BELLIN MEMORIAL HOSPITAL INC: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization: BELLIN MEMORIAL HOSPITAL INC (EIN 39-0884478)
Tax period: 2014-10-01 to 2015-09-30
Filed: 2016-08-15
IRS object ID: 201642289349303394
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	2016-08-15T11:30:55-05:00	ReturnTs
Tax Period End	2015-09-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

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

Preparer Firm Name PreparerFirmName

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

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 12237	AddressLine1Txt
City	GREEN BAY	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	543072237	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2014-10-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	390884478	EIN

Business Name BusinessName

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

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

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 23400	AddressLine1Txt
City	GREEN BAY	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54305	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	JAMES DIETSCHE	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	9204457260	PhoneNum
Signature	2016-08-15	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	TERRI REXRODE CPA MST	PreparerPersonNm
PTIN	P00096513	PTIN
Phone	9206620016	PhoneNum
Preparation	2016-08-15	PreparationDt

Field	Value	IRS element (for citing)
Tax	2014	TaxYr
Build TS	2016-09-27 15:27:22Z	BuildTS

Form 990 IRS990

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

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 23400	AddressLine1Txt
City	GREEN BAY	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54305	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$464,433,932	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.BELLIN.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1908	FormationYr
Legal Domicile State	WI	LegalDomicileStateCd
Activity Or Mission	BELLIN MEMORIAL HOSPITAL, INC. (BMH) PROVIDES HEALTH CARE SERVICES AND OTHER FINANCIAL SUPPORT THROUGH VARIOUS PROGRAMS THAT ARE DESIGNED, AMONG OTHER MATTERS, TO ENHANCE THE HEALTH OF THE COMMUNITY AND IMPROVE THE HEALTH OF LOW-INCOME PATIENTS. CONSISTENT WITH THE MISSION OF BMH, CARE IS PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. IN ADDITION, BMH PROVIDES SERVICES INTENDED TO BENEFIT THE POOR AND UNDERSERVED, INCLUDING THOSE PERSONS WHO CANNOT AFFORD HEALTH INSURANCE BECAUSE OF INADEQUATE RESOURCES OR ARE UNINSURED OR UNDERINSURED. HEALTH CARE SERVICES TO PATIENTS UNDER GOVERNMENT PROGRAMS, SUCH AS MEDICAID, ARE ALSO CONSIDERED PART OF THE BELLIN HEALTH BENEFITS PROVIDED TO THE COMMUNITY SINCE A SUBSTANTIAL PORTION OF SUCH SERVICES ARE REIMBURSED AT AMOUNTS LESS THAN COST.	ActivityOrMissionDesc
Voting Members Governing Body	22	VotingMembersGoverningBodyCnt
Voting Members Independent	16	VotingMembersIndependentCnt
Total Employee	3482	TotalEmployeeCnt
Total Volunteers	400	TotalVolunteersCnt
Total Gross UBI	$7,857,359	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	-$1,285,635	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$891,863	PYContributionsGrantsAmt
CY Contributions Grants	$1,097,065	CYContributionsGrantsAmt
PY Program Service Revenue	$420,816,902	PYProgramServiceRevenueAmt
CY Program Service Revenue	$449,192,956	CYProgramServiceRevenueAmt
PY Investment Income	$6,685,782	PYInvestmentIncomeAmt
CY Investment Income	$5,978,466	CYInvestmentIncomeAmt
PY Other Revenue	-$5,639,259	PYOtherRevenueAmt
CY Other Revenue	$3,911,513	CYOtherRevenueAmt
PY Total Revenue	$422,755,288	PYTotalRevenueAmt
CY Total Revenue	$460,180,000	CYTotalRevenueAmt
PY Grants And Similar Paid	$374,013	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$1,225,882	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$211,696,605	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$227,999,752	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$175,184,267	PYOtherExpensesAmt
CY Other Expenses	$194,357,613	CYOtherExpensesAmt
PY Total Expenses	$387,254,885	PYTotalExpensesAmt
CY Total Expenses	$423,583,247	CYTotalExpensesAmt
PY Revenues Less Expenses	$35,500,403	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$36,596,753	CYRevenuesLessExpensesAmt
Total Assets BOY	$424,570,585	TotalAssetsBOYAmt
Total Assets EOY	$454,995,944	TotalAssetsEOYAmt
Total Liabilities BOY	$137,984,774	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$140,678,606	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$286,585,811	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$314,317,338	NetAssetsOrFundBalancesEOYAmt
Mission	TO ENGAGE INDIVIDUALS, FAMILIES, EMPLOYERS AND COMMUNITIES IN THEIR LIFELONG JOURNEY TOWARD OPTIMAL HEALTH AND TO PROVIDE SAFE, EASY-TO-USE, HIGH QUALITY, COST-EFFECTIVE, TOTAL HEALTH SOLUTIONS.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$319,900,266	ExpenseAmt
Grant	$1,225,882	GrantAmt
Revenue	$429,739,769	RevenueAmt
Desc	THE HOSPITAL PROVIDES ACUTE HOSPITAL CARE TO RESIDENTS OF NORTHEASTERN WISCONSIN. DURING FISCAL YEAR 2015 33,329 INPATIENT DAYS WERE PROVIDED (30,590 ADULTS AND PEDIATRICS), AS COMPARED TO 33,964 (31,324 ADULTS AND PEDIATRICS) IN FISCAL YEAR 2014. THE NUMBER OF OUTPATIENTS REGISTERED FOR 2015 AND 2014 WERE 256,348 AND 247,851, RESPECTIVELY. BELLIN MEMORIAL HOSPITAL ALSO PROVIDED 741,432 (AS COMPARED TO 565,546 IN 2014) PHYSICIAN CLINIC VISITS THROUGH BELLIN MEDICAL AND SPECIALTY GROUPS.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$17,491,452	ExpenseAmt
Revenue	$14,058,890	RevenueAmt
Desc	NORTHREACH HEALTHCARE IS A PRIMARY CARE ORGANIZATION WITH SERVICE LINES OF FAMILY PRACTICE, OB/GYN, PEDIATRICS, AND INTERNAL MEDICINE. NORTHREACH PROVIDES SERVICE TO MARINETTE COUNTY, MENOMINEE COUNTY, AND THE SURROUNDING AREAS.	Desc

Field	Value	IRS element (for citing)
Total Program Service Expenses	$337,391,718	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Temp Or Permanent Endowments	Yes (1)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	0	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (1)	TaxExemptBondsInd
Invest Tax Exempt Bonds	0	InvestTaxExemptBondsInd
Escrow Account	0	EscrowAccountInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	Yes (1)	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	Yes (1)	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (1)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	319	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	3482	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	22	GoverningBodyVotingMembersCnt
Independent Voting Member	16	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (1)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (1)	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	WI	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	JAMES DIETSCHE CFOVP	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	9204457260	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	744 S WEBSTER AVENUE	AddressLine1Txt
City	GREEN BAY	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54301	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (33 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Highest Compensated EmployeeHighestCompensatedEmployeeInd
TERRY FULWILER
CHAIR	0.50	Yes (X)	Yes (X)	$0	$0	$0
ELL LEE DDS
VICE CHAIR	0.50	Yes (X)	Yes (X)	$0	$0	$0
MARK MCMULLEN
SECRETARY	0.50	Yes (X)	Yes (X)	$0	$0	$0
JOHN UNDERWOOD
FORMER TREASURER	0.50	Yes (X)	Yes (X)	$0	$0	$0
NANCY ARMBRUST
BOARD MEMBER	0.50	Yes (X)		$0	$0	$0
G CORT CONDON
BOARD MEMBER	0.50	Yes (X)		$0	$0	$0
DANIEL GULLING
BOARD MEMBER	0.50	Yes (X)		$0	$0	$0
ROBERT MEAD MD - TERMED
BOARD MEMBER/PRESIDENT BMG	50.00	Yes (X)		$251,405	$0	$34,533
FRED SCHMIDT MD
BOARD MEMBER	0.50	Yes (X)		$0	$0	$0
DANIEL ARIENS
BOARD MEMBER	0.50	Yes (X)		$0	$0	$0
WILLIAM WITTMAN MD
BOARD MEMBER/BMG PHYSICIAN	50.00	Yes (X)		$294,847	$0	$25,594
LARRY BORGARD
BOARD MEMBER	0.50	Yes (X)		$0	$0	$0
JOHN JONES
BOARD MEMBER	0.50	Yes (X)		$0	$0	$0
SUSAN FINCO
BOARD MEMBER	0.50	Yes (X)		$0	$0	$0
MICHAEL HADDAD
BOARD MEMBER	0.50	Yes (X)		$0	$0	$0
LOREN FUGLESTAD MD
BOARD MEMBER/BMG PHYSICIAN	50.00	Yes (X)		$298,785	$0	$58,814
CHRISTINE VANDENHOUTEN
BOARD MEMBER	0.50	Yes (X)		$0	$0	$0
JOHN DYKEMA
TREASURER	0.50	Yes (X)	Yes (X)	$0	$0	$0
ROBERT CLAUSEN
BOARD MEMBER	0.50	Yes (X)		$0	$0	$0
GEORGE KERWIN
PRESIDENT/CEO	50.00	Yes (X)	Yes (X)	$847,178	$0	$35,246
PATRICK MANSKY MD - TERMED
BOARD MEMBER/PHYSICIAN	50.00	Yes (X)		$737,082	$0	$22,872
DENIS HOGAN
BOARD MEMBER	0.50	Yes (X)		$0	$0	$0
CYNTHIA LASECKI MD
BOARD MEMBER/PHYSICIAN	50.00	Yes (X)		$267,092	$0	$17,188
MARK RINGWELSKI MD
BOARD MEMBER/PHYSICIAN	50.00	Yes (X)		$254,486	$0	$26,784
SABINA SINGH MD
BOARD MEMBER/PHYSICIAN	50.00	Yes (X)		$241,181	$0	$16,693
JAMES DIETSCHE
CFO	50.00		Yes (X)	$361,178	$0	$30,986
PETER KNOX
EXECUTIVE VP	50.00		Yes (X)	$423,233	$0	$36,235
CHRISTINE WOLESKE
EXECUTIVE VP	50.00		Yes (X)	$378,894	$0	$36,573
CHRISTOPHER WOLFRAM MD
PHYSICIAN	40.00			$943,854	$0	$30,397	Yes (X)
TIMOTHY TANKE MD
PHYSICIAN	40.00			$875,354	$0	$30,586	Yes (X)
RICHARD TIMMONS MD
PHYSICIAN	40.00			$852,348	$0	$35,024	Yes (X)
JAMES RIDER MD
PHYSICIAN	40.00			$782,531	$0	$34,098	Yes (X)
PAUL HUDSON MD
PHYSICIAN	40.00			$823,014	$0	$37,352	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$8,632,462	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$508,975	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	261	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
BLR FURTHER LLC
4841 SUMMER AVENUE	MEMPHIS	TN	38122	ADVERTISING	$2,324,948
NORDIC CONSULTING
740 REGENT STREET SUITE 400	MADISON	WI	53715	EPIC CONSULTING SERVICES	$1,564,857
AMERI EBO LLC
1851 S ALVERNO ROAD	MANITOWOC	WI	54220	COLLECTION SERVICES	$1,503,073
IEI GENERAL CONTRACTORS INC
1725 MIDWAY ROAD	DE PERE	WI	54115	CONSTRUCTION SERVICES	$1,293,707
BAY TOWEL LINEN & UNIFORM RENTAL
2580 S BROADWAY	GREEN BAY	WI	54304	CONTRACTED SERVICES	$1,045,844

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	55	CntrctRcvdGreaterThan100KCnt
Related Organizations	$622,793	RelatedOrganizationsAmt
All Other Contributions	$474,272	AllOtherContributionsAmt
Total Contributions	$1,097,065	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
NET PATIENT SERVICE REVENUE	621500	$440,803,346	$433,663,578	$7,139,768
CONTRACTED SERVICES	621110	$3,449,030	$3,449,030
MISCELLANEOUS	621110	$2,594,951	$2,594,951
CAFETERIA	621110	$853,690			$853,690
ACO INCENTIVE	621110	$616,132	$616,132

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$875,807	TotalRevenueColumnAmt
Related Or Exempt Func Income	$69,948	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$717,591	UnrelatedBusinessRevenueAmt
Exclusion	$88,268	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$449,192,956	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$3,966,013	TotalRevenueColumnAmt
Exclusion	$3,966,013	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$3,126,293	RealAmt
Personal	$53,271	PersonalAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$2,307,581	RealAmt
Personal	$53,271	PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$818,712	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$818,712	TotalRevenueColumnAmt
Exclusion	$818,712	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$2,430,114	SecuritiesAmt
Other	$1,475,419	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt
Other	$1,893,080	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$2,430,114	SecuritiesAmt
Other	-$417,661	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,012,453	TotalRevenueColumnAmt
Exclusion	$2,012,453	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
INCOME FROM HEALTHCARE AFFILIATES	900099	$2,384,599	$2,384,599
EHR INCENTIVE	621110	$708,202	$708,202

Field	Value	IRS element (for citing)
Other Revenue Total	$3,092,801	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$460,180,000	TotalRevenueColumnAmt
Related Or Exempt Func Income	$443,486,440	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$7,857,359	UnrelatedBusinessRevenueAmt
Exclusion	$7,739,136	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$1,225,882	TotalAmt
Program Services	$1,225,882	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$4,696,878	TotalAmt
Program Services	$2,547,355	ProgramServicesAmt
Management And General	$2,149,523	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$183,486,692	TotalAmt
Program Services	$160,654,091	ProgramServicesAmt
Management And General	$22,832,601	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$8,186,167	TotalAmt
Program Services	$6,989,940	ProgramServicesAmt
Management And General	$1,196,227	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$19,996,268	TotalAmt
Program Services	$16,896,916	ProgramServicesAmt
Management And General	$3,099,352	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$11,633,747	TotalAmt
Program Services	$9,909,434	ProgramServicesAmt
Management And General	$1,724,313	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$609,287	TotalAmt
Program Services	$609,287	ProgramServicesAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$718,611	TotalAmt
Program Services	$19,930	ProgramServicesAmt
Management And General	$698,681	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$574,547	TotalAmt
Management And General	$574,547	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$27,601,305	TotalAmt
Program Services	$17,457,166	ProgramServicesAmt
Management And General	$10,144,139	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$7,138,285	TotalAmt
Program Services	$46,917	ProgramServicesAmt
Management And General	$7,091,368	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,603,951	TotalAmt
Program Services	$1,197,894	ProgramServicesAmt
Management And General	$406,057	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$7,347,313	TotalAmt
Program Services	$3,588,747	ProgramServicesAmt
Management And General	$3,758,566	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$10,782,824	TotalAmt
Program Services	$10,229,306	ProgramServicesAmt
Management And General	$553,518	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$1,090,987	TotalAmt
Program Services	$625,515	ProgramServicesAmt
Management And General	$465,472	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$1,360,295	TotalAmt
Program Services	$651,633	ProgramServicesAmt
Management And General	$708,662	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$4,441,033	TotalAmt
Program Services	$375,971	ProgramServicesAmt
Management And General	$4,065,062	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$19,273,882	TotalAmt
Program Services	$14,336,443	ProgramServicesAmt
Management And General	$4,937,439	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$1,274,621	TotalAmt
Program Services	$828,405	ProgramServicesAmt
Management And General	$446,216	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
SUPPLIES	$70,015,754	$69,244,208	$771,546
DUES/SUBSCRIPTIONS	$11,564,867	$9,769,580	$1,795,287
EQUIPMENT RENT/MAINT	$10,109,303	$766,440	$9,342,863
BAD DEBTS	$8,554,024	$8,541,603	$12,421

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$10,296,724	TotalAmt
Program Services	$879,055	ProgramServicesAmt
Management And General	$9,417,669	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$423,583,247	TotalAmt
Program Services	$337,391,718	ProgramServicesAmt
Management And General	$86,191,529	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$11,959	BOYAmt
EOY	$15,994	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$73,187,804	BOYAmt
EOY	$90,773,641	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$44,842,167	BOYAmt
EOY	$48,389,694	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$10,078,772	BOYAmt
EOY	$6,347,210	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$5,206,341	BOYAmt
EOY	$4,987,231	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$6,755,553	BOYAmt
EOY	$6,774,092	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$327,606,716	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$182,650,726	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$145,265,557	BOYAmt
EOY	$144,955,990	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$112,501,590	BOYAmt
EOY	$123,364,419	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$10,702,660	BOYAmt
EOY	$13,839,345	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$6,455,873	BOYAmt
EOY	$6,105,842	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$9,562,309	BOYAmt
EOY	$9,442,486	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$424,570,585	BOYAmt
EOY	$454,995,944	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$43,246,768	BOYAmt
EOY	$38,980,842	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$428,585	BOYAmt
EOY	$320,036	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$69,788,940	BOYAmt
EOY	$72,367,813	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$24,520,481	BOYAmt
EOY	$29,009,915	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$137,984,774	BOYAmt
EOY	$140,678,606	EOYAmt

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

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$283,186,098	BOYAmt
EOY	$310,758,298	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,084,305	BOYAmt
EOY	$1,388,632	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$2,315,408	BOYAmt
EOY	$2,170,408	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$286,585,811	BOYAmt
EOY	$314,317,338	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$424,570,585	BOYAmt
EOY	$454,995,944	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$36,596,753	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$5,593,100	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$3,272,126	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

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

Schedule A IRS990ScheduleA

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

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

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

Contributor US Address ContributorUSAddress

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

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

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$23,519	OtherActivitiesAmt
Total Lobbying Expenditures	$23,519	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1:	FormAndLineReferenceDesc
Explanation	AHA AND WHA DUES	ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

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

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

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

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

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

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

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

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$2,220,544	BeginningYearBalanceAmt
Contributions	$129,100	ContributionsAmt
Investment Earnings Or Losses	-$1,472	InvestmentEarningsOrLossesAmt
Other Expenditures	$108,994	OtherExpendituresAmt
End Year Balance	$2,239,178	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.00000	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.95060	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.04940	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	Yes (1)	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (1)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (1)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$7,155,673	OtherCostOrOtherBasisAmt
Book Value	$7,155,673	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$124,908,703	OtherCostOrOtherBasisAmt
Depreciation	$51,844,632	DepreciationAmt
Book Value	$73,064,071	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,348,682	OtherCostOrOtherBasisAmt
Depreciation	$1,750,694	DepreciationAmt
Book Value	$597,988	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$188,215,815	OtherCostOrOtherBasisAmt
Depreciation	$129,055,400	DepreciationAmt
Book Value	$59,160,415	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$4,977,843	OtherCostOrOtherBasisAmt
Book Value	$4,977,843	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$144,955,990	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDesc	AmtAmt
DEFERRED COMPENSATION	$7,784,726
NONCONTROLLING INTEREST OF CONSOLIDATED AFFILIATE	$1,042,246
CAPITAL LEASE OBLIGATIONS	$9,977,061
INTEREST RATE SWAP VALUATION	$9,159,347
DUE TO AFFILIATES	$1,046,535

Field	Value	IRS element (for citing)
Total Liability	$29,009,915	TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt	$444,882,787	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	-$5,593,100	NetUnrealizedGainsInvstAmt
Other Revenue	-$11,292,866	OtherRevenueAmt
Revenue Not Reported	-$16,885,966	RevenueNotReportedAmt
Revenue Subtotal	$461,768,753	RevenueSubtotalAmt
Other Revenues Not Included	-$1,588,753	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	-$1,588,753	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$460,180,000	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$417,672,163	TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included	-$5,371,610	OtherExpensesIncludedAmt
Expenses Not Reported	-$5,371,610	ExpensesNotReportedAmt
Expenses Subtotal	$423,043,773	ExpensesSubtotalAmt
Other Expenses Not Included	$539,474	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$539,474	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$423,583,247	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART V, LINE 4:	ENDOWMENT FUNDS ARE INTENDED TO BE USED FOR HEALTH CARE SERVICES AND EMPLOYEE TRAINING AND DEVELOPMENT.
PART XI, LINE 2D - OTHER ADJUSTMENTS:	LOSS ON SWAP AGREEMENT -1,632,401. NON-CONTROLLING INTEREST -1,928,003. LOSS OF DEBT REFUNDING -7,732,462.
PART XI, LINE 4B - OTHER ADJUSTMENTS:	TRANSFER FROM FOUNDATION 622,793. HOSPITAL SUPPLIES 149,306. RENTAL EXPENSES -2,360,852.
PART XII, LINE 2D - OTHER ADJUSTMENTS:	RENTAL EXPENSES 2,360,852. LOSS OF DEBT REFUNDING -7,732,462.
PART XII, LINE 4B - OTHER ADJUSTMENTS:	REALLOCATION OF SUPPLIES EXPENSE TO 990T 149,306. EXPENSES PAID FOR BY FOUNDATION TRANSFERS 390,168.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	0	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,056,792	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$3,056,792	NetCommunityBenefitExpnsAmt
Total Expense	0.00740	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$50,654,535	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$27,555,811	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$23,098,724	NetCommunityBenefitExpnsAmt
Total Expense	0.05570	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$53,711,327	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$27,555,811	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$26,155,516	NetCommunityBenefitExpnsAmt
Total Expense	0.06310	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$3,137,180	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$3,137,180	NetCommunityBenefitExpnsAmt
Total Expense	0.00760	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,980,152	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,980,152	NetCommunityBenefitExpnsAmt
Total Expense	0.00480	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,387,111	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,387,111	NetCommunityBenefitExpnsAmt
Total Expense	0.00330	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,504,443	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$6,504,443	NetCommunityBenefitExpnsAmt
Total Expense	0.01570	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$60,215,770	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$27,555,811	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$32,659,959	NetCommunityBenefitExpnsAmt
Total Expense	0.07880	TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,549,795	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,549,795	NetCommunityBenefitExpnsAmt
Total Expense	0.00370	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,549,795	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,549,795	NetCommunityBenefitExpnsAmt
Total Expense	0.00370	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$3,316,682	BadDebtExpenseAmt
Reimbursed By Medicare	$121,516,195	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$168,277,444	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$46,761,249	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

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

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp

Entity Name EntityName

Field	Value	IRS element (for citing)
Business Name Line1	1 BELLIN ORTHOPEDIC SURGERY CENTER LLC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Primary Activities	ORTHOPEDIC SURGERY CENTER	PrimaryActivitiesTxt
Org Profit Or Ownership	0.55000	OrgProfitOrOwnershipPct
Physicians Profit Or Ownership	0.45000	PhysiciansProfitOrOwnershipPct

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

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

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

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	744 S WEBSTER AVENUE	AddressLine1Txt
City	GREEN BAY	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54305	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.BELLIN.ORG	WebsiteAddressTxt
State License	147	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

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

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
CHNA Conducted	14	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (1)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	WWW.BELLIN.ORG/PATIENTS_VISITORS/COMPANY-INFORMATION/COMMUNITY-HEALTH	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	14	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	WWW.BELLIN.ORG/PATIENTS_VISITORS/COMPANY-INFORMATION/COMMUNITY-HEALTH	StrategyWebsiteURLTxt
Strategy Attached	Yes (1)	StrategyAttachedInd
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	400.000000000000	FPGFamilyIncmLmtDscntCarePct
Income Level Criteria	Yes (X)	IncomeLevelCriteriaInd
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	WWW.BELLIN.ORG/PATIENTS_VISITORS/PATIENT-INFORMATION/FINANCIAL-ASSISTANCE	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
FAP Notice Displayed	Yes (X)	FAPNoticeDisplayedInd
FAP Actions On Nonpayment	0	FAPActionsOnNonpaymentInd
Collection Activities	0	CollectionActivitiesInd
FAP Notified Upon Admission	Yes (X)	FAPNotifiedUponAdmissionInd
FAP Notified Before Discharge	Yes (X)	FAPNotifiedBeforeDischargeInd
FAP Notified All Patients	Yes (X)	FAPNotifiedAllPatientsInd
Documented Elig Determination	Yes (X)	DocumentedEligDeterminationInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Other Method Used	Yes (X)	OtherMethodUsedInd
Amounts Generally Billed	Yes (1)	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (8 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
BELLIN MEMORIAL HOSPITAL	PART V, SECTION B, LINE 5: THE BROWN COUNTY AND CITY OF DE PERE HEALTH DEPARTMENTS CONVENED A COMMUNITY HEALTH NEEDS ASSESSMENT STEERING COMMITTEE THAT INCLUDED REPRESENTATIVES FROM BELLIN HEALTH, ST. MARYS AND ITS SISTER HOSPITAL, ST. VINCENTS, AURORA HEALTH, BROWN COUNTY UNITED WAY, AND THE REGIONAL OFFICE OF WISCONSIN'S DEPARTMENT OF HEALTH. THIS STEERING COMMITTEE WORKED TO IDENTIFY REPRESENTATIVES THAT COULD BROADLY REPRESENT THE COMMUNITY IN ACTUALLY CONDUCTING THE NEEDS ASSESSMENT AND SETTING PRIORITIES. THESE INDIVIDUALS WERE REFERRED TO AS COMMUNITY PARTNERS AND ARE THE FOLLOWING:ACHIEVE BROWN COUNTY: ADAM HARDYAGING AND DISABILITY RESOURCE CENTER: MEREDITH HANSEN, JANELLE WATSONAURORA BAYCARE MEDICAL CENTER: AMY HERDEE, MARK HUBERBAY AREA COMMUNITY COUNCIL: BOB WOESSNERBC PLANNING AND LAND SERVICES DEPARTMENT: DAN TEATERSBELLIN COLLEGE: KATHIE DE MUTHBELLIN HEALTH: SHARLA BAENEN, LAURA CORMIER, CHRISTOPHER ELFNER, LAURA HIEB, JOHN ROCHELEAU, JODI WILMETBROWN COUNTY EXECUTIVE OFFICE: TROY STRECKENBACHBROWN COUNTY COMMUNITY TREATMENT CENTER: TINA CAZZOLABROWN COUNTY HEALTH DEPARTMENT: DEBORAH ARMBRUSTER, JUDY FRIEDERICHS, ROB GOLLMAN, STACY ROSS, PATTI SMEESTER, CHUA XIONGBROWN COUNTY HUMAN SERVICES: MARY MICELI-WINKBROWN COUNTY ORAL HEALTH PARTNERSHIP: CARRIE STEMPSKIBROWN COUNTY UNITED WAY: HOWARD ENDOW, SARAH INMAN, GREG MAASS, JILL SOBIECK, ASHLEY VANDENBOOMENCATHOLIC CHARITIES: CELIA LATOURCENTER FOR CHILDHOOD SAFETY: KIMBERLY HESSCITY OF DE PERE BOARD OF HEALTH: MIKE DONOVAN, PATRICIA FINDER-STONEDE PERE HEALTH DEPARTMENT: ERIN BONGERS, CHRYSTAL WOLLERELIZK INSURANCE: ELIZABETH KOSTICHKAGREATER GREEN BAY CHAMBER: GRANT DVORAKGREATER GREEN BAY YMCA: SANDY ATKINSHOSPITAL SISTERS HEALTH SYSTEM: ELAINE DOXTATOR, PATTI GLASER-MARTIN, HEIDI SELBERGLIBERTA: BARBARA CONIFFLIVE54218: JOHN DYE, MELINDA MORELLA, JEN VAN DEN ELZENN.E.W. COMMUNITY CLINIC: JAMIE CAMPBELL, BONNIE KUHR, SETH MOORE, CATHERINE THERRIENN.E.W. CURATIVE REHABILITATION: STEVE MCCARTHYNORTHEAST WISCONSIN TECHNICAL COLLEGE: SCOTT ANDERSONPREVEA HEALTH: ANGELA RALEIGHSCHNEIDER NATIONAL: CHRISTINE SCHNEIDERST. NORBERT COLLEGE:ST. NICHOLAS HOSPITAL: MARY PALUCHNIAKST. VINCENT HOSPITAL: DONNA BOEHM, CAROLINE GLANDER, KAITLIN SWANSONSTATE OF WISCONSIN-DIVISION OF PUBLIC HEALTH: ELIZABETH SCHEELKUNIFIED SCHOOL DISTRICT OF DE PERE: MARGIE HEMPELUW-GREEN BAY: THOMAS ERDMAN, SARAH HIMMELHEBER, CHRISTINE VANDENHOUTEN, LEANNE ZHUBROWN COUNTY UW-EXTENSION: KAREN EARLYWEST DE PERE SCHOOL DISTRICT: DAWN SCHAEFERWI DEPARTMENT OF HEALTH NORTHEAST REGION: CHRISTOPHER COLLETTA** STEERING COMMITTEE MEMBER
BELLIN MEMORIAL HOSPITAL	PART V, SECTION B, LINE 6A: AURORA BAYCARE MEDICAL CENTER (GREEN BAY) AND ST. MARY'S AND ST. VINCENT HOSPITALS (HSHS, GREEN BAY)
BELLIN MEMORIAL HOSPITAL	PART V, SECTION B, LINE 6B: BROWN COUNTY HEALTH DEPARTMENT, CITY OF DE PERE HEALTH DEPARTMENT, BROWN COUNTY UNITED WAY, AND WI DIVISION OF PUBLIC HEALTH NE REGIONAL OFFICE
BELLIN MEMORIAL HOSPITAL	PART V, SECTION B, LINE 11: THE 2012-2014 CHNA FOCUSED ON:- ORAL HEALTH- ADEQUATE AND APPROPRIATE FOOD AND NUTRITION- ALCOHOL AND OTHER DRUG ABUSE (AODA)THE 2015-2017 CHNA RECOMMENDED CONTINUED WORK IN THESE THREE AREAS. IT ALSO IDENTIFIED ADDITIONAL AREAS OF NEED AND RECOMMENDED DEVELOPING WORK TEAMS TO FOCUS ON:- MENTAL HEALTH- PHYSICAL ACTIVITY
BELLIN MEMORIAL HOSPITAL	PART V, SECTION B, LINE 22D: PATIENTS CAN QUALIFY FOR COMMUNITY CARE OR A DISCOUNT DEPENDING ON LEVEL OF QUALIFICATION PRIMARILY DEPENDENT ON INCOME LEVEL AND FAMILY SIZE. THE DISCOUNT IS TAKEN FROM 80% OF GROSS CHARGES. A FAP ELIGIBLE PATIENT WILL NEVER BE RESPONSIBLE FOR MORE THAN 15% OF THEIR ANNUAL INCOME.
BELLIN MEMORIAL HOSPITAL	PART V, SECTION B, LINE 23: THERE IS A POSSIBILITY UNDER THE POLICY AS IT CURRENTLY EXISTS THAT THIS MAY HAPPEN; HOWEVER, THE PROBABILITY IS REMOTE. A PATIENT COULD QUALIFY UNDER THE FINANCIAL ASSISTANCE AND GET A PERCENTAGE DISCOUNT (IN ADDITION TO THE 20% SELF PAY DISCOUNT) THAT IS LESS THAN THE DISCOUNT GIVEN TO AN INDIVIDUAL WITH INSURANCE. THIS WILL BE CORRECTED BY 09/30/16 TO ELIMINATE THIS REMOTE POSSIBILITY.
PART V, SECTION B, LINE 16	FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY
BELLIN MEMORIAL HOSPITAL PART V, SECTION B, LINE 16C WEBSITE:	WWW.BELLIN.ORG/PATIENTS_VISITORS/PATIENT-INFORMATION/FINANCIAL-ASSISTANCE

Field	Value	IRS element (for citing)
Facility	45	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (45 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
THE CANCER TEAM OF BELLIN HEALTH
1580 COMMANCHE AVENUE	GREEN BAY	WI	54313	HOSPITAL BASED SITE
CARDIOLOGY ASSOCIATES OF BELLIN HEALTH
744 S WEBSTER AVENUE	GREEN BAY	WI	54301	HOSPITAL BASED SITE
FAMILY MEDICAL CENTER ASHWAUBENON
1630 COMMANCHE AVENUE	GREEN BAY	WI	54313	PROVIDER CLINIC SITE
FAMILY MEDICAL CENTER DE PERE EAST
555 REDBIRD CIRCLE	DE PERE	WI	54115	PROVIDER CLINIC SITE
BELLIN HEALTH GENERATIONS
704 S WEBSTER AVENUE SUITE 300	GREEN BAY	WI	54301	PROVIDER CLINIC SITE
FAMILY MEDICAL CENTER HOWARD
2714 RIVERVIEW	GREEN BAY	WI	54313	PROVIDER CLINIC SITE
FAMILY MEDICAL CENTER BELLEVUE
3263 EATON ROAD	GREEN BAY	WI	543116830	PROVIDER CLINIC SITE
BELLIN HEALTH SURGICAL ASSOCIATES
720 S VAN BUREN STREET SUITE 201	GREEN BAY	WI	54301	PROVIDER CLINIC SITE
FAMILY MEDICAL CENTER DE PERE WEST
1800 LAWRENCE DRIVE	DE PERE	WI	54115	PROVIDER CLINIC SITE
BELLIN HEALTH IRON MOUNTAIN
440 WOODWARD AVENUE	IRON MOUNTAIN	MI	49801	PROVIDER CLINIC SITE
BELLIN HEALTH CARDIOVASCULAR & THORACIC
720 S VAN BUREN STREET SUITE 303	GREEN BAY	WI	54301	PROVIDER CLINIC SITE
BELLIN HEALTH NORTHREACH INTERNAL MEDICI
3123 SHORE DRIVE SUITE 102	MARINETTE	WI	54143	PROVIDER CLINIC SITE
BELLIN HEALTH ESCANABA
610 S LINCOLN ROAD	ESCANABA	MI	49829	PROVIDER CLINIC SITE
FAMILY MEDICAL CENTER GREEN BAY
704 S WEBSTER AVENUE	GREEN BAY	WI	54301	PROVIDER CLINIC SITE
BELLIN HEALTH NORTHREACH PEDIATRICS
1106 UNIVERSTIY DRIVE	MARINETTE	WI	54143	PROVIDER CLINIC SITE
BELLIN HEALTH NORTHREACH CRIVITZ MEDICAL
218 S HWY 141	CRIVITZ	WI	54114	PROVIDER CLINIC SITE
FAMILY MEDICAL CENTER KEWAUNEE
575 4TH STREET	KEWAUNEE	WI	54216	PROVIDER CLINIC SITE
BELLIN HEALTH NORTHREACH FAMILYCARE MEDI
3123 SHORE DRIVE	MARINETTE	WI	54143	PROVIDER CLINIC SITE
BELLIN HEALTH NORTHREACH MENOMINEE MEDIC
1100 10TH STREET	MENOMINEE	MI	49858	PROVIDER CLINIC SITE
FAMILY MEDICAL CENTER ALGOMA
831 PARKER AVENUE	ALGOMA	WI	54201	PROVIDER CLINIC SITE
NEUROLOGY CONSULTANTS OF BELLIN HEALTH
725 S WEBSTER AVENUE	GREEN BAY	WI	54301	PROVIDER CLINIC SITE
FAMILY MEDICAL CENTER BRILLION
964 W RYAN STREET SUITE B	BRILLION	WI	54110	PROVIDER CLINIC SITE
BELLIN HEALTH OCONTO FALLS
107 E HIGHLAND DRIVE	OCONTO FALLS	WI	54154	PROVIDER CLINIC SITE
BELLIN HEALTH ASTHMA & ALLERGY
519 S MONROE AVENUE	GREEN BAY	WI	54301	PROVIDER CLINIC SITE
BELLIN HEALTH NORTHREACH OBGYN
3123 SHORE DRIVE SUITE 201	MARINETTE	WI	54143	PROVIDER CLINIC SITE
FAMILY MEDICAL CENTER DENMARK
595 COUNTY ROAD R	DENMARK	WI	54208	PROVIDER CLINIC SITE
BELLIN HEALTH NORTHREACH PESHTIGO FAMILY
441 FRENCH STREET	PESHTIGO	WI	54143	PROVIDER CLINIC SITE
FAMILY MEDICAL CENTER SEYMOUR
405 COMMERCIAL STREET	SEYMOUR	WI	54165	PROVIDER CLINIC SITE
BELLIN HEALTH NORTHREACH URGENT CARE
3200 SHORE DRIVE	MARINETTE	WI	54143	PROVIDER CLINIC SITE
FAMILY MEDICAL CENTER WRIGHTSTOWN
555 QUALITY COURT	WRIGHTSTOWN	WI	54180	PROVIDER CLINIC SITE
FAMILY MEDICAL CENTER LUXEMBURG
140 B SCHOOL CREEK TRAIL	LUXEMBURG	WI	54217	PROVIDER CLINIC SITE
FAMILY MEDICAL CENTER MANITOWOC
3415 CUSTER STREET SUITE D	MANITOWOC	WI	54221	PROVIDER CLINIC SITE
BELLIN HEALTH MARINETTE MENOMINEE CLINIC
3200 SHORE DRIVE	MARINETTE	MI	54143	PROVIDER CLINIC SITE
FAMILY MEDICAL CENTER PULASKI
331 W GREEN BAY STREET	PULASKI	WI	541620109	PROVIDER CLINIC SITE
BELLIN HEALTH NORTHREACH DAGGETT MEDICAL
106 S SCHOOL ROAD	DAGGETT	MI	49821	PROVIDER CLINIC SITE
BELLIN HEALTH NORTHREACH AFTER HOURS MAR
1106 UNIVERSTIY DRIVE	MARINETTE	MI	54143	PROVIDER CLINIC SITE
BELLIN HEALTH ASTHMA & ALLERGY - NEENAH
119 E BELL STREET SUITE B	NEENAH	WI	54957	PROVIDER CLINIC SITE
BELLIN HEALTH FAST CARE ASHWAUBENON
301 BAY PARK SQUARE	GREEN BAY	WI	54304	CONVENIENT CARE CENTER
BELLIN HEALTH FAST CARE EAST TOWNE MALL
2430 E MASON STREET	GREEN BAY	WI	54302	CONVENIENT CARE CENTER
BELLIN HEALTH NORTHREACH LABORATORY
3200 SHORE DRIVE	MARINETTE	WI	54143	PROVIDER CLINIC SITE
FAMILY MEDICAL CENTER BONDUEL
401 W MILL STREET	BONDUEL	WI	54107	PROVIDER CLINIC SITE
BELLIN HEALTH ENDOCRINOLOGY
720 S VAN BUREN STREET SUITE 104	GREEN BAY	WI	54301	PROVIDER CLINIC SITE
BELLIN HEALTH FAST CARE SUAMICO
2318 LINEVILLE ROAD	SUAMICO	WI	54173	CONVENIENT CARE CENTER
BELLIN HEALTH NORTHREACH FAST CARE MARIN
2741 ROOSEVELT ROAD	MARINETTE	MI	54143	CONVENIENCE CARE CENTER
FAMILY MEDICAL CENTER SURING
307 MANOR DRIVE	SURING	WI	54174	PROVIDER CLINIC SITE

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 6A:	BELLIN MEMORIAL HOSPITAL IN INCLUDED IN THE BELLIN HEALTH SYSTEMS, INC. COMMUNITY BENEFIT REPORT.
PART I, LINE 7:	AMOUNTS ARE CALCULATED BASED ON COST TO CHARGE RATIOS AND AMOUNTS PER THE FINANCIAL STATEMENTS.
PART I, LN 7 COL(F):	BAD DEBT EXPENSE OF $8,554,024 INCLUDED ON FORM 990, PART IX, LINE 25 WAS EXCLUDED FROM THE DENOMINATOR PER INSTRUCTIONS WHEN CALCULATING THE PERCENT TOTAL EXPENSES ON SCHEDULE H.
PART II, COMMUNITY BUILDING ACTIVITIES:	COMMUNITY BUILDING ACTIVITIES FOCUS ON SOCIAL CONDITIONS THAT CONTRIBUTE TO HEALTH PROBLEMS, SUCH AS HOMELESSNESS, POVERTY, AND OTHER LIVING CONDITIONS AFFECTING THE QUALITY OF LIFE. THESE RANGE FROM DEVELOPING COMMUNITY LEADERS, DISASTER READINESS, AND SUPPORT OF LOCAL ECONOMIC DEVELOPMENT, TO HEALTH IMPROVEMENT ADVOCACY. BELLIN MEMORIAL HOSPITAL IS ACTIVE IN THE GREEN BAY PUBLIC SCHOOLS WITH OUR THRIVE PROGRAM THAT ASSISTS IN SETTING AND MEETING HEALTH AND WELLNESS GOALS FOR STUDENTS IN THIS SCHOOL SYSTEM. BELLIN ALSO HOLDS AN ANNUAL BELLIN RUN/WALK 10K EVENT EACH YEAR WITH OVER 18,000 PARTICIPANTS OF ALL AGES LEARNING FIRST HAND THE VALUE OF EXERCISE IN DAILY LIFE.
PART III, LINE 4:	THE ATTACHED FINANCIAL STATEMENTS DO NOT CONTAIN A SPECIFIC BAD DEBT EXPENSE FOOTNOTE. HOWEVER, THE SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES DESCRIBES THE PROVISION FOR BAD DEBT ON PAGES 13 AND 14 OF THE FINANCIAL STATEMENTS. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR A PORTION OF THE BILL), BELLIN HEALTH SYSTEMS RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCES FOR DOUBTFUL ACCOUNTS.
PART III, LINE 8:	THE AMOUNTS REPORTED FOR MEDICARE WERE CALCULATED USING A COST TO CHARGE RATIO. THE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT FOR THE FOLLOWING REASONS. IRS REV RUL 69-545 WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS STATES THAT IF A HOSPITAL SERVICES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. IN ADDITION, FOR-PROFIT HOSPITALS HAVE CARVED OUT HIGH-MARGIN SERVICES (I.E. ONCOLOGY, ORTHO, ETC) LEAVING GENERAL ACUTE CARE HOSPITALS WITH LOWER-MARGIN MEDICARE SERVICES. THIS MEANS THAT THE SHORTFALL IS NOT NECESSARILY FROM INEFFICIENT OPERATIONS. MEDICARE CAN BE THE LARGEST PAYOR AND HOSPITALS HAVE NO ABILITY TO DENY COVERAGE. THIS, IN TURN, IS A PROMOTION OF ACCESS TO HEALTHCARE SERVICES (A COMMUNITY BENEFIT). ALSO, ELDERLY PATIENTS ARE OFTEN UNDERSERVED AND EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES.
PART III, LINE 9B:	PATIENTS EXPRESSING CONCERNS ABOUT THEIR ABILITY TO PAY FOR SERVICES ARE OFFERED INFORMATION ABOUT OUR COMMUNITY CARE PROGRAM AND, IF REQUESTED, ARE PROVIDED A COMMUNITY CARE APPLICATION. A COMPLETED APPLICATION WILL BE RETURNED ALONG WITH A COPY OF THE MOST RECENT FEDERAL INCOME TAX RETURN. WE MAY ALSO REQUEST THE MOST RECENT THREE MONTHS OF CHECK STUBS, AND EMPLOYER LETTER OR PROOF OF OTHER EARNINGS (SOCIAL SECURITY, PENSION, DISABILITY INCOME). IN ADDITION WE WILL REVIEW THE NET ASSETS AVAILABLE TO BE USED TOWARDS PAYMENT OF THE BILL. ONCE A COMPLETED APPLICATION AND OTHER MATERIALS ARE RECEIVED THEY WILL BE REVIEWED BY A FINANCIAL ADVISOR. THE ADJUSTED INCOME WHICH IS DETERMINED WILL BE COMPARED TO GOVERNMENT FEDERAL POVERTY GUIDELINES AND THE APPROVED DISCOUNT FROM FULL CHARGES WILL BE DETERMINED BASED ON WHERE THE PATIENT FALLS WITHIN OUR GUIDELINES.
PART VI, LINE 2:	BELLIN MEMORIAL HOSPITAL HAS COMPLETED A COMMUNITY NEEDS ASSESSMENT AND IT IS POSTED ON BELLIN.ORG
PART VI, LINE 3:	FINANCIAL COUNSELORS ADVISE PATIENTS OF ASSISTANCE PROGRAMS AS WELL AS SERVICE CALLED HRS ERASE IS USED TO REVIEW SELF PAY ACCOUNTS FOR POSSIBLE COVERAGE THROUGH GOVERNMENT PROGRAMS.
PART VI, LINE 4:	BELLIN MEMORIAL HOSPITAL SERVES NORTHEAST WISCONSIN AND UPPER MICHIGAN. OUR CURRENT PAYOR SUPPLEMENTAL INFORMATION MIX IS 44.3% MEDICARE AND 10.98% MEDICAID. 12% OF THE POPULATION IS BELOW THE POVERTY LEVEL AND 13.5% OF THE POPULATION IS OVER AGE 65.
PART VI, LINE 5:	A MAJORITY OF BELLIN MEMORIAL HOSPITAL'S GOVERNING BODY IS COMPRISED OF PERSON WHO RESIDE IN BELLIN MEMORIAL HOSPITAL'S PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEROF. IN ADDITION, BELLIN MEMORIAL HOSPITAL EXTENDS MEDICAL STAFF PRIVELEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR ALL OF ITS DEPARTMENTS. BELLIN MEMORIAL HOSPITAL APPLIES SURPLUS FUNDS TO IMPROVEMENTS IN PATIENT CARE, EDUCATION AND FACILITIES.
PART VI, LINE 6:	BELLIN HEALTH IS A COMMUNITY-OWNED NOT-FOR-PROFIT ORGANIZATION RESPONSIBLE FOR THE PHYSICAL AND EMOTIONAL HEALTH OF PEOPLE LIVING IN NORTHEAST WISCONSIN AND THE UPPER PENINSULA OF MICHIGAN. DIRECTLY, AND IN PARTNERSHIP WITH COMMUNITIES, EMPLOYERS, SCHOOLS, AND GOVERNMENT OFFICIALS, WE GUIDE INDIVIDUALS AND FAMILIES IN THEIR LIFELONG JOURNEY TOWARD OPTIMAL HEALTH. WE ARE COMMITTED TO PROVIDING SAFE, RELIABLE, COST-EFFECTIVE TOTAL HEALTH SOLUTIONS WITH RESPECT AND COMPASSION. OUR INNOVATIVE WORK WILL IMPACT HEALTHCARE DELIVERY IN OUR REGION AS WELL AS THROUGHOUT THE WORLD.
PART VI, LINE 7, REPORTS FILED WITH STATES	WI

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (16 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt
NEW COMMUNITY CLINIC
622 BODART STREET	GREEN BAY	WI	54301	391200636	501(C)3	$100,000	SUPPORT FREE COMMUNITY HEALTH CLINIC
GREEN BAY PUBLIC SCHOOLS
PO BOX 23387	GREEN BAY	WI	543053387	396002329	GOVT - PUBLIC SCHOOL	$63,333	HEALTH & WELLNESS PROGRAM
FESTIVAL FOODS TURKEY TROT
2250 WEST MASON STREET	GREEN BAY	WI	54303	391814712		$15,000	TURKET TROT RUN FOR CHARITY
ENCOMPASS EARLY EDUCATION & CARE
PO BOX 1627	GREEN BAY	WI	54305	390824004	501(C)3	$5,000	DONATION
KIWANIS SKI CLUB
PO BOX 475	IRON MOUNTAIN	MI	49801	383254313	501(C)3	$25,000	DONATION
UW OSHKOSH
842 ALGOMA BOULEVARD	OSHKOSH	WI	54901	391805963	GOVT - STATE AGENCY	$60,000	SUPPORT ORGANIZATION'S ACTIVITIES
NORTHEAST WISCONSIN TECHNICAL COLLEGE
2740 WEST MASON STREET	GREEN BAY	WI	54307	391087141	GOVT - STATE AGENCY	$20,000	HEALTH SCIENCE SIMULATION LAB
SCHOOL DISTRICT OF WEST DEPERE
665 GRANT STREET	DE PERE	WI	54115		GOVT - PUBLIC SCHOOL	$33,333	DONATION
GREATER GREEN BAY COMMUNITY FOUNDATION
310 WEST WALNUT STREET SUITE 350	GREEN BAY	WI	54303	391699966	501(C)3	$5,000	GREEN BAY NEIGHBORHOOD LEADERSHIP COUNCIL
BROWN COUNTY UNITED WAY
112 NORTH ADAMS STREET SUITE 201	GREEN BAY	WI	54301	390806299	501(C)3	$21,069	DONATION
UNIVERSITY OF WISCONSIN - GREEN BAY FOUNDATION
2420 NICOLET DRIVE	GREEN BAY	WI	543117001	391805963	GOVT - PUBLIC SCHOOL	$20,000	MEMORIAL SCHOLARSHIP
BROWN COUNTY MEDICAL SOCIETY ALLIANCE
563 CARTER COURT SUITE B	KIMBERLY	WI	54136	391516026	501(C)3	$5,000	SPONSORSHIP
BELLIN COLLEGE
3201 EATON ROAD	GREEN BAY	WI	54311	391620530	501(C)3	$774,446	BUILD OUT LAB AND LEARNING SPACE
BELLIN COLLEGE
3201 EATON ROAD	GREEN BAY	WI	54311	391620530	501(C)3	$12,500	NURSING CAMPS
ALZHEIMERS NE WISCONSIN CHAPTER
2900 CURRY LANE SUITE A	GREEN BAY	WI	54311	133039601	501(C)3	$6,200	FUNDRAISER EVENTS
GREATER GREEN BAY COMMUNITY FOUNDATION
310 WEST WALNUT STREET SUITE 350	GREEN BAY	WI	54303	391699966	501(C)3	$60,000	ACHIEVE BROWN COUNTY

Field	Value	IRS element (for citing)
Total501c3 Org	15	Total501c3OrgCnt
Total Other Org	1	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

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

Schedule J IRS990ScheduleJ

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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (16 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
ROBERT MEAD MD - TERMED
BOARD MEMBER/PRESIDENT BMG	$203,948	$0	$46,683	$0	$774	$0	$14,345	$0	$20,188	$0	$285,938	$0	$0	$0
WILLIAM WITTMAN MD
BOARD MEMBER/BMG PHYSICIAN	$222,927	$0	$70,732	$0	$1,188	$0	$9,847	$0	$15,747	$0	$320,441	$0	$0	$0
LOREN FUGLESTAD MD
BOARD MEMBER/BMG PHYSICIAN	$186,428	$0	$112,087	$0	$270	$0	$39,184	$0	$19,630	$0	$357,599	$0	$0	$0
GEORGE KERWIN
PRESIDENT/CEO	$499,437	$0	$305,100	$0	$42,641	$0	$18,141	$0	$17,105	$0	$882,424	$0	$0	$0
PATRICK MANSKY MD - TERMED
BOARD MEMBER/PHYSICIAN	$603,874	$0	$132,794	$0	$414	$0	$13,050	$0	$9,822	$0	$759,954	$0	$0	$0
CYNTHIA LASECKI MD
BOARD MEMBER/PHYSICIAN	$117,516	$0	$149,306	$0	$270	$0	$13,611	$0	$3,577	$0	$284,280	$0	$0	$0
MARK RINGWELSKI MD
BOARD MEMBER/PHYSICIAN	$201,100	$0	$52,612	$0	$774	$0	$8,991	$0	$17,793	$0	$281,270	$0	$0	$0
SABINA SINGH MD
BOARD MEMBER/PHYSICIAN	$162,189	$0	$78,722	$0	$270	$0	$9,371	$0	$7,322	$0	$257,874	$0	$0	$0
JAMES DIETSCHE
CFO	$300,908	$0	$60,000	$0	$270	$0	$9,514	$0	$21,472	$0	$392,164	$0	$0	$0
PETER KNOX
EXECUTIVE VP	$302,459	$0	$120,000	$0	$774	$0	$18,988	$0	$17,247	$0	$459,468	$0	$0	$0
CHRISTINE WOLESKE
EXECUTIVE VP	$301,793	$0	$60,000	$0	$17,101	$0	$16,385	$0	$20,188	$0	$415,467	$0	$0	$0
CHRISTOPHER WOLFRAM MD
PHYSICIAN	$536,182	$0	$407,492	$0	$180	$0	$11,767	$0	$18,630	$0	$974,251	$0	$0	$0
TIMOTHY TANKE MD
PHYSICIAN	$531,121	$0	$343,819	$0	$414	$0	$12,956	$0	$17,630	$0	$905,940	$0	$0	$0
RICHARD TIMMONS MD
PHYSICIAN	$533,224	$0	$318,350	$0	$774	$0	$13,621	$0	$21,403	$0	$887,372	$0	$0	$0
JAMES RIDER MD
PHYSICIAN	$502,207	$0	$280,144	$0	$180	$0	$11,957	$0	$22,141	$0	$816,629	$0	$0	$0
PAUL HUDSON MD
PHYSICIAN	$651,134	$0	$171,700	$0	$180	$0	$13,354	$0	$23,998	$0	$860,366	$0	$0	$0

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

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

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Total ProceedsTotalProceedsAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Substantial CompletionSubstantialCompletionYr	Current RefundingCurrentRefundingInd	Advance RefundingAdvanceRefundingInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd	Other Spent ProceedsOtherSpentProceedsAmt
A	$2,815,000	$12,944,000	$79,844	2001	Yes (1)	0	Yes (1)	Yes (1)
B		$44,994,006	$528,236	2009	0	Yes (1)	Yes (1)	Yes (1)	$44,465,770

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Any Research AgreementsAnyResearchAgreementsInd	Private Bus Use By OthersPrivateBusUseByOthersPct	Total Private Business UseTotalPrivateBusinessUsePct	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd	Engage Bond Counsel ContractsEngageBondCounselContractsInd
A	0	Yes (1)	0	0	0.00970	0.00970	0	0	Yes (1)
B	0	Yes (1)	Yes (1)	0	0.01000	0.01000	Yes (1)	0	Yes (1)	Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

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

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

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

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
INTEGRYS ENERGY GROUP INC
BOARD MEMBER LARRY BORGARD IS PRESIDENT & COO - UTILITIES AT INTEGRYS	$3,232,227	INTEGRYS ENERGY GROUP PROVIDES UTILITY SERVICES TO BELLIN MEMORIAL HOSPITAL	0
ASSOCIATED BANK
BOARD MEMBER DENIS HOGAN IS MARKET PRESIDENT	$211,539	BANKING SERVICES	0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6	THE ORGANIZATION HAS ONE CORPORATE MEMBER, BELLIN HEALTH SYSTEMS, INC.
FORM 990, PART VI, SECTION A, LINE 7A	THE CORPORATE MEMBER, BELLIN HEALTH SYSTEMS, INC. HAS THE POWER TO APPOINT AND REMOVE BOARD MEMBERS.
FORM 990, PART VI, SECTION A, LINE 7B	THE CORPORATE MEMBER, BELLIN HEALTH SYSTEMS, INC., HAS THE POWER TO APPROVE MAJOR EXPENDITURES AND LONG-TERM BORROWINGS.
FORM 990, PART VI, SECTION B, LINE 11	THE FORM 990 IS REVIEWED IN DETAIL BY SENIOR ADMINISTRATION AND IS PRESENTED TO THE EXECUTIVE COMMITTEE IN ITS ENTIRETY FOR A REVIEW OF THE DOCUMENT.
FORM 990, PART VI, SECTION B, LINE 12C	EACH YEAR A CONFLICT OF INTEREST REQUEST DOCUMENT IS PROVIDED TO EACH BOARD MEMBER. ALL DOCUMENTS ARE PROVIDED BACK TO ADMINISTRATION AND REVIEWED. ALL EMPLOYEES ARE REQUIRED TO REVIEW THE CONFLICT OF INTEREST POLICY AS PART OF ANNUAL MANDATORY EDUCATION. IF THERE IS A CONFLICT OF INTEREST, THE CORPORATE COMPLIANCE OFFICER AND CORPORATE COMPLIANCE COMMITTEE WHICH IS A COMMITTEE OF THE BOARD OF DIRECTORS IS NOTIFIED. THE CORPORATE COMPLIANCE OFFICER AND CORPORATE COMPLIANCE COMMITTEE ADDRESSES THE ISSUE.
FORM 990, PART VI, SECTION B, LINE 15	COMPENSATION FOR THE CEO AND KEY EXECUTIVES ARE SET BY THE EXECUTIVE COMMITTEE OF THE BOARD SUPPORTED BY MARKET DATA FROM SURVEYS AND AN INDEPENDENT CONSULTANTS REPORT. THE COMPENSATION IS DETERMINED BY MEMBERS OF THE EXECUTIVE COMMITTEE WITHOUT CONFLICT AND IS DOCUMENTED. CEO COMPENSATION: CEO PRESENTS RESULTS OF PERFORMANCE OBJECTIVES TO THE EXECUTIVE COMMITTEE IN JANUARY OF EACH YEAR. THE CHAIR APPLIES A FORMULA TO THE RESULTS AND COMES UP WITH A RECOMMENDATION. THE CHAIR FACILITATES GETTING APPROVAL FROM OTHER MEMBERS OF THE EXECUTIVE COMMITTEE. SENIOR LEADERS: COMPENSATION FOR THOSE WHO REPORT TO THE CEO IS TAKEN TO THE EXECUTIVE COMMITTEE FOR DISCUSSION/APPROVAL.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION BELIEVES THE FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND POLICIES ARE THE PROPERTY OF THE ORGANIZATION AND ARE NOT AVAILABLE FOR PUBLIC INSPECTION.
FORM 990, PART XI, LINE 9:	CHANGE IN INTEREST IN FOUNDATION 288,278. INTEREST RATE SWAP AGREEMENT -1,632,401. NON-CONTROLLING INTEREST IN CONSOLIDATED AFFILIATE -1,928,003.
FORM 990, PART XI, LINE 2B-2C	BELLIN MEMORIAL HOSPITAL, INC. IS INCLUDED IN THE CONSOLIDATED AUDIT OF BELLIN HEALTH SYSTEMS, INC. THE BOARD OF DIRECTORS OF BELLIN HEALTH SYSTEMS, INC. ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT AUDITOR. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

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

US Address USAddress

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

Field	Value	IRS element (for citing)
EIN	391999260	EIN
Primary Activities	PRIMARY AND SPECIALTY PHYSICIAN CLINICS	PrimaryActivitiesTxt
Legal Domicile State	WI	LegalDomicileStateCd
Total Income	$14,043,902	TotalIncomeAmt
End Of Year Assets	$4,393,213	EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

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

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 entries)

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

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Predominant Income TypePredominantIncomeTypeTxt	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Disproportionate AllocationsDisproportionateAllocationsInd	General Or Managing PartnerGeneralOrManagingPartnerInd	OwnershipOwnershipPct	Direct Controlling NADirectControllingNACd
BELLIN ORTHOPEDIC SURGERY CENTER LLC
2223 LIME KILN RD	GREEN BAY	WI	54311	264677834	AMBULATORY ORTHOPEDIC SURGERY	WI	BELLIN MEMORIAL HOSPITAL INC	RELATED	$2,717,271	$708,968	0	0	0.55000
D1 SPORTS TRAINING OF GREEN BAY LLC
SOUTH SPRINGS DRIVE	FRANKLIN	TN	37067	454848172	SPORTS TRAINING	TN								N/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

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

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

Transactions Related Org TransactionsRelatedOrgGrp (13 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
OCONTO HOSPITAL & MEDICAL CENTER
D	$12,716,664	ACTUAL
OCONTO HOSPITAL & MEDICAL CENTER
D	$3,058,756	ACTUAL
OCONTO HOSPITAL & MEDICAL CENTER
O	$688,551	ACTUAL
OCONTO HOSPITAL & MEDICAL CENTER
M	$1,105,247	ACTUAL
OCONTO HOSPITAL & MEDICAL CENTER
Q	$4,050,000	ACTUAL
BELLIN COLLEGE
B	$786,946	ACTUAL
BELLIN HEALTH FOUNDATION
C	$622,793	ACTUAL
BELLIN PSYCHIATRIC CENTER
L	$1,926,768	ACTUAL
BELLIN PSYCHIATRIC CENTER
J	$5,818	ACTUAL
BELLIN PSYCHIATRIC CENTER
D	$3,291,878	ACTUAL
BELLIN COLLEGE
L	$297,638	ACTUAL
BELLIN COLLEGE
N	$329,760	ACTUAL
BELLIN HEALTH FOUNDATION
Q	$422,207	ACTUAL