2011-08-12T09:17:42-07:00 2010-09-30 990 2009-10-01 390808503 GOOD SAMARITAN HEALTH CENTER OF MERRILL WISCONSIN INC GOOD 7155365511 601 SOUTH CENTER AVENUE MERRILL WI 54452 William Hinner 2011-08-12 2009 2016-02-24 21:20:13Z Kristine M McGarigle 601 S Center Ave Merrill WI 54452 26236722 false false 0928 X http://www.ministryhealth.org/GSHC/home.nws X 1950 WI GOOD SAMARITAN HEALTH CENTER'S 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 COMMUNITIES WE SERVE. 12 10 261 136 0 36635 28631 26313080 25573814 314289 469960 148940 164317 26812944 26236722 2500 0 14682586 15623423 0 0 10091113 10169801 24773699 25795724 2039245 440998 31911394 32629410 2788114 2849289 29123280 29780121 GOOD SAMARITAN HEALTH CENTER'S 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 COMMUNITIES WE SERVE. false false 23023508 25604170 THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT, EMERGENCY ROOM AND ANCILLARY SERVICES REGARDLESS OF AN INDIVIDUALS ABILITY TO PAY OR METHOD OF PAYMENT. THE HOSPITAL ALSO PROVIDES EDUCATIONAL PROGRAMS AND SERVICES ON HEALTH CARE ISSUES TO THE COMMUNITY IT SERVES. SEE SCHEDULE H FOR FURTHER DETAILS. 23023508 true true false true false false false false false false true false true false false false false false false false false true false false true false false false false false false false false false false false false false false false false true true false false true 45 0 true 261 true false false false false false false false false false false false 0 false false false false false false false false 12 10 false false false false true true true true true false false false true true true true true true true true false false WI X X Wm Hinner -Rgnl VP Finance-CFO 7153465000 601 Center Avenue South Merrill WI 54452 William J Hinner 2.50 X 0 267390 54840 Sister Maria Vinton 1.00 X 0 0 0 Shannon M Murray 1.00 X 0 0 0 Robyn Schertz 40.00 X 379862 0 34743 Robert Johnson 1.00 X 0 0 0 Randolph B Waskin 40.00 X 319270 0 24734 Micheal Ravn 1.00 X X 0 0 0 Michael R Willman 1.00 X X 0 0 0 Michael Hammer 40.00 X X 0 238440 43542 Linda Semling Peterson 1.00 X 0 0 0 Kristine M McGarigle 40.00 X X 0 123303 25241 Kevin A Cohrs 1.00 X 0 0 0 Julie Bushor 1.00 X 0 0 0 Jeffrey L Martin 5.00 X X 0 518118 126291 Jeffrey C Craig 0. X 348130 0 26723 Gregory Dodge MD 1.00 X 0 0 0 Eric D Barnes 40.00 X 228384 0 13580 David M Burnett 40.00 X 224644 0 25168 Barb Haffemann 1.00 X 0 0 0 Allen K Pennebecker 4.00 X 0 175654 67571 1500290 1322905 442433 11 false true false Weatherby Locums Inc PO Box 972633 Dallas TX 753972633 Medical Staff 137243 Shared Medical Services Inc - HD MRI Imaging PO Box 330 Cottage Grove WI 535270330 MRI Medical Services 263318 Marshfield Laboratories 1000 North Oak Ave Marshfield WI 544495795 Lab/Medical Testing 124017 Marshfield Clinic - Merrill Center 1205 ODay Street Merrill WI 54452 Medical Staff 409619 Holster Construction Inc 2808 Franklin St Wausau WI 54403 Construction&Repairs 148902 6 3750 23645 1236 28631 Program Service - Rents 531120 87589 87589 Program Service 900099 25486225 25486225 25573814 465436 465436 0 0 5875 5875 5875 5875 4524 4524 4524 4524 0 0 0 PCard Merchant Rebates 900099 7685 7685 Interest Received Pt Acct 900099 15291 15291 Cafeteria 722210 128086 128086 7380 7380 158442 26236722 25604170 603921 500 500 2000 2000 0 0 0 0 11438130 10527033 911097 1281702 1273725 7977 2214079 1957954 256125 689512 660026 29486 0 63166 63166 11070 11070 0 0 12545 12545 663751 584139 79612 138049 138049 1597409 1524105 73304 263995 249022 14973 0 673553 671387 2166 23070 21173 1897 0 60725 57495 3230 0 0 1417843 1382470 35373 69147 69147 PURCHASE SERVICES 2186130 1583983 602147 PHARMACEUTICALS 542926 542926 MHC EXECUTIVE SERVICES 627591 153802 473789 FOOD 217491 194220 23271 BAD DEBT 1487944 1487944 113396 67912 45484 25795724 23023508 2772216 0 4087481 878894 4101678 2264638 0 3126861 2961454 0 0 18068 8272 611585 569388 53278 48137 26328042 20121685 7055412 6206357 11416644 18882705 0 0 0 1440387 809565 31911394 32629410 2541561 2664944 246553 184345 2788114 2849289 X 29123280 29780121 29123280 29780121 31911394 32629410 X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false true 3745 3745 false false Part II-B, Line 1i Part II-B, Line 1i - Other Activities Description Good Samaritan Health Center of Merrill WI Inc belongs to a number of trade associations (WHA, CHA, AHA, RWHC, MGMA). These 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 amounts. The amount reported on (1i) represents the sum of all trade association dues related to lobby expense. 83511 83511 7479461 5455874 2023587 592776 523722 69054 9221104 7189715 2031389 8951190 6952374 1998816 6206357 Third Party Liabilities 184345 184345 Part XI, Line 8 Part XI, Line 8: Other Changes in Net Assets or Fund Balances Market Adjustments $215843 true true true X true X true true false false true true 776 297380 297380 0.01220 5334 3504399 2079585 1424814 0.05860 6110 3801779 2079585 1722194 0.06680 16 1413 97365 450 96915 0.00400 1 6 49803 49803 0.00200 1 20 25740 25740 0.00110 7 1082 120668 120668 0.00500 25 2521 293576 450 293126 0.01140 25 8631 4095355 2080035 2015320 0.07810 1 2017 2017 0.00010 1 79 27677 27677 0.00110 2 140 771 771 1 45 9488 9488 0.00040 5 264 39953 39953 0.00150 false 956153 11179780 10993047 186733 X true true Bone & Joint Clinic

100 Eagle Dr Merrill WI 54452

Rehab Clinic Menard Center

503 South Center Ave Merrill WI 54452

Physical & Occupational Therapy Good Samaritan Health Center

601 S Center Ave Merrill WI 54452

X X X X As 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. Amounts 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. Prior year cost report settlements are excluded from the shortfall calculation in order to get a true fiscal year shortfall amount. Bad debt expense of $1,487,944 is excluded from the total operating expenses of $25,795,724 when calculating percentage of total expenses in Part 1, Line 7, Column F and Part II, Lines 1-10, Column F. However, due to an issue witht he software, the amount is incorrectly included when calculating the percentage on the total lines for Part I - 7D, 7J, 7K and Part II Line 10. The correct percentages reported should be 7.08%, 1.21%, 8.29% and 0.16% respectively. No footnote exists in the organization's financials 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. Any 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. The 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. Physical and Occupation Therapy Rehabilitation Clinic While 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: -Emergency Room and Walk In Clinic Services-Oncology Program-Swing Bed Facilities-Lab Testing and Ancillary Diagnostics (Ultrasound, Radiology, Mammography, etc.) The 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. The 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. The city of Merrill is located in southern Lincoln County located in the northern portion of Wisconsin. Merrill serves as the county seat and is the largest city in the county. The population of Lincoln county as of the 2000 census data was 29,641. According to the 2000 Census (2010 Census data had not been finalized) there were 10,146 people living in Merrill, consisiting of 4183 households and 2631 families. Preliminary 2010 Census data shows a decrease in the population of Merrill. The population density of the city of Merrill was 1441.7 people per square mile. The population consisted of 97.80% White, 1.00% Hispanic, 0.20% African American, 0.50% Native American, 0.40% Asian, 0.10% Other. Of the 4183 households in Merrill, 31% of those had children under 18 years old living at home. The 4183 households are categorized as 47.20% were married couples living together, 11.90% had a female householder with no husband present, and 37.10% were non-families. 32.30% of the households consisted of individuals and 17.60% had someone 65 and older living alone. The age of the population is widely spread. 25.30% were under 18, 8.50% were 18-24, 27.50% were 25-44, 19.10% were 45-64, and 19.70% were 65 and older. The median income for a household was $33,098 and the median income for a family was $45,860. The per capita income for the city was $17,429. The largest industry in Merrill is manufacturing (32.9%), more than double the next two largest industries. Retail trade (14.50%) and Educational, health, and social services (15.4%) are the next largest industries in Merrill. Roughly 5.7% of families and 9.50% of the population were below the poverty line. That includes 10.77% of those under 18 years old and 15.00% of those 65 and older.The unadjusted seasonal unemployment rate for Lincoln County as of September 2010 was 9.30%, compared to a state unemployment rate of 7.10% and a national unemployment rate of 9.20%. Community-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. The organization provides various community health education programs. They include Health Promotion and Wellness, Prenatal/Childbirth Classes for at-risk population, school health education programs, child safety programs, advanced health directive education and various support groups. The organization also provides various clinical services to the community. They include free clinic, diabetes education, prostate and various other screenings, and school and athletic exams. The organization also provided job shadowing and mentoring opportunities for the community. The 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.The hospital participates in government-sponsored health programs (Medicare, Medicaid, CHAMPUS, Tricare. )The hospital offers volunteer opportunities to the community. There are 136 volunteers that serve the hospital as needed.Various financial programs are available to patients of Good Samaritan Health Centery. They include discounted and/or free care depending on individual circumstances. The facility also offers payment plans for those self pay patients.Good Samaritan Health Center is a critical access hospital that has in patient and swing beds. They also provide emergency and walk in clinic services. As a critical access hospital, the organization serves as a critical point in stabilizing patients for transport to other facilities. The 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.The organization has a foundation which is included within the operations of the organization. The foundation provides programs and cash donations which help support the mission of the organization and the affiliated health care system.. The Foundation made donations to local charitable organizations. They included cash donations to Merrill Food Pantry to replenish the shelves as needed, St Vincent's Free Clinic for equipment and medicine, Comunidad Hispana for various programs and assistance for the local Hispanic population, and local schools to help promote a healthy lifestyle. WI X X X X false true false false false false false false false false William J Hinner 239162 18037 10191 41503 13337 322230 Robyn Schertz 352728 27134 13045 21698 414605 Randolph B Waskin 319270 6339 18395 344004 Michael Hammer 183032 27077 28331 26325 17217 281982 Jeffrey L Martin 417040 46530 54548 110735 15556 644409 Jeffrey C Craig 319625 28505 4900 21823 374853 Eric D Barnes 198654 13230 16500 4207 9373 241964 David M Burnett 195544 12600 16500 4031 21137 249812 Allen K Pennebecker 149599 26055 50573 16998 243225 Form 990, Part VI, Line 19 Form 990, Part VI, Line 19: Other Organization Documents Publicly Available The 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 15b Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees The 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 12c Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts The Board members complete each year a Board of Directors Conflict of Interest & Insider Transaction Policy Questionnaire. 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 11 Form 990, Part VI, Line 11: Form 990 Review Process Completed thorugh joint efforts of shared finance function with review and guidance of legal council and corporate oversight. Form 990 is presented to our 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 7a Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body Ministry Health Care, Inc has the reserved powers to appoint and remove, with or without cause, the directors, authorize vacancies, and determine the number of directors. Form 990, Part VI, Line 6 Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder Ministry Health Care, Inc has certain reserves and influential powers over all of its wholly owned healthcare facilities. Good Samaritan Health Center is one of Ministry Health Cares owned facilities Good Samaritan Health Center Foundation 601 S Center Ave Merrill WI 54452 391627755 To support the mission of Good Samaritan Health Center WI 501(c)(3) 11-I N/A Ministry Health Care 11925 West Lake Park Drive Suite 1 Milwaukee WI 53224 391490371 Management support for integrated healthcare system WI 501(c)(3) 11-O N/A false false false false false false false false true false false false true true true false false false Good Samaritan Health Center Foundation n 65530 Ministry Health Care o 1074923 Ministry Health Care n 1441622