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ASPIRUS RHINELANDER & TOMAHAWK HOSPITALS & CLINICS INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
ASPIRUS RHINELANDER & TOMAHAWK HOSPITALS & CLINICS INC (EIN 39-1390638)
Tax period
2010-10-01 to 2011-09-30
Filed
2012-07-25
IRS object ID
201242079349300509
Schema version
2010v3.2
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)
Timestamp2012-07-25T07:44:45-07:00Timestamp
Tax Period End Date2011-09-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2010-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN391390638EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Sacred Heart-St Marys Hospitals IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSACRNameControl
Phone7153612942Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 347AddressLine1
CityStevens PointCity
StateWIState
ZIP Code54481ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMONICA HILTName
TitlePresidentTitle
Date Signed2012-07-25DateSigned
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts139141690GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web Sitewww.ministryhealth.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1981YearFormation
State Legal DomicileWIStateLegalDomicile
Activity Or Mission DescriptionSHSM HOSPITAL MISSION AS A CATHOLIC HOSPITAL IS TO FURTHER THE HEALING MINISTRY OF JESUS BY CONTINUALLY IMPROVING THE HEALTH AND WELL-BEING OF ALL PEOPLE, ESPECIALLY THE POOR. WE PROVIDE ACUTE HEALTH CARE SERVICES TO THE COMMUNITY REGARDLESS OF A PERSON'S ABILITY TO PAY.ActivityOrMissionDescription
Nbr Voting Members Governing Body9NbrVotingMembersGoverningBody
Nbr Independent Voting Members7NbrIndependentVotingMembers
Total Nbr Employees1795TotalNbrEmployees
Total Nbr Volunteers233TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year425546ContributionsGrantsPriorYear
Contributions Grants Current Year460548ContributionsGrantsCurrentYear
Program Service Revenue Prior Year129949909ProgramServiceRevenuePriorYear
Program Service Revenue CY138266104ProgramServiceRevenueCY
Investment Income Prior Year-75771InvestmentIncomePriorYear
Investment Income Current Year-76856InvestmentIncomeCurrentYear
Other Revenue Prior Year754105OtherRevenuePriorYear
Other Revenue Current Year415038OtherRevenueCurrentYear
Total Revenue Prior Year131053789TotalRevenuePriorYear
Total Revenue Current Year139064834TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year79625782SalariesEtcPriorYear
Salaries Etc Current Year80469914SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year47022667OtherExpensePriorYear
Other Expenses Current Year52534321OtherExpensesCurrentYear
Total Expenses Prior Year126648449TotalExpensesPriorYear
Total Expenses Current Year133004235TotalExpensesCurrentYear
Revenues Less Expenses Prior Year4405340RevenuesLessExpensesPriorYear
Revenues Less Expenses CY6060599RevenuesLessExpensesCY
Total Assets BOY114559746TotalAssetsBOY
Total Assets EOY114207615TotalAssetsEOY
Total Liabilities BOY45015023TotalLiabilitiesBOY
Total Liabilities EOY43354332TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY69544723NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY70853283NetAssetsOrFundBalancesEOY
Mission DescriptionSHSM HOSPITAL MISSION AS A CATHOLIC HOSPITAL IS TO FURTHER THE HEALING MINISTRY OF JESUS BY CONTINUALLY IMPROVING THE HEALTH AND WELL-BEING OF ALL PEOPLE, ESPECIALLY THE POOR. WE PROVIDE ACUTE HEALTH CARE SERVICES TO THE COMMUNITY REGARDLESS OF A PERSON'S ABILITY TO PAY.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense115431712Expense
Revenue138681142Revenue
DescriptionSACRED HEART/ST MARY'S HOSPITALS PROVIDE INPATIENT, OUTPATIENT, EMERGENCY ROOM, AND ANCILLARY SERVICES TO ANY INDIVIDUAL REGARDLESS OF THEIR ABILITY TO PAY OR THEIR METHOD OF PAYMENT. THE HOSPITAL ALSO PROVIDES EDUCATIONAL PROGRAMS AND SERVICES TO THE COMMUNITY ON VARIOUS HEALTH CARE ISSUES.Description
Total Program Service Expense115431712TotalProgramServiceExpense
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 FootnotefalseReportFin48Footnote
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
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
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 RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109669NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees1795NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Form8886 T FiledfalseForm8886TFiled
Non Deductible ContributionsfalseNonDeductibleContributions
Non Deductible DisclosurefalseNonDeductibleDisclosure
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Quid Pro Quo DisclosurefalseQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Form720 FiledfalseForm720Filed
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members9NbrVotingGoverningBodyMembers
Number Independent Voting Members7NumberIndependentVotingMembers
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
Policies Reference ChaptersfalsePoliciesReferenceChapters
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
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonWilliam HinnerNamePerson
Telephone Number7153465078TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO Box 347AddressLine1
CityStevens PointCity
StateWIState
ZIP Code54481ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (19 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployeeIndividual Trustee Or DirectorIndividualTrusteeOrDirectorFormerFormer
WILLIAM ERICKSON
VP-OPERATIONS40.00X021425049335
SUSAN L STACY
PYSCHOLOGIST40.00137684028321X
STEVE AGNOLI
Chairman1.00X000X
ROGER ERDAHL
Secretary1.00X000X
ROBERT SOOKOCHOFF MD
BOARD MEMBER40.00036992975527X
RANDY PLANTENBERG
BOARD MEMBER1.00000X
RAJ K JAIN
OCCUP MED DIRECTOR32.00144331027215X
NANCY FRASIER
BOARD MEMBER1.00000X
MONICA HILT
President & CEO32.00X039594336535X
MARLEEN A BRYAN
ADV PRACTICE NURSE36.00139159027408X
KATHRYN L LAPIERRE
PYSCHOLOGIST36.0014564202809X
JIM BROWN
BOARD MEMBER1.00000X
JILL SPIECKERMAN
VP-PATIENT SVCS40.00X014041521889
GREGG ALBERT
Treasurer1.00X000X
GARY W DOUGLAS
MEDICAL PHYSICIST32.00154494013956X
CATHY BUKOWSKI
REGIONAL CFO20.00X020521724394
BRIAN KIEF
REGIONAL CEO40.00054334638302X
BART LAMERS
VICE CHAIRMAN1.00X000X
ANN ZENK
VP-PATIENT SVCS40.00X032749658
FieldValueIRS element (for citing)
Total Reportable Comp From Org721310TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1901849TotalReportableCompFrmRltdOrgs
Total Other Compensation346349TotalOtherCompensation
Number Individuals GT100 K19NumberIndividualsGT100K
Formers ListedtrueFormersListed
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
WEATHERBY LOCUMS INC
PO BOX 972633DALLASTX753972633STAFFING262491
MARSHFIELD LABORATORIES
1000 NORTH OAK AVENUEMARSHFIELDWI544495795LAB TESTING SVCS581393
JUDGES CLEANERS INC
2150 MAPLE DRIVEPLOVERWI54467LAUNDRY SERVICES250651
HEALTHCARE BUSINESS SERVICE INC
PO BOX 989MARSHFIELDWI544490989BILLING SERVICES800085
ETRANS PLUS
2525 PERIMETER PLACE DRIVENASHVILLETN37214TRANSCRIPTION SERVIC215587
FieldValueIRS element (for citing)
Number Of Contractors GT100 K15NumberOfContractorsGT100K
Government Grants389241GovernmentGrants
All Other Contributions71307AllOtherContributions
Total Contributions460548TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
PRORGAM SERVICE RENT532000348874348874
PROGRAM SERVICE REVENUE900099108155199108155199
PROGRAM SERVICE AMBULANCE621910972861972861
CLINIC REVENUE6211102878917028789170
FieldValueIRS element (for citing)
Total Program Service Revenue138266104TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other76856Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-76856Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-76856TotalRevenueColumn
Exclusion-$76,856ExclusionAmount

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 IncomeRelatedOrExemptFunctionIncome
PURCHASE DISCOUNTS900099109969109969
INTEREST523000149444149444
CAFETERIA722210366835366835

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column-211210TotalRevenueColumn
Related Or Exempt Function Income-211210RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue415038TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column139064834TotalRevenueColumn
Related Or Exempt Function Income138681142RelatedOrExemptFunctionIncome
Exclusion-$76,856ExclusionAmount

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

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total62647394Total
Program Services57266528ProgramServices
Management And General5380866ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total4274345Total
Program Services4234662ProgramServices
Management And General39683ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total10156309Total
Program Services8501850ProgramServices
Management And General1654459ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3391866Total
Program Services3186141ProgramServices
Management And General205725ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total572963Total
Program Services20ProgramServices
Management And General572943ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total10020Total
Management And General10020ManagementAndGeneral

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)
Total2173Total
Management And General2173ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total2199773Total
Program Services1237171ProgramServices
Management And General962602ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total602453Total
Program Services1868ProgramServices
Management And General600585ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total10142883Total
Program Services9871344ProgramServices
Management And General271539ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total2205887Total
Program Services2127963ProgramServices
Management And General77924ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2401337Total
Program Services2394134ProgramServices
Management And General7203ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total299241Total
Program Services265116ProgramServices
Management And General34125ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total330731Total
Program Services306069ProgramServices
Management And General24662ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total1770081Total
Program Services1770081ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total6885887Total
Program Services6161964ProgramServices
Management And General723923ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total846839Total
Program Services452822ProgramServices
Management And General394017ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
STATE ASSESSMENT27430762743075
PURCHASE SERVICES950328054654644037816
PHARMACEUTICALS41560804156080
MHC EXECUTIVE SERVICES18414321841432
BAD DEBT72633217263321

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total-1243136Total
Program Services-1973961ProgramServices
Management And General730826ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total133004235Total
Program Services115431712ProgramServices
Management And General17572523ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY10607888BOY
EOY8607778EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1885898BOY
EOY2194296EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY18137632BOY
EOY21659324EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY671070BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1992785BOY
EOY2010446EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY277496BOY
EOY159620EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis129921979LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec60084757LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY72325317BOY
EOY69837222EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY5776283BOY
EOY7327956EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY2885377BOY
EOY2410973EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY114559746BOY
EOY114207615EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY13761445BOY
EOY11999064EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY162320BOY
EOY1594EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY26690576BOY
EOY24934874EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY4400682BOY
EOY6418800EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY45015023BOY
EOY43354332EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY68979695BOY
EOY70287768EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY565028BOY
EOY565515EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY69544723BOY
EOY70853283EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY114559746BOY
EOY114207615EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses6060599ReconcilationRevenueExpenses
Reconcilation Other Changes-4752039ReconcilationOtherChanges
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)
Form4720 Filed4955 TaxfalseForm4720Filed4955Tax
Correction MadefalseCorrectionMade
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$8,027OtherActivitiesAmount
Total Lobbying Expenditures IIB8027TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3
Form4720 Filed4912 TaxfalseForm4720Filed4912Tax

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierPart II-B, Line 1iIdentifier
Return ReferencePart II-B, Line 1i - Other Activities DescriptionReturnReference
ExplanationSacred Heart/St Mary's belongs to a number of trade asscociations (WHA, CHA, AHA) The associations are paid annual dues and a percentage of the dues are related to lobbying done by the trade association. Lobby percentages range between 5 - 24% of the annual ammounts. The amount reported on line (1i) represents the sum of all trade association dues related to lobby expense.Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis2704728OtherCostOrOtherBasis
Book Value2704728BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis68192951OtherCostOrOtherBasis
Depreciation15445999Depreciation
Book Value52746952BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1640621OtherCostOrOtherBasis
Depreciation815956Depreciation
Book Value824665BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis57383679OtherCostOrOtherBasis
Depreciation43822802Depreciation
Book Value13560877BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings69837222TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDue third PartyDescription
Amount$6,418,800Amount
FieldValueIRS element (for citing)
Total Of Amounts6418800TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierPart XI, Line 8Identifier
Return ReferencePart XI, Line 8: Other Changes in Net Assets or Fund BalancesReturnReference
ExplanationMinistry Medical Group-Northern Region Trf Woodruff Loss $414304 Intercompany Transfers-Rent to MHC $62952 DONATED CAPITAL $162326 FOUNDATION CONTRIBUTION $490 $ -0 HOSPICE/HOME HEALTH $ -239889 SJH OUTREACH ALLOCATION $ -3999996 EHR FUNDING $ -1470780Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent150XPcent150
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)
Total Community Benefit Expense1659410TotalCommunityBenefitExpense
Net Community Benefit Expense1659410NetCommunityBenefitExpense
Percent Of Total Expense0.01250PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense15886633TotalCommunityBenefitExpense
Direct Offsetting Revenue9884000DirectOffsettingRevenue
Net Community Benefit Expense6002633NetCommunityBenefitExpense
Percent Of Total Expense0.04510PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense17546043TotalCommunityBenefitExpense
Direct Offsetting Revenue9884000DirectOffsettingRevenue
Net Community Benefit Expense7662043NetCommunityBenefitExpense
Percent Of Total Expense0.05760PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense309373TotalCommunityBenefitExpense
Net Community Benefit Expense309373NetCommunityBenefitExpense
Percent Of Total Expense0.00230PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense76295TotalCommunityBenefitExpense
Net Community Benefit Expense76295NetCommunityBenefitExpense
Percent Of Total Expense0.00060PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense109165TotalCommunityBenefitExpense
Net Community Benefit Expense109165NetCommunityBenefitExpense
Percent Of Total Expense0.00080PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense494833TotalCommunityBenefitExpense
Net Community Benefit Expense494833NetCommunityBenefitExpense
Percent Of Total Expense0.00370PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense18040876TotalCommunityBenefitExpense
Direct Offsetting Revenue9884000DirectOffsettingRevenue
Net Community Benefit Expense8156876NetCommunityBenefitExpense
Percent Of Total Expense0.06130PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense989TotalCommunityBuildingExpense
Net Community Building Expense989NetCommunityBuildingExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense989TotalCommunityBuildingExpense
Net Community Building Expense989NetCommunityBuildingExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$2,301,769BadDebtExpenseAmount
Amount Reimbursed By Medicare37158000AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare42022408CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-4864408MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CarefalseProvisionForCharityCare
Number Of Hospital Facilities2NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeCritical Access HospitalCriticalAccessHospitalEr24 HoursEr24HoursLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgical
SACRED HEART HOSPITAL
2401 WEST MOHAWK DRIVETOMAHAWKWI54487XX
ST MARYS HOSPITAL
12251 NORTH SHORE DRIVERHINELANDERWI54501XXX

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (2 entries)

Hospital Facility NumberHospitalFacilityNumberCHNA ConductedCHNAConductedEligibility Criteria ExplainedEligibilityCriteriaExplainedUses FPG FreeUsesFPGFreeFPG Free PercentFPGFreePercentUses FPG DiscountedUsesFPGDiscountedFPG Discount PercentFPGDiscountPercentExplains BasisExplainsBasisIncome LevelIncomeLevelAsset LevelAssetLevelMedical IndigencyMedicalIndigencyInsurance StatusInsuranceStatusUninsured DiscountUninsuredDiscountMedicaid MedicareMedicaidMedicareState RegulationStateRegulationExplains Application MethodExplainsApplicationMethodIncludes Publicity MeasuresIncludesPublicityMeasuresAvailable On RequestAvailableOnRequestActions On NonpaymentActionsOnNonpaymentPermit Report To Credit AgencyPermitReportToCreditAgencyPermit LawsuitPermitLawsuitCollection ActivitiesCollectionActivitiesReport To Credit AgencyReportToCreditAgencyLawsuitLawsuitNotify Upon AdmissionNotifyUponAdmissionNotify Before DischargeNotifyBeforeDischargeNotified All PatientsNotifiedAllPatientsDocumented DeterminationDocumentedDeterminationNondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicyUsed Other MethodUsedOtherMethodAmounts Generally BilledAmountsGenerallyBilledGross ChargesGrossCharges
SACRED HEART HOSPITAL
2falsetruetrue150.0000true400.0000trueXXXXXXXtruetrueXtrueXXtrueXXXXXXtrueXfalsetrue
ST MARYS HOSPITAL
1truetrue150.0000true400.0000trueXXXXXXXtruetrueXtrueXXtrueXXXXXXtrueXfalsetrue

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities7NumberOfOtherFacilities

Other Facilities OtherFacilities (7 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
MMG LAONA
4876 MILL STREETLAONAWI54541OUTPATIENT PHYSICIAN CLINIC
MMG WOODRUFF
240 MAPLE STREETWOODRUFFWI54568OUTPATIENT PHYSICIAN CLINIC
MMG CRANDON
400 WEST GLEN STREETCRANDONWI54520OUTPATIENT PHYSICIAN CLINIC
MMG EAGLE RIVER
930 EAST WALL STREETEAGLE RIVERWI54521OUTPATIENT PHYSICIAN CLINIC
MMG TOMAHAWK
401 WEST MOHAWK DRIVETOMAHAWKWI54487OUTPATIENT PHYSICIAN CLINIC
MMG RIVERSIDE
1020 KABEL AVENUERHINELANDERWI54501OUTPATIENT PHYSICIAN CLINIC
MMG RHINELANDER
2251 NORTH SHORE DRIVERHINELANDERWI54501OUTPATIENT PHYSICIAN CLINIC

Form990 Schedule H Part VI Form990ScheduleHPartVI (18 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part VI - Additional InformationAs part of Ministry Health Care, Inc., the organization files an annual community benefit report on its webpage. The report can be viewed by visiting www.ministryhealth.org/MinistryHealth/Community.nws.
Part VI - States Where Community Benefit Report FiledWI
Part VI - Affilated Health Care System Roles and PromotionThe organization is part of an affiliated health care system called Ministry Health Care, Inc. The mission of Ministry as a Catholic health care system is to further the healing ministry of Jesus by continually improving the health and well being of all people, especially the poor, in the communities served. Ministry supports such non-hospital facilities as the Agape Community Center. As a community center, it has the unique advantage of welcoming youth, adults, families and seniors into the facility through a broad range of educational, social, recreational, cultural, health and life-long learning opportunities in an impoverished portion of Milwaukee. Our Catholic Identity expects leaders to initiate and support efforts to reach out to the poor and vulnerable people, especially where no one else wants to go. Health care can become very bureaucratic and burdened with oversight of finances, regulatory requirements and strategic planning. Our focus on these issues may cause us to lose touch with those for whom we have a primary responsibility-those who are poor and vulnerable. Tithing of time allows us to look into the face of the poor, hear the voice of the poor, and help us better understand the daily challenges and barriers they face. As an affiliated health system, all leaders with direct reports are required to provide service to the poor. This also includes physician leaders and hourly supervisory staff. The organization also participates in the Ministry Health Care Fund which provides monies for special projects within the communities we serve. All organizations sponsored or co-sponsored by Ministry Health Care, Inc. set aside monies each year to assist with the needs of the community and the poor. As the Ministry Health Care Fund, these dollars are funneled back into our communities for a variety of programs and services through a community assets and needs assessment process.A foundation exists but is not included within the operations of the organization. The foundation is operated as a separate entity but does provide programs and cash donations which help support the mission of the organization and the affiliated health care system.
Part VI - Explanation Of How Organization Furthers Its Exempt PurposeThe organization strives to further its exempt purposes by the following: (1) The organization's governing board consists primarily of persons who reside within the primary service area. They are not employees of the organization. (2) As mentioned, the organization provides several services which are not otherwise available being in a rural setting. (3) Based on the organization's mission, emergency rooms are made available to all patients regardless of the ability to pay. (4) The organization also participates in the education and training of healthcare professionals through internship programs.Sacred Heart/St Mary's participates in government sponosored health programs (Medicare, Medicaid, Champus, Tricare).Sacred Heart is a critical access hospital in Tomahawk, Wisconsin and St. Mary's is a Sole Community Hospital in Rhinelander, Wisconsin. Both hospitals and hospital-based clinics serve poor rural communities. St. Mary's provides inpatient and outpatient mental health and AODA services at a financial loss to the organization which is somewhat unique to small rural communities. Persons in need of mental health or AODA services would otherwise have to travel several hundred miles to seek care.Sacred Heart-St. Mary's Hospitals serves four Native American Tribes in surrounding communities. Tribal services are paid under Medicare-like rates under Contract Health Services reimbursement program under the federal Indian Health Program. The organization also participates in government sponsored health programs such as Medicare, Medicaid, Champus. The organization strives to be a low-cost provider by continually reducing internal costs through efficiency measures which in turn, is passed on to patients through market-based prices. The uninsured members of the community access healthcare through the emergency department and medical clinics. All medically necessary medical services are provided in an inpatient, outpatient or clinic setting for persons in need of care regardless of their ability to pay.Sacred Heart/St Mary's Hospitals fund a Community Link Coordinator who works in conjunctions with our Patient Family Services department in meeting the special needs of our community. This team helps our community members navigate the various governmental programs by helping our uninsured population apply for State Medicaid programs and the organization's own Community Care (charity care) program. The Community Care program provides financial assistance and sliding scale discounts to patients who meet certain income and asset criteria, up to 400% of the federal poverty guidelines.
Part VI - Community Building ActivitiesCommunity-building activities include programs that, while not directly related to health care, provide opportunities to address the root causes of health problems, such as poverty, homelessness, and environmental problems. These activities support community assets by offering the expertise and resources of the organization. Costs for these activities include cash, in-kind donations, and expenditures for the development of a variety of community health programs and partnerships.
Part VI - Community InformationWhile there is growing agreement in the United States about what constitutes a non-profit hospital's 'community benefit', this is a work in progress. The organization provided significant charity care and other community benefits as defined by the IRS. But in addition, we believe that we provide a critically important community benefit, which is not quantified. Our hospital, like most rural hospitals, was created and is maintained in order to provide care locally-care that without our hospital, would not be available locally.Certain specialized services available include: Diabetes education and management,; Speech Therapy; Wound care and management; Palliative Care services; Pain Management services; Mental Health and AODA services; Women's health services; Inpatient and Outpatient.Sacred Heart Hospital is located in Tomahawk, WI and serves the surrounding communities. According the the 2010 census, Tomahawk had a population of 3,397, with a median age of 44.8. The median income for a household in the city was $44,677 in 2009. The percentage of residents living in poverty in 2009 was 12.2%. The unemployment rate in March 2012 was 10.6% versus the Wisconsin state average of 7.5%. The town covers a total area of 8.8 miles. Tomahawk is located in Lincoln County which had a population of 29,404 in July 2009. The median income for a household was $44,660 in 2009. The median age was 39 years. The unemployment rate in March 2012 was 10.6%.St Mary's Hospital is located in Rhinelander, WI and serves the surrounding communities. According the the 2010 census, Rhinelander had a population of 7,798. The median age was 40 years. The median income for a household in the city was $32,623 in 2009. The unemployment rate in March 2012 was 11.7% versus the Wisconsin state average of 7.5%. The town covers a total area of 7.9 miles. Rhinelander is located in Oneida County which had a population of 35,930 in July 2009. The median income for a household was $42,946 in 2009 The unemployment rate in April 2010 was 11.2%.
Part VI - Patient Education of Eligibility for AssistanceThe organization goes to great lengths in order to inform and educate patients/persons who may be billed for patient care about their eligibility for assistance under federal, state or local government programs and under the organization's charity care policy. The charity care policy and application is posted on the organization's website. Admissions and other key areas contain summary information of the charity care policy. As part of the intake/discharge process, patients are provided with a copy of the policy and other information for financial assistance. If during the course of the patient registration process, care encounter, treatment, or upon discharge it becomes evident that a patient may need financial assistance, the patient shall be referred to the organization's community care program. Patients may be identified as needing financial assistance at any time during the course of an encounter. A referral for consideration of community care financial assistance can be initiated by any member of the hospital's workforce, including medical staff members, who become aware of the patient's potential need for community care financial assistance. The charity care policy was also translated into dialects prevalent in the community in order to reach out to those that may speak another language (Spanish and Hmong). Patient Registration staff and Financial Counselors are provided with scripts to follow when interacting with patients. As part of the charity care process, patients must register with the county public assistance to see if they may qualify under any other federal or state programs.
Part VI - Needs AssessmentThe organization performs community needs assessments as needed. Planning workgroups consisting of community partners are formed to define the community and its needs through review of Health People Initiatives, census documents, and local government health and welfare agencies. Considering other community resources/assets, data collection methods are used to identify particular problems or subgroups and areas known to have high poverty rates and to be underserved. The data is analyzed and priorities are set based on trending information which may target a specific need. When a need is identified, the hospital develops a plan to implement a program either through community collaboration or individually. Outcomes from the programs are measured and considered in subsequent community needs assessments. Community benefit plans are presented to senior leadership and board members to ensure the findings are incorporated into the organization's strategy and policy development. For example, senior leaders are required to provide direct service to the poor hours as part of their performance goals.
Part V, Line 21 - Charge Patients Amount Equal Gross Charge for ServicesA PATIENT COULD BE CHARGED AN AMOUNT EQUAL TO THE GROSS CHARGE IN THE FOLLOWING CIRCUMSTANCE. IF A PATIENT IS INSURED BY A NON-CONTRACTED PAYER, THAT PAYER OR PATIENT WOULD BE RESPONSIBLE FOR 100% OF THE BILLED CHARGES. IF A SERVICE OR VISIT UNDER THAT SCENARIO FELL UNDER THE CO-PAY, COINSURANCE, OR DEDUCTIBLE PORTION OF THE PLAN, OR IF THE SERVICE WAS NOT COVERED BY THE PLAN, THE PATIENT COULD BE FINANCIALLY RESPONSIBLE FOR 100% OF THE GROSS CHARGES.Number of Hospital Faciltiy - 2
Part V, Line 21 - Charge Patients Amount Equal Gross Charge for ServicesA PATIENT COULD BE CHARGED AN AMOUNT EQUAL TO THE GROSS CHARGE IN THE FOLLOWING CIRCUMSTANCE: IF A PATIENT IS INSURED BY A NON CONTRACTED PAYER, THAT PAYER OR PATIENT WOULD BE RESPONSIBLE FOR 100% OF THE BILLED CHARGES. IF A SERVICE OR VISIT UNDER THAT SCENARIO FELL UNDER THE CO-PAY, COINSURANCE, OR DEDUCTIBLE PORTION OF THE PLAN, OR IF THE SERVICE WAS NOT COVERED BY THE PLAN, THE PATIENT COULD BE FINANCIALLY RESPONSIBLE FOR 100% OF GROSS CHARGES.Number of Hospital Faciltiy - 1
Part V, Line 19d - Other Billing Determination of Individuals Without InsuranceMINISTRY HEALTH CARE'S POLICY IS TO OFFER 10% DISCOUNT TO OUR UNINSURED POPULATION.Number of Hospital Faciltiy - 2
Part V, Line 19d - Other Billing Determination of Individuals Without InsuranceMINISTRY HEALTH CARE'S POLICY IS TO OFFER 10% DISCOUNT TO OUR UNINSURED POPULATIONNumber of Hospital Faciltiy - 1
Part III, Line 9b - Provisions On Collection Practices For Qualified PatientsThe organization has a debt collection policy which sets forth collection practices for patients who are known to qualify or may qualify for financial assistance under the charity care program. Sufficient financial counseling support is made available to patients so they can easily access patient financial service representatives and have their questions answered, and gain an understanding of the reasons why they owe a balance. Accounts are designated as charity care in the business offices so no additional time is spent on collection efforts.
Part III, Line 8 - Explanation Of Shortfall As Community BenefitThe shortfall associated with Medicare should be considered a community benefit for several reasons. First, IRS Rev. Rul. 69-545, which established the community benefit standard for non-profit hospitals, states that if a hospital serves patients with government health benefits, including Medicare, then this is an indication that the hospital operates to promote the health of the community. This implies that treating Medicare patients is a community benefit. Second, for-profit specialty hospitals have been carving out certain high-margin services (i.e. cardiac, orthopedics, and oncology), leaving general acute care hospitals with lower-margin Medicare services. This indicates that Medicare losses can be a result of rendering these lower-margin services (which benefit the community) rather than inefficient operations. Lastly, the community which the organization serves has Medicare as the largest payer. The organization must accept these patients regardless of whether they make a surplus or deficit from providing such services. If the Medicare participation is premised on this fact, then providing Medicare services promotes access to healthcare services which is a community benefit. The demographic of the community is also an aging and underserved population who experience issues with access to healthcare services. Without tax-exempt hospitals providing Medicare services, CMS would bear the burden of directly providing services to the elderly.
Part III, Line 4 - Bad Debt ExpenseNo footnote exists in the organization's financial statements that describe bad debt expense. Bad debt expense is recorded in a consistent manner with the organization's collection policies. Bad debt expense includes accounts which are written off and estimates made on live accounts based on historical payment trends and account modeling.A number of patients are truly unable to pay their out-of-pocket liability, but do not complete the process required to apply for financial assistance under the hospital's charity care policy. These patients would qualify for charity care if they completed the charity application, so the bad debt expense associated with treating them should be treated as community benefit. The organization does have a presumptive eligibility program in place to help identify indigent patients and minimize the instances of when they become a bad debt. The administrative requirements to determine whether patients who do not cooperate with the financial assistance process would have qualified for charity can be burdensome, particularly for small balances. The organization continues serving patients even after the patients have generated significant bad debt which is evidence that the care is given for community benefit motivations.
Part I, Line 7, Column F - Explanation of Bad Debt ExpenseBad Debt expense of $7,263,321 is excluded from total operating expenses of $133,004,235 when calculating percentage of total expense in Part I, Line 7, Col F.
Part I, Line 7 - Explanation of Costing MethodologyAmounts calculated in Part I, Line 7 are determined both on a cost accounting system and a cost-to-charge ratio. Other Benefits are determined based on the direct and indirect costs (where allocated) associated with a program net of earned revenue. Detail for each program/activity is maintained and determined at the department level. Charity care and means-tested programs are determined based on a cost-to-charge ratio consistent with Worksheet 2, Ratio of Patient Care Cost to Charges.
Part I, Line 6a - Related Organization Community Benefit ReportAs part of Ministry Health Inc., the organization files an annual community benefit report for all owned entities on its webpage. The report can be viewed by visiting www.ministryhealth.org/MinistryHealth/community.nws. Each facility is included within the report.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgtrueCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgtrueCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsBase Compensation Filing OrgBaseCompensationFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrg
WILLIAM ERICKSON
16573425832226843009519240263585
SUSAN L STACY
137213471293125390166005
ROBERT SOOKOCHOFF MD
36507348565324222285445456
RAJ K JAIN
12127023061255524660171546
MONICA HILT
3042998174499001490221633432478
MARLEEN A BRYAN
138834325291624492166567
JILL SPIECKERMAN
11062629789173944495162304
GARY W DOUGLAS
15441975312510831168450
CATHY BUKOWSKI
1636352420717375158028592229611
BRIAN KIEF
43258397630131331532622976581648

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSch J, Part I, Line 1aIdentifier
Return ReferencePart I, Line 1a: Relevant information in regards to selections on 1a.ReturnReference

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
SCHEDULE H, PART 1, LINE 6AMINISTRY HEALTH CARE PUBLISHES AN ANNUAL COMMUNITY BENEFIT REPORT FOR ALL OWNED ENTITIES. SACRED HEART/ST MARY'S IS OWNED BY MINISTRY HEALTH CARE. EACH FACILITY IS INCLUDED WITHIN THE REPORT.
FORM 990 PART IX LINE 24 - OTHER EXPSEXECUTIVES ARE EMPLOYED BY MINISTRY HEALTH CARE INC (39-1490371) AND THEIR SALARIES AND BENEFITS ARE ALLOCATED TO INDIVIDUAL FACILITIES BASED ON HOURS DEDICATED. SACRED HEART/ST MARY'S REIMBURSES THE CORPORATE OFFICE FOR ITS SHARE AND THESE EXPENSES ARE INCLUDED ON FORM 990, PART IX, LINE 24 UNDER MHC EXECUTIVE SERVICES. PLEASE SEE FORM 990 PART VII SECTION A AND SCHEDULE J FOR ADDITIONAL DISCLOSURES REGARDING EXECUTIVE COMPENSATION.
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableThe Ministry Web Page is available to the public for inspection with a good deal of information regarding whom Ministry Health Care is and the entities included along with our mission. The Articles of Incorporation, Bylaws, conflicts policy, and financial statements are not included on any web page. However if an inquiry is made for any documents they are shared as appropriate.Form 990, Part VI, Line 19
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesTHE MINISTRY BOARD OF DIRECTORS HAS A COMPENSATION COMMITTEE THAT IS ASSISTED BY AN INDEPENDENT OUTSIDE CONSULTING FIRM, SULLIVAN COTTER. SULLIVAN COTTER, IN PARTNERSHIP WITH THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS, REVIEWS MARKET DATA FOR COMPENSATION AND BENEFITS AND COMPARABILITY DATA ON EVERY MINISTRY HEALTH CARE EXECUTIVE.Form 990, Part VI, Line 15b
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsThe Board members complete each year a Board of Directors Conflict of Interest & Insider Transaction Questionaire. A standard annual refresher is completed each year in the fall. Any significant reported items are corrected promptly through the Ministry Corporate Compliance Officer and local administrator.Form 990, Part VI, Line 12c
Form 990, Part VI, Line 11: Form 990 Review ProcessForm 990 is completed through joint efforts of shared finance function with review and guidance of legal council and corporate oversight. Form 990 is presented to the hospital's governing body at the most recent board committee meeting. The President/CFO presents and briefly explains the form and its purpose.Form 990, Part VI, Line 11
Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing BodyMinistry Healthcare Inc. has certain reserve and influential powers over each of its wholly owned healthcare facilities. Sacred Heart/St. Mary's is one of those Ministry owned facilities.Form 990, Part VI, Line 7a
Form 990, Part VI, Line 6: Explanation of Classes of Members or ShareholderMinistry Health Care Inc has certain reserves and influential powers over all of its wholly owned healthcare facilities. SHSM is one of Ministry Health Care's owned facilitiesForm 990, Part VI, Line 6

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1MINISTRY HEALTH CAREBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line111925 W LAKE PARK DRAddressLine1
CityMILWAUKEECity
StateWIState
ZIP Code53224ZIPCode
FieldValueIRS element (for citing)
EIN391490371EIN
Primary ActivitiesMANAGEMENT SUPPORT FOR INTEGRATED HEALTHCARE SYSTEMPrimaryActivities
Legal Domicile StateWILegalDomicileState
Exempt Code Section501(C)(3)ExemptCodeSection
Public Charity Status11C Type IIIPublicCharityStatus
Direct Controlling Entity NAN/ADirectControllingEntityNA
Controlled OrgfalseControlledOrg
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 OrgtrueLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
MINISTRY HEALTH CARE
o7675977COST
MINISTRY HEALTH CARE
n5940236PAY RECORDS
MINISTRY HEALTH CARE
i50370SQ FTG FMV
MINISTRY HEALTH CARE
e19907399PRINCIPLE PAYME