2016-05-16T18:04:47-05:00 2015-06-30 861065772 Deloitte Tax LLP 555 East Wells Street Suite 1400 Milwaukee WI 53202 990 2014-07-01 390806324 Door County Memorial Hospital DOOR 9207435566 323 South 18th Avenue Sturgeon Bay WI 54235 Brian Regan Interim CFO 2016-05-16 true Rachel Becker P00966076 4142713000 2014 2016-08-17 19:52:53Z Ministry Door County Medical Center Brian Stephens 323 South 18th Avenue Sturgeon Bay WI 54235 77992465 false 0928 X www.ministryhealth.org/dcmh/home.nws X 1944 WI To improve the health and well-being of all people in the communities we serve. 16 13 717 130 0 0 699382 224901 69727370 77061808 1020464 -72603 475010 534631 71922226 77748737 12000 12000 0 0 43108512 44487849 0 0 0 22328403 24371962 65448915 68871811 6473311 8876926 83365693 92782314 19496911 19215283 63868782 73567031 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. false false 50290329 12000 77061808 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. 50290329 true true false true false false false false false false true false false true true true false true false false false false false false false false true true true false true true false false false false false true false false false false false false false false false true true true false false true 108 0 true 717 true false false false false false false false false false false X 16 13 true false false false true true true true true false false true true true true true true false false false WI X Craig Aittama 7153465161 5700 Lands End Way 2nd Floor Stevens Point WI 54482 JOSEPH MCMAHON TREASURER 1.00 0 X X 0 0 0 PATRICK O'HERN CHAIRMAN 1.00 0 X X 0 0 0 CATHY WIESE SECRETARY 1.00 0 X X 0 0 0 GERALD WORRICK CORP PRESIDENT - CEO 40.00 0.30 X X 0 415198 15826 GREGORY CASPERSON MEMBER-AT-LARGE (Done 9/30/14) 1.00 0 X 0 0 0 CORWIN DAHL BOARD MEMBER 1.00 0 X 0 0 0 BARTH GUILETTE BOARD MEMBER 1.00 0 X 0 0 0 JAMES HEISE MEDICAL STAFF PRESIDENT 40.00 0 X 286470 0 31212 TOM HERLACHE BOARD MEMBER 1.00 0 X 0 0 0 ERIC PAULSEN BOARD MEMBER 1.00 0 X 0 0 0 SALLY PFEIFER MEMBER AT LARGE 1.00 0 X 0 0 0 JEFF RABAS BOARD MEMBER 1.00 0 X 0 0 0 DR KELTON REITZ BOARD MEMBER 40.00 0 X 300137 0 32271 GRACE ROSSMAN BOARD MEMBER 1.00 0 X 0 0 0 DAVID WARD BOARD MEMBER 1.00 0 X 0 0 0 DR RICHARD HOGAN BOARD MEMBER 40.00 0 X 344342 0 35686 WILLIAM MUNDY BOARD MEMBER 1.00 0 X 0 0 0 NICHOLAS DESIEN MIINISTRY HEALTH CARE CEO 1.00 54.60 X 0 2134343 18803 JEFFREY FRANCIS MINISTRY HEALTH CARE CAFO 1.00 53.80 X 0 1021840 19803 BRIAN STEPHENS CFO 40.00 0 X 118167 0 27235 MICHAEL BRUNO PHYSICIAN 40.00 0 X 464521 0 35109 STEVEN DAVIS PHYSICIAN 40.00 0 X 508172 0 36379 BRIAN E MATYSIAK PHYSICIAN 40.00 0 X 388488 0 35802 RALPH BRADLY NELSON PHYSICIAN 40.00 0 X 411678 0 24068 DR DANIEL TOMASZEWSKI PHYSICIAN 40.00 0 X 901244 0 36379 JEFF BADGER FORMER OFFICER 0.00 0.00 X 0 659840 13832 ROBERT SCIESZINSKI FORMER CFO 0.00 0 X 0 146315 9703 3723219 4377536 372109 53 true true true INFINITY HEALTHCARE INC 111 E WISCONSIN AVE STE 2000 MILWAUKEE WI 53402 ER PHYSICIANS 2141465 NORTHERN X RAY CO INC 2118 4TH AVENUE SOUTH MINNEAPOLIS MN 55404 RADIOLOGY EQUIPMENT SERVICE CONTRACT 583030 BERNERS SCHOBER ASSOCIATES 310 PINE STREET GREEN BAY WI 54301 ARCHITECT PLANNING/CONSULTING 344926 PARK PLACE INTERNATIONAL LLC 7227 CHAGRIN ROAD CHAGRIN FALLS OH 44023 SOFTWARE MAINT CONTRACTS 274449 MEDICAL STAFFING SOLUTIONS INC PO BOX 101 RICE LAKE WI 54868 AGENCY STAFFING 214148 16 X 16000 0 0 8338 6500 194063 224901 Net Patient Revenue 622110 75454287 75454287 Oncology Clinic Rev. 621110 716259 716259 Occupational Health 622000 261080 261080 Medicare and Medicaid 900099 373608 373608 256574 256574 0 0 77061808 -72603 -72603 426737 0 243728 0 183009 0 183009 183009 0 0 Cafeteria Sales 722210 233531 233531 Lifeline Equipment 900099 118091 118091 0 0 0 0 351622 77748737 77061808 0 462028 12000 12000 0 0 0 0 0 0 1605757 930949 674808 32476141 24707209 7768932 0 1751074 1328887 422187 0 6440057 4835746 1604311 0 2214820 1568874 645946 0 31836 31836 0 0 124747 0 124747 0 -1544 0 -1544 0 6041 0 6041 0 0 0 0 0 0 0 3094241 2845326 248915 0 756441 0 756441 0 7449948 6895573 554375 0 991036 150465 840571 0 0 0 0 0 1433787 1242763 191024 0 142879 84118 58761 0 0 0 0 0 546232 281669 264563 0 269496 269496 0 0 0 0 0 0 3798912 2430200 1368712 0 201371 195870 5501 0 Purchased Services 4061835 2030240 2031595 0 WI Hospital Assessment 274380 274380 0 0 Dues and Licenses 268702 159118 109584 0 Community Relations 97746 7406 90340 0 823876 8204 815672 0 68871811 50290329 18581482 0 2978 2978 7665252 12033689 0 0 10361306 11070039 136950 108053 0 0 202494 0 997491 995910 1861062 1785399 32094597 7291258 22367718 24803339 0 0 0 0 2405975 0 37364467 41982907 83365693 92782314 4951251 6458248 0 0 0 0 10064309 9613899 0 0 0 2585651 2084651 0 0 1895700 1058485 19496911 19215283 X 63349523 72486968 519259 1080063 0 0 0 0 0 0 0 0 63868782 73567031 83365693 92782314 X 8876926 15089 806234 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 6041 6041 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. 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. 0 4203537 4203537 0 14191258 1485777 12705481 0 13465243 5715014 7750229 0 234559 90467 144092 24803339 Other Receivables 991094 Foundation Receivables 1045898 Interest in Investments Held by Ascension Health Alliance 36115389 Due From Third Party Payers 3830526 41982907 0 Intercompany Debt with Ministry Health Care, Inc. 328899 due to Third Party Payors 729586 1058485 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote 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. true true X true X true X true true false true true 0 834236 0 834236 0.0121 0 8324623 6662267 1662356 0.0241 0 0 0 0 0.0 0 0 9158859 6662267 2496592 0.0362 20 1493 951523 -221180 1172703 0.0170 7 144 177372 0 177372 0.0026 2 3045 908489 294723 613766 0.0089 0 0 0 0 0 0.0 8 796 374579 0 374579 0.0054 37 5478 2411963 73543 2338420 0.0340 37 5478 11570822 6735810 4835012 0.0702 0 0 0 0 0 0.0 0 0 0 0 0 0.0 1 0 11809 0 11809 0.0002 1 0 746 0 746 0.0000 1 0 22902 0 22902 0.0003 1 61 22916 0 22916 0.0003 2 0 6895 0 6895 0.0001 2 96 178867 0 178867 0.0026 0 0 0 0 0 0.0 8 157 244135 0 244135 0.0035 false 1423702 0 34142822 32862205 1280617 X true true 1 1 Door County Memorial Hospital 323 South 18th Avenue Sturgeon Bay WI 54235 www.ministryhealth.org/dcmh/home.nws 1064 X X X X Door County Memorial Hospital 1 false false true X X X X X X X X X 12 true false false true X http://ministryhealth.org/DoorCountyMemorial/Ministry_Door_County_Medical_Center_CHNA_5_28_2013FINAL X true 12 true http://ministryhealth.org/DoorCountyMemorial/MDCMC_Implementation_Plan_FINAL3_28_2013_FINAL.pdf false false true X 2.0 3.0 X X X X X true true X X X true X http://ministryhealth.org/Ministry_Health_Care/Financial_Assistance_Program_RC08.pdf X http://ministryhealth.org/Ministry_Health_Care/MHC_FinancialAid_Application_REV4.pdf X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - 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. 4 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 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 false Community Clinic of Door County Inc 1623 Rhode Island Street Sturgeon Bay WI 54235 223905485 Section 501(c)(3) 0 12000 FMV Lab Services We provide assistance to the Community Clinic by providing free lab services that amounted to $12,000 1 false true false false false false false false false GERALD WORRICK CORP PRESIDENT - CEO 0 245300 0 81697 0 88201 0 0 0 15826 0 431024 0 0 JAMES HEISE MEDICAL STAFF PRESIDENT 286037 0 0 0 433 0 10664 0 20548 0 317682 0 0 0 DR KELTON REITZ BOARD MEMBER 299704 0 0 0 433 0 15600 0 16671 0 332408 0 0 0 DR RICHARD HOGAN BOARD MEMBER 342991 0 0 0 1351 0 15600 0 20086 0 380028 0 0 0 JEFF BADGER FORMER OFFICER 0 264031 0 374899 0 20910 0 0 0 13832 0 673672 0 0 ROBERT SCIESZINSKI FORMER CFO 0 81495 0 37970 0 26850 0 0 0 9703 0 156018 0 0 NICHOLAS DESIEN MIINISTRY HEALTH CARE CEO 0 1009502 0 1079643 0 45198 0 0 0 18803 0 2153146 0 0 JEFFREY FRANCIS MINISTRY HEALTH CARE CAFO 0 438327 0 141768 0 441745 0 0 0 19803 0 1041644 0 0 MICHAEL BRUNO PHYSICIAN 463949 0 0 0 572 0 15600 0 19509 0 499630 0 0 0 STEVEN DAVIS PHYSICIAN 507235 0 0 0 937 0 15600 0 20779 0 544551 0 0 0 BRIAN E MATYSIAK PHYSICIAN 388181 0 0 0 307 0 15600 0 20202 0 424290 0 0 0 RALPH BRADLY NELSON PHYSICIAN 410490 0 0 0 1188 0 15600 0 8468 0 435746 0 0 0 DR DANIEL TOMASZEWSKI PHYSICIAN 900919 0 0 0 325 0 15600 0 20779 0 937623 0 0 0 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 A Wisconsin Health & Education Facilities Authority 391337855 10000000 Refund debt issued 10/21/2009 false false false A 386100 10000000 10000000 true false true true A false false true true false 0.0 0.0 0.0 false false true A false true false false true false false false true A true DR TOMASZEWSKI HIGHEST COMPENSATED EMPLOYEE EMPLOYEE RETENTION LOAN X 150000 79149 false true true BRIAN MATYSIAK HIGHEST COMPENSATED EMPLOYEE RETENTION LOAN X 85000 28904 false true true 108053 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; 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 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 true CALUMET MEDICAL CENTER INC 614 MEMORIAL DRIVE CHILTON WI 53014 390905385 HOSPITAL WI 501(c)(3 3 AFFINITY HEALTH SYSTEM true CATALPA HEALTH INC N4642 COUNTY N APPLETON WI 54914 454681563 MENTAL HEALTH FACILITY WI 501(c)(3 3 ST ELIZABETH HOSPITAL INC 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 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 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 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 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 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 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 true HOWARD YOUNG FOUNDATION INC 240 MAPLE STREET WOODRUFF WI 54568 391521169 CHARITABLE FOUNDATION WI 501(c)(3 7 HOWARD YOUNG HEALTH CARE INC 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 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 true MERCY HEALTH FOUNDATION INC PO BOX 3370 OSHKOSH WI 54903 237140261 CHARITABLE FOUNDATION WI 501(c)(3 9 AFFINITY HEALTH SYSTEM 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 true MINISTRY HOMECARE INC 611 STJOSEPH AVENUE 4S MARSHFIELD WI 54449 391936201 HOME CARE/ HOSPICE WI 501(c)(3 9 MINISTRY HEALTH CARE INC 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 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 true OUR LADY OF VICTORY HOSPITAL 1120 PINE STREET STANLEY WI 54768 390807065 HOSPITAL WI 501(c)(3 3 MINISTRY HEALTH CARE INC 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 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 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 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 true ST ELIZABETH HOSPITAL INC 1506 S ONEIDA STREET APPLETON WI 54915 390816818 HOSPITAL WI 501(c)(3 3 MINISTRY HEALTH CARE INC 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 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 true NETWORK HEALTH SYSTEM INC 1570 APPLETON RD MENASHA WI 54952 391127163 CLINICAL HEALTHCARE SERVICES WI 501(c)(3 3 AFFINITY HEALTH SYSTEM true TWIN MED LLP PO BOX 8005 MENASHA WI 54952 391180341 RENTAL PROPERTY WI NA N/A 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 false false true false false false false false false false false false false false true true false true false Ministry Health Care Inc P 1414998 FMV Mercy Medical Center of Oshkosh Inc O 120000 FMV Ministry Medical Group O 70334 FMV Ministry Health Care Inc O 908107 email from Renee Johnson dated 1/26/16 Schedule R