2018-05-11T12:18:55-05:00 2017-06-30 990 2016-07-01 390873606 The Howard Young Medical Center Inc HOWA 7153568000 240 Maple Street Woodruff WI 54568 Tonya Mershon Tax Officer 2018-05-11 2016 2022-09-23 18:48:47Z Bernard Sherry 400 W River Woods Parkway Glendale WI 53212 57418617 false 0928 X www.ministryhealth.org X 1948 WI To improve the health and well-being of all people in the communities we serve. X 9 8 359 191 3740 -17 1445873 3040467 56146209 53797320 420033 -35885 814280 502029 58826395 57303931 0 0 27877728 22162742 0 0 22021903 25446905 49899631 47609647 8926764 9694284 173693841 88300966 20068255 22017509 153625586 66283457 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 28656552 53807333 THE HOWARD YOUNG MEDICAL CENTER, INC. ("THE HOSPITAL") PROVIDES INPATIENT, OUTPATIENT, EMERGENCY ROOM AND ANCILLARY SERVICES REGARDLESS OF AN INDIVIDUAL'S ABILITY TO PAY OR METHOD OF PAYMENT. THE HOSPITAL ALSO PROVIDES EDUCATION PROGRAMS AND SERVICES ON HEALTH CARE ISSUES TO THE COMMUNITY IT SERVES. DURING FISCAL 2017, THE HOSPITAL COUNTED 8,840 TOTAL PATIENT DAYS, TOTAL DISCHARGES of 2,409, AND 28,538 OUTPATIENT VISITS, AND ITS EMERGENCY DEPARTMENT RECEIVED 10,752 VISITS. SEE SCHEDULE H FOR FURTHER DETAILS REGARDING THE COMMUNITY BENEFITS THAT THE HOWARD YOUNG MEDICAL CENTER, INC. PROVIDES. 28656552 true true false true false false false false false true true true false true true true false true false false false false false false false false true true false false true false false false false false false true false true false false true false true true true false false true 10 0 true 359 true true true false false false false false false false false false X 9 8 false true false false true true true true true false false false true true true true true false false false WI X David Mannes 4144654571 400 W River Woods Parkway Glendale WI 53212 SANDY ANDERSON REGIONAL VP & HOSPITAL PRESIDENT (EX-OFFICIO) 5.0 36.3 X X 0 542366 30952 BILL ARVOLD CHAIRMAN 0.3 1.9 X X 0 0 0 RAY BURGAN VICE-CHAIRMAN 0.3 1.9 X X 0 0 0 NANCY M SCHULLER SECRETARY 0.3 1.9 X X 0 0 0 RANDY PLANTENBERG TREASURER 0.3 1.9 X X 0 0 0 NANCY FRAISER BOARD MEMBER 0.3 1.9 X 0 0 0 ARTHUR C HELGERSON DDS BOARD MEMBER 0.3 1.9 X 0 0 0 MARGARET S JOHNSON BOARD MEMBER 0.3 1.9 X 0 0 0 JUDY SMOLAREK RN MSN FP BOARD MEMBER 0.3 1.9 X 0 0 0 ELMER LINBOOM MD Medical Staff President 0.3 40.9 X 0 365252 37723 DANIEL E NEUFELDER SVP, HOSPITAL OPERATIONS & PRESIDENT, AHS (END 9/2016) 0.5 39.0 X 0 1825757 28416 SHISHIR N SHETH MD NR REGIONAL VP 0.3 42.9 X 0 512793 25296 JOHN CRUMP MD MEDICAL STAFF PRESIDENT 0.3 0.9 X 0 0 0 DEBORAH KAROW VP PATIENT CARE 10.0 30.0 X 0 186287 27523 LAURIE R OUNGST CHIEF OPERATING OFFICER 5.0 35.3 X 0 192772 38045 TERESA J THEILER VP QUALITY & PATIENT SAFETY (END 7/2016) 0.3 40.0 X 0 164516 24457 LAURIE DEMRO CRNA 40.0 0 X 244650 0 36028 LONNA L GROSSKOPF CRNA 40.0 0 X 250330 0 47196 DAVID W KOSKI Physician Hospitalist 40.0 0 X 237150 0 18724 KEVIN R KRUEGER CRNA 40.0 0 X 240957 0 36759 DAVID J SELL CRNA 40.0 0 X 244791 0 19154 NICHOLAS DESIEN FORMER OFFICER (END 12/2015) 0.0 0.0 X 0 2710823 443 JEFFREY FRANCIS FORMER OFFICER (END 9/2015) 0.0 0.0 X 0 225000 0 MONICA A HILT FORMER OFFICER (END 1/2015) 0.0 40.0 X 0 732037 40775 ANN M ZENK FORMER OFFICER (END 7/2015) 0.0 40.0 X 0 207773 25986 1217878 7665376 437477 19 true true false MARSHFIELD CLINIC 1000 N OAK AVE MARSHFIELD WI 544495703 PHYSICIAN SERVICES 107749 1 991026 2049441 70500 3040467 NET PATIENT REVENUE 622110 52617361 52617361 AMBULANCE SERVICES 621910 449219 449219 Income From Affiliates 561000 309568 309568 RENT FROM AFFILIATES 531190 222740 222740 REHAB SERVICES 622000 198432 198432 0 0 0 0 53797320 402248 2026 402248 2026 404274 404274 42500 78385 0 -35885 -35885 -35885 76875 36301 40574 40574 PHARMACY REVENUE 446110 10013 10013 Other Miscellaneous Revenue 900999 43428 43428 Reference Lab 621500 3740 3740 0 0 0 0 57181 57303931 53807333 3740 452391 17557206 16228695 1328511 764755 706888 57867 2686260 2482997 203263 1154521 1067161 87360 4366 4366 62375 62375 1286994 1109002 177992 0 10251 245 10006 233021 48419 184602 480 480 749703 330 749373 82286 71730 10556 36494 29024 7470 429492 429492 3695002 1002310 2692692 102379 102379 Corporate Overhead Allocation 9008320 9008320 Medical Supplies 4743875 4743875 Purchased Services 3088519 753497 2335022 Provider Tax 1086650 1086650 826698 411899 414799 0 47609647 28656552 18953095 0 1275 -6016 16751829 6486477 6622359 0 0 0 1479741 1665881 14722 4355 33276306 9741449 23462678 23534857 44045398 48746796 0 1069773 49845 80381948 7682889 173693841 88300966 2327261 2492372 0 17740994 19525137 20068255 22017509 X 107104108 14528689 2476080 3007972 44045398 48746796 153625586 66283457 173693841 88300966 X 9694284 -97036413 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 4366 4366 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. The Howard Young Medical Center, 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 is specifically allocable to lobbying. The Howard Young Medical Center, 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. 44045398 6865840 2049067 115375 48746796 46961389 -1584543 1232455 98993 44045398 47483727 1304856 1641656 185538 46961389 41832772 0 7307270 0 1581416 74899 47483727 40021399 0 2968498 0 1157125 0 41832772 0.0 1.0 0.0 true false 3178349 3178349 16228601 3860877 12367724 12567802 5445907 7121895 1301554 434665 866889 23534857 HYMC Trust Indenture 48746796 F 48746796 Interests in investments held by Ascension Health Alliance Due from Affiliates 2587014 Estimated Settlements from Third-Party Payor 32000 Other Receivables 2020664 Miscellaneous Current Assets 35239 HYHF Trust Receivable (FASB 136) 3007972 7682889 Asset retirement obligation intercompany payables other liabilities Intercompany Debt 12203669 Estimated Settlement to Third-Party Payor 625521 Due to Affiliates 6242390 AH Savings Plan Liability 213277 Asset Retirement Obligation 154887 Accrued Tax Liability 23860 Recovery Tail Liability 61533 19525137 X Schedule D, Part V, Line 4 Intended uses of endowment funds The Howard Young Trust was established by S. Howard Young in 1975 as a mechanism to ensure the Hospital continues to have access to funding for capital needs, medical service continuation and service growth to meet the community's needs. 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, 2017. true true X true X 250 true X true true false true true 0 0 437989 0 437989 0.0092 0 0 8199703 5056609 3143094 0.0660 0 0 0 0 0 0.0 0 0 8637692 5056609 3581083 0.0752 7 0 156777 15954 140823 0.0030 3 3 201650 0 201650 0.0042 0 0 0 0 0 0.0 0 0 0 0 0 0.0 1 0 29755 0 29755 0.0006 11 3 388182 15954 372228 0.0078 11 3 9025874 5072563 3953311 0.0830 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 false 575716 0 23601303 24973873 -1372570 X true true 1 1 The Howard Young Medical Center Inc 240 Maple Street Woodruff WI 54568 www.ministryhealth.org 201 X X X The Howard Young Medical Center Inc 1 false false true X X X X X X X X X 15 true true true true X https://healthcare.ascension.org/locations/wisconsin/woodruff-howard-young-medical-center/community- X true 15 true https://healthcare.ascension.org/locations/wisconsin/woodruff-howard-young-medical-center/community- false true X 250.0 400.0 X X X X X true true X X X true X https://healthcare.ascension.org/financial-assistance/wisconsin X https://healthcare.ascension.org/financial-assistance/wisconsin X https://healthcare.ascension.org/financial-assistance/wisconsin X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - THE HOWARD YOUNG MEDICAL CENTER, INC.. Input into the CHNA from community members, including members of medically underserved, low-income and minority populations and from organizations that serve those populations, was sought in multiple ways. (a) A community survey was conducted in Summer-Fall 2015 that asked participants to share their perceptions on the health of the community and to identity health priority areas. The survey also asked questions about the participants' current health status and barriers to care. The survey was distributed online through the health departments' websites and Facebook. In an effort to insure representation from vulnerable groups, such as low-income, minority and medically underserved populations paper copies of the survey were distributed to identify community sites that serve these populations. (b) In December 2015, a community forum was held, at which input was received from both the general public and from representatives of organizations that serve medically underserved, low-income and minority populations. (c) Multiple focus groups were held to offer opportunities for the voices of specific communities (e.g., college students, Native American tribes) to be heard. (d) Key-informant interviews were conducted with community members that work to improve the health of the community, especially within the vulnerable populations including the low-income and medically underserved. The organizations involved in the above efforts are listed below. Community Needs Assessment Team / December 2015 Community Forum * Forest County Health Department * Oneida County Health Department * Vilas County Health Department * Ministry St. Mary's Hospital * Ministry Health Care * UW-Extension - Oneida County * Division of Public Health, Northern Region Office * Commission on Aging * Marshfield Clinic * Rhinelander School District * Crandon Public Library * Lac du Flambeau School District * Oneida County Social Services * Tri-County Council on Domestic Violence and Sexual Assault * Vilas County Health Department Board of Health * Holy Family Church * UW-Extension-Forest County * Nicolet College * Ministry Health - Sacred Heart * Forest County Office on Aging * Northwoods United Way, Inc. * UW-Extension-Forest and Vilas Counties * Sokaogon Mole Lake Clinic * Family & Child Learning Center * Blackwell Job Corps * Forest County Tribal AmeriCorps * Ministry Health-Howard Young * Forest County Potawatomi Health & Wellness * City of Rhinelander Police Department * Tri-County Counsel * Department of Aging * Tri County Council * ADRC * Sunshine for Humanity * Vilas County Emergency Management * Demmer Library * Petersen Christianson Healthcare * Great Lakes Intertribal Council * Vilas County Sheriff's Department * Oneida County Social Services * Nicolet College Focus Groups: AODA Coalition Mental Health Inter-Agency Coalition LEAN Coalition Nicolet College Nursing Students RHS CHANGE/Fact Group Vilas County Fire Chief's and Emergency Services Association Community Coalition of Forest County Forest County School Administrators of Crandon, Laona and Wabeno Key Informant Interviews: Northwoods Alliance for Temporary Housing Police / Law Enforcement Tri-County Counsel on Domestic Violence University of Wisconsin-Extension School District Tribal Social Services Economic Development Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - the howard young medical center, inc.. THE CHNA WAS CONDUCTED WITH THE FOLLOWING HOSPITAL FACILITY(S) St. Mary's Hospital Eagle River Memorial Hospital Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - the howard young medical center, inc.. THE CHNA WAS CONDUCTED THE FOLLOWING NON-HOSPITAL FACILITY(S): Forest County Health Department Vilas County Health Department Oneida County Health Department Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - THE HOWARD YOUNG MEDICAL CENTER, INC.. Using the CHNA completed in June 2016, the hospital developed, adopted, and worked on executing a three-year Implementation Strategy to address priority community health needs. In Fiscal Year 2017 (Tax Year 2016), the hospital implemented the following plan to address the priority needs: Mental Health -- Increase community members' awareness of and ability to access behavioral health services. -- Conducted suicide prevention training (Question, Persuade, Refer) -- Participated in the mental health and AODA coalition -- Initiated planning for the 2018 Mental Health Summit Chronic Disease -- Increase the proportion of residents of Forest, Oneida and Vilas Counties who have a healthy diet and regular physical activity. -- Conducted a Healthy Hospital Physical Activity Environmental Scan (to inform future improvements in the hospital's physical activity environment) -- Installed water bottle filling stations in the hospital to encourage water consumption -- Participated in the local chronic disease prevention coalition AODA -- There will be coordinated and strengthened efforts to connect people with resources and healthy alternatives for prevention and early intervention of alcohol and other drug abuse in Northern Region Ministry hospitals and clinics. -- Participated in the mental health and AODA coalition -- Improved the sharing of resources/information with patients being discharged with AODA issues The description below includes the needs not being addressed as well as the reason why the needs are not being addressed. In addition to the three health issues selected as the top priorities, stakeholders identified transportation as a concern that could impact access to services in Forest, Oneida, and Vilas counties. While this issue will not be addressed by our hospitals as a priority health need, we will provide support to those community efforts whenever possible. Transportation issues have been raised as a barrier for residents living in the three counties. Transportation can impact a person's ability to get to services to meet their needs. There is a new transportation program that has started in our area that serves Oneida and Vilas Counties. Forest County had been a partner at the table, but is no longer part of the program. The new transportation program will be addressing transportation issues and conducting a gap analysis, therefore, the hospitals will not be addressing this issue at this time. However, the hospitals' administrations are interested in knowing more about how the gaps are being filled and will be open to hearing more about these needs when the gap analysis is completed. 0 Schedule H, Part V, Section B, Line 17 Billing and Collection Policy During tax year 2017, the organization learned via verbal comments of IRS agents at public events that the IRS intends that the "readily obtainable" standard in the 501(r) regulations for the AGB calculation and billing and collection policy is only met if those items are posted to the organization's web site. The organization had interpreted that web posting standard to be a safe harbor after consulting with external counsel and tax advisors, and timely took other steps to make the information readily obtainable. Consequently, the organization does not believe its decision to not post these documents to its web site rises to the level of a failure, nor does it believe the circumstances were either willful or egregious, having otherwise timely taken the steps necessary to attain and continue to maintain compliance with the other requirements related to the billing and collection policy and the AGB, as part of its policies and procedures for ensuring compliance with all aspects of 501(r). However, the organization is making this voluntary disclosure in order to communicate to the IRS the changes it is undertaking in response to the recent IRS informal guidance on this specific point concerning the "readily obtainable" standard, and the fact that the organization has started the work necessary to post its AGB information and billing and collection policy to its web site and will complete those additional postings as soon as reasonably possible. The other web postings required under 501(r) (i.e., those related to the community health needs assessment and the financial assistance policy) were timely completed and continue to remain in place as required. The organization believes its safeguards worked as intended in this case (i.e., the organization has regular communications with a number of external law firms and tax consultants and the timely attention to the recent guidance was supported by the framework of regular access to subject matter experts). These changes are in the process of being incorporated into corporate policies and procedures that apply to the organization. Schedule H, Part I, Line 6a Community benefit report prepared by related organization THE HOWARD YOUNG MEDICAL CENTER, INC. IS INCLUDED IN THE ANNUAL COMMUNITY BENEFIT REPORT WHICH IS PUBLISHED BY MINISTRY HEALTH CARE, INC. (EIN: 39-1490371) AND AVAILABLE TO THE PUBLIC ON ITS WEBSITE, WWW.MINISTRYHEALTH.ORG. THIS REPORT INCLUDES ALL OF THE RELATED ENTITIES WITHIN THE MINISTRY HEALTH CARE, INC. NETWORK OF HOSPITALS, CLINICS AND OTHER HEALTH-RELATED ORGANIZATIONS. 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 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 2017 was $1,341,311 at charges, ($575,716 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 19. 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 HOWARD YOUNG MEDICAL CENTER, INC. 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 - The Howard Young Medical Center, Inc.: Line 16a URL: https://healthcare.ascension.org/financial-assistance/wisconsin; Schedule H, Part V, Section B, Line 16b FAP Application website - The Howard Young Medical Center, Inc.: Line 16b URL: https://healthcare.ascension.org/financial-assistance/wisconsin; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - The Howard Young Medical Center, 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, Howard Young Medical Center 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. Howard Young Medical Center 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 The Organization goes to great lengths in order to inform and educate patients/persons who may be billed for patient care about their eligibility for assistance under federal, state or local government programs and under the Organization's Charity Care Policy. The Charity Care Policy and application is posted on the Organization's website. Admissions and other key areas contain summary information of the Charity Care Policy. As part of the intake/discharge process, patients are provided with a copy of the policy and other information for financial assistance. If a patient indicates they are unable to pay their bill at any point during pre-service, admission, discharge or billing process, the financial counselors will assist the patient in either securing a funding source (grants, COBRA coverage, disability benefits, Medicaid, VA, etc.) if eligible or assist them in completing a financial assistance application. If during the course of the patient registration process, care encounter, treatment, or upon discharge it becomes evident that a patient may need financial assistance, the patient shall be referred to the Organization's Community Care Program. Patients may be identified as needing financial assistance at any time during the course of an encounter. A referral for consideration of Community Care Financial Assistance can be initiated by any member of the Hospital's workforce, including medical staff members, who become aware of the patient's potential need for Community Care Financial Assistance. The Charity Care Policy was also translated into dialects prevalent in the community in order to reach out to those that may speak another language Spanish and Hmong). Patient registration staff and financial counselors are provided with scripts to follow when interacting with patients. As part of the charity care process, patients must register with the county public assistance to see if they may qualify under any other federal or state programs. Schedule H, Part VI, Line 4 Community information While there is growing agreement in the United States about what constitutes a non-profit hospital's community benefit, this is a work in progress. The Organization provided significant charity care and other community benefits as defined by the IRS. But, in addition, we believe that we provide a critically important community benefit, which is not quantified. Our Hospital, like most rural hospitals, was created and is maintained in order to provide care locally - care that without our Hospital, may not be available locally. Certain specialized services available include: diabetes education and management, speech therapy, wound care and management, palliative care services, pain management services, and inpatient dialysis services. The Howard Young Medical Center, Inc. is located in Woodruff, Wisconsin and services the surrounding communities. Per the Home Town Locator Woodruff had a population of 2,210 as of July 1, 2015. According to the 2010 census, with 18.8% under the age of 19, 4.0% from 20-24 years of age, 19.0% from 25-44 years of age, 29.7% from 45-64 years of age, and 28.5% over the age of 65. The median income in 2010 for a household was $42,306. The per capita income of the town in 2010 was $27,086. The town has a total of 35.6 square miles, of which 7.0 square miles is water. The median age is 50.3 years. Woodruff is located in Oneida County Wisconsin. According to the 2010 census, Oneida County had a population of 35,998 people, with 18.4% under the age of 18 and 21.7% over the age of 65. The median age was 48.0 years. The median household income in 2010 was $45,857. About 9.9% of the population was below the poverty level. The unemployment rate for December 2011 in Oneida County was 9.3% compared to the state rate of 7.0%. 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. They 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. The Howard Young Medical Center, Inc. is also involved in the following efforts which further its tax exempt status: - The Hospital participates in government-sponsored health programs (Medicare, Medicaid, Champus, Tricare). - The facility strives to be a low-cost/low-charge provider by utilizing the lean six sigma approach to improve patient safety, patient quality of services and patient satisfaction. - The Howard Young Medical Center, Inc. emergency room serves all people regardless of their ability to pay. - Charity care is available to all in the community based on need and is subject to sliding scale discounts. - The Howard Young Medical Center, Inc. has a volunteer services program where community members utilize the Hospital as a vehicle to connect with and contribute to individuals and the overall community through volunteering. - The Howard Young Medical Center, Inc. encourages their management team to participate in the Local Good Pantry's Distribution Day. Nutritionists are available to discuss healthy food choices, clinical services such as blood pressure checks and cholesterol screening along with educational sessions have been developed. They also have networked with a local optometry office to provide eye care screenings and eyeglass assistance. Schedule H, Part VI, Line 6 Affiliated health care system THE HOWARD YOUNG MEDICAL CENTER, INC. IS AN AFFILIATE OF MINISTRY HEALTH, INC. AND ASCENSION HEALTH. THE HOWARD YOUNG MEDICAL CENTER, 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 ORGANIZATIONS/ENTITIES OF ASCENSION SPONSOR ARE THE DAUGHTERS OF CHARITY OF ST. VINCENT DE PAUL, ST. LOUISE PROVINCE; THE CONGREGATION OF ST. JOSEPH; THE CONGREGATION OF THE SISTERS OF ST. JOSEPH OF CARONDELET; THE CONGREGATION OF ALEXIAN BROTHERS OF THE IMMACULATE CONCEPTION PROVINCE, INC. - AMERICAN PROVINCE; AND THE SISTERS OF THE SORROWFUL MOTHER OF THE THIRD ORDER OF ST. FRANCIS OF ASSISI - US/CARIBBEAN PROVINCE. The System directs its governance and management activities toward strong, vibrant, Catholic Health Ministries united in service and healing and dedicates its resources to spiritually centered care that sustains and improves the health of the individuals and communities it serves. In accordance with the System's mission of service to those persons living in poverty and to other vulnerable persons, each Health Ministry accepts patients regardless of their ability to pay. The System uses four categories to identify the resources utilized for the care of persons living in poverty and for community benefit programs: Traditional charity care includes the cost of services provided to persons who cannot afford health care because of inadequate resources and/or who are uninsured or underinsured. Unpaid cost of public programs, excluding Medicare, represents the unpaid cost of services provided to persons covered by public programs for persons living in poverty and for other vulnerable persons. Cost of other programs for persons living in poverty and for other vulnerable persons includes unreimbursed costs of programs intentionally designed to serve the persons living in poverty and the other vulnerable persons of the community, including substance abusers, the homeless, victims of child abuse, and persons with acquired immune deficiency syndrome. Community benefit consists of the unreimbursed costs of community benefit programs and services for the general community, not solely for the persons living in poverty, including health promotion and education, health clinics and screenings, and medical research. Discounts are provided to all uninsured patients, including those with the means to pay. Discounts provided to those patients who did not qualify for assistance under charity care guidelines are not included in the cost of providing care to persons living in poverty or in the cost of other community benefit programs. The cost of providing care to persons living in poverty and of other community benefit programs is estimated using internal cost data and is estimated by reducing charges forgone by a factor derived from the ratio of total operating expenses to billed charges for patient care. true true false false false false false false false SANDY ANDERSON REGIONAL VP & HOSPITAL PRESIDENT (EX-OFFICIO) 0 394768 0 140786 0 6812 0 13250 0 17702 0 573318 0 0 NICHOLAS DESIEN FORMER OFFICER (END 12/2015) 0 190823 0 0 0 2520000 0 443 0 0 0 2711266 0 0 JEFFREY FRANCIS FORMER OFFICER (END 9/2015) 0 0 0 0 0 225000 0 0 0 0 0 225000 0 0 MONICA A HILT FORMER OFFICER (END 1/2015) 0 493948 0 231779 0 6310 0 17225 0 23550 0 772812 0 0 ANN M ZENK FORMER OFFICER (END 7/2015) 0 193236 0 12720 0 1817 0 13317 0 12669 0 233759 0 0 ELMER LINBOOM MD Medical Staff President 0 281390 0 20000 0 63862 0 12119 0 25604 0 402975 0 0 DANIEL E NEUFELDER SVP, HOSPITAL OPERATIONS & PRESIDENT, AHS (END 9/2016) 0 861918 0 713099 0 250740 0 15900 0 12516 0 1854173 0 0 SHISHIR N SHETH MD NR REGIONAL VP 0 462113 0 16025 0 34655 0 17225 0 8071 0 538089 0 0 DEBORAH KAROW VP PATIENT CARE 0 170186 0 11868 0 4233 0 10425 0 17098 0 213810 0 0 LAURIE R OUNGST CHIEF OPERATING OFFICER 0 179230 0 12128 0 1414 0 12002 0 26043 0 230817 0 0 TERESA J THEILER VP QUALITY & PATIENT SAFETY (END 7/2016) 0 153412 0 10010 0 1094 0 9487 0 14970 0 188973 0 0 LAURIE DEMRO CRNA 211349 0 20721 0 12580 0 11805 0 24223 0 280678 0 0 0 LONNA L GROSSKOPF CRNA 216258 0 17263 0 16809 0 15762 0 31434 0 297526 0 0 0 DAVID W KOSKI Physician Hospitalist 160465 0 28476 0 48209 0 11863 0 6861 0 255874 0 0 0 KEVIN R KRUEGER CRNA 216310 0 16853 0 7794 0 15611 0 21148 0 277716 0 0 0 DAVID J SELL CRNA 219478 0 16663 0 8650 0 15273 0 3881 0 263945 0 0 0 Schedule J, Part II OFFICER COMPENSATION JOHN CRUMP, MEDICAL STAFF PRESIDENT, WAS PAID BY MARSHFIELD CLINIC FOR SERVICES PROVIDED TO THE HOWARD YOUNG MEDICAL CENTER, INC. FOR THE YEAR ENDED JUNE 30, 2017, $28,075 WAS PAID TO MARSHFIELD CLINIC BY THE HOWARD YOUNG MEDICAL CENTER FOR THESE SERVICES. IN ADDITION, THE HOWARD YOUNG MEDICAL CENTER PAID MARSHFIELD CLINIC $13,216 FOR MEDICAL SERVICES PROVIDED OUTSIDE OF THE SCOPE OF HIS DUTIES AS MEDICAL STAFF PRESIDENT. Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation MINISTRY HEALTH CARE, INC., A RELATED ORGANIZATION OF THE HOWARD YOUNG MEDICAL CENTER, 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: Nicholas Desien - $2,520,000 Jeffrey Francis - $225,000 Daniel Neufelder - $234,000 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. Wendy Hunter Sister of Deborah Karow 74942 Wendy Hunter is an employee of The Howard Young Medical Center, Inc. and receives compensation from the organization. false X Medical Equipment 2 70500 Cost 0 false true false Schedule M, Part I Explanations of reporting method for number of contributions Other - Medical Equipment Number of items received. CASH ACCOUNTS TRANSFERED TO PARENT'S BALANCE SHEET 2016-10-31 19048561 ACTUAL COST (CASH) 391490371 MINISTRY HEALTH CARE INC 10925 W LAKE PARK DR STE 100 MILWAUKEE WI 53224 501(C)(3) CASH ACCOUNTS TRANSFERED TO SYSTEM OFFICE BALANCE SHEET 2016-07-31 76686412 ACTUAL COST (CASH) 453358926 ASCENSION HEALTH ALLIANCE PO BOX 45998 ST LOUIS MO 63145 501(C)(3) false false false false Schedule N, Part II CASH TRANSFER THE HOWARD YOUNG MEDICAL CENTER, INC. TRANSFERRED ITS BEGINNING HSD CASH BALANCE TO ASCENSION HEALTH ALLIANCE (45-3358926) AS OF JULY 1, 2016 AND OTHER CASH BALANCES TO MINISTRY HEALTH CARE, INC. (39-1490371) AS OF OCTOBER 31, 2016. 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 THE HOWARD YOUNG MEDICAL CENTER, 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 THE HOWARD YOUNG MEDICAL CENTER, 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 3 Delegation of management duties ONE OF THE MEDICAL STAFF PRESIDENTS IS PAID BY MARSHFIELD CLINIC FOR HIS SERVICES TO THE HOWARD YOUNG MEDICAL CENTER, INC. SEE SCHEDULE J, PART III FOR ADDITIONAL DISCLOSURE. Form 990, Part VI, Line 6 Classes of members or stockholders The Howard Young Medical Center, Inc. has a single corporate member, Ministry Health Care, Inc. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body The Howard Young Medical Center, Inc. has a single corporate member, Ministry Health Care, Inc., who has the ability to elect members to the governing body of The Howard Young Medical Center, Inc. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders All decisions that have a material impact to The Howard Young Medical Center, 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 XI, Line 9 Other changes in net assets or fund balances Net Asset Transfers with Affiliates - -27215841; Change in Value of Beneficial Interest Trust - 6865840; Net Asset Transfer to Alpha Fund - -76686412; Form 990, Part XII, Line 2b Audited Financial Statement The activity of The Howard Young Medical Center, Inc. is reported in the consolidated financial statements of Ascension Health Alliance. No individual audit of The Howard Young Medical Center, Inc. is completed. Therefore, the attached audited financial statements are of Ascension Health Alliance and Affiliates, which include the activity of The Howard Young Medical Center, Inc.. Form 990, Part XII, Line 2c Audit Committee The Howard Young Medical Center, 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. 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