HOLY FAMILY MEMORIAL INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: HOLY FAMILY MEMORIAL INC (EIN 39-0806395)
Tax period: 2012-01-01 to 2012-12-31
Filed: 2013-11-15
IRS object ID: 201313199349308226
Schema version: 2012v2.1
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule G
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-11-15T14:58:34-06:00	Timestamp
Tax Period End Date	2012-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Field	Value	IRS element (for citing)
EIN	391173131	EIN

Preparer Firm Business Name PreparerFirmBusinessName

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

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	100 MARITIME DRIVE SUITE 2B	AddressLine1
City	MANITOWOC	City
State	WI	State
ZIP Code	54220	ZIPCode

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

Filer Filer

Field	Value	IRS element (for citing)
EIN	390806395	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	HOLY FAMILY MEMORIAL INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	HOLY	NameControl
Phone	9203202011	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2300 WESTERN AVE PO BOX 1450	AddressLine1
City	MANITOWOC	City
State	WI	State
ZIP Code	542211450	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	MARK HERZOG	Name
Title	PRESIDENT / CEO	Title
Phone	9203203470	Phone
Date Signed	2013-11-15	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	KELLY BLOCK CPA	Name
PTIN	P00199509	PTIN
Phone	9206845500	Phone

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2016-03-07 17:11:31Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	MARK HERZOG	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	2300 WESTERN AVE PO BOX 1450	AddressLine1
City	MANITOWOC	City
State	WI	State
ZIP Code	542211450	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	129906048	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.HFMHEALTH.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1899	YearFormation
State Legal Domicile	WI	StateLegalDomicile
Activity Or Mission Description	HEALTH CARE SERVICESSEE SCHEDULE OHOLY FAMILY MEMORIAL IS A NETWORK OF HEALTH PROFESSIONALS WHO, ROOTED IN THE HEALING MINISTRY OF JESUS CHRIST, PROVIDE SERVICES TO HELP INDIVIDUALS AND OUR COMMUNITIES ACHIEVE HEALTHIER LIVES. HFM PROVIDES ACUTE, OUTPATIENT, CLINIC, HOME CARE AND HOSPICE SERVICES FOR MANITOWOC COUNTY, STRIVING FOR MEDICIAL EXCELLENCE AND VALUED OUTCOMES WITHIN A COMPASSIONATE, VALUES BASED, CHRISTIAN ENVIRONMENT.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	20	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	13	NbrIndependentVotingMembers
Total Nbr Employees	1268	TotalNbrEmployees
Total Nbr Volunteers	386	TotalNbrVolunteers
Total Gross UBI	7256	TotalGrossUBI
Net Unrelated Business Txbl Income	-15936	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	933186	ContributionsGrantsPriorYear
Contributions Grants Current Year	760996	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	129021726	ProgramServiceRevenuePriorYear
Program Service Revenue CY	126777153	ProgramServiceRevenueCY
Investment Income Prior Year	3611146	InvestmentIncomePriorYear
Investment Income Current Year	1731265	InvestmentIncomeCurrentYear
Other Revenue Prior Year	605790	OtherRevenuePriorYear
Other Revenue Current Year	224576	OtherRevenueCurrentYear
Total Revenue Prior Year	134171848	TotalRevenuePriorYear
Total Revenue Current Year	129493990	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	42000	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	44350	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	77340656	SalariesEtcPriorYear
Salaries Etc Current Year	78476976	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	249566	TotalFundrsngExpCurrentYear
Other Expense Prior Year	49572482	OtherExpensePriorYear
Other Expenses Current Year	48878691	OtherExpensesCurrentYear
Total Expenses Prior Year	126955138	TotalExpensesPriorYear
Total Expenses Current Year	127400017	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	7216710	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	2093973	RevenuesLessExpensesCY
Total Assets BOY	169230414	TotalAssetsBOY
Total Assets EOY	170044589	TotalAssetsEOY
Total Liabilities BOY	70216195	TotalLiabilitiesBOY
Total Liabilities EOY	65733371	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	99014219	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	104311218	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	HOLY FAMILY MEMORIAL IS A NETWORK OF HEALTH PROFESSIONALS WHO, ROOTED IN THE HEALING MINISTRY OF JESUS CHRIST, PROVIDE SERVICES TO HELP INDIVIDUALS AND OUR COMMUNITIES ACHIEVE HEALTHIER LIVES.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	115202476	Expense
Grants	44350	Grants
Revenue	128479133	Revenue
Description	HOLY FAMILY MEMORIAL IS AN INTEGRATED NETWORK PROVIDING HEALTH CARE SERVICES INTENDED TO BENEFIT THE HEALTH AND WELLBEING OF THE COMMUNITIES IT SERVES. THESE SERVICES INCLUDE PRIMARY AND SPECIALTY CLINIC CARE, PREVENTIVE CARE SUCH AS HEALTH SCREENINGS, VACCINATION CLINICS AND HEALTH EDUCATION CLASSES, 24/7 EMERGENCY CARE, URGENT CARE, INPATIENT ACUTE CARE, OUTPATIENT CARE, HOME CARE AND HOSPICE, HOME MEDICAL EQUIPMENT, PRESCRIPTIONS, OCCUPATIONAL HEALTH SERVICES, AND MEDICALLY BASED FITNESS AND WELLNESS CENTER. HOLY FAMILY MEMORIAL HAS BEEN ABLE TO ACHIEVE A GREATER IMPACT IN THE COMMUNITY BY PARTNERING FINANCIAL, HUMAN AND PROGRAMMATIC RESOURCES WITH OTHER ORGANIZATIONS. THESE PARTNERSHIPS INCLUDE A COMMITMENT TO COLLABORATE WITH OTHER HEALTH AND SOCIAL SERVICE AGENCIES TO IMPROVE ACCESS TO CARE, FOCUS ON PREVENTIVE SERVICES, REDUCE COMMUNITY HEALTH RISKS AND CONTRIBUTE TO A HEALTHIER, VIBRANT COMMUNITY.HOLY FAMILY MEMORIAL PROVIDES MEDICALLY NECESSARY SERVICES WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICIES. IN ASSESSING A PATIENT'S ABILITY TO PAY, HOLY FAMILY MEMORIAL UTILIZES GENERALLY RECOGNIZED POVERTY INCOME LEVELS OF THE COMMUNITIES IT SERVES AND CONSIDERS SITUATIONS WHERE INCURRED CHARGES ARE SIGNIFICANT WHEN COMPARED TO THE PATIENT'S FINANCIAL RESOURCES. BECAUSE HOLY FAMILY MEMORIAL DOES NOT EXPECT TO RECEIVE PAYMENT OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THESE AMOUNTS ARE NOT INCLUDED IN NET PATIENT SERVICE REVENUES. HOLY FAMILY MEMORIAL'S TOTAL COMMUNITY BENEFIT INCLUDES THE COST OF CHARITY CARE AND UNPAID COST OF PUBLIC PROGRAMS (MEDICARE AND MEDICAID) AS WELL AS THOSE DISCUSSED ABOVE. HOLY FAMILY MEMORIAL'S COMMUNITY BENEFIT WAS APPROXIMATELY $23,755,000 FOR THE YEAR ENDED DECEMBER 2012. THIS AMOUNT INCLUDES THE NET COST OF CHARITY CARE OF APPROXIMATELY $1,304,000. MORE INFORMATION AVAILABLE FROM OUR COMMUNITY BENEFIT REPORT WHICH CAN BE LOCATED ON OUR WEBSITE AT WWW.HFMHEALTH.ORG.	Description
Total Program Service Expense	115202476	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	1	LobbyingActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	1	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	1	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	0	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	0	ReportFin48Footnote
Independent Audit Financial Stmt	1	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	1	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	1	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Financial Stmt Attached	1	FinancialStmtAttached
Grants To Organizations	0	GrantsToOrganizations
Grants To Individuals	1	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	1	TaxExemptBonds
Invest Tax Exempt Bonds	0	InvestTaxExemptBonds
Escrow Account	0	EscrowAccount
On Behalf Of Issuer	0	OnBehalfOfIssuer
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	1	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	1	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	1	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	1	RelatedOrgControlledEntity
Transaction Related Entity	1	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	20	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	1268	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	1	UnrelatedBusinessIncome
Form990-T Filed	1	Form990-TFiled
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	1	QuidProQuoContributions
Quid Pro Quo Disclosure	1	QuidProQuoDisclosure
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Form8899 Filed	0	Form8899Filed
Form1098 C Filed	0	Form1098CFiled
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	20	NbrVotingGoverningBodyMembers
Number Independent Voting Members	13	NumberIndependentVotingMembers
Family Or Business Relationship	0	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	1	MembersOrStockholders
Election Of Board Members	1	ElectionOfBoardMembers
Decisions Subject To Approval	1	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	0	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	1	InvestmentInJointVenture
Written Policy Or Procedure	1	WrittenPolicyOrProcedure
States Where Copy Of Return Is Filed	WI	StatesWhereCopyOfReturnIsFiled
Other Website	X	OtherWebsite
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	MARK HERZOG PRESIDENT CEO	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	9203203470	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	2300 WESTERN AVENUE	AddressLine1
City	MANITOWOC	City
State	WI	State
ZIP Code	542211450	ZIPCode

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

Form990 Part VII Section A Form990PartVIISectionA (32 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee	FormerFormer
RYAN M DOPIRAK MD
PHYSICIAN COUNCIL CHAIR/PHYSICIAN	40.00	X	1125856	0	30592
GARY SCHMIDT MD
DIRECTOR	40.00	X	184896	0	17124
PRADEEP GIRIYAPPA MD
DIRECTOR	40.00	X	269087	0	28251
MICHAEL B MCCORMICK MD
DIRECTOR	40.00	X	322828	0	33561
JAMES W HOFTIEZER MD
DIRECTOR	40.00	X	606786	0	30278
WILLIAM D HAMPTON MD
DIRECTOR	40.00	X	334244	0	28396
MARY A GOVIER MD
DIRECTOR	40.00	X	177651	0	24373
LEE KUMMER
DIRECTOR	2.00	X	0	0	0
DONALD R BRISCH
DIRECTOR	2.00	X	0	0	0
JANE L PFEFFER
VICE CHAIR	2.00	X	0	0	0	X
WILLIAM R CASEY
TREASURER	2.00	X	0	0	0	X
MARK SWANSON
DIRECTOR	2.00	X	0	0	0
WILLIAM C CENSKY
CHAIR	2.00	X	0	0	0	X
SISTER PAULA VANDEN HOGEN
DIRECTOR	2.00	X	0	0	0
LAURIE CRAWFORD
SECRETARY	2.00	X	0	0	0	X
SISTER JAN VILLEMURE
DIRECTOR	2.00	X	0	0	0
SISTER LORITA GAFFNEY
DIRECTOR	2.00	X	0	0	0
KATHLEEN A ZUCCHI
DIRECTOR	2.00	X	0	0	0
SISTER LAURA WOLF
DIRECTOR	2.00	X	0	0	0
SISTER MARDELLE MEINHOLZ
DIRECTOR	2.00	X	0	0	0
SISTER MARY ANN NUGENT
DIRECTOR	2.00	X	0	0	0
MARK P HERZOG
DIRECTOR, PRESIDENT, CEO	40.00	X	596911	0	114507	X
PATRICIA HUETTL
CHIEF FINANCIAL OFFICER	40.00		239906	0	61714	X
STEVEN D DRIGGERS MD
CHIEF MEDICAL OFFICER	40.00		563702	0	99167		X
MARY MAURER
CHIEF INNOVATION OFFICER	40.00		261784	0	43336		X
MARCIA DONLON VP MEDICAL
CENTER/CHIEF NURSING OFFICER	40.00		167060	0	44963		X
KIRK DIMITRIS MD
PHYSICIAN	40.00		1207031	0	28572			X
DAVID MIKOLYZK MD
PHYSICIAN	40.00		803515	0	30454			X
MILAN JORDAN MD
PHYSICIAN	40.00		760253	0	20462			X
NANCY N BUTLER MD
PHYSICIAN	40.00		737863	0	19502			X
JEFFREY A JACOBY MD
PHYSICIAN	40.00		1301264	0	30710			X
PATRICK J BRANDEL
FORMER CFO	0.00		105893	0	0				X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	9766530	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	685962	TotalOtherCompensation
Number Individuals GT100 K	71	NumberIndividualsGT100K
Formers Listed	1	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
CARETECH SOLUTIONS
901 WILSHIRE DRIVE STE 250	TROY	MI	48084	IT SERVICES	5726012
PATRIOT MEDICAL TECH
PO BOX 415000	NASHVILLE	TN	372415000	BIO-MED SERVICES	1272347
PHILIPPI QUALITY CONSTRUCTION
1226 SOUTH 32ND STREET	MANITOWOC	WI	54220	GENERAL CONTRACTOR	470346
RADIATION ONCOLOGY SPECIALISTS
PO BOX 678	STURGEON BAY	WI	54235	CANCER CARE SERVICES	445674
QUEST DIAGNOSTICS INC
PO BOX 12989	CHICAGO	IL	60693	LABORATORY	410697

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	18	NumberOfContractorsGT100K
Fundraising Events	42131	FundraisingEvents
Government Grants	146781	GovernmentGrants
All Other Contributions	572084	AllOtherContributions
Noncash Contributions	6010	NoncashContributions
Total Contributions	760996	TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue	ExclusionExclusionAmount
INTEGRATED HEALTH CARE	900099	111413262	111413262	0	$0
LAB	621500	9604784	9592375	12409	$0
PHARMACY	446110	5759107	5688478	0	$70,629

Field	Value	IRS element (for citing)
Total Program Service Revenue	126777153	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	1735090	TotalRevenueColumn
Related Or Exempt Function Income	1735090	RelatedOrExemptFunctionIncome

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	326061	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	357194	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	-31133	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	-31133	TotalRevenueColumn
Exclusion	-$31,133	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Other	3185	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Other	7010	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Other	-3825	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	-3825	TotalRevenueColumn
Exclusion	-$3,825	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Income Fundraising Events	100622	GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events	42131	CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses	40698	FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	59924	TotalRevenueColumn
Exclusion	$59,924	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Income Gaming	12410	GrossIncomeGaming
Gaming Direct Expenses	7156	GamingDirectExpenses

Net Income From Gaming NetIncomeFromGaming

Field	Value	IRS element (for citing)
Total Revenue Column	5254	TotalRevenueColumn
Exclusion	$5,254	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue
MISCELLANEOUS	900003	145756	$145,756
INVESTMENT HFHS & DME	446110	44775		49928	-5153

Field	Value	IRS element (for citing)
Total Other Revenue	190531	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	129493990	TotalRevenueColumn
Related Or Exempt Function Income	128479133	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	7256	UnrelatedBusinessRevenue
Exclusion	$246,605	ExclusionAmount

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	44350	Total
Program Services	44350	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	4986176	Total
Program Services	2695485	ProgramServices
Management And General	2290691	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	59764578	Total
Program Services	55412418	ProgramServices
Management And General	4211663	ManagementAndGeneral
Fundraising	140497	Fundraising

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	339179	Total
Program Services	155922	ProgramServices
Management And General	179167	ManagementAndGeneral
Fundraising	4090	Fundraising

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	9625202	Total
Program Services	9003300	ProgramServices
Management And General	569291	ManagementAndGeneral
Fundraising	52611	Fundraising

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	3761841	Total
Program Services	3408803	ProgramServices
Management And General	343410	ManagementAndGeneral
Fundraising	9628	Fundraising

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	133576	Total
Management And General	133576	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	112781	Total
Management And General	112781	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	391945	Total
Program Services	390721	ProgramServices
Management And General	1224	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	456520	Total
Program Services	49958	ProgramServices
Management And General	406562	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	16541101	Total
Program Services	16351432	ProgramServices
Management And General	182208	ManagementAndGeneral
Fundraising	7461	Fundraising

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	3357944	Total
Program Services	3357944	ProgramServices

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	2689964	Total
Program Services	2598688	ProgramServices
Management And General	60304	ManagementAndGeneral
Fundraising	30972	Fundraising

Travel Travel

Field	Value	IRS element (for citing)
Total	387005	Total
Program Services	251293	ProgramServices
Management And General	135034	ManagementAndGeneral
Fundraising	678	Fundraising

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	285380	Total
Program Services	165964	ProgramServices
Management And General	119416	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	2307214	Total
Program Services	2307214	ProgramServices

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	9003444	Total
Program Services	8775471	ProgramServices
Management And General	225302	ManagementAndGeneral
Fundraising	2671	Fundraising

Insurance Insurance

Field	Value	IRS element (for citing)
Total	820857	Total
Program Services	820857	ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Management And GeneralManagementAndGeneral	Program ServicesProgramServices	FundraisingFundraising
NON-OP INC TAX	59999	59999
PURCHASED SERVICES	5621315	2103969	3516388	958
STATE PROVIDER ASSESSME	3176800		3176800
MAINTENANCE	2691366	32021	2659345

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	841480	Total
Program Services	60123	ProgramServices
Management And General	781357	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	127400017	Total
Program Services	115202476	ProgramServices
Management And General	11947975	ManagementAndGeneral
Fundraising	249566	Fundraising

Field	Value	IRS element (for citing)
Joint Costs	X	JointCosts

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	9393054	BOY
EOY	11487108	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	3404090	BOY
EOY	3911962	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	23190	BOY
EOY	20269	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	21425602	BOY
EOY	18598147	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	606872	BOY
EOY	0	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	2058558	BOY
EOY	1945539	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	5411183	BOY
EOY	6130142	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	174376001	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	105100350	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	71883833	BOY
EOY	69275651	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	30122020	BOY
EOY	34883872	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	20116445	BOY
EOY	19549808	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	3749813	BOY
EOY	3814204	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	1035754	BOY
EOY	427887	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	169230414	BOY
EOY	170044589	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	14880465	BOY
EOY	13673022	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	66476	BOY
EOY	29660	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	54233175	BOY
EOY	51602802	EOY

Escrow Account Liability EscrowAccountLiability

Field	Value	IRS element (for citing)
BOY	1035754	BOY
EOY	427887	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	325	BOY
EOY	0	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	70216195	BOY
EOY	65733371	EOY

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

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	97376300	BOY
EOY	102395650	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	209193	BOY
EOY	273086	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	1428726	BOY
EOY	1642482	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	99014219	BOY
EOY	104311218	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	169230414	BOY
EOY	170044589	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	2093973	ReconcilationRevenueExpenses
Reconciliation Unrealized Invest	2984823	ReconciliationUnrealizedInvest
Reconcilation Other Changes	218203	ReconcilationOtherChanges
Info In Schedule O Part XII	X	InfoInScheduleOPartXII
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited

FS Audited Basis FSAuditedBasis

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

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

Schedule A IRS990ScheduleA

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

Schedule 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)
Volunteers	0	Volunteers
Paid Staff Or Management	1	PaidStaffOrManagement
Media Advertisements	0	MediaAdvertisements
Mailings Members	0	MailingsMembers
Publications Or Broadcast	0	PublicationsOrBroadcast
Grants Other Organizations	0	GrantsOtherOrganizations
Direct Contact Legislators	1	DirectContactLegislators
Direct Contact Legislators	$1,242	DirectContactLegislatorsAmount
Rallies Demonstrations	0	RalliesDemonstrations
Other Activities	1	OtherActivities
Other Activities	$12,332	OtherActivitiesAmount
Total Lobbying Expenditures IIB	13574	TotalLobbyingExpendituresIIB
Not Described In501c3	0	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	EXPLANATION OF LOBBYING ACTIVITIES:	Identifier
Return Reference	PART II-B, LINE 1:	ReturnReference
Explanation	LINE 1 B & G: HFM SENT A REPRESENTATIVE TO WASHINGTON DC ON TWO OCCASIONS TO DISCUSS SPECIFIC LEGISLATIVE MATTERS WITH THEIR FEDERAL REPRESENTATIVES. HFM ALSO ATTENDED ONE DAY WHERE A SMALL NUMBER OF STAFF VISITED THE CAPITAL TO EDUCATE THEIR LEGISLATORS ON VARIOUS HEALTHCARE TOPICS. LINE I: HOLY FAMILY MEMORIAL BELONGS TO HOSPITAL ASSOCIATIONS WHICH USE A PERCENTAGE OF THE DUES FOR LOBBYING PURPOSES.	Explanation

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Agent Trustee Etc	0	AgentTrusteeEtc
Included On FS	0	IncludedOnFS

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	1637918	BeginningOfYearBalance
Contributions	514026	Contributions
Other Expenditures	236377	OtherExpenditures
End Of Year Balance	1915567	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	1602667	BeginningOfYearBalance
Contributions	202680	Contributions
Investment Earnings Or Losses	-9775	InvestmentEarningsOrLosses
Grants Or Scholarships	500	GrantsOrScholarships
Other Expenditures	157154	OtherExpenditures
End Of Year Balance	1637918	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	1429395	BeginningOfYearBalance
Contributions	240013	Contributions
Investment Earnings Or Losses	162063	InvestmentEarningsOrLosses
Grants Or Scholarships	500	GrantsOrScholarships
Other Expenditures	228304	OtherExpenditures
End Of Year Balance	1602667	EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	1223863	BeginningOfYearBalance
Contributions	485645	Contributions
Investment Earnings Or Losses	-107593	InvestmentEarningsOrLosses
Grants Or Scholarships	500	GrantsOrScholarships
Other Expenditures	172020	OtherExpenditures
End Of Year Balance	1429395	EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	1372479	BeginningOfYearBalance
Contributions	316645	Contributions
Investment Earnings Or Losses	-303997	InvestmentEarningsOrLosses
Grants Or Scholarships	500	GrantsOrScholarships
Other Expenditures	160764	OtherExpenditures
End Of Year Balance	1223863	EndOfYearBalance

Field	Value	IRS element (for citing)
Board Designated EOY Balance	0.94000	BoardDesignatedEOYBalance
Permanent Endowment EOY Balance	0.06000	PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs	0	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	1	EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R	1	AreRelatedOrgsListedScheduleR

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	4885385	OtherCostOrOtherBasis
Book Value	4885385	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	106092798	OtherCostOrOtherBasis
Depreciation	59624960	Depreciation
Book Value	46467838	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	5397801	OtherCostOrOtherBasis
Depreciation	4220473	Depreciation
Book Value	1177328	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	56023850	OtherCostOrOtherBasis
Depreciation	40526888	Depreciation
Book Value	15496962	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	1976167	OtherCostOrOtherBasis
Depreciation	728029	Depreciation
Book Value	1248138	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	69275651	TotalOfBookValueLandBuildings

Financial Derivatives FinancialDerivatives

Field	Value	IRS element (for citing)
Book Value	19549808	BookValue
Method Of Valuation	C	MethodOfValuation

Field	Value	IRS element (for citing)
Total Of Book Value Securities	19549808	TotalOfBookValueSecurities
Tot Revenue Etc Audited Fincl Stmt	132359359	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	2984823	NetUnrealizedGainsInvestments
Other Revenues	-119454	OtherRevenues
Revenue Not Rptd F990	2865369	RevenueNotRptdF990
Revenue Subtotal	129493990	RevenueSubtotal
Revenue Not Rptd On Fin Stmt	0	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	129493990	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	127340008	TotExpensesEtcAuditedFinclStmt
Other Expenses Included	-60009	OtherExpensesIncluded
Expenses Not Rptd F990	-60009	ExpensesNotRptdF990
Expenses Subtotal	127400017	ExpensesSubtotal
Expenses Not Rptd On Fin Stmt	0	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	127400017	TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:	PART V, LINE 4:	HOLY FAMILY MEMORIAL'S ENDOWMENT FUNDS WERE ESTABLISHED TO PROVIDE FINANCIAL SUPPORT ON AN ONGOING BASIS TO MEET THE CURRENT AND FUTURE NEEDS OF HOLY FAMILY MEMORIAL AND THE PEOPLE IT SERVES. FUNDS ARE USED FOR CAPITAL EQUIPMENT, MAJOR BUILDING IMPROVEMENTS, PROGRAM DEVELOPMENT, AND OPERATIONS.
PART XI, LINE 2D - OTHER ADJUSTMENTS:		TAXES -59,999. RESTRICTED DONATIONS RECORDED TO BALANCE SHEET -59,455.
PART XII, LINE 2D - OTHER ADJUSTMENTS:		TAXES -59,999. ROUNDING -10.

Schedule G IRS990ScheduleG

Events Information EventsInformation

Field	Value	IRS element (for citing)
Name Of Event1	PAINT THE NIGHT PINK	NameOfEvent1
Gross Receipts Event1	17792	GrossReceiptsEvent1
Charitable Contributions Event1	7850	CharitableContributionsEvent1
Gross Revenue Event1	9942	GrossRevenueEvent1
Other Direct Expenses Event1	20349	OtherDirectExpensesEvent1
Name Of Event2	SAMARITAN DAY	NameOfEvent2
Gross Receipts Event2	95929	GrossReceiptsEvent2
Charitable Contributions Event2	31953	CharitableContributionsEvent2
Gross Revenue Event2	63976	GrossRevenueEvent2
Other Direct Expenses Event2	19619	OtherDirectExpensesEvent2
Total Number Of Other Events	3	TotalNumberOfOtherEvents
Gross Receipts Other Events	29032	GrossReceiptsOtherEvents
Charitable Contrib Other Events	2328	CharitableContribOtherEvents
Gross Revenue Other Events	26704	GrossRevenueOtherEvents
Other Direct Expenses Other Events	730	OtherDirectExpensesOtherEvents
Gross Receipts Total	142753	GrossReceiptsTotal
Charitable Contributions Total	42131	CharitableContributionsTotal
Gross Revenue Total Events	100622	GrossRevenueTotalEvents
Other Direct Expenses Total Events	40698	OtherDirectExpensesTotalEvents
Direct Expense Summary Events	40698	DirectExpenseSummaryEvents
Net Income Summary	59924	NetIncomeSummary

Field	Value	IRS element (for citing)
Gaming With Nonmembers	1	GamingWithNonmembers
Percentage Of Gaming Othr Facility	1.00000	PercentageOfGamingOthrFacility

Name Of Gaming Rec Keeper Bus NameOfGamingRecKeeperBus

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

Address Of Gaming Rec Keeper US AddressOfGamingRecKeeperUS

Field	Value	IRS element (for citing)
Address Line1	PO BOX 1450	AddressLine1
City	MANITOWOC	City
State	WI	State
ZIP Code	542211450	ZIPCode

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
FPG Reference Free Care	1	FPGReferenceFreeCare
Pcent200	X	Pcent200
FPG Reference Discounted Care	1	FPGReferenceDiscountedCare
Pcent200 D	X	Pcent200D
Free Disc Care Medically Indigent	1	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	1	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	0	ExpensesExceededBudget
Annual Community Benefit Report	1	AnnualCommunityBenefitReport
Report Publically Available	1	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Persons Served	1741	PersonsServed
Total Community Benefit Expense	1304494	TotalCommunityBenefitExpense
Net Community Benefit Expense	1304494	NetCommunityBenefitExpense
Percent Of Total Expense	0.01020	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Persons Served	53719	PersonsServed
Total Community Benefit Expense	12345020	TotalCommunityBenefitExpense
Direct Offsetting Revenue	3609686	DirectOffsettingRevenue
Net Community Benefit Expense	8735334	NetCommunityBenefitExpense
Percent Of Total Expense	0.06860	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Persons Served	55460	PersonsServed
Total Community Benefit Expense	13649514	TotalCommunityBenefitExpense
Direct Offsetting Revenue	3609686	DirectOffsettingRevenue
Net Community Benefit Expense	10039828	NetCommunityBenefitExpense
Percent Of Total Expense	0.07880	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Persons Served	9656	PersonsServed
Total Community Benefit Expense	136554	TotalCommunityBenefitExpense
Net Community Benefit Expense	136554	NetCommunityBenefitExpense
Percent Of Total Expense	0.00110	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Persons Served	901	PersonsServed
Total Community Benefit Expense	385600	TotalCommunityBenefitExpense
Net Community Benefit Expense	385600	NetCommunityBenefitExpense
Percent Of Total Expense	0.00300	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Persons Served	34	PersonsServed
Total Community Benefit Expense	88811	TotalCommunityBenefitExpense
Direct Offsetting Revenue	50656	DirectOffsettingRevenue
Net Community Benefit Expense	38155	NetCommunityBenefitExpense
Percent Of Total Expense	0.00030	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Persons Served	946	PersonsServed
Total Community Benefit Expense	140774	TotalCommunityBenefitExpense
Net Community Benefit Expense	140774	NetCommunityBenefitExpense
Percent Of Total Expense	0.00110	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Persons Served	11537	PersonsServed
Total Community Benefit Expense	751739	TotalCommunityBenefitExpense
Direct Offsetting Revenue	50656	DirectOffsettingRevenue
Net Community Benefit Expense	701083	NetCommunityBenefitExpense
Percent Of Total Expense	0.00550	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Persons Served	66997	PersonsServed
Total Community Benefit Expense	14401253	TotalCommunityBenefitExpense
Direct Offsetting Revenue	3660342	DirectOffsettingRevenue
Net Community Benefit Expense	10740911	NetCommunityBenefitExpense
Percent Of Total Expense	0.08430	PercentOfTotalExpense

Economic Development EconomicDevelopment

Field	Value	IRS element (for citing)
Persons Served	200	PersonsServed
Total Community Building Expense	6432	TotalCommunityBuildingExpense
Net Community Building Expense	6432	NetCommunityBuildingExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Community Support CommunitySupport

Field	Value	IRS element (for citing)
Persons Served	14	PersonsServed
Total Community Building Expense	2389	TotalCommunityBuildingExpense
Net Community Building Expense	2389	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

Field	Value	IRS element (for citing)
Total Community Building Expense	2264	TotalCommunityBuildingExpense
Net Community Building Expense	2264	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Persons Served	1208	PersonsServed
Total Community Building Expense	3398	TotalCommunityBuildingExpense
Net Community Building Expense	3398	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Persons Served	1422	PersonsServed
Total Community Building Expense	14483	TotalCommunityBuildingExpense
Net Community Building Expense	14483	NetCommunityBuildingExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	1	BadDebtExpenseReported
Bad Debt Expense	$1,801,769	BadDebtExpenseAmount
Amount Attributable To	502695	AmountAttributableTo
Amount Reimbursed By Medicare	42849617	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	55859190	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-13009573	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	1	WrittenDebtCollectionPolicy
Provision For Charity Care	1	ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (2 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivity	Organization Profit Or OwnershipOrganizationProfitOrOwnership	Officers Etc Profit Or OwnershipOfficersEtcProfitOrOwnership	Physicans Profit Or OwnershipPhysicansProfitOrOwnership
1 YORK STREET PROPERTIES LLC
REAL ESTATE	0.36000	0.00000	0.00000
2 HOLY FAMILY MEMORIAL CANCER CENTER - ST VINCENT CANCER COLLABORATIVE
PROFESSIONAL CANCER CARE SERVICES	0.50000	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	HOLY FAMILY MEMORIAL INC	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	2300 WESTERN AVE PO BOX 1450	AddressLine1
City	MANITOWOC	City
State	WI	State
ZIP Code	542211450	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	HOLY FAMILY MEMORIAL INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
Eligibility Criteria Explained	1	EligibilityCriteriaExplained
Uses FPG Free	1	UsesFPGFree
FPG Free Percent	100.000000000000	FPGFreePercent
Uses FPG Discounted	1	UsesFPGDiscounted
FPG Discount Percent	200.000000000000	FPGDiscountPercent
Explains Basis	1	ExplainsBasis
Income Level	X	IncomeLevel
Asset Level	X	AssetLevel
Medical Indigency	X	MedicalIndigency
Insurance Status	X	InsuranceStatus
Uninsured Discount	X	UninsuredDiscount
Explains Application Method	1	ExplainsApplicationMethod
Includes Publicity Measures	1	IncludesPublicityMeasures
Available On Request	X	AvailableOnRequest
Other Publicity	X	OtherPublicity
Actions On Nonpayment	1	ActionsOnNonpayment
Collection Activities	0	CollectionActivities
Nondiscrim Emergency Care Policy	1	NondiscrimEmergencyCarePolicy
Used Other Method	X	UsedOtherMethod
Amounts Generally Billed	0	AmountsGenerallyBilled
Gross Charges	0	GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	2	NumberOfOtherFacilities

Other Facilities OtherFacilities (2 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType
HOLY FAMILY HEALTH SERVICES INC
3310 CALUMET AVENUE	MANITOWOC	WI	54220	RETAIL PHARMACY
NORTH END HOME MEDICAL SERVICES LLC
3310 CALUMET AVENUE	MANITOWOC	WI	54220	DURABLE MEDICAL EQUIPMENT

Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)

ExplanationExplanation	Return ReferenceReturnReference	IdentifierIdentifier
PART I, LINE 7: COMMUNITY BENEFITS ARE PROGRAMS OR ACTIVITIES THAT PROVIDE CARE AND/OR PROMOTE HEALTH AND HEALING AS A RESPONSE TO IDENTIFIED COMMUNITY NEEDS. HOLY FAMILY MEMORIAL'S COMMUNITY BENEFIT PROGRAMS INCLUDE SERVICES FOR THOSE WHO CAN NOT AFFORD HEALTH CARE AND INITIATIVES FOR IMPROVING HEALTH IN THE BROADER COMMUNITY. PROVIDING COMMUNITY BENEFITS DEMONSTRATES THAT HOLY FAMILY MEMORIAL IS FULFILLING ITS CHARITABLE MISSION AND DEMONSTRATING ITS PREFERENTIAL TAX STATUS IS DESERVED.
PERCENTAGE OF COMMUNITY BENEFIT EXPENSE TO OVERALL ENTITY'S EXPENSES.	SCHEDULE H, PART 1, LINE 7, COLUMN F
PART II: COMMUNITY BUILDING ACTIVITIES INDICATED IN PART II PROMOTE THE HEALTH OF THE MANITOWOC COMMUNITY BY ACTIVELY ADDRESSING EXPRESSED AND REPORTED ISSUES. SPECIFICALLY, THROUGH THE PROGRAMS INDICATED, HOLY FAMILY MEMORIAL AND IN PARTNERSHIP WITH OTHERS, WORKS DILIGENTLY TO ACHIEVE AN OVERALL HEALTHIER COMMUNITY. MAJOR INITIATIVES WITH DISCERNABLE POSITIVE RESULTS INCLUDE: IMPROVED ACCESS TO HEALTH INFORMATION AND PROVIDER RESOURCES, REDUCTION IN COMMUNITY FALLS, REDUCTION IN ADULT SMOKING POPULATION RATES, REDUCTION IN TEENAGE PREGNANCY RATES AND REDUCTION IN TEENAGE AND ADULT DRINKING RATES.
PART III, LINE 4: AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS ESTABLISHED ON AN AGGREGATE BASIS BY USING HISTORICAL WRITE-OFF FACTORS APPPLIED TO UNPAID ACCOUNTS BASED ON AGING. LOSS RATE FACTORS ARE BASED ON HISTORICAL LOSS EXPERIENCE AND ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE ORGANIZATION'S ABILITY TO COLLECT OUTSTANDING AMOUNTS. UNCOLLECTIBLE AMOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE.
PART III, LINE 8: HOLY FAMILY MEMORIAL IS A LICENSED MEDICARE PROVIDER WITH APPROXIMATLEY 46.8 PERCENT OF ITS PATIENT BASE QUALIFYING FOR THIS PROGRAM. AT PRESENT, THE REIMBURSEMENT RATE FOR THE MEDICARE PROGRAM DOES NOT FULLY COVER THE COST OF CARE TO THESE PATIENTS. THIS REPRESENTS THE ESTIMATED SHORTFALL CREATED WHEN HOLY FAMILY MEMORIAL RECEIVES PAYMENTS BELOW THE COSTS OF TREATING MEDICARE AND OTHER PUBLIC PROGRAM BENEFICIARIES.COST METHODOLOGY = COST TO CHARGE RATIO
PART III, LINE 9B: PAYMENT OPTIONS AS WELL AS COMMUNITY CARE ASSISTANCE IS NOTED ON ALL COLLECTION LETTERS, AS WELL AS INSURANCE BENEFIT PAPERWORK THAT IS SENT TO PATIENTS FOR INPATIENT, SDS, MRI, CT AND ER SERVICES. A PATIENT FINANCIAL ADVISOR AND/OR ELIGIBILITY SPECIALIST SEES SELF-PAY INPATIENTS TO INTERVIEW AND ADVISE PATIENTS OF ANY PROGRAMS THEY MAY QUALIFY FOR INCLUDING, BUT NOT LIMITED TO MEDICAID, VETERANS ADMINISTRATION, OR OUR OWN CHARITY CARE PROGRAM. IF THEY MAY QUALIFY FOR MEDICAID OR VETERANS ADMINISTRATION, THE ELIGIBILITY SPECIALIST WILL HELP THEM COMPLETE THE APPLICATION PROCESS AND FOLLOW UP ON THEIR APPLICATION THROUGH TO APPROVAL/DISAPPROVAL. FOR THE NETWORK CHARITY PROGRAM, AN APPLICATION IS PROVIDED AND THE PATIENT IS INSTRUCTED ON WHOM TO CALL FOR ASSISTANCE IN APPLYING. WHEN CONTACTING PATIENTS BY PHONE, THE PATIENT FINANCIAL ADVISOR IS TRAINED TO IDENTIFY PATIENTS WHO MAY QUALIFY FOR OUTSIDE STATE OR FEDERAL ASSISTANCE AND WILL DIRECT THOSE PATIENTS ON WHERE TO GO TO APPLY FOR THOSE PROGRAMS. THE ELIGIBILITY SPECIALIST WILL ASSIST AS WELL.
THROUGH ANALYTICAL TOOLS, A COLLECTION PREDICTION SCORE IS APPLIED TO ALL ACCOUNTS WRITTEN OFF TO BAD DEBT THROUGH A COLLECTION AGENCY. THOSE SCORING LOW/UNCOLLECTIBLE ARE ASSUMED CHARITY/COMMUNITY BENEFIT.	SCHEDULE H, PART III, LINE 3:
PART V, SECTION B, LINE 14G: HOLY FAMILY MEMORIAL'S COMMUNITY CARE PROGRAM IS COMMUNICATED ON THE HOSPITAL FACILITY'S WEBSITE SUMMARIZING THE ELIGIBILITY REQUIREMENTS TO INCLUDE SERVICES COVERED, INCOME GUIDELINES, APPLICATION FORM, AND OTHER DOCUMENTS NEEDED FOR COMPLETION OF THE APPLICATION. THE COMMUNITY CARE PROGRAM IS ALSO COMMUNICATED VIA PAYMENT GUIDELINE BROCHURES AVAILABLE IN THE REGISTRATION AREAS AT ALL HFM LOCATIONS THROUGHOUT THE COMMUNITY, AND TO PATIENTS IN COMMUNICATION WITH PRICE ESTIMATIONS AND COLLECTIONS, BOTH VERBAL AND WRITTEN. THE POLICY IS ALSO AVAILABLE UPON REQUEST.		HOLY FAMILY MEMORIAL INC
PART V, SECTION B, LINE 20D: THE HOSPITAL FACILITY USED THE AVERAGE OF ITS FIVE LOWEST NEGOTIATED COMMERCIAL INSURANCE RATES WHEN CALCULATING THE MAXIMUM AMOUNTS THAT CAN BE CHARGED.		HOLY FAMILY MEMORIAL INC
PART VI, LINE 2: HOLY FAMILY MEMORIAL UTILIZES FOUR DISTINCT PROCESSES TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITIES WE SERVE. FIRST, AS A PART OF THE ANNUAL STRATEGIC PLANNING PROCESS, AN ENVIRONMENTAL ASSESSMENT IS DONE. INCLUDED IN THAT REPORT AND ANALYSIS IS CURRENT POPULATION DATA INCLUDING DEMOGRAPHICS, UTILIZATION, MORTALITY INFORMATION, DEMAND FORECASTING, PREVALENT DISEASE STATES AND FEEDBACK FROM VARIOUS CONSTITUENCIES RELATIVE TO PERCEIVED MET AND UNMET COMMUNITY HEALTH NEEDS. SECOND, HOLY FAMILY MEMORIAL PARTICIPATES IN A TRI-ANNUAL FULL COMMUNITY HEALTH ASSESSMENT PROCESS IN CONJUNCTION WITH HEALTHIEST MANITOWOC COUNTY 2020. THIS ASSESSMENT CONSISTS OF INPUT OBTAINED FROM HUNDREDS OF COMMUNITY RESIDENTS, INCLUDING ALL AGE GROUPS, BEGINNING FROM HIGH SCHOOL AGE. THE INFORMATION IS TABULATED, ANALYZED AND UTILIZED TO DETERMINE PRIORITIZED HEALTH NEEDS. HOLY FAMILY MEMORIAL USES THIS INFORMATION IN ITS ANNUAL COMMUNITY BENEFIT PLANS. THIRD, HOLY FAMILY MEMORIAL CONDUCTS REGULAR INPUT SESSSIONS WITH LOCAL EMPLOYERS TO ASCERTAIN HEALTH NEEDS FROM AN OCCUPATIONAL HEALTH PERSPECTIVE. THIS INFORMATION IS THEN UTILIZED TO DEVELOP AND PROVIDE NEEDED EMPLOYER/EMPLOYEE HEALTH SERVICES THROUGHOUT THE BUSINESS COMMUNITY. LASTLY, HOLY FAMILY MEMORIAL UTILIZES A COMBINATION OF PATIENT FEEDBACK FROM ONGOING PATIENT SATISFACTION SURVEYS (CONDUCTED POST PROVISION OF SERVICES) AND COMMUNITY RESEARCH STUDIES COMMISSIONED BY HOLY FAMILY MEMORIAL, TO ASSESS PROGRAM AND SERVICE HEALTH CARE NEEDS OF THE COMMUNITY.
PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE AREAS / WEBSITE / BROCHURES / ADMISSIONS STAFF / COLLECTION CORRESPONDENTS AS WELL AS INSURANCE BENEFIT PAPERWORK THAT IS SENT TO PATIENTS FOR INPATIENT, SDS, MRI, CT SERVICES. A PATIENT FINANCIAL ADVISOR AND/OR ELIGIBILITY SPECIALIST SEES/COMMUNICATES TO SELF-PAY INPATIENTS TO INTERVIEW AND ADVISE PATIENT OF ANY PROGRAMS THEY MAY QUALIFY FOR INCLUDING, BUT NOT LIMITED TO MEDICAID, VETERANS ADMINISTRATION OR OUR OWN CHARITY PROGRAM. IF THEY QUALIFY FOR MEDICAID OR VETERANS ADMINISTRATION, WE ASSIST THEM IN COMPLETING THE APPLICATION AND FOLLOW UP ON THE APPLICATION THROUGH APPROVAL. FOR THE NETWORK CHARITY PROGRAM, AN APPLICATION IS PROVIDED WHICH INCLUDES WHOM TO CALL FOR ASSISTANCE IN APPLYING. WHEN CONTACTING PATIENTS BY PHONE, THE PATIENT FINANCIAL ADVISOR OR ELIGIBILITY SPECIALIST IS TRAINED TO IDENTIFY PATIENTS WHO MAY QUALIFY FOR OUTSIDE STATE OR FEDERAL ASSISTANCE AND WILL ASSIST THOSE PATIENTS ON APPLYING FOR THOSE PROGRAMS.
PART VI, LINE 4: THE COMMUNITY THAT HOLY FAMILY MEMORIAL SERVICES IS CONSIDERED TO BE LOCATED IN THE RURAL LAKESHORE REGION OF NORTHEAST WISCONSIN. THE PRIMARY SERVICE AREA IS MANITOWOC COUNTY WITH SECONDARY NEIGHBORING COUNTIES; BROWN, KEWAUNEE, CALUMET AND SHEBOYGAN. SPECIFICALLY, THE COMMUNITY SERVED IS AN OLDER POPULATION WITH 16% OF THE PEOPLE AGE 65 OR OLDER WITH MEDIAN HOUSEHOLD INCOME OF APPROXIMATELY $45,000. 14.5% OF OUR SERVICES ARE DEDICATED TO PROVIDING CARE TO MEDICAID AND SELF-PAY PATIENTS. THE 2013 SERVICE AREA IS EXPECTED TO REMAIN AT 2012 LEVELS WITH A SLIGHT GROWTH TOWARD THE 65+ AGE AND RETRACTION OF THOSE 18-44. REFLECTIVE OF THIS NUMBER IS THAT OVER 47% OF OUR SERVICES ARE DEDICATED TO PROVIDING CARE TO MEDICARE PATIENTS. THE COMMUNITY IS MAINLY CAUCASIAN WITH SEVERAL OTHER NATIONALITIES INCLUDING AFRICAN AMERICAN, ASIAN AND HISPANIC. OTHER PROVIDERS IN THE AREA CONSIST OF THE AURORA MEDICAL GROUP, MANITOWOC SURGERY CENTER, AND SEVERAL OTHER INDEPENDENT PROVIDERS.
PART VI, LINE 5: ALL OF HOLY FAMILY MEMORIAL'S BOARD MEMBERS RESIDE IN THE PRIMARY SERVICE AREA. THE BOARD CONSISTS OF COMMUNITY REPRESENTATIVES, PHYSICIANS AND REPRESENTATIVES OF THE SPONSOR ORGANIZATION. THE MEDICAL/DENTAL STAFF IS OPEN TO ALL QUALIFIED PROVIDERS WHO MEET THE REQUIREMENTS OF MEDICAL/DENTAL STAFF MEMBERSHIP. THE NETWORK OF PHYSICIANS AND OTHER PROVIDERS IS COMMITTED TO PROVIDING EACH PATIENT WITH THE HIGHEST LEVEL OF PERSONAL CARE, RESPECT AND COMPASSION TO ENHANCE THE PATIENT'S QUALITY OF LIFE AND HEALTH STATUS. ALL SURPLUS FUNDS ARE REINVESTED IN THE ORGANIZATION TO PURCHASE NECESSARY MEDICAL EQUIPMENT, COMPENSATE EMPLOYEES, AND PLAN FOR FUTURE NEEDS. NONE OF THE SUPRLUS EARNINGS BENEFIT ANY INDIVIDUALS OR OTHER CORPORATE ENTITIES.
PART VI, LINE 6: THE HEALTH CARE NETWORK IS SPONSORED BY THE FRANCISCAN SISTERS OF CHRISTIAN CHARITY, LOCATED AT HOLY FAMILY CONVENT, MANITOWOC, WISCONSIN. THE CONVENT, SITUATED ON SILVER LAKE, THREE MILES WEST OF LAKE MICHIGAN, IS HOME FOR OVER 350 CONGREGATION MEMBERS WHO SERVE THROUGHOUT THE UNITED STATES AND ARE PRIMARILY ENGAGED IN EDUCATION, PARISH AND HEALTH MINISTRIES. THE HEALTHCARE MINISTRY SPANS THREE STATES - WISCONSIN, NEBRASKA AND OHIO - AND HAS EXISTED FOR OVER 100 YEARS. THE MISSION OF THE FRANCISCAN SISTERS OF CHRISTIAN CHARITY HEALTHCARE MINISTRY IS TO CARRY OUT THE COMMITMENT OF THE SPONSOR IN THE HEALING MISSION OF THE CATHOLIC CHURCH THROUGH THE PROVISION OF QUALITY HEALTHCARE SERVICES TO THE PEOPLE OF GOD IN OUR COMMUNITIES.
WI,NE	PART VI, LINE 7	REPORTS FILED WITH STATES

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	1	RecordsMaintained

Form990 Schedule I Part III Form990ScheduleIPartIII (2 entries)

Type Of GrantTypeOfGrant	Number Of RecipientsNumberOfRecipients	Amount Of Cash GrantAmountOfCashGrant	Method Of ValuationMethodOfValuation
SCHOLARSHIPS	12	36100	ACTUAL TUITION COST
SCHOLARSHIPS - EDUCATION	7	8250	ACTUAL TUITION COST

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Explanation	HOLY FAMILY MEMORIAL'S SCHOLARSHIP PROGRAM IS DESIGNED AS A RECRUITMENT TOOL FOR EMPLOYMENT OF CANDIDATES IN SPECIFIED POSITIONS, CONSIDERED DIFFICULT TO FILL AND TO ASSIST STUDENTS IN THEIR PURSUIT OF A HEALTH CARE RELATED DEGREE. AREAS OF STUDY INCLUDE NURSING, PHARMACY, PHYSICAL THERAPY AND OTHERS. IN RETURN FOR THE SCHOLARSHIP, AN EMPLOYMENT SERVICE COMMITMENT IS MADE. IN ORDER TO BE ELIGIBLE: 1) STUDENTS MUST BE ACCEPTED INTO AN ACCREDITED PROGRAM 2) CANDIDATES MUST BE ATTENDING SCHOOL AS A FULL OR PART TIME STUDENT AND REMAIN IN THAT STATUS 3) STUDENTS MUST HAVE AND MAINTAIN A 3.0 CUMULATIVE GRADE POINT AVERAGE. SCHOLARSHIPS ARE AWARDED ON THE BASIS OF GRADE POINT AVERAGE, VERIFIED WITH OFFICIAL TRANSCRIPT OF GRADES, COMPLETION OF EMPLOYMENT APPLICATION AND PERSONAL INTERVIEW. THE SCHOLARSHIP IS USED FOR TUITION COST. THE SCHOLARSHIPS ARE GIVEN OUT EACH SEMESTER AND ARE PAID DIRECTLY TO THE SCHOOL THE STUDENT ATTENDS. APPLICANTS WHO ARE AWARDED THE SCHOLARSHIP MUST MAKE A SIX-MONTH COMMITMENT TO WORK AT HOLY FAMILY MEMORIAL FOR EACH SEMESTER THE SCHOLARSHIP IS AWARDED. THE SCHOLARSHIP RECIPIENT MUST REPAY THE FULL AMOUNT OF THE SCHOLARSHIP IF HE/SHE: 1) DROPS OUT OF SCHOOL 2) FALLS BELOW A 3.0 CUMULATIVE GRADE POINT AVERAGE 3) DOES NOT ACCEPT EMPLOYMENT 4) DOES NOT COMPLETE FULL LENGTH OF EMPLOYMENT COMMITMENT 5) DOES NOT OBTAIN WISCONSIN LICENSURE, AS REQUIRED. THE SCHOLARSHIP AWARD THROUGH EDUCATION ARE USED TO PROMOTE HEALTH CARE CAREERS. THE REQUIREMENTS FOR THE MEDICAL/DENTAL ENDOWMENT INCLUDE ACCEPTANCE AT AN ACCREDITED COLLEGE, UNIVERSITY, OR TECHNICAL SCHOOL, A MANITOWOC COUNTY RESIDENT, A GRADE POINT AVERAGE OF 3.0 OR ABOVE IS DESIRED, DEMONSTRATED HEALTH CAREER INTEREST AND FINANCIAL NEED. THESE SCHOLARSHIPS ARE OFFERED FOR ONE YEAR WITH POSSIBLE CONTINUATION BASED ON MEETING CRITERIA. THE CRITERIA FOR THE RONCALLI SCHOLARSHIP INCLUDES ACCEPTANCE AT AN ACCREDITED COLLEGE, UNIVERSITY, OR TECHNICAL SCHOOL, A MANITOWOC COUNTY RESIDENT, A GRADE POINT AVERAGE OF 3.0 OR ABOVE IS DESIRED, AND DEMONSTRATED HEALTH CAREER INTEREST. THESE SCHOLARSHIPS ARE PROVIDED FOR ONE YEAR.	Explanation

Schedule J IRS990ScheduleJ

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

Form990 Schedule J Part II Form990ScheduleJPartII (18 entries)

TitleTitle	Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
RYAN M DOPIRAK MD
PHYSICIAN COUNCIL CHAIR/PHYSICIAN	495011	0	598497	0	32348	0	9299	0	21293	0	1156448	0	15000	0
GARY SCHMIDT MD
DIRECTOR	164821	0	2875	0	17200	0	3892	0	13232	0	202020	0	0	0
PRADEEP GIRIYAPPA MD
DIRECTOR	185351	0	52410	0	31326	0	9299	0	18952	0	297338	0	15000	0
MICHAEL B MCCORMICK MD
DIRECTOR	270363	0	0	0	52465	0	9299	0	24262	0	356389	0	15000	0
JAMES W HOFTIEZER MD
DIRECTOR	304802	0	292320	0	9664	0	5549	0	24729	0	637064	0	0	0
WILLIAM D HAMPTON MD
DIRECTOR	286733	0	24960	0	22551	0	9299	0	19097	0	362640	0	0	0
MARY A GOVIER MD
DIRECTOR	169468	0	250	0	7933	0	3838	0	20535	0	202024	0	0	0
MARK P HERZOG
DIRECTOR, PRESIDENT, CEO	413994	0	45284	0	137633	0	92026	0	22481	0	711418	0	117698	0
PATRICIA HUETTL
CHIEF FINANCIAL OFFICER	219778	0	17661	0	2467	0	39460	0	22254	0	301620	0	0	0
STEVEN D DRIGGERS MD
CHIEF MEDICAL OFFICER	406996	0	36851	0	119855	0	80228	0	18939	0	662869	0	100548	0
MARY MAURER
CHIEF INNOVATION OFFICER	190009	0	16249	0	55526	0	40160	0	3176	0	305120	0	49237	0
MARCIA DONLON VP MEDICAL
CENTER/CHIEF NURSING OFFICER	132310	0	12758	0	21992	0	24283	0	20680	0	212023	0	0	0
KIRK DIMITRIS MD
PHYSICIAN	445245	0	702078	0	59708	0	9299	0	19273	0	1235603	0	10000	0
DAVID MIKOLYZK MD
PHYSICIAN	442225	0	342732	0	18558	0	9299	0	21155	0	833969	0	0	0
MILAN JORDAN MD
PHYSICIAN	297027	0	429247	0	33979	0	9299	0	11163	0	780715	0	0	0
NANCY N BUTLER MD
PHYSICIAN	299739	0	389929	0	48195	0	9299	0	10203	0	757365	0	15000	0
JEFFREY A JACOBY MD
PHYSICIAN	498680	0	737072	0	65512	0	9299	0	21411	0	1331974	0	15000	0
PATRICK J BRANDEL
FORMER CFO	0	0	0	0	105893	0	0	0	0	0	105893	0	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

Return ReferenceReturnReference	ExplanationExplanation
PART I, LINE 1A	ONE KEY EMPLOYEE WAS REIMBURSED $1,400 FOR SOCIAL CLUB DUES.
PART I, LINE 4A	PATRICK BRANDEL, FORMER CFO, RECEIVED SEVERANCE PAYMENTS TOTALING $105,893.
PART I, LINE 6	THE SENIOR SUCCESSSHARE PROGRAM IS AN AT RISK COMPENSATION PROGRAM WHICH IS BASED ON BALANCED STRATEGIC ACCOMPLISHMENTS AS APPROVED ANNUALLY BY THE COMPENSATION AND EVALUATION SUBCOMMITTEE OF THE BOARD OF DIRECTORS. ELIGIBLE PERSONS INCLUDE THE PRESIDENT/CEO, CHIEF MEDICAL OFFICER, CHIEF FINANCIAL OFFICER, AND CHIEF INNOVATION OFFICER.
PART I, LINE 7	A PORTION OF PHYSICIAN SALARY IS BASED ON INDIVIDUAL PRODUCTION PERSONALLY RENDERED SERVICES.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Bond ReferenceBondReferenceCd	Issuer EINIssuerEIN	CUSIP NumberCUSIPNumber	Date IssuedDateIssued	Issue PriceIssuePrice	Description Of PurposeDescriptionOfPurpose	DefeasedDefeased	On Behalf Of IssuerOnBehalfOfIssuer	Pool FinancingPoolFinancing
WISCONSIN HEALTH AND EDUCATION FACILITIES
A	391337855	97710VPE2	2003-09-09	9922000	SEE SCHEDULE K, PART V	0	0	0
WISCONSIN HEALTH AND EDUCATION FACILITIES
B	391337855	97710V2S6	2007-04-26	45170000	SEE SCHEDULE K, PART V	0	0	0

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Bond ReferenceBondReferenceCd	Amount RetiredAmountRetired	Total ProceedsTotalProceeds	Issuance Costs From ProceedsIssuanceCostsFromProceeds	Capital ExpendituresCapitalExpenditures	Year Of Subst CompletionYearOfSubstCompletion	Current RefundingCurrentRefunding	Advance RefundingAdvanceRefunding	Final Allocation MadeFinalAllocationMade	Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind	Amount In Reserve FundAmountInReserveFund	Refunding EscrowRefundingEscrow
A	1576000	9922000	244000	9677000	2006	0	0	1	1
B	3607000	45170000	485000	4990000	2009	1	1	1	1	3550000	16347000

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedProperty	Any Lease ArrangementsAnyLeaseArrangements	Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty	Any Research AgreementsAnyResearchAgreements	Bond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTest	Change In Use Bond Financed PropChangeInUseBondFinancedProp	Non Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
A	0	0	0	0	0	0	1
B	0	0	0	0	0	0	1

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiled	Rebate Not Due YetRebateNotDueYet	Exception To RebateExceptionToRebate	No Rebate DueNoRebateDue	Variable Rate IssueVariableRateIssue	Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds	Gross Proceeds Invested In GICGrossProceedsInvestedInGIC	Gross Proceeds InvestedGrossProceedsInvested	Written Proc To Monitor ReqsWrittenProcToMonitorReqs
A	0	0	0	1	1	0	0	0	1
B	0	0	0	1	0	0	0	0	1

Form990 Schedule K Part V Form990ScheduleKPartV (2 entries)

Bond ReferenceBondReferenceCd	Proc To Undertk Corrective ActionProcToUndertkCorrectiveAction
A	1
B	1

Form990 Schedule K Part VI Form990ScheduleKPartVI (3 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
SCHEDULE K PART IV, ARBITRAGE, LINE 2C	DATE REBATE COMPUTATION PERFORMED	ISSUER NAME: WISCONSIN HEALTH AND EDUCATION FACILITIES DATE THE REBATE COMPUTATION WAS PERFORMED: 10/06/2008 ISSUER NAME: WISCONSIN HEALTH AND EDUCATION FACILITIES DATE THE REBATE COMPUTATION WAS PERFORMED: 06/01/2012
PART I, LINE A, COLUMN F:		THE PURPOSE OF THE BOND ISSUE WAS A PROJECT CONSISTING OF THE CONSTRUCTION, RENOVATION AND EQUIPPING OF AMBULATORY CARE, DIAGNOSTIC IMAGING, REHABILITATION, OCCUPATIONAL MEDICINE, PRIMARY CARE AND ORTHOPEDIC FACILITIES AT CERTAIN HOLY FAMILY MEMORIAL HEALTH FACILITIES.
PART I, LINE B, COLUMN F:		THE PURPOSE OF THE BOND ISSUE WERE 1) THE ACQUISITION, CONSTRUCTION, RENOVATION, REMODELING AND EQUIPPING OF CERTAIN HOSPITAL AND OTHER HEALTHCARE FACILITIES AS IDENTIFIED IN A NOTICE OF PUBLIC HEARING PUBLISHED IN CONNECTION WITH THE ISSUANCE OF THE BONDS INCLUDING THE ACQUISITION OF TELEMETRY MONITORS AND AN MRI SYSTEM 2) THE CURRENT REFUNDING OF ALL THE WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY REVENUE (WHEFA) BONDS, SERIES 1995, 3) THE ADVANCE REFUNDING OF ALL OF THE WHEFA BONDS, SERIES 1998A, AND 4) THE ADVANCE REFUNDING OF A PORTION OF THE WHEFA BONDS, SERIES 2003A.

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (4 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
LINDA BRANDEL
SPOUSE OF FORMER CFO	14625	WAGES	0
CLAIRE JORDAN
SPOUSE OF HIGHEST COMPENSATED EMPLOYEE	32181	WAGES	0
NORTH END HOME MED SCS LLC
SERVE AS DIRECTORS ON BOTH ORGANIZATIONS	83211	100% OWNED LLC - INCOME FROM CONT. OPS	0
HOLY FAMILY HEALTH SERVICES
SERVE AS DIRECTORS ON BOTH ORGANIZATIONS	-6745	100% OWNED FOR PROFIT - INCOME FROM CONT. OPS	0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 6	HOLY FAMILY MEMORIAL IS SPONSORED BY FRANCISCAN SISTERS OF CHRISTIAN CHARITY SPONSORED MINISTRIES, INC. WHICH IS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7A	HOLY FAMILY MEMORIAL OPERATES AN INTEGRATED HEALTHCARE DELIVERY SYSTEM, PRIMARILY TO THE RESIDENTS OF MANITOWOC COUNTY, WISCONSIN. HOLY FAMILY MEMORIAL IS OPERATED BY FRANCISCAN SISTERS OF CHRISTIAN CHARITY SPONSORED MINISTRIES, INC., WHICH IS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION. FRANCISCAN SISTERS OF CHRISTIAN CHARITY SPONSORED MINISTRIES, INC. IS A NOT-FOR-PROFIT HEALTHCARE HOLDING COMPANY INCORPORATED TO MONITOR AND MANAGE HEALTHCARE OPERATIONS. THE BOARD OF DIRECTORS SHALL CONSIST OF NO MORE THAN EIGHTEEN INDIVIDUALS. THE PRESIDENT OF THE CORPORATION AND CHAIR OF THE PHYSICIAN COUNCIL SHALL BE EX-OFFICIO MEMBERS WITH FULL VOTING PRIVILEGES. IN ADDITION TO THE EX-OFFICIO BOARD POSITIONS, THE BOARD OF DIRECTORS SHALL INCLUDE FOUR MEMBERS OF FRANCISCAN SISTERS OF CHRISTIAN CHARITY AND AT LEAST FOUR PHYSICIANS.
FORM 990, PART VI, SECTION A, LINE 7B	SOME DECISIONS OF THE GOVERNING BODY ARE SUBJECT TO APPROVAL BY THE MEMBER AS OUTLINED IN THE CORPORATE BYLAWS. FOR EXAMPLE, THE GOVERNING BOARD SUBMITS NAMES OF NEW BOARD MEMBERS TO THE MEMBER AND THE MEMBER APPOINTS THEM. APPROVAL OF THE PHILOSOPHY, MISSION & VISION STATEMENTS, MORTGAGE, LEASE OR SALE OF REAL ESTATE MUST BE APPROVED BY THE MEMBER. A CERTIFIED AUDIT OF CORPORATE FUNDS OR THE ANNUAL FISCAL AUDITOR MUST BE APPROVED BY THE MEMBER, ETC.
FORM 990, PART VI, SECTION B, LINE 11	THE CHAIR OF THE GOVERNING BOARD REVIEWS THE 990 PRIOR TO FILING. AN OVERVIEW OF THE 990 ALONG WITH SPECIFIC SECTIONS ON GOVERNANCE, COMMUNITY BENEFITS, AND CONFLICT OF INTEREST IS PRESENTED TO THE BOARD OR BOARD COMMITTEE. THE COMPENSATION AND EVALUATION SUBCOMMITTEE REVIEWS THE 990 SECTIONS RELATED TO COMPENSATION PRIOR TO FILING. COPIES ARE AVAILABLE TO ALL BOARD MEMBERS.
FORM 990, PART VI, SECTION B, LINE 12C	ANNUALLY, GOVERNING BOARD MEMBERS ARE PROVIDED A COPY OF THE CONFLICT OF INTEREST POLICY TO REVIEW AND SIGN THE CERTIFICATION ON WHICH THEY DISCLOSE ANY CONFLICTS. AT EACH BOARD OR COMMITTEE MEETING WHERE THERE WILL BE A VOTE, THE CHAIRPERSON ASKS IF THERE ARE ANY CONFLICTS TO THE PARTICULAR ISSUE. IF THERE IS A CONFLICT, THAT PERSON ABSTAINS FROM DISCUSSION & VOTING. ALL PHYSICIANS, NETWORK LEADERS, AND KEY EMPLOYEES SIGN A CONFLICT OF INTEREST ANNUALLY. CONFLICT OF INTEREST IS MONITORED THROUGH HOLY FAMILY MEMORIAL'S COMPLIANCE DEPARTMENT.
FORM 990, PART VI, SECTION B, LINE 15	LINES 15 A & B - HOLY FAMILY MEMORIAL HAS A SENIOR LEADER COMPENSATION POLICY. THE PROCESS OF DETERMINING THESE SALARIES ARE GOVERNED BY THE COMPENSATION AND EVALUATION SUBCOMMITTEE OF THE BOARD. THE POLICY COVERS THE FOLLOWING POSITIONS: PRESIDENT AND CEO, CHIEF FINANCIAL OFFICER, CHIEF MEDICAL OFFICER, AND CHIEF INNOVATION OFFICER. EXECUTIVE SALARY DATA IS EVALUATED(LAST DONE 12/10/12) USING THREE OR MORE MAIN DATA SOURCES FROM NATIONALLY RECOGNIZED EXECUTIVE COMPENSATION FIRMS. TOTAL COMPENSATION FOR EACH SENIOR LEADER (SALARY, BENEFITS AND INCENTIVE) IS EVALUATED FOR MEMBERS OF THE SENIOR LEADERSHIP TEAM. ALSO CONSIDERED ARE CURRENT MARKET CONDITIONS, INDEPENDENT CONSULTANT INPUT, EXTERNAL NATIONAL COMPENSATION DATA, AND MARKET COMPETITIVENESS. THE POLICY REFLECTS HFM'S MISSION AND VALUES AND THE LOCAL COMMUNITY EXPERIENCE BY EMPHASIZING REWARDS BASED ON WELL ROUNDED ACCOMPLISHMENTS IN THE AREAS OF MISSION AND RELATIONSHIPS, KEY STRATEGIES, AND OPERATIONS.
FORM 990, PART VI, SECTION C, LINE 19	HOLY FAMILY MEMORIAL'S ARTICLES OF INCORPORATION ARE PUBLICLY AVAILABLE FROM THE WI DEPARTMENT OF FINANCIAL INSTITUTIONS. THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST. HOLY FAMILY MEMORIAL'S FINANCIAL STATEMENTS ARE AVAILABLE ON THE DACBOND.COM WEBSITE AND HOLY FAMILY MEMORIAL SUBMITS FINANCIAL INFORMATION TO THE STATE OF WI ANNUALLY. OUR FORM 990 IS AVAILABLE UPON REQUEST AND CAN BE SEEN ON THE GUIDESTAR WEBSITE.
FORM 990, PART VII, SECTION A, PART 1A LINES 1 THROUGH 7:	HOLY FAMILY MEMORIAL'S BOARD OF DIRECTORS INCLUDES SEVEN EMPLOYED PHYSICIANS. THE COMPENSATION REPORTED FOR THESE DIRECTORS IS FOR THEIR SERVICES AS A PHYSICIAN.
FORM 990, PART XI, LINE 9:	CHANGE IN RESTRICTED ASSETS 277,649. RESTRICTED DONATIONS RECORDED TO BALANCE SHEET -59,455. ROUNDING 9.	CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XII, LINE 2C:	THE ORGANIZATION HAS NOT CHANGED ITS OVERSIGHT PROCESS OR SELECTION PROCESS DURING THE TAX PROCESS.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

Field	Value	IRS element (for citing)
Business Name Line1	NORTH END HOME MED SCS LLC	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	3310 CALUMET AVENUE	AddressLine1
City	MANITOWOC	City
State	WI	State
ZIP Code	54220	ZIPCode

Field	Value	IRS element (for citing)
EIN	391868808	EIN
Primary Activities	MEDICAL EQUIPMENT	PrimaryActivities
Legal Domicile State	WI	LegalDomicileState
Total Income	-5153	TotalIncome
EOY Assets	2067315	EOYAssets

Direct Controlling Entity Name DirectControllingEntityName

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

Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Direct Controlling Entity NADirectControllingEntityNA	Controlled OrgControlledOrg
FRANCISCAN SISTERS OF CHRISTIAN CHARITY
1415 SOUTH RAPIDS ROAD	MANITOWOC	WI	54220	391530622	HEALTHCARE	WI	501(C)(3)	LINE 1	N/A	0
ST PAUL ELDER SERVICES INC
316 EAST 14TH STREET	KAUKAUNA	WI	54130	391029149	ELDER CARE	WI	501(C)(3)	LINE 1	N/A	0
GOOD SAMARITAN MEDICAL CENTER
800 FOREST AVENUE	ZANESVILLE	OH	43701	314379479	HOLDING CO.	OH	501(C)(3)	LINE 3	N/A	0
FRANCISCAN CARE SERVICES INC
430 N MONITOR ST	WEST POINT	NE	68788	470486026	HEALTHCARE	NE	501(C)(3)	LINE 3	N/A	0
SILVER LAKE COLLEGE OF THE HOLY FAMILY INC
2406 SOUTH ALVERNO ROAD	MANITOWOC	WI	54220	390980974	HIGHER EDUCATION	WI	501(C)(3)	LINE 2	N/A	0
HOLY FAMILY CONVENT OF THE FRANCISCAN SISTERS OF CHRISTIAN CHARITY
2409 SOUTH ALVERNO ROAD	MANITOWOC	WI	54220	390808523	RELIGIOUS	WI	501(C)(3)	LINE 1	N/A	0

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

Field	Value	IRS element (for citing)
Business Name Line1	HOLY FAMILY HEALTH SERVICES	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	3310 CALUMET AVENUE	AddressLine1
City	MANITOWOC	City
State	WI	State
ZIP Code	54220	ZIPCode

Field	Value	IRS element (for citing)
EIN	391572253	EIN
Primary Activity	PHARMACY	PrimaryActivity
Legal Domicile State	WI	LegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	HOLY FAMILY MEMORIAL INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Type Of Entity	C	TypeOfEntity
Share Of Total Income	49928	ShareOfTotalIncome
Share Of EOY Assets	1344357	ShareOfEOYAssets
Percentage Ownership	1.00000	PercentageOwnership
Controlled Org	0	ControlledOrg

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

Transactions Related Orgs Table TransactionsRelatedOrgsTable (8 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved	Method Of Amt DeterminationMethodOfAmtDetermination
HOLY FAMILY HEALTH SERVICES - INTEREST ON LOAN
A	0	ACTUAL EXPENSE
HOLY FAMILY HEALTH SERVICES - HFM LOAN TO HOLY FAMILY HEALTH SERVICES
D	0	LOAN BALANCE PAID OFF JAN 2012
HOLY FAMILY HEALTH SERVICES - REIMBURSEMENT OF SALARYBENEFITSUPPLIESRENT
Q	1109554	ACTUAL EXPENSE
FRANCISCAN SISTERS OF CHRISTIAN CHARITY - BUILDING RENT
J	51000	ACTUAL EXPENSE
FRANCISCAN SISTERS OF CHRISTIAN CHARITY - AUDIT FEES
P	89600	ACTUAL EXPENSE
FRANCISCAN SISTERS OF CHRISTIAN CHARITY - ADMINISTRATIVE SERVICES
P	704000	ACTUAL EXPENSE
FRANCISCAN SISTERS OF CHRISTIAN CHARITY-LIABBUILDINGWORKERS COMP INSURANC
P	1406934	ACTUAL EXPENSE
FRANCISCAN SISTERS OF CHRISTIAN CHARITY - HEALTH INSURANCE PREMIUMS
P	10481000	ACTUAL EXPENSE