AGNESIAN HEALTHCARE INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: AGNESIAN HEALTHCARE INC (EIN 39-0807236)
Tax period: 2012-07-01 to 2013-06-30
Filed: 2014-05-14
IRS object ID: 201421349349306187
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
Form 990
Schedule A
Schedule C
Schedule D
Schedule H
Schedule J
Schedule K
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2014-05-14T15:10:57-05:00	Timestamp
Tax Period End Date	2013-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Field	Value	IRS element (for citing)
EIN	390758449	EIN

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	WIPFLI LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 12237	AddressLine1
City	GREEN BAY	City
State	WI	State
ZIP Code	543072237	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2012-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	390807236	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	AGNESIAN HEALTHCARE INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	AGNE	NameControl
Phone	9209262300	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	430 EAST DIVISION ST	AddressLine1
City	FOND DU LAC	City
State	WI	State
ZIP Code	53935	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	BONNIE SCHMITZ	Name
Title	VP AND CFO	Title
Phone	9209262300	Phone
Date Signed	2014-05-13	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	TERRI REXRODE CPA MST	Name
PTIN	P00096513	PTIN
Phone	9206620016	Phone
Date Prepared	2014-05-13	DatePrepared

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2015-11-30 17:44:51Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	STEVEN LITTLE CEO	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	430 EAST DIVISION ST	AddressLine1
City	FOND DU LAC	City
State	WI	State
ZIP Code	53935	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	397721644	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
All Affiliates Included	1	AllAffiliatesIncluded
Group Exemption Number	0928	GroupExemptionNumber
Organization501c3	X	Organization501c3
Web Site	WWW.AGNESIAN.COM	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1892	YearFormation
State Legal Domicile	WI	StateLegalDomicile
Activity Or Mission Description	AGNESIAN HEALTHCARE IS A LOCALLY-BASED, INTEGRATED HEALTHCARE SYSTEM WHICH BEGAN ITS MISSION IN 1892. THE SYSTEM IS COMPRISED OF SEVEN MINISTRIES - ST. AGNES HOSPITAL, WAUPUN MEMORIAL HOSPITAL, RIPON MEDICAL CENTER, ST. FRANCIS HOME, FOND DU LAC REGIONAL CLINIC, CONSULTANTS LABORATORY OF WISCONSIN, AND AGNESIAN HEALTHCARE ENTERPRISES. AGNESIAN PROVIDES A CONTINUUM OF HEALTHCARE SERVICES FROM BIRTH TO END OF LIFE, PREVENTIVE HEALTHCARE DIAGNOSIS, TREATMENT AND FOLLOWUP, ASSISTED LIVING, AND INDEPENDENT SKILL CARE SERVICES.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	16	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	12	NbrIndependentVotingMembers
Total Nbr Employees	3230	TotalNbrEmployees
Total Nbr Volunteers	630	TotalNbrVolunteers
Total Gross UBI	5698765	TotalGrossUBI
Net Unrelated Business Txbl Income	598454	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	0	ContributionsGrantsPriorYear
Contributions Grants Current Year	0	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	303846638	ProgramServiceRevenuePriorYear
Program Service Revenue CY	309916813	ProgramServiceRevenueCY
Investment Income Prior Year	4671883	InvestmentIncomePriorYear
Investment Income Current Year	8489027	InvestmentIncomeCurrentYear
Other Revenue Prior Year	15415062	OtherRevenuePriorYear
Other Revenue Current Year	15364161	OtherRevenueCurrentYear
Total Revenue Prior Year	323933583	TotalRevenuePriorYear
Total Revenue Current Year	333770001	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	0	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	131086985	SalariesEtcPriorYear
Salaries Etc Current Year	136508008	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	173115111	OtherExpensePriorYear
Other Expenses Current Year	173932625	OtherExpensesCurrentYear
Total Expenses Prior Year	304202096	TotalExpensesPriorYear
Total Expenses Current Year	310440633	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	19731487	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	23329368	RevenuesLessExpensesCY
Total Assets BOY	405106873	TotalAssetsBOY
Total Assets EOY	470805863	TotalAssetsEOY
Total Liabilities BOY	179598113	TotalLiabilitiesBOY
Total Liabilities EOY	208582531	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	225508760	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	262223332	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	THE MISSION OF AGNESIAN HEALTHCARE IS TO PROVIDE COMPASSIONATE CARE THAT BRINGS HOPE, HEALTH AND WHOLENESS TO THOSE WE SERVE BY HONORING THE SACREDNESS AND DIGNITY OF ALL PERSONS AT EVERY STAGE OF LIFE. WE ARE ROOTED IN THE HEALING MINISTRY OF THE CATHOLIC CHURCH AS WE CONTINUE THE MISSION OF OUR SPONSOR, THE CONGREGATION OF SISTERS OF ST AGNES.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	205719455	Expense
Revenue	293043925	Revenue
Description	AGNESIAN HEALTHCARE OPERATES ST. AGNES HOSPITAL, A 160-BED GENERAL/SURGICAL ACUTE CARE HOSPITAL WHICH PROVIDES INPATIENT AND OUTPATIENT SERVICES TO RESIDENTS OF FOND DU LAC AND THE SURROUNDING COUNTIES. DURING FISCAL YEAR 2013, ST. AGNES HOSPITAL HAD 6,899 INPATIENT ADMISSIONS, WITH TOTAL PATIENT DAYS OF 28,468. THERE WAS A TOTAL OF 28,016 EMERGENCY ROOM VISITS AND 12,880 SURGERIES PERFORMED IN FY13. IN ADDITION, ST. AGNES HOSPITAL PROVIDED 402,034 PHYSICIAN CLINIC VISITS, 106,379 MEDICAL IMAGING PROCEDURES, AND 1,305,390 PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY UNITS. THERE WERE 1,614 CARDIAC CATH LAB VISITS AND 41,558 HOSPICE DAYS. THE HOSPITAL ALSO OPERATES SAMARITAN CLINIC, A FREE CLINIC OFFERING MEDICAL SERVICES TO QUALIFIED INDIVIDUALS. SAMARITAN CLINIC PROVIDED 5,018 VISITS TO PATIENTS, AT A COST OF $686,304 FOR FY13. THE HOSPITAL MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY IT PROVIDES TO ITS PATIENTS. THE COST OF SERVICES AND SUPPLIES FURNISHED UNDER THE HOSPITAL'S CHARITY CARE POLICY WAS $3,432,216. IN ADDITION TO QUALITY HEALTH CARE SERVICES, ST. AGNES HOSPITAL PROVIDES ITS COMMUNITIES WITH EDUCATION, SUPPORT GROUPS AND OTHER COMMUNITY BENEFITS. THE NET COST OF THESE COMMUNITY BENEFITS WAS $3,562,857.	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	13011665	Expense
Revenue	16373861	Revenue
Description	AGNESIAN HEALTHCARE OPERATES CONSULTANTS LABORATORY OF WISCONSIN, AN INDEPENDENT REFERENCE LAB SERVING FOND DU LAC, DODGE, OUTAGAMIE, WINNEBAGO AND COLUMBIA COUNTIES. CLW PROVIDED 1,142,773 TESTS DURING FISCAL YEAR 2013. THE LABORATORY ALSO PROVIDES THE COMMUNITY WITH CAREER EDUCATION, CONTRIBUTIONS AND SERVICES TO SAMARITAN CLINIC. THE NET COST OF THESE COMMUNITY BENEFITS WAS $330,846. THE COST OF SERVICES AND SUPPLIES FURNISHED UNDER THE CHARITY CARE POLICY WAS $129,221.	Description

Activity3 Activity3

Field	Value	IRS element (for citing)
Expense	6775122	Expense
Revenue	8978648	Revenue
Description	AGNESIAN HEALTHCARE OPERATES AGNESIAN ENTERPRISES, WHICH IS COMPRISED OF EIGHT PHARMACIES SERVING FOND DU LAC AND SURROUNDING TOWNS, AS WELL AS AGNESIAN HEALTH SHOPPE, WHICH SERVES THE POPULATION WITH HOSPITAL (INPATIENT AND OUTPATIENT), CLINIC AND HOME HEALTH EQUIPMENT. AGNESIAN ENTERPRISES FILLED 434,971 PRESCRIPTIONS DURING FY13. AGNESIAN HEALTH SHOPPE PROVIDES RETAIL SALES OF DURABLE MEDICAL EQUIPMENT, AS WELL AS TELECARE AND HOME OXYGEN SERVICES. THE COST OF SERVICES AND SUPPLIES FURNISHED UNDER AHE'S CHARITY CARE POLICY WAS $15,000. AGNESIAN HEALTHCARE ENTERPRISES CONTRIBUTES TO COMMUNITY BENEFIT WITH SEVERAL SUPPORT GROUPS. THE COST OF COMMUNITY BENEFIT WAS $3,181.	Description

Field	Value	IRS element (for citing)
Total Program Service Expense	225506242	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	0	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	1	LobbyingActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	1	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	1	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	1	ReportFin48Footnote
Independent Audit Financial Stmt	0	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	1	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Financial Stmt Attached	1	FinancialStmtAttached
Grants To Organizations	0	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	1	TaxExemptBonds
Invest Tax Exempt Bonds	0	InvestTaxExemptBonds
Escrow Account	0	EscrowAccount
On Behalf Of Issuer	0	OnBehalfOfIssuer
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	1	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	1	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	1	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	1	RelatedOrgControlledEntity
Transaction Related Entity	0	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	281	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	3230	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	1	UnrelatedBusinessIncome
Form990-T Filed	1	Form990-TFiled
Foreign Financial Account	1	ForeignFinancialAccount
Name Of Foreign Country	CJ	NameOfForeignCountry
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	16	NbrVotingGoverningBodyMembers
Number Independent Voting Members	12	NumberIndependentVotingMembers
Family Or Business Relationship	0	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	1	MembersOrStockholders
Election Of Board Members	1	ElectionOfBoardMembers
Decisions Subject To Approval	1	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	1	InvestmentInJointVenture
Written Policy Or Procedure	1	WrittenPolicyOrProcedure
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	LESLIE STEPHANY	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	9209264512	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	430 EAST DIVISION STREET	AddressLine1
City	FOND DU LAC	City
State	WI	State
ZIP Code	54935	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (33 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee	FormerFormer
STEVEN N LITTLE
PRESIDENT AND CEO	50.00	X	X	764859	0	35201
SR MARY NOEL BROWN
EX-OFFICIO	1.00	X		0	0	0
JAMES R CHATTERTON
VICE CHAIRPERSON	1.00	X	X	0	0	0
DENISE DEVERAUX
DIRECTOR	1.00	X		0	0	0
JOAN KARSTEN
DIRECTOR	1.00	X		0	0	0
SR ANN KOERNER
EX-OFFICIO	1.00	X		0	0	0
SR HERTHA LONGO
DIRECTOR	1.00	X		0	0	0
STEPHEN MASSICK MD
DIRECTOR	1.00	X		0	0	0
WAYNE MATZKE
TREASURER	1.00	X	X	0	0	0
ROBERT MIKKELSON MD
DIRECTOR	1.00	X		0	0	0
H JACK POLLEI
DIRECTOR	1.00	X		10042	0	0
JOSEPH REITEMEIER
CHAIRPERSON	1.00	X	X	0	0	0
JAMES B SIMON
SECRETARY	1.00	X	X	4859	0	0
MICHAEL STRINGENZ MD
DIRECTOR	1.00	X		0	0	0
JEFFERY STRONG MD
DIRECTOR	1.00	X		0	0	0
DR JUDITH WESTPHAL
DIRECTOR	1.00	X		0	0	0
ALLAN MILANI MD
EX-OFFICIO	1.00	X		464776	0	24695
JAMES P MUGAN
SR VP CLINICAL SERVICES &	50.00			345315	0	38946	X
BONNIE SCHMITZ
CHIEF FINANCIAL OFFICER	50.00			296640	0	22465	X
DENNIS YUNK
SR VP CLINIC ADMINISTRATOR	50.00			274980	0	29865	X
CAROL B HYLAND
PRESIDENT AND CEO - CLW	50.00			263848	0	31734	X
DOUGLAS D TROST
CEO - ST FRANCIS HOME	50.00			220682	0	30136	X
SR MARY MOLLISON
VP SPIRITUALITY AND CARE T	50.00			214662	0	9271	X
BARBARA LKNUTZEN
PRES AND CEO-AHE AND PERFO	50.00			205693	0	25899	X
SUSAN L EDMINSTER
VP - HUMAN RESOURCES	50.00			202817	0	18660	X
NANCY A BIRSCHBACH
VP - CIO	50.00			175189	0	31367	X
JILL A STENSON
VP NURSING	50.00			172491	0	17170	X
JOHN CHOI MD
ANESTHESIOLOGIST - PAIN RE	50.00			983914	0	31933		X
YASIR HATAHET MD
INTENSIVIST	50.00			855374	0	40652		X
PONTUS OSTMAN MD
ANESTHESIOLOGIST - PAIN RE	50.00			801295	0	15985		X
HONG C WANG MD
RADIATION ONCOLOGIST	50.00			595869	0	32562		X
STEVEN FLURRY MD
ANESTHESIOLOGIST	50.00			588271	0	30910		X
ROBERT A FALE
FORMER PRESIDENT AND CEO	40.00			478292	0	13172			X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	7919868	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	480623	TotalOtherCompensation
Number Individuals GT100 K	140	NumberIndividualsGT100K
Formers Listed	1	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
FOND DU LAC REGIONAL CLINIC
420 E DIVISION ST	FOND DU LAC	WI	54935	PHYSICIAN SERVICES	51442636
CERNER CORP
2800 ROCKCREEK PKWY	KANSAS CITY	MO	64141	COMPUTER SERVICES	8678458
IBM CORPORATION
1 NEW ORCHARD RD	ARMONK	NY	105041722	COMPUTER SERVICES	8534858
CD SMITH CONSTRUCTION
PO BOX 1066	FOND DU LAC	WI	54935	CONSTRUCTION	5686980
AMERICAN HEALTHCARE SERVICES
PO BOX 945	TRAVERSE CITY	MI	49685	TEMPORARY STAFFING	1304382

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	67	NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue
NET PATIENT SERVICE REVENUE	621400	194037946	192099590	1938356
MEDICARE/MEDICAID SERVICE REVENUE	621400	115878867	115878867

Field	Value	IRS element (for citing)
Total Program Service Revenue	309916813	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	5256125	TotalRevenueColumn
Exclusion	$5,256,125	ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

Field	Value	IRS element (for citing)
Total Revenue Column	95081	TotalRevenueColumn
Exclusion	$95,081	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	46130252	Securities
Other	73305	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	43046860	Securities
Other	18876	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	3083392	Securities
Other	54429	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	3137821	TotalRevenueColumn
Exclusion	$3,137,821	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	30494468	GrossSalesOfInventory
Cost Of Goods Sold	20885907	CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	9608561	TotalRevenueColumn
Related Or Exempt Function Income	5873295	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	3735266	UnrelatedBusinessRevenue

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue	ExclusionExclusionAmount
WORK INJURY - SAH	592512	1324359	1324359
CAFETERIA SALES	900099	1210918		25143	$1,185,775
CLINIC REIMBURSEMENT	621110	755420	755420

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	2464903	TotalRevenueColumn
Related Or Exempt Function Income	2464903	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Other Revenue	5755600	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	333770001	TotalRevenueColumn
Related Or Exempt Function Income	318396434	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	5698765	UnrelatedBusinessRevenue
Exclusion	$9,674,802	ExclusionAmount

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	X	InfoInScheduleOPartIX

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	4095145	Total
Program Services	464776	ProgramServices
Management And General	3630369	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	114954178	Total
Program Services	94463873	ProgramServices
Management And General	20490305	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	6015311	Total
Program Services	4517887	ProgramServices
Management And General	1497424	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	3628363	Total
Program Services	252831	ProgramServices
Management And General	3375532	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	7815011	Total
Program Services	6028072	ProgramServices
Management And General	1786939	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	240776	Total
Program Services	1148	ProgramServices
Management And General	239628	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	136671	Total
Management And General	136671	ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	617224	Total
Management And General	617224	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	61656928	Total
Program Services	58697102	ProgramServices
Management And General	2959826	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	1481765	Total
Program Services	46782	ProgramServices
Management And General	1434983	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	49182521	Total
Program Services	45611264	ProgramServices
Management And General	3571257	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	25461758	Total
Program Services	8391	ProgramServices
Management And General	25453367	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	5235834	Total
Program Services	1667992	ProgramServices
Management And General	3567842	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	630701	Total
Program Services	520703	ProgramServices
Management And General	109998	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	676277	Total
Program Services	459521	ProgramServices
Management And General	216756	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	4473513	Total
Management And General	4473513	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	12972000	Total
Program Services	5766957	ProgramServices
Management And General	7205043	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	2329696	Total
Program Services	1303959	ProgramServices
Management And General	1025737	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
HOSPITAL ASSESSMENT TAX	5151952	5151952
MISCELLANEOUS EXPENSES	2284053	236657	2047396
LOSS ON DEFEASANCE OF B	734929		734929
DUES, SUBSCRIPTIONS AND	666027	306375	359652

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	310440633	Total
Program Services	225506242	ProgramServices
Management And General	84934391	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	5837093	BOY
EOY	8477558	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	8935657	BOY
EOY	13801713	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	44502314	BOY
EOY	48131908	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	4857997	BOY
EOY	4643411	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	2612600	BOY
EOY	2771241	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	305678988	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	158229944	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	136806603	BOY
EOY	147449044	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	146174087	BOY
EOY	169914673	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	55380522	BOY
EOY	75616315	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	405106873	BOY
EOY	470805863	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	27123150	BOY
EOY	31020630	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	125173728	BOY
EOY	142479805	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	27301235	BOY
EOY	35082096	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	179598113	BOY
EOY	208582531	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	212398409	BOY
EOY	251329672	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	10649139	BOY
EOY	8737112	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	2461212	BOY
EOY	2156548	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	225508760	BOY
EOY	262223332	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	405106873	BOY
EOY	470805863	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	23329368	ReconcilationRevenueExpenses
Reconciliation Unrealized Invest	6047675	ReconciliationUnrealizedInvest
Reconcilation Donated Services	50848	ReconcilationDonatedServices
Reconcilation Other Changes	7286681	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited

FS Audited Basis FSAuditedBasis

Field	Value	IRS element (for citing)
Financial Statement Consolidated	X	FinancialStatementConsolidated

Field	Value	IRS element (for citing)
Audit Committee	1	AuditCommittee
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	Volunteers
Paid Staff Or Management	0	PaidStaffOrManagement
Media Advertisements	0	MediaAdvertisements
Mailings Members	0	MailingsMembers
Publications Or Broadcast	0	PublicationsOrBroadcast
Grants Other Organizations	0	GrantsOtherOrganizations
Direct Contact Legislators	0	DirectContactLegislators
Rallies Demonstrations	0	RalliesDemonstrations
Other Activities	1	OtherActivities
Other Activities	$16,982	OtherActivitiesAmount
Total Lobbying Expenditures IIB	16982	TotalLobbyingExpendituresIIB
Not Described In501c3	0	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	EXPLANATION OF LOBBYING ACTIVITIES:	Identifier
Return Reference	PART II-B, LINE 1:	ReturnReference
Explanation	OTHER LOBBYING ACTIVITIES: LOBBYING PORTION OF WHA AND AHA DUES.	Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	1004976	BeginningOfYearBalance
Investment Earnings Or Losses	57144	InvestmentEarningsOrLosses
Other Expenditures	40000	OtherExpenditures
Administrative Expenses	2733	AdministrativeExpenses
End Of Year Balance	1019387	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	992140	BeginningOfYearBalance
Investment Earnings Or Losses	15366	InvestmentEarningsOrLosses
Administrative Expenses	2530	AdministrativeExpenses
End Of Year Balance	1004976	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	996299	BeginningOfYearBalance
Investment Earnings Or Losses	48126	InvestmentEarningsOrLosses
Other Expenditures	50000	OtherExpenditures
Administrative Expenses	2285	AdministrativeExpenses
End Of Year Balance	992140	EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	1020134	BeginningOfYearBalance
Investment Earnings Or Losses	23156	InvestmentEarningsOrLosses
Other Expenditures	45000	OtherExpenditures
Administrative Expenses	1991	AdministrativeExpenses
End Of Year Balance	996299	EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	1014822	BeginningOfYearBalance
Contributions	45000	Contributions
Investment Earnings Or Losses	-37548	InvestmentEarningsOrLosses
Administrative Expenses	2140	AdministrativeExpenses
End Of Year Balance	1020134	EndOfYearBalance

Field	Value	IRS element (for citing)
Permanent Endowment EOY Balance	1.00000	PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs	0	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	1	EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R	1	AreRelatedOrgsListedScheduleR

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	6165464	OtherCostOrOtherBasis
Book Value	6165464	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	145319866	OtherCostOrOtherBasis
Depreciation	59666962	Depreciation
Book Value	85652904	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	2958597	OtherCostOrOtherBasis
Depreciation	1161294	Depreciation
Book Value	1797303	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	137204580	OtherCostOrOtherBasis
Depreciation	97401688	Depreciation
Book Value	39802892	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	14030481	OtherCostOrOtherBasis
Book Value	14030481	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	147449044	TotalOfBookValueLandBuildings

Other Assets OtherAssets (10 entries)

DescriptionDescription	Book ValueBookValue
DUE FROM AFFILIATED ENTITIES	1628018
LONG-TERM DEBT FROM AFFILIATED ENTITY	5000000
INVESTMENT - MERCURY CLINIC	3005130
INVESTMENT - SAH FOUNDATION	9833328
OTHER RECEIVABLES	800795
BOND DEFERRED FINANCING COSTS	1163208
ASSETS WHOSE USE IS LIMITED - BOND FUNDS	26345637
ASSETS WHOSE USE IS LIMITED - PHYSICIAN SUPPLEMENTAL BENEFIT PLAN	24936423
MISCELLANEOUS RECEIVABLES	2228137
DUE FROM FOUNDATION	675639

Field	Value	IRS element (for citing)
Total Book Value Other Assets	75616315	TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (6 entries)

DescriptionDescription	AmountAmount
CAPITAL LEASE PAYABLE	$7,565,556
PHYSICIANS SUPPLEMENTAL BENEFIT PLAN	$24,228,143
FUND BAL SWAP MKT ADJUSTMENT	$2,055,151
DUE TO MEDICARE/MEDICAID	$310,385
EXECUTIVE DEFERRED COMPENSATION PLAN	$708,280
LAND CONTRACT - FAMILY FOOT CLINIC	$214,581

Field	Value	IRS element (for citing)
Total Of Amounts	35082096	TotalOfAmounts
Footnote In Part XIII	X	FootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:	PART V, LINE 4:	AGNESIAN HEALTHCARE, INC. HOLDS AN ENDOWMENT FROM THE CONGREGATION OF THE SISTERS OF ST. AGNES. THE ORIGINAL ENDOWMENT OF $1,000,000 IS PERMANENTLY RESTRICTED. INCOME GENERATED FROM THE ENDOWMENT IS UNRESRICTED AND TO BE USED AT THE DISCRETION OF THE CHIEF EXECUTIVE OFFICER TO FUND PROGRAMS SUCH AS DOMESTIC VIOLENCE, CHARITY CARE, ETC.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:	PART X, LINE 2:	IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, ASC TOPIC 740-10, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, REQUIRES AN ORGANIZATION TO ASSESS WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE 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 THE TAX POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. AGNESIAN HEALTHCARE, INC. RECORDED NO ASSETS OR LIABILITIES FOR UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS. FEDERAL RETURNS FOR THE YEARS ENDED 2010, 2011, AND 2012 REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
Policy Applied To All Hospitals	X	PolicyAppliedToAllHospitals
FPG Reference Free Care	1	FPGReferenceFreeCare

Other Percentage OtherPercentage

Field	Value	IRS element (for citing)
Other	X	Other
Free Other Percentage	165.000000000000	FreeOtherPercentage

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	1	FPGReferenceDiscountedCare
Pcent300	X	Pcent300
Free Disc Care Medically Indigent	1	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	1	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	1	ExpensesExceededBudget
Unable To Provide Care	0	UnableToProvideCare
Annual Community Benefit Report	1	AnnualCommunityBenefitReport
Report Publically Available	1	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	3576437	TotalCommunityBenefitExpense
Net Community Benefit Expense	3576437	NetCommunityBenefitExpense
Percent Of Total Expense	0.01150	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	11380592	TotalCommunityBenefitExpense
Net Community Benefit Expense	11380592	NetCommunityBenefitExpense
Percent Of Total Expense	0.03670	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	14957029	TotalCommunityBenefitExpense
Net Community Benefit Expense	14957029	NetCommunityBenefitExpense
Percent Of Total Expense	0.04820	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1205960	TotalCommunityBenefitExpense
Direct Offsetting Revenue	74381	DirectOffsettingRevenue
Net Community Benefit Expense	1131579	NetCommunityBenefitExpense
Percent Of Total Expense	0.00360	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	465729	TotalCommunityBenefitExpense
Net Community Benefit Expense	465729	NetCommunityBenefitExpense
Percent Of Total Expense	0.00150	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	853790	TotalCommunityBenefitExpense
Net Community Benefit Expense	853790	NetCommunityBenefitExpense
Percent Of Total Expense	0.00280	PercentOfTotalExpense

Research Research

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1559	TotalCommunityBenefitExpense
Net Community Benefit Expense	1559	NetCommunityBenefitExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1222756	TotalCommunityBenefitExpense
Net Community Benefit Expense	1222756	NetCommunityBenefitExpense
Percent Of Total Expense	0.00390	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	3749794	TotalCommunityBenefitExpense
Direct Offsetting Revenue	74381	DirectOffsettingRevenue
Net Community Benefit Expense	3675413	NetCommunityBenefitExpense
Percent Of Total Expense	0.01180	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	18706823	TotalCommunityBenefitExpense
Direct Offsetting Revenue	74381	DirectOffsettingRevenue
Net Community Benefit Expense	18632442	NetCommunityBenefitExpense
Percent Of Total Expense	0.06000	PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

Field	Value	IRS element (for citing)
Total Community Building Expense	987	TotalCommunityBuildingExpense
Net Community Building Expense	987	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Economic Development EconomicDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	3988	TotalCommunityBuildingExpense
Net Community Building Expense	3988	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Community Support CommunitySupport

Field	Value	IRS element (for citing)
Total Community Building Expense	1215	TotalCommunityBuildingExpense
Net Community Building Expense	1215	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Leadership Development LeadershipDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	5240	TotalCommunityBuildingExpense
Net Community Building Expense	5240	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Coalition Building CoalitionBuilding

Field	Value	IRS element (for citing)
Total Community Building Expense	20029	TotalCommunityBuildingExpense
Net Community Building Expense	20029	NetCommunityBuildingExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

Field	Value	IRS element (for citing)
Total Community Building Expense	136	TotalCommunityBuildingExpense
Net Community Building Expense	136	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	152194	TotalCommunityBuildingExpense
Net Community Building Expense	152194	NetCommunityBuildingExpense
Percent Of Total Expense	0.00050	PercentOfTotalExpense

Other Other

Field	Value	IRS element (for citing)
Total Community Building Expense	37682	TotalCommunityBuildingExpense
Net Community Building Expense	37682	NetCommunityBuildingExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Total Community Building Expense	221471	TotalCommunityBuildingExpense
Net Community Building Expense	221471	NetCommunityBuildingExpense
Percent Of Total Expense	0.00070	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	1	BadDebtExpenseReported
Bad Debt Expense	$15,298,309	BadDebtExpenseAmount
Amount Attributable To	0	AmountAttributableTo
Amount Reimbursed By Medicare	102118000	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	137871622	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-35753622	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Other	X	Other

Field	Value	IRS element (for citing)
Written Debt Collection Policy	1	WrittenDebtCollectionPolicy
Provision For Charity Care	1	ProvisionForCharityCare
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	1	FacilityNumber

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	ST AGNES HOSPITAL	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	430 E DIVISION STREET	AddressLine1
City	FOND DU LAC	City
State	WI	State
ZIP Code	54935	ZIPCode

Field	Value	IRS element (for citing)
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Er24 Hours	X	Er24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	ST AGNES HOSPITAL	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
CHNA Conducted	1	CHNAConducted
Community Definition	X	CommunityDefinition
Community Demographics	X	CommunityDemographics
Existing Resources	X	ExistingResources
How Data Obtained	X	HowDataObtained
Community Health Needs	X	CommunityHealthNeeds
Other Health Issues	X	OtherHealthIssues
Identifying Process	X	IdentifyingProcess
Consulting Process	X	ConsultingProcess
Information Gaps	X	InformationGaps
Needs Assessment Conducted	12	NeedsAssessmentConducted
Take Into Account	1	TakeIntoAccount
Other Facilities	1	OtherFacilities
CHNA Widely Available	1	CHNAWidelyAvailable
Own Website	X	OwnWebsite
On Request	X	OnRequest
Other Method	X	OtherMethod
Adopt Implement Strategy	X	AdoptImplementStrategy
Execute Implement Strategy	X	ExecuteImplementStrategy
Develop Community Plan	X	DevelopCommunityPlan
Participate Community Plan	X	ParticipateCommunityPlan
Include Operational Plans	X	IncludeOperationalPlans
Adopt Budget	X	AdoptBudget
Prioritize Health Needs	X	PrioritizeHealthNeeds
Prioritize Services	X	PrioritizeServices
Other Needs Addressed	X	OtherNeedsAddressed
All Needs Addressed	1	AllNeedsAddressed
Organization Incur Excise Tax	0	OrganizationIncurExciseTax
Eligibility Criteria Explained	1	EligibilityCriteriaExplained
Uses FPG Free	1	UsesFPGFree
FPG Free Percent	165.000000000000	FPGFreePercent
Uses FPG Discounted	1	UsesFPGDiscounted
FPG Discount Percent	300.000000000000	FPGDiscountPercent
Explains Basis	1	ExplainsBasis
Income Level	X	IncomeLevel
Asset Level	X	AssetLevel
Uninsured Discount	X	UninsuredDiscount
State Regulation	X	StateRegulation
Other Factors	X	OtherFactors
Explains Application Method	1	ExplainsApplicationMethod
Includes Publicity Measures	1	IncludesPublicityMeasures
Posted On Website	X	PostedOnWebsite
Posted In Emergency Room	X	PostedInEmergencyRoom
Posted In Admission Office	X	PostedInAdmissionOffice
Provided On Admission	X	ProvidedOnAdmission
Available On Request	X	AvailableOnRequest
Actions On Nonpayment	1	ActionsOnNonpayment
Permit Report To Credit Agency	X	PermitReportToCreditAgency
Permit Other Actions	X	PermitOtherActions
Collection Activities	0	CollectionActivities
Notify Upon Admission	X	NotifyUponAdmission
Notify Before Discharge	X	NotifyBeforeDischarge
Notified All Patients	X	NotifiedAllPatients
Documented Determination	X	DocumentedDetermination
Nondiscrim Emergency Care Policy	1	NondiscrimEmergencyCarePolicy
Used Other Method	X	UsedOtherMethod
Amounts Generally Billed	0	AmountsGenerallyBilled
Gross Charges	1	GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	3	NumberOfOtherFacilities

Other Facilities OtherFacilities (3 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType
FOND DU LAC REGIONAL CLINIC
420 E DIVISION STREET	FOND DU LAC	WI	54935	OUTPATIENT PHYSICIAN CLINIC
CONSULTANTS LAB OF WISCONSIN LLC
430 E DIVISION STREET	FOND DU LAC	WI	54935	LABORATORY AND TESTING
AGNESIAN HEALTHCARE ENTERPRISES LLC
430 E DIVISION STREET	FOND DU LAC	WI	54935	PHARMACEUTICALS, HOME HEALTH, MEDICAL SUPPLIES

Form990 Schedule H Part VI Form990ScheduleHPartVI (24 entries)

ExplanationExplanation	Return ReferenceReturnReference	IdentifierIdentifier
PART I, LINE 6A: AN ANNUAL COMMUNITY BENEFIT REPORT IS COMPLETED BY THE FINANCE DEPARTMENT AND DISTRIBUTED TO THE PUBLIC THROUGH THE PUBLIC RELATIONS OFFICE OF AGNESIAN HEALTHCARE, INC.
PART I, LINE 7: A COST-TO-CHARGE RATIO WAS USED TO COMPUTE COST OF COMMUNITY BENEFIT SERVICES. OVERALL COSTS LESS TAXES WERE DIVISIBLE BY TOTAL CHARGES.
PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES INCLUDES SAMARITAN CLINIC, A CLINIC OFFERING FREE MEDICAL SERVICES TO QUALIFIED INDIVIDUALS. SAMARITAN CLINIC COSTS WERE $686,304 FOR FISCAL YEAR 2013. THE SAMARITAN HEALTH CLINIC PROVIDES PATIENTS WITH IMPORTANT BASIC HEALTH SERVICES, MEDICATIONS AND URGENT DENTAL NEEDS AT NO CHARGE TO THE PATIENT.
PART I, L7 COL(F): BAD DEBT EXPENSES INCLUDED ON FORM 990, PART VIII, LINE 2 WAS $15,298,309 AND WAS EXCLUDED FROM THE DENOMINATOR PER INSTRUCTIONS.
WORKFORCE DEVELOPMENT INCLUDES JOB SHADOWING, CAREERS CAMP, AND THE HEALTHCARE YOUTH APPRENTICE PROGRAM. THESE PROGRAMS ALLOW STUDENTS AND OTHERS TO LEARN ABOUT DIFFERENT OCCUPATIONS IN THE HEALTHCARE INDUSTRY BY BECOMING CERTIFIED AND GAINING ACTUAL WORK EXPERIENCE. THE PROGRAMS ALSO PROMOTE THESE STUDENTS TO BRING VALUABLE HEALTHCARE KNOWLEDGE BACK TO THEIR FAMILIES AND THE COMMUNITY.	PART II, LINE 8
PART III, LINE 4: THE CARRYING AMOUNTS OF ACCOUNTS RECEIVABLE ARE REDUCED BY ALLOWANCES THAT REFLECT MANAGEMENT'S BEST ESTIMATE OF THE AMOUNTS THAT WILL NOT BE COLLECTED. MANAGEMENT PROVIDES FOR CONTRACTUAL ADJUSTMENTS UNDER TERMS OF THIRD-PARTY REIMBURSEMENT AGREEMENTS THROUGH A CHARGE TO CONTRACTUAL ADJUSTMENTS AND A CREDIT TO THE ALLOWANCE FOR CONTRACTUAL ADJUSTMENTS. IN ADDITION, MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY FROM 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 LIKELIHOOD 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 ACCOUNTS RECEIVABLE. THE COSTING METHODOLOGY FOR DETERMINING BAD DEBTS IS A COST TO CHARGE RATIO.
PART III, LINE 8: MEDICARE SHORTFALL IS NOT TREATED AS A COMMUNITY BENEFIT. TO ARRIVE AT COST OF MEDICARE SERVICES, THE TOTAL EXPENSE LESS OTHER OPERATING REVENUE IS MULTIPLIED BY THE RATIO OF MEDICARE REVENUE TO TOTAL REVENUE.ALTHOUGH MEDICARE SHORTFALL HAS NOT BEEN REPORTED AS A COMMUNITY BENEFIT, IT SHOULD BE TREATED AS A COMMUNITY BENEFIT BECAUSE IT PROMOTES ACCESS TO HEALTHCARE TO THE UNDERSERVED ELDERLY POPULATION, WHO WOULD NOT HAVE ACCESS TO LOCAL CARE IF WE WERE NOT ABLE TO SERVE THEM. ALTHOUGH OUR HOSPITAL IS EFFICIENTLY OPERATED, THE CALCULATIONS USED FOR MEDICARE REIMBURSEMENT DO NOT ALLOW FOR PAYMENTS THAT COVER COSTS OF NECESSARY SERVICES.
PART III, LINE 9B: A ZERO DOLLAR AMOUNT WAS ESTIMATED FOR THE AMOUNT OF BAD DEBTS ATTRIBUTABLE TO PATIENTS WHO WOULD QUALIFY FOR FINANCIAL ASSISTANCE. IF PATIENTS QUALIFY, THEIR EXPENSES ARE RECLASSIFIED AS CHARITY CARE. PATIENTS WHO RECEIVED A COLLECTION NOTICE COULD APPLY FOR CHARITY CARE. IF THEIR APPLICATION IS APPROVED, THIS WOULD TRIGGER A TRANSFER OF EXPENSES FROM BAD DEBT TO CHARITY CARE.
AGNESIAN HEALTHCARE, INC. HAS A WRITTEN DEBT COLLECTION POLICY. PAYMENT IS DUE WITHIN 30 DAYS OF RECEIPT OF A STATEMENT. IF PATIENTS DO NOT SET UP ACCEPTABLE PAYMENT ARRANGEMENTS, BILLS WILL BE REFERRED TO AN OUTSIDE COLLECTION AGENCY. FINANCIAL COUNSELORS WORK WITH ALL PATIENTS ON AN INDIVIDUAL BASIS AND MAY OFFER EXTENDED MONTHLY PAYMENTS WITHOUT INTEREST BASED ON DOLLAR AMOUNT, PRIVATE PAY DISCOUNTS (INDIVIDUALS WHO DO NOT HAVE INSURANCE COVERING EMERGANCY OR OTHER MEDICALLY NECESSARY CARE ARE BILLED AT A REDUCED RATE), OR GUARANTEED BANK LOANS.	PART III, LINE 9A
PART V, SECTION B, LINE 3: THE CHNA WAS COMMISSIONED BY THE FDL COMMUNITY HEALTH ASSESSMENT TASK FORCE, WHICH INCLUDED EXECUTIVES FROM THE FOLLOWING ORGANIZATIONS: FDL AREA BUSINESS ON HEALTH, FDL COUNTY HEALTH DEPT, FDL YMCA, AGNESIAN HEALTHCARE, FDL AREA UNITED WAY, FDL SCHOOL DISTRICT, WAUPUN MEMORIAL HOSPITAL, RIPON MEDICAL CENTER, AND AURORA HEALTHCARE. THE TASK FORCE REVIEWED COUNTY AND STATE SPECIFIC DISEASE INCIDENCE AND DEATH DATA, AS WELL AS ECONOMIC, DEMOGRAPHIC, AND HEALTH STATUS DATA. TO SUPPLEMENT THIS DATA, COMMUNITY AND STAKEHOLDER OPINION SURVEYS WERE CONDUCTED TO DETERMINE WHAT PEOPLE IN FDL COUNTY PERCEIVED AS THE MAJOR HEALTH PROBLEMS IN THE COUNTY. COMMUNITY MEMBERS WERE SCIENTIFICALLY SELECTED SO THAT THE SURVEY WOULD BE REPRESENTATIVE OF ALL ADULTS 18 YEARS OLD AND OLDER. A TOTAL OF 800 TELEPHONE INTERVIEWS WERE COMPLETED WITH COMMUNITY MEMBERS. IN ADDITION, SURVEYS WERE CONDUCTED AMONG FDL COUNTY STAKEHOLDERS. STAKEHOLDERS WERE DEFINED AS PEOPLE WHO WERE INVOLVED WITH HUMAN RESOURCE ISSUES SUCH AS BENEFITS, INSURANCE, SICK TIME OR DISABILITY ISSUES AS WELL AS PEOPLE WHO WERE INVOLVED WITH OR AWARE OF THE HEALTH ISSUES RESIDENTS AND FAMILIES FACE THROUGH THEIR PLACE OF WORK OR VOLUNTEER RELATIONSHIPS. A TOTAL OF 84 SURVEYS WERE COMPLETED AMONG STAKEHOLDERS. AFTER COMPLETION OF THE CHNA, THE FOND DU LAC COUNTY HEALTHY 2020 COALITION WAS FORMED TO ADDRESS THE NEEDS IDENTIFIED IN THE CHNA. THE HEALTHY 2020 STEERING COMMITTEE INCLUDES THE FOLLOWING MEMBERS: GREGG BREWER, AGNESIAN HEALTHCARE EMPLOYEE ASSISTANCE PROGRAM DIRECTOR JEFF BUTZ, WELLNESS DIRECTOR OF FOND DU LAC AREA BUSINESS ON HEALTH, AN EMPLOYER-OWNED BUSINESS COALITION FOCUSING ON HEALTH; DIANE CAPPOZZO, RN, FOND DU LAC COUNTY HEALTH DEPARTMENT NURSE; DR STEVE DI SALVO, PRESIDENT, MARIAN UNIVERSITY; ERIN GERRED, FDL COUNTY DIRECTOR OF ADMINISTRATION; GREG GILES, FDL FAMILY YMCA EXECUTIVE DIRECTOR; BILL LAMB, CHIEF OF POLICE, FDL CITY POLICE DEPARTMENT; STEVE LITTLE, CEO, AGNESIAN HEALTHCARE; SR. MARY MOLLISON, VP OF CARE TRANSITION, AGNESIAN HEALTHCARE; WARREN POST, MD, FDL BOARD OF HEALTH MEDICAL DIRECTOR; TINA POTTER, FDL AREA UNITED WAY EXECUTIVE DIRECTOR; SANDI ROEHRIG, FDL AREA FOUNDATION EXECUTIVE DIRECTOR; MARTY RYAN, ROTARY REPRESENTATIVE; KEVIN SHAW, ST. MARY'S SPRINGS ACADEMY PRESIDENT; MARIAN SHERIDAN, FDL SCHOOL DISTRICT HEALTH AND SAFETY COORDINATOR; MICHELLE TIDEMANN, FDL COUNTY UW-EXTENSION; DEANN THURMER, COO, WAUPUN MEMORIAL HOSPITAL; KATHERINE VERGOS, COO, RIPON MEDICAL CENTER; JENNIFER WALTERS, MANAGER OF GROWTH AND MARKET DEVELOPMENT, AURORA HEALTHCARE. THE HEALTHY 2020 COMMITTEE HAS TAKEN THE LEAD ON DISTRIBUTION OF INFORMATION TO THE PUBLIC, AS WELL AS CONTINUING COMMUNITY UPDATES AND ASSESSMENT OF PROGRESS.		ST. AGNES HOSPITAL
PART V, SECTION B, LINE 4: HOSPITALS INCLUDED IN THE CHNA WERE AGNESIAN HEALTHCARE (ST. AGNES HOSPITAL), WAUPUN MEMORIAL HOSPITAL AND RIPON MEDICAL CENTER.		ST. AGNES HOSPITAL
PART V, SECTION B, LINE 5C: IN ADDITION TO THE HOSPITAL'S WEBSITE, THE HEALTHY 2020 COALITION MADE THE RESULTS OF THE CHNA WIDELY AVAILABLE THROUGH A SERIES OF COMMUNITY MEETINGS, DISTRIBUTION OF COMMUNITY HEALTH IMPROVEMENT PLAN FLYERS, NEWSPAPER ARTICLES, AND THE HEALTHY 2020 WEBSITE, WWW.LIVINGWELLFDL.ORG. IN ADDITION, THE FULL REPORT IS AVAILABLE ON THE FOND DU LAC COUNTY WEBSITE.		ST. AGNES HOSPITAL
PART V, SECTION B, LINE 6I: AS A RESULT OF THE CHNA, FOUR MAJOR AREAS OF CONCERN WERE DETERMINED, AND A STRATEGIC ACTION PLAN HAS BEEN DEVELOPED FOR EACH AREA. (1) INCREASE THE NUMBER OF FDL COUNTY RESIDENTS WHO ARE AT A HEALTHY WEIGHT - AGNESIAN HEALTHCARE HAS COLLABORATED WITH THE YMCA BY HIRING AND PROVIDING FUNDING FOR A WELLNESS COORDINATOR FOR OUTREACH INTO THE COMMUNITY. THE WELLNESS COORDINATOR IS DEVELOPING AND IMPLEMENTING A COMMUNITY EDUCATION CAMPAIGN ON HEALTHY EATING AND ACTIVE LIVING, INCLUDING THE 5,2,1,0 CAMPAIGN IN THE SCHOOL DISTRICT. (2) INCREASE DENTAL CARE ACCESS FOR CHILDREN AND ADULTS WITH MEDICAID - AGNESIAN HEALTHCARE HAS PROVIDED FUNDING TO FOND DU LAC COUNTY TO EXTEND THEIR PROGRAM TO PROVIDE DENTAL CARE TO ADULTS WHO DO NOT CURRENTLY HAVE ACCESS TO DENTAL CARE. IN ADDITION, AGNESIAN HEALTHCARE HAS PROVIDED FUNDING TO THE SAVE A SMILE INITIATIVE, WHICH PROVIDES ACCESS TO DENTAL CARE FOR CHILDREN UTILIZING THE MEDICAID PROGRAM. (3) IMPROVE MENTAL HEALTH ACCESS - AGNESIAN HEALTHCARE ASSOCIATES ARE PARTICIPATING ON A COMMUNITY-WIDE TASK FORCE TO PROVIDE EDUCATIONAL PROGRAMS TO DECREASE THE STIGMA SURROUNDING MENTAL HEALTH ISSUES. AGNESIAN HEALTHCARE IS PARTNERING WITH THE YMCA TO PROVIDE CITY AND COUNTY EVENTS AND EDUCATION. FUNDING HAS ALSO BEEN PROVIDED TO SHARDS, A MENTAL HEALTH PROVIDER WHICH PROVIDES MENTAL HEALTH COUNSELING TO THOSE WITHOUT INSURANCE. (4)DECREASE BINGE DRINKING AND OVER-CONSUMPTION OF ALCOHOL AMONG YOUTH AND ADULTS - AGNESIAN HEALTHCARE HAS PARTICIPATED ON A TASK FORCE TO ASSIST THE POLICE DEPARMENT IN OBTAINING A GRANT TO INCREASE OWI PATROLS. THE TASK FORCE IS ALSO DEVELOPING A DRUG COURT, AND PARTICIPATING IN MEDIA MARKETING CAMPAIGNS TO DISCOURAGE BINGE DRINKING.		ST. AGNES HOSPITAL
PART V, SECTION B, LINE 7: THE HOSPITAL IS PARTICIPATING IN THE INITIATIVES NOTED IN QUESTION 6 TO ADDRESS THE NEEDS IDENTIFIED IN THE CHNA. OUR INITIATIVES ARE ALREADY SHOWING POSITIVE RESULTS. THE UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE PRODUCES A WELL-KNOWN DOCUMENT TITLED "COUNTY HEALTH RANKINGS AND ROADMAPS." THE MOST CURRENT REPORT SHOWS THAT FOND DU LAC COUNTY HAS IMPROVED FROM THE RANK OF 33 TO RANK OF 22 IN THE STATE. IN ORDER TO FURTHER HELP COMMUNITY MEMBERS TAKE POSITIVE STEPS IN IMPROVING THEIR HEALTH, AGNESIAN HEALTCARE DISTRIBUTED 2014 WELLNESS CALENDARS TO 78,000 RESIDENTS.		ST. AGNES HOSPITAL
PART V, SECTION B, LINE 12H: UNINSURED PATIENTS ARE AUTOMATICALLY GIVEN A 15% DISCOUNT.		ST. AGNES HOSPITAL
PART V, SECTION B, LINE 16E: COLLECTION AGENCIES ARE ENGAGED TO COLLECT UNPAID BALANCES. THESE AGENCIES ARE AUTHORIZED TO REPORT TO CREDIT AGENCIES. COLLECTION AGENCIES ARE AUTHORIZED BY THE HOSPITAL TO ESTABLISH GARNISHMENT AGAINST WAGES ON UNPAID BALANCES THEY ARE ATTEMPTING TO COLLECT.		ST. AGNES HOSPITAL
PART V, SECTION B, LINE 20D: UNINSURED PATIENTS AUTOMATICALLY RECEIVE A 15% DISCOUNT OFF GROSS CHARGES.		ST. AGNES HOSPITAL
PART V, SECTION B, LINE 22: UNINSURED PATIENTS WOULD AUTOMATICALLY RECEIVE A 15% DISCOUNT. INSURED PATIENTS WHO ARE PART OF AN INSURANCE PLAN WITHOUT A NEGOTIATED RATE WITH THE HOSPITAL MIGHT PAY FULL CHARGES IF THE ENTIRE CHARGE WAS APPLIED TO THEIR DEDUCTIBLE.		ST. AGNES HOSPITAL
PART VI, LINE 2: IN ADDITION TO THE CHNA NOTED ABOVE, THE HOSPITAL'S SENIOR LEADERS MEET REGULARLY WITH COMMUNITY LEADERS TO GATHER INPUT FROM AND RESPOND TO PATIENT AND CUSTOMER NEEDS. SENIOR LEADERS AND MEMBERS OF THE WORKFORCE PARTICIPATE IN A VARIETY OF ORGANIZATIONS IN SUPPORT OF AGNESIAN HEALTHCARE INC.'S KEY COMMUNITIES. THROUGH THE HOSPITAL'S PARTICIPATION IN THESE ACTIVITIES, COMMUNITY MEMBERS LEARN OF THE HOSPITAL'S COMMITTMENT TO COMMUNITY-WIDE HEALTHCARE AND PROVIDE AGNESIAN HEALTHCARE WITH INSIGHTS INTO COMMMUNITY HEALTH NEEDS AND DESIRES.
PART VI, LINE 3: FINANCIAL COUNSELORS AT AGNESIAN HEALTHCARE ASSIST PATIENTS WITH APPLICATION TO COMMUNITY CARE. PATIENTS CAN BE REFERRED TO COMMUNITY CARE BY CLERGY, DEPARTMENTS OF AGNESIAN HEALTHCARE, SISTERS OF ST. AGNES, AREA SOCIAL AND HEALTH AGENCIES, FAMILY OR SELF. THE APPLICATION IS COMPLETED BY THE PATIENT WITH ASSISTANCE FROM THE FINANCIAL COUNSELOR IF NEEDED. THE FINANCIAL COUNSELOR WILL COMMUNICATE TO THE PATIENT WHAT PROGRAMS THEY WILL BE ELIGIBLE FOR, AS WELL AS PROVIDE NOTIFICATION OF APPROVAL OR DENIAL OF THEIR APPLICATION IN A TIMELY MANNER.
PART VI, LINE 4: COMMUNITY CARE APPLICATIONS ARE ACCEPTED ONLY FROM PATIENTS OF AGNESIAN HEALTHCARE WHO RESIDE IN THE COUNTIES OF CALUMET, COLUMBIA, DODGE, FOND DU LAC, GREEN LAKE, MARQUETTE, WASHINGTON, WAUSHARA OR WINNEBAGO. INDIVIDUALS MUST BE A RESIDENT OF ONE OF THOSE AREAS FOR A MINIMUM OF THREE MONTHS AND PROVIDE SUPPORTING DOCUMENTATION. ON OCCASION, INDIVIDUALS ARE NOT COMMUNITY MEMBERS BUT MAY NEED ASSISTANCE; THOSE APPLICATIONS ARE CONSIDERED ON A CASE-BY-CASE BASIS. THE SAMARITAN CLINIC SERVES PATIENTS FROM FOND DU LAC AND DODGE COUNTIES.
PART VI, LINE 5: AGNESIAN HEALTHCARE LEADERS DEVELOP GRANT APPLICATIONS IN SUPPORT OF PROGRAMS AND SERVICES SERVING THE GREATER NEEDS OF THE COMMUNITY, INCLUDING HOSPICE HOPE, DOMESTIC VIOLENCE PROGRAMS, CARDIAC CARE, AND PREVENTIVE HEALTH SERVICES AND SCREENINGS. PROVIDING THESE SERVICES LOCALLY IS A FOCUS OF OUR COMMUNITY BENEFIT PROGRAM. AGNESIAN HEALTHCARE OFFERS PROGRAMS TO THE COMMUNITY THAT ALLOW STUDENTS AND OTHERS TO LEARN ABOUT DIFFERENT OCCUPATIONS IN THE HEALTHCARE INDUSTRY BY BECOMING CERTIFIED AND GAINING ACTUAL WORK EXPERIENCE. THE DIFFERENT PROGRAMS PROVIDE HANDS-ON OPPORTUNITIES AND ALLOW JOB SHADOWING SO THE FUTURE OF THE PROFESSION CAN GAIN CONFIDENCE AND SKILLS. IN ADDITION, AGNESIAN HEALTHCARE SHARES ITS PROFESSIONAL STAFF EXPERTISE TO OFFER HEALTH EDUCATION CLASSES, HEALTH SCREENINGS, SUPPORT GROUPS, AND OTHER HEALTH PROMOTION ACTIVITIES THROUGHOUT THE YEAR. OTHER COMMUNITY ACTIVITIES INCLUDE SUPPORT AND TRAINING FOR THE DODGE CORRECTIONAL INSTITUTIONAL HOSPICE PROGRAM, SHARPS DISPOSAL SERVICE, ADOPT-A-FAMILY, DONATIONS TO FOOD PANTRIES, AND LEADERSHIP PARTICIPATION IN COMMUNITY NONPROFIT ORGANIZATIONS.
PART VI, LINE 6: AGNESIAN HEALTHCARE, INC. IS AN INTEGRATED, COMPREHENSIVE NOT-FOR-PROFIT HEALTHCARE DELIVERY SYSTEM COMPRISED OF SEVEN MINISTRIES: AGNESIAN HEALTHCARE ENTERPRISES, LLC, CONSULTANTS LAB OF WI, LLC, FOND DU LAC REGIONAL CLINIC, ST. AGNES HOSPITAL, ST. FRANCIS HOME, WAUPUN MEMORIAL HOSPITAL AND RIPON MEDICAL CENTER. AGNESIAN PROVIDES A CONTINUUM OF HEALTHCARE SERVICES FROM BIRTH TO END OF LIFE, PREVENTIVE HEALTHCARE, DIAGNOSIS, TREATMENT AND FOLLOWUP, ASSISTED LIVING, AND INDEPENDENT AND SKILL CARE SERVICES. AGNESIAN HEALTHCARE IS COMMITTED TO ENSURING THAT INDIVIDUALS NEEDING VITAL HEALTHCARE SERVICES GET THE HELP THEY NEED AND DESERVE.
WI	PART VI, LINE 7	REPORTS FILED WITH STATES

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Idemnification Gross Up Payments	X	IdemnificationGrossUpPayments
Club Dues Or Fees	X	ClubDuesOrFees
Written Policy Re T And E Expenses	1	WrittenPolicyReTAndEExpenses
Substantiation Required	1	SubstantiationRequired
Independent Consultant	X	IndependentConsultant
Written Employment Contract	X	WrittenEmploymentContract
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	0	SeverancePayment
Supplemental Nonqual Retire Plan	1	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	1	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	0	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	0	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (18 entries)

TitleTitle	Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
STEVEN N LITTLE
PRESIDENT AND CEO	518132	0	246727	0	0	0	0	0	35201	0	800060	0	0	0
ALLAN MILANI MD
EX-OFFICIO	464776	0	0	0	0	0	0	0	24695	0	489471	0	0	0
JAMES P MUGAN
SR VP CLINICAL SERVICES &	259237	0	86078	0	0	0	0	0	38946	0	384261	0	0	0
BONNIE SCHMITZ
CHIEF FINANCIAL OFFICER	264048	0	32592	0	0	0	0	0	22465	0	319105	0	0	0
DENNIS YUNK
SR VP CLINIC ADMINISTRATOR	239580	0	27354	0	8046	0	0	0	29865	0	304845	0	0	0
CAROL B HYLAND
PRESIDENT AND CEO - CLW	235027	0	28821	0	0	0	0	0	31734	0	295582	0	0	0
DOUGLAS D TROST
CEO - ST FRANCIS HOME	196306	0	19527	0	4849	0	0	0	30136	0	250818	0	0	0
SR MARY MOLLISON
VP SPIRITUALITY AND CARE T	149983	0	54324	0	10355	0	0	0	9271	0	223933	0	0	0
BARBARA LKNUTZEN
PRES AND CEO-AHE AND PERFO	176359	0	22353	0	6981	0	0	0	25899	0	231592	0	0	0
SUSAN L EDMINSTER
VP - HUMAN RESOURCES	189139	0	13678	0	0	0	0	0	18660	0	221477	0	0	0
NANCY A BIRSCHBACH
VP - CIO	155508	0	19681	0	0	0	0	0	31367	0	206556	0	0	0
JILL A STENSON
VP NURSING	152340	0	20151	0	0	0	0	0	17170	0	189661	0	0	0
JOHN CHOI MD
ANESTHESIOLOGIST - PAIN RE	546794	0	437120	0	0	0	0	0	31933	0	1015847	0	0	0
YASIR HATAHET MD
INTENSIVIST	527051	0	328323	0	0	0	0	0	40652	0	896026	0	0	0
PONTUS OSTMAN MD
ANESTHESIOLOGIST - PAIN RE	407284	0	394011	0	0	0	0	0	15985	0	817280	0	0	0
HONG C WANG MD
RADIATION ONCOLOGIST	595869	0	0	0	0	0	0	0	32562	0	628431	0	0	0
STEVEN FLURRY MD
ANESTHESIOLOGIST	588271	0	0	0	0	0	0	0	30910	0	619181	0	0	0
ROBERT A FALE
FORMER PRESIDENT AND CEO	169948	0	76479	0	231865	0	0	0	13172	0	491464	0	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReference	ExplanationExplanation
PART I, LINE 1A	ALL GROSSUP PAYMENTS AND SOCIAL CLUB DUES ARE INCLUDED ON FORM 1099. THESE PAYMENTS ARE MADE FOR TWO MEMBERS OF THE BOARD OF DIRECTORS.
PART I, LINE 4B	ALL EXECUTIVES EXCEPT CEO PARTICIPATE IN A 457(B) SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN.
PART I, LINE 5	COMPENSATION FOR SOME EMPLOYED PHYSICIANS IS BASED ON A PERCENTAGE OF GROSS BILLINGS.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)

Bond ReferenceBondReferenceCd	Issuer EINIssuerEIN	CUSIP NumberCUSIPNumber	Date IssuedDateIssued	Issue PriceIssuePrice	Description Of PurposeDescriptionOfPurpose	DefeasedDefeased	On Behalf Of IssuerOnBehalfOfIssuer	Pool FinancingPoolFinancing
WI HEALTH AND EDUC FACILITIES AUTHORITY
A	391337855	97710BGG1	2008-12-11	49330000	REFUNDING OF 2001 ISSUE, PRIVATE ROOM PROJECT	0	0	0
WI HEALTH AND EDUC FACILITIES AUTHORITY
B	391337855	97710BYW6	2010-12-01	57260000	REFUNDING OF 2001 ISSUE, PRIVATE ROOM PROJECT	0	0	0
WI HEALTH AND EDUC FACILITIES AUTHORITY
C	391337855	NONEAVAIL	2011-12-15	10020000	PARTIAL REFUNDING OF 1998 ISSUE	0	0	0
WI HEALTH AND EDUC FACILITIES AUTHORITY
D	391337855	97710B7C0	2013-03-14	5705000	CONSTRUCTION AND EXPANSION OF FACILITIES	0	0	0

Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)

Bond ReferenceBondReferenceCd	Amount RetiredAmountRetired	Total ProceedsTotalProceeds	Issuance Costs From ProceedsIssuanceCostsFromProceeds	Working Capital ExpendituresWorkingCapitalExpenditures	Year Of Subst CompletionYearOfSubstCompletion	Current RefundingCurrentRefunding	Final Allocation MadeFinalAllocationMade	Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind	Amount In Reserve FundAmountInReserveFund	Refunding EscrowRefundingEscrow	Capital ExpendituresCapitalExpenditures	Amount UnspentAmountUnspent	Capitalized InterestCapitalizedInterest
A	1925000	49330000	430000	48900000	2005	1	1	1
B	2715000	57260000	767686			1	0	1	4518399	31465565	22727526	2431172
C	1862000	10020000	90000		2011	1	1	1		9930000
D		5705000	32111			0	0	1			460633	5150603	61653

Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)

Bond ReferenceBondReferenceCd	Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers	Total Private Business UseTotalPrivateBusinessUse	Bond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTest	Non Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
A	0.01470	0.01470	1	1
B			1	1
C			1	1
D			1	1

Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiled	Variable Rate IssueVariableRateIssue	Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds	Term Of HedgeTermOfHedge	Superintegrated HedgeSuperintegratedHedge	Hedge TerminatedHedgeTerminated	Gross Proceeds Invested In GICGrossProceedsInvestedInGIC	Gross Proceeds InvestedGrossProceedsInvested	Written Proc To Monitor ReqsWrittenProcToMonitorReqs
PIPER JAFFRAY
A	1	1	1	28.000000000000	0	0	0	0	0
(no name)
B	1	0	0				0	0	0
(no name)
C	1	0	0				0	0	0
(no name)
D	1	0	0				0	0	0

Form990 Schedule K Part V Form990ScheduleKPartV (4 entries)

Bond ReferenceBondReferenceCd	Proc To Undertk Corrective ActionProcToUndertkCorrectiveAction
A	1
B	1
C	1
D	1

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	WI HEALTH AND EDUC FACILITIES AUTHORITY	BusinessNameLine1

Field	Value	IRS element (for citing)
Issuer EIN	391337855	IssuerEIN
CUSIP Number	97710B7C0	CUSIPNumber
Date Issued	2013-03-14	DateIssued
Issue Price	53273496	IssuePrice
Description Of Purpose	CONSTRUCTION AND EXPANSION OF FACILITIES	DescriptionOfPurpose
Defeased	0	Defeased
On Behalf Of Issuer	0	OnBehalfOfIssuer
Pool Financing	0	PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Total Proceeds	53276496	TotalProceeds
Capitalized Interest	569394	CapitalizedInterest
Issuance Costs From Proceeds	296559	IssuanceCostsFromProceeds
Capital Expenditures	4254141	CapitalExpenditures
Amount Unspent	48156402	AmountUnspent
Current Refunding	0	CurrentRefunding
Advance Refunding	0	AdvanceRefunding
Final Allocation Made	0	FinalAllocationMade
Adequate Books And Recds Maintaind	1	AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Owning Bond Financed Property	0	OwningBondFinancedProperty
Any Lease Arrangements	0	AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty	0	MngmentCntrctBondFinancdPrprty
Any Research Agreements	0	AnyResearchAgreements
Bond Iss Meet Prvt Security Pay Test	1	BondIssMeetPrvtSecurityPayTest
Change In Use Bond Financed Prop	0	ChangeInUseBondFinancedProp
Non Qualified Bond Remed Procdrs	1	NonQualifiedBondRemedProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	1	Form8038TFiled
Variable Rate Issue	0	VariableRateIssue
Hedge Identified In Books And Recds	0	HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC	0	GrossProceedsInvestedInGIC
Gross Proceeds Invested	0	GrossProceedsInvested
Written Proc To Monitor Reqs	0	WrittenProcToMonitorReqs

Form990 Schedule K Part V Form990ScheduleKPartV

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Proc To Undertk Corrective Action	1	ProcToUndertkCorrectiveAction

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (4 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
JOSEPH REITEMEIER
DIRECTOR	373224	JOSEPH REITEMEIER IS PRESIDENT OF FOND DU LAC ASSOCIATION OF COMMERCE. AGNESIAN HEALTHCARE, INC. PROVIDED OCCUPATIONAL HEALTH SERVICES TO THE ASSOCIATION OF COMMERCE, BILLING $2,364 FOR THESE SERVICES IN FISCAL YEAR 2013. IN ADDITION, AGNESIAN HEALTHCARE, INC. PURCHASED SERVICES TOTALING $370,860 FROM THE ASSOCIATION OF COMMERCE DURING FISCAL YEAR 2013.	0
JOSEPH REITEMEIER
DIRECTOR	45136	JOSEPH REITEMEIER IS PRESIDENT OF FOND DU LAC ASSOCIATION OF COMMERCE. HIS DAUGHTER-IN-LAW, JENNIFER REITEMEIER, IS EMPLOYED AS AN RN AT AGNESIAN HEALTHCARE, EARNING AN ANNUAL SALARY OF $45,136.	0
WAYNE MATZKE
DIRECTOR	169106	WAYNE MATZKE IS CEO OF GRANDE CHEESE. AGNESIAN HEALTHCARE PROVIDED OCCUPATIONAL HEALTH SERVICES TO GRANDE CHEESE, BILLING $169,106 IN FISCAL YEAR 2013.	0
DENISE DEVERAUX
DIRECTOR	482254	DENISE DEVERAUX IS VICE PRESIDENT OF HUMAN RESOURCES AT MERCURY MARINE. AGNESIAN HEALTHCARE PROVIDED OCCUPATIONAL HEALTH SERVICES TO MERCURY MARINE, BILLING $482,254 IN FISCAL YEAR 2013.	0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 6	THE ORGANIZATION HAS TWO CLASSES OF MEMBERS - CLASS A MEMBERS WHO ARE MEMBERS OF THE CONGREGATION OF THE SISTERS OF ST. AGNES AND CLASS B MEMBERS WHO CONSTITUTE THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7A	THE CLASS A MEMBERS, WHO ARE THE GENERAL COUNCIL OF THE CONGREGATION OF SISTERS OF ST. AGNES, HAVE THE POWER TO ELECT OR APPOINT THE CLASS B MEMBERS. THE CLASS B MEMBERS CONSTITUTE THE BOARD OF DIRECTORS. THE CLASS B MEMBERS HAVE THE POWER, UPON THE RECOMMENDATION OF THE BOARD OF DIRECTORS, TO APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, THE PRESIDENT/CHIEF EXECUTIVE OFFICER OF THE CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7B	THE CONGREGATION OF THE SISTERS OF ST. AGNES SPONSORSHIP MINISTRIES IS THE CLASS B MEMBER WHO IS RESPONSIBLE FOR APPROVING CERTAIN RESERVED POWERS OF THE CORPORATION DELIGATED TO THEM BY CLASS A. THE GENERAL COUNCIL OF THE CONGREGATION OF SISTERS OF ST. AGNES IS THE CLASS A MEMBER WHO IS RESPONSIBLE FOR APPROVING CERTAIN RESERVED POWERS OF THE CORPORATION.
FORM 990, PART VI, SECTION B, LINE 11	THE FINANCE DEPARTMENT PREPARES THE FORM 990 AND THE RETURN IS REVIEWED BY THE DIRECTOR OF FINANCE AND CFO. A FINAL COPY OF THE 2012 FORM 990 IS PROVIDED TO THE BOARD EXECUTIVE COMMITTEE FOR REVIEW AND APPROVAL TO THE AGNESIAN HEALTHCARE BOARD BEFORE THE RETURN IS FILED WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C	WE HAVE A WRITTEN CONFLICT OF INTEREST AND INSIDER TRANSACTION POLICY THAT REQUIRES EACH DIRECTOR, PRINCIPAL OFFICER, TRUSTEE OR COMMITTEE MEMBER TO DISCLOSE ON AN ANNUAL BASIS TO THE DESIGNATED AUTHORITY A CONFLICT OF INTEREST DISCLOSURE STATEMENT. THE DESIGNATED AUTHORITY ENSURES THAT ALL STATEMENTS ARE COMPLETED, REVIEWS THEM FOR CONFLICTS, AND SUBMITS TO THE BOARD FOR REVIEW ANY CONFLICT OF INTEREST DISCLOSURE STATEMENTS THAT DISCLOSE ACTUAL OR POTENTIAL CONFLICTS.
FORM 990, PART VI, SECTION B, LINE 15	DETERMINATION OF COMPENSATION OF THE CEO AND OFFICERS INCLUDES ANALYSIS OF COMPARABLE COMPENSATION SURVEYS BY AN INDEPENDENT COMPENSATION CONSULTANT, WHO RECOMMENDS RANGES OF APPROPRIATE COMPENSATION TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS APPROVES THE COMPENSATION PACKAGE FOR OFFICERS, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATIONS AND DECISION IS INCLUDED IN THE BOARD MINUTES. THE FINAL AGREEMENT IS DOCUMENTED WITH A WRITTEN CONTRACT, WHICH IS SIGNED BY BOTH PARTIES.
FORM 990, PART VI, SECTION C, LINE 19	AGNESIAN HEALTHCARE'S POLICY AND PROCEDURE FIN1069 DEFINES THE PROCEDURE FOR MAKING ANNUAL INFORMATION RETURNS AVAILABLE FOR PUBLIC INSPECTION. INDIVIDUALS REQUESTING INSPECTION ARE REFERRED TO THE ADMINISTRATION OFFICE, WHERE THEY ARE PROVIDED WITH THE DOCUMENTS AND A CONFERENCE ROOM FOR INSPECTING DOCUMENTS. PHOTOCOPIES WILL BE PROVIDED TO THE REQUESTOR. ANYONE MAY INSPECT THE RETURNS UPON DEMAND, WITHOUT AN APPOINTMENT OR ANY FOREWARNING, DURING AGNESIAN HEALTHCARE INC'S NORMAL BUSINESS HOURS. GOVERNING DOCUMENTS AND CONFLICT OF INTEREST STATEMENTS ARE NOT AVAILABLE FOR PUBLIC INSPECTION, BUT CAN BE MADE AVAILABLE IF THE REQUESTING PARTY HAS A BONAFIDE REASON. ALL FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC THROUGH A POSTING ON A PUBLIC WEBSITE.
FORM 990, PART IX, LINE 11G	PURCHASED SERVICES - PHYSICIANS: PROGRAM SERVICE EXPENSES 53,720,671. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 53,720,671. PURCHASED SERVICES - LABORATORY: PROGRAM SERVICE EXPENSES 181,137. MANAGEMENT AND GENERAL EXPENSES 479,088. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 660,225. PURCHASED SERVICES - LAUNDRY: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 651,231. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 651,231. PURCHASED SERVICES - ELEVATOR: PROGRAM SERVICE EXPENSES 5,812. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,812. PURCHASED SERVICES - MISCELLANEOUS: PROGRAM SERVICE EXPENSES 1,503,369. MANAGEMENT AND GENERAL EXPENSES 398,515. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,901,884. PURCHASED SERVICES - REFERENCE TESTS: PROGRAM SERVICE EXPENSES 866,633. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 866,633. PURCHASED SERVICES - HOUSEKEEPING: PROGRAM SERVICE EXPENSES 64,613. MANAGEMENT AND GENERAL EXPENSES 161,787. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 226,400. PURCHASED SERVICES - IT: PROGRAM SERVICE EXPENSES 1,279,183. MANAGEMENT AND GENERAL EXPENSES 15,635. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,294,818. PURCHASED SERVICES - TRANSCRIPTION: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 283,048. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 283,048. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 846,224. MANAGEMENT AND GENERAL EXPENSES 250,459. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,096,683. PROFESSIONAL FEES - MEDICAL DIRECTOR: PROGRAM SERVICE EXPENSES 223,977. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 223,977. PROFESSIONAL FEES - COLLECTION: PROGRAM SERVICE EXPENSES 5,483. MANAGEMENT AND GENERAL EXPENSES 720,063. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 725,546.	OTHER FEES
FORM 990, PART XI, LINE 9:	CAPITAL CONTRIBUTIONS FROM AFFILIATES 5,000,000. CHANGE IN SWAP FUND BALANCE 1,136,608. CHANGE IN FUND BALANCE - SAH FOUNDATION 1,150,073.	CHANGES IN NET ASSETS OR FUND BALANCES:

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Total IncomeTotalIncome	EOY AssetsEOYAssets	Direct Controlling Entity NADirectControllingEntityNA
CONSULTANTS LABORATORY OF WISCONSIN LLC
430 E DIVISION STREET	FOND DU LAC	WI	54935	391528550	LAB SERVICES	WI	20586441	15109731	N/A
AGNESIAN HEALTHCARE ENTERPRISES LLC
430 E DIVISION STREET	FOND DU LAC	WI	54935	392038757	RETAIL PHARMACY	WI	9481185	8461959	N/A

Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Direct Controlling Entity NADirectControllingEntityNA	Controlled OrgControlledOrg
ST FRANCIS HOME OF FOND DU LAC
33 EVERETT STREET	FOND DU LAC	WI	54935	391029998	NURSING HOME	WI	501(C)(3)	9	N/A	0
CONGREGATION OF SISTERS OF ST AGNES
320 COUNTY ROAD K	FOND DU LAC	WI	54935	390806217	CONVENT	WI	501(C)(3)	1	N/A	0
AGNESIAN HEALTHCARE FOUNDATION
430 E DIVISION STREET	FOND DU LAC	WI	54935	391684956	FOUNDATION	WI	501(C)(3)	11	N/A	0
WAUPUN MEMORIAL HOSPITAL
620 WEST BROWN STREET	WAUPUN	WI	53963	390806265	HOSPITAL	WI	501(C)(3)	3	N/A	0
RIPON MEDICAL CENTER
933 NEWBURY STREET	RIPON	WI	54971	391101287	HOSPITAL	WI	501(C)(3)	3	N/A	0

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	0	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	0	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	1	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	1	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	0	LoansOrGuaranteesFromOtherOrg
Dividends Related Organization	0	DividendsRelatedOrganization
Sale Of Assets To Other Org	0	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	0	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	0	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	1	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	0	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	1	PerformOfServicesByOtherOrgs
Sharing Of Facilities	0	SharingOfFacilities
Sharing Of Paid Employees	1	SharingOfPaidEmployees
Reimbursement Paid To Other Org	1	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	1	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	0	OtherTransferToOtherOrg
Other Transfer From Other Org	0	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (7 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved	Method Of Amt DeterminationMethodOfAmtDetermination
AGNESIAN HEALTHCARE FOUNDATION INC
C	809567	CASH RECEIPTS
ST FRANCIS HOME
D	5000000	BOND VALUE
ST FRANCIS HOME
M	35225	CASH PAYMENTS
CONGREGATION OF SISTERS OF ST AGNES
M	296295	CASH PAYMENTS
CONGREGATION OF SISTERS OF ST AGNES
O	432156	CASH PAYMENTS
WAUPUN MEMORIAL HOSPITAL
P	452829	CASH TRANSFER
RIPON MEDICAL CENTER
P	1747	CASH TRANSFER