2018-05-11T12:17:01-05:00 2017-06-30 990 2016-07-01 390847631 St Joseph's Hospital of Marshfield Inc STJO 3147338000 611 Saint Joseph Avenue Marshfield WI 544491898 Tonya Mershon Tax Officer 2018-05-11 2016 2022-09-23 18:48:47Z Bernard Sherry 400 W River Woods Parkway Glendale WI 53212 625124844 false 0928 X www.stjosephs-marshfield.org X 1955 WI To improve the health and well-being of all people in the communities we serve. X 11 10 1766 450 12656 0 730565 995535 316593019 298383181 1892154 167061559 2625053 1000124 321840791 467440399 0 0 116100289 75310160 0 197860 162228795 191410359 278329084 266720519 43511707 200719880 577686045 5290635 36880189 34942944 540805856 -29652309 Our Mission as part of a Catholic health care system is to further the healing ministry of Jesus by continually improving the health and well-being of all people, especially the poor, in the communities we serve. false false 181107825 297728835 SAINT JOSEPH'S HOSPITAL OF MARSHFIELD, INC. PROVIDES INPATIENT, OUTPATIENT, EMERGENCY ROOM AND ANCILLARY SERVICES REGARDLESS OF AN INDIVIDUAL'S ABILITY TO PAY OR METHOD OF PAYMENT. THE HOSPITAL ALSO PROVIDES EDUCATIONAL PROGRAMS AND SERVICES ON HEALTH CARE ISSUES TO THE COMMUNITY IT SERVES. SEE SCHEDULE H FOR FURTHER DETAILS REGARDING THE COMMUNITY BENEFITS THAT SAINT JOSEPH'S HOSPITAL OF MARSHFIELD, INC. PROVIDES. 181107825 true true false true false false false false false true true false false true true true false true false false false false false false false false true true false false true false false false false false false false false true false false true false true true true false false true 85 0 true 1766 true true true false false false false false false false false false X 11 10 false false false false true true true true true false false false true true true true true false false false WI X David Mannes 4144654571 400 W River Woods Parkway Glendale WI 53212 BRIAN KIEF SJH PRESIDENT (EX OFFICIO) (END 3/2017) 20.0 24.7 X X 0 1234458 41545 JEREMY NORMINGTON-SLAY PRESDIENT, MERCY MEDICAL CENTER (EX OFFICIO) (START 5/2017) 1.0 43.1 X X 0 305876 36968 KEVIN NOEL CHAIRMAN 1.0 2.5 X X 0 0 0 KATHY DAVIES VICE-CHAIRMAN 1.0 2.5 X X 0 0 0 BRENDA DILLENBURG SECRETARY/TREASURER 1.0 2.5 X X 0 0 0 BILL ARCISZEWSKI DIRECTOR 1.0 2.5 X 0 0 0 DAN BURNS DIRECTOR 1.0 2.5 X 0 0 0 BILL CRESKE DIRECTOR (END 1/2017) 1.0 2.5 X 0 0 0 DAVID EISENREICH DIRECTOR 1.0 2.5 X 0 0 0 SHERYL JONES DIRECTOR 1.0 2.5 X 0 0 0 VAL MINDAK DIRECTOR (END 4/2017) 1.0 2.5 X 0 0 0 RICK RETTLER DIRECTOR 1.0 2.5 X 0 0 0 SUSAN RYMAN DIRECTOR (END 5/2017) 1.0 2.5 X 0 0 0 JAMIE SCHAEFER DIRECTOR 1.0 2.5 X 0 0 0 JAMES WEISHAN DIRECTOR 1.0 2.5 X 0 0 0 DANIEL E NEUFELDER SVP, HOSPITAL OPERATIONS & PRESIDENT, AHS (END 9/2016) 1.0 38.5 X 0 1825757 28416 LAYTON ANDERSON VP, HOSPITAL OPERATIONS 40.0 1.0 X 0 297005 38722 SHARON B KOSTROSKI SJH VP QUALITY & SAFETY 40.0 0.0 X 0 225801 21464 LEIGH J ASCHBRENNER Clinical Pharmacist 7/70 40.0 0 X 152542 0 11443 JUSTIN GUTHMAN Dir Pharmacy 40.0 0 X 172242 0 12617 THOMAS RYAN System Dir Med Transport Srvcs 40.0 0 X 179781 0 33154 ROSEMARIE T SCHROEDER Dir Patient Care Srvcs 40.0 0 X 170995 0 17765 ANDREW W WEIER Sys Dir Quality Data Mgmt & An 40.0 0 X 149525 0 39867 NICHOLAS DESIEN FORMER OFFICER (END 12/2015) 0.0 0.0 X 0 2710823 443 JEFFREY FRANCIS FORMER OFFICER (END 9/2015) 0.0 0.0 X 0 225000 0 825085 6824720 282404 40 true true false COVIDIEN LP 15 CROSBY DRIVE BEDFORD MA 01730 SERVICE OF MEDICAL DEVICES 254696 BOLDT PROCUREMENT 2525 NORTH ROEMER ROAD PO BOX 419 APPLETON WI 54912 GENERAL CONTRACTORS 113004 2 995535 872744 995535 Net Patient Revenue 621990 293444431 293444431 Pharmacy Sales 446110 4256154 4243498 12656 Rent from Exempt Organizations 531120 641690 641690 Services to Affiliates 561000 40906 40906 0 0 0 0 298383181 478 478 25165 86451 -61286 0 -61286 -61286 323891505 156830424 0 167061081 167061081 167061081 0 0 0 1627100 767570 859530 859530 Miscellaneous Revenue 900099 201880 201880 0 0 0 0 201880 467440399 297728835 12656 168703373 59775067 51944477 7754430 76160 -323732 -281323 -41997 -412 11435678 9937594 1483514 14570 4423147 3843710 573801 5636 70 70 13090 13090 20539771 15141400 5398371 0 13520 12419 1101 1088536 401250 673003 14283 89716 45012 44704 3234007 35631 3198376 349531 327135 21027 1369 46354 36689 5424 4241 1315043 2998716 -1683711 38 706679 104696 601983 Medical Supplies 50146957 50146957 Corporate Overhead 49528392 49528392 Purchased Services 43021622 32526979 10482866 11777 Contract Labor 11401226 11322750 78476 9915845 2563733 7281914 70198 266720519 181107825 85414834 197860 6473 0 76758575 75000 0 0 0 323192 19026 11311 1347 7013029 9964 0 0 1206925 0 492377851 5186645 577686045 5290635 3977816 2271383 0 32902373 32671561 36880189 34942944 X 539869725 -29727309 760801 -100330 175330 175330 540805856 -29652309 577686045 5290635 X 200719880 8533 -771186578 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 13090 13090 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY LOBBYING EXPENSES REPRESENT THE PORTION OF DUES PAID TO NATIONAL AND STATE HOSPITAL ASSOCIATIONS THAT IS SPECIFICALLY ALLOCABLE TO LOBBYING. ST. JOSEPH'S HOSPITAL OF MARSHFIELD, INC. DOES NOT PARTICIPATE IN OR INTERVENE IN (INCLUDING THE PUBLISHING OR DISTRIBUTING OR STATEMENTS) ANY POLITICAL CAMPAIGN ON BEHALF OF (OR IN OPPOSITION TO) ANY CANDIDATE FOR PUBLIC OFFICE. Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY LOBBYING EXPENSES REPRESENT THE PORTION OF DUES PAID TO NATIONAL AND STATE HOSPITAL ASSOCIATIONS THAT IS SPECIFICALLY ALLOCABLE TO LOBBYING. ST. JOSEPH'S HOSPITAL OF MARSHFIELD, INC. DOES NOT PARTICIPATE IN OR INTERVENE IN (INCLUDING THE PUBLISHING OR DISTRIBUTING OR STATEMENTS) ANY POLITICAL CAMPAIGN ON BEHALF OF (OR IN OPPOSITION TO) ANY CANDIDATE FOR PUBLIC OFFICE. 180445 15396 195841 204005 0 -18048 5512 180445 204146 1559 0 1700 204005 185944 0 18202 0 0 0 204146 156092 0 29852 0 0 0 185944 0.0 0.51 0.49 false true true 9964 9964 1347 1347 0 9964 Accounts receivable- all other Intercompany-Ministry Health Care, Inc. Interest in investments held by Ascension Health Alliance assets held for sale Due to Affiliates 878850 Estimated Settlements from Third-Party Payor 3429303 Other Receivables 828379 Miscellaneous Current Assets 50113 5186645 liability on assets held for sale other liabilities Estimated Settlement to Third-Party Payor 7005997 Due to Affiliates 10895359 Asset retirement obligation 320403 Savings Plan Liability 722379 Estimated Future Liability from Sale 6000000 Accrued Outstanding Checks 7727423 32671561 X Schedule D, Part V, Line 4 Intended uses of endowment funds Stevens Endowment - fund and support continued education/conferences for birth center nurses at St. Joseph's Hospital of Marshfield, Inc.: Deitman Endowment - fund and support continued critical care nursing education at St. Joseph's Hospital of Marshfield, Inc.; Nursing Endowment - to support St. Joseph's Hospital of Marshfield, Inc. nursing education needs. Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote THE SYSTEM ACCOUNTS FOR UNCERTAINTY IN INCOME TAX POSITIONS BY APPLYING A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE SYSTEM HAS DETERMINED THAT NO MATERIAL UNRECOGNIZED TAX BENEFITS OR LIABILITIES EXIST AS OF JUNE 30, 2017. true true X true X 250 true X true true true false true true 0 0 1988631 0 1988631 0.0075 0 0 47321891 27971316 19350575 0.0726 0 0 0 0 0 0.0 0 0 49310522 27971316 21339206 0.0800 12 4289 730147 4665 725482 0.0027 5 645 11282325 3170462 8111863 0.0304 2 0 14261335 10811337 3449998 0.0129 0 0 0 0 0 0.0 10 28 471862 174272 297590 0.0011 29 4962 26745669 14160736 12584933 0.0472 29 4962 76056191 42132052 33924139 0.1272 0 0 0 0 0 0.0 0 0 0 0 0 0.0 0 0 0 0 0 0.0 1 1008 2730 0 2730 0.0000 0 0 0 0 0 0.0 1 160 14652 0 14652 0.0001 0 0 0 0 0 0.0 1 0 16255 0 16255 0.0001 0 0 0 0 0 0.0 3 1168 33637 0 33637 0.0001 false 2007731 0 119895910 131967363 -12071453 X true true 1 1 Saint Joseph's Hospital of Marshfield Inc 611 Saint Joseph Avenue Marshfield WI 54449 http://ministryhealth.org 5297-800 X X X X X Saint Joseph's Hospital of Marshfield Inc 1 false false true X X X X X X X X X 15 true true true true X https://www.marshfieldclinic.org/locations/marshfield-medical-center/community-health-needs X true 15 true https://www.marshfieldclinic.org/locations/marshfield-medical-center/community-health-needs false true X 250.0 400.0 X X X X X true true X X X true X https://healthcare.ascension.org/financial-assistance/wisconsin X https://healthcare.ascension.org/financial-assistance/wisconsin X https://healthcare.ascension.org/financial-assistance/wisconsin X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - ST JOSEPH'S HOSPITAL OF MARSHFIELD, INC.. St. Joseph's Hospital CHNA process included multiple efforts to seek input from community members, including members of medically underserved, low income and minority populations and from organizations that serve those populations. Approaches included the following: (a) In Fall 2015, an electronic and paper survey was distributed throughout the community. The surveys asked about the level of importance of various health issues. To reach diverse populations in Wood County, the survey was offered in English, Hmong and Spanish. In addition, the survey was designed for an 8th grade reading level and reading ease through the use of the "Affordable Language Services" Tool. 1600 surveys were completed. (b) Building on the results of the survey, a community stakeholder meeting was held in October 2015. At this meeting, participants identified their top health issues. (c) In order to gather additional information on community health needs, barriers and resources, from disparate, underrepresented and vulnerable populations in Wood County, focus groups were held with representatives from multiple organizations that serve those populations. (d) In addition to the focus groups, six key informant interviews were conducted with physicians in Wood County. The interviews included questions on the perceived needs, barriers and resources of disparate, underrepresented and vulnerable populations. The organizations involved in the above efforts are listed below. Community Survey: * Employers distributed to employee base (i.e. MSJH, MC, Aspirus Riverview and others) * Distributed through local chamber of commerce to local businesses * St. Vincent DePaul Outreach center * School district * Technical schools and university systems * Public service organizations * Community service groups Stakeholder forum: * Wood County Public Health * Ministry Saint Joseph's Hospital * Ministry Medical Group - Employer Solutions * YMCA * United Way of Marshfield * United Way of Wisconsin Rapids * Wood County Sheriff Department * City of Marshfield * City of Wisconsin Rapids * Legacy Foundation * Marshfield Clinic * Aspirus Riverview Hospital and Clinic * Wood County Human Services * Nekoosa School District * Security Health Plan * UW-Stevens Point * Childrearing Inc. * Incourage * Wood County Dispatch * WI State Assembly * St. Vincent de Paul Outreach center * Clear Green Action * North Central Community action * Aging and Disability Resource Center * Opportunity Development Center * Boys and Girls Club * Wisconsin Energy * Marshfield Public Library * UW-Wood County Extension * Port Edwards School District * Wisconsin Rapids police department Focus groups and Key informant interviews: * Hispanic community (minority population) * Hmong community (minority population) * Women, Infant and Children [ WIC] (low-income population) * Food pantry and soup kitchens clients (low-income population) * Elderly population (i.e. Forum 55) * Physician and healthcare providers (emergency physicians; primary care physicians; case managers) * Patients served by the St. Vincent DePaul Free Medical Clinic (medically-underserved population) * Religious community Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - st. joseph's hospital of marshfield, inc.. The CHNA was conducted with the following hospital facility(s): Aspirus Riverview Hospital and Clinics Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - st. joseph's hospital of marshfield, inc.. The CHNA was conducted with the following non-hospital facility(s): Wood County Health Department, Marshfield Clinic, the Legacy Foundation Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - ST. JOSEPH'S HOSPITAL OF MARSHFIELD, 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: Healthy Growth and Development -- Continued to work on improving support for breastfeeding mothers -- Provided early oral health packets to families with a new baby -- Implemented the Period of Purple Crying program in the Birth Center (to help prevent shaken baby syndrome) Chronic Disease -- Supported a free clinic with staff, services and funding AODA -- Improved opioid prescribing practices in the outpatient setting -- Eliminated the use of codeine-containing drugs in children and post-partum mothers -- Trained physicians and staff on substance abuse behaviors and risk in obstetrics population Mental Health -- Trained Emergency Department staff on de-escalation -- Provided Case Management Department with community resource information -- Trained staff in trauma-informed care and Child Life Intervention St. Joseph's Hospital plans to address all of the priorities identified within the resource capabilities of the organization. 0 Schedule H, Part V, Section B, Line 17 Billing and Collection Policy During tax year 2017, the organization learned via verbal comments of IRS agents at public events that the IRS intends that the "readily obtainable" standard in the 501(r) regulations for the AGB calculation and billing and collection policy is only met if those items are posted to the organization's web site. The organization had interpreted that web posting standard to be a safe harbor after consulting with external counsel and tax advisors, and timely took other steps to make the information readily obtainable. Consequently, the organization does not believe its decision to not post these documents to its web site rises to the level of a failure, nor does it believe the circumstances were either willful or egregious, having otherwise timely taken the steps necessary to attain and continue to maintain compliance with the other requirements related to the billing and collection policy and the AGB, as part of its policies and procedures for ensuring compliance with all aspects of 501(r). However, the organization is making this voluntary disclosure in order to communicate to the IRS the changes it is undertaking in response to the recent IRS informal guidance on this specific point concerning the "readily obtainable" standard, and the fact that the organization has started the work necessary to post its AGB information and billing and collection policy to its web site and will complete those additional postings as soon as reasonably possible. The other web postings required under 501(r) (i.e., those related to the community health needs assessment and the financial assistance policy) were timely completed and continue to remain in place as required. The organization believes its safeguards worked as intended in this case (i.e., the organization has regular communications with a number of external law firms and tax consultants and the timely attention to the recent guidance was supported by the framework of regular access to subject matter experts). These changes are in the process of being incorporated into corporate policies and procedures that apply to the organization. Schedule H, Part I, Line 6a Community benefit report prepared by related organization SAINT JOSEPH'S HOSPITAL OF MARSHFIELD 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 II Community Building Activities St. Joseph's Hospital participates in several coalitions and other collaborative efforts whose purpose is to improve the health of the community. The regional and state trauma advisory committee is one of those coalitions. By working together with other organizations in the community , we expect to have a greater impact on health. According to the County Health Rankings site, with a shared vision and commitment to improved health, working together can yield better results than working alone. In addition, St. Joseph's Hospital provides training opportunities for area youth with developmental disabilities. According to the County Health Rankings, employment provides income and, often, benefits that can support healthy lifestyle choices. Unemployment and under employment limit these choices, and negatively affect both quality of life and health overall. St. Joseph's Hospital also participates in a community sharps program. By safely removing sharps from the environment, we make the community safer in terms of injury and infection. 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 $5,605,652 at charges, ($2,007,731 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. JOSEPH'S HOSPITAL OF MARSHFIELD 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 - Saint Joseph's Hospital of Marshfield, Inc.: Line 16a URL: https://healthcare.ascension.org/financial-assistance/wisconsin; Schedule H, Part V, Section B, Line 16b FAP Application website - Saint Joseph's Hospital of Marshfield, Inc.: Line 16b URL: https://healthcare.ascension.org/financial-assistance/wisconsin; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - Saint Joseph's Hospital of Marshfield, 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, St. Joseph'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. St. Joseph's Hospital utilizes this information to determine develop programs and services to be provided for the community. These needs and initiatives are presented to senior leadership and board members to ensure the findings are considered in developing the organization's strategy, policy development, and internal financial and operational decisions. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance Ministry Health Care, Inc. has financial counselors located at every hospital. If a patient indicates they are unable to pay their bill at any point during pre-service, admission, discharge or billing process, the financial counselors will assist the patient either in securing a funding source (grants, Cobra coverage, disability benefits, Medicaid, VA, etc) if eligible or assist them in completing a financial assistance application. Schedule H, Part VI, Line 4 Community information While there is growing agreement in the United States about what constitutes a non-profit hospital's "Community Benefit", this is a work in progress. Saint Joseph's Hospital of Marshfield, 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. Our Hospital, 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. As of the 2010 census, the population of Marshfield was 19,118. The 2014 estimated population is 18,691. Based on the 2010 census, the racial make-up was 93.5% White, 0.7% African American, 0.2% Native American, 2.3% Asian, 2.4% Hispanic, and 0.9% of other races. 18.4% were over 65 year old and 20.9% under 18. The median household income for the last five years was $42,448 and 13.2% of the population was below the poverty line. Schedule H, Part VI, Line 5 Promotion of community health The Organization strives to further its exempt purposes by the following: - The Organization's governing board consists primarily of persons who reside within the primary service area who are not employees of the Organization. - As mentioned, the Organization provides several services which are not otherwise available being in a rural setting. - Based on the Organization's mission, emergency rooms are made available to all patients regardless of the ability to pay. - The Organization also participates in the education and training of healthcare professionals through internship programs. - The Hospital participates in government-sponsored health programs (Medicare, Medicaid, Champus, Tricare). - The Hospital offers volunteer opportunities to the community or evidence of the Organization's responsiveness to the community, including opportunities for community involvement in governance and advisory groups and examples of programs that were established in the tax year that responded to community needs. - The Facility strives to be a low-cost/low-charge facility. - Advocates community-wide, state or national efforts to improve health of the population and increase access. - Partnerships with others in the community (including public health departments) to improve community health and well-being. - The role of the emergency department and urgent care units in serving all persons regardless of ability to pay. - Availability of financial assistance and sliding scale discounts and changes to financial assistance or collection policies that would be viewed as constructive. - The Organization is a sole community hospital. - Community members utilize the Hospital as a vehicle to connect with and contribute to individuals and the overall community through philanthropy and volunteering. - Programs are having an impact on community health especially prevention activities, efforts to improve health and increase access to health care services, and reducing health care costs. Schedule H, Part VI, Line 6 Affiliated health care system ST. JOSEPH'S HOSPITAL OF MARSHFIELD, INC. IS AN AFFILIATE OF MINISTRY HEALTH, INC. AND ASCENSION HEALTH. ST. JOSEPH'S HOSPITAL OF MARSHFIELD, INC.'S AFFILIATES ARE LARGE MULTI-FACETED, INTEGRATED, NOT-FOR-PROFIT MINISTRIES INCLUDING HOSPITAL AND NON-HOSPITAL MINISTRIES (PHYSICIAN GROUP PRACTICES, HOSPITAL ORGANIZATIONS, RESEARCH, HOME HEALTH, DURABLE MEDICAL EQUIPMENT AND SENIOR FACILITIES). THESE MINISTRIES WORK TOGETHER TO CARE FOR PATIENTS, JOINED BY COMMON SYSTEMS AND A PHILOSOPHY OF SERVING AS A HEALING PRESENCE WITH SPECIAL CONCERN FOR OUR NEIGHBORS ESPECIALLY THOSE WHO ARE VULNERABLE. THIS COMMUNITY BENEFIT HAPPENS THROUGH ITS FOCUS ON PATIENT CARE, EDUCATION AND RESEARCH. THE ORGANIZATIONS WORK TOGETHER TO SERVE THEIR COMMUNITIES AT THE LOCAL, REGIONAL, STATE AND NATIONAL LEVEL. ASCENSION HEALTH ALLIANCE, D/B/A ASCENSION (ASCENSION), IS A MISSOURI NONPROFIT CORPORATION FORMED ON SEPTEMBER 13, 2011. ASCENSION IS THE SOLE CORPORATE MEMBER AND PARENT ORGANIZATION OF ASCENSION HEALTH, A CATHOLIC NATIONAL HEALTH SYSTEM CONSISTING PRIMARILY OF NONPROFIT CORPORATIONS THAT OWN AND OPERATE LOCAL HEALTHCARE FACILITIES, OR HEALTH MINISTRIES, LOCATED IN 23 OF THE UNITED STATES AND THE DISTRICT OF COLUMBIA. ASCENSION IS SPONSORED BY ASCENSION SPONSOR, A PUBLIC JURIDIC PERSON. THE PARTICIPATING ORGANIZATIONS/ENTITIES OF ASCENSION SPONSOR ARE THE DAUGHTERS OF CHARITY OF ST. VINCENT DE PAUL, ST. LOUISE PROVINCE; THE CONGREGATION OF ST. JOSEPH; THE CONGREGATION OF THE SISTERS OF ST. JOSEPH OF CARONDELET; THE CONGREGATION OF ALEXIAN BROTHERS OF THE IMMACULATE CONCEPTION PROVINCE, INC. - AMERICAN PROVINCE; AND THE SISTERS OF THE SORROWFUL MOTHER OF THE THIRD ORDER OF ST.FRANCIS OF ASSISI - US/CARIBBEAN PROVINCE. The System directs its governance and management activities toward strong, vibrant, Catholic Health Ministries united in service and healing and dedicates its resources to spiritually centered care that sustains and improves the health of the individuals and communities it serves. In accordance with the System's mission of service to those persons living in poverty and to other vulnerable persons, each Health Ministry accepts patients regardless of their ability to pay. The System uses four categories to identify the resources utilized for the care of persons living in poverty and for community benefit programs: Traditional charity care includes the cost of services provided to persons who cannot afford health care because of inadequate resources and/or who are uninsured or underinsured. Unpaid cost of public programs, excluding Medicare, represents the unpaid cost of services provided to persons covered by public programs for persons living in poverty and for other vulnerable persons. Cost of other programs for persons living in poverty and for other vulnerable persons includes unreimbursed costs of programs intentionally designed to serve the persons living in poverty and the other vulnerable persons of the community, including substance abusers, the homeless, victims of child abuse, and persons with acquired immune deficiency syndrome. Community benefit consists of the unreimbursed costs of community benefit programs and services for the general community, not solely for the persons living in poverty, including health promotion and education, health clinics and screenings, and medical research. Discounts are provided to all uninsured patients, including those with the means to pay. Discounts provided to those patients who did not qualify for assistance under charity care guidelines are not included in the cost of providing care to persons living in poverty or in the cost of other community benefit programs. The cost of providing care to persons living in poverty and of other community benefit programs is estimated using internal cost data and is estimated by reducing charges forgone by a factor derived from the ratio of total operating expenses to billed charges for patient care. Schedule H, Part VI, Line 7 State filing of community benefit report WI true true false false false false false false false BRIAN KIEF SJH PRESIDENT (EX OFFICIO) (END 3/2017) 0 519335 0 661025 0 54098 0 15900 0 25645 0 1276003 0 0 JEREMY NORMINGTON-SLAY PRESDIENT, MERCY MEDICAL CENTER (EX OFFICIO) (START 5/2017) 0 252210 0 52363 0 1303 0 13122 0 23846 0 342844 0 0 NICHOLAS DESIEN FORMER OFFICER (END 12/2015) 0 190823 0 0 0 2520000 0 443 0 0 0 2711266 0 0 JEFFREY FRANCIS FORMER OFFICER (END 9/2015) 0 0 0 0 0 225000 0 0 0 0 0 225000 0 0 DANIEL E NEUFELDER SVP, HOSPITAL OPERATIONS & PRESIDENT, AHS (END 9/2016) 0 861918 0 713099 0 250740 0 15900 0 12516 0 1854173 0 0 LAYTON ANDERSON VP, HOSPITAL OPERATIONS 0 174868 0 101809 0 20328 0 13242 0 25480 0 335727 0 0 SHARON B KOSTROSKI SJH VP QUALITY & SAFETY 0 188819 0 12889 0 24093 0 12681 0 8783 0 247265 0 0 LEIGH J ASCHBRENNER Clinical Pharmacist 7/70 144165 0 0 0 8377 0 9412 0 2031 0 163985 0 0 0 JUSTIN GUTHMAN Dir Pharmacy 151853 0 10980 0 9409 0 6757 0 5860 0 184859 0 0 0 THOMAS RYAN System Dir Med Transport Srvcs 157565 0 0 0 22216 0 8512 0 24642 0 212935 0 0 0 ROSEMARIE T SCHROEDER Dir Patient Care Srvcs 144792 0 0 0 26203 0 8109 0 9656 0 188760 0 0 0 ANDREW W WEIER Sys Dir Quality Data Mgmt & An 148433 0 0 0 1092 0 9442 0 30425 0 189392 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation MINISTRY HEALTH CARE, INC., A RELATED ORGANIZATION OF SAINT JOSEPH'S HOSPITAL OF MARSHFIELD, INC., USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S CEO/EXECUTIVE DIRECTOR: - 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. X Capital Equipment 17 872744 Cost 0 false true false Schedule M, Part I Explanations of reporting method for number of contributions Other - Capital Equipment Number of contributions. false false false false true true false RECEIVABLES, INVENTORY AND CAPITAL ASSETS 2017-06-30 323959942 BOOK VALUE 810977948 MCHS HOSPITALS INC 1000 NORTH OAK AVENUE MARSHFIELD WI 54449 501(c)(3) CASH ACCOUNTS TRANSFERRED TO PARENT'S BALANCE SHEET 2016-07-01 328825228 FMV 453358926 ASCENSION HEALTH ALLIANCE PO BOX 45998 ST LOUIS MO 63145 501(C)(3) false false false false Schedule N, Part II CASH TRANSFER ST. JOSEPH'S HOSPITAL OF MARSHFIELD, INC. TRANSFERRED ITS BEGINNING HSD CASH BALANCE TO ASCENSION HEALTH ALLIANCE (45-3358926) AS OF JULY 1, 2016. Form 990, Part VI, Line 15a PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL THE PROCESS OF DETERMINING THE AMOUNT OF COMPENSATION PAID TO THE ORGANIZATION'S CEO, EXECUTIVE DIRECTOR OR TOP MANAGEMENT OFFICIAL IS PERFORMED BY MINISTRY HEALTH CARE, INC. AND ITS SUBSIDIARY ORGANIZATIONS. MINISTRY HEALTH CARE, INC. IS THE SOLE CORPORATE MEMBER OF ST. JOSEPH'S HOSPITAL OF MARSHFIELD, INC. THE PROCESS INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE EXECUTIVE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE ORGANIZATION'S CEO, EXECUTIVE DIRECTOR OR TOP MANAGEMENT OFFICIAL'S SALARY WAS COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE MINUTES. THE INDIVIDUAL WAS NOT PRESENT WHEN THEIR COMPENSATION WAS DECIDED. Form 990, Part VI, Line 15b PROCESS TO ESTABLISH COMPENSATION OF OTHER OFFICERS OR KEY EMPLOYEES THE PROCESS OF DETERMINING THE AMOUNT OF COMPENSATION PAID TO THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES IS PERFORMED BY MINISTRY HEALTH CARE, INC. AND ITS SUBSIDIARY ORGANIZATIONS. MINISTRY HEALTH CARE, INC. IS THE SOLE CORPORATE MEMBER OF ST. JOSEPH'S HOSPITAL OF MARSHFIELD, 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 Saint Joseph's Hospital of Marshfield, Inc. has a single corporate member, Ministry Health Care, Inc. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body Saint Joseph's Hospital of Marshfield, Inc. has a single corporate member, Ministry Health Care, Inc., who has the ability to elect members to the governing body of Saint Joseph's Hospital of Marshfield Inc. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders All decisions that have a material impact to Saint Joseph's Hospital of Marshfield, Inc. financial information or corporation as a whole are subject to approval by its sole corporate member, Ministry Health Care, Inc. Form 990, Part VI, Line 11b Review of form 990 by governing body DURING THE RETURN PREPARATION PROCESS, THE TAX DEPARTMENT WORKS WITH OTHER FUNCTIONAL AREAS INCLUDING FINANCE, ACCOUNTING, TREASURY, LEGAL, HUMAN RESOURCES, AND CORPORATE COMPLIANCE FOR ADVICE, INFORMATION AND ASSISTANCE IN ORDER TO PREPARE A COMPLETE AND ACCURATE RETURN. UPON COMPLETION, THE FORM 990 IS REVIEWED BY THE ORGANIZATION'S INTERNAL TAX DEPARTMENT WHICH CONSISTS OF ATTORNEYS AND CPAS. A COMPLETE FINAL COPY OF THE RETURN IS PROVIDED TO THE ORGANIZATION'S PRESIDENT, FINANCIAL OFFICER, AND/OR OTHER KEY OFFICERS IN LIEU OF THE FULL BOARD. Form 990, Part VI, Line 12c Conflict of interest policy The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflicts of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose. Form 990, Part VI, Line 19 Required documents available to the public The Organization will provide any documents open to public inspection upon request. Form 990, Part XI, Line 9 Other changes in net assets or fund balances Net Asset Transfers with Affiliates - -XXX-XX-XXXX; Net Asset Transfer to Alpha Fund - -XXX-XX-XXXX; Form 990, Part XII, Line 2b Audited Financial Statements The activity of St. Joseph's Hospital of Marshfield, Inc. is reported in the consolidated financial statements of Ascension Health Alliance. No individual audit of St. Joseph's Hospital of Marshfield, Inc. is completed. Therefore, the attached audited financial statements are of Ascension Health Alliance and Affiliates, which include the activity of St. Joseph's Hospital of Marshfield, Inc.. Form 990, Part XII, Line 2c Audit Committee St. Joseph's Hospital of Marshfield, Inc. is included in the consolidated financial statements of Ascension Health Alliance. The Finance and Audit committee of Ascension Health Alliance's Board assumes responsibility for the consolidated organization as a whole. 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SUSSEX INC 400 WEST RIVER WOODS PARKWAY GLENDALE WI 53212 391361100 HEALTHCARE WI NA C Corporation true false true false false false false false false false false true true true false true true true false true FOUNDATION OF SAINT JOSEPH'S HOSPITAL OF MARSHFIELD INC C 995535 FAIR MARKET VALUE FOUNDATION OF SAINT JOSEPH'S HOSPITAL OF MARSHFIELD INC L 58552 FAIR MARKET VALUE FOUNDATION OF SAINT JOSEPH'S HOSPITAL OF MARSHFIELD INC O 187531 FAIR MARKET VALUE ASCENSION SACRED HEART-ST MARY'S HOSPITALS INC L 118810 FAIR MARKET VALUE ASCENSION ST MICHAEL'S HOSPITAL INC L 51153 FAIR MARKET VALUE ASCENSION ST CLARE'S HOSPITAL INC L 527408 FAIR MARKET VALUE THE HOWARD YOUNG MEDICAL CENTER INC L 99531 FAIR MARKET VALUE