2013-08-08T12:58:15-07:00 2012-09-30 990 2011-10-01 721531917 ST CLARES HOSPITAL OF WESTON INC STCL 7153933000 3400 MINISTRY PARKWAY WESTON WI 54476 MARY KRUEGER 2013-08-08 2011 2016-02-24 21:20:13Z MARY KRUEGER 3400 MINISTRY PARKWAY WESTON WI 54476 105178108 false false 0928 X WWW.MINISTRYHEALTH.ORG X 2002 WI ST CLARES MISSION AS A CATHOLIC HOSPITAL IS TO FURTHER THE HEALING MINISTRY OF JESUS BY CONTINUALLY IMPROVING THE HEALTH AND WELL-BEING OF ALL PEOPLE, ESPECIALLY THE POOR. WE PROVIDE ACUTE HEALTH CARE SERVICES TO THE COMMUNITY REGARDLESS OF A PERSON'S ABILITY TO PAY. 13 9 579 176 0 32381 65817 94941769 105494505 8653 4864 -3190337 -405704 91792466 105159482 0 0 34796787 37513269 0 0 58544424 63653800 93341211 101167069 -1548745 3992413 133806222 124177623 185701402 183714934 -51895180 -59537311 ST CLARES MISSION AS A CATHOLIC HOSPITAL IS TO FURTHER THE HEALING MINISTRY OF JESUS BY CONTINUALLY IMPROVING THE HEALTH AND WELL-BEING OF ALL PEOPLE, ESPECIALLY THE POOR. WE PROVIDE ACUTE HEALTH CARE SERVICES TO THE COMMUNITY REGARDLESS OF A PERSON'S ABILITY TO PAY. false false 96064104 104221081 THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT, EMERGENCY ROOM AND ANCILLARY SERVICES REGARDLESS OF AN INDIVIDUAL'S ABILITY TO PAY OR METHOD OF PAYMENT. THE HOSPITAL ALSO PROVIDES EDUCATIONAL PROGRAMS AND SERVICES ON HEALTH CARE ISSUES TO THE COMMUNITY IT SERVES. SEE SCHEDULE H FOR FURTHER DETAILS. 96064104 true true false true false false false false false false true false false true true false false true false false false false false false false false true true false false true false false false false false false false false false false false true false false false false true true true false true true 49 0 true 579 true false false false false false false false false false false false 0 false false false false false false false false false false false X 13 9 false false false false true true true true true false false false false true true true true true true true false false WI X X JEFF BADGER VP CORP FIN TRS 7153433163 4941 KIRSCHLING CRT STEVENS PT WI 54481 X TEE DALY 0.25 X 0 0 0 SISTER MARIA VINTON 0.25 X 0 0 0 JOANNE LEONARD 0.25 X 0 0 0 MIKE KRYDA 0.25 X X 0 453755 16573 MARY JO JOHNSON 0.25 X 0 0 0 KEVIN NOEL 0.25 X 0 0 0 KRISTINE GILMORE 0.25 X X 0 0 0 TIM BODETTE 0.25 X X 0 0 0 JIM FRINGS 0.25 X 0 0 0 THOMAS FELCH 0.25 X 0 0 0 LARRY HEGLAND 10.00 X X 0 384589 37079 MARY KRUEGER 40.00 X X 0 381867 40444 JEFF MARTIN 6.00 X X 0 804211 45600 KRISTINE MCGARIGLE 0.25 X 0 194505 32211 RACHEL YARON 20.00 X 0 199919 13168 COLLEEN HOERNEMAN 40.00 X 0 202550 22263 WILLIAM HINNER 0.25 X 0 338703 47433 MAHER SALEM 40.00 X 122258 0 18900 RAYMOND BAKER 40.00 X 120686 0 21883 SUSAN DRAEGER 40.00 X 120941 0 8837 MARIA HEGLAND 40.00 X 124212 0 3182 ROBERT MIDDLETON 40.00 X 138197 0 24425 626294 2960099 331998 18 false true false MEDDATA PO BOX 2065 SEATTLE WA 981112065 BILLING SERVICES 383344 MARSHFIELD CLINIC 1000 NORTH OAK AVE MARSHFIELD WI 544495779 MEDICAL SERVCS/STFF 918791 JUDGES CLEANERS INC 2150 MAPLE DRIVE PLOVER WI 54467 LAUNDRY SERVICES 391176 JOHNSON CONTROLS PO BOX 905240 CHARLOTTE NC 282905240 EQUIP INSTL & MAINT 462950 ADVANCE ICU CARE PO BOX 790379 ST LOUIS MO 63179 MEDICAL SERVICES 450000 14 48828 16989 65817 RENT INCOMES 532000 920567 920567 PROGRAM SERVICE REVENUES 900099 96284125 96284125 DTC INCOME 621500 7090508 7090508 CAPITAL LEASE INTEREST 900099 1199305 1199305 105494505 22438 22438 0 0 35438 35438 35438 35438 1052 18626 -17574 -17574 -17574 0 0 0 STIMULUS DOLLARS 900099 2453872 2453872 MINISTRY HOSPICE 621610 284002 284002 CAFETERIA 722210 697713 697713 -3876729 -4011298 134569 -441142 105159482 104221081 872584 0 0 0 0 0 0 29723376 28041352 1682024 1447409 1438107 9302 4637043 4174521 462522 1705441 1670627 34814 0 186007 5750 180257 2000 2000 0 0 0 2334120 2225921 108199 173374 173374 13540066 13350853 189213 2258361 2256742 1619 0 1454573 1455506 -933 52088 41217 10871 0 189185 126583 62602 10798642 10798642 0 6773318 6637273 136045 156857 152442 4415 Pharmaceuticals 2633923 2633923 BAD DEBT 4400305 4400305 UNDERARRANGEMENTS 7303654 7303654 PURCHASED SERVICES 7836714 6996666 840048 3560613 2352020 1208593 101167069 96064104 5102965 0 1400 1700 4904210 6468575 0 9346220 11090899 0 0 0 2219091 1971086 287536 306793 126591189 52833509 76378331 73757680 0 0 0 0 40669434 30580890 133806222 124177623 30692526 31134008 479455 455047 154529421 152125879 185701402 183714934 X -51895180 -59537311 -51895180 -59537311 133806222 124177623 X 3992413 -11634544 X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false true 7780 7780 false false Part II-B, Line 1i Part II-B, Line 1i - Other Activities Description ST CLARE'S HOSPITAL OF WESTON INC BELONGS TO A NUMBER OF TRADE ASSOCIATIONS (WHA,CHA,AHA,RWHC,MGMA). THESE ASSOCIATIONS ARE PAID ANNUAL DUES AND A PERCENTAGE OF THE DUES ARE RELATED TO LOBBYING DONE BY THE TRADE ASSOCIATION. LOBBY PERCENTAGES RANGE BETWEEN 5%-24% OF THE ANNUAL AMOUNTS. THE AMOUNT REPORTED ON SCHEDULE C, PT II-B, LINE 1(i) REPRESENTS THE SUM OF ALL TRADE ASSOCIATION DUES RELATED TO LOBBY EXPENSE. 1558074 1558074 90359671 26177297 64182374 1179942 876480 303462 33493502 25779732 7713770 73757680 OTHER ACCOUNTS RECEIVABLE 2687002 INVESTMENT IN DTC 4955336 CAPITAL LEASE 22938552 30580890 NOTE PAYABLE TO MHC (RELATED PARTY) 152139637 EST DUE TO THIRD PARTY PAYOR -13758 152125879 Part XI, Line 8 Part XI, Line 8: Other Changes in Net Assets or Fund Balances CASH TRANSFER TO ST CLARES FOUNDATION $ -7682 SJH OUTREACH ALLOCATION $ -2199997 HOSPICE/HOME HEALTH $ -121870 EHR FUNDING $ -154505 DTC INVESTMENT TRNSFR $ -9150490 true true true X true X true true false false true true 1038620 1038620 0.01030 11338837 9218837 2120000 0.02100 12377457 9218837 3158620 0.03130 8 80 60214 60214 0.00060 6 29 122891 3000 119891 0.00120 10 82391 82391 0.00080 24 109 265496 3000 262496 0.00260 24 109 12642953 9221837 3421116 0.03390 1 40660 40660 0.00040 1 4290 4290 2 44950 44950 0.00040 true 4401362 40442921 51208198 -10765277 X true true THE DIAGNOSTIC & TRMNT CNTR OUTPATIENT/DIAGNOSTIC SERVS 0.50000 1 0 ST CLARES HOSPITAL OF WESTON

3400 MINISTRY PARKWAY WESTON WI 54476

X X X ST CLARES HOSPITAL OF WESTON 1 true true 200.0000 true 400.0000 true X X X X X X true true X X X X X X true X false X X X X true X false false 1 THE DIAGNOSTIC & TREATMENT CENTER

3401 CRANBERRY BLVD WESTON WI 54476

OUTPATIENT/DIAGNOSTIC SERVICES Part VI - States Where Community Benefit Report Filed WI Part VI - Affilated Health Care System Roles and Promotion The organization is part of an affiliated health care system called Ministry Health Care, Inc. The mission of Ministry as a Catholic health care system is to further the healing ministry of Jesus by continually improving the health and well being of all people, especially the poor, in the communities served. Ministry supports such non-hospital facilities as the Agape Community Center. As a community center, it has the unique advantage of welcoming youth, adults, families and seniors into the facility through a broad range of educational, social, recreational, cultural, health and life-long learning opportunities in an impoverished portion of Milwaukee. Our Catholic Identity expects leaders to initiate and support efforts to reach out to the poor and vulnerable people, especially where no one else wants to go. Health care can become very bureaucratic and burdened with oversight of finances, regulatory requirements and strategic planning. Our focus on these issues may cause us to lose touch with those for whom we have a primary responsibility-those who are poor and vulnerable. Tithing of time allows us to look into the face of the poor, hear the voice of the poor, and help us better understand the daily challenges and barriers they face. As an affiliated health system, all leaders with direct reports are required to provide service to the poor. This also includes physician leaders and hourly supervisory staff. The organization has a foundation which is not included within the operations of the organization. The foundation provides programs and cash donations which help support the mission of the organization and the affiliated health care system. Part VI - Explanation Of How Organization Furthers Its Exempt Purpose The organization strives to further its exempt purposes by the following: (1) The organization's governing board consists primarily of persons who reside within the primary service area. They are not employees of the organization. (2) As mentioned, the organization provides several services which are not otherwise available being in an urban setting. (3) Based on the organization's mission, emergency rooms are made available to all patients regardless of the ability to pay. (4) The organization also participates in the education and training of healthcare professionals through internship programs.St. Clare's Hospital is also involved in the following efforts to further its tax exempt status. Examples Include: The hospital participates in government-sponsored health programs (Medicare, Medicaid, CHAMPUS, Tricare)The role of the emergency department in serving all persons regardless of ability to pay.Financial assistance available based on individual circumstances and subject to sliding scale discounts.St. Clare's Hospital offers a volunteer services program where community members utilize the hospital as a vehicle to connect with and contribute to individuals and the overall community through volunteering. Part VI - Community Building Activities Community-building activities include programs that, while not directly related to health care, provide opportunities to address the root causes of health problems, such as poverty, homelessness, and environmental problems. These activities support community assets by offering the expertise and resources of the organization. Costs for these activities include cash, in-kind donations, and expenditures for the development of a variety of community health programs and partnerships.St. Clare's Hospital in collaboration with the community, help to identify various health problems affecting the surrounding area, causes leading to these health problems, and actions taken to communicate these issues. These are being done with various health fairs and education related to those at-risk population. The organization in conjunction with its foundation have a fund set up for patients who may need assistance with food, medication, clothing, transportation or basic needs when they leave the hospital. Part VI - Community Information While there is growing agreement in the United States about what constitutes a non-profit hospital's 'community benefit', this is a work in progress. The organization provided significant charity care and other community benefits as defined by the IRS. But in addition, we believe that we provide a critically important community benefit, which is not quantified. Our hospital, like most hospitals, was created and is maintained in order to provide care locally-care that without our hospital, would not be available locally.Certain specialized services available include: emergency services, surgical services, inpatient medical services, & obstetrics.St. Clare's Hospital serves Weston, WI and the surrounding areas including Schofield, Rothschild, Rib Mountain, & Wausau.As of the 2010 Census, Weston had a population of 14,868. An increase of 23.1% compared to the 2000 census data. There were 5,796 households based on 2007-2011 data, with an average person per household being 2.49. The median household income was $55,636 and there were 6.1% of the population below the poverty level.In the village the population was spread out with 29.6% age 19 & under, 26.7% from 20 to 39, 32.1% from 40 to 64, 19.7% from 45 to 64, and 11.6% who were 65 years of age or older. Part VI - Patient Education of Eligibility for Assistance The organization has financial counselors located at every hospital. If a patient indicates they are unable to pay their bill at any point during pre-service, admission, discharge or billing process, the financial counselors will assist the patient in either securing a funding source (grants, COBRA coverage, Disability benefits, Medicaid, VA, etc) if eligible or assist them in completing a financial assistance application. Part VI - Needs Assessment The organization performs community needs assessments as needed. Planning workgroups consisting of community partners are formed to define the community and its needs through review of Health People Initiatives, census documents, and local government health and welfare agencies. Considering other community resources/assets, data collection methods are used to identify particular problems or subgroups and areas known to have high poverty rates and to be underserved. The data is analyzed and priorities are set based on trending information which may target a specific need. When a need is identified, the hospital develops a plan to implement a program either through community collaboration or individually. Outcomes from the programs are measured and considered in subsequent community needs assessments. Community benefit plans are presented to senior leadership and board members to ensure the findings are incorporated into the organization's strategy and policy development. For example, senior leaders are required to provide direct service to the poor hours as part of their performance goals. Number of Hospital Faciltiy - 0 Part V, Line 15e - Other Collection Actions Against a Patient Ministry makes every effort to determine patient's eligibility for assistance prior to billing. If patient is uncooperative or unresponsive, the patient account may be referred to a collection agency for further billing effort. If patient does indicate inability to pay, we will stop collection efforts and work with patient to complete a financial assistance application. We do not file liens, lawsuits, or report to credit agency, until all determination efforts have been exhausted. Part III, Line 9b - Provisions On Collection Practices For Qualified Patients The organization has a debt collection policy which sets forth collection practices for patients who are known to qualify or may qualify for financial assistance under the charity care program. Sufficient financial counseling support is made available to patients so they can easily access patient financial service representatives and have their questions answered, and gain an understanding of the reasons why they owe a balance. Accounts are designated as charity care in the business offices so no additional time is spent on collection efforts. Part I, Line 7, Column F - Explanation of Bad Debt Expense Bad Debt expense of $4,400,305 is excluded from total operating expenses of $101,167,069 when calculating percentage of total expense in Part I, Line 7, Col F. Part I, Line 7 - Explanation of Costing Methodology Amounts calculated in Part I, Line 7 are determined both on a cost accounting system and a cost-to-charge ratio. Other Benefits are determined based on the direct and indirect costs (where allocated) associated with a program net of earned revenue. Detail for each program/activity is maintained and determined at the department level. Charity care and means-tested programs are determined based on a cost-to-charge ratio consistent with Worksheet 2, Ratio of Patient Care Cost to Charges. Part I, Line 6a - Related Organization Community Benefit Report As part of Ministry Health Care, Inc., the organization files an annual community benefit report for all owned entities on its webpage. The report can be viewed by visiting www.ministryhealth.org/MinistryHealth/Community.nws. Each facility is included within the report. X true true X X X X false true false false false false false false false false WILLIAM HINNER 238588 56804 43311 30531 16902 386136 ROBERT MIDDLETON 133328 4869 2858 21567 162622 RACHEL YARON 127933 39326 32660 12419 749 213087 MIKE KRYDA 200525 65010 188220 8160 8413 470328 MARY KRUEGER 212404 88601 80862 24716 15728 422311 LARRY HEGLAND 240253 62426 81910 19080 17999 421668 KRISTINE MCGARIGLE 136984 37730 19791 14450 17761 226716 JEFF MARTIN 422518 208046 173647 29556 16044 849811 COLLEEN HOERNEMAN 133351 36570 32629 20797 1466 224813 Sch J, Part I, Line 1a Part I, Line 1a: Relevant information in regards to selections on 1a. SOCIAL CLUB DUES PROVIDED ON BEHALF OF:MARY KRUEGER $5,097LARRY HEGLAND $5,097 X 12734 X 1 14899 false false false FORM 990 PART IX LINE 24 - OTHER EXPS EXECUTIVES ARE EMPLOYED BY MINISTRY HEALTH CARE INC (39-1490371) AND THEIR SALARIES AND BENEFITS ARE ALLOCATED TO INDIVIDUAL FACILITIES BASED ON HOURS DEDICATED. ST CLARES REIMBURSES THE CORPORATE OFFICE FOR ITS SHARE AND THESE EXPENSES ARE INCLUDED ON FORM 990, PART IX, LINE 24 UNDER MINISTRY EXECUTIVE SERVICES. PLEASE SEE FORM 990 PART VII SECTION A AND SCHEDULE J FOR ADDITIONAL DISCLOSURES REGARDING EXECUTIVE COMPENSATION. Form 990, Part VI, Line 19 Form 990, Part VI, Line 19: Other Organization Documents Publicly Available THE MINISTRY WEB PAGE IS AVAILABLE TO THE PUBLIC FOR INSPECTION WITH A GOOD DEAL OF INFORMATION REGARDING WHOM MINISTRY HEALTH CARE IS AND THE ENTITIES INCLUDED ALONG WITH OUR MISSION. THE ARTICLES OF INCORPORATION, BYLAWS, CONFLICTS POLICY, AND FINANCIAL STATEMENTS ARE NOT INCLUDED ON ANY WEB PAGE. HOWEVER IF AN INQUIRY IS MADE FOR ANY DOCUMENTS THEY ARE SHARED AS APPROPRIATE. Form 990, Part VI, Line 15b Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees THE MINISTRY BOARD OF DIRECTORS HAS A COMPENSATION COMMITTEE THAT IS ASSISTED BY AN INDEPENDENT OUTSIDE CONSULTING FIRM; SULLIVAN COTTER. SULLIVAN COTTER, IN PARTNERSHIP WITH THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS, REVIEWS MARKET DATA FOR COMPENSATION AND BENEFITS AND COMPARABILITY DATA ON EVERY MINISTRY HEALTH CARE EXECUTIVE. Form 990, Part VI, Line 12c Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts THE BOARD MEMBERS COMPLETE EACH YEAR A "BOARD OF DIRECTORS CONFLICT OF INTEREST & INSIDER TRANSACTION POLICY QUESTIONNAIRE". A STANDARD ANNUAL REFRESHER IS COMPLETED EACH YEAR IN THE FALL. ANY SIGNIFICANT REPORTED ITEMS ARE CORRECTED PROMPTLY THROUGH THE MINISTRY CORPORATE COMPLIANCE OFFICER AND LOCAL ADMINISTRATOR. Form 990, Part VI, Line 11 Form 990, Part VI, Line 11: Form 990 Review Process FORM 990 IS COMPLETED THROUGH JOINT EFFORTS OF SHARED FINANCE FUNCTION WITH REVIEW AND GUIDANCE OF LEGAL COUNCIL AND CORPORATE OVERSIGHT. FORM 990 WAS NOT PRESENTED TO THE HOSPITAL'S GOVERNING BODY BEFORE THE FILING DEADLINE DUE TO TIME CONSTRAINTS. THE PRESIDENT & FINANCE DIRECTOR WILL PRESENT AND BRIEFLY EXPLAIN THE FORM AND ITS PURPOSE AT THE NEXT BOARD MEETING IN AUGUST 2013. Form 990, Part VI, Line 7b Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or Shareholders MINISTRY HEALTH CARE INC HAS CERTAIN RESERVES AND INFLUENTIAL POWERS OVER ALL OF ITS WHOLLY OWNED HEALTHCARE FACILITIES. ST CLARE'S HOSPITAL IS ONE OF MINISTRY HEALTH CARE'S OWNED FACILITIES. Form 990, Part VI, Line 7a Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body MINISTRY HEALTH CARE INC HAS CERTAIN RESERVES AND INFLUENTIAL POWERS OVER ALL OF ITS WHOLLY OWNED HEALTHCARE FACILITIES. ST CLARE'S HOSPITAL IS ONE OF MINISTRY HEALTH CARE'S OWNED FACILITIES. Form 990, Part VI, Line 6 Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder MINISTRY HEALTH CARE INC HAS CERTAIN RESERVES AND INFLUENTIAL POWERS OVER ALL OF ITS WHOLLY OWNED HEALTHCARE FACILITIES. ST CLARE'S HOSPITAL IS ONE OF MINISTRY HEALTH CARE'S OWNED FACILITIES. FOUNDATION OF ST CLARES HOSPITAL 3400 MINISTRY PARKWAY WESTON WI 54476 753193633 FOUNDATION WI 501(c)(3) 11-1 N/A true MINISTRY HEALTH CARE 11925 W LAKE PARK DR MILWAUKEE WI 53224 391490371 MANAGEMENT COMPANY WI 501(c)(3) 11-O N/A false false false true false true false false false true false false true true true true true true true FOUNDATION OF ST CLARES HOSPITAL q 7681 GL DETAIL FOUNDATION OF ST CLARES HOSPITAL n -131 PAYROLL JRNL FOUNDATION OF ST CLARES HOSPITAL c 36095 DISTR JRNL MINISTRY HEALTH CARE o 16512086 COST MINISTRY HEALTH CARE n 5338829 PAY RECORDS MINISTRY HEALTH CARE i 10572 SQ FTG FMV MINISTRY HEALTH CARE e 152139638 PRINCIPLE PYMNT THE DIAGNOSTIC & TREATMENT CENTER 3401 CRANBERRY BLVD WESTON WI 54476 200691634 OUTPATIENT SERVICES WI true 4965987 false false