2019-05-14T17:35:59-05:00 2018-06-30 990 2017-07-01 390808443 Ascension St Michael's Hospital Inc ASCE 3147338000 900 Illinois Avenue Stevens Point WI 54481 Tonya Mershon Tax Officer 2019-05-14 2017 2019-02-21 02:37:17Z Debra Standridge 400 W River Woods Parkway Glendale WI 53212 190845358 false 0928 X https://healthcare.ascension.org/Locations/Wisconsin/WIAPM/Stevens-Point-Saint-Michaels-Hospital X 1955 WI TO IMPROVE THE HEALTH AND WELL-BEING OF ALL PEOPLE IN THE COMMUNITIES WE SERVE. 13 13 1198 200 0 0 239855 246897 184656053 189325843 -8086 -4777 965743 1065180 185853565 190633143 0 356074 0 0 92762925 82095432 0 0 0 84677916 103018708 177440841 185470214 8412724 5162929 116346533 121137970 39053957 36473427 77292576 84664543 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 123656969 356074 189325843 Ascension St. Michael's Hospital, Inc. is a 50-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. Michael's Hospital, Inc. treated 4,180 adults and children for a total of 12,516 patient days of service. The hospital also provided services for 474,449 outpatient visits, which included 3,084 outpatient surgeries and 19,007 Emergency Room Visits. See Schedule H for a non-exhaustive list of community benefit programs and descriptions. 123656969 true true false true false false false false true true false false true true true false true false false false false false false false false true true true false true false false false false false false false false false false false false false true true true false false true 160 0 true 1198 true true true false false false false false true false false false X 13 13 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 RICK RETTLER CHAIR 1.0 4.0 X X 0 0 0 JAMIE SCHAEFER VICE CHAIR 1.0 4.0 X X 0 0 0 BRENDA DILLENBURG SECRETARY/TREASURER 1.0 4.0 X X 0 0 0 KEVIN NOEL BOARD MEMBER 1.0 4.0 X 0 0 0 BILL ARCISZEWSKI BOARD MEMBER 1.0 4.0 X 0 0 0 DAN BURNS BOARD MEMBER 1.0 4.0 X 0 0 0 DAVID EISENREICH BOARD MEMBER 1.0 4.0 X 0 0 0 SHERYL JONES BOARD MEMBER 1.0 4.0 X 0 0 0 JAMES WEISHAN BOARD MEMBER 1.0 4.0 X 0 0 0 ANGELA BAILEY BOARD MEMBER 1.0 4.0 X 0 0 0 CLYDE NELSON BOARD MEMBER 1.0 4.0 X 0 0 0 PATRICIA WESENBERG BOARD MEMBER 1.0 5.0 X 0 0 0 JOSEPH KINSELLA BOARD MEMBER 1.0 5.0 X 0 0 0 JEREMY NORMINGTON-SLAY PRESIDENT-NORTH CENTRAL REGION 5.0 45.0 X 0 386774 43762 JONATHAN SOHN CFO - ASCENSION, WI 2.0 48.0 X 0 903904 48367 DEBRA STANDRIDGE INTERIM PRESIDENT 8.0 42.0 X 0 825914 36007 ROBYN SCHERTZ VP MEDICAL AFFAIRS 50.0 0.0 X 0 390293 49970 CRYSTAL J KIRSCHLING CHIEF ADMIN OFFICER/VP PATIENT CARE 49.0 1.0 X 0 225849 47890 CHERYL ANN PAVELEC-MARTI CHIEF OPERATING OFFICER 25.0 25.0 X 0 224982 34491 JOSEPH P KIM MD PHYSICIAN 50.0 0 X 973643 0 48171 PATRICK K SAFO MD PHYSICIAN 50.0 0 X 848462 0 41765 TODD M WILLIAMS MD PHYSICIAN 50.0 0 X 819346 0 53723 SHILOH A SIMONS MD PHYSICIAN 50.0 0 X 801914 0 52018 STEVEN J SLEZAK MD PHYSICIAN 50.0 0 X 799740 0 42184 DANIEL E NEUFELDER FORMER OFFICER (END 9/2016) 0.0 0.0 X 0 996775 0 BRIAN J KIEF FORMER OFFICER (END 3/2017) 0.0 0.0 X 0 500718 14977 JEFFREY L MARTIN FORMER OFFICER (END 12/2016) 0.0 0.0 X 0 587495 4471 4243105 5042704 517796 96 true true false MARSHFIELD CLINIC 1000 N OAK AVE MARSHFIELD WI 54499 PHYSICIAN SERVICES 771070 ELLIS STONE ODP LLC 3201 STANLEY STREET STEVENS POINT WI 544811349 CONSTRUCTION SERVICES 760804 HAYES LOCUMS LLC 5100 N FEDERAL HWY 203 FORT LAUDERDALE FL 33308 STAFFING SERVICES 659466 DELTA HEALTHCARE PLACEMENT LLC PO BOX 202940 DALLAS TX 75320 HEALTHCARE STAFFING 347341 RADIATION ONCOLOGY SPECIALISTS SC 1843 MICHIGAN STREET STURGEON BAY WI 542351007 ONCOLOGY SERVICES 338000 15 X 0 0 0 46431 91722 108744 246897 NET PATIENT SERVICE REVENUE 621990 187181970 187181970 SERVICES TO AFFILIATES 900099 1272800 1272800 INTEGRATED LAB 621500 840058 792062 47996 PHARMACY REVENUE 446110 26648 26648 MANAGEMENT FEES 561000 4367 4367 0 0 0 0 189325843 20747 20747 0 0 0 0 44027 0 45291 -1264 0 -1264 -1264 0 141400 166924 0 -25524 -25524 -25524 0 0 0 0 0 0 0 0 CAFETERIA/VENDING REVENUE 722514 707328 707328 EMPLOYEE ASSISTANCE PROGRAM 624100 227845 227845 FOCUS ON ENERGY REBATE 900099 30000 30000 101271 0 0 101271 1066444 190633143 189277847 0 1108399 356074 356074 67129541 64057073 3072468 10932155 10431799 500356 4033736 3849115 184621 7559 7559 3527941 3218285 309656 0 15379 18547 -3168 344697 269482 75215 20335 13069 7266 2387287 354428 2032859 350891 327614 23277 110675 110202 473 304 304 8392739 2983682 5409057 2340 2340 MEDICAL SUPPLIES 24124337 23976283 148054 MANAGEMENT FEE TO AFFILIATE 19279068 19279068 CORPORATE ALLOCATIONS 16005243 16005243 PURCHASED SERVICES 11932147 3522368 8409779 16517766 10168644 6349122 0 185470214 123656969 61813245 0 251397 6270 4508034 108706 0 0 27959033 27884200 0 0 0 0 0 0 2409696 2734115 18914 30707 116238672 41065222 70647812 75173450 0 0 0 0 0 57278 10551647 15143244 116346533 121137970 9859500 10156786 0 0 140096 162579 0 0 0 0 0 0 0 0 0 0 29054361 26154062 39053957 36473427 X 72794661 79696307 2457227 2927398 2040688 2040838 X 77292576 84664543 116346533 121137970 X 5162929 -36080 2245118 X false true X true true true X false false false false false false false false true 7559 7559 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 are specifically allocated to lobbying. Ascension St Michael's Hospital Inc does not participate in or intervene in (including the publishing or distributing 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 are specifically allocated to lobbying. Ascension St Michael's Hospital Inc does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office. 2282906 150 73922 23570 2333408 2190300 115666 23060 2282906 2205348 278 6798 22124 2190300 2242492 147 74840 112131 2205348 2192062 38158 86289 51366 22651 2242492 0.0 0.87 0.13 false true true 3297402 3297402 65607082 16702087 48904995 42910 17769 25141 37233732 23825668 13408064 10057546 519698 9537848 75173450 DUE FROM AFFILIATES 7217248 OTHER CURRENT ASSETS 83343 ESTIMATED 3RD PARTY PAYOR SETTLEMENTS 1193539 ASSETS HELD FOR SALE 336161 OTHER RECEIVABLES 1340380 SECURITY DEPOSIT 6535 INTEREST IN SAINT MICHAELS FOUNDATION OF STEVENS POINT 4966038 15143244 0 Intercompany debt with Ministry Health Care Inc. PROPERTY TAX LIABILITY ESTIMATED 3RD PARTY PAYOR SETTLEMENT 1190905 DUE TO AFFILIATES 23994932 OTHER LIABILITIES ASSET RETIREMENT OBLIGATION 186168 RECOVERY TAIL LIABILITY 230385 AH SAVINGS LIABILITY ACCRUED TAX LIABILITY 551672 26154062 X Schedule D, Part V, Line 4 Intended uses of endowment funds INCOME FROM THE MINISTRY DENTAL CENTER ENDOWMENT IS AVAILABLE TO COVER OPERATION DEFICITS. THIS ENSURES DENTAL CARE CAN BE PROVIDED TO THOSE WHO COULD NOT OTHERWISE AFFORD TO PAY. THIS ENDOWMENT IS ADMINISTERED BY SAINT MICHAEL'S FOUNDATION OF STEVENS POINT, INC. (39-1657410). 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 3019981 3019981 0.0163 27139168 12190587 14948581 0.0806 0 0.0 0 0 30159149 12190587 17968562 0.0969 106593 0 106593 0.0006 145730 0 145730 0.0008 0 0 0 0.0 0 0 0 0.0 51470 0 51470 0.0003 0 0 303793 0 303793 0.0016 0 0 30462942 12190587 18272355 0.0985 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2602 2602 0.0000 0 0.0 0 0 2602 0 2602 0.0000 false 2494861 48945 53263094 72903512 -19640418 X true true 1 1 ASCENSION ST MICHAEL'S HOSPITAL INC 900 ILLINOIS AVENUE STEVENS POINT WI 54481 https://healthcare.ascension.org/Locations/Wisconsin/WIAPM/Stevens-Point-Saint-Michaels-Hospital 0146 X X X ASCENSION ST MICHAEL'S HOSPITAL INC 1 false false true X X X X X X X X X 15 true false true true X https://healthcare.ascension.org/Locations/Wisconsin/WIAPM/Stevens-Point-Saint-Michaels-Hospital/Com X true 15 true https://healthcare.ascension.org/Locations/Wisconsin/WIAPM/Stevens-Point-Saint-Michaels-Hospital/Com 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 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 - ASCENSION ST. MICHAEL'S HOSPITAL, INC.. ASCENSION ST. MICHAEL'S HOSPITAL, INC.'S CHNA PROCESS INCLUDED A NUMBER OF 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 SURVEY WAS SENT TO OVER 4000 RANDOMLY-IDENTIFIED RESIDENTS OF PORTAGE COUNTY. SECOND, IN SUMMER 2015, 100 COPIES OF THE SURVEY WERE DISTRIBUTED TO AGENCIES FOCUSED ON SERVING MEDICALLY UNDERSERVED, LOW INCOME AND MINORITY POPULATIONS IN PORTAGE COUNTY, INCLUDING THE MINISTRY DENTAL CENTER, PORTAGE COUNTY MEALS ON WHEELS, PORTAGE COUNTY HEALTH & HUMAN SERVICES WIC PROGRAM, AND PORTAGE COUNTY DEPARTMENT OF AGING. FINALLY, KEY STAKEHOLDERS MET IN FALL 2015 TO IDENTIFY PRIORITIES. THE LIST OF ORGANIZATIONS PARTICIPATING IN THE FALL 2015 KEY STAKEHOLDER MEETINGS ARE LISTED BELOW. * PORTAGE COUNTY PUBLIC HEALTH (PUBLIC HEALTH OFFICER) * UNITED WAY OF PORTAGE COUNTY (SERVES POOR, DISPARATE AND VULNERABLE COMMUNITY MEMBERS) * MINISTRY SAINT MICHAEL'S HOSPITAL * MINISTRY MEDICAL GROUP (MMG) * MINISTRY DENTAL CENTER (SERVES THE POOR, DISPARATE AND VULNERABLE POPULATION) * EMPLOYER SOLUTIONS Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - ASCENSION ST. MICHAEL'S HOSPITAL, INC.. THE CHNA WAS CONDUCTED WITH THE FOLLOWING NON-HOSPITAL FACILITY(S): PORTAGE COUNTY HEALTH DEPARTMENT, UNITED WAY OF PORTAGE COUNTY Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - ASCENSION ST. MICHAEL'S HOSPITAL, 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 2018 (TAX YEAR 2017), THE HOSPITAL IMPLEMENTED THE FOLLOWING PLAN TO ADDRESS THE PRIORITY NEEDS: ORAL HEALTH: IMPROVE ORAL HEALTH IN THE COMMUNITY. -- PROVIDED DENTAL CARE TO THOUSANDS OF PATIENTS WITH MEDICAID THROUGH A DENTAL CLINIC. -- PROVIDED EARLY ORAL HEALTH EDUCATION MATERIALS AND SUPPLIES TO NEW MOMS/FAMILIES WHO DELIVERED AT THE HOSPITAL -- INCORPORATED EARLY ORAL HEALTH EDUCATION MATERIALS INTO MULTIPLE EVENTS AND GROUPS (E.G., PREGNANCY FAIR, NEW MOMS GROUP) -- INCREASED REFERRALS OF PREGNANT WOMEN FOR DENTAL CARE OBESITY: DECREASE OBESITY FOR ADULTS AND CHILDREN IN PORTAGE COUNTY. -- PROVIDED THE BOYS AND GIRLS CLUB WITH FUNDING TO IMPLEMENT 'TRIPLE PLAY' WHICH FOCUSES ON STUDENTS' MENTAL, PHYSICAL AND INTERPERSONAL HEALTH. -- PROVIDED THE YMCA WITH FUNDING TO IMPLEMENT 'FOOD AND FUN', A PROGRAM TO INCREASE PHYSICAL ACTIVITY AND KNOWLEDGE ABOUT HEALTHY EATING IN SCHOOL AGE CHILDREN -- ACHIEVED 'BABY FRIENDLY HOSPITAL' STATUS (WHICH ACTIVELY PROMOTES BREASTFEEDING) -- WORKED WITH TWO AREA BUSINESSES AND MULTIPLE DAYCARES TO BECOME MORE BREASTFEEDING-FRIENDLY ---------------------------------------------------------------------------------------------------------------------------------------- THE DESCRIPTION BELOW INCLUDES THE NEEDS NOT BEING ADDRESSED AS WELL AS THE REASON WHY THE NEEDS ARE NOT BEING ADDRESSED. THE FOLLOWING NEEDS WILL NOT BE ADDRESSED: ALCOHOL AND DRUG USE AND MISUSE; VANDALISM; DOMESTIC VIOLENCE. ST. MICHAEL'S WILL NOT BE INCLUDING THESE PRIORITIES IN OUR IMPLEMENTATION PLAN BECAUSE OTHER COMMUNITY ORGANIZATIONS ARE ADDRESSING THE NEEDS AND THE HOSPITAL LACKS THE RELATIVE EXPERTISE TO EFFECTIVELY ADDRESS THE NEEDS. OTHER COMMUNITY ORGANIZATIONS WITHIN OUR PORTAGE COUNTY ARE BETTER EQUIPPED TO ADDRESS THESE IDENTIFIED PRIORITIES. IN ADDITION, THERE ARE FINANCIAL CONSTRAINTS TO BEING ABLE TO EFFECTIVELY LEAD EACH OF THESE PRIORITIES. 21 MINISTRY MEDICAL GROUP 824 Illinois Avenue Stevens Point WI 54481 OP CLINIC MINISTRY MEDICAL GROUP-PLOVER 2401 Plover Road Plover WI 54467 OP CLINIC MINISTRY MEDICAL GROUP-POINT 3398 E Maria Drive Stevens Point WI 54481 PSYCHIATRIC SERVICES MINISTRY MEDICAL GROUP EMPLOYER SOLUTIONS 5412 Highway 10 East Stevens Point WI 54481 OCCUPATIONAL HEALTH SERVICES MINISTRY ST MICHAEL'S HOSPITAL REHAB 2401 Plover Rd Plover WI 54467 CARDIAC REHAB AND PHYSICAL THERAPY MINISTRY MEDICAL GROUP - HOOVER 3500 Hoover Road Stevens Point WI 54481 OP CLINIC MINISTRY ST MICHAEL'S HOSPITAL REHAB 3500 Hoover Road Stevens Point WI 54481 PHYSICAL AND OCCUPATIONAL THERAPY SERVICES MINISTRY DENTAL CLINIC 3504 E Maria Drive Stevens Point WI 54481 DENTAL CLINIC MINISTRY MEDICAL GROUP - PFP 3301 Stanley Street Stevens Point WI 54481 OP CLINIC MINISTRY BEHAVIORAL HEALTH 209 Prentice Street N Stevens Point WI 54481 OP ALCOHOL AND CHEMICAL DEPENDENCY TREATMENT CENTER MINISTRY MEDICAL GROUP - COL 190 Grand Seasons Drive Waupaca WI 54981 OP CLINIC AND PSYCHIATRIC SERVICES MINISTRY BEHAVIORAL HEALTH 201 Prentice Street N Stevens Point WI 54481 RESIDENTIAL ALCOHOL AND CHEMICAL DEPENDENCY TREATMENT CENTER MINISTRY MEDICAL GROUP - IOLA 205 S Main Street Iola WI 54945 OP CLINIC AND PHYSICAL THERAPY MINISTRY BEHAVIORAL HEALTH 190 Grand Seasons Drive Waupaca WI 54981 ALCOHOL AND CHEMICAL DEPENDENCY TREATMENT CENTER MINISTRY MEDICAL GROUP-AMHERST 272 Christy Street Amherst WI 54406 OP CLINIC MINISTRY MEDICAL GROUP EMPLOYER SOLUTIONS 1020 Kabel Avenue Rhinelander WI 54501 OCCUPATIONAL HEALTH SERVICES MINISTRY MEDICAL GROUP EMPLOYER SOLUTIONS 3301 Cranberry Blvd Weston WI 54476 OCCUPATIONAL HEALTH SERVICES MINISTRY MEDICAL GROUP EMPLOYER SOLUTIONS 601 S Center Avenue Merrill WI 54452 OCCUPATIONAL HEALTH SERVICES MINISTRY MEDICAL GROUP 1000 Riverview Expressway Wisconsin Rapids WI 54494 ENT AND OPTHAMALOGY SERVICES AEAS 2811 8th Street S Suite 80 Wisconsin Rapids WI 54494 EMPLOYEE ASSISTANCE AND COUNSELING PROGRAMS AEAS 1820 Post Road Suite 5 Plover WI 54467 EMPLOYEE ASSISTANCE AND COUNSELING PROGRAMS 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. MICHAEL'S HOSPITAL PROVIDED HOSPITAL TOURS TO AREA YOUTH. ASSURING THAT RURAL COMMUNITIES HAVE A VIBRANT HEALTH CARE WORKFORCE IN THE FUTURE WILL HELP INCREASE ACCESS TO QUALITY OF CARE IN THE FUTURE. 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 $5,077,673 AT CHARGES, ($2,494,861 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 - ASCENSION ST. MICHAEL'S HOSPITAL, INC.: Line 16a URL: https://healthcare.ascension.org/Financial-Assistance/wisconsin; Schedule H, Part V, Section B, Line 16b FAP Application website - ASCENSION ST. MICHAEL'S 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 - ASCENSION ST. MICHAEL'S 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. MICHAEL'S HOSPITAL 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 ST. MICHAEL'S 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 MINISTRY HEALTH CARE, INC. ("MHC") HAS FINANCIAL COUNSELORS LOCATED AT EVERY HOSPITAL. 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 PROGRAM. Schedule H, Part VI, Line 4 Community information ASCENSION ST. MICHAEL'S HOSPITAL, INC. SERVES STEVENS POINT, WI AND THE SURROUNDING VILLAGES AND TOWNS, INCLUDING PLOVER, WHITING, CUSTER, PARK RIDGE, STOCKTON, AND THE TOWN OF HULL. IT IS LOCATED IN THE CENTER OF THE STATE IN PORTAGE COUNTY. ACCORDING TO 2010 CENSUS INFORMATION, THE CITY OF STEVENS POINT HAS A POPULATION OF OVER 26,000 WHILE PORTAGE COUNTY'S POPULATION EXCEEDS 70,000. THE RACIAL MAKEUP OF THE CITY IS 91.7% WHITE, 4.68% ASIAN, 0.92% AFRICAN AMERICAN, 0.43% NATIVE AMERICAN AND 2.27% FROM OTHER RACES. THE POPULATION AGE IS WIDESPREAD, WITH 16% UNDER THE AGE OF 18, 31.2% FROM AGES 18 TO 24, 27.3% FROM AGES 25 TO 49, 13.5% FROM AGES 50 TO 64, AND 12% WHO WERE 65 YEARS OF AGE AND ABOVE. BASED ON 2010 ESTIMATES, THE PER CAPITA INCOME OF THE CITY WAS $21,653. ABOUT 17.3% OF THE POPULATION HAD INCOMES BELOW THE POVERTY LINE. LIKE MUCH OF THE COUNTRY, THE AREA CONTINUES TO FEEL THE EFFECTS OF THE ECONOMIC DOWNTURN AND HAS EXPERIENCED A VERY SLOW RECOVERY AFTER THE SIGNIFICANT LOSS OF JOBS SINCE 2009. STEVENS POINT IS HOME TO THE UNIVERSITY OF WISCONSIN - STEVENS POINT, WHICH ENROLLS ALMOST 10,000 STUDENTS IN BOTH UNDERGRADUATE AND GRADUATE DEGREE PROGRAMS. MID-STATE TECHNICAL COLLEGE ("MSTC"), A TECHNICAL COLLEGE, IS ALSO LOCATED IN THE CITY. MAJOR EMPLOYERS INCLUDE SENTRY INSURANCE, THE UNIVERSITY OF WISCONSIN - STEVENS POINT, MINISTRY HEALTH CARE, INC., ASSOCIATED BANC-CORP AND TRAVEL GUARD. 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. CERTAIN SPECIALIZED SERVICES AVAILABLE INCLUDE: DENTAL SERVICES TO PRIMARILY THE INDIGENT, FERTILITY CLINIC SERVICES AND WIC HOME VISITS TO NEW MOTHERS AND INFANTS. Schedule H, Part VI, Line 6 Affiliated health care system ASCENSION ST. MICHAEL'S HOSPITAL, INC. IS AN AFFILIATE OF MINISTRY HEALTH, INC. AND ASCENSION HEALTH. ASCENSION ST. MICHAEL'S HOSPITAL, INC.'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 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 23 OF THE UNITED STATES AND THE DISTRICT OF COLUMBIA. ASCENSION IS SPONSORED BY ASCENSION SPONSOR, A PUBLIC JURIDIC PERSON. THE PARTICIPATING 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 SAINT MICHAEL'S FOUNDATION OF STEVENS POINT INC 900 ILLINOIS AVENUE STEVENS POINT WI 54481 391657410 501(C)(3) 356074 OPERATING SUPPORT 1 0 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. THE FINANCE COMMITTEE ENSURES THAT FUNDS ARE DISTRIBUTED APPROPRIATELY ACCORDING TO ASCENSION HEALTH'S STRATEGIC BUSINESS PLAN AND CONSISTENT WITH CORPORATE POLICIES AND PROCEDURES. true true false false false false false false false DANIEL E NEUFELDER FORMER OFFICER (END 9/2016) 0 0 0 0 0 996775 0 0 0 0 0 996775 0 0 BRIAN J KIEF FORMER OFFICER (END 3/2017) 0 133012 0 0 0 367706 0 3926 0 11051 0 515695 0 0 JEFFREY L MARTIN FORMER OFFICER (END 12/2016) 0 20411 0 0 0 567084 0 541 0 3930 0 591966 0 0 JEREMY NORMINGTON-SLAY PRESIDENT-NORTH CENTRAL REGION 0 301660 0 76438 0 8676 0 13500 0 30262 0 430536 0 0 JONATHAN SOHN CFO - ASCENSION, WI 0 505898 0 270732 0 127274 0 14885 0 33482 0 952271 0 0 DEBRA STANDRIDGE INTERIM PRESIDENT 0 493219 0 207295 0 125400 0 9931 0 26076 0 861921 0 0 ROBYN SCHERTZ VP MEDICAL AFFAIRS 0 387250 0 1476 0 1567 0 16200 0 33770 0 440263 0 0 CRYSTAL J KIRSCHLING CHIEF ADMIN OFFICER/VP PATIENT CARE 0 179124 0 41495 0 5230 0 14828 0 33062 0 273739 0 0 CHERYL ANN PAVELEC-MARTI CHIEF OPERATING OFFICER 0 179009 0 41495 0 4478 0 14068 0 20423 0 259473 0 0 JOSEPH P KIM MD PHYSICIAN 741929 0 229954 0 1760 0 13245 0 34926 0 1021814 0 0 0 PATRICK K SAFO MD PHYSICIAN 356867 0 478231 0 13364 0 14237 0 27528 0 890227 0 0 0 TODD M WILLIAMS MD PHYSICIAN 518214 0 298030 0 3102 0 17550 0 36173 0 873069 0 0 0 SHILOH A SIMONS MD PHYSICIAN 526154 0 273570 0 2190 0 16200 0 35818 0 853932 0 0 0 STEVEN J SLEZAK MD PHYSICIAN 498208 0 293378 0 8154 0 15702 0 26482 0 841924 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation MINISTRY HEALTH CARE, INC., A RELATED ORGANIZATION OF ASCENSION ST MICHAEL'S HOSPITAL, 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: DANIEL NEUFELDER - $994,500 JEFFREY L MARTIN - $541,385 BRIAN KIEF - $325,725 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 MINISTRY HEALTH CARE, INC. AND ITS SUBSIDIARY ORGANIZATIONS. MINISTRY HEALTH CARE, INC. IS THE SOLE CORPORATE MEMBER OF ASCENSION ST. MICHAEL'S HOSPITAL, 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 ST. MICHAEL'S HOSPITAL, 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' 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 MICHAEL'S HOSPITAL 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 ST MICHAEL'S HOSPITAL INC. HAS A SINGLE CORPORATE MEMBER, MINISTRY HEALTH CARE, INC. WHO HAS THE ABILITY TO ELECT MEMBERS TO THE GOVERNING BODY OF ST. MICHAEL'S HOSPITAL OF STEVENS POINT, INC.. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders ALL DECISIONS THAT HAVE A MATERIAL IMPACT TO THE ASCENSION ST MICHAEL'S HOSPITAL INC 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 11d Other Miscellaneous Revenue OTHER MISCELLANEOUS REVENUE - Total Revenue: 101271, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 101271; Form 990, Part XI, Line 9 Other changes in net assets or fund balances CHANGE IN VALUE OF BENEFICIAL INTEREST IN SAINT MICHAEL'S FOUNDATION OF STEVENS POINT, INC. - 468124; TRANSFERS WITH ALPHA FUND - 3470937; TRANSFER WITH AFFILIATE - -1693943; Form 990, Part XII, Line 2b AUDITED FINANCIAL STATEMENTS THE ACTIVITY OF ASCENSION ST. MICHAEL'S HOSPITAL, INC. IS REPORTED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF ASCENSION HEALTH ALLIANCE. NO INDIVIDUAL AUDIT OF ASCENSION ST. MICHAEL'S HOSPITAL, INC. IS COMPLETED. THEREFORE, THE ATTACHED AUDITED FINANCIAL STATEMENTS ARE OF ASCENSION HEALTH ALLIANCE AND AFFILIATES, WHICH INCLUDE THE ACTIVITY OF ASCENSION ST. MICHAEL'S HOSPITAL, INC. Form 990, Part XII, Line 2c AUDIT COMMITTEE ASCENSION ST. MICHAEL'S HOSPITAL, 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 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 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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 DER 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 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