2021-05-13T11:46:06-05:00 2020-06-30 350921680 CROWE LLP 225 West Wacker Drive Suite 2600 Chicago IL 606061224 990 2019-07-01 390810545 St Joseph's Hospital of the Hospital Sisters of the Third Order of St Franc is STJO 7157231811 2661 COUNTY HIGHWAY I Chippewa Falls WI 54729 PATRICIA ALLEN DIVISION CHIEF FINANCIAL OFFICER 2021-05-13 true MALLORY FAIRLESS P01321579 3128997000 2019 2022-09-23 18:48:47Z Andy Bagnall 2661 COUNTY HIGHWAY I Chippewa Falls WI 54729 57444052 false 0928 X WWW.STJOESCHIPFALLS.COM X 1885 WI ST. JOSEPH'S MISSION IS TO DELIVER COMPASSIONATE HEALTH CARE TO PEOPLE IN NEED AND TO BE THE PREFERRED CHOICE FOR HEALTH CARE IN THE CHIPPEWA VALLEY. 11 8 428 74 0 0 95296 1283795 56632208 51227419 2761256 4460376 542347 472462 60031107 57444052 0 0 0 27793024 30361257 0 0 0 30743471 29362524 58536495 59723781 1494612 -2279729 144268365 145611794 39163635 48435239 105104730 97176555 THE MISSION OF ST. JOSEPH'S HOSPITAL IS TO REVEAL AND EMBODY CHRIST'S PEOPLE IN NEED. REFLECTING OUR HIGH REGARD FOR ONE ANOTHER AS INSPIRED BY OUR FRANCISCAN TRADITION, ST. JOSEPH'S GOAL IS TO BE THE PREFERRED CHOICE FOR HEALTH CARE IN THE CHIPPEWA VALLEY. false false 46004823 51227419 SEE SCHEDULE O - PROGRAM SERVICE ACCOMPLISHMENTS 46004823 true true false true false false false false false true false false false true true false true false false false false false false false false true true false false true false false false false false false false false false false false false true true false false false true X 1081 0 true 428 true false false false false false false false false false false false false X 11 8 false false false false true true true true true false false true true true true true true true true true true X Patty Allen 7157176121 2661 COUNTY HIGHWAY I CHIPPEWA FALLS WI 547291498 ANDREW J BAGNALL PRESIDENT & Division CEO - Wisconsin 8.0 52.0 X X 0 525682 194216 GERALD JACOBSON 2019 & 2020 Secretary 1.0 1.0 X X 0 0 0 JAMES E DOCKSEY 2019 & 2020 Vice Chair 1.0 1.0 X X 0 0 0 Jeff Halloin 2019 & 2020 Chair 1.0 1.0 X X 0 0 0 JOHN WAGNER CEO/PRESIDENT - SJCF 58.0 2.0 X X 0 107038 11076 GREG HEILER MD BOARD MEMBER 1.0 1.0 X 0 0 0 LON BLASER DO BOARD MEMBER 1.0 1.0 X 0 0 0 Patti Darley BOARD MEMBER 1.0 1.0 X 0 0 0 PETER MANNIX Board Member/HSHS VP 1.0 59.0 X 0 481334 22963 SR BERNADINE GUTOWSKI OSF BOARD MEMBER 1.0 2.0 X 0 0 0 Tina Nazier Board Member 1.0 1.0 X 0 0 0 ANN M CARR TREASURER 0.3 59.3 X 0 336583 297864 PATRICIA ALLEN DIVISION CFO - WISCONSIN 10.0 50.0 X 0 317363 49044 Beth Stokka MANAGER - PHARMACY 40.0 0 X 163836 0 114737 DEBRA ANN LAUER Director Home Health/Hospice 40.0 0 X 144416 0 179148 Peter Pokrzywinski Pharmacist 40.0 0 X 151109 0 143578 RHONDA ADLER PHARMACIST 40.0 0 X 174627 0 119742 SARA JORGENSON PHARMACIST 40.0 0 X 166412 0 132419 CHARISSE OLAND Former PRESIDENT 0.0 X 0 290792 0 JULIE MANAS Former PRES / CEO WESTERN WI DIV 0.0 X 0 104254 0 800400 2163046 1264787 19 true true false INFINITY HEALTHCARE 111 E WISCONSIN AVE MILWAUKEE WI 53202 PROVIDER COVERAGE 2297664 ANESTHESIA MANAGEMENT SOLUTIONS 28 N PALAFOX STREET PENSACOLA FL 32502 PROFESSIONAL SERVICES 1639224 DIVERSIFIED CLINICAL SVC INC PO BOX 636981 CINCINNATI OH 45263 PROFESSIONAL SERVICES 709689 Compass One healthcare PO box 102289 Alanta GA 30368 CONTRACTED SERVICES 591770 Medical Solutions 1010 N 102ND STREET SUITE 300 OMAHA NE 68114 STAFFING 297908 15 90681 1193114 1283795 PATIENT SERVICE REVENUE 621990 51035617 51035617 Other Department Revenue 900099 191802 191802 0 0 0 0 51227419 1287112 1287112 411755 411755 0 411755 411755 3173264 3173264 0 3173264 3173264 GIFT SHOP REVENUE 453220 39932 39932 CAFETERIA REVENUE 722514 20775 20775 0 0 0 0 60707 57444052 51227419 0 4932838 X 22265459 17402021 4863438 1651002 1290423 360579 5037438 3937261 1100177 1407358 1099991 307367 12192 12192 2287120 2287120 16451424 12400466 4050958 0 233305 191690 41615 93506 93506 1250589 1250589 220972 216597 4375 1550 1550 157772 157772 2896597 2357090 539507 225726 131192 94534 Clinical supplies 3483355 3474774 8581 MEDICAID ASSESSMENT 1062264 1062264 EQUIPMENT RENTAL 981971 981971 0 4181 113438 -109257 0 59723781 46004823 13718958 0 151924 2310562 0 0 5789712 6417931 0 0 0 0 62516 0 422624 428639 252794 281771 70624677 46548172 24951422 24076505 112075019 111744520 0 0 0 562354 351866 144268365 145611794 6254164 13597060 0 0 15514647 14805440 0 0 0 0 0 6486 17394824 20026253 39163635 48435239 X 98807522 90670790 6297208 6505765 0 0 0 105104730 97176555 144268365 145611794 X -2279729 -2309157 -3339289 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 8838 8838 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY St. Joseph's Hospital (The Hospital) IS A MEMBER OF THE CATHOLIC HEALTH ASSOCIATION ("CHA"), THE WISCONSIN HEALTH ASSOCIATION ("WHA"), AND THE AMERICAN HOSPITAL ASSOCIATION ("AHA"). AS A MEMBER OF THESE ORGANIZATIONS, THE HOSPITAL PAYS DUES, WITH PART OF THESE DUES BEING ATTRIBUTABLE TO LOBBYING FEES PAID BY THE ORGANIZATIONS. THE AMOUNT LISTED IS THE AMOUNT ATTRIBUTABLE TO THE HOSPITAL FROM ITS DUES PAID. THE ASSOCIATIONS THE HOSPITAL PAYS ARE AS FOLLOWS: - AMERICAN HOSPITAL ASSOCIATION ("AHA") AT 23.32% LOBBYING EXPENSE - CATHOLIC HEALTH ASSOCIATION ("CHA") AT 3.55% LOBBYING EXPENSE - WISCONSIN HOSPITAL ASSOCIATION ("WHA") AT 16.70% LOBBYING EXPENSE THE TOTAL AMOUNT OF ANNUAL DUES PAID TO EACH ASSOCIATION IS MULTIPLIED BY THE PERCENTAGE OF DUES ALLOCATED TO LOBBYING EXPENSE TO CALCULATE THE TOTAL LOBBYING EXPENDITURES PAID. 383686 383686 21065678 10188592 10877086 24456692 20165629 4291063 24718621 16193951 8524670 24076505 RATE SWAP AGREEMENTS 4556362 MINIMUM PENSION LIABILITY 15469891 20026253 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote HSHS and the Foundation are Illinois not-for-profit organizations as described in Section 501(c) (3) of the Internal Revenue Code (the Code) and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Kiara, Inc. is an Illinois for-profit corporation that recognizes income taxes under the asset-and-liability method. Deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the consolidated financial statement carrying amounts of existing assets and liabilities and their respective tax basis and operating loss and tax credit carryforwards. Deferred tax assets and liabilities are measured using the enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. The net operating loss carryforwards result in a deferred tax asset of $83,066 and $70,000 at June 30, 2020 and 2019, respectively. In assessing the realizability of deferred tax assets, management considers whether it is more likely than not that some portion or all of the deferred tax assets will not be realized. The ultimate realization of deferred tax assets is dependent upon the generation of future taxable income during the periods in which those temporary differences become deductible. Management considers projected future taxable income and tax planning strategies in making this assessment. Based upon the level of historical taxable losses and projections for future taxable losses over the periods for which the deferred tax assets are deductible, management believes it is more likely Kiara, Inc. will not realize the majority of the benefits of these deductible differences. Full valuation allowances have been applied against the deferred tax assets attributable to the net operating loss carryforwards not realized as of June 30, 2020 and 2019 in the accompanying consolidated financial statements due to the uncertainty of realization. HSHS recognizes the tax benefit from an uncertain tax position only if it is more likely than not the tax position will be sustained on examination by the taxing authorities, based on the technical merits of the position. As of June 30, 2020 and 2019, HSHS does not have any liabilities for unrecognized tax benefits. true true X true X true X true true true false true true 570565 0 570565 0.0096 12152233 7513615 4638618 0.0777 2250349 1848023 402326 0.0067 0 0 14973147 9361638 5611509 0.0940 124302 0 124302 0.0021 0 0.0 3827895 2753474 1074421 0.0180 0 0.0 22781 22781 0.0004 0 0 3974978 2753474 1221504 0.0205 0 0 18948125 12115112 6833013 0.1144 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 54152 54152 0.0009 0 0 54152 0 54152 0.0009 true 0 1546677 12449317 22080258 -9630941 X true true 1 1 ST JOSEPH'S HOSPITAL 2661 COUNTY HIGHWAY I CHIPPEWA FALLS WI 54729 http://www.stjoeschipfalls.com/ 15 X X X ST JOSEPH'S HOSPITAL 1 false false true X X X X X X X X X 17 true true true true X https://www.hshs.org/HSHSFamily/media/St.Josephs-Chippewa-Falls/Chippewa-Community-Health-Assessment X https://www.chippewahealth.org X X true 17 true https://www.hshs.org/HSHSFamily/media/St.Josephs-Chippewa-Falls/Chippewa-Community-Health-Needs-Asse false true X 200.0 400.0 X X X X X X true true X X X true X http://www.hshs.org/fap X http://www.hshs.org/fap X http://www.hshs.org/fap X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3E Yes, The significant health needs are a prioritized description of the significant health needs of the community and were identified through the CHNA process. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - HSHS St. Joseph's Hospital, Chippewa Falls. The FY2018 Community Health Needs Assessment (CHNA) Partnership Committee was comprised of representatives from nine community organizations in Chippewa and Eau Claire, WI counties. Membership included the chief health officers from both the Chippewa County and Eau Claire County Public Health Departments. Also, on the committee were the Executive Director and the Director of Community Health from the United Way of the Greater Chippewa Valley, along with Directors of Community Health from HSHS Sacred Heart and St. Joseph's Hospitals and Mayo Clinic Health System. In addition, the committee included the Policy and Systems Manager of the Eau Claire County Health Department, the Administrator of Marshfield Clinic Health System and a Community Health Educator from HSHS. The committee also invited input on the CHNA from local health coalitions, Eau Claire Healthy Communities and Chippewa Health Improvement Partnership. These coalitions have membership that represents all twelve community sectors. The CHNA process included a variety of data collection methods to connect with several different demographic groups in the community and to develop a thorough understanding of health issues facing the Chippewa Valley. These methods included primary qualitative data collection through an online and hardcopy community health survey (an abbreviated hard copy survey was created for residents with limited health literacy), survey outreach with underrepresented demographic groups, community conversations (to prioritize health focus areas), and coalition meetings (to further evaluate the top five health focus areas). A translator was present during survey outreach sessions to assist community residents with a language barrier. The link to the web survey was widely distributed through the networks of each of the partner organizations as well as more than 70 community organizations including public and private schools. Community organizations included the Salvation Army, Aging and Disability Resource Center, Boys & Girls Club of the Greater Chippewa Valley, Family Resource Center, Western Dairyland Head Start, local churches and food pantries, University of Wisconsin-Extension, Eau Claire Area Hmong Mutual Assistance Association, Family Promise of the Chippewa Valley, Eau Claire YMCA, Eau Claire Chamber of Commerce, Catholic Charities, Bolton Refuge House, Hope Gospel Mission, and others. The survey launch was announced by a press release and was widely advertised in local newspapers, television media outlets, social media, and flyers throughout the county. Special effort was made to ensure the survey was available to underrepresented groups who can be at the highest risk of suffering from health disparities. Hardcopy surveys were also made available throughout the county by request from the project manager. A total of 1,225 Chippewa County residents completed the survey, and results are reportable at a 95% confidence level. Survey respondents represented a wide range of county residents, including a variety of income and educational levels, ages, and household sizes. One-quarter of the survey respondents were from Chippewa Falls. Twenty-four percent identified as health care providers and 5% emergency services personnel, indicating many residents not employed in a healthcare related field also participated in the survey. Analysis of the survey demographics in Chippewa County indicated that a low number of responses were received from the over 70 age group, as well as from community members with highest education level designation of high school. Therefore, targeted sessions were held to engage these two groups and gather information on barriers and resources needed for making healthy choices in the community. These sessions were held in December 2017 throughout the county: Chippewa Valley Correctional Treatment Facility, Eau Claire Area Hmong Mutual Assistance Association, L.E. Phillips Senior Center, Agnes Table, The Community Table, and WIC Clinic in Chippewa Falls. Each session was conducted by at least one CHNA partner organization representative. Session participants had the choice to complete the community health survey online or hardcopy. An abbreviated assessment was offered as an option during the outreach. Overall, 127 surveys were completed through the targeted outreach sessions. Secondary data gathered throughout the CHNA process, insight from the community, and coalition conversations with members of the community health coalitions for Chippewa and Eau Claire counties provided additional perspective on the disparities among populations within Chippewa County. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - HSHS St. Joseph's Hospital, Chippewa Falls. The FY2018 CHNA was conducted with sister-hospital HSHS Sacred Hospital, Eau Claire, WI, Mayo Clinic Health System, and Marshfield Clinic Health System, of Eau Claire, WI. Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - HSHS St. Joseph's Hospital, Chippewa Falls. The hospital's FY2018 CHNA was conducted with Eau Claire Healthy Communities Coalition, Eau Claire County, Wisconsin; Chippewa County Department of Public Health, Chippewa County, Wisconsin; Chippewa Health Improvement Partnership, Chippewa County, Wisconsin; United Way of the Greater Chippewa Valley, Chippewa and Eau Claire County, Wisconsin. Schedule H, Part V, Section B, Line 7 Facility , 1 Facility , 1 - HSHS St. Joseph's Hospital, Chippewa Falls. HARD COPIES OF THE CHNA ARE AVAILABLE FREE OF CHARGE THROUGH THE HOSPITAL'S COMMUNITY HEALTH AND MARKETING DEPARTMENTS, AS WELL AS THROUGH THE HOSPITAL'S COMMUNITY HEALTH COALITION, CHIPPEWA HEALTH IMPROVEMENT PARTNERSHIP. The CHNA results were also announced by the hospital and partnering agencies via a press release and subsequently multiple media interviews followed to discuss the results and potential implementation plans. The CHNA results are frequently discussed by HSHS Community Health colleagues on television news programs and local newspapers as part of stories to explain why the hospital is implementing a program or hosting an event. The CHNA has been utilized by several community partners to guide their Community Health Improvement Plans (CHIP), including the CHIP for Chippewa County Health Department and Chippewa Health Improvement Partnership Coalition. The link for the hospital webpage where the CHNA is located is often requested and sent to area organizations. The CHNA results are also discussed at a variety of events and presentations that the hospital's Community Health department is involved in such as presentations to area service clubs, area mentor clubs, at the onset of Mental Health First Aid, ACES and QPR trainings, and hospital board and other committee meetings. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - HSHS St. Joseph's Hospital, Chippewa Falls. Based on the FY2018 CHNA planning and development process, the following top three community health needs were identified and have been the primary focus areas for HSHS St. Joseph's Hospital's (SJCF) community benefit in FY2020: * Mental Health * Substance Abuse * High-Risk Alcohol Consumption Mental Health HSHS St. Joseph's Hospital (SJCF) led the implementation and/or continuation of multiple efforts to improve the mental health and emotional wellbeing of residents of the area that the hospital serves. The SJCF Community Benefit Implementation Plan includes several evidence-based strategies to positively impact the top identified need for both Chippewa and Eau Claire counties which was mental health. These strategies were selected with the understanding that behavioral health and mental illness are affected by a multitude of factors at the intrapersonal, interpersonal, community, and societal levels, with no factor singly explaining the prevention, care and treatment, or rehabilitation of mental illness. Goal: In partnership with the Chippewa County Public Health Department and other organizations, HSHS St. Joseph's Hospital will continue existing efforts, while enhancing others, to educate/create awareness of mental health and increase access to mental health services in the community, including services offered by the hospital. St. Joseph's Hospital will also continue to host and support the substance abuse initiatives of the Eau Claire County Healthy Communities Coalition and Chippewa Health Improvement Partnership (CHIP). Strategy 1: Mental Health Awareness and Education HSHS St. Joseph's Hospital will develop, promote, and/or participate in a minimum of five mental health awareness events, activities, and/or educational sessions annually to raise awareness of mental health issues. FY2020 Outcomes SJCF Community Health sponsors and leads Chippewa Health Improvement Partnership (CHIP), a 100-member community health coalition. The coalition's Mental Health action team completed a project with a goal of increasing awareness of the importance of sleep in early childhood; the team purchased the board book, SleepyHeads. The book along with educational materials about the importance of sleep was given to home visiting agencies in Chippewa County-Early Head Start in Chippewa Falls, Stanley/Boyd, Cadott, and Colfax (serves Bloomer area), River Source Family Center, and Birth to 3 programs. These books along with a brochure were taken to families during a home visit to provide education about healthy sleep habits, how much sleep does your child need, and bedtime routines. The group served 120 families. SJCF Community Health staff presented a program at the Chippewa Falls School Districts' annual Teen Mental Health Summit entitled, "Understanding the Culture of Poverty." Forty-eight people attended the two sessions. Thirty-seven evaluations were returned, and 99% of evaluators indicated the session was useful and provided helpful material. Prevent Suicide Chippewa Valley Coalition -HSHS St. Joseph's Hospital along with community partners joined together to form Prevent Suicide Chippewa Valley Coalition (PSCVC). This coalition is made up of 20 members from area agencies that have a goal of reducing suicide in our communities. Members include Eau Claire County and Chippewa County Public Health and Department of Human Services, Mayo Health System, Marshfield Clinic Health System, NAMI, local church pastors, University of WI Eau Claire, Northwest Connections Crisis as well as others. PSCVC provides suicide prevention education in the community and provides grant opportunities to agencies and groups working on suicide prevention initiatives. To raise awareness of suicide in our community PSCVC hosts a yearly public walk and day of remembrance. The event is called Sharing Hope: Walk to Prevent Suicide. In September of 2019, this walk was attended by over 1000 people. The walk is a fund raiser and all the proceeds go back into the community for mental health initiatives. PSCVC provides grants to area non-profit agencies for initiatives related to improving mental health. FY20 grantees included: a grant for Crisis Intervention Training of community members, a jail reentry program grant, a grant to the LGBTQ Community Center and a grant to a Mental Health Group Home. Strategy 2: Promote Resilience for Chippewa Valley Youth SJCF will continue to promote resilience and other protective factors in youth through active participation in the Mental Health Matters grant project from Advancing a Healthier Wisconsin Endowment-Medical College of Wisconsin. The hospital's Community Health Department will also assist the area school district in coordinating a Teen Mental Health Summit FY2020 Outcomes SJCF is an active participant of a community collaboration that is working to create awareness of the effect of trauma and adverse childhood experiences (ACE's) on brain development and how to create resilience in youth. From July 2019-June 2020, the collaborative provided 22 community awareness presentations on ACES/Resilience to approximately 586 youth-serving professionals from education, healthcare, community-based organizations, and government sectors in Chippewa and Eau Claire counties. 89% of attendees completed the evaluation of the program and results are as follows: * Participants reported an increase in their level of knowledge after the workshop compared to their reported level of knowledge before the workshop for all 5 workshop learning objectives * 89% of workshop participants reported at least one action they plan to take in their work based on what they learned and discussed in the workshop. * 72% workshop participants reported at least one action they would like their organization to take based on what they learned and discussed in the workshop. SJCF partnered with the Chippewa Falls Area Unified School District in coordinating a Teen Mental Health Summit held at the Chippewa Valley Technical College in Chippewa Falls in August 2019. The keynote speaker presented a program on Lessons Learned from Columbine. The event offered also offered 14 breakout sessions throughout the day. 200 people attended the event and evaluation comments included: "This has been an awesome workshop." "Thank you for providing more opportunities to learn and continue to learn about mental health issues in our area." "Very interesting summit." "A lot of good information. I think it is great to offer this at NO COST."" Great job today. Very well organized!" "Super information, very useful." Strategy 3: Increase Community Access to Mental and Behavioral Health Services The hospital's Behavioral Health Services will continue to provide frontline care to address patients' mental and behavioral health needs by offering outpatient psychiatric consultations by a psychiatrist at Prevea Health, provide detox, in-patient and out-patient behavioral health services, as well as residential alcohol and other drug treatment at L.E. Phillips Libertas Treatment Center located on the campus of HSHS St. Joseph's Hospital in Chippewa Falls, Wisconsin. Goals for the hospital's Behavioral Health Services include: imbed Behavioral Health into primary clinics (placement of a mental health/substance abuse clinician within clinic settings); open a 12 bed Inpatient Behavioral Health adolescent unit in St. Joseph's Hospital; expand reach of outpatient behavioral health counseling services by utilizing telehealth equipment; continue support of mental health services provided by L.E. Phillips Libertas Treatment Center to the patients of the Open Door Clinic; and implement school-based counseling in at least two schools. Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - HSHS St. Joseph's Hospital, Chippewa Falls. FY2020 Outcomes Behavioral Care was embedded into the new Prevea Clinics in Rice Lake and Ladysmith. The hospital will be embedding Behavioral Care into the Altoona Clinic and the Menomonie Clinic when opened. SJCF continues to develop plans and secure funding for an increase in inpatient behavioral health adolescent services. Telehealth between Prevea Behavioral Care to Lake Holcombe School District students has been offered since October 2019. L.E. Phillip Treatment Center continues to provide counseling services to those patients referred through the Open-Door Free Clinic. Prevea Health Counselors provided school-based counseling in seven schools in Chippewa County. Strategy 4: Promote and Support Suicide Prevention Efforts Chippewa County's suicide crude death rate (2016-WISH) is 14 per 100,000 population compared to 15 for State (2016-American Foundation for Suicide Prevention) and 13.5 in the United States (2016-American Foundation for Suicide Prevention). The Healthy People 2020 target for the United States is 10.2. In partnership with the Chippewa County Public Health Department and other organizations, HSHS St. Joseph's Hospital will provide/promote local QPR and Mental Health First Aid training as a means of suicide prevention. FY2020 Outcomes SJCF's Community Health department is leading suicide prevention activities across multiple sectors and settings in collaboration with the public health department of Chippewa County, Chippewa County School Districts and multiple other community partners to promote awareness that suicide is a preventable public health problem. Strategies include community trainings of an evidence-based suicide prevention program, QPR (question, persuade & refer). One of the strategies was to "blanket" the area with QPR gatekeeper training - the three simple steps anyone can learn to help prevent suicide. Per the surgeon general's national strategy for suicide prevention, a gatekeeper is someone in a position to recognize a crisis and the warning signs that someone may be contemplating suicide. In FY2020, HSHS SJCF provided 11 gatekeeper trainings to 163 adults as well as 22 sessions to 854 youth in the same time period. Eighty-five percent of attendees indicated an increased knowledge of community resources. SJCF provided 6 of the 8-hour classes in FY20 to 169 participants. Attendees at Mental Health First Aid classes gave the class an average score of 4.67 on a 5-point Likert-type scale for improvement of knowledge when reaching out and helping a person with a mental health need. Substance Abuse According to the national Office of Disease Prevention and Health Promotion, substance abuse has a major impact on individuals, families, and communities resulting in teenage pregnancy, HIV/AIDS, other STDs, domestic violence, child abuse and neglect, motor vehicle crashes, physical fights, escalation of crime, homicide, and suicide. Goal: In partnership with the Chippewa County Health Department and other organizations, HSHS St. Joseph's Hospital will educate/create awareness of substance abuse issues and increase awareness of and access to substance abuse services in the community, including services offered by the hospital and affiliates. Strategy 1: Increase Community Access to Substance Abuse Services HSHS St. Joseph's Hospital will enhance community access to substance abuse services. Behavioral Health hospital colleagues will participate in a state-wide project of expanding access to treatment around opioid addiction. SJCF will have developed/implemented a Medication Assisted Treatment (MAT) Program for opioid addiction for WWD HSHS/Prevea - Behavioral Health program. FY2020 Outcomes SHEC colleagues participated in a state-wide project of expanding access to treatment around opioid addiction. In September 2018, HSHS St. Joseph's, HSHS Sacred Heart, and Prevea Health opened a Medication Assisted Treatment Program for opioid addiction. HSHS St. Joseph's reviewed and revised the curriculum at the hospital's LE Phillips Treatment Center and have moved to utilizing Dialetic Behavioral Therapy as our foundation for treatment, an evidence-based treatment. This approach as resulted in a 95% or above patient satisfaction rate for the last four quarters. Strategy 2: Substance Abuse Awareness and Education HSHS St. Joseph's Hospital will develop, coordinate, promote, and/or participate in a minimum of four Substance Abuse awareness, education events, and/or activities to raise awareness and educate about substance abuse issues. FY2020 Outcomes Students Against Destructive Decisions-SJCF in partnership with Eau Claire Alliance for Substance Abuse Prevention hosted a day-long leadership training for SADD (Students Against Destructive Decisions) to be prevention leaders (55 youth and 6 SADD advisors in 2019) for 6 Eau Claire county high schools. Training topics included leadership, alcohol and other drug use topics, mental health, and creating activisms during the school year. Take a Stand Against Meth Campaign-SJCF in partnership with business, faith, school, service organization and criminal justice leaders launched a county wide campaign aimed at reducing the number of meth-related referrals to the District Attorney, reduce the number of children removed from their homes and increase student feelings of safety as measured by the Youth Risk Behavior Survey. The campaign hosted community kick-off events in four county communities. The campaign also created social media posts educating the community about addiction and using the tipster line. Tipster data shows a 110% increase in Tipster line use since the launch of the campaign. SJCF provided 6, eight-hour Mental Health First Aid (MHFA) classes in FY2020 to 169 participants. Part of the curriculum of MHFA is a two-hour section about substance use disorder. Effective in 2019, a required addition to the curriculum of this class is a chapter specifically on opioid response, including how to use Narcan. Strategy 3: Reduce the Stigma Associated with Addiction HSHS St. Joseph's Hospital will develop, coordinate, promote, and/or participate in Substance Abuse awareness, education events, and/or activities to reduce the stigma associated with addiction. FY2020 Outcomes SJCF sponsors and leads Chippewa Health Improvement Partnership (CHIP), a 100-member community health coalition. CHIP uses social media to educate the public about addiction to reduce the associated stigma and encourage more people to seek treatment. CHIP messages eight to 10 educational posts per month. Examples of posts include: Recovery month information, "What if They Won't Seek Help" and "Addiction can Happen to Anyone, Anywhere, Anytime." Schedule H, Part V, Section B, Line 11 Facility , 3 Facility , 3 - HSHS St Joseph's Hospital Chippewa Falls. High-Risk Alcohol Consumption The misuse and abuse of alcohol, over-the-counter medications, illicit drugs, and tobacco affect the health and well-being of millions of Americans (SAMHSA 2018). SAMHSA's National Survey on Drug Use and Health (NSDUH) - 2014 (PDF | 3.4 MB) reports that in 2014 there were 139.7 million current alcohol users aged 12 or older, with 23% classified as binge drinkers and 6.2% as heavy drinkers. About 17 million of these, or 6.4%, met criteria for an alcohol use disorder in the past year. Excessive alcohol use, including underage drinking and binge drinking (drinking 5 or more drinks on a single occasion for men or 4 or more drinks on an occasion for women), can increase a person's risk of developing serious health problems, including brain and liver damage, heart disease, hypertension, and fetal damage in pregnant women. According to the Centers for Disease Control and Prevention (CDC), alcohol use causes 88,000 deaths a year. 47% of the driving deaths in Chippewa County are associated with alcohol involvement (Wisconsin Epidemiological Profile on Alcohol and Other Drug Use, 2016). Goal: In partnership with the Chippewa County Public Health Department and other organizations, HSHS St. Joseph's Hospital will educate and/or create awareness of issues related to alcohol misuse and create awareness of and access to Alcohol and Other Drug Abuse services in the community, including services offered by the hospital and affiliates. St. Joseph's Hospital will also continue to host and support the substance abuse initiatives of the Chippewa County healthy communities' coalition, Chippewa Health Improvement Partnership (CHIP). Strategy 1: Non-Alcoholic Events/Activities The hospital will support and/or fund area events and activities which are alcohol-free to curb underage drinking and increase number of alcohol-free events in the community. FY2020 Outcomes: SJCF participated as a sponsor of One Fest; a Christian music concert. This sponsorship aligns with our strategy to support local events where alcohol is not available. Strategy 2: Alcohol Misuse Community Awareness and Education The hospital will coordinate/host/actively participate in a minimum of five events/activities where education related to high-risk drinking is provided. FY2020 Outcomes SJCF is an active member of Eau Claire Healthy Communities High Risk Drinking Prevention Action Team. The High- Risk Drinking Prevention Action Team helps the community understand and avoid the high-risk uses of alcohol, including binge, heavy, and underage drinking, as well as drinking during pregnancy. FY2020 activities included: Getting an ordinance enacted that will enable law enforcement to act on public excessive intoxication and advocating for the city council to review criteria for alcohol license to include prevention best practices. SJCF sponsors and leads Chippewa Health Improvement Partnership (CHIP), a 100-member community health coalition. CHIP's AODA Action Team completed four festival survey's in Chippewa County to collect data on practices used to curb underage and excessive drinking at festivals. The team then presented findings and made discussed best practices with organizers of one of the festivals. Outcomes of that discussion are still pending as the event was cancelled due to Covid 19. Other CHNA Identified Needs: Chronic Disease Prevention SJCF is always concerned with the prevention and management of chronic disease and continues to incorporate this focus area into community awareness and education events/activities. An example is an educational program provided Community Health focused on Colorectal Cancer prevention with Dr. Neal Christiansen, Medical Oncologist. The event was held in partnership with the Eau Claire Senior Center. 20 people attended the December 2019 program. Evaluation results: 100% rated the program excellent. 100% indicated that they gained information that they were unaware of prior to the program. 93% indicated they plan to change something about their daily routine for better health after attending the program. Obesity SJCF supports and actively participates in the Chippewa Health Improvement action team - Challenge Chippewa, which works to positively impact physical fitness and overall wellbeing. This team hosted a nutrition event FY2020 that promoted families cooking together and eating together. The class was held in the local middle school food lab. The classes sold out with 12 families participating. Physical Activity SJCF supports the community need of physical activity by providing financial and in-kind support to area efforts including the Altoona Bike Rodeo, YMCA sponsorship, YMCA Kids Expo and support of area school athletics. Healthy Growth and Development The hospital supports the Infant Mental Health Action Team of Chippewa Health Improvement Partnership (CHIP) whose work impacts this focus area. SJCF will continue its coordination and support of its First Connections program which is a partnership between SJCF and the Family Support Center, Chippewa Falls that provide a visit by a family services case worker to all parents in SJCF's Birth Center to evaluate risk factors and provide information/referral. Monthly data is collected as to number of families seen, the degree of risk is assessed, and referrals made to community services for the families who are assessed to have heightened risk. In FY2020, 243 new parent visits were made with referrals as follows: Dad gift vouchers and swaddler vouchers given to parents (Referrals to Public Health Department to redeem these gifts); Baby & Me - First Time Parents Playgroup. In addition, referrals were made to other supportive services including WIC, Public Health Department car seat safety, Dolly Parton Imagination Library, Rural Playgroups, Chippewa Falls Playgroups, Head Start, Public Health Department Immunization clinics and Home visiting program. Healthy Nutrition This is the ninth season that SJCF and the Partners of St Joseph's Hospital offered plots in its community garden to feed those in need. Beginning mid-May 2020, for a small fee, individuals and families whose budgets do not allow for fresh produce, or who struggle to put food on the table, had the opportunity to grow their own fresh produce in the hospital's community garden. Plots are 12 feet by 24 feet and irrigation is included. People who need the food are encouraged to keep their entire yield. Service organizations also are welcome to rent plots and are asked to donate their harvest to local food pantries through SJCF. Through a community health needs assessment of Chippewa County, it was determined that food insecurity is a significant problem. The community requested that the hospital and its committees look at ways to get food to people and people to food. We have found that food insecurity can also be a problem for middle class families. It may be the family of four who have high medical bills, the mechanic who recently lost his job, or the single mom whose car just died. Unfortunately, fresh food gets cut from already slim budgets because of accessibility, cost and other factors. The community garden helps to cover this gap. The hospital also provides meals to the local Meals on Wheels program. Injury & Violence The community has a well-established, well- respected community sexual assault and domestic violence agency that is the lead on this area; the hospital provides financial support. As an outcome of the prioritization process, the following community health needs were also identified to a lesser degree and were not addressed directly by the hospital for the reasons indicated: Reproductive/sexual health. SJCF does not take the lead in this area as it is best served by the Chippewa County Health Department and other agencies with expertise in the area. Environmental/occupational health. The Chippewa County Health Department leads activities for environmental/occupational health as they have expertise in this area. Tobacco use and exposure. SJCF is a smoke-free campus and advocates for smoking cessation but efforts in the community are best led through the Chippewa County Health Department and other community agencies with expertise in this area. Communicable disease prevention and control. The Chippewa County Health Department leads activities for communicable disease prevention as they have expertise in this area. Oral health. The Chippewa County Health Department leads activities for oral disease prevention as well as the Marshfield Clinic Dental Center provides dental care to the community regardless of payment ability. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - St. Joseph's Hospital (SJCF). Presumptive eligibility is presumed under certain circumstances for uninsured patients based on their enrollment in other means-tested programs or other sources of information, not provided directly by the patient. Once determined, presumptive eligibility provides individuals participating in one of the following categories with a 100% write off. These programs are granted by outside organizations based on screening criteria of less than 200% of the FPG. 1. Homelessness 2. Deceased with no estate 3. Mental incapacitation with no one to act on patient's behalf 4. Medicaid eligibility, but not on date of service or for non-covered services 5. Incarceration in a penal institution 6. Enrollment in the following assistance programs for low-income individuals: 6a. Temporary Assistance for Needy Families (TANF) 6b. Illinois Housing Development Authority's Rental Housing Support Program 6c. Wisconsin Department of Health Services Housing Assistance Program 7. Participation in Women, Infants and Children programs (WIC); 8. Supplemental Nutrition Assistance Program (SNAP) eligibility; 9. Illinois Free Lunch and Breakfast Program; 10. Wisconsin Free Lunch Program; 11. Low Income Home Energy Assistance Program (LIHEAP); 12. Wisconsin Home Energy Assistance Program (WHEAP); 13. Enrollment in an organized community-based program providing access to medical care that assesses and documents limited low-income financial status as criteria; 14. Receipt of grant assistance for medical services 0 Schedule H, Part I, Line 7g Subsidized Health Services NO COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC ARE INCLUDED ON LINE 7G. Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance CHARITY 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 FY20 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. Schedule H, Part II Community Building Activities St. Joseph's Hospital (SJCF) has a 139 year history of giving back to the community and addressing community need at the most basic level. The hospital embraces catholic social teaching's preferential option to care for the poor and vulnerable, and works tirelessly to also improve the health of the broader communities it serves. SJCF invested $54,152 and served over 1,000 individuals through its community building initiatives in FY20. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount FOR FINANCIAL STATEMENT PURPOSES, HOSPITAL SISTERS HEALTH SYSTEM HAS ADOPTED ACCOUNTING STANDARDS UPDATE NO. 2014-09 (TOPIC 606). IMPLICIT PRICE CONCESSIONS INCLUDES BAD DEBTS. THEREFORE, BAD DEBTS ARE INCLUDED IN NET PATIENT REVENUE IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15 AND BAD DEBT EXPENSE IS NOT SEPARATELY REPORTED AS AN EXPENSE. Schedule H, Part III, Line 3 Bad Debt Expense Methodology St. Joseph's Hospital of the Hospital Sisters of the Third Order of St. Francis strongly believes that its charity care, and the related community benefit obtained from such care, is understated because of those patients who potentially qualify for charity care but do not wish to apply for it. In addition, some care is not classified as charity because of missing documentation on patient resources. Thus, the hospital's bad debt includes a portion that could be classified as charity care if application for such care was sought and/or completed. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote The text of the footnote to the organization's financial statements that describes bad debt expense can be found on page 19 of the HSHS consolidated audit report. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs The 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 leadership continually advocates for improved Medicare payment so that the cost of quality care to those patients who are not able to afford it is not compromised and is fairly subsidized by all payers. The IRS does not classify this shortfall in Medicare payments as Community Benefit. However, we believe it is an important contribution made by the hospital to the health and well-being of the community. If the Medicare program did not exist, many Medicare patients would be eligible for financial assistance or other means-tested government programs. Further, by absorbing this shortfall and providing care below cost to these individuals, the Hospital is relieving the burden of the government. Accordingly, this shortfall restricts the Hospital's ability to make funds available to provide for financial assistance and other Community Benefit. The hospital's Medicare shortfall at cost for fiscal year 2020 was $9,630,941. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance Every effort is made prior to, during and after provision of medical services to determine whether a patient is eligible for charity/community care and to assist the patient in completing the application and provide adequate documentation. If the patient qualified for charity/community care for the full balance of their account, the entire amount is written off to charity/community care and hence no debt collection is pursued. If the patient qualified for charity/community care for a portion of their account balance, that portion is written off to charity/community care, with the patient being responsible for the remainder of the balance. Additionally, reasonable effort will be made to obtain third-party or government payer reimbursement on behalf of the patient. If those efforts are not fruitful, an offer will be extended to the patient to make installment payments on their balance. Only at such point that the patient defaults on installment payments or refuses to cooperate with the hospital's efforts to be reimbursed will the account be sent to collections. The hospital will make reasonable efforts to determine whether a patient is eligible under the financial assistance policy before it engages in an ECA. To the extent a patient is determined to be eligible for financial assistance under the FAP, the hospital will take all reasonably available measures to reverse any ECA taken against the patient to obtain payment for the care. Schedule H, Part V, Section B, Line 16a FAP website - ST JOSEPH'S HOSPITAL: Line 16a URL: http://www.hshs.org/fap; Schedule H, Part V, Section B, Line 16b FAP Application website - ST JOSEPH'S HOSPITAL: Line 16b URL: http://www.hshs.org/fap; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - ST JOSEPH'S HOSPITAL: Line 16c URL: http://www.hshs.org/fap; Schedule H, Part VI, Line 2 Needs assessment In addition to the triennial CHNA, St. Joseph's Hospital (SJCF) uses many approaches to continually assess the health care needs of the community. SJCF uses Press Ganey Patient Experience Solutions to garner feedback to understand patient preferences and develop improvement plans. SJCF also utilizes face to face opportunities with patients to gauge community perception through regular leader rounding. Quarterly, SJCF engages in discussions about community health needs through the hospital's board of directors and advisory council. Membership consists of community members who represent varying sectors of the Chippewa valley including non-profit agencies, schools and businesses. SJCF has a 74-plus Volunteer Partners program whose members are a valuable source of feedback from the community to the hospital and back. Recognizing the need to hear from the youth sector, SJCF through its involvement with Chippewa Health Improvement Partnership started a youth advisory council. This group meets monthly through the school year with SJCF Community Health staff to discuss the health needs of the community from a youth perspective. SJCF leadership and Community Health staff participates in community groups and coalitions that address the needs of the underserved and minority populations. These groups include the Chippewa Valley YMCA, The Open Door Clinic, The Family Support Center, The Boys and Girls Club, The Mission Coalition, Eau Claire Healthy Communities and the Chippewa Valley Council on Hunger and Homelessness. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance Financial assistance brochures are accessible by patients in all predominate waiting areas/rooms. They are also provided to the public at a variety of community events/presentations and health fairs that the hospitals are involved in or coordinates.The Registration Department provides brochures to patients upon registration regarding the Financial Assistance Program available to them at the Hospital. The brochures are also supplied in waiting and ancillary areas for easy access by the patient. To better serve our patient population, the Hospital offers information on our financial assistance program in Spanish. This includes the Financial Assistance Policy, Brochure and Application, which allows the hospital to serve populations in its county and the surrounding area for whom Spanish is their primary language. Patients are also provided a Fair Billing Act notification at the point of registration regarding separate physician billing they can expect to receive, plus information about the patient's financial responsibility if their insurance plan is out of network. One-on-one conversations to educate patients about financial assistance often stem from patients receiving a statement or a pre-collection letter. At that point, the customer service representative or cashier, or other qualified staff, will inform/educate the caller about financial assistance options. The first pre-collection letter reminds the patient their account is in delinquent status. It also informs them they may be eligible for financial assistance through the organization's charity care program. The letter provides direct contact information to begin the application process for charity care and lists the Internet address where the policy can be obtained. A third-party vendor also assists individuals in determining their eligibility for state health plans or insurance on the open health insurance marketplace. They can also assist with the application process. Schedule H, Part VI, Line 4 Community information HSHS St. Joseph's Hospital (SJCF) is an acute care community hospital located in Chippewa Falls, Wisconsin. Chippewa Falls is approximately 90 miles east of the twin cities and 100 miles north of LaCrosse, WI. Chippewa Falls has a population of 14,035 (2017) and is the county seat of Chippewa County which has a population of 63,813 (54 percent urban, 46 percent rural) in 2017. The average income of this population is $52,657, and approximately 11.5% are living below federal poverty guidelines. Chippewa County is HSHS St. Joseph's Hospital's primary service area. Its secondary service area includes surrounding counties: portions of Barron, Clark, Dunn, Rusk and Taylor counties. Chippewa County is the largest of the six counties. Five out of six service area counties are considered rural by the U.S. Department of Agriculture. Evidence continues to suggest that rural settings in the U.S. exhibit pronounced needs in the areas of health, education, and economic security. Approximately, 46% of the residents in the county are living in a rural location compared to the state rate of 29.8%. Rural populations suffer from health inequities regarding access to food and physical activity locations. Rural residents have less access to fresh and healthy food, as convenience stores and fast food restaurants are often more common in villages than grocery stores. 19% of the residents do not have adequate access to locations for physical activity. Improper access can deter county residents from pursuing healthy behaviors, such as exercising outdoors. Chippewa County has 17% (6,740 residents) who lack adequate access to food within the community, which is higher than the state rate. Low-income residents who do not live close (rural areas are defined as less than ten miles from a grocery store; non-rural, less than one mile) to a grocery store in the county is 3,154 residents, which is similar to the state rate. The percentage of children in the county who attend a public school and are eligible for free or reduced price lunch has continued to increase- currently 42% of children are eligible. It is important to be mindful of the rural distinction to better address these disparities by focusing programs and services appropriately to these communities. Chippewa County has eight public and private school districts, Chippewa Valley Technical College campus, and Lakeland College. Economic drivers in the county include production agriculture, computer information systems, and seasonal tourism focused on outdoor recreation. Three hospitals serve Chippewa County: HSHS St. Joseph's Hospital in Chippewa Falls, Mayo Clinic Health System-Chippewa Valley in Bloomer, and Our Lady of Victory Medical Center in Stanley. The service area population is aging, much like the rest of the nation. The largest segment of growth from 2000 to 2010 occurred in the 18 to 64 year-old age category with a growth rate of 16.9 percent followed by a 10.3 percent growth rate in the 65+ year old age category. The number of 0 to 18 years olds is declining. Combined population growth for these six counties was approximately 6.6 percent between 2000 and 2010. Along with the aging population come increased health care costs with chronic disease. Studies indicate that the health of the aging population can be maintained and chronic diseases can be reduced by promoting healthy behaviors and expanding preventive health services. The service area's racial profile is primarily white (93.7 percent), higher than the state (86.2 percent) and nation (72.4 percent). The largest minority population in the service area is Hispanic or Latino (1.7 percent), with other races making up the remaining 3 percent of the population. Several unique minority populations are found in Western Wisconsin, Including the Amish, Mennonites and Hmong. Wisconsin has the fourth largest Amish population in the nation. Several communities of Amish are located throughout Chippewa and the surrounding counties with significant settlements in Barron, Buffalo and Clark counties. Determining an accurate number of Amish and Mennonites living in the state is not easy as the census bureau and other statistical agencies do not have data on religious affiliation. Chippewa County is federally- designated as a medically underserved area even though there are two acute-care hospitals that offer tertiary level services including cardiovascular surgery, neurosurgery, oncology and trauma level II in nearby Eau Claire: HSHS Sacred Heart Hospital (SHEC) and Mayo Clinic Health System - Eau Claire, in addition to Oakleaf Surgical Hospital and Marshfield Medical Center-Eau Claire. HSHS and Mayo Health System have extensive penetration in Eau Claire and surrounding counties. Likewise, the Oakleaf Medical Network and Marshfield Clinic offer services at several sites throughout Chippewa and Eau Claire counties. Residents located on the periphery of SJCF's service area have access to equivalent and even greater levels of acute care. To the west, the twin cities market boasts several large community hospitals with trauma level 1 and an academic medical center. A comprehensive health care network, including two hospitals, a large multi-specialty group practice, and a regional community clinic, exists to the south in La Crosse. To the east, Ministry Health Care, St. Joseph's Hospital, Marshfield and the Marshfield Clinic physician group provide both acute care and primary care services. Uninsured or underinsured residents suffer from health disparities regarding access to care. 10% of adults and 4% of children in the county do not have insurance. In the last year, 25% of residents did not get the recommended dental or medical care, which is higher than the Wisconsin rate. An area of high concern is the lack of health care providers who accept Badgercare, the healthcare coverage program for low-income Wisconsin residents. Schedule H, Part VI, Line 5 Promotion of community health As a healing ministry of the Catholic Church and an affiliate of Hospital Sisters Health System (HSHS), HSHS St. Joseph's Hospital is committed to delivering high quality, compassionate, and cost-effective health care services to all. Founded in 1885 the hospital brings a healing presence and improves the health of our community, especially those persons who are sick, poor, and disadvantaged. Because of the hospital's mission and heritage, the hospital is dedicated to promoting the health of Chippewa County and surrounding areas. The hospital is governed by a Board of Directors, most of who reside in the hospital's primary service area and are neither employees nor independent contractors of the hospital (nor family members thereof). The Board ensures that St. Joseph's Hospital is responding to community need. There are also other bodies that assist St. Joseph's Hospital's connection with the community, such as the hospital Advisory Council, Patient and Family Advisory Council, The Foundation of HSHS St. Joseph's Hospital, and Volunteer Partners Board. Consistent with its exempt purpose, St. Joseph's Hospital has an open medical staff with privileges available to all qualified physicians in the area. The hospital also operates an Emergency Department that is open 24 hours to all persons regardless of their ability to pay. As a not-for-profit hospital, HSHS St. Joseph's Hospital reinvests surplus funds to support the mission of the organization and promote the health of the community rather than distributing surplus funds as profits to shareholders or individuals. Funds not committed to ongoing operations are generally used to upgrade facilities, secure new technologies, improve patient care, and support initiatives designed to promote health and ensure access for all. For example, SJCF continues to partner with Prevea Health, a multi-specialty health care organization based in Green Bay, Wisconsin that has been a part of the Western Wisconsin region since 2015. Prevea Health works extensively with SJCF and sister hospital HSHS Sacred Heart Hospital in Eau Claire. In partnership with SJCF, Prevea opened clinics in Menomonie, Chippewa Falls, Altoona and Ladysmith in FY19. Prevea President and CEO and Chief Medical Officer and Vice President of Clinical Operations - Western Wisconsin worked closely with HSHS Wisconsin to serve the common good of communities during the pandemic through consistent educational messaging, testing sites, processing COVID lab tests, etc. A need was identified to have more advanced care planning discussions with patients and families. Part of the care planning discussion involves provision of care in the most appropriate setting. As a result, SJCF/SHEC Spiritual Care team partnered with Prevea to hold advance care planning session discussions, complete advance directives, enter advance directives into the medical record so physicians and staff can follow patient's wishes when patients become incapacitated. By working together, we can be sure we are providing the most appropriate care that aligns with the patient's wishes in the setting that is most conducive. HSHS St. Joseph's Hospital also devotes significant resources to access for patients who cannot afford care, along with other Community Benefits. In FY2020, HSHS St. Joseph's Hospital provided more than 6.4 million in Community Benefit, including financial assistance at cost, unpaid costs of Medicaid and other public programs, and a range of diverse programs designed to enhance access and improve community health. Additionally, in FY2020, HSHS St. Joseph's Hospital provided 1.5 (at cost) in uncompensated care to patients who did not qualify for charity care or public assistance and more than 8.8 million (at cost) in excess of Medicare payment for health care services. HSHS St. Joseph's Hospital provides a range of Community Benefit initiatives and programs that further our mission and long-standing commitment to our community. In many cases, these Community Benefits would not exist without the leadership role played by HSHS St. Joseph's Hospital and they often relieve a burden that would otherwise be carried by government. Schedule H, Part VI, Line 6 Affiliated health care system Headquartered in Springfield, Illinois, Hospital Sisters Health System (HSHS) is a highly integrated, multi-institutional health care system comprised of 15 hospitals and more than 200 physician practice sites in Illinois and Wisconsin. HSHS is sponsored by Hospital Sisters Ministries (HSM), which is a public juridic person of the Roman Catholic Church. HSHS continues the health care ministries begun by its founders, the Hospital Sisters of St. Francis, more than 140 years ago, in rural and midsized communities throughout Illinois and Wisconsin. HSHS provides compassionate, holistic, high quality, and cost-effective health care through its acute care hospitals, physician practices, home health programs, palliative and hospice programs, and community outreach services. In addition, HSHS affiliated hospitals include critical access facilities that offer essential health services that otherwise would not be available in many communities. Our mission calls us to reveal and embody Christ's healing love for all people, and we extend our high quality Franciscan health care ministry beyond the walls of our hospitals by providing community health improvement services with special emphasis on the poor and vulnerable. In addition to providing community health improvement services to the broader community, HSHS cares for everyone who comes to its facilities, regardless of their ability to pay. In tandem with a variety of cross sector community partners, HSHS's Community Benefit initiatives are strategically planned and professionally implemented to improve access to health care services; enhance the health of the community; advance medical or general health care knowledge; and relieve or reduce the burden of government to improve health. The COVID-19 pandemic caused an unprecedented disruption in healthcare services across the United States. HSHS responded with services that benefited our communities, including free telehealth screenings, free testing, and coordination with other healthcare providers in the communities we serve to best ensure access to needed care. In FY2020, HSHS collectively provided $244.0 million in Community Benefit (10.0% of total hospital expenses) including more than $1 million in response to the pandemic. Of the total Community Benefit provided, HSHS spent $26.9 million provided for Financial Assistance (aka Charity Care) and $173.3 million for unreimbursed care provided as part of the Medicaid program. In addition, HSHS hospitals committed significant resources to treat Medicare patients. The cost of providing services to primarily elderly beneficiaries of the Medicare program - in excess of governmental and managed care contract payments - was $183.9 million. HSHS hospitals also recorded $26.4 million in uncollectible accounts. While HSHS does not count the latter two amounts as Community Benefit, they nonetheless reflect our commitment to serving all persons in need of care. In addition to the dollars invested in our Community Benefit programs, HSHS continues to reinvest any surplus revenue from operations and investments into new medical technology, facility infrastructure and health care services in our communities. By doing so, we ensure our ability to meet the ongoing demand for high quality, efficient and easily accessible health care. Schedule H, Part VI, Line 7 State filing of community benefit report WI X X X X X true true false false false false false false false JULIE MANAS Former PRES / CEO WESTERN WI DIV 0 0 0 0 0 104254 0 0 0 0 0 104254 0 0 CHARISSE OLAND Former PRESIDENT 0 0 0 1897 0 288895 0 0 0 0 0 290792 0 0 ANDREW J BAGNALL PRESIDENT & Division CEO - Wisconsin 0 420632 0 6235 0 98815 0 158857 0 35359 0 719898 0 73273 PETER MANNIX Board Member/HSHS VP 0 266251 0 9432 0 205651 0 0 0 22963 0 504297 0 170017 PATRICIA ALLEN DIVISION CFO - WISCONSIN 0 294810 0 2793 0 19760 0 26885 0 22159 0 366407 0 0 ANN M CARR TREASURER 0 272481 0 4651 0 59451 0 272885 0 24979 0 634447 0 29653 RHONDA ADLER PHARMACIST 116596 0 58031 0 0 0 108492 0 11250 0 294369 0 0 0 SARA JORGENSON PHARMACIST 116502 0 49520 0 390 0 120129 0 12290 0 298831 0 0 0 Peter Pokrzywinski Pharmacist 146521 0 4588 0 0 0 121952 0 21626 0 294687 0 0 0 Beth Stokka MANAGER - PHARMACY 163446 0 0 0 390 0 113785 0 952 0 278573 0 0 0 DEBRA ANN LAUER Director Home Health/Hospice 143801 0 0 0 615 0 159315 0 19833 0 323564 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation PLEASE SEE RESPONSE TO FORM 990, PART VI, LINE 15A IN SCHEDULE O. Schedule J, Part I, Line 4a Severance or change-of-control payment ORGANIZATION: HOSPITAL SISTERS HEALTH SYSTEM, INC. EIN: 37-1058692 INTERESTED PERSON: JULIE MANAS AMOUNT: $91,708 TERMS: COMPENSATION PAID AS A RESULT OF A SEVERANCE FROM THE POSITION OF PRESIDENT/CEO WESTERN WI DIVISION. ORGANIZATION: Hospital Sisters Health System, Inc. EIN: 37-1058692 INTERESTED PERSON: Charisse Oland AMOUNT: $273,514 TERMS: COMPENSATION PAID AS A RESULT OF A SEVERANCE FROM THE POSITION OF President. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan HSHS EXECUTIVES ELIGIBLE TO PARTICIPATE IN SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) ARE DEFINED IN THE SERP PLAN DOCUMENTS. THE SERP WAS ESTABLISHED TO PROVIDE ADDITIONAL RETIREMENT BENEFITS TO ENSURE REASONABLE MARKET COMPETITIVE BENEFITS IN ACCORDANCE WITH THE HSHS EXECUTIVE COMPENSATION PHILOSOPHY ESTABLISHED BY THE HSHS COMPENSATION COMMITTEE. THE PLAN PROVIDES A DEFINED RETIREMENT CONTRIBUTION TO PARTICIPANTS COMMENCING ON JANUARY 1, 2008, EQUAL TO A PERCENTAGE OF COMPENSATION AS DEFINED IN THE SERP PLAN DOCUENTS FOR THE PLAN YEAR. PARTICIPANTS CONSTRUCTIVELY RECEIVE A DISTRIBUTION FROM THE PLAN NO LATER THAN MARCH 15TH OF THE CALENDAR YEAR FOLLOWING THE CALENDAR YEAR IN WHICH AN AMOUNT IS VESTED AND TAXABLE PURSUANT TO A VESTING SCHEDULE AS SPECIFIED IN THE PLAN DOCUMENT. THE ACTUAL DISTRIBUTION OF THE VESTED BENEFIT UNDER THE PLAN IS PAID IN A SINGLE LUMP SUM TO THE PARTICIPANT OR THE PARTICIPANT'S BENEFICIARY UPON THE EARLIER OF THE PARTICIPANT'S TERMINATION OF EMPLOYMENT, DEATH, OR TOTAL AND PERMANENT DISABILITY. THE FOLLOWING INTERESTED PERSONS CONSTRUCTIVELY RECEIVED DEFERRALS TO THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2019 THESE DEFERRALS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C). Andy Bagnall -- $54,432 Ann Carr -- $30,435 John Wagner -- $5,862 THE FOLLOWING INTERESTED PERSONS RECEIVED DISTRIBUTIONS FROM THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2019 THESE PAYMENTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III) AND SCHEDULE J, PART II, COLUMN (F), AS APPLICABLE. Andy Bagnall -- $73,273 Ann Carr -- $29,653 Peter Mannix -- $170,017 Form 990, Part III, Line 4a PROGRAM SERVICE ACCOMPLISHMENTS ST. JOSEPH'S HOSPITAL PROVIDES QUALITY MEDICAL HEALTHCARE TO THE SURROUNDING COMMUNITY REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND FINANCIAL STABILITY OF ST. JOSEPH'S HOSPITAL, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. AND, FURTHER THAT OUR MISSION IS TO SERVE THE COMMUNITY BY PROVIDING HEALTHCARE SERVICES AND HEALTHCARE EDUCATION. INHERENT IN OUR MISSION, WE PROVIDE CARE TO THE POOR, THE ELDERLY, AND THE NEEDY OF THE COMMUNITY THROUGH VARIOUS PROGRAMS AND SERVICES. THESE ACTIVITIES INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, AND SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED, MEDICALLY UNDER SERVED, AND VARIETY OF COMMUNITY SUPPORT ENDEAVORS. ST. JOSEPH'S HOSPITAL PROVIDED THE FOLLOWING SERVICES IN FISCAL YEAR 06/30/20: 4,065 ADULT AND PEDIATRIC INPATIENT DAYS OF CARE, 8,442 ALCOHOL AND DRUG ABUSE INPATIENT DAYS OF CARE, 30,003 OUTPATIENT HOSPITAL VISITS, 15,290 HOME HEALTH VISITS, 26,591 HOSPICE DAYS. ST. JOSEPH'S HOSPITALPROVIDES BOTH BENEFITS TO THE POOR AND FOR THE BROADER COMMUNITY. BENEFITS TO THE POOR ARE PROVIDED IN THE FORM OF TRADITIONAL CHARITY CARE, FOR THOSE WHO CANNOT AFFORD TO PAY, AS WELL AS UNPAID COSTS OF PUBLIC PROGRAMS SUCH AS MEDICAID AND GENERAL RELIEF. TOTAL VALUE OF THESE NON-REIMBURSED BENEFITS FOR THE POOR WERE $5,212,602 IN FISCAL YEAR 06/30/20. ST. JOSEPH'S HOSPITAL ALSO PROVIDES NUMEROUS BENEFITS TO THE BROADER CHIPPEWA VALLEY AREA. THESE BENEFITS ARE PROVIDED BY OUR PARTICIPATION IN THE MEDICARE PROGRAM, PROVIDING MANY PROGRAMS AND SERVICES FREE OR AT A REDUCED PRICE AND PROVIDING SERVICES THAT BENEFIT THE COMMUNITY BUT HAVE A NEGATIVE MARGIN. THE UNPAID OR NON-REIMBURSED COST OF PARTICIPATION IN THE MEDICARE PROGRAM WAS $8,844,427 IN FISCAL YEAR 06/30/20. TOTAL QUANTIFIABLE BENEFITS FOR THE BROADER COMMUNITY WERE $1,189,667 IN FISCAL YEAR 06/30/20. THE FOLLOWING IS A LISTING OF SPECIFIC EXAMPLES OF SERVICES INCLUDED IN THE ABOVE FIGURES: *MEALS REIMBURSED AT LESS THAN COST TO ELDERLY OF THE COMMUNITY. *ORGAN AND TISSUE DONATION PROGRAM COORDINATED WITH PASTORAL CARE, NURSING SERVICES, AND THE WISCONSIN EYE BANK AND ORGAN PROCUREMENT SERVICE IN MADISON, WISCONSIN. *PASTORAL CARE SERVICES PROVIDED 24 HOURS PER DAY. *PHYSICIAN REFERRAL SERVICE FOR NEW RESIDENTS OF THE AREA. *PARTICIPANT IN THE PROJECT CARE SEAT PROGRAM OFFERING INFANT CAR SEATS AT A MINIMAL RENTAL RATE. *SHARPS DISPOSAL PROGRAM FOR THOSE IN THE COMMUNITY WHO MUST DISPOSE OF NEEDLES AND SYRINGES. *SOCIAL SERVICE DEPARTMENT TO ASSIST FAMILIES WITH EMOTIONAL AND SOCIAL PROBLEMS. *HOSPICE GRIEF SUPPORT PROGRAM TO HELP THOSE WHO HAVE LOST LOVED ONES DEAL WITH THE GRIEVING PROCESS. *SHARE PROGRAM TO HELP THOSE WHO HAVE LOST INFANTS TO MISCARRIAGE, ECTOPIC PREGNANCY, STILLBIRTH OR NEWBORN DEATH. *BABY-SITTERS CLINIC. *BACK IN BALANCE SPONSORED BY PHYSICAL THERAPY DEPARTMENT FOR PEOPLE WITH CHRONIC BACK PAIN. *BIG KID/LITTLE KID PROGRAM TO PREPARE EXPECTANT PARENTS AND BIGGER BROTHERS AND SISTERS FOR THE NEW ADDITION TO THE FAMILY. *FREE BLOOD PRESSURE SCREENING OFFERED IN THE HOSPITAL EMERGENCY ROOM. *CHILDREN'S HEALTH FAIR FOR AREA FIRST GRADERS THAT ALLOWS THEM TO SEE A HOSPITAL BEFORE THEY NEED TO USE ONE. *DIABETES CONSULTATION AND DIABETES EDUCATION OFFERED AT NOMINAL FEES TO NEW DIABETICS AND THEIR FAMILIES. *EMERGENCY NURSES C.A.R.E. (CANCEL ALCOHOL-RELATED EMERGENCIES) PROGRAM TO EDUCATE THE YOUTH OF THE COMMUNITY ABOUT THE DANGERS OF DRINKING AND DRIVING. *FIRST CARE PROGRAM IS A RESPONDER/FIRST AID PROGRAM FOR FARM FAMILIES. *FRESH START QUIT SMOKING CLINIC OFFERED AT A NOMINAL FEE FOR THOSE WISHING TO QUIT SMOKING. *HOSPICE VOLUNTEER TRAINING PROGRAM TO TRAIN PEOPLE TO HELP SUPPORT HOSPICE PATIENTS AND FAMILIES. *NATURAL FAMILY PLANNING PROGRAM TO HELP THOSE WISHING TO PRACTICE BIRTH CONTROL WITHOUT THE USE OF CHEMICALS OR OTHER MEDICAL DEVICES. *PRENATAL CLASSES FOR FIRST TIME PARENTS AND REFRESHER CLASSES FOR PARENTS EXPECTING ANOTHER CHILD OFFERED AT NO COST. *SPEAKERS' BUREAU FOR CLUBS AND ORGANIZATIONS OFFERED AT NO CHARGE ON MANY DIFFERENT HEALTH CARE TOPICS. *THE MOBILE HEALTH UNIT OFFERS DIAGNOSTIC HEALTH TESTS AND SCREENINGS, HEALTH EDUCATION, WELLNESS AND PREVENTION INFORMATION TO THE COMMUNITY AT REDUCED FEES. *FREE SCREENING TO DETERMINE IF SOMEONE HAS A DEPENDENCY ON ALCOHOL/DRUGS. *FREE PROGRAMS FOCUSING ON VARIOUS ASPECTS AND OUTCOMES OF CHEMICAL DEPENDENCY. *INFANT MASSAGE CLASSES OFFERED AT A MINIMAL FEE. PARENTS LEARN TECHNIQUES OF MASSAGE FROM A PHYSICAL THERAPIST THAT WILL HELP TO COMFORT THEIR INFANT AND HELP THEIR CHILD RELAX AND SLEEP. *WOMEN'S HEALTH CENTER OFFERED SEVERAL FREE EDUCATIONAL PROGRAMS TO THE PUBLIC FOCUSING ON SUCH TOPICS AS BREAST DISEASE AND OSTEOPOROSIS. *FREE STROKE PREVENTION SCREEN CLINIC PROVIDED. BLOOD PRESSURE, PULSE, AND CHOLESTEROL CHECK ALONG WITH FAMILY HISTORY. *FREE DEPRESSION SCREENING CLINIC OFFERED TO HELP PEOPLE DETERMINE IF THEY HAVE DEPRESSION. *CLASSES FOR PARENTS AND YOUTHS TO PREPARE FOR THE TIME THE YOUTHS BECOME ADOLESCENTS. *FREE PUBLIC/COMMUNITY FORUM FOCUSING ON THE SOCIETAL PROBLEMS ASSOCIATED WITH CHEMICAL DEPENDENCY. *CO-SPONSORED TWO SENIOR FUN DAYS FOR AREA SENIORS TO LEARN ABOUT HEALTH, HEALTH SCREENINGS OFFERED. *CO-SPONSORED CHILDCARE WORKSHOPS AS A RESOURCE OF CONTINUING EDUCATION FOR CHILDCARE PROVIDERS. Form 990, Part IV, Line 24a TAX EXEMPT BONDS ST JOSEPHS 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. Form 990, Part V, Line 1a NUMBER REPORTED IN BOX 3 OF FORM 1096 THE FORM 1096, ANNUAL SUMMARY AND TRANSMITTAL OF U.S. INFORMATION RETURN IS FILED BY THE ORGANIZATION'S PARENT, HOSPITAL SISTERS HEALTH SYSTEM (HSHS) ON THE ORGANIZATION'S BEHALF TO TRANSMIT TO THE IRS FORMS 1099, 1098, 5498, AND W-2G. THE ORGANIZATION IS UNABLE TO DETERMINE THE NUMBER OF FORMS 1099, 1098, 5498 AND W-2G FILED BY HSHS, ON THEIR BEHALF. HOWEVER, AS THE PARENT ORGANIZATION, HSHS ENSURES THAT THE FILING ORGANIZATION COMPLIES WITH ALL INFORMATION RETURN REPORTING REQUIREMENTS AND BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS AND REPORTABLE GAMING WINNINGS TO PRIZE WINNERS, AS APPLICABLE. Form 990, Part VI, Line 13 WHISTLEBLOWER POLICY PROVISIONS WITHIN THE CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY PROVIDE PROTECTIONS FOR WHISTLEBLOWER TYPE ACTIVITIES. Form 990, Part VI, Line 16b JOINT VENTURES HOSPITAL SISTERS HEALTH SYSTEM ADOPTED A JOINT VENTURE COMPLIANCE PROGRAM POLICY EFFECTIVE ON JANUARY 1, 2012 FOR ALL SYSTEM HOSPITALS, INCLUDING ST. JOSEPH'S HOSPITAL. THE OVERALL PURPOSE OF THE POLICY IS TO PROVIDE PRACTICAL GUIDELINES FOR ETHICAL BUSINESS CONDUCT, TO ACHIEVE COMPLIANCE, AND TO DETECT AND PREVENT VIOLATIONS OF APPLICABLE LAWS. THE POLICY REQUIRES ST. JOSEPH'S HOSPITAL, AND ALL HSHS HOSPITALS, TO EVALUATE THEIR PARTICIPATION IN JOINT VENTURE ARRANGEMENTS, INCLUDING UNDER APPLICABLE FEDERAL TAX LAWS, AND TO SAFEGUARD ST. JOSEPH'S HOSPITAL'S TAX EXEMPT STATUS WITH RESPECT TO ANY JOINT VENTURE ARRANGEMENTS. Form 990, Part VI, Line 1a GOVERNING BODY DELEGATED BROAD AUTHORITY TO AN EXECUTIVE COMMITTEE PER ARTICLE 5.5 OF THE ORGANIZATION'S BY-LAWS, THE GOVERNING BODY DELEGATES BROAD AUTHORITY TO AN EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE SHALL BE VESTED WITH AND MAY IN ITS DISCRETION EXERCISE THE FULL POWERS, DUTIES, RESPONSIBILITIES, AND AUTHORITY OF THE BOARD EXCEPT WHERE PROHIBITED BY LAW AND SUBJECT TO ANY LIMITATIONS IMPOSED BY THE BYLAWS OR THE BOARD OF DIRECTORS. AS PROVIDED IN THE BY-LAWS, THE EXECUTIVE COMMITTEE SHALL CONSIST OF FIVE TO SIX MEMBERS, INCLUDING THE CHAIRPERSON OF THE BOARD, THE VICE CHAIRPERSON, THE PRESIDENT AND OTHER MEMBERS SELECTED FROM AMONG THE DIRECTORS BY THE BOARD. Form 990, Part VI, Line 6 Classes of members or stockholders THE SOLE CORPORATE MEMBER OF ST. JOSEPH'S HOSPITAL CHIPPEWA FALLS (THE CORPORATION) IS HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body PURSUANT TO SECTION 2.3 OF THE CORPORATION'S BYLAWS, THE ORGANIZATION'S MEMBER, HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, HAS THE RIGHT TO APPOINT AND REMOVE THE CORPORATION'S BOARD OF DIRECTORS, CHAIRPERSON OF THE BOARD AND PRESIDENT. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders RESPONSIBILITY FOR THE POLICY AND OPERATIONS OF ST. JOSEPH'S HOSPITAL CHIPPEWA FALLS (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 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 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 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 DEBT INCURRED BY THE CORPORATION OR ANY AFFILIATE IN AN AMOUNT IN EXCESS OF LIMITS SET FROM TIME TO TIME BY THE MEMBER. (H) 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; (I)APPROVE THE STRATEGIC PLAN AND ANNUAL GOALS OF THE CORPORATION OR OF ANY AFFILIATE; (J) APPROVE THE SALE OF SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION OR OF ANY AFFILIATE; (K) APPROVE THE MERGER OR DISSOLUTION OF THE CORPORATION OR OF ANY AFFILIATE; (L) ADOPT OR AMEND THE PLAN FOR MINISTRY EDUCATION AND GOVERNANCE FOR THE CORPORATION AND ITS AFFILIATES; (M) APPROVE THE CORPORATION'S MISSION ACCOUNTABILITY REPORTS AND THOSE OF ANY AFFILIATE; (N) 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 (O) ADOPT POLICIES TO IMPLEMENT THE RESERVED POWERS OF HSSI. Form 990, Part VI, Line 11b Review of form 990 by governing body THE HOSPITAL EMPLOYS CROWE LLP TO ASSIST IN THE OVERALL PREPARATION, REVIEW AND ELECTRONIC SUBMISSION OF ITS FORM 990. CROWE LLP 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. Form 990, Part VI, Line 12c Conflict of interest policy THE 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, 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. Form 990, Part VI, Line 15a Process to establish compensation of top management official THE 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 HSHS EXECUTIVES, (the top management official, other officers and key employees). INTEGRATED HEALTHCARE STRATEGIES ("IHS"), THE CONSULTANTS UTILIZED BY THE COMMITTEE, USE DATA FROM MULTIPLE TAX-EXEMPT PEER GROUP SOURCES (derived from a full market review conducted every other year) TO DETERMINE SALARY RANGES, INCENTIVE OPPORTUNITY RANGES AND BENEFITS FOR THE HSHS executives. 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. 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. The process for reviewing compensation by the compensation committee is completed each fiscal year. Form 990, Part VI, Line 15b Process to establish compensation of other employees PLEASE SEE RESPONSE TO FORM 990, PART VI, LINE 15A. Form 990, Part VI, Line 19 Required documents available to the public BOARD-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. Form 990, Part IX, Line 11g Other Fees Other Professional - Total Expense: 5056470, Program Service Expense: 4395338, Management and General Expenses: 661132, Fundraising Expenses: ; Purchased Professional Services - Total Expense: 5838943, Program Service Expense: 3773370, Management and General Expenses: 2065573, Fundraising Expenses: ; Shared Service Fee - Total Expense: 5556011, Program Service Expense: 4231758, Management and General Expenses: 1324253, Fundraising Expenses: ; Form 990, Part X, Line 11 POOLED INVESTMENT ACCOUNT ST. JOSEPH'S HOSPITAL'S CASH RESERVES ARE INVESTED IN A POOLED INVESTMENT ACCOUNT. PARTICIPATION IN THE POOLED FUND IS LIMITED TO THE 501(C)(3) HOSPITALS AND RELATED HEALTH SERVICES ORGANIZATIONS SPONSORED BY THE HOSPITAL SISTERS HEALTH SYSTEM. THE POOLED ACCOUNT CONSISTS OF CASH, AND EQUITY AND DEBT SECURITIES THAT ARE PUBLICLY TRADED. IN ACCORDANCE WITH THE PROVISIONS OF SFAS NO. 124 "ACCOUNTING FOR CERTAIN INVESTMENTS HELD BY NOT-FOR-PROFIT ORGANIZATIONS," INVESTMENTS IN EQUITY SECURITIES WITH READILY DETERMINABLE 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 PARTICIPANTS. Form 990, Part XI, Line 9 Other changes in net assets or fund balances Change in Temporarily Restricted Net Assets - 181513; Change in Permanently Restricted Net Assets - 27045; Transfer to Affiliates - 275300; CHANGE IN NET PERIODIC PENSION COSTS - NET OF SERVICE COSTS - -2401607; CHANGE IN FAIR VALUE OF THE INTEREST RATE SWAPS - -1421540; KIARA CLINICAL INTEGRATION NETWORK LLC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 261417684 HEALTHCARE IL -1065421 2091139 HSSI PHYSICIAN CLINICAL INTEGRATION NETWORK LLC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371668647 HEALTHCARE IL 706293 10243449 KCIN HSHS ACO LLC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 320465666 HEALTHCARE & SOCIAL ASSISTANCE IL -458206 453719 KCIN HOSPITAL SISTERS OF ST FRANCIS FOUNDATION 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371186514 HEALTHCARE IL 501(c)(3) 7 HSHS true HOSPITAL SISTERS HEALTHCARE WEST INC 2661 COUNTY HIGHWAY 1 CHIPPEWA FALLS WI 54729 510157933 HEALTHCARE WI 501(c)(3) Type I HSSI true SACRED HEART HOSPITAL 990 WEST CLAIREMONT AVENUE EAU CLAIRE WI 54701 390807060 HEALTHCARE WI 501(c)(3) 3 HSSI true ST ANTHONY'S HOSPITAL 503 N MAPLE STREET EFFINGHAM IL 62401 370661233 HEALTHCARE IL 501(c)(3) 3 HSSI true ST ELIZABETH'S HOSPITAL ONE ST ELIZABETHS BLVD OFALLON IL 62269 370663567 HEALTHCARE IL 501(c)(3) 3 HSSI true ST NICHOLAS HOSPITAL 3100 SUPERIOR AVENUE SHEBOYGAN WI 53081 390808480 HEALTHCARE WI 501(c)(3) 3 HSSI true ST JOHN'S HOSPITAL 800 EAST CARPENTER STREET SPRINGFIELD IL 62769 370661238 HEALTHCARE IL 501(c)(3) 3 HSSI true ST JOSEPH'S HOSPITAL 9515 HOLY CROSS LANE BREESE IL 62230 371208459 HEALTHCARE IL 501(c)(3) 3 HSSI true ST MARY'S HOSPITAL 1800 E LAKE SHORE DRIVE DECATUR IL 62521 370661244 HEALTHCARE IL 501(c)(3) 3 HSSI true ST MARY'S HOSPITAL MEDICAL CENTER 1762 SHAWANO AVENUE GREEN BAY WI 54303 390818682 HEALTHCARE WI 501(c)(3) 3 HSSI true ST VINCENT HOSPITAL 835 S VAN BUREN GREEN BAY WI 51301 390817529 HEALTHCARE WI 501(c)(3) 3 HSSI true ST JOSEPH'S HOSPITAL 12866 TROXLER AVENUE HIGHLAND IL 62249 370663568 HEALTHCARE IL 501(c)(3) 3 HSSI true ST FRANCIS HOSPITAL 1215 FRANCISCAN DRIVE LITCHFIELD IL 62056 370661236 HEALTHCARE IL 501(c)(3) 3 HSSI true HOSPITAL SISTERS SERVICES INC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371163402 HEALTHCARE IL 501(c)(3) Type III-FI HSHS true HSHS MEDICAL GROUP INC 3215 EXECUTIVE PARK DRIVE SPRINGFIELD IL 62703 263956318 HEALTHCARE IL 501(c)(3) Type III-FI HSSI true HSHS WISCONSIN MEDICAL GROUP INC 3215 EXECUTIVE PARK DRIVE SPRINGFIELD IL 62703 264515959 HEALTHCARE WI 501(c)(3) Type III-FI HSSI true ORANGE CROSS AMBULANCE INC 919 ASHLAND AVENUE SHEBOYGAN WI 53081 391860942 HEALTHCARE WI 501(c)(3) 10 ST NICHOLAS true UNITY LIMITED PARTNERSHIP 2366 OAK RIDGE CIRCLE DE PERE WI 54115 391750729 HEALTHCARE WI 501(c)(3) 10 HSSI true PRAIRIE EDUCATION & RESEARCH COOPERATIVE 317 NORTH 5TH STREET SPRINGFIELD IL 62701 371157915 HEALTHCARE IL 501(c)(3) 4 HSSI true ST CLARE MEMORIAL HOSPITAL 855 S MAIN STREET OCONTO FALLS WI 54154 390848401 HEALTHCARE WI 501(c)(3) 3 HSSI true HSHS HOLY FAMILY HOSPITAL 200 HEALTHCARE DRIVE GREENVILLE IL 62246 370792770 HEALTHCARE IL 501(c)(3) 3 HSSI true UTLAUT MEMORIAL FOUNDATION 200 HEALTHCARE DRIVE GREENVILLE IL 62246 371140166 FUNDRAISING IL 501(c)(3) Type II HSSI true HSHS GOOD SHEPHERD HOSPITAL INC 200 SOUTH CEDAR STREET SHELBYVILLE IL 62565 370512290 HEALTHCARE IL 501(c)(3) 3 HSSI true SHELBY MEMORIAL HOSPITAL EMPLOYEE BENEFIT TRUST 200 SOUTH CEDAR STREET SHELBYVILLE IL 62565 371778753 TRUST IL 501(a) HSSI true SOUTHERN ILLINOIS CARDIOVASCULAR FACILITY INC ONE ST ELIZABETHS BLVD OFALLON IL 62269 371276333 HEALTHCARE IL 501(c)(3) 3 ST ELIZABETH'S HOSPITAL false HOSPITAL SISTERS MISSION OUTREACH CORPORATION 4849 LAVERNA ROAD SPRINGFIELD IL 62707 352271729 RECYCLING MEDICAL SUPPLIES IL 501(c)(3) HSHS true HOSPITAL SISTERS HEALTH SYSTEM 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371058692 HEALTHCARE IL 501(c)(3) Type III-FI NA false PAIN CENTER OF WISCONSIN 4131 W LOOMIS ROAD SUITE 300 GREENFIELD WI 53221 263155343 HEALTHCARE WI ST VINCENT Related -12402 266872 false false 0.5 PAIN CENTER OF WISCONSIN - OCONTO FALLS LLC 4131 W LOOMIS ROAD SUITE 300 GREENFIELD WI 53221 364717036 HEALTHCARE WI ST CLARE Related -70585 97862 false false 0.5 CARPENTER STREET HOTEL LLC 525 NORTH SIXTH STREET SPRINGFIELD IL 62702 364128127 HOTEL IL LASANTE INC N/A 0 SPRINGFIELD URGENT CARE REAL ESTATE LLC PO BOX 19456 SPRINGFIELD IL 627949456 030413258 RENTAL REAL ESTATE IL LASANTE INC N/A 0 PRAIRIE HEART INSTITUTE MANAGEMENT COMPANY LLC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 261479945 MEDICAL IL HSHS Related -6697 17910 false true 1 SOUTHWEST ILLINOIS HEALTH SERVICES REAL ESTATE LLP 4000 NORTH ILLINOIS STREET SWANSEA IL 62226 823633320 REAL ESTATE IL ST ELIZABETH'S Related 282559 1572355 false false 0.5 KIARA INC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371163401 HEALTHCARE IL HSHS C Corporation -43228090 38923072 1 true LASANTE WISCONSIN INC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 391572196 HEALTHCARE IL KIARA INC C Corporation true LASANTE INC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371163400 HEALTHCARE IL KIARA INC C Corporation true PRAIRIE CARDIOVASCULAR 619 EAST MASON SUITE 4P57 SPRINGFIELD IL 62701 371071858 HEALTHCARE IL KIARA INC C Corporation true PREVEA HEALTH SERVICES INC 2710 EXECUTIVE DRIVE GREEN BAY WI 54304 391839351 HEALTHCARE WI HSSI C Corporation -3206 44317532 0.5 true PREVEA CLINIC INC 2710 EXECUTVE DRIVE GREEN BAY WI 54304 391839349 HEALTHCARE WI PHSI C Corporation true RENAISSANCE QUALITY INSURANCE LTD PO BOX 1159 GRAND CAYMAN CJ KY11102 980669953 INSURANCE CJ HSSI C Corporation 0 148104719 1 true OJV INC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 460873384 HEALTHCARE IL LASANTE INC C Corporation true false false true true false false false false false true true false true true true true true false false Schedule R, Part V, Line 2 TRANSACTIONS WITH RELATED ENTITIES ANY TRANSACTIONS LISTED ON SCHEDULE R, PART V, LINE 1 AND NOT ON SCHEDULE R, PART V, LINE 2 ARE BETWEEN RELATED 501(C)(3) AND DO NOT REQUIRE REPORTING ON THIS SECTION. Schedule R, Part VII Related Organizations DUE TO THE INCREASINGLY COMPLEX ORGANIZATION STRUCTURE OF HOSPITAL SISTERS HEALTH SYSTEM AND AFFILIATES, THE FILING ORGANIZATION HAS ELECTED TO REPORT ALL ORGANIZATIONS WITHIN HOSPITAL SISTERS HEALTH SYSTEM AS RELATED, REGARDLESS OF OWNERSHIP INTEREST OR "CONTROL" AS DEFINED BY THE INSTRUCTIONS TO SCHEDULE R. THE INTENT OF THIS REPORTING IS TO PROMOTE TRANSPARENCY AND INCREASE CONSISTENCY ACROSS THE NUMEROUS FORM 990 SUBMISSIONS BY HOSPITAL SISTERS HEALTH SYSTEM AND AFFILIATES.