HOLY FAMILY MEMORIAL INC: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization: HOLY FAMILY MEMORIAL INC (EIN 39-0806395)
Tax period: 2014-01-01 to 2014-12-31
Filed: 2015-11-16
IRS object ID: 201543209349312649
Schema version: 2014v5.0
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule G
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2015-11-16T16:02:51-06:00	ReturnTs
Tax Period End	2014-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	391173131	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	SCHENCK SC	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	100 MARITIME DRIVE SUITE 2B	AddressLine1Txt
City	MANITOWOC	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54220	ZIPCd

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

Filer Filer

Field	Value	IRS element (for citing)
EIN	390806395	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	HOLY FAMILY MEMORIAL INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	HOLY	BusinessNameControlTxt
Phone	9203202011	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2300 WESTERN AVE PO BOX 1450	AddressLine1Txt
City	MANITOWOC	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	542211450	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	MARK HERZOG	PersonNm
Person Title	PRESIDENT / CEO	PersonTitleTxt
Phone	9203203470	PhoneNum
Signature	2015-11-16	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	KELLY BLOCK CPA	PreparerPersonNm
PTIN	P00199509	PTIN
Phone	9206845500	PhoneNum

Field	Value	IRS element (for citing)
Tax	2014	TaxYr
Build TS	2016-04-25 22:37:26Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	MARK HERZOG	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2300 WESTERN AVE PO BOX 1450	AddressLine1Txt
City	MANITOWOC	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	542211450	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$132,980,139	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.HFMHEALTH.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1899	FormationYr
Legal Domicile State	WI	LegalDomicileStateCd
Activity Or Mission	HEALTH CARE SERVICESSEE SCHEDULE O HOLY FAMILY MEMORIAL IS A NETWORK OF HEALTH PROFESSIONALS WHO, ROOTED IN THE HEALING MINISTRY OF JESUS CHRIST, PROVIDE SERVICES TO HELP INDIVIDUALS AND OUR COMMUNITIES ACHIEVE HEALTHIER LIVES. HFM PROVIDES ACUTE, OUTPATIENT, CLINIC, HOME CARE AND HOSPICE SERVICES FOR MANITOWOC COUNTY, STRIVING FOR MEDICIAL EXCELLENCE AND VALUED OUTCOMES WITHIN A COMPASSIONATE, VALUES BASED, CHRISTIAN ENVIRONMENT.	ActivityOrMissionDesc
Voting Members Governing Body	18	VotingMembersGoverningBodyCnt
Voting Members Independent	13	VotingMembersIndependentCnt
Total Employee	1277	TotalEmployeeCnt
Total Volunteers	312	TotalVolunteersCnt
Total Gross UBI	$38,323	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	-$14,580	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$596,002	PYContributionsGrantsAmt
CY Contributions Grants	$151,025	CYContributionsGrantsAmt
PY Program Service Revenue	$132,958,817	PYProgramServiceRevenueAmt
CY Program Service Revenue	$128,259,931	CYProgramServiceRevenueAmt
PY Investment Income	$3,202,328	PYInvestmentIncomeAmt
CY Investment Income	$3,632,177	CYInvestmentIncomeAmt
PY Other Revenue	$179,589	PYOtherRevenueAmt
CY Other Revenue	$1,993	CYOtherRevenueAmt
PY Total Revenue	$136,936,736	PYTotalRevenueAmt
CY Total Revenue	$132,045,126	CYTotalRevenueAmt
PY Grants And Similar Paid	$65,719	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$60,800	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$78,978,708	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$76,650,015	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$240,200	CYTotalFundraisingExpenseAmt
PY Other Expenses	$53,410,505	PYOtherExpensesAmt
CY Other Expenses	$50,847,874	CYOtherExpensesAmt
PY Total Expenses	$132,454,932	PYTotalExpensesAmt
CY Total Expenses	$127,558,689	CYTotalExpensesAmt
PY Revenues Less Expenses	$4,481,804	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$4,486,437	CYRevenuesLessExpensesAmt
Total Assets BOY	$176,647,204	TotalAssetsBOYAmt
Total Assets EOY	$176,983,319	TotalAssetsEOYAmt
Total Liabilities BOY	$64,072,941	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$60,795,601	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$112,574,263	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$116,187,718	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	HOLY FAMILY MEMORIAL IS A NETWORK OF HEALTH PROFESSIONALS WHO, ROOTED IN THE HEALING MINISTRY OF JESUS CHRIST, PROVIDE SERVICES TO HELP INDIVIDUALS AND OUR COMMUNITIES ACHIEVE HEALTHIER LIVES.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$115,442,567	ExpenseAmt
Grant	$60,800	GrantAmt
Revenue	$131,896,273	RevenueAmt
Desc	HOLY FAMILY MEMORIAL IS AN INTEGRATED NETWORK PROVIDING HEALTH CARE SERVICES INTENDED TO BENEFIT THE HEALTH AND WELLBEING OF THE COMMUNITIES IT SERVES. THESE SERVICES INCLUDE PRIMARY AND SPECIALTY CLINIC CARE, PREVENTIVE CARE SUCH AS HEALTH SCREENINGS, VACCINATION CLINICS AND HEALTH EDUCATION CLASSES, 24/7 EMERGENCY CARE, WALK-IN, INPATIENT ACUTE CARE, OUTPATIENT CARE, HOME CARE AND HOSPICE, HOME MEDICAL EQUIPMENT, PRESCRIPTIONS, OCCUPATIONAL HEALTH SERVICES, AND MEDICALLY BASED FITNESS AND WELLNESS. HOLY FAMILY MEMORIAL HAS BEEN ABLE TO ACHIEVE A GREATER IMPACT IN THE COMMUNITY BY PARTNERING FINANCIAL, HUMAN AND PROGRAMMATIC RESOURCES WITH OTHER ORGANIZATIONS. (CONTINUED ON SCHEDULE O)THESE PARTNERSHIPS INCLUDE A COMMITMENT TO COLLABORATE WITH OTHER HEALTH AND SOCIAL SERVICE AGENCIES TO IMPROVE ACCESS TO CARE, FOCUS ON PREVENTIVE SERVICES, REDUCE COMMUNITY HEALTH RISKS AND CONTRIBUTE TO A HEALTHIER, VIBRANT COMMUNITY.HOLY FAMILY MEMORIAL PROVIDES MEDICALLY NECESSARY SERVICES WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICIES. IN ASSESSING A PATIENT'S ABILITY TO PAY, HOLY FAMILY MEMORIAL UTILIZES GENERALLY RECOGNIZED POVERTY INCOME LEVELS OF THE COMMUNITIES IT SERVES AND CONSIDERS SITUATIONS WHERE INCURRED CHARGES ARE SIGNIFICANT WHEN COMPARED TO THE PATIENT'S FINANCIAL RESOURCES. BECAUSE HOLY FAMILY MEMORIAL DOES NOT EXPECT TO RECEIVE PAYMENT OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THESE AMOUNTS ARE NOT INCLUDED IN NET PATIENT SERVICE REVENUES. HOLY FAMILY MEMORIAL'S TOTAL COMMUNITY BENEFIT INCLUDES THE COST OF CHARITY CARE AND UNPAID COST OF PUBLIC PROGRAMS (MEDICARE AND MEDICAID) AS WELL AS THOSE DISCUSSED ABOVE. HOLY FAMILY MEMORIAL'S COMMUNITY BENEFIT WAS APPROXIMATELY $23,957,000 FOR THE YEAR ENDED DECEMBER 2014. THIS AMOUNT INCLUDES THE NET COST OF CHARITY CARE OF APPROXIMATELY $985,000. MORE INFORMATION AVAILABLE FROM OUR COMMUNITY BENEFIT REPORT WHICH CAN BE LOCATED ON OUR WEBSITE AT WWW.HFMHEALTH.ORG.	Desc
Total Program Service Expenses	$115,442,567	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Temp Or Permanent Endowments	Yes (1)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	Yes (1)	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	0	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	Yes (1)	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	Yes (1)	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	0	GrantsToOrganizationsInd
Grants To Individuals	Yes (1)	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (1)	TaxExemptBondsInd
Invest Tax Exempt Bonds	0	InvestTaxExemptBondsInd
Escrow Account	0	EscrowAccountInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (1)	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	Yes (1)	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	Yes (1)	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (1)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	34	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	1277	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	Yes (1)	QuidProQuoContributionsInd
Quid Pro Quo Contri Discl	Yes (1)	QuidProQuoContriDisclInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Form8899 Filedind	0	Form8899Filedind
Form1098 C Filed	0	Form1098CFiledInd
DAF Excess Business Holdings	0	DAFExcessBusinessHoldingsInd
Taxable Distributions	0	TaxableDistributionsInd
Distribution To Donor	0	DistributionToDonorInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	18	GoverningBodyVotingMembersCnt
Independent Voting Member	13	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	0	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	WI	StatesWhereCopyOfReturnIsFldCd
Other Website	Yes (X)	OtherWebsiteInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MARK HERZOG PRESIDENT CEO	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	9203203470	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2300 WESTERN AVENUE	AddressLine1Txt
City	MANITOWOC	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	542211450	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (30 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
RYAN M DOPIRAK MD
PHYSICIAN COUNCIL CHAIR	40.00	Yes (X)	$1,139,160	$0	$31,808
MATTHEW L CAMPBELL MD
PHYSICIAN COUNCIL CHAIR	40.00	Yes (X)	$322,699	$0	$29,000
XA XIONG MD
DIRECTOR	40.00	Yes (X)	$189,733	$0	$26,278
MARY A GOVIER MD
DIRECTOR	40.00	Yes (X)	$92,653	$0	$14,318
DEREK R BOWN DC
DIRECTOR	40.00	Yes (X)	$126,916	$0	$26,938
DONALD R BRISCH
TREASURER	2.00	Yes (X)	$0	$0	$0	Yes (X)
WILLIAM R CASEY
CHAIR	2.00	Yes (X)	$0	$0	$0	Yes (X)
LAURIE CRAWFORD
SECRETARY	2.00	Yes (X)	$0	$0	$0	Yes (X)
JEFFREY S DUNN
DIRECTOR	2.00	Yes (X)	$0	$0	$0
SISTER LORITA M GAFFNEY
DIRECTOR	2.00	Yes (X)	$0	$0	$0
MARILYN KAUFMANN
DIRECTOR	2.00	Yes (X)	$0	$0	$0
SISTER MARLITA HENSELER
DIRECTOR	2.00	Yes (X)	$0	$0	$0
DENISE KITZROW
VICE CHAIR	2.00	Yes (X)	$0	$0	$0	Yes (X)
JANE L PFEFFER
DIRECTOR	2.00	Yes (X)	$0	$0	$0
SISTER JAN VILLEMURE
DIRECTOR	2.00	Yes (X)	$0	$0	$0
SISTER ELAINE TURBA
DIRECTOR	2.00	Yes (X)	$0	$0	$0
KATHLEEN A ZUCCHI
DIRECTOR	2.00	Yes (X)	$0	$0	$0
SISTER LAURA WOLF
DIRECTOR	2.00	Yes (X)	$0	$0	$0
MARK P HERZOG
DIRECTOR, PRESIDENT, CEO	40.00	Yes (X)	$875,557	$0	$133,477	Yes (X)
PATRICIA HUETTL
CHIEF FINANCIAL OFFICER	40.00		$273,628	$0	$69,523	Yes (X)
STEVEN D DRIGGERS MD
CHIEF MEDICAL OFFICER	40.00		$531,886	$0	$84,903		Yes (X)
MARY MAURER
CHIEF INNOVATION OFFICER	40.00		$364,956	$0	$44,517		Yes (X)
KIRK DIMITRIS MD
PHYSICIAN	40.00		$1,201,017	$0	$26,324			Yes (X)
DAVID MIKOLYZK MD
PHYSICIAN	40.00		$982,468	$0	$31,278			Yes (X)
MICHAEL ROSENBERG MD
PHYSICIAN	40.00		$570,245	$0	$26,579			Yes (X)
NANCY N BUTLER MD
PHYSICIAN	40.00		$606,802	$0	$13,323			Yes (X)
JEFFREY A JACOBY MD
PHYSICIAN	40.00		$619,756	$0	$16,189			Yes (X)
JANE CURRAN-MEULI
EXECUTIVE VP, COO	40.00		$144,198	$0	$12,237			Yes (X)
WILLIAM D HAMPTON MD
FORMER DIRECTOR	40.00		$292,173	$0	$29,079				Yes (X)
WILLIAM C CENSKY
FORMER CHAIR	2.00		$0	$0	$0				Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$8,333,847	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$615,771	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	82	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (1)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
CARETECH SOLUTIONS
901 WILSHIRE DRIVE STE 250	TROY	MI	48084	IT SERVICES	$6,120,575
COMPLETERX LTD
3100 S GESSNER STE 640	HOUSTON	TX	77063	PHARMACY SERVICES	$5,665,114
PATRIOT MEDICAL TECH
PO BOX 415000	NASHVILLE	TN	372415000	BIO-MED SERVICES	$1,161,463
SCHAUS ROOFING & MECHANICAL
2901 CALUMET AVENUE	MANITOWOC	WI	54220	MAINTENANCE SERVICES	$766,123
RADIATION ONCOLOGY SPECIALISTS
PO BOX 678	STURGEON BAY	WI	54235	CANCER CARE SERVICES	$589,085

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	15	CntrctRcvdGreaterThan100KCnt
Fundraising	$39,054	FundraisingAmt
Government Grants	$55,225	GovernmentGrantsAmt
All Other Contributions	$56,746	AllOtherContributionsAmt
Noncash Contributions	$15,008	NoncashContributionsAmt
Total Contributions	$151,025	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
INTEGRATED HEALTH CARE	900099	$110,996,173	$110,996,173
LAB	621500	$10,988,609	$10,958,384	$30,225
PHARMACY	446110	$6,275,149	$6,275,149

Field	Value	IRS element (for citing)
Total Program Service Revenue	$128,259,931	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$3,631,801	TotalRevenueColumnAmt
Related Or Exempt Func Income	$3,631,801	RelatedOrExemptFuncIncomeAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$255,663	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$744,732	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	-$489,069	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$489,069	TotalRevenueColumnAmt
Exclusion	-$489,069	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$35,620	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Other	$35,244	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Other	$376	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$376	TotalRevenueColumnAmt
Exclusion	$376	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$134,259	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$39,054	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$22,823	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$111,436	TotalRevenueColumnAmt
Exclusion	$111,436	ExclusionAmt

Field	Value	IRS element (for citing)
Gaming Gross Income	$5,347	GamingGrossIncomeAmt
Gaming Direct Expenses	$2,945	GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,402	TotalRevenueColumnAmt
Exclusion	$2,402	ExclusionAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$162,381	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$129,269	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$33,112	TotalRevenueColumnAmt
Unrelated Business Revenue	$33,112	UnrelatedBusinessRevenueAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
MISCELLANEOUS	900003	$452,885	$143,539	-$25,014	$334,360
INVESTMENT HFHS & DME	446110	-$108,773	-$108,773

Field	Value	IRS element (for citing)
Other Revenue Total	$344,112	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$132,045,126	TotalRevenueColumnAmt
Related Or Exempt Func Income	$131,896,273	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$38,323	UnrelatedBusinessRevenueAmt
Exclusion	-$40,495	ExclusionAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$60,800	TotalAmt
Program Services	$60,800	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$5,041,106	TotalAmt
Program Services	$2,427,048	ProgramServicesAmt
Management And General	$2,614,058	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$58,381,997	TotalAmt
Program Services	$53,972,065	ProgramServicesAmt
Management And General	$4,257,671	ManagementAndGeneralAmt
Fundraising	$152,261	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$1,376,214	TotalAmt
Program Services	$1,232,619	ProgramServicesAmt
Management And General	$139,139	ManagementAndGeneralAmt
Fundraising	$4,456	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$8,317,444	TotalAmt
Program Services	$8,189,868	ProgramServicesAmt
Management And General	$106,936	ManagementAndGeneralAmt
Fundraising	$20,640	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$3,533,254	TotalAmt
Program Services	$3,201,338	ProgramServicesAmt
Management And General	$321,384	ManagementAndGeneralAmt
Fundraising	$10,532	FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$305,778	TotalAmt
Program Services	$20,017	ProgramServicesAmt
Management And General	$262,241	ManagementAndGeneralAmt
Fundraising	$23,520	FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$38,897	TotalAmt
Management And General	$38,897	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$140,930	TotalAmt
Management And General	$140,930	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$1,456,112	TotalAmt
Program Services	$1,456,112	ProgramServicesAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$476,444	TotalAmt
Program Services	$31,032	ProgramServicesAmt
Management And General	$445,412	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$423,057	TotalAmt
Program Services	$309,408	ProgramServicesAmt
Management And General	$108,859	ManagementAndGeneralAmt
Fundraising	$4,790	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$4,953,461	TotalAmt
Program Services	$4,953,461	ProgramServicesAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$2,236,974	TotalAmt
Program Services	$1,460,242	ProgramServicesAmt
Management And General	$759,512	ManagementAndGeneralAmt
Fundraising	$17,220	FundraisingAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$384,211	TotalAmt
Program Services	$248,220	ProgramServicesAmt
Management And General	$135,500	ManagementAndGeneralAmt
Fundraising	$491	FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$312,803	TotalAmt
Program Services	$180,106	ProgramServicesAmt
Management And General	$132,697	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$2,041,125	TotalAmt
Program Services	$2,041,125	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$7,162,632	TotalAmt
Program Services	$7,018,498	ProgramServicesAmt
Management And General	$143,403	ManagementAndGeneralAmt
Fundraising	$731	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$827,003	TotalAmt
Program Services	$826,006	ProgramServicesAmt
Management And General	$997	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
MEDICAL/SURGICAL SUPPLI	$16,153,480	$16,153,480
PURCHASED SERVICES	$6,495,988	$4,543,629	$1,946,928	$5,431
STATE PROVIDER ASSESSME	$2,943,244	$2,943,244
MAINTENANCE	$2,866,548	$2,784,474	$82,074

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,629,187	TotalAmt
Program Services	$1,389,775	ProgramServicesAmt
Management And General	$239,284	ManagementAndGeneralAmt
Fundraising	$128	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$127,558,689	TotalAmt
Program Services	$115,442,567	ProgramServicesAmt
Management And General	$11,875,922	ManagementAndGeneralAmt
Fundraising	$240,200	FundraisingAmt

Field	Value	IRS element (for citing)
Joint Costs	Yes (X)	JointCostsInd

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$8,531,070	BOYAmt
EOY	$12,353,542	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$4,555,671	BOYAmt
EOY	$4,793,820	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$20,269	BOYAmt
EOY	$17,668	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$21,930,752	BOYAmt
EOY	$19,541,149	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$300,000	BOYAmt
EOY	$300,000	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$2,251,697	BOYAmt
EOY	$2,229,888	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$7,393,728	BOYAmt
EOY	$6,769,043	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$174,544,160	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$110,831,132	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$66,469,229	BOYAmt
EOY	$63,713,028	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$41,497,975	BOYAmt
EOY	$46,012,548	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$19,892,686	BOYAmt
EOY	$17,728,459	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$3,381,711	BOYAmt
EOY	$3,356,697	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$422,416	BOYAmt
EOY	$167,477	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$176,647,204	BOYAmt
EOY	$176,983,319	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$14,813,355	BOYAmt
EOY	$14,093,992	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$30,639	BOYAmt
EOY	$33,691	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$48,806,531	BOYAmt
EOY	$46,500,241	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$422,416	BOYAmt
EOY	$167,477	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$200	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$64,072,941	BOYAmt
EOY	$60,795,601	EOYAmt

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

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$110,297,499	BOYAmt
EOY	$113,656,774	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$350,024	BOYAmt
EOY	$519,926	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,926,740	BOYAmt
EOY	$2,011,018	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$112,574,263	BOYAmt
EOY	$116,187,718	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$176,647,204	BOYAmt
EOY	$176,983,319	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$4,486,437	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$1,127,161	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$254,179	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

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

Schedule A IRS990ScheduleA

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

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

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

Contributor US Address ContributorUSAddress

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

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

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	Yes (1)	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	Yes (1)	DirectContactLegislatorsInd
Direct Contact Legislators	$1,894	DirectContactLegislatorsAmt
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$8,672	OtherActivitiesAmt
Total Lobbying Expenditures	$10,566	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1:	FormAndLineReferenceDesc
Explanation	EXPLANATION: PART II-B, LINES 1B & 1G: HOLY FAMILY MEMORIAL SENT A REPRESENTATIVE TO WASHINGTON D.C. TWICE IN 2014, IN PART, TO DISCUSS SPECIFIC LEGISLATIVE MATTERS WITH THEIR FEDERAL REPRESENTATIVES. HOLY FAMILY MEMORIAL ALSO SENT A REPRESENTATIVE TO THE CAPITAL TO EDUCATE THEIR LEGISLATORS ON VARIOUS HEALTHCARE TOPICS. EXPLANATION: PART II-B, LINE 1I, OTHER ACTIVITIES: HOLY FAMILY MEMORIAL BELONGS TO THE WISCONSIN HEALTHCARE ASSOCIATION AND THE AMERICAN HEALTHCARE ASSOCIATION, WHICH USE A PERCENTAGE OF DUES FOR LOBBYING PURPOSES.	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Agent Trustee Etc	0	AgentTrusteeEtcInd
Incl Escrow Custodial Acct Liab	0	InclEscrowCustodialAcctLiabInd

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$2,276,763	BeginningYearBalanceAmt
Contributions	$428,510	ContributionsAmt
Investment Earnings Or Losses	$61,207	InvestmentEarningsOrLossesAmt
Other Expenditures	$235,539	OtherExpendituresAmt
End Year Balance	$2,530,941	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,915,567	BeginningYearBalanceAmt
Contributions	$374,287	ContributionsAmt
Investment Earnings Or Losses	$179,201	InvestmentEarningsOrLossesAmt
Other Expenditures	$192,292	OtherExpendituresAmt
End Year Balance	$2,276,763	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,637,918	BeginningYearBalanceAmt
Contributions	$514,026	ContributionsAmt
Other Expenditures	$236,377	OtherExpendituresAmt
End Year Balance	$1,915,567	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,602,667	BeginningYearBalanceAmt
Contributions	$202,680	ContributionsAmt
Investment Earnings Or Losses	-$9,775	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$500	GrantsOrScholarshipsAmt
Other Expenditures	$157,154	OtherExpendituresAmt
End Year Balance	$1,637,918	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$1,429,395	BeginningYearBalanceAmt
Contributions	$240,013	ContributionsAmt
Investment Earnings Or Losses	$162,063	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$500	GrantsOrScholarshipsAmt
Other Expenditures	$228,304	OtherExpendituresAmt
End Year Balance	$1,602,667	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.94000	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.06000	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.00000	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (1)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (1)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$4,915,540	OtherCostOrOtherBasisAmt
Book Value	$4,915,540	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$101,808,660	OtherCostOrOtherBasisAmt
Depreciation	$58,117,028	DepreciationAmt
Book Value	$43,691,632	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$5,229,767	OtherCostOrOtherBasisAmt
Depreciation	$4,819,977	DepreciationAmt
Book Value	$409,790	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$60,661,463	OtherCostOrOtherBasisAmt
Depreciation	$47,025,748	DepreciationAmt
Book Value	$13,635,715	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,928,730	OtherCostOrOtherBasisAmt
Depreciation	$868,379	DepreciationAmt
Book Value	$1,060,351	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$63,713,028	TotalBookValueLandBuildingsAmt

Financial Derivatives FinancialDerivativesGrp

Field	Value	IRS element (for citing)
Book Value	$17,728,459	BookValueAmt
Method Valuation	F	MethodValuationCd

Field	Value	IRS element (for citing)
Total Book Value Securities	$17,728,459	TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

Field	Value	IRS element (for citing)
Desc	SECURITY DEPOSIT	Desc
Amt	$200	Amt

Field	Value	IRS element (for citing)
Total Liability	$200	TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt	$130,902,912	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	-$1,127,161	NetUnrealizedGainsInvstAmt
Other Revenue	-$45	OtherRevenueAmt
Revenue Not Reported	-$1,127,206	RevenueNotReportedAmt
Revenue Subtotal	$132,030,118	RevenueSubtotalAmt
Other Revenues Not Included	$15,008	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	$15,008	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$132,045,126	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$127,543,636	TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included	-$45	OtherExpensesIncludedAmt
Expenses Not Reported	-$45	ExpensesNotReportedAmt
Expenses Subtotal	$127,543,681	ExpensesSubtotalAmt
Other Expenses Not Included	$15,008	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$15,008	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$127,558,689	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART V, LINE 4:	HOLY FAMILY MEMORIAL'S ENDOWMENT FUNDS WERE ESTABLISHED TO PROVIDE FINANCIAL SUPPORT ON AN ONGOING BASIS TO MEET THE CURRENT AND FUTURE NEEDS OF HOLY FAMILY MEMORIAL AND THE PEOPLE IT SERVES. FUNDS ARE USED FOR CAPITAL EQUIPMENT, MAJOR BUILDING IMPROVEMENTS, PROGRAM DEVELOPMENT, AND OPERATIONS.
PART XI, LINE 2D - OTHER ADJUSTMENTS:	AUDITOR RECLASS OF PURCHASED SERVICES FOR HOLY FAMILY HEALTH SERVICES -45.
PART XI, LINE 4B - OTHER ADJUSTMENTS:	NON-CASH CONTRIBUTIONS (NON-SERVICE RELATED) 15,008.
PART XII, LINE 2D - OTHER ADJUSTMENTS:	AUDITOR RECLASS OF PURCHASED SERVICES FOR HOLY FAMILY HEALTH SERVICES -45.
PART XII, LINE 4B - OTHER ADJUSTMENTS:	NON-CASH CONTRIBUTIONS (NON-SERVICE RELATED) 15,008.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Event1	SAMARITAN DAY	Event1Nm
Gross Receipts Event1	$94,228	GrossReceiptsEvent1Amt
Charitable Contri Event1	$27,777	CharitableContriEvent1Amt
Gross Revenue Event1	$66,451	GrossRevenueEvent1Amt
Other Direct Expenses Event1	$9,304	OtherDirectExpensesEvent1Amt
Event2	MARITIME MARATHON	Event2Nm
Gross Receipts Event2	$37,259	GrossReceiptsEvent2Amt
Charitable Contri Event2	$5,600	CharitableContriEvent2Amt
Gross Revenue Event2	$31,659	GrossRevenueEvent2Amt
Other Direct Expenses Event2	$12,114	OtherDirectExpensesEvent2Amt
Other Events Total	2	OtherEventsTotalCnt
Gross Receipts Other Events	$41,826	GrossReceiptsOtherEventsAmt
Charitable Contri Other Events	$5,677	CharitableContriOtherEventsAmt
Gross Revenue Other Events	$36,149	GrossRevenueOtherEventsAmt
Non Cash Prizes Other Events	$100	NonCashPrizesOtherEventsAmt
Oth Direct Expnss Other Events	$1,305	OthDirectExpnssOtherEventsAmt
Gross Receipts Total	$173,313	GrossReceiptsTotalAmt
Charitable Contributions Tot	$39,054	CharitableContributionsTotAmt
Gross Revenue Total Events	$134,259	GrossRevenueTotalEventsAmt
Non Cash Prizes Total Events	$100	NonCashPrizesTotalEventsAmt
Oth Direct Expnss Total Events	$22,723	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$22,823	DirectExpenseSummaryEventsAmt
Net Income Summary	$111,436	NetIncomeSummaryAmt

Field	Value	IRS element (for citing)
Licensed	Yes (1)	LicensedInd
Gaming Own Facility	1.00000	GamingOwnFacilityPct
Gaming Other Facility	0.00000	GamingOtherFacilityPct

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent100	Yes (X)	Percent100Ind
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent200 D	Yes (X)	Percent200DInd
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	0	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Persons Served	1639	PersonsServedCnt
Total Community Benefit Expns	$984,967	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$984,967	NetCommunityBenefitExpnsAmt
Total Expense	0.00770	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Persons Served	36596	PersonsServedCnt
Total Community Benefit Expns	$12,971,279	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,929,267	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$9,042,012	NetCommunityBenefitExpnsAmt
Total Expense	0.07090	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Persons Served	38235	PersonsServedCnt
Total Community Benefit Expns	$13,956,246	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,929,267	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$10,026,979	NetCommunityBenefitExpnsAmt
Total Expense	0.07860	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Persons Served	5131	PersonsServedCnt
Total Community Benefit Expns	$123,524	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$123,524	NetCommunityBenefitExpnsAmt
Total Expense	0.00100	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Persons Served	482	PersonsServedCnt
Total Community Benefit Expns	$130,104	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$130,104	NetCommunityBenefitExpnsAmt
Total Expense	0.00100	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$192,480	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$151,983	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$40,497	NetCommunityBenefitExpnsAmt
Total Expense	0.00030	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Persons Served	485	PersonsServedCnt
Total Community Benefit Expns	$93,346	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$93,346	NetCommunityBenefitExpnsAmt
Total Expense	0.00070	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Persons Served	6098	PersonsServedCnt
Total Community Benefit Expns	$539,454	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$151,983	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$387,471	NetCommunityBenefitExpnsAmt
Total Expense	0.00300	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Persons Served	44333	PersonsServedCnt
Total Community Benefit Expns	$14,495,700	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,081,250	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$10,414,450	NetCommunityBenefitExpnsAmt
Total Expense	0.08160	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Persons Served	50	PersonsServedCnt
Total Community Benefit Expns	$7,890	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$7,890	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$27,655	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$27,655	NetCommunityBenefitExpnsAmt
Total Expense	0.00020	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$907	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$907	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Persons Served	659	PersonsServedCnt
Total Community Benefit Expns	$3,499	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$3,499	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Persons Served	709	PersonsServedCnt
Total Community Benefit Expns	$39,951	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$39,951	NetCommunityBenefitExpnsAmt
Total Expense	0.00030	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$1,354,947	BadDebtExpenseAmt
Bad Debt Expense Attributable	$285,894	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$44,492,004	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$58,034,855	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$13,542,851	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

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

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp

Entity Name EntityName

Field	Value	IRS element (for citing)
Business Name Line1	1 YORK STREET PROPERTIES LLC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Primary Activities	REAL ESTATE	PrimaryActivitiesTxt
Org Profit Or Ownership	0.36000	OrgProfitOrOwnershipPct
Ofcr Etc Profit Or Ownership	0.00000	OfcrEtcProfitOrOwnershipPct
Physicians Profit Or Ownership	0.00000	PhysiciansProfitOrOwnershipPct

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

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	HOLY FAMILY MEMORIAL INC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2300 WESTERN AVE PO BOX 1450	AddressLine1Txt
City	MANITOWOC	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	542211450	ZIPCd

Field	Value	IRS element (for citing)
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	HOLY FAMILY MEMORIAL INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
CHNA Conducted	13	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (1)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	WWW.HFMHEALTH.ORG	OwnWebsiteURLTxt
Other Website	Yes (X)	OtherWebsiteInd
Other Website URL	HEALTHIESTMC.ORG; MANITOWOCHEALTHDEPT.INFO	OtherWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	14	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	HFMHEALTH.ORG;HEALTHIESTMC.ORG;MANITOWOCHEALTHDEPT.INFO	StrategyWebsiteURLTxt
Strategy Attached	0	StrategyAttachedInd
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	100.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	200.000000000000	FPGFamilyIncmLmtDscntCarePct
Income Level Criteria	Yes (X)	IncomeLevelCriteriaInd
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Collection Activities	0	CollectionActivitiesInd
FAP Notified All Patients	Yes (X)	FAPNotifiedAllPatientsInd
Documented Elig Determination	Yes (X)	DocumentedEligDeterminationInd
Other Actions Taken	Yes (X)	OtherActionsTakenInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Other Method Used	Yes (X)	OtherMethodUsedInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
HOLY FAMILY MEMORIAL, INC	PART V, SECTION B, LINE 5: THE COMMUNITY HEALTH ASSESSMENT CONDUCTED PERSONAL FACE TO FACE INPUT SESSIONS WITH THE DIRECTOR AND MANAGER OF PUBLIC HEALTH FROM THE MANITOWOC COUNTY HEALTH DEPARTMENT, THE DIRECTOR OF NORTHEASTERN WI AREA HEALTH AND EDUCATION CENTER AND THE DIRECTOR OF THE UNITED WAY - MANITOWOC COUNTY. WE CONDUCTED A COMMUNITY HEALTH TELEPHONE AND ONLINE SURVEY WITH 400 INPUTS FROM CITIZENS, A PHYSICIAN SURVEY WITH 25 INPUTS, A SOCIAL SERVICE AGENCY SURVEY WITH 25 INPUTS, FACE TO FACE INTERVIEWS WITH 20 BUSINESS LEADERS IN OUR COMMUNITY, AND A FOCUS GROUP WITH REPRESENTATIVES FROM THE HMONG COMMUNITY.
HOLY FAMILY MEMORIAL, INC	PART V, SECTION B, LINE 6A: THE CHNA WAS CONDUCTED COLLABORATIVELY WITH AURORA MEDICAL CENTER - MANITOWOC COUNTY.
HOLY FAMILY MEMORIAL, INC	PART V, SECTION B, LINE 11: HFM IDENTIFIED FOUR SIGNIFICANT NEEDS IN OUR CHNA AND HAVE IMPLEMENTED A MULTIDISCIPLINARY COMMUNITY BENEFIT TEAM TO OWN, LEAD AND MONITOR PROGRESS ON THE 4 MAIN GOALS, WHICH INCLUDE: REDUCE DEATH RATE IN MANITOWOC COUNTY FROM FALLS; IMPROVE HEALTH LITERACY; INCREASE IMMUNIZATION RATES IN ADOLESCENTS INCLUDING COLLEGE-AGE FRESHMEN; INCREASE PHYSICAL ACTIVITY AND GOOD NUTRITION. THE TEAMS HAVE ALL FORMED COLLABORATIVE COMMUNITY COALITIONS TO ADDRESS THE SPECIFIC MEASURES FOR EACH GOAL AND REPORT ACTIVITY AND PROGRESS ON A QUARTERLY BASIS. OTHER HEALTH NEEDS WHICH SURFACED IN THE CHNA, WHILE NOT SPECIFICALLY OWNED AND LED BY HFM, ARE BEING ADDRESSED BY PARTNERSHIPS WITH OTHER COMMUNITY GROUPS OF WHICH AN HFM LEADER IS AN ACTIVE, ENGAGED PARTICIPANT. THESE GOALS INCLUDE: ACCESS TO PRIMARY CARE; CHRONIC DISEASE MANAGEMENT; ADULT OBESITY AND POOR NUTRITION; ACCESS TO MENTAL HEALTH CARE AND TOBACCO, ALCOHOL AND OTHER SUBSTANCE ABUSE. COMMUNITY COALITIONS ARE WORKING HARD ON THESE COMMUNITY HEALTH NEEDS AS WELL AS HFM STAFF MEMBERS.
HOLY FAMILY MEMORIAL, INC	PART V, SECTION B, LINE 16I: HOLY FAMILY MEMORIAL'S COMMUNITY CARE PROGRAM IS COMMUNICATED ON THE WEBSITE SUMMARIZING THE ELIGIBILITY REQUIREMENTS TO INCLUDE SERVICES COVERED, INCOME GUIDELINES, APPLICATION FORM, AND OTHER DOCUMENTS NEEDED FOR COMPLETION OF THE APPLICATION. THE COMMUNITY CARE PROGRAM IS ALSO COMMUNICATED VIA PAYMENT GUIDELINE BROCHURES AVAILABLE IN THE REGISTRATION AREAS AT ALL HFM LOCATIONS THROUGHOUT THE COMMUNITY, AND TO PATIENTS IN COMMUNICATION WITH PRICE ESTIMATIONS AND COLLECTIONS, BOTH VERBAL AND WRITTEN. THE POLICY IS ALSO AVAILABLE UPON REQUEST.
HOLY FAMILY MEMORIAL, INC	PART V, SECTION B, LINE 20E: PAYMENT GUIDELINES AND FINANCIAL ASSISTANCE POLICY IS POSTED IN PATIENT ROOMS AND LOBBIES, ADMISSION/REGISTRATION AREAS, GIVEN TO ALL SURGERY PATIENTS, AND PUBLISHED ON THE BACK OF ALL PATIENT STATEMENTS.
HOLY FAMILY MEMORIAL, INC	PART V, SECTION B, LINE 22D: THE HOSPITAL FACILITY USED THE AVERAGE OF ITS FIVE LOWEST NEGOTIATED COMMERCIAL INSURANCE RATES WHEN CALCULATING THE MAXIMUM AMOUNTS THAT CAN BE CHARGED.

Field	Value	IRS element (for citing)
Facility	2	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
HOLY FAMILY HEALTH SERVICES INC
3310 CALUMET AVENUE	MANITOWOC	WI	54220	RETAIL PHARMACY
NORTH END HOME MEDICAL SERVICES LLC
3310 CALUMET AVENUE	MANITOWOC	WI	54220	DURABLE MEDICAL EQUIPMENT

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 7:	COMMUNITY BENEFITS ARE PROGRAMS OR ACTIVITIES THAT PROVIDE CARE AND/OR PROMOTE HEALTH AND HEALING AS A RESPONSE TO IDENTIFIED COMMUNITY NEEDS. HOLY FAMILY MEMORIAL'S COMMUNITY BENEFIT PROGRAMS INCLUDE SERVICES FOR THOSE WHO CAN NOT AFFORD HEALTH CARE AND INITIATIVES FOR IMPROVING HEALTH IN THE BROADER COMMUNITY. PROVIDING COMMUNITY BENEFITS DEMONSTRATES THAT HOLY FAMILY MEMORIAL IS FULFILLING ITS CHARITABLE MISSION AND DEMONSTRATING ITS PREFERENTIAL TAX STATUS IS DESERVED.
SCHEDULE H, PART I, LINE 7, COLUMN F	PERCENTAGE OF COMMUNITY BENEFIT EXPENSE TO OVERALL ENTITY'S EXPENSES.
PART II, COMMUNITY BUILDING ACTIVITIES:	COMMUNITY BUILDING ACTIVITIES INDICATED IN PART II PROMOTE THE HEALTH OF THE MANITOWOC COMMUNITY BY ACTIVELY ADDRESSING EXPRESSED AND REPORTED ISSUES. SPECIFICALLY, THROUGH THE PROGRAMS INDICATED, HOLY FAMILY MEMORIAL AND IN PARTNERSHIP WITH OTHERS, WORKS DILIGENTLY TO ACHIEVE AN OVERALL HEALTHIER COMMUNITY. MAJOR INITIATIVES WITH POSITIVE RESULTS INCLUDE: IMPROVED ACCESS TO HEALTH CARE, IMPROVED MENTAL HEALTH ACCESS AND CARE, INCREASED EXERCISE FOR ADULTS AND CHILDREN, HEALTHY FOOD OPTIONS IN SCHOOLS, AND ACCESS TO FRESH FRUITS AND VEGETABLES FOR THE POOR.
PART III, LINE 4:	AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS ESTABLISHED ON AN AGGREGATE BASIS BY USING HISTORICAL WRITE-OFF FACTORS APPLIED TO UNPAID ACCOUNTS BASED ON AGING. LOSS RATE FACTORS ARE BASED ON HISTORICAL LOSS EXPERIENCE AND ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE ORGANIZATION'S ABILITY TO COLLECT OUTSTANDING AMOUNTS. UNCOLLECTIBLE AMOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN THE PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE.
PART III, LINE 8:	HOLY FAMILY MEMORIAL IS A LICENSED MEDICARE PROVIDER WITH APPROXIMATLEY 47 PERCENT OF ITS PATIENT BASE QUALIFYING FOR THIS PROGRAM. AT PRESENT, THE REIMBURSEMENT RATE FOR THE MEDICARE PROGRAM DOES NOT FULLY COVER THE COST OF CARE TO THESE PATIENTS. THIS REPRESENTS THE ESTIMATED SHORTFALL CREATED WHEN HOLY FAMILY MEMORIAL RECEIVES PAYMENTS BELOW THE COSTS OF TREATING MEDICARE AND OTHER PUBLIC PROGRAM BENEFICIARIES.COST METHODOLOGY = COST TO CHARGE RATIO
PART III, LINE 9B:	PAYMENT OPTIONS AS WELL AS COMMUNITY CARE ASSISTANCE IS NOTED ON ALL COLLECTION LETTERS, AS WELL AS INSURANCE BENEFIT PAPERWORK THAT IS SENT TO PATIENTS FOR INPATIENT, SAME DAY SURGERY, MRI, CT SCAN, ER SERVICES. A PATIENT FINANCIAL ADVISOR AND/OR ELIGIBILITY SPECIALIST SEES SELF-PAY INPATIENTS TO INTERVIEW & ADVISE PATIENTS OF ANY PROGRAMS THEY MAY QUALIFY FOR INCLUDING, BUT NOT LIMITED TO MEDICAID, VETERANS ADMINISTRATION, OR OUR OWN CHARITY CARE PROGRAM. IF THEY MAY QUALIFY FOR MEDICAID OR VETERANS ADMINISTRATION, THE ELIGIBILITY SPECIALIST WILL HELP THEM COMPLETE THE APPLICATION PROCESS AND FOLLOW UP ON THEIR APPLICATION THROUGH TO APPROVAL/DISAPPROVAL. FOR THE NETWORK CHARITY PROGRAM, AN APPLICATION IS PROVIDED AND THE PATIENT IS INSTRUCTED ON WHOM TO CALL FOR ASSISTANCE IN APPLYING. WHEN CONTACTING PATIENTS BY PHONE, THE PATIENT FINANCIAL ADVISOR IS TRAINED TO IDENTIFY PATIENTS WHO MAY QUALIFY FOR OUTSIDE STATE OR FEDERAL ASSISTANCE AND WILL DIRECT THOSE PATIENTS ON WHERE TO GO TO APPLY FOR THOSE PROGRAMS. THE ELIGIBILITY SPECIALIST WILL ASSIST AS WELL.
SCHEDULE H, PART III, LINE 3:	THROUGH ANALYTICAL TOOLS, A COLLECTION PREDICTION SCORE IS APPLIED TO ALL ACCOUNTS WRITTEN OFF TO BAD DEBT THROUGH A COLLECTION AGENCY. THOSE SCORING LOW/UNCOLLECTIBLE ARE ASSUMED CHARITY/COMMUNITY BENEFIT.
PART VI, LINE 2:	HOLY FAMILY MEMORIAL UTILIZES FOUR DISTINCT PROCESSES TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITIES WE SERVE. FIRST, AS A PART OF THE ANNUAL STRATEGIC PLANNING PROCESS, AN ENVIRONMENTAL ASSESSMENT IS DONE. INCLUDED IN THAT REPORT AND ANALYSIS IS CURRENT POPULATION DATA, COMMUNITY INPUT AND INPUT FROM VARIOUS CONSTITUENCIES RELATIVE TO PERCEIVED MET AND UNMET COMMUNITY HEALTH NEEDS. SECOND, HOLY FAMILY MEMORIAL PARTICIPATES IN A TRI-ANNUAL FULL COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS IN PARTNERSHIP WITH HEALTHIEST MANITOWOC COUNTY, AURORA MEDICAL CENTER, MANITOWOC COUNTY PUBLIC HEALTH DEPT AND THE UNITED WAY. THIS ASSESSMENT CONSISTS OF INPUT OBTAINED FROM HUNDREDS OF COMMUNITY RESIDENTS, LEADERS, BUSINESSES; INCLUDING ALL AGE GROUPS, BEGINNING FROM HIGH SCHOOL AGE. THE INFORMATION IS TABULATED, ANALYZED AND UTILIZED TO DETERMINE PRIORITIZED HEALTH NEEDS. HOLY FAMILY MEMORIAL USES THIS INFORMATION IN ITS COMMUNITY IMPLEMENTATION PLAN. THIRD, HOLY FAMILY MEMORIAL CONDUCTS REGULAR INPUT SESSSIONS WITH LOCAL EMPLOYERS TO ASCERTAIN HEALTH NEEDS FROM AN OCCUPATIONAL HEALTH PERSPECTIVE. THIS INFORMATION IS THEN UTILIZED TO DEVELOP AND PROVIDE NEEDED EMPLOYER/EMPLOYEE HEALTH SERVICES THROUGHOUT THE BUSINESS COMMUNITY. LASTLY, HOLY FAMILY MEMORIAL UTILIZES A COMBINATION OF PATIENT FEEDBACK FROM ONGOING PATIENT SATISFACTION SURVEYS (CONDUCTED POST PROVISION OF SERVICES) AND COMMUNITY RESEARCH STUDIES COMMISSIONED BY HOLY FAMILY MEMORIAL, TO ASSESS PROGRAM AND SERVICE HEALTH CARE NEEDS OF THE COMMUNITY.
PART VI, LINE 3:	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE AREAS / WEBSITE / BROCHURES / ADMISSIONS STAFF / COLLECTION CORRESPONDENTS AS WELL AS INSURANCE BENEFIT PAPERWORK THAT IS SENT TO PATIENTS FOR INPATIENT, SAME DAY SURGERY, MRI, AND CT SCANS. A PATIENT FINANCIAL ADVISOR AND/OR ELIGIBILITY SPECIALIST SEES/COMMUNICATES TO SELF-PAY INPATIENTS TO INTERVIEW AND ADVISE PATIENT OF ANY PROGRAMS THEY MAY QUALIFY FOR INCLUDING, BUT NOT LIMITED TO MEDICAID, VETERANS ADMINISTRATION OR OUR OWN CHARITY PROGRAM. IF THEY QUALIFY FOR MEDICAID OR VETERANS ADMINISTRATION, WE ASSIST THEM IN COMPLETING THE APPLICATION AND FOLLOW UP ON THE APPLICATION THROUGH APPROVAL. FOR THE NETWORK CHARITY PROGRAM, AN APPLICATION IS PROVIDED AND THE PATIENT IS INSTRUCTED ON WHOM TO CALL FOR ASSISTANCE IN APPLYING. WHEN CONTACTING PATIENTS BY PHONE, THE PATIENT FINANCIAL ADVISOR OR ELIGIBILITY SPECIALIST IS TRAINED TO IDENTIFY PATIENTS WHO MAY QUALIFY FOR OUTSIDE STATE OR FEDERAL ASSISTANCE AND WILL ASSIST THOSE PATIENTS ON APPLYING FOR THOSE PROGRAMS.
PART VI, LINE 4:	THE COMMUNITY THAT HOLY FAMILY MEMORIAL SERVICES IS CONSIDERED TO BE LOCATED IN THE RURAL LAKESHORE REGION OF NORTHEAST WISCONSIN. THE PRIMARY SERVICE AREA IS MANITOWOC COUNTY WITH SECONDARY NEIGHBORING COUNTIES; BROWN, KEWAUNEE, CALUMET AND SHEBOYGAN. SPECIFICALLY, THE COMMUNITY SERVED IS AN OLDER POPULATION WITH 18.1% OF THE PEOPLE AGE 65 OR OLDER WITH MEDIAN HOUSEHOLD INCOME OF APPROXIMATELY $50,000. 14.3% OF OUR SERVICES ARE DEDICATED TO PROVIDING CARE TO MEDICAID AND SELF-PAY PATIENTS. THE 2014 SERVICE AREA IS EXPECTED TO REMAIN AT 2013 LEVELS WITH A SLIGHT GROWTH TOWARD THE 65+ AGE AND RETRACTION OF THOSE 18-44. REFLECTIVE OF THIS NUMBER IS THAT OVER 47% OF OUR SERVICES ARE DEDICATED TO PROVIDING CARE TO MEDICARE PATIENTS. THE COMMUNITY IS MAINLY CAUCASIAN WITH SEVERAL OTHER NATIONALITIES INCLUDING AFRICAN AMERICAN, ASIAN AND HISPANIC. OTHER PROVIDERS IN THE AREA CONSIST OF THE AURORA MEDICAL GROUP, MANITOWOC SURGERY CENTER, AND SEVERAL OTHER INDEPENDENT PROVIDERS.
PART VI, LINE 5:	ALL OF HOLY FAMILY MEMORIAL'S BOARD MEMBERS RESIDE IN THE PRIMARY SERVICE AREA. THE BOARD CONSISTS OF COMMUNITY REPRESENTATIVES, PHYSICIANS AND REPRESENTATIVES OF THE SPONSOR ORGANIZATION. THE MEDICAL/DENTAL STAFF IS OPEN TO ALL QUALIFIED PROVIDERS WHO MEET THE REQUIREMENTS OF MEDICAL/DENTAL STAFF MEMBERSHIP. THE NETWORK OF PHYSICIANS AND OTHER PROVIDERS ARE COMMITTED TO PROVIDING EACH PATIENT WITH THE HIGHEST LEVEL OF PERSONAL CARE, RESPECT AND COMPASSION TO ENHANCE THE PATIENT'S QUALITY OF LIFE AND HEALTH STATUS. ALL SURPLUS FUNDS ARE REINVESTED IN THE ORGANIZATION TO PURCHASE NECESSARY MEDICAL EQUIPMENT, COMPENSATE EMPLOYEES, AND PLAN FOR FUTURE NEEDS. NONE OF THE SURPLUS EARNINGS BENEFIT ANY INDIVIDUALS OR OTHER CORPORATE ENTITIES.
PART VI, LINE 6:	THE HEALTH CARE NETWORK IS SPONSORED BY THE FRANCISCAN SISTERS OF CHRISTIAN CHARITY, LOCATED AT HOLY FAMILY CONVENT, MANITOWOC, WISCONSIN. THE CONVENT, SITUATED ON SILVER LAKE, THREE MILES WEST OF LAKE MICHIGAN, IS HOME FOR OVER 350 CONGREGATION MEMBERS WHO SERVE THROUGHOUT THE UNITED STATES AND ARE PRIMARILY ENGAGED IN EDUCATION, PARISH AND HEALTH MINISTRIES. THE HEALTHCARE MINISTRY SPANS THREE STATES - WISCONSIN, NEBRASKA AND OHIO - AND HAS EXISTED FOR OVER 100 YEARS. THE MISSION OF THE FRANCISCAN SISTERS OF CHRISTIAN CHARITY HEALTHCARE MINISTRY IS TO CARRY OUT THE COMMITMENT OF THE SPONSOR IN THE HEALING MISSION OF THE CATHOLIC CHURCH THROUGH THE PROVISION OF QUALITY HEALTHCARE SERVICES TO THE PEOPLE OF GOD IN OUR COMMUNITIES.
PART VI, LINE 7, REPORTS FILED WITH STATES	WI,NE

Schedule I IRS990ScheduleI

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

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (2 entries)

Grant TypeGrantTypeTxt	RecipientRecipientCnt	Cash GrantCashGrantAmt	Valuation Method UsedValuationMethodUsedDesc
SCHOLARSHIPS	10	$10,500	ACTUAL TUITION COST
SCHOLARSHIPS - EDUCATION	12	$34,300	ACTUAL TUITION COST

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE I, PART III:	FormAndLineReferenceDesc
Explanation	HOLY FAMILY MEMORIAL'S SCHOLARSHIP PROGRAM IS DESIGNED AS A RECRUITMENT TOOL FOR EMPLOYMENT OF CANDIDATES IN SPECIFIED POSITIONS, CONSIDERED DIFFICULT TO FILL AND TO ASSIST STUDENTS IN THEIR PURSUIT OF A HEALTH CARE RELATED DEGREE. AREAS OF STUDY INCLUDE NURSING, PHARMACY, PHYSICAL THERAPY AND OTHERS. IN RETURN FOR THE SCHOLARSHIP, AN EMPLOYMENT SERVICE COMMITMENT IS MADE. IN ORDER TO BE ELIGIBLE: 1) STUDENTS MUST BE ACCEPTED INTO AN ACCREDITED PROGRAM 2) CANDIDATES MUST BE ATTENDING SCHOOL AS A FULL OR PART TIME STUDENT AND REMAIN IN THAT STATUS 3) STUDENTS MUST HAVE AND MAINTAIN A 3.0 CUMULATIVE GRADE POINT AVERAGE. SCHOLARSHIPS ARE AWARDED ON THE BASIS OF GRADE POINT AVERAGE, VERIFIED WITH OFFICIAL TRANSCRIPT OF GRADES, COMPLETION OF EMPLOYMENT APPLICATION AND PERSONAL INTERVIEW. THE SCHOLARSHIP IS USED FOR TUITION COST. THE SCHOLARSHIPS ARE GIVEN OUT EACH SEMESTER AND ARE PAID DIRECTLY TO THE SCHOOL THE STUDENT ATTENDS. APPLICANTS WHO ARE AWARDED THE SCHOLARSHIP MUST MAKE A SIX-MONTH COMMITMENT TO WORK AT HOLY FAMILY MEMORIAL FOR EACH SEMESTER THE SCHOLARSHIP IS AWARDED. THE SCHOLARSHIP RECIPIENT MUST REPAY THE FULL AMOUNT OF THE SCHOLARSHIP IF HE/SHE: 1) DROPS OUT OF SCHOOL 2) FALLS BELOW A 3.0 CUMULATIVE GRADE POINT AVERAGE 3) DOES NOT ACCEPT EMPLOYMENT 4) DOES NOT COMPLETE FULL LENGTH OF EMPLOYMENT COMMITMENT 5) DOES NOT OBTAIN WISCONSIN LICENSURE, AS REQUIRED. THE SCHOLARSHIP AWARD THROUGH EDUCATION ARE USED TO PROMOTE HEALTH CARE CAREERS. THE REQUIREMENTS FOR THE MEDICAL/DENTAL ENDOWMENT INCLUDE ACCEPTANCE AT AN ACCREDITED COLLEGE, UNIVERSITY, OR TECHNICAL SCHOOL, A MANITOWOC COUNTY RESIDENT, A GRADE POINT AVERAGE OF 3.0 OR ABOVE IS DESIRED, DEMONSTRATE HEALTH CAREER INTEREST AND FINANCIAL NEED. THESE SCHOLARSHIPS ARE OFFERED FOR ONE YEAR WITH POSSIBLE CONTINUATION BASED ON MEETING CRITERIA. THE CRITERIA FOR THE RONCALLI SCHOLARSHIP INCLUDES ACCEPTANCE AT AN ACCREDITED COLLEGE, UNIVERSITY, OR TECHNICAL SCHOOL, A MANITOWOC COUNTY RESIDENT, A GRADE POINT AVERAGE OF 3.0 OR ABOVE IS DESIRED, AND DEMONSTRATED HEALTH CAREER INTEREST. THESE SCHOLARSHIPS ARE PROVIDED FOR ONE YEAR.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Idemnification Gross Up Pmts	Yes (X)	IdemnificationGrossUpPmtsInd
Club Dues Or Fees	Yes (X)	ClubDuesOrFeesInd
Written Policy Ref T And E Expnss	Yes (1)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (1)	SubstantiationRequiredInd
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	0	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	Yes (1)	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	Yes (1)	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (15 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
RYAN M DOPIRAK MD
PHYSICIAN COUNCIL CHAIR	$697,915	$0	$380,705	$0	$60,540	$0	$5,646	$0	$28,411	$0	$1,173,217	$0	$0	$0
MATTHEW L CAMPBELL MD
PHYSICIAN COUNCIL CHAIR	$316,213	$0	$0	$0	$6,486	$0	$5,646	$0	$25,603	$0	$353,948	$0	$0	$0
XA XIONG MD
DIRECTOR	$177,175	$0	$12,000	$0	$558	$0	$1,623	$0	$26,617	$0	$217,973	$0	$0	$0
DEREK R BOWN DC
DIRECTOR	$117,811	$0	$8,738	$0	$367	$0	$2,284	$0	$26,015	$0	$155,215	$0	$0	$0
MARK P HERZOG
DIRECTOR, PRESIDENT, CEO	$497,586	$0	$69,455	$0	$308,516	$0	$108,172	$0	$27,553	$0	$1,011,282	$0	$0	$0
PATRICIA HUETTL
CHIEF FINANCIAL OFFICER	$238,727	$0	$30,125	$0	$4,776	$0	$42,581	$0	$29,191	$0	$345,400	$0	$0	$0
STEVEN D DRIGGERS MD
CHIEF MEDICAL OFFICER	$419,553	$0	$54,217	$0	$58,116	$0	$58,811	$0	$27,309	$0	$618,006	$0	$0	$0
MARY MAURER
CHIEF INNOVATION OFFICER	$183,018	$0	$26,468	$0	$155,470	$0	$43,217	$0	$3,415	$0	$411,588	$0	$0	$0
KIRK DIMITRIS MD
PHYSICIAN	$714,570	$0	$485,961	$0	$486	$0	$5,646	$0	$22,927	$0	$1,229,590	$0	$0	$0
DAVID MIKOLYZK MD
PHYSICIAN	$699,707	$0	$268,813	$0	$13,948	$0	$5,646	$0	$27,881	$0	$1,015,995	$0	$0	$0
MICHAEL ROSENBERG MD
PHYSICIAN	$508,682	$0	$8,000	$0	$53,563	$0	$5,646	$0	$23,182	$0	$599,073	$0	$0	$0
NANCY N BUTLER MD
PHYSICIAN	$348,904	$0	$156,088	$0	$101,810	$0	$5,646	$0	$9,926	$0	$622,374	$0	$0	$0
JEFFREY A JACOBY MD
PHYSICIAN	$273,742	$0	$345,422	$0	$592	$0	$5,646	$0	$11,668	$0	$637,070	$0	$0	$0
JANE CURRAN-MEULI
EXECUTIVE VP, COO	$133,586	$0	$8,740	$0	$1,872	$0	$2,654	$0	$10,848	$0	$157,700	$0	$0	$0
WILLIAM D HAMPTON MD
FORMER DIRECTOR	$246,183	$0	$23,217	$0	$22,773	$0	$5,646	$0	$25,682	$0	$323,501	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 1A	CIVIC PAY, CEO, CFO, KEY EMPLOYEES (5 EMPLOYEES - $1,650-$5,776), BENEFIT TREATED AS TAXABLE INCOME
PART I, LINE 6	THE SENIOR SUCCESSSHARE PROGRAM IS AN AT RISK COMPENSATION PROGRAM WHICH IS BASED ON BALANCED STRATEGIC ACCOMPLISHMENTS AS APPROVED ANNUALLY BY THE COMPENSATION AND EVALUATION SUBCOMMITTEE OF THE BOARD OF DIRECTORS. ELIGIBLE PERSONS INCLUDE THE PRESIDENT/CEO, CHIEF MEDICAL OFFICER, CHIEF FINANCIAL OFFICER, AND CHIEF INNOVATION OFFICER.
PART I, LINE 7	A PORTION OF PHYSICIAN SALARY IS BASED ON INDIVIDUAL PRODUCTION FOR PERSONALLY RENDERED SERVICES.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
WISCONSIN HEALTH AND EDUCATION FACILITIES
A	391337855	97710V2S6	2007-04-26	$45,170,000	SEE SCHEDULE K, PART V	0	0	0
WISCONSIN HEALTH AND EDUCATION FACILITIES
B	391337855		2014-12-19	$7,830,000	SEE SCHEDULE K, PART V	0	0	0

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Total ProceedsTotalProceedsAmt	In Reserve FundInReserveFundAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Capital ExpendituresCapitalExpendituresAmt	Substantial CompletionSubstantialCompletionYr	Current RefundingCurrentRefundingInd	Advance RefundingAdvanceRefundingInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$6,702,000	$45,170,000	$3,555,000	$485,000	$4,990,000	2009	Yes (1)	Yes (1)	Yes (1)	Yes (1)
B		$7,830,000		$18,000		2006	Yes (1)	0	Yes (1)	Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Any Research AgreementsAnyResearchAgreementsInd	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	0	0	0	0	0	0	Yes (1)
B	0	0	0	0	0	0	Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

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

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

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

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

PART I, LINE B, COLUMN F:

THE PURPOSE OF THE BOND ISSUE WAS TO REFUND SERIES 2003B, ISSUED ON 09/09/2003.

PART I, LINE A, COLUMN F:

THE PURPOSE OF THE BOND ISSUE WERE 1) THE ACQUISITION, CONSTRUCTION, RENOVATION, REMODELING AND EQUIPPING OF CERTAIN HOSPITAL AND OTHER HEALTHCARE FACILITIES AS IDENTIFIED IN A NOTICE OF PUBLIC HEARING PUBLISHED IN CONNECTION WITH THE ISSUANCE OF THE BONDS INCLUDING THE ACQUISITION OF TELEMETRY MONITORS AND AN MRI SYSTEM 2) THE CURRENT REFUNDING OF ALL THE WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY REVENUE (WHEFA) BONDS, SERIES 1995, 3) THE ADVANCE REFUNDING OF ALL OF THE WHEFA BONDS, SERIES 1998A, AND 4) THE ADVANCE REFUNDING OF A PORTION OF THE WHEFA BONDS, SERIES 2003A.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
NORTH END HOME MED SVC LLC
SERVE AS DIRECTORS ON BOTH ORGANIZATIONS	-$182,418	INCOME FROM CONTINUOUS OPS - 100% OWNED	0
HOLY FAMILY HEALTH SERVICES
SERVE AS DIRECTORS ON BOTH ORGANIZATIONS	$232,037	INCOME FROM CONTINUOUS OPERATIONS - 100% OWNED	0
LINDSAY FROLICH
DAUGHTER OF DIRECTOR	$45,821	EMPLOYMENT BY ORGANIZATION	0
KATHERINE CASEY
DAUGHTER OF DIRECTOR	$27,712	EMPLOYMENT BY ORGANIZATION	0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6	HOLY FAMILY MEMORIAL IS SPONSORED BY FRANCISCAN SISTERS OF CHRISTIAN CHARITY SPONSORED MINISTRIES, INC. WHICH IS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7A	HOLY FAMILY MEMORIAL OPERATES AN INTEGRATED HEALTHCARE DELIVERY SYSTEM, PRIMARILY TO THE RESIDENTS OF MANITOWOC COUNTY, WISCONSIN. HOLY FAMILY MEMORIAL IS OPERATED BY FRANCISCAN SISTERS OF CHRISTIAN CHARITY SPONSORED MINISTRIES, INC., WHICH IS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION. FRANCISCAN SISTERS OF CHRISTIAN CHARITY SPONSORED MINISTRIES, INC. IS A NOT-FOR-PROFIT HEALTHCARE HOLDING COMPANY INCORPORATED TO MONITOR AND MANAGE HEALTHCARE OPERATIONS. THE BOARD OF DIRECTORS SHALL CONSIST OF NO MORE THAN EIGHTEEN INDIVIDUALS. THE PRESIDENT OF THE CORPORATION AND CHAIR OF THE PHYSICIAN COUNCIL SHALL BE EX-OFFICIO MEMBERS WITH FULL VOTING PRIVILEGES. IN ADDITION TO THE EX-OFFICIO BOARD POSITIONS, THE BOARD OF DIRECTORS SHALL INCLUDE FOUR MEMBERS OF FRANCISCAN SISTERS OF CHRISTIAN CHARITY AND AT LEAST FOUR PHYSICIANS.
FORM 990, PART VI, SECTION A, LINE 7B	SOME DECISIONS OF THE GOVERNING BODY ARE SUBJECT TO APPROVAL BY THE MEMBER AS OUTLINED IN THE CORPORATE BYLAWS. FOR EXAMPLE, THE GOVERNING BOARD SUBMITS NAMES OF NEW BOARD MEMBERS TO THE MEMBER AND THE MEMBER APPOINTS THEM. APPROVAL OF THE BUDGET, MORTGAGE, PHILOSOPHY, MISSION & VISION, LEASE OR SALE OF REAL ESTATE MUST BE APPROVED BY THE MEMBER. A CERTIFIED AUDIT OF CORPORATE FUNDS OR THE ANNUAL FISCAL AUDIT MUST BE APPROVED BY THE MEMBER.
FORM 990, PART VI, SECTION B, LINE 11	THE CHAIR OF THE GOVERNING BOARD REVIEWS THE 990 PRIOR TO FILING. AN OVERVIEW OF THE 990 ALONG WITH SPECIFIC SECTIONS ON GOVERNANCE, COMMUNITY BENEFITS, AND CONFLICT OF INTEREST IS PRESENTED TO THE BOARD OR BOARD COMMITTEE. THE COMPENSATION AND EVALUATION SUBCOMMITTEE REVIEWS THE 990 SECTIONS RELATED TO COMPENSATION PRIOR TO FILING. COPIES ARE AVAILABLE TO ALL BOARD MEMBERS.
FORM 990, PART VI, SECTION B, LINE 12C	ANNUALLY, GOVERNING BOARD MEMBERS ARE PROVIDED A COPY OF THE CONFLICT OF INTEREST POLICY TO REVIEW AND SIGN THE CERTIFICATION ON WHICH THEY DISCLOSE ANY CONFLICTS. AT EACH BOARD OR COMMITTEE MEETING WHERE THERE WILL BE A VOTE, THE CHAIRPERSON ASKS IF THERE ARE ANY CONFLICTS TO THE PARTICULAR ISSUE. IF THERE IS A CONFLICT, THAT PERSON ABSTAINS FROM DISCUSSION & VOTING. ALL PHYSICIANS, LEADERS, AND KEY EMPLOYEES SIGN A CONFLICT OF INTEREST ANNUALLY. CONFLICT OF INTEREST IS MONITORED THROUGH HOLY FAMILY MEMORIAL'S COMPLIANCE DEPARTMENT.
FORM 990, PART VI, SECTION B, LINE 15	LINES 15 A & B - HOLY FAMILY MEMORIAL HAS A SENIOR LEADER COMPENSATION POLICY. THE PROCESS OF DETERMINING THESE SALARIES IS GOVERNED BY THE COMPENSATION AND EVALUATION SUBCOMMITTEE OF THE BOARD. THE POLICY COVERS THE FOLLOWING POSITIONS: PRESIDENT AND CEO, CHIEF FINANCIAL OFFICER, CHIEF MEDICAL OFFICER AND CHIEF INNOVATION OFFICER. SENIOR LEADER SALARY DATA IS EVALUATED ANNUALLY BY AN EXTERNAL EXECUTIVE COMPENSATION FIRM. TOTAL COMPENSATION FOR SENIOR LEADERS (SALARY, BENEFITS AND INCENTIVE) IS EVALUATED EVERY THREE YEARS BY AN EXTERNAL EXECUTIVE COMPENSATION FIRM (LAST DONE OCT 2014). ALSO CONSIDERED ARE CURRENT MARKET CONDITIONS AND MARKET COMPETITIVENESS. THE POLICY REFLECTS HOLY FAMILY MEMORIAL'S MISSION AND VALUES AND THE LOCAL COMMUNITY EXPERIENCE BY EMPHASIZING REWARDS BASED ON WELL ROUNDED ACCOMPLISHMENTS IN THE AREAS OF MISSION AND RELATIONSHIPS, KEY STRATEGIES AND OPERATIONS, INCLUDING FINANCE.
FORM 990, PART VI, SECTION C, LINE 19	HOLY FAMILY MEMORIAL'S ARTICLES OF INCORPORATION ARE PUBLICLY AVAILABLE FROM THE WI DEPARTMENT OF FINANCIAL INSTITUTIONS. THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON REQUEST. HOLY FAMILY MEMORIAL'S FINANCIAL STATEMENTS ARE AVAILABLE ON THE DACBOND.COM WEBSITE AND HOLY FAMILY MEMORIAL SUBMITS FINANCIAL INFORMATION TO THE STATE OF WI ANNUALLY. FORM 990 IS AVAILABLE UPON REQUEST AND CAN BE SEEN ON THE GUIDESTAR WEBSITE.
FORM 990, PART VII, SECTION A, PART 1A LINES 1 THROUGH 5:	HOLY FAMILY MEMORIAL'S BOARD OF DIRECTORS INCLUDES SIX EMPLOYED PROVIDERS. THE COMPENSATION REPORTED FOR THESE DIRECTORS IS FOR THEIR SERVICES AS A PROVIDER.
FORM 990, PART XI, LINE 9:	RESTRICTED CONTRIBUTIONS NET OF ASSETS RELEASED 254,179.
FORM 990, PART XII, LINE 2C:	THE ORGANIZATION HAS NOT CHANGED ITS OVERSIGHT PROCESS OR SELECTION PROCESS DURING THE TAX PROCESS.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

Field	Value	IRS element (for citing)
Business Name Line1	NORTH END HOME MED SCS LLC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3310 CALUMET AVENUE	AddressLine1Txt
City	MANITOWOC	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54220	ZIPCd

Field	Value	IRS element (for citing)
EIN	391868808	EIN
Primary Activities	MEDICAL EQUIPMENT	PrimaryActivitiesTxt
Legal Domicile State	WI	LegalDomicileStateCd
Total Income	-$181,554	TotalIncomeAmt
End Of Year Assets	$1,815,867	EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	HFM INC	BusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Direct Controlling NADirectControllingNACd	Controlled OrganizationControlledOrganizationInd
FRANCISCAN SISTERS OF CHRISTIAN CHARITY
1415 SOUTH RAPIDS ROAD	MANITOWOC	WI	54220	391530622	HEALTHCARE	WI	501(C)(3)	LINE 1	N/A	0
ST PAUL ELDER SERVICES INC
316 EAST 14TH STREET	KAUKAUNA	WI	54130	391029149	ELDER CARE	WI	501(C)(3)	LINE 1	N/A	0
GOOD SAMARITAN MEDICAL CENTER
800 FOREST AVENUE	ZANESVILLE	OH	43701	314379479	HOLDING CO.	OH	501(C)(3)	LINE 3	N/A	0
FRANCISCAN CARE SERVICES INC
430 N MONITOR ST	WEST POINT	NE	68788	470486026	HEALTHCARE	NE	501(C)(3)	LINE 3	N/A	0
SILVER LAKE COLLEGE OF THE HOLY FAMILY INC
2406 SOUTH ALVERNO ROAD	MANITOWOC	WI	54220	390980974	HIGHER EDUCATION	WI	501(C)(3)	LINE 2	N/A	0
HOLY FAMILY CONVENT OF THE FRANCISCAN SISTERS OF CHRISTIAN CHARITY
2409 SOUTH ALVERNO ROAD	MANITOWOC	WI	54220	390808523	RELIGIOUS	WI	501(C)(3)	LINE 1	N/A	0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	HOLY FAMILY HEALTH SERVICES	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3310 CALUMET AVENUE	AddressLine1Txt
City	MANITOWOC	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54220	ZIPCd

Field	Value	IRS element (for citing)
EIN	391572253	EIN
Primary Activities	PHARMACY	PrimaryActivitiesTxt
Legal Domicile State	WI	LegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	HFM INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Entity Type	C	EntityTypeTxt
Share Of Total Income	$156,540	ShareOfTotalIncomeAmt
Share Of EOY Assets	$1,900,185	ShareOfEOYAssetsAmt
Ownership	1.00000	OwnershipPct
Controlled Organization	0	ControlledOrganizationInd

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

Transactions Related Org TransactionsRelatedOrgGrp (6 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
HOLY FAMILY HEALTH SERVICES - REIMBURSEMENT OF SALARYBENEFITSUPPLIESRENT
Q	$973,255	ACTUAL REVENUE
FRANCISCAN SISTERS OF CHRISTIAN CHARITY - BUILDING RENT
J	$56,100	ACTUAL REVENUE
FRANCISCAN SISTERS OF CHRISTIAN CHARITY - AUDIT FEES
P	$95,000	ACTUAL EXPENSE
FRANCISCAN SISTERS OF CHRISTIAN CHARITY - ADMINISTRATIVE SERVICES
P	$740,000	ACTUAL EXPENSE
FRANCISCAN SISTERS OF CHRISTIAN CHARITY-LIABBUILDINGWORKERS COMP INSURANC
P	$1,392,265	ACTUAL EXPENSE
FRANCISCAN SISTERS OF CHRISTIAN CHARITY - HEALTH INSURANCE PREMIUMS
P	$9,821,000	ACTUAL EXPENSE