DOOR COUNTY MEMORIAL HOSPITAL: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization: DOOR COUNTY MEMORIAL HOSPITAL (EIN 39-0806324)
Tax period: 2014-07-01 to 2015-06-30
Filed: 2016-05-16
IRS object ID: 201621379349310437
Schema version: 2014v6.0
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2016-05-16T18:04:47-05:00	ReturnTs
Tax Period End	2015-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	861065772	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

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

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	555 East Wells Street Suite 1400	AddressLine1Txt
City	Milwaukee	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	53202	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2014-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	390806324	EIN

Business Name BusinessName

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

Field	Value	IRS element (for citing)
Business Name Control	DOOR	BusinessNameControlTxt
Phone	9207435566	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	323 South 18th Avenue	AddressLine1Txt
City	Sturgeon Bay	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54235	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Brian Regan	PersonNm
Person Title	Interim CFO	PersonTitleTxt
Signature	2016-05-16	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Rachel Becker	PreparerPersonNm
PTIN	P00966076	PTIN
Phone	4142713000	PhoneNum

Field	Value	IRS element (for citing)
Tax	2014	TaxYr
Build TS	2016-08-17 19:52:53Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	Ministry Door County Medical Center	BusinessNameLine1Txt

Principal Ofcr Business Name PrincipalOfcrBusinessName

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

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	323 South 18th Avenue	AddressLine1Txt
City	Sturgeon Bay	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54235	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$77,992,465	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Group Exemption	0928	GroupExemptionNum
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	www.ministryhealth.org/dcmh/home.nws	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1944	FormationYr
Legal Domicile State	WI	LegalDomicileStateCd
Activity Or Mission	To improve the health and well-being of all people in the communities we serve.	ActivityOrMissionDesc
Voting Members Governing Body	16	VotingMembersGoverningBodyCnt
Voting Members Independent	13	VotingMembersIndependentCnt
Total Employee	717	TotalEmployeeCnt
Total Volunteers	130	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$699,382	PYContributionsGrantsAmt
CY Contributions Grants	$224,901	CYContributionsGrantsAmt
PY Program Service Revenue	$69,727,370	PYProgramServiceRevenueAmt
CY Program Service Revenue	$77,061,808	CYProgramServiceRevenueAmt
PY Investment Income	$1,020,464	PYInvestmentIncomeAmt
CY Investment Income	-$72,603	CYInvestmentIncomeAmt
PY Other Revenue	$475,010	PYOtherRevenueAmt
CY Other Revenue	$534,631	CYOtherRevenueAmt
PY Total Revenue	$71,922,226	PYTotalRevenueAmt
CY Total Revenue	$77,748,737	CYTotalRevenueAmt
PY Grants And Similar Paid	$12,000	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$12,000	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$43,108,512	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$44,487,849	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$22,328,403	PYOtherExpensesAmt
CY Other Expenses	$24,371,962	CYOtherExpensesAmt
PY Total Expenses	$65,448,915	PYTotalExpensesAmt
CY Total Expenses	$68,871,811	CYTotalExpensesAmt
PY Revenues Less Expenses	$6,473,311	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$8,876,926	CYRevenuesLessExpensesAmt
Total Assets BOY	$83,365,693	TotalAssetsBOYAmt
Total Assets EOY	$92,782,314	TotalAssetsEOYAmt
Total Liabilities BOY	$19,496,911	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$19,215,283	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$63,868,782	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$73,567,031	NetAssetsOrFundBalancesEOYAmt
Mission	Our mission as a Catholic health care system is to further the healing ministry of Jesus by continually improving the health and well-being of all people, especially the poor, in the communities we serve.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$50,290,329	ExpenseAmt
Grant	$12,000	GrantAmt
Revenue	$77,061,808	RevenueAmt
Desc	DOOR COUNTY MEMORIAL HOSPITAL ("THE HOSPITAL") IS A FULLY ACCREDITED, ACUTE-CARE HOSPITAL AND OUTPATIENT MEDICAL CENTER, WITH 25 LICENSED BEDS. THE HOSPITAL OFFERS A FULL RANGE OF SERVICES AND SPECIALTIES, INCLUDING HOME HEALTH, A SKILLED NURSING FACILITY FOR LONG-TERM CARE AND REHABILITATION SERVICES, A REHAB SERVICES DEPARTMENT AND MINISTRY NORTH SHORE MEDICAL CLINIC. DURING FISCAL 2015, THE HOSPITAL COUNTED 4,077 INPATIENT DAYS, INCLUDING SWING BED. THE HOSPITAL'S OUTPATIENT FACILITIES, WHICH INCLUDE ITS REHABILITATION AGENCY, 30 BED EXTENDED CARE FACILITY, AND THE NORTH SHORE MEDICAL CLINIC SERVED 60,687 VISITS, AND THE NORTH SHORE MEDICAL CLINIC, INCLUDING ITS URGENT CARE FACILITY, RECEIVED 66,369 VISITS ALONE. SEE SCHEDULE H FOR FURTHER DETAILS REGARDING THE COMMUNITY BENEFITS DOOR COUNTY MEMORIAL HOSPITAL PROVIDES.	Desc
Total Program Service Expenses	$50,290,329	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	Yes (true)	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	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (true)	TaxExemptBondsInd
Invest Tax Exempt Bonds	false	InvestTaxExemptBondsInd
Escrow Account	false	EscrowAccountInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	Yes (true)	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	108	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	717	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
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	16	GoverningBodyVotingMembersCnt
Independent Voting Member	13	IndependentVotingMemberCnt
Family Or Business Rln	Yes (true)	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 (27 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	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
JOSEPH MCMAHON
TREASURER	1.00	0	Yes (X)	Yes (X)	$0	$0	$0
PATRICK O'HERN
CHAIRMAN	1.00	0	Yes (X)	Yes (X)	$0	$0	$0
CATHY WIESE
SECRETARY	1.00	0	Yes (X)	Yes (X)	$0	$0	$0
GERALD WORRICK
CORP PRESIDENT - CEO	40.00	0.30	Yes (X)	Yes (X)	$0	$415,198	$15,826
GREGORY CASPERSON
MEMBER-AT-LARGE (Done 9/30/14)	1.00	0	Yes (X)		$0	$0	$0
CORWIN DAHL
BOARD MEMBER	1.00	0	Yes (X)		$0	$0	$0
BARTH GUILETTE
BOARD MEMBER	1.00	0	Yes (X)		$0	$0	$0
JAMES HEISE
MEDICAL STAFF PRESIDENT	40.00	0	Yes (X)		$286,470	$0	$31,212
TOM HERLACHE
BOARD MEMBER	1.00	0	Yes (X)		$0	$0	$0
ERIC PAULSEN
BOARD MEMBER	1.00	0	Yes (X)		$0	$0	$0
SALLY PFEIFER
MEMBER AT LARGE	1.00	0	Yes (X)		$0	$0	$0
JEFF RABAS
BOARD MEMBER	1.00	0	Yes (X)		$0	$0	$0
DR KELTON REITZ
BOARD MEMBER	40.00	0	Yes (X)		$300,137	$0	$32,271
GRACE ROSSMAN
BOARD MEMBER	1.00	0	Yes (X)		$0	$0	$0
DAVID WARD
BOARD MEMBER	1.00	0	Yes (X)		$0	$0	$0
DR RICHARD HOGAN
BOARD MEMBER	40.00	0	Yes (X)		$344,342	$0	$35,686
WILLIAM MUNDY
BOARD MEMBER	1.00	0	Yes (X)		$0	$0	$0
NICHOLAS DESIEN
MIINISTRY HEALTH CARE CEO	1.00	54.60		Yes (X)	$0	$2,134,343	$18,803
JEFFREY FRANCIS
MINISTRY HEALTH CARE CAFO	1.00	53.80		Yes (X)	$0	$1,021,840	$19,803
BRIAN STEPHENS
CFO	40.00	0		Yes (X)	$118,167	$0	$27,235
MICHAEL BRUNO
PHYSICIAN	40.00	0			$464,521	$0	$35,109	Yes (X)
STEVEN DAVIS
PHYSICIAN	40.00	0			$508,172	$0	$36,379	Yes (X)
BRIAN E MATYSIAK
PHYSICIAN	40.00	0			$388,488	$0	$35,802	Yes (X)
RALPH BRADLY NELSON
PHYSICIAN	40.00	0			$411,678	$0	$24,068	Yes (X)
DR DANIEL TOMASZEWSKI
PHYSICIAN	40.00	0			$901,244	$0	$36,379	Yes (X)
JEFF BADGER
FORMER OFFICER	0.00	0.00			$0	$659,840	$13,832		Yes (X)
ROBERT SCIESZINSKI
FORMER CFO	0.00	0			$0	$146,315	$9,703		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$3,723,219	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$4,377,536	TotReportableCompRltdOrgAmt
Total Other Compensation	$372,109	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	53	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	Yes (true)	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
INFINITY HEALTHCARE INC
111 E WISCONSIN AVE STE 2000	MILWAUKEE	WI	53402	ER PHYSICIANS	$2,141,465
NORTHERN X RAY CO INC
2118 4TH AVENUE SOUTH	MINNEAPOLIS	MN	55404	RADIOLOGY EQUIPMENT SERVICE CONTRACT	$583,030
BERNERS SCHOBER ASSOCIATES
310 PINE STREET	GREEN BAY	WI	54301	ARCHITECT PLANNING/CONSULTING	$344,926
PARK PLACE INTERNATIONAL LLC
7227 CHAGRIN ROAD	CHAGRIN FALLS	OH	44023	SOFTWARE MAINT CONTRACTS	$274,449
MEDICAL STAFFING SOLUTIONS INC
PO BOX 101	RICE LAKE	WI	54868	AGENCY STAFFING	$214,148

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	16	CntrctRcvdGreaterThan100KCnt
Info In Schedule O Part VIII	Yes (X)	InfoInScheduleOPartVIIIInd
Federated Campaigns	$16,000	FederatedCampaignsAmt
Membership Dues	$0	MembershipDuesAmt
Fundraising	$0	FundraisingAmt
Related Organizations	$8,338	RelatedOrganizationsAmt
Government Grants	$6,500	GovernmentGrantsAmt
All Other Contributions	$194,063	AllOtherContributionsAmt
Total Contributions	$224,901	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Net Patient Revenue	622110	$75,454,287	$75,454,287
Oncology Clinic Rev.	621110	$716,259	$716,259
Occupational Health	622000	$261,080	$261,080
Medicare and Medicaid	900099	$373,608	$373,608

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$256,574	TotalRevenueColumnAmt
Related Or Exempt Func Income	$256,574	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$77,061,808	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$72,603	TotalRevenueColumnAmt
Exclusion	-$72,603	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$426,737	RealAmt
Personal	$0	PersonalAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$243,728	RealAmt
Personal	$0	PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$183,009	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$183,009	TotalRevenueColumnAmt
Exclusion	$183,009	ExclusionAmt

Gain Or Loss GainOrLossGrp

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

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt
Cafeteria Sales	722210	$233,531	$233,531
Lifeline Equipment	900099	$118,091	$118,091

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	$351,622	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$77,748,737	TotalRevenueColumnAmt
Related Or Exempt Func Income	$77,061,808	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$462,028	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$12,000	TotalAmt
Program Services	$12,000	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$1,605,757	TotalAmt
Program Services	$930,949	ProgramServicesAmt
Management And General	$674,808	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$32,476,141	TotalAmt
Program Services	$24,707,209	ProgramServicesAmt
Management And General	$7,768,932	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$1,751,074	TotalAmt
Program Services	$1,328,887	ProgramServicesAmt
Management And General	$422,187	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$6,440,057	TotalAmt
Program Services	$4,835,746	ProgramServicesAmt
Management And General	$1,604,311	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$2,214,820	TotalAmt
Program Services	$1,568,874	ProgramServicesAmt
Management And General	$645,946	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$31,836	TotalAmt
Program Services	$31,836	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$124,747	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$124,747	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	-$1,544	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	-$1,544	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$6,041	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$6,041	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Fundraising	$0	FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$3,094,241	TotalAmt
Program Services	$2,845,326	ProgramServicesAmt
Management And General	$248,915	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$756,441	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$756,441	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$7,449,948	TotalAmt
Program Services	$6,895,573	ProgramServicesAmt
Management And General	$554,375	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$991,036	TotalAmt
Program Services	$150,465	ProgramServicesAmt
Management And General	$840,571	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$1,433,787	TotalAmt
Program Services	$1,242,763	ProgramServicesAmt
Management And General	$191,024	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$142,879	TotalAmt
Program Services	$84,118	ProgramServicesAmt
Management And General	$58,761	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$546,232	TotalAmt
Program Services	$281,669	ProgramServicesAmt
Management And General	$264,563	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$269,496	TotalAmt
Program Services	$269,496	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$3,798,912	TotalAmt
Program Services	$2,430,200	ProgramServicesAmt
Management And General	$1,368,712	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$201,371	TotalAmt
Program Services	$195,870	ProgramServicesAmt
Management And General	$5,501	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
Purchased Services	$4,061,835	$2,030,240	$2,031,595	$0
WI Hospital Assessment	$274,380	$274,380	$0	$0
Dues and Licenses	$268,702	$159,118	$109,584	$0
Community Relations	$97,746	$7,406	$90,340	$0

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$823,876	TotalAmt
Program Services	$8,204	ProgramServicesAmt
Management And General	$815,672	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$68,871,811	TotalAmt
Program Services	$50,290,329	ProgramServicesAmt
Management And General	$18,581,482	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$2,978	BOYAmt
EOY	$2,978	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$7,665,252	BOYAmt
EOY	$12,033,689	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

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

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$10,361,306	BOYAmt
EOY	$11,070,039	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$136,950	BOYAmt
EOY	$108,053	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

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

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$202,494	BOYAmt
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$997,491	BOYAmt
EOY	$995,910	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$1,861,062	BOYAmt
EOY	$1,785,399	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$32,094,597	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$7,291,258	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$22,367,718	BOYAmt
EOY	$24,803,339	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

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

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$2,405,975	BOYAmt
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$37,364,467	BOYAmt
EOY	$41,982,907	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$83,365,693	BOYAmt
EOY	$92,782,314	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$4,951,251	BOYAmt
EOY	$6,458,248	EOYAmt

Grants Payable GrantsPayableGrp

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

Deferred Revenue DeferredRevenueGrp

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

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$10,064,309	BOYAmt
EOY	$9,613,899	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

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

Loans From Officers Directors LoansFromOfficersDirectorsGrp

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

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$2,585,651	BOYAmt
EOY	$2,084,651	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

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

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,895,700	BOYAmt
EOY	$1,058,485	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$19,496,911	BOYAmt
EOY	$19,215,283	EOYAmt

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

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$63,349,523	BOYAmt
EOY	$72,486,968	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$519,259	BOYAmt
EOY	$1,080,063	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

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

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

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

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

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

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

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

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$63,868,782	BOYAmt
EOY	$73,567,031	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$83,365,693	BOYAmt
EOY	$92,782,314	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$8,876,926	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$15,089	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$806,234	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	false	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

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

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

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

Contributor US Address ContributorUSAddress

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

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

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	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	$6,041	OtherActivitiesAmt
Total Lobbying Expenditures	$6,041	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	FormAndLineReferenceDesc
Explanation	Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. Door County Memorial Hospital 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.	ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$4,203,537	OtherCostOrOtherBasisAmt
Book Value	$4,203,537	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$14,191,258	OtherCostOrOtherBasisAmt
Depreciation	$1,485,777	DepreciationAmt
Book Value	$12,705,481	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$13,465,243	OtherCostOrOtherBasisAmt
Depreciation	$5,715,014	DepreciationAmt
Book Value	$7,750,229	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$234,559	OtherCostOrOtherBasisAmt
Depreciation	$90,467	DepreciationAmt
Book Value	$144,092	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$24,803,339	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDesc	Book ValueBookValueAmt
Other Receivables	$991,094
Foundation Receivables	$1,045,898
Interest in Investments Held by Ascension Health Alliance	$36,115,389
Due From Third Party Payers	$3,830,526

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$41,982,907	TotalBookValueOtherAssetsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDesc	AmtAmt
Intercompany Debt with Ministry Health Care, Inc.	$328,899
due to Third Party Payors	$729,586

Field	Value	IRS element (for citing)
Total Liability	$1,058,485	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	From the consolidated audited financial statements of Ministry Health Care, Inc., which includes the activity of Door County Memorial Hospital: The Health Ministry accounts for uncertainty in income tax positions by applying a recognition threshold and measurement attribute for financial statement recognition and measurement of tax position taken or expected to be taken in a tax return.	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
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent300	Yes (X)	Percent300Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	false	ExpensesExceedBudgetInd
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	$834,236	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$834,236	NetCommunityBenefitExpnsAmt
Total Expense	0.0121	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$8,324,623	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$6,662,267	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,662,356	NetCommunityBenefitExpnsAmt
Total Expense	0.0241	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
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 Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$9,158,859	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$6,662,267	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,496,592	NetCommunityBenefitExpnsAmt
Total Expense	0.0362	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	20	ActivitiesOrProgramsCnt
Persons Served	1493	PersonsServedCnt
Total Community Benefit Expns	$951,523	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	-$221,180	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,172,703	NetCommunityBenefitExpnsAmt
Total Expense	0.0170	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Activities Or Programs	7	ActivitiesOrProgramsCnt
Persons Served	144	PersonsServedCnt
Total Community Benefit Expns	$177,372	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$177,372	NetCommunityBenefitExpnsAmt
Total Expense	0.0026	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Persons Served	3045	PersonsServedCnt
Total Community Benefit Expns	$908,489	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$294,723	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$613,766	NetCommunityBenefitExpnsAmt
Total Expense	0.0089	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	8	ActivitiesOrProgramsCnt
Persons Served	796	PersonsServedCnt
Total Community Benefit Expns	$374,579	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$374,579	NetCommunityBenefitExpnsAmt
Total Expense	0.0054	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	37	ActivitiesOrProgramsCnt
Persons Served	5478	PersonsServedCnt
Total Community Benefit Expns	$2,411,963	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$73,543	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,338,420	NetCommunityBenefitExpnsAmt
Total Expense	0.0340	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	37	ActivitiesOrProgramsCnt
Persons Served	5478	PersonsServedCnt
Total Community Benefit Expns	$11,570,822	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$6,735,810	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,835,012	NetCommunityBenefitExpnsAmt
Total Expense	0.0702	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	1	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$11,809	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$11,809	NetCommunityBenefitExpnsAmt
Total Expense	0.0002	TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$746	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$746	NetCommunityBenefitExpnsAmt
Total Expense	0.0000	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$22,902	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$22,902	NetCommunityBenefitExpnsAmt
Total Expense	0.0003	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	61	PersonsServedCnt
Total Community Benefit Expns	$22,916	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$22,916	NetCommunityBenefitExpnsAmt
Total Expense	0.0003	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$6,895	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,895	NetCommunityBenefitExpnsAmt
Total Expense	0.0001	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Persons Served	96	PersonsServedCnt
Total Community Benefit Expns	$178,867	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$178,867	NetCommunityBenefitExpnsAmt
Total Expense	0.0026	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	8	ActivitiesOrProgramsCnt
Persons Served	157	PersonsServedCnt
Total Community Benefit Expns	$244,135	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$244,135	NetCommunityBenefitExpnsAmt
Total Expense	0.0035	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	false	BadDebtExpenseReportedInd
Bad Debt Expense	$1,423,702	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$34,142,822	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$32,862,205	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$1,280,617	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	Door County Memorial Hospital	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	323 South 18th Avenue	AddressLine1Txt
City	Sturgeon Bay	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54235	ZIPCd

Field	Value	IRS element (for citing)
Website Address	www.ministryhealth.org/dcmh/home.nws	WebsiteAddressTxt
State License	1064	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Critical Access Hospital	Yes (X)	CriticalAccessHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	Door County Memorial Hospital	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	12	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	false	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	false	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	http://ministryhealth.org/DoorCountyMemorial/Ministry_Door_County_Medical_Center_CHNA_5_28_2013FINAL	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	12	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	http://ministryhealth.org/DoorCountyMemorial/MDCMC_Implementation_Plan_FINAL3_28_2013_FINAL.pdf	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	2.0	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	3.0	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/Ministry_Health_Care/Financial_Assistance_Program_RC08.pdf	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	http://ministryhealth.org/Ministry_Health_Care/MHC_FinancialAid_Application_REV4.pdf	FAPAppAvailableOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
FAP Notice Displayed	Yes (X)	FAPNoticeDisplayedInd
FAP Actions On Nonpayment	Yes (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 (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

Schedule H, Part V, Section B, Line 5 Facility , 1

Facility , 1 - Door County Memorial Hospital. The assessment team comprised of private and public Door County organization members including: hospital representatives, medical staff and administrators; public health nurses and educators; elementary, high school and post-high school educators, nurses and administrators; police and emergency personnel; child, women's, family and senior social services; as well as interested community members in the health needs assessment process. Public Health Experts: - Rhonda Kolberg, Director/Health Officer, Door County Public Health Department RN, BSN, MS - Dennis Hibray, Regional Director, North East/Green Bay Region, Wisconsin Division of Public Health, BS Environmental Health - Elizabeth Farley, AmeriCorps Door County Public Health Department BS, Psychology - Vicki Dantoin, RN BSN, Public Health Nurse - Myria Normann, RN BSN, Public Health Nurse - Sue Powers, RN BSN, Public Health Nurse, more than 21 years as health officer and experience with community needs assessments - Adams, Jessica - HELP of Door County - Comfort, Chris - Community Clinic of Door County - Farley, Elizabeth - AmeriCorps member working at Health Department - Fischer, Jennifer - Women's & Children's Center, MDCMC - Graf, Katie - Social Services, MDCMC - Grohskopf, Kevin - Business Development & Outreach, MDCMC - Guenzel, Josephine - Community Clinic of Door County - Herlache, Tim - Sturgeon Bay Fire Department - Hibray, Dennis - Public Health, NE Region, WI - Johnson, Susan - Chaplain, MDCMC - Knutson, Beverly - Door County Senior Resource Center - Kohnle, Amy - United Way - Laporte, Larry - Board of Health - Meeuwsen, Sarah - Community Clinic of Door County - Mertens, Teresa - WIC - Moeller, Mark - Board of Health - Osborne, Marcia - Northwest Technical College - Peterson, Pam - Door County UW Extension - Rudd, Rhonda - Community Member - Serpe, Michael - Door County Administrator - Stutting, Joe - Superintendent, Sturgeon Bay Schools - Teichtler, John - Door County Sanitarian - Trepto, Judy - Community Member - Weber, Cindy - YMCA of Door County - Weber, Jane - Community Member - Zakrzewski, Joy - Chaplain Scandia Village.

Schedule H, Part V, Section B, Line 11 Facility , 1

Facility , 1 - Door County Memorial Hospital. Using the CHNA completed in tax year 2012, the hospital developed, adopted, and worked on executing a 2012 Implementation Strategy to address priority community health needs. In 2014, the hospital implemented the following plan to address the priority needs: 1. Food, Nutrition, Exercise - Increase awareness of healthy nutrition by implementing visual indicators in food establishments (restaurants, schools, grocery stores) - Increase healthier options on school menus. - Provide community garden. 2. Mental Health - Provide a mental health resource guide for Door County. - Hold mental health awareness events. - Participate on the Door County Mental Health Focus Group 3. Oral Health - Continue to maintain the Door County Dental Clinic - Provide fluoride varnish clinics to children in Door County - Provide dental care to underserved adults in Door County - Provide educational presentations or publicity messages that address oral health issues in Door County.

Field	Value	IRS element (for citing)
Facility	4	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
North Shore Medical Clinic
323 South 18th Avenue	Sturgeon Bay	WI	54235	OP Phys Clinic
North Shore Medical Clinic
3711 Highway 42	Fish Creek	WI	54212	OP Phys Clinic
North Shore Medical Clinic
815 Jefferson Street	Algoma	WI	54201	OP Phys Clinic
North Shore Medical Clinic
910 Main Road	Washington Island	WI	54201	OP Phys Clinic

Supplemental Information Detail SupplementalInformationDetail (16 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part I, Line 6a Community benefit report prepared by related organization	Door County Memorial Hospital is included in the annual community benefit report which is published by Ministry Health Care, Inc. (EIN: 39-1490371) and available to the public on its website, www.ministryhealth.org. This report includes all of the related entities within the Ministry Health Care, Inc. network of hospitals, clinics and other health-related organizations.
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance	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 charge. 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	Some of the things included in this area are working with community organizations such as Rotary, Leadership of Door County, and Loaves and Fishes. Workforce development includes health care career presentations and school/community programs that allow job shadowing and monitoring. Support a community garden and work with local emergency agencies regarding disaster readiness. Door County Memorial Hospital participates in community efforts such as Door Cancer, Inc., Leadership DC, childbirth, baby care and Parkinson's classes, health fairs, and Food for Health. Many employees also volunteer in the community for programs including Habitat for Humanity, Relay for Life, Door County Triathlon, and others.
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	Door County Memorial Hospital 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 footnote of the consolidated financial statements of Ministry Health Care, Inc., which includes the activity of Door County Memorial Hospital: The provision for doubtful accounts is based upon management's assessment of expected net collections considering historical experience, economic conditions, trends in health care 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.
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	Door County Memorial Hospital ("DCMH") 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	- Door County Memorial Hospital: Line 16a URL: http://ministryhealth.org/Ministry_Health_Care/Financial_Assistance_Program_RC08.pdf;
Schedule H, Part V, Section B, Line 16b FAP Application website	- Door County Memorial Hospital: Line 16b URL: http://ministryhealth.org/Ministry_Health_Care/MHC_FinancialAid_Application_REV4.pdf;
Schedule H, Part VI, Line 2 Needs assessment	The Organization performs community needs assessments as needed. Planning workgroups consisting of community partners are formed to define the community and its needs through review of 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 in subsequent community needs assessments. Community benefit plans are presented to senior leadership and board members to ensure the findings are incorporated into the Organization's strategy and policy development. For example, senior leaders are required to provide direct service hours to the poor as part of their performance goals.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	The Organization goes to great lengths in order to inform and educate patients/persons who may be billed for patient care about their eligibility for assistance under federal, state or local government programs and under the Organization's Charity Care Policy. The Charity Care Policy and application is posted on the Organization's website. Admissions and other key areas contain summary information of the Charity Care Policy. As part of the intake/discharge process, patients are provided with a copy of the policy and other information for financial assistance. If during the course of the patient registration process, treatment, or upon discharge it becomes evident that a patient may need financial assistance, the patient shall be referred to the Organization's Community Care program. Patients may be identified as needing financial assistance at any time during the course of an encounter. A referral for consideration of Community Care Financial Assistance can be initiated by any member of the hospital's workforce, including medical staff members, who become aware of the patient's potential need for Community Care Financial Assistance. The Charity Care Policy was also translated into dialects prevalent in the community in order to reach out to those that may speak another language. Patient registration staff and financial counselors are provided with scripts to follow when interacting with patients. As part of the charity care process, patients must register with the county public assistance to see if they may qualify under any other federal or state programs.
Schedule H, Part VI, Line 4 Community information	While there is growing agreement in the United States about what constitutes a non-profit hospital's "community benefit", this is a work in progress. Door County Memorial Hospital ("DCMH") provided significant charity care and other community benefits as defined by the IRS. But in addition, we believe that we provide a critically important community benefit, which is not quantified. Our Hospital, like most rural hospitals, was created and is maintained in order to provide care locally - care that without our Hospital, would not be available locally. The City of Sturgeon Bay is located in Door County. The population of Door County, as of the 2010 census data, is 27,785. According to the 2008 - 2012 American Community Survey 5-Year Estimates data, there were 27,872 people living in Door County, consisting of 13,695 households and 8,560 families. The population consisted of 95.3% White, 2.4 % Hispanic, 0.5% African American, 0.5% Native American, 0.5 % Asian, and 0.8% Other. Of the 13,695 households in Door County, 20.3% of those had children under the age of 18, living at home. The 13,695 households are categorized as 53.1% married couples living together, 4.2% had a male head of household with no wife present, 5.2% had a female head of household with no husband present, and 37.5% were non-families. 29.1% of the households consisted of individuals and 12.4% had someone 65 and older living alone. The age population is widely spread. 19.7% were under 18, 3.7% were 19-24, 20.0% were 25-44, 33.9% were 45-64, and 22.7% were 65+. The median income for a household was $48,707 and the median income for a family was $61,047. The per capita income for the county was $30,509. The largest industry in Door County is educational, health and social services (18.8%). Arts, entertainment and recreation (16.1%) and manufacturing (14.0%) are the next largest industries in Door County. Roughly 6.2% of families and 11.4% of the population were below the poverty line. That includes 20.7% of those under 18 years old and 7.9% of those 65 and older. The unadjusted seasonal unemployment rate for Door County, as of 2012 was 4.5%, 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 local board for Door County Memorial Hospital is made up of community members that live in our primary service area. Door County Memorial Hospital partners with the local YMCA on various events promoting health and well-being in the community. Door County Memorial Hospital extends medical privileges to all qualified physicians in the community. Door County Memorial Hospital participates in Medicare, Medicaid, and other government sponsored programs.
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. Return Reference Identifier Explanation 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 $12,600 AND $18,400 FOR THE YEARS ENDED JUNE 30, 2015 AND 2014, 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 H, Part VI, Line 7 State filing of community benefit report	WI

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Community Clinic of Door County Inc	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1623 Rhode Island Street	AddressLine1Txt
City	Sturgeon Bay	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54235	ZIPCd

Field	Value	IRS element (for citing)
Recipient EIN	223905485	RecipientEIN
IRC Section	Section 501(c)(3)	IRCSectionDesc
Cash Grant	$0	CashGrantAmt
Non Cash Assistance	$12,000	NonCashAssistanceAmt
Valuation Method Used	FMV	ValuationMethodUsedDesc
Non Cash Assistance	Lab Services	NonCashAssistanceDesc
Purpose Of Grant	We provide assistance to the Community Clinic by providing free lab services that amounted to $12,000	PurposeOfGrantTxt

Field	Value	IRS element (for citing)
Total501c3 Org	1	Total501c3OrgCnt

Schedule J IRS990ScheduleJ

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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
GERALD WORRICK
CORP PRESIDENT - CEO	$0	$245,300	$0	$81,697	$0	$88,201	$0	$0	$0	$15,826	$0	$431,024	$0	$0
JAMES HEISE
MEDICAL STAFF PRESIDENT	$286,037	$0	$0	$0	$433	$0	$10,664	$0	$20,548	$0	$317,682	$0	$0	$0
DR KELTON REITZ
BOARD MEMBER	$299,704	$0	$0	$0	$433	$0	$15,600	$0	$16,671	$0	$332,408	$0	$0	$0
DR RICHARD HOGAN
BOARD MEMBER	$342,991	$0	$0	$0	$1,351	$0	$15,600	$0	$20,086	$0	$380,028	$0	$0	$0
JEFF BADGER
FORMER OFFICER	$0	$264,031	$0	$374,899	$0	$20,910	$0	$0	$0	$13,832	$0	$673,672	$0	$0
ROBERT SCIESZINSKI
FORMER CFO	$0	$81,495	$0	$37,970	$0	$26,850	$0	$0	$0	$9,703	$0	$156,018	$0	$0
NICHOLAS DESIEN
MIINISTRY HEALTH CARE CEO	$0	$1,009,502	$0	$1,079,643	$0	$45,198	$0	$0	$0	$18,803	$0	$2,153,146	$0	$0
JEFFREY FRANCIS
MINISTRY HEALTH CARE CAFO	$0	$438,327	$0	$141,768	$0	$441,745	$0	$0	$0	$19,803	$0	$1,041,644	$0	$0
MICHAEL BRUNO
PHYSICIAN	$463,949	$0	$0	$0	$572	$0	$15,600	$0	$19,509	$0	$499,630	$0	$0	$0
STEVEN DAVIS
PHYSICIAN	$507,235	$0	$0	$0	$937	$0	$15,600	$0	$20,779	$0	$544,551	$0	$0	$0
BRIAN E MATYSIAK
PHYSICIAN	$388,181	$0	$0	$0	$307	$0	$15,600	$0	$20,202	$0	$424,290	$0	$0	$0
RALPH BRADLY NELSON
PHYSICIAN	$410,490	$0	$0	$0	$1,188	$0	$15,600	$0	$8,468	$0	$435,746	$0	$0	$0
DR DANIEL TOMASZEWSKI
PHYSICIAN	$900,919	$0	$0	$0	$325	$0	$15,600	$0	$20,779	$0	$937,623	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

Schedule J, Part I, Line 3 EXPLANATION

MINISTRY HEALTH CARE, INC., A RELATED ORGANIZATION OF DOOR COUNTY MEMORIAL HOSPITAL, 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 4b Supplemental nonqualified retirement plan

Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment witht he organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part ll, Column B in the year paid. The following individual received distributions of: JEFFREY FRANCIS $260,079

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	Wisconsin Health & Education Facilities Authority	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Bond Issuer EIN	391337855	BondIssuerEIN
Issue Price	$10,000,000	IssuePriceAmt
Purpose	Refund debt issued 10/21/2009	PurposeDesc
Defeased	false	DefeasedInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Pool Financing	false	PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Retired	$386,100	RetiredAmt
Total Proceeds	$10,000,000	TotalProceedsAmt
Other Spent Proceeds	$10,000,000	OtherSpentProceedsAmt
Current Refunding	Yes (true)	CurrentRefundingInd
Advance Refunding	false	AdvanceRefundingInd
Final Allocation Made	Yes (true)	FinalAllocationMadeInd
Adequate Books And Rec Maint	Yes (true)	AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Owning Bond Financed Property	false	OwningBondFinancedPropertyInd
Any Lease Arrangements	false	AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop	Yes (true)	MgmtContractBondFincdPropInd
Engage Bond Counsel Contracts	Yes (true)	EngageBondCounselContractsInd
Any Research Agreements	false	AnyResearchAgreementsInd
Private Bus Use By Others	0.0	PrivateBusUseByOthersPct
Private Bus Concerning UBI	0.0	PrivateBusConcerningUBIPct
Total Private Business Use	0.0	TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test	false	BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop	false	ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond Remdtd	Yes (true)	ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	false	Form8038TFiledInd
Rebate Not Due Yet	Yes (true)	RebateNotDueYetInd
Exception To Rebate	false	ExceptionToRebateInd
No Rebate Due	false	NoRebateDueInd
Variable Rate Issue	Yes (true)	VariableRateIssueInd
Hedge Identified In Bks And Rec	false	HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC	false	GrossProceedsInvestedInGICInd
Gross Proceeds Invested	false	GrossProceedsInvestedInd
Written Proc To Monitor Reqs	Yes (true)	WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Procedures Corrective Action	Yes (true)	ProceduresCorrectiveActionInd

Schedule L IRS990ScheduleL

Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (2 entries)

Relationship With OrgRelationshipWithOrgTxt	Loan PurposeLoanPurposeTxt	Loan From OrganizationLoanFromOrganizationInd	Original PrincipalOriginalPrincipalAmt	Balance DueBalanceDueAmt	DefaultDefaultInd	Board Or Committee ApprovalBoardOrCommitteeApprovalInd	Written AgreementWrittenAgreementInd
DR TOMASZEWSKI
HIGHEST COMPENSATED EMPLOYEE	EMPLOYEE RETENTION LOAN	Yes (X)	$150,000	$79,149	false	Yes (true)	Yes (true)
BRIAN MATYSIAK
HIGHEST COMPENSATED EMPLOYEE	RETENTION LOAN	Yes (X)	$85,000	$28,904	false	Yes (true)	Yes (true)

Field	Value	IRS element (for citing)
Total Balance Due	$108,053	TotalBalanceDueAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part VI, Line 15 ADDITIONAL INFORMATION	IN DETERMINING COMPENSATION OF THE ORGANIZATION'S CEO, THE PROCESS PERFORMED BY MINISTRY HEALTH CARE, INC., A RELATED ORGANIZATION OF DOOR COUNTY MEMORIAL HOSPITAL, INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE COMPENSATION COMMITTEE, WHICH IS ASSISTED BY AN INDEPENDENT CONSULTING FIRM, 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. 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 DOOR COUNTY MEMORIAL HOSPITAL, INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE COMPENSATION COMMITTEE, ASSISTED BY AN INDEPENDENT CONSULTING FIRM, 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 2 EXPLANATION	MANY OF THE PERSONS LISTED ON PART VII HAVE A "BUSINESS RELATIONSHIP" WITH EACH OTHER BY VIRTUE OF EMPLOYMENT BY MINISTRY HEALTH CARE, INC. RELATED ENTITIES.
Form 990, Part VI, Line 6 Classes of members or stockholders	Door County Memorial Hospital has a single corporate member, Ministry Health Care, Inc.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	Door County Memorial Hospital has a single corporate member, Ministry Health Care, Inc., who has the ability to elect members to the governing body of Door County Memorial Hospital.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	All decisions that have a material impact to Door County Memorial Hospital financial information or corporation as a whole are subject to approval by its sole corporate member, Ministry Health Care, Inc.
Form 990, Part VI, Line 11b Review of form 990 by governing body	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 who Ministry Health Care, Inc. is and the entities included along with our mission. The Articles of Incorporation, Bylaws, Conflict of Interest Policy and financial statements are not included on any web page. However, if any inquiry is made for any documents they are shared as appropriate.
Form 990, Part VIII, Line 2f Other Program Service Revenue	Clinic Subsidy - Total Revenue: 135000, Related or Exempt Function Revenue: 135000, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; All Other Misc - Total Revenue: 121574, Related or Exempt Function Revenue: 121574, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; - Total Revenue: , Related or Exempt Function Revenue: , 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	Form 990, Part XI, line 9, Changes in Net Assets: Increase in Restricted Funds - 801234; Form 990, Part Xl, Line9, Changes in Net Assets: Capital Donation - 5000;

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (31 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
ASCENSION HEALTH ALLIANCE
PO BOX 45998	STLOUIS	MO	63145	453358926	NATIONAL HEALTH SYSTEM	MO	501(c)(3	Type I	NA	false
ASCENSION HEALTH
PO BOX 45998	STLOUIS	MO	63145	311662309	NATIONAL HEALTH SYSTEM	MO	501(c)(3	Type I	ASCENSION HEALTH ALLIANCE	false
MINISTRY HEALTH CARE INC
10925 W LAKE PARK DR STE 100	MILWAUKEE	WI	53224	391490371	PARENT CORPORATION	WI	501(c)(3	Type II	ASCENSION HEALTH	false
AFFINITY HEALTH SYSTEM
1570 MIDWAY PLACE	MENASHA	WI	54952	391568866	SUPPORT RELATED HEALTHCARE ORGANIZATIONS	IL	501(c)(3	Type II	MINISTRY HEALTH CARE INC	Yes (true)
AGAPE COMMUNITY CENTER OF MILWAUKEE INC
6100 NORTH 42ND STREET	MILWAUKEE	WI	53209	391461846	COMMUNITY CENTER	WI	501(c)(3	7	MINISTRY HEALTH CARE INC	Yes (true)
CALUMET MEDICAL CENTER INC
614 MEMORIAL DRIVE	CHILTON	WI	53014	390905385	HOSPITAL	WI	501(c)(3	3	AFFINITY HEALTH SYSTEM	Yes (true)
CATALPA HEALTH INC
N4642 COUNTY N	APPLETON	WI	54914	454681563	MENTAL HEALTH FACILITY	WI	501(c)(3	3	ST ELIZABETH HOSPITAL INC	Yes (true)
SAINT MICHAEL'S FOUNDATION OF STEVENS POINT INC
900 ILLINOIS AVENUE	STEVENS POINT	WI	54481	391657410	CHARITABLE FOUNDATION	WI	501(c)(3	Type I	SAINT MICHAEL'S HOSPITAL OF STEVENS POINT	Yes (true)
DR KATE NEWCOMB CONVALESCENT CENTER INC
PO BOX 829	WOODRUFF	WI	54568	391357365	NURSING/ASSISTED LIVING SERVICES	WI	501(c)(3	9	HOWARD YOUNG HEALTH CARE INC	Yes (true)
EAGLE RIVER MEMORIAL HOSPTIAL INCORPORATED
201 HOSPITAL ROAD	EAGLE RIVER	WI	54521	390985690	HOSPITAL	WI	501(c)(3	3	THE HOWARD YOUNG MEDICAL CENTER INC	Yes (true)
FOUNDATION OF SAINT CLARE'S HOSPITAL OF WESTON INC
3400 MINISTRY PARKWAY	WESTON	WI	54476	753193633	CHARITABLE FOUNDATION	WI	501(c)(3	Type I	MINISTRY HEALTH CARE INC	Yes (true)
FOUNDATION OF SAINT JOSEPH'S HOSPITAL OF MARSHFIELD
611 SAINT JOSEPH AVENUE	MARSHFIELD	WI	54449	391684957	CHARITABLE FOUNDATION	WI	501(c)(3	Type I	SAINT JOSEPH'S HOSPITAL OF MARSHFIELD INC	Yes (true)
GOOD SAMARITAN HEALTH CENTER OF MERRILL WISCONSIN INC
601 SOUTH CENTER AVENUE	MERRILL	WI	54452	390808503	HOSPITAL	WI	501(c)(3	3	MINISTRY HEALTH CARE INC	Yes (true)
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	GOOD SAMARITAN HEALTH CENTER OF MERRILL	Yes (true)
HOWARD YOUNG FOUNDATION INC
240 MAPLE STREET	WOODRUFF	WI	54568	391521169	CHARITABLE FOUNDATION	WI	501(c)(3	7	HOWARD YOUNG HEALTH CARE INC	Yes (true)
HOWARD YOUNG HEALTH CARE INC
240 MAPLE STREET	WOODRUFF	WI	54568	391499115	HOME OFFICE	WI	501(c)(3	Type II	MINISTRY HEALTH CARE INC	Yes (true)
THE HOWARD YOUNG MEDICAL CENTER INC
240 MAPLE STREET	WOODRUFF	WI	54568	390873606	HOSPITAL	WI	501(c)(3	3	HOWARD YOUNG HEALTH CARE INC	Yes (true)
MERCY HEALTH FOUNDATION INC
PO BOX 3370	OSHKOSH	WI	54903	237140261	CHARITABLE FOUNDATION	WI	501(c)(3	9	AFFINITY HEALTH SYSTEM	Yes (true)
MERCY MEDICAL CENTER OF OSHKOSH INC
500 S OAKWOOD ROAD	OSHKOSH	WI	54904	390806268	HOSPITAL	WI	501(c)(3	3	MINISTRY HEALTH CARE INC	Yes (true)
MINISTRY HOMECARE INC
611 STJOSEPH AVENUE 4S	MARSHFIELD	WI	54449	391936201	HOME CARE/ HOSPICE	WI	501(c)(3	9	MINISTRY HEALTH CARE INC	Yes (true)
MINISTRY MEDICAL GROUP INC
824 ILLINOIS AVENUE	STEVENS POINT	WI	54481	391965593	CLINICS	WI	501(c)(3	Type III-FI	MINISTRY HEALTH CARE INC	Yes (true)
MINISTRY WEIGHT MANAGEMENT INC
2251 NORTH SHORE DRIVE	RHINELANDER	WI	54501	391829015	HEALTH SERVICES	WI	501(c)(3	3	SACRED HEART - ST MARY'S HOSPITALS INC	Yes (true)
OUR LADY OF VICTORY HOSPITAL
1120 PINE STREET	STANLEY	WI	54768	390807065	HOSPITAL	WI	501(c)(3	3	MINISTRY HEALTH CARE INC	Yes (true)
SACRED HEART-ST MARY'S HOSPITALS INC
PO BOX 347	STEVENS POINT	WI	54481	391390638	HOSPITAL	WI	501(c)(3	3	MINISTRY HEALTH CARE INC	Yes (true)
SAINT CLARE'S HOSPITAL OF WESTON INC
3400 MINISTRY PARKWAY	WESTON	WI	54476	721531917	HOSPITAL	WI	501(c)(3	3	MINISTRY HEALTH CARE INC	Yes (true)
SAINT ELIZABETH'S HOSPITAL OF WABASHA INC
1200 GRANT BLVD WEST	WABASHA	MN	55981	410693877	HOSPITAL	MN	501(c)(3	3	MINISTRY HEALTH CARE INC	Yes (true)
SAINT ELIZABETH'S HOSPITAL FOUNDATION INC
1506 S ONEIDA STREET	APPLETON	WI	54915	391256677	CHARITABLE FOUNDATION	WI	501(c)(3	7	AFFINITY HEALTH SYSTEM	Yes (true)
ST ELIZABETH HOSPITAL INC
1506 S ONEIDA STREET	APPLETON	WI	54915	390816818	HOSPITAL	WI	501(c)(3	3	MINISTRY HEALTH CARE INC	Yes (true)
SAINT JOSEPH'S HOSPITAL OF MARSHFIELD INC
611 SAINT JOSEPH AVENUE	MARSHFIELD	WI	54449	391847631	HOSPITAL	WI	501(c)(3	3	MINISTRY HEALTH CARE INC	Yes (true)
SAINT MICHAEL'S HOSPTIAL OF STEVENS POINT INC
900 ILLINOIS AVENUE	STEVENS POINT	WI	54481	390808443	HOSPITAL	WI	501(c)(3	3	MINISTRY HEALTH CARE INC	Yes (true)
NETWORK HEALTH SYSTEM INC
1570 APPLETON RD	MENASHA	WI	54952	391127163	CLINICAL HEALTHCARE SERVICES	WI	501(c)(3	3	AFFINITY HEALTH SYSTEM	Yes (true)

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

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd
NETWORK HEALTH PLAN INC
1570 MIDWAY PLACE	MENASHA	WI	54952	391442058	INSURANCE	WI	NA	C Corporation	false
MINISTRY HOLDINGS INC
1570 MIDWAY PLACE	MENASHA	WI	54952	422966177	INSURANCE HOLDING COMPANY	WI	NA	C Corporation	false
NETWORK HEALTH INSURANCE CORPORATION
1570 MIDWAY PLACE	MENASHA	WI	54952	392020474	INSURANCE	WI	NA	C Corporation	false

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	false	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	false	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	false	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (true)	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (4 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
Ministry Health Care Inc
P	$1,414,998	FMV
Mercy Medical Center of Oshkosh Inc
O	$120,000	FMV
Ministry Medical Group
O	$70,334	FMV
Ministry Health Care Inc
O	$908,107	email from Renee Johnson dated 1/26/16 Schedule R