BELLIN MEMORIAL HOSPITAL INC: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization: BELLIN MEMORIAL HOSPITAL INC (EIN 39-0884478)
Tax period: 2017-10-01 to 2018-09-30
Filed: 2019-08-15
IRS object ID: 201942279349300444
Schema version: 2017v2.3
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule K
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2019-08-15T07:43:35-05:00	ReturnTs
Tax Period End	2018-09-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	390758449	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	WIPFLI LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 12237	AddressLine1Txt
City	GREEN BAY	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	543072237	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2017-10-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	390884478	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	BELLIN MEMORIAL HOSPITAL INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	BELL	BusinessNameControlTxt
Phone	9204457260	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	744 S WEBSTER AVENUE	AddressLine1Txt
City	GREEN BAY	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54301	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	JAMES DIETSCHE	PersonNm
Person Title	COO/CFO	PersonTitleTxt
Phone	9204457260	PhoneNum
Signature	2019-08-13	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	TERRI REXRODE CPA MST	PreparerPersonNm
PTIN	P00096513	PTIN
Phone	9206620016	PhoneNum
Preparation	2019-08-13	PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	74.87.127.216	IPv4AddressTxt

Field	Value	IRS element (for citing)
IP	2019-08-13	IPDt
IP Tm	15:38:18	IPTm
IP Timezone	CD	IPTimezoneCd
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	DA39A3EE5E6B4B0D3255BFEF95601890AFD80709	AtSubmissionCreationDeviceId
At Submission Filing Device Id	A43ECD1EE6AF4781A69F6BFA161A98BDE8FA2C07	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2017	TaxYr
Build TS	2019-02-21 02:37:17Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	JAMES DIETSCHE	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	744 S WEBSTER AVENUE	AddressLine1Txt
City	GREEN BAY	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54301	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$528,906,977	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.BELLIN.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1908	FormationYr
Legal Domicile State	WI	LegalDomicileStateCd
Activity Or Mission	BELLIN MEMORIAL HOSPITAL, INC. (BMH) PROVIDES HEALTH CARE SERVICES AND OTHER FINANCIAL SUPPORT THROUGH VARIOUS PROGRAMS THAT ARE DESIGNED, AMONG OTHER MATTERS, TO ENHANCE THE HEALTH OF THE COMMUNITY AND IMPROVE THE HEALTH OF LOW-INCOME PATIENTS. CONSISTENT WITH THE MISSION OF BMH, CARE IS PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. IN ADDITION, BMH PROVIDES SERVICES INTENDED TO BENEFIT THE POOR AND UNDERSERVED, INCLUDING THOSE PERSONS WHO CANNOT AFFORD HEALTH INSURANCE BECAUSE OF INADEQUATE RESOURCES OR ARE UNINSURED OR UNDERINSURED. HEALTH CARE SERVICES TO PATIENTS UNDER GOVERNMENT PROGRAMS, SUCH AS MEDICAID, ARE ALSO CONSIDERED PART OF THE BELLIN HEALTH BENEFITS PROVIDED TO THE COMMUNITY SINCE A SUBSTANTIAL PORTION OF SUCH SERVICES ARE REIMBURSED AT AMOUNTS LESS THAN COST.	ActivityOrMissionDesc
Voting Members Governing Body	23	VotingMembersGoverningBodyCnt
Voting Members Independent	16	VotingMembersIndependentCnt
Total Employee	4010	TotalEmployeeCnt
Total Volunteers	373	TotalVolunteersCnt
Total Gross UBI	$6,290,178	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	-$1,244,507	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$1,284,229	PYContributionsGrantsAmt
CY Contributions Grants	$1,294,974	CYContributionsGrantsAmt
PY Program Service Revenue	$481,484,956	PYProgramServiceRevenueAmt
CY Program Service Revenue	$508,484,698	CYProgramServiceRevenueAmt
PY Investment Income	$5,294,369	PYInvestmentIncomeAmt
CY Investment Income	$10,935,435	CYInvestmentIncomeAmt
PY Other Revenue	$5,240,007	PYOtherRevenueAmt
CY Other Revenue	$5,592,117	CYOtherRevenueAmt
PY Total Revenue	$493,303,561	PYTotalRevenueAmt
CY Total Revenue	$526,307,224	CYTotalRevenueAmt
PY Grants And Similar Paid	$812,484	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$801,651	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$264,768,020	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$284,196,452	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$191,048,949	PYOtherExpensesAmt
CY Other Expenses	$213,207,746	CYOtherExpensesAmt
PY Total Expenses	$456,629,453	PYTotalExpensesAmt
CY Total Expenses	$498,205,849	CYTotalExpensesAmt
PY Revenues Less Expenses	$36,674,108	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$28,101,375	CYRevenuesLessExpensesAmt
Total Assets BOY	$568,232,083	TotalAssetsBOYAmt
Total Assets EOY	$592,686,809	TotalAssetsEOYAmt
Total Liabilities BOY	$179,599,438	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$175,184,761	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$388,632,645	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$417,502,048	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	BELLIN HEALTH IS A COMMUNITY-OWNED NOT-FOR-PROFIT ORGANIZATION RESPONSIBLE FOR IMPROVING THE HEALTH AND WELLBEING OF PEOPLE LIVING IN NORTHEAST WISCONSIN AND THE UPPER PENINSULA OF MICHIGAN, AND ALL OTHERS WE SERVE. WE CARRY OUT THIS RESPONSIBILITY THROUGH INDIVIDUALIZED CARE EXCELLENCE, COMMUNITY HEALTH IMPROVEMENT, AND EQUITABLE HEALTHCARE FINANCING PLANS ALL DESIGNED TO POSITIVELY IMPACT HEALTH AND WELLBEING. WE ARE STEADFAST IN OUR COMMITMENT TO PROVIDING COMPASSIONATE, SAFE, AND COORDINATED CARE THAT IS ACCESSIBLE AND AFFORDABLE FOR EVERYONE. WE BUILD TRUSTED RELATIONSHIPS AND ADVANCE TRUE COLLABORATION, FUELING OUR DESIRE TO CONSTANTLY IMPROVE AND INNOVATE.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$411,421,281	ExpenseAmt
Grant	$801,651	GrantAmt
Revenue	$505,655,653	RevenueAmt
Desc	THE HOSPITAL PROVIDES ACUTE HOSPITAL CARE TO RESIDENTS OF NORTHEASTERN WISCONSIN. DURING FISCAL YEAR 2018 32,030 INPATIENT DAYS WERE PROVIDED (29,157 ADULTS AND PEDIATRICS), AS COMPARED TO 32,562 (29,659 ADULTS AND PEDIATRICS) IN FISCAL YEAR 2017. THE NUMBER OF OUTPATIENTS REGISTERED FOR 2018 AND 2017 WERE 245,407 AND 247,677, RESPECTIVELY. BELLIN MEMORIAL HOSPITAL ALSO PROVIDED 847,166 (AS COMPARED TO 798,411 IN 2017) PHYSICIAN CLINIC VISITS THROUGH BELLIN MEDICAL AND SPECIALTY GROUPS.	Desc
Total Program Service Expenses	$411,421,281	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Temp Or Permanent Endowments	Yes (1)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	0	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (1)	TaxExemptBondsInd
Invest Tax Exempt Bonds	0	InvestTaxExemptBondsInd
Escrow Account	0	EscrowAccountInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	0	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (1)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	310	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	4010	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	23	GoverningBodyVotingMembersCnt
Independent Voting Member	16	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (1)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (1)	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	WI	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	JAMES DIETSCHE COOCFO	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	9204457260	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	744 S WEBSTER AVE	AddressLine1Txt
City	GREEN BAY	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54301	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (31 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Highest Compensated EmployeeHighestCompensatedEmployeeInd
TERRY FULWILER
BOARD CHAIR	0.50	Yes (X)	Yes (X)	$0	$0	$0
ELL LEE DDS
BOARD VICE CHAIR	0.50	Yes (X)	Yes (X)	$0	$0	$0
MARK MCMULLEN
BOARD SECRETARY	0.50	Yes (X)	Yes (X)	$0	$0	$0
NANCY ARMBRUST
BOARD MEMBER	0.50	Yes (X)		$0	$0	$0
G CORT CONDON
BOARD MEMBER	0.50	Yes (X)		$0	$0	$0
DANIEL GULLING
BOARD MEMBER	0.50	Yes (X)		$0	$0	$0
FRED SCHMIDT MD
BOARD MEMBER	50.00	Yes (X)		$422,587	$0	$16,956
DANIEL ARIENS
BOARD MEMBER	0.50	Yes (X)		$0	$0	$0
WILLIAM WITTMAN MD
BOARD MEMBER/BMG PHYSIAN	50.00	Yes (X)		$284,866	$0	$25,550
JOHN JONES
BOARD MEMBER	0.50	Yes (X)		$0	$0	$0
SUSAN FINCO
BOARD MEMBER	0.50	Yes (X)		$0	$0	$0
MICHAEL HADDAD
BOARD MEMBER	0.50	Yes (X)		$0	$0	$0
CHRISTINE VANDENHOUTEN
BOARD MEMBER	0.50	Yes (X)		$0	$0	$0
JOHN DYKEMA
TREASURER	0.50	Yes (X)	Yes (X)	$0	$0	$0
ROBERT CLAUSEN
BOARD MEMBER	0.50	Yes (X)		$0	$0	$0
GEORGE KERWIN
BELLIN CEO/BOARD MEMBER	50.00	Yes (X)	Yes (X)	$993,768	$0	$44,396
KARL SCHMIDT
BOARD MEMBER	0.50	Yes (X)		$0	$0	$0
PAUL CASEY MD
BOARD MEMBER/PRESIDENT MED	50.00	Yes (X)		$97,903	$0	$0
CYNTHIA LASECKI MD - TERMED
BOARD MEMBER/FORMER PRESID	50.00	Yes (X)		$296,925	$0	$19,299
SABINA SINGH MD
BOARD MEMBER/PRESIDENT BEL	50.00	Yes (X)		$241,428	$0	$21,833
MARK RINGWELSKI MD
BOARD MEMBER/PRESIDENT BEL	50.00	Yes (X)		$339,992	$0	$35,411
ROBERT MEAD
BOARD MEMBER/PRESIDENT MEDICAL STAFF	50.00	Yes (X)		$269,890	$0	$34,594
BARB GILLING
BOARD MEMBER	0.50	Yes (X)		$0	$0	$0
BILL BOHN
BOARD MEMBER	0.50	Yes (X)		$0	$0	$0
JAMES DIETSCHE
COO/CFO	50.00		Yes (X)	$445,836	$0	$31,975
CHRISTINE WOLESKE
EXECUTIVE VP/COO	50.00		Yes (X)	$495,234	$0	$35,899
CHRISTOPHER WOLFRAM MD
PHYSICIAN	40.00			$991,863	$0	$33,514	Yes (X)
DAVID STAMPFL MD
PHYSICIAN	40.00			$1,170,292	$0	$20,913	Yes (X)
PAUL HUDSON MD
PHYSICIAN	40.00			$934,440	$0	$37,257	Yes (X)
PATRICK MCKENZIE MD
PHYSICIAN	40.00			$1,197,377	$0	$50,245	Yes (X)
JAMES SPEARS MD
PHYSICIAN	40.00			$1,213,127	$0	$29,875	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$9,395,528	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$437,717	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	354	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
MIRON CONSTRUCTION
1471 MCMAHON DRIVE	NEENAH	WI	54956	CONSTRUCTION SERVICES	$13,129,657
IEI GENERAL CONTRACTORS
1725 MIDWAY ROAD	DE PERE	WI	54115	CONSTRUCTION SERVICES	$8,535,010
AMERIEBO LLC
1851 S ALVERNO ROAD	MANITOWOC	WI	54220	BILLING/COLLECTION SERVICES	$2,003,914
THARIO BUILDING SERVICES
2936 HOMGREN WAY	GREEN BAY	WI	54304	BUILDING SERVICES	$1,542,796
BAY TOWEL LINEN & UNIFORM
2580 S BROADWAY	GREEN BAY	WI	54304	LAUNDRY AND LINEN SERVICES	$1,428,963

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	62	CntrctRcvdGreaterThan100KCnt
Related Organizations	$886,699	RelatedOrganizationsAmt
All Other Contributions	$408,275	AllOtherContributionsAmt
Total Contributions	$1,294,974	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
NET PATIENT SERVICE REVENUE	621500	$497,433,287	$491,599,837	$5,833,450
RENT FROM AFFILIATES	621110	$3,237,864	$3,237,864
ACO INCENTIVE	621110	$2,414,758	$2,414,758
CONTRACTED SERVICES	621110	$1,883,204	$1,883,204
MISCELLANEOUS	621110	$1,606,735	$1,606,735

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,908,850	TotalRevenueColumnAmt
Related Or Exempt Func Income	$67,635	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$456,728	UnrelatedBusinessRevenueAmt
Exclusion	$1,384,487	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$508,484,698	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$5,930,702	TotalRevenueColumnAmt
Exclusion	$5,930,702	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$2,598,145	RealAmt
Personal	$39,975	PersonalAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$1,851,648	RealAmt
Personal	$39,975	PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$746,497	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$746,497	TotalRevenueColumnAmt
Exclusion	$746,497	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$4,938,372	SecuritiesAmt
Other	$774,491	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt
Other	$708,130	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$4,938,372	SecuritiesAmt
Other	$66,361	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$5,004,733	TotalRevenueColumnAmt
Exclusion	$5,004,733	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
BOSC K-1 INCOME	900099	$7,119,668	$7,119,668
EHR INCENTIVE	621110	$2,107,474	$2,107,474
LOSS FROM HEALTHCARE AFFILIATES	900099	-$4,381,522	-$4,381,522

Field	Value	IRS element (for citing)
Other Revenue Total	$4,845,620	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$526,307,224	TotalRevenueColumnAmt
Related Or Exempt Func Income	$505,655,653	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$6,290,178	UnrelatedBusinessRevenueAmt
Exclusion	$13,066,419	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$801,651	TotalAmt
Program Services	$801,651	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$4,154,343	TotalAmt
Program Services	$2,009,332	ProgramServicesAmt
Management And General	$2,145,011	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$225,389,060	TotalAmt
Program Services	$198,521,892	ProgramServicesAmt
Management And General	$26,867,168	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$10,223,915	TotalAmt
Program Services	$8,805,965	ProgramServicesAmt
Management And General	$1,417,950	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$30,128,245	TotalAmt
Program Services	$25,851,907	ProgramServicesAmt
Management And General	$4,276,338	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$14,300,889	TotalAmt
Program Services	$12,407,890	ProgramServicesAmt
Management And General	$1,892,999	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$449,057	TotalAmt
Program Services	$447,398	ProgramServicesAmt
Management And General	$1,659	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$371,322	TotalAmt
Management And General	$371,322	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$904,090	TotalAmt
Management And General	$904,090	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$564,710	TotalAmt
Management And General	$564,710	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$30,249,893	TotalAmt
Program Services	$20,962,851	ProgramServicesAmt
Management And General	$9,287,042	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$6,484,984	TotalAmt
Program Services	$54,309	ProgramServicesAmt
Management And General	$6,430,675	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$5,514,629	TotalAmt
Program Services	$1,961,970	ProgramServicesAmt
Management And General	$3,552,659	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$8,248,792	TotalAmt
Program Services	$4,029,215	ProgramServicesAmt
Management And General	$4,219,577	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$10,711,290	TotalAmt
Program Services	$9,901,375	ProgramServicesAmt
Management And General	$809,915	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$1,317,935	TotalAmt
Program Services	$688,812	ProgramServicesAmt
Management And General	$629,123	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$1,401,878	TotalAmt
Program Services	$837,361	ProgramServicesAmt
Management And General	$564,517	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$5,442,647	TotalAmt
Program Services	$738,229	ProgramServicesAmt
Management And General	$4,704,418	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$22,730,250	TotalAmt
Program Services	$15,384,517	ProgramServicesAmt
Management And General	$7,345,733	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$846,331	TotalAmt
Program Services	$489,947	ProgramServicesAmt
Management And General	$356,384	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
SUPPLIES	$77,058,683	$76,678,044	$380,639
EQUIPMENT RENT/MAINT	$12,376,682	$10,136,498	$2,240,184
BAD DEBTS	$10,661,684	$10,525,890	$135,794
DUES/SUBSCRIPTIONS	$9,827,706	$7,965,145	$1,862,561

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$8,045,183	TotalAmt
Program Services	$2,221,083	ProgramServicesAmt
Management And General	$5,824,100	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$498,205,849	TotalAmt
Program Services	$411,421,281	ProgramServicesAmt
Management And General	$86,784,568	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$15,342	BOYAmt
EOY	$16,627	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$78,649,140	BOYAmt
EOY	$63,635,290	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$52,251,544	BOYAmt
EOY	$65,168,926	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$23,012,579	BOYAmt
EOY	$29,368,778	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$6,090,710	BOYAmt
EOY	$5,961,521	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$7,723,527	BOYAmt
EOY	$7,055,831	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$409,236,591	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$210,641,829	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$197,658,270	BOYAmt
EOY	$198,594,762	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$167,759,089	BOYAmt
EOY	$190,336,351	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$16,325,625	BOYAmt
EOY	$12,138,364	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$2,596,515	BOYAmt
EOY	$4,083,644	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$16,149,742	BOYAmt
EOY	$16,326,715	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$568,232,083	BOYAmt
EOY	$592,686,809	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$50,443,691	BOYAmt
EOY	$53,414,786	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$166,955	BOYAmt
EOY	$114,004	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$61,503,730	BOYAmt
EOY	$56,304,865	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$67,485,062	BOYAmt
EOY	$65,351,106	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$179,599,438	BOYAmt
EOY	$175,184,761	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$384,361,949	BOYAmt
EOY	$412,921,645	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,773,393	BOYAmt
EOY	$2,083,050	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$2,497,303	BOYAmt
EOY	$2,497,353	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$388,632,645	BOYAmt
EOY	$417,502,048	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$568,232,083	BOYAmt
EOY	$592,686,809	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$28,101,375	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$155,731	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$923,759	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$20,028	OtherActivitiesAmt
Total Lobbying Expenditures	$20,028	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1:	FormAndLineReferenceDesc
Explanation	AHA AND WHA DUES	ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$2,689,035	BeginningYearBalanceAmt
Contributions	$50	ContributionsAmt
Investment Earnings Or Losses	$32,052	InvestmentEarningsOrLossesAmt
Other Expenditures	$23,882	OtherExpendituresAmt
End Year Balance	$2,697,255	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$2,637,679	BeginningYearBalanceAmt
Contributions	$7,394	ContributionsAmt
Investment Earnings Or Losses	$56,750	InvestmentEarningsOrLossesAmt
Other Expenditures	$12,788	OtherExpendituresAmt
End Year Balance	$2,689,035	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$2,283,113	BeginningYearBalanceAmt
Contributions	$319,500	ContributionsAmt
Investment Earnings Or Losses	$45,890	InvestmentEarningsOrLossesAmt
Other Expenditures	$10,824	OtherExpendituresAmt
End Year Balance	$2,637,679	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$2,446,300	BeginningYearBalanceAmt
Contributions	$101,050	ContributionsAmt
Investment Earnings Or Losses	-$255,551	InvestmentEarningsOrLossesAmt
Other Expenditures	$8,686	OtherExpendituresAmt
End Year Balance	$2,283,113	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$2,417,823	BeginningYearBalanceAmt
Investment Earnings Or Losses	$35,966	InvestmentEarningsOrLossesAmt
Other Expenditures	$7,489	OtherExpendituresAmt
End Year Balance	$2,446,300	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.00000	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.92590	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.07410	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	Yes (1)	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (1)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (1)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$8,310,489	OtherCostOrOtherBasisAmt
Book Value	$8,310,489	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$186,361,625	OtherCostOrOtherBasisAmt
Depreciation	$64,541,228	DepreciationAmt
Book Value	$121,820,397	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,604,830	OtherCostOrOtherBasisAmt
Depreciation	$1,842,933	DepreciationAmt
Book Value	$761,897	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$208,995,992	OtherCostOrOtherBasisAmt
Depreciation	$144,257,668	DepreciationAmt
Book Value	$64,738,324	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,963,655	OtherCostOrOtherBasisAmt
Book Value	$2,963,655	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$198,594,762	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDesc	AmtAmt
DEFERRED COMPENSATION	$11,723,716
NONCONTROLLING INTEREST OF CONSOLIDATED AFFILIATE	$1,372,860
CAPITAL LEASE OBLIGATIONS	$47,365,163
INTEREST RATE SWAP VALUATION	$4,889,367

Field	Value	IRS element (for citing)
Total Liability	$65,351,106	TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt	$515,405,201	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	-$155,731	NetUnrealizedGainsInvstAmt
Other Revenue	-$16,291,104	OtherRevenueAmt
Revenue Not Reported	-$16,446,835	RevenueNotReportedAmt
Revenue Subtotal	$531,852,036	RevenueSubtotalAmt
Investment Expenses Not Incld	$564,710	InvestmentExpensesNotIncldAmt
Other Revenues Not Included	-$6,109,522	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	-$5,544,812	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$526,307,224	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$488,670,493	TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included	$7,035,340	OtherExpensesIncludedAmt
Expenses Not Reported	$7,035,340	ExpensesNotReportedAmt
Expenses Subtotal	$481,635,153	ExpensesSubtotalAmt
Investment Expenses Not Incld2	$564,710	InvestmentExpensesNotIncld2Amt
Other Expenses Not Included	$16,005,986	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$16,570,696	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$498,205,849	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART V, LINE 4:	ENDOWMENT FUNDS ARE INTENDED TO BE USED FOR HEALTH CARE SERVICES AND EMPLOYEE TRAINING AND DEVELOPMENT.
PART XI, LINE 2D - OTHER ADJUSTMENTS:	GAIN ON SWAP AGREEMENT 2,405,379. NON-CONTROLLING INTEREST -3,203,815. PROVISION FOR BAD DEBTS -10,661,684. LOSS ON DICKINSON TRANSACTION -4,830,984.
PART XI, LINE 4B - OTHER ADJUSTMENTS:	TRANSFER FROM FOUNDATION 886,699. HOSPITAL SUPPLIES 39,119. RENTAL EXPENSES -1,891,623. RENT FROM AFFILIATES 3,237,864. BOSC EXPENSES -8,381,581.
PART XII, LINE 2D - OTHER ADJUSTMENTS:	RENTAL EXPENSES 1,891,623. RENT FROM AFFILIATES -3,237,864. BOSC EXPENSES 8,381,581.
PART XII, LINE 4B - OTHER ADJUSTMENTS:	REALLOCATION OF SUPPLIES EXPENSE TO 990T 39,119. EXPENSES PAID FOR BY FOUNDATION TRANSFERS 474,199. PROVISION FOR BAD DEBTS 10,661,684. LOSS ON DICKINSON TRANSACTION 4,830,984.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Free Care Other	220.000000000000	FreeCareOtherPct

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (1)	ExpensesExceedBudgetInd
Unable To Provide Care	0	UnableToProvideCareInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,877,517	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$4,877,517	NetCommunityBenefitExpnsAmt
Total Expense	0.01000	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$56,352,582	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$30,861,220	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$25,491,362	NetCommunityBenefitExpnsAmt
Total Expense	0.05240	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$61,230,099	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$30,861,220	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$30,368,879	NetCommunityBenefitExpnsAmt
Total Expense	0.06240	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,661,873	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$4,661,873	NetCommunityBenefitExpnsAmt
Total Expense	0.00960	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,972,177	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$5,972,177	NetCommunityBenefitExpnsAmt
Total Expense	0.01230	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,886,363	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,886,363	NetCommunityBenefitExpnsAmt
Total Expense	0.00390	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$12,520,413	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$12,520,413	NetCommunityBenefitExpnsAmt
Total Expense	0.02580	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$73,750,512	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$30,861,220	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$42,889,292	NetCommunityBenefitExpnsAmt
Total Expense	0.08820	TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$628,253	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$628,253	NetCommunityBenefitExpnsAmt
Total Expense	0.00130	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$628,253	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$628,253	NetCommunityBenefitExpnsAmt
Total Expense	0.00130	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$4,856,676	BadDebtExpenseAmt
Reimbursed By Medicare	$142,020,265	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$204,219,405	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$62,199,140	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp

Entity Name EntityName

Field	Value	IRS element (for citing)
Business Name Line1	1 BELLIN ORTHOPEDIC SURGERY CENTER LLC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Primary Activities	ORTHOPEDIC SURGERY CENTER	PrimaryActivitiesTxt
Org Profit Or Ownership	0.55000	OrgProfitOrOwnershipPct
Physicians Profit Or Ownership	0.45000	PhysiciansProfitOrOwnershipPct

Field	Value	IRS element (for citing)
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	BELLIN MEMORIAL HOSPITAL	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	744 S WEBSTER AVE	AddressLine1Txt
City	GREEN BAY	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54305	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.BELLIN.ORG	WebsiteAddressTxt
State License	147	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	BELLIN MEMORIAL HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	17	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (1)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	HTTPS://WWW.BELLIN.ORG/IMAGES/UPLOADS/BROWN_COUNTY-FY2018_CHNA_EDITS_04_10_	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	17	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	HTTPS://WWW.BELLIN.ORG/IMAGES/UPLOADS/BROWN_COUNTY_FY2018_IMPLEMENTATION_PL	StrategyWebsiteURLTxt
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	220.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	400.000000000000	FPGFamilyIncmLmtDscntCarePct
Income Level Criteria	Yes (X)	IncomeLevelCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Other Method	Yes (X)	OtherMethodInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	HTTPS://WWW.BELLIN.ORG/IMAGES/UPLOADS/BUSOF.001_-_FINANCIAL_ASSISTANCE.PDF	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	HTTPS://WWW.BELLIN.ORG/IMAGES/UPLOADS/COMMUNITY_CARE_APPLICATION.PDF	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	HTTPS://WWW.BELLIN.ORG/IMAGES/UPLOADS/PLAIN_LANGUAGE_SUMMARY_-_FINANCIAL_AS	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
BELLIN MEMORIAL HOSPITAL	PART V, SECTION B, LINE 5: THIS YEAR'S ASSESSMENT BUILT ON COLLABORATION, ACTIVELY SEEKING INPUT FROM A BROAD CROSS SECTION OF COMMUNITY STAKEHOLDERS WITH THE GOAL OF REACHING CONSENSUS ON PRIORITIES TO MUTUALLY FOCUS HUMAN, MATERIAL AND FINANCIAL RESOURCES ON. BELOW IS A LISTING OF PARTICIPANTS IN A CHNA SUMMIT IN WHICH HEALTH PRIORITIES WERE DETERMINED.-CITY OF GREEN BAY - PARKS & RECREATION-NORTHEASTERN WISCONSIN TECHNICAL COLLEGE-CITY OF DE PERE - HEALTH DEPARTMENT-BELLIN HEALTH-BROWN COUNTY PUBLIC HEALTH-ASHWAUBENON SCHOOLS-INTERN SCHOOL SOCIAL WORKER (HSSD)-WILLOW CREEK BEHAVIORAL HEALTH-HSHS ST VINCENT HOSPITAL/ ST MARY'S HOSPITAL-LIVE 54218-BELLIN PSYCHIATRIC CENTER-BROWN COUNTY BOARD-WIC-FAMILY & CHILDCARE RESOURCES OF NEW-AGING AND DISABILITY RESOURCE CENTER-BROWN COUNTY BOARD OF HEALTH-WI DHS DIVISION OF PUBLIC HEALTH-HOWARD SUAMICO SCHOOLS-CONNECTIONS FOR MENTAL WELLNESS-PULASKI COMMUNITY SCHOOLS-ST NORBERT COLLEGE-HSHS LIBERTAS TREATMENT CENTER-SHERMAN COUNSELING-UW EXTENSIONS-AIDS RESOURCE CENTER OF WISCONSIN (ARCW)-FOUNDATIONS-BOCE/ETC.-AURORA BEHAVIORAL HEALTH - UWGB-UNITED WAY - BROWN COUNTY-EX PRISONER OPPORTUNITIES-INTEGRATED COMMUNITY SOLUTIONS-OCONTO COUNTY PUBLIC HEALTH-RETIRED LAW ENFORCEMENT - DE PERE-BELLIN COLLEGE-BROWN COUNTY - CTC-UW GREEN BAY-ONEIDA NATION-BROWN COUNTY CHILD AND ADOLESCENT BEHAVIORAL HEALTH-PREVEA HEALTH-BROWN COUNTY HEALTH & HUMAN SERVICES-NEW COMMUNITY CLINIC-NEW COMMUNITY CLINIC & BROWN COUNTY BOARD OF HEALTH-GREEN BAY AREA PUBLIC SCHOOLS-CITY OF GREEN BAY - MAYOR-AURORA BAYCARE MEDICAL CENTER (ABMC)-ORAL HEALTH PARTNERSHIP-COMMUNITY VOLUNTEER-CITY OF DE PERE-JOSHUA - BC MENTAL HEALTH TASK FORCE - CONNECTIONS FOR MENTAL WELLNESS-DIOCESE OF GB CATHOLIC CHARITIES-BAY AREA COMMUNITY COUNCIL (BACC)-DARJUNE/EXPOTO ENSURE THAT THE NEEDS OF THESE GROUPS WERE ADEQUATELY REPRESENTED, WE INCLUDED REPRESENTATIVES FROM BROWN COUNTY HEALTH AND HUMAN SERVICES (PUBLIC HEALTH, AGING & DISABILITY RESOURCE CENTER, AND CHILD & FAMILY SERVICES); VARIOUS BROWN COUNTY DEPARTMENTS INCLUDING HEAD START, PROBATION & PAROLE, VICTIM/WITNESS SERVICES, VETERANS SERVICES; LOVE, INC.; BROWN COUNTY INTERFAITH ORGANIZATION; LOCAL SCHOOL DISTRICTS; BROWN COUNTY INTERFAITH; PARTNERS FOR COMMUNITY DEVELOPMENT; FAMILY RESOURCE CENTER OF BROWN COUNTY; SAFE HARBOR. THESE ORGANIZATIONS SERVE THE UNDER-RESOURCED IN OUR COMMUNITY, INCLUDING LOW-INCOME SENIORS, CHILDREN LIVING IN POVERTY, FAMILIES WHO STRUGGLE WITH SHELTER AND FOOD INSECURITY; VETERANS AND VICTIMS OF DOMESTIC VIOLENCE.
BELLIN MEMORIAL HOSPITAL	PART V, SECTION B, LINE 6A: AURORA BAYCARE MEDICAL CENTER (GREEN BAY) AND ST. MARY'S AND ST. VINCENT HOSPITALS (HSHS, GREEN BAY)
BELLIN MEMORIAL HOSPITAL	PART V, SECTION B, LINE 6B: BROWN COUNTY HEALTH DEPARTMENT, CITY OF DE PERE HEALTH DEPARTMENT, AND BROWN COUNTY UNITED WAY.
BELLIN MEMORIAL HOSPITAL	PART V, SECTION B, LINE 11: THE MOST RECENT CHNA IDENTIFIED COMMUNITY NEEDS FOR FISCAL YEARS 2018 THROUGH 2020. THE NEEDS IDENTIFIED ARE: MENTAL HEALTH, PHYSICAL ACTIVITY, OBESITY, AND NUTRITION, AND HEALTH INEQUALITY. BELLIN REPRESENTATIVES LEAD THE INITIATIVES. A SUMMARY OF HOW BELLIN HAS BEEN ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA IS AS FOLLOWS:MENTAL HEALTH: LONG-TERM PERFORMANCE INDICATORS: BY JULY 2020, THE AVERAGE NUMBER OF POOR MENTAL HEALTH DAYS PER 30 DAYS, AS REPORTED BY COUNTY RESIDENTS, WILL DECREASE FROM 3.4 TO 3.2. STRATEGY ONE: SCREENING TOOL ASSESSMENT AND BEST PRACTICE IDENTIFICATION BELLIN HEALTH WILL WORK COLLABORATIVELY WITH THE BROWN COUNTY HEALTH DEPARTMENT AND MENTAL HEALTH TASK FORCE TO: -ASSIST IN COMPLETING AN INVENTORY OF CURRENT BEHAVIORAL HEALTH SCREENING TOOLS USED ACROSS SETTINGS. -ASSIST IN COMPLETING AN INVENTORY OF CURRENT SUICIDE RISK SCREENING TOOLS USED ACROSS SETTINGS (CONSIDER COLLABORATION WITH THE BROWN COUNTY COALITION FOR SUICIDE PREVENTION ON THIS ACTIVITY). -IDENTIFY BEST PRACTICE BEHAVIORAL HEALTH SCREENING TOOLS AND DEVELOP RECOMMENDATIONS FOR TOOLS USED IN VARIOUS COMMUNITY SETTINGS. -IDENTIFY BEST PRACTICE SUICIDE RISK SCREENING TOOLS AND DEVELOP RECOMMENDATIONS FOR TOOLS USED IN VARIOUS COMMUNITY SETTINGS. STRATEGY TWO: "NO WRONG DOOR" ACCESS PLATFORM FOR MENTAL HEALTH TREATMENT AND PROVIDERS BELLIN HEALTH WILL WORK COLLABORATIVELY WITH THE BROWN COUNTY HEALTH DEPARTMENT AND MENTAL HEALTH TASK FORCE TO: -IMPLEMENT TRILOGY NETWORK OF CARE IN COLLABORATION WITH NEW CONNECTIONS -WORK WITH PRIMARY CARE PROVIDERS TO IDENTIFY EDUCATION NEEDS AND STRENGTHEN PRIMARY CARE AS THE ENTRY POINT TO "RIGHT CARE, RIGHT PERSON, RIGHT TIME" MENTAL HEALTH TREATMENT. -INVESTIGATE AND IMPLEMENT A "NO WRONG DOOR" REFERRAL PROCESS BETWEEN COMMUNITY AGENCIES TO GUARANTEE THE RIGHT ACCESS AT THE RIGHT TIME. STRATEGY THREE: DEVELOP A NETWORK OF PEER SUPPORT, INCREASING AVAILABILITY OF IMMEDIATE RESOURCES TO COMMUNITY BELLIN HEALTH WILL WORK COLLABORATIVELY WITH THE BROWN COUNTY HEALTH DEPARTMENT AND MENTAL HEALTH TASK FORCE TO: -COMPLETE AN INVENTORY OF CURRENT MENTAL HEALTH PEER SUPPORT RESOURCES AVAILABLE IN THE COMMUNITY. -IDENTIFY EDUCATIONAL/TRAINING PROGRAMS AVAILABLE TO THOSE INTERESTED IN PROVIDING PEER SUPPORT IN THE COMMUNITY (E.G. QPR, MENTAL HEALTH FIRST AID, ETC.). -DEVELOP A PEER SUPPORT NETWORK, IMPLEMENT SERVICES AND PROVIDE RESOURCE CONTACTS TO COMMUNITY ORGANIZATIONS AND AGENCIES. PHYSICAL ACTIVITY, OBESITY, AND NUTRITION:LONG-TERM PERFORMANCE INDICATORS: BY 2020, INCREASE NUMBER OF INDIVIDUALS WITH A HEALTHY WEIGHT BY THREE PERCENT, AS EVIDENCED BY AN INCREASE IN THE NUMBER OF COMMUNITY MEMBERS WITH A BMI UNDER 30. (BASELINE MEASURE: 72 PERCENT AT HEALTHY WEIGHT, BASED ON COUNTY HEALTH RANKINGS 2017- 2013 DATA).STRATEGY ONE: FOOD AS MEDICINE BELLIN HEALTH WILL WORK COLLABORATIVELY WITH THE BROWN COUNTY HEALTH DEPARTMENT TO IMPROVE EQUITABLE ACCESS TO HEALTHY FOOD, AND INCREASE THE PROPORTION OF BROWN COUNTY RESIDENTS WHO CONSUME THE RECOMMENDED NUMBER OF SERVINGS OF FRUITS AND VEGETABLES BY AT LEAST TWO PERCENT (SHORT TERM) AND FOUR PERCENT (LONG TERM) BY: -ESTABLISHING RELATIONSHIPS WITH VARIOUS COMMUNITY GROUPS AND OFFERING ASSISTANCE TO FACILITATE CHANGE OR MAINTENANCE FOR PROGRAMS THAT FOCUS ON CONSUMPTION OF HEALTHY FOODS -MONITORING HEALTHY FOOD DONATIONS AT SCOUTING FOR FOODS DRIVE -MAINTAINING AND PROMOTING FOOD DRIVE 5 TOOLKIT -MONITORING AND ENCOURAGING FOOD PANTRY INFRASTRUCTURE THAT PROMOTES HEALTHY FOOD CHOICES -INSTITUTE A PLATFORM OF HEALTHY SNACKS IN THE SCHOOL SYSTEM BY ELIMINATING CANDY, HIGH FAT SNACKS AND SODA FROM VENDING MACHINES AND CAFETERIAS -TRACKING THE RATIO OF ELIGIBILITY FOR EBT PROGRAM TO THOSE WHO USE THE DOUBLE YOUR BUCKS PROGRAM AT THE FARMER'S MARKET -BEN'S WISH PROGRAM THAT ASSISTS LOCAL COMMUNITIES IN FIGHTING FOOD INSECURITY ISSUES THROUGH FOOD DRIVE COLLECTION, WEEKEND BACKPACK PROGRAM AND EDUCATIONAL ACTIVITIES. STRATEGY TWO: MOVEMENT AS MEDICINE BELLIN HEALTH WILL WORK COLLABORATIVELY WITH THE BROWN COUNTY HEALTH DEPARTMENT TO DECREASE PHYSICAL INACTIVITY (SHORT-TERM BY TWO PERCENT, LONG-TERM BY FOUR PERCENT) THROUGH EMPOWERING COMMUNITY MEMBERS TO USE ACTIVE MEANS OF TRANSPORT/MOVEMENT BY PARTNERING WITH THE GREATER GREEN BAY ACTIVE COMMUNITY ALLIANCE. ENCOURAGE BROWN COUNTY RESIDENTS TO UTILIZE COMMUNITY RESOURCES (E.G. WALKING/BIKING TRAILS, FITNESS CENTERS, ETC) AND FACILITATE CAMPAIGN(S) THAT PROMOTE(S) HEALTHY LIFESTYLES THROUGH SAFE AND AFFORDABLE MODES OF PHYSICAL ACTIVITY (AS MEASURED BY A DECREASE IN PHYSICAL INACTIVITY) BY STRUCTURING THE WORK AROUND THE THREE ES (ENGINEERING, EDUCATION, ENFORCEMENT). TOGETHER, WE WILL ACCOMPLISH THIS BY: -INVENTORYING EXISTING INITIATIVES THAT ARE IN ALIGNMENT WITH THIS OBJECTIVE. -PARTNERING WITH THE GREATER GREEN BAY ACTIVE COMMUNITY ALLIANCE TO CREATE A MORE ACTIVE AND CONNECTED COMMUNITY. -DEVELOPING AN EDUCATIONAL STRATEGY USING THE THREE ES IN PARTNERSHIP WITH THE GREATER GREEN BAY ACTIVE COMMUNITY ALLIANCE. -MONITORING UTILIZATION TRENDS OF ACTIVE DESIGN AND INFRASTRUCTURE TO IDENTIFY GAPS AND OPPORTUNITIES TO IMPROVE. STRATEGY THREE: CULTURE CHANGE: BELLIN HEALTH WILL WORK COLLABORATIVELY WITH THE BROWN COUNTY HEALTH DEPARTMENT TO LINK LIFE STUDY DATA, CHIP AND THE GROW PROJECT TOGETHER TO COLLABORATE ON COMMUNITY INITIATIVES. TOGETHER WE WILL CREATE A COMMUNITY DRIVEN BY MULTI-SECTORED PARTNERSHIPS SUPPORTIVE OF CULTURAL WELL-BEING THAT IMPROVES THE HEALTH OF BROWN COUNTY BY: -CONVENING MEETINGS WITH LEADERSHIP FROM LIFE STUDY, CHIP AND THE GROW PROJECT. -TESTING A COMMUNITY EDUCATION PLATFORM SUPPORTING THE CONNECTION BETWEEN NUTRITION, MOVEMENT AND HEALTH STATUS. -ENGAGING AND EMPOWERING THE GROWTH AND DEVELOPMENT OF RELATIONSHIPS BETWEEN AGENCIES IN THE FOOD-RELATED AND WELL-BEING SECTORS. -ADOPTING HEALTHFUL HOSPITAL FOOD AMERICAN MEDICAL ASSOCIATION RESOLUTION 406.HEALTH EQUALITY:IN ADDITION TO THE THREE COMMUNITY TEAMS, BELLIN IS HAS AN INTERNAL TEAM FOCUSED ON ADDRESSING HEALTH EQUITY. PRIMARY DRIVERS IN THIS WORK INCLUDE: LEADERSHIP AND ADVOCACY AS HEALTHCARE LEADERS FOR HEALTH EQUITY, ORGANIZATION FOCUS TO ADDRESS OPPORTUNITIES FOR HEALTH CARE EQUITY AND PARTNERSHIPS WITH THE KEY STAKEHOLDERS AND COMMUNITIES. ONE OF THE KEY PROJECT THAT THIS TEAM WILL FOCUS ON US THE COLLECTION AND USE OF REAL (RACE, ETHNICITY AND LANGUAGE) DATA. SOME ADDITIONAL PROJECTS THAT THE TEAM HAS PRIORITIZED FALL UNDER THE SECONDARY DRIVERS OF DEVELOPING A RECRUITMENT AND RETENTION STRATEGY TO EVOLVE THE WORKFORCE TO REFLECT THE COMMUNITY WE LIVE IN, AND THE QUALITATIVE AND QUANTITATIVE UNDERSTANDING OF THE POPULATIONS WE SERVE BY ADDRESSING THE SOCIAL DETERMINATES OF HEALTH. NEXT STEPS THE IMPLEMENTATION PLAN OUTLINES A THREE-YEAR COMMUNITY HEALTH IMPROVEMENT PROCESS. ANNUALLY, THE HOSPITAL WILL: -REVIEW THE IMPLEMENTATION PLAN AND UPDATE STRATEGIES FOR THE FOLLOWING FISCAL YEAR -SET AND TRACK ANNUAL PERFORMANCE INDICATORS FOR EACH IMPLEMENTATION STRATEGY -TRACK PROGRESS TOWARD MID TERM PERFORMANCE INDICATORS -REPORT PROGRESS TOWARD THE PERFORMANCE INDICATORS TO THE HOSPITAL BOARD, COMMUNITY BENEFIT ADVISORY COMMITTEE
BELLIN MEMORIAL HOSPITAL	PART V, SECTION B, LINE 13H: PRESUMPTIVE ELIGIBILITY INCLUDES FACTORS AS: HOMELESS, DECEASED WITH NO ESTATE, APPROVED COURT BANKRUPTCY, REFERRED FROM A FREE CLINIC, PAYMENT ASSISTANCE RANKOR ELIGIBLE FOR STATE OF WI FOOD SHARE PROGRAM.
BELLIN MEMORIAL HOSPITAL	PART V, SECTION B, LINE 15E: DISCLOSURE UNDER REVENUE PROCEDURE 2015-21:DURING FISCAL YEAR 2017 WE COMPLETED AN IRS 501(R) AUDIT. PURSUANT TO REVENUE PROCEDURE 2015-21, WE WANT TO MAKE THE FOLLOWING DISCLOSURE. IRC 501(R)(4) AND THE RELATED TREASURY REGULATIONS REQUIRE A HOSPITAL ORGANIZATION TO MAKE THE FAP WIDELY AVAILABLE ON A WEBSITE. THE FAP ON THE WEBSITE IS REQUIRED TO INCLUDE MULTIPLE PROVISIONS INCLUDING THE BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS, AND COLLECTION ACTIONS YOUR HOSPITAL MAY TAKE AGAINST PATIENTS IN THE EVENT OF NONPAYMENT. THESE REQUIREMENTS WERE ORIGINALLY MISSING FROM THE FAP ON OUR WEBSITE. THE FAP ON OUR WEBSITE HAS SINCE BEEN UPDATED TO INCLUDE THESE PROVISIONS. IN ADDITION 501(R)(4) HAS A TRANSLATION REQUIREMENT. IT IS REQUIRED THAT OUR WEBSITE HAVE THE FAP DOCUMENTS TRANSLATED INTO SPANISH. THE TRANSLATED FAP DOCUMENTS WERE MISSING FROM OUR WEBSITE AND HAVE SINCE BEEN ADDED.THIS AUDIT WAS CONCLUDED ON SEPTEMBER 13, 2017. THE AUDIT COVERED THE TAX PERIOD ENDING SEPTEMBER 30, 2014.TO BELLIN'S KNOWLEDGE, NO ONE WAS HARMED BY THE LACK OF THE ABOVE IN THE MENTIONED TIMEFRAME. IF WE BECOME AWARE OF ANY HARM FROM THESE MISSTEPS, WE WILL PROMPTLY CORRECT THE SITUATION.

Field	Value	IRS element (for citing)
Facility	35	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (35 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
1 - THE CANCER TEAM OF BELLIN HEALTH
1580 COMMANCHE AVE	GREEN BAY	WI	54313	PROVIDER CLINIC SITE
2 - CARDIOLOGY ASSOCIATES OF BELLIN HEALTH
744 S WEBSTER AVE	GREEN BAY	WI	54301	HOSPITAL BASED SITE
3 - FAMILY MEDICAL CENTER ASHWAUBENON
1630 COMMANCHE AVE	GREEN BAY	WI	54313	PROVIDER CLINIC SITE
4 - BELLIN HEALTH CARDIOVASCULAR & THORACIC
720 S VAN BUREN ST SUITE 303	GREEN BAY	WI	54301	PROVIDER CLINIC SITE
5 - BELLIN HEALTH SURGICAL ASSOCIATES
720 S VAN BUREN ST SUITE 201	GREEN BAY	WI	54301	PROVIDER CLINIC SITE
6 - GASTROENTEROLOGY ASSOCIATES OF GREEN BAY
725 S WEBSTER AVE	GREEN BAY	WI	54301	PROVIDER CLINIC SITE
7 - FAMILY MEDICAL CENTER DE PERE EAST
555 REDBIRD CIRCLE	DE PERE	WI	54115	PROVIDER CLINIC SITE
8 - BELLIN HEALTH GENERATIONS
704 S WEBSTER AVE SUITE 300	GREEN BAY	WI	54301	PROVIDER CLINIC SITE
9 - FAMILY MEDICAL CENTER HOWARD
2714 RIVERVIEW	GREEN BAY	WI	54313	PROVIDER CLINIC SITE
10 - FAMILY MEDICAL CENTER BELLEVUE
3263 EATON RD	GREEN BAY	WI	543116830	PROVIDER CLINIC SITE
11 - FAMILY MEDICAL CENTER DE PERE WEST
1800 LAWRENCE DR	DE PERE	WI	54115	PROVIDER CLINIC SITE
12 - BELLIN HEALTH IRON MOUNTAIN
440 WOODWARD AVE	IRON MOUNTAIN	MI	49801	PROVIDER CLINIC SITE
13 - NEUROLOGY CONSULTANTS OF BELLIN HEALTH
725 S WEBSTER AVE	GREEN BAY	WI	54301	PROVIDER CLINIC SITE
14 - BELLIN HEALTH TITLETOWN SPORTS MEDICINE
1970 S RIDGE RD	GREEN BAY	WI	54304	PROVIDER CLINIC SITE
15 - BELLIN HEALTH ESCANABA
610 S LINCOLN ROAD	ESCANABA	MI	49829	PROVIDER CLINIC SITE
16 - FAMILY MEDICAL CENTER GREEN BAY
704 S WEBSTER AVE	GREEN BAY	WI	54301	PROVIDER CLINIC SITE
17 - FAMILY MEDICAL CENTER KEWAUNEE
575 - 4TH STREET	KEWAUNEE	WI	54216	PROVIDER CLINIC SITE
18 - FAMILY MEDICAL CENTER ALGOMA
831 PARKER AVE	ALGOMA	WI	54201	PROVIDER CLINIC SITE
19 - FAMILY MEDICAL CENTER BRILLION
964 W RYAN ST SUITE B	BRILLION	WI	54110	PROVIDER CLINIC SITE
20 - BELLIN HEALTH OCONTO FALLS
107 E HIGHLAND DR	OCONTO FALLS	WI	54154	PROVIDER CLINIC SITE
21 - BELLIN HEALTH ASTHMA & ALLERGY
519 S MONROE AVENUE	GREEN BAY	WI	54301	PROVIDER CLINIC SITE
22 - FAMILY MEDICAL CENTER DENMARK
595 COUNTY ROAD R	DENMARK	WI	54208	PROVIDER CLINIC SITE
23 - FAMILY MEDICAL CENTER SEYMOUR
405 COMMERCIAL ST	SEYMOUR	WI	54165	PROVIDER CLINIC SITE
24 - FAMILY MEDICAL CENTER WRIGHTSTOWN
555 QUALITY CT	WRIGHTSTOWN	WI	54180	PROVIDER CLINIC SITE
25 - FAMILY MEDICAL CENTER LUXEMBURG
140 B SCHOOL CREEK TRAIL	LUXEMBURG	WI	54217	PROVIDER CLINIC SITE
26 - FAMILY MEDICAL CENTER MANITOWOC
3415 CUSTER ST SUITE D	MANITOWOC	WI	54221	PROVIDER CLINIC SITE
27 - FAMILY MEDICAL CENTER PULASKI
723 S WISCONSIN ST	PULASKI	WI	541620109	PROVIDER CLINIC SITE
28 - BELLIN HEALTH ASTHMA & ALLERGY - NEENAH
119 E BELL ST SUITE B	NEENAH	WI	54957	PROVIDER CLINIC SITE
29 - BELLIN HEALTH FAST CARE ASHWAUBENON
301 BAY PARK SQUARE	GREEN BAY	WI	54304	CONVENIENT CARE CENTER
30 - BELLIN HEALTH FAST CARE EAST TOWNE MALL
2430 E MASON STREET	GREEN BAY	WI	54302	CONVENIENT CARE CENTER
31 - FAMILY MEDICAL CENTER BONDUEL
401 W MILL ST	BONDUEL	WI	54107	PROVIDER CLINIC SITE
32 - BELLIN HEALTH ENDOCRINOLOGY
720 S VAN BUREN ST SUITE 104	GREEN BAY	WI	54301	PROVIDER CLINIC SITE
33 - BELLIN HEALTH FAST CARE SUAMICO
2318 LINEVILLE ROAD	SUAMICO	WI	54173	CONVENIENT CARE CENTER
34 - FAMILY MEDICAL CENTER SURING
307 MANOR DR	SURING	WI	54174	PROVIDER CLINIC SITE
35 - FAMILY MEDICAL CENTER STURGEON BAY
311 N 3RD AVE	STURGEON BAY	WI	54235	PROVIDER CLINIC SITE

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 6A:	BELLIN MEMORIAL HOSPITAL IN INCLUDED IN THE BELLIN HEALTH SYSTEMS, INC. COMMUNITY BENEFIT REPORT.
PART I, LINE 7:	AMOUNTS ARE CALCULATED BASED ON COST TO CHARGE RATIOS AND AMOUNTS PER THE FINANCIAL STATEMENTS.
PART I, LN 7 COL(F):	BAD DEBT EXPENSE OF $11,536,684 INCLUDED ON FORM 990, PART IX, LINE 25 WAS EXCLUDED FROM THE DENOMINATOR PER INSTRUCTIONS WHEN CALCULATING THE PERCENT TOTAL EXPENSES ON SCHEDULE H.
PART II, COMMUNITY BUILDING ACTIVITIES:	COMMUNITY BUILDING ACTIVITIES FOCUS ON SOCIAL CONDITIONS THAT CONTRIBUTE TO HEALTH PROBLEMS, SUCH AS HOMELESSNESS, POVERTY, AND OTHER LIVING CONDITIONS AFFECTING THE QUALITY OF LIFE. THESE RANGE FROM DEVELOPING COMMUNITY LEADERS, DISASTER READINESS, AND SUPPORT OF LOCAL ECONOMIC DEVELOPMENT, TO HEALTH IMPROVEMENT ADVOCACY. BELLIN MEMORIAL HOSPITAL IS ACTIVE IN THE GREEN BAY PUBLIC SCHOOLS WITH OUR THRIVE PROGRAM THAT ASSISTS IN SETTING AND MEETING HEALTH AND WELLNESS GOALS FOR STUDENTS IN THIS SCHOOL SYSTEM. BELLIN ALSO HOLDS AN ANNUAL BELLIN RUN/WALK 10K EVENT EACH YEAR WITH OVER 13,000 PARTICIPANTS OF ALL AGES LEARNING FIRST HAND THE VALUE OF EXERCISE IN DAILY LIFE.
PART III, LINE 2:	THE BAD DEBT EXPENSE AT COST IS CALCULATED BASED ON THE COST TO CHARGE RATIOS.
PART III, LINE 3:	THE HOSPITAL UTILIZES HFMA #15 THEREFORE NONE OF THE BAD DEBT WOULD BE DEEMED CHARITY CARE.
PART III, LINE 4:	THE ATTACHED FINANCIAL STATEMENTS DO NOT CONTAIN A SPECIFIC BAD DEBT EXPENSE FOOTNOTE. HOWEVER, THE SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES DESCRIBES THE PROVISION FOR BAD DEBT ON PAGES 12 AND 13 OF THE FINANCIAL STATEMENTS. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR A PORTION OF THE BILL), BELLIN HEALTH SYSTEMS RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCES FOR DOUBTFUL ACCOUNTS.
PART III, LINE 8:	THE AMOUNTS REPORTED FOR MEDICARE WERE CALCULATED USING A COST TO CHARGE RATIO. THE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT FOR THE FOLLOWING REASONS. IRS REV RUL 69-545 WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS STATES THAT IF A HOSPITAL SERVICES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. IN ADDITION, FOR-PROFIT HOSPITALS HAVE CARVED OUT HIGH-MARGIN SERVICES (I.E. ONCOLOGY, ORTHO, ETC) LEAVING GENERAL ACUTE CARE HOSPITALS WITH LOWER-MARGIN MEDICARE SERVICES. THIS MEANS THAT THE SHORTFALL IS NOT NECESSARILY FROM INEFFICIENT OPERATIONS. MEDICARE CAN BE THE LARGEST PAYOR AND HOSPITALS HAVE NO ABILITY TO DENY COVERAGE. THIS, IN TURN, IS A PROMOTION OF ACCESS TO HEALTHCARE SERVICES (A COMMUNITY BENEFIT). ALSO, ELDERLY PATIENTS ARE OFTEN UNDERSERVED AND EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES.
PART III, LINE 9B:	FOR PATIENTS WHO CANNOT MEET THE EXPECTATIONS OF THE DEBT COLLECTION POLICY, THE ORGANIZATION OFFERS FINANCIAL ASSITANCE. THE ORGANIZATION WILL NOT ENGAGE IN EXTRAORDINARY COLLECTION ACTIONS BEFORE DETERMING WHETHER A GUARANTOR IS ELIGILBE FOR ASSISTANCE UNTER THE FINANCIAL ASSISTANCE POLICY. ALL PATIENTS ARE OFFERED A PLAIN LANGUAGE SUMMARY EXPLAINING THE FINANCIAL ASSISTANCE PROGRAM AS PART OF THE REGISTRATION PROCESS IN ADDITION, ALL STATEMENTS INCLUDE INFORMATION REGARDING FINANCIAL ASSISTANCE AVAILABILITY.
PART VI, LINE 2:	BELLIN MEMORIAL HOSPITAL HAS COMPLETED A COMMUNITY NEEDS ASSESSMENT AND IT IS POSTED ON BELLIN.ORG
PART VI, LINE 3:	FINANCIAL COUNSELORS ADVISE PATIENTS OF ASSISTANCE PROGRAMS AS WELL AS SERVICE CALLED HRS ERASE IS USED TO REVIEW SELF PAY ACCOUNTS FOR POSSIBLE COVERAGE THROUGH GOVERNMENT PROGRAMS.
PART VI, LINE 4:	BELLIN MEMORIAL HOSPITAL SERVES NORTHEAST WISCONSIN AND UPPER MICHIGAN. OUR CURRENT PAYOR SUPPLEMENTAL INFORMATION MIX IS 48.65% MEDICARE AND 9.7% MEDICAID. 10% OF THE POPULATION IS BELOW THE POVERTY LEVEL AND 14.9% OF THE POPULATION IS OVER AGE 65.
PART VI, LINE 5:	A MAJORITY OF BELLIN MEMORIAL HOSPITALS GOVERNING BODY IS COMPRISED OF PERSON WHO RESIDE IN BELLIN MEMORIAL HOSPITAL'S PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEROF. IN ADDITION, BELLIN MEMORIAL HOSPITAL EXTENDS MEDICAL STAFF PRIVELEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR ALL OF ITS DEPARTMENTS. BELLIN MEMORIAL HOSPITAL APPLIES SURPLUS FUNDS TO IMPROVEMENTS IN PATIENT CARE, EDUCATION AND FACILITIES.
PART VI, LINE 6:	BELLIN HEALTH IS A COMMUNITY-OWNED NOT-FOR-PROFIT ORGANIZATION RESPONSIBLE FOR THE PHYSICAL AND EMOTIONAL HEALTH OF PEOPLE LIVING IN NORTHEAST WISCONSIN AND THE UPPER PENINSULA OF MICHIGAN. DIRECTLY, AND IN PARTNERSHIP WITH COMMUNITIES, EMPLOYERS, SCHOOLS, AND GOVERNMENT OFFICIALS, WE GUIDE INDIVIDUALS AND FAMILIES IN THEIR LIFELONG JOURNEY TOWARD OPTIMAL HEALTH. WE ARE COMMITTED TO PROVIDING SAFE, RELIABLE, COST-EFFECTIVE TOTAL HEALTH SOLUTIONS WITH RESPECT AND COMPASSION. OUR INNOVATIVE WORK WILL IMPACT HEALTHCARE DELIVERY IN OUR REGION AS WELL AS THROUGHOUT THE WORLD.
PART VI, LINE 7, REPORTS FILED WITH STATES	WI

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (1)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (30 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt
NEW COMMUNITY CLINIC
622 BODART STREET	GREEN BAY	WI	54301	391200636	501(C)3	$100,000	SUPPORT FREE COMMUNITY HEALTH CLINIC
GREEN BAY PUBLIC SCHOOLS
PO BOX 23387	GREEN BAY	WI	543053387	396002329	GOVT - PUBLIC SCHOOL	$53,500	HEALTH & WELLNESS PROGRAM
FESTIVAL FOODS TURKEY TROT
2250 W MASON ST	GREEN BAY	WI	54303	391814712		$15,000	TURKET TROT RUN FOR CHARITY
DOWNTOWN GREEN BAY INC
130 E WALNUT ST	GREEN BAY	WI	54301	391858389	501(C)3	$8,500	FARMERS MARKET
ENCOMPASS EARLY EDUCATION & CARE
2589 S WEBSTER AVE	GREEN BAY	WI	54301	390824004	501(C)3	$7,500	DONATION
KIWANIS SKI CLUB
PO BOX 475	IRON MOUNTAIN	MI	49801	383254313	501(C)3	$25,000	DONATION
UNIVERSITY OF WI - OSHKOSH
842 ALGOMA BLVD	OSHKOSH	WI	54901	391805963	GOVT- STATE AGENCY	$60,000	SUPPORT ORGANIZATION'S ACTIVITIES
NORTHEAST WISCONSIN TECHNICAL COLLEGE
2740 W MASON ST	GREEN BAY	WI	54307	391087141	GOVT- STATE AGENCY	$20,000	HEALTH SCIENCE SIMULATION LAB
GREATER GREEN BAY COMMUNITY FOUNDATION
310 W WALNUT ST SUITE 350	GREEN BAY	WI	54303	391699966	501(C)3	$72,000	GREEN BAY NEIGHBORHOOD LEADERSHIP COUNCIL, ACHIEVE BROWN COUNTY
BROWN COUNTY UNITED WAY
112 N ADAMS ST STE 201	GREEN BAY	WI	54301	390806299	501(C)3	$10,000	DONATION
AMERICAN HEART ASSOCIATION
2850 DAIRY DR STE 300	MADISON	WI	53718	135613797	501(C)3	$5,000	DONATION
BELLIN COLLEGE
3201 EATON RD	GREEN BAY	WI	54311	391620530	501(C)3	$43,245	CONTRIBUTION TO MCW LEASE
BOYS & GIRLS CLUB OF GREEN BAY
1400 LOMBARDI AVE STE 60	GREEN BAY	WI	54304	396102943	501(C)3	$5,000	DONATION
BRIAN LAVIOLETTE SCHOLARSHIP
1135 PLEASANT VALLEY DR	ONEIDA	WI	54155	391836591	501(C)3	$5,500	BELLIN COLLEGE SCHOLARSHIP
CEREBRAL PALSY INC
2801 S WEBSTER AVE	GREEN BAY	WI	54301	390901265	501(C)3	$20,000	CAPITAL CAMPAIGN - BUILDING EXPANSION
CROHNS & COLITIS FOUNDATION
1126 S 70TH ST STE 112-1B	MILWAUKEE	WI	53214	136193105	501(C)3	$10,000	DONATION
HOWARD SUAMICO SCHOOL DISTRICT
2706 LINEVILLE RD	GREEN BAY	WI	543137151	396031599	GOVT - PUBLIC SCHOOL	$50,000	ATHLETIC PROGRAMS - FIELD SURFACE
MARINETTE MENOMINEE AREA COMMUNITY FOUNDATION
1101 11TH AVE	MENOMINEE	WI	49858	383264725	501(C)3	$10,500	DONATION
UNIVERSITY OF WI - GREEN BAY
2420 NICOLET DR	GREEN BAY	WI	54311	391805963	GOVT- STATE AGENCY	$20,000	MARK REINKE, MD MEMORIAL SCHOLARSHIP
ALGOMA SCHOOL DISTRICT
1715 DIVISION ST	ALGOMA	WI	54201	391032686	GOVT - PUBLIC SCHOOL	$20,500	DONATION
ALTRUSA HOUSE
1116 E MASON ST	GREEN BAY	WI	54301	391593989	501(C)3	$25,000	COMMUNITY SPONSORSHIP
BIG BROTHERS BIG SISTERS OF GREEN BAY
520 N BROADWAY ST STE 220	GREEN BAY	WI	54303	391274696	501(C)3	$5,000	DONATION
BOYS & GIRLS CLUB OF DOOR COUNTY
55 S THIRD AVE	STURGEON BAY	WI	54235	392038359	501(C)3	$5,000	COMMUNITY SPONSORSHIP
DOCTORS IN RECITAL INC
N9349 ABITZ LN	DYCKESVILLE	WI	54217	391516026	501(C)3	$10,736	DONATION
FAMILY SERVICES
300 CROOKS ST	GREEN BAY	WI	54305	390827320	501(C)3	$43,500	DONATION
FOUNDATIONS HEALTH & WHOLENESS
1061 W MASON ST	GREEN BAY	WI	54303	391047205	501(C)3	$5,000	DONATION
GREEN BAY AREA CHAMBER OF COMMERCE
300 N BROADWAY ST STE 3A	GREEN BAY	WI	54303	390318170	501(C)3	$26,000	DONATION
NEIGHBORHOOD HOUSING SERVICE
437 S JACKSON ST	GREEN BAY	WI	54301	391402851	501(C)3	$10,000	DONATION
VILLAGE OF ASHWAUBENON
2155 HOLMGREN WAY	GREEN BAY	WI	543044605	396031398	GOVT- STATE AGENCY	$25,000	DONATION - AQUATIC CENTER
WRIGHTSTOWN SCHOOL DISTRICT
PO BOX 128	WRIGHTSTOWN	WI	541800128	391016208	GOVT - PUBLIC SCHOOL	$10,000	DONATION

Field	Value	IRS element (for citing)
Total501c3 Org	30	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 2:	FormAndLineReferenceDesc
Explanation	THE ORGANIZATION REQUIRES A COMPREHENSIVE REQUEST OF THE GRANTEE TO PROVIDE RATIONALE FOR THE REQUEST. REQUIRED INFORMATION TO BE PROVIDED BY THE GRANTEE INCLUDES, TAX-EXEMPT STATUS, IDENTIFICATION OF USE OF RESOURCES AND FOLLOW UP INFORMATION AS TO THE UTILIZATION OF THE RESOURCES. THE ORGANIZATION REVIEWS EACH GRANTEE REQUEST IN RELATIONSHIP TO THE MISSION OF THE ORGANIZATION AND COMMUNITY SUPPORT. ALL REQUESTS REQUIRE APPROVAL BY SENIOR LEADERSHIP OF THE ORGANIZATION.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Club Dues Or Fees	Yes (X)	ClubDuesOrFeesInd
Written Policy Ref T And E Expnss	Yes (1)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (1)	SubstantiationRequiredInd
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	0	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
FRED SCHMIDT MD
BOARD MEMBER	$349,233	$0	$71,894	$0	$1,460	$0	$7,870	$0	$9,086	$0	$439,543	$0	$0	$0
WILLIAM WITTMAN MD
BOARD MEMBER/BMG PHYSIAN	$222,852	$0	$60,826	$0	$1,188	$0	$10,230	$0	$15,320	$0	$310,416	$0	$0	$0
GEORGE KERWIN
BELLIN CEO/BOARD MEMBER	$583,335	$0	$383,600	$0	$26,833	$0	$26,556	$0	$17,840	$0	$1,038,164	$0	$0	$0
CYNTHIA LASECKI MD - TERMED
BOARD MEMBER/FORMER PRESID	$140,516	$0	$155,995	$0	$414	$0	$16,435	$0	$2,864	$0	$316,224	$0	$0	$0
SABINA SINGH MD
BOARD MEMBER/PRESIDENT BEL	$172,162	$0	$68,996	$0	$270	$0	$10,511	$0	$11,322	$0	$263,261	$0	$0	$0
MARK RINGWELSKI MD
BOARD MEMBER/PRESIDENT BEL	$295,786	$0	$43,432	$0	$774	$0	$16,750	$0	$18,661	$0	$375,403	$0	$0	$0
ROBERT MEAD
BOARD MEMBER/PRESIDENT MEDICAL STAFF	$193,983	$0	$74,719	$0	$1,188	$0	$15,486	$0	$19,108	$0	$304,484	$0	$0	$0
JAMES DIETSCHE
COO/CFO	$355,422	$0	$90,000	$0	$414	$0	$11,241	$0	$20,734	$0	$477,811	$0	$0	$0
CHRISTINE WOLESKE
EXECUTIVE VP/COO	$382,057	$0	$100,000	$0	$13,177	$0	$18,080	$0	$17,819	$0	$531,133	$0	$0	$0
CHRISTOPHER WOLFRAM MD
PHYSICIAN	$537,302	$0	$454,381	$0	$180	$0	$14,130	$0	$19,384	$0	$1,025,377	$0	$0	$0
DAVID STAMPFL MD
PHYSICIAN	$485,231	$0	$684,427	$0	$634	$0	$0	$0	$20,913	$0	$1,191,205	$0	$0	$0
PAUL HUDSON MD
PHYSICIAN	$653,016	$0	$281,244	$0	$180	$0	$16,376	$0	$20,881	$0	$971,697	$0	$0	$0
PATRICK MCKENZIE MD
PHYSICIAN	$1,196,190	$0	$0	$0	$1,187	$0	$30,715	$0	$19,530	$0	$1,247,622	$0	$0	$0
JAMES SPEARS MD
PHYSICIAN	$746,572	$0	$465,368	$0	$1,187	$0	$13,261	$0	$16,614	$0	$1,243,002	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 1A	FormAndLineReferenceDesc
Explanation	BELLIN MEMORIAL HOSPITAL PAYS FOR A PORTION OF MEMBERSHIP DUES AT A LOCAL COUNTRY CLUB FOR CHRISTINE WOLESKE IN ORDER TO HOLD VARIOUS EVENTS AT THE CLUB. THIS BENEFIT IS TREATED AS TAXABLE COMPENSATION.	ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY
A	391337855	97712DLH7	2015-04-09	$44,994,006	REFUND AND LEGALLY DEFEASE	0	0	0
WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY
B	391337855		2011-11-23	$12,944,000	REFINANCING OF 2001 BONDS	0	0	0

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Total ProceedsTotalProceedsAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Other Spent ProceedsOtherSpentProceedsAmt	Substantial CompletionSubstantialCompletionYr	Current RefundingCurrentRefundingInd	Advance RefundingAdvanceRefundingInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$1,654,230	$44,994,006	$528,236	$44,465,770	2009	0	Yes (1)	Yes (1)	Yes (1)
B	$1,160,000	$12,944,000	$79,844		2001	Yes (1)	0	Yes (1)	Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Engage Bond Counsel ContractsEngageBondCounselContractsInd	Any Research AgreementsAnyResearchAgreementsInd	Private Bus Use By OthersPrivateBusUseByOthersPct	Total Private Business UseTotalPrivateBusinessUsePct	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	0	Yes (1)	Yes (1)	Yes (1)	0	0.01000	0.01000	Yes (1)	0	Yes (1)
B	0	Yes (1)	Yes (1)	Yes (1)	0	0.01000	0.01000	0	0	Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	Rebate Not Due YetRebateNotDueYetInd	Exception To RebateExceptionToRebateInd	No Rebate DueNoRebateDueInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A	0	Yes (1)	0	0	0	0	0	0	Yes (1)
B	Yes (1)				0	0	0	0	Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (1)
B	Yes (1)

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6	THE ORGANIZATION HAS ONE CORPORATE MEMBER, BELLIN HEALTH SYSTEMS, INC.
FORM 990, PART VI, SECTION A, LINE 7A	THE CORPORATE MEMBER, BELLIN HEALTH SYSTEMS, INC. HAS THE POWER TO APPOINT BOARD MEMBERS.
FORM 990, PART VI, SECTION A, LINE 7B	THE CORPORATE MEMBER, BELLIN HEALTH SYSTEMS, INC., HAS THE POWER TO APPROVE MAJOR EXPENDITURES AND LONG-TERM BORROWINGS.
FORM 990, PART VI, SECTION B, LINE 11B	THE FORM 990 IS REVIEWED IN DETAIL BY SENIOR ADMINISTRATION AND IS PRESENTED TO THE EXECUTIVE COMMITTEE IN ITS ENTIRETY FOR A REVIEW OF THE DOCUMENT.
FORM 990, PART VI, SECTION B, LINE 12C	EACH YEAR A CONFLICT OF INTEREST REQUEST DOCUMENT IS PROVIDED TO EACH BOARD MEMBER. ALL DOCUMENTS ARE PROVIDED BACK TO ADMINISTRATION AND REVIEWED. ALL EMPLOYEES ARE REQUIRED TO REVIEW THE CONFLICT OF INTEREST POLICY AS PART OF ANNUAL MANDATORY EDUCATION. IF THERE IS A CONFLICT OF INTEREST, THE CORPORATE COMPLIANCE OFFICER AND CORPORATE COMPLIANCE COMMITTEE WHICH IS A COMMITTEE OF THE BOARD OF DIRECTORS IS NOTIFIED. THE CORPORATE COMPLIANCE OFFICER AND CORPORATE COMPLIANCE COMMITTEE ADDRESSES THE ISSUE.
FORM 990, PART VI, SECTION B, LINE 15	COMPENSATION FOR THE CEO AND KEY EXECUTIVES ARE SET BY THE EXECUTIVE COMMITTEE OF THE BOARD SUPPORTED BY MARKET DATA FROM SURVEYS AND AN INDEPENDENT CONSULTANTS REPORT. THE COMPENSATION IS DETERMINED BY MEMBERS OF THE EXECUTIVE COMMITTEE WITHOUT CONFLICT AND IS DOCUMENTED. CEO COMPENSATION: CEO PRESENTS RESULTS OF PERFORMANCE OBJECTIVES TO THE EXECUTIVE COMMITTEE IN JANUARY OF EACH YEAR. THE CHAIR APPLIES A FORMULA TO THE RESULTS AND COMES UP WITH A RECOMMENDATION. THE CHAIR FACILITATES GETTING APPROVAL FROM OTHER MEMBERS OF THE EXECUTIVE COMMITTEE. SENIOR LEADERS: COMPENSATION FOR THOSE WHO REPORT TO THE CEO IS TAKEN TO THE EXECUTIVE COMMITTEE FOR DISCUSSION/APPROVAL.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION BELIEVES THE FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND POLICIES ARE THE PROPERTY OF THE ORGANIZATION AND ARE NOT AVAILABLE FOR PUBLIC INSPECTION.
FORM 990, PART XI, LINE 9:	CHANGE IN INTEREST IN FOUNDATION 408,875. INTEREST RATE SWAP AGREEMENT 2,405,379. CHANGE IN EQUITY - NARAYAN AMARNANI, MD SC 1,313,320. NON-CONTROLLING INTEREST IN CONSOLIDATED AFFILIATE -3,203,815.
FORM 990, PART XI, LINE 2B-2C	BELLIN MEMORIAL HOSPITAL, INC. IS INCLUDED IN THE CONSOLIDATED AUDIT OF BELLIN HEALTH SYSTEMS, INC. THE BOARD OF DIRECTORS OF BELLIN HEALTH SYSTEMS, INC. ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT AUDITOR. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd	Direct Controlling NADirectControllingNACd
LAKE MICHIGAN HEALTH SERVICES INC
744 SOUTH WEBSTER AVE	GREEN BAY	WI	54305	391512903	SUPPORT PURPOSES OF BELLIN MEMORIAL HOSPITAL	WI	501(C)(3)	LINE 12B, II	BELLIN HEALTH SYSTEMS INC	Yes (1)
BELLIN COLLEGE INC
3201 EATON ROAD	GREEN BAY	WI	54311	391620530	NURSING COLLEGE	WI	501(C)(3)	LINE 2	BELLIN HEALTH SYSTEMS INC	Yes (1)
THE BELLIN HEALTH FOUNDATION INC
PO BOX 23400	GREEN BAY	WI	54305	391809171	FOUNDATION	WI	501(C)(3)	LINE 7	BELLIN HEALTH SYSTEMS INC	Yes (1)
BELLIN PSYCHIATRIC CENTER INC
PO BOX 23725	GREEN BAY	WI	54305	391657627	PPSYCHIATRIC HOSPITAL	WI	501(C)(3)	LINE 3	BELLIN HEALTH SYSTEMS INC	Yes (1)
OCONTO HOSPITAL & MEDICAL CENTER INC
PO BOX 357	OCONTO	WI	54153	061745397	HOSPITAL	WI	501(C)(3)	LINE 3	BELLIN MEMORIAL HOSPITAL INC	Yes (1)
BELLIN HEALTH SYSTEMS INC
744 SOUTH WEBSTER AVE	GREEN BAY	WI	54305	391512904	SUPPORT OF HEALTHCARE ORGANIZATIONS	WI	501(C)(3)	LINE 12B, II		0	N/A
UNITY LIMITED PARTNERSHIP
2366 OAK RIDGE CIRCLE	DE PERE	WI	54115	391750729	HOSPICE, PALLIATIVE & BEREAVEMENT SERVICES	WI	501(C)(3)	LINE 10	BELLIN MEMORIAL HOSPITAL INC	Yes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd	OwnershipOwnershipPct	Direct Controlling NADirectControllingNACd
BELLIN ORTHOPEDIC SURGERY CENTER LLC
2223 LIME KILN RD	GREEN BAY	WI	54311	264677834	AMBULATORY ORTHOPEDIC SURGERY	WI	BELLIN MEMORIAL HOSPITAL INC	RELATED	$3,257,785	$931,870	0	0	0.55000
D1 SPORTS TRAINING OF GREEN BAY LLC
SOUTH SPRINGS DRIVE	FRANKLIN	TN	37067	454848172	SPORTS TRAINING	TN								N/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	OwnershipOwnershipPct
BEL-REGIONAL HOME MEDICAL INC
617 S ROOSEVELT	GREEN BAY	WI	54301	391504766	DURABLE MEDICAL EQUIPMENT, RETAIL PHARMACY, FITNESS	WI	N/A	C	Yes (1)
BELLIN INVESTMENTS INC
PO BOX 23400	GREEN BAY	WI	54305	391564939	OTHER	WI	N/A	C	Yes (1)
NARAYAN AMARNANI MD SC
725 S WEBSTER AVE	GREEN BAY	WI	54301	391325918	MEDICAL CLINIC	WI		C	Yes (1)	BELLIN MEMORIAL HOSPITAL	1.00000

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	Yes (1)	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (1)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (1)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	Yes (1)	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (1)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (1)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (1)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (1)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (1)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (1)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (1)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	0	TransferToOtherOrgInd
Transfer From Other Org	Yes (1)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (20 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
OCONTO HOSPITAL & MEDICAL CENTER
D	$11,316,660	ACTUAL
OCONTO HOSPITAL & MEDICAL CENTER
Q	$11,000,000	ACTUAL
OCONTO HOSPITAL & MEDICAL CENTER
O	$4,666,986	ACTUAL
OCONTO HOSPITAL & MEDICAL CENTER
M	$4,590,016	ACTUAL
OCONTO HOSPITAL & MEDICAL CENTER
J	$3,216,331	ACTUAL
BELLIN COLLEGE
L	$391,649	ACTUAL
BELLIN COLLEGE
N	$378,691	ACTUAL
BELLIN HEALTH FOUNDATION
C	$886,699	ACTUAL
BELLIN PSYCHIATRIC CENTER
L	$2,297,627	ACTUAL
BELLIN PSYCHIATRIC CENTER
D	$2,517,088	ACTUAL
BELLIN COLLEGE
Q	$269,045	ACTUAL
BELLIN HEALTH FOUNDATION
Q	$313,301	ACTUAL
BELLIN HEALTH FOUNDATION
O	$432,044	ACTUAL
BELLIN HEALTH FOUNDATION
S	$1,200,000	ACTUAL
BELLIN COLLEGE
D	$1,172,775	ACTUAL
BELLIN PSYCHIATRIC CENTER
D	$6,334,817	ACTUAL
OCONTO HOSPITAL & MEDICAL CENTER
D	$25,000,000	ACTUAL
BELLIN HEALTH FOUNDATION
D	$1,065,868	ACTUAL
BEL-REGIONAL HOME MEDICAL INC
D	$5,548,031	ACTUAL
OCONTO HOSPITAL & MEDICAL CENTER
D	$2,034,132	ACTUAL