2015-05-12T14:19:36-05:00 2014-06-30 861065772 Deloitte Tax LLP 555 East Wells Street Suite 1400 Milwaukee WI 53202 990 2013-07-01 391965593 Ministry Medical Group Inc MINI 4143591060 11925 W Lake Park Drive 100 Milwaukee WI 532243014 Jeffrey Francis Ministry Health Care CAFO 4143591060 2015-05-12 1 Rachel Becker P00966076 4142713000 2013 2016-03-07 17:11:31Z Michael P Hanson 11925 W Lake Park Drive 100 Milwaukee WI 532243014 126896000 0 0928 X www.ministryhealth.org X 1999 WI To improve the health and well-being of all people in the communities we serve. 6 0 937 0 0 0 0 0 91858203 126896000 0 0 0 0 91858203 126896000 8000 8000 0 0 91575391 125330673 0 0 0 274812 1557327 91858203 126896000 0 0 15830210 16508739 16260657 16897404 -430447 -388665 Ministry Medical Group, Inc.'s mission is to further the healing ministry of Jesus by continually improving the health and well-being of all people, especially the poor. We provide health care services to the community regardless of a person's ability to pay. 0 0 123748238 8000 126896000 Ministry Medical Group, Inc. ("MMG") provides health care services regardless of an individual's ability to pay or methods of payment. Health care services of approximately 454,039 patient visits is provided at 25 sites in rural North Central Wisconsin and includes the provision of charity care. MMG also provides educational programs and services on healthcare issues to the community it serves. 123748238 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 2 0 1 937 1 0 0 0 0 0 0 0 0 0 0 X 6 0 1 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 X Jeffrey Francis 4143593145 222 W College Avenue 3rd Floor Appleton WI 54911 Robert M Sookochoff MD President 40.00 1.00 X X 530981 0 46232 Michael P Hanson COO (Non-Voting) 35.00 5.30 X X 459952 0 45950 Mark Fenlon MD Board Member/CR Regional VP 40.00 0.00 X X 463872 0 49739 Pete Sanderson MD Board Member/NR Regional VP 40.00 0.00 X X 291276 0 74860 Terri Hahn MD Board Member 40.00 0.20 X 221852 0 58260 Theodore Shinners MD Board Member 40.00 0.00 X 795517 0 84598 Robert Tillotson DO Board Member 40.00 0.00 X 622907 0 74818 James Stewart Watson President & CEO (Thru 1/14) 40.00 0.00 X X 731049 0 22096 Nicholas Desien Ministry Health Care CEO 1.00 55.30 X 0 2061606 41974 Jeffrey Francis Ministry Health Care CAFO 1.00 64.90 X 0 522252 124025 Katherine A Richards-Bess VP - Northern Region 40.00 0.00 X 233114 0 43361 Steven R Brown Physician, Clinic 40.00 0.00 X 867081 0 89819 Anthony J Rutkowski Physician 40.00 0.00 X 882338 0 84177 Jonathan W Currie Physician 40.00 0.00 X 871617 0 71913 James Dyreby Physician 40.00 0.00 X 714913 0 67297 Andrew M Wilke Physician 40.00 0.00 X 742454 0 82836 Jeff Badger Former Officer 1.00 51.00 X 0 497813 62987 William J Hinner Former Officer 0.00 40.30 X 0 280084 42118 8428923 3361755 1167060 142 1 1 0 0 Net Patient Revenue 622110 101643160 101643160 Services to Affiliates 622110 16095840 16095840 Anesthesia Allocation 622110 4143256 4143256 Weston/RibMtn Alloc. 622110 2424570 2424570 Merrill Allocation 622110 744884 744884 1844290 1844290 126896000 126896000 126896000 0 0 8000 8000 4097289 2418458 1678831 96377967 95524245 853722 6980778 6947904 32874 12674858 12266015 408843 5199781 5026289 173492 91878 91878 818295 818295 647154 647154 126896000 123748238 3147762 0 1031768 723792 506506 506506 1153203 1142019 3335709 3073997 190828 12471 951913 125945 656958 825968 57077 103816 8898161 10120170 15830210 16508739 12825369 13622001 1131161 1123467 2304127 2151936 16260657 16897404 X -430447 -388665 0 0 -430447 -388665 15830210 16508739 X 0 41782 X 0 1 X 1 1 1 X X X 0 0 0 Ministry Health Care Inc 391490371 Line 11A- Supported 1 1 1 0 1 0 Part I, Line 11h: Ministry Medical Group, Inc. provided non-cash reimbursements for expenses with a value of $18,904,359 to Ministry Health Care, Inc. 247774 247774 354550 33611 320939 349589 92334 257255 825968 Other Provider-Based Clinic Assets 10119177 Other Assets 993 10120170 Intercompany Liability with Ministry Health Care, Inc. 2000000 Other Liabilities 151936 2151936 X Part X, Line 2: From the consolidated audited financial statements of Ministry Health Care, Inc., which includes the activity of Ministry Medical Group, Inc.: 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. X 1 1 0 1 0 0 0 0 0 0 0 Robert M Sookochoff MD President 359241 0 36105 0 135635 0 30300 0 15932 0 577213 0 0 0 Michael P Hanson COO (Non-Voting) 299202 0 45610 0 115140 0 30300 0 15650 0 505902 0 0 0 Mark Fenlon MD Board Member/CR Regional VP 312483 0 32823 0 118566 0 30300 0 19439 0 513611 0 0 0 Pete Sanderson MD Board Member/NR Regional VP 235703 0 0 0 55573 0 45160 0 29700 0 366136 0 0 0 Terri Hahn MD Board Member 178429 0 0 0 43423 0 38525 0 19735 0 280112 0 0 0 Theodore Shinners MD Board Member 745578 0 0 0 49939 0 40100 0 44498 0 880115 0 0 0 Robert Tillotson DO Board Member 565665 0 0 0 57242 0 44893 0 29925 0 697725 0 0 0 James Stewart Watson President & CEO (Thru 1/14) 448800 0 91492 0 190757 0 15000 0 7096 0 753145 0 0 0 Nicholas Desien Ministry Health Care CEO 0 1004953 0 329299 0 727354 0 15000 0 26974 0 2103580 0 0 Jeffrey Francis Ministry Health Care CAFO 0 427032 0 63804 0 31416 0 101523 0 22502 0 646277 0 0 Katherine A Richards-Bess VP - Northern Region 174156 0 17663 0 41295 0 25109 0 18252 0 276475 0 0 0 Steven R Brown Physician, Clinic 807344 0 0 0 59737 0 45600 0 44219 0 956900 0 0 0 Anthony J Rutkowski Physician 812387 0 0 0 69951 0 40100 0 44077 0 966515 0 0 0 Jonathan W Currie Physician 799573 0 5000 0 67044 0 40100 0 31813 0 943530 0 0 0 James Dyreby Physician 651693 0 0 0 63220 0 45600 0 21697 0 782210 0 0 0 Andrew M Wilke Physician 680993 0 5000 0 56461 0 40100 0 42736 0 825290 0 0 0 Jeff Badger Former Officer 0 405962 0 56934 0 34917 0 44888 0 18099 0 560800 0 0 William J Hinner Former Officer 0 243208 0 14811 0 22065 0 28175 0 13943 0 322202 0 0 Part I, Line 1a Ministry Medical Group, Inc. made payments for health or social club dues/orientation fees for one officer. The personal use of those facilities is included in the taxable income of the recipient and in Column B (III) on Schedule J, Part II. The provision of these benefits is evaluated by an independent consultant on behalf of the compensation committee of the board of directors. Part I, Line 3 Ministry Health Care, Inc., a related organization of Ministry Medical Group, Inc., uses the following to establish the compensation of the organization's CEO: - Compensation Committee - Independent Compensation Consultant - Compensation Survey or Study, and - Approval by the Board or Compensation Committee Part I, Line 4b 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 with the 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 II, Column B in the year paid. The following individuals received current year distributions of: Mark Fenlon $68,212 Michael Hanson $62,861 Katherine Richards-Bess $17,633 Robert Sookochoff $90,775 Form 990, Part VI, Section A, line 2 Many of the persons listed on Part VII have a "business relationship" with each other by virtue of employment by related Ministry Health Care, Inc. related entities. Form 990, Part VI, Section A, line 4 Ministry Medical Group, Inc. ("MMG") has begun the process of standardizing their governing documents to reflect the change in sponsorship from Marian Health System, Inc. to Ascension Health. MMG has amended and restated its Articles of Incorporation and Bylaws which are effective starting October 1, 2013. Form 990, Part VI, Section A, line 6 Ministry Medical Group, Inc. has a single corporate member, Ministry Health Care, Inc. Form 990, Part VI, Section A, line 7a Ministry Medical Group, Inc. has a single corporate member, Ministry Health Care, Inc., who has the ability to elect members to the governing body of Ministry Medical Group, Inc. Form 990, Part VI, Section A, line 7b All decisions that have a material impact to Ministry Medical Group, Inc. financial information or corporation as a whole are subject to approval by its sole corporate member, Ministry Health Care, Inc. Form 990, Part VI, Section B, line 11 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, Section B, line 12c 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 Conflicts 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, Section B, line 15 In determining compensation of the organization's CEO, the process performed by Ministry Health Care, Inc., a related organization of Ministry Medical Group, Inc., 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 Ministry Medical Group, Inc. 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, Section C, line 19 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, Conflicts of Interest Policy, and financial statements are not included on any web page. However, if an inquiry is made for any documents they are shared as appropriate. Form 990, Part XI, line 9: Corporate Funding of Change in Equity 41,782. Ascension Health Alliance PO BOX 45998 St Louis MO 631455998 453358926 National Health System MO Section 501(c)(3) Schedule A, Line 11a N/A 0 Ascension Health PO Box 45998 St Louis MO 631453806 311662309 National Health System MO Section 501(c)(3) Schedule A, Line 11a Ascension Health Alliance 0 Ministry Health Care Inc 10925 W Lake Park Dr Ste 100 Milwaukee WI 53224 391490371 Parent Corporation WI Section 501(c)(3) Schedule A, Line 11b Ascension Health 0 Agape Community Center of Milwaukee Inc 6100 North 42nd Street Milwaukee WI 532093560 391461846 Community Center WI Section 501(c)(3) Schedule A, Line 7 Ministry Health Care Inc 1 Calumet Medical Center Inc 614 Memorial Drive Chilton WI 53014 390905385 Hospital WI Section 501(c)(3) Schedule A, Line 3 Affinity Health System 1 Catalpa Health Inc N4642 County N Appleton WI 54914 454681563 Mental Health Facility WI Section 501(c)(3) Schedule A, Line 3 St Elizabeth Hospital Inc 1 Saint Michael's Foundation of Stevens Point Inc 900 Illinois Avenue Stevens Point WI 54481 391657410 Charitable Foundation WI Section 501(c)(3) Schedule A, Line 11a Saint Michael's Hospital of Stevens Point Inc 1 Door County Memorial Hospital 323 South 18th Avenue Sturgeon Bay WI 54235 390806324 Hospital WI Section 501(c)(3) Schedule A, Line 3 Ministry Health Care Inc 1 Dr Kate Newcomb Convalescent Center Inc PO Box 829 Woodruff WI 54568 391357365 LTC Facility WI Section 501(c)(3) Schedule A, Line 9 Howard Young Health Care Inc 1 Eagle River Memorial Hospital Incorporated 201 Hospital Road Eagle River WI 54521 390985690 Hospital WI Section 501(c)(3) Schedule A, Line 3 The Howard Young Medical Center Inc 1 Foundation of Saint Clare's Hospital of Weston Inc 3400 Ministry Parkway Weston WI 54476 753193633 Charitable Foundation WI Section 501(c)(3) Schedule A, Line 11a Ministry Health Care Inc 1 Foundation of Saint Joseph's Hospital of Marshfield Inc 611 Saint Joseph Avenue Marshfield WI 54449 391684957 Charitable Foundation WI Section 501(c)(3) Schedule A, Line 11a Saint Joseph's Hospital of Marshfield Inc 1 Good Samaritan Health Center of Merrill Wisconsin Inc 601 South Center Avenue Merrill WI 54452 390808503 Hospital WI Section 501(c)(3) Schedule A, Line 3 Ministry Health Care Inc 1 Good Samaritan Health Center Foundation of Merrill Wisconsin Inc 601 South Center Avenue Merrill WI 54452 391627755 Charitable Foundation WI Section 501(c)(3) Schedule A, Line 11a Good Samaritan Health Center of Merrill Wisconsin Inc 1 Howard Young Foundation Inc 240 Maple Street Woodruff WI 54568 391521169 Charitable Foundation WI Section 501(c)(3) Schedule A, Line 7 Howard Young Health Care Inc 1 Howard Young Health Care Inc 240 Maple Street Woodruff WI 54568 391499115 Home Office WI Section 501(c)(3) Schedule A, Line 11b Ministry Health Care Inc 1 The Howard Young Medical Center Inc 240 Maple Street Woodruff WI 54568 390873606 Hospital WI Section 501(c)(3) Schedule A, Line 3 Howard Young Health Care Inc 1 Mercy Health Foundation Inc PO Box 3370 Oshkosh WI 54903 237140261 Charitable Foundation WI Section 501(c)(3) Schedule A, Line 9 Affinity Health System 1 Mercy Medical Center of Oshkosh Inc 500 S Oakwood Road Oshkosh WI 54904 390806268 Hospital WI Section 501(c)(3) Schedule A, Line 3 Ministry Health Care Inc 1 Ministry Home Care Inc 611 St Joseph Avenue 4S Marshfield WI 54449 391936201 Home Care/Hospice WI Section 501(c)(3) Schedule A, Line 9 Ministry Health Care Inc 1 Ministry Weight Management Inc 2251 North Shore Drive Rhinelander WI 54501 391829015 Health Services WI Section 501(c)(3) Schedule A, Line 3 Sacred Heart-St Mary's Hospitals Inc 1 Network Health System Inc 1570 Appleton Rd Menasha WI 54952 391127163 Clinical Healthcare Services WI Section 501(c)(3) Schedule A, Line 3 Affinity Health System 1 Our Lady of Victory Hospital Inc 1120 Pine Street Stanley WI 54768 390807065 Hospital WI Section 501(c)(3) Schedule A, Line 3 Ministry Health Care Inc 1 Sacred Heart-St Mary's Hospitals Inc PO Box 347 Stevens Point WI 54481 391390638 Hospital WI Section 501(c)(3) Schedule A, Line 3 Ministry Health Care Inc 1 Saint Clare's Hospital of Weston Inc 3400 Ministry Parkway Weston WI 54476 721531917 Hospital WI Section 501(c)(3) Schedule A, Line 3 Ministry Health Care Inc 1 Saint Elizabeth's Hospital of Wabasha Inc 1200 Grant Blvd West Wabasha MN 55981 410693877 Hospital MN Section 501(c)(3) Schedule A, Line 3 Ministry Health Care Inc 1 St Elizabeth Hospital Foundation Inc 1506 S Oneida Street Appleton WI 54915 391256677 Charitable Foundation WI Section 501(c)(3) Schedule A, Line 7 Affinity Health System 1 St Elizabeth Hospital Inc 1506 S Oneida Street Appleton WI 54915 390816818 Hospital WI Section 501(c)(3) Schedule A, Line 3 Ministry Health Care Inc 1 Saint Joseph's Hospital of Marshfield Inc 611 Saint Joseph Avenue Marshfield WI 54449 390847631 Hospital WI Section 501(c)(3) Schedule A, Line 3 Ministry Health Care Inc 1 Saint Michael's Hospital of Stevens Point Inc 900 Illinois Avenue Stevens Point WI 54481 390808443 Hospital WI Section 501(c)(3) Schedule A, Line 3 Ministry Health Care Inc 1 Affinity Health System 1570 Midway Place Menasha WI 54952 391568866 Support Related Healthcare Organziations IL Section 501(c)(3) Schedule A, Line 11b Ministry Health Care Inc 1 Twin Med LLP PO Box 8005 Menasha WI 54952 391180341 Rental Property WI N/A Network Health Plan Inc 1570 Midway Place Menasha WI 54952 391442058 Insurance WI N/A C 0 Network Health Insurance Corporation 1570 Midway Place Menasha WI 54952 392020474 Insurance WI N/A C 0 Ministry Holdings Inc 1570 Midway Place Menasha WI 54952 422966177 Insurance Holding Company WI N/A C 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 1 Ministry Health Care Inc O 11701882 FMV Ministry Health Care Inc E 2063880 FMV Ministry Health Care Inc P 18904359 FMV Sacred Heart-St Mary's Hospitals Inc O 11096134 FMV Saint Joseph's Hospital of Marshfield Inc O 161526 FMV Saint Michael's Hospital of Stevens Point Inc O 14488543 FMV Saint Clare's Hospital of Weston Inc O 8743630 FMV Eagle River Memorial Hospital Incorporated O 1716686 FMV Good Samaritan Health Center of Merrill Wisconsin Inc O 3641868 FMV Our Lady of Victory Hospital Inc O 124816 FMV The Howard Young Medical Center Inc O 2804939 FMV Saint Clare's Hospital of Weston Inc Q 2409664 FMV Sacred Heart-St Mary's Hospitals Inc Q 1062642 FMV Saint Michael's Hospital of Stevens Point Inc Q 668901 FMV Good Samaritan Health Center of Merrill Wisconsin Inc S 739396 FMV Saint Clare's Hospital of Weston Inc R 246684 FMV Sacred Heart-St Mary's Hospitals Inc P 63823 FMV