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SACRED HEART HOSPITAL OF THE HOSPIT AL SISTERS-3RD ORDER OF ST FRANCIS: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
SACRED HEART HOSPITAL OF THE HOSPIT AL SISTERS-3RD ORDER OF ST FRANCIS (EIN 39-0807060)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-05-15
IRS object ID
201241369349303644
Schema version
2010v3.7
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)
Timestamp2012-05-15T12:02:05-05:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1191 West Nationwide Blvd Ste 500AddressLine1
CityColumbusCity
StateOHState
ZIP Code432152568ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN390807060EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1SACRED HEART HOSPITAL OF HOSPITALBusinessNameLine1
Business Name Line2SISTERS OF THIRD ORDER OF ST FRANCISBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlSACRNameControl
Phone7157176122Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1900 WEST CLAIREMONT AVENUEAddressLine1
CityEAU CLAIRECity
StateWIState
ZIP Code54701ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameSTEPHEN RONSTROMName
TitleCEOTitle
Date Signed2012-05-14DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameKPMG LLPName
Phone6142492300Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer Personjulie manasNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1900 West Clairemont AveAddressLine1
CityEAU CLAIRECity
StateWIState
ZIP Code54701ZIPCode
FieldValueIRS element (for citing)
Gross Receipts224705630GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web SiteWWW.SACREDHEARTHOSPITAL-EC.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1890YearFormation
State Legal DomicileWIStateLegalDomicile
Activity Or Mission DescriptionTo provide the means whereby Sacred Heart can Continue their apostolic mission to serve the sick, the aged, the poor and the terminally ill without regard to race, color, creed, or national origin.ActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees1496TotalNbrEmployees
Total Nbr Volunteers305TotalNbrVolunteers
Total Gross UBI1224903TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year703572ContributionsGrantsPriorYear
Contributions Grants Current Year396423ContributionsGrantsCurrentYear
Program Service Revenue Prior Year188035215ProgramServiceRevenuePriorYear
Program Service Revenue CY206954736ProgramServiceRevenueCY
Investment Income Prior Year3343430InvestmentIncomePriorYear
Investment Income Current Year13997746InvestmentIncomeCurrentYear
Other Revenue Prior Year3251948OtherRevenuePriorYear
Other Revenue Current Year3344179OtherRevenueCurrentYear
Total Revenue Prior Year195334165TotalRevenuePriorYear
Total Revenue Current Year224693084TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year79180139SalariesEtcPriorYear
Salaries Etc Current Year88352274SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year88964813OtherExpensePriorYear
Other Expenses Current Year104100767OtherExpensesCurrentYear
Total Expenses Prior Year168144952TotalExpensesPriorYear
Total Expenses Current Year192453041TotalExpensesCurrentYear
Revenues Less Expenses Prior Year27189213RevenuesLessExpensesPriorYear
Revenues Less Expenses CY32240043RevenuesLessExpensesCY
Total Assets BOY361656889TotalAssetsBOY
Total Assets EOY414270452TotalAssetsEOY
Total Liabilities BOY115018136TotalLiabilitiesBOY
Total Liabilities EOY108056774TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY246638753NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY306213678NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionSee Schedule O - Organization's MissionMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense155698682Expense
Revenue207033724Revenue
DescriptionSEE SCHEDULE O - PART III Line 4ADescription
Total Program Service Expense155698682TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntitytrueDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109642NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees1496NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonSTEVE PALECEKNamePerson
Telephone Number7157173783TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1900 WEST CLAIREMONT AVENUEAddressLine1
CityEAU CLAIRECity
StateWIState
ZIP Code54701ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (22 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
SISTER MARYBETH CULNAN OSF
DIRECTOR1.0X000
Greg Heiler MD
Director1.0X000
ROBERT KRAUSE
CHAIRPERSON1.0X000X
JEFFREY R HALLOIN
VICE CHAIRPERSON1.0X000X
Sr Trudy O'Conner OSF
Director1.0X000
Dennis Breen MD
DIRECTOR1.0X000
JULIE FURST-BOWE EDD
DIRECTOR1.0X000
JAMES DOCKSEY
Secretary1.0X000X
JAKE LEINENKUGEL
DIRECTOR1.0X000
STEPHEN RONSTROM
CEO70.0X0475612136808X
Karen Hebert
Director1.0X000
Ann Carr
Treasurer0.25X0191336109542X
Sister Janice Schneider OSF
Former Director1.0X000
Chris Longbella MD
Former Director1.0X10384500
Thomas Pellar MD
Former Director1.0X000
FAYE DEICH
Chief Operating Officer40.0284532093585X
Amy Dwyer
Chief Nursing Officer40.01699540106148X
John Lamoureux
Physician40.0313088077436X
Lance Levendowski
Radiation Physics Director40.0210203031213X
John Waciuma
Physician40.021750802363X
Brent Jensen
Physician40.0193055013490X
donald joyce
asst administrator40.02001050-6460X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1692290TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs666948TotalReportableCompFrmRltdOrgs
Total Other Compensation564125TotalOtherCompensation
Number Individuals GT100 K60NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
HT Klatzke and Associates
1511 East Superior StDULUTHMN55812Advertising Consult.2345483
Aramark Management Services
24863 Network PlaceCHICAGOIL60673Management Services1505382
Medical Staffing Solutions
PO BOX 101RICE LAKEWI54868CONTRACTED LABOR1425017
MCKAY CONSULTING
8590 BUSINESS PARK DRIVESHREVEPORTLA71105CONSULTING1275107
Marshfield Clinic
1000 North Oak StreetMARSHFIELDWI54449Med. Dir. Leadership1048811
FieldValueIRS element (for citing)
Number Of Contractors GT100 K42NumberOfContractorsGT100K
Related Organizations396423RelatedOrganizations
Total Contributions396423TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
NET PATIENT REVENUE900099205246575205246575
DEPARTMENTAL REVENUE900099189138189138
OTHER OPERATING REVENUE900099514438514438
LABRATORY62150010045851004585
FieldValueIRS element (for citing)
Total Program Service Revenue206954736TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column14009542TotalRevenueColumn
Exclusion$14,009,542ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real1779228Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real1779228Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column1779228TotalRevenueColumn
Exclusion$1,779,228ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other750Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other12546Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-11796Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-11796TotalRevenueColumn
Exclusion-$11,796ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
SHARED SERVICE INCOME62150029930678988220318
EMPLOYEE & SENIOR CAFETERIA722210983269$983,269
GIFT SHOP453220282376$282,376
FieldValueIRS element (for citing)
Total Other Revenue1564951TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column224693084TotalRevenueColumn
Related Or Exempt Function Income206029139RelatedOrExemptFunctionIncome
Unrelated Business Revenue1224903UnrelatedBusinessRevenue
Exclusion$17,042,619ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total65929512Total
Program Services58833528ProgramServices
Management And General7095984ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total4548612Total
Program Services4059046ProgramServices
Management And General489566ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total12948805Total
Program Services11555127ProgramServices
Management And General1393678ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total4925345Total
Program Services4395231ProgramServices
Management And General530114ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total8670000Total
Management And General8670000ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total878928Total
Management And General878928ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total20741104Total
Program Services9160492ProgramServices
Management And General11580612ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total3234724Total
Management And General3234724ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total749833Total
Program Services620200ProgramServices
Management And General129633ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total475645Total
Program Services475645ProgramServices

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2248289Total
Program Services1751693ProgramServices
Management And General496596ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total142119Total
Program Services41029ProgramServices
Management And General101090ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total336147Total
Program Services201314ProgramServices
Management And General134833ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total765107Total
Management And General765107ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total12539472Total
Program Services12282648ProgramServices
Management And General256824ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total866663Total
Program Services108517ProgramServices
Management And General758146ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
CLINICAL SUPPLIES3687732736645271232056
MEDICAID ASSESSMENT57599055759905
PROVISION FOR BAD DEBT39338723933872
EQUIPMENT RENTAL17045071704507
RECRUITMENT EXPENSE11257711125771

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total3051354Total
Program Services3044886ProgramServices
Management And General6468ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total192453041Total
Program Services155698682ProgramServices
Management And General36754359ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY440405BOY
EOY611422EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY3297830BOY
EOY1212908EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY8495425BOY
EOY10755435EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY23784195BOY
EOY27874568EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY6266508BOY
EOY5708568EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY817693BOY
EOY527337EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis212378448LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec109911086LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY100170519BOY
EOY102467362EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY206532457BOY
EOY253736297EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY11851857BOY
EOY11376555EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY361656889BOY
EOY414270452EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY17050011BOY
EOY20895477EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY61858751BOY
EOY60712969EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY36109374BOY
EOY26448328EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY115018136BOY
EOY108056774EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY240732022BOY
EOY298997116EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1579295BOY
EOY2248106EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY4327436BOY
EOY4968456EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY246638753BOY
EOY306213678EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY361656889BOY
EOY414270452EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses32240043ReconcilationRevenueExpenses
Reconcilation Other Changes27334882ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

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 C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$6,468OtherActivitiesAmount
Total Lobbying Expenditures IIB6468TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3
Form4720 Filed4912 TaxfalseForm4720Filed4912Tax

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierSchedule C Part IVIdentifier
ExplanationSACRED HEART HOSPITAL ("THE HOSPITAL") IS A MEMBER OF THE CATHOLIC HEALTH ASSOCIATION ("CHA"), THE WISCONSIN HEALTH ASSOCIATION ("WHA"), AND THE AMERICAN HEALTH ASSOCIATION ("AHA"). AS A MEMBER OF THESE ORGANIZATIONS, THE HOSPITAL PAYS DUES AND PART OF THESE DUES ARE ATTRIBUTABLE TO LOBBYING FEES PAID BY THE ORGANIZATIONS. THE AMOUNT LISTED ABOVE IS THE AMOUNT ATTRIBUTABLE TO THE HOSPITAL FROM ITS DUES PAID.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis501443OtherCostOrOtherBasis
Book Value501443BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis108063700OtherCostOrOtherBasis
Depreciation43866275Depreciation
Book Value64197425BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis3478868OtherCostOrOtherBasis
Depreciation1974533Depreciation
Book Value1504335BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis97871572OtherCostOrOtherBasis
Depreciation64070278Depreciation
Book Value33801294BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2462865OtherCostOrOtherBasis
Book Value2462865BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings102467362TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
ACCRUED PENSION LIABILITY$22,567,907
INTEREST RATE SWAP PROGRAMS$3,178,363
OTHER LONG-TERM LIABILITIES$375,000
ESTIMATED SELF-INSURANCE LIABI$327,058
FieldValueIRS element (for citing)
Total Of Amounts26448328TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierASC SUBTOPIC 740-10Identifier
ExplanationON JULY 1, 2007, HSHS ADOPTED ASC SUBTOPIC 740-10, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES - AN INTERPRETATION OF FASB STATEMENT NO.109. ASC SUBTOPIC 740-10 ADDRESSES THE DETERMINATION OF HOW TAX BENEFITS CLAIMED OR EXPECTED TO BE CLAIMED ON A TAX RETURN SHOULD BE RECORDED IN THE CONSOLIDATED FINANCIAL STATEMENTS. UNDER ASC SUBTOPIC 740-10, HSHS MUST RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFITS RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. ASC SUBTOPIC 740-10 ALSO PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES ON INCOME TAXES, ACCOUNTING IN INTERIM PERIODS, AND REQUIRES INCREASED DISCLOSURES. AT THE DATE OF ADOPTION, AND AS OF JUNE 30, 2011 AND 2010, HSHS DOES NOT HAVE A LIABILITY FOR UNRECOGNIZED TAX BENEFITS.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served1050PersonsServed
Total Community Benefit Expense4772734TotalCommunityBenefitExpense
Net Community Benefit Expense4772734NetCommunityBenefitExpense
Percent Of Total Expense0.02530PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served15440PersonsServed
Total Community Benefit Expense34000669TotalCommunityBenefitExpense
Direct Offsetting Revenue23298966DirectOffsettingRevenue
Net Community Benefit Expense10701703NetCommunityBenefitExpense
Percent Of Total Expense0.05670PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served507PersonsServed
Total Community Benefit Expense795087TotalCommunityBenefitExpense
Direct Offsetting Revenue563001DirectOffsettingRevenue
Net Community Benefit Expense232086NetCommunityBenefitExpense
Percent Of Total Expense0.00120PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Number Of Activities Or Programs3NumberOfActivitiesOrPrograms
Persons Served16997PersonsServed
Total Community Benefit Expense39568490TotalCommunityBenefitExpense
Direct Offsetting Revenue23861967DirectOffsettingRevenue
Net Community Benefit Expense15706523NetCommunityBenefitExpense
Percent Of Total Expense0.08320PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs114NumberOfActivitiesOrPrograms
Persons Served36828PersonsServed
Total Community Benefit Expense1276174TotalCommunityBenefitExpense
Direct Offsetting Revenue287924DirectOffsettingRevenue
Net Community Benefit Expense1059828NetCommunityBenefitExpense
Percent Of Total Expense0.00560PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs11NumberOfActivitiesOrPrograms
Persons Served638PersonsServed
Total Community Benefit Expense1051218TotalCommunityBenefitExpense
Net Community Benefit Expense1051218NetCommunityBenefitExpense
Percent Of Total Expense0.00560PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs3NumberOfActivitiesOrPrograms
Persons Served374PersonsServed
Total Community Benefit Expense5338530TotalCommunityBenefitExpense
Net Community Benefit Expense5338530NetCommunityBenefitExpense
Percent Of Total Expense0.02830PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Benefit Expense754TotalCommunityBenefitExpense
Net Community Benefit Expense754NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs25NumberOfActivitiesOrPrograms
Persons Served153591PersonsServed
Total Community Benefit Expense92328TotalCommunityBenefitExpense
Direct Offsetting Revenue18879DirectOffsettingRevenue
Net Community Benefit Expense73449NetCommunityBenefitExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs154NumberOfActivitiesOrPrograms
Persons Served191431PersonsServed
Total Community Benefit Expense7759004TotalCommunityBenefitExpense
Direct Offsetting Revenue306803DirectOffsettingRevenue
Net Community Benefit Expense7523779NetCommunityBenefitExpense
Percent Of Total Expense0.03990PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs157NumberOfActivitiesOrPrograms
Persons Served208428PersonsServed
Total Community Benefit Expense47327494TotalCommunityBenefitExpense
Direct Offsetting Revenue24168770DirectOffsettingRevenue
Net Community Benefit Expense23230302NetCommunityBenefitExpense
Percent Of Total Expense0.12310PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$1,691,565BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare71226652AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare95011680CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-23785028MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1Sacred Heart HosptialBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1900 West Clairemont AveAddressLine1
CityEau ClaireCity
StateWIState
ZIP Code54701ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Teaching HospitalXTeachingHospital
Er24 HoursXEr24Hours
OtherBehavioral Health Dialysis Inpatient RehabOther

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Sacred Heart HosptialBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
Part I, Line 3cNot applicable as the organization does follow FPG to determine eligibility for providing charity and discounted care to low-income uninsured and underinsured individuals.
Part I, Line 6aSacred Heart Hospital did not prepare a community benefit report during this tax year.
Part 1, Line 7gThe hospital does not have sufficient information at this time to determine if subsidized services exist based on the definition and calculations required by the IRS and will continue to work and provide such information in next year's return.
Part I, Line 7, column (F)The percent of charity care and certain other benefits as a percent of total expenses less bad debt is 12.31%. The percent of bad debt as a percent of total expenses less bad debt is 2.1%. THE AMOUNT OF BAD DEBT EXPENSE REMOVED WHEN CALCULATING THE PERCENTAGES IN PART I, LINE 7, COLUMN (F) WAS $3,933,872.
Part I, Line 7Charity care is calculated by determining the total amount from patient billing that is written off to charity care charge codes or allowances. This amount matches the number that is reported on our fiscal year ending 2011 audited financial statements. The total charity care dollar amount is then reduced to cost by applying the hospital's cost to charge ratio as calculated on IRS schedule H - worksheet 2.
Part IIThe hospital continues to be involved in hundreds of community building activities each year that address the root cause of heath care problems or work to lay a foundation for a healthier, safer, and better educated community. These activities are most often conducted through the hospital's two holistic healing centers: The Center for Healthy Living, and The Healing Place: A Center for Life's Journeys. The hospital's Regional Cancer Center also offers numerous, ongoing programs related to cancer care. The hospital offers various health screenings, such as blood pressure screenings, at many health fairs in the community throughout the year. The hospital also conducts numerous "Green" environmental stewardship and sustainability efforts (recycling and reusing) including donating surplus food to the St. Francis Food Pantry, and donating used equipment to Third World countries via the Hospital Sisters Mission Outreach. For a more complete and thorough listing of sustainability efforts and free programs offered throughout the year by Sacred Heart Hospital, see explanation for Part 6, Line 5 of this form.
Part III, Line 4The hospital strongly believes that its charity care, and the related community benefit obtained from such care, is understated because of those patients that potentially qualify for charity care but do not wish to apply for it. In addition, some care is not classified as charity due to missing documentation on patient resources. Thus, the hospital's bad debt may include a portion that could be classified as charity care if application for such care was sought and/or completed. Currently, the hospital is implementing processes, procedures, and systems to more effectively determine charity care that will reduce a patient's documentation requirements and ease the patient's emotional burden in applying for charity care. This will provide a more accurate reporting of charity care services provided by the hospital. The hospital computes the cost of bad debt by applying the ratio of patient care cost to charges to the total charges written off as bad debt expense. The patient care cost is determined by adjusting the total annual operating expense by the cost of non-patient care activities, bad debt expenses, Medicaid provider taxes and community benefit expense. The adjusted operating cost is then divided by the total gross patient charges to calculate the ratio of patient care cost to charges.
Part III, Line 8The hospital continually strives to provide excellent patient care in the most cost effective fashion. Nonetheless, the Medicare program, in many cases, does not provide payment that covers the full cost of the care provided. Since it is the mission of the hospital to respond to community need, hospital management continually advocates for improved Medicare payment so that the cost of quality care to those patients that are not able to afford it is not compromised and is fairly subsidized by all payers. While this shortfall in Medicare payments is not classified as community benefit by the IRS, we nonetheless believe it is an important contribution made by the hospital to the health and well-being of the community. Our mission calls us to serve all patients with the highest possible quality and efficiency, even if we are not paid fully for doing so. The hospital computes the unpaid costs of providing care to Medicare patients by comparing the cost of the services to the reimbursement received from Medicare during the year. The cost of Medicare services is calculated by applying the ratio of patient care cost to charges to the annual Medicare charges. The patient care cost is determined by adjusting the total annual operating expense by the cost of non-patient care activities, bad debt expenses, Medicaid provider taxes and community benefit expense. The difference between the reimbursement received and the calculated cost of the services is reported as the Medicare shortfall. Sacred Heart Hospital committed significant resources to service the Medicare population. The cost (as determined using the cost to charge ratio) of providing services to primarily elderly beneficiaries of the Medicare program in excess of governmental and managed care contract payments was $23,785,028 for the year ended June 30, 2011.
Part III, Line 9bPatients are informed of our financial payment options (including Community Care) at the time of registration via the registrars and other hospital personnel, and through our patient statement process; information is also available on our website. The hospital employs financial counselors who are responsible for educating patients about potential eligibility for assistance under federal, state, or local government programs, or under the hospital's charity care policy or uninsured patient discount policy. If it is determined that a patient may be eligible for assistance, the financial counselor will assist the patient with applications for the appropriate program. Collection efforts include a series of patient statements, letters, and phone calls; all of which include discussion about the Community Care program. Patients who qualify for the Community Care program can receive up to 100% reduction in their financial obligation. Patients who are granted a partial reduction are expected to set up reasonable payment arrangements to pay the remaining balance. Patients who are referred to a collection agency are encouraged to make payment arrangements with the agency. A 10% prompt payment discount is available to all patients if payment in full is received within 30 days of the first statement. If a patient is unable to pay their balance in full within 30 days of the first statement or need to make alternative payment arrangements, they are responsible for contacting Patient Financial Services to avoid further collection activity. Patients without insurance receive an uninsured discount, which is reflected on the patient statement. Uninsured patients may qualify for an additional discount based on household income and family size, and may take advantage of the prompt payment discount. Patient Financial Services can assist patients in this regard. Patients are informed payment options include: * Cash, Check, or Credit Card (Visa, Mastercard, and Discover) * Helping Hands Lending Program: in collaboration with a local financial institution, the hospital offers a lending program, which provides an interest-bearing monthly payment option. * Community Care: A hospital-based financial assistance program provides full or partial reductions to patients who are not able to meet their obligations and who meet certain income and asset criteria. Patient Financial Services can offer information to patients. Sacred Heart Hospital devotes significant resources to access for patients who cannot afford care, along with other community benefits. In fiscal year 2011, in accordance with standards defined by the Catholic Health Association USA ("CHAUSA"), Sacred Heart Hospital has recognized an unreimbursed cost of community benefit of $23,230,302. The cost of servicing the people qualifying for public indigent programs (including Medicaid and other public programs) was $10,701,703. The cost of our hospital based community care program was $4,772,734. Sacred Heart also provided benefits of $7,755,865 to the community through many reduced price services and free programs offered throughout the year based upon activities and services that Sacred Heart Hospital believes will serve a bona fide community health need.
Needs AssessmentThe "Imagining the Future" listening campaign, a grassroots approach to discover what services the community believes an ideal healthcare system ought to provide, was conducted from October to December 2010. Deeply rooted in the hospital's Franciscan mission, it was a holistic and spiritual process of discernment which stimulated open, honest, and non-judgmental sharing of insights about healthcare delivery in the context of the physical, emotional, and spiritual needs of the broader community. * The initiative included more than 1,400 participants and began with two large town hall-like meetings hosted by the hospital CEO and 35 smaller visioning sessions led by hospital leaders. Community members also participated online and through social media (Facebook and Twitter). In all, we received 2,830 ideas regarding the future of healthcare. * Focus groups included constituents that are often overlooked: low-income, vulnerable populations and minority groups. It captured the voices of special populations, Hmong Mutual Assistance Association members, Amish farmers, seniors, young children, and other diverse groups. The visioning sessions allowed us to gather mission-critical information, and gave community members the opportunity to articulate their vision of an ideal healthcare system for their community that improved health, healing, and well-being. The goal was to engage and empower community members and hospital leaders so that together we could shape an ideal local healthcare system. * In 2011, a committee was commissioned to divide the 2,830 comments into 600 categories. A Community Dream Team and a Colleague Dream Team were formed to assess each request to determine if it was something that could be responded to in the short term or long term range. More than 100 actionable items were assessed and/or implemented over the first six months. * A Community Health Needs Assessment Team ("CHNA") was established to facilitate the completion of Sacred Heart Hospital's FY2011 Community Health Needs Assessment. The objectives of the CHNA team are: * To identify key health priorities in SHH's service area through analysis of quantitative and qualitative health information and validation of these priorities via key community stakeholders (e.g., City/County Health Department and others) * Develop an implementation plan to address identified community health priorities * Ensure execution of implementation plan and develop measures to assess impact of implementation strategies on community health
Patient Education of Eligibility for AssistanceUpon admission to Sacred Heart Hospital, patients are given a "Guide to Services" booklet which includes a section about Hospital Bills and the availability of financial assistance. The availability of Financial Counselors and their contact information is also provided in the guide. Additionally, patients in Admitting have available to them a print brochure About Your Hospital Bill that thoroughly explains financial assistance, medical claims, charity care, etc., another print brochure is devoted specifically to thoroughly explaining the hospital's Charity Care program. Social Services staff informs and assist patients and family members about financial assistance programs the hospital offers and their eligibility and provides assistance in helping patients and family members access financial assistance. A public notice of medical assistance regarding prescriptions and pharmaceuticals for Social Security members is also posted outside the Admitting area. Sacred Heart Hospital has devoted significant, in-depth information and education on its web homepage focusing on financial assistance, hospital billing, medical claims, and charity care. Patients that do not have health insurance are informed of the hospital discount available to them, how to access hospital financial counselors, and the availability of charity care and eligibility requirements. Eligibility forms and application forms are available for downloading from the website.
Community InformationSacred Heart Hospital provides quality medical healthcare regardless of race, creed, sex, national origin, handicap, age, or ability to pay. Although reimbursement for services rendered is critical to the operation and stability of Sacred Heart Hospital, it is recognized that not all individuals possess the ability to purchase essential medical services. Furthermore, our mission is to serve the community with respect to providing healthcare services and healthcare education. Health activities and programs to support the community are considered where there is a demonstrated need. These activities include behavioral health services, wellness programs, community education programs, special programs for the elderly, and a variety of broad community support activities. Sacred Heart Hospital provided 46,187 adult and pediatric days of care and 106,715 outpatient visits during fiscal year ended June 30, 2011. Approximately 60% of the inpatients treated at Sacred Heart Hospital reside in Chippewa and Eau Claire County, WI. Persons eligible for Medicare account for 51% of the patient revenues generated at the hospital and Medicaid eligible patients generate 15%. Likewise 27% of the revenue is generated from patients who have managed care/commercial insurance coverage. The remaining 7% of the patient revenues come from patients without any insurance.
Promotion of Community HealthThe range of services, programs, and benefits provided by Sacred Heart Hospital flows from our longstanding commitment to our mission of addressing the needs of our community. In many cases, these services often relieve a burden that would otherwise be carried by the government. The Hospital is governed by a Board of Directors, the majority of which is comprised of persons who reside in the organization's service area and who are neither employees nor contractors of the hospital (nor family members there of). The Board ensures that the hospital responds to community needs. Also consistent with its tax exempt purpose, the hospital has an open medical staff with privileges available to all qualified physicians in the area. As part of Sacred Heart Hospital's mission to provide healing and hope to the people we serve, we have developed community benefit initiatives that 1) expand access to health care, 2) enhance overall health status, and 3) promote medical education. The hospital strengthens the health of our communities by continually reinvesting any surplus revenue from operations and investments into new medical technology, facility infrastructure, and health care services. These investments ensure that our hospital can continue to provide high quality, compassionate care to all who walk through our doors. In accordance with standards defined by the Catholic Health Association USA ("CHAUSA"), Sacred Heart Hospital has recognized an unreimbursed cost of community benefit of $23,230,302. The cost of servicing the people qualifying for public indigent programs (including Medicaid and other public programs) was $10,701,703. The cost of our hospital based community care program was $4,772,734. Sacred Heart also provided benefits of $7,755,865 to the community through many reduced price services and free programs offered throughout the year based upon activities and services that Sacred Heart Hospital believes will serve a bona fide community health need. These include: * The Healing Place: A Center for Life's Journeys is Sacred Heart Hospital's free grief and holistic healing center for those experiencing loss and/or adjustment issues, such as those brought about by death, divorce, disability/illness, unemployment, military service, etc. Support services include: grief support groups, 1:1 counseling, workshops, presentations for individuals and families dealing with loss and major life transitions. During the past year, The Healing Place has offered: * 1:1 counseling to anyone needing help with a life adjustment issue * Evening and Daytime Spouse Loss groups for those who have lost a spouse, both time limited and on-going * SHARE Support Group for miscarriage, stillbirth, and early infant death * Parents Grief Group for parents who have lost a child * Suicide Survivor's Group for those who have lost a loved one to suicide * Classes for teaching resiliency/coping skills/stress management * Workshops and presentations for various institutions and businesses on topics related to grief, loss, and coping * Special programs and workshops including Grief in the Workplace and Grief and the Holidays * Support groups for those experiencing divorce or loss of a parent * All day retreat on parenting a child with a disability, open to parents, family, and caregivers * Center for Healthy Living and other educational classes and resources including: * Prepared Childbirth (Lamaze, prenatal, sibling classes and lactation consulting) * CPR classes * Babysitting Seminars * Pediatric Health Fair with hands-on activities in health, wellness and safety for second grade students in Eau Claire County * Wellness programs, services, and retreats * Participation in community and local business health fairs * Caring for the Caregiver Workshop * Great Escape Women's Fitness Camp, annual event, includes classes in exercise and meditation; health, wellness and prevention education; and health and wellness coaching * Center for Medical Excellence Community Health Information Room with access to print and electronic medical journals and other health resources for patient, family, and community use * Annual "Woman to Woman" Healthcare Expo, includes health and prevention services with motivational speaker * Indoor Sports Center "Get Hooked on Health" Kids Expo (safety education, health & wellness) * Spirit of Women education programs, speakers, and free screenings * Monthly car seat installations and education programs specific for WIC families * Helmet fitting clinics * Celebration of Woman Event (with Junior League of Eau Claire) * Monthly Meditation Program offerings * "Day of Dance" to celebrate health and learn about cardiovascular disease, including BMI testing, blood pressure, and sleep apnea screenings * Joint Renew Camp for patients who will undergo joint replacement surgery * Safety Town program - specific for pre K-K students to teach basic safety (taught in Bloomer, Menomonie, and Eau Claire) * Coat Drive collects over 6,000 coats annually and gives to those in need * Cancer care related programs: * Look Good, Feel Better - A program for women to help them cope with the impact of cancer treatment on body image. Includes beauty makeovers and wigs as needed. Monthly program * Touched by Cancer - A support group for cancer patients and their families. Seminars on cancer-related issues such as nutrition, stress-reduction, family issues, cancer in the workplace, spiritual support. Meets twice a month. * Eau Claire Partners- A support group of breast cancer patients and survivors. Dealing with issues related to body image, sexuality, finding clothes and lingerie that fit, side-effects of breast cancer treatment, etc. Meets twice a month. * Yoga - Stress-reduction yoga class for cancer patients and survivors. Meets weekly in 6-week sessions. * C.L.I.M.B./C.H.A.T. - Programs for school age children (CLIMB) and teens (CHAT) to help them understand and cope with having a parent or family member in treatment for cancer. Meets weekly in 6-week sessions. * Livestrong(c) - A program co-sponsored by the Lance Armstrong Foundation in conjunction with the YMCA. This is a program of exercise for cancer patients that helps them maintain conditioning and decrease fatigue during treatment. It starts in the cancer center with volunteers from the UW-EC physical therapy program hosting a 6 week session. Patients wishing to continue after 6 weeks can do so at no charge at the EC YMCA through a grant from the Lance Armstrong Foundation. * I Can Cope - A discussion group for cancer patients and their families that is independent, and involves open discussion as to issues patients encounter, and related coping strategies. Meets once a month * Nutritional support counseling from a Registered Dietitian to help cancer patients deal with the dietary impact of cancer treatment * Music Therapy - Led by student volunteers of the UW-EC music program. Students provide music and song for patients waiting for treatment. The Threshold singers, another volunteer group, provide a capella song at the bedside for cancer patients on the oncology unit. * Pet Therapy - Numerous volunteers bring AKC-certified pet therapy dogs to the cancer center to visit with patients and their families awaiting treatment. * Oncology Nurse Navigator - a free, mission-driven program of support for newly diagnosed cancer patients. The navigator assists patients in setting up appointments, arranging transportation, finding appropriate support groups, and accessing counseling and spiritual support. * Pastoral Counseling - Spiritual support is available to any patient upon request through Pastoral Care Department. * Ongoing support programs: * Adults with Lung Problems * Eau Claire Partner's Breast Cancer Group, support group for breast cancer survivors * Trust in Life series by The Healing Place * Survivorship Care Plan Program * YANAS (You Are Not Alone Sister) Breast Cancer Group * Alzheimer's support group * Amputee Clinic * Multiple Sclerosis support group, * Spinal Cord injury support group * Spirit of Women, ongoing program around women's health issues sponsored by the Center for Healthy Living * Meal programs & support including: * Meals for Senior Citizens and congregate site meals * Thanksgiving St. Francis Food Pantry food drive collection program for needy families * Coat, mitten, linen and blanket drive * Christmas Sponsor-A-Family drive * Weekend Kids' Meal Program, donating 870 pounds of food to Feed My People food bank * Peanut Butter for Haiti food drive * Health screenings including: * Blood pressure screenings at health fairs * Stroke Prevention Clinic/screenings * "HeartAware" online cardiovascular disease screening tool * Services to the community, including: * Center for Spiritual Care pastoral care chaplain and volunteer assistance with over 500 Power of Attorney for Health Care (Advance Directive) forms * Community and clergy presentation by best-selling author, Dr. David Dosa, on "The Power of Min
Affiliated Health Care SystemSacred Heart Hospital - EAU CLAIRE is an affiliate of Hospital Sisters Health System. The mission of Hospital Sisters Health System ("HSHS") is to serve those in need through a health care ministry that values compassion, respect and reverence for life. The nearly 14,000 colleagues who make up HSHS are dedicated to this mission and to providing high quality health care to whoever seeks our services. By living our mission each day, HSHS colleagues constantly strive to provide the highest quality and most cost-effective and compassionate health care to those we are privileged to serve. Our health care ministry extends across 12 communities in Wisconsin and Illinois and includes 13 hospitals, dozens of community-based health centers and clinics, and more than 2,000 physician partners. As part of our mission to provide healing and hope to the three million people we serve, we have developed Community Benefit initiatives that 1) expand access to health care, 2) enhance overall health status and 3) promote medical education. In the Fiscal Year that ended June 30, 2011, HSHS hospitals provided $166.1 million in Community Benefits (or 8.7% of total expenses), an increase of $15.7 million from FY 2010. Of this amount, $37.1 million was provided for charity care and $99.8 million was the amount of unreimbursed care provided under the Medicaid program. In addition, HSHS hospitals committed significant resources in serving the Medicare population. The cost of providing services to primarily elderly beneficiaries of the Medicare program, in excess of governmental and managed care contract payments, was $183.8 million during Fiscal Year 2011. HSHS hospitals also recorded $103.9 million in uncollectible accounts. HSHS strengthens the health of our communities by continually reinvesting any surplus revenue from operations and investments into new medical technology, facility infrastructure and health care services. These investments ensure that our hospitals can continue to provide high quality, compassionate care to our patients. During Fiscal Year 2011, HSHS also continued to invest in our Care Integration strategy that places the patient at the center of our work while allowing us to deliver care in a more cost-effective and efficient manner. These investments are designed to better coordinate care, improve health outcomes, create new efficiencies, and help ensure that patients (especially those with chronic conditions) get well and stay well. Our Care Integration strategy is delivering promising results. An example is our three Medical Home pilot projects. Diabetic Patients enrolled in Medical Homes in rural Illinois experienced an average 42 percent decrease in their blood glucose levels while their unplanned readmissions to the hospital dropped to zero. HSHS is making significant progress implementing interoperable health information technologies and robust health information exchanges. In central Illinois, HSHS is joining with other health care providers to develop a statewide Health Information Exchange ("HIE") that will allow health care providers to exchange clinical information, such as medication histories and test results, access that information at the point of care and make better informed decisions with their patients. HSHS understands that our investments in information technology will have a positive impact on the quality, safety and efficiency of health care. 1. Expanding access to health care An integral component of our Community Benefit initiatives is to provide care to every patient who seeks our services without exception. To that end, HSHS hospitals have established Charity Care program guidelines that cover 100% of hospital charges for individuals and families who earn 125% to 250% of the federal poverty level. HSHS hospital's Charity Care guidelines have sliding scales, in some instances providing up to a 50% discount on charges for those earning up to 600% of the federal poverty level. HSHS hospitals have created simple forms for those wishing to apply for Charity Care and assign counselors to visit with inpatients who are uninsured to let them know about our charity care policies and provide assistance filling out applications for financial assistance or enrollment in publicly funded health care programs. HSHS hospitals also work collaboratively with others to enhance access to health care services for those in need. St. John's Hospital in Springfield, IL has partnered with Memorial Medical Center, Southern Illinois University School and Medicine and other community partners to support the Coordinated Access to Community Health ("CATCH") initiative. The free program is being made available to uninsured adults in Sangamon County to help them access routine medical care, specialty doctors and affordable medicine. Launched in May 2011, CATCH enrolls patients as they visit social service agencies or when they leave hospital emergency rooms. Enrollees are then referred to Springfield's federally funded primary care clinic, Capitol Community Health Center, or participating doctors' private offices. Grants from St. John's Hospital, Memorial Medical Center, United Way of Central Illinois and the Dominican Sisters offset CATCH's first year of expenses. Patient advocates at St. John's Hospital and Memorial Medical Center help uninsured patients find primary or specialty doctors and make appointments, and arrange for financial assistance from participating social service agencies for prescription drugs. In the first three months since the program was launched, CATCH signed up more than 250 physicians in the community who agreed to see patients at no charge. The program endeavors to enroll up to 6,000 uninsured patients within the next few years. By making it easier for uninsured residents to get preventive health care services, CATCH organizers believe uninsured patients' medical problems will be addressed early, helping improve their quality of life. St. Mary's Hospital Medical Center in Green Bay, WI supports the NEW Community Clinic, a 38-year-old free health center for the uninsured and underinsured. St. Mary's provides free and discounted laboratory and radiology services to the clinic. More than 70 percent of patients say the clinic's care allowed them to avoid having to seek care in a local Emergency Room. For the past decade, St. Anthony's Memorial Hospital in Effingham, IL has teamed up with Effingham Catholic Charities to co-sponsor the Prescription Assistance Program. Catholic Charities' staff members work with clients who need prescription medication but may not be able to afford them because they are uninsured or underinsured. Due to the financial support of St. Anthony's, the program is able to provide needed prescriptions to dozens of residents each month. St. Francis Hospital in Litchfield, IL collaborated with local dental care providers to coordinate and provide a free day of dental care to uninsured individuals. The collaboration was the result of a community needs assessment that determined access to dental care was a priority in the community. The "Community Day of Dental Care" provided free dental cleanings, X-Rays, and extractions to 90 uninsured individuals. Among those 90 people served included a military veteran who has been unable to obtain dental care after a St. Louis facility closed. He was able to have five teeth extracted. Another person served was a young woman who needed some minor restorative care which greatly improved her appearance. She was very grateful because she had a job interview coming up and would be able to attend the interview feeling better about her appearance. 2. Enhancing the health status of the community Another component of our Community Benefit initiatives is to improve the quality of life in our communities. Our hospitals work closely with a wide array of public and private organizations that share our commitment to enhancing health and wellness. We know that by working together, we can maximize our efforts by sharing resources, reduce duplication of services, and make it easier for residents to get the services and knowledge they need to live healthier lives. HSHS hospitals also understand they need to listen closely to the residents of the communities they serve to ensure the health care needs of all are being met. Sacred Heart Hospital in Eau Claire, WI invited more than 1,400 area residents to share their vision for health care during a series of focus groups. Participants included constituents that are often overlooked: low-income, vulnerable populations and minority groups. The visioning sessions captured the voices of special populations, Among Mutual Assistance Association members, Amish farmers, seniors, young children and other diverse groups. The feedback provided led to more than 100 actionable items that were assessed and/or implemented over the first six months since the sessions concluded. One action taken by Sacred Heart Hospital and St. Joseph's Hospital
STATE FILING OF COMMUNITY BENEFIT REPORTWI,990 SCHEDULE H, PART VI

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (9 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
STEPHEN RONSTROM
036431903260007869301079920361660619770050304
Ann Carr
0152228011100028008092165018090030159100
John Lamoureux
28125602653905293076962012940391344000
Lance Levendowski
193703000165000113860206470242236000
John Waciuma
217508000000026150220123000
Brent Jensen
193055000005810084620207327000
FAYE DEICH
262757015400063750727740216310378937000
Amy Dwyer
16995400000914940151790276627000
donald joyce
181029000190760-24585018461019398100

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
Corporate Technologies
Board Chair is a Partner1332009Purchase Computer equipmentfalse
pathology service corporation
board member is a partner360900hospital based pathology svcs.false
Net Tel
Board Chair is a Partner74752Telecommunications Equipmentfalse

Form990 Schedule L Part V Form990ScheduleLPartV

FieldValueIRS element (for citing)
Identifierbusiness transactions with interested personsIdentifier
Return Referenceschedule l, part ivReturnReference
Explanationbusiness transactions with interested persons were compliant with the organization's conflict of interest policy. any transactions requiring board approval were reviewed by an independent board prior to being approved.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (16 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S MISSIONPART III LINE 1THE PRIMARY PURPOSE OF SACRED HEART HOSPITAL IS TO PROVIDE A STRUCTURE AND THE MEANS WHEREBY THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST. FRANCIS CAN CONTINUE THEIR APOSTOLIC MISSION TO SERVE THE SICK, THE AGED, THE POOR AND THE TERMINALLY ILL WITHOUT REGARD TO RACE, COLOR, CREED OR NATIONAL ORIGIN. THE PRIMARY CONCERN OF SACRED HEART HOSPITAL AND THE HOSPITAL SISTERS IS THE PATIENT'S WELL BEING... SPIRITUALLY, PHYSICALLY, PSYCHOLOGICAL AND SOCIAL.
PROGRAM SERVICES REVENUE - ACCOMPLISHMENTSFORM 990 PART III, LINE 4ASacred Heart Hospital provides quality medical healthcare regardless of race, creed, sex, national origin, handicap, age, or ability to pay. Although reimbursement for services rendered is critical to the operation and stability of Sacred Heart Hospital, it is recognized that not all individuals possess the ability to purchase essential medical services. Furthermore, our mission is to serve the community with respect to providing healthcare services and healthcare education. Health activities and programs to support the community are considered where there is a demonstrated need. These activities include behavioral health services, wellness programs, community education programs, special programs for the elderly, and a variety of broad community support activities. Sacred Heart Hospital provided 46,187 adult and pediatric days of care and 106,715 outpatient visits during fiscal year ended June 30, 2011. Sacred Heart Hospital provides care to persons covered by governmental programs at or below cost. Recognizing our mission to the community, services are provided to both Medicare and Medicaid Patients. In accordance with standards defined by the Catholic Health Association USA ("CHAUSA"), Sacred Heart Hospital has recognized an unreimbursed cost of community benefit of $23,230,302. The cost of servicing the people qualifying for public indigent programs (including Medicaid and other public programs) was $10,701,703. The cost of our hospital based community care program was $4,772,734. Sacred Heart also provided benefits of $704,435 to the community through many reduced price services and free programs offered throughout the year based upon activities and services that Sacred Heart Hospital believes will serve a bona fide community health need. These include: * The Healing Place: A Center for Life's Journeys is Sacred Heart Hospital's free grief and holistic healing center for individuals who have experienced a loss or are dealing with a major life transition. Support includes: grief support groups, counseling, workshops, presentations to grieving individuals and families such as: o Evening and Daytime Spouse Loss groups for those who have lost a spouse o SHARE Support Group for miscarriage, stillbirth and early infant death o Parents Grief Group for parents who have lost a child o Adult Loss of a Parent for those who have lost a parent o Suicide Survivor's Group for those who have lost a loved one to suicide o Workshops and presentations to healthcare, spirituality, educational and mental health institutions on topics related to grief and loss. o Special programs and workshops including Grief in the Workplace and Grief and the Holidays o New support services, short-term counseling, classes and workshops provide support for those coping with non-death-related life transitions including: divorce or separation, illness, disability, job changes, military deployment and retirement * Center for Healthy Living and other educational classes and resources including: o Prepared Childbirth (Lamaze, prenatal, sibling classes and lactation consulting) o CPR classes o Babysitting/Smarter Sitter Seminars o Pediatric Health Fair with hands-on activities in health, wellness and safety for second grade students in Eau Claire County o Wellness programs, services and retreats o Participation in health fairs o Caring for the Caregiver Workshop o Center for Medical Excellence Community Health Information Room with access to print and electronic medical journals and other health resources for patient, family, and community use o Annual "Woman to Woman" Healthcare Expo o Indoor Sports Center "Get Hooked on Health" Kids Expo (safety education, health & wellness) o Spirit of Women education programs, speakers and screenings o Car seat installations and education programs o Helmet fitting clinics o Celebration of Woman Event (with Junior League of Eau Claire) o Monthly Meditation Program * Cancer care related programs: o Look Good, Feel Better - A program for women to help them cope with the impact of cancer treatment on body image. Includes beauty makeovers and wigs as needed. Monthly program o Touched by Cancer - A support group for cancer patients and their families. Seminars on cancer-related issues such as nutrition, stress-reduction, family issues, cancer in the workplace, spiritual support. Meets twice a month. o Eau Claire Partners- A support group of breast cancer patients and survivors. Dealing with issues related to body image, sexuality, finding clothes and lingerie that fit, side-effects of breast cancer treatment, etc. Meets twice a month. o Yoga - Stress-reduction yoga class for cancer patients and survivors. Meets weekly in 6-week sessions. o C.L.I.M.B./C.H.A.T. - Programs for school age children (CLIMB) and teens (CHAT) to help them understand and cope with having a parent or family member in treatment for cancer. Meets weekly in 6-week sessions. o Livestrong - A program co-sponsored by the Lance Armstrong Foundation in conjunction with the YMCA. This is a program of exercise for cancer patients that helps them maintain conditioning and decrease fatigue during treatment. It starts in the cancer center with volunteers from the UW-EC physical therapy program hosting a 6 week session. Patients wishing to continue after 6 weeks can do so at no charge at the EC YMCA through a grant from the Lance Armstrong Foundation. o I Can Cope - A discussion group for cancer patient and their families that is independent and involves open discussion as to issues patients encounter and coping strategies. Meets once a month o Music Therapy - Led by student volunteers of the UW-EC music program. Students provide music and song for patients waiting for treatment. The Threshold singers, another volunteer group, provide a capella song at the bedside for cancer patients on the oncology unit. o Pet Therapy - Numerous volunteers bring AKC-certified pet therapy dogs to the cancer center to visit with patients and their families awaiting treatment. o Oncology Nurse Navigator - a free, mission-driven program of support for newly diagnosed cancer patients. The navigator assist patients in setting up appointments, arranging transportation, finding appropriate support groups, and accessing counseling and spiritual support. o Pastoral Counseling - Spiritual support is available to any patient upon request through Pastoral Care Department. * Support groups for diseases/disorders such as Alzheimer's, Amputee Clinic, Multiple Sclerosis, Spinal Cord injury, and others * Breastfeeding support group * Meal programs & support including: o Meals for Senior Citizens and congregate site meals o Thanksgiving St. Francis Food Pantry food drive collection program for needy families o Coat, mitten, linen and blanket drive o Christmas Sponsor-A-Family drive
program service revenue* Health screenings including: o Blood pressure screenings at health fairs o Stroke Prevention Clinic/screenings o "HeartAware" online cardiovascular disease screening tool * Services to the community, including: o Center for Spiritual Care pastoral care chaplain and volunteer assistance with over 500 Power of Attorney for Health Care (Advance Directive) forms o Symposium on Advance Directives and end-of-life decisions o A variety of student intern programs, work shadowing, and tours o Overnight accommodations for families of critically ill patients o Patient follow-up post discharge calls program o Medical equipment, supplies, laboratory services, imaging services donated to the Chippewa Valley Free Clinic and its patients below the federal poverty level o Symposium support and sponsorship for the Catholic Medical Association o Disaster preparedness planning o Influenza/H1N1 community education * Hosting meetings, drives and sponsorships for: o Red Cross blood drives o Catholic Charities events and education o Sojourner House - Eau Claire homeless shelter o Diocese of La Crosse Office of Family Life o United Way events o Relay for Life - American Cancer Society o Special Olympics Polar Plunge o American Heart Association Heart Walk o Brain Injury Association of Wisconsin o Breakfast in the Valley o Red Cross Real Heroes banquet o Producers & Buyers Co-op: Linking Local Farms and Institutions, organizational support for meetings and organizational and secretarial support to encourage local food sourcing by institutions to benefit the local economy (in partnership with River Country RC&D and local family farms) o Logistical support and meeting space for the Chippewa Valley Internetworking Consortium to help expand fiber broadband infrastructure and service to the community and to rural and underserved areas to support telemedicine and other health projects, along with city/county governments, EMS, libraries and schools/education o Local "green" and environmental sustainability educational events * First Aid booths for community events/festivals, including: o Buckshot Run o Country Jam o Festival in the Pines o International Fall Festival * "Green" environmental stewardship and sustainability efforts (recycling and reusing) including: o Food scrap produce were donated to a local ranch for animal feed o The hospital donated leftover food to the St. Francis Food Pantry o Donated used equipment to Third World countries via the Hospital Sisters Mission Outreach: Medical equipment went to needy hospitals and clinics in third world countries such as Mongolia and Ukraine and to U.S. Navy Project Handclasp. Equipment included beds, wheelchairs, exam lights, walkers, x-ray aprons, medical carts, surgical instruments, stretchers, linens and various other items * The "Imagining the Future" listening campaign, a grassroots approach to discover what services the community believes an ideal healthcare system ought to provide, was conducted from October to December 2010. Deeply rooted in the hospital's Franciscan mission, it was a holistic and spiritual process of discernment which stimulated open, honest, and non-judgmental sharing of insights about healthcare delivery in the context of the physical, emotional and spiritual needs of the broader community. o The initiative included more than 1,400 participants and began with two large town hall-like meetings hosted by the hospital CEO and 35 smaller visioning sessions led by hospital leaders. Community members also participated online and through social media (Facebook and Twitter). In all, we received 2,830 ideas regarding the future of healthcare. o Focus groups included constituents that are often overlooked: low-income, vulnerable populations and minority groups. It captured the voices of special populations, Hmong Mutual Assistance Association members, Amish farmers, seniors, young children and other diverse groups. The visioning sessions allowed us to gather mission-critical information, and gave community members the opportunity to articulate their vision of an ideal healthcare system for their community that improved health, healing and well-being. The goal was to engage and empower community members and hospital leaders so that together we could shape an ideal local healthcare system. o A committee was commissioned to divide the 2,830 comments into 600 categories. A Community Dream Team and a Colleague Dream Team were formed to assess each request to determine if it was something that could be responded to in the short term or long term range. More than 100 actionable items were assessed and/or implemented over the first six months. Sacred Heart Hospital has prepared the financial information in this report in accordance with CHAUSA community benefit reporting guidelines. These guidelines recommend the following: * Report community care at cost, not charges. * Do not include bad debt, contractual allowances, and quick pay discounts as part of charity care expense. * Do not count Medicare shortfall as a community benefit. * Report the net expense for community benefit services, i.e., the total community benefit expense minus any associated revenue from patients, payers, and other external sources. The Catholic Health Association's reporting guidelines reflect a conservative approach to reporting quantifiable community benefit. The goal of the reporting guidelines is to produce community benefit financial reports that reflect true costs and that describe community benefit activities that increase access to health care and improve community health. In summary Sacred Heart Hospital financially contributed to the community $23,230,302 for fiscal year ended June 30, 2011 as follows: Charity care - at cost, not including bad debt $4,772,734 Government sponsored health care - net expense 10,701,703 Unpaid cost of public indigent care programs (includes Medicaid and other public programs) Community Benefit Programs - net expense 7,755,865 ------------ Total quantifiable community benefit $23,230,302 ============ In addition to the amounts reported above, Sacred Heart Hospital committed significant resources to service the Medicare population. The cost (as determined using the cost to charge ratio) of providing services to primarily elderly beneficiaries of the Medicare program in excess of governmental and managed care contract payments was $23,785,028 for the year ended June 30, 2011. TAX-EXEMPT BONDS FORM 990, PART IV, LINE 24 SACRED HEART HOSPITAL HOLDS A LIABILITY ON ITS BOOKS FOR TAX-EXEMPT BONDS, WHICH IS AN ALLOCATION FROM ITS SOLE CORPORATE MEMBER, HOSPITAL SISTERS SERVICES, INC. AS A RESULT, THIS QUESTION WAS ANSWERED NO, AND SCHEDULE K WILL BE COMPLETED ON THE HOSPITAL SISTERS SERVICES, INC. FORM 990.
RIGHTS OF MEMBERS TO ELECT GOVERNING BODYFORM 990 PART VI, LINES 6 & 7ATHE SENIOR GOVERNING BODY OF SACRED HEART HOSPITAL (THE "CORPORATION") IS THE MEMBER OF THE CORPORATION, WHICH IS HOSPITAL SISTERS HEALTH SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. PURSUANT TO SECTION 2.3 OF THE CORPORATION'S BYLAWS, HSSI HAS THE RIGHT TO APPOINT AND REMOVE THE CORPORATION'S BOARD OF DIRECTORS, CHAIRPERSON OF THE BOARD AND PRESIDENT.
MEMBER RESERVED POWERSFORM 990 PART VI, LINE 7BResponsibility for the policy and operations of Sacred Heart Hospital (the "Corporation") is vested in its Board of Directors, except with respect to specific powers reserved in the Corporation's Bylaws to the Corporation's Member, Hospital Sisters Health Services, Inc. ("HSSI"), an Illinois not for profit corporation exempt from federal taxation under Section 501(c)(3) of the Internal Revenue Code. The member of HSSI is Hospital Sisters Health System ("HSHS"), an Illinois not for profit corporation exempt from federal taxation under Section 501(c)(3) of the Internal Revenue Code. The members of HSHS are the individual sisters who from time to time are the duly elected Provincial Superior and Provincial Councilors, respectively of the American Province of the Hospital Sisters of St. Francis ("American Province"). The American Province is the United States organization of the Congregation of the Hospital Sisters of the Third Order Regular of St. Francis, a religious institute of the Roman Catholic Church. The governance and operations of the Corporation are subject to HSSI's right to exercise these reserved powers with respect to the Corporation and organizations of which the Corporation is either, directly or indirectly, a controlling member or a controlling shareholder ("Affiliates"). HSSI's right to exercise certain of these reserved powers is, in turn, subject to the approval of HSHS and HSHS' members. The reserved powers include all rights granted to HSSI by law and the right to: (a) Adopt, approve amendments to, or amend any statement of philosophy, mission, mission integration or values or any name, logo, or mark of the Corporation or of any Affiliate; (b) Adopt, approve amendments to, or amend the Articles of Incorporation of the Corporation or of any Affiliate; (c) Adopt, approve amendments to, or amend the Bylaws of the Corporation or of any Affiliate; (d) Appoint and remove the Board of Directors, any one or more of the Directors of the Corporation or of any Affiliate, and the Chairperson and President of the Corporation or of any Affiliate; (e) Approve the recommendation of the Board of Directors to appoint or remove the Board of Directors, any one or more Directors of the Corporation or of any Affiliate, or the Chairperson and President of the Corporation or of any Affiliate. (f) With respect to the Corporation or any Affiliate, approve the purchase, sale, alienation, exchange, lease or encumbrance of any real property of the Corporation or of any Affiliate, which property has a value in excess of limits set from time to time by HSSI; (g) Approve the operating and capital budgets of the Corporation or of any Affiliate, and any deviations by the Corporation or of any Affiliate from such budgets in an amount or percentage specified by HSSI from time to time; (h) Approve the strategic plan and goals of the Corporation or of any Affiliate; (i) Approve the sale of substantially all of the assets of the Corporation or of any Affiliate; (j) Approve the merger or dissolution of the Corporation or of any Affiliate; (k) Adopt or amend the plan for ministry education and governance for the Corporation and its Affiliates; (l) Approve the Corporation's Mission Accountability Reports and those of any Affiliate; (m) Approve the financial policies and procedures of the Corporation or of any Affiliate and approve any deviations from such policies and procedures by the Corporation or any Affiliate; and (n) Adopt policies to implement the Reserved Powers of HSSI.
FORM 990 REVIEW PROCESSFORM 990 PART VI, LINE 11bThe hospital employs KPMG to assist in the overall review and electronic submission of its Form 990. KPMG provides guidance in identifying critical errors in the return submission and feedback on quantitative and qualitative responses. Additionally, the hospital CFO performs a thorough review of the return and reviews it with the hospital CEO and/or senior leaders before presenting it in its entirety to the hospital Board for questioning and review prior to the return's signing and submission to the IRS.
CONFLICT OF INTEREST POLICYFORM 990 PART VI, LINE 12CThe organization is subject to the corporate compliance program and conflict of interest policy ("policy") of Hospital Sisters Health System, an Illinois not for profit corporation exempt from federal taxation under section 501(c)(3) of the internal revenue code. A REVISED CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY HAVE BEEN IMPLEMENTED SINCE JANUARY, 2009 TO MANAGE CONFLICTS OF INTEREST USING A SYSTEM-WIDE PROTOCOL FOR DISCLOSURE STATEMENTS. IN ACCORDANCE WITH the organizaton's CONFLICT OF INTEREST POLICY, ALL COVERED PERSONS HAVE A DUTY TO COMPLY WITH THE CONFLICT OF INTEREST POLICY FOR ANY CONTRACT, TRANSACTION, RELATIONSHIP, OR ACTIVITY CONTEMPLATED, ENTERED INTO, OR CONDUCTED AT HSHS OR ITS AFFILIATES. THE POLICY DEFINES COVERED PERSONS AS BOARD MEMBERS, BOARD COMMITTEE MEMBERS, OFFICERS, BOARD DESIGNEES, SENIOR MANAGEMENT, MEMBERS OF ANY COMMITTEE THAT OVERSEES THE APPROVAL OF PHARMACEUTICALS AND MEDICAL DEVICES, and ANY OTHER INDIVIDUAL WHO HOLDS A POSITION OF TRUST. ON AN ANNUAL BASIS, Hospital Sisters Health System, ("HSHS") DISCLOSES A COPY OF THE CONFLICT OF INTEREST POLICY (AND ALL CORRESPONDING PROCEDURES, GUIDELINES, FORMS, AND TOOLS) TO ALL COVERED PERSONS, AND ADVISES ALL COVERED PERSONS IN WRITING OF ANY SUBSTANTIVE CHANGES TO THIS POLICY AND SUCH RELATED MATERIALS. COVERED PERSONS ARE REQUIRED TO REVIEW AND COMPLETE THE CORRESPONDING CONFLICT OF INTEREST STATEMENT. THE SYSTEM OFFICE VICE PRESIDENT - SYSTEM RESPONSIBILITY, VICE PRESIDENT - RISK & COMPLIANCE, OR MEMBERS OF THE AUDIT AND INTEGRITY COMMITTEE ("COMMITTEE") ARE AVAILABLE TO ANSWER ANY QUESTIONS A COVERED PERSON MAY HAVE. IN ADDITION, IF, AT ANY TIME AFTER SUBMITTING AN ANNUAL CONFLICT OF INTEREST STATEMENT, A COVERED PERSON BECOMES AWARE OF AN INTEREST THAT HE OR SHE WOULD HAVE HAD TO DISCLOSE AT THE ANNUAL INTERVAL, THE COVERED PERSON IS REQUIRED PROMPTLY TO DISCLOSE THE INTEREST TO THE COMMITTEE USING THE HSHS CONFLICT OF INTEREST DISCLOSURE STATEMENT. COMPLETED CONFLICT OF INTEREST STATEMENTS ARE SUBMITTED TO THE COMMITTEE, WHICH IS RESPONSIBLE FOR IDENTIFYING, ASSESSING, AND MANAGING CONFLICTS OF INTEREST THAT ARISE IN THE COURSE OF CONDUCTING THE AFFAIRS OF HSHS AND ITS AFFILIATES. IF THE COMMITTEE DETERMINES THAT A CONFLICT OF INTEREST EXISTS, THE CONFLICT OF INTEREST POLICY REQUIRES HSHS NOT TO ENGAGE IN, OR ENTER INTO, A PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY UNLESS THE COMMITTEE OR, WHERE NECESSARY, THE BOARD OF DIRECTORS (ACTING THROUGH ITS DISINTERESTED MEMBERS), HAS INVESTIGATED ALTERNATIVES TO THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY AND, IN THE ABSENCE OF ALTERNATIVES THAT ARE IN THE BEST INTERESTS OF HSHS, HAS DETERMINED: 1. THAT, REGARDLESS OF WHETHER THE COVERED PERSON PARTICIPATES IN THE IMPLEMENTATION OF THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY; 2. THE CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY IS IN THE BEST INTERESTS OF HSHS; 3. THE CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY IS FAIR AND REASONABLE FROM THE PERSPECTIVE OF HSHS; AND 4. HSHS CANNOT OBTAIN A MORE ADVANTAGEOUS CONTRACT, TRANSACTION, ARRANGEMENT OR ACTIVITY WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES. IN DETERMINING WHETHER A CONTRACT, TRANSACTION OR ARRANGEMENT IS FAIR AND REASONABLE TO HSHS, THE COMMITTEE SHALL CONSIDER, WHERE APPLICABLE: 1. APPRAISALS OR OTHER INDEPENDENT VALUATIONS OF THE FAIR MARKET VALUE OF THE CONTRACT, TRANSACTION, OR ARRANGEMENT; 2. INFORMATION REGARDING COMPARABLE CONTRACTS, TRANSACTIONS, OR ARRANGEMENTS BETWEEN UNRELATED PARTIES; 3. OFFERS FROM COMPARABLE COMPETING ENTITIES; AND/OR 4. STUDIES OF COMPARABLE COMPENSATION ARRANGEMENTS. IN ANY CASE IN WHICH THE COMMITTEE FINDS, AFTER TAKING THE STEPS DESCRIBED ABOVE, THAT HSHS SHOULD PARTICIPATE IN A PROPOSED TRANSACTION OR ARRANGEMENT DESPITE THE EXISTENCE OF A CONFLICT OF INTEREST, THE COMMITTEE SHALL DEVELOP, IMPLEMENT, MONITOR, AND ENFORCE COMPLIANCE WITH, A CONFLICT MANAGEMENT PLAN FOR MANAGING THE CONFLICT OF INTEREST AS IT CONSIDERS NECESSARY FOR SUCH FINDINGS TO REMAIN VALID THROUGHOUT THE LIFE OF THE CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY. ALL CONFLICT MANAGEMENT PLANS SHALL: 1. STATE THAT THE COMMITTEE WILL OVERSEE, MONITOR, AND ENFORCE COMPLIANCE WITH THE PLAN THROUGHOUT THE COURSE OF THE STUDY AND SPECIFY MEANS FOR DOING SO, INCLUDING, WITHOUT LIMITATION, THAT THE APPROPRIATE INDIVIDUALS MUST PROVIDE THE COMMITTEE WITH WRITTEN REPORTS PERTAINING TO COMPLIANCE WITH THE CONFLICT MANAGEMENT PLAN, THAT THE COMMITTEE SHALL HAVE THE RIGHT TO AUDIT THE STUDY FOR SUCH COMPLIANCE, AND THE RIGHT TO IMPOSE SANCTIONS FOR NON-COMPLIANCE; 2. STATE THAT THE PLAN MUST BE SHARED WITH COVERED PERSON WHOSE INTERESTS IT WAS DEVELOPED TO MANAGE; 3. STATE THAT THE PLAN MUST BE SHARED WITH, AND PERIODIC REPORTS ON COMPLIANCE WITH THE PLAN MUST BE PROVIDED TO, THE BOARD, SENIOR MANAGEMENT AND/OR GOVERNMENT AGENCIES; AND 4. PROVIDE FOR SUCH OTHER MANAGEMENT STEPS AND MECHANISMS THE COMMITTEE CONSIDERS NECESSARY AND APPROPRIATE. IN ADDITION TO THE COMMITTEE, THE SYSTEM OFFICE VICE PRESIDENTS OF SYSTEM RESPONSIBILITY AND RISK & COMPLIANCE MAY RETAIN SUCH INDEPENDENT ADVISORS OR EXPERTS AS DEEMED NECESSARY TO ASSIST IN MAKING ITS DETERMINATIONS AND DECISIONS. IF THE COMMITTEE DETERMINES THAT THE CONTEMPLATED TRANSACTION, RELATIONSHIP ARRANGEMENT, OR ACTIVITY CANNOT PROCEED DUE TO A CONFLICT OF INTEREST, THE COMMITTEE SHALL INFORM THE APPLICABLE COVERED PERSON OR DECISION-MAKING BODY OF SUCH DETERMINATION WITHIN ONE WEEK OF THE COMMITTEE MEETING AT WHICH THE CONTEMPLATED TRANSACTION WAS DISCUSSED. THE COMMITTEE SHALL DOCUMENT ITS REJECTION OF THE CONTEMPLATED TRANSACTION IN THE COMMITTEE'S MEETING MINUTES.
WHISTLEBLOWER POLICYFORM 990 PART VI, LINE 13Provisions within the Corporate Compliance Program and Conflict of Interest Policy provide protections for whistleblower type activities.
Determination of CEO & Key employee CompensationFORM 990 PART VI, LINE 15The Compensation Committee ("Committee") is comprised of independent members of the Board of Directors. The Committee develops a compensation philosophy for the System and all affiliates. The Committee selects and hires the independent compensation consultant to develop comparability data and advise the Committee during its deliberations regarding all elements of total compensation for all disqualified individuals. Integrated Healthcare Strategies ("IHS"), the consultants utilized by the Committee, use data from multiple tax-exempt peer group sources to determine salary ranges, incentive opportunity ranges, and benefits for the disqualified individuals. IHS then assists the Committee in preparing contemporaneous documentation of all actions. Each Committee meeting is conducted with the intent to create a rebuttable presumption of reasonableness for all elements of executive total compensation for the disqualified individuals. The Chairman makes this declaration and also inquires if there are any conflicts of interest by any attendees. Any conflicts are disclosed and the Committee then acts in a manner to avoid any conflicted individual participating in any manner where a conflict might exist. At the end of the meeting, the Committee prepares contemporaneous minutes that record all actions taken during the meeting.
FINANCIAL STATEMENTS AVAILABLE TO THE PUBLICFORM 990 PART VI, LINE 19Board-approved financial statements are made available to the public upon request. The governing documents and conflict of interest policy are not made available to the general public at this time.
GRANTS, SCHOLARSHIPS, FELLOWSHIPS, STUDENT LOANFORM 990 PART IX, LINE 2Sacred Heart Hospital participates in various Federal loan and grant programs. These programs are administered in accordance with guidelines established by the U.S. Department of Education and the U.S. Department of Health and Human Services. These programs are audited annually in accordance with OMB Circular A-133 "Audits of Institutions of Higher Education and Other Nonprofit Institutions".
POOLED INVESTMENT ACCOUNTFORM 990 PART X, LINE 11SACRED HEART HOSPITAL USES ITS POOLED INVESTMENTS TO CARRY ON ITS MISSION OF CARING FOR THE SICK. THE HOSPITAL'S CASH RESERVES ARE INVESTED IN A POOLED INVESTMENT ACCOUNT MAINTAINED BY HOSPITAL SISTERS HEALTH SYSTEM ("HSHS"). PARTICIPATION IN THE POOLED FUND IS LIMITED TO THE 501(C)(3) HOSPITALS AND HEALTH SERVICES ORGANIZATIONS SPONSORED BY HSHS. THE POOLED ACCOUNT CONSISTS OF CASH, EQUITY AND DEBT SECURITIES THAT ARE PUBLICLY TRADED. IN ACCORDANCE WITH THE PROVISIONS OF STATEMENT OF FINANCIAL ACCOUNTING STANDARDS ("SFAS") NO. 124 "ACCOUNTING FOR CERTAIN INVESTMENTS HELD BY NOT-FOR-PROFIT ORGANIZATIONS", INVESTMENTS IN EQUITY SECURITIES WITH READILY DETERMINABLE FAIR VALUES, AND ALL INVESTMENTS IN DEBT SECURITIES, ARE REPORTED AT FAIR VALUE ON THE BALANCE SHEET. READILY DETERMINABLE FAIR VALUES AND ALL INVESTMENTS IN DEBT SECURITIES ARE REPORTED AT FAIR VALUE ON THE BALANCE SHEET. INCOME, REALIZED AND UNREALIZED GAINS AND LOSSES ARE POOLED AND ALLOCATED TO THE PARTICIPANTS. INDIVIDUAL COMPONENTS OF ASSETS AND REVENUE ARE NOT IDENTIFIED TO THE INDIVIDUAL HOSPITAL PARTICIPANTS.
Other Changes in Net AssetsPart XI, Line 5Pension Related Funding Change 8,850,000 increase in temporarily restricted net assets 669,000 increase in permanently restricted net assets 641,000 Unrealized Gain 18,316,377 Transfer To Affiliates (1,141,495) ------------ Total 27,334,882 ============
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:SISTER MARYBETH CULNAN, O.S.F. TITLE:DIRECTOR HOURS:74
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:STEPHEN RONSTROM TITLE:CEO HOURS:5
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:Ann Carr TITLE:Treasurer HOURS:75

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateTotal IncomeTotalIncomeEOY AssetsEOYAssetsBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
SPRINGFIELD HEALTH PARTNERS LLC
4936 LAVERNA ROADSPRINGFIELDIL62707371364419HEALTHCAREIL00HSHS MG
Kiara Clinical Integration Network LLC
4936 Laverna RoadspringfieldIL62707261417684healthcareIL00kiara inc

Form990 Schedule R Part II Form990ScheduleRPartII (23 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Hospital Sisters Health System
4936 LAVERNA ROADSPRINGFIELDIL62707371058692HEALTHCAREIL501(c)(3)11ANA
Hospital Sisters Services Inc
4936 LAVERNA ROADSPRINGFIELDIL62707371163402HEALTHCAREIL501(c)(3)11ANA
Hospital Sisters of St Francis FDTN
4936 LAVERNA ROADSPRINGFIELDIL62707371186514HEALTHCAREIL501(c)(3)11ANA
HSHS Health Care Trust Fund
4936 LAVERNA ROADSPRINGFIELDIL62707371137724HEALTHCAREIL501(c)(9)NoneNA
St Anthony's Hospital
503 N MAPLE STREETEFFINGHAMIL624012099370661233HEALTHCAREIL501(c)(3)3NA
St Elizabeth's Hospital
211 SOUTH THIRD STREETBELLEVILLEIL622201998370663567HEALTHCAREIL501(c)(3)3NA
St Francis Hospital
1215 FRANCISCAN DRIVELITCHFIELDIL62056370661236HEALTHCAREIL501(c)(3)3NA
St John's Hospital
800 EAST CARPENTER STREETSPRINGFIELDIL62769370661238HEALTHCAREIL501(c)(3)3NA
St Joseph's Hospital
9515 HOLY CROSS LANEBREESEIL622300099371208459HEALTHCAREIL501(c)(3)3NA
St Joseph's Hospital
1515 MAIN STREETHIGHLANDIL62249370663568HEALTHCAREIL501(c)(3)3NA
St Joseph's Hospital
2661 COUNTY HIGHWAY 1CHIPPEWA FALLSWI54729390810545HEALTHCAREWI501(c)(3)3NA
St Mary's Hospital
1800 E LAKE SHORE DRIVEDECATURIL62521370661244HEALTHCAREIL501(c)(3)3NA
St Mary's Hospital
111 SPRING STREETSTREATORIL613643332372169181HEALTHCAREIL501(c)(3)3NA
St Mary's Medical Center
1726 SHAWANO AVENUEGREEN BAYWI54303390818682HEALTHCAREWI501(c)(3)3NA
St Nicholas Hospital
3100 SUPERIOR AVENUESHEBOYGANWI530811948390808480HEALTHCAREWI501(c)(3)3NA
St Vincent Hospital
835 S VAN BURENGREEN BAYWI54301390817529HEALTHCAREWI501(c)(3)3NA
Hospital Sisters Healthcare West Inc
2661 COUNTY HIGHWAY ICHIPPEWA FALLSWI54729510157933HEALTHCAREWI501(c)(3)11ANA
HSHS Self Insurance TRUST Fund
4936 LAVERNA ROADSPRINGFIELDIL62707371120626INSURANCEIL501(c)(3)11ANA
HSHS Medical Group Inc
4936 laverna roadspringfieldIL62707263956318healthcareIL501(c)(3)11ANA
hshs WISCONSIN MEDICAL GROUP INC
8040 excelsior drive STE 200madisonWI53717264515959healthcareWI501(c)(3)11ana
Orange Cross Ambulance Inc
919 ASHLAND AVENUESHEBOYGANWI53081391860942HEALTHCAREWI501(c)(3)9ST NICHOLAS
WISCONSIN UPPER PENINSULA ONCOLOGY MGMT
835 S VAN BURENGREEN BAYWI543013256391677100HEALTHCAREWI501(c)(3)3ST VINCENT
UNITY LIMITED PARTNERSHIP
2366 OAK RIDGE CIRCLEDE PEREWI54115391750729HEALTHCAREWI501(c)(3)9HSSI

Form990 Schedule R Part III Form990ScheduleRPartIII (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsCode VCodeVAmountGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnership
Memorial and St Elizabeth's Healthcare
4000 North Illinois StreetSwanseaIL62226371312961HealthcareILSt Elizabeth'srelated00false$0false0.00000
Prairie Heart Institute - Carbondale LLC
800 EAst Carpenter StreetSpringfieldIL62769371321197HealthcareILSt John'sRelated00false$0false0.00000
Northeast Wisconsin Radiation Therapy Se
1821 S Webster Avenue STE 300Green BayWI543079047263749065HealthcareWIHSSIrelated00false$0false0.00000
Pain Center of Wisconsin
4131 W Loomis Road STE 300GreenfieldWI53221263155343HealthcareWISt Vincentrelated00false$0false0.00000
Surgery Center of Sheboygan LLC
3141 Saemann AvenueSheboyganWI53081260822209HealthcareWISt Nicholasrelated00false$0false0.00000
Prevea Ventures LLC
2710 Executive DriveGreen BayWI54304203775127HealthcareWIHSSIrelated00false$0false0.00000
Carpenter Street Hotel LLC
525 North Sixth StreetspringfieldIL62702364128127hotelILlasante increlated00false$0false0.00000
Springfield Urgent Care Real Estate LLC
PO Box 19456springfieldIL627949456030413258rent. real esILlasante increlated00false$0false0.00000

Form990 Schedule R Part IV Form990ScheduleRPartIV (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipLegal Domicile Foreign CountryLegalDomicileForeignCountry
Kiara Inc
4936 Laverna ROAdSpringfieldIL62707371163401HealthCareILHSHSC Corp000.00000
LaSante Wisconsin Inc
4936 Laverna ROAdSpringfieldIL62707391572196HealthCareILKiara IncC Corp000.00000
LaSante Inc
4936 Laverna ROAdSpringfieldIL62707371163400HealthCareILKiara IncC Corp000.00000
Prairie Cardiovascular
619 East Mason STE 4P57SpringfieldIL62701371071858HealthCareILKiara IncC Corp000.00000
Prevea Health Services
2710 EXECUTIVE DRIVEGreen BayWI54304391839351HealthCareWIHSSIC Corp000.00000
Prevea Clinic Inc
2710 EXECUTIVE DRIVEGreen BayWI54304391839349HealthCareWIHSSIC Corp000.00000
Prevea Health Network
2710 EXECUTIVE DRIVEGreen BayWI54304392000537HealthCareWIHSSIC Corp000.00000
Renaissance quality insurance
980669953InsuranceHSSIC Corp000.00000CJ
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
IdentifierTransactions with related entitiesIdentifier
Return ReferenceForm 990, Schedule R, Part V, Line 2ReturnReference
ExplanationTHE TRANSACTIONS REPORTED IN QUESTION 1 ARE BETWEEN RELATED 501(C)(3) PUBLIC CHARITIES AND ARE NOT REPORTED IN THIS SECTION.Explanation