2019-05-14T17:34:27-05:00 2018-06-30 861065772 DELOITTE TAX LLP 111 MONUMENT CIRCLE SUITE 4200 INDIANAPOLIS IN 462045108 990 2017-07-01 391390638 Ascension Sacred Heart-St Mary's Hospitals Inc ASCE 3147338000 PO Box 347 Stevens Point WI 54481 Tonya Mershon Tax Officer 2019-05-14 true SAMANTHA BOKORI P01057347 3174648600 2017 2019-02-21 02:37:17Z Bernard Sherry 400 W River Woods Parkway Glendale WI 53212 147174046 false 0928 X https://healthcare.ascension.org/Locations/Wisconsin/WIAPM/Tomahawk-Sacred-Heart-Hospital X 1981 WI TO IMPROVE THE HEALTH AND WELL-BEING OF ALL PEOPLE IN THE COMMUNITIES WE SERVE. 8 7 816 139 0 4329 475087 465645 148702968 145886119 294743 -111001 387941 528864 149860739 146769627 0 0 0 0 69269133 60981184 0 0 117217 72079988 90281900 141349121 151263084 8511618 -4493457 94684836 85273835 45600704 28583376 49084132 56690459 OUR MISSION AS PART OF A CATHOLIC HEALTH CARE SYSTEM IS TO FURTHER THE HEALING MINISTRY OF JESUS BY CONTINUALLY IMPROVING THE HEALTH AND WELL-BEING OF ALL PEOPLE, ESPECIALLY THE POOR, IN THE COMMUNITIES WE SERVE. false false 94110491 0 145992468 Ascension Sacred Heart-St. Mary's Hospitals, Inc. is a 82-bed hospital campus providing services without regard to patient race, creed, national origin, economic status, or ability to pay. During fiscal year 2018, Ascension Sacred Heart-St. Mary's Hospitals, Inc. treated 2,956 adults and children for a total of 11,427 patient days of service. The hospital also provided services for 317,679 outpatient visits, which included 3,050 outpatient surgeries and 16,362 Emergency Room Visits. See Schedule H for a non-exhaustive list of community benefit programs and descriptions. 94110491 true true false true false false false false false true false false true 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 true true false false true 89 0 true 816 true false false false false false false true false false false X 8 7 false false false false true true true true true false false false true true true true true false false false WI X Sara O'Brien 3147338070 11775 BORMAN DRIVE MARYLAND HEIGHTS MO 63146 RAY BURGAN VICE CHAIR 1.0 5.0 X X 0 0 0 MARGARET S JOHNSON SECRETARY/TREASURER 1.0 5.0 X X 0 0 0 SANDRA L LATZEL-ANDERSON BOARD MEMBER/HOSPITAL PRESIDENT (EX-OFFICIO) 8.0 42.0 X X 0 473504 33538 JUDY SMOLAREK RN MSN FP CHAIR 1.0 5.0 X X 0 0 0 SISTER ELIZABETH AMMAN OP BOARD MEMBER 1.0 5.0 X 0 0 0 FR JIM FOSDICK BOARD MEMBER 1.0 5.0 X 0 0 0 ARTHUR C HELGERSON DDS BOARD MEMBER 1.0 5.0 X 0 0 0 JESICA WITTE BOARD MEMBER 1.0 5.0 X 0 0 0 LORI J DARR VP-FINANCE WISCONSIN 5.0 45.0 X 0 402935 46724 MARK BANAS MD MEDICAL STAFF PRESIDENT-SACRED HEART 10.0 40.0 X 0 725996 54222 RUSSELL S SUDBURY MD MEDICAL STAFF PRESIDENT-SAINT MARY'S 25.0 25.0 X 0 624150 57034 TERESA J THEILER CAO - VP PATIENT CARE 50.0 0.0 X 0 190470 22849 CARMEN A VIEGUT DIRECTOR OF NURSING 50.0 0 X 104666 0 30872 KAY E ANDERSON REG DIR REHAB SERVICES 50.0 0 X 129007 0 24869 CHERYL ANN BASZYNSKI CLINICAL PHARMACIST 50.0 0 X 128080 0 21914 BRADLEY M JAMISON LEAD PHARMACIST 50.0 0 X 134873 0 34488 CHRISTOPHER J KOENIGS MEDICAL PHYSICIST 50.0 0 X 176846 0 32872 LORI L MOTT PHYSICIAL THERAPIST 50.0 0 X 128334 0 33547 MONICA A HILT FORMER OFFICER (END 1/2015) 0.0 50.0 X 0 531126 44932 DANIEL E NEUFELDER FORMER OFFICER (END 9/2016) 0.0 0.0 X 0 996775 0 SHISHIR N SHETH MD FORMER OFFICER (END 6/2017) 0.0 50.0 X 310998 222408 38707 ANN M ZENK FORMER OFFICER (END 6/2017) 0.0 0.0 X 0 90398 14486 1112804 4257762 491054 83 true true false DELTA LOCUM TENENS PO BOX 202940 DALLAS TX 753202940 STAFFING SERVICES 425547 SYNTHES USA SALES LLC 1101 SYNTHES AVE MONUMENT CO 80132 MEDICAL DEVICES 254728 SUPERIOR HEALTH LINENS 230006 MOMENTUM PL CHICAGO IL 606895325 LAUNDRY SERVICES 176445 ENCORE ONE LLC 124 N 121ST STREET WAUWATOSA WI 532263802 INVESTMENT SERVICES 150388 FUSION MEDICAL STAFFING LLC 11850 NICHOLAS STREET 100 OMAHA NE 68154 STAFFING SERVICES 145589 5 X 0 0 0 0 455273 10372 7785 465645 NET PATIENT SERVICE REVENUE 621990 134805275 134805275 SERVICES TO AFFILIATES 561000 4952174 4952174 PHARMACY REVENUE 446110 4300289 4300289 AMBULANCE REVENUE 621910 1761593 1761593 66788 66788 0 0 145886119 254424 254424 0 0 0 0 156581 0 0 156581 0 156581 156581 0 6600 372025 0 -365425 -365425 -365425 6107 0 6107 6107 0 0 53446 32394 21052 21052 CAFETERIA/VENDING REVENUE 722514 210576 210576 FOCUS ON ENERGY REBATE 900099 84938 84938 MEDICAL DIRECTOR FEES 561000 21411 21411 28199 0 0 28199 345124 146769627 145992468 0 311514 135538 130116 5422 49359879 47433392 1835098 91389 8506504 8174513 316218 15773 2979263 2862978 110781 5504 79 79 46770 46770 7024 7024 3079928 2946637 133291 0 8108 5641 2192 275 206499 131080 74941 478 38446 35032 3414 1856176 321907 1534269 224870 206432 17308 1130 49258 44780 4478 5977451 2809564 3167579 308 MANAGEMENT FEE TO AFFILIATE 18533579 18533579 MEDICAL SUPPLIES 17557880 17561979 -5163 1064 CORPORATE ALLOCATIONS 15553517 15553517 PHYSICIAN FEES TO AFFILIATE 12101303 4584006 7517297 15041012 6862355 8177361 1296 151263084 94110491 57035376 117217 380592 4715 679161 1534424 88431 43462 21550659 17874449 0 0 0 0 0 0 2356902 2176935 37987 27882 84812460 31445675 55617790 53366785 2603110 0 0 0 156975 75358 11213229 10169825 94684836 85273835 6677130 6917909 0 0 255245 154377 0 0 0 0 0 0 0 0 0 0 38668329 21511090 45600704 28583376 X 48341585 55902265 742547 788194 0 0 0 0 0 0 0 0 49084132 56690459 94684836 85273835 X -4493457 -1087835 13187619 X false true X true true true X false false false false false false false false true 7024 7024 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY LOBBYING EXPENSES REPRESENT THE PORTION OF DUES PAID TO NATIONAL AND STATE HOSPITAL ASSOCIATIONS THAT IS SPECIFICALLY ALLOCABLE TO LOBBYING. ASCENSION SACRED HEART-ST MARY'S HOSPITALS, INC. DOES NOT PARTICIPATE IN OR INTERVENE IN (INCLUDING THE PUBLISHING OR DISTRIBUTION OF STATEMENTS) ANY POLITICAL CAMPAIGN ON BEHALF OF (OR IN OPPOSITION TO) ANY CANDIDATE FOR PUBLIC OFFICE. Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY LOBBYING EXPENSES REPRESENT THE PORTION OF DUES PAID TO NATIONAL AND STATE HOSPITAL ASSOCIATIONS THAT IS SPECIFICALLY ALLOCABLE TO LOBBYING. ASCENSION SACRED HEART-ST MARY'S HOSPITALS, INC. DOES NOT PARTICIPATE IN OR INTERVENE IN (INCLUDING THE PUBLISHING OR DISTRIBUTION OF STATEMENTS) ANY POLITICAL CAMPAIGN ON BEHALF OF (OR IN OPPOSITION TO) ANY CANDIDATE FOR PUBLIC OFFICE. 4473253 4473253 49473165 10872918 38600247 282412 134137 148275 27407916 19119014 8288902 3175714 1319606 1856108 53366785 Interest in investments held by Ascension Health Alliance DUE FROM AFFILIATES 6821519 ESTIMATED 3RD PARTY PAYOR SETTLEMENTS 1566742 OTHER RECEIVABLES 969026 OTHER CURRENT ASSETS 40990 INTEREST IN FOUNDATIONS 771548 10169825 0 Estimated Settlement to Third-Party Payor 2234041 Intercompany debt with Ministry Health Care, Inc. Due To Affiliates 18960484 AH Savings Plan Liability Recovery Tail Liability 177277 Accrued Taxes 139288 Other Liabilities 21511090 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote THE SYSTEM ACCOUNTS FOR UNCERTAINTY IN INCOME TAX POSITIONS BY APPLYING A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE SYSTEM HAS DETERMINED THAT NO MATERIAL UNRECOGNIZED TAX BENEFITS OR LIABILITIES EXIST AS OF JUNE 30, 2018. true true X true X 250 true X true true false true true 2763077 116138 2646939 0.0175 23965150 12296396 11668754 0.0771 0 0.0 0 0 26728227 12412534 14315693 0.0946 117447 1523 115924 0.0008 81533 0 81533 0.0005 0 0 0 0.0 0 0 0 0.0 412279 295868 116411 0.0008 0 0 611259 297391 313868 0.0021 0 0 27339486 12709925 14629561 0.0967 2947 0 2947 0.0000 0 0.0 0 0.0 0 0.0 0 0.0 1221 0 1221 0.0000 0 0.0 0 0.0 0 0.0 0 0 4168 0 4168 0.0000 false 1559399 28655 54593271 69888401 -15295130 X true true 2 1 ST MARY'S HOSPITAL 2251 North Shore Drive RHINELANDER WI 54501 https://healthcare.ascension.org/Locations/Wisconsin/WIAPM/Rhinelander-Saint-Marys-Hospital 138 X X X 2 SACRED HEART HOSPITAL 401 WEST MOHAWK DRIVE TOMAHAUK WI 54487 https://healthcare.ascension.org/Locations/Wisconsin/WIAPM/Tomahawk-Sacred-Heart-Hospital 1016 X X X ST MARY'S HOSPITAL 1 false false true X X X X X X X X X 15 true true true true X https://healthcare.ascension.org/Locations/Wisconsin/WIAPM/Rhinelander-Saint-Marys-Hospital/Communit X true 15 true https://healthcare.ascension.org/Locations/Wisconsin/WIAPM/Rhinelander-Saint-Marys-Hospital/Communit false true X 250.0 400.0 X X X X X true true X X X true X https://healthcare.ascension.org/Financial-Assistance/wisconsin X https://healthcare.ascension.org/Financial-Assistance/wisconsin X https://healthcare.ascension.org/Financial-Assistance/wisconsin X X X X X X true X false X X X X true X false false SACRED HEART HOSPITAL 2 false false true X X X X X X X X X 15 true true true true X https://healthcare.ascension.org/Locations/Wisconsin/WIAPM/Tomahawk-Sacred-Heart-Hospital/Community- X true 15 true https://healthcare.ascension.org/Locations/Wisconsin/WIAPM/Tomahawk-Sacred-Heart-Hospital/Community- false true X 250.0 400.0 X X X X X true true X X X true X https://healthcare.ascension.org/Financial-Assistance/wisconsin X https://healthcare.ascension.org/Financial-Assistance/wisconsin X https://healthcare.ascension.org/Financial-Assistance/wisconsin 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 ST. MARY'S HOSPITAL TO BETTER TARGET COMMUNITY RESOURCES ON THE SERVICE AREA'S MOST PRESSING HEALTH NEEDS, THE HOSPITAL PARTICIPATED IN A GROUP DISCUSSION WITH ORGANIZATIONAL DECISION MAKERS AND COMMUNITY LEADERS TO PRIORITIZE THE SIGNIFICANT COMMUNITY HEALTH NEEDS WHILE CONSIDERING SEVERAL CRITERIA: ALIGNMENT WITH ASCENSION HEALTH STRATEGIES OF HEALTHCARE THAT LEAVES NO ONE BEHIND; CARE FOR THE POOR AND VULNERABLE; OPPORTUNITIES FOR PARTNERSHIP; AVAILABILITY OF EXISTING PROGRAMS AND RESOURCES; ADDRESSING DISPARITIES OF SUBGROUPS; AVAILABILITY OF EVIDENCE-BASED PRACTICES; AND COMMUNITY INPUT. THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AS IDENTIFIED THROUGH THE CHNA. SEE SCHEDULE H, PART V, LINE 7 FOR THE LINK TO THE CHNA AND SCHEDULE H, PART V, LINE 11 FOR HOW THOSE NEEDS ARE BEING ADDRESSED. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - ST. MARY'S HOSPITAL. INPUT INTO THE CHNA FROM COMMUNITY MEMBERS, INCLUDING MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS AND FROM ORGANIZATIONS THAT SERVE THOSE POPULATIONS, WAS SOUGHT IN MULTIPLE WAYS. (A) A COMMUNITY SURVEY WAS CONDUCTED IN SUMMER-FALL 2015 THAT ASKED PARTICIPANTS TO SHARE THEIR PERCEPTIONS ON THE HEALTH OF THE COMMUNITY AND TO IDENTITY HEALTH PRIORITY AREAS. THE SURVEY ALSO ASKED QUESTIONS ABOUT THE PARTICIPANTS' CURRENT HEALTH STATUS AND BARRIERS TO CARE. THE SURVEY WAS DISTRIBUTED ONLINE THROUGH THE HEALTH DEPARTMENTS' WEBSITES AND FACEBOOK. IN AN EFFORT TO INSURE REPRESENTATION FROM VULNERABLE GROUPS, SUCH AS LOW-INCOME, MINORITY AND MEDICALLY UNDERSERVED POPULATIONS PAPER COPIES OF THE SURVEY WERE DISTRIBUTED TO IDENTIFY COMMUNITY SITES THAT SERVE THESE POPULATIONS. (B) IN DECEMBER 2015, A COMMUNITY FORUM WAS HELD, AT WHICH INPUT WAS RECEIVED FROM BOTH THE GENERAL PUBLIC AND FROM REPRESENTATIVES OF ORGANIZATIONS THAT SERVE MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS. (C) MULTIPLE FOCUS GROUPS WERE HELD TO OFFER OPPORTUNITIES FOR THE VOICES OF SPECIFIC COMMUNITIES (E.G., COLLEGE STUDENTS, NATIVE AMERICAN TRIBES) TO BE HEARD. (D) KEY-INFORMANT INTERVIEWS WERE CONDUCTED WITH COMMUNITY MEMBERS THAT WORK TO IMPROVE THE HEALTH OF THE COMMUNITY, ESPECIALLY WITHIN THE VULNERABLE POPULATIONS INCLUDING THE LOW-INCOME AND MEDICALLY UNDERSERVED. THE ORGANIZATIONS INVOLVED IN THE ABOVE EFFORTS ARE LISTED BELOW. COMMUNITY NEEDS ASSESSMENT TEAM / DECEMBER 2015 COMMUNITY FORUM * FOREST COUNTY HEALTH DEPARTMENT * ONEIDA COUNTY HEALTH DEPARTMENT * VILAS COUNTY HEALTH DEPARTMENT * MINISTRY ST. MARY'S HOSPITAL * MINISTRY HEALTH CARE * UW-EXTENSION - ONEIDA COUNTY * DIVISION OF PUBLIC HEALTH, NORTHERN REGION OFFICE * COMMISSION ON AGING * MARSHFIELD CLINIC * RHINELANDER SCHOOL DISTRICT * CRANDON PUBLIC LIBRARY * LAC DU FLAMBEAU SCHOOL DISTRICT * ONEIDA COUNTY SOCIAL SERVICES * TRI-COUNTY COUNCIL ON DOMESTIC VIOLENCE AND SEXUAL ASSAULT * VILAS COUNTY HEALTH DEPARTMENT BOARD OF HEALTH * HOLY FAMILY CHURCH * UW-EXTENSION-FOREST COUNTY * NICOLET COLLEGE * MINISTRY HEALTH - SACRED HEART * FOREST COUNTY OFFICE ON AGING * NORTHWOODS UNITED WAY, INC. * UW-EXTENSION-FOREST AND VILAS COUNTIES * SOKAOGON MOLE LAKE CLINIC * FAMILY & CHILD LEARNING CENTER * BLACKWELL JOB CORPS * FOREST COUNTY TRIBAL AMERICORPS * MINISTRY HEALTH-HOWARD YOUNG * FOREST COUNTY POTAWATOMI HEALTH & WELLNESS * CITY OF RHINELANDER POLICE DEPARTMENT * TRI-COUNTY COUNSEL * DEPARTMENT OF AGING * TRI COUNTY COUNCIL * ADRC * SUNSHINE FOR HUMANITY * VILAS COUNTY EMERGENCY MANAGEMENT * DEMMER LIBRARY * PETERSEN CHRISTIANSON HEALTHCARE * GREAT LAKES INTERTRIBAL COUNCIL * VILAS COUNTY SHERIFF'S DEPARTMENT * ONEIDA COUNTY SOCIAL SERVICES * NICOLET COLLEGE FOCUS GROUPS: AODA COALITION MENTAL HEALTH INTER-AGENCY COALITION LEAN COALITION NICOLET COLLEGE NURSING STUDENTS RHS CHANGE/FACT GROUP VILAS COUNTY FIRE CHIEF'S AND EMERGENCY SERVICES ASSOCIATION COMMUNITY COALITION OF FOREST COUNTY FOREST COUNTY SCHOOL ADMINISTRATORS OF CRANDON, LAONA AND WABENO KEY INFORMANT INTERVIEWS: NORTHWOODS ALLIANCE FOR TEMPORARY HOUSING POLICE / LAW ENFORCEMENT TRI-COUNTY COUNSEL ON DOMESTIC VIOLENCE UNIVERSITY OF WISCONSIN-EXTENSION SCHOOL DISTRICT TRIBAL SOCIAL SERVICES ECONOMIC DEVELOPMENT Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - ST. MARY'S HOSPITAL. The CHNA was conducted with the following hospital facilities: - Ascension Eagle River Hospital, Inc. - Howard Young Medical Center Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - ST. MARY'S HOSPITAL. The CHNA was conducted with the following non-hospital facilities: Forest County Health Department, Vilas County Health Department and Oneida County Health Department Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - ST. MARY'S HOSPITAL. HOW ADDRESSING THE SIGNIFICANT NEEDS .... USING THE CHNA COMPLETED IN FISCAL YEAR 2016 (TAX YEAR 2015), THE HOSPITAL DEVELOPED, ADOPTED, AND WORKED ON EXECUTING A THREE-YEAR IMPLEMENTATION STRATEGY TO ADDRESS PRIORITY COMMUNITY HEALTH NEEDS. IN FISCAL YEAR 2018 (TAX YEAR 2017), THE HOSPITAL IMPLEMENTED THE FOLLOWING PLAN TO ADDRESS THE PRIORITY NEEDS: MENTAL HEALTH -- INCREASE COMMUNITY MEMBERS' AWARENESS OF AND ABILITY TO ACCESS BEHAVIORAL HEALTH SERVICES. -- PARTICIPATED IN THE REGIONAL MENTAL HEALTH AND ALCOHOL AND OTHER DRUG ABUSE (AODA) COALITION. MENTAL HEALTH-RELATED COALITION ACTIVITIES INCLUDED PARTNERING WITH THE SCHOOLS FOR YOUTH RISK BEHAVIOR SURVEYS AND CONDUCTING 'QUESTION, PERSUADE, REFER (QPR)' SUICIDE PREVENTION TRAININGS. -- LED THE PLANNING FOR AND CONDUCTED A BIENNIAL MENTAL HEALTH SUMMIT -- CONTRIBUTED FINANCIALLY TO THE COUNTY PUBLIC HEALTH DEPARTMENT'S MENTAL HEALTH EFFORTS -- SUPPORTED A LOCAL MEMORY CAFE (WHICH PROVIDES SUPPORT AND RESOURCES FOR FAMILIES OF A LOVED ONE WITH DEMENTIA) CHRONIC DISEASE -- INCREASE THE PROPORTION OF RESIDENTS OF FOREST, ONEIDA AND VILAS COUNTIES WHO HAVE A HEALTHY DIET AND REGULAR PHYSICAL ACTIVITY. -- PARTICIPATED IN THE REGIONAL CHRONIC DISEASE PREVENTION COALITION -- CONDUCTED 'STRONG BONES' STRENGTHENING CLASSES -- INSTALLED AND REGULARLY ROTATED POINT-OF-DECISION PROMPTS FOR PHYSICAL ACTIVITY, HEALTHY EATING AND WATER CONSUMPTION -- CONTRIBUTED FINANCIALLY TO THE COUNTY PUBLIC HEALTH DEPARTMENT'S CHRONIC DISEASE EFFORTS ALCOHOL AND OTHER DRUG ABUSE (AODA) -- THERE WILL BE COORDINATED AND STRENGTHENED EFFORTS TO CONNECT PEOPLE WITH RESOURCES AND HEALTHY ALTERNATIVES FOR PREVENTION AND EARLY INTERVENTION OF ALCOHOL AND OTHER DRUG ABUSE IN NORTHERN REGION MINISTRY HOSPITALS AND CLINICS. -- PARTICIPATED IN THE REGIONAL MENTAL HEALTH AND AODA COALITION. AODA-RELATED COALITION ACTIVITIES INCLUDED: HOSTING VIEWINGS OF A DOCUMENTARY ABOUT A BOY WHO DIED OF A DRUG OVERDOSE; HOSTING DRUG TAKE-BACK EVENTS; PROMOTING 'PARENTS WHO HOST LOSE THE MOST' UNDERAGE DRINKING PREVENTION EFFORTS; PARTNERING WITH THE SCHOOLS FOR YOUTH RISK BEHAVIOR SURVEYS; CONDUCTING MULTIPLE TRAININGS (E.G., DRUG RECOGNITION FOR OFFICERS AND PARENTS AND NALOXONE USE). THE DESCRIPTION BELOW INCLUDES THE NEEDS NOT BEING ADDRESSED AS WELL AS THE REASON WHY THE NEEDS ARE NOT BEING ADDRESSED. IN ADDITION TO THE THREE HEALTH ISSUES SELECTED AS THE TOP PRIORITIES, STAKEHOLDERS IDENTIFIED TRANSPORTATION AS A CONCERN THAT COULD IMPACT ACCESS TO SERVICES IN FOREST, ONEIDA, AND VILAS COUNTIES. WHILE THIS ISSUE WILL NOT BE ADDRESSED BY OUR HOSPITALS AS A PRIORITY HEALTH NEED, WE WILL PROVIDE SUPPORT TO THOSE COMMUNITY EFFORTS WHENEVER POSSIBLE. TRANSPORTATION ISSUES HAVE BEEN RAISED AS A BARRIER FOR RESIDENTS LIVING IN THE THREE COUNTIES. TRANSPORTATION CAN IMPACT A PERSON'S ABILITY TO GET TO SERVICES TO MEET THEIR NEEDS. THERE IS A NEW TRANSPORTATION PROGRAM THAT HAS STARTED IN OUR AREA THAT SERVES ONEIDA AND VILAS COUNTIES. FOREST COUNTY HAD BEEN A PARTNER AT THE TABLE BUT IS NO LONGER PART OF THE PROGRAM. THE NEW TRANSPORTATION PROGRAM WILL BE ADDRESSING TRANSPORTATION ISSUES AND CONDUCTING A GAP ANALYSIS, THEREFORE, THE HOSPITALS WILL NOT BE ADDRESSING THIS ISSUE AT THIS TIME. HOWEVER, THE HOSPITALS' ADMINISTRATIONS ARE INTERESTED IN KNOWING MORE ABOUT HOW THE GAPS ARE BEING FILLED AND WILL BE OPEN TO HEARING MORE ABOUT THESE NEEDS WHEN THE GAP ANALYSIS IS COMPLETED. Schedule H, Part V, Section B, Line 3E SACRED HEART HOSPITAL TO BETTER TARGET COMMUNITY RESOURCES ON THE SERVICE AREA'S MOST PRESSING HEALTH NEEDS, THE HOSPITAL PARTICIPATED IN A GROUP DISCUSSION WITH ORGANIZATIONAL DECISION MAKERS AND COMMUNITY LEADERS TO PRIORITIZE THE SIGNIFICANT COMMUNITY HEALTH NEEDS WHILE CONSIDERING SEVERAL CRITERIA: ALIGNMENT WITH ASCENSION HEALTH STRATEGIES OF HEALTHCARE THAT LEAVES NO ONE BEHIND; CARE FOR THE POOR AND VULNERABLE; OPPORTUNITIES FOR PARTNERSHIP; AVAILABILITY OF EXISTING PROGRAMS AND RESOURCES; ADDRESSING DISPARITIES OF SUBGROUPS; AVAILABILITY OF EVIDENCE-BASED PRACTICES; AND COMMUNITY INPUT. THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AS IDENTIFIED THROUGH THE CHNA. SEE SCHEDULE H, PART V, LINE 7 FOR THE LINK TO THE CHNA AND SCHEDULE H, PART V, LINE 11 FOR HOW THOSE NEEDS ARE BEING ADDRESSED. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - SACRED HEART HOSPITAL. SACRED HEART HOSPITAL'S CHNA PROCESS INCLUDED TWO SPECIFIC EFFORTS TO SEEK INPUT FROM COMMUNITY MEMBERS, INCLUDING MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS AND FROM ORGANIZATIONS THAT SERVE THOSE POPULATIONS. FIRST, A PAPER SURVEY WAS MADE AVAILABLE AT COMMUNITY AGENCIES AND SITES THAT SERVE LOW-INCOME, MINORITY AND MEDICALLY-UNDERSERVED POPULATIONS. DISTRIBUTED IN SUMMER 2015, THE SURVEY ASKED PARTICIPANTS THEIR PERCEPTION OF THE TOP PRIORITY HEALTH NEEDS IN LINCOLN COUNTY AND ABOUT THEIR OWN PHYSICAL, MENTAL AND ORAL HEALTH. SECOND, A COMMUNITY HEALTH NEEDS ASSESSMENT MEETING WAS HELD IN OCTOBER 2015. PARTICIPANTS INCLUDED A REPRESENTATIVES FROM A VARIETY OF ORGANIZATIONS. AT THE MEETING, STAKEHOLDERS PARTICIPATED IN A FACILITATED DISCUSSION ABOUT THE COMMUNITY HEALTH DATA, PROGRESS ON THE PREVIOUS PRIORITY AREAS, AND ANY EMERGING NEEDS. THE LIST OF ORGANIZATIONS PARTICIPATING IN THE OCTOBER 2015 STAKEHOLDER MEETING IS BELOW. * LINCOLN COUNTY HEALTH DEPARTMENT * NORTHERN REGION MINISTRY MEDICAL GROUP * MINISTRY HEALTH CARE * MERRILL AREA UNITED WAY* * BRIDGE DENTAL CLINIC* * UW EXTENSION LINCOLN COUNTY * ST. VINCENT DEPAUL* * DHHS LINCOLN COUNTY * NORTH CENTRAL COMMUNITY ACTION PROGRAM* * UW EXTENSION LINCOLN COUNTY, NUTRITION EDUCATION PROGRAM* * MINISTRY GOOD SAMARITAN HEALTH CENTER * MINISTRY MEDICAL GROUP TOMAHAWK * MINISTRY SACRED HEART HOSPITAL * MINISTRY BEHAVIORAL HEALTH SERVICES * TOMAHAWK SCHOOL DISTRICT *DENOTES ORGANIZATIONS OR PROGRAMS REPRESENTING MEDICALLY UNDERSERVED, LOW-INCOME, AND/OR MINORITY POPULATIONS. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - SACRED HEART HOSPITAL. THE CHNA WAS CONDUCTED WITH THE FOLLOWING HOSPITAL FACILITY(S): - ASCENSION GOOD SAMARITAN HOSPITAL, INC. Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - SACRED HEART HOSPITAL. THE CHNA WAS CONDUCTED WITH THE FOLLOWING NON-HOSPITAL FACILITY(S): LINCOLN COUNTY HEALTH DEPARTMENT Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - SACRED HEART HOSPITAL. HOW ADDRESSED NEEDS IN FY18..... USING THE CHNA COMPLETED IN FISCAL YEAR 2016 (TAX YEAR 2015) THE HOSPITAL DEVELOPED, ADOPTED, AND WORKED ON EXECUTING A THREE-YEAR IMPLEMENTATION STRATEGY TO ADDRESS PRIORITY COMMUNITY HEALTH NEEDS. IN FISCAL YEAR 2018 (TAX YEAR 2017), THE HOSPITAL IMPLEMENTED THE FOLLOWING PLAN TO ADDRESS THE PRIORITY NEEDS: MENTAL HEALTH -- LED THE PLANNING FOR AND CONDUCTED A BIENNIAL MENTAL HEALTH SUMMIT -- DISTRIBUTED A MENTAL HEALTH RESOURCE GUIDE. -- DISTRIBUTED MENTAL HEALTH POSTERS, CRISIS INTERVENTION CARDS, AND HOPELINE (TEXT-BASED SUICIDE PREVENTION 'HOTLINE') MATERIALS. -- AS PART OF THE COUNTY MENTAL HEALTH COALITION, CONDUCTED MENTAL HEALTH FIRST AID FOR YOUTH CLASSES AND 'TAKING CARE OF YOU' (STRESS MANAGEMENT AND MINDFULNESS) -- PROVIDED FUNDING FOR THE LINCOLN COUNTY HEALTH DEPARTMENT TO SUPPORT MENTAL HEALTH PRIORITY -- PROVIDED FUNDING FOR THE SCHOOL DISTRICT OF TOMAHAWK TO PROMOTE AODA PREVENTION, EDUCATION AND MENTAL HEALTH ORAL HEALTH -- DISTRIBUTED ADULT ORAL HEALTH MESSAGES VIA BILLBOARDS AND DISPLAYS. -- DISTRIBUTED ORAL HEALTH KITS TO INDIVIDUALS WHO ARE VULNERABLE OR WITH LOW INCOME. -- DISTRIBUTED THE LINCOLN COUNTY ORAL HEALTH RESOURCE GUIDE. -- CONDUCTED "SUGAR OUT DAY" PRESENTATIONS IN A GRADE SCHOOL. -- PROVIDED FUNDING FOR LINCOLN COUNTY PUBIC HEALTH TO SUPPORT ORAL HEALTH PRIORITY NUTRITION -- PROVIDED FUNDING FOR APPLIANCES OFFERED AT COOKING CLASSES -- PROVIDED FUNDING FOR THE AVAILABILITY OF ELECTRONIC BENEFIT TRANSFER (EBT) AT THE LOCAL FARMERS MARKET. -- PROVIDED FUNDING FOR LINCOLN COUNTY PUBLIC HEALTH TO SUPPORT NUTRITION PRIORITY THE DESCRIPTION BELOW INCLUDES THE NEEDS NOT BEING ADDRESSED AS WELL AS THE REASON WHY THE NEEDS ARE NOT BEING ADDRESSED. IN ADDITION TO THE THREE HEALTH ISSUES SELECTED AS TOP PRIORITY, STAKEHOLDERS IDENTIFIED SEVERAL OTHER SIGNIFICANT HEALTH ISSUES IN LINCOLN COUNTY. THESE ISSUES WILL NOT BE ADDRESSED BY SACRED HEART AS PRIORITY HEALTH NEEDS BECAUSE THEY ARE BEING ADDRESSED BY OTHER ORGANIZATIONS IN THE COMMUNITY. HOWEVER, WE WILL PROVIDE SUPPORT TO THOSE COMMUNITY EFFORTS WHENEVER POSSIBLE. THOSE NEEDS, ALCOHOL AND DRUG USE AND DOMESTIC VIOLENCE AND TRAUMA, ARE DESCRIBED BELOW. ALCOHOL AND DRUG USE: THE STAKEHOLDERS IDENTIFIED ALCOHOL MISUSE AND DRUG USE, PARTICULARLY HEROIN AND OTHER OPIATES, AS EMERGING ISSUES TO BE ADDRESSED IN THE COMMUNITY. THE LINCOLN COUNTY AODA COALITION WILL BE ADDRESSING THESE ISSUES. A REPRESENTATIVE FROM EITHER SACRED HEART OR GOOD SAMARITAN HEALTH CENTER (A PARTNER WITH SACRED HEART IN THE CHNA PROCESS) OF THE HOSPITALS WILL ATTEND THE QUARTERLY MEETING. DOMESTIC VIOLENCE AND TRAUMA: THE STAKEHOLDERS ALSO IDENTIFIED TRAUMA AND DOMESTIC VIOLENCE AS EMERGING ISSUES. HAVEN, A DOMESTIC ABUSE SHELTER LOCATED IN SOUTHERN LINCOLN COUNTY, PROVIDES EMERGENCY SERVICES, SHELTER AND SUPPORT TO VICTIMS THROUGHOUT THE AREA. 8 MMG RHINELANDER 2251 North SHore Drive Rhinelander WI 54501 OUTPATIENT PHYSICIAN CLINIC MMG TOMAHAWK 401 West Mohawk Tomahawk WI 54487 OUTPATIENT PHYSICIAN CLINIC MMG EAGLE RIVER 930 East Wall Street Eagle River WI 54521 OUTPATIENT PHYSICIAN CLINIC MMG CRANDON 400 West Glen Street Crandon WI 54520 OUTPATIENT PHYSICIAN CLINIC MMG RIVERSIDE 1020 Kabel Avenue Rhinelander WI 54501 OUTPATIENT PHYSICIAN CLINIC MMG WOODRUFF 240 Maple Street Woodruff WI 54568 OUTPATIENT PHYSICIAN CLINIC SACRED HEART-ST MARY'S HOSPITALS INC - HEAD 2 TOE PHYSICAL THERAPY 202 W Mohawk Dr Tomahawk WI 54487 OUTPATIENT REHABILITATION MMG LAONA 4876 Mill Street Laona WI 54541 OUTPATIENT PHYSICIAN CLINIC Schedule H, Part I, Line 3c FACTORS IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE IN ADDITION TO USING FPG, ASCENSION SACRED HEART-ST. MARY'S HOSPITAL'S, INC. ALSO USES AN ASSET LEVEL TEST, MEDICAL INDIGENCY, INSURANCE STATUS, UNDERINSURANCE STATUS, AND RESIDENCY AS FACTORS IN DETERMINING ELIGIBILITY FOR FREE AND DISCOUNTED CARE. Schedule H, Part I, Line 6a Community benefit report prepared by related organization MINISTRY HEALTH CARE, INC. EIN: 39-1490371 Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance THE COST OF PROVIDING CHARITY CARE, MEANS-TESTED GOVERNMENT PROGRAMS, AND OTHER COMMUNITY BENEFIT PROGRAMS IS ESTIMATED USING INTERNAL COST DATA, AND IS CALCULATED IN COMPLIANCE WITH CATHOLIC HEALTH ASSOCIATION ("CHA") GUIDELINES. THE ORGANIZATION USES A COST ACCOUNTING SYSTEM THAT ADDRESSES ALL PATIENT SEGMENTS (FOR EXAMPLE, INPATIENT, OUTPATIENT, EMERGENCY ROOM, PRIVATE INSURANCE, MEDICAID, MEDICARE, UNINSURED, OR SELF PAY). THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE. FOR THE INFORMATION IN THE TABLE, A COST-TO-CHARGE RATIO WAS CALCULATED AND APPLIED. Schedule H, Part II Community Building Activities ASCENSION ST. MARY'S ASCENSION ST. MARY'S HOSPITAL PARTICIPATES IN SEVERAL COMMUNITY COALITIONS, COLLABORATIVE EFFORTS AND NON-PROFITS WITH THE COMMUNITY WHOSE PURPOSE IS TO IMPROVE THE HEALTH OF THE COMMUNITY, INCLUDING HABITAT FOR HUMANITY, LOCAL COALITIONS, AND COUNTY DEATH REVIEWS. BY WORKING TOGETHER WITH OTHER ORGANIZATIONS IN THE COMMUNITY, WE EXPECT TO HAVE A GREATER IMPACT ON HEALTH. ACCORDING TO THE COUNTY HEALTH RANKINGS SITE, WITH A SHARED VISION AND COMMITMENT TO IMPROVED HEALTH, WORKING TOGETHER CAN YIELD BETTER RESULTS THAN WORKING ALONE. ASCENSION SACRED HEART ASCENSION SACRED HEART HOSPITAL PARTICIPATES IN HEALTHY PEOPLE LINCOLN COUNTY, A COLLABORATIVE THAT FOCUSES ON IMPROVING THE HEALTH OF THE COMMUNITY. ASCENSION SACRED HEART ALSO ASSISTED IN A COMMUNITY POVERTY SIMULATION TRAINING. BY WORKING TOGETHER WITH OTHER ORGANIZATIONS IN THE COMMUNITY, WE EXPECT TO HAVE A GREATER IMPACT ON HEALTH. ACCORDING TO THE COUNTY HEALTH RANKINGS SITE, WITH A SHARED VISION AND COMMITMENT TO IMPROVED HEALTH, WORKING TOGETHER CAN YIELD BETTER RESULTS THAN WORKING ALONE. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE AND REASONABLE EFFORTS TO COLLECT FROM THE PATIENT HAVE BEEN EXHAUSTED, THE CORPORATION FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITHIN COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY ASCENSION HEALTH. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE CORPORATION'S POLICIES. AFTER APPLYING THE COST-TO-CHARGE RATIO, THE SHARE OF THE BAD DEBT EXPENSE IN FISCAL YEAR 2018 WAS $3,338,699 AT CHARGES, ($1,559,399 AT COST). Schedule H, Part III, Line 3 Bad Debt Expense Methodology ASCENSION SACRED HEART-ST. MARY'S HOSPITALS, INC. HAS A VERY ROBUST FINANCIAL ASSISTANCE PROGRAM; THEREFORE, WE DO NOT TYPICALLY HAVE MUCH TO REPORT AS BAD DEBT ATTRIBUTABLE TO FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. THEREFORE, WE DO NOT INCLUDE THIS PORTION OF BAD DEBT AS COMMUNITY BENEFIT. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote THE ORGANIZATION IS PART OF THE ASCENSION HEALTH ALLIANCE'S CONSOLIDATED AUDIT IN WHICH THE FOOTNOTE THAT DISCUSSES THE BAD DEBT EXPENSE IS LOCATED ON PAGE 21. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs A COST TO CHARGE RATIO IS APPLIED TO THE ORGANIZATION'S MEDICARE EXPENSE TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT. ASCENSION HEALTH AND ITS RELATED HEALTH MINISTRIES FOLLOW THE CATHOLIC HEALTH ASSOCIATION (CHA) GUIDELINES FOR DETERMINING COMMUNITY BENEFIT. CHA COMMUNITY BENEFIT REPORTING GUIDELINES SUGGEST THAT MEDICARE SHORTFALL IS NOT TREATED AS COMMUNITY BENEFIT. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance THE ORGANIZATION FOLLOWS THE ASCENSION GUIDELINES FOR COLLECTION PRACTICES RELATED TO PATIENTS QUALIFYING FOR CHARITY OR FINANCIAL ASSISTANCE. A PATIENT CAN APPLY FOR CHARITY OR FINANCIAL ASSISTANCE AT ANY TIME DURING THE COLLECTION CYCLE. ONCE QUALIFYING DOCUMENTATION IS RECEIVED THE PATIENT'S ACCOUNT IS ADJUSTED. PATIENT ACCOUNTS FOR THE QUALIFYING PATIENT IN THE PREVIOUS SIX MONTHS MAY ALSO BE CONSIDERED FOR CHARITY OR FINANCIAL ASSISTANCE. ONCE A PATIENT QUALIFIES FOR CHARITY OR FINANCIAL ASSISTANCE, ALL COLLECTION ACTIVITY IS SUSPENDED. Schedule H, Part V, Section B, Line 16a FAP website - ST. MARY'S HOSPITAL: Line 16a URL: https://healthcare.ascension.org/Financial-Assistance/wisconsin; - SACRED HEART HOSPITAL: Line 16a URL: https://healthcare.ascension.org/Financial-Assistance/wisconsin; Schedule H, Part V, Section B, Line 16b FAP Application website - ST. MARY'S HOSPITAL: Line 16b URL: https://healthcare.ascension.org/Financial-Assistance/wisconsin; - SACRED HEART HOSPITAL: Line 16b URL: https://healthcare.ascension.org/Financial-Assistance/wisconsin; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - ST. MARY'S HOSPITAL: Line 16c URL: https://healthcare.ascension.org/Financial-Assistance/wisconsin; - SACRED HEART HOSPITAL: Line 16c URL: https://healthcare.ascension.org/Financial-Assistance/wisconsin; Schedule H, Part VI, Line 2 Needs assessment IN ADDITION TO THE CHNA REPORTED IN PART V, SECTION B, ASCENSION SACRED HEART-ST. MARY'S HOSPITALS USES BOTH HOSPITAL DATA AND RELIABLE, THIRD PARTY REPORTS, INCLUDING DATA FROM GOVERNMENT SOURCES, TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY IT SERVES. THESE REPORTS PROVIDE INFORMATION ABOUT KEY HEALTH, SOCIOECONOMIC, AND DEMOGRAPHIC INDICATORS THAT POINT TO AREAS OF NEED. ASCENSION SACRED HEART-ST MARY'S HOSPITALS UTILIZES THIS INFORMATION TO DETERMINE AND DEVELOP PROGRAMS AND SERVICES TO BE PROVIDED FOR THE COMMUNITY. THESE NEEDS AND INITIATIVES ARE PRESENTED TO SENIOR LEADERSHIP AND BOARD MEMBERS TO ENSURE THE FINDINGS ARE CONSIDERED IN DEVELOPING THE ORGANIZATION'S STRATEGY, POLICY DEVELOPMENT, AND INTERNAL FINANCIAL AND OPERATIONAL DECISIONS Schedule H, Part VI, Line 3 Patient education of eligibility for assistance THE ORGANIZATION GOES TO GREAT LENGTHS IN ORDER TO INFORM AND EDUCATE PATIENTS/PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE OR LOCAL GOVERNMENT PROGRAMS AND UNDER THE ORGANIZATION'S CHARITY CARE POLICY. THE CHARITY CARE POLICY AND APPLICATION IS POSTED ON THE ORGANIZATION'S WEBSITE. ADMISSIONS AND OTHER KEY AREAS CONTAIN SUMMARY INFORMATION OF THE CHARITY CARE POLICY. AS PART OF THE INTAKE/DISCHARGE PROCESS, PATIENTS ARE PROVIDED WITH A COPY OF THE POLICY AND OTHER INFORMATION FOR FINANCIAL ASSISTANCE. IF A PATIENT INDICATES THEY ARE UNABLE TO PAY THEIR BILL AT ANY POINT DURING PRE-SERVICE, ADMISSION, DISCHARGE OR BILLING PROCESS, THE FINANCIAL COUNSELORS WILL ASSIST THE PATIENT IN EITHER SECURING A FUNDING SOURCE (GRANTS, COBRA COVERAGE, DISABILITY BENEFITS, MEDICAID, VA, ETC.)IF ELIGIBLE OR ASSIST THEM IN COMPLETING A FINANCIAL ASSISTANCE APPLICATION. IF DURING THE COURSE OF THE PATIENT REGISTRATION PROCESS, CARE ENCOUNTER, TREATMENT, OR UPON DISCHARGE IT BECOMES EVIDENT THAT A PATIENT MAY NEED FINANCIAL ASSISTANCE, THE PATIENT SHALL BE REFERRED TO THE ORGANIZATION'S COMMUNITY CARE PROGRAM. PATIENTS MAY BE IDENTIFIED AS NEEDING FINANCIAL ASSISTANCE AT ANY TIME DURING THE COURSE OF AN ENCOUNTER. A REFERRAL FOR CONSIDERATION OF COMMUNITY CARE FINANCIAL ASSISTANCE CAN BE INITIATED BY ANY MEMBER OF THE HOSPITAL'S WORKFORCE, INCLUDING MEDICAL STAFF MEMBERS, WHO BECOME AWARE OF THE PATIENTS POTENTIAL NEED FOR COMMUNITY CARE FINANCIAL ASSISTANCE. THE CHARITY CARE POLICY WAS ALSO TRANSLATED INTO DIALECTS PREVALENT IN THE COMMUNITY IN ORDER TO REACH OUT TO THOSE THAT MAY SPEAK ANOTHER LANGUAGE (SPANISH AND HMONG). PATIENT REGISTRATION STAFF AND FINANCIAL COUNSELORS ARE PROVIDED WITH SCRIPTS TO FOLLOW WHEN INTERACTING WITH PATIENTS. AS PART OF THE CHARITY CARE PROCESS, PATIENTS MUST REGISTER WITH THE COUNTY PUBLIC ASSISTANCE TO SEE IF THEY MAY QUALIFY UNDER ANY OTHER FEDERAL OR STATE PROGRAMS. Schedule H, Part VI, Line 4 Community information WHILE THERE IS GROWING AGREEMENT IN THE UNITED STATES ABOUT WHAT CONSTITUTES A NON-PROFIT HOSPITAL'S COMMUNITY BENEFIT, THIS IS A WORK IN PROGRESS. THE ORGANIZATION PROVIDED SIGNIFICANT CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS. BUT IN ADDITION, WE BELIEVE THAT WE PROVIDE A CRITICALLY IMPORTANT COMMUNITY BENEFIT, WHICH IS NOT QUANTIFIED. OUR HOSPITAL, LIKE MOST RURAL HOSPITALS, WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE CARE LOCALLY - CARE THAT WITHOUT OUR HOSPITAL, MAY NOT BE AVAILABLE LOCALLY. CERTAIN SPECIALIZED SERVICES AVAILABLE INCLUDE: DIABETES EDUCATION AND MANAGEMENT, SPEECH THERAPY, WOUND CARE AND MANAGEMENT, PALLIATIVE CARE SERVICES, PAIN MANAGEMENT SERVICES, AND INPATIENT DIALYSIS SERVICES. SACRED HEART HOSPITAL IS LOCATED IN TOMAHAWK, WI AND SERVES THE SURROUNDING COMMUNITIES. ACCORDING TO THE 2011 CENSUS, TOMAHAWK HAS A POPULATION OF 3,401 WITH A MEDIAN AGE OF 44.8. THE MEDIAN INCOME FOR A HOUSEHOLD IN THE CITY WAS $44,677 IN 2009. THE PERCENTAGE OF RESIDENTS LIVING IN POVERTY IN 2009 WAS 12.2%. THE UNEMPLOYMENT RATE IN AUGUST 2012 WAS 9.4% VERSUS THE WISCONSIN STATE AVERAGE OF 7.1%. THE TOWN COVERS A TOTAL AREA OF 8.8 MILES. TOMAHAWK IS LOCATED IN LINCOLN COUNTY WHICH HAS A POPULATION OF 29,404 IN JULY 2009. THE MEDIAN INCOME FOR A HOUSEHOLD WAS $44,660 IN 2009. THE MEDIAN AGE WAS 39 YEARS. THE UNEMPLOYMENT RATE WAS IN MARCH 2012 WAS 10.6%. ST. MARY'S HOSPITAL IS LOCATED IN RHINELANDER, WI AND SERVES THE SURROUNDING COMMUNITIES. ACCORDING TO THE 2011 CENSUS, RHINELANDER HAS A POPULATION OF 7,786. THE MEDIAN AGE WAS 40 YEARS. THE MEDIAN INCOME FOR A HOUSEHOLD IN THE CITY WAS $32,623 IN 2009. THE UNEMPLOYMENT RATE IN AUGUST 2012 WAS 7.8% VERSUS THE WISCONSIN STATE AVERAGE OF 7.1%. THE TOWN COVERS A TOTAL AREA OF 7.9 MILES. RHINELANDER IS LOCATED IN ONEIDA COUNTY WHICH HAD A POPULATION OF 35,801 IN JULY 2011. THE MEDIAN INCOME FOR A HOUSEHOLD WAS $42,946 IN 2009. THE UNEMPLOYMENT RATE IN APRIL 2010 WAS 7.8%. Schedule H, Part VI, Line 5 Promotion of community health THE ORGANIZATION STRIVES TO FURTHER ITS EXEMPT PURPOSES BY THE FOLLOWING: (1) THE ORGANIZATION'S GOVERNING BOARD CONSISTS PRIMARILY OF PERSONS WHO RESIDE WITHIN THE PRIMARY SERVICE AREA WHO ARE NOT EMPLOYEES OF THE ORGANIZATION. (2) AS MENTIONED, THE ORGANIZATION PROVIDES SEVERAL SERVICES WHICH ARE NOT OTHERWISE AVAILABLE BEING IN A RURAL SETTING. (3) BASED ON THE ORGANIZATION'S MISSION, EMERGENCY ROOMS ARE MADE AVAILABLE TO ALL PATIENTS REGARDLESS OF THE ABILITY TO PAY. (4) THE ORGANIZATION ALSO PARTICIPATES IN THE EDUCATION AND TRAINING OF HEALTHCARE PROFESSIONALS THROUGH INTERNSHIP PROGRAMS. ASCENSION SACRED HEART-ST. MARY'S HOSPITAL, INC. PARTICIPATES IN GOVERNMENT SPONSORED HEALTH PROGRAMS (MEDICARE, MEDICAID, CHAMPUS, TRICARE). SACRED HEART IS A CRITICAL ACCESS HOSPITAL IN TOMAHAWK, WISCONSIN AND ST. MARY'S IS A SOLE COMMUNITY HOSPITAL IN RHINELANDER, WISCONSIN. BOTH HOSPITALS AND HOSPITAL-BASED CLINICS SERVE POOR RURAL COMMUNITIES. ST. MARY'S PROVIDES INPATIENT AND OUTPATIENT MENTAL HEALTH AND AODA SERVICES AT A FINANCIAL LOSS TO THE ORGANIZATION WHICH IS SOMEWHAT UNIQUE TO SMALL RURAL COMMUNITIES. PERSONS IN NEED OF MENTAL HEALTH OR AODA SERVICES WOULD OTHERWISE HAVE TO TRAVEL SEVERAL HUNDRED MILES TO SEEK CARE. ASCENSION SACRED HEART-ST. MARY'S HOSPITALS, INC. SERVES FOUR NATIVE AMERICAN TRIBES IN SURROUNDING COMMUNITIES. TRIBAL SERVICES ARE PAID UNDER MEDICARE-LIKE RATE UNDER CONTRACT HEALTH SERVICES REIMBURSEMENT PROGRAM UNDER THE FEDERAL INDIAN HEALTH PROGRAM. THE ORGANIZATION ALSO PARTICIPATES IN GOVERNMENT SPONSORED HEALTH PROGRAMS SUCH AS MEDICARE, MEDICAID, CHAMPUS. THE ORGANIZATION STRIVES TO BE A LOW-COST PROVIDER BY CONTINUALLY REDUCING INTERNAL COSTS THROUGH EFFICIENCY MEASURES WHICH IN TURN, IS PASSED ON TO PATIENTS THROUGH MARKET-BASKET PRICES. THE UNINSURED MEMBERS OF THE COMMUNITY ACCESS HEALTHCARE THROUGH THE EMERGENCY DEPARTMENT AND MEDICAL CLINICS. ALL MEDICALLY NECESSARY MEDICAL SERVICES ARE PROVIDED IN AN INPATIENT, OUTPATIENT OR CLINIC SETTING FOR PERSONS IN NEED OF CARE REGARDLESS OF THEIR ABILITY TO PAY. ASCENSION SACRED HEART-ST. MARY'S HOSPITALS, INC. FUNDS A COMMUNITY LINK COORDINATOR WHO WORKS IN CONJUNCTION WITH OUR PATIENT FAMILY SERVICES DEPARTMENT IN MEETING THE SPECIAL NEEDS OF OUR COMMUNITY. THIS TEAM HELPS OUR COMMUNITY MEMBERS NAVIGATE THE VARIOUS GOVERNMENTAL PROGRAMS BY HELPING OUR UNINSURED POPULATION APPLY FOR STATE MEDICAID PROGRAMS AND THE ORGANIZATION'S OWN COMMUNITY CARE (CHARITY CARE) PROGRAM. THE COMMUNITY CARE PROGRAM PROVIDES FINANCIAL ASSISTANCE AND SLIDING SCALE DISCOUNTS TO PATIENTS WHO MEET CERTAIN INCOME AND ASSET CRITERIA, UP TO 400% OF THE FEDERAL POVERTY GUIDELINES. Schedule H, Part VI, Line 6 Affiliated health care system AS PART OF MINISTRY HEALTH, INC., ASCENSION SACRED HEART-ST. MARY'S HOSPITALS, INC. IS A MEMBER OF ASCENSION HEALTH ALLIANCE. THESE MEMBERS ARE LARGE MULTI-FACETED, INTEGRATED, NOT-FOR-PROFIT MINISTRIES INCLUDING HOSPITAL AND NON-HOSPITAL MINISTRIES (PHYSICIAN GROUP PRACTICES, HOSPITAL ORGANIZATIONS, RESEARCH, HOME HEALTH, DURABLE MEDICAL EQUIPMENT AND SENIOR FACILITIES). THESE MINISTRIES WORK TOGETHER TO CARE FOR PATIENTS, JOINED BY COMMON SYSTEMS AND A PHILOSOPHY OF SERVING AS A HEALING PRESENCE WITH SPECIAL CONCERN FOR OUR NEIGHBORS ESPECIALLY THOSE WHO ARE VULNERABLE. THIS COMMUNITY BENEFIT HAPPENS THROUGH ITS FOCUS ON PATIENT CARE, EDUCATION AND RESEARCH. THE ORGANIZATIONS WORK TOGETHER TO SERVE THEIR COMMUNITIES AT THE LOCAL, REGIONAL, STATE AND NATIONAL LEVEL. ASCENSION HEALTH ALLIANCE, D/B/A ASCENSION (ASCENSION), IS A MISSOURI NONPROFIT CORPORATION FORMED ON SEPTEMBER 13, 2011. ASCENSION IS THE SOLE CORPORATE MEMBER AND PARENT ORGANIZATION OF ASCENSION HEALTH, A CATHOLIC NATIONAL HEALTH SYSTEM CONSISTING PRIMARILY OF NONPROFIT CORPORATIONS THAT OWN AND OPERATE LOCAL HEALTHCARE FACILITIES, OR HEALTH MINISTRIES, LOCATED IN 22 OF THE UNITED STATES AND THE DISTRICT OF COLUMBIA. ASCENSION IS SPONSORED BY ASCENSION SPONSOR, A PUBLIC JURIDIC PERSON. THE PARTICIPATING ORGANIZATIONS/ENTITIES OF ASCENSION SPONSOR ARE THE DAUGHTERS OF CHARITY OF ST. VINCENT DE PAUL, ST. LOUISE PROVINCE; THE CONGREGATION OF ST. JOSEPH; THE CONGREGATION OF THE SISTERS OF ST. JOSEPH OF CARONDELET; THE CONGREGATION OF ALEXIAN BROTHERS OF THE IMMACULATE CONCEPTION PROVINCE, INC. - AMERICAN PROVINCE; AND THE SISTERS OF THE SORROWFUL MOTHER OF THE THIRD ORDER OF ST. FRANCIS OF ASSISI - US/CARIBBEAN PROVINCE. THE SYSTEM DIRECTS ITS GOVERNANCE AND MANAGEMENT ACTIVITIES TOWARD STRONG, VIBRANT, CATHOLIC HEALTH MINISTRIES UNITED IN SERVICE AND HEALING AND DEDICATES ITS RESOURCES TO SPIRITUALLY CENTERED CARE THAT SUSTAINS AND IMPROVES THE HEALTH OF THE INDIVIDUALS AND COMMUNITIES IT SERVES. IN ACCORDANCE WITH THE SYSTEM'S MISSION OF SERVICE TO THOSE PERSONS LIVING IN POVERTY AND TO OTHER VULNERABLE PERSONS, EACH HEALTH MINISTRY ACCEPTS PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE SYSTEM USES FOUR CATEGORIES TO IDENTIFY THE RESOURCES UTILIZED FOR THE CARE OF PERSONS LIVING IN POVERTY AND FOR COMMUNITY BENEFIT PROGRAMS: TRADITIONAL CHARITY CARE INCLUDES THE COST OF SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD HEALTH CARE BECAUSE OF INADEQUATE RESOURCES AND/OR WHO ARE UNINSURED OR UNDERINSURED. UNPAID COST OF PUBLIC PROGRAMS, EXCLUDING MEDICARE, REPRESENTS THE UNPAID COST OF SERVICES PROVIDED TO PERSONS COVERED BY PUBLIC PROGRAMS FOR PERSONS LIVING IN POVERTY AND FOR OTHER VULNERABLE PERSONS. COST OF OTHER PROGRAMS FOR PERSONS LIVING IN POVERTY AND FOR OTHER VULNERABLE PERSONS INCLUDES UNREIMBURSED COSTS OF PROGRAMS INTENTIONALLY DESIGNED TO SERVE THE PERSONS LIVING IN POVERTY AND THE OTHER VULNERABLE PERSONS OF THE COMMUNITY, INCLUDING SUBSTANCE ABUSERS, THE HOMELESS, VICTIMS OF CHILD ABUSE, AND PERSONS WITH ACQUIRED IMMUNE DEFICIENCY SYNDROME. COMMUNITY BENEFIT CONSISTS OF THE UNREIMBURSED COSTS OF COMMUNITY BENEFIT PROGRAMS AND SERVICES FOR THE GENERAL COMMUNITY, NOT SOLELY FOR THE PERSONS LIVING IN POVERTY, INCLUDING HEALTH PROMOTION AND EDUCATION, HEALTH CLINICS AND SCREENINGS, AND MEDICAL RESEARCH. DISCOUNTS ARE PROVIDED TO ALL UNINSURED PATIENTS, INCLUDING THOSE WITH THE MEANS TO PAY. DISCOUNTS PROVIDED TO THOSE PATIENTS WHO DID NOT QUALIFY FOR ASSISTANCE UNDER CHARITY CARE GUIDELINES ARE NOT INCLUDED IN THE COST OF PROVIDING CARE TO PERSONS LIVING IN POVERTY OR IN THE COST OF OTHER COMMUNITY BENEFIT PROGRAMS. THE COST OF PROVIDING CARE TO PERSONS LIVING IN POVERTY AND OF OTHER COMMUNITY BENEFIT PROGRAMS IS ESTIMATED USING INTERNAL COST DATA AND IS ESTIMATED BY REDUCING CHARGES FORGONE BY A FACTOR DERIVED FROM THE RATIO OF TOTAL OPERATING EXPENSES TO BILLED CHARGES FOR PATIENT CARE. true true false false false false false false false SANDRA L LATZEL-ANDERSON BOARD MEMBER/HOSPITAL PRESIDENT (EX-OFFICIO) 0 354518 0 78674 0 40312 0 13500 0 20038 0 507042 0 0 MONICA A HILT FORMER OFFICER (END 1/2015) 0 398789 0 89542 0 42795 0 17550 0 27382 0 576058 0 0 DANIEL E NEUFELDER FORMER OFFICER (END 9/2016) 0 0 0 0 0 996775 0 0 0 0 0 996775 0 0 SHISHIR N SHETH MD FORMER OFFICER (END 6/2017) 282309 194157 0 10000 28689 18251 11080 6470 7721 13436 329799 242314 0 0 ANN M ZENK FORMER OFFICER (END 6/2017) 0 88606 0 0 0 1792 0 5868 0 8618 0 104884 0 0 LORI J DARR VP-FINANCE WISCONSIN 0 282993 0 63992 0 55950 0 14850 0 31874 0 449659 0 0 MARK BANAS MD MEDICAL STAFF PRESIDENT-SACRED HEART 0 720414 0 0 0 5582 0 17550 0 36672 0 780218 0 0 RUSSELL S SUDBURY MD MEDICAL STAFF PRESIDENT-SAINT MARY'S 0 567934 0 50838 0 5378 0 17550 0 39484 0 681184 0 0 TERESA J THEILER CAO - VP PATIENT CARE 0 170435 0 15321 0 4714 0 6917 0 15932 0 213319 0 0 KAY E ANDERSON REG DIR REHAB SERVICES 118264 0 9835 0 908 0 8703 0 16166 0 153876 0 0 0 BRADLEY M JAMISON LEAD PHARMACIST 134406 0 0 0 467 0 8034 0 26454 0 169361 0 0 0 CHRISTOPHER J KOENIGS MEDICAL PHYSICIST 176695 0 0 0 151 0 5665 0 27207 0 209718 0 0 0 LORI L MOTT PHYSICIAL THERAPIST 93524 0 34361 0 449 0 3186 0 30361 0 161881 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation ASCENSION HEALTH, A RELATED ORGANIZATION OF ASCENSION SACRED HEART-ST. MARY'S HOSPITALS, INC., USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S CEO: - COMPENSATION COMMITTEE, - INDEPENDENT COMPENSATION CONSULTANT, - COMPENSATION SURVEY OR STUDY, AND - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. Schedule J, Part I, Line 4a Severance or change-of-control payment THE FOLLOWING INDIVIDUAL(S) RECEIVED SEVERANCE PAYMENTS FROM THE ORGANIZATION OR A RELATED ORGANIZATION DURING THE CALENDAR YEAR 2017: DANIEL NEUFELDER - $994,500 Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan ELIGIBLE EXECUTIVES PARTICIPATE IN A PROGRAM THAT PROVIDES FOR SUPPLEMENTAL RETIREMENT BENEFITS. THE PAYMENT OF BENEFITS UNDER THE PROGRAM, IF ANY, IS ENTIRELY DEPENDENT UPON THE FACTS AND CIRCUMSTANCES UNDER WHICH THE EXECUTIVE TERMINATES EMPLOYMENT WITH THE ORGANIZATION. BENEFITS UNDER THE PROGRAM ARE UNFUNDED AND NON-VESTED. DUE TO THE SUBSTANTIAL RISK OF FORFEITURE PROVISION, THERE IS NO GUARANTEE THAT THESE EXECUTIVES WILL EVER RECEIVE ANY BENEFIT UNDER THE PROGRAM. ANY AMOUNT ULTIMATELY PAID UNDER THE PROGRAM TO THE EXECUTIVE IS REPORTED AS COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN B IN THE YEAR PAID. NO INDIVIDUALS RECEIVED CURRENT YEAR DISTRIBUTIONS. Form 990, Part VI, Line 15a PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL THE PROCESS OF DETERMINING THE AMOUNT OF COMPENSATION PAID TO THE ORGANIZATION'S CEO, EXECUTIVE DIRECTOR OR TOP MANAGEMENT OFFICIAL IS PERFORMED BY ASCENSION HEALTH , A RELATED ORGANIZATION OF ASCENSION SACRED HEART-ST. MARY'S HOSPITALS, INC. THE PROCESS INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE EXECUTIVE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE ORGANIZATION'S CEO, EXECUTIVE DIRECTOR OR TOP MANAGEMENT OFFICIAL'S SALARY WAS COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE MINUTES. THE INDIVIDUAL WAS NOT PRESENT WHEN THEIR COMPENSATION WAS DECIDED. Form 990, Part VI, Line 15b PROCESS TO ESTABLISH COMPENSATION OF OTHER OFFICERS OR KEY EMPLOYEES THE PROCESS OF DETERMINING THE AMOUNT OF COMPENSATION PAID TO THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES IS PERFORMED BY MINISTRY HEALTH CARE, INC. AND ITS SUBSIDIARY ORGANIZATIONS. MINISTRY HEALTH CARE, INC. IS THE SOLE CORPORATE MEMBER OF ASCENSION SACRED HEART-ST. MARY'S HOSPITALS, INC. THE PROCESS INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE EXECUTIVE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE OFFICERS' AND KEY EMPLOYEES' SALARIES WERE COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE MINUTES. INDIVIDUALS WERE NOT PRESENT WHEN THEIR COMPENSATION WAS DECIDED. Form 990, Part VI, Line 6 Classes of members or stockholders ASCENSION SACRED HEART-ST. MARY'S HOSPITALS, INC. HAS A SINGLE CORPORATE MEMBER, MINISTRY HEALTH CARE, INC. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body ASCENSION SACRED HEART-ST. MARY'S HOSPITALS, INC. HAS A SINGLE CORPORATE MEMBER, MINISTRY HEALTH CARE, INC., WHO HAS THE ABILITY TO ELECT MEMBERS TO THE GOVERNING BODY OF ASCENSION SACRED HEART-ST MARY'S HOSPITALS, INC. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders ALL DECISIONS THAT HAVE A MATERIAL IMPACT TO ASCENSION SACRED HEART-ST. MARY'S HOSPITALS, INC.'S FINANCIAL INFORMATION OR CORPORATION AS A WHOLE ARE SUBJECT TO APPROVAL BY ITS SOLE CORPORATE MEMBER, MINISTRY HEALTH CARE, INC Form 990, Part VI, Line 11b Review of form 990 by governing body DURING THE RETURN PREPARATION PROCESS, THE TAX DEPARTMENT WORKS WITH OTHER FUNCTIONAL AREAS INCLUDING FINANCE, ACCOUNTING, TREASURY, LEGAL, HUMAN RESOURCES, AND CORPORATE COMPLIANCE FOR ADVICE, INFORMATION AND ASSISTANCE IN ORDER TO PREPARE A COMPLETE AND ACCURATE RETURN. UPON COMPLETION, THE FORM 990 IS REVIEWED BY THE ORGANIZATION'S INTERNAL TAX DEPARTMENT WHICH CONSISTS OF ATTORNEYS AND CPAS. A COMPLETE FINAL COPY OF THE RETURN IS PROVIDED TO THE ORGANIZATION'S PRESIDENT, FINANCIAL OFFICER, AND/OR OTHER KEY OFFICERS IN LIEU OF THE FULL BOARD. Form 990, Part VI, Line 12c Conflict of interest policy THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY IN THAT ANY DIRECTOR, PRINCIPAL OFFICER, OR MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS, WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST, MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF THE COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. THE REMAINING INDIVIDUALS ON THE GOVERNING BOARD OR COMMITTEE WILL DECIDE IF CONFLICTS OF INTEREST EXIST. EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS ANNUALLY SIGNS A STATEMENT WHICH AFFIRMS SUCH PERSON HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY, AND UNDERSTANDS THAT THE ORGANIZATION IS CHARITABLE AND IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ITS TAX-EXEMPT PURPOSE. Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION WILL PROVIDE ANY DOCUMENTS OPEN TO PUBLIC INSPECTION UPON REQUEST. Form 990, Part VIII, Line 2f Other Program Service Revenue MANAGEMENT FEES - Total Revenue: 66788, Related or Exempt Function Revenue: 66788, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part VIII, Line 11d Other Miscellaneous Revenue MISCELLANEOUS REVENUE - Total Revenue: 27865, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 27865; ESCHEATMENT REVENUE - Total Revenue: 209, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 209; MEDICAL RECORDS FEE - Total Revenue: 125, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 125; Form 990, Part XI, Line 9 Other changes in net assets or fund balances TRANSFER TO AFFILIATES - -22240007; TRANSFERS FROM ALPHA FUND - 35335239; CHANGE IN INTEREST IN FOUNDATIONS - 92387; Form 990, Part XII, Line 2b AUDITED FINANCIAL STATEMENTS THE ACTIVITY OF ASCENSION SACRED HEART-ST. MARY'S HOSPITALS, INC. IS REPORTED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF ASCENSION HEALTH ALLIANCE. NO INDIVIDUAL AUDIT OF ASCENSION SACRED HEART-ST. MARY'S HOSPITALS, INC. IS COMPLETED. THEREFORE, THE ATTACHED AUDITED FINANCIAL STATEMENTS ARE OF ASCENSION HEALTH ALLIANCE AND AFFILIATES, WHICH INCLUDE THE ACTIVITY OF ASCENSION SACRED HEART-ST. MARY'S HOSPITALS, INC. Form 990, Part XII, Line 2c AUDIT COMMITTEE ASCENSION SACRED HEART-ST. MARY'S HOSPITALS, INC. IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF ASCENSION HEALTH ALLIANCE. THE FINANCE AND AUDIT COMMITTEE OF ASCENSION HEALTH ALLIANCE'S BOARD ASSUMES RESPONSIBILITY FOR THE CONSOLIDATED ORGANIZATION AS A WHOLE. VOLUNTEERS OF SACRED HEART-SAINT MARY'S HOSPITALS LLC 2251 North Shore Drive Rhinelander WI 54501 474417715 FUNDRAISING WI 60585 53677 Ascension Sacred Heart-St Mary's Hospitals Inc AFFINITY HEALTH SYSTEM 1570 MIDWAY PLACE MENASHA WI 54952 391568866 HEALTH SYSTEM IL 501(c)(3) Type II MINISTRY HEALTH CARE INC true AGAPE COMMUNITY CENTER OF MILWAUKEE INC 6100 NORTH 42ND STREET MILWAUKEE WI 53209 391641846 COMMUNITY CENTER WI 501(c)(3) 7 MINISTRY HEALTH CARE INC true ASCENSION ALL SAINTS HOSPITAL INC (FKA WHEATON FRANCISCAN HEALTHCARE-ALL SA INTS INC) 3801 SPRING STREET RACINE WI 53405 391264986 HOSPITAL WI 501(c)(3) 3 WHEATON FRANCISCAN HEALTHCARE-SOUTHEAST WISCONSIN INC true ASCENSION CALUMET HOSPITAL INC 614 MEMORIAL DRIVE CHILTON WI 53014 390905385 HOSPITAL WI 501(c)(3) 3 MINISTRY HEALTH CARE INC true ASCENSION EAGLE RIVER HOSPITAL INC 201 HOSPITAL ROAD EAGLE RIVER WI 54521 390985690 HOSPITAL WI 501(c)(3) 3 MINISTRY HEALTH CARE INC true ASCENSION GOOD SAMARITAN HOSPITAL INC 601 SOUTH CENTER AVENUE MERRILL WI 54452 390808503 HOSPITAL WI 501(c)(3) 3 MINISTRY HEALTH CARE INC true ASCENSION HEALTH ALLIANCE PO BOX 45998 ST LOUIS MO 63145 453358926 NATIONAL HEALTH MO 501(c)(3) Type I NA false ASCENSION HEALTH PO BOX 45998 ST LOUIS MO 63145 311662309 NATIONAL HEALTH MO 501(c)(3) Type I ASCENSION HEALTH ALLIANCE false ASCENSION MEDICAL GROUP-FOX VALLEY WISCONSIN INC (FKA NETWORK HEALTH SYSTEM INC) 1570 APPLETON RD MENASHA WI 54952 391127163 CLINICAL HEALTHCARE SERVICES WI 501(c)(3) 3 AFFINITY HEALTH SYSTEM true ASCENSION MEDICAL GROUP-NORTHERN WISCONSIN INC (FKA MINISTRY MEDICAL GROUP INC) 824 ILLINOIS AVENUE STEVENS POINT WI 54481 391965593 MEDICAL GROUP WI 501(c)(3) Type III-FI MINISTRY HEALTH CARE INC true ASCENSION MEDICAL GROUP-SOUTHEAST WISCONSIN INC (FKA WHEATON FRANCISCAN MED ICAL GROUP INC) 400 WEST RIVER WOODS PARKWAY GLENDALE WI 53212 391791586 MEDICAL GROUP WI 501(c)(3) 3 WHEATON FRANCISCAN HEALTHCARE-SOUTHEAST WISCONSIN INC true ASCENSION NE WISCONSIN INC (FKA ST ELIZABETH HOSPITAL INC) 1506 S ONEIDA STREET APPLETON WI 54915 390816818 HOSPITAL WI 501(c)(3) 3 MINISTRY HEALTH CARE INC true ASCENSION OUR LADY OF VICTORY HOSPITAL INC 1120 PINE STREET STANLEY WI 54768 390807065 HOSPITAL WI 501(c)(3) 3 MINISTRY HEALTH CARE INC true ASCENSION SE WISCONSIN HOSPITAL INC (FKA WHEATON FRANCISCAN INC) 5000 WEST CHAMBERS STREET MILWAUKEE WI 53210 390816857 HOSPITAL WI 501(c)(3) 3 WHEATON FRANCISCAN HEALTHCARE-SOUTHEAST WISCONSIN INC true ASCENSION ST CLARE'S HOSPITAL INC 3400 MINISTRY PARKWAY WESTON WI 54476 721531917 HOSPITAL WI 501(c)(3) 3 MINISTRY HEALTH CARE INC true ASCENSION ST FRANCIS HOSPITAL INC (FKA WHEATON FRANCISCAN HEALTHCARE-ST FRA NCIS INC) 3237 SOUTH 16TH STREET MILWAUKEE WI 53215 390907740 HOSPITAL WI 501(c)(3) 3 WHEATON FRANCISCAN HEALTHCARE-SOUTHEAST WISCONSIN INC true ASCENSION ST MICHAEL'S HOSPITAL INC 900 ILLINOIS AVENUE STEVENS POINT WI 54481 390808443 HOSPITAL WI 501(c)(3) 3 MINISTRY HEALTH CARE INC true ASCENSION WISCONSIN LABORATORIES INC (FKA WHEATON FRANCISCAN LABORATORIES I NC) 3237 SOUTH 16TH STREET MILWAUKEE WI 53215 391701402 LABORATORY WI 501(c)(3) 10 WHEATON FRANCISCAN HEALTHCARE-SOUTHEAST WISCONSIN INC true ASCENSION WISCONSIN PHARMACYINC (FKA WHEATON FRANCISCAN HEALTHCARE-PHARMACY ENTERPRISES AND FRANCISCAN WOODS INC) 19525 WEST NORTH AVENUE BROOKFIELD WI 53005 391613624 PHARMACY WI 501(c)(3) 10 WHEATON FRANCISCAN HEALTHCARE-SOUTHEAST WISCONSIN INC true CATALPA HEALTH INC N4642 COUNTY N APPLETON WI 54914 454681563 BEHAVIORAL HEALTH SERVICES WI 501(c)(3) 3 AFFINITY HEALTH SYSTEM true COLUMBIA COLLEGE OF NURSING Inc 4425 NORTH PORT WASHINGTON ROAD GLENDALE WI 53212 391596986 COLLEGE WI 501(c)(3) 2 COLUMBIA ST MARY'S HOSPITAL MILWAUKEE INC true COLUMBIA ST MARY'S HOSPITAL MILWAUKEE INC 4425 NORTH PORT WASHINGTON ROAD GLENDALE WI 53212 390806315 HOSPITAL WI 501(c)(3) 3 COLUMBIA ST MARY'S INC true COLUMBIA ST MARY'S HOSPITAL OZAUKEE INC 4425 NORTH PORT WASHINGTON ROAD GLENDALE WI 53212 390807063 HOSPITAL WI 501(c)(3) 3 COLUMBIA ST MARY'S INC true COLUMBIA ST MARY'S INC 4425 NORTH PORT WASHINGTON ROAD GLENDALE WI 53212 391834639 PARENT CORPORATION WI 501(c)(3) Type I ASCENSION HEALTH false DR KATE NEWCOMB CONVALESCENT CENTER INC PO BOX 829 WOODRUFF WI 54568 391357365 NURSING/ASSISTED LIVING SERVICES WI 501(c)(3) 10 HOWARD YOUNG HEALTH CARE INC true FOUNDATION OF SAINT JOSEPH'S HOSPITAL OF MARSHFIELD Inc 611 SAINT JOSEPH AVENUE MARSHFIELD WI 54449 391684957 FOUNDATION WI 501(c)(3) Type I SAINT JOSEPH'S HOSPITAL OF MARSHFIELD INC true FOUNDATION OF SAINT CLARE'S HOSPITAL OF WESTON INC 3400 MINISTRY PARKWAY WESTON WI 54476 753193633 FOUNDATION WI 501(c)(3) Type I ASCENSION ST CLARE'S HOSPITAL INC true GOOD SAMARITAN HEALTH CENTER FOUNDATION OF MERRILL WISCONSIN INC 601 SOUTH CENTER AVENUE MERRILL WI 54452 391627755 FOUNDATION WI 501(c)(3) Type I ASCENSION GOOD SAMARITAN HOSPITAL INC true HOWARD YOUNG HEALTH CARE INC 240 MAPLE STREET WOODRUFF WI 54568 391499115 HOME OFFICE WI 501(c)(3) Type II MINISTRY HEALTH CARE INC true MERCY HEALTH FOUNDATION INC PO BOX 3370 OSHKOSH WI 54903 237140261 FOUNDATION WI 501(c)(3) 10 AFFINITY HEALTH SYSTEM true MERCY MEDICAL CENTER OF OSHKOSH INC 500 S OAKWOOD ROAD OSHKOSH WI 54904 390806268 HOSPITAL WI 501(c)(3) 3 MINISTRY HEALTH CARE INC true METRO PHYSICIANS INC 400 WEST RIVER WOODS PARKWAY GLENDALE WI 53212 943436893 Medical Group WI 501(c)(3) 3 ASCENSION MEDICAL GROUP-SOUTHEAST WISCONSIN INC (FKA WHEATON FRANCISCAN MED ICAL GROUP INC) true MINISTRY HEALTH CARE INC 10925 W LAKE PARK DR STE 100 MILWAUKEE WI 53224 391490371 PARENT CORPORATION WI 501(c)(3) Type II ASCENSION HEALTH false MINISTRY WEIGHT MANAGEMENT INC 2251 NORTH SHORE DRIVE RHINELANDER WI 54501 391829015 SPECIALTY HEALTH SERVICES WI 501(c)(3) 3 ASCENSION SACRED HEART-STMARY'S HOSPITALS INC true SACRED HEART REHABILITATION INSTITUTE Inc 4425 NORTH PORT WASHINGTON ROAD GLENDALE WI 53212 390902199 REHAB SERVICES WI 501(c)(3) 3 COLUMBIA ST MARY'S INC true SAINT ELIZABETH'S HOSPITAL OF WABASHA INC 1200 GRANT BLVD WEST WABASHA MN 55981 410693877 HOSPITAL MN 501(c)(3) 3 MINISTRY HEALTH CARE INC true ST JOSEPH'S HOSPITAL OF MARSHFIELD INC 611 SAINT JOSEPH AVENUE MARSHFIELD WI 54449 390847631 HOSPITAL WI 501(c)(3) 3 MINISTRY HEALTH CARE INC true SAINT MICHAEL'S FOUNDATION OF STEVENS POINT INC 900 ILLINOIS AVENUE STEVENS POINT WI 54481 391657410 FOUNDATION WI 501(c)(3) Type I ASCENSION ST MICHAEL'S HOSPITAL INC true ST ELIZABETH HOSPITAL FOUNDATION INC 1506 S ONEIDA STREET APPLETON WI 54915 391256677 FOUNDATION WI 501(c)(3) 7 AFFINITY HEALTH SYSTEM true THE HOWARD YOUNG MEDICAL CENTER INC 240 MAPLE STREET WOODRUFF WI 54568 390873606 HOSPITAL WI 501(c)(3) 3 MINISTRY HEALTH CARE INC true VOLUNTEERS IN PARTNERSHIP WITH WHEATON FRANCISCAN HEALTHCARE-ALL SAINTS INC 3807 SPRING STREET RACINE WI 53405 930838390 FOUNDATION WI 501(c)(3) 10 ASCENSION ALL SAINTS HOSPITAL INC (FKA WHEATON FRANCISCAN HEALTHCARE-ALL SA INTS INC) true WHEATON FRANCISCAN - ELMBROOK MEMORIAL FOUNDATION INC 3237 SOUTH 16TH STREET MILWAUKEE WI 53215 392028808 FOUNDATION WI 501(c)(3) Type I ASCENSION SE WISCONSIN HOSPITAL INC (FKA WHEATON FRANCISCAN INC) true WHEATON FRANCISCAN - ST JOSEPH FOUNDATION INC 5000 WEST CHAMBERS STREET MILWAUKEE WI 53210 391636804 FOUNDATION WI 501(c)(3) Type I ASCENSION SE WISCONSIN HOSPITAL INC (FKA WHEATON FRANCISCAN INC) true WHEATON FRANCISCAN HEALTHCARE-SOUTHEAST WISCONSIN INC 400 WEST RIVER WOODS PARKWAY GLENDALE WI 53212 391568865 PARENT CORPORATION IL 501(c)(3) Type III-FI ASCENSION HEALTH false WHEATON FRANCISCAN HEALTHCARE - ALL SAINTS FOUNDATION INC 3805B SPRING STREET RACINE WI 53405 391570877 FOUNDATION WI 501(c)(3) 7 ASCENSION ALL SAINTS HOSPITAL INC (FKA WHEATON FRANCISCAN HEALTHCARE-ALL SA INTS INC) true WHEATON FRANCISCAN HEALTHCARE-CIRCLE OF LIFE FOUNDATION INC 4300 BROWN DEER ROAD SUITE 250 BROWN DEER WI 53223 562426294 FOUNDATION WI 501(c)(3) Type I ASCENSION WISCONSIN PHARMACY INC (FKA WHEATON FRANCISCAN HEALTHCARE-PHARMAC Y ENTERPRISES & FRANCISCAN WOODS INC) true WHEATON FRANCISCAN HEALTHCARE - ELMBROOK MEMORIAL AUXILIARY 19333 WEST NORTH AVENUE BROOKFIELD WI 53045 396068950 AUXILIARY WI 501(c)(3) Type III-FI ASCENSION SE WISCONSIN HOSPITAL INC (FKA WHEATON FRANCISCAN INC) true WHEATON FRANCISCAN HEALTHCARE - FOUNDATION FOR ST FRANCIS AND FRANKLIN INC 3237 SOUTH 16TH STREET MILWAUKEE WI 53215 320135258 FOUNDATION WI 501(c)(3) Type I ASCENSION ST FRANCIS HOSPITAL INC (FKA WHEATON FRANCISCAN HEALTHCARE-ST FRA NCIS INC) true WHEATON FRANCISCAN HEALTHCARE-FRANKLIN INC 10101 SOUTH 27TH STREET FRANKLIN WI 53132 562592868 HOSPITAL WI 501(c)(3) 3 WHEATON FRANCISCAN HEALTHCARE-SOUTHEAST WISCONSIN INC true WISCONSIN PSYCHOANALYTIC FOUNDATION INC 2323 NORTH LAKE DRIVE 1ST FLOOR MILWAUKEE WI 53211 391377923 FOUNDATION WI 501(c)(3) 7 COLUMBIA ST MARY'S HOSPITAL MILWAUKEE INC true TWINMED LLP 222 W COLLEGE AVE SUITE 3B APPLETON WI 54911 391180341 REAL ESTATE WI NA N/A PROSPECT MEDICAL COMMONS CONDOMINIUM ASSOCIATION INC 4425 N PORT WASHINGTON RD GLENDALE WI 53212 208042108 CONDO ASSOCIATION WI NA C Corporation true FRANKLIN MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION INC 400 WEST RIVER WOODS PARKWAY GLENDALE WI 53212 341983857 CONDO ASSOCIATION WI NA C Corporation true WHEATON FRANCISCAN HOLDINGS INC 400 WEST RIVER WOODS PARKWAY GLENDALE WI 53212 391836357 HOLDING CO WI NA C Corporation true WHEATON FRANCISCAN PROVIDER NETWORK INC 400 WEST RIVER WOODS PARKWAY GLENDALE WI 53212 391952140 PROVIDER CONTRACT WI NA C Corporation true MADISON MEDICAL AFFILIATES INC 4425 N PORT WASHINGTON RD GLENDALE WI 53212 391855720 HEALTHCARE WI NA C Corporation true WHEATON WAY CONDOMINIUM OWNERS ASSOCIATION INC 10101 SOUTH 27TH STREET FRANKLIN WI 53123 300659830 CONDO ASSOCIATION WI NA C Corporation true WHEATON FRANCISCAN ENTERPRISES INC 400 WEST RIVER WOODS PARKWAY GLENDALE WI 53212 391985204 HOLDING CO WI NA C Corporation true WHEATON FRANCISCAN MEDICAL GROUP - SUSSEX INC 400 WEST RIVER WOODS PARKWAY GLENDALE WI 53212 391361100 HEALTHCARE WI NA C Corporation true false false false false false false false false false true true true true true true true true true false ASCENSION CALUMET HOSPITAL INC L 154883 FAIR MARKET VALUE ASCENSION CALUMET HOSPITAL INC Q 956022 FAIR MARKET VALUE ASCENSION GOOD SAMARITAN HOSPITAL INC Q 50354 FAIR MARKET VALUE ASCENSION MEDICAL GROUP-FOX VALLEY INC (FKA NETWORK HEALTH SYSTEM INC) L 403089 FAIR MARKET VALUE ASCENSION MEDICAL GROUP-FOX VALLEY INC (FKA NETWORK HEALTH SYSTEM INC) Q 607799 FAIR MARKET VALUE ASCENSION MEDICAL GROUP-NORTHERN WISCONSIN INC (FKA MINISTRY MEDICAL GROUP INC) L 7296034 FAIR MARKET VALUE ASCENSION MEDICAL GROUP-NORTHERN WISCONSIN INC (FKA MINISTRY MEDICAL GROUP INC) Q 796741 FAIR MARKET VALUE ASCENSION ST CLARES HOSPITAL INC Q 99275 FAIR MARKET VALUE ASCENSION ST MICHAEL'S HOSPITAL INC L 700272 FAIR MARKET VALUE ASCENSION ST MICHAEL'S HOSPITAL INC P 504268 FAIR MARKET VALUE ASCENSION ST MICHAEL'S HOSPITAL INC Q 967254 FAIR MARKET VALUE THE HOWARD YOUNG MEDICAL CENTER INC K 184623 FAIR MARKET VALUE THE HOWARD YOUNG MEDICAL CENTER INC L 345594 FAIR MARKET VALUE THE HOWARD YOUNG MEDICAL CENTER INC P 132000 FAIR MARKET VALUE THE HOWARD YOUNG MEDICAL CENTER INC Q 120478 FAIR MARKET VALUE