ST MARYS HOSPITAL MEDICAL CENTER OF GREEN BAY INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: ST MARYS HOSPITAL MEDICAL CENTER OF GREEN BAY INC (EIN 39-0818682)
Tax period: 2011-07-01 to 2012-06-30
Filed: 2013-05-14
IRS object ID: 201301349349305315
Schema version: 2011v1.5
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 B
Schedule C
Schedule D
Schedule H
Schedule J
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-05-14T15:10:22-05:00	Timestamp
Tax Period End Date	2012-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

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

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	191 West Nationwide Blvd Ste 500	AddressLine1
City	Columbus	City
State	OH	State
ZIP Code	432152568	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2011-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	390818682	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	ST MARY'S HOSPITAL MEDICAL CENTER OF	BusinessNameLine1
Business Name Line2	GREEN BAY INC - HOSPITAL SISTERS	BusinessNameLine2

Field	Value	IRS element (for citing)
In Care Of Name	% GREG SIMIA	InCareOfName
Name Control	STMA	NameControl
Phone	9204984200	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1726 SHAWANO AVENUE	AddressLine1
City	GREEN BAY	City
State	WI	State
ZIP Code	54303	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	THERESE PANDL	Name
Title	CHIEF EXECUTIVE OFFICER	Title
Date Signed	2013-01-23	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	KPMG LLP	Name
Phone	6142492300	Phone

Field	Value	IRS element (for citing)
Tax Year	2011	TaxYear
Build TS	2016-03-07 17:11:31Z	BuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

Field	Value	IRS element (for citing)
Business Name Line1	GREEN BAY INC - HOSPITAL SISTERS	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	THERESE PANDL	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	1726 SHAWANO AVENUE	AddressLine1
City	GREEN BAY	City
State	WI	State
ZIP Code	54303	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	121794574	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Group Exemption Number	0928	GroupExemptionNumber
Organization501c3	X	Organization501c3
Web Site	WWW.STMGB.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1900	YearFormation
State Legal Domicile	WI	StateLegalDomicile
Activity Or Mission Description	TO CONTINUE CHRIST'S HEALING LOVE THROUGH DELIVERY OF COMPETENT & COMPASSIONATE HEALTHCARE IN AN ENVIRONMENT SENSITIVE TO THE NEEDS OF ALL PEOPLE.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	11	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	7	NbrIndependentVotingMembers
Total Nbr Employees	837	TotalNbrEmployees
Total Nbr Volunteers	100	TotalNbrVolunteers
Total Gross UBI	929417	TotalGrossUBI
Net Unrelated Business Txbl Income	-1407112	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	315925	ContributionsGrantsPriorYear
Contributions Grants Current Year	969249	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	113895764	ProgramServiceRevenuePriorYear
Program Service Revenue CY	115430881	ProgramServiceRevenueCY
Investment Income Prior Year	3340201	InvestmentIncomePriorYear
Investment Income Current Year	774768	InvestmentIncomeCurrentYear
Other Revenue Prior Year	773655	OtherRevenuePriorYear
Other Revenue Current Year	1580363	OtherRevenueCurrentYear
Total Revenue Prior Year	118325545	TotalRevenuePriorYear
Total Revenue Current Year	118755261	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	47558268	SalariesEtcPriorYear
Salaries Etc Current Year	47352045	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	64383917	OtherExpensePriorYear
Other Expenses Current Year	63374287	OtherExpensesCurrentYear
Total Expenses Prior Year	111942185	TotalExpensesPriorYear
Total Expenses Current Year	110726332	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	6383360	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	8028929	RevenuesLessExpensesCY
Total Assets BOY	158314133	TotalAssetsBOY
Total Assets EOY	163199187	TotalAssetsEOY
Total Liabilities BOY	66139699	TotalLiabilitiesBOY
Total Liabilities EOY	76275384	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	92174434	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	86923803	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	SEE SCHEDULE O	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	14122298	Expense
Revenue	35247491	Revenue
Description	SURGERY - see schedule O	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	5989580	Expense
Revenue	26338793	Revenue
Description	RADIOLOGY SERVICES - see schedule O	Description

Activity3 Activity3

Field	Value	IRS element (for citing)
Expense	4346438	Expense
Revenue	17239755	Revenue
Description	HEART & VASCULAR CENTER - see schedule O	Description

Field	Value	IRS element (for citing)
Total Of Other Program Service Exp	66291393	TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev	35110063	TotalOfOtherProgramServiceRev
Total Program Service Expense	90749709	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	true	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	true	LobbyingActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	false	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	true	ReportProgRelInvest
Report Other Assets	false	ReportOtherAssets
Report Other Liabilities	true	ReportOtherLiabilities
Report Fin48 Footnote	true	ReportFin48Footnote
Independent Audit Financial Stmt	false	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	true	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	false	FundraisingActivities
Gaming	false	Gaming
Hospital	true	Hospital
Financial Stmt Attached	true	FinancialStmtAttached
Grants To Organizations	false	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	true	ScheduleJRequired
Tax Exempt Bonds	false	TaxExemptBonds
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	true	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	true	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	true	DisregardedEntity
Related Entity	true	RelatedEntity
Related Org Controlled Entity	false	RelatedOrgControlledEntity
Transaction Related Entity	false	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	37	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Number Of Employees	837	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	true	UnrelatedBusinessIncome
Form990-T Filed	true	Form990-TFiled
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Quid Pro Quo Contributions	false	QuidProQuoContributions
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOf
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	11	NbrVotingGoverningBodyMembers
Number Independent Voting Members	7	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	true	MembersOrStockholders
Election Of Board Members	true	ElectionOfBoardMembers
Decisions Subject To Approval	true	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	true	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	true	WhistleblowerPolicy
Document Retention Policy	true	DocumentRetentionPolicy
Compensation Process CEO	true	CompensationProcessCEO
Compensation Process Other	true	CompensationProcessOther
Investment In Joint Venture	true	InvestmentInJointVenture
Written Policy Or Procedure	true	WrittenPolicyOrProcedure
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	GREG SIMIA	NamePerson
Telephone Number	9208845595	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	1726 SHAWANO AVENUE	AddressLine1
City	GREEN BAY	City
State	WI	State
ZIP Code	54303	ZIPCode

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	X	InfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (21 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
THERESE PANDL
PRESIDENT/CEO	20.0	X	X	0	575727	192393
JUDY NAGEL
DIRECTOR	1.0	X		0	0	0
SISTER BERNADINE GUTOWSKI OSF
DIRECTOR	1.0	X		0	0	0
ROBERT BURNS
director	1.0	X		0	0	0
JOHN HAGER
SECRETARY	1.0	X	X	0	0	0
KENNETH JOHNSON MD
DIRECTOR	1.0	X		0	0	0
DJ LONG
CHAIR PERSON	1.0	X		0	0	0
Daniel J Platkowski
DIRECTOR	1.0	X		0	0	0
FRANK MIKELL
DIRECTOR	40.0	X		0	718147	119424
DR KEN HUJET
DIRECTOR	1.0	X		0	0	0
BETSY MITCHELL
DIRECTOR	1.0	X		0	0	0
ANN M CARR
TREASURER	0.25		X	0	225812	215561
LAWRENCE J CONNORS
COO	40.0		X	188584	0	140707
greg simia
division cfo	20.0		X	0	216664	12262
AMY J UNRATH
DIVISION ADMINISTRATOR	40.0			231875	0	243698	X
JOHN DAUL
CRNA	40.0			181757	0	103159		X
MARY ALICE JOHNSON
CRNA	40.0			181661	0	180345		X
CRAIG BABIARZ
CRNA	40.0			186399	0	42379		X
STEPHEN KORDIYAK
CRNA	40.0			179758	0	82579		X
GABRIEL LEIS
CRNA	40.0			198553	0	38364		X
DONNA A HUTCHINSON
CFO/ASSISTANT ADMINISTRATOR	0.0			73160	0	198091			X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	1421747	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	1736350	TotalReportableCompFrmRltdOrgs
Total Other Compensation	1568962	TotalOtherCompensation
Number Individuals GT100 K	37	NumberIndividualsGT100K
Formers Listed	true	FormersListed
Total Comp GT150 K	true	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
ST VINCENT HOSPITAL
835 S VAN BUREN STREET	GREEN BAY	WI	54303	SHARED SERVICES	21895736
CARDINAL HEALTH
PO BOX 70539	CHICAGO	IL	60673	MEDICAL SUPPLIES	5243851
PREVEA CLINIC
PO BOX 19070	GREEN BAY	WI	54307	SHARED LABOR	3483277
SIEMENS MEDICAL SOLUTIONS
51 VALLEY STREAM PARKWAY	MALVERN	PA	19355	MEDICAL SUPPLIES	2448378
ZIMMER US INC
W165 N5815 RIDGEWOOD DR	MENOMONEE FALLS	WI	53051	MEDICAL SUPPLIES	2012301

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	56	NumberOfContractorsGT100K
Related Organizations	969249	RelatedOrganizations
Total Contributions	969249	TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue
PATIENT SERVICES	900099	113936103	113936103
LABORATORY SERVICES	621500	651361		651361
PREVEA INVESTMENT GAIN/LOSS	900099	843417	843417

Field	Value	IRS element (for citing)
Total Program Service Revenue	115430881	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	-1199256	TotalRevenueColumn
Exclusion	-$1,199,256	ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	2991571	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	3010425	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	-18854	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	-18854	TotalRevenueColumn
Exclusion	-$18,854	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	2002912	Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Other	28888	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	2002912	Securities
Other	-28888	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	1974024	TotalRevenueColumn
Exclusion	$1,974,024	ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue
OTHER REVENUE	900099	861750	$861,750
CHILDCARE REVENUE	624410	737467		459411	278056

Field	Value	IRS element (for citing)
Total Other Revenue	1599217	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	118755261	TotalRevenueColumn
Related Or Exempt Function Income	115238931	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	929417	UnrelatedBusinessRevenue
Exclusion	$1,617,664	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	0	Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	0	Total

Foreign Grants ForeignGrants

Field	Value	IRS element (for citing)
Total	0	Total

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	0	Total

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	0	Total

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	35148302	Total
Program Services	31770527	ProgramServices
Management And General	3377775	ManagementAndGeneral
Fundraising	0	Fundraising

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	2283067	Total
Program Services	2063208	ProgramServices
Management And General	219859	ManagementAndGeneral
Fundraising	0	Fundraising

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	7672957	Total
Program Services	6934051	ProgramServices
Management And General	738906	ManagementAndGeneral
Fundraising	0	Fundraising

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	2247719	Total
Program Services	2031264	ProgramServices
Management And General	216455	ManagementAndGeneral
Fundraising	0	Fundraising

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	5860260	Total
Program Services	0	ProgramServices
Management And General	5860260	ManagementAndGeneral
Fundraising	0	Fundraising

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	352044	Total
Program Services	0	ProgramServices
Management And General	352044	ManagementAndGeneral
Fundraising	0	Fundraising

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	8487956	Total
Program Services	6260341	ProgramServices
Management And General	2227615	ManagementAndGeneral
Fundraising	0	Fundraising

Advertising Advertising

Field	Value	IRS element (for citing)
Total	757156	Total
Program Services	251	ProgramServices
Management And General	756905	ManagementAndGeneral
Fundraising	0	Fundraising

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	260509	Total
Program Services	240659	ProgramServices
Management And General	19850	ManagementAndGeneral
Fundraising	0	Fundraising

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	0	Total

Royalties Royalties

Field	Value	IRS element (for citing)
Total	0	Total

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	3528409	Total
Program Services	3426287	ProgramServices
Management And General	102122	ManagementAndGeneral
Fundraising	0	Fundraising

Travel Travel

Field	Value	IRS element (for citing)
Total	38659	Total
Program Services	28537	ProgramServices
Management And General	10122	ManagementAndGeneral
Fundraising	0	Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

Field	Value	IRS element (for citing)
Total	0	Total

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	42086	Total
Program Services	39383	ProgramServices
Management And General	2703	ManagementAndGeneral
Fundraising	0	Fundraising

Interest Interest

Field	Value	IRS element (for citing)
Total	1076179	Total
Program Services	0	ProgramServices
Management And General	1076179	ManagementAndGeneral
Fundraising	0	Fundraising

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	0	Total

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	4897058	Total
Program Services	4215560	ProgramServices
Management And General	681498	ManagementAndGeneral
Fundraising	0	Fundraising

Insurance Insurance

Field	Value	IRS element (for citing)
Total	319041	Total
Program Services	85085	ProgramServices
Management And General	233956	ManagementAndGeneral
Fundraising	0	Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
SUPPLIES - MED/SURG/O2/DRUGS	16174214	16174214
PREVEA INVESTMENT AND LEASE	10564743	10564743
BAD DEBT EXPENSE	5129876	5129876
MEDICAID TAX ASSESSMENT	3415106		3415106

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	2470991	Total
Program Services	1785723	ProgramServices
Management And General	685268	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	110726332	Total
Program Services	90749709	ProgramServices
Management And General	19976623	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	2584	BOY
EOY	2579	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	5222105	BOY
EOY	6691890	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	13730953	BOY
EOY	12784813	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
BOY	250000	BOY
EOY	0	EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	476737	BOY
EOY	465724	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	2477670	BOY
EOY	2479268	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	442018	BOY
EOY	421457	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	156799798	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	79261559	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	75424932	BOY
EOY	77538239	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	49928874	BOY
EOY	51620725	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	8627051	BOY
EOY	9578157	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	1731209	BOY
EOY	1616335	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	158314133	BOY
EOY	163199187	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	15576505	BOY
EOY	17161138	EOY

Grants Payable GrantsPayable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	33637883	BOY
EOY	32993547	EOY

Escrow Account Liability EscrowAccountLiability

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Loans From Officers Directors LoansFromOfficersDirectors

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	16925311	BOY
EOY	26120699	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	66139699	BOY
EOY	76275384	EOY

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

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	84324387	BOY
EOY	79921595	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	5552567	BOY
EOY	4704337	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	2297480	BOY
EOY	2297871	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	92174434	BOY
EOY	86923803	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	158314133	BOY
EOY	163199187	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	8028929	ReconcilationRevenueExpenses
Reconcilation Other Changes	-13279560	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited
Audit Committee	true	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
Federal Grant Audit Required	true	FederalGrantAuditRequired
Federal Grant Audit Performed	true	FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

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

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

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

Contributor Address US ContributorAddressUS

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbying
Total Direct Lobbying		TotalDirectLobbying
Total Lobbying Expenditures		TotalLobbyingExpenditures
Other Exempt Purpose Expenditures		OtherExemptPurposeExpenditures
Total Exempt Purpose Expenditures		TotalExemptPurposeExpenditures
Lobbying Nontaxable		LobbyingNontaxableAmount
Grassroots Nontaxable		GrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non Tx		TotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying Nontx		TotLobbyExpendMnsLobbyingNontx
Volunteers	false	Volunteers
Paid Staff Or Management	false	PaidStaffOrManagement
Media Advertisements	false	MediaAdvertisements
Mailings Members	false	MailingsMembers
Publications Or Broadcast	false	PublicationsOrBroadcast
Grants Other Organizations	false	GrantsOtherOrganizations
Direct Contact Legislators	false	DirectContactLegislators
Rallies Demonstrations	false	RalliesDemonstrations
Other Activities	true	OtherActivities
Other Activities	$9,868	OtherActivitiesAmount
Total Lobbying Expenditures IIB	9868	TotalLobbyingExpendituresIIB
Not Described In501c3	false	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	Description of other lobbying activities	Identifier
Return Reference	schedule C, Part II-B, Question 1I	ReturnReference
Explanation	ST. MARY'S HOSPITAL MEDICAL CENTER OF GREEN BAY, INC. ("THE HOSPITAL") IS A MEMBER OF THE CATHOLIC HEALTH ASSOCIATION ("CHA"), THE WISCONSIN HEALTH ASSOCIATION ("WHA"), THE NATIONAL ASSOCIATION FOR HOME CARE AND HOSPICE, AND THE AMERICAN HEALTH ASSOCIATION ("AHA"). AS A MEMBER OF THESE ORGANIZATIONS, THE HOSPITAL PAYS DUES, with PART OF THESE DUES being ATTRIBUTABLE TO LOBBYING FEES PAID BY THE ORGANIZATIONS. THE AMOUNT LISTED ABOVE IS THE AMOUNT ATTRIBUTABLE TO THE HOSPITAL FROM ITS DUES PAID.	Explanation

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amts		ArtPublicExhibitionAmts
Held Works Of Art Amts		HeldWorksOfArtAmts
Current Year Minus3 Years		CurrentYearMinus3Years

Land Land

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	0	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	2276732	OtherCostOrOtherBasis
Book Value	2276732	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	0	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	63134444	OtherCostOrOtherBasis
Depreciation	23816744	Depreciation
Book Value	39317700	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	0	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	645540	OtherCostOrOtherBasis
Depreciation	275756	Depreciation
Book Value	369784	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	0	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	38556462	OtherCostOrOtherBasis
Depreciation	25114753	Depreciation
Book Value	13441709	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	0	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	52186620	OtherCostOrOtherBasis
Depreciation	30054306	Depreciation
Book Value	22132314	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	77538239	TotalOfBookValueLandBuildings

Investments Program Related InvestmentsProgramRelated (5 entries)

DescriptionDescription	Book ValueBookValue	Method Of ValuationMethodOfValuation
INVESTMENT IN PREVEA	6439267	C
INV. - COMMUNITY MEMORIAL HOSP	1435363	C
INVESTMENT IN UNITY	1288747	C
INV. IN ONCOLOGY JOINT VENTURE	389323	C
INV. IN CATHOLIC FOUNDATION	25457	F

Field	Value	IRS element (for citing)
Total Of Book Value Program Related	9578157	TotalOfBookValueProgramRelated
Federal Income Tax Liability	0	FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescription	AmountAmount
ACCRUED PENSION LIABILITY	$25,426,099
SETTLEMENT VALUE OF CONSTR RET	$357,572
RETIRE OBLIGATION ASBESTOS	$223,885
ESTIMATED SELF-INSURANCE	$113,143

Field	Value	IRS element (for citing)
Total Of Amounts	26120699	TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

Field	Value	IRS element (for citing)
Identifier	ASC SUBTOPIC 740-10	Identifier
Explanation	ON JULY 1, 2007, HSHS ADOPTED ASC SUBTOPIC 740-10,ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES - AN INTERPRETATION OF FASB STATEMENT NO.109. ASC SUBTOPIC 740-10 ADDRESSES THE DETERMINATION OF HOW TAX BENEFITS CLAIMED OR EXPECTED TO BE CLAIMED ON A TAX RETURN SHOULD BE RECORDED IN THE CONSOLIDATED FINANCIAL STATEMENTS. UNDER ASC SUBTOPIC 740-10, HSHS MUST RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFITS RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. ASC SUBTOPIC 740-10 ALSO PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES ON INCOME TAXES, ACCOUNTING IN INTERIM PERIODS, AND REQUIRES INCREASED DISCLOSURES. AT THE DATE OF ADOPTION, AND AS OF JUNE 30, 2012 AND 2011, HSHS DOES NOT HAVE A LIABILITY FOR UNRECOGNIZED TAX BENEFITS.	Explanation

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	true	CharityCarePolicy
Written Policy	true	WrittenPolicy
FPG Reference Free Care	true	FPGReferenceFreeCare

Other Percentage OtherPercentage

Field	Value	IRS element (for citing)
Other	X	Other
Free Other Percentage	225.	FreeOtherPercentage

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

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	2160	PersonsServed
Total Community Benefit Expense	2653308	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	2653308	NetCommunityBenefitExpense
Percent Of Total Expense	0.02510	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	20290	PersonsServed
Total Community Benefit Expense	15931970	TotalCommunityBenefitExpense
Direct Offsetting Revenue	11331027	DirectOffsettingRevenue
Net Community Benefit Expense	4600943	NetCommunityBenefitExpense
Percent Of Total Expense	0.04360	PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	2	NumberOfActivitiesOrPrograms
Persons Served	574	PersonsServed
Total Community Benefit Expense	29280	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	29280	NetCommunityBenefitExpense
Percent Of Total Expense	0.00030	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	4	NumberOfActivitiesOrPrograms
Persons Served	23024	PersonsServed
Total Community Benefit Expense	18614558	TotalCommunityBenefitExpense
Direct Offsetting Revenue	11331027	DirectOffsettingRevenue
Net Community Benefit Expense	7283531	NetCommunityBenefitExpense
Percent Of Total Expense	0.06900	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	57	NumberOfActivitiesOrPrograms
Persons Served	8600	PersonsServed
Total Community Benefit Expense	215475	TotalCommunityBenefitExpense
Direct Offsetting Revenue	11522	DirectOffsettingRevenue
Net Community Benefit Expense	203953	NetCommunityBenefitExpense
Percent Of Total Expense	0.00190	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	8	NumberOfActivitiesOrPrograms
Persons Served	97	PersonsServed
Total Community Benefit Expense	32328	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	32328	NetCommunityBenefitExpense
Percent Of Total Expense	0.00030	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	7	NumberOfActivitiesOrPrograms
Persons Served	360	PersonsServed
Total Community Benefit Expense	1507486	TotalCommunityBenefitExpense
Direct Offsetting Revenue	565822	DirectOffsettingRevenue
Net Community Benefit Expense	941664	NetCommunityBenefitExpense
Percent Of Total Expense	0.00890	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	72	NumberOfActivitiesOrPrograms
Persons Served	9057	PersonsServed
Total Community Benefit Expense	1755289	TotalCommunityBenefitExpense
Direct Offsetting Revenue	577344	DirectOffsettingRevenue
Net Community Benefit Expense	1177945	NetCommunityBenefitExpense
Percent Of Total Expense	0.01110	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	76	NumberOfActivitiesOrPrograms
Persons Served	32081	PersonsServed
Total Community Benefit Expense	20369847	TotalCommunityBenefitExpense
Direct Offsetting Revenue	11908371	DirectOffsettingRevenue
Net Community Benefit Expense	8461476	NetCommunityBenefitExpense
Percent Of Total Expense	0.08010	PercentOfTotalExpense

Community Support CommunitySupport

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	2	NumberOfActivitiesOrPrograms
Persons Served	21	PersonsServed
Total Community Building Expense	226	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	226	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Coalition Building CoalitionBuilding

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	1	NumberOfActivitiesOrPrograms
Persons Served	32	PersonsServed
Total Community Building Expense	222	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	222	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	3	NumberOfActivitiesOrPrograms
Persons Served	53	PersonsServed
Total Community Building Expense	448	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	448	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	true	BadDebtExpenseReported
Bad Debt Expense	$1,951,245	BadDebtExpenseAmount
Amount Attributable To	839947	AmountAttributableTo
Amount Reimbursed By Medicare	31667296	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	44744642	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-13077346	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Cost To Charge Ratio	X	CostToChargeRatio

Field	Value	IRS element (for citing)
Written Debt Collection Policy	true	WrittenDebtCollectionPolicy
Provision For Charity Care	true	ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (7 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivity	Organization Profit Or OwnershipOrganizationProfitOrOwnership	Officers Etc Profit Or OwnershipOfficersEtcProfitOrOwnership	Physicans Profit Or OwnershipPhysicansProfitOrOwnership
Prevea Clinic - PHS
HEALTHCARE	0.25000	0.00000	0.50000
Prevea Health Ntwrk
healthcare	0.25000	0.00000	0.50000
Prevea Ventures
healthcare	0.25000	0.00000	0.50000
Prevea health srvcs
healthcare	0.25000	0.00000	0.50000
unity limited pship
healthcare	0.10000	0.00000	0.00000
NE WI RAD THERAPY
healthcare	0.25000	0.00000	0.50000
community mem hospit
healthcare	0.07200	0.00000	0.00000

Field	Value	IRS element (for citing)
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 MARY'S HOSPITAL MEDICAL CENTER	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	1726 SHAWANO AVENUE	AddressLine1
City	GREEN BAY	City
State	WI	State
ZIP Code	54303	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 MARY'S HOSPITAL MEDICAL CENTER	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
CHNA Conducted	true	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	11	NeedsAssessmentConducted
Take Into Account	true	TakeIntoAccount
Other Facilities	true	OtherFacilities
CHNA Widely Available	true	CHNAWidelyAvailable
Own Website	X	OwnWebsite
On Request	X	OnRequest
Adopt Implement Strategy	X	AdoptImplementStrategy
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
All Needs Addressed	false	AllNeedsAddressed
Eligibility Criteria Explained	true	EligibilityCriteriaExplained
Uses FPG Free	true	UsesFPGFree
FPG Free Percent	225.	FPGFreePercent
Uses FPG Discounted	true	UsesFPGDiscounted
FPG Discount Percent	300.	FPGDiscountPercent
Explains Basis	true	ExplainsBasis
Income Level	X	IncomeLevel
Asset Level	X	AssetLevel
Medical Indigency	X	MedicalIndigency
Insurance Status	X	InsuranceStatus
Uninsured Discount	X	UninsuredDiscount
Explains Application Method	true	ExplainsApplicationMethod
Includes Publicity Measures	true	IncludesPublicityMeasures
Posted On Website	X	PostedOnWebsite
Attached To Invoices	X	AttachedToInvoices
Available On Request	X	AvailableOnRequest
Other Publicity	X	OtherPublicity
Actions On Nonpayment	true	ActionsOnNonpayment
Collection Activities	false	CollectionActivities
Nondiscrim Emergency Care Policy	true	NondiscrimEmergencyCarePolicy
Used Other Method	X	UsedOtherMethod
Amounts Generally Billed	false	AmountsGenerallyBilled
Gross Charges	false	GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (20 entries)

IdentifierIdentifier	ExplanationExplanation
SCHEDULE H, PART I, LINE 3C	NOT APPLICABLE AS THE ORGANIZATION DOES FOLLOW FPG TO DETERMINE ELIGIBILITY FOR PROVIDING CHARITY AND DISCOUNTED CARE TO LOW-INCOME, UNINSURED, AND UNDERINSURED INDIVIDUALS.
SCHEDULE H, PART I, LINE 6A	ST. MARY'S COMMUNITY BENEFIT REPORT IS AVAILABLE UPON REQUEST AT WWW.STMGB.ORG.
SCHEDULE H, PART I, LINE 7G	THE HOSPITAL DOES NOT HAVE SUFFICIENT INFORMATION AT THIS TIME TO DETERMINE IF SUBSIDIZED SERVICES EXIST BASED ON THE DEFINITION AND CALCULATIONS REQUIRED BY THE IRS AND WILL CONTINUE TO WORK AND PROVIDE SUCH INFORMATION IN NEXT YEAR'S RETURN.
SCHEDULE H, PART I, LINE 7, COLUMN (F)	THE PERCENT OF CHARITY CARE AND CERTAIN OTHER BENEFITS AT COST AS A PERCENT OF TOTAL EXPENSES LESS BAD DEBT IS 8.01%. THE AMOUNT OF BAD DEBT EXPENSE REMOVED WHEN CALCULATING THE PERCENTAGES IN PART I, LINE 7, COLUMN F WAS $5,129,875.
SCHEDULE H, PART I, LINE 7	CHARITY CARE IS CALCULATED BY DETERMINING THE TOTAL AMOUNT FROM PATIENT BILLING THAT IS WRITTEN OFF TO CHARITY CARE CHARGE CODES OR ALLOWANCES. THIS AMOUNT MATCHES THE NUMBER THAT IS REPORTED ON OUR FISCAL YEAR ENDING 2012 AUDITED FINANCIAL STATEMENTS. THE TOTAL CHARITY CARE DOLLAR AMOUNT IS THEN REDUCED TO COST BY APPLYING THE HOSPITAL'S COST TO CHARGE RATIO AS CALCULATED ON IRS SCHEDULE H - WORKSHEET J.
SCHEDULE H, PART II	THE COMMUNITY BUILDING ACTIVITIES THAT WE HAVE TRACKED AND REPORTED IN OUR COMMUNITY BENEFIT REPORT ARE A MINOR POTION OF OUR TOTAL COMMUNITY BENEFIT EFFORTS. THEY CONSIST PRIMARILY OF ACTIVELY PARTICIPATING IN AND SUPPORTING THE WORK OF COMMUNITY GROUPS TO ADVANCE COMMUNITY AWARENESS ABOUT HEALTH ISSUES.
SCHEDULE H, PART III, LINE 4	THE HOSPITAL STRONGLY BELIEVES THAT ITS CHARITY CARE, AND THE RELATED COMMUNITY BENEFIT OBTAINED FROM SUCH CARE, IS UNDERSTATED BECAUSE OF THOSE PATIENTS THAT POTENTIALLY QUALIFY FOR CHARITY CARE BUT DO NOT WISH TO APPLY FOR IT. IN ADDITION, SOME CARE IS NOT CLASSIFIED AS CHARITY DUE TO MISSING DOCUMENTATION ON PATIENT RESOURCES. THUS, THE HOSPITAL'S BAD DEBT MAY INCLUDE A PORTION THAT COULD BE CLASSIFIED AS CHARITY CARE IF APPLICATION FOR SUCH CARE WAS SOUGHT AND/OR COMPLETED. CURRENTLY, THE HOSPITAL IS IMPLEMENTING PROCESSES, PROCEDURES, AND SYSTEMS TO MORE EFFECTIVELY DETERMINE CHARITY CARE THAT WILL REDUCE A PATIENT'S DOCUMENTATION REQUIREMENTS AND EASE THE PATIENT'S EMOTIONAL BURDEN IN APPLYING FOR CHARITY CARE. THIS WILL PROVIDE A MORE ACCURATE REPORTING OF CHARITY CARE SERVICES PROVIDED BY THE HOSPITAL. THE HOSPITAL COMPUTES THE COST OF BAD DEBT BY APPLYING THE RATIO OF PATIENT CARE COST TO CHARGES TO THE TOTAL CHARGES WRITTEN OFF AS BAD DEBT EXPENSE. THE PATIENT CARE COST IS DETERMINED BY REDUCING THE TOTAL ANNUAL OPERATING EXPENSE BY THE BAD DEBT EXPENSES, MEDICAID PROVIDER TAXES, AND COMMUNITY BENEFIT EXPENSE. THE ADJUSTED OPERATING COST IS THEN DIVIDED BY THE TOTAL GROSS PATIENT CHARGES TO CALCULATE THE RATIO OF PATIENT CARE COST TO CHARGES.
SCHEDULE H, PART III, LINE 8	THE HOSPITAL CONTINUALLY STRIVES TO PROVIDE EXCELLENT PATIENT CARE IN THE MOST COST EFFECTIVE FASHION. NONETHELESS, THE MEDICARE PROGRAM, IN MANY CASES, DOES NOT PROVIDE PAYMENT THAT COVERS THE FULL COST OF THE CARE PROVIDED. SINCE IT IS THE MISSION OF THE HOSPITAL TO RESPOND TO COMMUNITY NEED, HOSPITAL MANAGEMENT CONTINUALLY ADVOCATES FOR IMPROVED MEDICARE PAYMENT SO THAT THE COST OF QUALITY CARE TO THOSE PATIENTS THAT ARE NOT ABLE TO AFFORD IT IS NOT COMPROMISED AND IS FAIRLY SUBSIDIZED BY ALL PAYERS. WHILE THIS SHORTFALL IN MEDICARE PAYMENTS IS NOT CLASSIFIED AS COMMUNITY BENEFIT BY THE IRS, WE NONETHELESS BELIEVE IT IS AN IMPORTANT CONTRIBUTION MADE BY THE HOSPITAL TO THE HEALTH AND WELL-BEING OF THE COMMUNITY. OUR MISSION CALLS US TO SERVE ALL PATIENTS WITH THE HIGHEST POSSIBLE QUALITY AND EFFICIENCY, EVEN IF WE ARE NOT PAID FULLY FOR DOING SO. THE HOSPITAL COMPUTES THE UNPAID COSTS OF PROVIDING CARE TO MEDICARE PATIENTS BY COMPARING THE COST OF THE SERVICES TO THE REIMBURSEMENT RECEIVED FROM MEDICARE DURING THE YEAR. THE COST OF MEDICARE SERVICES IS CALCULATED BY APPLYING THE RATIO OF PATIENT CARE COST TO CHARGES TO THE ANNUAL MEDICARE CHARGES. THE PATIENT CARE COST IS DETERMINED BY REDUCING THE TOTAL ANNUAL OPERATING EXPENSE BY BAD DEBT EXPENSES, MEDICAID PROVIDER TAXES, AND COMMUNITY BENEFIT EXPENSE. THE DIFFERENCE BETWEEN THE REIMBURSEMENT RECEIVED AND THE CALCULATED COST OF THE SERVICES IS REPORTED AS THE MEDICARE SHORTFALL.
SCHEDULE H, PART III, LINE 9B	EVERY EFFORT IS MADE PRIOR TO, DURING, AND AFTER PROVISION OF MEDICAL SERVICES TO DETERMINE WHETHER A PATIENT IS ELIGIBLE FOR CHARITY/COMMUNITY CARE AND TO ASSIST THE PATIENT IN COMPLETING THE APPLICATION AND PROVIDING ADEQUATE DOCUMENTATION. IF THE PATIENT QUALIFIES FOR CHARITY/COMMUNITY CARE FOR THE FULL BALANCE OF THEIR ACCOUNT, THE ENTIRE AMOUNT IS WRITTEN OFF TO CHARITY/COMMUNITY CARE AND HENCE NO DEBT COLLECTION IS PURSUED. IF THE PATIENT QUALIFIES FOR CHARITY/COMMUNITY CARE FOR A PORTION OF THEIR ACCOUNT BALANCE, THAT PORTION IS WRITTEN OFF TO CHARITY/COMMUNITY CARE, WITH THE PATIENT BEING RESPONSIBLE FOR THE REMAINDER OF THE BALANCE. ADDITIONALLY, REASONABLE EFFORT WILL BE MADE TO OBTAIN THIRD-PARTY OR GOVERNMENT PAYOR REIMBURSEMENT ON BEHALF OF THE PATIENT. IF THOSE EFFORTS ARE NOT FRUITFUL, AN OFFER WILL BE EXTENDED TO THE PATIENT TO MAKE INSTALLMENT PAYMENTS ON THEIR BALANCE. ONLY AT SUCH POINT THAT THE PATIENT DEFAULTS ON INSTALLMENT PAYMENTS OR REFUSES TO COOPERATE WITH THE HOSPITAL'S EFFORTS TO BE REIMBURSED WILL THE ACCOUNT BE SENT TO COLLECTIONS. FOR ADDITIONAL INFORMATION, SEE RESPONSE TO QUESTION VI, 3.
Part V, Section B, Line 3	THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS TRULY A COLLABORATIVE EFFORT. IN WISCONSIN, PUBLIC HEALTH DEPARTMENTS CONDUCT COMMUNITY HEALTH NEEDS ASSESSMENTS EVERY FIVE YEARS. THE BROWN COUNTY AND CITY OF DEPERE PUBLIC HEALTH DEPARTMENTS COLLABORATE ON THE ONE FOR BROWN COUNTY, THE COUNTY IN WHICH GREEN BAY IS LOCATED. WHEN A LEADER FROM ST. MARY'S APPROACHED THE HEALTH DEPARTMENTS ABOUT POSSIBLE OPPORTUNITIES TO COLLABORATE, THEY NOT ONLY WILLINGLY AGREED TO FIND WAYS TO DO SO, THEY ALSO AGREED TO MODIFY THEIR EVERY-FIVE-YEAR PROCESS TO MEET THE HOSPITALS' EVERY- THREE-YEAR TIME FRAME AND TO BEGIN TO CONDUCT THE LOCAL NEEDS ASSESSMENT IMMEDIATELY. IN THE PAST, THE BROWN COUNTY/CITY OF DEPERE HEALTH DEPARTMENTS WOULD THEMSELVES CONVENE THE COMMUNITY WIDE PLANNING TEAM AND THE SUBSEQUENT ACTION PLANNING TEAMS. ONCE CONTACTED ABOUT OPPORTUNITIES TO COLLABORATE, THEY INSTEAD CONVENED A COMMUNITY HEALTH NEEDS ASSESSMENT STEERING COMMITTEE THAT INCLUDED REPRESENTATIVES OF ST. MARY'S AND ITS SISTER HOSPITAL ST. VINCENT, THE LOCAL UNITED WAY, THE OTHER NOT FOR PROFIT HOSPITAL IN GREEN BAY, AND REPRESENTATIVES OF THE REGIONAL OFFICE OF WISCONSIN'S DEPARTMENT OF HEALTH. THIS STEERING COMMITTEE THEN WORKED TO IDENTIFY REPRESENTATIVES WHO COULD BROADLY REPRESENT THE COMMUNITY IN ACTUALLY CONDUCTING THE NEEDS ASSESSMENT AND SETTING PRIORITIES. THESE INDIVIDUALS WERE REFERRED TO AS OUR COMMUNITY "PARTNERS". ALL STEERING COMMITTEE MEMBERS WERE ASSIGNED PEOPLE TO CONTACT TO INVITE THEM INTO THE PROCESS AS PARTNERS. THIS RESULTED IN A COMMUNITY PARTNER GROUP THAT WAS BROADLY REPRESENTATIVE OF THE COMMUNITY: MANY COMMUNITY SERVICE AGENCIES, EDUCATIONAL INSTITUTIONS, GOVERNMENT, HEALTH CARE, LOW INCOME AND MINORITY POPULATION REPRESENTATIVES, PUBLIC HEALTH EXPERTS, AND OTHERS (SEE PARTNER LISTING AT THE END OF THIS REPORT). THE STEERING COMMITTEE ALSO DECIDED THE FORMAT FOR EACH MEETING, EVALUATED THE EFFECTIVENESS OF EACH MEETING AFTER IT OCCURRED, DEVELOPED THE PRIORITIZATION PROCESS, AND EVALUATED THE EFFECTIVENESS OF THE ENTIRE PROCESS. STEERING COMMITTEE MEMBERS ALL ASSUMED RESPONSIBILITIES FOR TASKS RELATED TO THE PROCESS DURING THE COURSE OF THE NEEDS ASSESSMENT. THE REPORT ENTITLED HEALTHY WISCONSIN 2020 AND THE HEALTH FOCUS AREAS CONTAINED WITHIN SERVED AS THE BASIS FOR THE HEALTH NEEDS ASSESSMENT. AN EPIDEMIOLOGIST FROM THE WISCONSIN DEPARTMENT OF HEALTH GATHERED DATA FROM SECONDARY SOURCES (SUCH AS PUBLIC HEALTH STATISTICS) ON HOW BROWN COUNTY AND THE CITY OF DEPERE COMPARES WITH THE STATE-WIDE DATA. ST. MARY'S HOSPITAL ALSO PROVIDED ADDITIONAL DATA WHEN AVAILABLE. MEETINGS OF ALL THE PARTNERS WERE HELD ONCE A MONTH FOR OVER SIX MONTHS. A PROFILE OF EACH HEALTH NEEDS AREA WAS DEVELOPED, AND THE "PARTNERS" REVIEWED THE DATA AT THESE MEETING WHERE THE INFORMATION WAS PRESENTED. THEY DISCUSSED KEY DATA POINTS AND ASSESSED WHAT IS CURRENTLY BEING DONE. BEFORE THE MEETING CONCLUDED, THEY THEN RATED THE HEALTH FOCUS AREA ON 3 CRITERIA --MAGNITUDE (NUMBER OF PEOPLE IMPACTED), SERIOUSNESS (LEVEL OF IMPACT OF THE PROBLEM), AND FEASIBILITY (WHETHER THERE ARE KNOWN INTERVENTIONS TO ADDRESS THE PROBLEM). THESE RATINGS WERE COMBINED, AND BASED ON THIS THE HEALTH FOCUS AREAS WERE NARROWED TO THE TOP EIGHT. AT A FINAL MEETING OF THE PARTNERS GROUP, A MULTI-VOTE APPROACH WAS USED TO NARROW THE TOP EIGHT TO THE TOP THREE. THE TOP THREE NEEDS WERE: ORAL HEALTH ADEQUATE AND APPROPRIATE FOOD AND NUTRITION, AND ALCOHOL AND OTHER DRUG ABUSE (AODA) THROUGHOUT THIS PROCESS, ST. MARY'S LEADERSHIP WAS ACTIVELY ENGAGED. THE PROGRESS OF THE NEEDS ASSESSMENT WAS REGULARLY REVIEWED BY AN INTERNAL COMMUNITY BENEFIT COMMITTEE. THE FINDINGS OF THE NEEDS ASSESSMENT WERE ALSO SHARED WITH OUR HOSPITAL'S COMMUNITY ADVISORY COMMITTEE FOR THEIR REACTION AND COMMENT. THE COMMUNITY ADVISORY COMMITTEE IS A GROUP OF OVER 25 COMMUNITY MEMBERS REPRESENTING BUSINESS, EDUCATION, NOT FOR PROFIT AGENCIES, LOW INCOME AND MINORITY POPULATIONS, CLERGY, AND OTHERS WHO SERVE AS ADVISORS TO THE HOSPITAL. THE INTERNAL COMMUNITY BENEFIT COMMITTEE AND THE COMMUNITY ADVISORY COMMITTEE SERVE BOTH ST. MARY'S AND ST. VINCENT BECAUSE THE TWO HOSPITALS PROVIDE COORDINATED SERVICES TO THE GREEN BAY AREA AS PART OF THE HOSPITAL SISTERS HEALTH SYSTEM EASTERN WISCONSIN DIVISION. BROWN COMMUNITY HEALTH NEEDS ASSESSMENT PARTNER LISTING: - AGING & DISABILITY RESOURCE CENTER, SUNNY ARCHAMBAULT - AURORA HEALTH SYSTEM, JULIE POMASL - BAY AREA COMMUNITY COUNCIL, PAT FINDER-STONE - BELLIN COLLEGE, KATHIE DEMUTH - BELLIN HEALTH, JODY WILMET - BELLIN HEALTH, LINDA ROETHLE - BOYS & GIRLS CLUB, JOHN BENBERG - BROWN COUNTY BOARD , MIKE FLECK - BROWN COUNTY BOARD OF HEALTH (BOARD MEMBER), AUDREY MURPHY - BROWN COUNTY COMMUNITY TREATMENT CENTER, MARY JOHNSON - BROWN COUNTY COOPERATIVE EXTENSION, JUDY KNUDSEN - BROWN COUNTY HEALTH DEPARTMENT, JUDY FRIEDERICHS (DIRECTOR, BROWN COUNTY HEALTH DEPARTMENT) - BROWN COUNTY HUMAN SERVICES, KEVIN LUNOG - BROWN COUNTY PLANNING, CHUCK LAMINE - BROWN COUNTY UNITED WAY, STEPHANIE FOLEY - CENTER FOR CHILDHOOD SAFETY/ SAFE KIDS GREATER GREEN BAY, JUSTINE LODL - CITY OF DE PERE BOARD OF HEALTH (BOARD MEMBER), PAT FINDER-STONE - CITY OF DE PERE HEALTH DEPARTMENT, MARY DORN, HEALTH DIRECTOR - DE PERE AREA CHAMBER OF COMMERCE, CHERYL DETRICK - DIVISION OF PUBLIC HEALTH NORTHEAST REGIONAL OFFICE, REBECCA HOVARTER, REGIONAL PUBLIC HEALTH NURSING CONSULTANT - DIVISION OF PUBLIC HEALTH NORTHEAST REGIONAL OFFICE, LYNN HRABIK, EPIDEMIOLOGIST - FAMILY SERVICES-CRISIS CENTER, TANA KOSS - GREATER GREEN BAY COMMUNITY FOUNDATION, MARTHA AHRENDT - GREATER GREEN BAY YMCA, SANDY ATKINS - GREEN BAY CHAMBER OF COMMERCE, NAN NELSON, CCE - HOMELESS POPULATION REPRESENTATIVE, SETH MOORE - N.E.W. COMMUNITY CLINIC, BONNIE KUHR - NWTC HEALTH SCIENCE, KAY TUPALA, DEAN - ONEIDA TRIBE OF INDIANS, MICHELLE MYERS - PARISH NURSE, KATIE DYKES - BROWN COUNTY SHERIFF REPRESENTATION --CHIEF'S GROUP, RANDY SCHULTZ - PREVEA HEALTH, DR. ASHOK RAI - ST. MARY'S HOSPITAL MEDICAL CENTER, HEIDI SELBERG - ST VINCENT HOSPITAL, HEIDI SELBERG - ST WILLEBROAD CATHOLIC PARISH, MARIA PLASCENCIA - SCHOOL REPRESENTATION --SUPERINTENDENT'S GROUP, BARB NATELLE - THE SALVATION ARMY, REBECCA LESPERANCE - UNITED HMONG AND ASIAN AMERICAN COMMUNITY CENTER, STARYOUNG THAO - UWGB-ENVIRONMENTAL SCIENCES, THOMAS ERDMAN - UW-GREEN BAY NURSING PROGRAM, CHRIS VANDENHOUTEN - WOMEN, INFANT AND CHILDREN (WIC), BONNIE KUHR
Part V, Section B, Line 4	Bellin Health was actively involved in the community health needs assessment.
Part V, Section B, Line 7	The board of directors approved the implementation strategy associated with the community health needs assessment in May, 2012. Thus, many of the activities identified in the implementation plan did not begin until after the end of the tax year. That said, some work on the oral health issue began in tax year 2012 through the formation of the community wide task force. They began their work by reviewing various models for addressing oral health issues in adults during tax year 2012, and began formulating action plans in the subsequent tax year. Our hospital actively supported the efforts of the NEW Community Clinic to apply for FQHC (federally qualified health center) status, which would allow them to provide dental services more easily and effectively than is currently the case; they were awarded this status at the end of June 2012. Our support of NEW Clinics application included donations to the current clinic location that were cited as part of the required matching funds and providing grant writing expertise and access to data to support the application. In addition, some work began with the alcohol and other drug needs issue through initiating discussions with local agencies on how medical clearance for alcohol intoxication is currently working. An issue that emerged during the course of the year was the influx of the Somali population to the Green Bay area. This first came to our attention by one of our community advisory committee members who shared some of the migration patterns that were emerging. We reviewed our experience and identified that we were, in fact, seeing a greater incidence of Somalis, and then acted to provide staff training on culturally appropriate responses. We also met with other community agencies to determine what services were being accessed by Somalis locally and if there were gaps that better coordination could address. This turned out to be a fairly intense but short term community need, as in a matter of months the migration continued and many Somalis left the Green Bay area for locations with better job prospects.
Part V, Section B, Line 13G	Our hospital posts our charity care policy and application on our website. In addition, charity care applications are available and prominently displayed in our waiting and registration areas. Our financial counselors are available to meet with patients on site before or at the time of service to assist them in identifying whether they are eligible for government aid or financial assistance, and to assist them in applying for programs for which they may be eligible. After patients receive service, our customer service representatives are also trained to assist them to apply for various government programs or for our charity care program. Our collectors are trained to provide this assistance as well. Last but not least, we have contracted with an outside firm to do active outreach with patients who may need additional assistance or advocacy to apply for benefits, appeal denials, or who need transportation to government agencies to apply for benefits.
Part V, Section B, Line 19D	The hospital sets the rate for billing individuals without insurance covering emergency or other medically necessary care at the hospitals lowest commercial rate.
Needs assessment	The FY 2012 Community Health Needs and associated implementation strategy will be used to guide our efforts in FY2013. For prior years, we employed a number of methods to assess health care needs: 1) We have a community advisory committee broadly representative of the community. This committee meets regularly to discuss hospital services and advise us on how well we are meeting community needs. As terms expire, committee members assist in identifying new members who can continue to assist us in this way. We include representatives from the neighboring communities we serve, as well as some potentially underserved groups such as Hmong or Native American leaders. 2) Hospital leadership meets with each committee member individually each year to learn more about their opinions about community needs. 3)we examine the reasons that self-pay and medical assistance patients come to our emergency department for care. 4) Hospital leadership serve on local social service agency boards, such as NEW Community Clinic. 5) Our Hispanic health educator/cultural liaisons assist using identifying needs of special subgroups of patients. THE COMMUNITY HEALTH NEEDS ASSESSMENT CAN BE ACCESSED AT: http://www.stmgb.org/Scripts/pageview.asp?id=325
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE	OUR HOSPITAL POSTS OUR CHARITY CARE POLICY AND APPLICATION ON OUR WEBSITE. IN ADDITION, CHARITY CARE APPLICATIONS ARE AVAILABLE AND PROMINENTLY DISPLAYED IN OUR REGISTRATION AREAS. OUR FINANCIAL COUNSELORS ARE AVAILABLE TO MEET WITH PATIENTS ON SITE BEFORE, OR AT, THE TIME OF SERVICE TO ASSIST THEM IN IDENTIFYING WHETHER THEY ARE ELIGIBLE FOR GOVERNMENT AID OR FINANCIAL ASSISTANCE, AND TO ASSIST THEM IN APPLYING FOR PROGRAMS FOR WHICH THEY MAY BE ELIGIBLE. AFTER PATIENTS RECEIVE SERVICE, OUR CUSTOMER SERVICE REPRESENTATIVES ARE ALSO TRAINED TO ASSIST THEM TO APPLY FOR VARIOUS GOVERNMENT PROGRAMS OR FOR OUR CHARITY CARE PROGRAM. OUR COLLECTORS ARE TRAINED TO PROVIDE THIS ASSISTANCE AS WELL. LAST BUT NOT LEAST, WE HAVE CONTRACTED WITH AN OUTSIDE FIRM TO DO ACTIVE OUTREACH WITH PATIENTS WHO MAY NEED ADDITIONAL ASSISTANCE OR ADVOCACY TO APPLY FOR BENEFITS, APPEAL DENIALS, OR WHO NEED TRANSPORTATION TO GOVERNMENT AGENCIES TO APPLY FOR BENEFITS.
Community Information	Brown County, Wisconsin is a primarily urban county, one of 72 Wisconsin counties located in the northeastern part of the state. Brown Countys population is primarily Caucasian, but there is a notable Native American population, as well as a growing Asian and Hispanic population. There are approximately 250,000 residents, of which about 42,000 are covered by Medicaid/Badger Care Plus. About 9% of Brown County Residents live at or below the federal poverty level, and 17% have incomes less than 200% percent of poverty (Source: WI DHS Public Health Profiles, Family Health Survey). Since most of the population resides in the Green Bay metro area, plans and services focus on this area.
PROMOTION OF COMMUNITY HEALTH	St. Marys Hospital Medical Center offers hope to our community in the tradition of the Hospital Sisters of St. Francis. As a healing ministry of the Catholic Church and an affiliate of the Hospital Sisters Health System (HSHS), St. Marys is committed to delivering high quality, compassionate, and cost-effective health care services to all. The hospital was founded over 100 years ago to bring a healing presence and improve the health of our community, especially for people who are sick, poor, and disadvantaged. Because of the hospitals purpose and tradition, it is organized to promote the health of Brown County, Wisconsin, and surrounding areas. The hospital is governed by a Board of Directors, the majority of which is comprised of persons who reside in the organizations primary service area and who are neither employees nor contractors of the hospital (nor family members thereof). The Board ensures that St. Marys is responding to community need. During the last year, for example, the Board reviewed the Community Health Needs Assessment and approved an implementation strategy for addressing selected needs. In addition our hospital Advisory Council, Friends of St. Marys Foundation and volunteers who assist in many areas of the hospital, provide the hospital with additional connections to and insights into the larger community and its health care needs. Also consistent with its exempt purpose, St. Marys has an open medical staff with privileges available to all qualified physicians in the area. In addition, the hospital operates an emergency department that is open 24 hours to all persons regardless of their ability to pay. As a not-for-profit hospital, St. Marys reinvests surplus funds into the mission of the organization and health of the community rather than distributing them as profits to shareholders or individuals. Funds not committed to ongoing operations are generally used to upgrade facilities, secure new technologies, improve patient care, and support initiatives designed to promote health and ensure access for all. For example, St. Marys is currently working with its parent organization, Hospital Sisters Health System, to continuously enhance quality and improve coordination of care both inside the hospital and with a growing number of physician partners. Supported by investments in information technology, this careintegration strategy is designed to better coordinate care, improve health outcomes, create new efficiencies, and help ensure that patients (especially those with chronic conditions) get well and stay well. For example, the new Epic electronic medical record system enables providers to connect with their patients medical record from wherever they are as well as allows emergency physicians access to patient medical records from any facility that has Epic. This reduces duplicate testing, puts critical health information at providers fingertips, helps better manage chronic conditions, and improves patient safety. A Heart Failure Clinic has been established to assist heart failure patients with maintaining good health and staying out of the hospital incorporating diet, exercise and other wellness information into the longterm care plan. This growing program has shown success in reducing readmissions, something that is also especially helpful for those with limited financial resources. St. Marys Hospital Medical Center provides significant resources to access for patients who cannot afford care, along with other community benefits. In fiscal year 2012, St. Marys provided over $8.5million in community benefit services, including charity care at cost, unpaid costs of Medicaid and other public programs, and a range of diverse programs designed to enhance access and improve community health. During this period, St. Marys provided $13.1 million (at cost) in excess of Medicare payment for health care services. Responding to Community Need The range of benefits provided by St. Marys flows from our mission and long-standing commitment to our community. In many cases, these programs would be unlikely to exist without the leadership role played by St. Marys, and they often relieve a burden that would otherwise be carried by government. An example of our community benefit initiatives is the support we provide to patients that pass each year through the doors of the NEW Community Clinic, a 38-year-old free health center for the uninsured and underinsured. St Marys provides free and discounted laboratory and radiology services to the clinic. More than 70 percent of patients say the clinics care prevented a trip to the emergency department. A Woman's Place at St. Mary's Hospital Medical Center has been a valued and trusted outreach center for women and their families throughout our area. Through A Woman's Place we reach our Hispanic neighbors to provide health and wellness education, health screenings, resources and referral services, facilitated by the role of a Hispanic Health Educator. Last year A Woman's Place touched the lives of more than 7,000 women through its Resource Center and consumer lending library, screenings for cardiovascular disease, osteoporosis and reproductive cancer; educational events and classes on a variety of health topics. An additional 65,000 women were touched through its quarterly health newsletter. St. Mary's sponsors a walking club at the local mall. More than 490 active members participate in a variety of health-related screenings and informational sessions throughout the season which runs from September through May each year. In addition to using the mall as a venue for walking, the program has been extended to include routes throughout the city. Routes and incentives for walking are posted on our website to encourage people of all ages to lead an active lifestyle. Hospital employees provide information at educational and public forums, such as the YMCA Healthyn Kids Day, A Day Just for Women, Brown County Aging Resource Center, the Big Event for Little Kids, a series of events during National Womens Health Week and the Einstein Project. Many underserved and uninsured of our community attend these events. The American Cancer Society Loan Closet - located at A Woman's Place - provides wigs, scarves, turbans, hats and breast prostheses for women living with the side effects of cancer treatments. Additionally, the Look Good, Feel Better program offers information and guidance to cancer patients looking to enhance their appearance. This gives patients a sense of control over physical changes they may experience. St. Mary's Hospital along with St. Vincent Hospital and Bellin Health supports Unity Hospice, a provider of appropriate and compassionate care for the terminally ill. These various efforts to serve the needs of our community result in real benefits for the people of Green Bay.
Affiliated health care system	ST. MARY'S HOSPITAL MEDICAL CENTER - GREEN BAY is an affiliate of Hospital Sisters Health System (HSHS), a health care ministry that includes 13 hospitals, scores of community-based health centers and clinics, and more than 2,000 physician partners across Illinois and Wisconsin. The Mission of HSHS is to reveal and embody Christs healing love for all people through our high quality Franciscan health care ministry. We live our Mission by healing those who seek our care, as well as through our Community Benefit initiatives. Working collaboratively with others in the 12 communities we serve, our Community Benefit efforts are successfully expanding access to care, improving the health status of residents, and furthering medical education and knowledge. Across HSHS, we collectively provided $174.2 million in Community Benefits (or 9.7% of total hospital expenses) in FY2012. Included in this amount was $43.1 million provided for Charity Care and $97.9 million for unreimbursed care provided under the Medicaid program. In addition, HSHS hospitals committed significant resources to care for Medicare patients. The cost of providing services to primarily elderly beneficiaries of the Medicare program - in excess of governmental and managed care contract payments - was $168.4 million. HSHS hospitals also recorded $106.6 million in uncollectible accounts. Beyond the dollars invested in our Community Benefit programs, HSHS also continues to reinvest any surplus revenue from operations and investments into new medical technology, facility infrastructure and health care services in our communities. By doing do, we ensure we are able to meet the ongoing demand for high quality, efficient and easily accessible health care. Recognizing that the health care delivery model in the U.S. is evolving, HSHS remains focused on implementing our Care Integration strategy. Care Integration coordinates the delivery of care around the needs of each patient. During FY2012, we made significant progress with this strategy as we further implemented interoperable health information technologies, expanded the number of Medical Homes, and strengthened our alignment with physicians. Greater access to care As a Franciscan health care ministry, HSHS is deeply committed to serving those who are most in need. We not only provide care to every patient who walks through our doors, but also reach out beyond the walls of our hospitals and clinics to care for the individual. Our efforts to ensure residents in the communities we serve receive the right care at the right time often involve partnering with others to achieve this goal. Across our two-state system, there are numerous examples of HSHS collaborating with other organizations to enhance access to care for those in need. In western Wisconsin, St. Josephs Hospital in Chippewa Falls works closely with the Chippewa Health Improvement Partnership (CHIP) to support the Open Door Clinic. The free medical clinic provides health care for those without insurance coverage. This past year, the clinic received a total of 2,216 patient visits, a 25% increase from the prior year. With more than 150 individuals volunteering, the clinic provided over 6,500 hours (including 700 physician hours and 1,500 nursing hours) of service to individuals. The Open Door Clinic is an example of HSHS providing leadership and support to a community-based program designed to meet the needs of those less fortunate. In northeastern Wisconsin, St. Vincent Hospital in Green Bay supports patient care for the uninsured at the NEW Community Clinic by paying a nurses salary and offering free and discounted laboratory and radiology services. More than 70% of patients who use the clinic report the care they received helped keep them out of the Emergency Department. St. Nicholas Hospital in Sheboygan proactively reaches out to local Hmong and Hispanic organizations to ensure these populations can participate in free screenings and health education programs. Through this ongoing outreach initiative, St. Nicholas engaged more than 350 people last year, and in many cases was able to identify critical health conditions early and provide appropriate follow-up care. A Woman's Place at St. Mary's Hospital Medical Center in Green Bay reaches out to Hispanic neighbors to provide health and wellness education, health screenings, resources and referral services. Last year A Woman's Place touched the lives of more than 7,000 women through health screenings, educational events, classes and its resource center. In southeast Illinois, area residents can get help filling a prescription through the long-term collaboration between St. Anthonys Memorial Hospital in Effingham and Catholic Charities. Last year, St. Anthonys helped underwrite the cost of prescription medications for more than 430 residents. In southwest Illinois, St. Joseph's Hospital in Highland recognized many rural residents did not have a reliable means of transportation and partnered with generous individuals in the community to offer a free transportation service. The Friends Van, fully supported by the Friends of St. Joseph's Hospital, provides free rides to medical, dental and other personal appointments within a 20-mile radius of Highland. In FY2012, the Friends Van transported 2,050 individuals for a total of 12,561 miles. In addition to programs such as these, HSHS makes sure that those who need financial assistance for care receive it. Our Charity Care program covers 100% of hospital charges for individuals and families who earn less than 200% of the federal poverty level. HSHS Charity Care programs have a sliding scale, in some instances providing up to a 60% discount on charges for those earning up to 600% of the federal poverty level. Counselors are available in our hospitals to explain our charity care policies to patients, provide them with assistance in filling out a simple application form, or help them enroll in publicly funded health care programs. Better community health As part of our mission to embody Christs healing love, we understand that we have a responsibility to improve the overall quality of life in our communities by supporting initiatives that promote health and wellness. We recognize we are most successful when we work together with a wide array of public and private organizations that share our commitment to improving lives. By doing so, we maximize our efforts and reduce the duplication of services.HSHS hospitals also understand we need to listen closely to the residents of the communities we serve to ensure the health care needs of all are being met. To that end, each of our 13 hospitals completed Community Health Needs Assessments (CHNA) during FY2012. The information gathered from these assessments is being used to help us develop new, and enhance existing, programs and services that best address the needs of the community. Among the many priority needs identified from the CHNAs include metabolic and cardiovascular disease management, adequate food and nutrition, and mental health. HSHS hospitals are addressing these and other needs by proactively offering educational opportunities, preventative screenings, and new or enhanced clinical services. To address metabolic disease management, St. Francis Hospital in Litchfield, Illinois, partners with Montgomery County Health Department to provide screening for diabetes and renal disease. ST. FRANCIS HOSPITAL teams up with Macoupin County Health Department to provide Diabetes Self-Management classes. St. Josephs Hospital in Breese, Illinois coordinates several community education seminars and health fairs on cardiovascular disease and healthy eating each year. Over 3,000 residents participated in these health events last year. Recognizing the importance of proper food and nutrition to overall health, St. Johns Hospital in Springfield initiated the Destination Dinner program which teaches families how to cook healthy, from-scratch meals, and eat together as a family. Families meet quarterly to learn new cooking skills. They also learn how to prepare a meal for a family of four on a budget of $8.00. In addition to raising awareness about how to eat healthy on a limited budget, the program brings families together around the dinner table, which research shows promotes healthy relationships, increased academic performance and decreased risk for substance abuse and risky sexual behavior. Sacred Heart Hospital in Eau Claire, Wisconsin addressed the need for access to mental health services for children and adolescents by opening an outpatient behavioral health clinic. Sacred Heart has also adopted screening tools for behavioral and mental health risk factors for use at affiliated clinics. The goal is to better identify mental health issues and provide earlier intervention. Sacred Heart Hospital is also working with the Chippewa Valley Free Clinic (CVFC) to develop expanded provider coverage for CVFC patients who require mental health services
STATE FILING OF COMMUNITY BENEFIT REPORT	WI

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188584	0	0	0	0	0	117182	0	24315	0	330081	0	0	0
AMY J UNRATH
231875	0	0	0	0	0	234896	0	9534	0	476305	0	0	0
DONNA A HUTCHINSON
73160	0	0	0	0	0	197001	0	1291	0	271452	0	0	0
JOHN DAUL
181757	0	0	0	0	0	82029	0	21903	0	285689	0	0	0
MARY ALICE JOHNSON
181661	0	0	0	0	0	157125	0	23993	0	362779	0	0	0
CRAIG BABIARZ
186399	0	0	0	0	0	34905	0	8195	0	229499	0	0	0
STEPHEN KORDIYAK
179758	0	0	0	0	0	61367	0	21986	0	263111	0	0	0
GABRIEL LEIS
198553	0	0	0	0	0	16534	0	22603	0	237690	0	0	0
greg simia
0	166664	0	50000	0	0	0	0	0	12262	0	228926	0	0
FRANK MIKELL
0	604272	0	0	0	113875	0	101313	0	18171	0	837631	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
THERESE PANDL	SCHEDULE J, PART I, LINE 4B	THERESE PANDL PARTICIPATED IN A SERP DURING THE YEAR IN THE AMOUNT OF $56,375.
ANN M. CARR	SCHEDULE J, PART I, LINE 4B	ANN M. CARR PARTICIPATED IN A SERP DURING THE YEAR IN THE AMOUNT OF $33,655.
FRANK MIKELL	SCHEDULE J, PART I, LINE 4B	FRANK MIKELL PARTICIPATED IN A SERP DURING THE YEAR IN THE AMOUNT OF $111,653.

Schedule L IRS990ScheduleL

Loan Table LoanTable (2 entries)

Purpose Of LoanPurposeOfLoan	Loan From OrganizationLoanFromOrganization	Original PrincipalOriginalPrincipalAmount	Balance DueBalanceDue	DefaultDefault	Approved By BoardApprovedByBoard	Written AgreementWrittenAgreement
THERESE PANDL
MORTGAGE EXTENSION	X	$250,000	274484	false	true	true
THERESE PANDL
STOCK PURCHASE	X	$4,125	4125	false	true	true

Field	Value	IRS element (for citing)
Total Balance Due	278609	TotalBalanceDue

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

Field	Value	IRS element (for citing)
Name Person	PREVEA CLINIC	NamePerson

Field	Value	IRS element (for citing)
Relationship	OFFICER	Relationship
Amount Of Transaction	3483277	AmountOfTransaction
Description Of Transaction	PHYSICIAN SERVICES	DescriptionOfTransaction
Sharing Of Revenues	false	SharingOfRevenues

Form990 Schedule L Part V Form990ScheduleLPartV (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
LOANS TO/FROM INTERESTED PERSONS	SCHEDULE L, PART II	ALL TRANSACTIONS INVOLVING INTERESTED PERSONS ARE DETERMINED TO BE CONSISTENT WITH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. ANY TRANSACTIONS REQUIRING BOARD APPROVAL ARE APPROVED BY AN INDEPENDENT BOARD PRIOR TO OCCURRING.
BUSINESS TRANSACTIONS WITH INTERESTED PERSONS	SCHEDULE L, PART IV	ALL TRANSACTIONS INVOLVING INTERESTED PERSONS ARE DETERMINED TO BE CONSISTENT WITH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. ANY TRANSACTIONS REQUIRING BOARD APPROVAL ARE APPROVED BY AN INDEPENDENT BOARD PRIOR TO OCCURRING.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (15 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
ORGANIZATION'S MISSION	FORM 990 PART III, LINE 1	TO CONTINUE CHRIST'S HEALING LOVE THROUGH DELIVERY OF COMPETENT & COMPASSIONATE HEALTHCARE IN AN ENVIRONMENT SENSITIVE TO THE NEEDS OF ALL PEOPLE. THE HOSPITAL IS COMMITTED TO PROVIDING A BROAD RANGE OF QUALITY INPATIENT AND OUTPATIENT SERVICES WITHOUT REGARD TO THE INDIVIDUAL'S RACE, CREED, HANDICAPS, OR FINANCIAL STATUS. PROGRAM SERVICE REVENUE - SURGERY FORM 990 PART III, LINE 4A SURGERY St. Mary's Hospital Medical Center Surgical Services Surgical Services at St. Mary's Hospital Medical Center are comprised of Central Processing, Anesthesia, Surgery and Recovery. This includes eight OR Suites, a C-Section Room and two minor treatment rooms, Services are available 24/7 and include both inpatient and outpatient procedures. In fiscal year 2011-2012, over 5,100 surgical procedures were performed. Surgical procedures include General, Orthopedic, Urology, Gynecology, Oral - Maxillofacial, and Organ procurement. Anesthesia and Central Processing also provide Hospital-wide services to Inpatient Nursing, Labor and Delivery and the Emergency Department. The Anesthesia department is comprised of nine employed Nurse Anesthetists and three Anesthesiologists on campus daily.
PROGRAM SERVICE REVENUE - RADIOLOGY SERVICES	FORM 990, PART III, LINE 4B	RADIOLOGY St. Mary's Hospital Medical Center Imaging Services: The Imaging services department at St. Mary's Hospital Medical Center provides Inpatient, Outpatient, and Emergency care. Overall, the department performs more than 50,000 inpatient and outpatient exams and procedures annually. Patients have access to the latest technology in Digital Mammography, Computed Tomography, MRI, Nuclear Medicine, and Ultrasound. Four Interventional Radiologists provide minimally invasive procedures using image guidance. The staff consists of Board Certified radiologists as well as licensed and certified technologists, nurses, and sonographers. The modalities are accredited and utilize state-of-the-art equipment to afford the radiologists optimal images for interpretation. The department and hospital are accredited by the Joint Commission. During FY2012 the department began using a new state of the art MRI wide bore scanner.
PROGRAM SERVICE REVENUE - HEART & VASCULAR CENTER	FORM 990, PART III, LINE 4C	HEART & VASCULAR CENTER St. Mary's Hospital Medical Center Cath Lab: The Cath Lab offers a complete array of catheterization laboratory procedures and noninvasive cardiovascular diagnostic procedures, doing over 1,000 cardiac catheterizations in FY2012. If needed, a state-of-the-art Cardiovascular operating center (CVOR) is available nearby at our sister facility, St. Vincent Hospital, for cutting-edge open heart procedures by our highly-skilled cardiothoracic surgeons. CVICU suites are also offered there. For those patients who need follow-up, a Cardio-Pulmonary Rehabilitation Program is offered on site at St. Mary's. FORM 990, PART III, LINE 4D OTHER PROGRAM SERVICES St. Mary's Hospital Medical Center Other Program Services at St. Mary's Hospital Medical Center is comprised of Family Birthing Center, Intensive Care, Emergency, Center for Digestive Health, Pharmacy, Laboratory, Respiratory Therapy, Rehabilitation Services and other services. In FY2012 the hospital had over 105,000 outpatient registrations, over 4,400 admissions, 15,440 patient days, 659 births and over 33,100 emergency room visits.
TAX EXEMPT BONDS	FORM 990, PART IV, LINE 24	ST MARY'S HOSPITAL MEDICAL CENTER OF GREEN BAY, INC. HOLDS A LIABILITY ON ITS BOOKS FOR TAX-EXEMPT BONDS, WHICH IS AN ALLOCATION FROM ITS SOLE CORPORATE MEMBER, HOSPITAL SISTERS SERVICES, INC. AS A RESULT, THIS QUESTION WAS ANSWERED NO, AND SCHEDULE K WILL BE COMPLETED ON THE HOSPITAL SISTERS SERVICES, INC. FORM 990.
RIGHTS OF MEMBERS TO ELECT GOVERNING BODY	FORM 990, PART VI, LINE 6 & 7A	THE SENIOR GOVERNING BODY OF ST. MARY'S HOSPITAL MEDICAL CENTER OF GREEN BAY INC (THE "CORPORATION") IS THE MEMBER OF THE CORPORATION, WHICH IS HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. PURSUANT TO SECTION 2.3 OF THE CORPORATION'S BYLAWS, HSSI HAS THE RIGHT TO APPOINT AND REMOVE THE CORPORATION'S BOARD OF DIRECTORS, CHAIRPERSON OF THE BOARD, AND PRESIDENT.
MEMBER RESERVED POWERS	FORM 990, PART VI, LINE 7B	RESPONSIBILITY FOR THE POLICY AND OPERATIONS OF ST. MARY'S HOSPITAL MEDICAL CENTER OF GREEN BAY INC. (THE "CORPORATION") IS VESTED IN ITS BOARD OF DIRECTORS, EXCEPT WITH RESPECT TO SPECIFIC POWERS RESERVED IN THE CORPORATION'S BYLAWS TO THE CORPORATION'S MEMBER, HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE MEMBER OF HSSI IS HOSPITAL SISTERS HEALTH SYSTEM ("HSHS"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE MEMBERS OF HSHS ARE THE INDIVIDUAL SISTERS WHO, FROM TIME TO TIME, ARE THE DULY ELECTED PROVINCIAL SUPERIOR AND PROVINCIAL COUNCILORS, RESPECTIVELY OF THE AMERICAN PROVINCE OF THE HOSPITAL SISTERS OF ST. FRANCIS ("AMERICAN PROVINCE"). THE AMERICAN PROVINCE IS THE UNITED STATES ORGANIZATION OF THE CONGREGATION OF THE HOSPITAL SISTERS OF THE THIRD ORDER REGULAR OF ST. FRANCIS, A RELIGIOUS INSTITUTE OF THE ROMAN CATHOLIC CHURCH. THE GOVERNANCE AND OPERATIONS OF THE CORPORATION ARE SUBJECT TO HSSI'S RIGHT TO EXERCISE THESE RESERVED POWERS WITH RESPECT TO THE CORPORATION AND ORGANIZATIONS OF WHICH THE CORPORATION IS EITHER, DIRECTLY OR INDIRECTLY, A CONTROLLING MEMBER OR A CONTROLLING SHAREHOLDER ("AFFILIATES"). HSSI'S RIGHT TO EXERCISE CERTAIN OF THESE RESERVED POWERS IS, IN TURN, SUBJECT TO THE APPROVAL OF HSHS AND HSHS' MEMBERS. THE RESERVED POWERS INCLUDE ALL RIGHTS GRANTED TO HSSI BY LAW AND THE RIGHT TO: (A) ADOPT, APPROVE AMENDMENTS TO, OR AMEND ANY STATEMENT OF PHILOSOPHY, MISSION, MISSION INTEGRATION OR VALUES, OR ANY NAME, LOGO, OR MARK OF THE CORPORATION OR OF ANY AFFILIATE; (B) ADOPT, APPROVE AMENDMENTS TO, OR AMEND THE ARTICLES OF INCORPORATION OF THE CORPORATION OR OF ANY AFFILIATE; (C) ADOPT, APPROVE AMENDMENTS TO, OR AMEND THE BYLAWS OF THE CORPORATION OR OF ANY AFFILIATE; (D) APPOINT AND REMOVE THE BOARD OF DIRECTORS, ANY ONE OR MORE OF THE DIRECTORS OF THE CORPORATION OR OF ANY AFFILIATE, AND THE CHAIRPERSON AND PRESIDENT OF THE CORPORATION OR OF ANY AFFILIATE; (E) APPROVE THE RECOMMENDATION OF THE BOARD OF DIRECTORS TO APPOINT OR REMOVE THE BOARD OF DIRECTORS, ANY ONE OR MORE DIRECTORS OF THE CORPORATION OR OF ANY AFFILIATE, OR THE CHAIRPERSON AND PRESIDENT OF THE CORPORATION OR OF ANY AFFILIATE. (F) WITH RESPECT TO THE CORPORATION OR ANY AFFILIATE, APPROVE THE PURCHASE, SALE, ALIENATION, EXCHANGE, LEASE, OR ENCUMBRANCE OF ANY REAL PROPERTY OF THE CORPORATION OR OF ANY AFFILIATE, WHICH PROPERTY HAS A VALUE IN EXCESS OF LIMITS SET FROM TIME TO TIME BY HSSI; (G) APPROVE THE OPERATING AND CAPITAL BUDGETS OF THE CORPORATION OR OF ANY AFFILIATE, AND ANY DEVIATIONS BY THE CORPORATION OR OF ANY AFFILIATE FROM SUCH BUDGETS IN AN AMOUNT OR PERCENTAGE SPECIFIED BY HSSI FROM TIME TO TIME; (H) APPROVE THE STRATEGIC PLAN AND GOALS OF THE CORPORATION OR OF ANY AFFILIATE; (I) APPROVE THE SALE OF SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION OR OF ANY AFFILIATE; (J) APPROVE THE MERGER OR DISSOLUTION OF THE CORPORATION OR OF ANY AFFILIATE; (K) ADOPT OR AMEND THE PLAN FOR MINISTRY EDUCATION AND GOVERNANCE FOR THE CORPORATION AND ITS AFFILIATES; (L) APPROVE THE CORPORATION'S MISSION ACCOUNTABILITY REPORTS AND THOSE OF ANY AFFILIATE; (M) APPROVE THE FINANCIAL POLICIES AND PROCEDURES OF THE CORPORATION OR OF ANY AFFILIATE, AND APPROVE ANY DEVIATIONS FROM SUCH POLICIES AND PROCEDURES BY THE CORPORATION OR ANY AFFILIATE; AND (N) ADOPT POLICIES TO IMPLEMENT THE RESERVED POWERS OF HSSI.
FORM 990 REVIEW PROCESS	FORM 990, PART VI, LINE 11B	THE HOSPITAL EMPLOYS KPMG TO ASSIST IN THE OVERALL PREPARATION, REVIEW AND ELECTRONIC SUBMISSION OF ITS FORM 990. KPMG PROVIDES GUIDANCE IN IDENTIFYING CRITICAL ERRORS IN THE RETURN SUBMISSION, AND FEEDBACK ON QUANTITATIVE AND QUALITATIVE RESPONSES. ADDITIONALLY, THE HOSPITAL CFO PERFORMS A THOROUGH REVIEW OF THE RETURN AND REVIEWS IT WITH THE HOSPITAL CEO AND/OR SENIOR LEADERS BEFORE PRESENTING IT IN ITS ENTIRETY TO THE HOSPITAL BOARD FOR QUESTIONING AND REVIEW PRIOR TO THE RETURN'S SIGNING AND SUBMISSION TO THE IRS.
CONFLICT OF INTEREST POLICY	FORM 990, PART VI, LINE 12C	THE ORGANIZATION IS SUBJECT TO THE CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY ("POLICY") OF HOSPITAL SISTERS HEALTH SYSTEM, AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. A REVISED CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY HAVE BEEN IMPLEMENTED SINCE JANUARY, 2009 TO MANAGE CONFLICTS OF INTEREST USING A SYSTEM-WIDE PROTOCOL FOR DISCLOSURE STATEMENTS. IN ACCORDANCE WITH THE ORGANIZATON'S CONFLICT OF INTEREST POLICY, ALL COVERED PERSONS HAVE A DUTY TO COMPLY WITH THE CONFLICT OF INTEREST POLICY FOR ANY CONTRACT, TRANSACTION, RELATIONSHIP, OR ACTIVITY CONTEMPLATED, ENTERED INTO, OR CONDUCTED AT HSHS OR ITS AFFILIATES. THE POLICY DEFINES COVERED PERSONS AS BOARD MEMBERS, BOARD COMMITTEE MEMBERS, OFFICERS, BOARD DESIGNEES, SENIOR MANAGEMENT, MEMBERS OF ANY COMMITTEE THAT OVERSEES THE APPROVAL OF PHARMACEUTICALS AND MEDICAL DEVICES, AND ANY OTHER INDIVIDUAL WHO HOLDS A POSITION OF TRUST. ON AN ANNUAL BASIS, HSHS DISCLOSES A COPY OF THE CONFLICT OF INTEREST POLICY (AND ALL CORRESPONDING PROCEDURES, GUIDELINES, FORMS, AND TOOLS) TO ALL COVERED PERSONS AND ADVISES ALL COVERED PERSONS IN WRITING OF ANY SUBSTANTIVE CHANGES TO THIS POLICY AND SUCH RELATED MATERIALS. COVERED PERSONS ARE REQUIRED TO REVIEW AND COMPLETE THE CORRESPONDING CONFLICT OF INTEREST STATEMENT. THE SYSTEM OFFICE VICE PRESIDENT - SYSTEM RESPONSIBILITY, VICE PRESIDENT - RISK & COMPLIANCE, OR MEMBERS OF THE AUDIT AND INTEGRITY COMMITTEE ("COMMITTEE") ARE AVAILABLE TO ANSWER ANY QUESTIONS A COVERED PERSON MAY HAVE. IN ADDITION, IF, AT ANY TIME AFTER SUBMITTING AN ANNUAL CONFLICT OF INTEREST STATEMENT, A COVERED PERSON BECOMES AWARE OF AN INTEREST THAT HE OR SHE WOULD HAVE HAD TO DISCLOSE AT THE ANNUAL INTERVAL, THE COVERED PERSON IS REQUIRED PROMPTLY TO DISCLOSE THE INTEREST TO THE COMMITTEE USING THE HSHS CONFLICT OF INTEREST DISCLOSURE STATEMENT. COMPLETED CONFLICT OF INTEREST STATEMENTS ARE SUBMITTED TO THE COMMITTEE, WHICH IS RESPONSIBLE FOR IDENTIFYING, ASSESSING, AND MANAGING CONFLICTS OF INTEREST THAT ARISE IN THE COURSE OF CONDUCTING THE AFFAIRS OF HSHS AND ITS AFFILIATES. IF THE COMMITTEE DETERMINES THAT A CONFLICT OF INTEREST EXISTS, THE CONFLICT OF INTEREST POLICY REQUIRES HSHS NOT TO ENGAGE IN, OR ENTER INTO A PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY UNLESS THE COMMITTEE OR, WHERE NECESSARY, THE BOARD OF DIRECTORS (ACTING THROUGH ITS DISINTERESTED MEMBERS), HAS INVESTIGATED ALTERNATIVES TO THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY AND, IN THE ABSENCE OF ALTERNATIVES THAT ARE IN THE BEST INTERESTS OF HSHS, HAS DETERMINED: 1. THAT, REGARDLESS OF WHETHER THE COVERED PERSON PARTICIPATES IN THE IMPLEMENTATION OF THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY; 2. THE CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY IS IN THE BEST INTERESTS OF HSHS; 3. THE CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY IS FAIR AND REASONABLE FROM THE PERSPECTIVE OF HSHS; AND 4. HSHS CANNOT OBTAIN A MORE ADVANTAGEOUS CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES. IN DETERMINING WHETHER A CONTRACT, TRANSACTION OR ARRANGEMENT IS FAIR AND REASONABLE TO HSHS, THE COMMITTEE SHALL CONSIDER, WHERE APPLICABLE: 1. APPRAISALS OR OTHER INDEPENDENT VALUATIONS OF THE FAIR MARKET VALUE OF THE CONTRACT, TRANSACTION, OR ARRANGEMENT; 2. INFORMATION REGARDING COMPARABLE CONTRACTS, TRANSACTIONS, OR ARRANGEMENTS BETWEEN UNRELATED PARTIES; 3. OFFERS FROM COMPARABLE COMPETING ENTITIES; AND/OR 4. STUDIES OF COMPARABLE COMPENSATION ARRANGEMENTS. IN ANY CASE IN WHICH THE COMMITTEE FINDS, AFTER TAKING THE STEPS DESCRIBED ABOVE, THAT HSHS SHOULD PARTICIPATE IN A PROPOSED TRANSACTION OR ARRANGEMENT DESPITE THE EXISTENCE OF A CONFLICT OF INTEREST, THE COMMITTEE SHALL DEVELOP, IMPLEMENT, MONITOR, AND ENFORCE COMPLIANCE WITH A CONFLICT MANAGEMENT PLAN FOR MANAGING THE CONFLICT OF INTEREST AS IT CONSIDERS NECESSARY FOR SUCH FINDINGS TO REMAIN VALID THROUGHOUT THE LIFE OF THE CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY. ALL CONFLICT MANAGEMENT PLANS SHALL: 1. STATE THAT THE COMMITTEE WILL OVERSEE, MONITOR, AND ENFORCE COMPLIANCE WITH THE PLAN THROUGHOUT THE COURSE OF THE STUDY AND SPECIFY MEANS FOR DOING SO, INCLUDING, WITHOUT LIMITATION, THAT THE APPROPRIATE INDIVIDUALS MUST PROVIDE THE COMMITTEE WITH WRITTEN REPORTS PERTAINING TO COMPLIANCE WITH THE CONFLICT MANAGEMENT PLAN, THAT THE COMMITTEE SHALL HAVE THE RIGHT TO AUDIT THE STUDY FOR SUCH COMPLIANCE AND THE RIGHT TO IMPOSE SANCTIONS FOR NON-COMPLIANCE; 2. STATE THAT THE PLAN MUST BE SHARED WITH COVERED PERSON WHOSE INTERESTS IT WAS DEVELOPED TO MANAGE; 3. STATE THAT THE PLAN MUST BE SHARED WITH, AND PERIODIC REPORTS ON COMPLIANCE WITH THE PLAN MUST BE PROVIDED TO, THE BOARD, SENIOR MANAGEMENT, AND/OR GOVERNMENT AGENCIES; AND 4. PROVIDE FOR SUCH OTHER MANAGEMENT STEPS AND MECHANISMS THE COMMITTEE CONSIDERS NECESSARY AND APPROPRIATE. IN ADDITION TO THE COMMITTEE, THE SYSTEM OFFICE VICE PRESIDENTS OF SYSTEM RESPONSIBILITY AND RISK & COMPLIANCE MAY RETAIN SUCH INDEPENDENT ADVISORS OR EXPERTS AS DEEMED NECESSARY TO ASSIST IN MAKING ITS DETERMINATIONS AND DECISIONS. IF THE COMMITTEE DETERMINES THAT THE CONTEMPLATED TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY CANNOT PROCEED DUE TO A CONFLICT OF INTEREST, THE COMMITTEE SHALL INFORM THE APPLICABLE COVERED PERSON OR DECISION-MAKING BODY OF SUCH DETERMINATION WITHIN ONE WEEK OF THE COMMITTEE MEETING AT WHICH THE CONTEMPLATED TRANSACTION WAS DISCUSSED. THE COMMITTEE SHALL DOCUMENT ITS REJECTION OF THE CONTEMPLATED TRANSACTION IN THE COMMITTEE'S MEETING MINUTES.
WHISTLEBLOWER POLICY	FORM 990, PART VI, LINE 13	PROVISIONS WITHIN THE CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY PROVIDE PROTECTIONS FOR WHISTLEBLOWER TYPE ACTIVITIES.
COMPENSATION PROCESS	FORM 990, PART VI, LINE 15a and 15b	THE COMPENSATION COMMITTEE ("COMMITTEE") IS COMPRISED OF INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS. THE COMMITTEE DEVELOPS A COMPENSATION PHILOSOPHY FOR THE SYSTEM AND ALL AFFILIATES. THE COMMITTEE SELECTS AND HIRES THE INDEPENDENT COMPENSATION CONSULTANT TO DEVELOP COMPARABILITY DATA AND ADVISE THE COMMITTEE DURING ITS DELIBERATIONS REGARDING ALL ELEMENTS OF TOTAL COMPENSATION FOR ALL DISQUALIFIED INDIVIDUALS. INTEGRATED HEALTHCARE STRATEGIES ("IHS"), THE CONSULTANTS UTILIZED BY THE COMMITTEE, USE DATA FROM MULTIPLE TAX-EXEMPT PEER GROUP SOURCES TO DETERMINE SALARY RANGES, INCENTIVE OPPORTUNITY RANGES, AND BENEFITS FOR THE DISQUALIFIED INDIVIDUALS. IHS THEN ASSISTS THE COMMITTEE IN PREPARING CONTEMPORANEOUS DOCUMENTATION OF ALL ACTIONS. EACH COMMITTEE MEETING IS CONDUCTED WITH THE INTENT TO CREATE A REBUTTABLE PRESUMPTION OF REASONABLENESS FOR ALL ELEMENTS OF EXECUTIVE TOTAL COMPENSATION FOR THE DISQUALIFIED INDIVIDUALS. THE CHAIRMAN MAKES THIS DECLARATION AND ALSO INQUIRES IF THERE ARE ANY CONFLICTS OF INTEREST BY ANY ATTENDEES. ANY CONFLICTS ARE DISCLOSED AND THE COMMITTEE THEN ACTS IN A MANNER TO AVOID ANY CONFLICTED INDIVIDUAL PARTICIPATING IN ANY MANNER WHERE A CONFLICT MIGHT EXIST. AT THE END OF THE MEETING, THE COMMITTEE PREPARES CONTEMPORANEOUS MINUTES THAT RECORD ALL ACTIONS TAKEN DURING THE MEETING.
DOCUMENTS AVAILABLE TO THE PUBLIC	FORM 990, PART VI, LINE 19	BOARD-APPROVED FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE GENERAL PUBLIC AT THIS TIME.
POOLED INVESTMENT ACCOUNT	FORM 990, PART X, LINE 11	THE HOSPITALS CASH RESERVES ARE INVESTED IN A POOLED INVESTMENT ACCOUNT MAINTAINED BY HOSPITAL SISTERS HEALTH SYSTEM ("HSHS"). PARTICIPATION IN THE POOLED FUND IS LIMITED TO THE 501(C)(3) HOSPITALS AND HEALTH SERVICES ORGANIZATIONS SPONSORED BY HSHS. THE POOLED ACCOUNT CONSISTS OF CASH, EQUITY, AND DEBT SECURITIES THAT ARE PUBLICLY TRADED. IN ACCORDANCE WITH THE PROVISIONS OF STATEMENT OF FINANCIAL ACCOUNTING STANDARDS ("SFAS") NO. 124 "ACCOUNTING FOR CERTAIN INVESTMENTS HELD BY NOT-FOR-PROFIT ORGANIZATIONS", INVESTMENTS IN EQUITY SECURITIES WITH READILY DETERMINABLE FAIR VALUES, AND ALL INVESTMENTS IN DEBT SECURITIES, ARE REPORTED AT FAIR VALUE ON THE BALANCE SHEET. INCOME, REALIZED AND UNREALIZED GAINS AND LOSSES ARE POOLED AND ALLOCATED TO THE PARTICIPANTS. INDIVIDUAL COMPONENTS OF ASSETS AND REVENUE ARE NOT IDENTIFIED TO THE INDIVIDUAL HOSPITAL PARTICIPANTS.
Other Changes in net assets or fund balances	Form 990, Part XI, Line 5	UNREALIZED GAIN $(2,192,015) TEMPORARILY RESTRICTED INCOME IN FOUNDATION (848,230) PERMANENTLY RESTRICTED INCOME IN FOUNDATION 390 RECOGNITION OF CHANGES IN PENSION FUNDED STATUS (8,964,000) TRANSFER TO AFFILIATES (1,263,000) ROUNDING (12,705) ------------ TOTAL OTHER CHANGE IN NET ASSETS OR FUND BALANCES (13,279,560) ============
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:FRANK MIKELL TITLE:DIRECTOR HOURS:59
HOURS DEVOTED FOR RELATED ORGANIZATION	FORM 990 PART VII	NAME:ANN M. CARR TITLE:TREASURER HOURS:60

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (3 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Total IncomeTotalIncome	EOY AssetsEOYAssets	Business Name Line1DirectControllingEntityName/BusinessNameLine1
KIARA CLINICAL INTEGRATION NETWORK LLC
4936 LAVERNA ROAD	SPRINGFIELD	IL	62707	261417684	HEALTHCARE	IL	0	0	HSSI
PHYSICIAN CLINICAL INTEGRATION NTWRK LLC
4936 Laverna ROAd	Springfield	IL	62707	371668647	HealthCare	IL	0	0	KCIN
SPRINGFIELD HEALTH PARTNERS LLC
4936 LAVERNA ROAD	SPRINGFIELD	IL	62707	371364419	HEALTHCARE	IL	0	0	HSHS MG

Form990 Schedule R Part II Form990ScheduleRPartII (23 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrgControlledOrg
HOSPITAL SISTERS HEALTH SYSTEM
4936 LAVERNA ROAD	SPRINGFIELD	IL	62707	371058692	HEALTHCARE	IL	501(c)(3)	11A	NA	false
HOSPITAL SISTERS SERVICES INC
4936 LAVERNA ROAD	SPRINGFIELD	IL	62707	371163402	HEALTHCARE	IL	501(c)(3)	11A	NA	false
HOSPITAL SISTERS OF ST FRANCIS FDTN
4936 LAVERNA ROAD	SPRINGFIELD	IL	62707	371186514	HEALTHCARE	IL	501(C)(3)	11A	NA	false
HSHS SELF INSURANCE TRUST FUND
4936 LAVERNA ROAD	SPRINGFIELD	IL	62707	371120626	INSURANCE	IL	501(c)(3)	11A	NA	false
HSHS HEALTH CARE PLAN TRUST FUND
4936 LAVERNA ROAD	SPRINGFIELD	IL	62707	371137724	HEALTHCARE	IL	501(C)(3)	N/A	NA	false
HOSPITAL SISTERS HEALTHCARE WEST INC
2661 COUNTY HIGHWAY I	CHIPPEWA FALLS	WI	54729	510157933	HEALTHCARE	WI	501(C)(3)	11A	NA	false
SACRED HEART HOSPITAL
900 WEST CLAIREMONT AVENUE	EAU CLAIRE	WI	54701	390807060	HEALTHCARE	WI	501(C)(3)	3	NA	false
ST ANTHONY'S HOSPITAL
503 N MAPLE STREET	EFFINGHAM	IL	62401	370661233	HEALTCARE	IL	501(C)(3)	3	NA	false
ST ELIZABETH'S HOSPITAL
211 SOUTH THIRD STREET	BELLEVILE	IL	62220	370663567	HEALTHCARE	IL	501(C)(3)	3	NA	false
ST NICHOLAS HOSPITAL
3100 SUPERIOR AVENUE	SHEBOYGAN	WI	53081	390808480	HEALTHCARE	WI	501(C)(3)	3	NA	false
ST JOHN'S HOSPITAL
800 EAST CARPENTER STREET	SPRINGFIELD	IL	62769	370661238	HEALTHCARE	IL	501(C)(3)	3	NA	false
ST JOSEPH'S HOSPITAL
9515 HOLY CROSS LANE PO BOX 9	BREESE	IL	62230	371208459	HEALTHCARE	IL	501(C)(3)	3	NA	false
ST JOSEPH'S HOSPITAL
2661 COUNTY HIGHWAY 1	CHIPPEWA FALLS	WI	54729	390810545	healthcare	WI	501(c)(3)	3	NA	false
ST MARY'S HOSPITAL
1800 E LAKE SHORE DRIVE	DECATUR	IL	62521	370661244	HEALTHCARE	IL	501(C)(3)	3	NA	false
ST MARY'S HOSPITAL
111 SPRING STREET	STREATOR	IL	61364	362169181	HEALTHCARE	IL	501(C)(3)	3	NA	false
STFRANCIS HOSPITAL
1215 FRANCISCAN DRIVE	LITCHFIELD	IL	62056	370661236	HEALTHCARE	IL	501(C)(3)	3	NA	false
ST VINCENT HOSPITAL
835 S VAN BUREN	GREEN BAY	WI	54301	390817529	HEALTHCARE	WI	501(C)(3)	3	NA	false
ST JOSEPH'S HOSPITAL
1515 MAIN STREET	HIGHLAND	IL	62249	370663568	HEALTHCARE	IL	501(C)(3)	3	NA	false
HSHS MEDICAL GROUP INC
3215 Executive Park Drive	SPRINGFIELD	IL	62703	263956318	HEALTHCARE	IL	501(C)(3)	11A	NA	false
HSHS WISCONSIN MEDICAL GROUP INC
3215 Executive Park Drive	Springfield	IL	62703	264515959	HEALTHCARE	WI	501(C)(3)	11A	NA	false
ORANGE CROSS AMBULANCE INC
919 ASHLAND AVE	SHEBOYGAN	WI	53081	391860942	HEALTHCARE	WI	501(C)(3)	9	STNICHOLAS	false
WISCONSIN UPPER PEN OCN MNGMT SERVICES
835 S VAN BUREN	GREEN BAY	WI	54301	391677100	HEALTHCARE	WI	501(C)(3)	3	ST VINCENT	false
UNITY LIMITED PARTNERSHIP
2366 OAK RIDGE CIRCLE	DE PERE	WI	54115	391750729	HEALTHCARE	WI	501(C)(3)	11A	HSSI	false

Form990 Schedule R Part III Form990ScheduleRPartIII (8 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Predominant Income TypePredominantIncomeType	Share Of Total IncomeShareOfTotalIncome	Share Of EOY AssetsShareOfEOYAssets	Disproportionate AllocationsDisproportionateAllocations	Code VCodeVAmount	General Or Managing PartnerGeneralOrManagingPartner	Percentage OwnershipPercentageOwnership	EINEIN
CARPENTER STREET HOTEL LLC
525 NORTH SIXTH STREET HOTEL	SPRINGFIELD	IL	62707	Hotel	IL	LASANTE INC	RELATED	-30639	1191792	false	$0	false	0.50500
NORTHEAST WISCONSIN RADIATION
1821 S WEBSTER AVENUE STE 30	GREEN BAY	WI	54301	HEALTHCARE	WI	HSSI	RELATED	438615	3757018	false	$0	false	0.50000
PRAIRIE HEART INSTITUTE - CARB
800 EAST CARPENTER STREET	SPRINGFIELD	IL	62769	HEALTHCARE	IL	ST JOHN'S	Related	-8272	20364	false	$0	false	0.50000
MEMORIAL AND ST ELIZABETH'S HOSPITAL
400 NORTH ILLINOIS STREET	SWANSEA	IL	62226	HEALTHCARE	IL	ST ELIZABETH'S	RELATED	2200182	8475835	false	$0	false	0.50000
PAIN CENTER OF WISCONSIN
4131 W LOOMIS ROAD STE 300	MILWAUKEE	WI	53221	HEALTHCARE	WI	ST VINCENT	RELATED	3153762	3085388	false	$0	false	0.50000
SURGERY CENTER OF SHEBOYGAN
3141 SAEMANN AVE	SHEBOYGAN	WI	53081	HEALTHCARE	WI	ST NICHOLAS	RELATED	661480	1585809	false	$0	false	0.50000
PREVEA VENTURES LLC
2710 EXECUTIVE DR	GREEN BAY	WI	54304	HEALTHCARE	WI	HSSI	RELATED	0	0	false	$0	false		203775127
SPRINGFIELD URGENT CARE REAL ESTATE
PO BOX 19456	SPRINGFIELD	IL	62794	RENT. REAL ESTATE	IL	LASANTE INC	RELATED	35277	1168057	false	$0	false	0.51000

Form990 Schedule R Part IV Form990ScheduleRPartIV (8 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Type Of EntityTypeOfEntity	Share Of Total IncomeShareOfTotalIncome	Share Of EOY AssetsShareOfEOYAssets	Percentage OwnershipPercentageOwnership
Kiara Inc
4936 Laverna ROAd	Springfield	IL	62707	371163401	HealthCare	IL	HSHS	C Corp	-2076455	9647670	1.00000
LASANTE INC
4936 Laverna ROAd	Springfield	IL	62707	371163400	HEALTHCARE	IL	Kiara Inc	C Corp	-30056	577154	1.00000
LaSante Wisconsin INC
4936 Laverna ROAd	Springfield	IL	62707	391572196	HealthCare	IL	Kiara Inc	C Corp	509460	9832286	1.00000
Prairie Cardiovascular
619 East Mason STE 4P57	Springfield	IL	62701	371071858	HealthCare	IL	Kiara Inc	C Corp	-20534879	15963339	1.00000
PREVEA HEALTH SERVICES
2710 EXECUTIVE DR	GREEN BAY	WI	54304	391839351	HEALTHCARE	WI	HSSI	C CORP	0	0
PREVEA CLINIC INC
2710 EXECUTIVE DR	GREEN BAY	WI	54304	391839349	HEALTHCARE	WI	HSSI	C CORP	0	0
PREVEA HEALTH NETWORK
2710 EXECUTIVE DR	GREEN BAY	WI	54304	392000537	HEALTHCARE	WI	HSSI	C CORP	0	0
RENAISSANCE QUALITY INSURANCE
				980669953	INSURANCE	CA	HSSI	C CORP	0	0

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

Form990 Schedule R Part VII Form990ScheduleRPartVII

Field	Value	IRS element (for citing)
Identifier	TRANSACTIONS WITH RELATED ORGANIZATIONS	Identifier
Return Reference	SCHEDULE R, PART V, LINE 2	ReturnReference
Explanation	ANY TRANSACTIONS LISTED ON SCHEDULE R, PART V, LINE 1 AND NOT ON SCHEDULE R, PART V, LINE 2 ARE BETWEEN RELATED 501(C)(3) AND DO NOT REQUIRE REPORTING ON THIS SECTION.	Explanation