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ASCENSION WISCONSIN INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
ASCENSION WISCONSIN INC (EIN 39-1834639)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-05-15
IRS object ID
201421359349308337
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)
Timestamp2014-05-15T15:56:00-05:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN861065772EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1DELOITTE TAX LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1555 E WELLS ST SUITE 1400AddressLine1
CityMILWAUKEECity
StateWIState
ZIP Code53202ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN391834639EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1COLUMBIA ST MARY'S INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCOLUNameControl
Phone4143262230Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line14425 NORTH PORT WASHINGTON ROAD NOAddressLine1
Address Line2301AddressLine2
CityGLENDALECity
StateWIState
ZIP Code53212ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameRHONDA ANDERSONName
TitleCSM PRESIDENT/CFOTitle
Phone4143262230Phone
Date Signed2014-05-15DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameRACHEL J BECKERName
PTINP00966076PTIN
Phone4142713000Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMARK TAYLORNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line14425 NORTH PORT WASHINGTON ROAD NOAddressLine1
Address Line2301AddressLine2
CityGLENDALECity
StateWIState
ZIP Code53212ZIPCode
FieldValueIRS element (for citing)
Gross Receipts126255378GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web SiteCOLUMBIA-STMARYS.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2001YearFormation
State Legal DomicileWIStateLegalDomicile
Activity Or Mission DescriptionHEALTH CARE SYSTEM DEDICATED TO MAKING A POSITIVE DIFFERENCE IN INDIVIDUALS AND OUR COMMUNITY.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees448TotalNbrEmployees
Total Nbr Volunteers11TotalNbrVolunteers
Total Gross UBI29000TotalGrossUBI
Net Unrelated Business Txbl Income1417NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year439143ContributionsGrantsPriorYear
Contributions Grants Current Year376402ContributionsGrantsCurrentYear
Program Service Revenue Prior Year112151825ProgramServiceRevenuePriorYear
Program Service Revenue CY116024234ProgramServiceRevenueCY
Investment Income Prior Year3500195InvestmentIncomePriorYear
Investment Income Current Year4455324InvestmentIncomeCurrentYear
Other Revenue Prior Year79742921OtherRevenuePriorYear
Other Revenue Current Year5398028OtherRevenueCurrentYear
Total Revenue Prior Year195834084TotalRevenuePriorYear
Total Revenue Current Year126253988TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year436410GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY429175GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year34658787SalariesEtcPriorYear
Salaries Etc Current Year38555157SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year121762418OtherExpensePriorYear
Other Expenses Current Year97433085OtherExpensesCurrentYear
Total Expenses Prior Year156857615TotalExpensesPriorYear
Total Expenses Current Year136417417TotalExpensesCurrentYear
Revenues Less Expenses Prior Year38976469RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-10163429RevenuesLessExpensesCY
Total Assets BOY285378938TotalAssetsBOY
Total Assets EOY493691681TotalAssetsEOY
Total Liabilities BOY220962152TotalLiabilitiesBOY
Total Liabilities EOY482096928TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY64416786NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY11594753NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionCOLUMBIA ST. MARY'S, INC. ("CSM") IS A HEALTH CARE PROVIDER FOUNDED IN RESPONSE TO IDENTIFIED COMMUNITY NEEDS, WHICH IS SPONSORED BY ASCENSION HEALTH, A CATHOLIC NATIONAL HEALTH SYSTEM, AND COLUMBIA HEALTH SYSTEM, A NON-SECTARIAN COMMUNITY HEALTH SYSTEM. CSM EXISTS TO MAKE A POSITIVE DIFFERENCE IN THE HEALTH STATUS AND LIVES OF INDIVIDUALS AND OUR COMMUNITY, WITH SPECIAL CONCERN FOR THOSE WHO ARE VULNERABLE. CSM AND ITS AFFILIATES ARE COMMITTED TO PROVIDING HIGH-QUALITY, ACCESSIBLE, VALUES-DRIVEN PROGRAMS AND SERVICES WITH EQUAL ATTENTION TO THE PHYSICIAL, SPIRITUAL, AND EMOTIONAL DIMENSIONS OF HEALTH.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense70063432Expense
Grants429175Grants
Revenue122062595Revenue
DescriptionCSM, INC EXISTS AS THE PARENT CORPORATION IN THE CSM SYSTEM, WHICH IS COMPRISED OF THREE HOSPITALS, (COLUMBIA ST. MARY'S HOSPITAL MILWAUKEE INC, COLUMBIA ST. MARY'S HOSPITAL OZAUKEE INC, AND SACRED HEART REHABILITATION INSTITUTE INC.), 61 COMMUNITY CLINICS, THE COLUMBIA COLLEGE OF NURSING, A PARTNERSHIP WITH THE ORTHOPAEDIC HOSPITAL OF WISCONSIN, A PARTNERSHIP WITH THE SLEEP WELLNESS INSTITUTE, AND FOUR URGENT CARE CENTERS. DURING FISCAL 2013, CSM'S HEALTH SYSTEM (SACRED HEART REHABILITATION, COLUMBIA ST. MARY'S MILWAUKEE, COLUMBIA ST. MARY'S OZAUKEE) PROVIDED CARE TO 328,397 PATIENTS. THE ESTIMATED UNREIMBURSED COST OF SERVICES PROVIDED TO THE ELDERLY, UNINSURED AND UNDERINSURED TOTALED $139,785,804. REFER TO THE COMMUNITY BENEFIT INFORMATION IN SCHEDULE H FOR DISCUSSION OF HOW CSM MAKES A POSITIVE DIFFERENCE IN THE HEALTH STATUS OF ITS COMMUNITY, FOCUSING ON THOSE WHO ARE VULNERABLE.Description
Total Program Service Expense70063432TotalProgramServiceExpense
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 Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest1ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
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 Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
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 Member1BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096131NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees448NumberOfEmployees
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 Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
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 Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1RHONDA ANDERSONBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number4143262230TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line14425 N PORT WASHINGTON ROAD NO 301AddressLine1
CityGLENDALECity
StateWIState
ZIP Code53212ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (31 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
GEORGE H HOFF
VICE CHAIR0.200.80X000
KEVIN GONIU MD
BOARD MEMBER AND CSM PHYSI0.2040.80X056853928044
MARK R TAYLOR
PRESIDENT/CEO1.0049.00X1605199040485X
MASON G ROSS
BOARD MEMBER0.200.80X000
MICHAEL GREBE
BOARD MEMBER0.200.80X000
R BRUCE MCDONALD
CHAIR0.200.80X000
RANDALL PERRY
SECRETARY/TREASURER0.200.80X000
ROBERT LYON MD
BOARD MEMBER0.200.80X000
ROBERT J VENABLE
BOARD MEMBER0.200.80X000
SISTER THERESA SULLIVAN DC
BOARD MEMBER0.200.80X000
TINA CHANG
BOARD MEMBER0.200.80X000
CHRISTINE NUERNBERG
BOARD MEMBER0.200.80X000
PATRICIA J DOLHUN MD
BOARD MEMBER0.200.80X000
MICHELLE S NETTLES
BOARD MEMBER, END 2/130.200.80X000
RHONDA ANDERSON
CSM PRESIDENT / CFO5.0045.00660752011123X
CHERYL HILL
VP/CHRO5.0045.00434537024771X
DAVID H SHAPIRO MD
CHIEF MEDICAL OFFICER5.0045.00448579020004X
GERRI LIETZ-STAFFILENO
VP HOSP OPERATIONS5.0045.00398589024492X
SUE SANICOLA
VP PHYSICIAN SERVICES5.0045.00324050028444X
WILLIAM HART
VP / COO6.0044.00497000013153X
DEBORAH FRIBERG
PRESIDENT HOSP DIV END 06/126.0044.00768773029832X
BRUCE MCCARTHY MD
PRESIDENT PHYSICIAN DIVISION5.0045.00835070035735X
CONSTANCE J BRADLEY
VP HOSP OPERATIONS7.0043.00333603017007X
MARIAN PURDUE
INTERIM PRES HOSP DIV (END 10/12)5.0045.0031700000X
ALLAN SPOONER
PRESIDENT HOSPITAL DIVISION5.0045.0020848901046X
PAUL WESTRICK
VP MISSION INTEGRATION40.00315344029057X
MITCH QUADE
DIRECTOR REVENUE CYCLE40.00184218031485X
ANDREW FERGUSUSON
FINANCIAL SERVICES OFFICER40.0023348605491X
DAVID MANNES
CONTROLLER40.00171996021955X
CLARISSA COX
VP QUALITY & CLINICAL INTEGRATION5.0045.0016619906938X
LEO P BRIDEAU
PRESIDENT/CEO END 02/110.0040.0072789800X
FieldValueIRS element (for citing)
Total Reportable Comp From Org8630782TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs568539TotalReportableCompFrmRltdOrgs
Total Other Compensation369062TotalOtherCompensation
Number Individuals GT100 K39NumberIndividualsGT100K
Formers Listed1FormersListed
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
HEALTHCARE SERVICES INC
3220 TILLMAN DRIVE SUITE 300BENSALEMPA33701HEALTHCARE SERVICES40736222
TRIMEDX LLC
6325 DIGITAL WAY SUITE 400INDIANAPOLISIN46278HEALTHCARE SERVICES8003619
ACCENTURE LLP
100 E WISCONSIN AVE SUITE 2100MILWAUKEEWI53202EHR PROJECT MANAGEMENT4282221
EAST LAKE TOWERS CORPORATE CENTER LP
4425 N PORT WASHINGTON ROADGLENDALEWI53212OCCUPANCY3621615
HUNTER PARTNERS LLC
111 SECOND AVE NE SUITE 900ST PETERSBURGFL33701CONSULTING2221755
FieldValueIRS element (for citing)
Number Of Contractors GT100 K46NumberOfContractorsGT100K
Related Organizations145953RelatedOrganizations
All Other Contributions230449AllOtherContributions
Total Contributions376402TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
CHARGEBACK ALLOCATE EXPENSES900099111431205111431205
JOINT VENTURE INCOME62211040444904044490
RENTAL INCOME-PHYSICIANS532000435630435630
EDUCATION REVENUE611710110331110331

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column2578TotalRevenueColumn
Related Or Exempt Function Income2578RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue116024234TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column3785991TotalRevenueColumn
Exclusion$3,785,991ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other670723Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other1390Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other669333Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column669333TotalRevenueColumn
Related Or Exempt Function Income669333RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionOTHER OPERATING REVENUEDescription
Business Code561499BusinessCode
Total Revenue Column5361577TotalRevenueColumn
Related Or Exempt Function Income5332577RelatedOrExemptFunctionIncome
Unrelated Business Revenue29000UnrelatedBusinessRevenue

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column36451TotalRevenueColumn
Related Or Exempt Function Income36451RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue5398028TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column126253988TotalRevenueColumn
Related Or Exempt Function Income122062595RelatedOrExemptFunctionIncome
Unrelated Business Revenue29000UnrelatedBusinessRevenue
Exclusion$3,785,991ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total429175Total
Program Services429175ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total6893743Total
Program Services3434839ProgramServices
Management And General3458904ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total20800811Total
Program Services5775140ProgramServices
Management And General15025671ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total10860603Total
Program Services214030ProgramServices
Management And General10646573ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total21641076Total
Program Services122444ProgramServices
Management And General21518632ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total698193Total
Management And General698193ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total305845Total
Program Services234020ProgramServices
Management And General71825ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total2502753Total
Program Services474971ProgramServices
Management And General2027782ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total3571646Total
Program Services125085ProgramServices
Management And General3446561ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total5224428Total
Management And General5224428ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total32491080Total
Program Services32210390ProgramServices
Management And General280690ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total6365573Total
Program Services4968724ProgramServices
Management And General1396849ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total105078Total
Program Services14886ProgramServices
Management And General90192ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total221826Total
Program Services76658ProgramServices
Management And General145168ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total11167730Total
Management And General11167730ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total12524685Total
Program Services12002865ProgramServices
Management And General521820ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total-302134Total
Management And General-302134ManagementAndGeneral

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
PURCHASED SERVICES1080429994139591390340
IMPAIRMENT WRITE-DOWNS44471674447167
PATIENT CARE SUPPLIES16938121614341532378

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total-16029972Total
Program Services404812ProgramServices
Management And General-16434784ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total136417417Total
Program Services70063432ProgramServices
Management And General66353985ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1190415BOY
EOY2092514EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY58145560BOY
EOY60700134EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY20490305BOY
EOY18608148EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY26366123BOY
EOY35603002EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY81822BOY
EOY81822EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY5075855BOY
EOY3246515EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis38903354LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec33062082LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY27153682BOY
EOY5841272EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY39472562BOY
EOY24690729EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY38691170BOY
EOY32490405EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY68711444BOY
EOY310337140EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY285378938BOY
EOY493691681EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY28946366BOY
EOY19764210EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY192015786BOY
EOY462332718EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY220962152BOY
EOY482096928EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY46601279BOY
EOY-5081670EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY12687910BOY
EOY11548826EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY5127597BOY
EOY5127597EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY64416786BOY
EOY11594753EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY285378938BOY
EOY493691681EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-10163429ReconcilationRevenueExpenses
Reconciliation Unrealized Invest1729375ReconciliationUnrealizedInvest
Reconcilation Prior Adjustment28395780ReconcilationPriorAdjustment
Reconcilation Other Changes-72783759ReconcilationOtherChanges
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 Committee0AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type2XSupportingOrg509a3Type2
Certification CheckboxXCertificationCheckbox
Written IRS DeterminationXWrittenIRSDetermination
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation (4 entries)

EINEINType Of OrganizationTypeOfOrganizationListed In Governing DocListedInGoverningDocSupported Organization NotifiedSupportedOrganizationNotifiedOrganized In USOrganizedInUSAmountAmount
CSM HOSPITAL MILWAUKEE
3908063153111$0
CSM HOSPITAL OZAUKEE
3908070633111$0
SACRED HEART REHABILITATION INSTITUTE
3909021993111$0
COLUMBIA COLLEGE OF NURSING INC
3915969862111$0
FieldValueIRS element (for citing)
Total Number Of Supported Orgs4TotalNumberOfSupportedOrgs
Sum Of Amounts0SumOfAmounts
General ExplanationSCHEDULE A, PART IV, SUPPLEMENTAL INFORMATION: COLUMBIA ST. MARY'S, INC. SUPPORTS THE PROVISION OF HEALTHCARE SERVICES AT THE CORPORATIONS TO WHICH IT IS A MEMBER BY THE PROVISION OF CENTRALIZED ADMINISTRATIVE SUPPORT, INCLUDING BILLING AND COLLECTIONS; IT; MANAGED CARE CONTRACTING; MEDICAL LIBRARY; CME; PROPERTY MANAGEMENT; ADMINISTRATIVE COSTS FOR CLINICAL INSTITUTES (INCLUDING ONCOLOGY, CARDIOLOGY, BARIATRICS, PEDIATRICS, STROKE AND NEUROSCIENCES); RESEARCH (INCLUDING ONCOLOGY, NEUROSCIENCES, AND GENERAL RESEARCH); MARKETING; LOGISTICS; EXTERNAL AFFAIRS; PUBLIC RELATIONS; AND CONSTRUCTION. COSTS OF CERTAIN OF THESE DEPARTMENTS ARE CHARGED TO THE MEMBERS THROUGH A MANAGEMENT FEE. TRANSACTIONS WITH EACH MEMBER ARE DELINEATED ON SCHEDULE R.GeneralExplanation

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators1DirectContactLegislators
Direct Contact Legislators$31,524DirectContactLegislatorsAmount
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$254OtherActivitiesAmount
Total Lobbying Expenditures IIB31778TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1:ReturnReference
ExplanationA KEY EMPLOYEE SPENDS 10% OF TIME (AMOUNT REPORTED ON LING G) RESEARCHING ISSUES AND PREPARING FOR MEETINGS AND PRESENTATIONS FOR: COUNTY OFFICIALS-FUNDING AND OPERATIONAL ISSUES RELATED TO THE GENERAL ASSISTANCE MEDICAL PROGRAM STATE LEGISLATORS, OTHER ELECTED OFFICIALS AND STAFF-LOBBYING ON MEDICAL ASSISTANCE FUNDING, PUBLIC HEALTH INITIATIVES, AND PROVIDER REGULATIONS; FEDERAL ELECTED OFFICIALS AND STAFF-LOBBYING AND MEDICARE AND MEDICAID FUNDING AND PROVIDER REGULATIONS. OTHER ACTIVITIES: REPRESENTS THE PORTION OF DUES PAID TO NATIONAL AND STATE HOSPITAL ASSOCIATIONS THAT IS SPECFICALLY ALLOCABLE TO LOBBYING.Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis764011OtherCostOrOtherBasis
Book Value764011BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis14241740OtherCostOrOtherBasis
Depreciation12797924Depreciation
Book Value1443816BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1836550OtherCostOrOtherBasis
Depreciation1637776Depreciation
Book Value198774BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis10852565OtherCostOrOtherBasis
Depreciation8926361Depreciation
Book Value1926204BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis11208488OtherCostOrOtherBasis
Depreciation9700021Depreciation
Book Value1508467BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings5841272TotalOfBookValueLandBuildings

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
DescriptionINVESTMENTS IN UNCONSOLIDATED ENTITIESDescription
Book Value24690729BookValue
Method Of ValuationCMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Program Related24690729TotalOfBookValueProgramRelated

Other Assets OtherAssets (4 entries)

DescriptionDescriptionBook ValueBookValue
DEFERRED COMPENSATION1248782
ASSETS HELD FOR SALE200000
PENSION PREFUNDING32349263
DUE FROM AFFILIATES276539095
FieldValueIRS element (for citing)
Total Book Value Other Assets310337140TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (6 entries)

DescriptionDescriptionAmountAmount
INTERCOMPANY DEBT TO ASCENSION HEALTH ALLIANCE$162,108,168
ACCRUED PENSION$3,231,597
DEFERRED COMPENSATION$1,248,782
MISC NONCURRENT LIABILITIES$3,478,882
MISC CURRENT LIABILITIES$6,186,262
INTERCOMPANY LIABILITIES$286,079,027
FieldValueIRS element (for citing)
Total Of Amounts462332718TotalOfAmounts

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
ExplanationPART X: ASC 740 FOOTNOTE REGARDING UNCERTAIN TAX POSITIONS IN AUDITED FINANCIALS: NOT APPLICABLE.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care0AmountsBudgetedForCharityCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense244565TotalCommunityBenefitExpense
Net Community Benefit Expense244565NetCommunityBenefitExpense
Percent Of Total Expense0.00180PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense4356347TotalCommunityBenefitExpense
Direct Offsetting Revenue2088989DirectOffsettingRevenue
Net Community Benefit Expense2267358NetCommunityBenefitExpense
Percent Of Total Expense0.01660PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense4600912TotalCommunityBenefitExpense
Direct Offsetting Revenue2088989DirectOffsettingRevenue
Net Community Benefit Expense2511923NetCommunityBenefitExpense
Percent Of Total Expense0.01840PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense4600912TotalCommunityBenefitExpense
Direct Offsetting Revenue2088989DirectOffsettingRevenue
Net Community Benefit Expense2511923NetCommunityBenefitExpense
Percent Of Total Expense0.01840PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$558,207BadDebtExpenseAmount
Amount Attributable To11164AmountAttributableTo
Amount Reimbursed By Medicare4605276AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare12029438CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-7424162MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

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

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

FieldValueIRS element (for citing)
Business Name Line11 ORTHOPAEDIC HOSPITAL OF WISCONSIN LLCBusinessNameLine1
FieldValueIRS element (for citing)
Description Ent Primary ActivityORTHOPEDIC SURGERIESDescriptionEntPrimaryActivity
Organization Profit Or Ownership0.50000OrganizationProfitOrOwnership
Physicans Profit Or Ownership0.50000PhysicansProfitOrOwnership
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1ORTHOPAEDIC HOSPITAL OF WISCONSIN LLCBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1475 WEST RIVER WOODS PARKWAYAddressLine1
CityGLENDALECity
StateWIState
ZIP Code53212ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1ORTHOPAEDIC HOSPITAL OF WISCONSINBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA Conducted1CHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
Needs Assessment Conducted13NeedsAssessmentConducted
Take Into Account1TakeIntoAccount
Other Facilities1OtherFacilities
CHNA Widely Available1CHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
All Needs Addressed0AllNeedsAddressed
Organization Incur Excise Tax0OrganizationIncurExciseTax
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent200.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent300.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Available On RequestXAvailableOnRequest
Actions On Nonpayment0ActionsOnNonpayment
Collection Activities0CollectionActivities
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (25 entries)

ExplanationExplanationIdentifierIdentifier
PART I, LINE 3C: THE HOSPITALS OF CSM PROVIDE MEDICALLY NECESSARY CARE TO ALL PATIENTS, REGARDLESS OF RACE, COLOR, CREED, ETHNIC ORIGIN, GENDER, DISABILITY OR ECONOMIC STATUS. OHOW'S SPECIFIC POLICY USES A PERCENTAGE OF FEDERAL POVERTY LEVEL (FPL) TO DETERMINE FREE AND DISCOUNTED CARE. AT A MINIMUM, PATIENTS WITH INCOME LESS THAN OR EQUAL TO 200% OF THE FPL, WHICH MAY BE ADJUSTED FOR COST OF LIVING UTILIZING THE LOCAL WAGE INDEX COMPARED TO NATIONAL WAGE INDEX, WILL BE ELIGIBLE FOR 100% CHARITY CARE WRITE OFF OF CHARGES FOR SERVICES THAT HAVE BEEN PROVIDED TO THEM.
PART I, LINE 6A: OHOW FILES AN ANNUAL COMMUNITY BENEFIT REPORT WITH THE WISCONSIN HOSPITAL ASSOCIATION ("WHA"). CSM DOES NOT FILE A COMMUNITY BENEFIT REPORT WITH THE WHA SINCE CSM DOES NOT HAVE ANY PATIENT CARE REVENUE. HOWEVER, CSM IS THE PARENT ENTITY OF 3 HOSPITALS, COLUMBIA ST. MARY'S HOSPITAL MILWAUKEE, INC., COLUMBIA ST. MARY'S HOSPITAL OZAUKEE, SACRED HEART REHABILITATION, INC., EACH OF WHICH FILE COMMUNITY BENEFIT REPORTS WITH WHA. CSM DOES, HOWEVER, DESCRIBE THE BENEFITS THAT THE CSM ORGANIZATION PROVIDES TO THE COMMUNITY ON ITS WEBSITE.
PART I, LINE 7: THE COST OF PROVIDING CHARITY CARE, MEANS TESTED GOVERNMENT PROGRAMS, AND COMMUNITY BENEFIT PROGRAMS IS ESTIMATED USING INTERNAL COST DATA, AND IS CALCULATED IN COMPLIANCE WITH CATHOLIC HEALTH ASSOCIATION ("CHA") GUIDELINES. THE ORGANIZATION USES A COST ACCOUNTING SYSTEM THAT ADDRESSES ALL PATIENT SEGMENTS (FOR EXAMPLE, INPATIENT, OUTPATIENT, EMERGENCY ROOM, PRIVATE INSURANCE, MEDICAID, MEDICARE, UNINSURED, OR SELF PAY). THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE. FOR CERTAIN CATEGORIES IN THE TABLE, THIS WAS A COST ACCOUNTING SYSTEM; IN OTHER CATEGORIES, A SPECIFIC COST-TO-CHARGE RATIO WAS APPLIED.PART I, LINE 7G: THE ORGANIZATION HAS NOT INCLUDED COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC AS PART OF SUBSIDIZED HEALTH SERVICES.
PART I, L7 COL(F): CSM'S SHARE OF THE AMOUNT OF BAD DEBT EXPENSE REPORTED BY OHOW IN 2013 BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES IN PART I, LINE 7, COLUMN (F) IS $558,207.
PART II: NO COMMUNITY BUILDING ACTIVITIES HAVE BEEN REPORTED BASED ON THE OHOW JOINT VENTURE; HOWEVER, IN ORDER TO ACCOMPLISH THE COLLABORATIVE WORK IN THE COMMUNITY AND TO OVERSEE ACCESS CLINICS AND OUTREACH PROGRAMS, CSM HAS A COMMUNITY SERVICES DEPARTMENT WHICH OVERSEES THE CSM COMMUNITY BENEFIT PROCESS. CSM, INC. PARTICIPATES IN COMMUNITY BUILDING ACTIVITIES THROUGH PROGRAMS SUCH AS INROADS, WHICH IS AN OPPORTUNITY FOR CULTURALLY DIVERSE COLLEGE STUDENTS TO SERVE AN INTERNSHIP OVER SUMMER BREAK TO FAMILIARIZE THEMSELVES WITH THE CHALLENGES AND OPPORTUNITIES IN HEALTH CARE AND GAIN REAL WORLD EXPERIENCE. INROADS IS REFLECTED IN THE COMMUNITY BUILDING SECTION OF THE REPORT. CSM IS A FOUNDING MEMBER OF THE MILWAUKEE HEALTH CARE PARTNERSHIP (MHCP), WHICH IS A COLLABORATION BETWEEN THE FIVE MILWAUKEE HEALTH SYSTEMS AND FEDERALLY QUALIFIED HEALTH CENTERS TO IMPROVE ACCESS TO HEALTH CARE IN THE COMMUNITY. THE PARTNERSHIP HAS WORKED WITH COUNTY HEALTH OFFICIALS TO IMPROVE BEHAVIORAL ACCESS AND PARTNERSHIP FUNDING SUPPORTS MENTAL HEALTH RESPITE BEDS IN THE COMMUNITY. CSM'S CEO AND VP OF MISSION SERVICES EACH SPEND SIGNIFICANT TIME IN MHCP COLLABORATIVE WORK. ACCESS TO HEALTH EDUCATION AND SCREENING IN MANY AREAS OF THE CITY IS BEST ACCOMPLISHED THROUGH CHURCH COLLABORATION. CSM EMPLOYS NURSES TO WORK IN COLLABORATION WITH CHURCHES AND COMMUNITY ORGANIZATIONS TO OFFER HEALTH EDUCATION, HEALTH SCREENING, AND CARE MANAGEMENT SUPPORT TO PARISHIONERS AND COMMUNITY MEMBERS IN A VARIETY OF OUTREACH PROGRAMS AFFILIATED WITH CHURCHES. CSM DEVELOPED THE BEGINNING STAGES OF A COLLABORATION WITH 44 CHURCH OF GOD IN CHRIST CHURCHES IN MILWAUKEE TO ACCOMPLISH BETTER HEALTH AWARENESS AND IMPROVE SCREENING RATES.
PART III, LINE 4: OHOW, WHICH FILES FINANCIAL STATEMENTS SEPARATE FROM CSM, INCLUDES THE FOLLOWING FOOTNOTE RELATED TO ACCOUNTS RECEIVABLES: "THE MAJORITY OF THE HOSPITAL'S ACCOUNTS RECEIVABLES ARE DUE FROM THIRD-PARTY PAYORS UNDER REIMBURSEMENT AGREEMENTS AND FROM PATIENTS FOR SERVICES PROVIDED. ACCOUNTS RECEIVABLE ARE DUE UPON RECEIPT OF INVOICE. RECEIVABLES ARE STATED NET OF ANY ALLOWANCE FOR CONTRACTUAL DISCOUNTS AND UNCOLLECTIBLE ACCOUNTS BY CONSIDERING THE NUMBER OF DAYS PAST DUE, COLLECTION HISTORY, AND THE GENERAL ECONOMY AND INDUSTRY AS A WHOLE. CONTRACTUAL ADJUSTMENTS ARE BASED ON EXPECTED PAYMENT RATES IN ACCORDANCE WITH THIRD-PARTY PAYOR AGREEMENTS. THE HOSPITAL WRITES OFF ACCOUNTS RECEIVABLE WHEN THEY ARE DETERMINED TO BE UNCOLLECTIBLE. PAYMENTS SUBSEQUENTLY RECEIVED ARE CREDITED TO THE ALLOWANCE FOR DOUBTFUL ACCOUNTS."
PART III, LINE 8: OHOW FOLLOWS THE CATHOLIC HEALTH ASSOCIATION ("CHA") GUIDELINES FOR DETERMINING COMMUNITY BENEFIT. CHA COMMUNITY BENEFIT REPORTING GUIDELINES SUGGEST THAT MEDICARE SHORTFALL IS NOT TREATED AS COMMUNITY BENEFIT.
PART III, LINE 9B: OHOW HAS A WRITTEN DEBT COLLECTION POLICY THAT ALSO INCLUDES A PROVISION ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. IF A PATIENT QUALIFIES FOR CHARITY OR FINANCIAL ASSISTANCE CERTAIN COLLECTION PRACTICES DO NOT APPLY.
PART V, SECTION B, LINE 3: THE HOSPITAL FACILITY TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH. THE COLLABORATION INCLUDED PARTICIPATION BY THE MILWAUKEE COUNTY HEALTH DEPARTMENT AND REPRESENTATIVES FROM HEALTH DEPARTMENTS IN MILWAUKEE COUNTY.THE CHNA TEAM DEVELOPED A MULTI-LEVEL ASSESSMENT PROCESS. THE FIRST LEVEL CONSISTED OF A SURVEY OF COUNTY RESIDENTS REGARDING THEIR HEALTH STATUS, HEALTH ACCESS AND THE PERCEPTION OF COMMUNITY NEEDS. WORKING TOGETHER, SURVEY QUESTIONS WERE DEVELOPED AND APPROVED. A CONSULTANT WAS CONTRACTED TO PERFORM THE SURVEY USING TECHNIQUES THAT THE CONSULTANT HAD USED IN SIMILAR SURVEYS OVER TEN YEARS. THE SURVEY WAS CONDUCTED OVER THE TELEPHONE TO CELL PHONE OWNERS AND "LAND LINE" TELEPHONE OWNERS. MORE THAN 1,900 PEOPLE WERE INTERVIEWED.THE SECOND LEVEL OF DATA GATHERING WAS PERFORMED BY THE CENTER FOR URBAN POPULATION HEALTH (CUPH) AS SECONDARY DATA GATHERING ABOUT COMMUNITY NEEDS BASED ON PUBLIC HEALTH AND OTHER PUBLICLY AVAILABLE INFORMATION. THE THIRD LEVEL OF DATA WAS GATHERED THROUGH A KEY STAKEHOLDER INTERVIEW PROCESS. THE MHCP MEMBERS HAD AGREED UPON THOSE DIVERSE PEOPLE WHO REPRESENTED KEY ASPECTS OF THE COMMUNITY. A SURVEY TOOL WAS DEVELOPED BY THE GROUP AND INTERVIEWS WERE SCHEDULED BY MHCP MEMBERS AND BY PUBLIC HEALTH STUDENTS WORKING WITH THE CITY OF MILWAUKEE HEALTH DEPARTMENT. IN ALL, 35 INDIVIDUAL INTERVIEWS AND FIVE GROUP INTERVIEWS WERE CONDUCTED BY TEAM MEMBERS.ORTHOPAEDIC HOSPITAL OF WISCONSIN
PART V, SECTION B, LINE 4: THE OTHER HOSPITAL FACILITIES WITH WHICH THE REPORTING HOSPITAL FACILITY CONDUCTED ITS CHNA, INCLUDE AURORA HEALTH CARE, CHILDREN'S HOSPITAL OF WISCONSIN, FROEDTERT HEALTH AND WHEATON FRANCISCAN HEALTHCARE. THESE FIVE HOSPITAL SYSTEMS HAVE DEVELOPED THE MILWAUKEE HEALTH CARE PARTNERSHIP (MHCP) TO COLLABORATE EFFORTS TO IMPROVE UNDERSTANDING OF HEALTH CARE NEEDS IN MILWAUKEE AND TO IMPROVE ACCESS TO HEALTH CARE.ORTHOPAEDIC HOSPITAL OF WISCONSIN
PART V, SECTION B, LINE 5C: WWW.COLUMBIA-STMARYS.ORG/SERVINGOURCOMMUNITYORTHOPAEDIC HOSPITAL OF WISCONSIN
PART V, SECTION B, LINE 7: THE MILWAUKEE CHNA IDENTIFIED SEVEN KEY ISSUES: INFANT MORTALITY, CHILDREN'S DENTAL NEEDS, BREAST CANCER, ACCESS TO CARE IN GENERAL, ACCESS TO CARE REGARDING MEDICAL SPECIALISTS, INAPPROPRIATE USE OF EMERGENCY DEPARTMENTS AND BEHAVIOR HEALTH. IN THE CASE OF OHOW, ONLY ACCESS TO CARE WAS FOCUSED ON BECAUSE IT IS A SPECIALTY HOSPITAL FOCUSING ON ORTHOPEDICS. COLUMBIA ST. MARY'S DOES NOT HAVE THE SCOPE AND CAPACITY TO ADDRESS THE OTHER IDENTIFIED OHOW NEEDS.ORTHOPAEDIC HOSPITAL OF WISCONSIN
PART V, SECTION B, LINE 10: ALL PATIENTS WITH INCOME LESS THAN 200% OF THE FEDERAL POVERTY LEVEL WILL BE ELIGIBLE FOR 100% CHARITY CARE WRITE-OFF OF THE CHARGES FOR SERVICES THAT HAVE BEEN PROVIDED. ELIGIBILITY MAY BE DETERMINED AT ANY POINT IN THE REVENUE CYCLE. FINANCIAL COUNSELORS PROVIDE ASSISTANCE TO THE PATIENTS TO DETERMINE IF THEY ARE ELIGIBLE FOR MEDICAID OR OTHER PUBLIC ASSISTANCE IN ORDER TO QUALIFY FOR CHARITY CARE. CREDIT REPORTS OR OTHER SIMILAR REPORTS MAY BE RUN TO VERIFY INFORMATION PROVIDED.ORTHOPAEDIC HOSPITAL OF WISCONSIN
PART V, SECTION B, LINE 11: PATIENTS WITH INCOMES ABOVE 300% OF THE POVERTY LEVEL MAY BE ELIGIBLE FOR SOME LEVEL OF DISCOUNT BASED ON A SUBSTANTIVE ASSESSMENT OF THEIR ABILITY TO PAY. THE ASSESSMENT CONSIDERS TOTAL INCOME AND DOLLAR AMOUNT OF PATIENT RESPONSIBILITY ON A SLIDING SCALE. A MEANS TEST IS PERFORMED THAT CONSIDERS INCOME, TOTAL MEDICAL BILL OBLIGATIONS, MORTGAGE PAYMENTS, UTILITY PAYMENTS, NUMBER OF FAMILY MEMBERS, AND ANY DISABILITY CONSIDERATIONS. PATIENTS WHO DO NOT QUALIFY FOR CHARITY CARE, BUT ARE IN NEED OF FINANCIAL ASSISTANCE, WILL BE OFFERED APPROPRIATE EXTENDED PAYMENT TERMS OR OTHER PAYMENT OPTIONS THAT TAKE INTO ACCOUNT THE PATIENT'S FINANCIAL STATUS.ORTHOPAEDIC HOSPITAL OF WISCONSIN
PART V, SECTION B, LINE 16E: THE FOLLOWING STEPS WERE FOLLOWED AND CONSIDERED REASONABLE EFFORTS FOR PURPOSES OF QUESTION 16:- NOTIFIED EACH INDIVIDUAL OF THE FACILITY'S FINANCIAL ASSISTANCE POLICY (FAP). THIS NOTIFICATION BEGAN ON THE DATE CARE WAS PROVIDED AND ENDED ON THE 120TH DAY AFTER THE FIRST BILLING STATEMENT WAS PROVIDED TO THE INDIVIDUAL.- INDIVIDUALS WERE NOTIFIED OF THE FAP BY METHODS AS NOTED IN QUESTION 14. THIS INCLUDES, BUT IS NOT LIMITED TO, PROVIDING THE FOLLOWING: - A BRIEF DESCRIPTION OF ELIGIBILITY REQUIREMENTS AND ASSISTANCE PROVIDED - DIRECTIONS ON HOW TO ACCESS THE FAP AND APPLICATION ON OUR WEBSITE AND PHYSICAL LOCATION OF APPLICATION FORMS - INSTRUCTIONS TO OBTAIN FREE COPY OF FAP AND APPLICATION BY MAIL - CONTACT INFORMATION FOR AN INDIVIDUAL/NONPROFIT ORGANIZATION TO ASSIST IF THE INDIVIDUAL HAS QUESTIONS - STATEMENT OF TRANSLATIONS OF FAP AS WELL AS PLAIN LANGUAGE SUMMARIES - STATEMENT THAT NO FAP-ELIGIBLE INDIVIDUAL WILL BE CHARGED MORE FOR EMERGENCY/MEDICALLY NECESSARY CARE THAN AGB - FOR INDIVIDUALS WHO SUBMITTED AN INCOMPLETE FAP, WE PROVIDED THAT INDIVIDUAL WITH INFORMATION RELEVANT TO ASSIST THEM WITH COMPLETION OF THE FAP.- FOR INDIVIDUALS WHO SUBMITTED A COMPLETE FAP, WE MADE AND DOCUMENTED A DETERMINATION AS TO WHETHER THAT PERSON WAS ELIGIBLE UNDER THE FACILITY'S FAP- WE DETERMINED ELIGIBILITY BASED ON OTHER MEANS SUCH AS ESTABLISHING THAT THE INDIVIDUAL IS ELIGIBLE UNDER ONE OR MORE MEANS TESTED PROGRAMS (AS NOTED IN QUESTION 12).ORTHOPAEDIC HOSPITAL OF WISCONSIN
PART V, SECTION B, LINE 17E: THE FOLLOWING STEPS WERE FOLLOWED AND CONSIDERED REASONABLE EFFORTS FOR PURPOSES OF QUESTION 17:- NOTIFIED EACH INDIVIDUAL OF THE FACILITY'S FINANCIAL ASSISTANCE POLICY (FAP). THIS NOTIFICATION BEGAN ON THE DATE CARE WAS PROVIDED AND ENDED ON THE 120TH DAY AFTER THE FIRST BILLING STATEMENT WAS PROVIDED TO THE INDIVIDUAL.- INDIVIDUALS WERE NOTIFIED OF THE FAP BY METHODS AS NOTED IN QUESTION 14. THIS INCLUDES, BUT IS NOT LIMITED TO, PROVIDING THE FOLLOWING: - A BRIEF DESCRIPTION OF ELIGIBILITY REQUIREMENTS AND ASSISTANCE PROVIDED - DIRECTIONS ON HOW TO ACCESS THE FAP AND APPLICATION ON OUR WEBSITE AND PHYSICAL LOCATION OF APPLICATION FORMS - INSTRUCTIONS TO OBTAIN FREE COPY OF FAP AND APPLICATION BY MAIL - CONTACT INFORMATION FOR AN INDIVIDUAL/NONPROFIT ORGANIZATION TO ASSIST IF THE INDIVIDUAL HAS QUESTIONS - STATEMENT OF TRANSLATIONS OF FAP AS WELL AS PLAIN LANGUAGE SUMMARIES - STATEMENT THAT NO FAP-ELIGIBLE INDIVIDUAL WILL BE CHARGED MORE FOR EMERGENCY/MEDICALLY NECESSARY CARE THAN AGB - FOR INDIVIDUALS WHO SUBMITTED AN INCOMPLETE FAP, WE PROVIDED THAT INDIVIDUAL WITH INFORMATION RELEVANT TO ASSIST THEM WITH COMPLETION OF THE FAP.- FOR INDIVIDUALS WHO SUBMITTED A COMPLETE FAP, WE MADE AND DOCUMENTED A DETERMINATION AS TO WHETHER THAT PERSON WAS ELIGIBLE UNDER THE FACILITY'S FAP- WE DETERMINED ELIGIBILITY BASED ON OTHER MEANS SUCH AS ESTABLISHING THAT THE INDIVIDUAL IS ELIGIBLE UNDER ONE OR MORE MEANS TESTED PROGRAMS (AS NOTED IN QUESTION 12).ORTHOPAEDIC HOSPITAL OF WISCONSIN
PART V, SECTION B, LINE 18E: QUESTION 18 IS MORE APPROPRIATELY ANSWERED AS NOT APPLICABLE AS THE BILLING AND COLLECTIONS POLICY OF OHOW DOES NOT ALLOW A HOSPITAL TO ENGAGE IN EXTRAORDINARY COLLECTION ACTIONS BEFORE THE ORGANIZATION MADE REASONABLE EFFORTS TO DETERMINE WHETHER THE INDIVIDUAL IS ELIGIBLE FOR ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY. REASONABLE EFFORTS TAKEN INCLUDE BUT ARE NOT LIMITED TO: - NOTIFYING INDIVIDUALS OF THE FINANCIAL ASSISTANCE POLICY IN COMMUNICATIONS WITH THE PATIENTS REGARDING THE PATIENTS' BILLS.ORTHOPAEDIC HOSPITAL OF WISCONSIN
PART V, SECTION B, LINE 20D: ALL PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE RECEIVE A MINIMUM DISCOUNT OF 40% OFF GROSS CHARGES FOR SERVICES PROVIDED TO THEM.ORTHOPAEDIC HOSPITAL OF WISCONSIN
PART V, SECTION B, LINE 21: THE FOLLOWING STEPS WERE FOLLOWED AND CONSIDERED REASONABLE EFFORTS FOLLOWED FOR PURPOSES OF IDENTIFYING PATIENTS ELIGIBLE FOR ASSISTANCE UNDER THE FACILITY'S FAP:- NOTIFIED EACH INDIVIDUAL OF THE HOSPITALS FINANCIAL ASSISTANCE POLICY (FAP). THIS NOTIFICATION BEGAN ON THE DATE CARE WAS PROVIDED AND ENDED ON THE 120TH DAY AFTER THE FIRST BILLING STATEMENT WAS PROVIDED TO THE INDIVIDUAL.- INDIVIDUALS WERE NOTIFIED OF THE FAP AS NOTED IN QUESTION 14. THIS INCLUDES, BUT IS NOT LIMITED TO, THE FOLLOWING: - BRIEF DESCRIPTION OF ELIGIBILITY REQUIREMENTS AND ASSISTANCE PROVIDED. - DIRECT INDIVIDUALS TO OUR WEBSITE AND PHYSICAL LOCATION OF APPLICATION FORMS - PROVIDED INSTRUCTIONS TO OBTAIN FREE COPY OF FAP AND APPLICATION BY MAIL - PROVIDED CONTACT INFORMATION FOR AN INDIVIDUAL/NONPROFIT ORGANIZATION TO ASSIST IF THE INDIVIDUAL HAS QUESTIONS - PROVIDED STATEMENT OF TRANSLATIONS OF FAP AS WELL AS PLAIN LANGUAGE SUMMARIES - PROVIDED STATEMENT THAT NO FAP-ELIGIBLE INDIVIDUAL WILL BE CHARGED MORE FOR EMERGENCY/MEDICALLY NECESSARY CARE THAN AGB- FOR INDIVIDUALS WHO SUBMITTED AN INCOMPLETE FAP, WE PROVIDED THAT INDIVIDUAL WITH INFORMATION RELEVANT TO ASSIST THEM WITH COMPLETION OF THE FAP- FOR INDIVIDUALS WHO SUBMITTED A COMPLETE FAP, WE MADE AND DOCUMENTED A DETERMINATION AS TO WHETHER THAT PERSON WAS ELIGIBLE UNDER THE FACILITY'S FAP.- WE DETERMINED ELIGIBILITY BASED ON OTHER MEANS SUCH AS ESTABLISHING THAT THE INDIVIDUAL IS ELIGIBLE UNDER ONE OR MORE MEANS TESTED PROGRAMS (AS NOTED IN QUESTION 12).ORTHOPAEDIC HOSPITAL OF WISCONSIN
PART V, SECTION B, LINE 22: THE FOLLOWING STEPS WERE FOLLOWED AND CONSIDERED REASONABLE EFFORTS FOLLOWED FOR PURPOSES OF IDENTIFYING PATIENTS ELIGIBLE FOR ASSISTANCE UNDER THE FACILITY'S FAP:- NOTIFIED EACH INDIVIDUAL OF THE HOSPITALS FINANCIAL ASSISTANCE POLICY (FAP). THIS NOTIFICATION BEGAN ON THE DATE CARE WAS PROVIDED AND ENDED ON THE 120TH DAY AFTER THE FIRST BILLING STATEMENT WAS PROVIDED TO THE INDIVIDUAL.- INDIVIDUALS WERE NOTIFIED OF THE FAP AS NOTED IN QUESTION 14. THIS INCLUDES, BUT IS NOT LIMITED TO, THE FOLLOWING: - BRIEF DESCRIPTION OF ELIGIBILITY REQUIREMENTS AND ASSISTANCE PROVIDED. - DIRECT INDIVIDUALS TO OUR WEBSITE AND PHYSICAL LOCATION OF APPLICATION FORMS - PROVIDED INSTRUCTIONS TO OBTAIN FREE COPY OF FAP AND APPLICATION BY MAIL - PROVIDED CONTACT INFORMATION FOR AN INDIVIDUAL/NONPROFIT ORGANIZATION TO ASSIST IF THE INDIVIDUAL HAS QUESTIONS - PROVIDED STATEMENT OF TRANSLATIONS OF FAP AS WELL AS PLAIN LANGUAGE SUMMARIES - PROVIDED STATEMENT THAT NO FAP-ELIGIBLE INDIVIDUAL WILL BE CHARGED MORE FOR EMERGENCY/MEDICALLY NECESSARY CARE THAN AGB- FOR INDIVIDUALS WHO SUBMITTED AN INCOMPLETE FAP, WE PROVIDED THAT INDIVIDUAL WITH INFORMATION RELEVANT TO ASSIST THEM WITH COMPLETION OF THE FAP- FOR INDIVIDUALS WHO SUBMITTED A COMPLETE FAP, WE MADE AND DOCUMENTED A DETERMINATION AS TO WHETHER THAT PERSON WAS ELIGIBLE UNDER THE FACILITY'S FAP.- WE DETERMINED ELIGIBILITY BASED ON OTHER MEANS SUCH AS ESTABLISHING THAT THE INDIVIDUAL IS ELIGIBLE UNDER ONE OR MORE MEANS TESTED PROGRAMS (AS NOTED IN QUESTION 12).ORTHOPAEDIC HOSPITAL OF WISCONSIN
PART VI, LINE 2: COLUMBIA ST. MARY'S, INC. SERVES THE MILWAUKEE AND OZAUKEE COMMUNITIES THROUGH A COMMUNITY BENEFIT PROCESS OVERSEEN BY THE MILWAUKEE COMMUNITY BENEFIT COMMITTEE AND THE OZAUKEE COMMUNITY BENEFIT COMMITTEE. THE PROCESS OF UNDERSTANDING COMMUNITY NEEDS THROUGH A COMMUNITY HEALTH NEEDS ASSESSMENT AND INTERPRETED THROUGH THE WORK OF COMMUNITY BENEFIT COMMITTEES TO LEAD TO A COMMUNITY BENEFIT PLAN FOR MILWAUKEE AND OZAUKEE COMMUNITIES IS CONSISTENT ACROSS THE ORGANIZATION. ALTHOUGH THE COMMUNITY BENEFIT PLAN OCCURS PRIMARILY IN THE MILWAUKEE, OZAUKEE AND SACRED HEART REHABILITATION INSTITUTE SETTINGS, THE WORK IS ALSO SUPPORTED BY DEPARTMENTS BEHIND THE SCENES ACROSS CSM, INCLUDING ACCOUNTING, HUMAN RESOURCES, PURCHASING, LEGAL COUNSEL AND OTHER ADMINISTRATIVE FUNCTIONS. PROGRAMS SUCH AS THE ORTHOPAEDIC HOSPITAL OF WISCONSIN HAVE ALSO CONTRIBUTED TO SUPPORT OF COMMUNITY BENEFIT PROGRAMMING. COMMUNITY BENEFIT COMMITTEES AT CSM HAVE CONSISTENT ROLES TO SUPPORT THE COMMUNITY BENEFIT FUNCTIONS. THE ROLES INCLUDE THE FOLLOWING: - DEVELOP COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TO DETERMINE COMMUNITY NEEDS- REVIEW CHNA AND CREATE COMMUNITY BENEFIT PLAN TO ADDRESS NEEDS- INCORPORATE COMMUNITY BENEFIT PLAN GOALS IN THE CSM INTEGRATED STRATEGIC, OPERATIONAL AND FINANCIAL PLAN (ISOFP) FOR BOARD LEVEL APPROVAL AND SUBMISSION TO ASCENSION HEALTH SYSTEM - DEVELOP A STRATEGY TO MEASURE AND INCREASE THE IMPACT OF COMMUNITY BENEFIT PLAN ELEMENTSTHE COMMUNITY HEALTH NEEDS ASSESSMENTS ARE SPECIFIC TO THE DEMOGRAPHICS AND HEALTH ISSUES TO THE COMMUNITY. THE NEEDS ASSESSMENTS IN FY13 INVOLVED THE GATHERING OF SECONDARY INFORMATION ABOUT THE COMMUNITIES FROM VARIED PUBLIC SOURCES INCLUDING STATE DATA, AND COUNTY DATA. THE MOST REMARKABLE NEEDS FOR THE SERVICE WERE ADDRESSED THROUGH COMMUNITY BENEFIT PLANS FOR EACH COMMUNITY.
PART VI, LINE 3: CSM ATTEMPTS TO IDENTIFY PATIENTS WHO MAY BE ELIGIBLE FOR CHARITY OR DISCOUNTED CARE AS OUTLINED IN THE CHARITY CARE POLICY DURING THE PRE-REGISTRATION, REGISTRATION, ADMISSIONS AND DISCHARGE PROCESSES. A COPY OF THE CHARITY CARE POLICY IS POSTED IN THE EMERGENCY ROOM, AND A SUMMARY OF THE POLICY IS PROVIDED TO PATIENTS WITH ADMISSION AND DISCHARGE PAPERWORK. CSM HAS TRAINED FINANCIAL COUNSELORS AVAILABLE TO DISCUSS PAYMENT OPTIONS TO THE PATIENTS. UPON MAKING AN APPOINTMENT, THE FINANCIAL COUNSELORS WILL MEET WITH THE PATIENT TO DETERMINE WHAT OTHER FINANCIAL ASSISTANCE PROGRAMS THE PATIENT MAY QUALIFY FOR.
PART VI, LINE 4: CSM PRIMARILY SERVES THE MILWAUKEE AND OZAUKEE COUNTIES IN SOUTHEASTERN WISCONSIN. OHOW IS LOCATED IN AN URBAN COMMUNITY WITHIN MILWAUKEE COUNTY. THE POPULATION OF MILWAUKEE COUNTY IS APPROXIMATELY 953,000, WITH OVER 20% OF THE HOUSEHOLDS LIVING AT OR BELOW FEDERAL POVERTY GUIDELINES. THE MEDIAN INCOME IS APPROXIMATELY $43,000, OVER 46% OF THE POPULATION IS A MINORITY, AND APPROXIMATELY 16% OF THE POPULATION SPEAK A LANGUAGE OTHER THAN ENGLISH. DISCOUNTS FOR THE UNINSURED AND UNDERINSURED ARE NOT INCLUDED IN PARTS I OR II OF SCHEDULE H.
PART VI, LINE 5: A HALLMARK OF CSM, INC. IS THE ABILITY TO PROACTIVELY MEET HEALTH NEEDS THROUGH PREVENTIVE PROGRAMS AND PROGRAMS TO ALLOW ACCESS TO PRIMARY AND SPECIALTY CARE. THE PROGRAMS ARE MOST OFTEN DELIVERED THROUGH PARTNERSHIP WITH OTHER NON-PROFIT ORGANIZATIONS IN HEALTH AND SOCIAL SERVICES. EACH HOSPITAL HAS ACCESS IMPROVEMENT PROGRAMS INCLUDING: ST. BENS CLINIC FOR THE HOMELESS, SETON DENTAL CLINIC, COMMUNITY CHRONIC DISEASE MANAGEMENT CLINIC, HUIRAS FAMILY COMMUNITY HEALTH CENTER, EL CENTRO DE SALUDE CLINIC SPONSORED BY THE COLUMBIA COLLEGE OF NURSING, THE CSM OB/CLINIC AND THE CSM FAMILY HEALTH CENTER. A PARTICULARLY STRONG PARTNER IN THESE ACTIVITIES HAS BEEN THE MEDICAL COLLEGE OF WISCONSIN IN SPONSORSHIP OF PROGRAMS: - THE FAMILY HEALTH CENTER, A RESIDENCY-BASED FAMILY MEDICINE CLINIC THAT PROVIDES PRIMARY CARE TO MORE THAN 9,000 INDIVIDUALS IN THE COMMUNITY.- THE OB/GYN CLINIC, A RESIDENCY-BASED PROGRAM THAT SERVES OVER 150 PATIENTS, 250 OB APPOINTMENTS PER MONTH, AND 325 DELIVERIES PER YEAR.- THE CHRONIC DISEASE MANAGEMENT CLINIC, WHICH SCREENS AND MANAGES HYPERTENSION, DIABETES, OBESITY, AND SMOKING FOR LOW INCOME ADULTS THROUGH A CLINIC BASED IN A FOOD PANTRY. - THE SATURDAY CLINIC FOR THE UNINSURED, WHICH USES MEDICAL STUDENTS AND VOLUNTEER PHYSICIANS TO SERVE HUNDREDS OF UNINSURED PATIENTS EACH YEAR.IN TURN, CSM ACROSS THE HOSPITAL SETTINGS HOSTS RESIDENTS FOR THEIR TRAINING GROWTH AND DEVELOPMENT. ALL OF THESE SERVICES ARE REPORTED AS PART OF THE COMMUNITY BENEFIT EXPENSES IN SECTION H OF THE APPROPRIATE HOSPITAL REPORT.
PART VI, LINE 6: THE CSM HEALTH SYSTEM FOCUSES ON CONTRIBUTING TO THE POSITIVE HEALTH STATUS OF THE COMMUNITIES IT SERVES. CSM IS AN ORGANIZATION COMPRISED OF THREE HOSPITALS, 61 COMMUNITY CLINICS, THE COLUMBIA COLLEGE OF NURSING, A PARTNERSHIP WITH THE ORTHOPAEDIC HOSPITAL OF WISCONSIN, A PARTNERSHIP WITH SLEEP SERVICES OF WISCONSIN, AND FOUR URGENT CARE CENTERS. CSM PROVIDES CARE FOR INDIVIDUALS AND FAMILIES THROUGHOUT MILWAUKEE, OZAUKEE, WASHINGTON, AND SHEBOYGAN COUNTIES - WITH MORE THAN 160 YEARS OF SERVICE TO INDIVIDUALS AND FAMILIES IN THESE COMMUNITIES.OHOW ITSELF IS A SPECIALTY HOSPITAL WHICH PERFORMS MORE THAN 5,000 SURGICAL PROCEDURES EACH YEAR AND OFFERS THE COMPLETE RANGE OF ORTHOPAEDIC SERVICES, INCLUDING JOINT REPLACEMENTS AND SPINE PROCEDURES, REHABILITATION, DIAGNOSTIC TESTING AND PAIN MANAGEMENT SERVICES. AS A MEMBER OF ASCENSION HEALTH, THE NATION'S LARGEST CATHOLIC HEALTHCARE SYSTEM, CSM CONTINUES TO BUILD AND STRENGTHEN SUSTAINABLE COLLABORATIVE EFFORTS THAT BENEFIT THE HEALTH OF INDIVIDUALS, FAMILIES, AND SOCIETY AS A WHOLE. THE GOAL OF CSM IS TO PERPETUATE THE HEALTH MISSION OF THE CHURCH. CSM FURTHERS THIS GOAL THROUGH DELIVERY OF PATIENT SERVICES, CARE TO THE ELDERLY AND INDIGENT, PATIENT EDUCATION AND HEALTH AWARENESS PROGRAMS FOR THE COMMUNITY, AND MEDICAL RESEARCH. OUR CONCERN FOR ALL HUMAN LIFE AND DIGNITY OF EACH PERSON LEADS THE ORGANIZATION TO PROVIDE MEDICAL SERVICES TO ALL PEOPLE IN THE COMMUNITY WITHOUT REGARD TO THE PATIENT'S RACE, CREED, NATIONAL ORIGIN, ECONOMIC STATUS, OR ABILITY TO PAY.CSM EMPLOYS A COMMUNITY BENEFIT PHILOSOPHY IN PROGRAM PLANNING AND IMPLEMENTATION. CSM PROVIDES FOR THE HEALTH OF THE COMMUNITY THROUGH FINANCIAL SUPPORT PROVIDED TO PATIENTS BY FINANCIAL DISCOUNTS AND CONTRACTS, BY DEVELOPING CLINICS AND SERVICES FOR SPECIFIC VULNERABLE GROUPS, BY SPONSORING COMMUNITY EDUCATION AND TRAINING AND BY COLLABORATING WITH GOVERNMENT PROGRAMS.DURING FISCAL 2013, THE CSM SYSTEM PROVIDED $48,073,173 IN UNREIMBURSED SERVICES, INCLUDING $12,629,416 IN TRADITIONAL CHARITY CARE, $12,361,841 IN DISCOUNTS TO THE UNINSURED, $14,341,463 IN COMMUNITY BENEFIT PROGRAMS, AND $21,116,886 IN OTHER UNPAID PUBLIC PROGRAMS, INCLUDING SUBSIDIZED HEALTH CARE, PROFESSIONAL EDUCATION, FINANCIAL CONTRIBUTIONS AND COMMUNITY BUILDING ACTIVITIES.IN ADDITION, THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF LOCAL COMMUNITY LEADERS AND PHYSICIANS, THE MAJORITY OF WHOM RESIDE WITHIN THE COMMUNITIES CSM SERVES AND ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY; HOWEVER, THE CLINICS WITHIN THE ORGANIZATION ARE SERVED BY PHYSICIANS AFFILIATED WITH CSM.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
UNITED WAY
225 W VINE STREETMILWAUKEEWI53212390806190501(C)(3)400000GENERAL CONTRIBUTION
MARQUETTE UNIVERSITY
1250 W WISCONSIN AVEMILWAUKEEWI53233390806251501(C)(3)12800GENERAL CONTRIBUTION
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants2TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: CONTRIBUTIONS TO GOVERNMENTS AND ORGANIZATIONS IN THE UNITED STATES ARE APPROVED BY THE BOARD OF DIRECTORS AND/OR THE PRESIDENT & CEO. ALL RECORDS OF OUTGOING CONTRIBUTIONS ARE RETAINED FOR A PERIOD OF 10 YEARS, PLUS THE CURRENT FISCAL YEAR, AND CAN BE LOCATED AT THE OFFICE CENTER AT 4425 NORTH PORT WASHINGTON RD, GLENDALE, WI 53212.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Housing Allowance Or ResidenceXHousingAllowanceOrResidence
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
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 Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (19 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
KEVIN GONIU MD
BOARD MEMBER AND CSM PHYSI047147407698902007605000023044059658300
MARK R TAYLOR
PRESIDENT/CEO578558090642501202160500003548501645684000
RHONDA ANDERSON
CSM PRESIDENT / CFO371606027520401394205000061230671875000
CHERYL HILL
VP/CHRO2410530172844020640050000197710459308000
DAVID H SHAPIRO MD
CHIEF MEDICAL OFFICER2874710139129021979050000150040468583000
GERRI LIETZ-STAFFILENO
VP HOSP OPERATIONS2227320154831021026050000194920423081000
SUE SANICOLA
VP PHYSICIAN SERVICES1763600127258020432042790241650352494000
WILLIAM HART
VP / COO293407020012603467031230100300510153000
DEBORAH FRIBERG
PRESIDENT HOSP DIV END 06/1222765303040090237111050000248320798605000
BRUCE MCCARTHY MD
PRESIDENT PHYSICIAN DIVISION500431032909105548050000307350870805000
CONSTANCE J BRADLEY
VP HOSP OPERATIONS20288801304340281050000120070350610000
MARIAN PURDUE
INTERIM PRES HOSP DIV (END 10/12)317000000000000317000000
ALLAN SPOONER
PRESIDENT HOSPITAL DIVISION7676509708903463500010460209535000
PAUL WESTRICK
VP MISSION INTEGRATION1712700122955021119038600251970344401000
MITCH QUADE
DIRECTOR REVENUE CYCLE1509630323680887034230280620215703000
ANDREW FERGUSUSON
FINANCIAL SERVICES OFFICER194076039149026103330021610238977000
DAVID MANNES
CONTROLLER1424580294330105035170184380193951000
CLARISSA COX
VP QUALITY & CLINICAL INTEGRATION1518780116870263403331036070173137000
LEO P BRIDEAU
PRESIDENT/CEO END 02/1100727898000000072789807278980

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
PART I, LINE 1APAYMENTS WERE MADE TO NEW PRESIDENT HOSPITAL DIVISION TO ASSIST WITH MOVING EXPENSES AND THE SALE OF HIS HOME IN CALENDAR YEAR 2012.
PART I, LINE 4BPART I, LINE 4B: ELIGIBLE EXECUTIVES PARTICIPATE IN A PROGRAM THAT PROVIDES FOR SUPPLEMENTAL RETIREMENT BENEFITS. THE PAYMENT OF BENEFITS UNDER THE PROGRAM, IF ANY, IS ENTIRELY DEPENDENT UPON THE FACTS AND CIRCUMSTANCES UNDER WHICH THE EXECUTIVE TERMINATES EMPLOYMENT WITH THE ORGANIZATION. BENEFITS UNDER THE PROGRAM ARE UNFUNDED AND NON-VESTED. DUE TO THE SUBSTANTIAL RISK OF FORFEITURE PROVISION, THERE IS NO GUARANTEE THAT THESE EXECUTIVES WILL EVER RECEIVE ANY BENEFIT UNDER THE PROGRAM. ANY AMOUNT ULTIMATELY PAID UNDER THE PROGRAM TO THE EXECUTIVE IS REPORTED AS COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN B, IN THE YEAR PAID. THE FILING ORGANIZATION, CSM INC, DID NOT CONTRIBUTE TO THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN FOR ANY OF THE EXECUTIVES IN THIS YEAR.
PART I, LINE 7BOARD MEMBERS, OFFICERS, KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES WHO ARE EMPLOYED BY THE CSM ORGANIZATIONS AND ARE MEDICAL DOCTORS ARE ELIGIBLE TO RECEIVE A PERCENTAGE OF THE REVENUE GENERATED FROM PATIENTS THEY SERVE, BASED ON ESTABLISHED GUIDELINES. OFFICERS AND KEY EMPLOYEES PARTICIPATE IN A MANAGEMENT INCENTIVE PLAN, WHEREBY CERTAIN FINANCIAL TRIGGERS OF THE CSM SYSTEM AS APPROVED BY THE BOARD MUST BE MET BEFORE ANY ELIGIBLE EMPLOYEE MAY RECEIVE PAYMENT OF THE INCENTIVE. ONCE THE TRIGGER IS MET, THE INCENTIVE IS MEASURED BASED ON VARIOUS ESTABLISHED GOALS, INCLUDING OPERATING MARGIN, PATIENT SATISFACTION, QUALITY, AND PRODUCTIVITY.
PART IIIPAYMENTS WERE MADE TO THE NEW PRESIDENT OF THE HOSPITAL DIVISION TO ASSIST WITH MOVING EXPENSES AND THE SALE OF HIS HOME. THE AMOUNTS WERE REPORTED AS TAXABLE COMPENSATION AND ARE INCLUDED SCHEDULE J, BOX B(III).SUPPLEMENTAL INFORMATION

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name PersonR BRUCE MCDONALDNamePerson
FieldValueIRS element (for citing)
RelationshipCHAIRRelationship
Amount Of Transaction202878AmountOfTransaction
Description Of TransactionCFO OF JOHNSON CONTROLS, INC., A PUBLIC COMPANY WHICH PROVIDES SERVICES TO CSM AND ITS AFFILIATES. ALL TRANSACTIONS ARE CONDUCTED AT ARMS' LENGTH.DescriptionOfTransaction
Sharing Of Revenues0SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 6CSM HAS TWO CORPORATE MEMBERS: ASCENSION HEALTH AND COLUMBIA HEALTH SYSTEM.
FORM 990, PART VI, SECTION A, LINE 7AONE OF CSM'S CORPORATE MEMBERS, ASCENSION HEALTH, HAS THE ABILITY TO ELECT MEMBERS TO THE GOVERNING BODY OF CSM.
FORM 990, PART VI, SECTION A, LINE 7BASCENSION HEALTH HAS DESIGNED A SYSTEM AUTHORITY MATRIX WHICH ASSIGNS AUTHORITY FOR KEY DECISIONS THAT ARE NECESSARY IN THE OPERATION OF THE SYSTEM. SPECIFIC AREAS THAT ARE IDENTIFIED IN THE AUTHORITY MATRIX ARE: NEW ORGANIZATIONS & MAJOR TRANSACTIONS; GOVERNING DOCUMENTS; APPOINTMENTS/REMOVALS; EVALUATION; DEBT LIMITS; STRATEGIC & FINANCIAL PLANS; ASSETS; SYSTEM POLICIES & PROCEDURES. THESE AREAS ARE SUBJECT TO CERTAIN LEVELS OF APPROVAL BY ASCENSION PER THE SYSTEM AUTHORITY MATRIX. COLUMBIA HEALTH SYSTEM HAS THE AUTHORITY TO APPROVE ANY CHANGES TO THE GOVERNING DOCUMENTS WHICH WOULD AFFECT ITS INTEREST OR RIGHTS IN CSM, THE MISSION AND VISION STATEMENTS OF CSM, AND ANY MAJOR CORPORATE STRUCTURAL TRANSACTIONS OF CSM.
FORM 990, PART VI, SECTION B, LINE 11MANAGEMENT, INCLUDING CERTAIN OFFICERS, WORKS DILIGENTLY TO COMPLETE THE FORM 990 AND ATTACHED SCHEDULES IN A THOROUGH MANNER. MANAGEMENT PRESENTS THE FORM TO THE BOARD, OR A DESIGNATED COMMITTEE, TO REVIEW AND ANSWER ANY QUESTIONS. PRIOR TO FILING THE RETURN, ALL BOARD MEMBERS ARE PROVIDED THE FORM 990 AND MANAGEMENT TEAM MEMBERS ARE AVAILABLE TO ANSWER ANY BOARD MEMBERS QUESTIONS.
FORM 990, PART VI, SECTION B, LINE 12CCSM HAS A WRITTEN CONFLICT OF INTEREST POLICY. THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE POLICY IN THAT ANY DIRECTOR, PRINCIPAL OFFICER, OR MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS, WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST, MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF THE COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. THE REMAINING INDIVIDUALS ON THE GOVERNING BOARD OR COMMITTEE MEETING WILL DECIDE IF CONFLICTS OF INTEREST EXIST. EACH DIRECTOR, PRINCIPAL OFFICER, AND MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS ANNUALLY SIGNS A STATEMENT WHICH AFFIRMS SUCH PERSON HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY, AND UNDERSTANDS THAT THE ORGANIZATION IS CHARITABLE AND IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ITS TAX EXEMPT PURPOSE.
FORM 990, PART VI, SECTION B, LINE 15IN DETERMINING COMPENSATION OF THE ORGANIZATION'S CEO, EXECUTIVE DIRECTOR, OR TOP MANAGEMENT OFFICIAL, THE PROCESS INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE CEO WAS COMPARED TO OTHER HOSPITALS IN THE AREA THAT HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE BOARD MINUTES. THE CEO WAS NOT PRESENT WHEN HIS COMPENSATION WAS DECIDED. IN DETERMINING COMPENSATION OF OTHER OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION, THE PROCESS INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATIONS, THE OTHER OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION WERE COMPARED TO OTHER HOSPITALS' EMPLOYEES IN THE AREA THAT HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE BOARD MINUTES.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION WILL PROVIDE ANY DOCUMENTS OPEN TO PUBLIC INSPECTION UPON REQUEST.
FORM 990, PART XI, LINE 9:DEFERRED PENSION COSTS -21,633,157. EQUITY TRANSFER -39,174,200. TRANSFER -A FFILIATES -9,775,448. TRANSFER - SPONSOR -2,200,954.CHANGES IN NET ASSETS OR FUND BALANCES:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
COLUMBIA ST MARY'S HOSPITAL MILWAUKEE INC
4425 NORTH PORT WASHINGTON ROADGLENDALEWI53212390806315HOSPITALWI501(C)(3)3COLUMBIA ST MARY'S INC1
COLUMBIA ST MARY'S HOSPITAL OZAUKEE INC
4425 NORTH PORT WASHINGTON ROADGLENDALEWI53212390807063HOSPITALWI501(C)(3)3COLUMBIA ST MARY'S INC1
SACRED HEART REHABILITATION INSTITUTE INC
4425 NORTH PORT WASHINGTON ROADGLENDALEWI53212390902199REHAB FACILITYWI501(C)(3)3COLUMBIA ST MARY'S HOSPITAL MILWAUKEE INC1
COLUMBIA COLLEGE OF NURSING INC
4425 NORTH PORT WASHINGTON ROADGLENDALEWI53212391596986COLLEGEWI501(C)(3)2COLUMBIA ST MARY'S HOSPITAL MILWAUKEE INC1
ASCENSION HEALTH
4600 EDMUNDSON ROADST LOUISMO63136311662309HEALTH SYSTEMMO501(C)(3)110N/A
HORIZON HOME CARE & HOSPICE INC
8949 N DEERBROOK TRLMILWAUKEEWI53223391171298HOME CARE/HOSPICEWI501(C)(3)30N/A
COLUMBIA HEALTH SYSTEM
4425 NORTH PORT WASHINGTON ROADGLENDALEWI53212391494977HEALTH SYSTEMWI501(C)(3)110N/A
COLUMBIA ST MARY'S FOUNDATION INC
4425 NORTH PORT WASHINGTON ROADGLENDALEWI53212391494981FOUNDATIONWI501(C)(3)70N/A

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnership
ORTHOPAEDIC HOSPITAL OF WISCONSIN LLC
575 RIVERWOODS PKWYGLENDALEWI53212392015655HEALTH CAREWICOLUMBIA ST MARY'S INCRELATED010.50000
SLEEP SERVICES OF WISCONSIN LLC
111 E KILBOURN AVE STE 1300MILWAUKEEWI53202273148310SLEEP SERVICESWICOLUMBIA ST MARY'S INCRELATED010.50000

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityPercentage OwnershipPercentageOwnershipControlled OrgControlledOrg
CSM STRATEGIC ALLIANCE
4425 NORTH PORT WASHINGTON RDGLENDALEWI53212391871856HEALTHCAREWICOLUMBIA ST MARY'S INCC0.500000
MADISON MEDICAL AFFILIATES INC
4425 NORTH PORT WASHINGTON RDGLENDALEWI53212391855720HEALTHCAREWICOLUMBIA ST MARY'S HOSPITAL MILWAUKEE INCC1.000000
PROSPECT MEDICAL COMMONS CONDO ASSOCIATION
4425 NORTH PORT WASHINGTON RDGLENDALEWI53212208042108CONDO ASSOCWICOLUMBIA ST MARY'S INCC0.700000
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 Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org1LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (27 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
COLUMBIA ST MARY'S HOSPITAL MILWAUKEE
K77255562
COLUMBIA ST MARY'S HOSPITAL OZAUKEE
K26664396
SACRED HEART REHABILITATION INSTITUTE
K2513549
COLUMBIA ST MARY'S HOSPITAL MILWAUKEE
P14915425
COLUMBIA ST MARY'S HOSPITAL OZAUKEE
P5536108
SACRED HEART REHABILITATION INSTITUTE
P401763
COLUMBIA ST MARY'S HOSPITAL MILWAUKEE
P1061064
ASCENSION HEALTH
E159774672
ASCENSION HEALTH
L4601921
ASCENSION HEALTH
L610945
ASCENSION HEALTH
L34165
ASCENSION HEALTH
E277000
ASCENSION HEALTH
L6338915
ASCENSION HEALTH
L888624
ASCENSION HEALTH
L825990
ASCENSION HEALTH
L33689204
ASCENSION HEALTH
J71825
COL CTR
O316515
ORTHOPAEDIC HOSPITAL OF WISCONSIN
O5678000
COLUMBIA ST MARY'S FOUNDATION INC
O278000
COLUMBIA COLLEGE OF NURSING
O470000
COLUMBIA ST MARY'S HOSPITAL MILWAUKEE
O71146000
COLUMBIA ST MARY'S HOSPITAL OZAUKEE
O36509000
MMA
O9384000
COLUMBIA ST MARY'S FOUNDATION INC
C145953
COLUMBIA ST MARY'S HOSPITAL MILWAUKEE
L2120080
COLUMBIA ST MARY'S HOSPITAL OZAUKEE
L23206