2013-05-15T15:47:32-05:00 2012-06-30 390758449 WIPFLI LLP 10000 INNOVATION DRIVE SUITE 250 MILWAUKEE WI 532264837 990 2011-07-01 390816845 UNITED HOSPITAL SYSTEM INC UNIT 2625778113 6308 8TH AVENUE KENOSHA WI 53143 THOMAS J KELLEY 2625778113 2013-05-15 1 JAY ADKISSON CPA P01360892 4144319300 2013-05-15 2011 2016-02-24 21:20:13Z THOMAS J KELLEY 6308 8TH AVENUE KENOSHA WI 53143 331067628 0 X WWW.UNITEDHOSPITALSYSTEM.ORG X 1910 WI UNITED HOSPITAL SYSTEM, INC. IS COMMITTED TO LIVING OUT THE HEALING MINISTRIES OF THE JUDEO-CHRISTIAN FAITHS BY PROVIDING EXCEPTIONAL AND COMPASSIONATE HEALTHCARE SERVICES THAT PROMOTES THE DIGNITY AND WELL-BEING OF THE PEOPLE WE SERVE. THIS IS OUR MISSION AND OUR REASON FOR BEING. WE STRIVE TO RECRUIT AND RETAIN THE BEST PHYSICIANS AND STAFF AND PURCHASE THE BEST DIAGNOSTIC AND CURATIVE MEDICAL EQUIPMENT THAT OUR FINANCIAL RESOURCES WILL PERMIT. WE ALSO STRIVE TO BE ACCESSIBLE TO ALL MEMBERS OF OUR COMMUNITY WITH EMERGENT AND URGENT HEALTHCARE NEEDS, IRRESPECTIVE OF THEIR ABILITY TO PAY. THIS IS OUR COMMITTMENT TO THE QUALITY, ACCESSIBILITY AND AFFORDABILITY FUNDAMENTALS AFFECTING THE DELIVERY OF HEALTHCARE. 14 11 2509 151 234491 -16528 39070 100831 284810928 303624543 2566994 1028282 710808 628391 288127800 305382047 9395 11745 0 0 142050026 144860983 0 0 0 124744225 132539069 266803646 277411797 21324154 27970250 311712686 323780841 80483668 118963026 231229018 204817815 X UNITED HOSPITAL SYSTEM, INC. IS A COMPREHENSIVE REGIONAL HEALTHCARE SYSTEM THAT HAS SERVED SOUTHEASTERN WISCONSIN AND NORTHERN ILLINOIS COMMUNITIES FOR MORE THAN 100 YEARS. UNITED HOSPITAL SYSTEM PROVIDES SERVICES PRIMARILY THROUGH THE KENOSHA MEDICAL CENTER CAMPUS AND THE ST. CATHERINE'S MEDICAL CENTER CAMPUS AND SEVERAL OTHER CLINIC LOCATIONS. WE, AT UNITED, ARE COMMITTED TO LIVING OUT THE HEALING MINISTRIES OF THE JUDEO-CHRISTIAN FAITHS BY PROVIDING EXCEPTIONAL AND COMPASSIONATE HEALTHCARE SERVICES THAT PROMOTES THE DIGNITY AND WELL BEING OF THE PEOPLE WE SERVE. THIS IS OUR MISSION AND OUR REASON FOR BEING. 0 0 233699858 11745 304031583 ACUTE CARE HOSPITAL THAT PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES TO ITS COMMUNITY. 233699858 1 1 0 0 0 0 0 0 0 1 1 1 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 1 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 1 68 0 1 2509 1 1 1 0 0 0 0 1 1 0 0 0 0 X 14 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 1 1 0 WI X THE ORGANIZATION 2625778113 6308 8TH AVENUE KENOSHA WI 53143 JAMES ARNESON 2.00 X X 0 0 0 DR F GREGORY CAMPBELL 2.00 X X 0 0 0 ROBERT A CORNOG 2.00 X X 0 0 0 RICHARD O SCHMIDT JR 45.00 X X 1033643 0 155434 EDWARD C EMMA 2.00 X 0 0 0 HAROLD W MAYER 2.00 X 0 0 0 A JAMES CICCHINI 2.00 X 0 0 0 JAMES CONCANNON MD 2.00 X 0 0 0 DON E KAELBER 2.00 X 0 0 0 RAYMOND KNIGHT MD 2.00 X 738397 0 51038 ROBERT LEE JR 2.00 X 0 0 0 JOSEPH F MADRIGRANO SR 2.00 X 0 0 0 LAWRENCE REIF MD 2.00 X 0 0 0 W HARLEY SOBIN MD 2.00 X 978181 0 51675 LINDA WOHLGEMUTH 45.00 X 421317 0 63429 CHARLES TALBERT - THRU JUN 2011 45.00 X 179352 0 33434 THOMAS KELLEY - BEGIN JUL 2011 45.00 X 225939 0 73594 SUSAN VENTURA 45.00 X 422309 0 63429 ASHWANI SETHI MD 40.00 X 977629 0 52054 MARIO GARRETTO MD 40.00 X 929846 0 52543 KATHERINE ABBO MD 40.00 X 600254 0 37787 RAMANUJA MANDA MD 40.00 X 597722 0 51572 WENDEL FRIEDL MD 40.00 X 937850 0 52566 8042439 0 738555 111 0 1 0 ECLIPSYS CORP PO BOX 8538 133 PHILADELPHIA PA 19171 IS SERVICES 2518604 H M P OF KENOSHA COUNTY LTD PO BOX 645037 CINCINNATI OH 45264 MEDICAL 1565263 QUEST DIAGNOSTICS 3924 COLLECTION CENTER DR CHICAGO IL 60693 MEDICAL 1262753 ALL SAINTS PO BOX 14759 MILWAUKEE WI 53214 MEDICAL 748414 WHEATON FRANCISCAN HEALTHCARE PO BOX 14759 MILWAUKEE WI 53214 MEDICAL 668174 29 23265 77566 100831 NET PATIENT SERVICE RE 623000 298212244 298212244 OTHER OPERATING REVENU 623990 5412299 5177808 234491 303624543 1273276 1273276 641531 0 641531 641531 641531 25230607 155000 25428202 202399 -197595 -47399 -244994 -244994 41840 23265 54980 -13140 -13140 305382047 304031583 234491 1015142 11745 11745 4491171 3562053 929118 110330756 92842390 17488366 6510943 5478903 1032040 16437005 6574782 9862223 7091108 5922587 1168521 13904719 8695588 5209131 343946 152945 191001 52995205 50434173 2561032 4669454 4669454 6224494 6105086 119408 567694 154874 412820 1192513 1073262 119251 15725243 14152719 1572524 1027164 440126 587038 BAD DEBTS 20309686 20309686 STATE HOSPITAL ASSESSME 7966879 7966879 REPAIRS 2098909 1480562 618347 GROCERIES 1710583 236222 1474361 3802580 3435822 366758 277411797 233699858 43711939 0 20231914 47819261 34535648 36239122 3582164 4213110 3612675 4212357 250122998 163970349 89867452 86152649 90616034 81786222 69266799 63358120 311712686 323780841 28597704 28493220 23675025 16378570 28210939 74091236 80483668 118963026 X 229216892 202778673 495243 520158 1516883 1518984 231229018 204817815 311712686 323780841 X 27970250 -54381453 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2012126 38761 11745 2039142 1998034 23485 9395 2012124 1973518 46211 21695 1998034 1955842 33529 15853 1973518 0.74000 0.26000 0 0 5519546 5519546 114805242 77447615 37357627 123948289 84920154 39028135 5849921 1602580 4247341 86152649 CASH EQUIVLENTS 8980022 C CERTIFICATE OF DEPOSIT 15000000 C FIXED INCOME FUNDS 19858253 C EQUITY MUTUAL FUNDS 29789964 C EQUITY SECURITIES 8157983 C 81786222 DUE FROM AFFILIATE 63358120 63358120 DEFERRED COMPENSATION 8067658 PENSION LIABILITY 66023578 74091236 305382047 277411797 27970250 -906169 -53475284 -54381453 -26411203 259560202 -906169 -44915676 -45821845 305382047 0 305382047 279655242 2398466 2398466 277256776 155021 155021 277411797 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: TEMPORARILY RESTRICTED NET ASSETS ARE RESTRICTED FOR EDUCATION SCHOLARSHIP GRANTS AND VARIOUS HEALTH CARE PROGRAMS. PERMANENTLY RESTRICTED NET ASSETS ARE TO BE HELD IN PERPETUITY, THE INCOME FROM WHICH IS EXPENDABLE FOR HOSPITAL DEVELOPMENT. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE CORPORATION DETERMINES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION ON THE TECHNICAL MERITS OF THE POSITION, ASSUMING THAT TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE LIKELY THAN NOT RECOGNITION THRESHOLD, THE BENEFIT OF THAT POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. THE CORPORATION RECORDED NO ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS IN 2011 AND 2010. TAX RETURNS FOR THE YEARS ENDED JUNE 30, 2008 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN MINIMUM PENSION OBLIGATION -44,964,082. REVENUE SHARING WITH AFFILIATE -8,654,478. MACRS DEPRECIATION ADJUSTMENT 143,276. TOTAL TO SCHEDULE D, PART XI, LINE 8: -53,475,284. PART XII, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN PENSION OBLIGATION OTHER THAN PENSION EXPENSE -44,964,082. REVENUE SHARING WITH AFFILIATE -8,654,478. SCHOLARSHIPS INCLUDED IN INCOME -11,745. RELATED ORGANIZATION REVENUE 8,671,360. FUNDRAISING EVENT EXPENSES 43,269. PART XIII, LINE 2D - OTHER ADJUSTMENTS: RELATED ORGANIZATION EXPENSES 2,355,197. FUNDRAISING EVENT EXPENSES 43,269. PART XIII, LINE 4B - OTHER ADJUSTMENTS: SCHOLARSHIPS INCLUDED IN INCOME 11,745. MACRS DEPRECIATION ADJUSTMENT 143,276. GOLF OUTING 65105 23265 41840 1100 8333 32080 13467 65105 23265 41840 1100 8333 32080 13467 54980 -13140 1 1 X 1 X 1 X 1 1 1 0 1 1 3421669 3421669 0.01330 42738413 25037152 17701261 0.06880 46160082 25037152 21122930 0.08210 554 62481 108319 108319 0.00040 78 660688 660688 0.00260 26 547 242132 242132 0.00090 580 63106 1011139 1011139 0.00390 580 63106 47171221 25037152 22134069 0.08600 1 1971 1971 0.00000 37 144518 144518 0.00050 10 150 1314 1314 0.00000 11 187 147803 147803 0.00050 1 7128699 0 46926231 62961424 -16035193 X 1 1 2 1 KENOSHA MEDICAL CENTER CAMPUS

6308 8TH AVENUE KENOSHA WI 53143

X X X 2 SAINT CATHERINE'S MEDICAL CENTER CAMPUS

9555 76TH STREET PLEASANT PRAIRIE WI 53158

X X X KENOSHA MEDICAL CENTER CAMPUS 1 0 1 1 200.000000000000 1 200.000000000000 1 X X X X X 1 1 X 1 X 1 X X X 1 X 0 0 SAINT CATHERINE'S MEDICAL CENTER CAMPUS 2 0 1 1 200.000000000000 1 200.000000000000 1 X X X X X 1 1 X 1 X 1 X X X 1 X 0 0 8 KENOSHA NORTHSIDE CLINIC

3601 30TH AVENUE SUITE 205 KENOSHA WI 53143

OUTPATIENT PHYSICIAN CLINIC PADDOCK LAKE FAMILY MEDICINE CLINIC

7322 236TH AVENUE PADDOCK LAKE WI 53168

OUTPATIENT PHYSICIAN CLINIC THE GURNEE CLINIC

1790 NATIONS DRIVE SUITE 106 GURNEE IL 60031

OUTPATIENT PHYSICIAN CLINIC LAKEVIEW RECPLEX

9900 TERWALL TERRACE PLEASANT PRAIRIE WI 53158

REHABILITATION CLINIC VERNON ELEMENTARY SCHOOL - POOL AREA

8518 22ND AVENUE KENOSHA WI 53143

REHABILITATION CLINIC NORTH CENTRAL CLINIC

6127 GREEN BAY ROAD SUITE 200 KENOSHA WI 53142

OUTPATIENT PHYSICIAN CLINIC SCMCC-MMB

9697 ST CATHERINES DRIVE PLESANT PRAIRIE WI 53158

OUTPATIENT PHYSICIAN CLINIC RCW ADMINISTRATIVE BUILDING

5000 68TH AVE KENOSHA WI 53144

ADMINISTRATIVE BUILDING PART I, LINE 7: THE COST METHOD USED TO CALCULATE THE COST OF THE COMMUNITY BENEFIT PROGRAMS WAS THE COST-TO-CHARGE RATIO. WORKSHEET 2 WAS USED TO CALCULTE THE RATIO OF PATIENT CARE COST TO CHARGES. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 20309686. PART II: MANY STAFF MEMBERS ARE UTILIZED TO PROMOTE THE HEALTH OF THE COMMUNITY AND THE GENERAL WELL-BEING OF THE COMMUNITY WE SERVE. THROUGH OUR EMERGENCY PREPAREDNESS COMMITTEE, STAFF ARE ALWAYS PLANNING AND PREPARING TO BE READY TO MEET THE NEEDS OF THE COMMUNITY AS EVENTS OCCUR. ADDITIONALLY, A VARIETY OF STAFF WORK WITH LOCAL SCHOOLS AND OTHER ORGANIZATIONS TO GIVE TALKS PROMOTING HEALTH AND CAREERS IN HEALTHCARE. A NUMBER OF STAFF MEMBERS ARE INVOLVED IN MENTORING PROGRAMS WITHIN THE LOCAL SCHOOLS. RECOGNIZING THE IMPORTANCE OF SUSTAINING AND GROWING OUR ECONOMY, WE PARTICIPATE IN OUR LOCAL BUSINESS ALLIANCE. PART III, LINE 4: MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY UNINSURED PATIENTS AND AMOUNTS PATIENTS ARE PERSONALLY RESPONSIBLE FOR, THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO A VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF HISTORICAL COLLECTION EXPERIENCE AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUTSTANDING AFTER MANAGEMENT HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO PATIENT ACCOUNTS RECEIVABLE. WORKSHEET A IN THE INSTRUCTIONS WAS USED TO DETERMINE THE COSTING METHODOLOGY. PART III, LINE 8: SCHEDULE H PART III SECTION B LINE 6 REPORTS "ALLOWABLE COSTS OF CARE" AS TAKEN FROM THE MOST RECENTLY FILED MEDICARE COST REPORT AVAILABLE AT THE TIME THE COMMUNITY BENEFIT REPORT IS PUBLISHED. THE MEDICARE COST REPORT CALCULATES ITS ALLOWABLE TOTAL COSTS BASED ON APPLICABLE MEDICARE REGULATIONS. MEDICARE AND MEDICAID COST IS DETERMINED USING INDIVIDUAL COST CENTER COST-TO-CHARGE RATIOS. THIS COST TO CHARGE RATIO IS DETERMINED USING ALL PAYER COST AND ALL PAYER CHARGES. THE COST TO CHARGE RATIO IS APPLIED TO THE ACTUAL MEDICARE AND MEDICAID CHARGES TO DETERMINE THE MEDICARE AND MEDICAID COST. THIS ORGANIZATION HAS ADOPTED THE COST AND CHARGE PRACTICES AS RECOMMENDED BY THE CATHOLIC HEALTH ASSOCIATION AND THE WISCONSIN, IOWA, OR ILLINOIS HOSPITAL ASSOCIATION AS APPLICABLE, AND THEREFORE, DOES NOT COUNT ANY MEDICARE SHORTFALL NUMBERS IN ITS ANNUAL REPORTING OF COMMUNITY BENEFIT AMOUNTS. PART III, LINE 9B: OUR COLLECTION PROCESS IS THE SAME FOR ALL PATIENTS, REGARDLESS IF THEY QUALIFY FOR FINANCIAL ASSISTANCE. WE BILL ALL INSURANCES. PATIENT DOES NOT RECEIVE A COPY OF THE BILL UNTIL IT IS THEIR BALANCE. WE SEND THREE STATEMENTS FROM OUR FINANCIAL SYSTEM. WE HAVE AN OUTSIDE COLLECTION AGENCY SEND OUT OUR REQUIRED FINAL REQUEST LETTERS. FROM THIS POINT THE OUTSTANDING BALANCE IS HANDLED BY THE COLLECTION AGENCY. THE ACCOUNT DOES STAY ACTIVE ON OUR FINANCIAL SYSTEM FOR ONE YEAR. AT THAT TIME THE OUTSTANDING BALANCE IS MOVED OVER TO A BAD DEBT STATUS. KENOSHA MEDICAL CENTER CAMPUS PART V, SECTION B, LINE 19D: SELF-PAY PATIENTS ARE OFFERED A FLAT DISCOUNT AND A PROMPT PAY DISCOUNT OFF BILLED SERVICES. MEANS TEST IS APPLIED TO DETERMINE IF ADDITIONAL DISCOUNTING IS POSSIBLE. PAYMENT AMOUNT IS DETERMINED BASED UPON 2012 HSS POVERTY GUIDELINES. SAINT CATHERINE'S MEDICAL CENTER CAMPUS PART V, SECTION B, LINE 19D: SELF-PAY PATIENTS ARE OFFERED A FLAT DISCOUNT AND A PROMPT PAY DISCOUNT OFF BILLED SERVICES. MEANS TEST IS APPLIED TO DETERMINE IF ADDITIONAL DISCOUNTING IS POSSIBLE. PAYMENT AMOUNT IS DETERMINED BASED UPON 2012 HSS POVERTY GUIDELINES. PART VI, LINE 2: IN AN EFFORT TO UNDERSTAND AND ASSIST IN ADDRESSING THE NEEDS OF THE COMMUNITY WE SERVE, UNITED HOSPITAL SYSTEM HAS INVOLVEMENT IN A VARIETY OF COMMUNITY COMMITTEES. UNITED HOSPITAL SYSTEM HAS MULTIPLE STAFF, MANAGEMENT AND ADMINISTRATIVE LEVEL EMPLOYEES PARTICIPATE IN COMMITTEES THAT ARE SET UP TO ASSESS AND ADDRESS NEEDS IN THE COMMUNITY SUCH AS A HEALTHY LIFESTYLE COMMITTEE, MENTAL HEALTH COMMITTEE, INJURY PREVENTION COMMITTEE, SUICIDE PREVENTION COMMITTEE, INFANT MORTALITY COMMITTEE. THROUGH OUR PARTICIPATION IN COMMUNITY COMMITTEES WE GAIN AN UNDERSTANDING ABOUT THE NEEDS OF THE COMMUNITY AS WELL AS THE OPPORTUNITY TO WORK TOGETHER TO ADDRESS THE NEEDS. PART VI, LINE 3: WHEN STATEMENTS ARE SENT FROM OUR FINANCIAL SYSTEM, THERE IS A PHONE NUMBER FOR THE PATIENT TO CALL FOR ASSISTANCE WITH THEIR BALANCES. PATIENTS CALL AND WE WORK WITH THEM TO SET UP PAYMENT ARRANGEMENTS. IF THEY EXPRESS ANY CONCERNS FOR FINANCIAL NEEDS WE OFFER TO SEND THEM A COMMUNITY CARE APPLICATION. PART VI, LINE 4: KENOSHA COUNTY IS A FAST GROWING LAKESHORE COUMMUNITY IN SOUTHEASTERN WISCONSIN. LOCATED BETWEEN CHICAGO AND MILWAUKEE, KENOSHA COUNTY BOASTS A DIVERSE ECONOMY. KENOSHA IS THE FOURTH LARGEST CITY IN THE STATE OF WISCONSIN WITH 99,218 RESIDENTS REPORTED IN THE 2010 CENSUS. KENOSHA IS NOW THE EIGHTH LARGEST COUNTY IN WISCONSIN IN TERMS OF POPULATION WITH 166,426 RESIDENTS. UNITED HOSPITAL SYSTEM SERVES PEOPLE IN SOUTHEASTERN WISCONSIN AND NORTHERN ILLINOIS THROUGH ITS TWO HOSPITAL CAMPUSES, ST CATHERINE'S MEDICAL CENTER AND KENOSHA MEDICAL CENTER. AURORA MEDICAL CENTER ALSO HAS A HOSPITAL CAMPUS IN KENOSHA. PART VI, LINE 5: UNITED HOSPITAL SYSTEM IS COMMITTED TO IMPROVING THE HEALTH OF OUR PATIENTS AND NEIGHBORS. WE OFFER A VARIETY OF COMMUNITY OUTREACH PROGRAMS TO HELP THE GENERAL PUBLIC MAINTAIN GOOD HEALTH. THESE INCLUDE FREE COMMUNITY EDUCATION SEMINARS, HEALTH SCREENINGS, AND VARIOUS SUPPORT GROUPS. 0 X SCHOLARSHIP FINANCIAL ASSISTANCE TO INDIVIDUALS 11 11745 X X 0 0 0 0 0 0 0 0 0 RICHARD O SCHMIDT JR 707668 0 312948 0 13027 0 130870 0 24564 0 1189077 0 0 0 RAYMOND KNIGHT MD 373604 0 0 0 364793 0 30870 0 20168 0 789435 0 0 0 W HARLEY SOBIN MD 259257 0 717892 0 1032 0 30870 0 20805 0 1029856 0 0 0 LINDA WOHLGEMUTH 349720 0 69275 0 2322 0 55870 0 7559 0 484746 0 0 0 CHARLES TALBERT - THRU JUN 2011 156852 0 22500 0 0 0 22598 0 10836 0 212786 0 0 0 THOMAS KELLEY - BEGIN JUL 2011 195605 0 30000 0 334 0 53426 0 20168 0 299533 0 0 0 SUSAN VENTURA 349470 0 69275 0 3564 0 55870 0 7559 0 485738 0 0 0 ASHWANI SETHI MD 444620 0 532457 0 552 0 30870 0 21184 0 1029683 0 0 0 MARIO GARRETTO MD 519101 0 409161 0 1584 0 30870 0 21673 0 982389 0 0 0 KATHERINE ABBO MD 598670 0 0 0 1584 0 30870 0 6917 0 638041 0 0 0 RAMANUJA MANDA MD 596138 0 0 0 1584 0 30870 0 20702 0 649294 0 0 0 WENDEL FRIEDL MD 242733 0 28875 0 666242 0 30870 0 21696 0 990416 0 0 0 ROBERT LEE DIRECTOR OF ORGANIZATION 307090 SERVICES PROVIDED BY LEE PLUMBING 0 FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS REVIEWED BY THE ORGANIZATION'S CFO AND CONTROLLER PRIOR TO FILING. A COPY OF THE 990 IS PROVIDED TO THE GOVERNING BOARD PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C UNITED HOSPITAL SYSTEM'S WRITTEN CONFLICT OF INTEREST POLICY FOR THE BOARD IS REVIEWED ANNUALLY BY EACH BOARD MEMBER, AND ANY POTENTIAL CONFLICTS OF INTEREST ARE DISCLOSED AT THAT TIME. THE WRITTEN CONFLICT OF INTEREST POLICY FOR EMPLOYEES IS REVIEWED DURING ORIENTATION AND PERIODICALLY AT ORGANIZATION MEETINGS, AND IS INCORPORATED INTO THE PERFORMANCE STANDARDS OF THEIR ANNUAL EVALUATIONS. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION FOR THE PRESIDENT, CEO AND GENERAL COUNSEL AND THE COMPENSATION FOR THE VICE PRESIDENTS REPORTING DIRECTLY TO THE PRESIDENT, CEO AND GENERAL COUNSEL ARE DETERMINED BY THE BOARD EXECUTIVE COMMITTEE WHICH SERVES AS THE BOARD COMPENSATION COMMITTEE. THE BOARD COMPENSATION COMMITTEE CONTRACTS WITH THE HEALTHCARE COMPENSATION FIRM NAMED THE GROVES GROUP, LLC, AND HAS UTILIZED THE PRESIDENT OF THE GROVES GROUP, LLC AS THE COMPENSATION CONSULTANT SINCE 2005. THE COMPENSATION CONSULTANT UTILIZES A METHODOLOGY THAT EVALUATES INTERNAL AND EXTERNAL EQUITY AFTER EVALUATING THE RESPONSIBILITIES OF EACH POSITION AND MAKES A RECOMMENDATION TO THE BOARD COMPENSATION COMMITTEE. THE BOARD COMPENSATION COMMITTEE HAS FOLLOWED THE DETAILED RECOMMENDATIONS OF THE COMPENSATION CONSULTANT ANNUALLY SINCE 2005 AND THE COMPENSATION CONSULTANT HAS BEEN RETAINED THROUGH 2015. FORM 990, PART VI, SECTION C, LINE 19 THESE DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -906,169. CHANGE IN MINIMUM PENSION OBLIGATION -44,964,082. REVENUE SHARING WITH AFFILIATE -8,654,478. MACRS DEPRECIATION ADJUSTMENT 143,276. TOTAL TO FORM 990, PART XI, LINE 5: -54,381,453. ST CATHERINE'S HOSPITAL INC 6308 8TH AVENUE KENOSHA WI 53143 390855075 HEALTHCARE WI 501(C)(3) LINE 11B, II 0 UHS INC 6308 8TH AVENUE KENOSHA WI 53143 391956749 HEALTHCARE WI 501(C)(3) LINE 9 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0