ASCENSION NE WISCONSIN INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization: ASCENSION NE WISCONSIN INC (EIN 39-0816818)
Tax period: 2016-07-01 to 2017-06-30
Filed: 2018-05-11
IRS object ID: 201831319349302298
Schema version: 2016v3.0
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 J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2018-05-11T12:16:14-05:00	ReturnTs
Tax Period End	2017-06-30	TaxPeriodEndDt
Return Type	990	ReturnTypeCd
Tax Period Begin	2016-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	390816818	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	St Elizabeth Hospital Inc	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	STEL	BusinessNameControlTxt
Phone	3147338000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1506 South Oneida Street	AddressLine1Txt
City	Appleton	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	549151397	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Tonya Mershon	PersonNm
Person Title	Tax Officer	PersonTitleTxt
Signature	2018-05-11	SignatureDt

Field	Value	IRS element (for citing)
Tax	2016	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Bernard Sherry	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	400 W River Woods Parkway	AddressLine1Txt
City	Glendale	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	53212	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$206,516,004	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Group Exemption	0928	GroupExemptionNum
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	www.affinityhealth.org	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1899	FormationYr
Legal Domicile State	WI	LegalDomicileStateCd
Activity Or Mission	To improve the health and well-being of all people in the communities we serve.	ActivityOrMissionDesc
Voting Members Governing Body	12	VotingMembersGoverningBodyCnt
Voting Members Independent	9	VotingMembersIndependentCnt
Total Employee	1381	TotalEmployeeCnt
Total Volunteers	280	TotalVolunteersCnt
Total Gross UBI	$222,740	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$494,496	PYContributionsGrantsAmt
CY Contributions Grants	$220,952	CYContributionsGrantsAmt
PY Program Service Revenue	$195,730,799	PYProgramServiceRevenueAmt
CY Program Service Revenue	$204,834,164	CYProgramServiceRevenueAmt
PY Investment Income	$27,515	PYInvestmentIncomeAmt
CY Investment Income	$109,291	CYInvestmentIncomeAmt
PY Other Revenue	$5,265,614	PYOtherRevenueAmt
CY Other Revenue	$854,356	CYOtherRevenueAmt
PY Total Revenue	$201,518,424	PYTotalRevenueAmt
CY Total Revenue	$206,018,763	CYTotalRevenueAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$83,567,284	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$64,712,182	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$86,159,250	PYOtherExpensesAmt
CY Other Expenses	$106,309,044	CYOtherExpensesAmt
PY Total Expenses	$169,726,534	PYTotalExpensesAmt
CY Total Expenses	$171,021,226	CYTotalExpensesAmt
PY Revenues Less Expenses	$31,791,890	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$34,997,537	CYRevenuesLessExpensesAmt
Total Assets BOY	$227,851,961	TotalAssetsBOYAmt
Total Assets EOY	$214,170,022	TotalAssetsEOYAmt
Total Liabilities BOY	$90,381,683	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$95,406,975	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$137,470,278	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$118,763,047	NetAssetsOrFundBalancesEOYAmt
Mission	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.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$108,896,873	ExpenseAmt
Revenue	$204,661,878	RevenueAmt
Desc	ST. ELIZABETH HOSPITAL, INC. PROVIDES INPATIENT, OUTPATIENT, EMERGENCY ROOM, AND ANCILLARY SERVICES REGARDLESS OF AN INDIVIDUAL'S ABILITY TO PAY. THE HOSPITAL ALSO PROVIDES EDUCATIONAL PROGRAMS AND SERVICES ON HEALTH CARE ISSUES TO THE COMMUNITY IT SERVES. SEE SCHEDULE H FOR FURTHER DETAILS.	Desc
Total Program Service Expenses	$108,896,873	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	false	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (true)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	38	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	1381	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	12	GoverningBodyVotingMembersCnt
Independent Voting Member	9	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	false	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	false	CompensationProcessCEOInd
Compensation Process Other	false	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
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	David Mannes	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	4144654571	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	400 W River Woods Parkway	AddressLine1Txt
City	Glendale	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	53212	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
JOHN RUSSO
CHAIRMAN	0.3	1.5	Yes (X)	Yes (X)	$0	$0	$0
WAYNE WIETING
VICE-CHAIRMAN	0.3	1.5	Yes (X)	Yes (X)	$0	$0	$0
MARK W FAUSTICH MD
SECRETARY	0.3	41.1	Yes (X)	Yes (X)	$0	$464,782	$33,026
BRIAN WALLACE
TREASURER	0.3	1.5	Yes (X)	Yes (X)	$0	$0	$0
LANE EARNS
BOARD MEMBER	0.3	1.5	Yes (X)		$0	$0	$0
MARLIN GREENFIELD
BOARD MEMBER	0.3	1.5	Yes (X)		$0	$0	$0
MARK KEHRBERG MD
BOARD MEMBER	0.4	1.6	Yes (X)		$0	$0	$0
KEVIN RAFLOFSKY
BOARD MEMBER	0.3	0	Yes (X)		$0	$0	$0
KATHRYN SIEMAN
BOARD MEMBER	0.3	1.5	Yes (X)		$0	$0	$0
SUDEEP S SODHI MD
BOARD MEMBER	0.3	41.1	Yes (X)		$0	$969,587	$48,890
MONICA VOMASTIC
BOARD MEMBER	0.3	1.5	Yes (X)		$0	$0	$0
WENDY SCHROEDER DO
BOARD MEMBER	0.3	41.1	Yes (X)		$0	$331,895	$49,240
MONICA A HILT
PRESIDENT, ST. ELIZABETH HOSPITAL	28.0	12.0		Yes (X)	$0	$732,037	$40,775
DANIEL E NEUFELDER
SR. VP HOSP OPS (END 9/2016)	10.0	29.5		Yes (X)	$0	$1,825,757	$28,416
LAWRENCE DONATELLE
VICE PRESIDENT OF MEDICAL AFFAIRS	40.0	0.0			$0	$334,728	$38,062	Yes (X)
TONYA L DEDERING
Reg Dir Foundations	40.0	0.6			$215,649	$0	$37,793		Yes (X)
MICHAEL A HOFMANN
Dir Patient Care Srvcs	40.0	0			$154,444	$0	$32,171		Yes (X)
FAYE E KAMRATH
Dir Radiology Srvcs	40.0	0			$165,654	$0	$25,448		Yes (X)
NANETTE W KRIZENEKSY
RN Lead-ICU MrktS	40.0	0			$181,642	$0	$42,742		Yes (X)
SCOTT D MOON
Sr Medical Physicist	40.0	0.0			$158,382	$58,105	$30,232		Yes (X)
NICHOLAS DESIEN
FORMER OFFICER (END 12/2015)	0.0	0.0			$0	$2,710,823	$443			Yes (X)
JEFFREY FRANCIS
FORMER OFFICER (END 9/2015)	0.0	0.0			$0	$225,000	$0			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$875,771	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$7,652,714	TotReportableCompRltdOrgAmt
Total Other Compensation	$407,238	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	37	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (3 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	Address Line2ContractorAddress/USAddress/AddressLine2Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
INTEGRATED HEALTH NETWORK OF WISCONSIN LLC
19601 W BLUEMOUND ROAD	SUITE 200	BROOKFIELD	WI	53045	MEDICAL SERVICES	$548,322
GREEN BAY ONCOLOGY LTD
1726 SHAWANO AVE		GREEN BAY	WI	543033216	ONCOLOGY SERVICES	$362,082
MOSAIC FAMILY HEALTH INC
229 S MORRISON STREET		APPLETON	WI	549115725	PHYSICIAN SERVICES	$151,492

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	3	CntrctRcvdGreaterThan100KCnt
Info In Schedule O Part VIII	Yes (X)	InfoInScheduleOPartVIIIInd
Related Organizations	$208,769	RelatedOrganizationsAmt
Government Grants	$8,426	GovernmentGrantsAmt
All Other Contributions	$3,757	AllOtherContributionsAmt
Total Contributions	$220,952	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
NET PATIENT REVENUE	621990	$202,024,511	$201,808,871	$215,640
RENT FROM AFFILIATES	531120	$2,633,631	$2,633,631
PHARMACY REVENUE	446110	$647,318	$647,318
Income from Affiliates	561000	$530,925	$530,925
EHR Incentive Revenue	621990	$350,048	$350,048

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$1,352,269	TotalRevenueColumnAmt
Related Or Exempt Func Income	-$1,352,269	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$204,834,164	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$33,009	TotalRevenueColumnAmt
Exclusion	-$33,009	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$17,776	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$17,776	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$17,776	TotalRevenueColumnAmt
Exclusion	$17,776	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$142,300	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Other	$0	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt
Other	$142,300	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$142,300	TotalRevenueColumnAmt
Exclusion	$142,300	ExclusionAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$1,047,040	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$497,241	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$549,799	TotalRevenueColumnAmt
Exclusion	$549,799	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	ExclusionExclusionAmt
EDUCATION REVENUE	611430	$43,354	$43,354
FITNESS CLUB	713940	$20,520		$20,520
RESEARCH REVENUE	900099	$9,440		$9,440

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$213,467	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$7,100	UnrelatedBusinessRevenueAmt
Exclusion	$206,367	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$286,781	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$206,018,763	TotalRevenueColumnAmt
Related Or Exempt Func Income	$204,661,878	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$222,740	UnrelatedBusinessRevenueAmt
Exclusion	$913,193	ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$51,717,607	TotalAmt
Program Services	$46,776,622	ProgramServicesAmt
Management And General	$4,940,985	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$914,490	TotalAmt
Program Services	$827,122	ProgramServicesAmt
Management And General	$87,368	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$8,273,030	TotalAmt
Program Services	$7,482,644	ProgramServicesAmt
Management And General	$790,386	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$3,807,055	TotalAmt
Program Services	$3,443,338	ProgramServicesAmt
Management And General	$363,717	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$9,000	TotalAmt
Program Services	$9,000	ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$1,080	TotalAmt
Program Services	$1,080	ProgramServicesAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$8,936	TotalAmt
Management And General	$8,936	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$4,368,757	TotalAmt
Program Services	$2,764,998	ProgramServicesAmt
Management And General	$1,603,759	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$5,142	TotalAmt
Program Services	$4,592	ProgramServicesAmt
Management And General	$550	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$879,848	TotalAmt
Program Services	$437,266	ProgramServicesAmt
Management And General	$442,582	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$55,760	TotalAmt
Program Services	$13,966	ProgramServicesAmt
Management And General	$41,794	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$4,075,598	TotalAmt
Program Services	$1,306,754	ProgramServicesAmt
Management And General	$2,768,844	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$64,766	TotalAmt
Program Services	$48,494	ProgramServicesAmt
Management And General	$16,272	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$36,479	TotalAmt
Program Services	$33,441	ProgramServicesAmt
Management And General	$3,038	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$2,210,647	TotalAmt
Management And General	$2,210,647	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$12,650,175	TotalAmt
Program Services	$6,328,905	ProgramServicesAmt
Management And General	$6,321,270	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$269,613	TotalAmt
Management And General	$269,613	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
Medical Supplies	$35,173,376	$35,173,376
Corporate Overhead Allocation	$29,762,149		$29,762,149
Purchased Services	$9,681,674	$2,220,932	$7,460,742
Provider Tax Expense	$4,320,293		$4,320,293

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$2,735,751	TotalAmt
Program Services	$2,024,343	ProgramServicesAmt
Management And General	$711,408	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$171,021,226	TotalAmt
Program Services	$108,896,873	ProgramServicesAmt
Management And General	$62,124,353	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$5,035	BOYAmt
EOY	$4,930	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$13,105,349	BOYAmt
EOY	$772,689	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$4,937	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$29,468,960	BOYAmt
EOY	$31,032,880	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$2,816,246	BOYAmt
EOY	$4,045,032	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$264,588	BOYAmt
EOY	$262,709	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$211,856,923	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$43,394,856	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$175,694,919	BOYAmt
EOY	$168,462,067	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$1,764,898	BOYAmt
EOY	$3,257,666	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$4,731,966	BOYAmt
EOY	$6,327,112	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$227,851,961	BOYAmt
EOY	$214,170,022	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$10,238,047	BOYAmt
EOY	$11,794,454	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$209,636	BOYAmt
EOY	$240,282	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$79,934,000	BOYAmt
EOY	$83,372,239	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$90,381,683	BOYAmt
EOY	$95,406,975	EOYAmt

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

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$137,222,396	BOYAmt
EOY	$118,445,336	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$247,882	BOYAmt
EOY	$317,711	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$137,470,278	BOYAmt
EOY	$118,763,047	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$227,851,961	BOYAmt
EOY	$214,170,022	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$34,997,537	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$48,377	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$53,656,391	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	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 (true)	AuditCommitteeInd
Federal Grant Audit Required	Yes (true)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (true)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

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

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$8,936	OtherActivitiesAmt
Total Lobbying Expenditures	$8,936	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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. St. Elizabeth Hospital, Inc. does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office.
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. St. Elizabeth Hospital, Inc. does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office.

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$4,067,024	OtherCostOrOtherBasisAmt
Book Value	$4,067,024	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$153,525,042	OtherCostOrOtherBasisAmt
Depreciation	$19,382,660	DepreciationAmt
Book Value	$134,142,382	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$6,425	OtherCostOrOtherBasisAmt
Depreciation	$321	DepreciationAmt
Book Value	$6,104	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$47,767,162	OtherCostOrOtherBasisAmt
Depreciation	$23,579,937	DepreciationAmt
Book Value	$24,187,225	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$6,491,270	OtherCostOrOtherBasisAmt
Depreciation	$431,938	DepreciationAmt
Book Value	$6,059,332	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$168,462,067	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (12 entries)

DescDesc	AmtAmt
Pension Liability
457(b) Plan
Deferred tax liability
other liabilities
Estimated Settlement to Third-Party Payor	$3,370,800
Due to Affiliates	$15,558,097
Lease Liability	$156,334
Net Long-Term Debt	$62,740,319
FIN48 Liability	$326,774
Other Miscellaneous Liabilities	$145,331
Recovery Tail Liability	$443,017
AH Savings Plan Liability	$631,567

Field	Value	IRS element (for citing)
Total Liability	$83,372,239	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote	FormAndLineReferenceDesc
Explanation	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.	ExplanationTxt

Schedule H IRS990ScheduleH

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

Free Care Oth Percentage FreeCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Free Care Other	250	FreeCareOtherPct

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

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$1,632,937	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,632,937	NetCommunityBenefitExpnsAmt
Total Expense	0.0095	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$2,781,115	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,781,115	NetCommunityBenefitExpnsAmt
Total Expense	0.0163	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$3,176	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,176	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$4,417,228	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,417,228	NetCommunityBenefitExpnsAmt
Total Expense	0.0258	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	9	ActivitiesOrProgramsCnt
Persons Served	1608	PersonsServedCnt
Total Community Benefit Expns	$266,720	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$8,940	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$257,780	NetCommunityBenefitExpnsAmt
Total Expense	0.0015	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Activities Or Programs	3	ActivitiesOrProgramsCnt
Persons Served	5	PersonsServedCnt
Total Community Benefit Expns	$1,711,868	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$176,948	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,534,920	NetCommunityBenefitExpnsAmt
Total Expense	0.0090	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$4,007,989	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,480,713	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,527,276	NetCommunityBenefitExpnsAmt
Total Expense	0.0089	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$19,064	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$19,064	NetCommunityBenefitExpnsAmt
Total Expense	0.0001	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	8	ActivitiesOrProgramsCnt
Persons Served	219	PersonsServedCnt
Total Community Benefit Expns	$75,327	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$75,327	NetCommunityBenefitExpnsAmt
Total Expense	0.0004	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	23	ActivitiesOrProgramsCnt
Persons Served	1832	PersonsServedCnt
Total Community Benefit Expns	$6,080,968	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,666,601	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,414,367	NetCommunityBenefitExpnsAmt
Total Expense	0.0200	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	23	ActivitiesOrProgramsCnt
Persons Served	1832	PersonsServedCnt
Total Community Benefit Expns	$10,498,196	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,666,601	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$7,831,595	NetCommunityBenefitExpnsAmt
Total Expense	0.0458	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	false	BadDebtExpenseReportedInd
Bad Debt Expense	$2,202,750	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$77,694,514	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$76,248,945	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$1,445,569	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 (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
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	St Elizabeth Hospital Inc	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1506 South Oneida Street	AddressLine1Txt
City	Appleton	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54915	ZIPCd

Field	Value	IRS element (for citing)
Website Address	www.affinityhealth.org	WebsiteAddressTxt
State License	88	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Teaching Hospital	Yes (X)	TeachingHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	St Elizabeth Hospital Inc	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	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	15	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (true)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	http://www.affinityhealth.org/Affinity-Files/Community-Health-Needs-Assessments/2016/StElizabethHosp	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	15	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	http://www.affinityhealth.org/Affinity-Files/Community-Health-Needs-Assessments/2016/StElizabethHosp	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	250.0	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	400.0	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	https://healthcare.ascension.org/financial-assistance/wisconsin	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	https://healthcare.ascension.org/financial-assistance/wisconsin	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	https://healthcare.ascension.org/financial-assistance/wisconsin	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 (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	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 (true)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - St. Elizabeth Hospital, Inc.. St. Elizabeth Hospital's CHNA process included three specific efforts to seek input from community members, including members of medically underserved, low-income and minority populations and from organizations that serve those populations. First, a telephone survey of Calumet County residents was conducted in early calendar year 2015. The survey resulted in the Outagamie County Behavioral Risk Factor Surveillance System (BRFSS) Study: 2015 Report, and included questions health practices and health-related risk behaviors. Second, in August and September 2015, key informant interviews were conducted with stakeholders in the community, including with leaders of organizations that serve the medically underserved, low-income and minority populations. Participants were asked about the most important health issues for the region as well as existing strategies, resources and barriers in addressing them. (See below for list of key informants' organizations.) Finally, in September and October 2015, a survey was distributed electronically to a variety of community partners and agencies that serve vulnerable populations, including the Women, Infants and Children (WIC) clinics, senior centers, food pantries, community clinics and others. The survey was available in Spanish for those organizations and agencies that serve Spanish-speaking individuals. The survey asked about the most important health issues for the region. Key informant interviews were conducted with representatives of the agencies listed below. These agencies serve Outagamie County exclusively. (Note: Some agencies are listed multiple times, reflecting interviews with multiple representatives from that organization.) * Outagamie County Sheriff's Department , ** * Valley Baptist Church , , ** * Outagamie County * University of Wisconsin- Extension , ** * Outagamie County Aging and Disability Resource Center , , ** * Outagamie County Public Health- Women, Infants, and Children (WIC) Program , ** * City of Appleton *** * Early Intervention Program (Birth to Three) * Outagamie County * Outagamie County * Community Early Learning Center Board * Appleton Downtown, Inc. * ThedaCare * Catalpa Health and Outagamie County * Rawhide Boys Ranch Key informant interviews were conducted with representatives of the agencies listed below. These agencies serve the Fox Valley Region. (Note: Some agencies are listed multiple times, reflecting interviews with multiple representatives from that organization.) * University of Wisconsin- Oshkosh Head Start , * * Samaritan Counseling Center , , ** * YMCA of the Fox Cities , , ** * City of Appleton Health Department , ,** * University of Wisconsin-Oshkosh Head Start , * * N. E. W. Mental Health Connection , , ** * Heart of the Valley Chamber of Commerce * Wisconsin DNR; Menasha Health Department * Goodwill Industries of North Central WI , , ** * Affinity Health System* , , ** * Casa Hispana ,** * Common Ground , ** * ESTHER , ** * University of Wisconsin- Oshkosh Head Start , * * J.J. Keller Foundation , * * ThedaCare Trauma * St. Therese Church , ** * INCLUDE , , ** * Appleton Health Department , , ** * Hope Clinic/Alliance , , ** * United Way Fox Cities , , ** * Appleton Health Department * Catalpa Health , , ** * ThedaCare at Work; Well City Fox Cities * East Central Wisconsin Regional Planning Commission * Appleton Health Department ** * Affinity Health System* , , ** * Outagamie County * Appleton Health Department * ThedaCare * Children's Hospital of Wisconsin- Fox Valley , , ** * Homeless Connections * * Children's Hospital of Wisconsin- Fox Valley , , ** * Child Care Resource & Referral , ** * Children's Hospital of Wisconsin- Fox Valley * City of Appleton Health Department * African Heritage, Inc. *** * Hispanic Chamber of Commerce of WI , ** * Weight of the Fox Valley/ United Way * Affinity Health System* , , ** * St. Elizabeth Hospital, Affinity Health System* , , ** * Harbor House , , ** * Wisconsin Safe and Healthy Schools Center , ** * Children's Hospital of Wisconsin- Fox Valley , , ** * Partnership Community Health Ctr. , , ** * Parent Connection of Family Services * City of Appleton Police * ThedaCare Trauma * U.S. Venture, Inc. * * Partnership Community Health Ctr. , , ** * ThedaCare , , ** * University of Wisconsin- Oshkosh Head Start , * * Big Brothers Big Sisters of the Fox Valley * * Evolve , , ** * Denotes that the organization and/or the key informant's position represents low-income populations Denotes that the organization and/or the key informant's position represents medically underserved populations * Denotes that the organization and/or the key informant's position represents minority populations * Affinity Health System is part of Ministry Health Care
Schedule H, Part V, Section B, Line 6a Facility , 1	Facility , 1 - St. Elizabeth Hospital, Inc.. The CHNA was conducted with the following hospital facility(s): Calumet Medical Center Mercy Medical Center Children's Hospital of Wisconsin - Fox Valley Aurora Medical Center Oshkosh ThedaCare Regional Medical Center - Appleton (formerly Appleton Medical Center) ThedaCare Regional Medical Center - Neenah (formerly ThedaClark)
Schedule H, Part V, Section B, Line 6b Facility , 1	Facility , 1 - St. Elizabeth Hospital, Inc.. The CHNA was conducted with the following non-hospital facility(s): Calumet Public Health Department Outagamie County Public Health Department Winnebago County Public Health Department City of Appleton Public Health Department City of Menasha Public Health Department
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - ST. ELIZABETH HOSPITAL, INC.. Using the CHNA completed in June 2016, the hospital developed, adopted, and worked on executing a three-year Implementation Strategy to address priority community health needs. In Fiscal Year 2017 (Tax Year 2016), the hospital implemented the following plan to address the priority needs: Mental Health: -- To reduce suicide rates in Outagamie County. -- Participated in the Zero Suicide initiative, which facilitated the self-assessments of six organization as they integrated suicide prevention strategies in their organizational policies. -- Financially supported the delivery of school-based behavioral health services in area school districts. Alcohol Misuse: -- To explore community based resources addressing alcohol misuse issues. -- Worked with community partners to develop an asset inventory tool to better understand the current status of community based alcohol misuse prevention efforts. Nutrition: -- Increase the proportion of residents of Outagamie County and the tri-county region overall, who have a healthy Body Mass Index. -- Participated in the regional Weight of the Fox Valley coalition, which successfully facilitated the adoption of a healthy weight-supportive resolution by 12 regional municipalities. Ascension NE Wisconsin St. Elizabeth Hospital also financially supported the Weight of the Fox Valley. -- Continued to pursue Baby Friendly Hospital status. The description below includes the needs not being addressed as well as the reason why the needs are not being addressed. In addition to the three health issues selected as top priority, stakeholders identified several other significant health issues in Outagamie County. These issues will be or are being addressed by other organizations in the community. While these issues will not be addressed by St. Elizabeth Hospital as priority health needs, we will provide support to those community efforts whenever possible. Chronic Disease Prevention: The stakeholders identified chronic diseases as an important health issue to be addressed in the community. Discussions with community leaders, public health organizations and St. Elizabeth leaders, revealed that by tackling the nutrition and physical activity needs of the community, often seen as proxy for obesity prevention, chronic diseases would also be positively affected. Many stated that many of the chronic diseases that need attention such as, diabetes, hypertension, high cholesterol, etc. can be positively influenced by working on obesity prevention efforts. Healthy Growth and Development: Many stakeholders identified healthy growth and development, especially early childhood growth and development, as a health need. Many community members there saw a need to support the development of healthy, well-rounded individuals. At the same time, respondents stated there are many existing organizations and programs in the community that address these issues, including the Fox Valley Early Childhood Coalition, Parent Connection, Community Early Learning Center, Birth To 3 Program, The Boys and Girls Club, Head Start, as well as school-based and YMCA- based programs. Given the variety of existing efforts in the community, St. Elizabeth will continue to support the public health departments and community organizations already in existence to address healthy growth and development issues whenever possible.

Field	Value	IRS element (for citing)
Facility	0	FacilityNum

Supplemental Information Detail SupplementalInformationDetail (17 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part I, Line 3c Other Factors other than FPG	It is the policy of St. Elizabeth Hospital, Inc. to provide medically necessary health care services to people in the communities it serves, regardless of their ability to pay. Affinity Care financial assistance is granted based upon the patient's inability to pay and to individuals who are uninsured, underinsured or medically indigent. Affinity Care works in collaboration with other financial (both public and private) assistance programs. This is to ensure holistic wellness of patients by facilitating knowledge of abailable services and programs for health while practicing good stewardship of funds. Key criteria utilized to determine eligibility for Affinity Care financial assistance includes family size, federal poverty income guidelines and available assets. The available asset test includes consideration of the amount of equity in a home, automobiles, and savings accounts which are considered part of total allowable income when assessing against the federal poverty income guidelines.
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	ST. ELIZABETH HOSPITAL, 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 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 $5,722,954 at charges, ($2,202,750 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	ST. ELIZABETH HOSPITAL, 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	- St. Elizabeth Hospital, Inc.: Line 16a URL: https://healthcare.ascension.org/financial-assistance/wisconsin;
Schedule H, Part V, Section B, Line 16b FAP Application website	- St. Elizabeth Hospital, Inc.: Line 16b URL: https://healthcare.ascension.org/financial-assistance/wisconsin;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- St. Elizabeth Hospital, Inc.: Line 16c URL: https://healthcare.ascension.org/financial-assistance/wisconsin;
Schedule H, Part VI, Line 2 Needs assessment	In addition to the CHNA reported in Part V, Section B, Saint Elizabeth's Hospital uses both hospital data and reliable, third party reports, including data from government sources, to assess the health needs of the community it serves. These reports provide information about key health, socioeconomic, and demographic indicators that point to areas of need. Saint Elizabeth's Hospital utilizes this information to determine develop programs and services to be provided for the community. These needs and initiatives are presented to senior leadership and board members to ensure the findings are considered in developing the organization's strategy, policy development, and internal financial and operational decisions.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	St. Elizabeth Hospital, Inc. 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 organizations Affinity Care Policy. The Affinity Care Policy and application is posted on the Organization's website. Admissions and other key areas contain summary information of the Affinity 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 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 organizations Affinity Care Program. Patients may be identified as needing financial assistance at any time during the course of an encounter. A referral for consideration of Affinity Care financial assistance can be initiated by any member of the Hospital's workforce, including medical staff members, who become aware of the patients potential need for Affinity Care financial assistance. The Affinity Care brochure 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 guidelines to follow when interacting with patients. As part of the Affinity 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 hospitals "community benefit," this is a work in progress. St. Elizabeth Hospital, Inc. 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. St. Elizabeth Hospital, Inc., like most community 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: I/P adult behavioral health services, I/P adolescent behavioral health services and neonatal intensive care services. The City of Appleton is located in Outagamie, Calumet, and Winnebago counties. According to the 2008-2012 American Community Survey 5-Year Estimates, there were 72,575 people living in Appleton, consisting of 28,428 households and 18,074 families. The population density of Appleton was 2,984.9 people per square mile. The population consisted of 86.0% White, 4.7% Hispanic, 1.6% African American, 0.5% Native American, 5.3% Asian, and 1.9% Other. Of the 28,428 households in Appleton, 32.8% of those had children under the age of 18, living at home. The 28,428 households are categorized as 49% married couples living together, 4.1% had a male head of household with no wife present, 10.5% had a female head of household with no husband present, and 47% were non-families. 29.6% of the households consisted of individuals and 10.1% had someone 65 and older living alone. The age population is widely spread. 28.9% were under 18, 6.5% were 19-24, 26.8% were 25-44, 26.3% were 45-64, and 11.5% were 65+. The median income for a household was $52,605 and the median income for a family was $66,781. The per capita income for the city was $27,106. The largest industry in Appleton is educational, health and social services (21.5%). Manufacturing (20.4%) and retail trade (11.4%) are the next largest industries in Appleton. Roughly 8% of families and 10.5% of the population were below the poverty line. That includes 13.5% of those under 18 years old and 7.4% of those 65 and older. The unadjusted seasonal unemployment rate for Outagamie, Calumet, and Winnebago Counties was 4.0%, 3.7%, and 4.3%, respectively, compared to a state unemployment rate of 5.1% and a national unemployment rate of 7.9%.
Schedule H, Part VI, Line 5 Promotion of community health	The Organization strives to further its exempt purposes by the following: (1) The Organization's governing board consists primarily of persons who reside within the primary service area who are not employees of the Organization. (2) As mentioned, the Organization provides several services which are not otherwise available being in a rural setting. (3) Based on the Organization's mission, emergency rooms are made available to all patients regardless of the ability to pay. (4) The Organization also participates in the education and training of healthcare professionals through internship programs. Certain specialized services available include: dental services to primarily the indigent, fertility clinic services and WIC home visits to new mothers and infants.
Schedule H, Part VI, Line 6 Affiliated health care system	ST. ELIZABETH HOSPITAL, INC. IS AN AFFILIATE OF MINISTRY HEALTH, INC. AND ASCENSION HEALTH. ST. ELIZABETH HOSPITAL, INC.'S AFFILIATES ARE LARGE MULTI-FACETED, INTEGRATED, NOT-FOR-PROFIT MINISTRIES INCLUDING HOSPITAL AND NON-HOSPITAL MINISTRIES (PHYSICIAN GROUP PRACTICES, HOSPITAL ORGANIZATIONS, RESEARCH, HOME HEALTH, DURABLE MEDICAL EQUIPMENT AND SENIOR FACILITIES). THESE MINISTRIES WORK TOGETHER TO CARE FOR PATIENTS, JOINED BY COMMON SYSTEMS AND A PHILOSOPHY OF SERVING AS A HEALING PRESENCE WITH SPECIAL CONCERN FOR OUR NEIGHBORS ESPECIALLY THOSE WHO ARE VULNERABLE. THIS COMMUNITY BENEFIT HAPPENS THROUGH ITS FOCUS ON PATIENT CARE, EDUCATION AND RESEARCH. THE ORGANIZATIONS WORK TOGETHER TO SERVE THEIR COMMUNITIES AT THE LOCAL, REGIONAL, STATE AND NATIONAL LEVEL. ASCENSION HEALTH ALLIANCE, D/B/A ASCENSION (ASCENSION), IS A MISSOURI NONPROFIT CORPORATION FORMED ON SEPTEMBER 13, 2011. ASCENSION IS THE SOLE CORPORATE MEMBER AND PARENT ORGANIZATION OF ASCENSION HEALTH, A CATHOLIC NATIONAL HEALTH SYSTEM CONSISTING PRIMARILY OF NONPROFIT CORPORATIONS THAT OWN AND OPERATE LOCAL HEALTHCARE FACILITIES, OR HEALTH MINISTRIES, LOCATED IN 23 OF THE UNITED STATES AND THE DISTRICT OF COLUMBIA. ASCENSION IS SPONSORED BY ASCENSION SPONSOR, A PUBLIC JURIDIC PERSON. THE PARTICIPATING OF ASCENSION SPONSOR ARE THE DAUGHTERS OF CHARITY OF ST. VINCENT DE PAUL, ST. LOUISE PROVINCE; THE CONGREGATION OF ST. JOSEPH; THE CONGREGATION OF THE SISTERS OF ST. JOSEPH OF CARONDELET; THE CONGREGATION OF ALEXIAN BROTHERS OF THE IMMACULATE CONCEPTION PROVINCE, INC. - AMERICAN PROVINCE; AND THE SISTERS OF THE SORROWFUL MOTHER OF THE THIRD ORDER OF ST.FRANCIS OF ASSISI - US/CARIBBEAN PROVINCE. The System directs its governance and management activities toward strong, vibrant, Catholic Health Ministries united in service and healing and dedicates its resources to spiritually centered care that sustains and improves the health of the individuals and communities it serves. In accordance with the System's mission of service to those persons living in poverty and to other vulnerable persons, each Health Ministry accepts patients regardless of their ability to pay. The System uses four categories to identify the resources utilized for the care of persons living in poverty and for community benefit programs: Traditional charity care includes the cost of services provided to persons who cannot afford health care because of inadequate resources and/or who are uninsured or underinsured. Unpaid cost of public programs, excluding Medicare, represents the unpaid cost of services provided to persons covered by public programs for persons living in poverty and for other vulnerable persons. Cost of other programs for persons living in poverty and for other vulnerable persons includes unreimbursed costs of programs intentionally designed to serve the persons living in poverty and the other vulnerable persons of the community, including substance abusers, the homeless, victims of child abuse, and persons with acquired immune deficiency syndrome. Community benefit consists of the unreimbursed costs of community benefit programs and services for the general community, not solely for the persons living in poverty, including health promotion and education, health clinics and screenings, and medical research. Discounts are provided to all uninsured patients, including those with the means to pay. Discounts provided to those patients who did not qualify for assistance under charity care guidelines are not included in the cost of providing care to persons living in poverty or in the cost of other community benefit programs. The cost of providing care to persons living in poverty and of other community benefit programs is estimated using internal cost data and is estimated by reducing charges forgone by a factor derived from the ratio of total operating expenses to billed charges for patient care.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	Yes (true)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 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
MARK W FAUSTICH MD
SECRETARY	$0	$452,697	$0	$5,000	$0	$7,085	$0	$17,225	$0	$15,801	$0	$497,808	$0	$0
SUDEEP S SODHI MD
BOARD MEMBER	$0	$961,795	$0	$0	$0	$7,792	$0	$17,225	$0	$31,665	$0	$1,018,477	$0	$0
WENDY SCHROEDER DO
BOARD MEMBER	$0	$328,887	$0	$2,000	$0	$1,008	$0	$14,575	$0	$34,665	$0	$381,135	$0	$0
NICHOLAS DESIEN
FORMER OFFICER (END 12/2015)	$0	$190,823	$0	$0	$0	$2,520,000	$0	$443	$0	$0	$0	$2,711,266	$0	$0
JEFFREY FRANCIS
FORMER OFFICER (END 9/2015)	$0	$0	$0	$0	$0	$225,000	$0	$0	$0	$0	$0	$225,000	$0	$0
MONICA A HILT
PRESIDENT, ST. ELIZABETH HOSPITAL	$0	$493,948	$0	$231,779	$0	$6,310	$0	$17,225	$0	$23,550	$0	$772,812	$0	$0
DANIEL E NEUFELDER
SR. VP HOSP OPS (END 9/2016)	$0	$861,918	$0	$713,099	$0	$250,740	$0	$15,900	$0	$12,516	$0	$1,854,173	$0	$0
LAWRENCE DONATELLE
VICE PRESIDENT OF MEDICAL AFFAIRS	$0	$306,377	$0	$20,790	$0	$7,561	$0	$17,225	$0	$20,837	$0	$372,790	$0	$0
TONYA L DEDERING
Reg Dir Foundations	$170,417	$0	$27,000	$0	$18,232	$0	$9,900	$0	$27,893	$0	$253,442	$0	$0	$0
MICHAEL A HOFMANN
Dir Patient Care Srvcs	$125,580	$0	$0	$0	$28,864	$0	$8,198	$0	$23,973	$0	$186,615	$0	$0	$0
FAYE E KAMRATH
Dir Radiology Srvcs	$133,671	$0	$0	$0	$31,983	$0	$8,899	$0	$16,549	$0	$191,102	$0	$0	$0
NANETTE W KRIZENEKSY
RN Lead-ICU MrktS	$180,143	$0	$0	$0	$1,499	$0	$12,167	$0	$30,575	$0	$224,384	$0	$0	$0
SCOTT D MOON
Sr Medical Physicist	$157,888	$57,917	$0	$0	$494	$188	$4,833	$9,480	$11,738	$4,181	$174,953	$71,766	$0	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation	Ministry Health Care, Inc., a related organization of St. Elizabeth Hospital, Inc., uses the following to establish the compensation of the organization's CEO: - Compensation Committee, - Independent Compensation Consultant, - Compensation Survey or Study, and - Approval by the Board or Compensation Committee.
Schedule J, Part I, Line 4a Severance or change-of-control payment	The following individual(s) received severance payments from the organization or a related organization: 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.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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 ST. ELIZABETH HOSPITAL, INC. THE PROCESS INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE EXECUTIVE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE ORGANIZATION'S CEO, EXECUTIVE DIRECTOR OR TOP MANAGEMENT OFFICIAL'S SALARY WAS COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE MINUTES. THE INDIVIDUAL WAS NOT PRESENT WHEN THEIR COMPENSATION WAS DECIDED.
Form 990, Part VI - Corporate Member Change	Due to a reorganization effective January 1, 2016, Affinity Health System is no longer a corporate member of St. Elizabeth Hospital, Inc. Ministry Healthcare, Inc. became the sole corporate member at that time.
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 ST. ELIZABETH HOSPITAL, INC. THE PROCESS INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE EXECUTIVE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE OFFICERS' SALARIES WERE COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE MINUTES. INDIVIDUALS WERE NOT PRESENT WHEN THEIR COMPENSATION WAS DECIDED.
Form 990, Part VI, Line 6 Classes of members or stockholders	St. Elizabeth Hospital, Inc. has a single corporate member, Ministry Healthcare, Inc.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	St. Elizabeth Hospital, Inc. has a single corporate member, Ministry Healthcare, Inc., who has the ability to elect members to the governing body of St. Elizabeth Hospital Inc.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	All decisions that have a material impact to St. Elizabeth Hospital, Inc. financial information or corporation as a whole are subject to approval by its sole corporate member, Ministry Healthcare, Inc.
Form 990, Part VI, Line 11b Review of form 990 by governing body	DURING THE RETURN PREPARATION PROCESS, THE TAX DEPARTMENT WORKS WITH OTHER FUNCTIONAL AREAS INCLUDING FINANCE, ACCOUNTING, TREASURY, LEGAL, HUMAN RESOURCES, AND CORPORATE COMPLIANCE FOR ADVICE, INFORMATION AND ASSISTANCE IN ORDER TO PREPARE A COMPLETE AND ACCURATE RETURN. UPON COMPLETION, THE FORM 990 IS REVIEWED BY THE ORGANIZATION'S INTERNAL TAX DEPARTMENT WHICH CONSISTS OF ATTORNEYS AND CPAS. A COMPLETE FINAL COPY OF THE RETURN IS PROVIDED TO THE ORGANIZATION'S PRESIDENT, FINANCIAL OFFICER, AND/OR OTHER KEY OFFICERS IN LIEU OF THE FULL BOARD.
Form 990, Part VI, Line 12c Conflict of interest policy	The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflicts of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose.
Form 990, Part VI, Line 19 Required documents available to the public	The Organization will provide any documents open to public inspection upon request.
Form 990, Part VIII, Line 2f Other Program Service Revenue	Income from Joint Ventures - Total Revenue: -1352269, Related or Exempt Function Revenue: -1352269, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue	Other Miscellaneous Revenue - Total Revenue: 213467, Related or Exempt Function Revenue: , Unrelated Business Revenue: 7100, Revenue Excluded from Tax Under Sections 512, 513, or 514: 206367;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	FASB 136 - 63411; Catalpa Temp Restricted Investment - 69829; Net Asset Transfers with Affiliates - -53789631;
Form 990, Part XII, Line 2b Audited Financial Statements	The activity of St. Elizabeth Hospital, Inc. is reported in the consolidated financial statements of Ascension Health Alliance. No individual audit of St. Elizabeth Hospital, Inc. is completed. Therefore, the attached audited financial statements are of Ascension Health Alliance and Affiliates, which include the activity of St. Elizabeth Hospital, Inc.
Form 990, Part XII, Line 2c Audit Committee	St. Elizabeth Hospital, Inc. is included in the consolidated financial statements of Ascension Health Alliance. The Finance and Audit committee of Ascension Health Alliance's Board assumes responsibility for the consolidated organization as a whole.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (52 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	Business Name Line2DisregardedEntityName/BusinessNameLine2Txt
ASCENSION HEALTH ALLIANCE
PO BOX 45998	ST LOUIS	MO	63145	453358926	NATIONAL HEALTH	MO	501(c)(3)	Type I	NA	false
ASCENSION HEALTH
PO BOX 45998	ST LOUIS	MO	63145	311662309	NATIONAL HEALTH	MO	501(c)(3)	Type I	ASCENSION HEALTH ALLIANCE	false
COLUMBIA ST MARY'S INC
4425 NORTH PORT WASHINGTON ROAD	GLENDALE	WI	53212	391834639	PARENT CORPORATION	WI	501(c)(3)	Type I	ASCENSION HEALTH	false
MINISTRY HEALTH CARE INC
10925 W LAKE PARK DR STE 100	MILWAUKEE	WI	53224	391490371	PARENT CORPORATION	WI	501(c)(3)	Type II	ASCENSION HEALTH	false
WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN INC
400 WEST RIVER WOODS PARKWAY	GLENDALE	WI	53212	391568865	PARENT CORPORATION	IL	501(c)(3)	Type III-FI	ASCENSION HEALTH	false
COLUMBIA ST MARY'S HOSPITAL MILWAUKEE INC
4425 NORTH PORT WASHINGTON ROAD	GLENDALE	WI	53212	390806315	HOSPITAL	WI	501(c)(3)	3	COLUMBIA ST MARY'S INC	Yes (true)
COLUMBIA ST MARY'S HOSPITAL OZAUKEE INC
4425 NORTH PORT WASHINGTON ROAD	GLENDALE	WI	53212	390807063	HOSPITAL	WI	501(c)(3)	3	COLUMBIA ST MARY'S INC	Yes (true)
SACRED HEART REHABILITATION INSTITUTE INC
4425 NORTH PORT WASHINGTON ROAD	GLENDALE	WI	53212	390902199	REHAB SERVICES	WI	501(c)(3)	3	COLUMBIA ST MARY'S INC	Yes (true)
AFFINITY HEALTH SYSTEM
1570 MIDWAY PLACE	MENASHA	WI	54952	391568866	HEALTH SYSTEM	IL	501(c)(3)	Type II	MINISTRY HEALTH CARE INC	Yes (true)
AGAPE COMMUNITY CENTER OF MILWAUKEE INC
6100 NORTH 42ND STREET	MILWAUKEE	WI	53209	391461846	COMMUNITY CENTER	WI	501(c)(3)	7	MINISTRY HEALTH CARE INC	Yes (true)
ASCENSION EAGLE RIVER MEMORIAL HOSPITAL INC FKA EAGLE RIVER MEMORIAL HOSPIT
201 HOSPITAL ROAD	EAGLE RIVER	WI	54521	390985690	HOSPITAL	WI	501(c)(3)	3	MINISTRY HEALTH CARE INC	Yes (true)	AL INC
ASCENSION GOOD SAMARITAN HOSPITAL INC FKA GOOD SAMARITAN HEALTH CENTER OF M
601 SOUTH CENTER AVENUE	MERRILL	WI	54452	390808503	HOSPITAL	WI	501(c)(3)	3	MINISTRY HEALTH CARE INC	Yes (true)	ERRILL WI INC
ASCENSION OUR LADY OF VICTORY HOSPITAL INC FKA OUR LADY OF VICTORY HOSPITAL
1120 PINE STREET	STANLEY	WI	54768	390807065	HOSPITAL	WI	501(c)(3)	3	MINISTRY HEALTH CARE INC	Yes (true)	INC
ASCENSION SACRED HEART-STMARY'S HOSPITALS INC FKA SACRED HEART-SAINT MARY'S
PO BOX 347	STEVENS POINT	WI	54481	391390638	HOSPITAL	WI	501(c)(3)	3	MINISTRY HEALTH CARE INC	Yes (true)	HOSPITALS INC
ASCENSION ST CLARE'S HOSPITAL INC FKA SAINT CLARE'S HOSPITAL OF WESTON INC
3400 MINISTRY PARKWAY	WESTON	WI	54476	721531917	HOSPITAL	WI	501(c)(3)	3	MINISTRY HEALTH CARE INC	Yes (true)
ASCENSION ST MICHAEL'S HOSPITAL INC FKA SAINT MICHAEL'S HOSPITAL OF STEVENS
900 ILLINOIS AVENUE	STEVENS POINT	WI	54481	390808443	HOSPITAL	WI	501(c)(3)	3	MINISTRY HEALTH CARE INC	Yes (true)	POINT INC
HOWARD YOUNG HEALTH CARE INC
240 MAPLE STREET	WOODRUFF	WI	54568	391499115	HOME OFFICE	WI	501(c)(3)	Type II	MINISTRY HEALTH CARE INC	Yes (true)
MERCY MEDICAL CENTER OF OSHKOSH INC
500 S OAKWOOD ROAD	OSHKOSH	WI	54904	390806268	HOSPITAL	WI	501(c)(3)	3	MINISTRY HEALTH CARE INC	Yes (true)
MINISTRY MEDICAL GROUP INC
824 ILLINOIS AVENUE	STEVENS POINT	WI	54481	391965593	MEDICAL GROUP	WI	501(c)(3)	Type III-FI	MINISTRY HEALTH CARE INC	Yes (true)
SAINT ELIZABETH'S HOSPITAL OF WABASHA INC
1200 GRANT BLVD WEST	WABASHA	MN	55981	410693877	MEDICAL GROUP	MN	501(c)(3)	3	MINISTRY HEALTH CARE INC	Yes (true)
ST JOSEPH'S HOSPITAL OF MARSHFIELD INC
611 SAINT JOSEPH AVENUE	MARSHFIELD	WI	54449	391847631	MEDICAL GROUP	WI	501(c)(3)	3	MINISTRY HEALTH CARE INC	Yes (true)
THE HOWARD YOUNG MEDICAL CENTER INC
240 MAPLE STREET	WOODRUFF	WI	54568	390873606	MEDICAL GROUP	WI	501(c)(3)	3	MINISTRY HEALTH CARE INC	Yes (true)
DOOR COUNTY MEMORIAL HOSPITAL INC
323 SOUTH 18TH AVENUE	STURGEON BAY	WI	54235	390806324	MEDICAL GROUP	WI	501(c)(3)	3	MINISTRY HEALTH CARE INC	Yes (true)
ASCENSION CALUMET HOSPITAL INC FKA CALUMET MEDICAL CENTER INC
614 MEMORIAL DRIVE	CHILTON	WI	53014	390905385	MEDICAL GROUP	WI	501(c)(3)	3	MINISTRY HEALTH CARE INC	Yes (true)
WHEATON FRANCISCAN HEALTHCARE - ALL SAINTS INC
3801 SPRING STREET	RACINE	WI	53405	391264986	MEDICAL GROUP	WI	501(c)(3)	3	WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN INC	Yes (true)
WHEATON FRANCISCAN HEALTHCARE - FRANKLIN INC
10101 SOUTH 27TH STREET	FRANKLIN	WI	53132	562592868	MEDICAL GROUP	WI	501(c)(3)	3	WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN INC	Yes (true)
WHEATON FRANCISCAN HEALTHCARE - PHARMACY ENTERPRISES & FRANCISCAN WOODS INC
19525 WEST NORTH AVENUE	BROOKFIELD	WI	53005	391613624	MEDICAL GROUP	WI	501(c)(3)	10	WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN INC	Yes (true)
WHEATON FRANCISCAN HEALTHCARE - ST FRANCIS INC
3237 SOUTH 16TH STREET	MILWAUKEE	WI	53215	390907740	MEDICAL GROUP	WI	501(c)(3)	3	WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN INC	Yes (true)
WHEATON FRANCISCAN LABORATORIES INC
3237 SOUTH 16TH STREET	MILWAUKEE	WI	53215	391701402	MEDICAL GROUP	WI	501(c)(3)	10	WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN INC	Yes (true)
WHEATON FRANCISCAN MEDICAL GROUP INC
400 WEST RIVER WOODS PARKWAY	GLENDALE	WI	53212	391791586	MEDICAL GROUP	WI	501(c)(3)	3	WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN INC	Yes (true)
WHEATON FRANCISCAN INC
5000 WEST CHAMBERS STREET	MILWAUKEE	WI	53210	390816857	HOSPITAL	WI	501(c)(3)	3	WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN INC	Yes (true)
WHEATON FRANCISCAN HOME HEALTH & HOSPICE INC
3070 North 51st Street Suite 406	MILWAUKEE	WI	53210	391559428	HOME HEALTH	WI	501(c)(3)	10	WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN INC	Yes (true)
CATALPA HEALTH INC
N4642 COUNTY N	APPLETON	WI	54914	454681563	BEHAVIORAL HEALTH SERVICES	WI	501(c)(3)	3	AFFINITY HEALTH SYSTEM	Yes (true)
MERCY HEALTH FOUNDATION INC
PO BOX 3370	OSHKOSH	WI	54903	237140261	FOUNDATION	WI	501(c)(3)	10	AFFINITY HEALTH SYSTEM	Yes (true)
NETWORK HEALTH SYSTEM INC
1570 APPLETON RD	MENASHA	WI	54952	391127163	CLINICAL HEALTHCARE SERVICES	WI	501(c)(3)	3	AFFINITY HEALTH SYSTEM	Yes (true)
ST ELIZABETH HOSPITAL FOUNDATION INC
1506 S ONEIDA STREET	APPLETON	WI	54915	391256677	FOUNDATION	WI	501(c)(3)	7	AFFINITY HEALTH SYSTEM	Yes (true)
GOOD SAMARITAN HEALTH CENTER FOUNDATION OF MERRILL WISCONSIN INC
601 SOUTH CENTER AVENUE	MERRILL	WI	54452	391627755	FOUNDATION	WI	501(c)(3)	Type I	ASCENSION GOOD SAMARITAN HOSPITAL INC	Yes (true)
MINISTRY WEIGHT MANAGEMENT INC
2251 NORTH SHORE DRIVE	RHINELANDER	WI	54501	391829015	SPECIALTY HEALTH SERVICES	WI	501(c)(3)	3	ASCENSION SACRED HEART - STMARY'S HOSPITALS INC	Yes (true)
FOUNDATION OF SAINT CLARE'S HOSPITAL OF WESTON INC
3400 MINISTRY PARKWAY	WESTON	WI	54476	753193633	FOUNDATION	WI	501(c)(3)	Type I	ASCENSION ST CLARE'S HOSPITAL INC	Yes (true)
SAINT MICHAEL'S FOUNDATION OF STEVENS POINT INC
900 ILLINOIS AVENUE	STEVENS POINT	WI	54481	391657410	Foundation	WI	501(c)(3)	Type I	ASCENSION ST MICHAEL'S HOSPITAL INC	Yes (true)
COLUMBIA COLLEGE OF NURSING INC
4425 NORTH PORT WASHINGTON ROAD	GLENDALE	WI	53212	391596986	COLLEGE	WI	501(c)(3)	2	COLUMBIA ST MARY'S HOSPITAL MILWAUKEE INC	Yes (true)
DR KATE NEWCOMB CONVALESCENT CENTER INC
PO BOX 829	WOODRUFF	WI	54568	391357365	NURSING/ASSISTED LIVING SERVICES	WI	501(c)(3)	10	HOWARD YOUNG HEALTH CARE INC	Yes (true)
FOUNDATION OF SAINT JOSEPH'S HOSPITAL OF MARSHFIELD INC
611 SAINT JOSEPH AVENUE	MARSHFIELD	WI	54449	391684957	FOUNDATION	WI	501(c)(3)	Type I	SAINT JOSEPH'S HOSPITAL OF MARSHFIELD INC	Yes (true)
VOLUNTEERS IN PARTNERSHIP WITH WHEATON FRANCISCAN HEALTHCARE - ALL SAINTS I
3807 SPRING STREET	RACINE	WI	53405	930838390	FOUNDATION	WI	501(c)(3)	10	WHEATON FRANCISCAN HEALTHCARE - ALL SAINTS INC	Yes (true)	NC
WHEATON FRANCISCAN HEALTHCARE - ALL SAINTS FOUNDATION INC
3805B SPRING STREET	RACINE	WI	53405	391570877	FOUNDATION	WI	501(c)(3)	7	WHEATON FRANCISCAN HEALTHCARE - ALL SAINTS INC	Yes (true)
WHEATON FRANCISCAN HEALTHCARE - CIRCLE OF LIFE FOUNDATION INC
4300 WEST BROWN DEER RD STE 2	BROWN DEER	WI	53223	562426294	FOUNDATION	WI	501(c)(3)	Type I	WHEATON FRANCISCAN HEALTHCARE - PHARMACY ENTERPRISES & FRANCISCAN WOODS INC	Yes (true)
WHEATON FRANCISCAN HEALTHCARE - FOUNDATION FOR ST FRANCIS AND FRANKLIN INC
3237 SOUTH 16TH STREET	MILWAUKEE	WI	53215	320135258	FOUNDATION	WI	501(c)(3)	Type I	WHEATON FRANCISCAN HEALTHCARE - ST FRANCIS INC	Yes (true)
METRO PHYSICIANS INC
400 WEST RIVER WOODS PARKWAY	GLENDALE	WI	53212	943436893	MEDICAL GROUP	WI	501(c)(3)	3	WHEATON FRANCISCAN MEDICAL GROUP	Yes (true)
WHEATON FRANCISCAN - ELMBROOK MEMORIAL FOUNDATION INC
3237 SOUTH 16TH STREET	MILWAUKEE	WI	53215	392028808	FOUNDATION	WI	501(c)(3)	Type I	WHEATON FRANCISCANL INC	Yes (true)
WHEATON FRANCISCAN - ST JOSEPH FOUNDATION INC
5000 WEST CHAMBERS STREET	MILWAUKEE	WI	53210	391636804	FOUNDATION	WI	501(c)(3)	Type I	WHEATON FRANCISCANL INC	Yes (true)
WHEATON FRANCISCAN HEALTHCARE - ELMBROOK MEMORIAL AUXILIARY
19333 WEST NORTH AVENUE	BROOKFIELD	WI	53045	396068950	AUXILIARY	WI	501(c)(3)	Type III-FI	WHEATON FRANCISCANL INC	Yes (true)
HORIZON HOME CARE & HOSPICE INC
8949 N DEERBROOK TRL	BROWN DEER	WI	53223	391171298	HOME CARE / HOSPICE	WI	501(c)(3)	3	NA	false

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

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

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	222 W COLLEGE AVE SUITE 3B	AddressLine1Txt
City	APPLETON	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54911	ZIPCd

Field	Value	IRS element (for citing)
EIN	391180341	EIN
Primary Activities	REAL ESTATE	PrimaryActivitiesTxt
Legal Domicile State	WI	LegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

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

Field	Value	IRS element (for citing)
Predominant Income Type	N/A	PredominantIncomeTypeTxt

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd
PROSPECT MEDICAL COMMONS CONDOMINIUM ASSOCIATION INC
4425 N PORT WASHINGTON RD	GLENDALE	WI	53212	208042108	CONDO ASSOCIATION	WI	NA	C Corporation	Yes (true)
FRANKLIN MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION INC
400 WEST RIVER WOODS PARKWAY	GLENDALE	WI	53212	341983857	CONDO ASSOCIATION	WI	NA	C Corporation	Yes (true)
WHEATON FRANCISCAN HOLDINGS INC
400 WEST RIVER WOODS PARKWAY	GLENDALE	WI	53212	391836357	HOLDING CO	WI	NA	C Corporation	Yes (true)
WHEATON FRANCISCAN PROVIDER NETWORK INC
400 WEST RIVER WOODS PARKWAY	GLENDALE	WI	53212	391952140	PROVIDER CONTRACT	WI	NA	C Corporation	Yes (true)
MADISON MEDICAL AFFILIATES INC
4425 N PORT WASHINGTON RD	GLENDALE	WI	53212	391855720	HEALTHCARE	WI	NA	C Corporation	Yes (true)
WHEATON WAY CONDOMINIUM OWNERS ASSOCIATION INC
10101 SOUTH 27TH STREET	FRANKLIN	WI	53123	300659830	CONDO ASSOCIATION	WI	NA	C Corporation	Yes (true)
WHEATON FRANCISCAN ENTERPRISES INC
400 WEST RIVER WOODS PARKWAY	GLENDALE	WI	53212	391985204	HOLDING CO	WI	NA	C Corporation	Yes (true)
WHEATON FRANCISCAN MEDICAL GROUP - SUSSEX INC
400 WEST RIVER WOODS PARKWAY	GLENDALE	WI	53212	391361100	HEALTHCARE	WI	NA	C Corporation	Yes (true)

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

Transactions Related Org TransactionsRelatedOrgGrp (15 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
ST ELIZABETH HOSPITAL FOUNDATION INC
L	$188,427	FAIR MARKET VALUE
AFFINITY MEDICAL GROUP
J	$2,631,321	FAIR MARKET VALUE
AFFINITY MEDICAL GROUP
K	$164,060	FAIR MARKET VALUE
AFFINITY MEDICAL GROUP
L	$1,160,015	FAIR MARKET VALUE
AFFINITY MEDICAL GROUP
M	$116,439	FAIR MARKET VALUE
AFFINITY MEDICAL GROUP
P	$132,735	FAIR MARKET VALUE
ASCENSION CALUMET HOSPITAL INC
L	$117,930	FAIR MARKET VALUE
ASCENSION CALUMET HOSPITAL INC
M	$141,149	FAIR MARKET VALUE
MERCY MEDICAL CENTER OF OSHKOSH INC
K	$445,178	FAIR MARKET VALUE
MERCY MEDICAL CENTER OF OSHKOSH INC
L	$428,309	FAIR MARKET VALUE
MERCY MEDICAL CENTER OF OSHKOSH INC
M	$256,577	FAIR MARKET VALUE
MERCY MEDICAL CENTER OF OSHKOSH INC
P	$130,098	FAIR MARKET VALUE
MERCY MEDICAL CENTER OF OSHKOSH INC
Q	$78,000	FAIR MARKET VALUE
ASCENSION ST MICHAEL'S HOSPITAL INC
L	$144,799	FAIR MARKET VALUE
ST ELIZABETH HOSPITAL FOUNDATION INC
C	$169,098	FAIR MARKET VALUE