Mercy Medical Center of Oshkosh Inc: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
Mercy Medical Center of Oshkosh Inc (EIN 39-0806268)
Tax period
2011-10-01 to 2012-09-30
Filed
2013-08-13
IRS object ID
201332259349303073
Schema version
2011v1.5
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-08-13T16:03:05-05:00Timestamp
Tax Period End Date2012-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN390758449EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1WIPFLI LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 12237AddressLine1
CityGREEN BAYCity
StateWIState
ZIP Code543072237ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN390806268EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MERCY MEDICAL CENTER OF OSHKOSH INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMERCNameControl
Phone9207382000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1500 S OAKWOOD RDAddressLine1
CityOSHKOSHCity
StateWIState
ZIP Code54904ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJEFF BADGERName
TitleCFOTitle
Phone9207382000Phone
Date Signed2013-08-13DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameTERRI REXRODE CPA MSTName
PTINP00096513PTIN
Phone9206620016Phone
Date Prepared2013-08-13DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJEFF BADGERNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1500 S OAKWOOD RDAddressLine1
CityOSHKOSHCity
StateWIState
ZIP Code54904ZIPCode
FieldValueIRS element (for citing)
Gross Receipts120591890GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web SiteWWW.AFFINITYHEALTH.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Type Of Organization TrustXTypeOfOrganizationTrust
Year Formation1891YearFormation
State Legal DomicileWIStateLegalDomicile
Activity Or Mission DescriptionWE PROUDLY SERVE THE OSHKOSH COMMUNITY WITH A HISTORY OF MORE THAN A CENTURY OF QUALITY CARE. THE FACILITY PROVIDES TOTAL HEALTH CARE, INCLUDING EMERGENCY/TRAUMA CARE AND SURGICAL SERVICES AS WELL AS MANY MEDICAL SPECIALTIES SUCH AS CARDIOLOGY, ONCOLOGY, ORTHOPEDICS, INTENSIVE CARE, OBSTETRICS AND NEUROSURGERY. MERCY IS THE HOME OF THE KENNEDY CENTER FOR THE HIP AND KNEE, A NATIONALLY-RECOGNIZED PROGRAM FOR HIP REPLACEMENT. WITH 157 PATIENT BEDS AND MORE THAN 300 MEDICAL STAFF, MERCY MEDICAL CENTER TREATS PATIENTS WITH DIGNITY AND COMPASSION.AVAILABLE SERVICES: CANCER; CARDIAC REHABILITATION; CARDIOVASCULAR SURGERY; DIABETES, NUTRITION AND ENDOCRINOLOGY; ER; GENERAL SURGERY; GYNECOLOGY; HOSPITALIST; LABORATORY; LIFELINE HOME MONITORING; NEPHROLOGY; OBSTETRICS; ORTHOPEDICS; PAIN MANAGEMENT; PALLIATIVE CARE (END OF LIFE CARE); PHARMACY; PSYCHIATRY/PSYCHOLOGY; PULMONOLOGY; RADIOLOGY; REHABILITATION SERVICES; SLEEP LAB; SPIRITUAL SERVICES; SPORTS MEDICINE; VASCULAR MEDICINE; WOUND CARE.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees951TotalNbrEmployees
Total Nbr Volunteers616TotalNbrVolunteers
Total Gross UBI100741TotalGrossUBI
Net Unrelated Business Txbl Income-126288NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year284320ContributionsGrantsPriorYear
Contributions Grants Current Year98839ContributionsGrantsCurrentYear
Program Service Revenue Prior Year120070923ProgramServiceRevenuePriorYear
Program Service Revenue CY116127223ProgramServiceRevenueCY
Investment Income Prior Year4817589InvestmentIncomePriorYear
Investment Income Current Year1614302InvestmentIncomeCurrentYear
Other Revenue Prior Year304534OtherRevenuePriorYear
Other Revenue Current Year792104OtherRevenueCurrentYear
Total Revenue Prior Year125477366TotalRevenuePriorYear
Total Revenue Current Year118632468TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year477961GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year54112272SalariesEtcPriorYear
Salaries Etc Current Year55562944SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year54897248OtherExpensePriorYear
Other Expenses Current Year54376008OtherExpensesCurrentYear
Total Expenses Prior Year109487481TotalExpensesPriorYear
Total Expenses Current Year109938952TotalExpensesCurrentYear
Revenues Less Expenses Prior Year15989885RevenuesLessExpensesPriorYear
Revenues Less Expenses CY8693516RevenuesLessExpensesCY
Total Assets BOY265742458TotalAssetsBOY
Total Assets EOY96663540TotalAssetsEOY
Total Liabilities BOY56327645TotalLiabilitiesBOY
Total Liabilities EOY66619098TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY209414813NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY30044442NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionMERCY MEDICAL CENTER HAS ADOPTED THE MISSION STATEMENT OF AFFINITY HEALTH SYSTEM. THE MISSION OF AFFINITY HEALTH SYSTEM IS TO LIVE OUT THE HEALING MINISTRY OF CHRIST BY PROVIDING SERVICES THAT PROMOTE THE HEALTH AND WELL-BEING OF THE COMMUNITIES WE SERVE, ESPECIALLY THE POOR.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense85025823Expense
Revenue115521780Revenue
DescriptionMERCY MEDICAL CENTER PROUDLY SERVES THE OSHKOSH COMMUNITY WITH A HISTORY OF MORE THAN A CENTURY OF QUALITY CARE. THE FACILITY PROVIDES TOTAL HEALTH CARE, INCLUDING EMERGENCY/TRAUMA CARE AND SURGICAL SERVICES AS WELL AS MANY MEDICAL SPECIALTIES SUCH AS CARDIOLOGY, ONCOLOGY, ORTHOPEDICS, INTENSIVE CARE, OBSTETRICS AND NEUROSURGERY. MERCY IS THE HOME OF THE KENNEDY CENTER FOR THE HIP AND KNEE, A NATIONALLY-RECOGNIZED PROGRAM FOR HIP REPLACEMENT. WITH 157 PATIENT BEDS AND MORE THAN 300 MEDICAL STAFF, MERCY MEDICAL CENTER TREATS PATIENTS WITH DIGNITY AND COMPASSION. AVAILABLE SERVICES: CANCER; CARDIAC REHABILITATION; CARDIOVASCULAR SURGERY; DIABETES, NUTRITION AND ENDOCRINOLOGY; ER; GENERAL SURGERY; GYNECOLOGY; HOSPITALIST; LABORATORY; LIFELINE HOME MONITORING; NEPHROLOGY; OBSTETRICS; ORTHOPEDICS; PAIN MANAGEMENT; PALLIATIVE CARE (END OF LIFE CARE); PHARMACY; PSYCHIATRY/PSYCHOLOGY; PULMONOLOGY; RADIOLOGY; REHABILITATION SERVICES; SLEEP LAB; SPIRITUAL SERVICES; SPORTS MEDICINE; VASCULAR MEDICINE; WOUND CARE.Description
Total Program Service Expense85025823TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109684NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees951NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledWIStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1JEFF BADGERBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number9207201300TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11570 MIDWAY PLACEAddressLine1
CityMENASHACity
StateWIState
ZIP Code54952ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (25 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
DANIEL E NEUFELDER
PRESIDENT/CEO - AHS10.30XX22829067120094161
JOHN RUSSO
BOARD SECRETARY0.30XX000
STEPHEN C MORTON
BOARD TREASURER0.30XX000
MARK W FAUSTICH MD
BOARD MEMBER0.30X038183135392
JOSEPH MCCORMICK MD
BOARD MEMBER0.30X096072540487
STACEY SENSOR DO
BOARD MEMBER0.30X051522342399
BARBARA J STRAND MD
BOARD MEMBER0.30X023461246933
FREDERICK KLEIN MD
BOARD MEMBER0.30X000
MARY HARP-JIRSCHELE
BOARD MEMBER0.30X000
RICHARD WELLS
BOARD MEMBER0.30X000
SUSAN VETTE
FORMER BOARD MEMBER0.30X000
THOMAS SCHMIDT
BOARD MEMBER0.30X000
WAYNE TREMBLY
BOARD MEMBER0.30X000
KATHRYN SIEMAN
BOARD MEMBER0.30X000
MONICA VOMASTIC
BOARD MEMBER0.30X000
CHRISTOPHER E ROCKE DO
FORMER BOARD MEMER0.30X023511736683
NICHOLAS DESIEN
PRESIDENT - MINISTRY0.30XX0201769758526
JOHN OLIVERIO
PRESIDENT - WHEATON0.30XX02520506161546
JEFF S BADGER
CFO - AHS10.00X11682334347169379
WILLIAM J CALHOUN
PRESIDENT - MMC40.00329006044177X
LARRY D CROTS
PHARMACIST40.0013700408057X
KENNETH J HERRERA
PHARMACIST40.00130434011607X
MICHAEL R MILLER
PHARMACIST40.00135062026863X
MATTHEW T SCHETTLE
PHARMACIST40.00129055030594X
NICHOLAS A SYLVIA
PHARMACY DIRECTOR40.00161313013020X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1366987TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs7880382TotalReportableCompFrmRltdOrgs
Total Other Compensation719824TotalOtherCompensation
Number Individuals GT100 K16NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
KENNEDY CENTER FOR THE HIP & KNEE
2700 W NINTH ST SUITE 100MILWAUKEEWI53224SALARIES, PROFESSIONAL FEES4168479
AFFINITY HEALTH SYSTEM INC
1570 MIDWAY PLMENASHAWI54952SALARIES, LEGAL, CONSULTING, MISC SERV2507450
MINISTRY HEALTH CARE INC
11925 W LAKE PARK DR SUITE 100MILWAUKEEWI53224MANAGEMENT1125519
ST ELIZABETH HOSPITAL
1506 S ONEIDA STAPPLETONWI54915SALARIES, LAB SERVICES, MED DIR FEES1063684
NETWORK HEALTH SYSTEM INC
1570 MIDWAY PLMENASHAWI54952PHYSICIAN SERVICES, SALARIES, MISC SERV551862
FieldValueIRS element (for citing)
Number Of Contractors GT100 K15NumberOfContractorsGT100K
Related Organizations98839RelatedOrganizations
Total Contributions98839TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
NET PATIENT REVENUE AN624100114592173114592173
CAFETERIA & VENDING72221061625113950$602,301
OTHER NON OPERATING RE624100298220$298,220
NURSE DIRECT SERVICES900099248704248704
GIFT SHOP & AUXILIARY453220213991$213,991

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column157884TotalRevenueColumn
Unrelated Business Revenue157884UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Total Program Service Revenue116127223TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1603523TotalRevenueColumn
Exclusion$1,603,523ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real2070623Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real1959422Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real111201Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column111201TotalRevenueColumn
Unrelated Business Revenue-71093UnrelatedBusinessRevenue
Exclusion$182,294ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other10779Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other0Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other10779Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column10779TotalRevenueColumn
Exclusion$10,779ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
E.H.R. INCENTIVE900099628487628487
P CARD REVENUE9000995241652416
FieldValueIRS element (for citing)
Total Other Revenue680903TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column118632468TotalRevenueColumn
Related Or Exempt Function Income115521780RelatedOrExemptFunctionIncome
Unrelated Business Revenue100741UnrelatedBusinessRevenue
Exclusion$2,911,108ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total759802Total
Management And General759802ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total41449743Total
Program Services31449895ProgramServices
Management And General9999848ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1628680Total
Program Services1235757ProgramServices
Management And General392923ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total9206005Total
Program Services6985035ProgramServices
Management And General2220970ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2518714Total
Program Services1911068ProgramServices
Management And General607646ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total2267Total
Management And General2267ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total34071Total
Management And General34071ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total13949576Total
Program Services7455521ProgramServices
Management And General6494055ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total20629040Total
Program Services19757647ProgramServices
Management And General871393ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total47859Total
Program Services39333ProgramServices
Management And General8526ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1982425Total
Program Services1449162ProgramServices
Management And General533263ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total210069Total
Program Services26787ProgramServices
Management And General183282ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total2364858Total
Program Services1728722ProgramServices
Management And General636136ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total6639444Total
Program Services4973205ProgramServices
Management And General1666239ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total326518Total
Management And General326518ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBT EXPENSE43430284343028
MEDICAID ASSESSMENT28637692863769
OTHER EXPENSES57430148825186050
GIFT SHOP & AUXILIARY E228376228376

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total180407Total
Program Services90267ProgramServices
Management And General90140ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total109938952Total
Program Services85025823ProgramServices
Management And General24913129ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY5159BOY
EOY5546EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY2360615BOY
EOY7868248EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY13640125BOY
EOY15507393EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY163821638BOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY2429825BOY
EOY2237042EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1094674BOY
EOY783639EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis178831717LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec116494702LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY67145127BOY
EOY62337015EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY1940005BOY
EOY1252313EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY13305290BOY
EOY6672344EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY265742458BOY
EOY96663540EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY11023506BOY
EOY11301489EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY34886662BOY
EOY44324624EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY10417477BOY
EOY10992985EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY56327645BOY
EOY66619098EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY209414813BOY
EOY30044442EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY209414813BOY
EOY30044442EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY265742458BOY
EOY96663540EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses8693516ReconcilationRevenueExpenses
Reconcilation Other Changes-188063887ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$7,633OtherActivitiesAmount
Total Lobbying Expenditures IIB7633TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1:ReturnReference
ExplanationWHA MEMBERSHIP DUES OF $6,425 AND CHA MEMBERSHIP DUES OF $1,208Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis882258OtherCostOrOtherBasis
Book Value882258BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis111309812OtherCostOrOtherBasis
Depreciation59322322Depreciation
Book Value51987490BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1021338OtherCostOrOtherBasis
Depreciation884684Depreciation
Book Value136654BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis61692323OtherCostOrOtherBasis
Depreciation53105331Depreciation
Book Value8586992BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis3925986OtherCostOrOtherBasis
Depreciation3182365Depreciation
Book Value743621BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings62337015TotalOfBookValueLandBuildings

Other Assets OtherAssets (3 entries)

DescriptionDescriptionBook ValueBookValue
OTHER A/R49988
OTHER ASSET1815750
RELATED PARTY A/R4806606
FieldValueIRS element (for citing)
Total Book Value Other Assets6672344TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
DUE TO 3RD PARTY - RESERVE$703,125
PENSION LIABILITY$9,860,974
457B PLAN$428,886
FieldValueIRS element (for citing)
Total Of Amounts10992985TotalOfAmounts
Total Revenue118632468TotalRevenue
Total Expenses109938952TotalExpenses
Excess Or Deficit For Year8693516ExcessOrDeficitForYear
Net Unrealized GL On Investments282259NetUnrealizedGLOnInvestments
Other-$188,346,146OtherAmount
Total Adjustments-188063887TotalAdjustments
Excess Or Deficit Per FS-179370371ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt120372308TotRevenueEtcAuditedFinclStmt
Other Revenues1959422OtherRevenues
Revenue Not Rptd F9901959422RevenueNotRptdF990
Revenue Subtotal118412886RevenueSubtotal
Other Revenues Not Included219582OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt219582RevenueNotRptdOnFinStmt
Total Revenue Per Form990118632468TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt111669998TotExpensesEtcAuditedFinclStmt
Other Expenses Included1959422OtherExpensesIncluded
Expenses Not Rptd F9901959422ExpensesNotRptdF990
Expenses Subtotal109710576ExpensesSubtotal
Other Expenses Not Included228376OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt228376ExpensesNotRptdOnFinStmt
Total Expenses Per Form990109938952TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:MINISTRY RECOGNIZES 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 TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. EXAMPLES OF TAX POSITIONS FOR MINISTRY'S NOT-FOR-PROFIT CORPORATIONS INCLUDE THEIR TAX-EXEMPT STATUS AND VARIOUS POSITIONS RELATED TO THE POTENTIAL SOURCES OF UNRELATED BUSINESS TAXABLE INCOME (UBIT). THE TAX BENEFITS RECOGNIZED IN THE FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50 PERCENT LIKELIHOOD OF BEING RECOGNIZED UPON ULTIMATE SETTLEMENT.
PART XI, LINE 8 - OTHER ADJUSTMENTS:PENSION ADJUSTMENT -726,916. TRANSFER OF DEBT TO MINISTRY -182,642,407. WORKERS COMPENSATION ADJUSTMENT -476,823. EQUITY DISTRIBUTION -4,500,000. TOTAL TO SCHEDULE D, PART XI, LINE 8: -188,346,146.
PART XII, LINE 2D - OTHER ADJUSTMENTS:EXPENSE ALLOCATED TO RENTAL INCOME 1,959,422.
PART XII, LINE 4B - OTHER ADJUSTMENTS:RESTRICTED CONTRIBUTIONS IN NET ASSETS 5,591. GIFT SHOP AND AUXILIARY REVENUE 213,991.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:EXPENSE ALLOCATED TO RENTAL INCOME 1,959,422.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:GIFT SHOP AND AUXILIARY EXPENSES 228,376.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare

Discounted Other DiscountedOther

FieldValueIRS element (for citing)
OtherXOther
Discounted Other Percentage662.000000000000DiscountedOtherPercentage
FieldValueIRS element (for citing)
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Persons Served408PersonsServed
Total Community Benefit Expense1083588TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense1083588NetCommunityBenefitExpense
Percent Of Total Expense0.01030PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Persons Served11052PersonsServed
Total Community Benefit Expense3333269TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense3333269NetCommunityBenefitExpense
Percent Of Total Expense0.03160PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Persons Served714PersonsServed
Total Community Benefit Expense345834TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense345834NetCommunityBenefitExpense
Percent Of Total Expense0.00330PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Persons Served12174PersonsServed
Total Community Benefit Expense4762691TotalCommunityBenefitExpense
Net Community Benefit Expense4762691NetCommunityBenefitExpense
Percent Of Total Expense0.04520PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs4NumberOfActivitiesOrPrograms
Persons Served3522PersonsServed
Total Community Benefit Expense336548TotalCommunityBenefitExpense
Direct Offsetting Revenue12375DirectOffsettingRevenue
Net Community Benefit Expense324173NetCommunityBenefitExpense
Percent Of Total Expense0.00310PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served232PersonsServed
Total Community Benefit Expense626870TotalCommunityBenefitExpense
Direct Offsetting Revenue125718DirectOffsettingRevenue
Net Community Benefit Expense501152NetCommunityBenefitExpense
Percent Of Total Expense0.00470PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served2253PersonsServed
Total Community Benefit Expense5113700TotalCommunityBenefitExpense
Direct Offsetting Revenue4989720DirectOffsettingRevenue
Net Community Benefit Expense123980NetCommunityBenefitExpense
Percent Of Total Expense0.00120PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Number Of Activities Or Programs0NumberOfActivitiesOrPrograms
Persons Served0PersonsServed

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served10906PersonsServed
Total Community Benefit Expense363296TotalCommunityBenefitExpense
Direct Offsetting Revenue1DirectOffsettingRevenue
Net Community Benefit Expense363295NetCommunityBenefitExpense
Percent Of Total Expense0.00340PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs10NumberOfActivitiesOrPrograms
Persons Served16913PersonsServed
Total Community Benefit Expense6440414TotalCommunityBenefitExpense
Direct Offsetting Revenue5127814DirectOffsettingRevenue
Net Community Benefit Expense1312600NetCommunityBenefitExpense
Percent Of Total Expense0.01240PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs10NumberOfActivitiesOrPrograms
Persons Served29087PersonsServed
Total Community Benefit Expense11203105TotalCommunityBenefitExpense
Direct Offsetting Revenue5127814DirectOffsettingRevenue
Net Community Benefit Expense6075291NetCommunityBenefitExpense
Percent Of Total Expense0.05760PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served2500PersonsServed
Total Community Building Expense1787TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense1787NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Building Expense307TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense307NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served156PersonsServed
Total Community Building Expense279TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense279NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs3NumberOfActivitiesOrPrograms
Persons Served2656PersonsServed
Total Community Building Expense2373TotalCommunityBuildingExpense
Net Community Building Expense2373NetCommunityBuildingExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$4,343,028BadDebtExpenseAmount
Amount Reimbursed By Medicare41800398AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare48416451CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-6616053MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1MERCY MEDICAL CENTERBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1500 S OAKWOOD RAODAddressLine1
CityOSHKOSHCity
StateWIState
ZIP Code54904ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1MERCY MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA Conducted0CHNAConducted
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent200.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent662.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Lowest Negotiated RatesXLowestNegotiatedRates
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
PART I, LINE 3C: IT IS THE POLICY OF MERCY MEDICAL CENTER TO PROVIDE MEDICALLY NECESSARY HEALTH CARE SERVICES TO PEOPLE IN THE COMMUNITIES IT SERVES, REGARDLESS OF THEIR ABILITY TO PAY. AFFINITY CARE FINANCIAL ASSISTANCE IS GRANTED BASED UPON THE PATIENT'S INABILITY TO PAY AND TO INDIVIDUALS WHO ARE UNINSURED, UNDERINSURED OR MEDICALLY INDIGENT. AFFINITY CARE WORKS IN COLLABORATION WITH OTHER FINANCIAL (BOTH PUBLIC AND PRIVATE) ASSISTANCE PROGRAMS. THIS IS TO ENSURE HOLISTIC WELLNESS OF PATIENTS BY FACILITATING KNOWLEDGE OF AVAILABLE SERVICES AND PROGRAMS FOR HEALTH WHILE PRACTICING GOOD STEWARDSHIP OF FUNDS. KEY CRITERIA UTILIZED TO DETERMINE ELIGIBILITY FOR AFFINITY CARE FINANCIAL ASSISTANCE INCLUDES FAMILY SIZE, FEDERAL POVERTY INCOME GUIDELINES AND AVAILABLE ASSETS. THE AVAILABLE ASSET TEST INCLUDES CONSIDERATION OF THE AMOUNT OF EQUITY IN A HOME, AUTOMOBILES, AND SAVINGS ACCOUNTS WHICH ARE CONSIDERED PART OF TOTAL ALLOWABLE INCOME WHEN ASSESSING AGAINST THE FEDERAL POVERTY INCOME GUIDELINES.
PART I, LINE 7: AMOUNTS CALCULATED IN PART I, LINE 7 ARE DETERMINED BOTH ON A COST ACCOUNTING SYSTEM AND A COST-TO-CHARGE RATIO. OTHER BENEFITS ARE DETERMINED BASED ON THE DIRECT AND INDIRECT COSTS (WHERE ALLOCATED) ASSOCIATED WITH A PROGRAM NET OF EARNED REVENUE. DETAIL FOR EACH PROGRAM/ACTIVITY IS MAINTAINED AND DETERMINED AT THE DEPARTMENT LEVEL. CHARITY CARE AND MEANS-TESTED PROGRAMS ARE DETERMINED BASED ON A COST-TO-CHARGE RATIO CONSISTENT WITH WORKSHEET 2, RATIO OF PATIENT CARE COST TO CHARGES. PRIOR YEAR COST REPORT SETTLEMENTS ARE EXCLUDED FROM THE SHORTFALL CALCULATION IN ORDER TO GET A TRUE FISCAL YEAR SHORTFALL AMOUNT.
PART I, L7 COL(F): BAD DEBT EXPENSE OF $4,343,028 INCLUDED ON FORM 990, PART IX, LINE 25 WAS EXCLUDED FROM THE DENOMINATOR PER INSTRUCTIONS WHEN CALCULATING THE PERCENT OF TOTAL EXPENSES ON SCHEDULE H.
PART II: 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.
PART III, LINE 4: NO FOOTNOTE EXISTS IN MERCY MEDICAL CENTER'S FINANCIALS STATEMENTS THAT DESCRIBE BAD DEBT EXPENSE. BAD DEBT EXPENSE IS RECORDED IN A CONSISTENT MANNER WITH THE ORGANIZATION'S COLLECTION POLICIES. BAD DEBT EXPENSE INCLUDES ACCOUNTS WHICH ARE WRITTEN OFF AND ESTIMATES MADE ON LIVE ACCOUNTS BASED ON HISTORICAL PAYMENT TRENDS AND ACCOUNT MODELING.A NUMBER OF PATIENTS ARE TRULY UNABLE TO PAY THEIR OUT-OF-POCKET LIABILITY, BUT DO NOT COMPLETE THE PROCESS REQUIRED TO APPLY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S AFFINITY CARE POLICY. THESE PATIENTS WOULD QUALIFY FOR AFFINITY CARE IF THEY COMPLETED THE CHARITY APPLICATION, SO THE BAD DEBT EXPENSE ASSOCIATED WITH TREATING THEM SHOULD BE TREATED AS COMMUNITY BENEFIT. THE ORGANIZATION DOES HAVE A PRESUMPTIVE ELIGIBILITY PROGRAM IN PLACE TO HELP IDENTIFY INDIGENT PATIENTS AND MINIMIZE THE INSTANCES OF WHEN THEY BECOME A BAD DEBT. THE ADMINISTRATIVE REQUIREMENTS TO DETERMINE WHETHER PATIENTS WHO DO NOT COOPERATE WITH THE FINANCIAL ASSISTANCE PROCESS WOULD HAVE QUALIFIED FOR CHARITY CAN BE BURDENSOME, PARTICULARLY FOR SMALL BALANCES.
PART III, LINE 8: THE SHORTFALL ASSOCIATED WITH MEDICARE SHOULD BE CONSIDERED A COMMUNITY BENEFIT FOR SEVERAL REASONS. FIRST, IRS REV. RUL. 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NON-PROFIT 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. THIS IMPLIES THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT. SECOND, FOR-PROFIT SPECIALTY HOSPITALS HAVE BEEN CARVING OUT CERTAIN HIGH-MARGIN SERVICES (I.E. CARDIAC, ORTHOPEDICS, AND ONCOLOGY), LEAVING GENERAL ACUTE CARE HOSPITALS WITH LOWER-MARGIN MEDICARE SERVICES. THIS INDICATES THAT MEDICARE LOSSES CAN BE A RESULT OF RENDERING THESE LOWER-MARGIN SERVICES (WHICH BENEFIT THE COMMUNITY) RATHER THAN INEFFICIENT OPERATIONS. LASTLY, THE COMMUNITY WHICH THE ORGANIZATION SERVES HAS MEDICARE AS THE LARGEST LAYER. THE ORGANIZATION MUST ACCEPT THESE PATIENTS REGARDLESS OF WHETHER THEY MAKE A SURPLUS OR DEFICIT FROM PROVIDING SUCH SERVICES. IF THE MEDICARE PARTICIPATION IS PREMISED ON THIS FACT, THEN PROVIDING MEDICARE SERVICES PROMOTES ACCESS TO HEALTHCARE SERVICES WHICH IS A COMMUNITY BENEFIT. THE DEMOGRAPHIC OF THE COMMUNITY IS ALSO AN AGING AND UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE SERVICES, CMS WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY.
PART III, LINE 9B: MERCY MEDICAL CENTER HAS A DEBT COLLECTION POLICY WHICH SETS FORTH COLLECTION PRACTICES FOR PATIENTS WHO ARE KNOWN TO QUALIFY OR MAY QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE CHARITY CARE PROGRAM. SUFFICIENT FINANCIAL COUNSELING SUPPORT IS MADE AVAILABLE TO PATIENTS SO THEY CAN EASILY ACCESS PATIENT FINANCIAL SERVICE REPRESENTATIVES AND HAVE THEIR QUESTIONS ANSWERED, AND GAIN AN UNDERSTANDING OF THE REASONS WHY THEY OWE A BALANCE. ACCOUNTS ARE DESIGNATED AS CHARITY CARE IN THE BUSINESS OFFICES SO NO ADDITIONAL TIME IS SPENT ON COLLECTION EFFORTS.
PART VI, LINE 2: MERCY MEDICAL CENTER PERFORMS COMMUNITY HEALTH NEEDS ASSESSMENTS AS NEEDED. PLANNING WORKGROUPS CONSISTING OF COMMUNITY PARTNERS (E.G. COMMUNITY HEALTH IMPROVEMENT PARTNERSHIP (CHIP) ARE FORMED TO DEFINE THE COMMUNITY AND ITS HEALTH NEEDS THROUGH REVIEW OF UNITED WAY LIFE STUDY RESULTS, HEALTHY PEOPLE INITIATIVES, CENSUS DOCUMENTS, AND LOCAL GOVERNMENT HEALTH AND WELFARE AGENCIES. CONSIDERING OTHER COMMUNITY RESOURCES/ASSETS, DATA COLLECTION METHODS ARE USED TO IDENTIFY PARTICULAR PROBLEMS OR SUBGROUPS AND AREAS KNOWN TO HAVE HIGH POVERTY RATES AND TO BE UNDERSERVED. THE DATA IS ANALYZED AND PRIORITIES ARE SET BASED ON TRENDING INFORMATION WHICH MAY TARGET A SPECIFIC NEED. WHEN A NEED IS IDENTIFIED, THE HOSPITAL WILL COLLABORATE THROUGH COMMUNITY PARTNERSHIPS (OR INDIVIDUALLY) TO ADDRESS THE IDENTIFIED NEED. OUTCOMES FROM THE PROGRAMS ARE MEASURED AND CONSIDERED IN SUBSEQUENT COMMUNITY HEALTH NEEDS ASSESSMENTS. THE LEADERSHIP AT AFFINITY TAKES THEIR COMMITMENT TO THE HEALTH AND WELL-BRING OF THE COMMUNITY IT SERVES VERY SERIOUSLY. IN FACT, IT IS CORE TO THE ORGANIZATION'S MISSION, "TO LIVE OUT THE HEALING MINISTRY OF CHRIST BY PROVIDING SERVICES THAT PROMOTE THE HEALTH AND WELL-BEING OF THE COMMUNITIES WE SERVE, ESPECIALLY THE POOR". SENIOR LEADERS AND MANAGEMENT ARE ALSO HIGHLY ENCOURAGED TO PROVIDE DIRECT SERVICE TO THE POOR IN THEIR COMMUNITIES. MERCY MEDICAL CENTER AND THE LEADERSHIP ALSO SUBSCRIBE TO PUBLICATIONS LIKE THE ADVISORY BOARD TO COMPARE NATIONAL TRENDS TO LOCAL TRENDS TO ENSURE THE HOSPITAL IS RESOURCING AREAS TO MEET PATIENT NEEDS.
PART VI, LINE 3: MERCY MEDICAL CENTER GOES TO GREAT LENGTHS IN ORDER TO INFORM AND EDUCATE PATIENTS/PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE OR LOCAL GOVERNMENT PROGRAMS AND UNDER THE ORGANIZATION'S AFFINITY CARE POLICY. THE AFFINITY CARE POLICY AND APPLICATION IS POSTED ON THE ORGANIZATION'S WEBSITE. ADMISSIONS AND OTHER KEY AREAS CONTAIN SUMMARY INFORMATION OF THE AFFINITY CARE POLICY. AS PART OF THE INTAKE/DISCHARGE PROCESS, PATIENTS ARE PROVIDED WITH A COPY OF THE POLICY AND OTHER INFORMATION FOR FINANCIAL ASSISTANCE. IF DURING THE COURSE OF THE PATIENT REGISTRATION PROCESS, CARE ENCOUNTER, TREATMENT, OR UPON DISCHARGE IT BECOMES EVIDENT THAT A PATIENT MAY NEED FINANCIAL ASSISTANCE, THE PATIENT SHALL BE REFERRED TO MERCY MEDICAL CENTER'S AFFINITY CARE PROGRAM. PATIENTS MAY BE IDENTIFIED AS NEEDING FINANCIAL ASSISTANCE AT ANY TIME DURING THE COURSE OF AN ENCOUNTER. A REFERRAL FOR CONSIDERATION OF AFFINITY CARE FINANCIAL ASSISTANCE CAN BE INITIATED BY ANY MEMBER OF THE HOSPITAL'S WORKFORCE, INCLUDING MEDICAL STAFF MEMBERS, WHO BECOME AWARE OF THE PATIENT'S POTENTIAL NEED FOR AFFINITY CARE FINANCIAL ASSISTANCE. THE AFFINITY CARE BROCHURE WAS ALSO TRANSLATED INTO DIALECTS PREVALENT IN THE COMMUNITY IN ORDER TO REACH OUT TO THOSE THAT MAY SPEAK ANOTHER LANGUAGE (SPANISH AND HMONG). PATIENT REGISTRATION STAFF AND FINANCIAL COUNSELORS ARE PROVIDED WITH GUIDELINES TO FOLLOW WHEN INTERACTING WITH PATIENTS. AS PART OF THE AFFINITY CARE PROCESS, PATIENTS MUST REGISTER WITH THE COUNTY PUBLIC ASSISTANCE TO SEE IF THEY MAY QUALIFY UNDER ANY OTHER FEDERAL OR STATE PROGRAMS.
PART VI, LINE 4: WHILE THERE IS GROWING AGREEMENT IN THE UNITED STATES ABOUT WHAT CONSTITUTES A NON-PROFIT HOSPITAL'S 'COMMUNITY BENEFIT', THIS IS A WORK IN PROGRESS. 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. MERCY MEDICAL CENTER, LIKE MOST COMMUNITY HOSPITALS, WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE CARE LOCALLY-CARE THAT WITHOUT OUR HOSPITAL, MAY NOT BE AVAILABLE LOCALLY.CERTAIN SPECIALIZED SERVICES AVAILABLE INCLUDE: I/P ADULT BEHAVIORAL HEALTH SERVICES, I/P REHABILITATION SERVICES, I/P SUB-ACUTE(SNF) SERVICES.
PART VI, LINE 5: MERCY MEDICAL CENTER'S GOVERNING BOARD CONSISTS PRIMARILY OF PERSONS WHO RESIDE WITHIN THE PRIMARY SERVICE AREA. THEY ARE NOT EMPLOYEES OF THE ORGANIZATION.THE ORGANIZATION STRIVES TO FURTHER ITS EXEMPT PURPOSES BY THE FOLLOWING:- MERCY MEDICAL CENTER PARTICIPATES IN GOVERNMENT-SPONSORED HEALTH PROGRAMS (MEDICARE, MEDICAID, CHAMPUS, GENERAL RELIEF, SPECIALIZED COUNTY PROGRAMS AND AREA PRISONS)- MERCY MEDICAL CENTER DONATES FOOD TO AREA SHELTERS.- MERCY HEALTH FOUNDATION DONATED FUNDS TO SUPPORT AREA ORGANIZATIONS THAT PROVIDE SERVICES TO THE FOLLOWING SECTORS OF OUR POPULATION: LOW-INCOME, PHYSICALLY AND MENTALLY CHALLENGED AND CHRONICALLY ILL. - MERCY MEDICAL CENTER WORKS WITH LOCAL POLICE DEPARTMENTS IN THE PERFORMANCE OF SEXUAL ASSAULT EXAMS. THE PATIENT DOES NOT INCUR A BILL FOR THE EXAM AND THE CHARGES ARE WRITTEN OFF. - MERCY MEDICAL CENTER PROVIDES COMMUNITY HEALTH IMPROVEMENT SERVICES THROUGH HEALTH EDUCATION LECTURES, HEALTH FAIRS AND SUPPORT GROUPS.- MERCY MEDICAL CENTER CONDUCTS CARDIAC AND PULMONARY REHABILITATION FAMILY EDUCATION SESSIONS.- DISCOUNTED CARE IS PROVIDED TO LOW INCOME FAMILIES UP TO 662% OF FEDERAL POVERTY GUIDELINES.- MERCY MEDICAL CENTER IS A DISPROPORTIONATE SHARE HOSPITAL WITH A COMBINED MEDICAID AND SSI UTILIZATION OF OVER 21.19%.- MERCY MEDICAL CENTER PROVIDES A SUBSIDY TO A SCHOOL OF RADIOLOGIC TECHNOLOGY PROGRAM.- MERCY MEDICAL CENTER SERVES AS A SPONSOR SITE FOR CLINICAL TRAINING OF COLLEGE STUDENTS IN VARIOUS HEALTH CARE PROGRAMS.- MERCY MEDICAL CENTER HELPS TO SUBSIDIZE AN AREA COMMUNITY CLINIC THAT SERVES THE UNINSURED AND LOW INCOME MEMBERS OF THE COMMUNITY. SUPPORT CONSISTS OF CASH DONATIONS FOR OPERATIONS, USE OF CLINIC BUILDING AND LAB AND X-RAY SERVICES.
PART VI, LINE 6: MERCY MEDICAL CENTER, OF OSHKOSH, WISCONSIN IS PART OF AN AFFILIATED HEALTH CARE SYSTEM CALLED AFFINITY HEALTH SYSTEM. AFFINITY HEALTH SYSTEM ALSO HAS TWO OTHER HOSPITALS, ST. ELIZABETH HOSPITAL, IN APPLETON, WI AND CALUMET MEDICAL CENTER, IN CHILTON, WI. THE LATTER HOSPITAL QUALIFIES AS A CRITICAL ACCESS HOSPITAL. IN ADDITION TO THE HOSPITALS, AFFINITY HEALTH SYSTEM ALSO HAS 25 AREA CLINICS UNDER THE CONTROL OF AFFINITY MEDICAL GROUP. THE MISSION OF AFFINITY, AS A CATHOLIC HEALTH CARE SYSTEM, IS TO LIVE OUT THE HEALING MINISTRY OF BY PROVIDING SERVICES THAT PROMOTE THE HEALTH AND WELL BEING OF THE COMMUNITIES WE SERVE, ESPECIALLY THE POOR. UNTIL FEBRUARY 7, 2012, AFFINITY HEALTH SYSTEM WAS SPONSORED EQUALLY BY TWO CATHOLIC HEALTH SYSTEMS, MINISTRY HEALTH CARE, HEADQUARTERED IN MILWAUKEE, WI AND WHEATON FRANCISCAN HEALTH CARE, ALSO HEADQUARTERED IN MILWAUKEE, WI. AS OF FEBRUARY 8, 2012 AFFINITY HEALTH SYSTEM IS SOLELY SPONSORED BY MINISTRY HEALTH CARE. MERCY MEDICAL CENTER AND ST. ELIZABETH HOSPITAL BOTH SUBSIDIZE AREA COMMUNITY MEDICAL CLINICS AS WELL AS COMMUNITY DENTAL CLINICS. THE 3 HOSPITALS AND THE 25 CLINICS PROVIDE FREE OR MINIMAL COST HEALTH EDUCATION, SUPPORT AND SCREENING SERVICES FOR THE POPULATIONS THEY SERVE. MERCY MEDICAL CENTER AND ST. ELIZABETH HOSPITAL BOTH PROVIDE SUPPORT FOR EDUCATIONAL PROGRAMS TO EDUCATE FUTURE HEALTH CARE PROFESSIONALS. THERE IS ALSO AN EXPECTATION THAT ALL PEOPLE IN MANAGEMENT SERVICES AT AFFINITY HEALTH SYSTEM WILL PROVIDE DIRECT SERVICES TO THE POOR. MERCY MEDICAL CENTER HAS A FOUNDATION WHICH IS NOT INCLUDED WITHIN THE OPERATIONS OF THE ORGANIZATION. THE FOUNDATION PROVIDES CASH DONATIONS WHICH HELP SUPPORT THE MISSION OF THE ORGANIZATION AND THE AFFILIATED HEALTH CARE SYSTEM. EXAMPLES OF THE DONATIONS ARE INCLUDED IN ITEM #5 (PART VI, LINE 5) ABOVE.
WIREPORTS FILED WITH STATESPART VI, LINE 7
PART VI, LINE 7: MERCY MEDICAL CENTER OF OSHOKSH, INC. FILES THEIR COMMUNITY BENEFIT RESULTS IN THE STATE OF WISCONSIN. THEIR DATA IS INCORPORATED INTO A REPORT FOR ALL AFFINITY HEALTH SYSTEM THAT ULTIMATELY IS PUBLISHED IN THE AREA NEWSPAPERS.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsXTravelForCompanions
Club Dues Or FeesXClubDuesOrFees
Personal ServicesXPersonalServices
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org1CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (13 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
DANIEL E NEUFELDER
16540748631557455168925542815960182325360456661665925218874146300
MARK W FAUSTICH MD
0378875000295602847806914041722300
JOSEPH MCCORMICK MD
095958500011400188270216600100121200
STACEY SENSOR DO
05128040002419022598019801055762200
BARBARA J STRAND MD
02332000001412022117024816028154500
CHRISTOPHER E ROCKE DO
0234764000353018046018637027180000
NICHOLAS DESIEN
0923911036264507311410396300188960207622300
JOHN OLIVERIO
0952774066250009052320995190620270268205200
JEFF S BADGER
869272555752289167302700520594112803316563281860613443139524200
WILLIAM J CALHOUN
2427900736960125200188270253500373183000
MICHAEL R MILLER
134965000970106310162320161925000
MATTHEW T SCHETTLE
1286640003910116960188980159649000
NICHOLAS A SYLVIA
161128000185011554014660174333000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINE 1BBUSINESS TRAVEL EXPENSES FOR SPOUSES OF EXECUTIVES AND COUNTRY CLUB MEMBERSHIP FOR EXECUTIVES ARE REIMBURSED AS PART OF THEIR EXECUTIVE FLEX CREDIT ACCOUNT. RECEIPTS ARE PROVIDED TO SR. ADMINISTRATIVE ASSISTANT IN HR WHO REVIEWS FOR ACCURACY, COMPLETES A REIMBURSEMENT FORM WITH SUBSTANTIATION TO PAYROLL FOR REIMBURSEMENT. THESE REIMBURSEMENTS ARE TAXABLE AND, WHEN ADDED TO THE COMPENSATION PACKAGE TAKEN AS A WHOLE, HAVE BEEN INCLUDED WHEN COMPARED TO THE COMPENSATION STUDIES.
PART I, LINE 6EXECUTIVE INCENTIVE PLAN WAS ACCRUED FOR HOWEVER NO PAYMENTS WERE MADE FOR FY 2012.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 6THE CORPORATE MEMBERS OF MERCY MEDICAL CENTER OF OSHKOSH, INC. ARE MINISTRY HEALTH CARE, INC. AND AFFINITY HEALTH SYSTEM.
FORM 990, PART VI, SECTION A, LINE 7AMINISTRY HEALTH CARE HAS THE POWER TO APPROVE AND REMOVE DIRECTORS FROM MERCY MEDICAL CENTER OF OSHKOSH, INC.
FORM 990, PART VI, SECTION A, LINE 7BAMENDMENTS OF THE ARTICLES OF INCORPORATION AND BYLAWS MUST BE APPROVED BY MINISTRY HEALTH CARE, INC.
FORM 990, PART VI, SECTION B, LINE 11THE CONTROLLER AND CFO OF AFFINITY HEALTH SYSTEM PERFORM A DETAIL REVIEW OF THE 990. AFTER MANAGEMENT'S REVIEW, A COPY OF THE 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CTHE BOARD OF DIRECTORS RECEIVES A CONFLICT OF INTEREST QUESTIONNAIRE EVERY YEAR.
FORM 990, PART VI, SECTION B, LINE 15EACH YEAR THE ORGANIZATION ENGAGES AN INDEPENDENT COMPENSATION FIRM TO PROVIDE MARKET DATA FOR CEO, EXECUTIVES AND KEY EMPLOYEE POSITIONS. THIS STUDY IS SHARED WITH THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS FOR THEIR REVIEW AND RECOMMENDATIONS REGARDING ANY COMPENSATION CHANGES. THE COMPENSATION COMMITTEE IS COMPRISED OF INDEPENDENT MEMBERS. THE CEO REVIEWS EACH EXECUTIVE AND KEY EMPLOYEE'S ANNUAL PERFORMANCE APPRAISAL RATINGS IN MAKING HIS COMPENSATION RECOMMENDATIONS TO THE COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE HAS THE FINAL AUTHORITY TO APPROVE ANY AND ALL AMOUNTS OF COMPENSATION FOR MEMBERS OF THE EXECUTIVE TEAM. THE FINAL APPROVAL OF COMPENSATION AMOUNTS ARE DOCUMENTED.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION BELIEVES THE FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND POLICIES ARE THE PROPERTY OF THE ORGANIZATION AND ARE NOT AVAILABLE FOR PUBLIC INSPECTION.
FORM 990, PART VIIMARK FAUSTICH, MD WORKED AN AVERAGE OF 40 HOURS PER WEEK FOR A RELATED ORGANIZATION. JOSEPH MCCORMICK, MD WORKED AN AVERAGE OF 40 HOURS PER WEEK FOR A RELATED ORGANIZATION. CHRISTOPHER ROCKE, DO WORKED AN AVERAGE OF 40 HOURS PER WEEK FOR A RELATED ORGANIZATION. STACEY SENSOR, DO WORKED AN AVERAGE OF 40 HOURS PER WEEK FOR A RELATED ORGANIZATION. BARBARA STRAND, MD WORKED AN AVERAGE OF 40 HOURS PER WEEK FOR A RELATED ORGANIZATION. DANIEL NEUFELDER WORKED AN AVERAGE OF 30 HOURS PER WEEK FOR RELATED ORGANIZATIONS. JEFF BADGER WORKED AN AVERAGE OF 30 HOURS PER WEEK FOR RELATED ORGANIZATIONS. JOHN OLIVERIO WORKED AN AVERAGE OF 40 HOURS PER WEEK FOR A RELATED ORGANIZATION. NICHOLAS DESIEN WORKED AN AVERAGE OF 40 HOURS PER WEEK FOR A RELATED ORGANIZATON.HOURS WORKED FOR RELATED ORGANIZATIONS
FORM 990, PART XI, LINE 5:NET UNREALIZED GAINS ON INVESTMENTS: 282,259. PENSION ADJUSTMENT -726,916. TRANSFER OF DEBT TO MINISTRY -182,642,407. WORKERS COMPENSATION ADJUSTMENT -476,823. EQUITY DISTRIBUTION -4,500,000. TOTAL TO FORM 990, PART XI, LINE 5: -188,063,887.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XII, LINE 2CPROCESS FOR OVERSIGHT OF AUDIT AND SELECTION OF AN INDEPENDENT ACCOUNTANT: MERCY MEDICAL CENTER OF OSHKOSH, INC. (ORGANIZATION) DOES NOT RECEIVE SEPARATELY AUDITED FINANCIAL STATEMENTS. THE ORGANIZATION IS AUDITED AND REPORTED THROUGH CONSOLIDATED FINANCIAL STATEMENTS. THE AUDIT COMMITTEE IS RESPONSIBLE FOR THE AUDITOR SELECTION. THE AUDIT STATEMENTS ARE REVIEWED BY THE CONTROLLER, CFO, MINISTRY HEALTH CFO, AND THE AUDIT COMMITTEE. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (31 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
AFFINITY HEALTH SYSTEM
1570 MIDWAY PLMENASHAWI54952391568866SUPPORT RELATED HEALTHCARE ORGANIZATIONSIL501(C)(3)LINE 11B, IIMINISTRY HEALTH CARE INC0
CALUMET MEDICAL CENTER INC
614 MEMORIAL DRIVECHILTONWI53014390905385HOSPITALWI501(C)(3)LINE 3AFFINITY HEALTH SYSTEM0
NETWORK HEALTH SYSTEM INC
1570 APPLETON ROADMENASHAWI54952391127163CLINICAL HEALTHCARE SERVICESWI501(C)(3)LINE 3AFFINITY HEALTH SYSTEM0
MERCY HEALTH FOUNDATION INC
PO BOX 3370OSHKOSHWI54903237140261PUBLIC WELFARE THROUGH COMMUNITY HEALTH DEVELOPMENTWI501(C)(3)LINE 9AFFINITY HEALTH SYSTEM0
ST ELIZABETH HOSPITAL FOUNDATION INC
1506 S ONEIDA STREETAPPLETONWI54915391256677RAISE FUNDS IN SUPPORT OF ST. ELIZABETH HOSPITAL AND RELATED ENTITIESWI501(C)(3)LINE 7AFFINITY HEALTH SYSTEM0
ST ELIZABETH HOSPITAL INC
1506 S ONEIDA STREETAPPLETONWI54915390816818HOSPITALWI501(C)(3)LINE 3AFFINITY HEALTH SYSTEM0
MARIAN HEALTH SYSTEMS INC
1923 SOUTH UTICA AVENUETULSAOK74104363659989PARENT CORPDE501(C)(3)LINE 11A, I0N/A
MINISTRY HEALTH CARE INC
11925 W LAKE PARK DR STE 100MILWAUKEEWI53224391490371PARENT CORP - MANAGEMENT SERVICESWI501(C)(3)LINE 11B, IIMARIAN HEALTH SYSTEM INC0
AGAPE COMMUNITY CENTER OF MILWAUKEE INC
6100 NORTH 42ND STREETMILWAUKEEWI53209391461846COMMUNITY CENTERWI501(C)(3)LINE 11A, IMINISTRY HEALTH CARE INC0
SACRED HEART-SAINT MARY'S HOSPITALS INC
401 WEST MOHAWK DRIVE/2251 NORTH SHTOMAHAWKRHINELANDERWI54487391390638HOSPITALSWI501(C)(3)LINE 3MINISTRY HEALTH CARE INC0
MINISTRY WEIGHT MANAGEMENT INC
2251 NORTH SHORE DRIVERHINELANDERWI54101391829015HEALTH SERVICESWI501(C)(3)LINE 3SACRED HEART-SAINT MARY'S HOSPITALS INC0
HOWARD YOUNG HEALTH CARE INC
240 MAPLE STREETWOODRUFFWI54568391499115HOME OFFICEWI501(C)(3)LINE 3MINISTRY HEALTH CARE INC0
HOWARD YOUNG MEDICAL CENTER INC
240 MAPLE STREETWOODRUFFWI54568390873606HOSPITALWI501(C)(3)LINE 3HOWARD YOUNG HEALTH CARE INC0
EAGLE RIVER MEMORIAL HOSPITAL
201 HOSPITAL ROADEAGLE RIVERWI54521390985690HOSPITALWI501(C)(3)LINE 3THE HOWARD YOUNG MEDICAL CENTER INC0
DR KATE NEWCOMB CONVALESCENT CENTER INC
301 ELM STWOODRUFFWI54568391357365LTC FACILITYWI501(C)(3)LINE 3HOWARD YOUNG HEALTH CARE INC0
SAINT MICHAEL'S HOSPITAL OF STEVENS POINT INC
900 ILLINOIS AVENUESTEVENS POINTWI54481390808443HOSPITALWI501(C)(3)LINE 3MINISTRY HEALTH CARE INC0
GOOD SAMARITAN HEALTH CENTER
601 SOUTH CENTER AVENUEMERRILLWI54452390808503HOSPITALWI501(C)(3)LINE 3MINISTRY HEALTH CARE INC0
SAINT CLAIRE'S HOSPITAL OF WESTON INC
3400 MINISTRY PARKWAYWESTONWI54476721531917HOSPITALWI501(C)(3)LINE 3MINISTRY HEALTH CARE INC0
MINISTRY MEDICAL GROUP INC
824 ILLINOIS AVENUESTEVENS POINTWI54481391965593CLINICSWI501(C)(3)LINE 3MINISTRY HEALTH CARE INC0
MINISTRY HOME CARE INC
611 ST JOSEPH AVENUE 4SMARSHFIELDWI54449391936201HOME CARE/HOSPICEWI501(C)(3)LINE 3MINISTRY HEALTH CARE INC0
SAINT JOSEPH'S HOSPITAL OF MARSHFIELD INC
611 SAINT JOSEPH AVENUEMARSHFIELDWI54449390847631HOSPITALWI501(C)(3)LINE 3MINISTRY HEALTH CARE INC0
OUR LADY OF VICTORY HOSPITAL INC
1120 PINE STREETSTANLEYWI54768390807065HOSPITALWI501(C)(3)LINE 3MINISTRY HEALTH CARE INC0
DOOR COUNTY MEMORIAL HOSPITAL
323 SOUTH 18TH AVENUESTURGEON BAYWI54235390806324HOSPITAL/CLINIC/NURSING HOMEWI501(C)(3)LINE 3MINISTRY HEALTH CARE INC0
SAINT ELIZABETHS HOSPITAL OF WABASHA INC
1200 GRANT BLVD WESTWABASHAMN55981410693877HOSPITAL/NURSING HOMEMN501(C)(3)LINE 3MINISTRY HEALTH CARE INC0
GOOD SAMARITAN HEALTH CENTER FOUNDATION OF MERRILL WISC INC
601 SOUTH CENTER AVENUESTEVENS POINTWI54452391627755CHARITABLE FOUNDATIONWI501(C)(3)LINE 11A, IMINISTRY HEALTH CARE INC0
FOUNDATION OF SAINT JOSEPHS HOSPITAL OF MARSHFIELD INC
611 SAINT JOSEPH AVENUEMARSHFIELDWI54449391684957CHARITABLE FOUNDATIONWI501(C)(3)LINE 11A, ISAINT JOSEPH'S HOSPITAL OF MARSHFIELD INC0
PARTNERS WITH SAINT JOSEPHS HOSPITAL OF MARSHFIELD INC
611 SAINT JOSEPH AVENUEMARSHFIELDWI54449396094701HOSPITAL AUXILIARYWI501(C)(3)LINE 11C, III-FISAINT JOSEPH'S HOSPITAL OF MARSHFIELD INC0
HOWARD YOUNG FOUNDATION INC
240 MAPLE STWOODRUFFWI54568391521169FOUNDATIONWI501(C)(3)LINE 7MINISTRY HEALTH CARE INC0
HOWARD YOUNG CLINICS INC
240 MAPLE STWOODRUFFWI54568391969706CLINICSWI501(C)(3)LINE 3HOWARD YOUNG HEALTH CARE INC0
SAINT MICHAELS FOUNDATION OF STEVENS POINT INC
900 ILLINOIS AVENUESTEVENS POINTWI54481391657410CHARITABLE FOUNDATIONWI501(C)(3)LINE 11A, ISAINT MICHAEL'S HOSPITAL OF STEVENS POINT INC0
FOUNDATION OF SAINT CLARES HOSPITAL OF WESTON INC
3400 MINISTRY PARKWAYWESTONWI54476753193633CHARITABLE FOUNDATIONWI501(C)(3)LINE 11A, IST CLARES HOSPITAL OF WESTON INC0

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1TWIN MED LLPBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 8005AddressLine1
CityMENASHACity
StateWIState
ZIP Code54952ZIPCode
FieldValueIRS element (for citing)
EIN391180341EIN
Primary ActivityRENTAL PROPERTYPrimaryActivity
Legal Domicile StateWILegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntity
NETWORK HEALTH PLAN INC
1570 MIDWAY PLACEMENASHAWI54952391442058INSURANCEWIN/AC
NETWORK HEALTH INSURANCE CORPORATION
1570 MIDWAY PLACEMENASHAWI54952392020474INSURANCEWIN/AC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org1LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

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