2015-05-12T13:59:18-05:00 2014-06-30 861065772 Deloitte Tax LLP 555 East Wells Street Suite 1400 Milwaukee MI 53202 990 2013-07-01 390873606 The Howard Young Medical Center Inc HOWA 7153568000 240 Maple Street Woodruff WI 54568 Jeffrey Francis Ministry Health Care CAFO 7153568000 2015-05-12 1 Rachel Becker P00966076 4142713000 2013 2016-03-07 17:11:31Z Monica Ann Hilt 240 Maple Street Woodruff WI 54568 62201587 0 0928 X www.ministryhealth.org X 1948 WI To improve the health and well-being of all people in the communities we serve. 12 11 405 253 6251 0 1223088 1984423 41405844 56844205 905923 2302055 371457 1065175 43906312 62195858 0 0 0 0 23805858 30880765 0 0 0 16632320 21661674 40438178 52542439 3468134 9653419 142376826 163583117 8845033 9683093 133531793 153900024 The Howard Young Medical Center, Inc.'s mission as a Catholic hospital is to further the healing ministry of Jesus by improving the health and well-being of all people, especially the poor. 0 0 40180322 57048784 The Howard Young Medical Center, Inc. ("the Hospital") provides inpatient, outpatient, emergency room and ancillary services regardless of an individual's ability to pay or method of payment. The Hospital also provides education programs and services on health care issues to the community it serves. During Fiscal 2014, the Hospital counted 9,925 total patient days, 2,654 total admissions, and 28,140 outpatient visits, and its emergency department received 10,838 visits.See Schedule H for further details regarding the community benefits that The Howard Young Medical Center, Inc. provides. 40180322 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 1 58 0 1 405 1 1 1 0 0 0 0 0 0 0 0 0 X 12 11 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 WI X Jeffrey Francis 4143593145 222 W College Ave 3rd Floor Appleton WI 54911 X Bill Arvold Chairman 0.30 0.90 X X 0 0 0 Nancy Schuller Vice Chairman 0.30 0.90 X X 0 0 0 Brian Eliason Secretary 0.30 0.90 X X 0 0 0 Lee Guenther Treasurer 0.30 0.90 X X 0 0 0 Randy Africano Thru 813 Board Member 0.30 0.90 X 0 0 0 Arthur C Helgerson DDS Board Member 0.30 0.90 X 0 0 0 Margaret S Johnson Board Member 0.30 0.90 X 0 0 0 Judy Smolarek Board Member 0.30 0.90 X 0 0 0 Kurt D Velduizen Board Member 0.30 1.20 X 0 0 0 Richard Wilson Board Member 0.30 0.90 X 0 0 0 Ric Brodhead MD Ex-Officio Board Member 0.30 0.90 X 0 0 0 Adrienne Laverdure Ex-Officio Board Member 0.30 0.90 X 0 0 0 Monica Ann Hilt Regional CEO/President 3.00 39.90 X X 0 402999 54840 Sheila Clough Thru 713 President 13.00 29.00 X X 137958 0 28830 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 Laurie Oungst VP - Operations 7.00 34.30 X 182072 0 20131 Deborah Karow VP - Patient Care 10.00 29.00 X 155631 0 63650 Laurie Demro CRNA 40.00 0.00 X 228125 0 21518 Lonna L Grosskopf CRNA 40.00 0.00 X 224194 0 65294 Ryan A Holt Physician 40.00 0.00 X 402619 0 79291 David W Koski Physician 40.00 0.00 X 319841 0 74232 Kevin R Krueger CRNA 40.00 0.00 X 235072 0 61090 Jeff Badger Former Officer 1.00 51.00 X 0 497813 62987 Catherine Bukowski Former Officer 0.00 0.00 X 0 225410 38887 Brian Kief Former Officer 0.00 41.60 X 0 513755 100768 1885512 4223835 837517 17 1 1 0 Marshfield Clinic 1000 North Oak Avenue Marshfield WI 544495779 MD Staffing/Medical Directors & Services 1197225 Weatherby Locums Inc PO Box 972633 Dallas TX 753972633 Physician Staffing 615702 Shared Medical Services Inc PO Box 330 Cottage Grove WI 535270330 MRI Services 454125 Rynders Companies Inc (Sch O) 10322 Hwy 70 East Minocqua WI 54548 Grounds Maintenance/Construction 425694 Roche Diagnostics Corp PO Box 660367 Dallas TX 752660367 Lab Testing 338743 15 375588 27419 1581416 32017 1984423 Net Patient Revenue 622110 54597313 54597313 Medicare & Medicaid 900099 1738250 1738250 Ambulance Services 621910 358846 358846 Rehab Revenue 622000 149796 149796 56844205 2300819 2300819 345192 0 345192 345192 345192 6965 5729 1236 1236 1236 Pharmacy Revenue 446110 344750 344750 Cafeteria Revenue 722210 130458 130458 Lifeline Revenue 900099 33945 33945 210830 204579 6251 719983 62195858 57048784 6251 3156400 588272 588272 23011882 19022653 3989229 1187164 1185646 1518 4827106 3476805 1350301 1266341 1259818 6523 4486 4486 75980 75980 2712274 1601756 1110518 437 437 5011493 4408929 602564 14671 14671 1179426 879563 299863 101839 101052 787 252673 73178 179495 481400 481400 2996578 2715729 280849 214164 206838 7326 Purchased Services 3754269 1488775 2265494 State Assessment 1382936 1382936 Pharmaceuticals 1330109 1321903 8206 Mgmt Fee - Affiliate 891529 276374 615155 1257410 282296 975114 52542439 40180322 12362117 0 14764990 8330968 391904 391904 6140286 6974420 1591782 1593677 47078 24899 27051479 2544413 23569957 24507066 41834035 47483727 1282763 2633985 52754031 71642471 142376826 163583117 5754853 6232941 91862 86584 2998318 3363568 8845033 9683093 X 90839570 104556075 859451 1860222 41832772 47483727 133531793 153900024 142376826 163583117 X 9653419 10233712 481100 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 4486 4486 0 Part II-B, Line 1: Lobbying expenses represent the portion of dues paid to national and state hospital associations that is specifically allocable to lobbying. The Howard Young Medical Center, Inc. does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office. 41832772 7307270 1581416 74899 47483727 40021399 2968498 1157125 41832772 35450699 6140071 1495165 74206 40021399 37659304 30400 -697469 1462450 79086 35450699 35978363 3289863 1527578 81344 37659304 1.00000 1 0 3178349 3178349 14657467 998034 13659433 833757 96185 737572 7782721 1365010 6417711 599185 85184 514001 24507066 HYMC Trust Indenture 47483727 F 47483727 Interests in Investments Held by Ascension Health Alliance 69371740 Misc. Receivables 2270731 71642471 Asset Retirement Obligation 153043 Due to Third Party Payors 3210525 3363568 X Part V, Line 4: The Howard Young Trust was established by S. Howard Young in 1975 as a mechanism to ensure the Hospital continues to have access to funding for capital needs, medical service continuation and service growth to meet the community's needs. Part X, Line 2: From the consolidated audited financial statements of Ministry Health Care, Inc., which includes the activity of The Howard Young Medical Center, 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. 1 1 X 1 X 1 X 1 1 0 1 1 560488 560488 0.01070 7013479 4429452 2584027 0.04920 7573967 4429452 3144515 0.05990 13 96 239805 292 239513 0.00460 2 10 193982 193982 0.00370 2 472462 264522 207940 0.00400 4 67280 67280 0.00130 21 106 973529 264814 708715 0.01360 21 106 8547496 4694266 3853230 0.07350 3 5228 5228 0.00010 2 7930 7930 0.00020 5 13158 13158 0.00030 0 3270966 25186634 27576197 -2389563 X 1 1 1 1 The Howard Young Medical Center Inc 240 Maple Street Woodruff WI 54568 www.ministryhealth.org 201 X X X The Howard Young Medical Center Inc 1 1 X X X X X X X X X 12 1 1 1 X See Narrative X X X X X X X 0 0 1 1 200.000000000000 1 300.000000000000 1 X X X X X X 1 1 X X 1 0 X X X X 1 X 0 0 The Howard Young Medical Center, Inc. Part V, Section B, Line 3: Facilitated by Oneida and Vilas County Health Department leaders, The Howard Young Medical Center, Inc. leadership joined an assessment team comprised of private and public Oneida and Vilas organization members including: hospital therapists, medical staff and administrators; clinic personnel; public health nurses and educators; behavioral health therapists and leaders; elementary, high school and post-high school educators, nurses and administrators; police and emergency personnel; child, women's, family and senior social services; as well as interested community members in the health needs assessment process.Angela Nimsgern, Regional Director, and Jim Lawrence, Public Health Educator, from the Division of Public Health, Northern Region Office, both serve as Northern Region Consultants for 15 Northern Wisconsin Health Departments. Angela and Jim directly participated in the assessment process and guided the team for "Data in A Day" review.Public Health Experts:Linda Conlon, Director and Health OfficerOneida County Health DepartmentBAN, Master in Public HealthTen years of experience as Oneida County Health Officer conducting and overseeing community needs assessments.Regina Egan, Health OfficerVilas County Health DepartmentRN, BSNSixteen years of experience as Vilas County Health Officer conducting and overseeing community needs assessments.Jim Lawrence, Health Educator ConsultantWisconsin Division of Public Health - Northern Regional officeMore than 20 years of experience in public health consulting.Angela Nimsgern, Regional DirectorWisconsin Division of Public Health - Northern Regional OfficeMaster in Public Health Administration, CHPMore than 12 years of experience with community health assessments process. The Howard Young Medical Center, Inc. Part V, Section B, Line 4: The CHNA was conducted with the following other hospital facilities:- Eagle River Memorial Hospital, Incorporated- Sacred Heart-St. Mary's Hospitals, Inc. The Howard Young Medical Center, Inc. Part V, Section B, Line 7: Areas the Hospital will not focus include oral health, mental health as well as alcohol and other drug abuse. This conclusion was reached based on several key factors including:- Recognition that three of the five priority health needs are interrelated as chronic disease can be impacted by an individual's improvement in physical activity and nutrition;- Recognition that the Hospital does not have expertise to drive improvements in oral health, mental health or AODA;- Poor and vulnerable community survey responses directing the Hospital to focus on chronic disease. The Howard Young Medical Center, Inc. Part V, Section B, Line 14g: A plain language summary of the financial assistance policy is available in the following locations:- The Hospital facilitiy's website- Attachment to billing invoices- Posted to the Hospital facility's emergency rooms and waiting rooms- Posted in the Hospital facility's admission offices- Provided, in writing, to patients on admission to the Hospital facility. Part V, Section B, Line 5a: The Hospital facility's CHNA can be found at the following website:http://ministryhealth.org/HowardYoungMedical/Howard_Young_Medical_Center_CHNA_5_28_2013_FINAL.pdf Part I, Line 6a: The Howard Young Medical Center, Inc. is included in the annual community benefit report which is published by Ministry Health Care, Inc. (EIN: 39-1490371) and available to the public on its website, www.ministryhealth.org. This report includes all of the related entities within the Ministry Health Care, Inc. network of hospitals, clinics and other health-related organizations. Part I, Line 7g: Amounts calculated in Part I, Line 7, are determined both on a cost accounting system and a cost-to-charge ratio. Other benefits are determined based on the direct and indirect costs (where allocated) associated with a program net of earned revenue. Detail for each program/activity is maintained and determined at the department level. Charity care and means-tested programs are determined based on a cost-to-charge ratio consistent with Worksheet 2, Ratio of Patient Care Cost to Charges. Part II, Community Building Activities: Community building activities include activities that, while not directly related to health care, provide opportunities to address the root causes of health problems, such as poverty, homelessness, and environmental problems. These activities support community assets by offering the expertise and resources of the Organization. Costs for these activities include cash, in-kind donations, and expenditures for the development of a variety of community health programs and partnerships. The Howard Young Medical Center, Inc. is involved in the Northwoods LEAN coalition. A coalition that promotes a culture of healthy living through physical activity and nutrition in Oneida and Vilas counties with a vision of living in a community that promotes and supports residents in achieving a healthy lifestyle across the lifespan. The Howard Young Medical Center, Inc. volunteer at Northland Pines High School which includes student job shadow programs. Part III, Line 2: Accounts are written off to bad debt after all internal collection efforts have been exhausted. Attempts to resolve these outstanding balances can include, but are not limited to statements being sent, phone calls and letters being sent. Account follow up protocol is based on personal pay balance size owed. Part III, Line 3: The Howard Young Medical Center, Inc. has a very robust financial assistance program; therefore, no estimate is made for bad debt attributed to financial assistance eligible patients. Part III, Line 4: From the footnote of the consolidated financial statements of Ministry Health Care, Inc., which includes the activity of The Howard Young Medical Center, Inc.:The provision for doubtful accounts is based upon management's assessment of expected net collections considering economic conditions, historical experience, trends in health care coverage, and other collection indicators. Periodically throughout the year, management assesses the adequacy of the allowance for doubtful accounts based upon historical write-off experience by payor category, including those amounts not covered by insurance. The results of this review are then used to make any modifications to the provision for doubtful accounts to establish an appropriate allowance for doubtful accounts. After satisfaction of amounts due from insurance and reasonable efforts to collect from the patient have been exhausted, the Health Ministry follows established guidelines for placing certain past-due patient balances with collection agencies, subject to the terms of certain restrictions on collection efforts as determined by Ascension Health. Accounts receivable are written off after collection efforts have been followed in accordance with the Health Ministry's policies.The methodology for determining the allowance for doubtful accounts and related write-offs on uninsured patient accounts has remained consistent with the prior year. The Health Ministry has not experienced material changes in write-off trends and has not materially changed its charity care policy in the current year. Part III, Line 8: Ascension Health and related Health Ministries follow the Catholic Health Association ("CHA") guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as a community benefit. Part III, Line 9b: The Organization has a debt collection policy which sets forth collection practices for patients who are known to qualify or may qualify for financial assistance under the Charity Care Program. Sufficient financial counseling support is made available to patients so they can easily access patient financial service representatives and have their questions answered, and gain an understanding of the reasons why they owe a balance. Accounts are designated as Charity Care in the business offices so no additional time is spent on collection efforts. Part VI, Line 2: The Organization performed a Community Health Needs Assessment in 2012 and will update it as required by the 501(r) regulations. Planning workgroups consisting of community partners are formed to define the community and its needs through review of healthy people initiatives, census documents, and local government health and welfare agencies. Considering other community resources/assets, data collection methods are used to identify particular problems or subgroups and areas known to have high poverty rates and to be underserved. The data is analyzed and priorities are set based on trending information which may target a specific need. When a need is identified, the Hospital develops a plan to implement a program either through community collaboration or individually. Outcomes from the programs are measured and considered in subsequent Community Health Needs Assessments. Community benefit plans are presented to senior leadership and board members to ensure the findings are incorporated into the Organization's strategy and policy development. For example, senior leaders are required to provide direct service to the poor in their communities, and their hours are included as part of their performance goals. Part VI, Line 3: The Organization goes to great lengths in order to inform and educate patients/persons who may be billed for patient care about their eligibility for assistance under federal, state or local government programs and under the Organization's Charity Care Policy. The Charity Care Policy and application is posted on the Organization's website. Admissions and other key areas contain summary information of the Charity Care Policy. As part of the intake/discharge process, patients are provided with a copy of the policy and other information for financial assistance. If a patient indicates they are unable to pay their bill at any point during pre-service, admission, discharge or billing process, the financial counselors will assist the patient in either securing a funding source (grants, COBRA coverage, disability benefits, Medicaid, VA, etc.) if eligible or assist them in completing a financial assistance application. If during the course of the patient registration process, care encounter, treatment, or upon discharge it becomes evident that a patient may need financial assistance, the patient shall be referred to the Organization's Community Care Program. Patients may be identified as needing financial assistance at any time during the course of an encounter. A referral for consideration of Community Care Financial Assistance can be initiated by any member of the Hospital's workforce, including medical staff members, who become aware of the patient's potential need for Community Care Financial Assistance. The Charity Care Policy was also translated into dialects prevalent in the community in order to reach out to those that may speak another language (Spanish and Hmong). Patient registration staff and financial counselors are provided with scripts to follow when interacting with patients. As part of the charity care process, patients must register with the county public assistance to see if they may qualify under any other federal or state programs. Part VI, Line 4: While there is growing agreement in the United States about what constitutes a non-profit hospital's community benefit, this is a work in progress. The Organization provided significant charity care and other community benefits as defined by the IRS. But, in addition, we believe that we provide a critically important community benefit, which is not quantified. Our Hospital, like most rural hospitals, was created and is maintained in order to provide care locally - care that without our Hospital, may not be available locally.Certain specialized services available include: diabetes education and management, speech therapy, wound care and management, palliative care services, pain management services, and inpatient dialysis services.The Howard Young Medical Center, Inc. is located in Woodruff, Wisconsin and services the surrounding communities. According to the 2010 census, Woodruff had a population of 2,055 people, with 18.8% under the age of 19, 4.0% from 20-24 years of age, 19.0% from 25-44 years of age, 29.7% from 45-64 years of age, and 28.5% over the age of 65. The median income in 2010 for a household was $42,306. The per capita income of the town in 2010 was $27,086. The town has a total of 35.6 square miles, of which 7.0 square miles is water. The median age is 50.3 years.Woodruff is located in Oneida County Wisconsin. According to the 2010 census, Oneida County had a population of 35,998 people, with 18.4% under the age of 18 and 21.7% over the age of 65. The median age was 48.0 years. The median household income in 2010 was $45,857. About 9.9% of the population was below the poverty level. The unemployment rate for December 2011 in Oneida County was 9.3% compared to the state rate of 7.0%. Part VI, Line 5: The Organization strives to further its exempt purposes by the following:(1) The Organization's governing board consists primarily of persons who reside within the primary service area. They are not employees of the Organization.(2) As mentioned, the Organization provides several services which are not otherwise available being in a rural setting.(3) Based on the Organization's mission, emergency rooms are made available to all patients regardless of the ability to pay.(4) The Organization also participates in the education and training of healthcare professionals through internship programs.The Howard Young Medical Center, Inc. is also involved in the following efforts which further its tax exempt status:- The Hospital participates in government-sponsored health programs (Medicare, Medicaid, Champus, Tricare).- The facility strives to be a low-cost/low-charge provider by utilizing the lean six sigma approach to improve patient safety, patient quality of services and patient satisfaction.- The Howard Young Medical Center, Inc. emergency room serves all people regardless of their ability to pay.- Charity care is available to all in the community based on need and is subject to sliding scale discounts.- The Howard Young Medical Center, Inc. has a volunteer services program where community members utilize the Hospital as a vehicle to connect with and contribute to individuals and the overall community through volunteering.- The Howard Young Medical Center, Inc. encourages their management team to participate in the Local Good Pantry's Distribution Day. Nutritionists are available to discuss healthy food choices, clinical services such as blood pressure checks and cholesterol screening along with educational sessions have been developed. They also have networked with a local optometry office to provide eye care screenings and eyeglass assistance. Part VI, Line 6: Ministry Health Care, Inc. ("Ministry" or "the Health Ministry") is a member of Ascension Health. Ascension Health Alliance, d/b/a Ascension (Ascension), is a Missouri nonprofit corporation formed on September 13, 2011. Ascension is the sole corporate member and parent organization of Ascension Health, a Catholic national health system consisting primarily of nonprofit corporations that own and operate local healthcare facilities, or Health Ministries, located in 23 of the United States and the District of Columbia. Ascension and its member organizations are hereafter referred to collectively as the System.Ascension is sponsored by Ascension Sponsor, a Public Juridic Person. The Participating Entities of Ascension Sponsor are the Daughters of Charity of St. Vincent de Paul, St. Louise Province; the Congregation of St. Joseph; the Congregation of the Sisters of St. Joseph of Carondelet; theCongregation of Alexian Brothers of the Immaculate Conception Province, Inc. American Province; and the Sisters of the Sorrowful Mother of the Third Order of St. Francis of Assisi US/Caribbean Province. As more fully described in the Organizational Changes note, Marian Health System, which was previously sponsored by the Sisters of the Sorrowful Mother of the Third Order of St. Francis of Assisi US/Caribbean Province, became part of Ascension Health on April 1, 2013.The Health Ministry is a Wisconsin non-stock, tax-exempt corporation that manages, promotes, and supports health care and related ministries in Wisconsin and Minnesota. The Health Ministry provides inpatient, outpatient, and emergency care services for the residents of Wisconsin and Minnesota. Admitting physicians are primarily practitioners in the local area. The Health Ministry is related to Ascension Health's other sponsored organizations through common control. Substantially all expenses of the Health Ministry are related to providing health care services.The consolidated financial statements include the following affiliates in which Ministry has a controlling interest or is the sole sponsor.Affiliate Organization - LocationAffinity Health System (Affinity)Calumet Medical Center, Inc. (CMC) - Chilton, WINetwork Health System, Inc. (NHS)Affinity Medical Group (AMG) - Fox Valley of WisconsinTwin Med, LLC - Fox Valley of WisconsinMercy Medical Center of Oshkosh, Inc. - Oskosh, WIMercy Health Foundation, Inc. - Oshkosh, WISt. Elizabeth Hospital, Inc. - Appleton, WICatalpa Health, Inc. - Appleton, WISt. Elizabeth Hospital Foundation, Inc. - Appleton, WIAgape Community Center of Milwaukee, Inc. - Milwaukee, WIDoor County Memorial Hospital (Door County) - Sturgeon Bay, WIGood Samaritan Health Center of Merrill, Wisconsin, Inc. - Merrill, WIGood Samaritan Health Center Foundation of Merrill, Wisconsin, Inc. - Merrill, WIHoward Young Health Care, Inc. (Howard Young)Dr. Kate Newcomb Convalescent Center, Inc. - Woodruff, WIThe Howard Young Medical Center, Inc. - Woodruff, WIHoward Young Foundation, Inc. - Woodruff, WIEagle River Memorial Hospital, Incorporated - Eagle River, WIMinistry Holdings, Inc.Network Health (NH) - Fox Valley of WisconsinNetwork Health Insurance Corporation (NHIC) - Fox Valley of WisconsinMinistry Home Care, Inc.Ministry Home Care Services - Various in WisconsinMinistry Medical Group, Inc.Our Lady of Victory Hospital, Inc. - Stanley, WISacred Heart-St. Mary's Hospitals, Inc. - Tomahawk, WI/Rhinelander, WISaint Clare's Hospital of Weston, Inc. - Weston, WIFoundation of Saint Clare's Hospital of Weston, Inc. - Weston, WISaint Elizabeth's Hospital of Wabasha, Inc. - Wabasha, MNSaint Joseph's Hospital of Marshfield, Inc. - Marshfield, WIFoundation of Saint Joseph's Hospital of Marshfield, Inc. - Marshfield, WISaint Michael's Hospital of Stevens Point, Inc. - Stevens Point, WISaint Michael's Foundation of Stevens Point, Inc. - Stevens Point, WIMission:The System directs its governance and management activities toward strong, vibrant, Catholic Health Ministries united in service and healing, and dedicates its resources to spiritually centered care which sustains and improves the health of the individuals and communities it serves. In accordance with the System's mission of service to those persons living in poverty and other vulnerable persons, each Health Ministry accepts patients regardless of their ability to pay. The System uses four categories to identify the resources utilized for the care of persons living in poverty and community benefit programs:- Traditional charity care includes the cost of services provided to persons who cannot afford healthcare because of inadequate resources and/or who are uninsured or underinsured.- Unpaid cost of public programs, excluding Medicare, represents the unpaid cost of services provided to persons covered by public programs for persons living in poverty and other vulnerable persons.- Cost of other programs for persons living in poverty and other vulnerable persons includes unreimbursed costs of programs intentionally designed to serve the persons living in poverty and other vulnerable persons of the community, including substance abusers, the homeless, victims of child abuse, and persons with acquired immune deficiency syndrome.- Community benefit consists of the unreimbursed costs of community benefit programs and services for the general community, not solely for the persons living in poverty, including health promotion and education, health clinics and screenings, and medical research.Discounts are provided to all uninsured patients, including those with the means to pay. Discounts provided to those patients who did not qualify for assistance under charity care guidelines are not included in the cost of providing care of persons living in poverty and other community benefit programs. The cost of providing care to persons living in poverty and other community benefit programs is estimated by reducing charges forgone by a factor derived from the ratio of each entity's total operating expenses to the entity's billed charges for patient care.The amount of traditional charity care provided, determined on the basis of cost, was approximately $18,380,000 for the year ended June 30, 2014. The amount of unpaid cost of public programs, cost of other programs for persons living in poverty and other vulnerable persons, and community benefit cost are reported in the accompanying supplementary information. Part VI, Line 7, Reports Filed With States WI 0 1 0 0 0 0 0 0 0 Monica Ann Hilt Regional CEO/President 0 310931 0 47232 0 44836 0 35406 0 19434 0 457839 0 0 Sheila Clough Thru 713 President 124801 0 0 0 13157 0 18353 0 10477 0 166788 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 Laurie Oungst VP - Operations 160099 0 10701 0 11272 0 18724 0 1407 0 202203 0 0 0 Deborah Karow VP - Patient Care 139927 0 9699 0 6005 0 19273 0 44377 0 219281 0 0 0 Laurie Demro CRNA 214367 0 0 0 13758 0 11300 0 10218 0 249643 0 0 0 Lonna L Grosskopf CRNA 183453 0 0 0 40741 0 38832 0 26462 0 289488 0 0 0 Ryan A Holt Physician 355745 0 5000 0 41874 0 37993 0 41298 0 481910 0 0 0 David W Koski Physician 259746 0 11634 0 48461 0 38763 0 35469 0 394073 0 0 0 Kevin R Krueger CRNA 195820 0 0 0 39252 0 36578 0 24512 0 296162 0 0 0 Jeff Badger Former Officer 0 405962 0 56934 0 34917 0 44888 0 18099 0 560800 0 0 Catherine Bukowski Former Officer 0 167000 0 16657 0 41753 0 32147 0 6740 0 264297 0 0 Brian Kief Former Officer 0 426500 0 51025 0 36230 0 81000 0 19768 0 614523 0 0 Part I, Line 3 Ministry Health Care, Inc., a related organization of The Howard Young Medical Center, 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. There were no distributions in the current year. X Equipment 3 20124 FMV X Supplies 14 11893 FMV 0 0 1 0 Part I, Column (b): The amounts showing in Column (b) represent the number of items received. 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 Ministry Health Care, Inc. related entities. Form 990, Part VI, Section A, line 6 The Howard Young Medical Center, Inc. has a single corporate member, Howard Young Health Care, Inc. Form 990, Part VI, Section A, line 7a The Howard Young Medical Center, Inc. has a single corporate member, Howard Young Health Care, Inc., who has the ability to elect members to the governing body of The Howard Young Medical Center, Inc. Form 990, Part VI, Section A, line 7b All decisions that have a material impact to The Howard Young Medical Center, Inc. financial information or corporation as a whole are subject to approval by its sole corporate member, Howard Young 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 The Howard Young Medical Center, Inc., included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Compensation Committee reviewed and approved the compensation. In the review of the compensation, the CEO was compared to individuals at other organizations in the area who hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes. The individual was not present when his compensation was decided. In determining compensation of other officers and key employees of the organization, the process performed by Ministry Health Care, Inc., a related organization of The Howard Young Medical Center, Inc., included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The Compensation Committee reviewed and approved the compensation. In the review of the compensation, the other officers and key employees of the organization were compared to individuals at other organizations in the area who hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the board minutes. Form 990, Part VI, 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 any inquiry is made for any documents they are shared as appropriate. Form 990, Part VII, Section B Amounts paid to Rynders Companies, Inc. represent payments for both services and goods. These amounts cannot be separated. Form 990, Part XI, line 9: Trust Distribution & Realized Gain -753,535. Final D&T Fixed Asset Reconciliation Adjustment 1,532,418. Change in Temp Restricted Funds 1,000,771. Equity Transfer to MMG Woodruff -825,961. Foundation Contribution - Non Capital -56,590. Interentity Transfers -2,536,749. EHR Equity Transfer 2,120,746. 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 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 Medical Group Inc 824 Illinois Avenue Stevens Point WI 54481 391965593 Clinics WI Section 501(c)(3) Schedule A, Line 11c 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 1 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 Ministry Health Care Inc O 6049490 FMV Ministry Health Care Inc Q 4734331 FMV Ministry Health Care Inc J 50610 FMV Sacred Heart-St Mary's Hospitals Inc O 86930 FMV Ministry Medical Group Inc O 2804939 FMV Saint Joseph's Hospital of Marshfield Inc O 109664 FMV Eagle River Memorial Hospital Incorporated O 741561 FMV Eagle River Memorial Hospital Incorporated Q 184001 FMV Howard Young Health Care Inc P 478214 FMV Howard Young Health Care Inc O 1029182 FMV Howard Young Foundation Inc C 375588 FMV Sacred Heart-St Mary's Hospitals Inc J 154769 FMV Sacred Heart-St Mary's Hospitals Inc Q 136560 FMV