2014-05-12T14:07:21-05:00 2013-06-30 KPMG LLP 191 West Nationwide Blvd Ste 500 Columbus OH 432152568 990 2012-07-01 390817529 ST VINCENT HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS % KELLY GIGOT STVI 9204330111 835 S VAN BUREN Suite GREEN BAY WI 543013256 KELLY GIGOT 9204330111 2014-05-07 true 6142492300 2012 2015-11-30 17:44:51Z Therese Pandl 2710 Executive Drive PO Box 19 Green Bay WI 54307 435862302 false 0928 X WWW.STVINCENTHOSPITAL.ORG X 1888 WI ST. VINCENT HOSPITAL'S MISSION IS TO CARRY OUT THE HEALING MINISTRY OF THE CATHOLIC CHURCH BY PROVIDING HIGH-QUALITY HOSPITAL SERVICES TO THE PEOPLE OF GREEN BAY, NORTHEAST WISCONSIN, AND NEARBY UPPER MICHIGAN. 12 9 2253 500 3899079 -2177673 1834503 3907101 410199647 417632154 2470350 12012568 852316 1808219 415356816 435360042 0 0 0 0 112196539 108512345 0 0 0 289501907 300767087 401698446 409279432 13658370 26080610 552025079 593393031 201244752 181262138 350780327 412130893 X St. Vincent Hospital's mission is to reveal and embody Christ's healing love for all people through our high quality Franciscan health care ministry. false false 24694216 52788216 SURGICAL SERVICES - SEE SCHEDULE O "PROGRAM SERVICE ACCOMPLISHMENTS" 10017009 42307551 RADIOLOGY SERVICES - SEE SCHEDULE O "PROGRAM SERVICE ACCOMPLISHMENTS" 8109253 21215563 HEART AND VASCULAR CENTER - SEE SCHEDULE O "PROGRAM SERVICE ACCOMPLISHMENTS" 304895685 297685111 347716163 true true false true false false false false false false true false true false true true false true false false false false false false false false true true false false true false false false true false false false true false false false false true true false false false true 100 0 true 2253 true true true false false false false false false false false false X 12 9 false false false false true true true true true false false true true true true true true true true true true X KELLY GIGOT 9204338287 835 S VAN BUREN GREEN BAY WI 54301 KENNETH HUJET MD 1.0 X 0 0 0 JOHN HAGER 1.0 X X 0 0 0 ROBERT BURNS 1.0 X 0 0 0 DANIEL PLATKOWSKI 1.0 X 0 0 0 JULES BLANK MD 1.0 X 0 0 0 KENNETH JOHNSON 26.0 14.0 X 0 69215 4195 FRANK MIKELL MD 1.0 59.0 X 0 841930 132140 BETSY MITCHELL 1.0 X 0 0 0 JUDY NAGEL 1.0 X X 0 0 0 THERESE PANDL 20.0 40.0 X X 0 663886 124666 D J LONG Jr 1.0 0.0 X X 0 0 0 Sr Bernadine Gutowski OSF 1.0 0.0 X 0 0 0 TIMOTHY JAHN MD 1.0 X 175538 0 10190 PAULA HAFEMAN 40.0 X 221084 0 16261 TANYA TOWNSEND 50.0 X 148144 0 11442 ANN M CARR 0.25 59.75 X 0 272146 138031 THOMAS R BAYER 40.0 X 221541 0 25088 KELLY GIGOT 40.0 X 206013 0 25572 CHRISTINE JENSEMA 50.0 X 151360 0 25775 GREGORY SIMIA 20.0 X 339812 0 24098 CURTIS WATSON 40.0 X 286731 0 21957 BRADLEY LYONS 50.0 X 193518 0 25449 TIFFANY SHAVE 40.0 X 202321 0 21782 SARAH LULLOFF MD 50.0 X 210128 0 22098 CHERYL BURKEL-EMMERS 50.0 X 190938 0 25826 2547128 1847177 654570 99 false true false EPIC SYSTEMS CORPORATION 1979 MILKY WAY VERONA WI 59593 MAINENANCE 2361158 CARDINAL HEALTH - PHARMACY 2901 ENLOE STREET HUDSON WI 54016 PHARMACY SERVICES 1802024 SODEXO INC AFFILIATES 4880 PAYSHERE CIR CHICAGO IL 60674 FOODSERVICE 1595236 BAYCARE CLINIC LLP 164 S BROADWAY GREEN BAY WI 54303 NEUROSURGICAL SERV. 1073500 GENERAL VASCULAR CONSULT LLC 720 S VAN BUREN ST SUITE 101 GREEN BAY WI 54301 TRAUMA SERVICES 802241 45 554886 3342535 9680 3907101 PATIENT SERVICE REVENUE 900099 413996441 413996441 OTHER OPERATING REVENUE 900099 1888032 1888032 REFERENCE LAB 621500 1747681 1747681 417632154 4458394 4458394 0 0 496082 1572 304242 2620 191840 -1048 190792 -1048 191840 135690 195398 7613882 -59708 7554174 7554174 0 0 0 PRINT SHOP 323100 350035 213326 136709 OTHER REVENUE 900099 1201528 1201528 CATERING 722320 65864 51088 14776 1617427 435360042 413996441 3899079 13557421 0 0 0 0 1717749 1717749 0 76295093 67578875 8716218 10851120 9399818 1451302 12960775 11227313 1733462 6687608 5793162 894446 0 503803 -592047 1095850 0 21571 378 21193 0 0 175942900 149600003 26342897 2013797 2038920 -25123 3493860 1186488 2307372 1461295 1135690 325605 0 13319310 11226246 2093064 272355 195117 77238 0 2154741 1849543 305198 1182972 1182972 0 15957494 11753967 4203527 2086918 1394085 692833 SUPPLIES 55471243 54760940 710303 EQUIPMENT RENTAL & MAINT. 10748521 10748521 BAD DEBT EXPENSES 9743401 9743401 MISCELLANEOUS 6392906 -1324257 7717163 0 409279432 347716163 61563269 0 X 9685900 12300177 10114543 6903469 0 0 81097240 66739818 0 0 0 0 464785 5450100 5196821 5267347 2650148 2305014 331256374 199337422 120931492 131918952 283363561 326413509 0 0 37514443 35438890 0 0 1006146 655755 552025079 593393031 43343005 49450937 0 0 0 0 77388398 77739461 0 0 0 0 0 0 0 0 80513349 54071740 201244752 181262138 X 344108890 404059142 3867496 5239697 2803941 2832054 350780327 412130893 552025079 593393031 X 26080610 13005928 22264028 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 21571 21571 false false DESCRIPTION OF OTHER LOBBYING ACTIVITIES SCHEDULE C, PART II B, QUESTION 1i ST. Vincent HOSPITAL (THE HOSPITAL) IS A MEMBER OF THE CATHOLIC HEALTH ASSOCIATION ("CHA"), THE WISCONSIN HEALTH ASSOCIATION ("WHA"),THE NATIONAL ASSOCIATION FOR HOME CARE AND HOSPICE, AND THE AMERICAN HEALTH ASSOCIATION ("AHA"). AS A MEMBER OF THESE ORGANIZATIONS, THE HOSPITAL PAYS DUES, With PART OF THESE DUES being ATTRIBUTABLE TO LOBBYING FEES PAID BY THE ORGANIZATIONS. THE AMOUNT LISTED ABOVE IS THE AMOUNT ATTRIBUTABLE TO THE HOSPITAL FROM ITS DUES PAID. 9558500 9558500 141465746 85108327 56357419 1553355 1322334 231021 166667082 112906761 53760321 12011691 12011691 131918952 INV - PREVEA PREF. 18238627 C INVESTMENT - UNITY 6241591 C INV - COMM MEMORIAL 2837804 C INVESTMENT - WUPOMS 2068445 C INV - PREVEA - COMMON 3076470 C INV - PAIN CENTER WI 1183047 C ONCOLOGY JOINT VENTURE 302467 C INV-HOLY FAMILY GOODWILL 1490439 C 35438890 0 ACCRUED BENEFIT LIABILITY 47024578 RETIREMENT OBLIGATION - ASBESTOS 654874 WORKERS COMPENSATION 351873 DUE TO MEDICARE 620076 CAP LEASE PAY-PREVEA 5420339 54071740 X SCHEDULE D, ASC SUBTOPIC 740-10 HSHS HAS ADOPTED ASC SUBTOPIC 740-10, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES - AN INTERPRETATION OF FASB STATEMENT NO.109. ASC SUBTOPIC 740-10 ADDRESSES THE DETERMINATION OF HOW TAX BENEFITS CLAIMED OR EXPECTED TO BE CLAIMED ON A TAX RETURN SHOULD BE RECORDED IN THE CONSOLIDATED FINANCIAL STATEMENTS. UNDER ASC SUBTOPIC 740-10, HSHS MUST RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFITS RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. ASC SUBTOPIC 740-10 ALSO PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES ON INCOME TAXES, ACCOUNTING IN INTERIM PERIODS, AND REQUIRES INCREASED DISCLOSURES. AS OF JUNE 30, 2013 AND 2012, HSHS DOES NOT HAVE AN ASSET OR LIABILITY FOR UNRECOGNIZED TAX BENEFITS. true true true X 225. true X true true false true true 7258775 7258775 0.01820 27283235 27283235 0.06830 4121417 1645941 2475476 0.00620 38663427 1645941 37017486 0.09270 1870 1343695 3100 1340595 0.00340 1136 706838 706838 0.00180 536 173322 173322 0.00050 127980 86973 86973 0.00020 131522 2310828 3100 2307728 0.00590 131522 40974255 1649041 39325214 0.09860 1400 2057 2057 1400 2057 2057 true 4781494 1821908 116967092 171721692 -54754600 X true true Unity Ltd Ptnrshp Healthcare 0.45000 NE Wisc Radiation Healthcare 0.25000 0.50000 Therapy Serv LLC Healthcare Pain Ctr of WI LLC Healthcare 0.50000 0.50000 WI UPPER PENINSULA HOSPITAL - HEALTHCARE SERVICES INC HEALTHCARE 0.50000 PREVEA HLTH SERV INC HEALTHCARE 0.25000 0.50000 COMMUNITY MEMORIAL HEALTHCARE 0.17000 HOLY FAMILY ONCOLOGY Healthcare 0.50000 1 1 St Vincent Hospital

835 S Van Buren Green Bay WI 54301

X X X St Vincent Hospital 1 true X X X X X X X X X 11 true true true X X X X X X X X X false false true true 225. true 300. true X X X X X X X true true X X X X true false true X false false Part I, Line 3c NOT APPLICABLE AS THE ORGANIZATION DOES FOLLOW FPG TO DETERMINE ELIGIBILITY FOR PROVIDING CHARITY AND DISCOUNTED CARE TO LOW-INCOME UNINSURED AND UNDERINSURED INDIVIDUALS. Part I, Line 6a Yes, The hospitals community benefit report can be accessed at www.stvincenthospital.org. Part I, Line 7, Column (F) The percentage of charity care and certain other benefits at cost as a percent of total expenses less bad debt is 9.86%. The amount of bad debt removed when calculating Part I, Line 7, Column (F) was $9,743,401. Part I, Line 7 Charity care is calculated by determining the total amount from patient billing that is written off to charity care charge codes or allowances. This amount matches the number that is reported on our fiscal year ending 2013 audited financial statements. The total charity care dollar amount is then reduced to cost by applying the hospital's cost to charge ratio as calculated on IRS Schedule H-Worksheet J. PART I, LINE 7G The hospital uses Lyons Software (CBISA) to determine subsidized services. Physician clinics were not included in the subsidized health services. Part II The community building activities that we have tracked and reported in our community benefit report are a minor potion of our total community benefit efforts. They consist primarily of actively participating in and supporting the work of community groups to advance community awareness about health issues such as leading the Oral Health Community Task Force and serving on the NEW Community Clinic Board. Part III, Line 4 The hospital strongly believes that its charity care, and the related community benefit obtained from such care, is understated because of those patients who potentially qualify for charity care but do not wish to apply for it. In addition, some care is not classified as charity because of missing documentation on patient resources. Thus, the hospital's bad debt includes a portion that could be classified as charity care if application for such care was sought and/or completed. Currently, the hospital is implementing processes, procedures and systems to more effectively determine charity care that will reduce a patient's documentation requirements and ease the patient's emotional burden in applying for charity care. This will provide a more accurate reporting of charity care services provided by the hospital. The hospital computes the cost of bad debt by applying the ratio of patient care cost to charges to the total charges written off as bad debt expense. The patient care cost is determined by reducing the total annual operating expense by non-patient care expenses, Medicaid provider taxes and community benefit expense. The adjusted operating cost is then divided by the total gross patient charges to calculate the ratio of patient care cost to charges. Part III, Line 8 The hospital continually strives to provide excellent patient care in the most cost effective fashion. Nonetheless, the Medicare program, in many cases, does not provide payment that covers the full cost of the care provided. Since it is the mission of the hospital to respond to community need, hospital management continually advocates for improved Medicare payment so that the cost of quality care to those patients that are not able to afford it is not compromised and is fairly subsidized by all payers. While this shortfall in Medicare payments is not classified as community benefit by the IRS, we nonetheless believe it is an important contribution made by the hospital to the health and well being of the community. Our mission calls us to serve all patients with the highest possible quality and efficiency, even if we are not paid fully for doing so. The hospital computes the unpaid costs of providing care to Medicare patients by comparing the cost of the services to the reimbursement received from Medicare during the year. The cost of Medicare services is calculated by applying the ratio of patient care cost to charges to the annual Medicare charges. The patient care cost is determined by reducing the total annual operating expense by bad debt expenses, Medicaid provider taxes and community benefit expense. The difference between the reimbursement received and the calculated cost of the services is reported as the Medicare shortfall.The hospital Medicare shortfall at cost for FY2013 is $54,754,600. Part III, Line 9b Every effort is made prior to, during, and after provision of medical services to determine whether a patient is eligible for charity/community care and to assist the patient in completing the application and providing adequate documentation. If the patient qualifies for charity/community care for the full balance of their account, the entire amount is written off to charity/community care and hence no debt collection is pursued. If the patient qualifies for charity/community care for a portion of their account balance, that portion is written off to charity/community care, with the patient being responsible for the remainder of the balance. Additionally, reasonable effort will be made to obtain third-party or government payer reimbursement on behalf of the patient. If those efforts are not fruitful, an offer will be extended to the patient to make installment payments on their balance. Only at such point that the patient defaults on installment payments or refuses to cooperate with the hospital's efforts to be reimbursed will the account be sent to collections. Part V, Section B, Line 3 The Community Health Needs Assessment was truly a collaborative effort. In Wisconsin, public health departments conduct community health needs assessments every five years. The Brown County and City of DePere Public Health Departments collaborate on the one for Brown County, the county in which Green Bay is located. When a leader from St. Vincent approached the health departments about possible opportunities to collaborate, they not only willingly agreed to find ways to do so, they also agreed to modify their every-five-year process to meet the hospitals' every- three-year time frame and to begin to conduct the local needs assessment immediately. In the past, the Brown County/City of DePere health departments would themselves convene the community wide planning team and the subsequent action planning teams. Once contacted about opportunities to collaborate, they instead convened a community health needs assessment steering committee that included representatives of St. Vincent and its sister hospital St. Mary's, the local United Way, the other not for profit hospital in Green Bay, and representatives of the regional office of Wisconsin's Department of Health. This steering committee then worked to identify representatives who could broadly represent the community in actually conducting the needs assessment and setting priorities. These individuals were referred to as our community "partners". All steering committee members were assigned people to contact to invite them into the process as partners. This resulted in a community partner group that was broadly representative of the community: many community service agencies, educational institutions, government, health care, low income and minority population representatives, public health experts, and others (see partner listing at the end of this report). The steering committee also decided the format for each meeting, evaluated the effectiveness of each meeting after it occurred, developed the prioritization process, and evaluated the effectiveness of the entire process. Steering committee members all assumed responsibilities for tasks related to the process during the course of the needs assessment. The report entitled Healthy Wisconsin 2020 and the health focus areas contained within served as the basis for the health needs assessment. An epidemiologist from the Wisconsin Department of Health gathered data from secondary sources (such as public health statistics) on how Brown County and the City of DePere compares with the state-wide data. St. Vincent Hospital also provided additional data when available. Meetings of all the partners were held once a month for over six months. A profile of each health needs area was developed, and the "partners" reviewed the data at these meeting where the information was presented. They discussed key data points and assessed what is currently being done. Before the meeting concluded, they then rated the health focus area on 3 criteria-magnitude (number of people impacted), seriousness (level of impact of the problem), and feasibility (whether there are known interventions to address the problem). These ratings were combined, and based on this the health focus areas were narrowed to the top eight. At a final meeting of the partners group, a multi-vote approach was used to narrow the top eight to the top three. The top three needs were: o oral health o adequate and appropriate food and nutrition, and o alcohol and other drug abuse (AODA) Throughout this process, St. Vincent's leadership was actively engaged. The progress of the needs assessment was regularly reviewed by an internal community benefit committee. The findings of the needs assessment were also shared with our hospital's community advisory committee for their reaction and comment. The community advisory committee is a group of over 25 community members representing business, education, not for profit agencies, low income and minority populations, clergy, and others who serve as advisors to the hospital. The internal Community Benefit Committee and the Community Advisory Committee serve both St. Mary's and St. Vincent because the two hospitals provide coordinated services to the Green Bay area as part of the Hospital Sisters Health System Eastern Wisconsin Division. Brown Community Health Needs Assessment Partner Listing: - Aging & Disability Resource Center, Sunny Archambault - Aurora Health System, Julie Pomasl - Bay Area Community Council, Pat Finder-Stone - Bellin College, Kathie DeMuth - Bellin Health, Jody Wilmet - Bellin Health, Linda Roethle - Boys & Girls Club, John Benberg - Brown County Board , Mike Fleck - Brown County Board of Health (board member), Audrey Murphy - Brown County Community Treatment Center, Mary Johnson - Brown County Cooperative Extension, Judy Knudsen - Brown County Health Department, Judy Friederichs (Director, Brown County Health Department) - Brown County Human Services, Kevin Lunog - Brown County Planning, Chuck Lamine - Brown County United Way, Stephanie Foley - Center for Childhood Safety/ Safe Kids Greater Green Bay, Justine Lodl - City of De Pere Board of Health (board member), Pat Finder- Stone - City of De Pere Health Department, Mary Dorn, Health Director - De Pere Area Chamber of Commerce, Cheryl Detrick - Division of Public Health Northeast Regional Office, Rebecca Hovarter, Regional Public Health Nursing Consultant - Division of Public Health Northeast Regional Office, Lynn Hrabik, Epidemiologist - Family Services-Crisis Center, Tana Koss - Greater Green Bay Community Foundation, Martha Ahrendt - Greater Green Bay YMCA, Sandy Atkins - Green Bay Chamber of Commerce, Nan Nelson, CCE - Homeless Population Representative, Seth Moore - N.E.W. Community Clinic, Bonnie Kuhr - NWTC Health Science, Kay Tupala, Dean - Oneida Tribe of Indians, Michelle Myers - Parish Nurse, Katie Dykes - Brown County Sheriff Representation-Chief's group, Randy Schultz - Prevea Health, Dr. Ashok Rai - St. Mary's Hospital Medical Center, Heidi Selberg - St Vincent Hospital, Heidi Selberg - St Willebroad Catholic Parish, Maria Plascencia - School Representation-Superintendent's group, Barb Natelle - The Salvation Army, Rebecca Lesperance - United Hmong and Asian American Community Center, Staryoung Thao - UWGB-Environmental Sciences, Thomas Erdman - UW-Green Bay Nursing Program, Chris Vandenhouten - Women, Infant and Children (WIC), Bonnie Kuhr Part V, Section B, Line 4 Bellin Health was actively involved in the community health needs assessment. Part V, Section B, Line 7 The St. Vincents board of directors approved an implementation strategy based on the CHNA from the prior reporting year. Based on the CHNA, three priority needs for the community were identified in FY2013: oral health; alcohol and other drug abuse (AODA); and adequate and appropriate food and nutrition. Oral Health In partnership with sister hospital St. Marys, St. Vincent Hospital supported the NEW Dental Clinic on the campus of Northeast Wisconsin Technical College (NWTC) to expand its services to accommodate up to 6,000 patients. St. Vincent actively supported the efforts of the NEW Community Clinic to apply for FQHC (federally qualified health center) status allowing the clinic to provide dental services more easily and effectively than had been the case in the past; they were awarded this status at the end of June 2012. St. Vincent Hospitals support of NEW Clinics application included donations to the current clinic location that were cited as part of the required matching funds, providing grant writing expertise and providing access to data to support the application. Most importantly, St. Vincent Hospital provided funds to purchase the capital equipment needed to open a dental clinic for low income uninsured and Medicaid patients at NEW Community Clinics location at Northeast Wisconsin Technical College; this enabled them to open a six-chair operatory in spring 2013. The NEW Community Clinics FQHC status also enabled them to be reimbursed for Medicaid patients dental care. This new program provides a viable alternative other than the ED for Medicaid and uninsured patients. Alcohol and Other Drug Abuse (AODA) Work began to address the AODA needs by initiating discussions with local agencies on how medical clearance for alcohol intoxication is currently working. These discussions led to efforts to develop a telemedicine approach for medical clearance for patients needing psychiatric clearance; these collaborative discussions continue. Adequate and Appropriate Food and Nutrition St. Vincent Hospital did not address this identified need as the other health system that participated in the community health needs assessment took the lead on addressing this need. St. Vincent Hospital focused its efforts on oral health and AODA. Part V, Section B, Line 12h Yes, the Financial Assistance Policy contains a detailed description of the Purpose, Definitions and Guidelines for financial assistance. Part V, Section B, Line 14G St. Vincent Hospital posts its charity care policy and application on our website. In addition, charity care applications are available and prominently displayed in our waiting and registration areas. Our financial counselors are available to meet with patients on site before or at the time of service to assist them in identifying whether they are eligible for government aid or financial assistance, and to assist them in applying for programs for which they may be eligible. After patients receive service, our customer service representatives are also trained to assist them to apply for various government programs or for our charity care program. Our collectors are trained to provide this assistance as well. Last but not least, we have contracted with an outside firm to do active outreach with patients who may need additional assistance or advocacy to apply for benefits, appeal denials, or who need transportation to government agencies to apply for benefits. Yes, section I of the Financial Assistance Policy describes the Communication of the Financial Assistance Program to Patients in detail. Part V, Section B, Line 20D The hospital sets the rate for billing individuals without insurance covering emergency or other medically necessary care at the hospitals lowest commercial rate. 2, NEED ASSESSMENT As indicated in Part V, Section B, St. Vincent Hospital conducted a Community Health Needs Assessment in our FY2012. Prior to completing the CHNA with our community partners, we employed a number of methods to assess health care needs: 1) we have a community advisory committee broadly representative of the community, which meets regularly to discuss hospital services and advise the hospital on how well we are meeting community needs. As terms expire, committee members assist in identifying new members. We include representatives from the neighboring communities we serve, as well as some potentially underserved groups such as Hmong and Native American leaders. 2) Hospital leadership meets with individual committee members each year to learn more about their opinions about community needs. 3) We examine the reasons that self-pay and medical assistance patients come to our ED for care. 4) Hospital leaders serve on local social service agency boards, such as NEW Community Clinic. 5) Our Hispanic health educator/cultural liaisons assist in identifying the needs of special subgroups of patients. 3, Patient education of eligibility for assistance Our hospital posts our charity care policy and application on our website. In addition, charity care applications are available and prominently displayed in our waiting and registration areas. Our financial counselors are available to meet with patients on site before or at the time of service to assist them in identifying whether they are eligible for government aid or financial assistance, and to assist them in applying for programs for which they may be eligible. After patients receive service, our customer service representatives are also trained to assist them to apply for various government programs or for our charity care program. Our collectors are trained to provide this assistance as well. Last but not least, we have contracted with an outside firm to do active outreach with patients who may need additional assistance or advocacy to apply for benefits, appeal denials, or who need transportation to government agencies to apply for benefits. 4, COMMUNITY INFORMATION Brown County, Wisconsin is a primarily urban county, one of 72 Wisconsin counties, and is located in the northeastern part of the state. Brown Countys population is predominantly Caucasian (85%), but there is a sizeable Hispanic population comprising about 7% of the population. The balance is made up almost equally of Asian, Native American and African Americans. There are approximately 250,000 residents, of which about 41,000 are covered by Medicaid/Badger Care Plus. About 11% of Brown County Residents live at or below the federal poverty level, (Source: WI DHS Public Health Profiles). According to the Wisconsin Department of Health Services, 6% of Brown Countys population is uninsured. Brown County contains a dental care HPSA (health professional shortage area) and the metro area is a MUA (medically underserved area), per maps on the Wisconsin DHS website. There are three not-for-profit general medical surgical hospitals and one for-profit general medical surgical hospital serving Brown County and the surrounding area. In addition, there is one not-for-profit psychiatric hospital and one county operated psychiatric hospital. Since most of the population resides in the Green Bay metro area, plans and services focus on this area. 5, PROMOTION OF COMMUNITY HEALTH St. Vincent Hospital offers hope to our community in the tradition of the Hospital Sisters of St. Francis. As a healing ministry of the Catholic Church and an affiliate of the Hospital Sisters Health System (HSHS), St. Vincent is committed to delivering high quality, compassionate, and cost-effective health care services to all. The hospital was founded over 125 years ago to bring a healing presence and improve the health of our community, especially for people who are sick, poor, and disadvantaged. Because of the hospital's purpose and tradition, it is organized to promote the health of Brown County, Wisconsin, and surrounding areas. The hospital is governed by a Board of Directors, the majority of whom who reside in the organization's primary service area and who are neither employees nor contractors of the hospital (nor family members thereof). The Board ensures that St. Vincent is responding to community need. During FY2012, for example, the Board reviewed the Community Health Needs Assessment and approved an implementation strategy for addressing selected needs. In addition our hospital Advisory Council, Friends of St. Vincent Foundation, Cancer Research Institute Board, and the St. Vincent Auxiliary, whose members assist in many areas of the hospital, provide the hospital with additional connections to and insights into the larger community and its health care needs. Also consistent with its exempt purpose, St. Vincent has an open medical staff with privileges available to all qualified physicians in the area. In addition, the hospital operates an emergency department that is open 24 hours to all persons regardless of their ability to pay. As a not-for-profit hospital, St. Vincent reinvests surplus funds into the mission of the organization and health of the community rather than distributing them as profits to shareholders or individuals. Funds not committed to ongoing operations are generally used to upgrade facilities, secure new technologies, improve patient care, and support initiatives designed to promote health and ensure access for all. For example, St. Vincent is currently working with its parent organization, Hospital Sisters Health System, to continuously enhance quality and improve coordination of care both inside the hospital and with a growing number of physician partners. Supported by investments in information technology, this "care integration" strategy is designed to better coordinate care, improve health outcomes, create new efficiencies, and help ensure that patients (especially those with chronic conditions) get well and stay well. For example, the Epic electronic medical record system enables providers to connect with their patients' medical records from wherever they are and allows emergency physicians access to patient medical records from any facility that has Epic. This reduces duplicate testing, puts critical health information at providers' fingertips, helps better manage chronic conditions, and improves patient safety. A Heart Failure Clinic has been established to assist heart failure patients to maintain good health and stay out of the hospital by incorporating diet, exercise and other wellness information into the long-term care plan. This growing program has shown success in reducing readmissions, something that is also especially helpful for those with limited financial resources. St. Vincent Hospital devotes significant resources to provide access for patients who cannot afford care, along with other community benefits. In Fiscal Year 2013, St. Vincent provided over $39 million in community benefit services, including charity care at cost, unpaid costs of Medicaid and other public programs, and a range of diverse programs designed to enhance access and improve community health. Additionally, during this period, St. Vincent provided over $54 million (at cost) in excess of Medicare payment for health care services. Responding to Community Need An example of our community benefit initiatives is the support we also provide to patients of the NEW Community Clinic. St. Vincent covers the cost of a school nurse employed by the NEW Community Clinic to serve high risk children. We also supply the clinic with free and discounted laboratory and radiology services. More than 70% of patients say the clinic's care prevented a trip to the Emergency Department. This year, St. Vincent Hospital, along with sister hospital St. Mary's Hospital Medical Center, provided funds to purchase the equipment necessary to operate a 6-chair dental operatory at the NEW Clinic's Northeast Wisconsin Technical College site. This donation will provide the facilities for as many as 6,000 additional patient visits annually for basic restorative and hygiene care for uninsured and Medicaid patients. St. Vincent Hospital has developed the Sexual Assault Nurse Examiner program to provide care and assistance for anyone who has been sexually assaulted; 12 nurses comprise the Sexual Assault Nurse Examiner (SANE) Program at St. Vincent Hospital. SANE operates in a specially designed room in the Emergency Center, one that is available around the clock to the victims of sexual assault, male or female, infant to elderly. The SANE staff greets them all with gentle words and compassionate medical care. The program, which began in 1992, is the regional site for such care, one where all the hospitals in Green Bay and the surrounding communities send sexual assault victims because only our SANE nurses have been properly trained to conduct the detailed medical examination, collect evidence, repair injury and later provide courtroom testimony that will be a key factor in getting convictions of the perpetrators of these crimes. Special tools, such as a picture book, have been developed to assist with examination and evidence gathering with some of our most tender victims-children. SANE reached over 170 patients this last year at a most vulnerable and devastating time of their lives and truly demonstrates the compassion and mission that is St. Vincent Hospital. SANE works closely with the police force and investigators in the area. In Fiscal Year 2013, St. Vincent spent over $706,000 in services by providing onsite training and education of nursing and allied health professionals within its facilities. We also provided training/education programs at schools such as the University of Wisconsin-Green Bay, Bellin College of Nursing, Northeast Wisconsin Technical College and others around the state. St. Vincent Hospital provided $659,538 in family support services. Professionals at the hospital assisted in excess of 5000 people to apply for the appropriate assistance, such as Social Security or Medical Assistance when they came to the hospital in a time of medical need. The cost included the salary of a cancer care coordinator as well as guidance, referrals, and aid in enrolling in public assistance and HRS Erase, a debt reduction program. When patients can't get to St. Vincent Hospital, or get to their doctor appointments from the hospital, St. Vincent finds a way to help. In the past year, we paid for over $2,500 in uncompensated ambulance and other vehicle rides for patients, either to or from the hospital or to help them get to their doctor appointments elsewhere. The following is a listing of some of the other services St. Vincent Hospital provided in FY2013: - Cash donations, used equipment, furnishings and printing services to local churches, organizations and schools; - Free support programs including cancer survivor and grief care; - Eagle III - transportation for critically ill and injured patients; provided over 4 FTE's and more than $88,000 in financial assistance to Eagle III for patients they served who were unable to pay their bill; - EnCare program - Emergency Room nurses give presentations at area schools and organizations and provide training on the dangers of drinking and driving; - "Every 15 Minutes" program, an in-depth program about the dangers and consequences of drinking and driving provided to teens around homecoming and prom times. - Hospital colleagues spoke at health fairs, schools, technical colleges, and a wide variety of organizations as well as providing logo items for prizes for the various functions; - Training for county health nurses, local paramedics and home health agencies; - Student intern programs with local colleges and universities, and a residency program; - Hospital colleagues serve on local health organization boards and donate their time and expertise during and after business hours; - Free translator service to those patients who do not speak English; - Training to regional staff in how to prepare patients for transport and other topics. - Laundry service for the local Altrusa House free of charge. - St. Vincent Hospital along with St. Mary's Hospital and Bellin Health supports Unity Hospice, a provider of appropriate and compassionate care for the terminally ill. - St. Vincent, along with St. Mary's H 6, AFFILIATED HEALTH CARE SYSTEM St. Vincent Hospital in Green Bay, Wisconsin is an affiliate of Hospital Sisters Health System (HSHS), a health care ministry that includes 13 hospitals, scores of community-based health centers and clinics, and hundreds of physician partners across Illinois and Wisconsin. The Mission of HSHS is to reveal and embody Christs healing love for all people through our high quality Franciscan health care ministry. We live our Mission by providing holistic healing to all who seek our care, as well as through Community Benefit. Working collaboratively with others in the communities we serve, our Community Benefit initiatives are strategically and successfully expanding access to care, improving the health status of residents, and furthering medical education and knowledge. In FY2013, our 13 hospitals responded to needs identified in each of their Community Health Needs Assessments (CHNAs) completed in FY2012. The information gathered from these assessments was used to develop new and enhance existing Community Benefit programs and services that best addressed community needs. Included among the many priority needs identified in our CHNAs were chronic disease prevention and management, obesity, adequate food and nutrition, mental health, and access to health care services. HSHS hospitals are proactively addressing these and other needs through patient, provider and community education, preventative screenings, self-management classes, and new or enhanced clinical services. Across HSHS, we collectively provided $185.6 million in Community Benefit (or 10.2% of total hospital expenses) in FY2013. Included in this amount was $45.9 million provided for Financial Assistance (i.e. Charity Care) and $104.2 million for unreimbursed care provided under the Medicaid program. In addition, HSHS hospitals committed significant resources to care for Medicare patients. The cost of providing services to primarily elderly beneficiaries of the Medicare program - in excess of governmental and managed care contract payments - was $152.3 million. HSHS hospitals also recorded $107.1 million in uncollectible accounts. In addition to the dollars invested in our Community Benefit programs, HSHS also continues to reinvest any surplus revenue from operations and investments into new medical technology, facility infrastructure and health care services in our communities. By doing so, we ensure we are able to meet the ongoing demand for high quality, efficient and easily accessible health care. Recognizing that the health care delivery model in the United States is evolving, HSHS remains focused on implementing our Care Integration strategy. Care Integration coordinates the delivery of care around the needs of each patient. During FY2013, we made significant progresswith this strategy as we further implemented interoperable health information technologies, expanded the number of Medical Homes, and strengthened our alignment with physicians. Greater access to care As a Franciscan health care ministry, HSHS is deeply committed to serving those who are most in need. We not only provide care to every patient who walks through our doors, but also reach out beyond the walls of our hospitals and clinics to care for those in our communities. Our efforts to ensure residents in the communities we serve receive the right care at the right time in the right setting often involve partnering with others to achieve this goal. Across our two-state System, there are numerous examples of HSHS collaborating with other organizations to enhance access to care for those in need. From 2006 to 2009, the United States saw a 16% increase in individuals seeking dental care at hospital emergency rooms. With the support of St. Marys Hospital Medical Center and St. Vincent Hospital in Green Bay, Wisconsin, the NEW Dental Clinic on the campus of Northeast Wisconsin Technical College expanded in FY2013 and was able to accommodate up to 6,000 visits. The clinic provides dental services to low-income and uninsured persons including the homeless in Brown County. St. Francis Hospital in Litchfield, Illinois partnered with Lewis & Clark Community College to bring their mobile health unit to the Litchfield area; the unit provides dental exams and screenings, x-rays and dental hygiene to those in need. In western Wisconsin, St. Josephs Hospital in Chippewa Falls works closely with the Chippewa Health Improvement Partnership (CHIP) to support the Open Door Clinic. The free medical clinic provides health care for those without insurance coverage. This past year, the clinic received a total of 2,672 patient visits, an 11% increase from the prior year. With more than 166 individuals volunteering, the clinic provided more than 6,751 hours (including 753 provider hours and 675 nursing hours) of service to individuals. The Open Door Clinic is an example of HSHS providing leadership and support to a community-based program designed to meet the needs of those less fortunate. In southeast Illinois, area residents can get help filling a prescription through the long-term collaboration between St. Anthonys Memorial Hospital in Effingham and Catholic Charities. Last year, St. Anthonys helped underwrite the cost of prescription medications for more than 280 residents. In southwest Illinois, St. Joseph's Hospital in Highland enhanced their offerings to their senior population based on their CHNA. Senior Renewal is an outpatient counseling program for senior adults who may be facing emotional and physical problems unique to the aging process such as feelings of loneliness, isolation and anxiety. Clients receive an intensive level of treatment without inpatient hospitalization through counseling strategies and education. In addition, in collaboration with the Illinois Department of Insurance, St. Josephs Hospital participates in the Senior Health Insurance Program (SHIP), a free health insurance counseling service for Medicare beneficiaries and their caregivers. In addition to programs such as these, HSHS makes sure that those who need financial assistance for care receive it. Our Financial Assistance (i.e. Charity Care) program covers 100% of hospital charges for individuals and families who earn less than 200% of the federal poverty level. HSHS Financial Assistance programs have a sliding scale, in some instances providing up to a 60% discount on charges for those earning up to 600% of the federal poverty level. Counselors are available in our hospitals to explain our financial assistance policies to patients, provide them with assistance in filling out a simple application form, or help them enroll in publicly funded health care programs. Better community health As part of our Mission to embody Christs healing love, we understand that we have a responsibility to improve the overall quality of life in our communities by supporting initiatives that promote health and wellness. We recognize we are most successful when we work together with a wide array of public and private organizations that share our commitment to improving lives. By doing so, we maximize our efforts and reduce the duplication of services. HSHS hospitals also understand we need to listen closely to the residents of the communities we serve to ensure the health care needs of all are being met. To that end, each of our 13 hospitals completed Community Health Needs Assessments (CHNA) during FY2012. The information gathered from these assessments is being used to help us develop new, and enhance existing, programs and services that best address the needs of the community. Among the many priority needs identified from the CHNAs include metabolic and cardiovascular disease management, adequate food and nutrition, and mental health. HSHS hospitals are addressing these and other needs by proactively offering educational opportunities, preventative screenings, and new or enhanced clinical services. In partnership with the Sangamon County Health Department (SCDH) and local farmers, St. Johns Hospital in Springfield, Illinois took a lead role in bringing a Farmers Market to the east side of Springfield. The East Side Farmers Market addresses three community needs: childhood obesity, childhood poverty (26% of children in Sangamon County live in poverty vs. 18% in the state) and providing fresh produce to persons living in a known food desert. WIC Cooking Classes are also offered in tandem with the East Side Farmers Market to teach participants how to prepare fresh produce. The Farmers Market and cooking classes are hosted at the SCDH. St. Marys Hospital in Streator, Illinois teamed up with the Streator YMCA to offer a 12 week weight loss program Healthy You to motivate 282 participants (nearly double the participants from last year) to lose weight and maintain a healthy lifestyle. The program included aerobics classes, cooking classes, and a maintenance program to encourage participants to weigh in monthly. A total of 191 participants completed the program, losing STATE FILING OF COMMUNITY BENEFIT REPORT 990 SCHEDULE H, PART VI WI, X true true X X X X X X false true false false false false false false false TIMOTHY JAHN MD 175538 0 0 0 0 0 0 0 10566 0 186104 0 0 0 FRANK MIKELL MD 0 602758 0 110977 0 128195 0 112963 0 20070 0 974963 0 59328 PAULA HAFEMAN 221084 0 0 0 0 0 0 0 17139 0 238223 0 0 0 THERESE PANDL 0 565288 0 77968 0 20630 0 100815 0 28586 0 793287 0 0 TANYA TOWNSEND 148144 0 0 0 0 0 0 0 12158 0 160302 0 0 0 ANN M CARR 0 193454 0 29440 0 49252 0 121170 0 17686 0 411002 0 18215 THOMAS R BAYER 221541 0 0 0 0 0 0 0 25991 0 247532 0 0 0 KELLY GIGOT 206013 0 0 0 0 0 0 0 26474 0 232487 0 0 0 CHRISTINE JENSEMA 151360 0 0 0 0 0 0 0 26561 0 177921 0 0 0 GREGORY SIMIA 339812 0 0 0 0 0 0 0 25043 0 364855 0 0 0 CURTIS WATSON 286731 0 0 0 0 0 0 0 22792 0 309523 0 0 0 BRADLEY LYONS 193518 0 0 0 0 0 0 0 26330 0 219848 0 0 0 TIFFANY SHAVE 202321 0 0 0 0 0 0 0 22593 0 224914 0 0 0 SARAH LULLOFF MD 210128 0 0 0 0 0 0 0 22974 0 233102 0 0 0 CHERYL BURKEL-EMMERS 190938 0 0 0 0 0 0 0 26637 0 217575 0 0 0 SCHEDULE J, PART I, LINE 1A SOCIAL DUES WERE PROVIDED TO THERESE PANDL. THIS BENEFIT WAS TREATED AS TAXABLE COMPENSATION TO THE RECIPIENT. ANN M. CARR SCHEDULE J, PART I, LINE 4B ANN M. CARR PARTICIPATED IN A SERP PLAN DURING THE YEAR IN THE AMOUNT OF $42,817. THERESE PANDL SCHEDULE J, PART I, LINE 4B THERESE PANDL PARTICPIATED IN A SERP DURING THE YEAR IN THE AMOUNT OF $64,900. FRANK MIKELL SCHEDULE J, PART I, LINE 4B FRANK MIKELL PARTICIPATED IN A SERP DURING THE YEAR IN THE AMOUNT OF $133,006. THERESE PANDL DIR/OFFICER Mortgage ext X 250000 251973 false true true THERESE PANDL DIR/OFFICER Stock purch X 4125 4125 false true true 256098 WI UPPER PENINSULA ONCOLOGY OFFICER 2541821 LEASED FACILITIES/EMPLOYEES MANAGEMENT SERVICES INC PREVEA Clinics Officer 1180411 LEASED FACILITiES/EQUIP LOANS TO/FROM INTERESTED PERSONS Schedule L, Part II ALL TRANSACTIONS WITH INTERESTED PERSONS ARE COMPLIANT WITH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. ANY TRANSACTIONS REQUIRING BOARD APPROVAL ARE REVIEWED BY AN INDEPENDENT BOARD PRIOR TO OCCURRING. BUSINESS TRANSACTIONS WITH INTERESTED PERSONS schedule l, part iv Kelly Gigot and Tom Bayer, both officers of SVGB, are board members of WUPOMS. Therese Pandl, President of SVGB, is a board member of Prevea Clinic. ALL TRANSACTIONS WITH INTERESTED PERSONS ARE COMPLIANT WITH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. ANY TRANSACTIONS REQUIRING BOARD APPROVAL ARE REVIEWED BY AN INDEPENDENT BOARD PRIOR TO OCCURRING. PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4A SURGERY St. Vincent Hospital Surgical Services Surgical Services is comprised of Pre-Operative Services (Preadmission Testing/AM Admit/Short Stay), 16 functional OR Suites and 2 Open Heart OR Suites, Central Processing/Distribution, Anesthesia, and Recovery. The 24/7 operations are conducted on 4th and 5th floor with the direct report of 167 employees. In FY2013, 9,120 surgical procedures were performed and patients cared for both on an inpatient and outpatient basis. The surgical procedures performed are General, Orthopedic, Neurosurgery, Urology, Gynecology, Ophthalmology, Oral Maxillofacial, Trauma, Cardiac surgery, and Organ procurement. Surgical Services collaborates and provides services in the Heart Center, Cancer Center, Women's and Children, Orthopedic Center, Trauma Center. Anesthesia and Central Processing/Distribution also provides Hospital wide services to Inpatient Nursing, Labor and Delivery and the Emergency Department. The Anesthesia department is comprised of 13 employed Nurse Anesthetists and 14 contracted Anesthesiologists. FORM 990, PART III, LINE 4B RADIOLOGY St. Vincent Hospital Imaging Services The Imaging services department at St. Vincent Hospital provides Inpatient, Outpatient, Emergency and Trauma care. Overall, the department performs more 100,000 exams and procedures annually. Patients have access to the latest technology in Computed Tomography, MRI, Nuclear Medicine, and Ultrasound. Five Interventional Radiologists provide minimally invasive procedures using image guidance. Through the departments fixed site PET/CT, patients have greater access to a technology which provides unique images for early diagnosis. The staff consists of Board Certified radiologists as well as licensed and certified technologists, nurses, and sonographers. The modalities utilize state-of-the-art equipment to afford the radiologists optimal images for interpretation. The department and hospital are accredited by the Joint Commission. Additionally, many of the modalities maintain separate accreditation to ensure quality in the work performed. FORM 990, PART III, LINE 4C HEART & VASCULAR CENTER St. Vincent Heart and Vascular Center The Cath Lab offers a complete array of catheterization laboratory procedures and noninvasive cardiovascular diagnostic procedures doing 1,773 cardiac catheterizations in FY2013. Just steps away, the state-of-the-art Cardiovascular operating center (CVOR) is available for cutting-edge open heart procedures by our highly-skilled cardiothoracic surgeons where 229 open heart surgeries were performed this year. In the same complex, CVICU suites are outfitted with up-to-the-minute monitoring devices that allow staff and physicians to keep careful watch over their patients while delivering hands-on care immediately after procedures. For those patients who need follow-up, a Cardio-Pulmonary Rehabilitation Program is offered. FORM 990, PART III, LINE 4d - Other Program Services St Vincent Hospital provides a wide array of services. Besides the programs listed above, we have a Regional Cancer Center that includes Peds Hematology/Oncology, Gyn Oncology, a Cancer Research Institute and Radiation Oncology on site as well as in two satellite offices in Marinette, WI and Sturgeon Bay, WI. We also have Orthopedic Services that includes Joint Care, Physical Therapy & Occupational Therapy. Our Women's Services Department provides Labor & Delivery Services, OB Clinic, Nurse Educators and Lactation Specialist. We provide Neonatal, Pediatric and General ICU as well as Intermediate Care Units. We have a 24 hour Emergency Department/Trauma Center with SANE nurses available. Our Pharmacy is also open 24 hours to meet patient needs. Our Pulmonary Functions Area includes a Bronchial Lab, Respiratory Care and a Sleep Center. We provide Dialysis for both inpatient and Outpatients. Our Home Health Care Department provides Care for patients that no longer require hospitalization but who continue care in some way. We provide a Wound Care Center that includes Hyperbaric treatments. We also have programs to increase patient care and satisfaction such as Case Management, Palliative Care, Infection Prevention, Spiritual Services, Continuous Process Improvement and Risk Management. RIGHTS OF MEMBERS TO ELECT GOVERNING BODY FORM 990 PART VI, LINES 6 & 7A THE SENIOR GOVERNING BODY OF ST. VINCENT HOSPITAL (THE CORPORATION) IS THE MEMBER OF THE CORPORATION, WHICH IS HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. PURSUANT TO SECTION 2.3 OF THE CORPORATION'S BYLAWS, HSSI HAS THE RIGHT TO APPOINT AND REMOVE THE CORPORATION'S BOARD OF DIRECTORS, CHAIRPERSON OF THE BOARD, AND PRESIDENT. MEMBER RESERVED POWERS FORM 990 PART VI, LINE 7B RESPONSIBILITY FOR THE POLICY AND OPERATIONS OF ST. VINCENT HOSPITAL (THE "CORPORATION") IS VESTED IN ITS BOARD OF DIRECTORS, EXCEPT WITH RESPECT TO SPECIFIC POWERS RESERVED IN THE CORPORATION'S BYLAWS TO THE CORPORATION'S MEMBER, HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE MEMBER OF HSSI IS HOSPITAL SISTERS HEALTH SYSTEM ("HSHS"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE MEMBERS OF HSHS ARE THE INDIVIDUAL SISTERS WHO, FROM TIME TO TIME, ARE THE DULY ELECTED PROVINCIAL SUPERIOR AND PROVINCIAL COUNCILORS, RESPECTIVELY, OF THE AMERICAN PROVINCE OF THE HOSPITAL SISTERS OF ST. FRANCIS ("AMERICAN PROVINCE"). THE AMERICAN PROVINCE IS THE UNITED STATES ORGANIZATION OF THE CONGREGATION OF THE HOSPITAL SISTERS OF THE THIRD ORDER REGULAR OF ST. FRANCIS, A RELIGIOUS INSTITUTE OF THE ROMAN CATHOLIC CHURCH. THE GOVERNANCE AND OPERATIONS OF THE CORPORATION ARE SUBJECT TO HSSI'S RIGHT TO EXERCISE THESE RESERVED POWERS WITH RESPECT TO THE CORPORATION AND ORGANIZATIONS OF WHICH THE CORPORATION IS EITHER, DIRECTLY OR INDIRECTLY, A CONTROLLING MEMBER OR A CONTROLLING SHAREHOLDER ("AFFILIATES"). HSSI'S RIGHT TO EXERCISE CERTAIN OF THESE RESERVED POWERS IS, IN TURN, SUBJECT TO THE APPROVAL OF HSHS AND HSHS' MEMBERS. THE RESERVED POWERS INCLUDE ALL RIGHTS GRANTED TO HSSI BY LAW AND THE RIGHT TO: (A) ADOPT, APPROVE AMENDMENTS TO, OR AMEND ANY STATEMENT OF PHILOSOPHY, MISSION, MISSION INTEGRATION OR VALUES, OR ANY NAME, LOGO, OR MARK OF THE CORPORATION OR OF ANY AFFILIATE; (B) ADOPT, APPROVE AMENDMENTS TO, OR AMEND THE ARTICLES OF INCORPORATION OF THE CORPORATION OR OF ANY AFFILIATE; (C) ADOPT, APPROVE AMENDMENTS TO, OR AMEND THE BYLAWS OF THE CORPORATION OR OF ANY AFFILIATE; (D) APPOINT AND REMOVE THE BOARD OF DIRECTORS, ANY ONE OR MORE OF THE DIRECTORS OF THE CORPORATION OR OF ANY AFFILIATE, AND THE CHAIRPERSON AND PRESIDENT OF THE CORPORATION OR OF ANY AFFILIATE; (E) APPROVE THE RECOMMENDATION OF THE BOARD OF DIRECTORS TO APPOINT OR REMOVE THE BOARD OF DIRECTORS, ANY ONE OR MORE DIRECTORS OF THE CORPORATION OR OF ANY AFFILIATE, OR THE CHAIRPERSON AND PRESIDENT OF THE CORPORATION OR OF ANY AFFILIATE. (F) WITH RESPECT TO THE CORPORATION OR ANY AFFILIATE, APPROVE THE PURCHASE, SALE, ALIENATION, EXCHANGE, LEASE, OR ENCUMBRANCE OF ANY REAL PROPERTY OF THE CORPORATION OR OF ANY AFFILIATE, WHICH PROPERTY HAS A VALUE IN EXCESS OF LIMITS SET FROM TIME TO TIME BY HSSI; (G) APPROVE THE OPERATING AND CAPITAL BUDGETS OF THE CORPORATION OR OF ANY AFFILIATE, AND ANY DEVIATIONS BY THE CORPORATION OR OF ANY AFFILIATE FROM SUCH BUDGETS IN AN AMOUNT OR PERCENTAGE SPECIFIED BY HSSI FROM TIME TO TIME; (H) APPROVE THE STRATEGIC PLAN AND GOALS OF THE CORPORATION OR OF ANY AFFILIATE; (I) APPROVE THE SALE OF SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION OR OF ANY AFFILIATE; (J) APPROVE THE MERGER OR DISSOLUTION OF THE CORPORATION OR OF ANY AFFILIATE; (K) ADOPT OR AMEND THE PLAN FOR MINISTRY EDUCATION AND GOVERNANCE FOR THE CORPORATION AND ITS AFFILIATES; (L) APPROVE THE CORPORATION'S MISSION ACCOUNTABILITY REPORTS AND THOSE OF ANY AFFILIATE; (M) APPROVE THE FINANCIAL POLICIES AND PROCEDURES OF THE CORPORATION OR OF ANY AFFILIATE, AND APPROVE ANY DEVIATIONS FROM SUCH POLICIES AND PROCEDURES BY THE CORPORATION OR ANY AFFILIATE; AND (N) ADOPT POLICIES TO IMPLEMENT THE RESERVED POWERS OF HSSI. FORM 990 REVIEW PROCESS FORM 990 PART VI, LINE 11b THE HOSPITAL EMPLOYS KPMG TO ASSIST IN THE OVERALL PREPARATION, REVIEW AND ELECTRONIC SUBMISSION OF ITS FORM 990. KPMG PROVIDES GUIDANCE IN IDENTIFYING CRITICAL ERRORS IN THE RETURN SUBMISSION, AND FEEDBACK ON QUANTITATIVE AND QUALITATIVE RESPONSES. ADDITIONALLY, THE HOSPITAL CFO PERFORMS A THOROUGH REVIEW OF THE RETURN, AND REVIEWS IT WITH THE HOSPITAL CEO AND/OR SENIOR LEADERS BEFORE PRESENTING IT IN ITS ENTIRETY TO THE HOSPITAL BOARD FOR QUESTIONING AND REVIEW PRIOR TO THE RETURN'S SIGNING AND SUBMISSION TO THE IRS. CONFLICT OF INTEREST POLICY FORM 990 PART VI, LINE 12C THE ORGANIZATION IS SUBJECT TO THE CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY ("POLICY") OF HOSPITAL SISTERS HEALTH SYSTEM, AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. A REVISED CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY HAVE BEEN IMPLEMENTED SINCE JANUARY 2009 TO MANAGE CONFLICTS OF INTEREST USING A SYSTEM-WIDE PROTOCOL FOR DISCLOSURE STATEMENTS. IN ACCORDANCE WITH THE ORGANIZATON'S CONFLICT OF INTEREST POLICY, ALL COVERED PERSONS HAVE A DUTY TO COMPLY WITH THE CONFLICT OF INTEREST POLICY FOR ANY CONTRACT, TRANSACTION, RELATIONSHIP, OR ACTIVITY CONTEMPLATED, ENTERED INTO, OR CONDUCTED AT HSHS OR ITS AFFILIATES. THE POLICY DEFINES COVERED PERSONS AS BOARD MEMBERS, BOARD COMMITTEE MEMBERS, OFFICERS, BOARD DESIGNEES, SENIOR MANAGEMENT, MEMBERS OF ANY COMMITTEE THAT OVERSEES THE APPROVAL OF PHARMACEUTICALS AND MEDICAL DEVICES, AND ANY OTHER INDIVIDUAL WHO HOLDS A POSITION OF TRUST. ON AN ANNUAL BASIS, HSHS DISCLOSES A COPY OF THE CONFLICT OF INTEREST POLICY (AND ALL CORRESPONDING PROCEDURES, GUIDELINES, FORMS, AND TOOLS) TO ALL COVERED PERSONS AND ADVISES ALL COVERED PERSONS IN WRITING OF ANY SUBSTANTIVE CHANGES TO THIS POLICY AND SUCH RELATED MATERIALS. COVERED PERSONS ARE REQUIRED TO REVIEW AND COMPLETE THE CORRESPONDING CONFLICT OF INTEREST STATEMENT. THE SYSTEM OFFICE VICE PRESIDENT - SYSTEM RESPONSIBILITY, VICE PRESIDENT - RISK & COMPLIANCE, OR MEMBERS OF THE AUDIT AND INTEGRITY COMMITTEE ("COMMITTEE") ARE AVAILABLE TO ANSWER ANY QUESTIONS A COVERED PERSON MAY HAVE. IN ADDITION, IF, AT ANY TIME AFTER SUBMITTING AN ANNUAL CONFLICT OF INTEREST STATEMENT, A COVERED PERSON BECOMES AWARE OF AN INTEREST THAT HE OR SHE WOULD HAVE HAD TO DISCLOSE AT THE ANNUAL INTERVAL, THE COVERED PERSON IS REQUIRED PROMPTLY TO DISCLOSE THE INTEREST TO THE COMMITTEE USING THE HSHS CONFLICT OF INTEREST DISCLOSURE STATEMENT. COMPLETED CONFLICT OF INTEREST STATEMENTS ARE SUBMITTED TO THE COMMITTEE, WHICH IS RESPONSIBLE FOR IDENTIFYING, ASSESSING, AND MANAGING CONFLICTS OF INTEREST THAT ARISE IN THE COURSE OF CONDUCTING THE AFFAIRS OF HSHS AND ITS AFFILIATES. IF THE COMMITTEE DETERMINES THAT A CONFLICT OF INTEREST EXISTS, THE CONFLICT OF INTEREST POLICY REQUIRES HSHS NOT TO ENGAGE IN, OR ENTER INTO, A PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY UNLESS THE COMMITTEE OR, WHERE NECESSARY, THE BOARD OF DIRECTORS (ACTING THROUGH ITS DISINTERESTED MEMBERS), HAS INVESTIGATED ALTERNATIVES TO THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY AND, IN THE ABSENCE OF ALTERNATIVES THAT ARE IN THE BEST INTERESTS OF HSHS, HAS DETERMINED: 1. THAT, REGARDLESS OF WHETHER THE COVERED PERSON PARTICIPATES IN THE IMPLEMENTATION OF THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY; 2. THE CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY IS IN THE BEST INTERESTS OF HSHS; 3. THE CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY IS FAIR AND REASONABLE FROM THE PERSPECTIVE OF HSHS; AND 4. HSHS CANNOT OBTAIN A MORE ADVANTAGEOUS CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES. IN DETERMINING WHETHER A CONTRACT, TRANSACTION OR ARRANGEMENT IS FAIR AND REASONABLE TO HSHS, THE COMMITTEE SHALL CONSIDER, WHERE APPLICABLE: 1. APPRAISALS OR OTHER INDEPENDENT VALUATIONS OF THE FAIR MARKET VALUE OF THE CONTRACT, TRANSACTION, OR ARRANGEMENT; 2. INFORMATION REGARDING COMPARABLE CONTRACTS, TRANSACTIONS, OR ARRANGEMENTS BETWEEN UNRELATED PARTIES; 3. OFFERS FROM COMPARABLE COMPETING ENTITIES; AND/OR 4. STUDIES OF COMPARABLE COMPENSATION ARRANGEMENTS. IN ANY CASE IN WHICH THE COMMITTEE FINDS, AFTER TAKING THE STEPS DESCRIBED ABOVE, THAT HSHS SHOULD PARTICIPATE IN A PROPOSED TRANSACTION OR ARRANGEMENT DESPITE THE EXISTENCE OF A CONFLICT OF INTEREST, THE COMMITTEE SHALL DEVELOP, IMPLEMENT, MONITOR, AND ENFORCE COMPLIANCE WITH, A CONFLICT MANAGEMENT PLAN FOR MANAGING THE CONFLICT OF INTEREST AS IT CONSIDERS NECESSARY FOR SUCH FINDINGS TO REMAIN VALID THROUGHOUT THE LIFE OF THE CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY. ALL CONFLICT MANAGEMENT PLANS SHALL: 1. STATE THAT THE COMMITTEE WILL OVERSEE, MONITOR, AND ENFORCE COMPLIANCE WITH THE PLAN THROUGHOUT THE COURSE OF THE STUDY AND SPECIFY MEANS FOR DOING SO, INCLUDING, WITHOUT LIMITATION, THAT THE APPROPRIATE INDIVIDUALS MUST PROVIDE THE COMMITTEE WITH WRITTEN REPORTS PERTAINING TO COMPLIANCE WITH THE CONFLICT MANAGEMENT PLAN, THAT THE COMMITTEE SHALL HAVE THE RIGHT TO AUDIT THE STUDY FOR SUCH COMPLIANCE AND THE RIGHT TO IMPOSE SANCTIONS FOR NON-COMPLIANCE; 2. STATE THAT THE PLAN MUST BE SHARED WITH COVERED PERSON WHOSE INTERESTS IT WAS DEVELOPED TO MANAGE; 3. STATE THAT THE PLAN MUST BE SHARED WITH, AND PERIODIC REPORTS ON COMPLIANCE WITH THE PLAN MUST BE PROVIDED TO, THE BOARD, SENIOR MANAGEMENT, AND/OR GOVERNMENT AGENCIES; AND 4. PROVIDE FOR SUCH OTHER MANAGEMENT STEPS AND MECHANISMS THE COMMITTEE CONSIDERS NECESSARY AND APPROPRIATE. IN ADDITION TO THE COMMITTEE, THE SYSTEM OFFICE VICE PRESIDENTS OF SYSTEM RESPONSIBILITY AND RISK & COMPLIANCE MAY RETAIN SUCH INDEPENDENT ADVISORS OR EXPERTS AS DEEMED NECESSARY TO ASSIST IN MAKING ITS DETERMINATIONS AND DECISIONS. IF THE COMMITTEE DETERMINES THAT THE CONTEMPLATED TRANSACTION, RELATIONSHIP ARRANGEMENT, OR ACTIVITY CANNOT PROCEED DUE TO A CONFLICT OF INTEREST, THE COMMITTEE SHALL INFORM THE APPLICABLE COVERED PERSON OR DECISION-MAKING BODY OF SUCH DETERMINATION WITHIN ONE WEEK OF THE COMMITTEE MEETING AT WHICH THE CONTEMPLATED TRANSACTION WAS DISCUSSED. THE COMMITTEE SHALL DOCUMENT ITS REJECTION OF THE CONTEMPLATED TRANSACTION IN THE COMMITTEE'S MEETING MINUTES. WHISTLEBLOWER POLICY FORM 990 PART VI, LINE 13 PROVISIONS WITHIN THE CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY PROVIDE PROTECTIONS FOR WHISTLEBLOWER TYPE ACTIVITIES. COMPENSATION PROCESS FORM 990 PART VI, LINE 15 THE COMPENSATION COMMITTEE (COMMITTEE) IS COMPRISED OF INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS. THE COMMITTEE DEVELOPS A COMPENSATION PHILOSOPHY FOR THE SYSTEM AND ALL AFFILIATES. THE COMMITTEE SELECTS AND HIRES THE INDEPENDENT COMPENSATION CONSULTANT TO DEVELOP COMPARABILITY DATA, AND ADVISE THE COMMITTEE DURING ITS DELIBERATIONS REGARDING ALL ELEMENTS OF TOTAL COMPENSATION FOR ALL DISQUALIFIED INDIVIDUALS. INTEGRATED HEALTHCARE STRATEGIES ("IHS"), THE CONSULTANTS UTILIZED BY THE COMMITTEE, USE DATA FROM MULTIPLE TAX-EXEMPT PEER GROUP SOURCES TO DETERMINE SALARY RANGES, INCENTIVE OPPORTUNITY RANGES, AND BENEFITS FOR THE DISQUALIFIED INDIVIDUALS. IHS THEN ASSISTS THE COMMITTEE IN PREPARING CONTEMPORANEOUS DOCUMENTATION OF ALL ACTIONS. EACH COMMITTEE MEETING IS CONDUCTED WITH THE INTENT TO CREATE A REBUTTABLE PRESUMPTION OF REASONABLENESS FOR ALL ELEMENTS OF EXECUTIVE TOTAL COMPENSATION FOR THE DISQUALIFIED INDIVIDUALS. THE CHAIRMAN MAKES THIS DECLARATION AND ALSO INQUIRES IF THERE ARE ANY CONFLICTS OF INTEREST BY ANY ATTENDEES. ANY CONFLICTS ARE DISCLOSED AND THE COMMITTEE THEN ACTS IN A MANNER TO AVOID ANY CONFLICTED INDIVIDUAL PARTICIPATING IN ANY MANNER WHERE A CONFLICT MIGHT EXIST. AT THE END OF THE MEETING, THE COMMITTEE PREPARES CONTEMPORANEOUS MINUTES THAT RECORD ALL ACTIONS TAKEN DURING THE MEETING. THE FOLLOWING DESCRIPTIONS PRESENT ST. VINCENT'S PROCESS FOR DETERMINATION OF COMPENSATION FOR VARIOUS INDIVIDUALS: OFFICER: PROCESS IS DONE AT THE HSHS SYSTEM OFFICE WITH INPUT FROM THE PRESIDENT AND CEO OF THE EASTERN WISCONSIN DIVISION. KEY EMPLOYEE: IF THE POSITION IS FOR A SENIOR LEADERSHIP MEMBER, THE PROCESS IS DONE AT THE HSHS SYSTEM OFFICE WITH INPUT FROM THE PRESIDENT AND CEO OF THE EASTERN WISCONSIN DIVISION. THIS PROCESS APPLIES TO TIMOTHY JAHN. IF THE POSITION IS A DIRECTOR POSITION AT ST. VINCENT HOSPITAL, ON AN ANNUAL BASIS AN OUTSIDE ORGANIZATION, CURRENTLY INTEGRATED HEALTHCARE STRATEGIES ("IHS"), COMPILES MARKET DATA FOR EACH POSITION AND PROVIDES RECOMMENDATIONS FOR THE SALARY RANGE FOR THESE POSITIONS. THE MANAGER OF PEOPLE SERVICES PROVIDES A RECOMMENDATION FOR ADJUSTMENT BASED UPON THE RECOMMENDED RANGE INFORMATION FROM IHS. THE WAGE AND SALARY COMMITTEE AT ST. VINCENT HOSPITAL, WHICH CONSISTS OF THE SENIOR LEADERSHIP TEAM AND MANAGER OF PEOPLE SERVICES, REVIEWS THE SALARY RANGE AND ADJUSTMENT RECOMMENDATIONS; DOCUMENTATION IS KEPT REGARDING ANY DEVIATIONS FROM THE RECOMMENDATIONS. HIGHEST PAID: ON AN ANNUAL BASIS SALARY RANGE RECOMMENDATIONS ARE MADE UTILIZING MARKET DATA THAT IS EXTRACTED FROM SALARY SURVEYS AND AGED TO ALIGN WITH THE COMPENSATION PROGRAM PHILOSOPHY. THE RECOMMENDATIONS FOR SALARY RANGE AND INDIVIDUAL PAY ADJUSTMENTS BY POSITION ARE THEN REVIEWED AND DISCUSSED DURING A MEETING OF THE WAGE AND SALARY COMMITTEE, WHICH CONSISTS OF THE SENIOR LEADERSHIP TEAM AND MANAGER OF PEOPLE SERVICES. DOCUMENTATION IS KEPT REGARDING APPROVAL AND/OR DEVIATIONS FROM THE RECOMMENDATIONS. JOINT VENTURES FORM 990 PART VI, LINE 16B HOSPITAL SISTERS HEALTH SYSTEM ADOPTED A JOINT VENTURE COMPLIANCE PROGRAM POLICY EFFECTIVE ON JANUARY 1, 2012 FOR ALL SYSTEM HOSPITALS, INCLUDING ST. VINCENT HOSPITAL. THE OVERALL PURPOSE OF THE POLICY IS TO PROVIDE PRACTICAL GUIDELINES FOR ETHICAL BUSINESS CONDUCT, TO ACHIEVE COMPLIANCE, AND TO DETECT AND PREVENT VIOLATIONS OF APPLICABLE LAWS. THE POLICY REQUIRES ST. VINCENT HOSPITAL, AND ALL HSHS HOSPITALS, TO EVALUATE THEIR PARTICIPATION IN JOINT VENTURE ARRANGEMENTS, INCLUDING UNDER APPLICABLE FEDERAL TAX LAWS, AND TO SAFEGUARD ST. VINCENT HOSPITAL'S TAX EXEMPT STATUS WITH RESPECT TO ANY JOINT VENTURE ARRANGEMENTS. DISCLOSURE DOCUMENTS AVAILABLE TO PUBLIC FORM 990 PART VI, LINE 19 BOARD-APPROVED FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE GENERAL PUBLIC AT THIS TIME. PUBLICLY TRADED SECURITIES FORM 990 PART X, LINE 11 INVESTMENTS IN SECURITIES AND RELATED INVESTMENT INCOME: THE HOSPITAL'S CASH RESERVES ARE INVESTED IN A POOLED INVESTMENT ACCOUNT. PARTICIPATION IN THE POOLED FUND IS LIMITED TO THE 501(C)(3) HOSPITALS AND RELATED HEALTH SERVICES ORGANIZATIONS SPONSORED BY HOSPITAL SISTERS HEALTH SYSTEM. THE POOLED ACCOUNT CONSISTS OF CASH, EQUITY, AND DEBT SECURITIES THAT ARE PUBLICLY TRADED. IN ACCORDANCE WITH THE PROVISIONS OF SFAS NO. 124 "ACCOUNTING FOR CERTAIN INVESTMENTS HELD BY NOT-FOR-PROFIT ORGANIZATIONS" INVESTMENTS IN EQUITY SECURITIES WITH READILY DETERMINABLE VALUES, AND ALL INVESTMENTS IN DEBT SECURITIES, ARE REPORTED AT FAIR VALUE ON THE BALANCE SHEET. INCOME, REALIZED AND UNREALIZED GAINS AND LOSSES ARE POOLED AND ALLOCATED TO THE PARTICIPANTS. INDIVIDUAL COMPONENTS OF ASSETS AND REVENUE ARE NOT IDENTIFIED TO THE INDIVIDUAL HOSPITAL PARTICIPANTS. Reconciliation of Change in Net Assets Form 990, Part XI, Line 5 TRANSFER TO/FROM AFFILIATES (3,645,084) RECOGNITION OF CHANGE IN PENSION FUNDED STATUS 26,284,030 TEMPORARILY RESTRICTED NET ASSETS 900,000 PERM RESTRICTED NET ASSETS - CONTRIBUTIONS 28,113 CHANGE IN FAIR VALUE OF INTEREST RATE SWAPS 764,877 SWAP PAYMENTS (1,048,161) LOSS ON EARLY EXTINGUISHMENT OF DEBT (957,353) OTHER (62,394) ---------- TOTAL 22,264,028 ========== Kiara Clinical Integration Network LLC 4936 Laverna Road SPRINGFIELD IL 62707 261417684 Health Care IL 0 HSSI Physician Clinical Integration Network 4936 Laverna Road SPRINGFIELD IL 62707 371668647 HEALTH CARE IL 0 KCIN SPRINGFIELD HEALTH PARTNERS LLC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371364419 HEALTHCARE IL 0 HSHS MG HOSPITAL SISTERS HEALTH SYSTEM 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371058692 HEALTHCARE IL 501(c)(3) 11A HSHS false HOSPITAL SISTERS SERVICES INC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371163402 HEALTHCARE IL 501(c)(3) 11A NA false HOSPITAL SISTERS OF ST FRANCIS FDTN 4936 LAVERNA RAOD SPRINGFIELD IL 62707 371186514 HEALTHCARE IL 501(c)(3) 11A HSHS false HSHS SELF INSURANCE TRUST FUND 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371120626 INSURANCE IL 501(c)(3) 11A HSHS false HSHS HEALTH CARE PLAN TRUST FUND 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371137724 HEALTHCARE IL 501(c)(9) N/A HSHS false HOSPITAL SISTERS HEALTHCARE WEST INC 2661 COUNTY HIGHWAY I CHIPPEWA FALLS WI 54729 510157933 HEALTHCARE WI 501(c)(3) 11A HSSI false SACRED HEART HOSPITAL 900 WEST CLAIREMONT AVENUE EAU CLAIRE WI 54701 390807060 HEALTHCARE WI 501(c)(3) 3 HSSI false ST ANTHONY'S HOSPITAL 503 N MAPLE STREET EFFINGHAM IL 62401 370661233 HEALTHCARE IL 501(c)(3) 3 HSSI false ST ELIZABETH'S HOSPITAL 211 SOUTH THIRD STREET BELLEVILLE IL 62220 370663567 HEALTHCARE IL 501(c)(3) 3 HSSI false ST NICHOLAS HOSPITAL 3100 SUPERIOR AVENUE SHEBOYGAN WI 53081 390808480 HEALTHCARE WI 501(c)(3) 3 HSSI false ST JOHN'S HOSPITAL 800 EAST CARPENTER STREET SPRINGFIELD IL 62769 370661238 HEALTHCARE IL 501(c)(3) 3 HSSI false ST JOSEPH'S HOSPITAL 9515 HOLY CROSS LANE PO BOX 9 BREESE IL 62230 371208459 HEALTHCARE IL 501(c)(3) 3 HSSI false ST JOSEPH'S HOSPITAL 2661 COUNTY HIGHWAY 1 CHIPPEWA FALLS WI 54729 390810545 HEALTHCARE WI 501(c)(3) 3 HSSI false ST MARY'S HOSPITAL 1800 E LAKE SHORE DRIVE DECATUR IL 62521 370661244 HEALTHCARE IL 501(c)(3) 3 HSSI false ST MARY'S HOSPITAL 111 SPRING STREET STREATOR IL 61364 362169181 HEALTHCARE IL 501(c)(3) 3 HSSI false ST MARY'S MEDICAL CENTER 1726 SHAWANO AVENUE GREEN BAY WI 54303 390818682 HEALTHCARE WI 501(c)(3) 3 HSSI false ST FRANCIS HOSPITAL 1215 FRANCISCAN DRIVE LITCHFIELD IL 62056 370661236 HEALTHCARE IL 501(c)(3) 3 HSSI false St Joseph's Hospital 1515 MAIN STREET HIGHLAND IL 62249 370663568 HEALTHCARE IL 501(c)(3) 3 HSSI false HSHS MEDICAL GROUP INC 3215 EXECUTIVE PARK DRIVE SPRINGFIELD IL 62703 263956318 HEALTHCARE IL 501(c)(3) 11A HSSI false HSHS WISCONSIN MEDICAL GROUP INC 3215 EXECUTIVE PARK DRIVE SPRINGFIELD IL 62703 264515959 HEALTHCARE IL 501(c)(3) 11A HSSI false ORANGE CROSS AMBULANCE INC 919 ASHLAND AVE SHEBOYGAN WI 53081 391860942 HEALTHCARE WI 501(c)(3) 9 ST NICHOLAS false WISCONSIN UPPER PEN OCN MNGMT SERVICES 835 S VAN BUREN GREEN BAY WI 54301 391677100 HEALTHCARE WI 501(c)(3) 3 ST VINCENT true UNITY LIMITED PARTNERSHIP 2366 OAK RIDGE CIRCLE DE PERE WI 54115 391750729 HEALTHCARE WI 501(c)(3) 11A HSSI false MEMORIAL AND ST ELIZABETH'S HOSPITAL 4000 NORTH ILLINOIS STREET Springfield IL 62769 HEALTHCARE IL ST ELIZABETH'S RELATED false 0 false PRAIRIE HEART INSTITUTE-CARB 800 EAST CARPENTER STREET SPRINGFIELD IL 62769 HEALTHCARE IL ST JOHN'S RELATED false 0 false NORTHEAST WISCONSIN RADIATION 1821 S WEBSTER AVENUE STE 30 GREEN BAY WI 54301 HEALTHCARE WI HSSI RELATED 94852 476507 false 0 false 0.50000 PAIN CENTER OF WISCONSIN 4131 W LOOMIS ROAD STE 300 MILWAUKEE WI 53221 HEALTHCARE WI ST VINCENT RELATED 1827303 1183047 false 0 false 0.50000 SURGERY CENTER OF SHEBOYGAN 3141 SAEMANN AVE SHEBOYGAN WI 53081 HEALTHCARE WI ST NICHOLAS RELATED false 0 false PREVEA VENTURES LLC 2710 EXECUTIVE DR GREEN BAY WI 54304 203775127 HEALTHCARE WI HSSI RELATED false 0 false CARPENTER STREET HOTEL LLC 525 NORTH SIXTH STREET SPRINGFIELD IL 62707 HOTEL IL LASANTE INC RELATED false 0 false SPRINGFIELD URGENT CARE REAL ESTATE PO BOX 19456 SPRINGFIELD IL 62794 RENT. REAL ES IL LASANTE INC RELATED false 0 false Kiara Inc 4936 Laverna ROAd Springfield IL 62707 371163401 HealthCare IL HSHS C Corp LaSante WISCONSIN INC 4936 Laverna ROAd Springfield IL 62707 391572196 HEALTHCARE IL Kiara Inc C Corp LaSante INC 4936 Laverna ROAd Springfield IL 62707 371163400 HealthCare IL Kiara Inc C Corp Prairie Cardiovascular 619 East Mason Suite 4P57 Springfield IL 62701 371071858 HEALTHCARE IL Kiara Inc C Corp PREVEA HEALTH SERVICES 2710 EXECUTIVE DR GREEN BAY WI 54304 391839351 HEALTHCARE WI HSSI C CORP PREVEA CLINIC INC 2710 EXECUTIVE DR GREEN BAY WI 54304 391839349 HEALTHCARE WI HSSI C CORP PREVEA HEALTH NETWORK 2710 EXECUTIVE DR GREEN BAY WI 54304 392000537 HEALTHCARE WI HSSI C CORP RENAISSANCE QUALITY INSURANCE 980669953 INSURANCE CA HSSI C CORP 0 0 false OJV INC 4936 LAVERNA RD SPRINGFIELD IL 62707 460873384 HEALTHCARE IL LASANTE INC C CORP 0 0 false true true true true false false true true true true true false false true true true true true true TRANSACTIONS WITH RELATED ENTITIES FORM 990, SCHEDULE R, PART V, LINE 2 TRANSACTIONS ARE BETWEEN RELATED 501(C)(3) AND DO NOT REQUIRE REPORTING ON THIS SECTION.