2014-08-14T14:10:05-05:00 2013-09-30 390758449 WIPFLI LLP PO BOX 12237 GREEN BAY WI 543072237 990 2012-10-01 061745397 OCONTO HOSPITAL AND MEDICAL CENTER OCON 9208351100 PO BOX 357 OCONTO WI 54153 CHRISTINE WOLESKE 9208351100 2014-08-14 1 TERRI REXRODE CPA MST P00096513 9206620016 2014-08-14 2012 2015-11-30 17:44:51Z CHRISTINE WOLESKE PO BOX 357 OCONTO WI 54153 10367025 0 X WWW.OCONTOHOSPITAL.ORG X 2005 WI OCONTO HOSPTIAL & MEDICAL CENTER, INC. (THE ORGANIZATION) IS YOUR HOME TOWN HOSPITAL, CREATED TO MAKE OUTSTANDING HEALTHCARE CONVENIENT. BACKED BY THE RESOURCES OF BELLIN HEALTH, OCONTO HOSPITAL & MEDICAL CENTER, INC. OFFERS OUTSTANDING HOSPITAL-BASED, EMERGENCY AND PRIMARY CARE SERVICES. OCONTO HOSPITAL & MEDICAL CENTER, INC. OFFERS THE CARE YOU NEED WHERE YOU WANT IT. 8 3 77 8 0 0 1482000 423807 5622385 9888992 2001 3813 -840 37353 7105546 10353965 0 0 0 0 2994332 4851357 0 0 0 2800839 6665493 5795171 11516850 1310375 -1162885 26367419 26480927 21143664 22771278 5223755 3709649 X THE MISSION OF OCONTO HOSPITAL & MEDICAL CENTER IS TO PROVIDE 24-HOUR LOCAL ACCESS TO EFFECTIVE, EFFICIENT HEALTH, WELLNESS AND PREVENTATIVE SERVICES TO OCONTO AND THE SURROUNDING RURAL COMMUNITIES. TOWARD THIS PURPOSE, OCONTO HOSPITAL & MEDICAL CENTER WORKS IN PARTNERSHIP WITH THE COMMUNITY, THE CITIZENS HOSPITAL FOUNDATION AND BELLIN HEALTH. 0 1 8931898 9885219 AS A KEY REGIONAL ASSET, THE ORGANIZATION IS A NOT-FOR-PROFIT HEALTHCARE PROVIDER. THE ORGANIZATION PROVIDES ACUTE HOSPITAL, EMERGENCY AND URGENT CARE TO RESIDENTS OF OCONTO WISCONSIN AND THE SURROUNDING COMMUNITIES. DURING THE PERIOD OF OCTOBER 1, 2012 TO SEPTEMBER 30, 2013, 539 INPATIENT DAYS WERE PROVIDED 167 SWING BED DAYS WERE PROVIDED. THE NUMBER OF OUTPATIENTS REGISTERED DURING THE SAME 12 MONTH PERIOD WAS 10,877. 8931898 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 77 1 0 0 0 0 0 0 0 0 0 0 X 8 3 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X SARA ARNDT 9204457260 2020 SOUTH WEBSTER AVE GREEN BAY WI 54301 CHRISTINE WOLESKE 0.50 50.00 X X 0 341470 34758 GEORGE KERWIN 0.50 50.00 X 0 877514 37717 SARA ARNDT 5.00 40.00 X 0 48965 20694 DAVID HONISH 0.50 X X 0 0 0 RODNEY R JOHNSON 0.50 X X 0 0 0 LAURA CORMIER 45.00 X 122393 0 18868 CHARLES HEYKA MD 14.00 36.00 X 66595 202376 27771 JOHN HONISH 0.50 X 0 0 0 ROBERT BIVINS MD 40.00 X 242969 0 28813 431957 1470325 168621 2 0 1 0 IEI GENERAL CONTRACTORS INC PO BOX 5067 DE PERE WI 541555067 CONTRACTOR SERVICES 6232637 BELLIN MEMORIAL HOSPITAL INC 744 S WEBSTER AVE GREEN BAY WI 54305 MANAGEMENT SERVICES 782414 JIN KIM MD 333 W MIFFLIN ST 1167 MADISON WI 53703 CONTRACTED ED PHYSICIAN SERVICES 268189 SOMERVILLE INC 2100 RIVERSIDE DR GREEN BAY WI 54301 ARCHITECT AND DESIGN SERVICES 131401 4 415000 8807 423807 NET PATIENT REVENUE 621300 9762077 9762077 RENT FROM AFFILIATES 900099 123142 123142 MISCELLANEOUS REVENUE 900099 3773 3773 9888992 3813 3813 50413 13060 37353 37353 37353 10353965 9885219 0 44939 X 216492 74871 141621 3917286 3747743 169543 176908 173501 3407 273923 268925 4998 266748 251537 15211 12673 12673 6884 6884 1244784 539478 705306 328608 328608 1580986 1561232 19754 41322 2036 39286 239702 232683 7019 41256 32124 9132 6000 6000 914760 914760 1637738 1494702 143036 14470 9314 5156 BAD DEBT EXPENSE 537636 537636 DUES, LICENSES AND SUBS 52890 6116 46774 5784 5784 11516850 8931898 2584952 0 303291 707124 33050 0 2007951 2302668 146211 308193 26830546 4182524 22695216 22648022 1181700 514920 26367419 26480927 675816 925797 14000000 13649999 6467848 8195482 21143664 22771278 X 4642293 3479406 581462 230243 5223755 3709649 26367419 26480927 X -1162885 -351221 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 661050 661050 15005641 1748255 13257386 171971 32265 139706 10991884 2402004 8589880 22648022 DUE TO AFFILIATE 8195482 8195482 X 9970775 18750 18750 9952025 401940 401940 10353965 11548660 13060 13060 11535600 -18750 -18750 11516850 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: IN ORDER TO ACCOUNT FOR UNCERTAIN TAX POSITIONS, BELLIN HEALTH SYSTEMS DETERMINES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THAT POSITION IS NOT RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS. BELLIN HEALTH SYSTEMS HAS NOT RECORDED ANY ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS AS OF SEPTEMBER 30, 2013 OR 2012. BELLIN HEALTH SYSTEMS' FEDERAL INCOME TAX RETURNS FOR YEARS ENDED SEPTEMBER 30, 2010, AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE EXPIRATION OF THE STATUTES OF LIMITATIONS RELATED TO THE VARIOUS STATE INCOME TAX RETURNS THAT BELLIN HEALTH SYSTEMS FILE VARIES BY STATE. GENERALLY, BELLIN HEALTH SYSTEMS' VARIOUS STATE INCOME TAX RETURNS FOR YEARS ENDED SEPTEMBER 30, 2009, AND BEYOND REMAIN SUBJECT TO EXAMINATION BY VARIOUS STATE TAXING AUTHORITIES. PART XI, LINE 2D - OTHER ADJUSTMENTS: RECLASS BETWEEN REVENUE AND EXPENSES 18,750. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL DEPRECIATION -13,060. OCONTO MEMORIAL HOSPITAL CITIZENS FOUNDATION, INC. REVENUE 375,000. BELLIN FOUNDATION REVENUE 40,000. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL DEPRECIATION 13,060. PART XII, LINE 4B - OTHER ADJUSTMENTS: RECLASS BETWEEN REVENUE AND EXPENSES -18,750. 1 1 1 X 1 X 1 1 0 0 295679 295679 0.02690 1857970 1376501 481469 0.04390 2153649 1376501 777148 0.07080 4 696 5321 5321 0.00050 17235 7515 9720 0.00090 4 767 3602 3602 0.00030 8 1463 26158 7515 18643 0.00170 8 1463 2179807 1384016 795791 0.07250 1 537636 2608584 2692666 -84082 X 1 0 1 1 OCONTO HOSPITAL & MEDICAL CENTER INC

820 ARBUTUS AVE OCONTO WI 54153

X X X OCONTO HOSPITAL & MEDICAL CENTER INC 1 1 X X X X X X X X 12 1 1 1 X X X X X X X X 0 0 1 1 200.000000000000 1 400.000000000000 1 X X X X 1 1 X X X X X 1 X 0 1 X 0 0 PART I, LINE 6A: BELLIN MEMORIAL HOSPITAL, INC. PART I, LINE 7: AMOUNTS ARE CALCULATED BASED ON THE COST TO CHARGE RATIOS AND WORKSHEET 2 PROVIDED BY THE IRS. PART I, L7 COL(F): BAD DEBT EXPENSE OF $537,636 INCLUDED ON FORM 990, PART IX, LINE 25 WAS EXCLUDED FROM THE DENOMINATOR PER INSTRUCTIONS WHEN CALCULATING THE PERCENT TOTAL EXPENSES ON SCHEDULE H. PART II: THE ORGANIZATION REPORTED NO COMMUNITY BUILDING ACTIVITIES REPORTED IN PART II. PART III, LINE 4: THE ATTACHED FINANCIAL STATEMENTS DO NOT CONTAIN A SPECIFIC BAD DEBT EXPENSE FOOTNOTE. HOWEVER, THE SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES DESCRIBES THE PROVISION FOR BAD DEBT ON PAGE 11 OF THE FINANCIAL STATEMENTS.FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR A PORTION OF THE BILL), BELLIN HEALTH SYSTEMS RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCES FOR DOUBTFUL ACCOUNTS. PART III, LINE 8: THE AMOUNTS REPORTED FOR MEDICARE WERE CALCULATED USING A COST TO CHARGE RATIO. THE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT FOR THE FOLLOWING REASONS. IRS REV RUL 69-545 WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. IN ADDITION, ELDERLY PATIENTS ARE OFTEN UNDERSERVED AND EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT EXEMPT HOSPITALS, CMS WOULD NEED TO PROVIDE THESE SERVICES. PART III, LINE 9B: WHEN A PATIENT QUALIFIES FOR CHARITY CARE HIS/HER ACCOUNT BALANCE ARE ADJUSTED TO REFLECT THE PORTION OF THE CHARGES THAT HE/SHE ARE STILL RESPONSIBLE FOR PAYING. IF THOSE PAYMENTS ARE NOT MADE AND THE PATIENT DOES NOT QUALIFY FOR ADDITIONAL ASSISTANCE, THE COLLECTORS WILL FOLLOW THE STANDARD WRITTEN COLLECTION POLICY. OCONTO HOSPITAL & MEDICAL CENTER, INC. PART V, SECTION B, LINE 3: DEVELOPED COUNTY WIDE INDIVIDUAL PUBLIC OPINION SURVEY THAT GENERATED OVER 600 RESPONSES. ASSESSMENT TEAM INCLUDED PARTICIPATION FROM SCHOOLS, LAW ENFORCEMENT, EMPLOYERS, HEALTHCARE PROVIDERS, CHURCHES, COUNTY AGENICES, UNITED WAY, PUBLIC OFFICIALS, PUBLIC HEALTH AND HEALTHCARE MEDICAL PROVIDERS. OCONTO HOSPITAL & MEDICAL CENTER, INC. PART V, SECTION B, LINE 4: COMMUNITY MEMORIAL HOSPITAL, OCONTO FALLS, WISCONSIN OCONTO HOSPITAL & MEDICAL CENTER, INC. PART V, SECTION B, LINE 5C: MADE AND CONTINUE TO MAKE PRESENTATIONS TO COMMUNITY ENTITIES THROUGHOUT THE COUNTY INCLUDING SCHOOLS, GOVERNMENT BOARDS, CHAMBER OF COMMERCE, AND CIVIC GROUPS.THE CHNA IS AVAILABLE AT THE ORGANIZATION'S WEBSITE: WWW.BELLIN.ORG OCONTO HOSPITAL & MEDICAL CENTER, INC. PART V, SECTION B, LINE 7: AS A COUNTY ASSESSMENT TEAM, WE PRIORITIZED THREE HEALTH FOCUS AREAS FOR THE NEXT 5 YEARS. OCONTO HOSPITAL & MEDICAL CENTER, INC. PART V, SECTION B, LINE 20D: PATIENTS CAN QUALIFY FOR COMMUNITY CARE OR A DISCOUNT DEPENDING ON LEVEL OF QUALIFICATION PRIMARILY DEPENDENT ON INCOME LEVEL AND FAMILY SIZE. THE DISCOUNT IS TAKEN FROM 80% OF GROSS CHARGES. A FAP ELIGIBLE PATIENT WILL NEVER BE RESPONSIBLE FOR MORE THAN 15% OF THEIR ANNUAL INCOME. PART VI, LINE 2: DURING THE FISCAL YEAR, THE ORGANIZATION DEVELOPED A COUNTY WIDE INDIVIDUAL PUBLIC OPINION SURVEY, WHICH GENERATED 600 RESPONSES. THE RESPONSES WERE GATHERED FROM A VARIETY OF SOURCES, WHICH INCLUDED BUT WERE NOT LIMITED TO SCHOOLS, LAW ENFORCEMENT, HEALTHCARE PROVIDERS, CHURCHES, COUNTY AGENCIES, THE UNITED WAY, PUBLIC OFFICIALS, AND PUBLIC HEALTH DEPARTMENTS. THE VARIETY OF ORGANIZATIONS THAT RESPONDED ALLOWED THE ORGANIZATION TO APPROPRIATELY ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITY. PART VI, LINE 3: INFORMATION ON GOVERNMENT ASSISTANCE PROGRAMS AND THE CHARITY CARE PROGRAM IS MADE AVAILABLE TO PATIENTS IN THE EMERGENCY ROOM AND AT THE TIME OF REGISTRATION. ADDITIONALLY, THE INFORMATION IS INCLUDED IN PATIENT STATEMENTS AND LETTERS FROM THE BILLING OFFICE. PART VI, LINE 4: THE ORGANIZATION IS LOCATED IN THE CITY OF OCONTO, WISCONSIN. ITS PRIMARY SERVICE AREA IS THE CITY OF OCONTO AND ITS SECONDARY SERVICE AREA SPREADS TO THE NORTHERN PORTION OF OCONTO COUNTY AND SOUTHERN MARINETTE COUNTY. THE CITY OF OCONTO HAS A POPULATION OF 4,500. 17% OF THE POPULATION IS OVER AGE 65 AND 8.8% OF THE POPULATION IS BELOW THE POVERTY LINE. PART VI, LINE 5: THE ORGANIZATION IS INVOLVED IN THE OCONTO/MARINETTE WELLNESS COALITION, OCONTO AREA CHAMBER OF COMMERCE BUSINESS EXPO, COPPERFEST SPONSORSHIP, NEWCAP AND HUMANE SOCIETY FOOD DRIVES. IN ADDITION THE ORGANIZATION IS A SOLE COMMUNITY HOSPITAL WITH AN EMERGENCY ROOM AVAILABLE TO ALL. PART VI, LINE 6: THE ORGANIZATION, IN PARTNERSHIP WITH BELLIN HEALTH SYSTEMS, INC., CONTINUES TO SERVE IT'S COMMUNITY. X X 0 0 0 0 0 0 0 0 0 CHRISTINE WOLESKE 0 281200 0 60000 0 270 0 13675 0 21083 0 376228 0 0 GEORGE KERWIN 0 414658 0 453500 0 9356 0 21611 0 16106 0 915231 0 0 CHARLES HEYKA MD 55104 186544 10717 15832 774 0 2877 5421 5399 14074 74871 221871 0 0 ROBERT BIVINS MD 238301 0 4398 0 270 0 13262 0 15551 0 271782 0 0 0 A WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTHORITY 391337855 2011-08-18 14000000 FACILITY AND SERVICE EXPANSION 0 0 0 A 350000 36149 132033 13831818 2012 0 0 1 1 A 0 0 0 0 0 0 1 A 0 1 0 0 0 0 0 0 A 1 CHANGES IN PROGRAM SERVICES FORM 990, PART III, LINE 3 THE OUTPATIENT SURGERY DEPARTMENT OPENED ON 10/01/12. THIS NEW SERVICE INCLUDES NON-EMERGENT OUTPATIENT SURGERIES AND GI PROCEDURES. FORM 990, PART VI, SECTION A, LINE 2 JOHN HONISH AND DAVID HONISH HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS TWO MEMBERS, BELLIN MEMORIAL HOSPITAL, INC. AND OCONTO MEMORIAL HOSPITAL CITIZENS FOUNDATION, INC. FORM 990, PART VI, SECTION A, LINE 7A THE MEMBERS OF THE ORGANIZATION HAVE THE POWER TO APPOINT/ELECT THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE MEMBERS ALSO HAVE THE POWER TO APPROVE, BUT NOT LIMITED TO, THE PHILOSOPHY, MISSION, AND VALUE OF THE ORGANIZATION, STRATEGIC PLANS, THE ANNUAL OPERATING AND CAPITAL BUDGET, AMENDMENTS OR RESTATEMENTS OF THE ARTICLES OF INCORPORATION AND BYLAWS. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED IN DETAIL BY SENIOR ADMINISTRATION AND IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUESTS AN ANNUAL UPDATE FROM ALL MEMBERS WHO SIGN THE POLICY. MEMBERS OF THE BOARD WHO HAVE A CONFLICT OF INTEREST WITH A BOARD DECISION ABSTAIN FROM VOTING ON THE ISSUE. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION OF KEY EXECUTIVES ARE SET BY THE EXECUTIVE COMMITTEE OF THE BOARD WITHOUT CONFLICT OF INTEREST AND IS SUPPORTED BY MARKET DATA FROM SURVEYS AND AN INDEPENDENT CONSULTANT'S REPORT. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION CONSIDERS THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS PROPERTY OF THE ORGANIZATION AND THEREFORE ARE NOT AVAILABLE TO THE PUBLIC. OTHER FEES FORM 990, PART IX, LINE 11G INTERCOMPANY IT SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 570,528. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 570,528. INTERCOMPANY MANGEMENT CHARGES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 134,778. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 134,778. CONTRACTED LABOR: PROGRAM SERVICE EXPENSES 349,768. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 349,768. CONTRACTED LABOR - ENVIRONMENTAL SERVICES: PROGRAM SERVICE EXPENSES 189,710. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 189,710. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN THE BELLIN HEALTH FOUNDATION, INC. -40,000. CHANGE IN INTEREST IN OCONTO MEMORIAL HOSPITAL CITIZENS' FOUNDATION, INC. -311,221. FORM 990, PART XI, LINE 2B-2C THE ORGANIZATION IS INCLUDED IN THE CONSOLIDATED AUDIT OF BELLIN HEALTH SYSTEMS, INC. THE BOARD OF DIRECTORS OF BELLIN HEALTH SYSTEMS, INC. ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT AND SELECTION OF AN INDEPENDENT AUDITOR. OCONTO MEMORIAL HOSPITAL CITIZENS FOUNDATION 405 1ST STRET OCONTO WI 54153 061745397 SUPPORTING ORGANIZATION WI 501(C) LINE 11B, II N/A 0 LAKE MICHIGAN HEALTH SERVICES INC 744 SOUTH WEBSTER AVE GREEN BAY WI 54305 391512903 SUPPORT PURPOSES OF BELLIN MEMORIAL HOSPITAL WI 501(C) LINE 11B, II BELLIN HEALTH SYSTEMS INC 1 BELLIN COLLEGE INC 3201 EATON ROAD GREEN BAY WI 54311 391620530 NURSING AND RADIOLOGIC SCIENCE COLLEGE WI 501(C) LINE 2 BELLIN HEALTH SYSTEMS INC 1 THE BELLIN HEALTH FOUNDATION INC PO BOX 23400 GREEN BAY WI 54305 391809171 FOUNDATION WI 501(C) LINE 7 BELLIN HEALTH SYSTEMS INC 1 BELLIN PSYCHIATRIC CENTER INC PO BOX 23725 GREEN BAY WI 54305 391657627 PPSYCHIATRIC HOSPITAL WI 501(C) LINE 3 BELLIN HEALTH SYSTEMS INC 1 BELLIN MEMORIAL HOSPITAL INC PO BOX 23400 GREEN BAY WI 54305 391900586 ACUTE CARE HOSPITAL WI 501(C) LINE 3 BELLIN HEALTH SYSTEMS INC 1 BELLIN HEALTH SYSTEMS INC 744 SOUTH WEBSTER AVE GREEN BAY WI 54305 391512904 SUPPORT OF HEALTHCARE ORGANIZATIONS WI 501(C) LINE 11B, II N/A 0 BELLIN ORTHOPEDIC SURGERY CENTER LLC 2223 LIME KILN RD GREEN BAY WI 54311 264677834 AMBULATORY ORTHOPEDIC SURGERY WI N/A BEL-REGIONAL HOME MEDICAL INC 617 S ROOSEVELT GREEN BAY WI 54301 391504766 DURABLE MEDICAL EQUIPMENT, RETAIL PHARMACY, FITNESS WI N/A C 0 BELLIN INVESTMENTS INC PO BOX 23400 GREEN BAY WI 54305 391564939 OTHER WI N/A C 0 UNITED PROVIDERS INC PO BOX 23400 GREEN BAY WI 54305 391907541 OTHER WI N/A C 0 0 0 1 0 1 0 0 0 0 1 0 0 1 0 1 1 0 0 0 OCONTO MEMORIAL HOSPITAL CITIZENS FOUNDATION C 375000 FMV BELLIN HEALTH FOUNDATION INC C 40000 FMV BELLIN MEMORIAL HOSPITAL INC E 14000000 FMV BEL-REGIONAL HOME MEDICAL INC I 120000 FMV BELLIN MEMORIAL HOSPITAL INC L 782414 FMV BELLIN MEMORIAL HOSPITAL INC N 374052 FMV BELLIN MEMORIAL HOSPITAL INC O 4200000 FMV BELLIN MEMORIAL HOSPITAL INC E 7483756 FMV