ASCENSION NE WISCONSIN INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- ASCENSION NE WISCONSIN INC (EIN 39-0816818)
- Tax period
- 2015-07-01 to 2016-06-30
- Filed
- 2017-05-10
- IRS object ID
- 201741309349302364
- 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 J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-05-10T13:01:09-05:00 | ReturnTs |
| Tax Period End | 2016-06-30 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390816818 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Elizabeth Hospital Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STEL | BusinessNameControlTxt |
| Phone | 9207382000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1506 South Oneida Street | AddressLine1Txt |
| City | Appleton | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 549151397 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Bill Hinner | PersonNm |
| Person Title | CFO Reg Health System,WI North | PersonTitleTxt |
| Signature | 2017-05-10 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Monica Hilt | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1506 South Oneida Street | AddressLine1Txt |
| City | Appleton | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 549151397 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $202,972,161 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.affinityhealth.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1899 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | To further the healing ministry of Jesus by improving the health and well-being of all people. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 1576 | TotalEmployeeCnt |
| Total Volunteers | 330 | TotalVolunteersCnt |
| Total Gross UBI | $201,147 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$64,920 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,196,319 | PYContributionsGrantsAmt |
| CY Contributions Grants | $494,496 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $195,612,809 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $195,730,799 | CYProgramServiceRevenueAmt |
| PY Investment Income | $142,556 | PYInvestmentIncomeAmt |
| CY Investment Income | $27,515 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,968,979 | PYOtherRevenueAmt |
| CY Other Revenue | $5,265,614 | CYOtherRevenueAmt |
| PY Total Revenue | $199,920,663 | PYTotalRevenueAmt |
| CY Total Revenue | $201,518,424 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $70,000 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $85,704,460 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $83,567,284 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $76,994,919 | PYOtherExpensesAmt |
| CY Other Expenses | $86,159,250 | CYOtherExpensesAmt |
| PY Total Expenses | $162,769,379 | PYTotalExpensesAmt |
| CY Total Expenses | $169,726,534 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $37,151,284 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $31,791,890 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $232,239,054 | TotalAssetsBOYAmt |
| Total Assets EOY | $227,851,961 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $126,799,006 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $90,381,683 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $105,440,048 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $137,470,278 | NetAssetsOrFundBalancesEOYAmt |
| Mission | The mission of St. Elizabeth Hospital, Inc. is to live out the healing ministry of Christ by providing services that promote the health and well-being of the communities we serve, especially the poor. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $128,121,767 | ExpenseAmt |
| Revenue | $198,423,586 | RevenueAmt |
| Desc | ST. ELIZABETH HOSPITAL, INC. PROVIDES INPATIENT, OUTPATIENT, EMERGENCY ROOM, AND ANCILLARY SERVICES REGARDLESS OF AN INDIVIDUAL'S ABILITY TO PAY. THE HOSPITAL ALSO PROVIDES EDUCATIONAL PROGRAMS AND SERVICES ON HEALTH CARE ISSUES TO THE COMMUNITY IT SERVES. SEE SCHEDULE H FOR FURTHER DETAILS. | Desc |
| Total Program Service Expenses | $128,121,767 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 84 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 1576 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Craig Aittama | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7153465161 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5700 Lands End Way 2nd Floor | AddressLine1Txt |
| City | Stevens Point | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54482 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (29 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| MONICA ANN HILT | ||||||||||
| PRESIDENT STE HOSPITAL | 28.0 | 15.5 | Yes (X) | Yes (X) | $0 | $709,688 | $64,149 | |||
| STEPHEN C MORTON | ||||||||||
| CHAIRMAN (END 12/2015) | 0.3 | 1.2 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| DANIEL NEUFELDER | ||||||||||
| SR. VP HOSP OPS (BOARD END 12/2015) | 10.0 | 53.9 | Yes (X) | Yes (X) | $0 | $2,171,860 | $190,168 | |||
| KATHRYN SIEMAN | ||||||||||
| VICE CHAIR | 0.3 | 1.5 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| WAYNE TREMBLY | ||||||||||
| SECRETARY | 0.3 | 1.5 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| JOHN RUSSO | ||||||||||
| CHAIRMAN (START 1/2016) | 0.3 | 1.5 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| BRIAN WALLACE | ||||||||||
| TREASURER (START 1/2016) | 0.3 | 1.5 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| LANE EARNS | ||||||||||
| BOARD MEMBER | 0.3 | 1.5 | Yes (X) | $0 | $0 | $0 | ||||
| MARK W FAUSTICH MD | ||||||||||
| BOARD MEMBER | 0.3 | 41.1 | Yes (X) | $0 | $438,031 | $21,791 | ||||
| MARLIN GREENFIELD | ||||||||||
| BOARD MEMBER | 0.3 | 1.5 | Yes (X) | $0 | $0 | $0 | ||||
| MARY HARP-JIRSCHELE | ||||||||||
| BOARD MEMBER (END 12/2015) | 0.3 | 1.2 | Yes (X) | $0 | $0 | $0 | ||||
| MARK KEHRBERG MD | ||||||||||
| CHIEF MEDICAL OFFICER | 10.0 | 30.6 | Yes (X) | $0 | $355,616 | $30,314 | ||||
| FREDERICK KLEIN MD | ||||||||||
| BOARD MEMBER (END 12/2015) | 0.3 | 1.2 | Yes (X) | $0 | $0 | $0 | ||||
| JOSEPH MCCORMICK MD | ||||||||||
| BOARD MEMBER (END 12/2015) | 0.3 | 41.2 | Yes (X) | $0 | $759,647 | $43,931 | ||||
| KEVIN RAFLOFSKY | ||||||||||
| BOARD MEMBER | 0.3 | 0 | Yes (X) | $0 | $0 | $0 | ||||
| STACEY SENSOR DO | ||||||||||
| BOARD MEMBER (END 12/2015) | 0.3 | 40.8 | Yes (X) | $0 | $356,855 | $26,385 | ||||
| SUDEEP SODHI MD | ||||||||||
| BOARD MEMBER | 0.3 | 41.1 | Yes (X) | $0 | $882,249 | $47,537 | ||||
| BARBARA J STRAND MD | ||||||||||
| BOARD MEMBER | 0.3 | 40.8 | Yes (X) | $0 | $332,440 | $23,405 | ||||
| MONICA VOMASTIC | ||||||||||
| BOARD MEMBER | 0.3 | 1.5 | Yes (X) | $0 | $0 | $0 | ||||
| WENDY SCHROEDER MD | ||||||||||
| BOARD MEMBER (START 1/2016) | 0.3 | 41.5 | Yes (X) | $0 | $258,146 | $48,066 | ||||
| NICHOLAS DESIEN | ||||||||||
| MINISTRY HEALTH CARE CEO (END 12/31/15) | 1.0 | 54.3 | Yes (X) | $0 | $2,799,737 | $271,786 | ||||
| JEFFREY FRANCIS | ||||||||||
| MINISTRY HEALTH CARE CAFO (END 9/9/15) | 1.0 | 53.8 | Yes (X) | $0 | $652,678 | $51,385 | ||||
| LAWRENCE DONATELLE | ||||||||||
| VICE PRESIDENT OF MEDICAL AFFAIRS | 40.0 | 0 | $0 | $388,198 | $33,501 | Yes (X) | ||||
| JENNIE REBECCA GAURKEE | ||||||||||
| PHARMACY DIRECTOR | 40.0 | 0 | $190,899 | $0 | $33,544 | Yes (X) | ||||
| BRIAN G HUMPHREY | ||||||||||
| SENIOR ULTRASOUND TECHNOLOGIST | 40.0 | 0 | $159,449 | $0 | $20,524 | Yes (X) | ||||
| NANETTE KRIZENESKY | ||||||||||
| REGISTERED NURSE LEAD-ICU | 36.0 | 0 | $206,801 | $0 | $39,429 | Yes (X) | ||||
| ERIC LOBB | ||||||||||
| MEDICAL PHYSICIST | 40.0 | 0 | $160,703 | $0 | $19,898 | Yes (X) | ||||
| ANNETTE SIEDSCHLAG | ||||||||||
| SUPERVISOR PHARMACY | 35.0 | 0 | $147,539 | $0 | $31,271 | Yes (X) | ||||
| TRAVIS D ANDERSEN | ||||||||||
| PRESIDENT (END 8/2014) | 0.0 | 46.0 | $0 | $1,068,528 | $61,462 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $865,392 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $11,173,673 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,058,546 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 27 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | Address Line2ContractorAddress/USAddress/AddressLine2Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|---|
| BOLDT PROCUREMENT LLC | ||||||
| 2525 N Roemer Rd | PO Box 419 | Appleton | WI | 54912 | Construction Services | $548,042 |
| NEW ANESTHESIOLOGY SC | ||||||
| 200 E Washington St | PO Box 8031 | Appleton | WI | 54912 | Medical Services | $321,720 |
| TOWNE PARK LTD | ||||||
| One Park Place Suite 200 | Annapolis | MD | 21401 | Transportation Services | $187,637 | |
| FRESENIUS MANAGEMENT SERVICES | ||||||
| PO Box 16343 | Chicago | IL | 60693 | Management Services | $184,594 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Info In Schedule O Part VIII | Yes (X) | InfoInScheduleOPartVIIIInd |
| Related Organizations | $474,540 | RelatedOrganizationsAmt |
| All Other Contributions | $19,956 | AllOtherContributionsAmt |
| Total Contributions | $494,496 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| Net Patient Revenue | 622110 | $195,764,000 | $195,764,000 | |
| Misc. Hospital Revenue | 622000 | $1,380,363 | $1,380,363 | |
| Outpatient Lab Revenue | 621500 | $194,547 | $194,547 | |
| Genetic Services | 900099 | $6,600 | $6,600 | |
| Equity Int. in Affiliates | 621500 | -$1,956,504 | -$1,956,504 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $341,793 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $341,793 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $195,730,799 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,912 | TotalRevenueColumnAmt |
| Exclusion | $8,912 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $2,685,242 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,446,106 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,239,136 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,239,136 | TotalRevenueColumnAmt |
| Exclusion | $1,239,136 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $26,234 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $7,631 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $18,603 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18,603 | TotalRevenueColumnAmt |
| Exclusion | $18,603 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| EHR Incentive Payment | 900099 | $1,670,917 | $1,670,917 | |
| Cafeteria Income | 722210 | $1,132,544 | $1,132,544 | |
| Other Non-Op. Revenue | 900099 | $1,223,017 | $1,223,017 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $4,026,478 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $201,518,424 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $198,423,586 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $201,147 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,399,195 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,795,906 | TotalAmt |
| Program Services | $52,041,382 | ProgramServicesAmt |
| Management And General | $12,754,524 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,991,385 | TotalAmt |
| Program Services | $1,991,385 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,860,534 | TotalAmt |
| Program Services | $9,755,874 | ProgramServicesAmt |
| Management And General | $3,104,660 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,919,459 | TotalAmt |
| Program Services | $3,919,459 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,703,484 | TotalAmt |
| Program Services | $1,754,682 | ProgramServicesAmt |
| Management And General | $2,948,802 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,423,991 | TotalAmt |
| Program Services | $25,824,569 | ProgramServicesAmt |
| Management And General | $599,422 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,975 | TotalAmt |
| Program Services | $24,975 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,872,604 | TotalAmt |
| Program Services | $3,583,954 | ProgramServicesAmt |
| Management And General | $288,650 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $457,801 | TotalAmt |
| Program Services | $119,766 | ProgramServicesAmt |
| Management And General | $338,035 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $365 | TotalAmt |
| Program Services | $365 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,161,639 | TotalAmt |
| Program Services | $1,161,639 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,803,551 | TotalAmt |
| Program Services | $11,129,378 | ProgramServicesAmt |
| Management And General | $2,674,173 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $630,942 | TotalAmt |
| Program Services | $614,091 | ProgramServicesAmt |
| Management And General | $16,851 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Purchased Services | $19,186,139 | $6,706,826 | $12,479,313 |
| Pharmaceuticals | $8,395,321 | $8,351,440 | $43,881 |
| Food | $424,440 | $357,464 | $66,976 |
| Dues | $174,087 | $30,573 | $143,514 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,899,911 | TotalAmt |
| Program Services | $753,945 | ProgramServicesAmt |
| Management And General | $6,145,966 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $169,726,534 | TotalAmt |
| Program Services | $128,121,767 | ProgramServicesAmt |
| Management And General | $41,604,767 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,415,110 | BOYAmt |
| EOY | $5,035 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $660,107 | BOYAmt |
| EOY | $13,105,349 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,358,025 | BOYAmt |
| EOY | $29,468,960 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,226,965 | BOYAmt |
| EOY | $2,816,246 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $206,896 | BOYAmt |
| EOY | $264,588 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $204,367,467 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $28,672,548 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $179,969,979 | BOYAmt |
| EOY | $175,694,919 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,764,898 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,401,972 | BOYAmt |
| EOY | $4,731,966 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $232,239,054 | BOYAmt |
| EOY | $227,851,961 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,090,959 | BOYAmt |
| EOY | $10,238,047 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $209,636 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $78,839,410 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,868,637 | BOYAmt |
| EOY | $79,934,000 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $126,799,006 | BOYAmt |
| EOY | $90,381,683 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $105,239,709 | BOYAmt |
| EOY | $137,222,396 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $200,339 | BOYAmt |
| EOY | $247,882 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $105,440,048 | BOYAmt |
| EOY | $137,470,278 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $232,239,054 | BOYAmt |
| EOY | $227,851,961 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $31,791,890 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $190,796 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $47,544 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $12,602 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $12,602 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY | Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. St. Elizabeth Hospital, Inc. does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office. |
| Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY | Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. St. Elizabeth Hospital, Inc. does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office. |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,137,024 | OtherCostOrOtherBasisAmt |
| Book Value | $4,137,024 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $139,813,818 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,565,626 | DepreciationAmt |
| Book Value | $127,248,192 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $50,701,609 | OtherCostOrOtherBasisAmt |
| Depreciation | $15,814,290 | DepreciationAmt |
| Book Value | $34,887,319 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,715,016 | OtherCostOrOtherBasisAmt |
| Depreciation | $292,632 | DepreciationAmt |
| Book Value | $9,422,384 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $175,694,919 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (8 entries)
| DescDesc | AmtAmt |
|---|---|
| Pension Liability | $438,512 |
| Due to third party payors | $841,518 |
| 457(b) Plan | $620,804 |
| Unspecified revenue | |
| Deferred tax liability | $311,216 |
| intercompany debt | $63,750,751 |
| intercompany payables | $12,902,741 |
| other liabilities | $1,068,458 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $79,934,000 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote | FormAndLineReferenceDesc |
| Explanation | THE SYSTEM ACCOUNTS FOR UNCERTAINTY IN INCOME TAX POSITIONS BY APPLYING A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE SYSTEM HAS DETERMINED THAT NO MATERIAL UNRECOGNIZED TAX BENEFITS OR LIABILITIES EXIST AS OF JUNE 30, 2016. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 250 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $222,462 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $222,462 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0013 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $4,228,812 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,228,812 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0249 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $7,553 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,553 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0000 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $4,458,827 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,458,827 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0263 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 16 | ActivitiesOrProgramsCnt |
| Persons Served | 2068 | PersonsServedCnt |
| Total Community Benefit Expns | $593,710 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,119 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $585,591 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0035 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $2,749,475 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $163,192 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,586,283 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0152 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $6,850,968 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,795,018 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,055,950 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0121 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 15 | ActivitiesOrProgramsCnt |
| Persons Served | 218 | PersonsServedCnt |
| Total Community Benefit Expns | $212,093 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $212,093 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0012 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 36 | ActivitiesOrProgramsCnt |
| Persons Served | 2286 | PersonsServedCnt |
| Total Community Benefit Expns | $10,406,246 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,966,329 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,439,917 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0321 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 36 | ActivitiesOrProgramsCnt |
| Persons Served | 2286 | PersonsServedCnt |
| Total Community Benefit Expns | $14,865,073 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,966,329 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,898,744 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0583 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $194 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $194 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0000 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $89 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $89 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0000 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Persons Served | 245 | PersonsServedCnt |
| Total Community Benefit Expns | $12,888 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $12,888 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0001 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 6 | ActivitiesOrProgramsCnt |
| Persons Served | 245 | PersonsServedCnt |
| Total Community Benefit Expns | $13,171 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $13,171 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0001 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReportedInd |
| Bad Debt Expense | $5,116,010 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $70,406,270 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $72,391,462 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$1,985,192 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Elizabeth Hospital Inc | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1506 South Oneida Street | AddressLine1Txt |
| City | Appleton | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54915 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.affinityhealth.org | WebsiteAddressTxt |
| State License | 88 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Teaching Hospital | Yes (X) | TeachingHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Elizabeth Hospital Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | http://www.affinityhealth.org/Affinity/For-Patients-and-Visitors/Community-Benefit-and-Outreach.htm | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | http://www.affinityhealth.org/Affinity/For-Patients-and-Visitors/Community-Benefit-and-Outreach.htm | StrategyWebsiteURLTxt |
| Strategy Attached | false | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 250.0 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.0 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | http://ministryhealth.org/MinistryHealth/AboutUs/BillingandPayment/FinancialAssistance.nws | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | http://ministryhealth.org/MinistryHealth/AboutUs/BillingandPayment/FinancialAssistance.nws | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | http://ministryhealth.org/MinistryHealth/AboutUs/BillingandPayment/FinancialAssistance.nws | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | 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 (true) | NondisEmergencyCarePolicyInd |
| Medicare Rates | Yes (X) | MedicareRatesInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part V, Section B, Line 5 Facility , 1 | Facility , 1 - st. elizabeth hospital, inc.. St. Elizabeth Hospital's CHNA process included three specific efforts to seek input from community members, including members of medically underserved, low-income and minority populations and from organizations that serve those populations. First, a telephone survey of Calumet County residents was conducted in early calendar year 2015. The survey resulted in the Outagamie County Behavioral Risk Factor Surveillance System (BRFSS) Study: 2015 Report, and included questions health practices and health-related risk behaviors. Second, in August and September 2015, key informant interviews were conducted with stakeholders in the community, including with leaders of organizations that serve the medically underserved, low-income and minority populations. Participants were asked about the most important health issues for the region as well as existing strategies, resources and barriers in addressing them. (See below for list of key informants' organizations.) Finally, in September and October 2015, a survey was distributed electronically to a variety of community partners and agencies that serve vulnerable populations, including the Women, Infants and Children (WIC) clinics, senior centers, food pantries, community clinics and others. The survey was available in Spanish for those organizations and agencies that serve Spanish-speaking individuals. The survey asked about the most important health issues for the region. Key informant interviews were conducted with representatives of the agencies listed below. These agencies serve Outagamie County exclusively. (Note: Some agencies are listed multiple times, reflecting interviews with multiple representatives from that organization.) * Outagamie County Sheriff's Department *, *** * Valley Baptist Church *, **, *** * Outagamie County * University of Wisconsin- Extension *, *** * Outagamie County Aging and Disability Resource Center *, **, *** * Outagamie County Public Health- Women, Infants, and Children (WIC) Program *, *** * City of Appleton *** * Early Intervention Program (Birth to Three) * Outagamie County * Outagamie County * Community Early Learning Center Board * Appleton Downtown, Inc. * ThedaCare * Catalpa Health and Outagamie County * Rawhide Boys Ranch Key informant interviews were conducted with representatives of the agencies listed below. These agencies serve the Fox Valley Region. (Note: Some agencies are listed multiple times, reflecting interviews with multiple representatives from that organization.) * University of Wisconsin- Oshkosh Head Start *, ** * Samaritan Counseling Center *, **, *** * YMCA of the Fox Cities *, **, *** * City of Appleton Health Department *, **, *** * University of Wisconsin-Oshkosh Head Start *, ** * N. E. W. Mental Health Connection *, **, *** * Heart of the Valley Chamber of Commerce * Wisconsin DNR; Menasha Health Department * Goodwill Industries of North Central WI *, **, *** * *Affinity Health System *, **, *** * Casa Hispana *, *** * Common Ground *, *** * ESTHER *, *** * University of Wisconsin- Oshkosh Head Start *, ** * J.J. Keller Foundation *, ** * ThedaCare Trauma * St. Therese Church *, *** * INCLUDE *, **, *** * Appleton Health Department *, **, *** * Hope Clinic/Alliance *, **, *** * United Way Fox Cities *, **, *** * Appleton Health Department * Catalpa Health *, **, *** * ThedaCare at Work; Well City Fox Cities * East Central Wisconsin Regional Planning Commission * Appleton Health Department ** * *Affinity Health System *, **, *** * Outagamie County * Appleton Health Department * ThedaCare * Children's Hospital of Wisconsin- Fox Valley *, **, *** * Homeless Connections * * Children's Hospital of Wisconsin- Fox Valley *, **, *** * Child Care Resource & Referral *, *** * Children's Hospital of Wisconsin- Fox Valley * City of Appleton Health Department * African Heritage, Inc. *** * Hispanic Chamber of Commerce of WI *, *** * Weight of the Fox Valley/ United Way * *Affinity Health System *, **, *** * *St. Elizabeth Hospital, Affinity Health System *, **, *** * Harbor House *, **, *** * Wisconsin Safe and Healthy Schools Center *, *** * Children's Hospital of Wisconsin- Fox Valley *, **, *** * Partnership Community Health Ctr. *, **, *** * Parent Connection of Family Services * City of Appleton Police * ThedaCare Trauma * U.S. Venture, Inc. * * Partnership Community Health Ctr. *, **, *** * ThedaCare *, **, *** * University of Wisconsin- Oshkosh Head Start *, ** * Big Brothers Big Sisters of the Fox Valley * * Evolve *, **, *** * Denotes that the organization and/or the key informant's position represents low-income populations ** Denotes that the organization and/or the key informant's position represents medically underserved populations *** Denotes that the organization and/or the key informant's position represents minority populations * Affinity Health System is part of Ministry Health Care |
| Schedule H, Part V, Section B, Line 6a Facility , 1 | Facility , 1 - St. Elizabeth Hospital, Inc.. The CHNA was conducted with the following hospital facility(s): - Calumet Medical Center - Mercy Medical Center - Children's Hospital of Wisconsin -- Fox Valley - Aurora Medical Center Oshkosh - ThedaCare Regional Medical Center - Appleton (formerly Appleton Medical Center) - ThedaCare Regional Medical Center - Neenah (formerly ThedaClark) |
| Schedule H, Part V, Section B, Line 6b Facility , 1 | Facility , 1 - St. Elizabeth Hospital, Inc.. The CHNA was conducted with the following non-hospital facility(s): Calumet Public Health Department, Outagamie County Public Health Department, Winnebago County Public Health Department, City of Appleton Public Health Department, City of Menasha Public Health Department |
| Schedule H, Part V, Section B, Line 11 Facility , 1 | Facility , 1 - St. Elizabeth Hospital, Inc.. Using the CHNA completed in June 2013, the hospital developed, adopted, and worked on executing a three-year Implementation Strategy to address priority community health needs. In Fiscal Year 2016 (Tax Year 2015), the hospital implemented the following plan to address the priority needs: 1. Access to healthcare: Continue to support services that improve community residents' and patients' access to healthcare. * Supported the Rural Health Initiative, which brings resources and prevention services on-site to area farms and agribusinesses. * Assisted community members in health care insurance enrollment. 2. Mental Health: Decrease rate of suicide in the Fox Valley * Promoted and participated in Zero Suicide Coalition in the Fox Valley. * Supported school based mental health programs. * Supported local Question, Persuade, Refer (QPR) suicide prevention training. * Contributed to the development of a mental health resource directory. 3. Obesity: Reduce obesity rates in Outagamie County * Obtained local communities' endorsement of Weight of the Fox Valley's resolution that supports a variety of efforts to address obesity. * Continued work with area business to create healthier choices for catering and restaurant options. Using the CHNA completed in June 2016, the hospital developed and adopted FY17-FY19 (tax years 2016-2018) Implementation Strategy. The following summarizes the strategies the hospital will implement during that time period to address the priority needs. Nutrition and Physical Activity * Weight of the Fox Valley - Weight of the Fox Valley (WOTFV) is a three-county initiative with a shared vision of working together to achieve and maintain a healthy weight at every age. Using a collective impact model, WOTFV strives to support mutually reinforcing activities conducted by a variety of community-based organizations committed to obesity prevention. * Promote Breastfeeding in the Hospital Setting - The 10 Steps to Baby Friendly Hospitals puts policies and procedures in place to support breastfeeding through the hospital setting. St. Elizabeth Hospital is working toward becoming a Baby-Friendly hospital. Mental Health * QPR - QPR stands for Question, Persuade, and Refer, a nationally recognized "best practice" method for suicide prevention and education. Trainings are organized for community members. * Test Your Mood Online Survey - This anonymous online mood survey allows respondents to choose from six different screening surveys (anxiety, PTSD, eating disorders, depression, alcohol use and bipolar disorder). The survey also provides respondents with a list of local resources they can access for further assistance. * Zero Suicide - The Zero Suicide Initiative is a commitment to suicide prevention in health and behavioral health care systems and includes a specific set of strategies and tools. The initiative uses a methodical approach to system-wide quality improvement to reduce the chances of suicidal individuals falling through the cracks in a healthcare system. * School-based Behavioral Health Services - School-based behavioral health programs such as PATH (Providing Access to Healing) are designed to improve access to mental health services for children and youth who unable to obtain care elsewhere in the community. PATH is a United Way sponsored program in existence in the Appleton Area School District (Outagamie County). Alcohol Misuse * Community Asset Inventory - In order to fully understand the issues surrounding alcohol misuse in our community, learn about the agencies and organizations that are involved in addressing this issues, and learn about the strategies currently used in the community, an environmental scan will be conducted that will serve to better guide our implementation strategies. * The Real Happy Hour - Research shows that family connectedness and parent-child bonding has positive effects including a reduction of substance abuse among adolescents, increased academic performance and more. The purpose of the Real Happy Hour is to increase family time and family connectedness across the tri-county area of the Fox Valley (Calumet, Outagamie and Winnebago). The description below includes the needs not being addressed as well as the reason why the needs are not being addressed. In addition to the three health issues selected as top priority, stakeholders identified several other significant health issues in Outagamie County. These issues will be or are being addressed by other organizations in the community. While these issues will not be addressed by St. Elizabeth Hospital as priority health needs, we will provide support to those community efforts whenever possible. Chronic Disease Prevention: The stakeholders identified chronic diseases as an important health issue to be addressed in the community. Discussions with community leaders, public health organizations and St. Elizabeth leaders, revealed that by tackling the nutrition and physical activity needs of the community, often seen as proxy for obesity prevention, chronic diseases would also be positively affected. Many stated that many of the chronic diseases that need attention such as, diabetes, hypertension, high cholesterol, etc. can be positively influenced by working on obesity prevention efforts. Healthy Growth and Development: Many stakeholders identified healthy growth and development, especially early childhood growth and development, as a health need. Many community members there saw a need to support the development of healthy, well-rounded individuals. At the same time, respondents stated there are many existing organizations and programs in the community that address these issues, including the Fox Valley Early Childhood Coalition, Parent Connection, Community Early Learning Center, Birth To 3 Program, The Boys and Girls Club, Head Start, as well as school-based and YMCA- based programs. Given the variety of existing efforts in the community, St. Elizabeth will continue to support the public health departments and community organizations already in existence to address healthy growth and development issues whenever possible. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 0 | FacilityNum |
Supplemental Information Detail SupplementalInformationDetail (17 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part I, Line 3c Other Factors other than FPG | It is the policy of St. Elizabeth Hospital, Inc. to provide medically necessary health care services to people in the communities it serves, regardless of their ability to pay. Affinity Care financial assistance is granted based upon the patient's inability to pay and to individuals who are uninsured, underinsured or medically indigent. Affinity Care works in collaboration with other financial (both public and private) assistance programs. This is to ensure holistic wellness of patients by facilitating knowledge of abailable services and programs for health while practicing good stewardship of funds. Key criteria utilized to determine eligibility for Affinity Care financial assistance includes family size, federal poverty income guidelines and available assets. The available asset test includes consideration of the amount of equity in a home, automobiles, and savings accounts which are considered part of total allowable income when assessing against the federal poverty income guidelines. |
| Schedule H, Part I, Line 6a Community benefit report prepared by related organization | ST. ELIZABETH HOSPITAL, INC. IS INCLUDED IN THE ANNUAL COMMUNITY BENEFIT REPORT WHICH IS PUBLISHED BY MINISTRY HEALTH CARE, INC. (EIN: 39-1490371) AND AVAILABLE TO THE PUBLIC ON ITS WEBSITE, WWW.MINISTRYHEALTH.ORG. THIS REPORT INCLUDES ALL OF THE RELATED ENTITIES WITHIN THE MINISTRY HEALTH CARE NETWORK OF HOSPITALS, CLINICS AND OTHER HEALTH-RELATED ORGANIZATIONS. |
| Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance | Amounts calculated in Part I, Line 7 are determined both on a cost accounting system and a cost-to-charge ratio. Other benefits are determined based on the direct and indirect costs (where allocated) associated with a program net of earned revenue. Detail for each program/activity is maintained and determined at the department level. Charity care and means-tested programs are determined based on a cost-to-charge ratio consistent with Worksheet 2, Ratio of Patient Care Cost to Charges. Prior year cost report settlements are excluded from the shortfall calculation in order to get a true fiscal year shortfall amount. |
| Schedule H, Part II Community Building Activities | In the area of community building, St. Elizabeth Hospital participates in several community coalitions and other collaborative efforts with the community whose purpose is to improve the health of the community. These include AVN/MVN Advisory Committee, and the Steering Committee for Autism. 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. St. Elizabeth Hospital also organizes and runs community events including Health Career Days and other job shadowing opportunities to area youth and community members. 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. Elizabeth also supports the Oshkosh Youth Leadership Future. We know that community leaders who are knowledgeable about both the asset and challenges our community has will help us to positively address the health issues of the future. |
| Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount | Accounts are written off to bad debt after all internal collection efforts have been exhausted. Attempts to resolve these outstanding balances can include, but are not limited to statements being sent, phone calls and letters being sent. Account follow up protocol is based on personal pay balance size owed. |
| Schedule H, Part III, Line 3 Bad Debt Expense Methodology | St. Elizabeth Hospital, Inc. has a very robust financial assistance program; therefore, no estimate is made for bad debt attributed to financial assistance eligible patients. |
| Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote | From the consolidated audited financial statements of Ministry Health Care, Inc. (which includes the activity of St. Elizabeth Hospital, Inc.): 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. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Health Ministry follows established guidelines for placing certain past-due patient balances with 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 Health Ministry's policies. The methodology for determining the allowance for doubtful accounts and related write-offs on uninsured patient accounts has remained consistent with the prior year. The Health Ministry has not experienced material changes in write-off trends and has not materially changed its charity care policy in the current year. |
| Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs | Ascension Health and related health ministries follow the Catholic Health Association ("CHA") guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as community benefit. |
| Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance | St. Elizabeth Hospital, Inc. has a debt collection policy which sets forth collection practices for patients who are known to qualify or may qualify for financial assistance under the charity care program. Sufficient financial counseling support is made available to patients so they can easily access patient financial service representatives and have their questions answered, and gain an understanding of the reasons why they owe a balance. Accounts are designated as charity care in the business offices so no additional time is spent on collection efforts. |
| Schedule H, Part V, Section B, Line 16a FAP website | - St. Elizabeth Hospital, Inc.: Line 16a URL: http://ministryhealth.org/MinistryHealth/AboutUs/BillingandPayment/FinancialAssistance.nws; |
| Schedule H, Part V, Section B, Line 16b FAP Application website | - St. Elizabeth Hospital, Inc.: Line 16b URL: http://ministryhealth.org/MinistryHealth/AboutUs/BillingandPayment/FinancialAssistance.nws; |
| Schedule H, Part V, Section B, Line 16c FAP plain language summary website | - St. Elizabeth Hospital, Inc.: Line 16c URL: http://ministryhealth.org/MinistryHealth/AboutUs/BillingandPayment/FinancialAssistance.nws; |
| Schedule H, Part VI, Line 2 Needs assessment | St. Elizabeth Hospital, Inc. performs community health needs assessments as needed. Planning workgroups consisting of community partners are formed to define the community and its health needs through review of United Way Life Study results, Healthy People Initiatives, census documents, and local government health and welfare agencies. Considering other community resources/assets, data collection methods are used to identify particular problems or subgroups and areas known to have high poverty rates and to be underserved. The data is analyzed and priorities are set based on trending information which may target a specific need. When a need is identified, the Hospital develops a plan to implement a program either through community collaboration or individually. Outcomes from the programs are measured and considered insubsequent community health needs assessments. The leadership at Affinity takes their commitment to the health and well-bring of the community it serves very seriously. In fact, it is core to the Organization's mission, "to live out the healing ministry of Christ by providing services that promote the health and well-being of the communities we serve, especially the poor." Senior leaders and management are also highly encouraged to provide direct service to the poor in their communities. St. Elizabeth and the leadership also subscribe to publications like the Advisory Board to compare national trends to local trends to ensure the hospital is resourcing areas to meet patient needs. |
| Schedule H, Part VI, Line 3 Patient education of eligibility for assistance | St. Elizabeth Hospital, Inc. goes to great lengths in order to inform and educate patients/persons who may be billed for patient care about their eligibility for assistance under federal, state or local government programs and under the organizations Affinity Care Policy. The Affinity Care Policy and application is posted on the Organization's website. Admissions and other key areas contain summary information of the Affinity Care Policy. As part of the intake/discharge process, patients are provided with a copy of the policy and other information for financial assistance. If during the course of the patient registration process, care encounter, treatment, or upon discharge it becomes evident that a patient may need financial assistance, the patient shall be referred to the organizations Affinity Care Program. Patients may be identified as needing financial assistance at any time during the course of an encounter. A referral for consideration of Affinity Care financial assistance can be initiated by any member of the Hospital's workforce, including medical staff members, who become aware of the patients potential need for Affinity Care financial assistance. The Affinity Care brochure was also translated into dialects prevalent in the community in order to reach out to those that may speak another language (Spanish and Hmong). Patient registration staff and financial counselors are provided with guidelines to follow when interacting with patients. As part of the Affinity Care process, patients must register with the county public assistance to see if they may qualify under any other federal or state programs. |
| Schedule H, Part VI, Line 4 Community information | While there is growing agreement in the United States about what constitutes a non-profit hospitals "community benefit," this is a work in progress. St. Elizabeth Hospital, Inc. provided significant charity care and other community benefits as defined by the IRS. But in addition, we believe that we provide a critically important community benefit, which is not quantified. St. Elizabeth Hospital, Inc., like most community hospitals, was created and is maintained in order to provide care locally, care that without our hospital, may not be available locally. Certain specialized services available include: I/P adult behavioral health services, I/P adolescent behavioral health services and neonatal intensive care services. The City of Appleton is located in Outagamie, Calumet, and Winnebago counties. According to the 2008-2012 American Community Survey 5-Year Estimates, there were 72,575 people living in Appleton, consisting of 28,428 households and 18,074 families. The population density of Appleton was 2,984.9 people per square mile. The population consisted of 86.0% White, 4.7% Hispanic, 1.6% African American, 0.5% Native American, 5.3% Asian, and 1.9% Other. Of the 28,428 households in Appleton, 32.8% of those had children under the age of 18, living at home. The 28,428 households are categorized as 49% married couples living together, 4.1% had a male head of household with no wife present, 10.5% had a female head of household with no husband present, and 47% were non-families. 29.6% of the households consisted of individuals and 10.1% had someone 65 and older living alone. The age population is widely spread. 28.9% were under 18, 6.5% were 19-24, 26.8% were 25-44, 26.3% were 45-64, and 11.5% were 65+. The median income for a household was $52,605 and the median income for a family was $66,781. The per capita income for the city was $27,106. The largest industry in Appleton is educational, health and social services (21.5%). Manufacturing (20.4%) and retail trade (11.4%) are the next largest industries in Appleton. Roughly 8% of families and 10.5% of the population were below the poverty line. That includes 13.5% of those under 18 years old and 7.4% of those 65 and older. The unadjusted seasonal unemployment rate for Outagamie, Calumet, and Winnebago Counties was 4.0%, 3.7%, and 4.3%, respectively, compared to a state unemployment rate of 5.1% and a national unemployment rate of 7.9%. |
| Schedule H, Part VI, Line 5 Promotion of community health | The Organization strives to further its exempt purposes by the following: (1) The Organization's governing board consists primarily of persons who reside within the primary service area who are not employees of the Organization. (2) As mentioned, the Organization provides several services which are not otherwise available being in a rural setting. (3) Based on the Organization's mission, emergency rooms are made available to all patients regardless of the ability to pay. (4) The Organization also participates in the education and training of healthcare professionals through internship programs. Certain specialized services available include: dental services to primarily the indigent, fertility clinic services and WIC home visits to new mothers and infants. |
| Schedule H, Part VI, Line 6 Affiliated health care system | MINISTRY HEALTH CARE, INC. (MINISTRY OR THE HEALTH MINISTRY) IS A MEMBER OF ASCENSION HEALTH. IN DECEMBER 2011, ASCENSION HEALTH ALLIANCE, DOING BUSINESS AS ASCENSION, BECAME 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 HEALTH CARE FACILITIES, OR HEALTH MINISTRIES, LOCATED IN 23 STATES AND THE DISTRICT OF COLUMBIA. IN ADDITION TO SERVING AS THE SOLE CORPORATE MEMBER OF ASCENSION HEALTH, ASCENSION SERVES AS THE MEMBER OR SHAREHOLDER OF VARIOUS OTHER SUBSIDIARIES. ASCENSION, ITS SUBSIDIARIES, AND THE HEALTH MINISTRIES ARE REFERRED TO COLLECTIVELY FROM TIME TO TIME HEREAFTER AS THE SYSTEM. ASCENSION IS SPONSORED BY ASCENSION SPONSOR, A PUBLIC JURIDIC PERSON. THE PARTICIPATING 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 HEALTH MINISTRY IS A WISCONSIN NON-STOCK, TAX-EXEMPT CORPORATION THAT MANAGES, PROMOTES, AND SUPPORTS HEALTH CARE AND RELATED MINISTRIES IN WISCONSIN AND MINNESOTA. THE HEALTH MINISTRY PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES FOR THE RESIDENTS OF WISCONSIN AND MINNESOTA. ADMITTING PHYSICIANS ARE PRIMARILY PRACTITIONERS IN THE LOCAL AREA. THE HEALTH MINISTRY IS RELATED TO ASCENSION HEALTH'S OTHER SPONSORED ORGANIZATIONS THROUGH COMMON CONTROL. SUBSTANTIALLY ALL EXPENSES OF THE HEALTH MINISTRY ARE RELATED TO PROVIDING HEALTH CARE SERVICES. EFFECTIVE NOVEMBER 1, 2014, THE HEALTH MINISTRY SOLD 50% OF ITS OWNERSHIP IN NETWORK HEALTH, INC. TO AN UNRELATED HEALTH SYSTEM (SEE NOTE 3). ON FEBRUARY 1, 2015, THE HEALTH MINISTRY TRANSFERRED ITS OWNERSHIP IN MINISTRY HOME CARE, INC. TO ASCENSION HEALTH. THE CONSOLIDATED FINANCIAL STATEMENTS INCLUDE THE FOLLOWING AFFILIATES LOCATED PRIMARILY IN WISCONSIN, IN WHICH MINISTRY HAS A CONTROLLING INTEREST AND/OR IS THE SOLE SPONSOR. AFFINITY HEALTH SYSTEM, INC. (AFFINITY): CALUMET MEDICAL CENTER, INC. (CMC): AFFINITY MEDICAL GROUP (AMG) TWIN MED, LLC MERCY MEDICAL CENTER, INC. MERCY HEALTH FOUNDATION ST. ELIZABETH HOSPITAL CATALPA HEALTH: ST. ELIZABETH FOUNDATION AGAPE COMMUNITY CENTER OF MILWAUKEE, INC. DOOR COUNTY MEMORIAL HOSPITAL (DOOR COUNTY) GOOD SAMARITAN HEALTH CENTER OF MERRILL GOOD SAMARITAN HEALTH CENTER FOUNDATION HOWARD YOUNG HEALTH CARE, INC. (HOWARD YOUNG): DR. KATE NEWCOMB CONVALESCENT CENTER HOWARD YOUNG MEDICAL CENTER, INC. DR. HOWARD YOUNG FOUNDATION EAGLE RIVER MEMORIAL HOSPITAL, INC. MINISTRY MEDICAL GROUP, INC. MINISTRY HOLDINGS, INC. (THROUGH NOVEMBER 1, 2014): NETWORK HEALTH (NH) (THROUGH NOVEMBER 1, 2014) NETWORK HEALTH INSURANCE CORPORATION (NHIC) (THRU NOVEMBER 1, 2014) OUR LADY OF VICTORY HOSPITAL SACRED HEART HOSPITAL-ST. MARY'S HOSPITAL, INC. ST. CLARE'S HOSPITAL OF WESTON, INC. FOUNDATION OF ST. CLARE'S HOSPITAL OF WESTON, INC. ST. ELIZABETH'S HOSPITAL OF WABASHA, INC. ST. JOSEPH'S HOSPITAL OF MARSHFIELD, INC. FOUNDATION OF ST. JOSEPH'S HOSPITAL OF MARSHFIELD, INC. ST. MICHAEL'S HOSPITAL OF STEVENS POINT, INC. ST. MICHAEL'S FOUNDATION OF STEVENS POINT, INC. 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: 1. 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. 2. 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. 3. 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. 4. 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. THE AMOUNT OF TRADITIONAL CHARITY CARE PROVIDED, DETERMINED ON THE BASIS OF COST, WAS APPROXIMATELY $495,863 AND $500,067 FOR THE YEARS ENDED JUNE 30, 2016 AND 2015, RESPECTIVELY. THE AMOUNT OF UNPAID COST OF PUBLIC PROGRAMS, COST OF OTHER PROGRAMS FOR PERSONS LIVING IN POVERTY AND FOR OTHER VULNERABLE PERSONS, AND COST OF COMMUNITY BENEFIT PROGRAMS ARE REPORTED IN THE ACCOMPANYING SUPPLEMENTARY INFORMATION. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (18 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MONICA ANN HILT | ||||||||||||||
| PRESIDENT STE HOSPITAL | $0 | $457,522 | $0 | $238,701 | $0 | $13,465 | $0 | $33,355 | $0 | $30,794 | $0 | $773,837 | $0 | $0 |
| DANIEL NEUFELDER | ||||||||||||||
| SR. VP HOSP OPS (BOARD END 12/2015) | $0 | $1,009,083 | $0 | $1,146,884 | $0 | $15,893 | $0 | $162,663 | $0 | $27,505 | $0 | $2,362,028 | $0 | $0 |
| MARK W FAUSTICH MD | ||||||||||||||
| BOARD MEMBER | $0 | $412,928 | $0 | $21,608 | $0 | $3,495 | $0 | $17,225 | $0 | $4,566 | $0 | $459,822 | $0 | $0 |
| MARK KEHRBERG MD | ||||||||||||||
| CHIEF MEDICAL OFFICER | $0 | $219,105 | $0 | $129,827 | $0 | $6,684 | $0 | $15,923 | $0 | $14,391 | $0 | $385,930 | $0 | $0 |
| JOSEPH MCCORMICK MD | ||||||||||||||
| BOARD MEMBER (END 12/2015) | $0 | $757,761 | $0 | $0 | $0 | $1,886 | $0 | $13,250 | $0 | $30,681 | $0 | $803,578 | $0 | $0 |
| STACEY SENSOR DO | ||||||||||||||
| BOARD MEMBER (END 12/2015) | $0 | $340,467 | $0 | $13,604 | $0 | $2,784 | $0 | $6,451 | $0 | $19,934 | $0 | $383,240 | $0 | $0 |
| SUDEEP SODHI MD | ||||||||||||||
| BOARD MEMBER | $0 | $878,922 | $0 | $0 | $0 | $3,327 | $0 | $17,225 | $0 | $30,312 | $0 | $929,786 | $0 | $0 |
| BARBARA J STRAND MD | ||||||||||||||
| BOARD MEMBER | $0 | $291,291 | $0 | $36,054 | $0 | $5,095 | $0 | $9,275 | $0 | $14,130 | $0 | $355,845 | $0 | $0 |
| WENDY SCHROEDER MD | ||||||||||||||
| BOARD MEMBER (START 1/2016) | $0 | $257,093 | $0 | $50 | $0 | $1,003 | $0 | $13,623 | $0 | $34,443 | $0 | $306,212 | $0 | $0 |
| TRAVIS D ANDERSEN | ||||||||||||||
| PRESIDENT (END 8/2014) | $0 | $563,273 | $0 | $433,518 | $0 | $71,737 | $0 | $25,800 | $0 | $35,662 | $0 | $1,129,991 | $0 | $0 |
| NICHOLAS DESIEN | ||||||||||||||
| MINISTRY HEALTH CARE CEO (END 12/31/15) | $0 | $1,298,254 | $0 | $1,454,145 | $0 | $47,338 | $0 | $242,978 | $0 | $28,808 | $0 | $3,071,523 | $0 | $0 |
| JEFFREY FRANCIS | ||||||||||||||
| MINISTRY HEALTH CARE CAFO (END 9/9/15) | $0 | $382,625 | $0 | $40,711 | $0 | $229,342 | $0 | $27,845 | $0 | $23,540 | $0 | $704,063 | $0 | $0 |
| LAWRENCE DONATELLE | ||||||||||||||
| VICE PRESIDENT OF MEDICAL AFFAIRS | $0 | $314,266 | $0 | $64,590 | $0 | $9,342 | $0 | $9,275 | $0 | $24,226 | $0 | $421,699 | $0 | $0 |
| JENNIE REBECCA GAURKEE | ||||||||||||||
| PHARMACY DIRECTOR | $179,017 | $0 | $1,000 | $0 | $10,882 | $0 | $9,390 | $0 | $24,154 | $0 | $224,443 | $0 | $0 | $0 |
| BRIAN G HUMPHREY | ||||||||||||||
| SENIOR ULTRASOUND TECHNOLOGIST | $158,870 | $0 | $0 | $0 | $579 | $0 | $10,155 | $0 | $10,369 | $0 | $179,973 | $0 | $0 | $0 |
| NANETTE KRIZENESKY | ||||||||||||||
| REGISTERED NURSE LEAD-ICU | $201,361 | $0 | $3,249 | $0 | $2,191 | $0 | $13,551 | $0 | $25,878 | $0 | $246,230 | $0 | $0 | $0 |
| ERIC LOBB | ||||||||||||||
| MEDICAL PHYSICIST | $160,135 | $0 | $0 | $0 | $568 | $0 | $7,951 | $0 | $11,947 | $0 | $180,601 | $0 | $0 | $0 |
| ANNETTE SIEDSCHLAG | ||||||||||||||
| SUPERVISOR PHARMACY | $145,066 | $0 | $1,700 | $0 | $773 | $0 | $8,212 | $0 | $23,059 | $0 | $178,810 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation | Ministry Health Care, Inc., a related organization of St. Elizabeth Hospital, Inc., uses the following to establish the compensation of the organization's CEO: - Compensation Committee, - Independent Compensation Consultant, - Compensation Survey or Study, and - Approval by the Board or Compensation Committee. |
| Schedule J, Part I, Line 4a Severance or change-of-control payment | The following individual(s) received severance payments from the organization or a related organization: Jennie Guarkee - $10,208 Jeffrey Francis - $225,000 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 15 COMPENSATION OF OFFICERS | IN DETERMINING COMPENSATION OF THE ORGANIZATION'S CEO, THE PROCESS, PERFORMED BY MINISTRY HEALTH CARE, INC., A RELATED ORGANIZATION OF ST. ELIZABETH HOSPITAL, INC., INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE CEO 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 BOARD MINUTES. THE INDIVIDUAL WAS NOT PRESENT WHEN HIS COMPENSATION WAS DECIDED. IN DETERMINING COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION, THE PROCESS, PERFORMED BY MINISTRY HEALTH CARE, INC., A RELATED ORGANIZATION OF ST. ELIZABETH HOSPITAL, INC., INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION 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 BOARD MINUTES. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | St. Elizabeth Hospital, Inc. has two corporate members, Ministry Healthcare, Inc. and Affinity Health System. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | St. Elizabeth Hospital, Inc. has two corporate members, Ministry Healthcare, Inc. and Affinity Health System, who have the ability to elect members to the governing body of St. Elizabeth Hospital Inc. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | All decisions that have a material impact to St. Elizabeth Hospital, Inc. financial information or corporation as a whole are subject to approval by its two corporate members, Ministry Healthcare, Inc. and Affinity Health System. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | Management, including certain officers, works diligently to complete the Form 990 and attached schedules in a thorough manner. Prior to filing the return, all Board Members are provided the Form 990 and management team members are available to answer any Board Members' questions. |
| 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 Conflict 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 Ministry web page is available to the public for inspection with a good deal of information regarding whom Ministry Health Care is and the entities included along with our mission. The Articles of Incorporation, Bylaws, Conflicts of Interest Policy, and financial statements are not included on any web page. However, if an inquiry is made for any documents, they are shared as appropriate. |
| Form 990, Part VII, Section B, Line 1 Independent Contractors | The payments reported on Form 990, Part VII, Section B for Boldt Procurement represent amounts for both services and materials. These amounts cannot be separated. |
| Form 990, Part VIII, Line 2f Other Program Service Revenue | 340B Pharmacy - Total Revenue: 341793, Related or Exempt Function Revenue: 341793, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | FASB 136 - -22579; Catalpa Temp Restricted Investment - 70123; |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (30 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ASCENSION HEALTH ALLIANCE | |||||||||||
| PO BOX 45998 | STLOUIS | MO | 63145 | 453358926 | NATIONAL HEALTH SYSTEM | MO | 501(c)(3 | Type I | N/A | false | |
| ASCENSION HEALTH | |||||||||||
| PO BOX 45998 | STLOUIS | MO | 63145 | 311662309 | NATIONAL HEALTH SYSTEM | MO | 501(c)(3 | Type I | false | ASCENSION HEALTH ALLIANCE | |
| MINISTRY HEALTH CARE INC | |||||||||||
| 10925 W LAKE PARK DR STE 100 | MILWAUKEE | WI | 53224 | 391490371 | PARENT CORPORATION | WI | 501(c)(3 | Type II | false | ASCENSION HEALTH | |
| AFFINITY HEALTH SYSTEM | |||||||||||
| 1570 MIDWAY PLACE | MENASHA | WI | 54952 | 391568866 | SUPPORT RELATED HEALTHCARE ORGANZIATIONS | IL | 501(c)(3 | Type II | Yes (true) | MINISTRY HEALTH CARE INC | |
| AGAPE COMMUNITY CENTER OF MILWAUKEE INC | |||||||||||
| 6100 NORTH 42ND STREET | MILWAUKEE | WI | 53209 | 391461846 | COMMUNITY CENTER | WI | 501(c)(3 | 7 | Yes (true) | MINISTRY HEALTH CARE INC | |
| CALUMET MEDICAL CENTER INC | |||||||||||
| 614 MEMORIAL DRIVE | CHILTON | WI | 53014 | 390905385 | HOSPITAL | WI | 501(c)(3 | 3 | Yes (true) | AFFINITY HEALTH SYSTEM | |
| CATALPA HEALTH INC | |||||||||||
| N4642 COUNTY N | APPLETON | WI | 54914 | 454681563 | MENTAL HEALTH FACILITY | WI | 501(c)(3 | 3 | Yes (true) | ST ELIZABETH HOSPITAL INC | |
| SAINT MICHAEL'S FOUNDATION OF STEVENS POINT INC | |||||||||||
| 900 ILLINOIS AVENUE | STEVENS POINT | WI | 54481 | 391657410 | CHARITABLE FOUNDATION | WI | 501(c)(3 | Type I | Yes (true) | SAINT MICHAEL'S HOSPITAL OF STEVENS POINT | |
| DOOR COUNTY MEMORIAL HOSPITAL | |||||||||||
| 323 SOUTH 18TH AVENUE | STURGEON BAY | WI | 54235 | 390806324 | HOSPITAL | WI | 501(c)(3 | 3 | Yes (true) | MINISTRY HEALTH CAREINC | |
| DR KATE NEWCOMB CONVALESCENT CENTER INC | |||||||||||
| PO BOX 829 | WOODRUFF | WI | 54568 | 391357365 | NURSING/ASSISTED LIVING SERVICES | WI | 501(c)(3 | 9 | Yes (true) | HOWARD YOUNG HEALTH CARE INC | |
| EAGLE RIVER MEMORIAL HOSPITAL INC | |||||||||||
| 201 HOSPITAL ROAD | EAGLE RIVER | WI | 54521 | 390985690 | HOSPITAL | WI | 501(c)(3 | 3 | Yes (true) | THE HOWARD YOUNG MEDICAL CENTER INC | |
| FOUNDATION OF SAINT CLARE'S HOSPITAL OF WESTON INC | |||||||||||
| 3400 MINISTRY PARKWAY | WESTON | WI | 54476 | 753193633 | CHARITABLE FOUNDATION | WI | 501(c)(3 | Type I | Yes (true) | ST CLARE'S HOSPITAL OF WESTON INC | |
| FOUNDATION OF SAINT JOSEPH'S HOSPITAL OF MARSHFIELD | |||||||||||
| 611 SAINT JOSEPH AVENUE | MARSHFIELD | WI | 54449 | 391684957 | CHARITABLE FOUNDATION | WI | 501(c)(3 | Type I | Yes (true) | SAINT JOSEPH'S HOSPITAL OF MARSHFIELD INC | |
| GOOD SAMARITAN HEALTH CENTER OF MERRILL WISCONSIN INC | |||||||||||
| 601 SOUTH CENTER AVENUE | MERRILL | WI | 54452 | 390808503 | HOSPITAL | WI | 501(c)(3 | 3 | Yes (true) | MINISTRY HEALTH CARE INC | |
| GOOD SAMARITAN HEALTH CENTER FOUNDATION OF MERRILL WISCONSIN INC | |||||||||||
| 601 SOUTH CENTER AVENUE | MERRILL | WI | 54452 | 391627755 | CHARITABLE FOUNDATION | WI | 501(c)(3 | Type I | Yes (true) | MINISTRY HEALTH CARE INC | |
| HOWARD YOUNG FOUNDATION INC | |||||||||||
| 240 MAPLE STREET | WOODRUFF | WI | 54568 | 391521169 | CHARITABLE FOUNDATION | WI | 501(c)(3 | 7 | Yes (true) | MINISTRY HEALTH CARE INC | |
| HOWARD YOUNG HEALTH CARE INC | |||||||||||
| 240 MAPLE STREET | WOODRUFF | WI | 54568 | 391499115 | HOME OFFICE | WI | 501(c)(3 | Type II | Yes (true) | MINISTRY HEALTH CARE INC | |
| THE HOWARD YOUNG MEDICAL CENTER INC | |||||||||||
| 240 MAPLE STREET | WOODRUFF | WI | 54568 | 390873606 | HOSPITAL | WI | 501(c)(3 | 3 | Yes (true) | HOWARD YOUNG HEALTH CARE INC | |
| MERCY HEALTH FOUNDATION INC | |||||||||||
| PO BOX 3370 | OSHKOSH | WI | 54903 | 237140261 | CHARITABLE FOUNDATION | WI | 501(c)(3 | 9 | Yes (true) | AFFINITY HEALTH SYSTEM | |
| MERCY MEDICAL CENTER OF OSHKOSH INC | |||||||||||
| 500 S OAKWOOD ROAD | OSHKOSH | WI | 54904 | 390806268 | HOSPITAL | WI | 501(c)(3 | 3 | Yes (true) | MINISTRY HEALTH CARE INC | |
| MINISTRY MEDICAL GROUP INC | |||||||||||
| 824 ILLINOIS AVENUE | STEVENS POINT | WI | 54481 | 391965593 | CLINICS | WI | 501(c)(3 | Type III-FI | Yes (true) | MINISTRY HEALTH CARE INC | |
| MINISTRY WEIGHT MANAGEMENT | |||||||||||
| 2251 NORTH SHORE DRIVE | RHINELANDER | WI | 54501 | 391829015 | HEALTH SERVICES | WI | 501(c)(3 | 3 | Yes (true) | SACRED HEART-ST MARY'S HOSPITAL | |
| NETWORK HEALTH SYSTEM INC | |||||||||||
| 1570 APPLETON RD | MENASHA | WI | 54952 | 391127163 | CLINICAL HEALTHCARE SERVICES | WI | 501(c)(3 | 3 | Yes (true) | AFFINITY HEALTH SYSTEM | |
| OUR LADY OF VICTORY HOSPITAL | |||||||||||
| 1120 PINE STREET | STANLEY | WI | 54768 | 390807065 | HOSPITAL | WI | 501(c)(3 | 3 | Yes (true) | MINISTRY HEALTH CARE INC | |
| SACRED HEART-STMARY'S HOSPITAL INC | |||||||||||
| PO BOX 347 | STEVENS POINT | WI | 54481 | 391390638 | HOSPITAL | WI | 501(c)(3 | 3 | Yes (true) | MINISTRY HEALTH CARE INC | |
| SAINT CLARE'S HOSPITAL OF WESTON INC | |||||||||||
| 3400 MINISTRY PARKWAY | WESTON | WI | 54476 | 721531917 | HOSPITAL | WI | 501(c)(3 | 3 | Yes (true) | MINISTRY HEALTH CARE INC | |
| SAINT ELIZABETH'S HOSPITAL OF WABASHA INC | |||||||||||
| 1200 GRANT BLVD WEST | WABASHA | MN | 55981 | 410693877 | HOSPITAL | MN | 501(c)(3 | 3 | Yes (true) | MINISTRY HEALTH CARE INC | |
| SAINT ELIZABETH'S HOSPITAL FOUNDATION INC | |||||||||||
| 1506 S ONEIDA STREET | APPLETON | WI | 54915 | 391256677 | CHARITABLE FOUNDATION | WI | 501(c)(3 | 7 | Yes (true) | AFFINITY HEALTH SYSTEM | |
| SAINT JOSEPH'S HOSPITAL OF MARSHFIELD INC | |||||||||||
| 611 SAINT JOSEPH AVENUE | MARSHFIELD | WI | 54449 | 391847631 | HOSPITAL | WI | 501(c)(3 | 3 | Yes (true) | MINISTRY HEALTH CARE INC | |
| SAINT MICHAEL'S HOSPITAL OF STEVENS POINT INC | |||||||||||
| 900 ILLINOIS AVENUE | STEVENS POINT | WI | 54481 | 390808443 | HOSPITAL | WI | 501(c)(3 | 3 | Yes (true) | MINISTRY HEALTH CARE INC | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TWIN MED LLP | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 8005 | AddressLine1Txt |
| City | MENASHA | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54952 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391180341 | EIN |
| Primary Activities | RENTAL PROPERTY | PrimaryActivitiesTxt |
| Legal Domicile State | WI | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | N/A | PredominantIncomeTypeTxt |
| Ownership | 0 | OwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (18 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| NETWORK HEALTH SYSTEM INC | ||
| K | $190,689 | FMV |
| NETWORK HEALTH SYSTEM INC | ||
| J | $2,542,837 | FMV |
| ST ELIZABETH HOSPITAL FOUNDATION INC | ||
| C | $456,866 | FMV |
| ST ELIZABETH HOSPITAL FOUNDATION INC | ||
| O | $404,804 | FMV |
| CALUMET MEDICAL CENTER INC | ||
| L | $58,284 | FMV |
| MERCY MEDICAL CENTER OF OSHKOSH INC | ||
| L | $325,251 | FMV |
| MERCY MEDICAL CENTER OF OSHKOSH INC | ||
| K | $86,958 | FMV |
| NETWORK HEALTH SYSTEM INC | ||
| O | $219,849 | FMV |
| CALUMET MEDICAL CENTER INC | ||
| O | $147,606 | FMV |
| MERCY MEDICAL CENTER OF OSHKOSH INC | ||
| O | $1,379,513 | FMV |
| NETWORK HEALTH SYSTEM INC | ||
| L | $121,745 | FMV |
| ST ELIZABETH HOSPITAL FOUNDATION INC | ||
| Q | $58,401 | FMV |
| MERCY MEDICAL CENTER OF OSHKOSH INC | ||
| P | $3,179,162 | FMV |
| SAINT CLARE'S HOPSITAL OF WESTON INC | ||
| P | $76,088 | FMV |
| Network Health System Inc | ||
| P | $632,949 | FMV |
| Network Health System Inc | ||
| M | $1,628,659 | FMV |
| SAINT CLARE'S HOPSITAL OF WESTON INC | ||
| O | $63,833 | FMV |
| NETWORK HEALTH SYSTEM INC | ||
| Q | $63,411 | FMV |
Comments