2015-05-15T15:12:34-05:00 2014-06-30 861065772 Deloitte Tax LLP 555 East Wells Street Suite 1400 Milwaukee WI 53202 990 2013-07-01 390847631 Saint Joseph's Hospital of Marshfield Inc STJO 7152955942 611 Saint Joseph Avenue Marshfield WI 544491898 BRIAN KIEF Ministry Health Care CAFO 7152955942 2015-05-15 1 Rachel Becker P00966076 4142713000 2013 2016-02-25 16:41:14Z Brian Kief 611 Saint Joseph Avenue Marshfield WI 544491898 373559982 0 0928 X www.stjosephs-marshfield.org X 1955 WI To further the healing ministry of Jesus by improving the health and well-being of all people. 12 11 2313 344 87095 -34081 240891 1184006 272912699 360332127 3378741 7056015 1980701 4774704 278513032 373346852 0 0 0 0 91943698 136879953 0 0 397338 148514592 189625066 240458290 326505019 38054742 46841833 420685314 483589473 49075103 32360206 371610211 451229267 Saint Joseph's Hospital of Marshfield, 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. 0 0 250693519 361895145 Saint Joseph's Hospital of Marshfield, Inc. provides inpatient, outpatient, emergency room and ancillary services regardless of an individual's ability to pay or method of payment. The Hospital also provides educational programs and services on health care issues to the community it serves. See Schedule H for further details regarding the community benefits that Saint Joseph's Hospital of Marshfield, Inc. provides. 250693519 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 0 0 0 0 0 1 1 1 0 0 1 146 0 1 2313 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 Avenue Appleton WI 54911 X Rick Mueller DMD Chairperson 1.00 0.00 X X 0 0 0 Brenda Dillenburg Vice-Chairperson 1.00 0.00 X X 0 0 0 Sister Barbara Hollweck Secretary 1.00 1.00 X X 0 0 0 William Sennholz Treasurer 1.00 0.00 X X 0 0 0 Lisa Benson MD Director 1.00 0.00 X 0 0 0 Jean Campbell Director 1.00 0.00 X 0 0 0 Bill Creske Director 1.00 0.00 X 0 0 0 Edward Fernandez MD Director 1.00 0.00 X 0 0 0 Josh Meissner Director 1.00 0.00 X 0 0 0 Bill Mork Director 1.00 0.00 X 0 0 0 Amy Nienast start 1013 Director 1.00 0.00 X 0 0 0 Kenneth Heiman end 1013 Director 1.00 40.00 X X 0 0 0 Brian Kief President 40.00 1.60 X X 513755 0 100769 Michael Kyrda MD end 1013 Board Member, VP-Corporate 10.00 30.00 X X 0 82704 7436 Nicholas Desien Ministry Health Care CEO 0.50 55.80 X 0 2061606 41974 Jeffrey Francis Ministry Health Care CAFO 0.50 65.40 X 0 522252 124025 Layton Anderson VP, Hospital Operations 40.00 0.00 X 160566 0 35882 Sharon B Kostroski SJH VP Quality & Safety 40.00 0.00 X 193990 0 37398 Larry Hegland Chief Medical Officer 10.00 10.00 X 0 312818 42802 Vanessa L Freitag Director Pharmacy 40.00 0.00 X 153330 0 42288 Michelle L Brenner Manager Pharmacy 40.00 0.00 X 158750 0 42624 Renee M Danhof Director Food & Nutrition Services 40.00 0.00 X 160617 0 47754 Benjamin J Jung Clinical Lead Pharmacist 40.00 0.00 X 150840 0 29871 Cynthia L Tullbane Director Clinical Resources Mgmt. 40.00 0.00 X 147309 0 1385 Jeff Badger Former Officer 0.00 52.00 X 0 497813 62987 Craig Cook Former Key Employee 0.00 0.00 X 0 356248 11832 1639157 3833441 629027 52 1 1 0 Marshfield Clinic 1000 North Oak Avenue Marshfield WI 54449 Medical Services 43692623 Air Methods Corporation PO Box 172892 Denver CO 802172892 Medical Services 3197383 Medical Staffing Solutions Inc PO Box 101 Rice Lake WI 54868 Agency 1420269 Medical College of WI 8701 Watertown Plank Rd Milwaukee WI 532260509 Agency 1406104 Masters Building Solutions Inc 908 Stewart St Madison WI 53713 Construction (Sch O) 1344284 21 435344 379265 369397 9766 1184006 Net Patient Revenue 622110 351480243 351480243 Pharmacy 446110 7564547 7477452 87095 Rent from Exempt Org. 532000 1126780 1126780 Medical Supplies 446110 86664 86664 73893 73893 360332127 7123076 7123076 45885 82856 -36971 -36971 -36971 46726 113787 -67061 -67061 -67061 18960 16487 2473 2473 Dietary/Cafeteria Sale 722210 2032309 2032309 Medicare Stimulus 900099 2023096 2023096 Purchase Discounts 900099 320496 320496 433301 433301 4809202 373346852 361895145 87095 10180606 1042360 802617 229320 10423 104593817 80597394 23901883 94540 2446483 2423762 18137 4584 22582167 15385553 7116805 79809 6215126 6104765 92643 17718 1154 1154 750 750 12070 12070 10576 10576 26293490 16368798 9924692 11278 11278 44720368 34775353 9910368 34647 416006 416006 5433349 3861348 1572001 674679 612445 48162 14072 1130930 171714 951071 8145 29 29 19506827 15138914 4367131 782 1102108 972977 129131 Purchased Services 44659967 32315096 12299228 45643 Pharmaceuticals 17665233 17588004 77229 SJH Outreach Allocation 12200000 12200000 State Assessment 9142892 9142892 6643360 1803420 4765035 74905 326505019 250693519 75414162 397338 100113578 13302336 1235922 1310922 49012785 56066851 52809 1712321 8439181 8954751 732843 767969 158880113 21108733 123361378 137771380 1458 11613933 4049085 126121427 259653858 420685314 483589473 33105918 25564571 58615 68709 15910570 6726926 49075103 32360206 X 371535211 450043906 1010031 75000 175330 371610211 451229267 420685314 483589473 X 46841833 11216550 21560673 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 12070 12070 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 Joseph's Hospital of Marshfield, 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. 0 185944 18202 204146 156092 29852 185944 152956 3136 156092 149898 3176 118 152956 147819 3577 1498 149898 0.00000 0.49000 0.51000 0 1 1 8263776 8263776 68103081 6483097 61619984 1599460 130882 1468578 47653181 8523389 39129792 33260615 5971365 27289250 137771380 Accounts Receivable - All Other 5473 Intercompany - Ministry Health Care, Inc. 2270063 Interest in Investments Held by Ascension Health Alliance 257378322 259653858 Accretion Amortization 198293 Asset Retirement Obligation 111054 Due to 3rd Party Medicare 3468757 Due to 3rd Party Other 3119225 Pension Reserve -612156 Unspecified Reserve 441753 6726926 X Part V, Line 4: Stevens Endowmwent - fund and support continued education/conferences for birth center nurses at St. Joseph's Hospital of Marshfield, Inc.: Deitman Endowment - fund and support continued critical care nursing education at St. Joseph's Hospital of Marshfield, Inc.; Nursing Endowment - to support St. Joseph's Hospital of Marshfield, Inc. nursing education needs. Part X, Line 2: From the consolidated audited financial statements of Ministry Health Care, Inc. which include the activity of Saint Joseph's Hospital of Marshfield, 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 1 0 1 1 3588868 3588868 0.01100 46033217 25103652 20929565 0.06410 0.00000 49622085 25103652 24518433 0.07510 20 1652451 6055 1646396 0.00500 7 12797251 2139382 10657869 0.03260 2 129929 129929 0.00040 0.00000 12 1037562 170462 867100 0.00270 41 15617193 2315899 13301294 0.04070 41 65239278 27419551 37819727 0.11580 1 250 20471 20471 0.00010 1 4460 4460 0.00000 2 168 24857 24857 0.00010 3 17 29407 29407 0.00010 7 435 79195 79195 0.00030 0 12641457 0 136174079 158190889 -22016810 X 1 1 1 1 Saint Joseph's Hospital of Marshfield 611 Saint Josephs Avenue Marshfield WI 54449 www.ministryhealth.org 5297-800 X X X X X St Joseph's Hospital of Marshfield Inc 1 1 X X X X X X X X X 12 1 1 1 X See Narrative X www.co.wood.wi.us X X X X X X X X X 1 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 St. Joseph's Hospital of Marshfield, Inc. Part V, Section B, Line 3: In 2012, a Community Health Needs Assessment (CHNA) was conducted by Wood County Health Department, Ministry Saint Joseph's Hospital and Riverview Hospital. The assessment team was comprised of health leaders and community stakeholders. This community team of Wood County representatives was formed to:1. Review health problems with preventable causes that impact our residents.2. Select top health priorities to be focused on in the next five years.3. Develop goals, measurable outcomes and strategies that will address the top health priorities.Public Health ExpertsThe team was led by Public Health and Demographic Experts:Sue Kunferman, RN, MSN, CPMDirector, Wood County Health DepartmentAngela Nimsgern, MPH, CPH - Regional DirectorWisconsin Division of Public Health, Northern Region OfficeMore than 12 years of experience with community health assessments.Jim Lawrence, RS - Public Health EducatorWisconsin Division of Public Health, Northern Region OfficeMore than 20 years of experience in public healthPeter Manley, BS, MS - Community Resource Development EducatorWood County University of Wisconsin Extension St. Joseph's Hospital of Marshfield, Inc. Part V, Section B, Line 4: The CHNA was conducted with Riverview Hospital (Wisconsin Rapids). St. Joseph's Hospital of Marshfield, Inc. Part V, Section B, Line 7: A plan has been developed which will focus on each of the identified priorities. However, there are two other Ministry hospitals within our service area - Ministry Saint Clare's Hospital in Marathon County and Ministry Our Lady of Victory in Clark County. Each of these hospitals will work with their county health department on their identified needs. Ministry Saint Joseph's Hospital will partner with these hospitals on efforts that cross our service areas.We will work with other health care providers, such as those at Riverview Hospital and Marshfield Clinic, within in our service area to further collaborate to improve outcomes, not lead the initiatives. St. Joseph's Hospital of Marshfield, 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 website is as follows:http://ministryhealth.org/SaintJosephsHospital/Ministry_Saint_Josephs_Hospital_CHNA_2013_FINAL3.pdf Part I, Line 6a: Saint Joseph's Hospital of Marshfield 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 network of hospitals, clinics and other health-related organizations. Part I, Line 7: 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 programs 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. Community Support includes disaster readiness such as mock crash drills in community, National Disaster Medical Team, state and regional disaster preparedness meetings. Environmental Improvements include waste reduction and sharps disposal (which involves the collection of home sharps). Coalition building includes activities such as hospital staff serving on Opportunity Development Center Board, United Way Board, Center for Family Visitation Consulting Committee, Medical Advisory Board, State and Regional Trauma Advisory Board, Healthy Lifestyles Coalition, Congestive Heart Failure Board. Workforce Development includes Health Career Connections for high school youth, job shadowing, and project search (which include helping those with disabilities train for potential work in a hospital setting). 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. 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 Joseph's Hospital of Marshfield, 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 consolidated financial statements of Ministry Health Care, Inc. which includes the activity of Saint Joseph's Hospital of Marshfield, Inc.:The provision for doubtful accounts is based upon management's assessment of expected net collections considering economic conditions, historical experience, trends in healthcare 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 the System. 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 fiscal 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 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 health needs through review of United Way Life Study results, 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 organizations strategy and policy development. Senior leaders and management are also highly encouraged to provide direct service to the poor in their communities. Part VI, Line 3: Ministry Health Care, Inc. 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 either in securing a funding source (grants, Cobra coverage, disability benefits, Medicaid, VA, etc) if eligible or assist them in completing a financial assistance application. 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. Saint Joseph's Hospital of Marshfield, Inc. 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 community hospitals, was created and is maintained in order to provide care locally - care that without our hospital, may not be available locally.As of the 2010 census, the population of Marshfield was 19,118. The 2013 estimated population is 18,750. Based on the 2010 census, the racial make-up was 93.5% White, 0.7% African American, 0.2% Native American, 2.3% Asian, 2.4% Hispanic, and 0.9% of other races. 18.4% were over 65 year old and 20.9% under 18. The median household income for the last five years was $42,448 and 13.2% of the population was below the poverty line. Part VI, Line 5: The Organization strives to further its exempt purposes by the following:- The Organization's governing board consists primarily of persons who reside within the primary service area who are not employees of the Organization.- As mentioned, the Organization provides several services which are not otherwise available being in a rural setting.- Based on the Organization's mission, emergency rooms are made available to all patients regardless of the ability to pay.- The Organization also participates in the education and training of healthcare professionals through internship programs.- The Hospital participates in government-sponsored health programs (Medicare, Medicaid, Champus, Tricare).- The Hospital offers volunteer opportunities to the community or evidence of the Organization's responsiveness to the community, including opportunities for community involvement in governance and advisory groups and examples of programs that were established in the tax year that responded to community needs.- The Facility strives to be a low-cost/low-charge facility.- Advocates community-wide, state or national efforts to improve health of the population and increase access.- Partnerships with others in the community (including public health departments) to improve community health and well-being.- The role of the emergency department and urgent care units in serving all persons regardless of ability to pay.- Availability of financial assistance and sliding scale discounts and changes to financial assistance or collection policies that would be viewed as constructive.- The Organization is a sole community hospital.- Community members utilize the Hospital as a vehicle to connect with and contribute to individuals and the overall community through philanthropy and volunteering.- Programs are having an impact on community health especially prevention activities, efforts to improve health and increase access to health care services, and reducing health care costs. Part VI, Line 6: Ministry Health Care, Inc. (Ministry or the Health Ministry) is a member of Ascension Health. In December 2011, Ascension Health Alliance, doing business as Ascension, became the sole corporate member and parent organization of Ascension Health, a Catholic, national health system consisting primarily of nonprofit corporations that own and operate local health care facilities, or Health Ministries, located in 23 of the United States and the District of Columbia. In addition to serving as the sole corporate member of Ascension Health, Ascension serves as the member or shareholder of various other subsidiaries. Ascension, its subsidiaries, and the Health Ministries are referred to collectively from time to time hereafter as the System.Ascension is sponsored by Ascension Sponsor, a Public Juridic Person. The Participating Entities of Ascension Sponsor are the Daughters of Charity of St. Vincent de Paul, St. Louise Province; the Congregation of St. Joseph; the Congregation of the Sisters of St. Joseph of Carondelet; the Congregation of Alexian Brothers of the Immaculate Conception Province, Inc. American Province; and the Sisters of the Sorrowful Mother of the Third Order of St. Francis of Assisi US/Caribbean Province. 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, Inc. (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, Inc. Oshkosh, WIMercy Health Foundation Oshkosh, WISt. Elizabeth Hospital Appleton, WICatalpa Health Appleton, WISt. Elizabeth Foundation Appleton, WIAgape Community Center of Milwaukee, Inc. Milwaukee, WIDoor County Memorial Hospital (Door County) Sturgeon Bay, WIGood Samaritan Health Center of Merrill Merrill, WIGood Samaritan Health Center Foundation Merrill, WIHoward Young Health Care, Inc. (Howard Young)Dr. Kate Newcomb Convalescent Center Woodruff, WIHoward Young Medical Center, Inc. Woodruff, WIHoward Young Foundation Woodruff, WIEagle River Memorial Hospital, Inc. 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 Stanley, WISacred Heart Hospital- Tomahawk, WI/Rhine-St. Mary's Hospital, Inc. -lander, WISt. Clare's Hospital of Weston, Inc. Weston, WIFoundation of St. Clare's Hospital of Weston, Inc. Weston, WISt. Elizabeth's Hospital of Wabasha, Inc. Wabasha, MNSt. Joseph's Hospital of Marshfield, Inc. Marshfield, WIFoundation of St. Joseph's Hospital of Marshfield, Inc. Marshfield, WISt. Michael's Hospital of Stevens Point, Inc. Stevens Point, WISt. 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 that sustains and improves the health of the individuals and communities it serves. In accordance with the System's mission of service to those persons living in poverty and 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 health care 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 using internal cost data and is estimated by reducing charges forgone by a factor derived from the ratio of total operating expenses to billed charges for patient care. The amount of traditional charity care provided, determined on the basis of cost, was approximately $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 1 1 0 0 0 0 0 0 0 Brian Kief President 426500 0 51025 0 36230 0 81000 0 19769 0 614524 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 Layton Anderson VP, Hospital Operations 150841 0 5472 0 4253 0 17500 0 18382 0 196448 0 0 0 Sharon B Kostroski SJH VP Quality & Safety 162781 0 8609 0 22600 0 20779 0 16619 0 231388 0 0 0 Larry Hegland Chief Medical Officer 0 265897 0 24091 0 22830 10631 18544 9085 4542 19716 335904 0 0 Vanessa L Freitag Director Pharmacy 140475 0 0 0 12855 0 11009 0 31279 0 195618 0 0 0 Michelle L Brenner Manager Pharmacy 146713 0 0 0 12037 0 9240 0 33384 0 201374 0 0 0 Renee M Danhof Director Food & Nutrition Services 132071 0 0 0 28546 0 25970 0 21784 0 208371 0 0 0 Benjamin J Jung Clinical Lead Pharmacist 118806 0 16779 0 15255 0 14284 0 15587 0 180711 0 0 0 Jeff Badger Former Officer 0 405962 0 56934 0 34917 0 44888 0 18099 0 560800 0 0 Craig Cook Former Key Employee 0 99134 0 0 0 257114 0 8378 0 3454 0 368080 0 0 Part I, Line 1a Social club dues are provided to an individual listed on Form 990, Part VII and expensed by the filing organization. The amount was included as reportable compensation for this individual. Part I, Line 3 Ministry Health Care, Inc., a related organization of Saint Joseph's Hospital of Marshfield, Inc., uses the following to establish the compensation of the organization's CEO/Executive Director: - Compensation Committee - Independent Compensation Consultant - Compensation Survey or Study, and - Approval by the Board or Compensation Committee Part I, Line 4a: The following individuals received a severance payment during calendar year 2013: Craig Cook - $166,378 Part I, Line 4b: Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment 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. No distributions were made from the plan in the current year. 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 related entities. Form 990, Part VI, Section A, line 6 Saint Joseph's Hospital of Marshfield, Inc. has a single corporate member, Ministry Health Care, Inc. Form 990, Part VI, Section A, line 7a Saint Joseph's Hospital of Marshfield, Inc. has a single corporate member, Ministry Health Care, Inc., who has the ability to elect members to the governing body of Saint Joseph's Hospital of Marshfield Inc. Form 990, Part VI, Section A, line 7b All decisions that have a material impact to Saint Joseph's Hospital of Marshfield, 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 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 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: The payments reported on Form 990, Part VII, Section B for Masters Building Solutions, Inc. represent amount for both services and expenses. These amounts cannot be separated. Form 990, Part XI, line 9: Final D&T Fixed Asset Reconciliation Adjustment -1,291,780. Year End Adjustments - Pension 10,819,244. Equity Transfer E HR 1,222,848. Capital Risk Transfers Intercompany -2,500,000. Intercompany Transfers 13,310,361. 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 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 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 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 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 1 1 1 0 0 0 1 0 0 1 0 1 0 1 1 1 1 1 1 Ministry Home Care Inc A 52695 FMV Foundation of Saint Joseph's Hospital of Marshfield Inc C 435344 FMV Ministry Health Care Inc J 509128 FMV Foundation of Saint Joseph's Hospital of Marshfield Inc L 397338 FMV Ministry Health Care Inc O 33632807 FMV Saint Clare's Hospital of Weston Inc O 454909 FMV Sacred Heart-Saint Mary's Hospitals Inc O 64975 FMV Saint Michael's Hospital of Stevens Point Inc O 147757 FMV Our Lady of Victory Hospital Inc O 60286 FMV The Howard Young Medical Center Inc O 109664 FMV Ministry Home Care Inc O 67703 FMV Ministry Medical Group Inc O 161526 FMV Ministry Health Care Inc P 55404728 FMV Ministry Health Care Inc R 2500000 FMV Foundation of Saint Joseph's Hospital of Marshfield Inc R 201618 FMV