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FROEDTERT SOUTH INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
FROEDTERT SOUTH INC (EIN 39-0816845)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-05-14
IRS object ID
201231359349305493
Schema version
2010v3.4
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-05-14T16:13:44-05:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1WIPFLI LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line110000 INNOVATION DRIVE SUITE 250AddressLine1
CityMILWAUKEECity
StateWIState
ZIP Code532264837ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN390816845EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1UNITED HOSPITAL SYSTEM INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlUNITNameControl
Phone2625778113Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line16308 8TH AVENUEAddressLine1
CityKENOSHACity
StateWIState
ZIP Code53143ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameTHOMAS J KELLEYName
TitleVP & CFOTitle
Phone2625778113Phone
Date Signed2012-05-14DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJAY ADKISSONName
Phone4144319300Phone
Date Prepared2012-05-14DatePrepared
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonTHOMAS J KELLEYNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line16308 8TH AVENUEAddressLine1
CityKENOSHACity
StateWIState
ZIP Code53143ZIPCode
FieldValueIRS element (for citing)
Gross Receipts289302876GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.UNITEDHOSPITALSYSTEM.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1910YearFormation
State Legal DomicileWIStateLegalDomicile
Activity Or Mission DescriptionUNITED 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.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees2482TotalNbrEmployees
Total Nbr Volunteers163TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year30988ContributionsGrantsPriorYear
Contributions Grants Current Year39070ContributionsGrantsCurrentYear
Program Service Revenue Prior Year276606527ProgramServiceRevenuePriorYear
Program Service Revenue CY284810928ProgramServiceRevenueCY
Investment Income Prior Year425963InvestmentIncomePriorYear
Investment Income Current Year2566994InvestmentIncomeCurrentYear
Other Revenue Prior Year33678OtherRevenuePriorYear
Other Revenue Current Year710808OtherRevenueCurrentYear
Total Revenue Prior Year277097156TotalRevenuePriorYear
Total Revenue Current Year288127800TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year21695GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY9395GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year133086264SalariesEtcPriorYear
Salaries Etc Current Year142050026SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year117738828OtherExpensePriorYear
Other Expenses Current Year124744225OtherExpensesCurrentYear
Total Expenses Prior Year250846787TotalExpensesPriorYear
Total Expenses Current Year266803646TotalExpensesCurrentYear
Revenues Less Expenses Prior Year26250369RevenuesLessExpensesPriorYear
Revenues Less Expenses CY21324154RevenuesLessExpensesCY
Total Assets BOY292432389TotalAssetsBOY
Total Assets EOY311712686TotalAssetsEOY
Total Liabilities BOY108291941TotalLiabilitiesBOY
Total Liabilities EOY80483668TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY184140448NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY231229018NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionUNITED 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.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense221271610Expense
Revenue285491454Revenue
DescriptionACUTE CARE HOSPITAL THAT PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES TO ITS COMMUNITY.Description
Total Program Service Expense221271610TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals1GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109669NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees2482NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy0WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledWIStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1THE ORGANIZATIONBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number2625778113TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line16308 8TH AVENUEAddressLine1
CityKENOSHACity
StateWIState
ZIP Code53143ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (24 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
JAMES ARNESON
CHAIRMAN2.00X000
DR F GREGORY CAMPBELL
VICE-CHAIRMAN2.00X000
ROBERT A CORNOG
SECRETARY/TREASURER/DIRECTOR2.00X000X
RICHARD O SCHMIDT JR
PRESIDENT/CEO/DIRECTOR45.00X9850700145965XX
EDWARD C EMMA
DIRECTOR2.00X000
HAROLD W MAYER
DIRECTOR2.00X000
GEORGE W ANDERSON
DIRECTOR2.00X000
A JAMES CICCHINI
DIRECTOR2.00X000
JAMES CONCANNON MD
DIRECTOR2.00X000
DON E KAELBER
DIRECTOR2.00X000
RAYMOND KNIGHT MD
DIRECTOR/PHYSICIAN2.00X377232042149
ROBERT LEE JR
DIRECTOR2.00X000
JOSEPH F MADRIGRANO SR
DIRECTOR2.00X000
LAWRENCE REIF MD
DIRECTOR2.00X000
W HARLEY SOBIN MD
DIRECTOR/PHYSICIAN2.00X932163042149X
WILLIAM PETASNICK
DIRECTOR2.00X000
LINDA WOHLGEMUTH
ASST SECRETARY/VP-COO-SCMCC45.00392565055154XX
CHARLES TALBERT
ASST TREASURER/VP-CFO45.00773710043209XX
SUSAN VENTURA
SVP/COO-KMCC45.00395607055154X
ASHWANI SETHI MD
PHYSICIAN40.00929016042149XX
MARIO GARRETTO MD
PHYSICIAN40.00881647093209XX
KATHERINE ABBO MD
PHYSICIAN40.00600419029512XX
RAMANUJA MANDA MD
PHYSICIAN40.00598675043608XX
KEVIN FULLIN MD
PHYSICIAN40.00597216042149XX
FieldValueIRS element (for citing)
Total Reportable Comp From Org7463320TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation634407TotalOtherCompensation
Number Individuals GT100 K105NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
ECLIPSYS CORP
PO BOX 8538 133PHILADELPHIAPA19171IS SERVICES3665986
H M P OF KENOSHA COUNTY LTD
PO BOX 645037CINCINNATIOH45264MEDICAL1602167
QUEST DIAGNOSTICS
3924 COLLECTION CENTER DRIVECHICAGOIL60693MEDICAL1146711
RILEY CONSTRUCTION CO INC
5301 99TH STREETKENOSHAWI53144BUILDING747663
ON CALL TRANSCRIPTION SOLUTIONS INC
BIN 88653MILWAUKEEWI53288MEDICAL TRANSCRIPTION740956
FieldValueIRS element (for citing)
Number Of Contractors GT100 K30NumberOfContractorsGT100K
All Other Contributions39070AllOtherContributions
Total Contributions39070TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SERVICE RE623000279050175279050175
OTHER OPERATING REVENU62399057607535760753
FieldValueIRS element (for citing)
Total Program Service Revenue284810928TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1461231TotalRevenueColumn
Exclusion$1,461,231ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real680526Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real680526Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column680526TotalRevenueColumn
Related Or Exempt Function Income680526RelatedOrExemptFunctionIncome

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities1320533Securities
Other913770Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities999997Securities
Other128543Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities320536Securities
Other785227Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column1105763TotalRevenueColumn
Exclusion$1,105,763ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events76818GrossIncomeFundraisingEvents
Fundraising Direct Expenses46536FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column30282TotalRevenueColumn
Exclusion$30,282ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column288127800TotalRevenueColumn
Related Or Exempt Function Income285491454RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$2,597,276ExclusionAmount

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total9395Total
Program Services9395ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total7463322Total
Management And General7463322ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total101625718Total
Program Services92035256ProgramServices
Management And General9590462ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total6466576Total
Program Services5455662ProgramServices
Management And General1010914ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total19442386Total
Program Services5678553ProgramServices
Management And General13763833ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total7052024Total
Program Services5902085ProgramServices
Management And General1149939ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total311739Total
Program Services141826ProgramServices
Management And General169913ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total50441501Total
Program Services48155174ProgramServices
Management And General2286327ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total6119124Total
Program Services5982218ProgramServices
Management And General136906ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total595770Total
Program Services165749ProgramServices
Management And General430021ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total1724642Total
Program Services1552178ProgramServices
Management And General172464ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total14900919Total
Program Services13410827ProgramServices
Management And General1490092ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1041471Total
Program Services386235ProgramServices
Management And General655236ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBTS1595112815951128
OTHER EXPENSES9681754965255529199
STATE HOSPITAL ASSESSME81212638121263
OUTSIDE SERVICES779963331316544667979
REPAIRS22730231647485625538

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total5782258Total
Program Services3892367ProgramServices
Management And General1889891ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total266803646Total
Program Services221271610ProgramServices
Management And General45532036ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY41553861BOY
EOY20231914EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY32052045BOY
EOY34535648EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY3194388BOY
EOY3582164EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY3117303BOY
EOY3612675EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis239754237LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec149886785LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY88185411BOY
EOY89867452EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY84808870BOY
EOY90616034EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY39520511BOY
EOY69266799EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY292432389BOY
EOY311712686EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY28025271BOY
EOY28597704EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY27593209BOY
EOY23675025EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY52673461BOY
EOY28210939EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY108291941BOY
EOY80483668EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY182142414BOY
EOY229216892EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY481569BOY
EOY495243EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1516465BOY
EOY1516883EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY184140448BOY
EOY231229018EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY292432389BOY
EOY311712686EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses21324154ReconcilationRevenueExpenses
Reconcilation Other Changes25764416ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance1998034BeginningOfYearBalance
Investment Earnings Or Losses23485InvestmentEarningsOrLosses
Other Expenditures9395OtherExpenditures
End Of Year Balance2012124EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance1973518BeginningOfYearBalance
Investment Earnings Or Losses46211InvestmentEarningsOrLosses
Other Expenditures21695OtherExpenditures
End Of Year Balance1998034EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1955842BeginningOfYearBalance
Investment Earnings Or Losses33529InvestmentEarningsOrLosses
Other Expenditures15853OtherExpenditures
End Of Year Balance1973518EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance0.75000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.25000TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis5519546OtherCostOrOtherBasis
Book Value5519546BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis113517993OtherCostOrOtherBasis
Depreciation72766025Depreciation
Book Value40751968BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis113541869OtherCostOrOtherBasis
Depreciation75681349Depreciation
Book Value37860520BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis7174829OtherCostOrOtherBasis
Depreciation1439411Depreciation
Book Value5735418BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings89867452TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
OTHER ASSETS280176
DUE FROM AFFILIATE68986623
FieldValueIRS element (for citing)
Total Book Value Other Assets69266799TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
DEFERRED COMPENSATION$4,905,837
PENSION LIABILITY$23,305,102
FieldValueIRS element (for citing)
Total Of Amounts28210939TotalOfAmounts
Total Revenue288127800TotalRevenue
Total Expenses266803646TotalExpenses
Excess Or Deficit For Year21324154ExcessOrDeficitForYear
Net Unrealized GL On Investments8292774NetUnrealizedGLOnInvestments
Other$17,471,642OtherAmount
Total Adjustments25764416TotalAdjustments
Excess Or Deficit Per FS47088570ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt288118405TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal288118405RevenueSubtotal
Other Revenues Not Included9395OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt9395RevenueNotRptdOnFinStmt
Total Revenue Per Form990288127800TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt266301840TotExpensesEtcAuditedFinclStmt
Other Expenses Included-9395OtherExpensesIncluded
Expenses Not Rptd F990-9395ExpensesNotRptdF990
Expenses Subtotal266311235ExpensesSubtotal
Other Expenses Not Included492411OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt492411ExpensesNotRptdOnFinStmt
Total Expenses Per Form990266803646TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:UHS, UNITED, AND ST. CATHERINE'S ARE NONPROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THEY ARE ALSO EXEMPT FROM STATE INCOME TAXES ON RELATED INCOME. 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 21,795,757. REVENUE SHARING WITH AFFILIATE -4,840,013. MACRS DEPRECIATION ADJUSTMENT 492,411. TEMPORARILY RESTRICTED EARNINGS 23,069. PERMENANTLY RESTRICTED EARNINGS 418.
PART XII, LINE 4B - OTHER ADJUSTMENTS:NET ASSETS RELEASED FROM RESTRICTIONS 9,395.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:SCHOLARSHIPS -9,395.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:MACRS DEPRECIATION ADJUSTMENT 492,411.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1GOLF OUTINGNameOfEvent1
Gross Receipts Event176818GrossReceiptsEvent1
Gross Revenue Event176818GrossRevenueEvent1
Other Direct Expenses Event146536OtherDirectExpensesEvent1
Gross Receipts Total76818GrossReceiptsTotal
Gross Revenue Total Events76818GrossRevenueTotalEvents
Other Direct Expenses Total Events46536OtherDirectExpensesTotalEvents
Direct Expense Summary Events46536DirectExpenseSummaryEvents
Net Income Summary30282NetIncomeSummary

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available0ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense3684187TotalCommunityBenefitExpense
Net Community Benefit Expense3684187NetCommunityBenefitExpense
Percent Of Total Expense0.01380PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense40670839TotalCommunityBenefitExpense
Direct Offsetting Revenue24682586DirectOffsettingRevenue
Net Community Benefit Expense15988253NetCommunityBenefitExpense
Percent Of Total Expense0.05990PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense44355026TotalCommunityBenefitExpense
Direct Offsetting Revenue24682586DirectOffsettingRevenue
Net Community Benefit Expense19672440NetCommunityBenefitExpense
Percent Of Total Expense0.07370PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs509NumberOfActivitiesOrPrograms
Persons Served22036PersonsServed
Total Community Benefit Expense154376TotalCommunityBenefitExpense
Net Community Benefit Expense154376NetCommunityBenefitExpense
Percent Of Total Expense0.00060PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense737865TotalCommunityBenefitExpense
Net Community Benefit Expense737865NetCommunityBenefitExpense
Percent Of Total Expense0.00280PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served1491PersonsServed
Total Community Benefit Expense264958TotalCommunityBenefitExpense
Net Community Benefit Expense264958NetCommunityBenefitExpense
Percent Of Total Expense0.00100PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs509NumberOfActivitiesOrPrograms
Persons Served23527PersonsServed
Total Community Benefit Expense1157199TotalCommunityBenefitExpense
Net Community Benefit Expense1157199NetCommunityBenefitExpense
Percent Of Total Expense0.00440PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs509NumberOfActivitiesOrPrograms
Persons Served23527PersonsServed
Total Community Benefit Expense45512225TotalCommunityBenefitExpense
Direct Offsetting Revenue24682586DirectOffsettingRevenue
Net Community Benefit Expense20829639NetCommunityBenefitExpense
Percent Of Total Expense0.07810PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense1913TotalCommunityBuildingExpense
Net Community Building Expense1913NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense126412TotalCommunityBuildingExpense
Net Community Building Expense126412NetCommunityBuildingExpense
Percent Of Total Expense0.00050PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs10NumberOfActivitiesOrPrograms
Total Community Building Expense1296TotalCommunityBuildingExpense
Net Community Building Expense1296NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs11NumberOfActivitiesOrPrograms
Total Community Building Expense129621TotalCommunityBuildingExpense
Net Community Building Expense129621NetCommunityBuildingExpense
Percent Of Total Expense0.00050PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$5,822,162BadDebtExpenseAmount
Amount Attributable To291108AmountAttributableTo
Amount Reimbursed By Medicare50035697AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare66325570CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-16289873MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities7NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (7 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalEr24 HoursEr24HoursOtherOther
KENOSHA MEDICAL CENTER CAMPUS
16308 8TH AVENUEKENOSHAWI53143XXX
SAINT CATHERINE'S MEDICAL CENTER CAMPUS
29555 76TH STREETPLEASANT PRAIRIEWI53158XXX
KENOSHA NORTHSIDE CLINIC
33601 30TH AVENUE SUITE 205KENOSHAWI53143OUTPATIENT PHYSICIAN CLINIC
PADDOCK LAKE FAMILY MEDICINE CLINIC
47322 236TH AVENUEPADDOCK LAKEWI53168OUTPATIENT PHYSICIAN CLINIC
THE GURNEE CLINIC
51790 NATIONS DRIVE SUITE 106GURNEEIL60031OUTPATIENT PHYSICIAN CLINIC
LAKEVIEW RECPLEX
69900 TERWALL TERRACEPLEASANT PRAIRIEWI53158REHABILITATION CLINIC
VERNON ELEMENTARY SCHOOL - POOL AREA
78518 22ND AVENUEKENOSHAWI53143REHABILITATION CLINIC

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (7 entries)

Hospital Facility NumberHospitalFacilityNumberEligibility Criteria ExplainedEligibilityCriteriaExplainedUses FPG FreeUsesFPGFreeFPG Free PercentFPGFreePercentUses FPG DiscountedUsesFPGDiscountedFPG Discount PercentFPGDiscountPercentExplains BasisExplainsBasisIncome LevelIncomeLevelAsset LevelAssetLevelMedical IndigencyMedicalIndigencyInsurance StatusInsuranceStatusUninsured DiscountUninsuredDiscountExplains Application MethodExplainsApplicationMethodIncludes Publicity MeasuresIncludesPublicityMeasuresAvailable On RequestAvailableOnRequestActions On NonpaymentActionsOnNonpaymentPermit Report To Credit AgencyPermitReportToCreditAgencyPermit LawsuitPermitLawsuitPermit Lien On ResidencePermitLienOnResidenceCollection ActivitiesCollectionActivitiesReport To Credit AgencyReportToCreditAgencyLawsuitLawsuitLien On ResidenceLienOnResidenceNotified All PatientsNotifiedAllPatientsDocumented DeterminationDocumentedDeterminationNondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicyUsed Other MethodUsedOtherMethodAmounts Generally BilledAmountsGenerallyBilledGross ChargesGrossCharges
KENOSHA MEDICAL CENTER CAMPUS
111200.0000000000001200.0000000000001XXXXX11X1XXX1XXXXX1X00
SAINT CATHERINE'S MEDICAL CENTER CAMPUS
211200.0000000000001200.0000000000001XXXXX11X1XXX1XXXXX1X00
KENOSHA NORTHSIDE CLINIC
311200.0000000000001200.0000000000001XXXXX11X1XXX1XXXXX1X00
PADDOCK LAKE FAMILY MEDICINE CLINIC
411200.0000000000001200.0000000000001XXXXX11X1XXX1XXXXX1X00
THE GURNEE CLINIC
511200.0000000000001200.0000000000001XXXXX11X1XXX1XXXXX1X00
LAKEVIEW RECPLEX
611200.0000000000001200.0000000000001XXXXX11X1XXX1XXXXX1X00
VERNON ELEMENTARY SCHOOL - POOL AREA
711200.0000000000001200.0000000000001XXXXX11X1XXX1XXXXX1X00

Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)

ExplanationExplanationIdentifierIdentifier
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: THE COSTING METHODOLOGY USED WAS THE COST TO CHARGE RATIO AND THE COST REPORT.
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.
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.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.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.KENOSHA NORTHSIDE CLINIC
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.PADDOCK LAKE FAMILY MEDICINE CLINIC
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.THE GURNEE CLINIC
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.LAKEVIEW RECPLEX
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.VERNON ELEMENTARY SCHOOL - POOL AREA
PART VI, LINE 2: NO INFORMATION AVAILABLE.
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.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained
No Grant More Than5000XNoGrantMoreThan5000

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantSCHOLARSHIP FINANCIAL ASSISTANCE TO INDIVIDUALSTypeOfGrant
Number Of Recipients14NumberOfRecipients
Amount Of Cash Grant9395AmountOfCashGrant

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
RICHARD O SCHMIDT JR
6766740297000011396012303002293501131035000
RAYMOND KNIGHT MD
37418400030480230300191190419381000
W HARLEY SOBIN MD
2592000671931010320230300191190974312000
LINDA WOHLGEMUTH
32703706320602322048030071240447719000
CHARLES TALBERT
3074800462666035640230300201790816919000
SUSAN VENTURA
32883706320603564048030071240450761000
ASHWANI SETHI MD
445184048328005520230300191190971165000
MARIO GARRETTO MD
5187440361319015840730300201790974856000
KATHERINE ABBO MD
5988350001584023030064820629931000
RAMANUJA MANDA MD
59764300010320230300205780642283000
KEVIN FULLIN MD
59618400010320230300191190639365000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL INFORMATIONIdentifier
Return ReferencePART IIIReturnReference
ExplanationSCHEDULE J, PART I, LINE 5B: CHARLES TALBERT RECEIVED A 2010 TAXABLE PAYOUT OF $401,891 RELATED TO A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN.Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1ROBERT LEEBusinessNameLine1
FieldValueIRS element (for citing)
RelationshipDIRECTOR OF ORGANIZATIONRelationship
Amount Of Transaction220767AmountOfTransaction
Description Of TransactionSERVICES PROVIDED BY LEE PLUMBINGDescriptionOfTransaction
Sharing Of Revenues0SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION B, LINE 11FORM 990 IS REVIEWED BY THE ORGANIZATION'S CFO AND CONTROLLER PRIOR TO FILING.
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 12C
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 B, LINE 15
THESE DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. FORM 990 AND 990-T ARE ALSO MADE AVAILABLE ON GUIDESTAR.FORM 990, PART VI, SECTION C, LINE 18
THESE DOCUMENTS ARE MADE AVAILABLE UPON REQUEST.FORM 990, PART VI, SECTION C, LINE 19
CHANGES IN NET ASSETS OR FUND BALANCES:NET UNREALIZED GAINS ON INVESTMENTS: 8,292,774. CHANGE IN MINIMUM PENSION OBLIGATION 21,795,757. REVENUE SHARING WITH AFFILIATE -4,840,013. MACRS DEPRECIATION ADJUSTMENT 492,411. TEMPORARILY RESTRICTED EARNINGS 23,069. PERMENANTLY RESTRICTED EARNINGS 418. TOTAL TO FORM 990, PART XI, LINE 5: 25,764,416.FORM 990, PART XI, LINE 5:
THE PROCESS THE COMMITTEE USES FOR OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR.FORM 990, PART XI, LINE 2C, FINANCIAL STATEMENTS AND REPORTING:

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1KENOSHA HEALTH SERVICE CORP 6308 8TH AVENUE KENOSHA WI 53143BusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line16308 8TH AVENUEAddressLine1
CityKENOSHACity
StateWIState
ZIP Code53143ZIPCode
FieldValueIRS element (for citing)
EIN391491236EIN
Primary ActivitiesHEALTHCAREPrimaryActivities
Legal Domicile StateWILegalDomicileState
Total Income611276TotalIncome
EOY Assets0EOYAssets

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusControlled OrgControlledOrg
ST CATHERINE'S HOSPITAL INC
6308 8TH AVENUEKENOSHAWI53143390855075HEALTHCAREWI501(C)(3)LINE 11B, II0
UHS INC
6308 8TH AVENUEKENOSHAWI53143391956749HEALTHCAREWI501(C)(3)LINE 90
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
ST CATHERINE'S HOSPITAL INC
J4656800AUDITED FINANCIAL STATEMENTS
ST CATHERINE'S HOSPITAL INC
Q4840013AUDITED FINANCIAL STATEMENTS