2015-05-13T09:19:44-05:00 2014-06-30 861065772 Deloitte Tax LLP 555 East Wells Street Suite 1400 Milwaukee WI 53202 990 2013-07-01 390808443 Saint Michael's Hospital of Stevens Point Inc STMI 7153465000 900 Illinois Avenue Stevens Point WI 54481 Jeffrey Francis Ministry Health Care CAFO 7153465000 2015-05-13 1 Rachel Becker P00966076 4142713000 2013 2016-02-25 16:41:14Z Jeffrey L Martin 900 Illinois Avenue Stevens Point WI 54481 191941871 0 0928 X www.ministryhealth.org/smh/ X 1955 WI To improve the health and well-being of all people in the communities we serve. 16 14 931 274 3979 -1749 399146 521814 135342859 188041963 496416 2885198 1232567 306217 137470988 191755192 8512 0 0 0 80850301 115016981 0 0 0 42094973 59534475 122953786 174551456 14517202 17203736 166251767 188771725 28053959 23657451 138197808 165114274 X Saint Michael's Hospital of Stevens Point, Inc.'s mission as a Catholic hospital is to further the healing ministry of Jesus by continually improving the health and well-being of all people, especially the poor. We provide acute health care services to the communities regardless of the person's ability to pay. 0 0 135870975 187571330 Saint Michael's Hospital of Stevens Point, 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.See Schedule H for further details regarding the community benefits that Saint Michael's Hospital of Stevens Point, Inc. provides. 135870975 1 1 0 1 0 0 0 0 0 1 1 0 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 1 125 0 1 931 1 1 1 0 0 0 0 0 0 0 0 0 X 16 14 1 0 1 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 James Schuh Chair 0.30 0.00 X X 0 0 0 Dick Okray Vice Chair 0.30 0.00 X X 0 0 0 Kathy Davies Secretary/Treasurer 0.30 0.00 X X 0 0 0 Jim Anderson Board Member 0.30 0.00 X 0 0 0 Sister Pat Belongia Board Member 0.30 20.00 X 0 25022 532 Sue Budjac Board Member 0.30 0.00 X 0 0 0 Nadine Davy Board Member 0.30 0.00 X 0 0 0 James Deweerd MD Thru 913 Board Member 0.30 0.00 X 0 0 0 Jeanne Groos MDStart 1013 Board Member 0.30 0.00 X 0 0 0 Joe Kinsella Board Member 0.30 0.00 X 0 0 0 Jeff Landin Board Member 0.30 0.00 X 0 0 0 Paul Munck MD Start 113 Board Member 0.30 0.00 X 0 0 0 Mary Patoka Board Member 0.30 0.00 X 0 0 0 Rick Rettler Board Member 0.30 0.00 X 0 0 0 James Weishan Board Member 0.30 0.00 X 0 0 0 Todd Williams MD Start 113 Board Member 0.30 0.00 X 0 0 0 Jeffrey L Martin President 30.00 10.80 X X 561639 0 136783 Nicholas Desien Ministry Health Care CEO 0.30 56.00 X 0 2061606 41974 Jeffrey Francis Ministry Health Care CAFO 0.30 65.60 X 0 522252 124025 David M Groen Director Pharmacy 40.00 0.00 X 158342 0 45237 George W Davidson Dentist Senior 40.00 0.00 X 169466 0 56381 Christopher J Thompson Clinical Staff Pharmacist 40.00 0.00 X 140637 0 43526 Tyler C Christopherson Dentist 40.00 0.00 X 129024 0 30282 Mark Kienbaum Clinical Staff Pharmacist 40.00 0.00 X 124096 0 20816 Jeff Badger Former Officer 0.30 51.70 X 0 497813 62987 1283204 3106693 562543 9 1 1 0 Ellis Stone Construction Co Inc PO Box 366 Stevens Point WI 54481 Contractor (Sch. O) 1520216 Marshfield Laboratories 1000 North Oak Avenue Marshfield WI 54449 Medical Services 892145 Weatherby Locums Inc PO Box 972633 Dallas TX 753972633 Locums 782532 Dakota Electric Service Inc 2801 E 21st Street Marshfield WI 54449 Maintenance Service 517617 Judge's Cleaners Inc 2150 Maple Drive Plover WI 54467 Laundry Service 335045 19 5000 231127 12759 272928 53650 521814 Net Patient Rev-Hosp. 622110 132143799 132143799 Net Patient Rev-Clinic 621400 52709558 52709558 Medicare/Medicaid 900099 2197580 2197580 Rent from Exempt Org. 531120 630431 630431 Pharmacy 900099 262446 262446 98149 98149 188041963 2920307 2920307 33383 0 33383 33383 33383 151570 186679 -35109 -35109 -35109 Cafeteria 722210 634851 3979 630872 Employee Assist. Prgrm 624100 444244 444244 Mfld Clinic Oncology 900099 -1044647 -1044647 238386 227919 10467 272834 191755192 187571330 3979 3658069 698422 698422 90095593 73531439 16564154 4709185 4676665 32520 14964388 10051623 4912765 4549393 4406682 142711 4732 4732 3150 3150 5381138 1605571 3775567 42731 41486 1245 15696770 13890427 1806343 327249 324699 2550 3822674 2709283 1113391 330359 298488 31871 1261728 616036 645692 228040 228040 10141597 8153043 1988554 955434 900116 55318 Purchased Services 12866815 4623381 8243434 0 Pharmaceuticals 5320942 5257310 63632 0 State Assessment 2930324 2930324 0 0 Anesthesia Services 668901 668901 0 0 -448109 952729 -1400838 174551456 135870975 38680481 0 11665438 45649008 509307 21011725 21743798 1257774 77 2209736 2184778 386040 227639 77267073 9593446 65764798 67673627 827102 2913117 5092749 5377164 24052835 76476780 166251767 188771725 16289950 11506321 76123 13326 11687886 12137804 28053959 23657451 X 138194141 162197490 3667 865506 2051278 138197808 165114274 166251767 188771725 X 17203736 7106290 2606440 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 0 0 1 4732 4732 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. Saint Michael's Hospital of Stevens Point, 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. 2192062 38158 86289 51366 22651 2242492 2117254 59121 38866 1037 22142 2192062 2091682 36147 10812 21387 2117254 2094568 9294 8948 21128 2091682 2021659 72690 21376 21157 2094568 0.00000 0.91000 0.09000 0 1 1 3367518 3367518 40404150 3257435 37146715 733917 115757 618160 28836227 6050288 22785939 3925261 169966 3755295 67673627 Interest in Investments Held by Ascension Health Alliance 75625730 Other Accounts Receivable 476515 Other Long-Term Assets 374535 76476780 Provider Related Clinic Charges 5292883 Intercompany Debt with Ministry Health Care, Inc. 3143663 Pension 1551627 Other 1387374 Third Party Liabilities 541622 Retirement Obligation 220635 12137804 X Part V, Line 4: Income from the Ministry Dental Center Endowment is available to cover operation deficits. This ensures dental care can be provided to those who could not otherwise afford to pay. Income from the Breast Care Center Endowment is available to support patients, programs and initiatives of the center at St. Michael's Hospital of Stevens Point, Inc. Both of these endowments are administered by St. Michael's Foundation of Stevens Point, Inc. (39-1657410). Part X, Line 2: From the consolidated audited financial statements of Ministry Health Care, Inc., which includes the activity of Saint Michael's Hospital of Stevens Point, 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 a tax position taken or expected to be taken in a tax return. 1 1 X 1 X 1 X 1 1 0 1 1 816 1630329 1630329 0.00930 15210 24223996 15749162 8474834 0.04860 1188 2376091 1442265 933826 0.00540 17214 28230416 17191427 11038989 0.06330 9 497 798702 20916 777786 0.00450 1 488103 488103 0.00280 0.00000 0.00000 7 454227 454227 0.00260 17 497 1741032 20916 1720116 0.00990 17 17711 29971448 17212343 12759105 0.07320 0.00000 0.00000 0.00000 0.00000 0.00000 0.00000 0.00000 0.00000 0.00000 0 9959521 0 46803620 65479172 -18675552 X 1 1 1 1 Saint Michael's Hospital 900 Illinois Avenue Stevens Point WI 54481 http://ministryhealth.org 0146 X X X Saint Michael's Hospital of Stevens Poin 1 1 X X X X X X X X X 12 1 0 1 X See Narrative X 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 Saint Michael's Hospital of Stevens Point, Inc. Part V, Section B, Line 3: The assessment process was a joint collaboration between Ministry Saint Michael's Hospital of Stevens Point, Inc., Portage County Health Department and United Way of Portage County. The three entities provided support for the assessment process, both in-kind and financial, with numerous other sponsors providing financial sponsorship. The Portage County Local Indicators for Excellence ("LIFE") report was guided by a 19-member steering committee made up of Portage County community leaders from local business, government, education, safety and health, and social service organizations. Additionally, over 60 volunteer leaders served on committees and developed community indicators that reflect Portage County data, statistics and community perspectives. Additional community input was obtained through household and key stakeholder surveys (key stakeholders included over 50 key Portage County business leaders). Additional detailed analysis of Portage County health issues was conducted by the Health and Wellness Sub-Committee.Public Health Experts:Public Health support and guidance was available from Portage County Health and Human Services.Jenny Gaffke, Public Health Officer/Division CoordinatorPortage County Health and Human Services DepartmentMasters of Public AdministrationSeven years of experience in public health roles and seven months in the Public Health Officer position.Gary Garske, Public Health PlannerPortage County Health and Human Services DepartmentMasters of Public HealthMore than 22 years in public health.Suzanne Oehlke, Public Health Nutrition/WIC ManagerPortage County Health and Human Services DepartmentMasters in Science in Nutritional Sciences/AdministrationMore than 30 years of service in public health.Melanie Baehr, Public Health Nursing SupervisorPortage County Health and Human Services Department RN, BSNMore than five years as a Public Health Nurse and 28 years of varied nursing experience. Saint Michael's Hospital of Stevens Point, Inc. Part V, Section B, Line 7: Ministry Saint Michael's Hospital of Stevens Point, Inc. ("MSMH") worked to identify the community health needs that they felt were within their scope of expertise. However, they did recognize that there were other needs that had been identified and are of continuing concern to the community: employment opportunities that generate a living wage; aging populations; benefits and academic achievement gap; low-income community: inability to save money, heating costs, and cost of car repairs. The reasons that the MSMH did not plan on addressing these community health issues was because the MSMH felt that these needs are being appropriately addressed by other community leaders, organizations and coalitions within Portage County and there are other community resources who can effectively address these needs. Saint Michael's Hospital of Stevens Point, 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 faciliity's CHNA can be found at the following website:http://ministryhealth.org/MinistryHealth/CommunityBenefits/SaintMichaelsHo spital.nws 22 Ministry Medical Group 824 Illinois Avenue Stevens Point WI 54481 OP Clinic Ministry Medical Group - Plover 2401 Plover Road Plover WI 54467 OP Clinic Ministry Medical Group - Point 3398 E Maria Drive Stevens Point WI 54481 Psychiatric Services Ministry Medical Group Occupational 5412 Highway 10 East Stevens Point WI 54481 Occupational Health Services, Occupational Therapy and Physical Therapy St Michael's Hospital Rehab 2401 Plover Road Plover WI 54467 Cardiac Rehab and Physical Therapy Ministry Dental Clinic 3504 E Maria Drive Stevens Point WI 54481 Dental Clinic Ministry Medical Group - Col 190 Grand Seasons Drive Waupaca WI 54981 OP Clinic and Psychiatric Services Ministry Medical Group - PFP 3301 Stanley Street Waupaca WI 54481 OP Clinic Ministry Behavioral Health 209 Prentice Street N Stevens Point WI 54481 OP Alcohol and Chemical Dependency Treatment Center Ministry Behavioral Health 201 Prentice Street N Stevens Point WI 54481 Residential Alcohol and Chemical Dependency Treatment Center Ministry Medical Group 400 Dewey Street Wisconsin Rapids WI 54494 ENT Services Ministry Medical Group Occupational 1020 Kabel Avenue Rhinelander WI 54501 Occupational Health Services Ministry Medical Group - Amherst 272 Christy Street Amherst WI 54406 OP Clinic Ministry Medical Group - Iola 205 S Main Street Iola WI 54945 OP Clinic and Physical Therapy Ministry Medical Group Occupational 3301 Cranberry Blvd Weston WI 54476 Occupational Health Services Ministry Behavioral Health 190 Grand Seasons Drive Waupaca WI 54981 Alcohol and Chemical Dependency Treatment Center AEAS 1820 Post Road Suite 5 Plover WI 54467 Employee Assistance and Counseling Programs AEAS 2811 8th Street S Suite 80 Wisconsin Rapids WI 54494 Employee Assistance and Counseling Programs Ministry Medical Group 1000 Riverview Expressway Wisconsin Rapids WI 54494 ENT and Opthamalogy Services Ministry Medical Group Occupational 601 S Center Avenue Merrill WI 54452 Occupational Health Services Ministry Medical Group - Hoover 3500 Hoover Road Stevens Point WI 54481 OP Clinic St Michael's Hospital Rehab 3500 Hoover Road Stevens Point WI 54481 Physical and Occupational Therapy Services Part I, Line 6a: Saint Michael's Hospital of Stevens Point, 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 1, 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 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: Saint Michael's Hospital of Stevens Point, 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 Saint Michael's Hospital of Stevens Point, 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 the 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 performs Community Health Needs Assessments as needed. Planning workgroups consisting of community partners are formed to define the community and its needs through review of healthy people initiatives, census documents, and local government health and welfare agencies. Considering other community resources/assets, data collection methods are used to identify particular problems or subgroups and areas known to have high poverty rates and to be underserved. The data is analyzed and priorities are set based on trending information which may target a specific need. When a need is identified, the Hospital develops a plan to implement a program either through community collaboration or individually. Outcomes from the programs are measured and considered in subsequent Community 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 the hours are included as part of their performance goals. Part VI, Line 3: Ministry Health Care, Inc. ("MHC") has financial counselors located at every hospital. 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 program. Part VI, Line 4: Saint Michael's Hospital of Stevens Point, Inc. serves Stevens Point, WI and the surrounding villages and towns, including Plover, Whiting, Custer, Park Ridge, Stockton, and the town of Hull. It is located in the center of the state in Portage County. According to 2010 census information, the city of Stevens Point has a population of over 26,000 while Portage County's population exceeds 70,000. The racial makeup of the city is 91.7% White, 4.68% Asian, 0.92% African American, 0.43% Native American and 2.27% from other races. The population age is widespread, with 16% under the age of 18, 31.2% from ages 18 to 24, 27.3% from ages 25 to 49, 13.5% from ages 50 to 64, and 12% who were 65 years of age and above. Based on 2010 estimates, the per capita income of the city was $21,653. About 17.3% of the population had incomes below the poverty line. Unemployment rates between October 2011 and September 2012 averaged about 8%. Like much of the country, the area continues to feel the effects of the economic downturn and has experienced a very slow recovery after the significant loss of jobs since 2009. Stevens Point is home to the University of Wisconsin - Stevens Point, which enrolls almost 10,000 students in both undergraduate and graduate degree programs. Mid-State Technical College ("MSTC"), a technical college, is also located in the city. Major employers include Sentry Insurance, the University of Wisconsin - Stevens Point, Ministry Health Care, Inc., Associated Banc-Corp and Travel Guard. 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 who 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.Certain specialized services available include: dental services to primarily the indigent, fertility clinic services and WIC home visits to new mothers and infants 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. - 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 Hospital, 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. X 1 1 0 1 0 0 0 0 0 0 0 Jeffrey L Martin President 428700 0 69766 0 63173 0 113532 0 23251 0 698422 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 David M Groen Director Pharmacy 138647 0 0 0 19695 0 16811 0 28426 0 203579 0 0 0 George W Davidson Dentist Senior 120742 0 0 0 48724 0 41273 0 15108 0 225847 0 0 0 Christopher J Thompson Clinical Staff Pharmacist 103614 0 16779 0 20244 0 16782 0 26744 0 184163 0 0 0 Tyler C Christopherson Dentist 117716 0 0 0 11308 0 7708 0 22574 0 159306 0 0 0 Mark Kienbaum Clinical Staff Pharmacist 107077 0 0 0 17019 0 16392 0 4424 0 144912 0 0 0 Jeff Badger Former Officer 0 405962 0 56934 0 34917 0 44888 0 18099 0 560800 0 0 Part I, Line 1a Saint Michael's Hospital of Stevens Point, 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 recipients 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 Saint Michael's Hospital of Stevens Point, 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 Supplies 13 52125 FMV 0 0 1 0 Part I, Column (b): The amounts showing in Column (b) represent the number of contributions. 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 Saint Michael's Hospital of Stevens Point, Inc. has begun the process of standardizing their governing documents to reflect the change in sponsorship from Marian Health System, Inc. to Ascension Health. Saint Michael's Hospital of Stevens Point, Inc. 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 Saint Michael's Hospital of Stevens Point, Inc. has a single corporate member, Ministry Health Care, Inc. Form 990, Part VI, Section A, line 7a Saint Michael's Hospital of Stevens Point, Inc. has a single corporate member, Ministry Health Care, Inc. who has the ability to elect members to the governing body of Saint Michael's Hospital of Stevens Point, Inc. Form 990, Part VI, Section A, line 7b All decisions that have a material impact to the Saint Michael's Hospital of Stevens Point, 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 Conflict of Interest Policy, has read and understands the policy, has agreed to comply with the policy, and understands that the Organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose. Form 990, Part VI, Section B, line 15 In determining compensation of the Organization's CEO, the process performed by Ministry Health Care, Inc., a related organization of Saint Michael's Hospital of Stevens Point, 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. 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 Saint Michael's Hospital of Stevens Point, 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, Conflict of Interest Policy and financial statements are not included on any web page. However, if any inquiry is made for any documents they are shared as appropriate. Form 990, Part VII, Section B: Amounts paid to Ellis Stone Construction Co., Inc. represent payments for both services and goods. These amounts cannot be separated. Form 990, Part XI, line 9: E HR Transfers 4,358,334. Fund Balance Transfer - Foundation -18,371. Final D&T Fixed Asset Reconciliation Adjustment 33,511. Pension Adjustment 2,666,295. MDC Loss Funding Transfer 100,000. MHC Risk Captial Transfer -533,333. SJH Outreach Allocation -3,999,996. 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 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 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 1 0 0 0 0 1 0 0 0 0 1 1 1 1 1 Saint Michael's Foundation of Stevens Point Inc R 112021 FMV Saint Michael's Foundation of Stevens Point Inc O 61634 FMV Ministry Health Care Inc O 15526026 FMV Saint Joseph's Hospital of Marshfield Inc O 147757 FMV Ministry Medical Group Inc O 14488543 FMV Ministry Health Care Inc R 761373 FMV Ministry Health Care Inc E 3143663 FMV Ministry Health Care Inc P 26101775 FMV Ministry Health Care Inc J 262379 FMV Saint Michael's Foundation of Stevens Point Inc C 229911 FMV Ministry Medical Group Inc Q 668901 FMV Mercy Medical Center of Oshkosh Inc Q 131200 FMV Ministry Home Care Inc S 52575 FMV