2019-05-14T17:48:39-05:00 2018-06-30 990 2017-07-01 390907740 ASCENSION ST FRANCIS HOSPITAL INC (FKA WHEATON FRANCISCAN HEALTHCARE - ST F RANCIS INC) ASCE 3147338000 3237 S 16th St Milwaukee WI 53215 Tonya Mershon Tax Officer 2019-05-14 2017 2020-01-14 16:20:31Z TRAVIS ANDERSEN 400 W RiVER WOODS PKWY GLENDALE WI 53212 173762871 false 0928 X https://healthcare.ascension.org/Locations/Wisconsin/WIWHE/Milwaukee-Ascension-St-Francis-Hospital X 1946 WI TO IMPROVE THE HEALTH AND WELL-BEING OF ALL PEOPLE IN THE COMMUNITIES WE SERVE. 9 2 1344 125 0 4343 479569 56053 185086889 171441626 117562 1345 2125937 2259450 187809957 173758474 490343 0 0 0 73948716 64755382 0 0 72598 98547914 113468791 172986973 178224173 14822984 -4465699 149779060 105283962 206077602 32404568 -56298542 72879394 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 108778627 0 171441626 ASCENSION ST. FRANCIS HOSPITAL, INC. (F/K/A WHEATON FRANCISCAN HEALTHCARE-ST. FRANCIS, INC.) IS A 155-BED HOSPITAL CAMPUS PROVIDING SERVICES WITHOUT REGARD TO PATIENT RACE, CREED, NATIONAL ORIGIN, ECONOMIC STATUS, OR ABILITY TO PAY. DURING FISCAL YEAR 2018, ASCENSION ST. FRANCIS HOSPITAL, INC. (F/K/A WHEATON FRANCISCAN HEALTHCARE-ST. FRANCIS, INC.) TREATED 6,197 ADULTS AND CHILDREN FOR A TOTAL OF 32,348 PATIENT DAYS OF SERVICE. THE HOSPITAL ALSO PROVIDED SERVICES FOR 160,773 OUTPATIENT VISITS, WHICH INCLUDED 1,984 OUTPATIENT SURGERIES AND 39,862 EMERGENCY ROOM VISITS. SEE SCHEDULE H FOR A NON-EXHAUSTIVE LIST OF COMMUNITY BENEFIT PROGRAMS AND DESCRIPTIONS. 108778627 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 false true true true false false true 122 0 true 1344 true false false false false false false true false false false X 9 2 false false false false true true true true true false false false true true true true true false false false WI X SARA OBRIEN 3147338070 11775 BORMAN DRIVE MARYLAND HEIGHTS MO 63146 TRAVIS D ANDERSEN CHAIR 1.0 49.0 X X 0 1367565 44454 TIMOTHY J RICHMAN VICE CHAIR 1.0 49.0 X X 0 407937 45835 JERRY M HARDACRE MD SECRETARY/TREASURER 1.0 49.0 X X 0 421566 45597 SETH R TEIGEN BOARD MEMBER/HOSPITAL PRESIDENT 24.0 26.0 X X 247446 0 35168 JAWWAD KHAN MD BOARD MEMBER 1.0 3.0 X 0 0 0 THOMAS MAHN MD BOARD MEMBER 1.0 49.0 X 0 448920 52569 JIM MAZZULLA MD BOARD MEMBER 1.0 3.0 X 0 0 0 BOBBY WU MD BOARD MEMBER 1.0 49.0 X 0 227691 22790 KEVIN JOHN KLUESNER BOARD MEMBER 1.0 49.0 X 0 338950 44158 JONATHAN SOHN CFO - ASCENSION, WI 1.0 49.0 X 0 903904 48367 JILL M BERG PHD VP-PATIENT CARE 25.0 25.0 X 0 286012 33902 MUSHIR B HASSAN VP-MEDICAL AFFAIRS 25.0 25.0 X 0 390267 52069 RHONDA A KAZIK VP-CNO 50.0 0 X 241255 0 10688 DEBRA GILBERTSON RN-NURSE PRACTITIONER 50.0 0 X 193912 0 17364 JEANEEN R DATKA LEAD - PHARMACIST 50.0 0 X 183911 0 15370 FREDDIE M REED-DAVIS RN-NURSE PRACTITIONER 50.0 0 X 175524 0 29003 MARLENE S JAMES REG DIR IMAGING SERVICES 50.0 0 X 173487 0 12546 CHRISTOPHER M TRZNADEL ADMIN DIR-PT CARE SRVCS OPS 50.0 0 X 166820 0 19863 DEBRA STANDRIDGE FORMER OFFICER (END 9/2016) 0.0 50.0 X 0 825914 36007 SUSAN BOLAND FORMER OFFICER (END 4/2017) 0.0 0.0 X 0 557653 14315 1382355 6176379 580065 43 true true false CENTER FOR NEUROLOGICAL DISORDERS SC 3237 S 16TH ST FLOOR 1 MILWAUKEE WI 532154526 NEUROLOGICAL SERVICES 326902 WISCONSIN VASCULAR ACCESS SERVICE LLC 6150 W LAYTON AVE GREENFIELD WI 532204608 PHYSICIAN SERVICES 261650 GREATER MILW CRITICAL CARE 3201 S 16TH ST SUITE 2015 MILWAUKEE WI 532154532 PHYSICIAN SERVICES 164450 WI CARDIOVASCULAR SERVICES LLC 10150 W NATIONAL AVE STE 190 SUITE 190 WEST ALLIS WI 53227 CARDIOVASCULAR SERVICES 153274 TRUST HEALTHCARE SERVICES LLC 2305 S BLACKMAN ROAD SUITE D SPRINGFIELD MO 658092809 STAFFING SERVICES 123960 8 X 0 0 0 56053 0 0 56053 NET PATIENT SERVICE REVENUE 621990 171189741 171189741 CONTRACTED SERVICES REVENUE 900099 251780 251780 MANAGEMENT FEES 561000 105 105 0 0 0 0 171441626 3590 3590 0 0 0 0 1250025 0 0 1250025 0 1250025 1250025 0 0 2245 0 -2245 -2245 -2245 0 0 0 0 96336 2152 94184 94184 CAFETERIA/VENDING REVENUE 722514 791983 791983 NEDUCAK RECORDS FEES 900099 123165 123165 93 0 0 93 915241 173758474 171441626 0 2260795 534557 507829 26728 50432184 47977030 2455154 10108836 9616647 492189 3679805 3500617 179188 5585 5585 13992 13992 4277026 510270 3771744 -4988 3788 2152 520 1116 276368 187760 84554 4054 66597 66597 2773288 5963 2767325 24026 9170 10302 4554 22794 18590 4586 -382 1521 1521 5035864 2499244 2536487 133 MEDICAL SUPPLIES 31258200 33728611 -2470411 MANAGEMENT FEE TO AFFILIATE 22735314 22735314 CORPORATE ALLOCATIONS 20672388 20672388 PURCHASED SERVICES 12007107 1427286 10579821 14294933 8719340 5507482 68111 178224173 108778627 69372948 72598 5050 5355 91058 0 0 0 26771892 23352226 0 0 0 0 0 0 5420109 5254821 0 93564 77205757 11627171 64191928 65578586 0 0 0 0 0 14370 53299023 10985040 149779060 105283962 11222174 9520062 0 0 0 0 0 0 0 0 0 0 0 0 0 0 194855428 22884506 206077602 32404568 X -56389600 72788336 91058 91058 0 0 -56298542 72879394 149779060 105283962 X -4465699 133643635 X false true X true false X false false false false false false false false true 13992 13992 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 St. Francis Hospital, Inc. does not participate in or intervene in (including the publishing or distributing or 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 St. Francis Hospital, Inc. does not participate in or intervene in (including the publishing or distributing or statements) any political campaign on behalf of (or in opposition to) any candidate for public office. 5760000 5760000 55623066 5043064 50580002 0 0 0 14213190 6319889 7893301 1609501 264218 1345283 65578586 DUE FROM AFFILIATES 9664177 OTHER MISCELLANEOUS ASSETS 6 ESTIMATED 3RD PARTY PAYOR SETTLEMENTS 1202624 OTHER RECEIVABLES 118233 10985040 0 LONG TERM FIN 47 LIABILITIES ESTIMATED 3RD PARTY PAYOR SETTLEMENT 3681297 DUE TO AFFILIATES 17164651 INTERCOMPANY DEBT WITH ASCENSION HEALTH ALLIANCE/OTHER DEBT OTHER LIABILITIES RECOVERY TAIL LIABILITY 432640 VALUATION ALLOWANCE 280211 ASSET RETIREMENT OBLIGATION 1108052 ACCRUED TAX LIABILITY 217655 22884506 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 true false true true 4055308 60659 3994649 0.0224 45558451 35366727 10191724 0.0572 0 0.0 0 0 49613759 35427386 14186373 0.0796 126631 12029 114602 0.0006 706379 0 706379 0.0040 3513 0 3513 0.0000 0 0 0 0.0 78178 0 78178 0.0004 0 0 914701 12029 902672 0.0051 0 0 50528460 35439415 15089045 0.0847 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 440 440 0.0000 0 0.0 0 0.0 0 0.0 0 0 440 0 440 0.0000 false 2575025 51221 67640238 78614093 -10973855 X true true 1 1 ASCENSION ST FRANCIS HOSPITAL INC 3237 SOUTH 16TH STREET MILWAUKEE WI 53215 https://healthcare.ascension.org/Locations/Wisconsin/WIWHE/Milwaukee-Ascension-St-Francis-Hospital 75 (WI) X X X SCHOOL OF ULTRASOUND 1 1 1 false false true X X X X X X X X X 15 true true false true X https://healthcare.ascension.org/Locations/Wisconsin/WIWHE/Milwaukee-Ascension-St-Francis-Hospital/C X X true 15 true https://healthcare.ascension.org/Locations/Wisconsin/WIWHE/Milwaukee-Ascension-St-Francis-Hospital/C false true X 250.0 400.0 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 X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3E 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, 1 Facility 1, 1 - ASCENSION ST. FRANCIS HOSPITAL, INC. (F/K/A WHEATON FRANCISCAN HEALTHCARE-ST. FRANCIS, INC.). WHEATON FRANCISCAN HEALTHCARE PARTNERED WITH THE MILWAUKEE HEALTH CARE PARTNERSHIP WHICH INCLUDES AURORA HEALTH CARE, CHILDREN'S HOSPITAL OF WISCONSIN, COLUMBIA ST. MARY'S HEALTH SYSTEM, FROEDTERT HEALTH AND PUBLIC HEALTH DEPARTMENTS TO COLLABORATIVELY CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT. THIRD-PARTY ORGANIZATIONS, JKV RESEARCH, LLC AND CENTER FOR URBAN POPULATION HEALTH WERE CONTRACTED TO HELP CONDUCT THE ASSESSMENT. THE ASSESSMENT CONSISTED OF 3 KEY PROCESSES IN ORDER TO OBTAIN DATA, A TELEPHONE HEALTH SURVEY, SECONDARY DATA RESEARCH AND KEY INFORMANT INTERVIEWS AND FOCUS GROUPS. A TOTAL OF 1,967 TELEPHONE INTERVIEWS WERE COMPLETED BETWEEN MARCH 16 AND JULY 14, 2015 FOR MILWAUKEE COUNTY INCLUDING 1,200 INTERVIEWS DURING THE SAME TIMEFRAME FOR THE CITY OF MILWAUKEE; 400 TELEPHONE INTERVIEWS WERE COMPLETED BETWEEN FEBRUARY 2 AND FEBRUARY 23, 2015 FOR WAUKESHA COUNTY; AND 1,967 TELEPHONE INTERVIEWS WERE COMPLETED BETWEEN FEBRUARY 2 AND MARCH 3, 2015 FOR RACINE COUNTY INCLUDING 400 INTERVIEWS DURING THE SAME TIMEFRAME FOR THE CITY OF RACINE. THE THIRD PIECE OF THE ASSESSMENT PROCESS WAS CONDUCTING INTERVIEWS AND FOCUS GROUPS WITH KEY STAKEHOLDERS IN THE COMMUNITY IN THE SPRING AND SUMMER OF 2015. A LIST OF THE ORGANIZATIONS THAT PROVIDE INPUT ARE LISTED BELOW. EACH OF THESE ORGANIZATIONS SERVES THE MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS. * UNITED WAY OF GREATER MILWAUKEE * CITY OF MILWAUKEE HEALTH DEPARTMENT * NORTH SHORE HEALTH DEPARTMENT * MILWAUKEE COUNTY OF HEALTH AND HUMAN SERVICES * CHILDREN'S HEALTH ALLIANCE OF WISCONSIN * NORTH SHORE HEALTH DEPARTMENT * UNITED COMMUNITY CENTER * THE FAYE MCBEATH FOUNDATION * AIDS RESOURCE CENTER OF WISCONSIN * COMMUNITY SERVICES FOR CHILDREN'S HOSPITAL AND HEALTH SYSTEM * CHILDREN'S HOSPITAL OF WISCONSIN * WISCONSIN DEPARTMENT OF PUBLIC HEALTH SERVICES * GREATER MILWAUKEE FOUNDATION * MILWAUKEE COMMON COUNCIL * WAUWATOSA HEALTH DEPARTMENT * HELEN BADER FOUNDATION * BLACK HEALTH COALITION OF WISCONSIN * MEDICAL COLLEGE OF WISCONSIN INSTITUTE FOR HEALTH AND SOCIETY * WEST ALLIS AND WEST MILWAUKEE HEALTH DEPARTMENT * SOUTH MILWAUKEE HEALTH DEPARTMENT * UW-MILWAUKEE JOSEPH J. ZILBER SCHOOL OF PUBLIC HEALTH * YWCA MILWAUKEE * HALES CORNERS HEALTH DEPARTMENT * MEDICAL SOCIETY OF MILWAUKEE COUNTY * OAK CREEK HEALTH DEPARTMENT * GREENFIELD HEALTH DEPARTMENT * SAINT FRANCIS HEALTH DEPARTMENT * GREENDALE HEALTH DEPARTMENT * UNCOM (UNITED NEIGHBORHOOD CENTERS OF MILWAUKEE * MILWAUKEE ORAL HEALTH TASK FORCE * COLUMBIA ST. MARY'S * MILWAUKEE HEALTH CARE PARTNERSHIP * LINDSAY HEIGHTS HEALTH ALLIANCE * COMMUNITY ADVOCATES * CUDAHY HEALTH DEPARTMENT * YMCA OF METRO MILWAUKEE * LATINO HEALTH COALITION * BOYS AND GIRLS CLUB OF GREATER MILWAUKEE * STAFF HOUSING AUTHORITY OF THE CITY OF MILWAUKEE * RESIDENTS FROM PARKLAWN AND HIGHLAND GARDENS Schedule H, Part V, Section B, Line 6a Facility 1, 1 Facility 1, 1 - ASCENSION ST. FRANCIS HOSPITAL, INC.. FOR ALL OUR HOSPITAL FACILITIES, OUR COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED WITH THE FOLLOWING OTHER HOSPITAL FACILITIES: AURORA HEALTH CARE CHILDREN'S HOSPITAL OF WISCONSIN COLUMBIA ST. MARY'S HEALTH SYSTEM FROEDTERT HEALTH. Schedule H, Part V, Section B, Line 7 Facility 1, 1 Facility 1, 1 - ASCENSION ST. FRANCIS HOSPITAL, INC.. SEVERAL REPORTS APPLICABLE TO OUR WISCONSIN HOSPITAL FACILITIES ARE AVAILABLE AT THE MILWAUKEE HEALTH CARE PARTNERSHIP'S (MHCP) WEBSITE AT HTTP://MKEHCP.ORG/PUBLICATIONS. MHCP IS A PUBLIC / PRIVATE CONSORTIUM DEDICATED TO IMPROVING HEALTH CARE COVERAGE, ACCESS, AND CARE COORDINATION FOR UNDERSERVED POPULATIONS IN MILWAUKEE COUNTY, WITH THE GOALS OF IMPROVING HEALTH OUTCOMES, ELIMINATING DISPARITIES, AND REDUCING THE TOTAL COST OF CARE. Schedule H, Part V, Section B, Line 11 Facility 1, 1 Facility 1, 1 - ASCENSION ST. FRANCIS HOSPITAL, INC.(F/K/A WHEATON FRANCISCAN HEALTHCARE-ST. FRANCIS, INC.). USING THE CHNA COMPLETED IN JUNE 2016, THE HOSPITAL DEVELOPED, ADOPTED, AND WORKED ON EXECUTING A THREE-YEAR IMPLEMENTATION STRATEGY TO ADDRESS PRIORITY COMMUNITY HEALTH NEEDS. IN FISCAL YEAR 2017 (TAX YEAR 2016), THE HOSPITAL IMPLEMENTED THE FOLLOWING PLAN TO ADDRESS THE PRIORITY NEEDS: AODA -- INFORMED PATIENTS ABOUT AODA SERVICES -- SCREENED NEWBORNS FOR AODA CONCERNS HEALTHY LIFESTYLES -- PROVIDED BREASTFEEDING EDUCATOIN TO NEW MOTHERS -- PROVIDED EDUCATIONAL INFORMATION ON HEALTHY EATING INFANT MORTALITY -- PROVIDED INFORMATION TO NEW MOTHERS ABOUT SAFE SLEEP -- COLLABORATED WITH LOCAL CHURCH ON HEALTH EDUCATION FOR COMMUNITY -- IMPROVED ACCESS TO PRENATAL DENTAL HEALTH SERVICES ------------------------------------------------------------------------------------------------------------------------------------ EXPLANATION ON NEEDS IDENTIFIED IN CHNA THAT ARE NOT BEING ADDRESSED: WHILE OUR ORGANIZATION UNDERSTANDS THE IMPORTANCE OF MEETING ALL OF THE NEEDS OF THE COMMUNITY, AN IN-DEPTH ASSESSMENT WAS COMPLETED IN WHICH THE KEY LEADERS INVOLVED WITH WORK WITHIN MOSH WERE ABLE TO IDENTIFY THE NEEDS THAT WOULD BE MOST IMPACTED BY THE SITE. THE TOP HEALTH NEEDS IDENTIFIED BY MOSH LEADERSHIP TEAM THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT THAT WERE NOT A PART OF THE CURRENT IMPLEMENTATION PLAN WERE AS FOLLOWS: COVERAGE: MOSH FEELS THAT THIS SIGNIFICANT NEED IS OUTSIDE OF OUR SCOPE OF SERVICES. WE ARE COMMITTED TO FOCUSING EFFORTS ON PROVIDING ACCESS TO CARE TO THOSE WITHIN OUR COMMUNITY REGARDLESS OF THEIR COVERAGE. WE WILL CONTINUE TO SUPPORT OTHER INITIATIVES REGARDING THIS NEED IN A SECONDARY CAPACITY WHEN NECESSARY. MENTAL AND BEHAVIORAL HEALTH: WHILE MOSH UNDERSTANDS THIS GROWING CONCERN, AT THE TIME OF ASSESSMENT, THE RESOURCES AND EXPERTISE WERE NOT AVAILABLE TO ADDRESS AND MAKE A MEANINGFUL IMPACT ON MENTAL AND BEHAVIORAL HEALTH. DURING THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS, THE MILWAUKEE HEALTH CARE PARTNERSHIP WAS MADE AWARE OF SEVERAL EXISTING STRATEGIES THROUGH OUR KEY INFORMANTS. KEY INFORMANTS NAMED THE FOLLOWING EXISTING STRATEGIES IN THE COUNTY TO ADDRESS MENTAL HEALTH: INPATIENT AND OUTPATIENT MENTAL HEALTH SERVICES; INCREASED BULLYING AWARENESS; HOUSING FIRST STRATEGY; COMMUNITY BEHAVIORAL HEALTH REDESIGN IS UNDERWAY; MILWAUKEE CENTER FOR INDEPENDENCE PROGRAMMING THAT MANAGES MEDICATION AND RE-INTEGRATES PEOPLE WITH MENTAL HEALTH ISSUES INTO THE COMMUNITY, JOBS, AND HOUSING; CRISIS INTERVENTION TRAINING FOR EMPLOYEES; EFFORTS WITHIN SCHOOLS AND SCHOOL-COMMUNITY PARTNERSHIPS; MENTAL AND BEHAVIORAL HEALTH TASK FORCES; IMPLEMENTING TRAUMA INFORMED CARE; AND MORE MENTAL HEALTH PROVIDERS ARE BEING ADDED IN THE COMMUNITY. ALCOHOL AND DRUG USE: WHILE MOSH UNDERSTANDS THIS GROWING CONCERN, AT THE TIME OF ASSESSMENT, THE RESOURCES AND EXPERTISE WERE NOT AVAILABLE TO ADDRESS AND MAKE A MEANINGFUL IMPACT ON ALCOHOL AND DRUG USE. DURING THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS, THE MILWAUKEE HEALTH CARE PARTNERSHIP WAS MADE AWARE OF SEVERAL EXISTING STRATEGIES THROUGH OUR KEY INFORMANTS. KEY INFORMANTS INDICATED A NUMBER OF ORGANIZATIONS ACROSS SECTORS ARE ALREADY ADDRESSING THESE ISSUES BY PROVIDING SERVICES, AND EDUCATION IS IN PLACE WITHIN THE SCHOOLS. SPECIFIC STRATEGIES NAMED INCLUDE NEEDLE EXCHANGE AND SHARPS COLLECTION PROGRAMS, PUBLIC CAMPAIGNS AND MEDIA COVERAGE OF THE ISSUES, PRESCRIPTION DRUG DROP OFF LOCATIONS, THE WISCONSIN PRESCRIPTION DRUG MONITORING PROGRAM (PDMP), MEDICATION LOCK BOXES SOLD AT COST, THE COMMUNITY HEALTH IMPROVEMENT PLAN, AND COMMUNITY CAPACITY BUILDING. WE ARE COMMITTED TO SUPPORTING THESE EFFORTS IN A SECONDARY CAPACITY AS NECESSARY. INJURY AND VIOLENCE: MOSH FEELS THAT THIS SIGNIFICANT NEED IS OUTSIDE OF OUR SCOPE OF SERVICES. DURING THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS, THE MILWAUKEE HEALTH CARE PARTNERSHIP WAS MADE AWARE OF SEVERAL EXISTING STRATEGIES THROUGH OUR KEY INFORMANTS. EXISTING STRATEGIES TO ADDRESS INJURY PREVENTION INCLUDE HOME ASSESSMENT, INJURY PREVENTION PROGRAMS FOR SENIORS, NEWSLETTERS, CAR SEAT CHECKS AND CAR SAFETY PROGRAMS, BICYCLE RODEOS, MESSAGES IN SCHOOL PLANNERS, PROMOTION OF HELMET USE, AND PEDESTRIAN SAFETY MESSAGING. RELATED TO CRIME, VALIDATED RISK ASSESSMENT TOOLS, ADDRESSING POVERTY, COMMUNITY POLICING, THE COMMUNITY JUSTICE COUNCIL, HOTSPOTTING, PROJECT UJIMA, THE MEDICAL COLLEGE OF WISCONSIN INJURY RESEARCH CENTER, AND THE MILWAUKEE PEACE SUMMIT WERE EXISTING STRATEGIES NAMED. REGARDING FAMILY VIOLENCE AND CHILD ABUSE, SOJOURNER FAMILY PEACE CENTER'S PROGRAMS; THE HMONG AMERICAN WOMEN'S ASSOCIATION'S PROGRAMS, SERVICES, AND SUPPORT WITHIN THE CLAN SYSTEM; THE SAFE AND SOUND COLLABORATIVE; FAMILY SUPPORT SERVICES; IMPLEMENTING TRAUMA INFORMED CARE PRINCIPLES; DENIM DAY AND OTHER AWARENESS CAMPAIGNS; AND MINDFULNESS PROGRAMS WERE NAMED AS EXISTING STRATEGIES TO ADDRESS VIOLENCE. DUE TO THE LACK OF RESOURCES AND EXPERTISE MOSH IN THIS AREA, WE HAVE COMMITTED TO SUPPORTING THIS NEED IN A SECONDARY CAPACITY AS NECESSARY. CHRONIC DISEASE, HIGH BLOOD PRESSURE, NUTRITION AND OBESITY: MOSH FEELS THAT THIS GROWING CONCERN IS OUTSIDE OF THEIR SCOPE OF SERVICES BUT IS AWARE THAT OUR FRANKLIN CAMPUS IS FOCUSING THEIR EFFORTS IN THIS NEED. MOSH IS COMMITTED TO SUPPORTING FRANKLIN IN A SECONDARY CAPACITY AS NECESSARY. Schedule H, Part V, Section B, Line 16 Facility 1, 1 Facility 1, 1 - ASCENSION ST. FRANCIS HOSPITAL, INC.. WHEATON FRANCISCAN HEALTHCARE TAKES SEVERAL PROACTIVE APPROACHES TO MAKE OUR PATIENTS AWARE OF OUR FINANCIAL ASSISTANCE POLICY. IN ADDITION TO OUR POLICY BEING POSTED ON OUR WEBSITE AND AVAILABLE TO ANYONE WHO REQUESTS ONE, THERE IS ABUNDANT SIGNAGE THROUGHOUT OUR FACILITY EXPLAINING OUR FINANCIAL ASSISTANCE POLICY AND HOW TO OBTAIN THE ACTUAL POLICY, IF DESIRED. NOTICES REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE ARE DISPLAYED IN HIGHLY VISIBLE LOCATIONS WHERE THERE IS A SIGNIFICANT VOLUME OF INPATIENT OR OUTPATIENT TRAFFIC SUCH AS IN PATIENT ADMITTING AND REGISTRATION AREAS (BOTH INPATIENT AND OUTPATIENT SETTINGS), PHYSICIAN OFFICES, AND EMERGENCY DEPARTMENTS. BROCHURES DESCRIBING THE POLICY ARE AVAILABLE IN THE SAME LOCATIONS, AND THE POLICY IS DISCUSSED AT THE TIME OF REGISTRATION OR PRE-REGISTRATION, ADMISSION, DISCHARGE, AND WITH BILLING FOR THOSE IDENTIFIED WITH A NEED. PATIENTS WHO CALL AND EXPRESS A FINANCIAL HARDSHIP WITH PAYING THEIR BILL WILL BE ASSISTED BY A CUSTOMER SERVICE REPRESENTATIVE, WHO WILL ASSIST THE PATIENT IN SETTING UP AN APPOINTMENT TO MEET WITH A FINANCIAL ADVOCATE WHO WILL GO OVER THE FINANCIAL ASSISTANCE POLICY IN DETAIL, GET THE FINANCIAL ASSISTANCE APPLICATION PROCESS STARTED, AND EDUCATE THE PATIENT REGARDING ANY QUESTIONS THEY MAY HAVE. LASTLY, OUR PATIENT STATEMENTS ALSO INCLUDE NOTIFICATIONS ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE AND A PHONE NUMBER TO CALL FOR MORE INFORMATION. ADDITIONALLY, OUR FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATION, AND PLAIN LANGUAGE SUMMARY ARE AVAILABLE ON OUR WEBSITE, HTTPS://WWW.MYWHEATON.ORG/ABOUT-WHEATON/BILLING-INFORMATION/#POLICY. THE FINANCIAL ASSISTANCE POLICY AND APPLICATION HAVE BEEN TRANSLATED INTO 8 LANGUAGES: ENGLISH, SPANISH, CHINESE, HMONG, LAOTIAN, ARABIC, RUSSIAN, AND SERBIAN/CROATIAN. IN THE CASE OF OUR PLAIN LANGUAGE SUMMARY, A 9TH LANGUAGE (TELUGU) IS AVAILABLE. 6 WHEATON FRANCISCAN HEALTHCARE - ST FRANCIS 2025 W OKLAHOMA AVE MILWAUKEE WI 53215 OUTPATIENT CLINIC WHEATON FRANCISCAN HEALTHCARE - ST FRANCIS 7410 W RAWSON AVE FRANKLIN WI 53132 OUTPATIENT CLINIC CANCER CARE WHEATON FRANCISCAN HEALTHCARE ST FRANCIS 3330 S 16TH STREET MILWAUKEE WI 53215 EDUCATION BUILDING WHEATON FRANCISCAN HEALTHCARE ST FRANCIS 3267 S 16TH STREET MILWAUKEE WI 53215 MEDICAL OFFICE BUILDING WHEATON FRANCISCAN HEALTHCARE ST FRANCIS 3201 S 16TH STREET MILWAUKEE WI 53215 MEDICAL OFFICE BUILDING ST FRANCIS OUTPATIENT CENTER 3237 SOUTH 16TH ST MILWAUKEE WI 53215 OUTPATIENT CENTER Schedule H, Part I, Line 7g Subsidized Health Services WHEATON FRANCISCAN HEALTHCARE HAS A SEPARATELY ORGANIZED ENTITY, ASCENSION MEDICAL GROUP-SOUTHEAST WISCONSIN, INC. (F/K/A WHEATON FRANCISCAN MEDICAL GROUP, INC.) WHERE ALL PHYSICIAN CLINIC COSTS ARE GROUPED. THE HOSPITAL HAS THEREFORE NOT INCLUDED ANY PHYSICIAN CLINIC COSTS IN SUBSIDIZED HEALTH SERVICES. 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. FRANCIS HOSPITAL, INC. (F/K/A WHEATON FRANCISCAN HEALTHCARE-ST. FRANCIS, INC.) PARTICIPATES ON A COMMUNITY COALITIONS AND OTHER COLLABORATIVE EFFORTS WITH THE COMMUNITY WHOSE PURPOSE IS TO IMPROVE THE HEALTH OF THE COMMUNITY. THIS INCLUDES THE MILWAUKEE LATINO HEALTH COALITION. 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 $8,046,954 AT CHARGES, ($2,575,025 AT COST). Schedule H, Part III, Line 3 Bad Debt Expense Methodology THE PROVISION FOR DOUBTFUL ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL EXPERIENCE, ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY, INCLUDING THOSE AMOUNTS NOT COVERED BY INSURANCE. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR DOUBTFUL ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS. 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 1 - ASCENSION ST. FRANCIS HOSPITAL, INC.: Line 16a URL: https://healthcare.ascension.org/Financial-Assistance/Wisconsin; Schedule H, Part V, Section B, Line 16b FAP Application website 1 - ASCENSION ST. FRANCIS HOSPITAL, INC.: Line 16b URL: https://healthcare.ascension.org/Financial-Assistance/Wisconsin; Schedule H, Part V, Section B, Line 16c FAP plain language summary website 1 - ASCENSION ST. FRANCIS HOSPITAL, INC.: 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 ST. FRANCIS HOSPITAL, INC. (F/K/A WHEATON FRANCISCAN HEALTHCARE-ST. FRANCIS, INC.) 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. ST. FRANCIS HOSPITAL UTILIZES THIS INFORMATION TO DETERMINE 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 ASCENSION ST. FRANCIS HOSPITAL, INC. (F/K/A WHEATON FRANCISCAN HEALTHCARE - ST. FRANCIS, INC.) IS COMMITTED TO DELIVERING EFFECTIVE, SAFE, PERSON-CENTRIC, HEALTH CARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. AS A NONPROFIT HOSPITAL (OR HEALTH SYSTEM), IT IS OUR MISSION AND PRIVILEGE TO PLAY THIS IMPORTANT ROLE IN OUR COMMUNITY. STAFF SCREEN UNINSURED PATIENTS AND IF FOUND POTENTIALLY ELIGIBLE FOR A GOVERNMENT FUNDING SOURCE, PROVIDE ASSISTANCE AND/OR RESOURCES TO THE PATIENT AND THEIR FAMILY. IF A PATIENT IS NOT ELIGIBLE FOR A PAYMENT SOURCE, WHEATON FRANCISCAN HEALTHCARE - ST. FRANCIS'S FINANCIAL ASSISTANCE POLICY COVERS PATIENTS WHO LACK THE FINANCIAL RESOURCES TO PAY FOR ALL OR PART OF THEIR BILLS. ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED UPON THE ANNUAL FEDERAL POVERTY GUIDELINES; WHEATON FRANCISCAN HEALTHCARE - ST. FRANCIS PROVIDES FINANCIAL ASSISTANCE FOR THOSE WHO EARN UP TO 400% OF THE FEDERAL POVERTY LEVEL. ASCENSION ST. FRANCIS HOSPITAL, INC. (F/K/A WHEATON FRANCISCAN HEALTHCARE - ST. FRANCIS, INC.) WIDELY PUBLICIZES ITS: - FINANCIAL ASSISTANCE POLICY - FINANCIAL ASSISTANCE APPLICATION - FINANCIAL ASSISTANCE POLICY SUMMARY - LIST OF PROVIDERS COVERED BY THE FINANCIAL ASSISTANCE POLICY VIA THE HOSPITAL FACILITY'S WEBSITE AT HTTPS://WWW.MYWHEATON.ORG/ABOUT-WHEATON/BILLING-INFORMATION/#POLICY ASCENSION ST. FRANCIS HOSPITAL, INC. (F/K/A WHEATON FRANCISCAN HEALTHCARE - ST. FRANCIS, INC.) MAKES PAPER COPIES OF ANY OF THESE DOCUMENTS AVAILABLE UPON REQUEST. - FINANCIAL ASSISTANCE POLICY - FINANCIAL ASSISTANCE APPLICATION - FINANCIAL ASSISTANCE POLICY SUMMARY - LIST OF PROVIDERS COVERED BY THE FINANCIAL ASSISTANCE POLICY - AMOUNT GENERALLY BILLED CALCULATION THE PAPER COPIES ARE MADE READILY AVAILABLE AS PART OF THE INTAKE, DISCHARGE AND CUSTOMER SERVICE PROCESSES. UPON REQUEST, PAPER COPIES CAN ALSO BE OBTAINED BY MAIL. ASCENSION ST. FRANCIS HOSPITAL, INC. (F/K/A WHEATON FRANCISCAN HEALTHCARE - ST. FRANCIS, INC.) INFORMS ITS PATIENTS OF THE FINANCIAL ASSISTANCE POLICY VIA A NOTICE ON PATIENT BILLING STATEMENTS, INCLUDING THE PHONE NUMBER AND WEB ADDRESS WHERE MORE INFORMATION MAY BE FOUND. ASCENSION ST. FRANCIS HOSPITAL, INC. (F/K/A WHEATON FRANCISCAN HEALTHCARE - ST. FRANCIS, INC.) ALSO INFORMS ITS PATIENTS OF THE FINANCIAL ASSISTANCE POLICY VIA SIGNAGE DISPLAYED IN THE EMERGENCY ROOM AND ADMISSIONS AREAS. Schedule H, Part VI, Line 4 Community information PLEASE SEE DETAILED INFORMATION PROVIDED AT SCHEDULE H PART V SECTION B LINES 1-12 AND PART VI LINE 5. Schedule H, Part VI, Line 5 Promotion of community health ASCENSION ST. FRANCIS HOSPITAL, INC. (F/K/A WHEATON FRANCISCAN HEALTHCARE - ST FRANCIS, INC.) GOVERNING BODY IS COMPRISED OF PERSONS REPRESENTING DIVERSE ASPECTS AND INTERESTS OF THE COMMUNITY. MANY MEMBERS OF WHEATON FRANCISCAN HEALTHCARE - ST FRANCIS GOVERNING BODY RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA; WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS OR SPECIALTIES. SURPLUS FUNDS TO FUND IMPROVEMENTS IN PATIENT CARE, MEDICAL EDUCATION, AND RESEARCH BY DONATIONS FROM WHEATON FRANCISCAN HEALTHCARE - FOUNDATION FOR ST. FRANCIS AND FRANKLIN, INC. PLEASE ALSO SEE PART III FOR COMMUNITY ACTIVITIES UNDERTAKEN BY THIS ORGANIZATION, AS WELL AS A COMPILATION OF REGIONAL CHARITY CARE INFORMATION. Schedule H, Part VI, Line 6 Affiliated health care system ASCENSION ST. FRANCIS HOSPITAL, INC. (F/K/A WHEATON FRANCISCAN HEALTHCARE - ST FRANCIS, INC.) IS AN AFFILIATE OF WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN, INC. AND ASCENSION HEALTH. ST FRANCIS'S AFFILIATES 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 POOR AND 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, 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 23 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. ASCENSION ST. FRANCIS HOSPITAL, INC. (F/K/A WHEATON FRANCISCAN HEALTHCARE - ST FRANCIS, INC.) PROMOTES THE HEALTH OF THE COMMUNITY BY PROVIDING HEALTHCARE SERVICES IN THE SOUTHEAST WISCONSIN AREA, OFTENTIMES REGARDLESS OF THE PERSON'S ABILITY TO PAY, BECAUSE IT IS OUR MISSION TO IMPROVE THE LIVES OF THOSE IN THE COMMUNITIES WE SERVE. true true false false false false false false false TRAVIS D ANDERSEN CHAIR 0 563166 0 701999 0 102400 0 13500 0 30954 0 1412019 0 0 TIMOTHY J RICHMAN VICE CHAIR 0 316516 0 68793 0 22628 0 14135 0 31700 0 453772 0 0 JERRY M HARDACRE MD SECRETARY/TREASURER 0 402548 0 14388 0 4630 0 17550 0 28047 0 467163 0 0 SETH R TEIGEN BOARD MEMBER/HOSPITAL PRESIDENT 221657 0 0 0 25789 0 12168 0 23000 0 282614 0 0 0 THOMAS MAHN MD BOARD MEMBER 0 418970 0 17866 0 12084 0 16200 0 36369 0 501489 0 0 BOBBY WU MD BOARD MEMBER 0 201748 0 25428 0 515 0 9997 0 12793 0 250481 0 0 KEVIN JOHN KLUESNER BOARD MEMBER 0 257247 0 58967 0 22736 0 16100 0 28058 0 383108 0 0 DEBRA STANDRIDGE FORMER OFFICER (END 9/2016) 0 493219 0 207295 0 125400 0 9931 0 26076 0 861921 0 0 SUSAN BOLAND FORMER OFFICER (END 4/2017) 0 167060 0 0 0 390593 0 7867 0 6448 0 571968 0 0 JONATHAN SOHN CFO - ASCENSION, WI 0 505898 0 270732 0 127274 0 14885 0 33482 0 952271 0 0 JILL M BERG PHD VP-PATIENT CARE 0 218607 0 50232 0 17173 0 14147 0 19755 0 319914 0 0 MUSHIR B HASSAN VP-MEDICAL AFFAIRS 0 187723 0 201189 0 1355 0 16582 0 35487 0 442336 0 0 RHONDA A KAZIK VP-CNO 193344 0 42551 0 5360 0 5924 0 4764 0 251943 0 0 0 DEBRA GILBERTSON RN-NURSE PRACTITIONER 191957 0 0 0 1955 0 11832 0 5532 0 211276 0 0 0 JEANEEN R DATKA LEAD - PHARMACIST 183473 0 0 0 438 0 11195 0 4175 0 199281 0 0 0 FREDDIE M REED-DAVIS RN-NURSE PRACTITIONER 175054 0 0 0 470 0 8315 0 20688 0 204527 0 0 0 MARLENE S JAMES REG DIR IMAGING SERVICES 154140 0 12354 0 6993 0 10935 0 1611 0 186033 0 0 0 CHRISTOPHER M TRZNADEL ADMIN DIR-PT CARE SRVCS OPS 146968 0 15114 0 4738 0 8321 0 11542 0 186683 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN, INC., A RELATED ORGANIZATION OF ASCENSION ST. FRANCIS HOSPITAL, INC., USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - 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 calendar year 2017: SUSAN BOLAND - $380,635 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 payments were made to listed persons in Part VII under the non-qualified retirement plan during the year. Form 990, Part VI, Line 15a PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL IN DETERMINING THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT, THE PROCESS PERFORMED BY WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN, INC., A RELATED ORGANIZATION OF ASCENSION ST. FRANCIS HOSPITAL, INC. (F/K/A WHEATON FRANCISCAN HEALTHCARE-ST. FRANCIS, INC.) INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE PRESIDENT 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 COMMITTEE MINUTES. THE INDIVIDUAL WAS NOT PRESENT WHEN HIS COMPENSATION WAS DECIDED. Form 990, Part VI, Line 15b PROCESS TO ESTABLISH COMPENSATION OF OTHER OFFICERS OR KEY EMPLOYEES IN DETERMINING COMPENSATION OF THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES, THE PROCESS PERFORMED BY WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN, INC., A RELATED ORGANIZATION OF ASCENSION ST. FRANCIS HOSPITAL, INC. (F/K/A WHEATON FRANCISCAN HEALTHCARE-ST. FRANCIS, INC.), 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' 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 ST. FRANCIS HOSPITAL, INC. (F/K/A WHEATON FRANCISCAN HEALTHCARE - ST. FRANCIS, INC.) HAS A SINGLE CORPORATE MEMBER, WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN, INC. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body ASCENSION ST. FRANCIS HOSPITAL, INC. (F/K/A WHEATON FRANCISCAN HEALTHCARE - ST. FRANCIS, INC.) HAS A SINGLE CORPORATE MEMBER, WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN, INC., WHO HAS THE ABILITY TO ELECT MEMBERS TO THE GOVERNING BODY OF WHEATON FRANCISCAN HEALTHCARE - ST. FRANCIS. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders ALL DECISIONS THAT HAVE A MATERIAL IMPACT TO ASCENSION ST. FRANCIS HOSPITAL, INC. (F/K/A WHEATON FRANCISCAN HEALTHCARE - ST. FRANCIS, INC.) FINANCIAL INFORMATION OR CORPORATION AS A WHOLE ARE SUBJECT TO APPROVAL BY ITS SOLE CORPORATE MEMBER, WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN, 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 11d Other Miscellaneous Revenue OTHER MISCELLANEOUS REVENUE - Total Revenue: 136279, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 136279; Services to Affiliates - Total Revenue: -136186, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: -136186; Form 990, Part XI, Line 9 Other changes in net assets or fund balances WRITE OFF OF NOTE PAYABLE WITH AFFILIATE - 1177986; TRANSFERS WITH ALPHA FUND - XXX-XX-XXXX; Form 990, Part XII, Line 2b AUDITED FINANCIAL STATEMENTS THE ACTIVITY OF ASCENSION ST. FRANCIS HOSPITAL, INC. (F/K/A WHEATON FRANCISCAN HEALTHCARE-ST. FRANCIS, INC.) IS REPORTED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF ASCENSION HEALTH ALLIANCE. NO INDIVIDUAL AUDIT OF ASCENSION ST. FRANCIS HOSPITAL, INC. (F/K/A WHEATON FRANCISCAN HEALTHCARE-ST. FRANCIS, INC.) IS COMPLETED. THEREFORE, THE ATTACHED AUDITED FINANCIAL STATEMENTS ARE OF ASCENSION HEALTH ALLIANCE AND AFFILIATES, WHICH INCLUDE THE ACTIVITY OF ASCENSION ST. FRANCIS HOSPITAL, INC. (F/K/A WHEATON FRANCISCAN HEALTHCARE-ST. FRANCIS, INC.). Form 990, Part XII, Line 2c AUDIT COMMITTEE ASCENSION ST. FRANCIS HOSPITAL, INC. (F/K/A WHEATON FRANCISCAN HEALTHCARE-ST. FRANCIS, 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. 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 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