodAmounts Generally BilledAmountsGenerallyBilledGross ChargesGrossCharges
KENOSHA MEDICAL CENTER CAMPUS
11XXXXXXXXX12101XXXXXXXXX0011200.0000000000001200.0000000000001XXXXX11X10XX1X00
SAINT CATHERINE'S MEDICAL CENTER CAMPUS
21XXXXXXXXX12101XXXXXXXXX0011200.0000000000001200.0000000000001XXXXX11X10XX1X00

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities8NumberOfOtherFacilities

Other Facilities OtherFacilities (8 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
KENOSHA NORTHSIDE CLINIC
3601 30TH AVENUE SUITE 205KENOSHAWI53143OUTPATIENT PHYSICIAN CLINIC
PADDOCK LAKE FAMILY MEDICINE CLINIC
7322 236TH AVENUEPADDOCK LAKEWI53168OUTPATIENT PHYSICIAN CLINIC
THE GURNEE CLINIC
1790 NATIONS DRIVE SUITE 106GURNEEIL60031OUTPATIENT PHYSICIAN CLINIC
LAKEVIEW RECPLEX
9900 TERWALL TERRACEPLEASANT PRAIRIEWI53158REHABILITATION CLINIC
VERNON ELEMENTARY SCHOOL - POOL AREA
8518 22ND AVENUEKENOSHAWI53143REHABILITATION CLINIC
NORTH CENTRAL CLINIC
6127 GREEN BAY ROAD SUITE 200KENOSHAWI53142OUTPATIENT PHYSICIAN CLINIC
SCMCC-MMB
9697 ST CATHERINES DRIVEPLESANT PRAIRIEWI53158OUTPATIENT PHYSICIAN CLINIC
RCW ADMINISTRATIVE BUILDING
5000 68TH AVEKENOSHAWI53144ADMINISTRATIVE BUILDING

Form990 Schedule H Part VI Form990ScheduleHPartVI (17 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
PART I, LINE 7: THE COST METHOD USED TO CALCULATE THE COST OF THE COMMUNITY BENEFIT PROGRAMS WAS THE COST-TO-CHARGE RATIO. WORKSHEET 2 WAS USED TO CALCULTE THE RATIO OF PATIENT CARE COST TO CHARGES.
PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 22674994.
PART II: MANY STAFF MEMBERS ARE UTILIZED TO PROMOTE THE HEALTH OF THE COMMUNITY AND THE GENERAL WELL-BEING OF THE COMMUNITY WE SERVE. THROUGH OUR EMERGENCY PREPAREDNESS COMMITTEE, STAFF ARE ALWAYS PLANNING AND PREPARING TO BE READY TO MEET THE NEEDS OF THE COMMUNITY AS EVENTS OCCUR. ADDITIONALLY, A VARIETY OF STAFF WORK WITH LOCAL SCHOOLS AND OTHER ORGANIZATIONS TO GIVE TALKS PROMOTING HEALTH AND CAREERS IN HEALTHCARE. A NUMBER OF STAFF MEMBERS ARE INVOLVED IN MENTORING PROGRAMS WITHIN THE LOCAL SCHOOLS. RECOGNIZING THE IMPORTANCE OF SUSTAINING AND GROWING OUR ECONOMY, WE PARTICIPATE IN OUR LOCAL BUSINESS ALLIANCE.
PART III, LINE 4: MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY UNINSURED PATIENTS AND AMOUNTS PATIENTS ARE PERSONALLY RESPONSIBLE FOR, THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO A VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF HISTORICAL COLLECTION EXPERIENCE AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUTSTANDING AFTER MANAGEMENT HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO PATIENT ACCOUNTS RECEIVABLE. WORKSHEET A IN THE INSTRUCTIONS WAS USED TO DETERMINE THE COSTING METHODOLOGY.
PART III, LINE 8: SCHEDULE H PART III SECTION B LINE 6 REPORTS "ALLOWABLE COSTS OF CARE" AS TAKEN FROM THE MOST RECENTLY FILED MEDICARE COST REPORT AVAILABLE AT THE TIME THE COMMUNITY BENEFIT REPORT IS PUBLISHED. THE MEDICARE COST REPORT CALCULATES ITS ALLOWABLE TOTAL COSTS BASED ON APPLICABLE MEDICARE REGULATIONS. MEDICARE AND MEDICAID COST IS DETERMINED USING INDIVIDUAL COST CENTER COST-TO-CHARGE RATIOS. THIS COST TO CHARGE RATIO IS DETERMINED USING ALL PAYER COST AND ALL PAYER CHARGES. THE COST TO CHARGE RATIO IS APPLIED TO THE ACTUAL MEDICARE AND MEDICAID CHARGES TO DETERMINE THE MEDICARE AND MEDICAID COST. THIS ORGANIZATION HAS ADOPTED THE COST AND CHARGE PRACTICES AS RECOMMENDED BY THE CATHOLIC HEALTH ASSOCIATION AND THE WISCONSIN, IOWA, OR ILLINOIS HOSPITAL ASSOCIATION AS APPLICABLE, AND THEREFORE, DOES NOT COUNT ANY MEDICARE SHORTFALL NUMBERS IN ITS ANNUAL REPORTING OF COMMUNITY BENEFIT AMOUNTS.
PART III, LINE 9B: OUR COLLECTION PROCESS IS THE SAME FOR ALL PATIENTS, REGARDLESS IF THEY QUALIFY FOR FINANCIAL ASSISTANCE. WE BILL ALL INSURANCES. PATIENT DOES NOT RECEIVE A COPY OF THE BILL UNTIL IT IS THEIR BALANCE. WE SEND THREE STATEMENTS FROM OUR FINANCIAL SYSTEM. WE HAVE AN OUTSIDE COLLECTION AGENCY SEND OUT OUR REQUIRED FINAL REQUEST LETTERS. FROM THIS POINT THE OUTSTANDING BALANCE IS HANDLED BY THE COLLECTION AGENCY. THE ACCOUNT DOES STAY ACTIVE ON OUR FINANCIAL SYSTEM FOR ONE YEAR. AT THAT TIME THE OUTSTANDING BALANCE IS MOVED OVER TO A BAD DEBT STATUS.
PART V, SECTION B, LINE 3: AS PART OF THE CHNA PROCESS, SEVERAL PERSONS WHO REPRESENT THE COMMUNITY SERVED BY UNITED HOSPITAL SYSTEM PROVIDED VALUE FEEDBACK REGARDING THEIR VIEWS OF THE HEALTHCARE CHALLENGES FACING OUR COMMUNITY. THOSE COMMUNITY REPRESENTATIVES INCLUDED [1] THE MEDICAL DIRECTOR OF THE HOSPITALIST GROUP CONTRACTED TO PROVIDE SERVICES AT UNITED HOSPITAL SYSTEM, [2] THE DIRECTOR/HEALTH OFFICER FROM THE KENOSHA PUBLIC HEALTH DEPARTMENT FOR KENOSHA COUNTY, WISCONSIN, [3] THE CHIEF EXECUTIVE OFFICER FOR THE UNITED WAY OF KENOSHA COUNTY, [4] A COMMUNITY-BASED, INDEPENDENT MASTERS OF SOCIAL WORK TRAINED MENTAL HEALTH PROFESSIONAL, [5] THE PRESIDENT OF THE KENOSHA AREA BUSINESS ALLIANCE (A KENOSHA BUSINESS COMMUNITY ORGANIZATION) AND [6] THE DIRECTOR OF THE KENOSHA COUNTY DIVISION OF AGING AND DISABILITY SERVICES.THE INFORMATION/FEEDBACK PROVIDED BY THESE PERSONS WHO REPRESENT THE COMMUNITY SERVED BY UNITED HOSPITAL SYSTEM WAS INCORPORATED INTO THE COMMUNITY HEALTH NEEDS ASSESSMENT, IDENTIFICATION, PRIORITIZATION AND IMPLEMENTATION PLANNING SUMMARY.KENOSHA MEDICAL CENTER CAMPUS
PART V, SECTION B, LINE 3: AS PART OF THE CHNA PROCESS, SEVERAL PERSONS WHO REPRESENT THE COMMUNITY SERVED BY UNITED HOSPITAL SYSTEM PROVIDED VALUE FEEDBACK REGARDING THEIR VIEWS OF THE HEALTHCARE CHALLENGES FACING OUR COMMUNITY. THOSE COMMUNITY REPRESENTATIVES INCLUDED [1] THE MEDICAL DIRECTOR OF THE HOSPITALIST GROUP CONTRACTED TO PROVIDE SERVICES AT UNITED HOSPITAL SYSTEM, [2] THE DIRECTOR/HEALTH OFFICER FROM THE KENOSHA PUBLIC HEALTH DEPARTMENT FOR KENOSHA COUNTY, WISCONSIN, [3] THE CHIEF EXECUTIVE OFFICER FOR THE UNITED WAY OF KENOSHA COUNTY, [4] A COMMUNITY-BASED, INDEPENDENT MASTERS OF SOCIAL WORK TRAINED MENTAL HEALTH PROFESSIONAL, [5] THE PRESIDENT OF THE KENOSHA AREA BUSINESS ALLIANCE (A KENOSHA BUSINESS COMMUNITY ORGANIZATION) AND [6] THE DIRECTOR OF THE KENOSHA COUNTY DIVISION OF AGING AND DISABILITY SERVICES.THE INFORMATION/FEEDBACK PROVIDED BY THESE PERSONS WHO REPRESENT THE COMMUNITY SERVED BY UNITED HOSPITAL SYSTEM WAS INCORPORATED INTO THE COMMUNITY HEALTH NEEDS ASSESSMENT, IDENTIFICATION, PRIORITIZATION AND IMPLEMENTATION PLANNING SUMMARY.SAINT CATHERINE'S MEDICAL CENTER CAMPUS
PART V, SECTION B, LINE 7: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED DURING THE 2013 TAX YEAR. AS PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, A THREE (3) YEAR ACTION PLAN WAS DEVELOPED IN AN EFFORT TO ADDRESS THE NEEDS IDENTIFIED WITHIN THE COMMUNITY HEALTH NEEDS ASSESSMENT. UNITED HOSPITAL SYSTEM IS ACTIVELY WORKING ON THE ACTION ITEMS ESTABLISHED FOR YEAR ONE.KENOSHA MEDICAL CENTER CAMPUS
PART V, SECTION B, LINE 7: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED DURING THE 2013 TAX YEAR. AS PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, A THREE (3) YEAR ACTION PLAN WAS DEVELOPED IN AN EFFORT TO ADDRESS THE NEEDS IDENTIFIED WITHIN THE COMMUNITY HEALTH NEEDS ASSESSMENT. UNITED HOSPITAL SYSTEM IS ACTIVELY WORKING ON THE ACTION ITEMS ESTABLISHED FOR YEAR ONE.SAINT CATHERINE'S MEDICAL CENTER CAMPUS
PART V, SECTION B, LINE 20D: SELF-PAY PATIENTS ARE OFFERED A FLAT DISCOUNT AND A PROMPT PAY DISCOUNT OFF BILLED SERVICES. MEANS TEST IS APPLIED TO DETERMINE IF ADDITIONAL DISCOUNTING IS POSSIBLE. PAYMENT AMOUNT IS DETERMINED BASED UPON 2012 HSS POVERTY GUIDELINES.KENOSHA MEDICAL CENTER CAMPUS
PART V, SECTION B, LINE 20D: SELF-PAY PATIENTS ARE OFFERED A FLAT DISCOUNT AND A PROMPT PAY DISCOUNT OFF BILLED SERVICES. MEANS TEST IS APPLIED TO DETERMINE IF ADDITIONAL DISCOUNTING IS POSSIBLE. PAYMENT AMOUNT IS DETERMINED BASED UPON 2012 HSS POVERTY GUIDELINES.SAINT CATHERINE'S MEDICAL CENTER CAMPUS
PART VI, LINE 2: IN AN EFFORT TO UNDERSTAND AND ASSIST IN ADDRESSING THE NEEDS OF THE COMMUNITY WE SERVE, UNITED HOSPITAL SYSTEM HAS INVOLVEMENT IN A VARIETY OF COMMUNITY COMMITTEES. UNITED HOSPITAL SYSTEM HAS MULTIPLE STAFF, MANAGEMENT AND ADMINISTRATIVE LEVEL EMPLOYEES PARTICIPATE IN COMMITTEES THAT ARE SET UP TO ASSESS AND ADDRESS NEEDS IN THE COMMUNITY SUCH AS A HEALTHY LIFESTYLE COMMITTEE, MENTAL HEALTH COMMITTEE, INJURY PREVENTION COMMITTEE, SUICIDE PREVENTION COMMITTEE, INFANT MORTALITY COMMITTEE. THROUGH OUR PARTICIPATION IN COMMUNITY COMMITTEES WE GAIN AN UNDERSTANDING ABOUT THE NEEDS OF THE COMMUNITY AS WELL AS THE OPPORTUNITY TO WORK TOGETHER TO ADDRESS THE NEEDS.
PART VI, LINE 3: WHEN STATEMENTS ARE SENT FROM OUR FINANCIAL SYSTEM, THERE IS A PHONE NUMBER FOR THE PATIENT TO CALL FOR ASSISTANCE WITH THEIR BALANCES. PATIENTS CALL AND WE WORK WITH THEM TO SET UP PAYMENT ARRANGEMENTS. IF THEY EXPRESS ANY CONCERNS FOR FINANCIAL NEEDS WE OFFER TO SEND THEM A COMMUNITY CARE APPLICATION.
PART VI, LINE 4: KENOSHA COUNTY IS A FAST GROWING LAKESHORE COUMMUNITY IN SOUTHEASTERN WISCONSIN. LOCATED BETWEEN CHICAGO AND MILWAUKEE, KENOSHA COUNTY BOASTS A DIVERSE ECONOMY. KENOSHA IS THE FOURTH LARGEST CITY IN THE STATE OF WISCONSIN WITH 99,218 RESIDENTS REPORTED IN THE 2010 CENSUS. KENOSHA IS NOW THE EIGHTH LARGEST COUNTY IN WISCONSIN IN TERMS OF POPULATION WITH 166,426 RESIDENTS. UNITED HOSPITAL SYSTEM SERVES PEOPLE IN SOUTHEASTERN WISCONSIN AND NORTHERN ILLINOIS THROUGH ITS TWO HOSPITAL CAMPUSES, ST CATHERINE'S MEDICAL CENTER AND KENOSHA MEDICAL CENTER. AURORA MEDICAL CENTER ALSO HAS A HOSPITAL CAMPUS IN KENOSHA.
PART VI, LINE 5: UNITED HOSPITAL SYSTEM IS COMMITTED TO IMPROVING THE HEALTH OF OUR PATIENTS AND NEIGHBORS. WE OFFER A VARIETY OF COMMUNITY OUTREACH PROGRAMS TO HELP THE GENERAL PUBLIC MAINTAIN GOOD HEALTH. THESE INCLUDE FREE COMMUNITY EDUCATION SEMINARS, HEALTH SCREENINGS, AND VARIOUS SUPPORT GROUPS.
WIREPORTS FILED WITH STATESPART VI, LINE 7

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained0RecordsMaintained

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantSCHOLARSHIP FINANCIAL ASSISTANCE TO INDIVIDUALSTypeOfGrant
Number Of Recipients9NumberOfRecipients
Amount Of Cash Grant9075AmountOfCashGrant

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Independent ConsultantXIndependentConsultant
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (11 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
RICHARD O SCHMIDT JR
PRESIDENT/CEO/DIRECTOR7361350325467012871011945002508701219010000
RAYMOND KNIGHT MD
DIRECTOR/PHYSICIAN37334100030480194500204270416266000
W HARLEY SOBIN MD
DIRECTOR/PHYSICIAN25835707511090158401945002042701050927000
LINDA WOHLGEMUTH
ASST SECRETARY/VP-COO-SCMC36304407204602322044450075500489412000
THOMAS KELLEY
ASST TREASURER/VP-CFO25296605000005020444500204270368345000
SUSAN VENTURA
SVP/COO-KMCC36304407204603564044450075500490654000
ASHWANI SETHI MD
PHYSICIAN4461800558746055201945002226601047194000
MARIO GARRETTO MD
PHYSICIAN5189800434749015840194500220750996838000
KATHERINE ABBO MD
PHYSICIAN6037080001584019450055640630306000
RAMANUJA MANDA MD
PHYSICIAN59988500015840194500184410639360000
JAMES SHAPIRO MD
PHYSICIAN25994203750000552019450020750657019000

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
ROBERT LEE
DIRECTOR289516SERVICES PROVIDED BY LEE PLUMBING0
DAVID RILEY
DIRECTOR1129442SERVICES PROVIDED BY RILEY CONSTRUCTION0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION B, LINE 11FORM 990 IS REVIEWED BY THE ORGANIZATION'S CFO AND CONTROLLER PRIOR TO FILING. A COPY OF THE 990 IS PROVIDED TO THE GOVERNING BOARD PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CUNITED HOSPITAL SYSTEM'S WRITTEN CONFLICT OF INTEREST POLICY FOR THE BOARD IS REVIEWED ANNUALLY BY EACH BOARD MEMBER, AND ANY POTENTIAL CONFLICTS OF INTEREST ARE DISCLOSED AT THAT TIME. THE WRITTEN CONFLICT OF INTEREST POLICY FOR EMPLOYEES IS REVIEWED DURING ORIENTATION AND PERIODICALLY AT ORGANIZATION MEETINGS, AND IS INCORPORATED INTO THE PERFORMANCE STANDARDS OF THEIR ANNUAL EVALUATIONS. IF A CONFLIC ARISES, DEPENDING UPON THE NATURE OF THE FINANCIAL INTEREST AND WORK DONE BY THE BOARD, SEVERAL ACTIONS MAY BE CONSIDERED: THE BOARD MEMBER WITH A FINANCIAL INTEREST WOULD NEED TO VOLUNTARILY EXCUSE HIM OR HERSELF FROM THE DELIBERATIONS OR VOTING ON SUCH A MATTER; OR, IF NECESSARY, THE BOARD WOULD DETERMINE THAT THE SUBJECT'S FINANCIAL INTEREST WAS AN ACTUAL CONFLICT OF INTEREST, IN WHICH CASE THE BOARD MEMBER WOULD BE INFORMED BY THE BOARD CHAIRPERSON THAT HE OR SHE WOULD NOT BE ALLOWED TO VOTE IN ANY SUCH MATTERS DUE TO THIS REAL OR PERCEIVED CONFLICT OF INTEREST. MINUTES OF THE BOARD MEETING WOULD DOCUMENT THIS DECISION PROCESS, AND REFLECT WHATEVER ACTION(S) ARE ULTIMATELY TAKEN.
FORM 990, PART VI, SECTION B, LINE 15THE COMPENSATION FOR THE PRESIDENT, CEO AND GENERAL COUNSEL AND THE COMPENSATION FOR THE VICE PRESIDENTS REPORTING DIRECTLY TO THE PRESIDENT, CEO AND GENERAL COUNSEL ARE DETERMINED BY THE BOARD EXECUTIVE COMMITTEE WHICH SERVES AS THE BOARD COMPENSATION COMMITTEE. THE BOARD COMPENSATION COMMITTEE CONTRACTS WITH THE HEALTHCARE COMPENSATION FIRM NAMED THE GROVES GROUP, LLC, AND HAS UTILIZED THE PRESIDENT OF THE GROVES GROUP, LLC AS THE COMPENSATION CONSULTANT SINCE 2005. THE COMPENSATION CONSULTANT UTILIZES A METHODOLOGY THAT EVALUATES INTERNAL AND EXTERNAL EQUITY AFTER EVALUATING THE RESPONSIBILITIES OF EACH POSITION AND MAKES A RECOMMENDATION TO THE BOARD COMPENSATION COMMITTEE. THE BOARD COMPENSATION COMMITTEE HAS FOLLOWED THE DETAILED RECOMMENDATIONS OF THE COMPENSATION CONSULTANT ANNUALLY SINCE 2005 AND THE COMPENSATION CONSULTANT HAS BEEN RETAINED THROUGH 2015.
FORM 990, PART VI, SECTION C, LINE 19THESE DOCUMENTS ARE MADE AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 9:CHANGE IN MINIMUM PENSION OBLIGATION 32,510,365. REVENUE SHARING WITH AFFILIATE -9,174,350. MACRS DEPRECIATION ADJUSTMENT -353,670.CHANGES IN NET ASSETS OR FUND BALANCES:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusControlled OrgControlledOrg
ST CATHERINE'S HOSPITAL INC
6308 8TH AVENUEKENOSHAWI53143390855075HEALTHCAREWI501(C)(3)LINE 11B, II0
UHS INC
6308 8TH AVENUEKENOSHAWI53143391956749HEALTHCAREWI501(C)(3)LINE 90
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg