FURP.ORG / PUBLIC DATA EXPLORER

ST VINCENT HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
ST VINCENT HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST (EIN 39-0817529)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-05-15
IRS object ID
201241369349302624
Schema version
2010v3.7
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)
Timestamp2012-05-15T09:47:21-05:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1191 West Nationwide Blvd Ste 500AddressLine1
CityColumbusCity
StateOHState
ZIP Code432152568ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN390817529EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1ST VINCENT HOSPITAL OF THE HOSPITALBusinessNameLine1
Business Name Line2SISTERS OF THE THIRD ORDER OF ST FRANCISBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlSTVINameControl
Phone9204330111Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1835 S VAN BURENAddressLine1
CityGREEN BAYCity
StateWIState
ZIP Code543013256ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameTherese PandlName
TitleCEOTitle
Phone9204338287Phone
Date Signed2012-05-14DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameKPMG LLPName
Phone6142492300Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonTherese PandlNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12710 Executive Drive PO Box 19AddressLine1
CityGreen BayCity
StateWIState
ZIP Code543078047ZIPCode
FieldValueIRS element (for citing)
Gross Receipts429320507GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web SiteWWW.STVINCENTHOSPITAL.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1888YearFormation
State Legal DomicileWIStateLegalDomicile
Activity Or Mission DescriptionST. VINCENT HOSPITAL'S MISSION IS TO CARRY OUT THE HEALING MINISTRY OF THE CATHOLIC CHURCH BY PROVIDING HIGH-QUALITY HOSPITAL SERVICES TO THE PEOPLE OF GREEN BAY, NORTHEAST WISCONSIN, AND NEARBY UPPER MICHIGAN.ActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees2202TotalNbrEmployees
Total Nbr Volunteers560TotalNbrVolunteers
Total Gross UBI1773716TotalGrossUBI
Net Unrelated Business Txbl Income-1903163NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1139684ContributionsGrantsPriorYear
Contributions Grants Current Year1676776ContributionsGrantsCurrentYear
Program Service Revenue Prior Year362959524ProgramServiceRevenuePriorYear
Program Service Revenue CY401928926ProgramServiceRevenueCY
Investment Income Prior Year6921744InvestmentIncomePriorYear
Investment Income Current Year19039973InvestmentIncomeCurrentYear
Other Revenue Prior Year5787981OtherRevenuePriorYear
Other Revenue Current Year1751777OtherRevenueCurrentYear
Total Revenue Prior Year376808933TotalRevenuePriorYear
Total Revenue Current Year424397452TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year114566473SalariesEtcPriorYear
Salaries Etc Current Year116869629SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year245846147OtherExpensePriorYear
Other Expenses Current Year280709692OtherExpensesCurrentYear
Total Expenses Prior Year360412620TotalExpensesPriorYear
Total Expenses Current Year397579321TotalExpensesCurrentYear
Revenues Less Expenses Prior Year16396313RevenuesLessExpensesPriorYear
Revenues Less Expenses CY26818131RevenuesLessExpensesCY
Total Assets BOY500145000TotalAssetsBOY
Total Assets EOY538097620TotalAssetsEOY
Total Liabilities BOY195438140TotalLiabilitiesBOY
Total Liabilities EOY169426556TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY304706860NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY368671064NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionST. VINCENT HOSPITAL'S MISSION IS TO CARRY OUT THE HEALING MINISTRY OF THE CATHOLIC CHURCH BY PROVIDING HIGH-QUALITY HOSPITAL SERVICES TO THE PEOPLE OF GREEN BAY, NORTHEAST WISCONSIN, AND NEARBY UPPER MICHIGAN.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense23115710Expense
Revenue44864921Revenue
DescriptionSurgical Services - See Schedule O "PROGRAM SERVICE ACCOMPLISHMENTS"Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense11524903Expense
Revenue37705232Revenue
DescriptionRadiology Services - See Schedule O "PROGRAM SERVICE ACCOMPLISHMENTS"Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense11718425Expense
Revenue20961929Revenue
DescriptionHeart and Vascular Center - See Schedule O "PROGRAM SERVICE ACCOMPLISHMENTS"Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense291758349Expense
Revenue298589305Revenue
DescriptionOTHER SERVICESDescription
FieldValueIRS element (for citing)
Total Of Other Program Service Exp291758349TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev298589305TotalOfOtherProgramServiceRev
Total Program Service Expense338117387TotalProgramServiceExpense
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 InvesttrueReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
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
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPtrueLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntitytrueDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096101NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees2202NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
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
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 VenturetrueInvestmentInJointVenture
Written Policy Or ProceduretrueWrittenPolicyOrProcedure
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonKELLY GIGOTNamePerson
Telephone Number9204338287TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1835 S VAN BURENAddressLine1
CityGREEN BAYCity
StateWIState
ZIP Code54301ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (24 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
SR MARYBETH CULNAN OSF
DIRECTOR1.0X000
SR BERNADINE GUTOWSKI OSF
DIRECTOR1.0X000
D J LONG
CHAIRPERSON1.0X000X
KEN JOHNSON MD
SECRETARY1.0X000X
JOHN HAGER
VICE CHAIR1.0X000X
ROLF LULLOFF MD
DIRECTOR1.0X000
JUDY NAGEL
DIRECTOR1.0X000
ROBERT BURNS
DIRECTOR1.0X000
THERESE PANDL
CEO20.0X0600501157219X
ROBERT ATWELL
Director1.0X000
DANIEL PLATKOWSKI
DIRECTOR1.0X000
ANN CARR
TREASURER0.10191336109541X
THOMAS R BAYER
COO40.0207735022947X
KELLY GIGOT
CFO40.0165017018241X
PAULA HAFEMAN
CNO40.017795800X
greg simia
division cfo20.0000X
KARL APPLETON
VICE PRESIDENT-FISCAL AFFAIRS40.0286007024050X
JOHN KLINKHAMMER
CRNA40.019701907680X
CURTIS WATSON
ANESTHESIA MANAGER40.0241525019635X
TAMARA LYDAY
DO40.025223107680X
TIFFANY SCHAVE
CRNA40.0209741014555X
Kristin A Powell
Physician40.0244129019635X
LARRY C MATHEWS
ASSISTANT ADMINISTRATOR40.017656603554X
ROBERT F BARTINGALE
ASSISTANT ADMINISTRATOR40.017817803884X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2336106TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs791837TotalReportableCompFrmRltdOrgs
Total Other Compensation408621TotalOtherCompensation
Number Individuals GT100 K55NumberIndividualsGT100K
Formers ListedtrueFormersListed
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
BAYCARE CLINIC LLP
164 S BROADWAYGREEN BAYWI54303NEUROSURGICAL SERV.1095000
EPIC
1979 MILKY WAYVERONAWI53593MAINTENANCE1107732
JANNX MEDICAL SYSTEMS
12166 OLD BIG BEND BLVD 300ST LOUISMO63122MAINTENANCE803225
KEY EQUIPMENT FINANCE INC
1000 S McCASLIN BLVDSUPERIORCO80027MAINTENANCE773947
VARIAN MEDICAL SYSTEMS
200 E HOWARD SUITE 202DES PLAINESIL60018MAINTENANCE755506
FieldValueIRS element (for citing)
Number Of Contractors GT100 K47NumberOfContractorsGT100K
Related Organizations902765RelatedOrganizations
Government Grants743231GovernmentGrants
All Other Contributions30780AllOtherContributions
Total Contributions1676776TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
PATIENT SERVICE REVENUE900099394177459394177459
OTHER OPERATING REVENUE90009961257526125752
REFERENCE LAB62150016257151625715
FieldValueIRS element (for citing)
Total Program Service Revenue401928926TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column19119418TotalRevenueColumn
Related Or Exempt Function Income192461RelatedOrExemptFunctionIncome
Exclusion$18,926,957ExclusionAmount

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)
Real578124Real
Personal1572Personal

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real252059Real
Personal2620Personal

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real326065Real
Personal-1048Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column325017TotalRevenueColumn
Unrelated Business Revenue-1048UnrelatedBusinessRevenue
Exclusion$326,065ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other4588931Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other4668376Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-79445Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-79445TotalRevenueColumn
Exclusion-$79,445ExclusionAmount

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 ColumnTotalRevenueColumnUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
PRINT SHOP323100357172140638$216,534
CATERING722320616848411$53,273
OTHER REVENUE9000991007904$1,007,904
FieldValueIRS element (for citing)
Total Other Revenue1426760TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column424397452TotalRevenueColumn
Related Or Exempt Function Income400495672RelatedOrExemptFunctionIncome
Unrelated Business Revenue1773716UnrelatedBusinessRevenue
Exclusion$20,451,288ExclusionAmount

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)
Total1455566Total
Management And General1455566ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total83832793Total
Program Services71037800ProgramServices
Management And General12794993ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total7675922Total
Program Services6393377ProgramServices
Management And General1282545ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total16846164Total
Program Services14031392ProgramServices
Management And General2814772ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total7059184Total
Program Services5879688ProgramServices
Management And General1179496ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total1139576Total
Program Services35882ProgramServices
Management And General1103694ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

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)
Total150725992Total
Program Services131342838ProgramServices
Management And General19383154ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total2194065Total
Program Services1515353ProgramServices
Management And General678712ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total3868045Total
Program Services1261588ProgramServices
Management And General2606457ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total1470005Total
Program Services942207ProgramServices
Management And General527798ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total12881837Total
Program Services10701609ProgramServices
Management And General2180228ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total266547Total
Program Services183132ProgramServices
Management And General83415ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total1745592Total
Program Services409009ProgramServices
Management And General1336583ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total694975Total
Management And General694975ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total15853354Total
Program Services11748493ProgramServices
Management And General4104861ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1583562Total
Program Services1034090ProgramServices
Management And General549472ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
SUPPLIES5770636356959486746877
EQUIPMENT RENTAL & MAINT.1272997912729979
BAD DEBT1049228810492288
MISCELLANEOUS733886514188335920032
DUES AND SUBSCRIPTIONS1864734318304

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total397579321Total
Program Services338117387ProgramServices
Management And General59461934ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY12129662BOY
EOY5271083EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY8848762BOY
EOY16484092EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY70679108BOY
EOY74959528EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY250000BOY
EOY254125EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY486409BOY
EOY475838EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY4880644BOY
EOY4963404EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY3119597BOY
EOY3011624EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis288250021LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec174183656LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY111905201BOY
EOY114066365EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY255649910BOY
EOY281372865EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY30168720BOY
EOY35876833EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY2026987BOY
EOY1361863EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY500145000BOY
EOY538097620EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY42290187BOY
EOY43600181EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY850226BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY80770596BOY
EOY79106064EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY71527131BOY
EOY46720311EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY195438140BOY
EOY169426556EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY299487667BOY
EOY362358779EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2592573BOY
EOY3548408EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2626620BOY
EOY2763877EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY304706860BOY
EOY368671064EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY500145000BOY
EOY538097620EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses26818131ReconcilationRevenueExpenses
Reconcilation Other Changes37146073ReconcilationOtherChanges
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)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$18,647OtherActivitiesAmount
Total Lobbying Expenditures IIB18647TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3
Form4720 Filed4912 TaxfalseForm4720Filed4912Tax

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF OTHER LOBBYING ACTIVITIESIdentifier
Return ReferenceSCHEDULE C, PART II B, QUESTION 11ReturnReference
ExplanationST. vincent HOSPITAL ("THE HOSPITAL") IS A MEMBER OF THE CATHOLIC HEALTH ASSOCIATION ("CHA"), THE WISCONSIN HEALTH ASSOCIATION ("WHA"), THE NATIONAL ASSOCIATION FOR HOME CARE AND HOSPICE, AND THE AMERICAN HEALTH ASSOCIATION ("AHA"). AS A MEMBER OF THESE ORGANIZATIONS, THE HOSPITAL PAYS DUES, With PART OF THESE DUES being ATTRIBUTABLE TO LOBBYING FEES PAID BY THE ORGANIZATIONS. THE AMOUNT LISTED ABOVE IS THE AMOUNT ATTRIBUTABLE TO THE HOSPITAL FROM ITS DUES PAID.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis9573500OtherCostOrOtherBasis
Book Value9573500BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis64396674OtherCostOrOtherBasis
Depreciation29762867Depreciation
Book Value34633807BookValue
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis207837285OtherCostOrOtherBasis
Depreciation144420789Depreciation
Book Value63416496BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis6442562OtherCostOrOtherBasis
Book Value6442562BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings114066365TotalOfBookValueLandBuildings

Investments Program Related InvestmentsProgramRelated (8 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
INV - PREVEA PREF.18428213C
INVESTMENT - UNITY5194876C
INV - COMM MEMORIAL3408968C
INV - HOLY FAMILY2861746C
INVESTMENT - WUPOMS2386449C
INV - PREVEA - COMMON1937557C
INV - PAIN CENTER WI1232363C
ONCOLOGY JOINT VENTURE426661C
FieldValueIRS element (for citing)
Total Of Book Value Program Related35876833TotalOfBookValueProgramRelated
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
ACCRUED BENEFIT LIABILITY$45,524,682
RETIREMENT OBLIGATION - ASBEST$629,784
WORKERS COMPENSATION$565,845
FieldValueIRS element (for citing)
Total Of Amounts46720311TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierASC SUBTOPIC 740-10Identifier
ExplanationON JULY 1, 2007, HSHS ADOPTED ASC SUBTOPIC 740-10, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES - AN INTERPRETATION OF FASB STATEMENT NO.109. ASC SUBTOPIC 740-10 ADDRESSES THE DETERMINATION OF HOW TAX BENEFITS CLAIMED OR EXPECTED TO BE CLAIMED ON A TAX RETURN SHOULD BE RECORDED IN THE CONSOLIDATED FINANCIAL STATEMENTS. UNDER ASC SUBTOPIC 740-10, HSHS MUST RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFITS RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. ASC SUBTOPIC 740-10 ALSO PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES ON INCOME TAXES, ACCOUNTING IN INTERIM PERIODS, AND REQUIRES INCREASED DISCLOSURES. AT THE DATE OF ADOPTION, AND AS OF JUNE 30, 2011 AND 2010, HSHS DOES NOT HAVE A LIABILITY FOR UNRECOGNIZED TAX BENEFITS.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage225.FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent300XPcent300
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)
Persons Served631PersonsServed
Total Community Benefit Expense5653264TotalCommunityBenefitExpense
Net Community Benefit Expense5356264NetCommunityBenefitExpense
Percent Of Total Expense0.01380PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense23241240TotalCommunityBenefitExpense
Net Community Benefit Expense23241240NetCommunityBenefitExpense
Percent Of Total Expense0.06000PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Number Of Activities Or Programs27NumberOfActivitiesOrPrograms
Persons Served264PersonsServed
Total Community Benefit Expense3353785TotalCommunityBenefitExpense
Direct Offsetting Revenue1997242DirectOffsettingRevenue
Net Community Benefit Expense1356543NetCommunityBenefitExpense
Percent Of Total Expense0.00350PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Number Of Activities Or Programs27NumberOfActivitiesOrPrograms
Persons Served895PersonsServed
Total Community Benefit Expense32248289TotalCommunityBenefitExpense
Direct Offsetting Revenue1997242DirectOffsettingRevenue
Net Community Benefit Expense29954047NetCommunityBenefitExpense
Percent Of Total Expense0.07730PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Persons Served21236PersonsServed
Total Community Benefit Expense2045723TotalCommunityBenefitExpense
Direct Offsetting Revenue234419DirectOffsettingRevenue
Net Community Benefit Expense1811304NetCommunityBenefitExpense
Percent Of Total Expense0.00470PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Persons Served750PersonsServed
Total Community Benefit Expense646181TotalCommunityBenefitExpense
Net Community Benefit Expense646181NetCommunityBenefitExpense
Percent Of Total Expense0.00170PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Persons Served32410PersonsServed
Total Community Benefit Expense87592TotalCommunityBenefitExpense
Net Community Benefit Expense87592NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Persons Served54396PersonsServed
Total Community Benefit Expense2779496TotalCommunityBenefitExpense
Direct Offsetting Revenue234419DirectOffsettingRevenue
Net Community Benefit Expense2545077NetCommunityBenefitExpense
Percent Of Total Expense0.00660PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs27NumberOfActivitiesOrPrograms
Persons Served55291PersonsServed
Total Community Benefit Expense35027785TotalCommunityBenefitExpense
Direct Offsetting Revenue2231661DirectOffsettingRevenue
Net Community Benefit Expense32499124NetCommunityBenefitExpense
Percent Of Total Expense0.08390PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Total Community Building Expense6364TotalCommunityBuildingExpense
Net Community Building Expense6364NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense6364TotalCommunityBuildingExpense
Net Community Building Expense6364NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$4,456,797BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare114275369AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare165602951CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-51327582MedicareSurplusOrShortfall

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 (10 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivityOrganization Profit Or OwnershipOrganizationProfitOrOwnershipPhysicans Profit Or OwnershipPhysicansProfitOrOwnership
Unity Ltd Ptnrshp
Healthcare0.45000
NE Wisc Radiation
Healthcare0.250000.50000
Therapy Serv LLC
Pain Ctr of WI LLC
Healthcare0.500000.50000
WI UPPER PENINSULA
Healthcare0.50000
ONCOLOGY MANAGEMENT
SERVICES INC
PREVEA HLTH SERV INC
Healthcare0.250000.50000
COMMUNITY MEMORIAL
HOSPITAL - HEALTHCARE0.16800
HOLY FAMILY ONCOLOGY
HEALTHCARE0.50000
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1ST VINCENT HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1835 S VAN BURENAddressLine1
CityGREEN BAYCity
StateWIState
ZIP Code54301ZIPCode
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 VINCENT HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
Part I, Line 3cNot applicable as the organization does follow FPG to determine eligibility for providing charity and discounted care to low-income uninsured and underinsured individuals.
Part I, Line 6aSt. Vincent's community benefit report is available upon request at www.stvincenthospital.org.
Part I, Line 7kThe percent of charity care and certain other benefits at cost as a percent of total expenses less bad debt is 8.39%. The amount of bad debt expense removed when calculating the percentages in Part I, line 7, column f was $ 10,492,288.
Part I, Line 7, column (F)The hospital does not have sufficient information at this time to determine if subsidized services exist based on the definition and calculations required by the IRS, and will continue to work and provide such information in next year's return.
Part I, Line 7Charity care is calculated by determining the total amount from patient billing that is written off to charity care charge codes or allowances. This amount matches the number that is reported on our fiscal year ending 2011 audited financial statements. The total charity care dollar amount is then reduced to cost by applying the hospital's cost to charge ratio as calculated on IRS schedule H - worksheet 2.
Part IIOur hospital has a long standing commitment to being environmentally sensitive, as part of our Franciscan heritage. There are many examples of how this is demonstrated, one of which is our participation in the Brown County Sharps programs. The hospital serves as a drop-off site for sharps, such as needles used to inject insulin. Community members drop these items at the hospital, which then pays to have them disposed of properly. We actively contribute to the Hospital Sisters Mission Outreach program, whereby surplus or otherwise unused hospital supplies are collected and distributed to missions in the US and many other countries. In addition, we participate in the Wisconsin Hospital Emergency Preparedness Plan ("WHEPP"). The purpose of the WHEPP is to develop processes to help participating institutions in Wisconsin meet community needs in a collaborative and organized manner during an incident emergency. The State of Wisconsin recognized that a mass casualty incident due to a biological, chemical, radiological, or natural disaster can easily overwhelm or damage the ability of local healthcare resources to meet community needs. Accordingly, WHEPP, a mutual aid plan, was developed to address this concern. We have actively participated in the organization and development of this group and led efforts in our region. As leaders in this group, we have helped to initiate the preparedness efforts by WHEPP that assist hospitals in our state to maintain the minimum levels of readiness that are expected by the federal and state governments. Another significant portion of the community building dollars is dedicated to workforce assistance and growth through support of the Green Bay Area Chamber of Commerce Youth Apprenticeship Program (on-the-job training) and Partners in Education, a local program which recognizes exceptional teachers and provides students with a variety of career exploration and experience programs. We support those who are related to the acute health care industry by maintaining regular communication and updating on trends and issues in the industry and fostering collaborative relationships. This is done through regular luncheon meetings with nursing home administrators and clergy, as well as through health care career talks to local students. St. Vincent Hospital has been a leader in cancer care for over 50 years. As part of this leadership, we have actively supported the efforts of the American Cancer Society ("ACS") projects to eliminate cancer, save lives, and diminish suffering. A portion of the community building dollars are dedicated to supporting various ACS efforts.
Part III, Line 4The hospital strongly believes that its charity care, and the related community benefit obtained from such care, is understated because of those patients that potentially qualify for charity care but do not wish to apply for it. In addition, some care is not classified as charity due to missing documentation on patient resources. Thus, the hospital's bad debt may include a portion that could be classified as charity care if application for such care was sought and/or completed. Currently, the hospital is implementing processes, procedures, and systems to more effectively determine charity care that will reduce a patient's documentation requirements and ease the patient's emotional burden in applying for charity care. This will provide a more accurate reporting of charity care services provided by the hospital. The hospital computes the cost of bad debt by applying the ratio of patient care cost to charges to the total charges written off as bad debt expense. The patient care cost is determined by reducing the total annual operating expense by the bad debt expenses, Medicaid provider taxes, and community benefit expense. The adjusted operating cost is then divided by the total gross patient charges to calculate the ratio of patient care cost to charges.
Part III, Line 8The hospital continually strives to provide excellent patient care in the most cost effective fashion. Nonetheless, the Medicare program, in many cases, does not provide payment that covers the full cost of the care provided. Since it is the mission of the hospital to respond to community need, hospital management continually advocates for improved Medicare payment so that the cost of quality care to those patients that are not able to afford it is not compromised and is fairly subsidized by all payers. While this shortfall in Medicare payments is not classified as community benefit by the IRS, we nonetheless believe it is an important contribution made by the hospital to the health and well-being of the community. Our mission calls us to serve all patients with the highest possible quality and efficiency, even if we are not paid fully for doing so. The hospital computes the unpaid costs of providing care to Medicare patients by comparing the cost of the services to the reimbursement received from Medicare during the year. The cost of Medicare services is calculated by applying the ratio of patient care cost to charges to the annual Medicare charges. The patient care cost is determined by reducing the total annual operating expense by bad debt expenses, Medicaid provider taxes, and community benefit expense. The difference between the reimbursement received and the calculated cost of the services is reported as the Medicare shortfall.
Part III, Line 9bApplications or requests for community care will be accepted from any patient without discrimination against race, ethnicity, sex, color, religion, origin or ancestry, age, marital status, disabilities or ability to pay. Every effort will be made by the hospital to assist patients in utilizing government & third party insurance plans or financial aid programs prior to providing community care. Patients will be required to apply for plans or programs for which they may be eligible. If the patient and or responsible party has collaborated with the hospital in seeking reimbursement from appropriate government & third party plans or charitable programs & agencies, relief from financial obligation is granted based on community care eligibility criteria.
Needs AssessmentWe employ a number of methods to assess health care needs: 1) we have a community advisory committee broadly representative of the community. This committee meets regularly to discuss hospital services and advise us on how well we are meeting community needs. As terms expire, committee members assist in identifying new members who can continue to assist us in this way. We make an effort to include members from the neighboring communities we serve, as well as some potentially underserved groups-such as Hmong or Native American leaders. 2) Hospital leadership meets with each committee member individually to learn more about their opinions about community needs. 3) We examine the reasons that self-pay and Medical Assistance patients come to our emergency department for care. 4) Hospital leadership serve on local social service agency boards, such as the N.E.W. Community Clinic (a "free clinic"), and meet with representatives of the Catholic Diocese to discuss community needs. 5) Our Hispanic Health Educator/Cultural Liaisons assist us in identifying needs of special subgroups of patients. During FY2011, St. Vincent leadership assisted with, and participated in, the Brown County Health Department's Community Health Improvement Process, a community needs assessment that reviews how Brown County compares to the rest of the state on indicators contained in "Healthy Wisconsin 2020". A group widely representative of the community has been convened to review the data and determine the high priority issues for Brown County. St. Vincent will examine the results of this study to determine how to best address the high priority needs.
Patient Education of Eligibility for AssistanceOur hospital posts our charity care ("community care") policy and application on our website. In addition, charity care applications are available and prominently displayed in our registration areas. Our financial counselors are available to meet with patients on site before or at the time of service to assist them in identifying whether they are eligible for government aid or financial assistance, and to assist them in applying for programs for which they may be eligible. After patients receive service, our customer service representatives are also trained to assist them to apply for various government programs or for our charity care program. Our collectors are trained to provide this assistance as well. Last but not least, we have contracted with an outside firm to do active outreach with patients who may need additional assistance or advocacy to apply for benefits, appeal denials, or who need transportation to government agencies to apply for benefits.
Community InformationSt. Vincent Hospital is located in Brown County, Wisconsin, an urban county with a population of about 250,000 people. While most patients come from Brown County, we also are a regional referral center, drawing patients from the neighboring rural communities and as far away as the upper peninsula of Michigan. Brown County's population is primarily Caucasian, but there is a notable Native American population, as well as a growing Asian and Hispanic population. Over 50 languages are spoken in Brown County, and we provide interpretation services for all.
Promotion of Community HealthOur hospitals have an open medical staff and boards comprised of community members. Funds over and above what is needed for operations are reinvested in the facility and program services, using generally accepted accounting principles and market assessment to ensure that the funds are being used wisely. Our hospitals were founded over 100 years ago by a group of Catholic sisters whose purpose was to extend Christ's healing love throughout our area. Because of that, we comply with the Ethical and Religious Directives for Health Care issued by the US Council of Catholic Bishops. We actively offer a variety of no-charge community and health education programs locally to assist community members in learning more about their health condition or possible health issues. St. Vincent Hospital devotes significant resources to access for patients who cannot afford care, along with other community benefits. In fiscal year 2011, St. Vincent provided over $32 million in community benefit services, including charity care at cost, unpaid costs of Medicaid and other public programs, and a range of diverse programs designed to enhance access and improve community health. Additionally, during this period, St. Vincent provided over $51 million (at cost) in excess of Medicare payment for health care services. An example of our community benefit initiatives is the support we also provide to patients of the NEW Community Clinic. St. Vincent covers the cost of a school nurse employed by the N.E.W. Community Clinic to serve high risk children. We also supply the clinic with free and discounted laboratory and radiology services. More than 70% of patients say the clinic's care prevented a trip to the Emergency Department. St. Vincent Hospital has developed the Sexual Assault Nurse Examiner program to provide care and assistance for anyone who has been sexually assaulted. A dozen nurses comprise the Sexual Assault Nurse Examiner ("SANE") Program at St. Vincent Hospital, all doing a job that not one of them enjoys but one each is committed to providing to the community. SANE operates in a specially designed room in the Emergency Center, one that is available around the clock to the victims of sexual assault, male or female, infant to elderly. The SANE staff greets them all with gentle words and compassionate medical care. The program, which began in 1992, is the regional site for such care, one where all the hospitals in Green Bay and the surrounding communities send sexual assault victims because only our SANE nurses have been properly trained to conduct the detailed medical examination, collect evidence, repair injury, and later provide courtroom testimony that will be a key factor in getting convictions of the perpetrators of these crimes. Special tools, such as a picture book, have been developed to assist with examination and evidence gathering with some of our most tender victims - children. SANE reaches approximately 200 people each year at a most vulnerable and devastating time of their lives and truly demonstrates the compassion and mission that is St. Vincent Hospital. SANE works closely with the police force and investigators in the area. In Fiscal Year 2011, St. Vincent spent over $682,000 in services by providing onsite training and education of nursing and allied health professionals within its facilities. We also provided training/education programs at schools such as the University of Wisconsin-Green Bay, Bellin College of Nursing, Northeast Wisconsin Technical College, and others around the state. St. Vincent Hospital provided $490,875 in family support services. Professionals at the hospital assisted in excess of 8,176 people to apply for the appropriate assistance, such as social security or Medical Assistance when they came to the hospital in a time of medical need. The cost included the salary of a cancer care coordinator as well as guidance, referrals, and aid in enrolling in public assistance and Hrs Erase, a debt reduction program. When patients can't get to St. Vincent Hospital, or get to their doctor appointments from the hospital, St. Vincent finds a way to help. In the past year, we paid for nearly $33,000 in uncompensated ambulance and other vehicle rides for patients, either to or from the hospital or to help them get to their doctor appointments elsewhere. The following is a listing of some of the other services St. Vincent Hospital provided in FY 11. * Donated food and cash to a local food pantry; * Donated the overhead costs related to operating a Back to School Store. Employees bring in school supplies and clothing for children that cannot afford these items. The items are donated to area schools for distribution to the children in need; * Donated cash, used equipment, furnishings, and printing services to local churches, organizations, and schools (for example, donated items to Habitat for Humanity's ReStore); * Provided educational classes including Lamaze, Teen Lamaze, cesarean birth, breast feeding, infant bath, diabetes education, cardiac rehabilitation, and women's health matters; * Provided support programs including cancer survivor, grief care, taking time, "I Can Cope", Alzheimer, Acoustic Neuroma, and brain tumor; * Sponsored employee blood drives for the Red Cross; * Eagle III - Provides transportation for critically ill and injured patients. We provided over 4 FTE's and served over 150 patients; and provided over $132,000 in financial assistance to Eagle III for patients they served who were unable to pay their bill; * EnCare program - Emergency room nurses go to area schools and organizations to give presentations and provide training on the dangers of drinking and driving; * The "Every 15 Minutes" program is a more in-depth program against drinking and driving provided to teens around homecoming and prom times; * Provided Pastoral Care and/Social Services to assist patient and family needs; * Provided employees as speakers at health fairs, schools, technical colleges, and a wide variety of organizations as well as providing logo items for prizes for the various functions; * Provided training to county health nurses, local paramedics, and home health agencies; * Provided free blood pressure checks at health fairs; * Operated a Prenatal Care Center for the broad community at a subsidized cost; * Eye enucleation, donor eye transplant center; * A variety of student intern programs set up with local colleges and universities. We also have a residency program; * Have numerous employees that sit on local health organization boards. They donate their time and expertise during and after business hours; * Provided free translator service to those patients that do not speak English; * Provided training to regional staff in how to prepare patients for transport and other topics. * Provided free parking to family members of intensive care patients. * Provided laundry service for the local Altrusa House free of charge. * St. Vincent Hospital along with St. Mary's Hospital and Bellin Health, supports Unity Hospice, a provider of appropriate care for the terminally ill. * St. Vincent, along with St. Mary's Hospital, held a community medical equipment drive to collect home medical equipment for the Hospital Sisters Mission Outreach program.
Affiliated Health Care SystemSt. Vincent Hospital is an affiliate of Hospital Sisters Health System. The mission of Hospital Sisters Health System ("HSHS") is to serve those in need through a health care ministry that values compassion, respect and reverence for life. The nearly 14,000 colleagues who make up HSHS are dedicated to this mission and to providing high quality health care to whoever seeks our services. By living our mission each day, HSHS colleagues constantly strive to provide the highest quality and most cost-effective and compassionate health care to those we are privileged to serve. Our health care ministry extends across 12 communities in Wisconsin and Illinois and includes 13 hospitals, dozens of community-based health centers and clinics, and more than 2,000 physician partners. As part of our mission to provide healing and hope to the three million people we serve, we have developed Community Benefit initiatives that 1) expand access to health care, 2) enhance overall health status and 3) promote medical education. In the Fiscal Year that ended June 30, 2011, HSHS hospitals provided $166.1 million in Community Benefits (or 8.7% of total expenses), an increase of $15.7 million from FY 2010. Of this amount, $37.1 million was provided for charity care and $99.8 million was the amount of unreimbursed care provided under the Medicaid program. In addition, HSHS hospitals committed significant resources in serving the Medicare population. The cost of providing services to primarily elderly beneficiaries of the Medicare program, in excess of governmental and managed care contract payments, was $183.8 million during Fiscal Year 2011. HSHS hospitals also recorded $103.9 million in uncollectible accounts. HSHS strengthens the health of our communities by continually reinvesting any surplus revenue from operations and investments into new medical technology, facility infrastructure and health care services. These investments ensure that our hospitals can continue to provide high quality, compassionate care to our patients. During Fiscal Year 2011, HSHS also continued to invest in our Care Integration strategy that places the patient at the center of our work while allowing us to deliver care in a more cost-effective and efficient manner. These investments are designed to better coordinate care, improve health outcomes, create new efficiencies, and help ensure that patients (especially those with chronic conditions) get well and stay well. Our Care Integration strategy is delivering promising results. An example is our three Medical Home pilot projects. Diabetic Patients enrolled in Medical Homes in rural Illinois experienced an average 42 percent decrease in their blood glucose levels while their unplanned readmissions to the hospital dropped to zero. HSHS is making significant progress implementing interoperable health information technologies and robust health information exchanges. In central Illinois, HSHS is joining with other health care providers to develop a statewide Health Information Exchange ("HIE") that will allow health care providers to exchange clinical information, such as medication histories and test results, access that information at the point of care and make better informed decisions with their patients. HSHS understands that our investments in information technology will have a positive impact on the quality, safety and efficiency of health care. 1. Expanding access to health care An integral component of our Community Benefit initiatives is to provide care to every patient who seeks our services without exception. To that end, HSHS hospitals have established Charity Care program guidelines that cover 100% of hospital charges for individuals and families who earn 125% to 250% of the federal poverty level. HSHS hospital's Charity Care guidelines have sliding scales, in some instances providing up to a 50% discount on charges for those earning up to 600% of the federal poverty level. HSHS hospitals have created simple forms for those wishing to apply for Charity Care and assign counselors to visit with inpatients who are uninsured to let them know about our charity care policies and provide assistance filling out applications for financial assistance or enrollment in publicly funded health care programs. HSHS hospitals also work collaboratively with others to enhance access to health care services for those in need. St. John's Hospital in Springfield, IL has partnered with Memorial Medical Center, Southern Illinois University School and Medicine and other community partners to support the Coordinated Access to Community Health ("CATCH") initiative. The free program is being made available to uninsured adults in Sangamon County to help them access routine medical care, specialty doctors and affordable medicine. Launched in May 2011, CATCH enrolls patients as they visit social service agencies or when they leave hospital emergency rooms. Enrollees are then referred to Springfield's federally funded primary care clinic, Capitol Community Health Center, or participating doctors' private offices. Grants from St. John's Hospital, Memorial Medical Center, United Way of Central Illinois and the Dominican Sisters offset CATCH's first year of expenses. Patient advocates at St. John's Hospital and Memorial Medical Center help uninsured patients find primary or specialty doctors and make appointments, and arrange for financial assistance from participating social service agencies for prescription drugs. In the first three months since the program was launched, CATCH signed up more than 250 physicians in the community who agreed to see patients at no charge. The program endeavors to enroll up to 6,000 uninsured patients within the next few years. By making it easier for uninsured residents to get preventive health care services, CATCH organizers believe uninsured patients' medical problems will be addressed early, helping improve their quality of life. St. Mary's Hospital Medical Center in Green Bay, WI supports the NEW Community Clinic, a 38-year-old free health center for the uninsured and underinsured. St. Mary's provides free and discounted laboratory and radiology services to the clinic. More than 70 percent of patients say the clinic's care allowed them to avoid having to seek care in a local Emergency Room. For the past decade, St. Anthony's Memorial Hospital in Effingham, IL has teamed up with Effingham Catholic Charities to co-sponsor the Prescription Assistance Program. Catholic Charities' staff members work with clients who need prescription medication but may not be able to afford them because they are uninsured or underinsured. Due to the financial support of St. Anthony's, the program is able to provide needed prescriptions to dozens of residents each month. St. Francis Hospital in Litchfield, IL collaborated with local dental care providers to coordinate and provide a free day of dental care to uninsured individuals. The collaboration was the result of a community needs assessment that determined access to dental care was a priority in the community. The "Community Day of Dental Care" provided free dental cleanings, X-Rays, and extractions to 90 uninsured individuals. Among those 90 people served included a military veteran who has been unable to obtain dental care after a St. Louis facility closed. He was able to have five teeth extracted. Another person served was a young woman who needed some minor restorative care which greatly improved her appearance. She was very grateful because she had a job interview coming up and would be able to attend the interview feeling better about her appearance. 2. Enhancing the health status of the community Another component of our Community Benefit initiatives is to improve the quality of life in our communities. Our hospitals work closely with a wide array of public and private organizations that share our commitment to enhancing health and wellness. We know that by working together, we can maximize our efforts by sharing resources, reduce duplication of services, and make it easier for residents to get the services and knowledge they need to live healthier lives. HSHS hospitals also understand they need to listen closely to the residents of the communities they serve to ensure the health care needs of all are being met. Sacred Heart Hospital in Eau Claire, WI invited more than 1,400 area residents to share their vision for health care during a series of focus groups. Participants included constituents that are often overlooked: low-income, vulnerable populations and minority groups. The visioning sessions captured the voices of special populations, Among Mutual Assistance Association members, Amish farmers, seniors, young children and other diverse groups. The feedback provided led to more than 100 actionable items that were assessed and/or implemented over the first six months since the sessions concluded. One action taken by Sacred Heart Hospital and St. Joseph's Hospital in Chippewa F
STATE FILING OF COMMUNITY BENEFIT REPORTWI,990 SCHEDULE H, PART VI

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
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

Form990 Schedule J Part II Form990ScheduleJPartII (13 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
THERESE PANDL
05447990354000203020132192029068076176100
ANN CARR
0152228011100028008092165018090030159100
THOMAS R BAYER
2026350510000000237670231502000
KELLY GIGOT
160717041000200000189300183947000
PAULA HAFEMAN
17795800000007370178695000
JOHN KLINKHAMMER
197019000000083730205392000
CURTIS WATSON
2415250000000204060261931000
TAMARA LYDAY
252231000000085000260731000
TIFFANY SCHAVE
2019740007767000152470224988000
Kristin A Powell
243779000350000204550264584000
KARL APPLETON
264207086000132000130000118700310877000
LARRY C MATHEWS
1539790002258700035540180120000
ROBERT F BARTINGALE
869510009122700042190182397000

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SEVERANCE PAYPART 1 LINE 4aRobert Bartingale received severance pay in the amount of $127,889 as part of his total compensation for the year.
Social Duesschedule j, part i, line 1aTherese Pandl received a benefit of $4,330 for social dues paid on her behalf. This was included in her annual reportable compensation disclosed on the Form 990, Part VII, and Schedule J, Part II.
greg simiaGREG SIMIA, DIVISION CFO, BEGAN HIS EMPLOYMENT DURING CALENDAR YEAR 2011. ACCORDINGLY, HE WOULD HAVE NO CALENDAR YEAR 2010 COMPENSATION FOR PURPOSES OF REPORTING ON FORM 990, PART VII, OR SCHEDULE J, PART II.

Schedule L IRS990ScheduleL

Loan Table LoanTable (2 entries)

Purpose Of LoanPurposeOfLoanLoan From OrganizationLoanFromOrganizationOriginal PrincipalOriginalPrincipalAmountBalance DueBalanceDueDefaultDefaultApproved By BoardApprovedByBoardWritten AgreementWrittenAgreement
THERESE PANDL
Mortgage extensionX$250,000250000falsetruetrue
THERESE PANDL
Stock purchaseX$4,1254125falsetruetrue
FieldValueIRS element (for citing)
Total Balance Due254125TotalBalanceDue

Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
WI UPPER PENINSULA ONCOLOGY
OFFICER1366126LEASED FACILITIESfalse
MANAGEMENT SERVICES INC
PREVEA Clinics
Officer1208714LEASED FACILITiES/EQUIPfalse

Form990 Schedule L Part V Form990ScheduleLPartV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Loans to/from interested personsSchedule L, Part IIAll transactions with interested persons are compliant with the organization's conflict of interest policy. any transactions requiring board approval are reviewed by an independent board prior to occurring.
business transactions with interested personsschedule l, part ivAll transactions with interested persons are compliant with the organization's conflict of interest policy. any transactions requiring board approval are reviewed by an independent board prior to occurring.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (13 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
PROGRAM SERVICE ACCOMPLISHMENTSFORM 990 PART III, LINE 4aHEART & VASCULAR CENTER St. Vincent Heart and Vascular Center: The Cath Lab offers a complete array of catheterization laboratory procedures and noninvasive cardiovascular diagnostic procedures doing 1,676 cardiac catheterizations in FY2011. Just steps away, the state-of-the-art Cardiovascular operating center ("CVOR") is available for cutting-edge open heart procedures by our highly-skilled cardiothoracic surgeons where 265 open heart surgeries were performed this year. In the same complex, CVICU suites are outfitted with up-to-the-minute monitoring devices that allow staff and physicians to keep careful watch over their patients while delivering hands-on care immediately after procedures. For those patients who need follow-up, a Cardio-Pulmonary Rehabilitation Program is offered. RADIOLOGY St. Vincent Hospital Imaging Services: The Imaging services department at St. Vincent Hospital provides Inpatient, Outpatient, Emergency, and Trauma care. Overall, the department performs more than 100,000 exams and procedures annually. Patients have access to the latest technology in Mammograms, Computed Tomography, MRI, Nuclear Medicine, and Ultrasound. Four Interventional Radiologists provide minimally invasive procedures using image guidance. And through the department's fixed site PET/CT, patients have greater access to this tool which provides unique images for early diagnoses. The staff consists of Board Certified radiologists as well as licensed and certified technologists, nurses, and sonographers. The modalities utilize state-of-the-art equipment to afford the radiologists optimal images for interpretation. The department and hospital are accredited by the Joint Commission. SURGERY St. Vincent Hospital Surgical Services Surgical Services is comprised of Pre-Operative Services (Preadmission Testing/AM Admit/Short Stay), 16 functional OR Suites, and 2 Open Heart OR Suites, Central Processing/Distribution, Anesthesia, and Recovery. The 24/7 operations are conducted on the 4th and 5th floor with the direct report of 185 employees. In fiscal year 2010-2011, 9,819 surgical procedures were performed and patients cared for both on an inpatient and outpatient basis. The surgical procedures performed are General, Orthopedic, Neurosurgery, Urology, Gynecology, Ophthalmology, Oral - Maxillofacial, Trauma, Cardiac surgery, and Organ procurement. Surgical Services collaborates and provides services in the Heart Center, Cancer Center, Women's and Children, Orthopedic Center, Trauma Center. Anesthesia and Central Processing/Distribution also provides Hospital wide services to Inpatient Nursing, Labor and Delivery, and the Emergency Department. The Anesthesia department is comprised of 13 employed Nurse Anesthetists and 10 contracted Anesthesiologists.
RIGHTS OF MEMBERS TO ELECT GOVERNING BODYFORM 990 PART VI, LINES 6 & 7ATHE SENIOR GOVERNING BODY OF ST. VINCENT HOSPITAL ("THE CORPORATION") IS THE MEMBER OF THE CORPORATION, WHICH IS HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. PURSUANT TO SECTION 2.3 OF THE CORPORATION'S BYLAWS, HSSI HAS THE RIGHT TO APPOINT AND REMOVE THE CORPORATION'S BOARD OF DIRECTORS, CHAIRPERSON OF THE BOARD, AND PRESIDENT.
MEMBER RESERVED POWERSFORM 990 PART VI, LINE 7BResponsibility for the policy and operations of St. Vincent Hospital (the "Corporation") is vested in its Board of Directors, except with respect to specific powers reserved in the Corporation's Bylaws to the Corporation's Member, Hospital Sisters Services, Inc. ("HSSI"), an Illinois not for profit corporation exempt from federal taxation under Section 501(c)(3) of the Internal Revenue Code. The member of HSSI is Hospital Sisters Health System ("HSHS"), an Illinois not for profit corporation exempt from federal taxation under Section 501(c)(3) of the Internal Revenue Code. The members of HSHS are the individual sisters who, from time to time, are the duly elected Provincial Superior and Provincial Councilors, respectively, of the American Province of the Hospital Sisters of St. Francis ("American Province"). The American Province is the United States organization of the Congregation of the Hospital Sisters of the Third Order Regular of St. Francis, a religious institute of the Roman Catholic Church. The governance and operations of the Corporation are subject to HSSI's right to exercise these reserved powers with respect to the Corporation and organizations of which the Corporation is either, directly or indirectly, a controlling member or a controlling shareholder ("Affiliates"). HSSI's right to exercise certain of these reserved powers is, in turn, subject to the approval of HSHS and HSHS' members. The reserved powers include all rights granted to HSSI by law and the right to: (a) Adopt, approve amendments to, or amend any statement of philosophy, mission, mission integration or values, or any name, logo, or mark of the Corporation or of any Affiliate; (b) Adopt, approve amendments to, or amend the Articles of Incorporation of the Corporation or of any Affiliate; (c) Adopt, approve amendments to, or amend the Bylaws of the Corporation or of any Affiliate; (d) Appoint and remove the Board of Directors, any one or more of the Directors of the Corporation or of any Affiliate, and the Chairperson and President of the Corporation or of any Affiliate; (e) Approve the recommendation of the Board of Directors to appoint or remove the Board of Directors, any one or more Directors of the Corporation or of any Affiliate, or the Chairperson and President of the Corporation or of any Affiliate. (f) With respect to the Corporation or any Affiliate, approve the purchase, sale, alienation, exchange, lease, or encumbrance of any real property of the Corporation or of any Affiliate, which property has a value in excess of limits set from time to time by HSSI; (g) Approve the operating and capital budgets of the Corporation or of any Affiliate, and any deviations by the Corporation or of any Affiliate from such budgets in an amount or percentage specified by HSSI from time to time; (h) Approve the strategic plan and goals of the Corporation or of any Affiliate; (i) Approve the sale of substantially all of the assets of the Corporation or of any Affiliate; (j) Approve the merger or dissolution of the Corporation or of any Affiliate; (k) Adopt or amend the plan for ministry education and governance for the Corporation and its Affiliates; (l) Approve the Corporation's Mission Accountability Reports and those of any Affiliate; (m) Approve the financial policies and procedures of the Corporation or of any Affiliate, and approve any deviations from such policies and procedures by the Corporation or any Affiliate; and (n) Adopt policies to implement the Reserved Powers of HSSI.
FORM 990 REVIEW PROCESSFORM 990 PART VI, LINE 11bThe hospital employs KPMG to assist in the overall review and electronic submission of its Form 990. KPMG provides guidance in identifying critical errors in the return submission, and feedback on quantitative and qualitative responses. Additionally, the hospital CFO performs a thorough review of the return, and reviews it with the hospital CEO and/or senior leaders before presenting it in its entirety to the hospital Board for questioning and review prior to the return's signing and submission to the IRS.
CONFLICT OF INTEREST POLICYFORM 990 PART VI, LINE 12CThe organization is subject to the corporate compliance program and conflict of interest policy ("policy") of Hospital Sisters Health System, an Illinois not for profit corporation exempt from federal taxation under section 501(c)(3) of the internal revenue code. A REVISED CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY HAVE BEEN IMPLEMENTED SINCE JANUARY, 2009 TO MANAGE CONFLICTS OF INTEREST USING A SYSTEM-WIDE PROTOCOL FOR DISCLOSURE STATEMENTS. IN ACCORDANCE WITH the organizaton's CONFLICT OF INTEREST POLICY, ALL COVERED PERSONS HAVE A DUTY TO COMPLY WITH THE CONFLICT OF INTEREST POLICY FOR ANY CONTRACT, TRANSACTION, RELATIONSHIP, OR ACTIVITY CONTEMPLATED, ENTERED INTO, OR CONDUCTED AT HSHS OR ITS AFFILIATES. THE POLICY DEFINES COVERED PERSONS AS BOARD MEMBERS, BOARD COMMITTEE MEMBERS, OFFICERS, BOARD DESIGNEES, SENIOR MANAGEMENT, MEMBERS OF ANY COMMITTEE THAT OVERSEES THE APPROVAL OF PHARMACEUTICALS AND MEDICAL DEVICES, and ANY OTHER INDIVIDUAL WHO HOLDS A POSITION OF TRUST. ON AN ANNUAL BASIS, HSHS DISCLOSES A COPY OF THE CONFLICT OF INTEREST POLICY (AND ALL CORRESPONDING PROCEDURES, GUIDELINES, FORMS, AND TOOLS) TO ALL COVERED PERSONS AND ADVISES ALL COVERED PERSONS IN WRITING OF ANY SUBSTANTIVE CHANGES TO THIS POLICY AND SUCH RELATED MATERIALS. COVERED PERSONS ARE REQUIRED TO REVIEW AND COMPLETE THE CORRESPONDING CONFLICT OF INTEREST STATEMENT. THE SYSTEM OFFICE VICE PRESIDENT - SYSTEM RESPONSIBILITY, VICE PRESIDENT - RISK & COMPLIANCE, OR MEMBERS OF THE AUDIT AND INTEGRITY COMMITTEE ("COMMITTEE") ARE AVAILABLE TO ANSWER ANY QUESTIONS A COVERED PERSON MAY HAVE. IN ADDITION, IF, AT ANY TIME AFTER SUBMITTING AN ANNUAL CONFLICT OF INTEREST STATEMENT, A COVERED PERSON BECOMES AWARE OF AN INTEREST THAT HE OR SHE WOULD HAVE HAD TO DISCLOSE AT THE ANNUAL INTERVAL, THE COVERED PERSON IS REQUIRED PROMPTLY TO DISCLOSE THE INTEREST TO THE COMMITTEE USING THE HSHS CONFLICT OF INTEREST DISCLOSURE STATEMENT. COMPLETED CONFLICT OF INTEREST STATEMENTS ARE SUBMITTED TO THE COMMITTEE, WHICH IS RESPONSIBLE FOR IDENTIFYING, ASSESSING, AND MANAGING CONFLICTS OF INTEREST THAT ARISE IN THE COURSE OF CONDUCTING THE AFFAIRS OF HSHS AND ITS AFFILIATES. IF THE COMMITTEE DETERMINES THAT A CONFLICT OF INTEREST EXISTS, THE CONFLICT OF INTEREST POLICY REQUIRES HSHS NOT TO ENGAGE IN, OR ENTER INTO, A PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY UNLESS THE COMMITTEE OR, WHERE NECESSARY, THE BOARD OF DIRECTORS (ACTING THROUGH ITS DISINTERESTED MEMBERS), HAS INVESTIGATED ALTERNATIVES TO THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY AND, IN THE ABSENCE OF ALTERNATIVES THAT ARE IN THE BEST INTERESTS OF HSHS, HAS DETERMINED: 1. THAT, REGARDLESS OF WHETHER THE COVERED PERSON PARTICIPATES IN THE IMPLEMENTATION OF THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY; 2. THE CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY IS IN THE BEST INTERESTS OF HSHS; 3. THE CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY IS FAIR AND REASONABLE FROM THE PERSPECTIVE OF HSHS; AND 4. HSHS CANNOT OBTAIN A MORE ADVANTAGEOUS CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES. IN DETERMINING WHETHER A CONTRACT, TRANSACTION OR ARRANGEMENT IS FAIR AND REASONABLE TO HSHS, THE COMMITTEE SHALL CONSIDER, WHERE APPLICABLE: 1. APPRAISALS OR OTHER INDEPENDENT VALUATIONS OF THE FAIR MARKET VALUE OF THE CONTRACT, TRANSACTION, OR ARRANGEMENT; 2. INFORMATION REGARDING COMPARABLE CONTRACTS, TRANSACTIONS, OR ARRANGEMENTS BETWEEN UNRELATED PARTIES; 3. OFFERS FROM COMPARABLE COMPETING ENTITIES; AND/OR 4. STUDIES OF COMPARABLE COMPENSATION ARRANGEMENTS. IN ANY CASE IN WHICH THE COMMITTEE FINDS, AFTER TAKING THE STEPS DESCRIBED ABOVE, THAT HSHS SHOULD PARTICIPATE IN A PROPOSED TRANSACTION OR ARRANGEMENT DESPITE THE EXISTENCE OF A CONFLICT OF INTEREST, THE COMMITTEE SHALL DEVELOP, IMPLEMENT, MONITOR, AND ENFORCE COMPLIANCE WITH, A CONFLICT MANAGEMENT PLAN FOR MANAGING THE CONFLICT OF INTEREST AS IT CONSIDERS NECESSARY FOR SUCH FINDINGS TO REMAIN VALID THROUGHOUT THE LIFE OF THE CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY. ALL CONFLICT MANAGEMENT PLANS SHALL: 1. STATE THAT THE COMMITTEE WILL OVERSEE, MONITOR, AND ENFORCE COMPLIANCE WITH THE PLAN THROUGHOUT THE COURSE OF THE STUDY AND SPECIFY MEANS FOR DOING SO, INCLUDING, WITHOUT LIMITATION, THAT THE APPROPRIATE INDIVIDUALS MUST PROVIDE THE COMMITTEE WITH WRITTEN REPORTS PERTAINING TO COMPLIANCE WITH THE CONFLICT MANAGEMENT PLAN, THAT THE COMMITTEE SHALL HAVE THE RIGHT TO AUDIT THE STUDY FOR SUCH COMPLIANCE AND THE RIGHT TO IMPOSE SANCTIONS FOR NON-COMPLIANCE; 2. STATE THAT THE PLAN MUST BE SHARED WITH COVERED PERSON WHOSE INTERESTS IT WAS DEVELOPED TO MANAGE; 3. STATE THAT THE PLAN MUST BE SHARED WITH, AND PERIODIC REPORTS ON COMPLIANCE WITH THE PLAN MUST BE PROVIDED TO, THE BOARD, SENIOR MANAGEMENT, AND/OR GOVERNMENT AGENCIES; AND 4. PROVIDE FOR SUCH OTHER MANAGEMENT STEPS AND MECHANISMS THE COMMITTEE CONSIDERS NECESSARY AND APPROPRIATE. IN ADDITION TO THE COMMITTEE, THE SYSTEM OFFICE VICE PRESIDENTS OF SYSTEM RESPONSIBILITY AND RISK & COMPLIANCE MAY RETAIN SUCH INDEPENDENT ADVISORS OR EXPERTS AS DEEMED NECESSARY TO ASSIST IN MAKING ITS DETERMINATIONS AND DECISIONS. IF THE COMMITTEE DETERMINES THAT THE CONTEMPLATED TRANSACTION, RELATIONSHIP ARRANGEMENT, OR ACTIVITY CANNOT PROCEED DUE TO A CONFLICT OF INTEREST, THE COMMITTEE SHALL INFORM THE APPLICABLE COVERED PERSON OR DECISION-MAKING BODY OF SUCH DETERMINATION WITHIN ONE WEEK OF THE COMMITTEE MEETING AT WHICH THE CONTEMPLATED TRANSACTION WAS DISCUSSED. THE COMMITTEE SHALL DOCUMENT ITS REJECTION OF THE CONTEMPLATED TRANSACTION IN THE COMMITTEE'S MEETING MINUTES.
WHISTLEBLOWER POLICYFORM 990 PART VI, LINE 13Provisions within the Corporate Compliance Program and Conflict of Interest Policy provide protections for whistleblower type activities.
COMPENSATION PROCESSFORM 990 PART VI, LINE 15The Compensation Committee ("Committee") is comprised of independent members of the Board of Directors. The Committee develops a compensation philosophy for the System and all affiliates. The Committee selects and hires the independent compensation consultant to develop comparability data, and advise the Committee during its deliberations regarding all elements of total compensation for all disqualified individuals. Integrated Healthcare Strategies ("IHS"), the consultants utilized by the Committee, use data from multiple tax-exempt peer group sources to determine salary ranges, incentive opportunity ranges, and benefits for the disqualified individuals. IHS then assists the Committee in preparing contemporaneous documentation of all actions. Each Committee meeting is conducted with the intent to create a rebuttable presumption of reasonableness for all elements of executive total compensation for the disqualified individuals. The Chairman makes this declaration and also inquires if there are any conflicts of interest by any attendees. Any conflicts are disclosed and the Committee then acts in a manner to avoid any conflicted individual participating in any manner where a conflict might exist. At the end of the meeting, the Committee prepares contemporaneous minutes that record all actions taken during the meeting. The following descriptions present St. Vincent's process for determination of compensation for various individuals: Officer: Process is done at the HSHS system office with input from the President and CEO of the Eastern Wisconsin Division. Key Employee: If the position is for a senior leadership member, the process is done at the HSHS system office with input from the President and CEO of the Eastern Wisconsin Division. This process applies to Robert Bartingale and Larry Mathews. If the position is a director position at St. Vincent Hospital, on an annual basis an outside organization, currently Integrated HealthCare Strategies ("IHS"), compiles market data for each position and provides recommendations for the salary range for these positions. The manager of People Services provides a recommendation for adjustment based upon the recommended range information from IHS. The Wage and Salary Committee at St. Vincent Hospital, which consists of the senior leadership team and manager of People Services, reviews the salary range and adjustment recommendations; documentation is kept regarding any deviations from the recommendations. Director: None of these individuals are on St. Vincent Hospital's payroll. Highest Paid: On an annual basis salary range recommendations are made utilizing market data that is extracted from salary surveys and aged to align with the compensation program philosophy. The recommendations for salary range and individual pay adjustments by position are then reviewed and discussed during a meeting of the Wage and Salary Committee, which consists of the senior leadership team and manager of People Services. Documentation is kept regarding approval and/or deviations from the recommendations.
DISCLOSURE DOCUMENTS AVAILABLE TO PUBLICFORM 990 PART VI, LINE 19Board-approved financial statements are made available to the public upon request. The governing documents and conflict of interest policy are not made available to the general public at this time.
PUBLICLY TRADED SECURITIESFORM 990 PART X, LINE 11Investments in securities and related investment income: The hospital's cash reserves are invested in a pooled investment account. Participation in the pooled fund is limited to the 501(c)(3) hospitals and related health services organizations sponsored by Hospital Sisters Health System. The pooled account consists of cash, equity, and debt securities that are publicly traded. In accordance with the provisions of SFAS no. 124 "accounting for certain investments held by not-for-profit organizations" investments in equity securities with readily determinable values, and all investments in debt securities, are reported at fair value on the balance sheet. Income, realized and unrealized gains and losses are pooled and allocated to the participants. Individual components of assets and revenue are not identified to the individual hospital participants.
Reconciliation of Change in Net AssetsForm 990, Part XI, Line 5Transfer from affliate (1,650,000) Assets released from restriction 192,000 Temporarily restricted income 955,000 permanently restricted income 137,000 Cumulative effect of change in accounting principle (491,970) Recognition of change in pension funded status 19,721,000 Unrealized gain 18,283,043 ----------- Total 37,146,073 ===========
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:THERESE PANDL TITLE:CEO HOURS:40
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:ANN CARR TITLE:TREASURER HOURS:75
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:greg simia TITLE:division cfo HOURS:40

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateTotal IncomeTotalIncomeEOY AssetsEOYAssetsBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
springfield health partners llc
4936 Laverna RoadspringfieldIL62707371364419healthcareIL00HSHS MG
Kiara Clinical Integration Network
4936 Laverna ROAdspringfieldIL62707261417684HealthCareIL00Kiara Inc

Form990 Schedule R Part II Form990ScheduleRPartII (23 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
HOSPITAL SISTERS HEALTH SYSTEM
4936 LAVERNA ROADSPRINGFIELDIL62707371058692HEALTHCAREIL501(c)(3)11ANA
HOSPITAL SISTERS SERVICES INC
4936 LAVERNA ROADSPRINGFIELDIL62707371163402HEALTHCAREIL501(c)(3)11ANA
HOSPITAL SISTERS OF ST FRANCIS FDTN
4936 LAVERNA ROADSPRINGFIELDIL62707371186514HEALTHCAREIL501(c)(3)11ANA
HSHS HEALTH CARE plan TRUST FUND
4936 LAVERNA ROADSPRINGFIELDIL62707371137724HEALTHCAREIL501(c)(9)N/ANA
ST ANTHONY'S HOSPITAL
503 N MAPLE STREETEFFINGHAMIL624012099370661233HEALTHCAREIL501(c)(3)3NA
ST ELIZABETH'S HOSPITAL
211 SOUTH THIRD STREETBELLEVILLEIL622201998370663567HEALTHCAREIL501(c)(3)3NA
ST FRANCIS HOSPITAL
1215 FRANCISCAN DRIVELITCHFIELDIL62056370661236HEALTHCAREIL501(c)(3)3NA
ST JOHN'S HOSPITAL
800 EAST CARPENTER STREETSPRINGFIELDIL62769370661238HEALTHCAREIL501(c)(3)3NA
ST JOSEPH'S HOSPITAL
9515 HOLY CROSS LANEBREESEIL622300099371208459HEALTHCAREIL501(c)(3)3NA
ST JOSEPH'S HOSPITAL
1515 MAIN STREETHIGHLANDIL62249370663568HEALTHCAREIL501(c)(3)3NA
ST JOSEPH'S HOSPITAL
2661 COUNTY HIGHWAY 1CHIPPEWA FALLSWI54729390810545HEALTHCAREWI501(c)(3)3NA
ST MARY'S HOSPITAL
1800 E LAKE SHORE DRIVEDECATURIL62521370661244HEALTHCAREIL501(c)(3)3NA
ST MARY'S HOSPITAL
111 SPRING STREETSTREATORIL613643332362169181HEALTHCAREIL501(c)(3)3NA
ST MARY'S MEDICAL CENTER
1726 SHAWANO AVENUEGREEN BAYWI54303390818682HEALTHCAREWI501(c)(3)3NA
ST NICHOLAS HOSPITAL
3100 SUPERIOR AVENUESHEBOYGANWI530811948390808480HEALTHCAREWI501(c)(3)3NA
SACRED HEART HOSPITAL
900 WEST CLAIREMONT AVEEAU CLAIREWI54701390807060HEALTHCAREWI501(c)(3)3NA
HOSPITAL SISTERS HEALTHCARE WEST INC
2661 COUNTY HIGHWAY ICHIPPEWA FALLSWI54729510157933HEALTHCAREWI501(c)(3)11ANA
HSHS SELF INSURANCE TRUST FUND
4936 LAVERNA ROADSPRINGFIELDIL62707371120626INSURANCEIL501(c)(3)11ANA
HSHS MEDICAL GROUP INC
4936 LAVERNA ROADSPRINGFIELDIL62707263956318HEALTHCAREIL501(c)(3)11ANA
HSHS WISCONSIN MEDICAL GROUP INC
8040 EXCELSIOR DRIVE STE 200MADISONWI53717264515959HEALTHCAREWI501(c)(3)11ANA
ORANGE CROSS AMBULANCE INC
919 ASHLAND AVENUESHEBOYGANWI53081391860942HEALTHCAREWI501(c)(3)9ST NICHOLAS
WISCONSIN UPPER PENINSULA ONCOLOGY MGMT
835 S VAN BURENGREEN BAYWI54301391677100HEALTHCAREWI501(c)(3)3NA
UNITY LIMITED PARTNERSHIP
2366 OAK RIDGE CIRCLEDE PEREWI54115391750729HEALTHCAREWI501(c)(3)9HSSI

Form990 Schedule R Part III Form990ScheduleRPartIII (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsCode VCodeVAmountGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnership
MEM & ST ELIZ Healthcare SVC
4000 North Illinois StreetSwanseaIL62226371312961HealthCareILSt Elizabeth'sRelated00false$0false0.00000
Prairie Heart Institute
800 East Carpenter StreetSpringfieldIL62769371321197HealthCareILSt John'sRelated00false$0false0.00000
Northeast Wisconsin Radiation
1821 S Webster Avenue Suite 300Green BayWI543079047263749065HealthCareWIHSSIRelated-931423639862false$0false0.25000
Pain Center of Wisconsin
4131 W Loomis Road Suite 300GreenfieldWI53221263155343HealthCareWINARelated00false$0false0.00000
Surgery Center of Sheboygan
3141 Saemann AveNUESheboyganWI53081260822209HealthCareWISt NicholasRelated00false$0false0.00000
Prevea Ventures LLC
2710 EXECUTIVE DRIVEGreen BayWI54304203775127HealthCareWIHSSIRelated00false$0false0.00000
CARPENTER STREET HOTEL LLC 3
HotelILLASANTE INCRelated00false$0false0.00000
SPRINGFIELD URGENT CARE REAL E
Rent. Real EstateILLASANTE INCRelated00false$0false0.00000

Form990 Schedule R Part IV Form990ScheduleRPartIV (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityProvince Or StateAddressForeign/ProvinceOrStateCountryAddressForeign/CountryPostal CodeAddressForeign/PostalCodeLegal Domicile Foreign CountryLegalDomicileForeignCountry
Kiara Inc
4936 Laverna ROAdSpringfieldIL62707371163401HealthCareILHSHSC Corp000.00000
LaSante Wisconsin Inc
4936 Laverna ROAdSpringfieldIL62707391572196HealthCareILKiara IncC Corp000.00000
LaSante Inc
4936 Laverna ROAdSpringfieldIL62707371163400HealthCareILKiara IncC Corp000.00000
Prairie Cardiovascular
619 East Mason Suite 4P57SpringfieldIL62701371071858HealthCareILKiara IncC Corp000.00000
Prevea Health Services
2710 EXECUTIVE DRIVEGreen BayWI54304391839351HealthCareWIHSSIC Corp000.00000
Prevea Clinic Inc
2710 EXECUTIVE DRIVEGreen BayWI54304391839349HealthCareWIHSSIC Corp000.00000
Prevea Health Network
2710 EXECUTIVE DRIVEGreen BayWI54304392000537HealthCareWIHSSIC Corp000.00000
Renaissance Quality Insurance
980669953insurancehssic corp000.00000PO Box 1159Grand CaymansCayman IslandsCJKY1-1102CJ
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 OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgtrueSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgtruePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
PREVEA CLINIC INC
j1205712
PREVEA HEALTH
n6445858

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
IdentifierTRANSACTIONS WITH RELATED ENTITIESIdentifier
Return ReferenceFORM 990, SCHEDULE R, PART V, LINE 2ReturnReference
ExplanationTHE TRANSACTIONS REPORTED IN QUESTION 1 AND NOT LISTED ON LINE 2 ARE BETWEEN RELATED 501(C)(3) PUBLIC CHARITIES AND ARE NOT REQUIRED TO BE REPORTED IN THIS SECTION.Explanation