SAINT ELIZABETHS HOSPITAL OF WABASHA INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- SAINT ELIZABETHS HOSPITAL OF WABASHA INC (EIN 41-0693877)
- Tax period
- 2010-10-01 to 2011-09-30
- Filed
- 2012-07-25
- IRS object ID
- 201222079349300047
- Schema version
- 2010v3.4
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-07-25T14:05:46-05:00 | Timestamp |
| Tax Period End Date | 2011-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 217 | AddressLine1 |
| City | AUSTIN | City |
| State | MN | State |
| ZIP Code | 55912 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410693877 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SAINT ELIZABETH'S HOSPITAL OF WABASHA INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | SAIN | NameControl |
| Phone | 6515655553 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 GRANT BLVD WEST | AddressLine1 |
| City | WABASHA | City |
| State | MN | State |
| ZIP Code | 55981 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | TOM CROWLEY | Name |
| Title | PRESIDENT | Title |
| Phone | 6515655553 | Phone |
| Date Signed | 2012-07-25 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | SHERRI WESSELS | Name |
| Phone | 5074347000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | TOM CROWLEY | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 GRANT BLVD WEST | AddressLine1 |
| City | WABASHA | City |
| State | MN | State |
| ZIP Code | 55981 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 24069002 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Group Exemption Number | 0928 | GroupExemptionNumber |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.STELIZABETHSWABASHA.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1955 | YearFormation |
| State Legal Domicile | MN | StateLegalDomicile |
| Activity Or Mission Description | OUR MISSION 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 WE SERVE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 10 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 413 | TotalNbrEmployees |
| Total Nbr Volunteers | 150 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 696263 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 365265 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 22914289 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 23663601 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 40363 | InvestmentIncomePriorYear |
| Investment Income Current Year | 40136 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 23650915 | TotalRevenuePriorYear |
| Total Revenue Current Year | 24069002 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 14191942 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 14309260 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 9162550 | OtherExpensePriorYear |
| Other Expenses Current Year | 8780475 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 23354492 | TotalExpensesPriorYear |
| Total Expenses Current Year | 23089735 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 296423 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 979267 | RevenuesLessExpensesCY |
| Total Assets BOY | 19047682 | TotalAssetsBOY |
| Total Assets EOY | 20076430 | TotalAssetsEOY |
| Total Liabilities BOY | 3672098 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 3707192 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 15375584 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 16369238 | NetAssetsOrFundBalancesEOY |
| Mission Description | OUR MISSION 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 WE SERVE. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 20335542 | Expense |
| Revenue | 23663601 | Revenue |
| Description | SINCE 1898 ST. ELIZABETH'S HAS BEEN SERVING THE HEALTHCARE NEEDS OF EASTERN MINNESOTA AND WESTERN WISCONSIN RESIDENTS, AND IS A MEMBER OF MINISTRY HEALTH CARE AND SPONSORED BY THE SISTERS OF THE SORROWFUL MOTHER. SINCE MAY, 1992, ST. ELIZABETH'S HAS BEEN A CRITICAL ACCESS HOSPITAL AND IS MEDICARE CERTIFIED FOR 25 ACUTE CARE/SWING BEDS. WE OFFER A BROAD RANGE OF ACUTE CARE, DIAGNOSTIC, EDUCATIONAL, EMERGENCY, AND SURGICAL SERVICES TO RESIDENTS WITHIN OUR SERVICE AREA. IN FY 2011, ST. ELIZABETH'S HAD 1,301 ACUTE CARE DAYS, 651 SWING BED DAYS, AND 25,976 OUTPATIENT ENCOUNTERS. ADDITIONALLY, ST. ELIZABETH'S IS CURRENTLY LICENSED FOR 100 NURSING HOME BEDS AND 45 ASSISTED LIVING APARTMENTS. ALL NURSING HOME BEDS ARE MEDICARE CERTIFIED. IN FY 2011, WE HAD 34,813 NURSING HOME DAYS AND 16,518 APARTMENT DAYS. | Description |
| Total Program Service Expense | 20335542 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 78 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 413 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 10 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | MN | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | JOHN WOLFE | NamePerson |
| Telephone Number | 6515655553 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 GRANT BLVD W | AddressLine1 |
| City | WABASHA | City |
| State | MN | State |
| ZIP Code | 55981 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (17 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| JEAN WODELE | |||||||
| CHAIR | 0.50 | X | 0 | 0 | 0 | ||
| SISTER BARBARA HOLLWECK | |||||||
| DIRECTOR | 0.50 | X | 0 | 0 | 0 | ||
| MARY BETH QUIRAM | |||||||
| DIRECTOR | 0.50 | X | 0 | 0 | 0 | ||
| BRIAN KELLY MD | |||||||
| DIRECTOR | 0.50 | X | 0 | 0 | 0 | ||
| CAROL WOODEN | |||||||
| DIRECTOR | 0.50 | X | 0 | 0 | 0 | ||
| DONALD JACOBY | |||||||
| VICE CHAIR | 0.50 | X | 0 | 0 | 0 | ||
| STEVEN SEDLMAYR | |||||||
| SECRETARY/TREASURER | 0.50 | X | 0 | 0 | 0 | ||
| JEREMY SOLBERG MD | |||||||
| DIRECTOR | 0.50 | X | 0 | 0 | 0 | ||
| ROB TAYLOR DO | |||||||
| DIRECTOR | 0.50 | X | 0 | 0 | 0 | ||
| RICHARD ZABEL | |||||||
| DIRECTOR | 0.50 | X | 0 | 0 | 0 | ||
| THOMAS CROWLEY | |||||||
| PRESIDENT | 40.00 | 234143 | 0 | 56469 | X | ||
| JOHN WOLFE | |||||||
| CFO | 40.00 | 121501 | 0 | 29123 | X | ||
| JONI LOMMEN | |||||||
| VP - CLINICAL SERVICES | 40.00 | 129490 | 0 | 33566 | X | ||
| JOHN HUST | |||||||
| CRNA | 40.00 | 169376 | 0 | 12787 | X | ||
| DR JOHN PETERSON | |||||||
| PSYCHIATRIST | 40.00 | 152480 | 0 | 10350 | X | ||
| KURT HENN | |||||||
| PHARMACIST | 40.00 | 119978 | 0 | 28690 | X | ||
| RITA FOX | |||||||
| VP - SENIOR SERVICES | 40.00 | 100575 | 0 | 15057 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1027543 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 186042 | TotalOtherCompensation |
| Number Individuals GT100 K | 7 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (4 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| MAYO CLINIC HEALTH SYSTEMS | |||||
| 500 W GRANT STREET | LAKE CITY | MN | 550411143 | LAB SERVICES | 263745 |
| ENHANCEMED MEDICAL PROFESSIONAL SERVICES | |||||
| PO BOX 4004 | ROCHESTER | MN | 55903 | E.R. COVERAGE | 196001 |
| MAYO MEDICAL LABORATORIES | |||||
| PO BOX 9146 | ROCHESTER | MN | 554809146 | LAB SERVICES | 128182 |
| PATRICIA P PEYLA CRNA MS | |||||
| 68034 COUNTY ROAD 76 | WABASHA | MN | 55981 | CRNA SERVICES | 110348 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 4 | NumberOfContractorsGT100K |
| Government Grants | 177468 | GovernmentGrants |
| All Other Contributions | 187797 | AllOtherContributions |
| Total Contributions | 365265 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT & RESIDENT | 623000 | 23489442 | 23489442 |
| OTHER OPERATING | 623000 | 174159 | 174159 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 23663601 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 33636 | TotalRevenueColumn |
| Exclusion | $33,636 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 6500 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 6500 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6500 | TotalRevenueColumn |
| Exclusion | $6,500 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 24069002 | TotalRevenueColumn |
| Related Or Exempt Function Income | 23663601 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $40,136 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 441236 | Total |
| Management And General | 441236 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10441868 | Total |
| Program Services | 9534636 | ProgramServices |
| Management And General | 907232 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 544691 | Total |
| Program Services | 505237 | ProgramServices |
| Management And General | 39454 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2144128 | Total |
| Program Services | 1944679 | ProgramServices |
| Management And General | 199449 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 737337 | Total |
| Program Services | 651098 | ProgramServices |
| Management And General | 86239 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1598898 | Total |
| Program Services | 1082880 | ProgramServices |
| Management And General | 516018 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 534473 | Total |
| Program Services | 534473 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 104991 | Total |
| Program Services | 101621 | ProgramServices |
| Management And General | 3370 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 75011 | Total |
| Program Services | 75011 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1383686 | Total |
| Program Services | 1383686 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 198090 | Total |
| Management And General | 198090 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| SUPPLIES | 1533311 | 1496706 | 36605 |
| PURCHASED SERVICES | 1242351 | 975118 | 267233 |
| DRUGS | 956731 | 956731 | |
| FOOD COSTS | 391617 | 391617 | |
| BAD DEBT EXPENSE | 330000 | 330000 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 431316 | Total |
| Program Services | 372049 | ProgramServices |
| Management And General | 59267 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23089735 | Total |
| Program Services | 20335542 | ProgramServices |
| Management And General | 2754193 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1668380 | BOY |
| EOY | 1659150 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3670473 | BOY |
| EOY | 4779219 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 389769 | BOY |
| EOY | 396457 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -2320 | BOY |
| EOY | 1300 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 29601818 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 18344277 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11784003 | BOY |
| EOY | 11257541 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1366781 | BOY |
| EOY | 1910109 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 170596 | BOY |
| EOY | 72654 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19047682 | BOY |
| EOY | 20076430 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2095292 | BOY |
| EOY | 2221473 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 116691 | BOY |
| EOY | 71883 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1120586 | BOY |
| EOY | 1029321 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 339529 | BOY |
| EOY | 384515 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3672098 | BOY |
| EOY | 3707192 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15375584 | BOY |
| EOY | 16369238 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15375584 | BOY |
| EOY | 16369238 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19047682 | BOY |
| EOY | 20076430 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 979267 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 14387 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 0 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 22023 | OtherCostOrOtherBasis |
| Book Value | 22023 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 17109378 | OtherCostOrOtherBasis |
| Depreciation | 9711115 | Depreciation |
| Book Value | 7398263 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 12470417 | OtherCostOrOtherBasis |
| Depreciation | 8633162 | Depreciation |
| Book Value | 3837255 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 11257541 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities (2 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| INVESTMENTS BY BOARD FOR CAPITAL PURPOSES | 1610109 | F |
| GOLF COURSE PREF STOCK | 300000 | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 1910109 | TotalOfBookValueSecurities |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DUE TO THIRD-PARTY PAYORS | $330,000 |
| ASSET RETIREMENT OBLIGATION | $54,515 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 384515 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X: | ReturnReference |
| Explanation | PER NOTE 2 OF THE FINANCIAL STATEMENTS FOR THE YEAR ENDING SEPTEMBER 30, 2011, THE CORPORATION IS COMPRISED OF TAX-EXEMPT CORPORATIONS THAT HAVE BEEN RECOGNIZED AS SUCH PURSUANT TO SECTIONS 501(C)(3) AND 509(A)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") WITH THE EXCEPTION OF TWO TAXABLE INSURANCE COMPANIES WHICH ARE A PART OF AFFINITY. THE CORPORATION IS, HOWEVER, SUBJECT TO FEDERAL AND STATE INCOME TAXES ON UNRELATED BUSINESS INCOME UNDER THE PROVISIONS OF SECTION 511 OF THE CODE. THE CORPORATION RECORDED ITS PROPORTIONAL SHARE OF INCOME TAXES RELATED TO THE AFFINITY INSURANCE COMPANIES OF $7,392 IN 2011 AND $5,982 IN 2010, INCLUDED IN NON-OPERATING GAINS/(LOSSES) - NET IN THE ACCOMPANYING CONSOLIDATED STATEMENTS OF OPERATIONS. NO OTHER TAX PROVISION WAS RECORDED IN 2011 AND 2010. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 400.000000000000 | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 0 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 102281 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 102281 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00400 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5201119 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4361850 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 839269 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03300 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5303400 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4361850 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 941550 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03700 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 580 | PersonsServed |
| Total Community Benefit Expense | 21535 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 690 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 20845 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00100 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 39492 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 39492 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00200 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 798176 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 798176 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03200 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 29649 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 29649 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00100 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 580 | PersonsServed |
| Total Community Benefit Expense | 888852 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 690 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 888162 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03600 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 580 | PersonsServed |
| Total Community Benefit Expense | 6192252 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4362540 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1829712 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07300 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 2693 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 2693 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 80 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 80 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 2720 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 2720 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 6637 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 6637 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 6913 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 6913 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 19043 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 19043 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00080 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $176,716 | BadDebtExpenseAmount |
| Amount Attributable To | 153284 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 5618500 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 5643282 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -24782 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST ELIZABETH HOSPITAL OF WABASHA INC | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1200 GRANT BLVD WEST | AddressLine1 |
| City | WABASHA | City |
| State | MN | State |
| ZIP Code | 55981 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Critical Access Hospital | X | CriticalAccessHospital |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 2 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (2 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| ST ELIZABETH NURSING HOME | ||||
| 1200 GRANT BLVD WEST | WABASHA | MN | 55981 | NURSING HOME |
| ST ELIZABETH ASSISTED LIVING APARTMENT | ||||
| 1200 GRANT BLVD WEST | WABASHA | MN | 55981 | RESIDENTIAL HOUSING W/SERVICES |
Form990 Schedule H Part VI Form990ScheduleHPartVI (16 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 3C: IT IS THE POLICY OF THE ORGANIZATION TO PROVIDE MEDICALLY NECESSARY HEALTH CARE SERVICES TO PEOPLE IN THE COMMUNITIES IT SERVES, REGARDLESS OF THEIR ABILITY TO PAY. COMMUNITY CARE FINANCIAL ASSISTANCE IS GRANTED BASED UPON THE PATIENT'S INABILITY TO PAY AND TO INDIVIDUALS WHO ARE UNINSURED, UNDERINSURED OR MEDICALLY INDIGENT. COMMUNITY 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 COMMUNITY CARE FINANCIAL ASSISTANCE IS 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 GUIDELINES. | ||
| PART I, LINE 6A: ST ELIZABETH'S IS PART OF AN AFFILIATED HEALTH CARE SYSTEM CALLED MINISTRY HEALTH CARE, INC. WHICH CONSISTS OF A NUMBER OF HEALTH CARE FACILITIES LOCATED THROUGHOUT CENTRAL AND NORTH CENTRAL WISCONSIN AND WESTERN MINNESOTA. THE CONSOLIDATED COMMUNITY BENEFITS REPORT IS AVAILABLE ON MINISTRY HEALTH CARE'S WEBSITE. | ||
| 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 EXLCUDED FROM A SHORTFALL CALCULATION IN ORDER TO GET A TRUE FISCAL YEAR SHORTFALL AMOUNT. | ||
| PART I, LINE 7G: THERE ARE NO SUBSDIZED COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC. | ||
| PART I, L7 COL(F): BAD DEBT EXPENSE THAT WAS SUBTRACTED FROM TOTAL EXPENSE TO OBTAIN THE % OF COMMUNITY BENEFIT TO TOTAL EXPENSE AMOUNTED TO $330,000. | ||
| 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. SAINT ELIZABETH'S HAS SPONSORED A NUMBER OF COMMUNITY-WIDE EDUCATIONAL OPPORTUNITIES, INLCUDING WOMEN'S WELLNESS, EDUCATIONAL LECTURES TO OUTSIDE ORGANIZATIONS, AND SENIOR WELLNESS BY SPONSORING A PROGRAM CALLED "FIT CITY SENIORS". CPR EDUCATION IS ALSO OFFERRED TO THE OVERALL COMMUNITY, AND SAINT ELIZABETH'S ALSO SPONSORS AN ALZHEIMER'S SUPPORT GROUP. | ||
| PART III, LINE 4: NO FOOTNOTE EXISTS IN THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES 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 CARE 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 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 PAYER. THE ORGANIZATION MUST ACCEPT THESE PATIENTS REGARDLESS OF WHETHER THEY MAKE A SURPLUS OR DEFICIT FROM PROVIDING SUCH SERVICES. IF THE MEDIARE 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: THE ORGANIZATION HAS A DEBT COLLECTION POLICY WHICH SETS FORTH COLLECTION PRACTICES FOR PATIENTS WHO ARE KNOWN TO QUALIFY OR MAY QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE CHARITY CARE PROGRAM. SUFFICIENT FINANCIAL COUNSELING SUPPORT IS 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 OFFICE SO NO ADDITIONAL TIME IS SPENT ON COLLECTION EFFORTS. | ||
| PART VI, LINE 8: AS PART OF MINISTRY HEALTH CARE, INC., THE ORGANIZATION FILES AN ANNUAL COMMUNITY BENEFIT REPORT ON ITS WEBPAGE. THE REPORT CAN BE VIEWED BY VISITING WWW.MINISTRYHEALTH.ORG/MINISTRY HEALTH/COMMUNITY.NEW. | ||
| PART I, LINE 3A AND 3B: LEVEL OF COMMUNITY CARE BASED ON INCOME, ASSETS, FAMILY SIZE. LIMIT IS 400% OF FPG. FOR THOSE UNDER 400% OF FPG, LIABILITY LIMITED TO 15% OF ANNUAL INCOME AND ASSETS. | ||
| PART VI, LINE 2: THE ORGANIZATION PERFORMS COMMUNITY NEEDS ASSESSMENTS AS NEEDED. PLANNING WORKGROUPS CONSISTING OF COMMUNITY PARTNERS ARE FORMED TO DEFINE THE COMMUNITY AND ITS NEEDS THROUGH REVIEW OF HEALTH PEOPLE INITIATIVES, CENSUS DOCUMENTS, AND LOCAL GOVERNMENT HEALTH AND WELFARE AGENCIES. CONSIDERING OTHER COMMUNITY RESOURCES/ASSETS, DATA COLLECTION METHODS ARE USED TO IDENTIFY PARTICULAR PROBLEMS OR SUBGROUPS AND AREAS KNOWN TO HAVE HIGH POVERTY RATES AND TO BE UNDERSERVED. THE DATA IS ANALYZED AND PRIORITIES ARE SET BASED ON TRENDING INFORMATION WHICH MAY TARGET A SPECIFIC NEED. WHEN A NEED IS IDENTIFIED, THE HOSPITAL DEVELOPS A PLAN TO IMPLEMENT A PROGRAM EITHER THROUGH COMMUNITY COLLABORATION OR INDIVIDUALLY. OUTCOMES FROM THE PROGRAMS ARE MEASURED AND CONSIDERED IN SUBSEQUENT COMMUNITY NEEDS ASSESSMENTS. COMMUNITY BENEFIT PLANS ARE PRESENTED TO SENIOR LEADERSHIP AND BOARD MEMBERS TO ENSURE THE FINDINGS ARE INCORPORATED INTO THE ORGANIZATION'S STRATEGY AND POLICY DEVELOPMENT. FOR EXAMPLE, SENIOR LEADERS ARE REQUIRED TO PROVIDE DIRECT SERVICE TO THE POOR HOURS AS PART OF THEIR PERFORMANCE GOALS. | ||
| PART VI, LINE 3: THE 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, SOCIAL SERVICES, 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). 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 ASISTANCE TO SEE IF THEY MAY QUALIFY UNDER ANY OTHER FEDERAL OR STATE PROGRAMS. | ||
| PART VI, LINE 4: SAINT ELIZABETH'S SERVES THE RESIDENTS OF ALL AGES IN WABASHA COUNTY, MINNESOTA AND BUFFALO AND PEPIN COUNTY IN WISCONSIN. 62% OF OUR PATIENTS RESIDE IN WABASHA COUNTY, WHICH IS OUR PRIMARY SERVICE AREA. COMMUNITIES SERVED WITHIN THIS SERVICE AREA INCLUDE: WABASHA, KELLOGG, PLAINVIEW, READS LANDING, MINNIESKA, AND THEILMANN. THE TOTAL POPULATION OF WABASHA COUNTY IS 21,731. WABASHA COUNTY'S POPULATION INCREASED 9.5% FROM 1990 TO 2000. OUR SECONDARY SERVICE AREA INCLUDES SURROUNDING COMMUNITIES IN MINNESOTA AND THE COMMUNITIES OF ALMA, NELSON, PEPIN, ARKANSAW, MAIDEN ROCK IN BUFFALO, PEPIN, AND PIERCE COUNTIES OF WESTERN WISCONSIN. 15% OF THE POPULATION IS 65 YEARS OF AGE AND OLDER; 4% LACK HEALTH INSURANCE; AND 10% LIVE AT OR BELOW THE POVERTY LEVEL. ALL PATIENTS ARE CARED FOR REGARDLESS OF GENDER, AGE, RELIGION, RACE OR FINANCIAL STATUS. 60% OF ACUTE CARE VOLUME IS FROM MEDICARE AND 7% IS MEDICAID. THE REMAINING 33% OF PAYER MIX IS DIVIDED AMONG MANAGED CARE, COMMERCIAL INSURANCE, SELF-PAY, AND CHARITY CARE. | ||
| PART VI, LINE 7: THE ORGANIZATION IS PART OF AN AFFILIATED HEALTH CARE SYSTEM CALL 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. DURING FY 2011, ST. ELIZABETH'S RECEIVED JUST OVER $179,000 TO HELP FUND VARIOUS CAPITAL EXPENDITURES THROUGHOUT THE YEAR. | ||
| MN | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| THOMAS CROWLEY | |||||||||||||
| 185422 | 0 | 0 | 0 | 48721 | 0 | 43520 | 0 | 12949 | 0 | 290612 | 0 | 0 | 0 |
| JOHN WOLFE | |||||||||||||
| 101283 | 0 | 0 | 0 | 20218 | 0 | 7373 | 0 | 21750 | 0 | 150624 | 0 | 0 | 0 |
| JONI LOMMEN | |||||||||||||
| 107474 | 0 | 0 | 0 | 22016 | 0 | 20180 | 0 | 13386 | 0 | 163056 | 0 | 0 | 0 |
| JOHN HUST | |||||||||||||
| 162525 | 0 | 0 | 0 | 6851 | 0 | 12236 | 0 | 551 | 0 | 182163 | 0 | 0 | 0 |
| DR JOHN PETERSON | |||||||||||||
| 135980 | 0 | 0 | 0 | 16500 | 0 | 10321 | 0 | 29 | 0 | 162830 | 0 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE 990 IS REVIEWED AT A REGULARLY SCHEDULED BOARD MEETING, PRIOR TO THE 990 BEING FILED WITH THE IRS. THE CFO PRESENTS TO THE BOARD, AND INCLUDES A GENERAL OVERVIEW OF THE 990, AS WELL AS SOME OF THE CHANGES NOW IMPLEMENTED AS PART OF THE REVISED 990 FORM. | |
| ANNUALLY, EACH BOARD MEMBER IS REQUIRED TO COMPLETE A "CONFLICT AND DUALITY OF INTEREST QUESTIONNAIRE" WHICH ASKS IF THEY, OR MEMBERS OF THEIR FAMILY, HAVE AFFILIATIONS OR INTERESTS THAT MIGHT POSSIBLY CONSTITUTE OR BE PERCEIVED TO CONSTITUTE A CONFLICT OR DUALITY OF INTEREST. WE HAVE NEVER HAD A MEMBER INDICATE SUCH A RELATIONSHIP. | FORM 990, PART VI, SECTION B, LINE 12C | |
| THE MINISTRY HEALTH CARE BOARD OF DIRECTORS HAS A COMPENSATION COMMITTEE THAT IS ASSISTED BY AN INDEPENDENT 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, SECTION B, LINE 15 | |
| THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. | FORM 990, PART VI, SECTION C, LINE 19 | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | NET UNREALIZED GAINS ON INVESTMENTS: 14,387. | FORM 990, PART XI, LINE 5: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MINISTRY HEALTH CARE | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 11925 WEST LAKE PARK DRIVE SUITE 10 | AddressLine1 |
| City | MILWAUKEE | City |
| State | WI | State |
| ZIP Code | 53224 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391490371 | EIN |
| Primary Activities | CORP OFFICE/PARENT CO OF ST ELIZABETH'S AND SEVERAL WI HEALTHCARE FACILITIES | PrimaryActivities |
| Legal Domicile State | WI | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | LINE 11-D,TYPE III-O | PublicCharityStatus |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Controlled Org | 0 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 1 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
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