ASCENSION ST CLARES HOSPITAL INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
ASCENSION ST CLARES HOSPITAL INC (EIN 72-1531917)
Tax period
2010-10-01 to 2011-09-30
Filed
2012-07-18
IRS object ID
201222009349300527
Schema version
2010v3.2
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)
Timestamp2012-07-18T13:15:18-07:00Timestamp
Tax Period End Date2011-09-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2010-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN721531917EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1ST CLARES HOSPITAL OF WESTON INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSTCLNameControl
Phone7153933000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line13400 MINISTRY PARKWAYAddressLine1
CityWESTONCity
StateWIState
ZIP Code54476ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMARY KRUEGERName
TitlePRESIDENT & COOTitle
Date Signed2012-07-18DateSigned
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMARY KRUEGERNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line13400 MINISTRY PARKWAYAddressLine1
CityWESTONCity
StateWIState
ZIP Code54476ZIPCode
FieldValueIRS element (for citing)
Gross Receipts91802685GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web SiteWWW.MINISTRYHEALTH.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2002YearFormation
State Legal DomicileWIStateLegalDomicile
Activity Or Mission DescriptionST 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.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees627TotalNbrEmployees
Total Nbr Volunteers176TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year25473ContributionsGrantsPriorYear
Contributions Grants Current Year32381ContributionsGrantsCurrentYear
Program Service Revenue Prior Year94834161ProgramServiceRevenuePriorYear
Program Service Revenue CY94941769ProgramServiceRevenueCY
Investment Income Prior Year-14854InvestmentIncomePriorYear
Investment Income Current Year8653InvestmentIncomeCurrentYear
Other Revenue Prior Year-2801257OtherRevenuePriorYear
Other Revenue Current Year-3190337OtherRevenueCurrentYear
Total Revenue Prior Year92043523TotalRevenuePriorYear
Total Revenue Current Year91792466TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year35467703SalariesEtcPriorYear
Salaries Etc Current Year34796787SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year61499811OtherExpensePriorYear
Other Expenses Current Year58544424OtherExpensesCurrentYear
Total Expenses Prior Year96967514TotalExpensesPriorYear
Total Expenses Current Year93341211TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-4923991RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-1548745RevenuesLessExpensesCY
Total Assets BOY134109434TotalAssetsBOY
Total Assets EOY133806222TotalAssetsEOY
Total Liabilities BOY181603932TotalLiabilitiesBOY
Total Liabilities EOY185701402TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-47494498NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-51895180NetAssetsOrFundBalancesEOY
Mission DescriptionST 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.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense88403687Expense
Revenue90910587Revenue
DescriptionTHE 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.Description
Total Program Service Expense88403687TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershiptrueActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109659NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees627NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Form8886 T FiledfalseForm8886TFiled
Non Deductible ContributionsfalseNonDeductibleContributions
Non Deductible DisclosurefalseNonDeductibleDisclosure
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Quid Pro Quo DisclosurefalseQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Form720 FiledfalseForm720Filed
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Policies Reference ChaptersfalsePoliciesReferenceChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledWIStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonWM HINNER VP-FINCL ANL PLNGNamePerson
Telephone Number7153465078TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line14941 KIRSCHLING CRTAddressLine1
CitySTEVENS PTCity
StateWIState
ZIP Code54481ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (21 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationIndividual Trustee Or DirectorIndividualTrusteeOrDirectorHighest Compensated EmployeeHighestCompensatedEmployee
WILLIAM HINNER
VP-FIN ANALYSIS15.00X031848241781
TIM BODETTE
VICE CHAIRPERSN0.25X000X
THOMAS FELCH
BOARD MEMBER0.25000X
TEE DALY
BOARD MEMBER0.25000X
SUSAN DRAEGER
CLINICL PHARMACIST40.00122624010056X
SISTER MARIA VINTON
BOARD MEMBER0.25000X
ROBERT MIDDLETON
PHARMACY DIRECTOR40.00136020025490X
RAYMOND BAKER
CLINCL PHARMACIST40.00117892023283X
RACHEL YARON
VP-QLTY & SFTY20.00X016625415101
MIKE KRYDA
SECR/TREASURER0.25X068430315712X
MARY KRUEGER
PRESIDENT & COO40.00X033248747095X
MARY JO JOHNSON
BOARD MEMBER0.25000X
MARIA HEGLAND
CLINICL PHARMACIST40.0012360503933X
LARRY HEGLAND
CHIEF MED OFFCR10.00X037072842038X
KRISTINE GILMORE
CHAIRPERSN0.25X000X
KEVIN NOEL
BOARD MEMBER0.25000X
JOANNE LEONARD
BOARD MEMBER0.25000X
JIM FRINGS
BOARD MEMBER0.25000X
JEFF MARTIN
REGIONAL CEO6.00X068920768445X
DEBRA SCHUSTER
MED DIR SURG SERV40.0016701500X
COLLEEN HOERNEMAN
VP-PATIENT CARE40.00X020554221372
FieldValueIRS element (for citing)
Total Reportable Comp From Org667156TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2767003TotalReportableCompFrmRltdOrgs
Total Other Compensation314306TotalOtherCompensation
Number Individuals GT100 K13NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
MARSHFIELD CLINIC
1000 NORTH OAK AVEMARSHFIELDWI544495779MEDICAL SERVCS/STFF1718380
LANDART INC
3808 E SELL STWAUSAUWI54403LANDSCAPING459028
JUDGES CLEANERS INC
2150 MAPLE DRIVEPLOVERWI54467LAUNDRY SERVICES403089
JOHNSON CONTROLS
PO BOX 905240CHARLOTTENC282905240EQUIP INSTL & MAINT477204
ADVANCE ICU CARE
PO BOX 790379ST LOUISMO63179MEDICAL SERVICES600000
FieldValueIRS element (for citing)
Number Of Contractors GT100 K15NumberOfContractorsGT100K
Related Organizations15336RelatedOrganizations
Government Grants17045GovernmentGrants
Total Contributions32381TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
RENT INCOMES532000911043911043
PROGRAM SERVICE REVENUES9000998580746785807467
DTC INCOME62150069631196963119
CAPITAL LEASE INTEREST90009912601401260140
FieldValueIRS element (for citing)
Total Program Service Revenue94941769TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column8653TotalRevenueColumn
Exclusion$8,653ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real32616Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real32616Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column32616TotalRevenueColumn
Exclusion$32,616ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other10219Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other10219Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
MINISTRY HOSPICE621610166199166199
GIFT SHOP453220162472$162,472
CAFETERIA722210645757$645,757

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column-4197381TotalRevenueColumn
Related Or Exempt Function Income-4197381RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue-3222953TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column91792466TotalRevenueColumn
Related Or Exempt Function Income90910587RelatedOrExemptFunctionIncome
Exclusion$849,498ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total27630611Total
Program Services26246847ProgramServices
Management And General1383764ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1253852Total
Program Services1241392ProgramServices
Management And General12460ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total4298558Total
Program Services3907412ProgramServices
Management And General391146ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1613766Total
Program Services1584012ProgramServices
Management And General29754ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total142373Total
Management And General142373ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total900Total
Program Services500ProgramServices
Management And General400ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1562222Total
Program Services997525ProgramServices
Management And General564697ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total175678Total
Program Services550ProgramServices
Management And General175128ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total12082109Total
Program Services11887567ProgramServices
Management And General194542ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total2010470Total
Program Services2004809ProgramServices
Management And General5661ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1571805Total
Program Services1570205ProgramServices
Management And General1600ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total40206Total
Program Services30371ProgramServices
Management And General9835ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total142324Total
Program Services118950ProgramServices
Management And General23374ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total10799668Total
Program Services10799668ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total6683675Total
Program Services6530715ProgramServices
Management And General152960ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total216074Total
Program Services215083ProgramServices
Management And General991ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
UNDERARRANGEMENTS68040956804095
PURCHASED SERVICES64226515889804532847
Pharmaceuticals22743522274352
BAD DEBT36896273689627
ANESTHESIA SERVICES23454512345451

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1580744Total
Program Services264752ProgramServices
Management And General1315992ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total93341211Total
Program Services88403687ProgramServices
Management And General4937524ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1400BOY
EOY1400EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY4844345BOY
EOY4904210EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY9570376BOY
EOY9346220EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY2521739BOY
EOY2219091EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY295087BOY
EOY287536EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis122977947LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec46599616LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY81018874BOY
EOY76378331EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY35857613BOY
EOY40669434EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY134109434BOY
EOY133806222EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY27390620BOY
EOY30692526EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY508201BOY
EOY479455EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY153705111BOY
EOY154529421EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY181603932BOY
EOY185701402EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-47494498BOY
EOY-51895180EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-47494498BOY
EOY-51895180EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY134109434BOY
EOY133806222EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-1548745ReconcilationRevenueExpenses
Reconcilation Other Changes-2851937ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

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)
Form4720 Filed4955 TaxfalseForm4720Filed4955Tax
Correction MadefalseCorrectionMade
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$7,253OtherActivitiesAmount
Total Lobbying Expenditures IIB7253TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3
Form4720 Filed4912 TaxfalseForm4720Filed4912Tax

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierPart II-B, Line 1iIdentifier
Return ReferencePart II-B, Line 1i - Other Activities DescriptionReturnReference
ExplanationST 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.Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1558074OtherCostOrOtherBasis
Book Value1558074BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis88807373OtherCostOrOtherBasis
Depreciation22527642Depreciation
Book Value66279731BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1179942OtherCostOrOtherBasis
Depreciation791308Depreciation
Book Value388634BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis31432558OtherCostOrOtherBasis
Depreciation23280666Depreciation
Book Value8151892BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings76378331TotalOfBookValueLandBuildings

Other Assets OtherAssets (3 entries)

DescriptionDescriptionBook ValueBookValue
OTHER ACCOUNTS RECEIVABLE2458302
INVESTMENT IN DTC14015317
CAPITAL LEASE24195815
FieldValueIRS element (for citing)
Total Book Value Other Assets40669434TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
NOTE PAYABLE TO MHC (RELATED PARTY)$152,139,637
EST DUE TO THIRD PARTY PAYOR$2,389,784
FieldValueIRS element (for citing)
Total Of Amounts154529421TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierPart XI, Line 8Identifier
Return ReferencePart XI, Line 8: Other Changes in Net Assets or Fund BalancesReturnReference
ExplanationMINISTRY HEALTH CARE EQUITY TRANSFER $ -0 CASH TRANSFER TO ST CLARES FOUNDATION $ -44713 SJH OUTREACH ALLOCATION $ -2199996 HOSPICE/HOME HEALTH $ -66004 EHR FUNDING $ -541224Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent150XPcent150
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense1264614TotalCommunityBenefitExpense
Net Community Benefit Expense1264614NetCommunityBenefitExpense
Percent Of Total Expense0.01410PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense13055850TotalCommunityBenefitExpense
Direct Offsetting Revenue12137118DirectOffsettingRevenue
Net Community Benefit Expense918732NetCommunityBenefitExpense
Percent Of Total Expense0.01020PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense14320464TotalCommunityBenefitExpense
Direct Offsetting Revenue12137118DirectOffsettingRevenue
Net Community Benefit Expense2183346NetCommunityBenefitExpense
Percent Of Total Expense0.02430PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense18853TotalCommunityBenefitExpense
Net Community Benefit Expense18853NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense86900TotalCommunityBenefitExpense
Net Community Benefit Expense86900NetCommunityBenefitExpense
Percent Of Total Expense0.00100PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense145986TotalCommunityBenefitExpense
Net Community Benefit Expense145986NetCommunityBenefitExpense
Percent Of Total Expense0.00160PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense251739TotalCommunityBenefitExpense
Net Community Benefit Expense251739NetCommunityBenefitExpense
Percent Of Total Expense0.00280PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense14572203TotalCommunityBenefitExpense
Direct Offsetting Revenue12137118DirectOffsettingRevenue
Net Community Benefit Expense2435085NetCommunityBenefitExpense
Percent Of Total Expense0.02710PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Total Community Building Expense18642TotalCommunityBuildingExpense
Net Community Building Expense18642NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense68TotalCommunityBuildingExpense
Net Community Building Expense68NetCommunityBuildingExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense18710TotalCommunityBuildingExpense
Net Community Building Expense18710NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$2,007,154BadDebtExpenseAmount
Amount Reimbursed By Medicare33372237AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare46250243CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-12878006MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

FieldValueIRS element (for citing)
Business Name Line1THE DIAGNOSTIC & TRMNT CNTRBusinessNameLine1
FieldValueIRS element (for citing)
Description Ent Primary ActivityOUTPATIENT/DIAGNOSTIC SERVSDescriptionEntPrimaryActivity
Organization Profit Or Ownership0.50000OrganizationProfitOrOwnership
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number0FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1ST CLARES HOSPITAL OF WESTONBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line13400 MINISTRY PARKWAYAddressLine1
CityWESTONCity
StateWIState
ZIP Code54476ZIPCode
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 Line1ST CLARES HOSPITAL OF WESTONBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent150.0000FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent400.0000FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Available On RequestXAvailableOnRequest
Actions On NonpaymenttrueActionsOnNonpayment
Permit Report To Credit AgencyXPermitReportToCreditAgency
Permit LawsuitXPermitLawsuit
Collection ActivitiestrueCollectionActivities
Report To Credit AgencyXReportToCreditAgency
LawsuitXLawsuit
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargestrueGrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities1NumberOfOtherFacilities

Other Facilities OtherFacilities

Name Name

FieldValueIRS element (for citing)
Business Name Line1THE DIAGNOSTIC & TREATMENT CENTERBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line13401 CRANBERRY BLVDAddressLine1
CityWESTONCity
StateWIState
ZIP Code54476ZIPCode
FieldValueIRS element (for citing)
Facility TypeOUTPATIENT/DIAGNOSTIC SERVICESFacilityType

Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part VI - States Where Community Benefit Report FiledWI
Part VI - Affilated Health Care System Roles and PromotionThe 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 also participates in the Ministry Health Care Fund which provides monies for special projects within the communities we serve. All organizations sponsored or co-sponsored by Ministry Health Care, Inc. set aside monies each year to assist with the needs of the community and the poor. As the Ministry Health Care Fund, these dollars are funneled back into our communities for a variety of programs and services through a community assets and needs assessment process.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 PurposeThe 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 ActivitiesCommunity-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 InformationWhile 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 5,570 households based on 2006-2010 data, with an average person per household being 2.55. The median household income was $55,367 and there were 6.3% 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 AssistanceThe organization 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 charity care policy. The charity care policy and application is posted on the organization's website. Admissions and other key areas contain summary information of the charity 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 the organization's community care program. Patients may be identified as needing financial assistance at any time during the course of an encounter. A referral for consideration of community 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 community care financial assistance. The charity care policy 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 scripts to follow when interacting with patients. As part of the charity 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 - Needs AssessmentThe 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.
Part V, Line 21 - Charge Patients Amount Equal Gross Charge for ServicesA PATIENT COULD BE CHARGED AN AMOUNT EQUAL TO THE GROSS CHARGE IN THE FOLLOWING CIRCUMSTANCE: IF A PATIENT IS INSURED BY A NON-CONTRACTED PAYER, THAT PAYER OR PATIENT WOULD BE RESPONSIBLE FOR 100% OF THE BILLED CHARGES. IF A SERVICE OR VISIT UNDER THAT SCENARIO FELL UNDER THE CO-PAY, COINSURANCE, OR DEDUCTIBLE PORTION OF THE PLAN, OR IF THE SERVICE WAS NOT COVERED BY THE PLAN, THE PATIENT COULD BE FINANCIALLY RESPONSIBLE FOR 100% OF GROSS CHARGES.Number of Hospital Faciltiy - 0
Part V, Line 19d - Other Billing Determination of Individuals Without InsuranceMINISTRY HEALTH CARE'S POLICY IS TO OFFER 10% DISCOUNT TO OUR UNINSURED POPULATION.Number of Hospital Faciltiy - 0
Part III, Line 9b - Provisions On Collection Practices For Qualified PatientsThe 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 III, Line 8 - Explanation Of Shortfall As Community BenefitThe 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 payer. 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 4 - Bad Debt ExpenseNo footnote exists in the organization'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 charity care policy. These patients would qualify for charity 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. The organization continues serving patients even after the patients have generated significant bad debt which is evidence that the care is given for community benefit motivations.
Part I, Line 7, Column F - Explanation of Bad Debt ExpenseBad Debt expense of $3,689,627 is excluded from total operating expenses of $93,341,211 when calculating percentage of total expense in Part I, Line 7, Col F.
Part I, Line 7 - Explanation of Costing MethodologyAmounts 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 ReportAs 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.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsBase Compensation Filing OrgBaseCompensationFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrg
WILLIAM HINNER
2665344963523132344718334360263
ROBERT MIDDLETON
1310854935280022690161510
RACHEL YARON
12797737029124814493608181355
MIKE KRYDA
4422419878414327881607552700015
MARY KRUEGER
24095576485150472879818297379582
LARRY HEGLAND
27196759110396512135920679412766
JEFF MARTIN
467885178374429484763220813757652
DEBRA SCHUSTER
167015167015
COLLEEN HOERNEMAN
156293314841776520797575226914

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSch J, Part I, Line 1aIdentifier
Return ReferencePart I, Line 1a: Relevant information in regards to selections on 1a.ReturnReference
ExplanationSOCIAL CLUB DUES PROVIDED ON BEHALF OF:MARY KRUEGER $4,689LARRY HEGLAND $4,689Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990 PART IX LINE 24 - OTHER EXPSEXECUTIVES 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: Other Organization Documents Publicly AvailableTHE 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 19
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesTHE 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 15b
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsTHE 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 12c
Form 990, Part VI, Line 11: Form 990 Review ProcessFORM 990 IS COMPLETED THROUGH JOINT EFFORTS OF SHARED FINANCE FUNCTION WITH REVIEW AND GUIDANCE OF LEGAL COUNCIL AND CORPORATE OVERSIGHT. FORM 990 IS PRESENTED TO THE HOSPITAL'S GOVERNING BODY AT THE MOST RECENT BOARD COMMITTEE MEETING. THE PRESIDENT/CFO PRESENTS AND BRIEFLY EXPLAINS THE FORM AND ITS PURPOSE.Form 990, Part VI, Line 11
Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing BodyMINISTRY 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 6: Explanation of Classes of Members or ShareholderMINISTRY 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

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
FOUNDATION OF ST CLARES HOSPITAL
3400 MINISTRY PARKWAYWESTONWI54476753193633FOUNDATIONWI501(c)(3)11-1N/Atrue
MINISTRY HEALTH CARE
11925 W LAKE PARK DRMILWAUKEEWI53224391490371MANAGEMENT COMPANYWI501(c)(3)11-ON/Afalse
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgtrueLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (7 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
FOUNDATION OF ST CLARES HOSPITAL
q44713GL DETAIL
FOUNDATION OF ST CLARES HOSPITAL
n37165PAYROLL JRNL
FOUNDATION OF ST CLARES HOSPITAL
c15336DISTR JRNL
MINISTRY HEALTH CARE
o14379592COST
MINISTRY HEALTH CARE
n5141925PAY RECORDS
MINISTRY HEALTH CARE
i10572SQ FTG FMV
MINISTRY HEALTH CARE
e15213938PRINCIPLE PYMNT

Form990 Schedule R Part VI Form990ScheduleRPartVI

Name Of Business NameOfBusiness

FieldValueIRS element (for citing)
Business Name Line1THE DIAGNOSTIC & TREATMENT CENTERBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line13401 CRANBERRY BLVDAddressLine1
CityWESTONCity
StateWIState
ZIP Code54476ZIPCode
FieldValueIRS element (for citing)
EIN200691634EIN
Primary ActivityOUTPATIENT SERVICESPrimaryActivity
Legal Domicile StateWILegalDomicileState
All Partners C3 StrueAllPartnersC3S
Share Of EOY Assets4864826ShareOfEOYAssets
Disproportionate AllocationsfalseDisproportionateAllocations
General Or Managing PartnerfalseGeneralOrManagingPartner

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