BELLIN MEMORIAL HOSPITAL INC: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization: BELLIN MEMORIAL HOSPITAL INC (EIN 39-0884478)
Tax period: 2015-10-01 to 2016-09-30
Filed: 2017-08-14
IRS object ID: 201732269349302318
Schema version: 2015v3.0
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 I
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2017-08-14T15:05:58-05:00	ReturnTs
Tax Period End	2016-09-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

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

Preparer Firm Name PreparerFirmName

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

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	PO Box 12237	AddressLine1Txt
City	Green Bay	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	543072237	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2015-10-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	390884478	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Bellin Memorial Hospital Inc	BusinessNameLine1Txt

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

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO Box 23400	AddressLine1Txt
City	Green Bay	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54305	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	JAMES DIETSCHE	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	9204457260	PhoneNum
Signature	2017-08-14	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Terri Rexrode CPA MST	PreparerPersonNm
PTIN	P00096513	PTIN
Phone	9206620016	PhoneNum
Preparation	2017-08-14	PreparationDt

Field	Value	IRS element (for citing)
Tax	2015	TaxYr
Build TS	2021-01-29 14:40:06Z	BuildTS

Form 990 IRS990

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

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO Box 23400	AddressLine1Txt
City	Green Bay	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54305	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$482,837,642	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.BELLIN.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1908	FormationYr
Legal Domicile State	WI	LegalDomicileStateCd
Activity Or Mission	BELLIN MEMORIAL HOSPITAL, INC. (BMH) PROVIDES HEALTH CARE SERVICES AND OTHER FINANCIAL SUPPORT THROUGH VARIOUS PROGRAMS THAT ARE DESIGNED, AMONG OTHER MATTERS, TO ENHANCE THE HEALTH OF THE COMMUNITY AND IMPROVE THE HEALTH OF LOW-INCOME PATIENTS. CONSISTENT WITH THE MISSION OF BMH, CARE IS PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. IN ADDITION, BMH PROVIDES SERVICES INTENDED TO BENEFIT THE POOR AND UNDERSERVED, INCLUDING THOSE PERSONS WHO CANNOT AFFORD HEALTH INSURANCE BECAUSE OF INADEQUATE RESOURCES OR ARE UNINSURED OR UNDERINSURED. HEALTH CARE SERVICES TO PATIENTS UNDER GOVERNMENT PROGRAMS, SUCH AS MEDICAID, ARE ALSO CONSIDERED PART OF THE BELLIN HEALTH BENEFITS PROVIDED TO THE COMMUNITY SINCE A SUBSTANTIAL PORTION OF SUCH SERVICES ARE REIMBURSED AT AMOUNTS LESS THAN COST.	ActivityOrMissionDesc
Voting Members Governing Body	22	VotingMembersGoverningBodyCnt
Voting Members Independent	15	VotingMembersIndependentCnt
Total Employee	3483	TotalEmployeeCnt
Total Volunteers	420	TotalVolunteersCnt
Total Gross UBI	$8,224,037	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	-$790,158	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$1,097,065	PYContributionsGrantsAmt
CY Contributions Grants	$922,507	CYContributionsGrantsAmt
PY Program Service Revenue	$449,192,956	PYProgramServiceRevenueAmt
CY Program Service Revenue	$472,729,864	CYProgramServiceRevenueAmt
PY Investment Income	$5,978,466	PYInvestmentIncomeAmt
CY Investment Income	$1,277,875	CYInvestmentIncomeAmt
PY Other Revenue	$3,911,513	PYOtherRevenueAmt
CY Other Revenue	$4,062,031	CYOtherRevenueAmt
PY Total Revenue	$460,180,000	PYTotalRevenueAmt
CY Total Revenue	$478,992,277	CYTotalRevenueAmt
PY Grants And Similar Paid	$1,225,882	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$607,321	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$227,999,752	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$255,739,020	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$194,357,613	PYOtherExpensesAmt
CY Other Expenses	$195,052,016	CYOtherExpensesAmt
PY Total Expenses	$423,583,247	PYTotalExpensesAmt
CY Total Expenses	$451,398,357	CYTotalExpensesAmt
PY Revenues Less Expenses	$36,596,753	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$27,593,920	CYRevenuesLessExpensesAmt
Total Assets BOY	$454,995,944	TotalAssetsBOYAmt
Total Assets EOY	$491,466,100	TotalAssetsEOYAmt
Total Liabilities BOY	$140,678,606	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$145,530,736	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$314,317,338	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$345,935,364	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	Bellin Health is a community-owned not-for-profit organization responsible for improving the health and wellbeing of people living in Northeast Wisconsin and the Upper Peninsula of Michigan, and all others we serve. We carry out this responsibility through individualized care excellence, community health improvement, and equitable healthcare financing plans all designed to positively impact health and wellbeing. We are steadfast in our commitment to providing compassionate, safe, and coordinated care that is accessible and affordable for everyone. We build trusted relationships and advance true collaboration, fueling our desire to constantly improve and innovate.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$370,867,487	ExpenseAmt
Grant	$606,348	GrantAmt
Revenue	$453,799,453	RevenueAmt
Desc	THE HOSPITAL PROVIDES ACUTE HOSPITAL CARE TO RESIDENTS OF NORTHEASTERN WISCONSIN. DURING FISCAL YEAR 2016 33,060 INPATIENT DAYS WERE PROVIDED (30,075 ADULTS AND PEDIATRICS), AS COMPARED TO 33,329 (30,590 ADULTS AND PEDIATRICS) IN FISCAL YEAR 2015. THE NUMBER OF OUTPATIENTS REGISTERED FOR 2016 AND 2015 WERE 241,774 AND 242,670, RESPECTIVELY. BELLIN MEMORIAL HOSPITAL ALSO PROVIDED 828,162 (AS COMPARED TO 745,126 IN 2015) PHYSICIAN CLINIC VISITS THROUGH BELLIN MEDICAL AND SPECIALTY GROUPS.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$16,149,096	ExpenseAmt
Grant	$973	GrantAmt
Revenue	$13,350,771	RevenueAmt
Desc	Northreach Healthcare is a primary care organization with service lines of family practice, ob/gyn, pediatrics, and internal medicine. NorthReach provides service to Marinette county, Menominee county, and the surrounding areas.	Desc

Field	Value	IRS element (for citing)
Total Program Service Expenses	$387,016,583	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Temp Or Permanent Endowments	Yes (1)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	0	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (1)	TaxExemptBondsInd
Invest Tax Exempt Bonds	0	InvestTaxExemptBondsInd
Escrow Account	0	EscrowAccountInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	Yes (1)	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	Yes (1)	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (1)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	325	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	3483	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	22	GoverningBodyVotingMembersCnt
Independent Voting Member	15	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (1)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (1)	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	WI	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	James Dietsche CFOVP	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	9204457260	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	744 S Webster Ave	AddressLine1Txt
City	green bay	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54301	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (32 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Highest Compensated EmployeeHighestCompensatedEmployeeInd
TERRY FULWILER
Chairperson	0.50	Yes (X)	Yes (X)	$0	$0	$0
ELL LEE DDS
Vice Chairperson	0.50	Yes (X)	Yes (X)	$0	$0	$0
MARK MCMULLEN
Secretary	0.50	Yes (X)	Yes (X)	$0	$0	$0
NANCY ARMBRUST
Board MEMBER	0.50	Yes (X)		$0	$0	$0
G CORT CONDON
Board MEMBER	0.50	Yes (X)		$0	$0	$0
Daniel Gulling
Board MeMBER	0.50	Yes (X)		$0	$0	$0
FRED SCHMIDT MD
BOARD MEMBER	0.50	Yes (X)		$0	$0	$0
DANIEL ARIENS
Board MEMBER	0.50	Yes (X)		$0	$0	$0
WILLIAM WITTMAN MD
Board Member	40.00	Yes (X)		$377,831	$0	$23,250
LARRY BORGARD
Board MEMBER	0.50	Yes (X)		$0	$0	$0
JOHN JONES
Board MEMBER	0.50	Yes (X)		$0	$0	$0
SUSAN FINCO
Board MEMBER	0.50	Yes (X)		$0	$0	$0
MICHAEL HADDAD
BOARD MEMBER	0.50	Yes (X)		$0	$0	$0
LOREN FUGLESTAD MD - Termed
Board Member/BMG physician	40.00	Yes (X)		$316,520	$0	$33,047
CHRISTINE VANDENHOUTEN
BOARD MEMBER	0.50	Yes (X)		$0	$0	$0
JOHN DYKEMA
Treasurer	0.50	Yes (X)	Yes (X)	$0	$0	$0
ROBERT CLAUSEN
BOARD MEMBER	0.50	Yes (X)		$0	$0	$0
GEORGE KERWIN
Bellin CEO/Board Member	50.00	Yes (X)	Yes (X)	$910,203	$0	$27,477
Paul Casey MD
Board Member/President Medical Staff	50.00	Yes (X)		$111,515	$0	$0
Cynthia Lasecki MD
Board Member/Former President Medical Staff	50.00	Yes (X)		$350,680	$0	$17,301
Sabina Singh MD
Board Member/President Bellin Medical Group	50.00	Yes (X)		$263,429	$0	$21,321
Mark Ringwelski MD
Board Member/FPresident Bellin Specialty Group	50.00	Yes (X)		$312,926	$0	$28,241
Karl Schmidt
Board Member	0.50	Yes (X)		$0	$0	$0
Dennis Hogan - Termed
Board Member	0.50	Yes (X)		$0	$0	$0
JAMES DIETSCHE
CFO	50.00		Yes (X)	$385,624	$0	$30,760
PETER KNOX
EXECUTIVE VP	50.00		Yes (X)	$376,989	$0	$34,275
CHRISTINE WOLESKE
EXECUTIVE VP	50.00		Yes (X)	$410,015	$0	$35,558
CHRISTOPHER WOLFRAM MD
Physician	40.00			$939,518	$0	$26,211	Yes (X)
TIMOTHY TANKE MD
Physician	40.00			$886,258	$0	$30,839	Yes (X)
RICHARD TIMMONS MD
PHYSICIAN	40.00			$824,336	$0	$32,558	Yes (X)
Vijaya Munagala MD
Physician	40.00			$789,439	$0	$28,985	Yes (X)
Paul Hudson MD
PHYSICIAN	40.00			$856,152	$0	$34,228	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$8,111,435	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$404,051	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	308	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
IEI General Contractors
1725 Midway Road	De Pere	WI	54115	Construction contractor services	$6,039,255
BLR Further LLC
4841 Summer Avenue	Memphis	TN	38122	Advertising/marketing services	$2,445,723
AmeriEBO LLC
1851 South Alverno Road	Manitowoc	WI	54220	Collections services	$1,709,919
Miron Construction Co Inc
PO Box 509	Neenah	WI	54957	Construction contractor services	$1,216,027
Bay Towel & Linen
2580 South Broadway	Green Bay	WI	54301	Linen services	$1,190,559

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	64	CntrctRcvdGreaterThan100KCnt
Related Organizations	$554,562	RelatedOrganizationsAmt
All Other Contributions	$367,945	AllOtherContributionsAmt
Total Contributions	$922,507	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
NET PATIENT SERVICE REVENUE	621500	$464,766,967	$457,173,783	$7,593,184
CONTRACTED SERVICES	621110	$3,078,643	$3,078,643
MISCELLANEOUS	621110	$2,631,757	$2,631,757
CAFETERIA	621110	$863,578			$863,578
ACO INCENTIVE	621110	$609,812	$609,812

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$779,107	TotalRevenueColumnAmt
Related Or Exempt Func Income	$91,255	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$630,853	UnrelatedBusinessRevenueAmt
Exclusion	$56,999	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$472,729,864	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,082,486	TotalRevenueColumnAmt
Exclusion	$2,082,486	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$3,156,971	RealAmt
Personal	$45,925	PersonalAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$2,659,914	RealAmt
Personal	$45,925	PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$497,057	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$497,057	TotalRevenueColumnAmt
Exclusion	$497,057	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$334,915	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$846,470	SecuritiesAmt
Other	$293,056	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	-$846,470	SecuritiesAmt
Other	$41,859	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$804,611	TotalRevenueColumnAmt
Exclusion	-$804,611	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Income FROM HEALTHCARE AFFILIATES	900099	$3,281,597	$3,281,597
EHR INCENTIVE	621110	$283,377	$283,377

Field	Value	IRS element (for citing)
Other Revenue Total	$3,564,974	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$478,992,277	TotalRevenueColumnAmt
Related Or Exempt Func Income	$467,150,224	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$8,224,037	UnrelatedBusinessRevenueAmt
Exclusion	$2,695,509	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$607,321	TotalAmt
Program Services	$607,321	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$4,066,962	TotalAmt
Program Services	$1,744,546	ProgramServicesAmt
Management And General	$2,322,416	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$203,472,603	TotalAmt
Program Services	$185,629,454	ProgramServicesAmt
Management And General	$17,843,149	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$9,152,929	TotalAmt
Program Services	$8,275,797	ProgramServicesAmt
Management And General	$877,132	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$26,272,558	TotalAmt
Program Services	$22,934,678	ProgramServicesAmt
Management And General	$3,337,880	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$12,773,968	TotalAmt
Program Services	$11,442,936	ProgramServicesAmt
Management And General	$1,331,032	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$636,232	TotalAmt
Program Services	$636,232	ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$621,851	TotalAmt
Management And General	$621,851	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$622,909	TotalAmt
Management And General	$622,909	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$27,202,082	TotalAmt
Program Services	$20,011,440	ProgramServicesAmt
Management And General	$7,190,642	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$7,630,896	TotalAmt
Program Services	$43,351	ProgramServicesAmt
Management And General	$7,587,545	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$4,960,659	TotalAmt
Program Services	$2,057,032	ProgramServicesAmt
Management And General	$2,903,627	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$7,699,772	TotalAmt
Program Services	$3,807,148	ProgramServicesAmt
Management And General	$3,892,624	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$11,118,215	TotalAmt
Program Services	$10,001,161	ProgramServicesAmt
Management And General	$1,117,054	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$1,097,813	TotalAmt
Program Services	$676,033	ProgramServicesAmt
Management And General	$421,780	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$1,698,577	TotalAmt
Program Services	$1,022,850	ProgramServicesAmt
Management And General	$675,727	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$3,838,662	TotalAmt
Program Services	$402,263	ProgramServicesAmt
Management And General	$3,436,399	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$18,461,552	TotalAmt
Program Services	$13,410,094	ProgramServicesAmt
Management And General	$5,051,458	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$871,334	TotalAmt
Program Services	$684,816	ProgramServicesAmt
Management And General	$186,518	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
Supplies expense	$77,151,680	$76,602,961	$548,719
Equipment Rent/Maint	$11,726,994	$10,084,183	$1,642,811
Dues & subscriptions	$10,051,961	$8,515,251	$1,536,710
Bad Debt expense	$6,705,765	$6,704,616	$1,149

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$2,955,062	TotalAmt
Program Services	$1,722,420	ProgramServicesAmt
Management And General	$1,232,642	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$451,398,357	TotalAmt
Program Services	$387,016,583	ProgramServicesAmt
Management And General	$64,381,774	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$15,994	BOYAmt
EOY	$17,432	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$90,773,641	BOYAmt
EOY	$80,772,767	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$48,389,694	BOYAmt
EOY	$48,985,833	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$6,347,210	BOYAmt
EOY	$2,968,083	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$4,987,231	BOYAmt
EOY	$5,813,537	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$6,774,092	BOYAmt
EOY	$5,826,209	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$367,306,413	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$195,531,478	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$144,955,990	BOYAmt
EOY	$171,774,935	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$123,364,419	BOYAmt
EOY	$135,677,068	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$13,839,345	BOYAmt
EOY	$17,958,742	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$6,105,842	BOYAmt
EOY	$5,368,296	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$9,442,486	BOYAmt
EOY	$16,303,198	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$454,995,944	BOYAmt
EOY	$491,466,100	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$38,980,842	BOYAmt
EOY	$47,700,716	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$320,036	BOYAmt
EOY	$230,863	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$72,367,813	BOYAmt
EOY	$67,651,129	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$29,009,915	BOYAmt
EOY	$29,948,028	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$140,678,606	BOYAmt
EOY	$145,530,736	EOYAmt

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

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$310,758,298	BOYAmt
EOY	$341,994,662	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,388,632	BOYAmt
EOY	$1,450,794	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$2,170,408	BOYAmt
EOY	$2,489,908	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$314,317,338	BOYAmt
EOY	$345,935,364	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$454,995,944	BOYAmt
EOY	$491,466,100	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$27,593,920	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$6,374,351	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$2,350,245	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

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

Schedule A IRS990ScheduleA

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

Schedule B IRS990ScheduleB

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	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$5,840	OtherActivitiesAmt
Total Lobbying Expenditures	$5,840	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part II-B, Line 1:	FormAndLineReferenceDesc
Explanation	AHA and WHA Dues	ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

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

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

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

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

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

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$2,372,548	BeginningYearBalanceAmt
Investment Earnings Or Losses	$48,841	InvestmentEarningsOrLossesAmt
Other Expenditures	$3,566	OtherExpendituresAmt
End Year Balance	$2,417,823	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$2,239,178	BeginningYearBalanceAmt
Contributions	$86,124	ContributionsAmt
Investment Earnings Or Losses	$68,097	InvestmentEarningsOrLossesAmt
Other Expenditures	$20,851	OtherExpendituresAmt
End Year Balance	$2,372,548	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.00000	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.94400	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.05600	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	Yes (1)	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (1)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (1)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$7,483,827	OtherCostOrOtherBasisAmt
Book Value	$7,483,827	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$134,067,453	OtherCostOrOtherBasisAmt
Depreciation	$56,654,528	DepreciationAmt
Book Value	$77,412,925	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,404,457	OtherCostOrOtherBasisAmt
Depreciation	$1,757,006	DepreciationAmt
Book Value	$647,451	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$200,839,132	OtherCostOrOtherBasisAmt
Depreciation	$137,119,944	DepreciationAmt
Book Value	$63,719,188	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$22,511,544	OtherCostOrOtherBasisAmt
Book Value	$22,511,544	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$171,774,935	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDesc	AmtAmt
Deferred compensation	$8,880,480
Noncontrolling interest of consolidated affiliate	$1,206,577
Capital lease obligations	$9,407,798
Interest rate swap valuation	$10,453,173

Field	Value	IRS element (for citing)
Total Liability	$29,948,028	TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt	$477,809,238	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	$6,374,351	NetUnrealizedGainsInvstAmt
Other Revenue	-$9,853,897	OtherRevenueAmt
Revenue Not Reported	-$3,479,546	RevenueNotReportedAmt
Revenue Subtotal	$481,288,784	RevenueSubtotalAmt
Other Revenues Not Included	-$2,296,507	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	-$2,296,507	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$478,992,277	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$447,214,305	TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included	$2,913,502	OtherExpensesIncludedAmt
Expenses Not Reported	$2,913,502	ExpensesNotReportedAmt
Expenses Subtotal	$444,300,803	ExpensesSubtotalAmt
Other Expenses Not Included	$7,097,554	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$7,097,554	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$451,398,357	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part V, Line 4:	ENDOWMENT FUNDS ARE INTENDED TO BE USED FOR HEALTH CARE SERVICES AND EMPLOYEE TRAINING AND DEVELOPMENT.
Part XI, Line 2d - Other Adjustments:	LOSS ON SWAP AGREEMENT -1,293,827. NON-CONTROLLING INTEREST -1,854,305. Provision for bad debts -6,705,765.
Part XI, Line 4b - Other Adjustments:	TRANSFER FROM FOUNDATION 554,562. HOSPITAL SUPPLIES 62,433. RENTAL EXPENSES -2,705,839. Loss from healthcare affiliates -207,663.
Part XII, Line 2d - Other Adjustments:	RENTAL EXPENSES 2,705,839. Loss from healthcare affiliates 207,663.
Part XII, Line 4b - Other Adjustments:	REALLOCATION OF SUPPLIES EXPENSE TO 990T 62,433. EXPENSES PAID FOR BY FOUNDATION TRANSFERS 329,356. Provision for bad debts 6,705,765.

Schedule H IRS990ScheduleH

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

Free Care Oth Percentage FreeCareOthPercentageGrp

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

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

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,251,326	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$2,251,326	NetCommunityBenefitExpnsAmt
Total Expense	0.00510	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$53,192,139	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$27,705,329	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$25,486,810	NetCommunityBenefitExpnsAmt
Total Expense	0.05730	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$55,443,465	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$27,705,329	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$27,738,136	NetCommunityBenefitExpnsAmt
Total Expense	0.06240	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,277,046	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$4,277,046	NetCommunityBenefitExpnsAmt
Total Expense	0.00960	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,285,907	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$3,285,907	NetCommunityBenefitExpnsAmt
Total Expense	0.00740	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$705,626	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$705,626	NetCommunityBenefitExpnsAmt
Total Expense	0.00160	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$8,268,579	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$8,268,579	NetCommunityBenefitExpnsAmt
Total Expense	0.01860	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$63,712,044	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$27,705,329	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$36,006,715	NetCommunityBenefitExpnsAmt
Total Expense	0.08100	TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$722,593	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$722,593	NetCommunityBenefitExpnsAmt
Total Expense	0.00160	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$722,593	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$722,593	NetCommunityBenefitExpnsAmt
Total Expense	0.00160	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$2,649,862	BadDebtExpenseAmt
Reimbursed By Medicare	$127,704,014	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$192,605,440	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$64,901,426	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

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

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp

Entity Name EntityName

Field	Value	IRS element (for citing)
Business Name Line1	1 Bellin Orthopedic Surgery Center LLC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Primary Activities	orthopedic surgery center	PrimaryActivitiesTxt
Org Profit Or Ownership	0.55000	OrgProfitOrOwnershipPct
Physicians Profit Or Ownership	0.45000	PhysiciansProfitOrOwnershipPct

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

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Bellin Memorial Hospital	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	744 S Webster Ave	AddressLine1Txt
City	Green Bay	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54305	ZIPCd

Field	Value	IRS element (for citing)
State License	147	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	Bellin Memorial Hospital	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Information Gaps	Yes (X)	InformationGapsInd
CHNA Conducted	14	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (1)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	www.bellin.org/patients_visitors/company-information/community-health	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	14	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	www.bellin.org/patients_visitors/company-information/community-health	StrategyWebsiteURLTxt
Strategy Attached	0	StrategyAttachedInd
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	220.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	400.000000000000	FPGFamilyIncmLmtDscntCarePct
Income Level Criteria	Yes (X)	IncomeLevelCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
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
FAP Notice Displayed	Yes (X)	FAPNoticeDisplayedInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Collection Activities	0	CollectionActivitiesInd
FAP Notified Upon Admission	Yes (X)	FAPNotifiedUponAdmissionInd
FAP Notified Before Discharge	Yes (X)	FAPNotifiedBeforeDischargeInd
FAP Notified All Patients	Yes (X)	FAPNotifiedAllPatientsInd
Documented Elig Determination	Yes (X)	DocumentedEligDeterminationInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Other Method Used	Yes (X)	OtherMethodUsedInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Bellin Memorial Hospital	Part V, Section B, Line 5: THE BROWN COUNTY AND CITY OF DE PERE HEALTH DEPARTMENTS CONVENED A COMMUNITY HEALTH NEEDS ASSESSMENT STEERING COMMITTEE THAT INCLUDED REPRESENTATIVES OF BELLIN HEALTH, ST. MARYS ANDITS SISTER HOSPITAL ST. VINCENT, THE LOCAL UNITED WAY, AND REPRESENTATIVES OF THE REGIONAL OFFICE OF WISCONSINS DEPARTMENT OF HEALTH. THIS STEERING COMMITTEE WORKED TO IDENTIFY REPRESENTATIVES THAT COULD BROADLY REPRESENT THE COMMUNITY IN ACTUALLY CONDUCTING THE NEEDS ASSESSMENT AND SETTING PRIORITIES. THESE INDIVIDUALS WERE REFERRED TO AS COMMUNITY PARTNERS.LIST OF NAMES FOLLOWS:AGING & DISABILITY RESOURCE CENTER, SUNNY ARCHAMBAULTAURORA HEALTH SYSTEM, JULIE POMASLBAY AREA COMMUNITY COUNCIL, PAT FINDER-STONEBELLIN COLLEGE, KATHIE DEMUTHBELLIN HEALTH, JODY WILMETBELLIN HEALTH, LINDA ROETHLEBOYS & GIRLS CLUB, JOHN BENBERGBROWN COUNTY BOARD, MIKE FLECKBROWN COUNTY BOARD OF HEALTH (BOARD MEMBER), AUDREY MURPHYBROWN COUNTY COMMUNITY TREATMENT CENTER, MARY JOHNSONBROWN COUNTY COOPERATIVE EXTENSION, JUDY KNUDSENBROWN COUNTY HEALTH DEPARTMENT, JUDY FRIEDERICHS (DIRECTOR, BROWN COUNTYHEALTH DEPARTMENT) *BROWN COUNTY HUMAN SERVICES, KEVIN LUNOGBROWN COUNTY PLANNING, CHUCK LAMINEBROWN COUNTY UNITED WAY, STEPHANIE FOLEY#CENTER FOR CHILDHOOD SAFETY/ SAFE KIDS GREATER GREEN BAY, JUSTINE LODLCITY OF DE PERE BOARD OF HEALTH (BOARD MEMBER), PAT FINDER-STONE *CITY OF DE PERE HEALTH DEPARTMENT, MARY DORN, HEALTH DIRECTOR *DE PERE AREA CHAMBER OF COMMERCE, CHERYL DETRICKDIVISION OF PUBLIC HEALTH NORTHEAST REGIONAL OFFICE, REBECCA HOVARTER,REGIONAL PUBLIC HEALTH NURSING CONSULTANT *DIVISION OF PUBLIC HEALTH NORTHEAST REGIONAL OFFICE, LYNN HRABIK,EPIDEMIOLOGIST *FAMILY SERVICES-CRISIS CENTER, TANA KOSS #GREATER GREEN BAY COMMUNITY FOUNDATION, MARTHA AHRENDTGREATER GREEN BAY YMCA, SANDY ATKINSGREEN BAY CHAMBER OF COMMERCE, NAN NELSON, CCEHOMELESS POPULATION REPRESENTATIVE, SETH MOORE #N.E.W. COMMUNITY CLINIC, BONNIE KUHR #NWTC HEALTH SCIENCE, KAY TUPALA, DEANONEIDA TRIBE OF INDIANS, MICHELLE MYERS #PARISH NURSE, KATIE DYKES #BROWN COUNTY SHERIFF REPRESENTATION - CHIEFS GROUP, CAPT. RANDY SCHULTZPREVEA HEALTH, DR. ASHOK RAIST. MARYS HOSPITAL MEDICAL CENTER, HEIDI SELBERGST. VINCENT HOSPITAL, HEIDI SELBERGST. WILLEBROAD CATHOLIC PARISH, MARIA PLASCENCIASCHOOL REPRESENTATION - SUPERINTENDENTS GROUP, BARB NATELLETHE SALVATION ARMY, REBECCA LESPERANCE #UNITED HMONG AND ASIAN AMERICAN COMMUNITY CENTER, STARYOUNG THAO #UWGB-ENVIRONMENTAL SCIENCES, THOMAS ERDMANUW-GREEN BAY NURSING PROGRAM, CHRIS VANDENHOUTENWOMEN, INFANT AND CHILDREN (WIC), BONNIE KUHR # STEERING COMMITTEE MEMBER** PERSON WITH SPECIAL KNOWLEDGE OF PUBLIC HEALTH, INCLUDING PUBLIC HEALTHDEPARTMENT LEADERSHIP STAFF AND MEMBERS OF GOVERNANCE BODIES FOR PUBLICHEALTH DEPARTMENTS.# REPRESENTATIVES OF UNDERSERVED, LOW INCOME, MINORITY OR CHRONIC DISEASE
Bellin Memorial Hospital	Part V, Section B, Line 6a: St. Mary's and St. Vincent Hospitals (HSHS, Green Bay)
Bellin Memorial Hospital	Part V, Section B, Line 6b: BROWN COUNTY HEALTH DEPARTMENT, CITY OF DE PERE HEALTH DEPARTMENT, BROWN COUNTY UNITED WAY, AND WI DIVISION OF PUBLIC HEALTH NE REGIONAL OFFICE
Bellin Memorial Hospital	Part V, Section B, Line 11: The most recent CHNA identified community needs from 2015 through 2017. We are in the process of leading a community reassessment.The needs identified are: Oral Health, Alcohol and Other Drug Abuse, Mental Health and Physical Activity and Nutrition. Bellin representatives lead the Alcohol and Other Drug Abuse and Mental Health Community Action teams and is active on the other teams. A summary of how Bellin has been addressing the needs identified in the CHNA is as follows:Oral Health: Bellin sponsored a legislative breakfast to improve health care policy and coverage of Medicaid patients. We have standardized our ED protocols to be consistent with the other health care systems for patients with oral pain., along with conducting a oral health screening pilot with our OB patients. Bellin donates funds annually to the NEW Community Clinic which has been able to expand access for oral care for Medicaid and uninsured patients. Alcohol and Other Drug Misuse: The Alcohol and Drug Task Force has three key focus areas: Access to Care, Public Policy, and Public Awareness. This past year the group has partnered with the Mental Health Task Force in establishing a goal of four days to treatment for those who are in need of Alcohol and Drug treatment. The team has partnered with local agencies to understand barriers to access-including financial, transportation, and education. Interventions are being tested to remove barriers. Under public awareness there has been work done to provide education within the Green Bay Public schools in a presentation called "Wrecked at the Weidner". This presentation was a community effort to address impaired/inattentive driving due to alcohol and drug use and texting. Nearly 3,000 youth attended. Multiple media outlets covered the impact of binge drinking on the communitywith responses from our local representatives. Work also occurred around advancing education surrounding Opioid and Heroin use within the community. Public policy: Action has been made by local representatives towards passing the ordinance around Social Hosting. Work also being prioritized with local festivals around "evidenced based strategies to decrease alcohol misuse". Alcohol compliance checks also started back up in the city of Green Bay to address the sale of alcohol to minors.Physical Activity and Nutrition: Bellin sponsors on a Community team which has focused on increasing healthy food donations at local food pantry's. This team has met monthly from 2015 until present. This team has effectively improved the percent of healthy foods by 2% every year. The team has also worked on the ability for EBT dollars to be used at the local farmers market, the creation of the Food Drive 5 Toolkit, and a collaborative Food Drive with the Boys and Girls Scouts of America.Mental Health: Brown County Mental Health Task Force Goal: Brown County will increase access to mental health services for all populations in the county by identifying gaps and disparities and creating a common platform that mental health providers, partner agencies, and stakeholders can access 1. By December 31, 2017, with a goal of getting to 0 suicides, the number of annual suicides in Brown County will decrease from 35 to 302. By December 31, 2017, the average number of poor mental health days per 30 days, as reported by county residents, will decrease from 3.2 to 3.0OBJECTIVE #1: By December 31, 2017, the task force will create a document accessible to all stakeholders that identifies the current state of mental health care in Brown County, including all available resources and services provided, gaps and disparities in care, needed programs, and ratio of specific mental health providers to population. We have evaluated best practice screening tools that can be implemented across community and healthcare settings (help identify current state of mental health and needs) In partnership with the St. Norbert College Strategic Research Center, we have identified disparities in poor mental health days in Brown County and created initiatives to address these areas. (see below)OBJECTIVE #2: By December 31, 2017, the mental health task force will create a draft proposal for creating a community-wide "No Wrong Door" access platform for mental health treatment and connection between mental health providers. (The goal is to create the right access at the right time by having a comprehensive view and collaborative connections between all Brown County mental health service providers.) We have selected our virtual online vendor for community-wide access platform. We received a $1M grant in collaboration with Connections for Mental Wellness to reduce the number of poor mental health days by: o Improving accesso Improving community members' knowledge of mental health and mental wellnesso Creating mentally healthy workplaceso Building the workforce (psychiatrists and mental health therapists)
Bellin Memorial Hospital	Part V, Section B, Line 13b: A patient's liability is capped to 15% of annual income. A patient who receives any percentage of charity care based on their income, will not be responsible for more than 15% of their annual income.
Bellin Memorial Hospital	Part V, Section B, Line 22d: The hospital looked at the average amount collected for all payers (including medicare and medicaid). Average collection rate was 44%. Any patient receiving Financial Assistance, will not be responsible for more than 44% of charges.

Field	Value	IRS element (for citing)
Facility	48	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (48 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
2 - The Cancer Team of Bellin Health
1580 Commanche Ave	Green Bay	WI	54313	Hospital Based Site
3 - Cardiology Associates of Bellin Health
744 S Webster Ave	Green Bay	WI	54301	Hospital Based Site
4 - Family Medical Center Ashwaubenon
1630 Commanche Ave	Green Bay	WI	54313	Provider Clinic Site
5 - Bellin Health Cardiovascular & Thoracic Su
720 S Van Buren St Suite 303	Green Bay	WI	54301	Provider Clinic Site
6 - Bellin Health Surgical Associates
720 S Van Buren St Suite 201	Green Bay	WI	54301	Provider Clinic Site
7 - Gastroenterology Associates of Green Bay
725 S Webster Ave	Green Bay	WI	54301	Provider Clinic Site
8 - Family Medical Center De Pere East
555 Redbird Circle	De Pere	WI	54115	Provider Clinic Site
9 - Bellin Health Generations
704 S Webster Ave Suite 300	Green Bay	WI	54301	Provider Clinic Site
10 - Family Medical Center Howard
2714 Riverview	Green Bay	WI	54313	Provider Clinic Site
11 - Family Medical Center Bellevue
3263 Eaton Rd	Green Bay	WI	543116830	Provider Clinic Site
12 - Family Medical Center De Pere West
1800 Lawrence Dr	De Pere	WI	54115	Provider Clinic Site
13 - Bellin Health Iron Mountain
440 Woodward Ave	Iron Mountain	MI	49801	Provider Clinic Site
14 - Neurology Consultants of Bellin Health
725 S Webster Ave	Green Bay	WI	54301	Provider Clinic Site
15 - Bellin Health Orthopedics
1630 Commanche Ave	Green Bay	WI	54313	Provider Clinic Site
16 - Bellin Health NorthReach Internal Medicine
3123 Shore Drive Suite 102	Marinette	WI	54143	Provider Clinic Site
17 - Bellin Health Escanaba
610 S Lincoln Road	ESCANABA	MI	49829	Provider Clinic Site
18 - Family Medical Center Green Bay
704 S Webster Ave	Green Bay	WI	54301	Provider Clinic Site
19 - Bellin Health NorthReach Pediatrics
1106 Universtiy Drive	Marinette	WI	54143	Provider Clinic Site
20 - Bellin Health NorthReach Crivitz Medical C
218 S Hwy 141	Crivitz	WI	54114	Provider Clinic Site
21 - Family Medical Center Kewaunee
575 - 4th Street	Kewaunee	WI	54216	Provider Clinic Site
22 - Bellin Health NorthReach FamilyCare Medica
3123 Shore Drive	Marinette	WI	54143	Provider Clinic Site
23 - Bellin Health Marinette Menominee Clinic
3200 Shore Drive	Marinette	MI	54143	Provider Clinic Site
24 - Family Medical Center Algoma
831 Parker Ave	Algoma	WI	54201	Provider Clinic Site
25 - Family Medical Center Brillion
964 W Ryan St Suite B	Brillion	WI	54110	Provider Clinic Site
26 - Bellin Health Oconto Falls
107 E Highland Dr	Oconto Falls	WI	54154	Provider Clinic Site
27 - Bellin Health Asthma & Allergy
519 S Monroe Avenue	Green Bay	WI	54301	Provider Clinic Site
28 - Bellin Health NorthReach OBGYN
3123 Shore Drive Suite 201	Marinette	WI	54143	Provider Clinic Site
29 - Family Medical Center Denmark
595 County Road R	Denmark	WI	54208	Provider Clinic Site
30 - Bellin Health NorthReach Peshtigo Family M
441 French St	Peshtigo	WI	54143	Provider Clinic Site
31 - Family Medical Center Seymour
405 Commercial St	Seymour	WI	54165	Provider Clinic Site
32 - Bellin Health NorthReach Urgent Care
3200 Shore Drive	Marinette	WI	54143	Provider Clinic Site
33 - Family Medical Center Wrightstown
555 Quality Ct	Wrightstown	WI	54180	Provider Clinic Site
34 - Family Medical Center Luxemburg
140 B School Creek Trail	Luxemburg	WI	54217	Provider Clinic Site
35 - Family Medical Center Manitowoc
3415 Custer St Suite D	Manitowoc	WI	54221	Provider Clinic Site
36 - Bellin Health NorthReach Menominee Medical
1100 10th Street	Menominee	MI	49858	Provider Clinic Site
37 - Family Medical Center Pulaski
723 S Wisconsin St	Pulaski	WI	541620109	Provider Clinic Site
38 - Bellin Health NorthReach Daggett Medical C
106 S School Rd	Daggett	MI	49821	Provider Clinic Site
39 - Bellin Health NorthReach After Hours Marin
1106 Universtiy Drive	Marinette	MI	54143	Provider Clinic Site
40 - Bellin Health Asthma & Allergy - Neenah
119 E Bell St Suite B	Neenah	WI	54957	Provider Clinic Site
41 - BELLIN HEALTH FAST CARE ASHWAUBENON
301 BAY PARK SQUARE	Green Bay	WI	54304	Convenient Care Center
42 - BELLIN HEALTH FAST CARE EAST TOWNE MALL
2430 E MASON STREET	Green Bay	WI	54302	Convenient Care Center
43 - Bellin Health NorthReach Laboratory
3200 Shore Drive	Marinette	WI	54143	Provider Clinic Site
44 - Family Medical Center Bonduel
401 W Mill St	Bonduel	WI	54107	Provider Clinic Site
45 - Bellin Health Endocrinology
720 S Van Buren Ste 104	Green Bay	WI	54301	Provider Clinic Site
46 - BELLIN HEALTH FAST CARE SUAMICO
2318 LINEVILLE ROAD	Suamico	WI	54173	Convenient Care Center
47 - Bellin Health NorthReach Fast Care Marinet
2741 Roosevelt Road	Marinette	MI	54143	Convenience Care Center
48 - Family Medical Center Suring
307 Manor Dr	Suring	WI	54174	Provider Clinic Site
49 - Family Medical Center Sturgeon Bay
311 N 3rd Ave	Sturgeon Bay	WI	43235	Provider Clinic Site

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Part I, Line 6a:	BELLIN MEMORIAL HOSPITAL IN INCLUDED IN THE BELLIN HEALTH SYSTEMS, INC. COMMUNITY BENEFIT REPORT.
Part I, Line 7:	AMOUNTS ARE CALCULATED BASED ON COST TO CHARGE RATIOS AND AMOUNTS PER THE FINANCIAL STATEMENTS.
Part I, Ln 7 Col(f):	BAD DEBT EXPENSE OF $6,705,765 INCLUDED ON FORM 990, PART IX, LINE 25 WAS EXCLUDED FROM THE DENOMINATOR PER INSTRUCTIONS WHEN CALCULATING THE PERCENT TOTAL EXPENSES ON SCHEDULE H.
Part II, Community Building Activities:	COMMUNITY BUILDING ACTIVITIES FOCUS ON SOCIAL CONDITIONS THAT CONTRIBUTE TO HEALTH PROBLEMS, SUCH AS HOMELESSNESS, POVERTY, AND OTHER LIVING CONDITIONS AFFECTING THE QUALITY OF LIFE. THESE RANGE FROM DEVELOPING COMMUNITY LEADERS, DISASTER READINESS, AND SUPPORT OF LOCAL ECONOMIC DEVELOPMENT, TO HEALTH IMPROVEMENT ADVOCACY. BELLIN MEMORIAL HOSPITAL IS ACTIVE IN THE GREEN BAY PUBLIC SCHOOLS WITH OUR THRIVE PROGRAM THAT ASSISTS IN SETTING AND MEETING HEALTH AND WELLNESS GOALS FOR STUDENTS IN THIS SCHOOL SYSTEM. BELLIN ALSO HOLDS AN ANNUAL BELLIN RUN/WALK 10K EVENT EACH YEAR WITH OVER 18,000 PARTICIPANTS OF ALL AGES LEARNING FIRST HAnD THE VALUE OF EXERCISE IN DAILY LIFE.
Part III, Line 2:	THE BAD DEBT EXPENSE AT COST IS CALCULATED BASED ON THE COST TO CHARGE RATIOS
Part III, Line 3:	The hospital utilizes HFMA #15 therefore none of the bad debt would be deemed charity care.
Part III, Line 4:	The attached financial statements do not contain a specific bad debt expense footnote. However, the summary of significant accounting policies describes the provision for bad debt on pages 12 and 13 of the financial statements.For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for a portion of the bill), Bellin Health Systems records a significant provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowances for doubtful accounts.
Part III, Line 8:	THE AMOUNTS REPORTED FOR MEDICARE WERE CALCULATED USING A COST TO CHARGE RATIO. THE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT FOR THE FOLLOWING REASONS. IRS REV RUL 69-545 WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS STATES THAT IF A HOSPITAL SERVICES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. IN ADDITION, FOR-PROFIT HOSPITALS HAVE CARVED OUT HIGH-MARGIN SERVICES (I.E. ONCOLOGY, ORTHO, ETC) LEAVING GENERAL ACUTE CARE HOSPITALS WITH LOWER-MARGIN MEDICARE SERVICES. THIS MEANS THAT THE SHORTFALL IS NOT NECESSARILY FROM INEFFICIENT OPERATIONS. MEDICARE CAN BE THE LARGEST PAYOR AND HOSPITALS HAVE NO ABILITY TO DENY COVERAGE. THIS, IN TURN, IS A PROMOTION OF ACCESS TO HEALTHCARE SERVICES (A COMMUNITY BENEFIT). ALSO, ELDERLY PATIENTS ARE OFTEN UNDERSERVED AND EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES.
Part III, Line 9b:	If a patient is known to qualify for charity care, the amount of charity care the patient receives is based on the patients income. We have a sliding scale that looks at your income as a % of the Federal Poverty Level. Income from 0-220% gets 100% charity care. Income 401% or more than the federal poverty level gets 0%. In between 220% and 400% is the sliding scale. Once qualified for charity care, this qualification is good for 6 months going forward.
Part VI, Line 2:	BELLIN MEMORIAL HOSPITAL HAS COMPLETED A COMMUNITY NEEDS ASSESSMENT AND IT IS POSTED ON BELLIN.ORG
Part VI, Line 3:	FINANCIAL COUNSELORS ADVISE PATIENTS OF ASSISTANCE PROGRAMS AS WELL AS SERVICE CALLED HRS ERASE IS USED TO REVIEW SELF PAY ACCOUNTS FOR POSSIBLE COVERAGE THROUGH GOVERNMENT PROGRAMS.
Part VI, Line 4:	BELLIN MEMORIAL HOSPITAL SERVES NORTHEAST WISCONSIN AND UPPER MICHIGAN. OUR CURRENT PAYOR SUPPLEMENTAL INFORMATION MIX IS 48.7% MEDICARE AND 9.8% MEDICAID. 12% OF THE POPULATION IS BELOW THE POVERTY LEVEL AND 13.5% OF THE POPULATION IS OVER AGE 65.
Part VI, Line 5:	A MAJORITY OF BELLIN MEMORIAL HOSPITALS GOVERNING BODY IS COMPRISED OF PERSON WHO RESIDE IN BELLIN MEMORIAL HOSPITAL'S PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEROF. IN ADDITION, BELLIN MEMORIAL HOSPITAL EXTENDS MEDICAL STAFF PRIVELEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR ALL OF ITS DEPARTMENTS. BELLIN MEMORIAL HOSPITAL APPLIES SURPLUS FUNDS TO IMPROVEMENTS IN PATIENT CARE, EDUCATION AND FACILITIES.
Part VI, Line 6:	BELLIN HEALTH IS A COMMUNITY-OWNED NOT-FOR-PROFIT ORGANIZATION RESPONSIBLE FOR THE PHYSICAL AND EMOTIONAL HEALTH OF PEOPLE LIVING IN NORTHEAST WISCONSIN AND THE UPPER PENINSULA OF MICHIGAN. DIRECTLY, AND IN PARTNERSHIP WITH COMMUNITIES, EMPLOYERS, SCHOOLS, AND GOVERNMENT OFFICIALS, WE GUIDE INDIVIDUALS AND FAMILIES IN THEIR LIFELONG JOURNEY TOWARD OPTIMAL HEALTH. WE ARE COMMITTED TO PROVIDING SAFE, RELIABLE, COST-EFFECTIVE TOTAL HEALTH SOLUTIONS WITH RESPECT AND COMPASSION. OUR INNOVATIVE WORK WILL IMPACT HEALTHCARE DELIVERY IN OUR REGION AS WELL AS THROUGHOUT THE WORLD.
Part VI, Line 7, Reports Filed With States	WI

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (19 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt
NEW Community Clinic
622 Bodart Street	Green Bay	WI	54301	391200636	501(c)3	$100,000	Support Free Community Health Clinic
GREEN BAY PUBLIC SCHOOLS
PO BOX 23387	Green Bay	WI	543053387	396002329	GOVT - PUBLIC SCHOOL	$63,333	HEALTH & WELLNESS PROGRAM
FESTIVAL FOODS TURKEY TROT
2250 W MASON ST	GREEN BAY	WI	54303	391814712		$15,000	TURKET TROT RUN FOR CHARITY
DOWNTOWN GREEN BAY INC
130 E WALNUT ST STE 501	GREEN BAY	WI	54301	391858389	501(c)3	$8,500	Winter Farmers Market
KIWANIS SKI CLUB
PO BOX 475	IRON MOUNTAIN	MI	49801	383254313	501(c)3	$25,000	DONATION
UW OSHKOSH
842 ALGOMA BLVD	OSHKOSH	WI	54901	391805963	Govt- STATE AGENCY	$60,000	SUPPORT ORGANIZATION'S ACTIVITIES
NORTHEAST WISCONSIN TECHNICAL COLLEGE
2740 W MASON ST	GREEN BAY	WI	54307	391087141	GOVT- STATE AGENCY	$21,000	HEALTH SCIENCE SIMULATION LAB
AMERICAN FOUNDATION OF COUNSELING
130 E WALNUT ST 7TH FLOOR	GREEN Bay	WI	54301	391047205	501(c)3	$8,000	ETHICS IN BUSINESS AWARDS AND MORE PROGRAM FOR MENTAL WELLNESS/TREATMENT INDIGENT POPULATION
GREATER GREEN BAY COMMUNITY FOUNDATION
310 W WALNUT ST SUITE 350	GREEN Bay	WI	54303	391699966	501(c)3	$40,200	Green Bay Neighboorhood Leadership Council, Women's Fund of Green Bay
UNITED WAY OF BROWN COUNTY
112 N ADAMS ST STE 201	GREEN BAY	WI	54301	390806299	501(c)3	$36,000	Donation
ALGOMA SCHOOL DISTRICT
1715 DIVISION ST	ALGOMA	WI	54201	391032686	GOVT - PUBLIC SCHOOL	$20,400	DONATION
ASHWAUBENON EDUCATION FOUNDATION
320 N BROADWAY ST SUITE 260	GREEn Bay	WI	54303	396000770	GOVT - PUBLIC SCHOOL	$5,000	DONATION
BRIAN LAVIOLETTE SCHOLARSHIP
1135 PLEASANT VALLEY DR	ONEIDA	WI	54155	391836591	501(c)3	$5,500	BELLIN COLLEGE SCHOLARSHIP
NEIGHBORHOOD HOUSING SERVICES OF GREEN BAY
437 S JACKSON ST	GREEN BAY	WI	54301	391402851	501(c)3	$10,000	PROGRAM ASSISTANCE
UNIVERSITY OF WISCONSIN - GREEN BAY FOUNDATION
2420 NICOLET DR	GREEN BAY	WI	54311	391805963	GOVT - PUBLIC SCHOOL	$20,000	MARK REINKE, MD MEMORIAL SCHOLARSHIP
BROWN COUNTY MEDICAL SOCIETY ALLIANCE
563 CARTER CT STE B	KIMBERLY	WI	54136	391516026	501(c)3	$5,000	2015 DOCTORS IN RECITAL SPONSORSHIP
BELLIN COLLEGE
3201 EATON RD	GREEN BAY	WI	54311	391620530	501(c)3	$63,938	BUILD OUT LAB AND NURSING CAMPS
UNITY HOSPICE
2366 OAK RIDGE CIRCLE	DE PERE	WI	54115	391750729	501(c)3	$5,500	DONATION
US VENTURE OPEN
425 BETTER WAY	APPLETON	WI	54915	391548450	501(c)3	$25,000	DONATION

Field	Value	IRS element (for citing)
Total501c3 Org	20	Total501c3OrgCnt
Total Other Org	0	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

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

Schedule J IRS990ScheduleJ

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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
WILLIAM WITTMAN MD
Board Member	$231,823	$0	$144,820	$0	$1,188	$0	$8,673	$0	$14,577	$0	$401,081	$0	$0	$0
LOREN FUGLESTAD MD - Termed
Board Member/BMG physician	$195,487	$0	$120,763	$0	$270	$0	$13,424	$0	$19,623	$0	$349,567	$0	$0	$0
GEORGE KERWIN
Bellin CEO/Board Member	$546,445	$0	$348,100	$0	$15,658	$0	$10,400	$0	$17,077	$0	$937,680	$0	$0	$0
Cynthia Lasecki MD
Board Member/Former President Medica	$184,632	$0	$165,778	$0	$270	$0	$13,742	$0	$3,559	$0	$367,981	$0	$0	$0
Sabina Singh MD
Board Member/President Bellin Medica	$184,631	$0	$78,528	$0	$270	$0	$10,460	$0	$10,861	$0	$284,750	$0	$0	$0
Mark Ringwelski MD
Board Member/FPresident Bellin Speci	$231,352	$0	$80,800	$0	$774	$0	$10,010	$0	$18,231	$0	$341,167	$0	$0	$0
JAMES DIETSCHE
CFO	$325,354	$0	$60,000	$0	$270	$0	$10,079	$0	$20,681	$0	$416,384	$0	$0	$0
PETER KNOX
EXECUTIVE VP	$325,801	$0	$50,000	$0	$1,188	$0	$17,698	$0	$16,577	$0	$411,264	$0	$0	$0
CHRISTINE WOLESKE
EXECUTIVE VP	$329,653	$0	$79,948	$0	$414	$0	$16,752	$0	$18,806	$0	$445,573	$0	$0	$0
CHRISTOPHER WOLFRAM MD
Physician	$552,922	$0	$386,416	$0	$180	$0	$7,588	$0	$18,623	$0	$965,729	$0	$0	$0
TIMOTHY TANKE MD
Physician	$552,221	$0	$333,623	$0	$414	$0	$12,432	$0	$18,407	$0	$917,097	$0	$0	$0
RICHARD TIMMONS MD
PHYSICIAN	$555,930	$0	$267,632	$0	$774	$0	$12,562	$0	$19,996	$0	$856,894	$0	$0	$0
Vijaya Munagala MD
Physician	$514,087	$0	$275,082	$0	$270	$0	$8,112	$0	$20,873	$0	$818,424	$0	$0	$0
Paul Hudson MD
PHYSICIAN	$681,661	$0	$174,311	$0	$180	$0	$13,547	$0	$20,681	$0	$890,380	$0	$0	$0

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

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

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Total ProceedsTotalProceedsAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Substantial CompletionSubstantialCompletionYr	Current RefundingCurrentRefundingInd	Advance RefundingAdvanceRefundingInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd	Other Spent ProceedsOtherSpentProceedsAmt
A	$1,040,000	$12,944,000	$79,844	2001	Yes (1)	0	Yes (1)	Yes (1)
B	$1,355,616	$44,994,006	$528,236	2009	0	Yes (1)	Yes (1)	Yes (1)	$44,465,770

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Engage Bond Counsel ContractsEngageBondCounselContractsInd	Any Research AgreementsAnyResearchAgreementsInd	Private Bus Use By OthersPrivateBusUseByOthersPct	Private Bus Concerning UBIPrivateBusConcerningUBIPct	Total Private Business UseTotalPrivateBusinessUsePct	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	0	Yes (1)	Yes (1)	Yes (1)	0	0.01000	0.00000	0.01000	0	0	Yes (1)
B	0	Yes (1)	Yes (1)	Yes (1)	0	0.01000		0.01000	Yes (1)	0	Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

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

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

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

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
Wisconsin Public Service Corp Constellation Energy Services & WE Energies
Board Member Larry Borgard is President & COO - Utilities at Integrys	$3,226,053	Integrys Energy Group provides utility services to Bellin Memorial Hospital	0
Associated Bank
Board Member Denis Hogan is Market President	$205,229	Banking Services	0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part VI, Section A, line 6	The organization has one corporate member, Bellin Health Systems, Inc.
Form 990, Part VI, Section A, line 7a	The corporate member, Bellin Health Systems, Inc. has the power to appoint board members.
Form 990, Part VI, Section A, line 7b	The corporate member, Bellin Health Systems, Inc., has the power to approve major expenditures and long-term borrowings.
Form 990, Part VI, Section B, line 11	The Form 990 is reviewed in detail by senior administration and is presented to the Executive Committee in its entirety for a review of the document.
Form 990, Part VI, Section B, line 12c	Each year a conflict of interest request document is provided to each board member. All documents are provided back to administration and reviewed. All employees are required to review the conflict of interest policy as part of annual mandatory education. If there is a conflict of interest, the corporate compliance officer and corporate compliance committee which is a committee of the board of directors is notified. The corporate compliance officer and corporate compliance committee addresses the issue.
Form 990, Part VI, Section B, line 15	Compensation for the CEO and key executives are set by the executive committee of the Board supported by market data from surveys and an independent consultants report. The compensation is determined by members of the executive committee without conflict and is documented. CEO Compensation: CEO presents results of Performance Objectives to the Executive Committee in January of each year. The Chair applies a formula to the results and comes up with a recommendation. The Chair facilitates getting approval from other members of the Executive Committee. Senior Leaders: Compensation for those who report to the CEO is taken to the Executive Committee for discussion/approval.
Form 990, Part VI, Section C, line 19	THE ORGANIZATION BELIEVES THE FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND POLICIES ARE THE PROPERTY OF THE ORGANIZATION AND ARE NOT AVAILABLE FOR PUBLIC INSPECTION.
Form 990, Part XI, line 9:	CHANGE IN INTEREST IN FOUNDATION 797,887. INTEREST RATE SWAP AGREEMENT -1,293,827. NON-CONTROLLING INTEREST IN CONSOLIDATED AFFILIATE -1,854,305.
FORM 990, PART XI, LINE 2B-2C	BELLIN MEMORIAL HOSPITAL, INC. IS INCLUDED IN THE CONSOLIDATED AUDIT OF BELLIN HEALTH SYSTEMS, INC. THE BOARD OF DIRECTORS OF BELLIN HEALTH SYSTEMS, INC. ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT AUDITOR. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

Field	Value	IRS element (for citing)
Business Name Line1	NORTHREACH HEALTHCARE LLC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3120 RIVERSIDE AVE GATE B BLDG 1	AddressLine1Txt
City	MARINETTE	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54143	ZIPCd

Field	Value	IRS element (for citing)
EIN	391999260	EIN
Primary Activities	PRIMARY AND SPECIALTY PHYSICIAN CLINICS	PrimaryActivitiesTxt
Legal Domicile State	WI	LegalDomicileStateCd
Total Income	$13,542,838	TotalIncomeAmt
End Of Year Assets	$785,285	EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

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

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd	Direct Controlling NADirectControllingNACd
LAKE MICHIGAN HEALTH SERVICES INC
744 SOUTH WEBSTER AVE	GREEN BAY	WI	54305	391512903	SUPPORT PURPOSES OF BELLIN MEMORIAL HOSPITAL	WI	501(c)(3)	Line 11b, II	Bellin Health Systems Inc	Yes (1)
BELLIN COLLEGE INC
3201 EATON ROAD	GREEN BAY	WI	54311	391620530	NURSING COLLEGE	WI	501(c)(3)	Line 2	Bellin Health Systems Inc	Yes (1)
THE BELLIN HEALTH FOUNDATION INC
PO BOX 23400	GREEN BAY	WI	54305	391809171	FOUNDATION	WI	501(c)(3)	Line 7	Bellin Health Systems Inc	Yes (1)
BELLIN PSYCHIATRIC CENTER INC
PO BOX 23725	GREEN BAY	WI	54305	391657627	PPSYCHIATRIC HOSPITAL	WI	501(c)(3)	Line 3	Bellin Health Systems Inc	Yes (1)
OCONTO HOSPITAL & MEDICAL CENTER INC
PO BOX 357	OCONTO	WI	54153	061745397	HOSPITAL	WI	501(c)(3)	Line 3	BELLIN MEMORIAL HOSPITAL INC	Yes (1)
BELLIN HEALTH SYSTEMS INC
744 SOUTH WEBSTER AVE	GREEN BAY	WI	54305	391512904	SUPPORT OF HEALTHCARE ORGANIZATIONS	WI	501(c)(3)	Line 11b, II		0	N/A
UNITY LIMITED PARTNERSHIP
2366 OAK RIDGE CIRCLE	DE PERE	WI	54115	391750729	HOSPICE, PALLIATIVE & BEREAVEMENT SERVICES	WI	501(c)(3)	Line 9	BELLIN MEMORIAL HOSPITAL INC	Yes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd	Direct Controlling NADirectControllingNACd
BELLIN ORTHOPEDIC SURGERY CENTER LLC
2223 LIME KILN RD	GREEN BAY	WI	54311	264677834	AMBULATORY ORTHOPEDIC SURGERY	WI	Bellin Memorial Hospital Inc	RELATED	$2,277,170	$566,118	0	0
D1 SPORTS TRAINING OF GREEN BAY LLC
SOUTH SPRINGS DRIVE	FRANKLIN	TN	37067	454848172	SPORTS TRAINING	TN							N/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Direct Controlling NADirectControllingNACd	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd
BEL-REGIONAL HOME MEDICAL INC
617 S ROOSEVELT	GREEN BAY	WI	54301	391504766	DURABLE MEDICAL EQUIPMENT, RETAIL PHARMACY, FITNESS	WI	N/A	C	0
BELLIN INVESTMENTS INC
PO BOX 23400	GREEN BAY	WI	54305	391564939	OTHER	WI	N/A	C	0

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

Transactions Related Org TransactionsRelatedOrgGrp (13 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
OCONTO HOSPITAL & MEDICAL CENTER
D	$12,249,995	ACTUAL
OCONTO HOSPITAL & MEDICAL CENTER
O	$657,118	ACTUAL
OCONTO HOSPITAL & MEDICAL CENTER
M	$1,233,599	ACTUAL
OCONTO HOSPITAL & MEDICAL CENTER
Q	$4,250,000	ACTUAL
bellin college
B	$63,938	ACTUAL
Bellin Health Foundation
C	$554,562	ActUAL
Bellin Psychiatric Center
L	$2,097,955	ActUAL
Bellin psychiatric Center
D	$3,060,492	ACTUAL
bellin college
L	$329,943	actual
bellin college
N	$350,014	aCTUAL
bellin health Foundation
Q	$560,294	aCTUAL
bellin health Foundation
O	$367,331	aCTUAL
bellin health Foundation
S	$1,345,000	aCTUAL