ASCENSION WISCONSIN INC: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- ASCENSION WISCONSIN INC (EIN 39-1834639)
- Tax period
- 2009-07-01 to 2010-06-30
- Filed
- 2011-05-16
- IRS object ID
- 201101369349302945
- Schema version
- 2009v1.7
- 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
- Form 990
- Schedule A
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-05-16T13:44:40-05:00 | Timestamp |
| Tax Period End Date | 2010-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELOITTE TAX LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 555 E Wells St Suite 1400 | AddressLine1 |
| City | Milwaukee | City |
| State | WI | State |
| ZIP Code | 53202 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391834639 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Columbia St Mary's Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | COLU | NameControl |
| Phone | 4143262230 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4425 NORTH PORT WASHINGTON ROAD | AddressLine1 |
| City | GLENDALE | City |
| State | WI | State |
| ZIP Code | 53212 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | RHONDA ANDERSON | Name |
| Title | EXECUTIVE VP FINANCE/CFO | Title |
| Phone | 4143262230 | Phone |
| Date Signed | 2011-05-16 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4142713000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | LEO BRIDEAU | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4425 NORTH PORT WASHINGTON ROAD | AddressLine1 |
| City | GLENDALE | City |
| State | WI | State |
| ZIP Code | 53212 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 27010189 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Group Exemption Number | 0928 | GroupExemptionNumber |
| Organization501c | X | Organization501c |
| Web Site | COLUMBIA-STMARYS.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2001 | YearFormation |
| State Legal Domicile | WI | StateLegalDomicile |
| Activity Or Mission Description | HEALTH CARE SYSTEM DEDICATED TO MAKING A POSITIVE DIFFERENCE IN INDIVIDUALS AND OUR COMMUNITY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 21 | TotalNbrEmployees |
| Total Nbr Volunteers | 12 | TotalNbrVolunteers |
| Total Gross UBI | 106322 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 16720 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 4293182 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 13846832 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1236795 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1332905 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 13221334 | OtherRevenuePriorYear |
| Other Revenue Current Year | 11830452 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 18751311 | TotalRevenuePriorYear |
| Total Revenue Current Year | 27010189 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 360000 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 943877 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 8133293 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 13997201 | OtherExpensePriorYear |
| Other Expenses Current Year | 16101502 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 14941078 | TotalExpensesPriorYear |
| Total Expenses Current Year | 24594795 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 3810233 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 2415394 | RevenuesLessExpensesCY |
| Total Assets BOY | 233657811 | TotalAssetsBOY |
| Total Assets EOY | 292829491 | TotalAssetsEOY |
| Total Liabilities BOY | 158280048 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 224000083 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 75377763 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 68829408 | NetAssetsOrFundBalancesEOY |
| Mission Description | COLUMBIA ST. MARY'S INC. ("CSM") IS A HEALTHCARE PROVIDER FOUNDED IN RESPONSE TO IDENTIFIED COMMUNITY NEEDS, WHICH IS SPONSORED BY ASCENSION HEALTH, A CATHOLIC NATIONAL HEALTH SYSTEM, AND COLUMBIA HEALTH SYSTEM, A NON-SECTARIAN COMMUNITY HEALTH SYSTEM. CSM EXISTS TO MAKE A POSITIVE DIFFERENCE IN THE HEALTH STATUS AND LIVES OF INDIVIDUALS AND OUR COMMUNITY, WITH SPECIAL CONCERN FOR THOSE WHO ARE VULNERABLE. CSM AND ITS AFFILIATES ARE COMMITTED TO PROVIDING HIGH-QUALITY, ACCESSIBLE, VALUES-DRIVEN PROGRAMS AND SERVICES WITH EQUAL ATTENTION TO THE PHYSICIAL, SPIRITUAL, AND EMOTIONAL DIMENSIONS OF HEALTH. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 20341231 | Expense |
| Revenue | 23734439 | Revenue |
| Description | CSM INC EXISTS AS THE PARENT CORPORATION IN THE CSM SYSTEM, WHICH IS COMPRISED OF FOUR HOSPITALS, (ST. MARY'S HOSPITAL MILWAUKEE INC, COLUMBIA HOSPITAL, COLUMBIA ST. MARY'S HOSPITAL OZAUKEE INC, AND SACRED HEART REHABILITIATION INSTITUTE INC.), 66 COMMUNITY CLINICS, THE COLUMBIA COLLEGE OF NURSING, SETON CHILDREN'S SCHOOL, A PARTNERSHIP WITH THE ORTHOPAEDIC HOSPITAL OF WISCONSIN, AND FOUR URGENT CARE CENTERS. DURING FISCAL 2010, CSM'S HEALTH SYSTEM PROVIDED CARE TO 246,625 PATIENTS. THE ESTIMATED UNREIMBURSED COST OF SERVICES PROVIDED TO THE ELDERLY, UNINSURED AND UNDERINSURED TOTALED $149,823,841. REFER TO THE COMMUNITY BENEFIT INFORMATION IN SCHEDULE H FOR DISCUSSION OF HOW CSM MAKES A POSITIVE DIFFERENCE IN THE HEALTH STATUS OF ITS COMMUNITY, FOCUSING ON THOSE WHO ARE VULNERABLE. | Description |
| Total Program Service Expense | 20341231 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | 1 | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 57 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 21 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Nbr Voting Governing Body Members | 15 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 1 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Rhonda Anderson | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 4143262230 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4425 N PORT WASHINGTON ROAD | AddressLine1 |
| City | GLENDALE | City |
| State | WI | State |
| ZIP Code | 53212 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (31 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|
| Christopher Doerr | ||||||||
| Chair | 1.00 | X | 0 | 0 | 0 | |||
| David Hoogerland MD | ||||||||
| Board Member AND CSM Physician | 5.00 | X | 0 | 432564 | 121867 | |||
| George H Hoff | ||||||||
| VICE Chair | 1.00 | X | 0 | 0 | 0 | |||
| James B Wigdale | ||||||||
| Vice Chair | 1.00 | X | 0 | 0 | 0 | |||
| Kevin Goniu MD | ||||||||
| Board Member AND CSM Physician | 5.00 | X | 0 | 639309 | 121858 | |||
| Leo P Brideau | ||||||||
| President/CEO | 10.00 | X | 1473308 | 0 | 101102 | X | ||
| MASON G ROSS | ||||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | |||
| Michael Grebe | ||||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | |||
| R Bruce McDonald | ||||||||
| CHAIR-ELECT | 1.00 | X | 0 | 0 | 0 | |||
| Randall Perry | ||||||||
| SECRETARY/TREASURER | 1.00 | X | 0 | 0 | 0 | |||
| Robert Lyon MD | ||||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | |||
| Robert Venable | ||||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | |||
| Sister Theresa Sullivan DC | ||||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | |||
| Tina Chang | ||||||||
| Board Member | 1.00 | X | 0 | 0 | 0 | |||
| CHRISTINE NUERNBERG | ||||||||
| BOArd Member | 1.00 | X | 0 | 0 | 0 | |||
| RHONDA ANDERSON | ||||||||
| EXEC VP FINAnce/CFO | 5.00 | 407494 | 0 | 69001 | X | |||
| Amy Marquardt | ||||||||
| VP Legal Services | 5.00 | 298810 | 0 | 71352 | X | |||
| Cheryl Hill | ||||||||
| VP Human Resources | 5.00 | 297147 | 0 | 83703 | X | |||
| David H Shapiro MD | ||||||||
| VP Medical Affairs | 5.00 | 384210 | 0 | 71879 | X | |||
| Gerri Lietz-Staffileno | ||||||||
| VP Hosp Operations | 5.00 | 0 | 270954 | 109265 | X | |||
| Karol Marciano | ||||||||
| Exec VP Business Developme | 5.00 | 353065 | 0 | 63358 | X | |||
| Mary Paul | ||||||||
| VP/CIO | 5.00 | 0 | 501197 | 46050 | X | |||
| Sue Sanicola | ||||||||
| VP CSM Comm Physicians | 5.00 | 241558 | 0 | 64704 | X | |||
| William Hart | ||||||||
| VP Support Services | 5.00 | 0 | 320296 | 43653 | X | |||
| DEBORAH FRIBERG | ||||||||
| EXEC VP/PRESIDENT CSM HOSPITAL MILW | 5.00 | 0 | 5308 | 0 | X | |||
| BRUCE MCCARTHY | ||||||||
| EXEC VP/PRESIDENT CSM PHYSICIAN DIV | 5.00 | 0 | 0 | 0 | X | |||
| Constance J Bradley | ||||||||
| VP Patient Services | 5.00 | 0 | 235716 | 33230 | X | |||
| Paul Westrick | ||||||||
| VP Mission Integration | 5.00 | 229529 | 0 | 96821 | X | |||
| David Olson | ||||||||
| EXEC VP/PRESIDENT CSM HOSPITAL OZ | 5.00 | 0 | 25017 | 0 | X | |||
| Brian Regan | ||||||||
| Exec VP Finance/CFO | 5.00 | 307340 | 0 | 36788 | X | |||
| Therese Pandl | ||||||||
| Exec VP/Chief Operating Officer | 0.00 | 0 | 774991 | 71841 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3992461 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 3175027 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 1206472 | TotalOtherCompensation |
| Number Individuals GT100 K | 9 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| CG SCHMIDT BARTON MALOW | |||||
| 26500 AMERICAN DRIVE | Southfield | MI | 48034 | PROJECT MANAGEMENT | 7021241 |
| HOK GROUP | |||||
| PO BOX 200119 | DALLAS | TX | 753200119 | ARCHITECTURAL DESIGN | 1151604 |
| MARSH USA INC | |||||
| PO BOX 1450 | NUBBEAOIKUS | MN | 554858625 | FINANCIAL SERVICES | 716595 |
| ZURICH NORTH AMERICA | |||||
| 8745 PAYSPHERE CIRCLE | CHICAGO | IL | 60674 | FINANCIAL SERVICES | 669034 |
| CHRISTOPHER SMOCKE & ASSOC INC | |||||
| 2221 NORTH TERRACE AVENUE | MILWAUKEE | WI | 53202 | DESIGN AND CONSTRUCTION | 499349 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 16 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Home office allocation | 900099 | 13805732 | 13805732 |
| Rental Income-Physicia | 532000 | 41100 | 41100 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 13846832 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1332905 | TotalRevenueColumn |
| Exclusion | $1,332,905 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| JOINT VENTURE INCOME | 622110 | 9674963 | 9674963 | |
| Capitalized Interest | 900099 | 1604553 | $1,604,553 | |
| GAIN/LOSS ON INVEST | 900099 | 292212 | $292,212 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 258724 | TotalRevenueColumn |
| Related Or Exempt Function Income | 106322 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 106322 | UnrelatedBusinessRevenue |
| Exclusion | $46,080 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 11830452 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 27010189 | TotalRevenueColumn |
| Related Or Exempt Function Income | 23628117 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 106322 | UnrelatedBusinessRevenue |
| Exclusion | $3,275,750 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 360000 | Total |
| Program Services | 360000 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4091909 | Total |
| Management And General | 4091909 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2192881 | Total |
| Program Services | 2105166 | ProgramServices |
| Management And General | 87715 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1073587 | Total |
| Program Services | 1030644 | ProgramServices |
| Management And General | 42943 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 332065 | Total |
| Program Services | 318782 | ProgramServices |
| Management And General | 13283 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 442851 | Total |
| Program Services | 425137 | ProgramServices |
| Management And General | 17714 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 111564 | Total |
| Program Services | 111564 | ProgramServices |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 650780 | Total |
| Program Services | 650780 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 742159 | Total |
| Program Services | 742159 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5657346 | Total |
| Program Services | 5657346 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1814 | Total |
| Program Services | 1814 | ProgramServices |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32231 | Total |
| Program Services | 32231 | ProgramServices |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3397095 | Total |
| Program Services | 3397095 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 859996 | Total |
| Program Services | 859996 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 66104 | Total |
| Program Services | 66104 | ProgramServices |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| Ascension Fees/Dues | 4322416 | 4322416 |
| AFFILIATION EXPENSE | 101579 | 101579 |
| SPECIAL PROGRAMS | 89547 | 89547 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 68871 | Total |
| Program Services | 68871 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24594795 | Total |
| Program Services | 20341231 | ProgramServices |
| Management And General | 4253564 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 703246 | BOY |
| EOY | 657752 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6878320 | BOY |
| EOY | 46409397 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 68176 | BOY |
| EOY | 4388169 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2004600 | BOY |
| EOY | 617320 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 708915 | BOY |
| EOY | 662258 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1535119 | BOY |
| EOY | 2152411 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 273579842 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 108890534 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 155952785 | BOY |
| EOY | 164689308 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38825241 | BOY |
| EOY | 39806060 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9611934 | BOY |
| EOY | 9029392 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17369475 | BOY |
| EOY | 24417424 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 233657811 | BOY |
| EOY | 292829491 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23716010 | BOY |
| EOY | 19869030 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 134564038 | BOY |
| EOY | 204131053 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 158280048 | BOY |
| EOY | 224000083 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 51211275 | BOY |
| EOY | 46835982 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18067766 | BOY |
| EOY | 15571920 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6098722 | BOY |
| EOY | 6421506 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 75377763 | BOY |
| EOY | 68829408 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 233657811 | BOY |
| EOY | 292829491 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type2 | X | SupportingOrg509a3Type2 |
| Certification Checkbox | X | CertificationCheckbox |
| Written IRS Determination | X | WrittenIRSDetermination |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation (5 entries)
| EINEIN | Type Of OrganizationTypeOfOrganization | Listed In Governing DocListedInGoverningDoc | Supported Organization NotifiedSupportedOrganizationNotified | Organized In USOrganizedInUS | AmountAmount |
|---|---|---|---|---|---|
| COLUMBIA ST MARY'S HOSPITAL MILWAUKEE | |||||
| 390806315 | 3 | 1 | 1 | 1 | $9,583,711 |
| COLUMBIA ST MARY'S HOSPITAL OZAUKEE | |||||
| 390807063 | 3 | 1 | 1 | 1 | $4,100,225 |
| SACRED HEART REHABILITATION INSTITUTION | |||||
| 390902199 | 3 | 1 | 1 | 1 | $121,795 |
| SETON CHILDREN'S SCHOOL | |||||
| 391391245 | 9 | 1 | 1 | 1 | $0 |
| COLUMBIA COLLEGE OF NURSING INC | |||||
| 391596986 | 2 | 1 | 1 | 1 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 5 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 13805731 | SumOfAmounts |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 1 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 1 | DirectContactLegislators |
| Direct Contact Legislators | $22,637 | DirectContactLegislatorsAmount |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $8,181 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 30818 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part II-B, Line 1i: | Identifier |
| Return Reference | Explanation of Other Lobbying Activities: | ReturnReference |
| Explanation | A key employee spends 10% of time (amount reported on line g) researching issues and preparing for meetings and presentations for: County officials - funding and operational issues related to the General Assistance Medical Program State Legislators, other elected officials and staff - lobbying on Medical Assistance funding, public health initiatives, and provider regulations; federal elected officials and staff - lobbying and Medicare and Medicaid funding and provider regulations. OTHER ACTIVITIES: AMOUNT PAID TO GOVERNMENT AFFAIRS CONSULTING FIRM PROVIDING LEGISLATIVE, REGULATORY, AND COMMUNICATIONS SERVICES. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 9243279 | OtherCostOrOtherBasis |
| Book Value | 9243279 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 105589911 | OtherCostOrOtherBasis |
| Depreciation | 68141598 | Depreciation |
| Book Value | 37448313 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1636737 | OtherCostOrOtherBasis |
| Depreciation | 306278 | Depreciation |
| Book Value | 1330459 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 46088507 | OtherCostOrOtherBasis |
| Depreciation | 38831276 | Depreciation |
| Book Value | 7257231 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 111021408 | OtherCostOrOtherBasis |
| Depreciation | 1611382 | Depreciation |
| Book Value | 109410026 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 164689308 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities (6 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| ORTHOPAEDIC HOSPITAL OF WISC LLC | 13211340 | C |
| HOME CARE MEDICAL | 967055 | C |
| CSM STRATEGIC ALLIANCE | 43395 | C |
| HORIZON HOMECARE | 3550844 | C |
| WI MEDICAL CYCLOTRON LLC | 40000 | C |
| CSM FOUNDATION (RESTRICTED FUNDS) | 21993426 | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 39806060 | TotalOfBookValueSecurities |
Other Assets OtherAssets (3 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Deferred Compensation | 440690 |
| Assets Held for sale | 4770111 |
| Pension Prefunding | 19206623 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 24417424 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (6 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Due to affiliates | $50,644,407 |
| INTERCOMPANY DEBT TO ASCENSION HEALTH | $145,678,466 |
| Deferred Pension | $1,767,648 |
| Deferred Compensation | $440,690 |
| Misc Noncurrent Liab | $2,436,692 |
| Misc Current Liabilities | $3,163,150 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 204131053 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | PART X: ASC 740 footnote regarding uncertain tax positions in audited financials: Not applicable. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 242716 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 242716 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01000 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4380330 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2449473 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1930857 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07950 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4623046 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2449473 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2173573 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08950 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4623046 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2449473 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2173573 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08950 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $90,608 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 1391681 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 4891229 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -3499548 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV
Name Of Entity NameOfEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ORTHOPAEDIC HOSPITAL OF WISCONSIN LLC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Ent Primary Activity | ORTHOPAEDIC SURGERIES | DescriptionEntPrimaryActivity |
| Organization Profit Or Ownership | 0.50000 | OrganizationProfitOrOwnership |
| Physicans Profit Or Ownership | 0.50000 | PhysicansProfitOrOwnership |
Form990 Schedule H Part V Form990ScheduleHPartV
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ORTHOPAEDIC HOSPITAL OF WISCONSIN LLC | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 475 WEST RIVER WOODS PARKWAY | AddressLine1 |
| City | GLENDALE | City |
| State | WI | State |
| ZIP Code | 53212 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Income Based Criteria | Part I, Line 3c: The hospitals of CSM provide medically necessary care to all patients, regardless of race, color, creed, ethnic origin, gender, disability or economic status. OHOW's specific policy uses a percentage of Federal Poverty Level (FPL) to determine free and discounted care. At a minimum, patients with income less than or equal to 200% of the FPL, which may be adjusted for cost of living utilizing the local wage index compared to national wage index, will be eligible for 100% charity care write off of charges for services that have been provided to them. | IncomeBasedCriteria |
| Annual Community Benefit Expln | Part I, Line 6a: OHOW files an annual community benefit report with the Wisconsin Hospital Association ("WHA"). CSM does not file a community benefit report with the WHA since CSM does not have any patient care revenue. However, CSM is the parent entity of 4 hospitals, Columbia Hospital, St. Mary's Hospital Milwaukee, Inc., Columbia St. Mary's Hospital Ozaukee, Sacred Heart Rehabilitation, Inc. each of which file community benefit reports with WHA. CSM does, however, prepares a report to the community, available on its website at www.columbia-stmarys.org, which describes the benefits that the CSM organization provides to the community. | AnnualCommunityBenefitExpln |
| Costing Method Used | Part I, Line 7: The cost of providing charity care, means tested government programs, and community benefit programs is estimated using internal cost data, and is calculated in compliance with Catholic Health Association ("CHA") guidelines. The organization uses a costing accounting system that addresses all patient segments (for example, inpatient, outpatient, emergency room, private insurance, Medicaid, Medicare, uninsured, or self pay). The best available data was used to calculate the amounts reported in the table. For certain categories in the table, this was a cost accounting system; in other categories, a specific cost- to-charge ration was applied.Part I, Line 7g: The organization has not included costs attributable to a physician clinic as part of subsidized health services. | CostingMethodUsed |
| Percent Of Total Expense Expln | Part I, Line 7f: CSM's share of the amount of bad debt expense reported by OHOW in 2009 but subtracted for purposes of calculating the percentages in Part I, Line 7, column (f) is $309,242. | PercentOfTotalExpenseExpln |
| Bad Debt Footnote | Part III, Line 4: OHOW, which files financial statements separate from CSM, includes the following footnote related to accounts receivables: "The majority of the Hospital's accounts receivables are due from third-party payors under reimbursement agreements and from patients for services provided. Accounts receivable are due upon receipt of invoice. Receivables are stated net of any allowance for contractual discounts and uncollectible accounts by considering the number of days past due, collection history, and the general economy and industry as a whole. Contractual adjustments are based on expected payment rates in accordance with third-party payor agreements. The Hospital writes off accounts receivable when they are determined to be uncollectible. Payments subsequently received are credited to the allowance for doubtful accounts." CSM's share of OHOW bad debt expense in 2009 was $309,242 at charges ($90,608 at cost). | BadDebtFootnote |
| Shortfall As Community Benefit | Part III, Line 8: OHOW follows the Catholic Health Association ("CHA") guidelines for determining community benefit. CHA community benefit reporting guidelines suggest that Medicare shortfall is not treated as community benefit. | ShortfallAsCommunityBenefit |
| Debt Collection Policy | Part III, Line 9b: OHOW has a written debt collection policy that also includes a provision on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance. If a patient qualifies for charity or financial assistance certain collection practices do not apply. | DebtCollectionPolicy |
| Number Of Facility Type Expln | Part V: COLUMBIA ST. MARY'S, INC. ("CSM") OWNS 50% OF A JOINT VENTURE THAT IS AN ENTITY TAXED AS A PARTNERSHIP, ORTHOPAEDIC HOSPITAL OF WISCONSIN, LLC ("OHOW"). THE INFORMATION REPORTED ON PARTS I, II AND III ONLY PERTAIN TO CSM'S SHARE OF OHOW'S ACTIVITY. FURTHER, OHOW MAINTAINS ITS BOOKS AND RECORDS ON A CALENDAR YEAR BASIS. AS A RESULT, ALL INFORMATION REPORTED ON THE 2009 SCHEDULE H REFLECTS OHOW'S 2009 CALENDAR YEAR RESULTS. | NumberOfFacilityTypeExpln |
| General Explanation | CSM DOES NOT FILE A COMMUNITY BENEFIT REPORT SINCE IT DOES NOT HAVE ANY PATIENT CARE REVENUE. HOWEVER, CSM'S FOUR HOSPITAL ORGANIZATIONS, COLUMBIA HOSPITAL, ST. MARY'S HOSPITAL MILWAUKEE, INC., COLUMBIA ST. MARY'S HOSPITAL OZAUKEE, AND SACRED HEART REHABILITATION, INC. EACH FILE COMMUNITY BENEFIT REPORTS WITH THE WISCONSIN HOSPITAL ASSOCIATION. | GeneralExplanation |
| Needs Assessment | Part VI, Line 2: The health needs of the communities which CSM serve are assessed as part of CSM overall through the work of the CSM Community Benefit Committee ("CBC"), which addresses the needs of CSM's three hospital campuses collectively. The CBC is guided by the mission statement of CSM, and is comprised of administrative level leadership, managers, and staff involved in direct service to vulnerable people. Additionally, CBC includes a representative of the Patient Family Advisory Committee of CSM as a structured method for receiving community input. The CBC roles include the following:- Develop Community Assessment to determine needs over a two year period to address through CSM resources.- Create a Community Benefit Plan to drive CSM activities over several years.- Review and provide input to Community Benefit Reports to Ascension Health, Wisconsin Health Association and CHA.- Develop annual community benefit goals to include within CSM Integrated, Strategic, Operational and Financial Plan.- Provide input to and advocate for CSM organizational policies focused on vulnerable populations (e.g. outreach screening guidelines, transportation, collection policies).- Develop and implement communication strategies to inform multiple communities about Community Benefit achievements.- Develop a strategy to measure and increase the impact of Community Benefit programs.In fiscal 2010, the CBC prepared a Milwaukee Needs Assessment and Ozaukee Needs Assessment to guide its planning. The assessments were developed by gathering key public health and disease specific assessments for each community and synthesizing the assessments into one document for Milwaukee and Ozaukee from public sources such as HRSA Community Health Status Report for Ozaukee County, the Ozaukee Health Initiative 2002-2007, Children's Health in Wisconsin (Center for Health Statistics), Start Smart Milwaukee State of Milwaukee's Children Health Report, Healthiest Wisconsin 2010, City of Milwaukee Health Dept. Report, City of Milwaukee Community Health Survey, HRSA Community Health Status Report for Milwaukee County, Wisconsin DHFS Family Health Survey, Wisconsin DHFS Health Insurance Coverage Report, Riverwest Health Initiatives Survey Report, Milwaukee's Commitment to Action: Report from the 2003 Urban Health Forum, Milwaukee Public Health Report by Aldermanic District, Wisconsin County Health Rankings 2006 and Wisconsin Nutrition and Physical Activity State Plan. Several of these surveys include direct citizen input regarding the state of their health.The Needs Assessment was discussed in detail by the CBC to gain the insight of those at CSM involved in all areas of health and community health. The plan that was subsequently developed focused on care for vulnerable people consistent with the CSM Mission Statement. | NeedsAssessment |
| Patient Education Assistance | Part VI, Line 3: CSM attempts to identify patients who may be eligible for charity or discounted care as outlined in the charity care policy during the pre-registration, registration, admissions and discharge processes. A copy of the charity care policy is posted in the emergency room, and a summary of the policy is provided to patients with admission and discharge paperwork. CSM has trained financial counselors available to discuss payment options to the patients. Upon making an appointment, the financial counselors will meet with the patient to determine what other financial assistance programs the patient may qualify for. | PatientEducationAssistance |
| Community Information | Part VI, Line 4: CSM primarily serves the Milwaukee and Ozaukee counties in southeastern Wisconsin. OHOW is located in an urban community within Milwaukee County. The population of Milwaukee County is approximately 960,000, with over 17% of the households living at or below federal poverty guidelines. The median income is approximately $46,000, over 42% of the population is a minority, and approximately 13% of the population speak a language other than English. Discounts for the uninsured and underinsured are not included in Parts I or II of Schedule H. | CommunityInformation |
| Community Building Activities | Part VI, Line 5: OHOW has not reported any community buidling activities; however, CSM provides significant community building activities throughout its system. In order to accomplish the collaborative work in the community and to oversee access clinics and outreach programs, CSM has a Community Services Department which oversees the CSM Community Benefit Process. Programs to promote the health of the communities which the CSM organizations are affiliated with include:- The INROADS Program -- this program is a collaboration between CSM and the Milwaukee INROADS cooperative to provide culturally diverse college students an opportunity to experience the healthcare workplace. CSM has a strong record of hiring INROADS graduates after their internship experience. - Milwaukee Health Care Partnership (MHCP) -- CSM is a founding member of the Milwaukee Health Care Partnership (MHCP), which is a collaboration between the five Milwaukee health systems and Federally Qualified Health Centers to improve access to health care in the community. The partnership has worked with County health officials to improve behavioral access and Partnership funding supports mental health respite beds in the community. CSM's CEO and Mission Access Vice President each spend significant time in MHCP collaborative work. - Collaboration with community churches -- Access to health education and screening in many areas of the city is best accomplished through church collaboration. CSM employs three nurses to work in collaboration with churches and community organizations to offer health education, health screening, and care management support to parishioners and community members in a variety of outreach programs affiliated with churches. CSM developed the beginning stages of a collaboration with 44 Church of God in Christ churches in Milwaukee to accomplish better health awareness and improve screening rates. | CommunityBuildingActivities |
| Other Information | Part VI, Line 6: Community benefit activities often focus on access to primary care through free or reduced cost clinics sponsored by CSM. Following are several examples in which the hospitals of CSM focus on the connection between community needs and Community Benefit Plan activities. Infant mortality, particularly among the African American community in Milwaukee, is a particular health issue needing improvement. CSM has been an important collaborator in city and state efforts to improve birth outcomes and reduce infant mortality rates in Milwaukee. CSM has supported the Lifecourse Initiative for Healthy Families as a community/academic partnership for initiation of a five year funded plan for mortality improvement. CSM has an internal committee, CSM Healthy Families, that meets to plan improvements in support to families. A particular focus has been that of Safe Sleep initiatives to assure that infants have a safe place to sleep by providing Pack and Play cribs for mothers without a dedicated infant sleep space. Additionally, parents are educated about the importance of an infant sleeping on his back through a "Back to Sleep" campaign of infant apparel with that message imprinted. CSM's Community Needs Assessment has identified access to primary care has been a community problem in Milwaukee. CSM has responded to that need by sponsoring St. Ben's Clinic, the Community-based Chronic Disease Management Clinic which is a hypertension treatment center housed in a food pantry, the Seton Dental Clinic and the Saturday Clinic for the Uninsured. CSM sponsors medical residency education programs through the CSM Family Health Center and the OB/GYN Clinic. Each center offers sliding fee scales to uninsured and underinsured patients. Lack of access to oral health care has also been identified in the Needs Assessment. CSM sponsored the Smart Smiles program of school-based oral health care to serve 4,000 children in fiscal 2010. Dentist assessment, oral hygiene care, dental sealants and fluoride treatments are provided in more than 30 schools to meet these needs. The St. Elizabeth Ann Seton Dental Clinic serves as the urgent dental care provider for uninsured people in Milwaukee. Disparities exist in cancer diagnosis and treatment in the communities CSM serves. CSM responded by providing a Breast Health Advocate to link African American and Hispanic women into mammography and further diagnostic testing to find disease earlier and to provide more effective treatment. Columbia College of Nursing students and faculty staff El Centro de Salud nursing center at the United Community Center, which provides immunizations, physicals, health education, health promotion, screening and support to students of United Community Center preschool, elementary and middle schools, as well as to adults in family programs and older adult services.CSM collaborates with the Medical College of Wisconsin in sponsoring the following:-The Family Health Center, a residency-based Family Medicine clinic that provides primary care to more than 9,000 individuals in the community.- The OB/GYN Clinic, a residency-based program that serves over 150 patients, 250 OB appointments per month, and 325 deliveries per year.- The Chronic Disease Management Clinic, which screens and manages hypertension, diabetes, obesity, and smoking for low income adults through a clinic based in a food pantry. - The Saturday Clinic for the Uninsured, which uses medical students and volunteer physicians to serve hundreds of uninsured patients each year.Housecalls for the Homebound provides high-quality primary care to approximately 90 elderly patients in their homes who are too frail to travel to physicians' offices. Additional areas of Community Support include CSM's partnership with Sixteenth Street Community Health Center (SSCHC), a Federally Qualified Health Center (FQHC) that serves primarily Hispanic and Asian people in Milwaukee. CSM is the primary hospital to accept admissions and work closely with SSCHC to improve the health of its patients. Many of its patients are uninsured and ineligible for coverage. This has impact on CSM's charity care funding. CSM also employs a cadre of skilled interpreters to assure that communication is excellent for Spanish-speaking patients. | OtherInformation |
| Affiliated Health Care System | Part VI, Line 7: The CSM health system focuses on contributing to the positive health status of the communities it serves. CSM is an organization comprised of FOUR hospitals, 66 community clinics, The Columbia College of Nursing, Seton Children's School, a partnership with the Orthopaedic Hospital of Wisconsin, and four Urgent Care Centers. CSM provides care for individuals and families throughout Milwaukee, Ozaukee, Washington, and Sheboygan counties - with more than 160 years of service to individuals and families in these communities.OHOW itself is a specialty hospital which performs more than 5,000 surgical procedures each year and offers the complete range of orthopaedic services, including joint replacements and spine procedures, rehabilitation, diagnostic testing and pain management services. As a member of Ascension Health, the nation's largest Catholic healthcare system, CSM continues to build and strengthen sustainable collaborative efforts that benefit the health of individuals, families, and society as a whole. The goal of CSM is to perpetuate the health mission of the church. CSM furthers this goal through delivery of patient services, care to the elderly and indigent, patient education and health awareness programs for the community, and medical research. Our concern for all human life and dignity of each person leads the organization to provide medical services to all people in the community without regard to the patient's race, creed, national origin, economic status, or ability to pay.CSM employs a Community Benefit Philosophy in program planning and implementation. CSM provides for the health of the community through financial support provided to patients by financial discounts and contracts, by developing clinics and services for specific vulnerable groups, by sponsoring community education and training and by collaborating with government programs.During fiscal 2010, the CSM system provided more than $76,293,000 in unreimbursed services, including $8,296,000 in traditional charity care, $4,682,000 in discounts to the uninsured, $15,497,000 in community benefit programs, and $47,818,000 in other unpaid public programs, including subsidized health care, professional education, financial contributions and community building activities.In addition, CSM's governing body is comprised of local community leaders and physicians, the majority of whom reside within the communities CSM serves and are neither employees nor contractors of the organization, nor family members thereof. The CSM hospitals extend medical staff privileges to all qualified physicians in its community; however, the clinics within the organization are served by physicians affiliated with CSM. | AffiliatedHealthCareSystem |
| Reports Filed With States | WI | ReportsFiledWithStates |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WISCONSIN PRIMARY HEALTH CARE ASSOCIATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4600 AMERICAN PARKWAY SUITE 204 | AddressLine1 |
| City | MADISON | City |
| State | WI | State |
| ZIP Code | 53718 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amount Of Cash Grant | 360000 | AmountOfCashGrant |
| Amount Of Non Cash Assistance | 0 | AmountOfNonCashAssistance |
| Purpose Of Grant | Contribution to Milwaukee Health Centers | PurposeOfGrant |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Procedure for Monitoring Grants in the U.S.: | Identifier |
| Return Reference | Part I, Line 2: | ReturnReference |
| Explanation | Schedule I, Part I, Line 2: CONTRIBUTIONS TO GOVERNMENTS AND ORGANIZATIONS IN THE UNITED STATES ARE APPROVED BY THE BOARD OF DIRECTORS AND/OR THE PRESIDENT & CEO. ALL RECORDS OF OUTGOING CONTRIBUTIONS ARE RETAINED FOR A PERIOD OF 10 YEARS, PLUS THE CURRENT FISCAL YEAR, AND CAN BE LOCATED AT THE OFFICE CENTER AT 4425 NORTH PORT WASHINGTON RD, GLENDALE, WI 53212. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 1 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (16 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| David Hoogerland MD | |||||||||||||
| 0 | 277661 | 0 | 130953 | 0 | 23950 | 0 | 77222 | 0 | 44645 | 0 | 554431 | 0 | 0 |
| Kevin Goniu MD | |||||||||||||
| 0 | 486446 | 0 | 128304 | 0 | 24559 | 0 | 60246 | 0 | 61612 | 0 | 761167 | 0 | 0 |
| Leo P Brideau | |||||||||||||
| 798447 | 0 | 476201 | 0 | 198660 | 0 | 28394 | 0 | 72708 | 0 | 1574410 | 0 | 0 | 0 |
| RHONDA ANDERSON | |||||||||||||
| 195895 | 0 | 34948 | 0 | 176651 | 0 | 42866 | 0 | 26135 | 0 | 476495 | 0 | 0 | 0 |
| Amy Marquardt | |||||||||||||
| 233573 | 0 | 57036 | 0 | 8201 | 0 | 54863 | 0 | 16489 | 0 | 370162 | 0 | 0 | 0 |
| Cheryl Hill | |||||||||||||
| 219299 | 0 | 53299 | 0 | 24549 | 0 | 52790 | 0 | 30913 | 0 | 380850 | 0 | 0 | 0 |
| David H Shapiro MD | |||||||||||||
| 285875 | 0 | 76138 | 0 | 22197 | 0 | 58604 | 0 | 13275 | 0 | 456089 | 0 | 0 | 0 |
| Gerri Lietz-Staffileno | |||||||||||||
| 0 | 201070 | 0 | 46991 | 0 | 22893 | 0 | 80675 | 0 | 28590 | 0 | 380219 | 0 | 0 |
| Karol Marciano | |||||||||||||
| 254858 | 0 | 74629 | 0 | 23578 | 0 | 39499 | 0 | 23859 | 0 | 416423 | 0 | 0 | 0 |
| Mary Paul | |||||||||||||
| 0 | 351746 | 0 | 90618 | 0 | 58833 | 0 | 33570 | 0 | 12480 | 0 | 547247 | 0 | 0 |
| Sue Sanicola | |||||||||||||
| 169501 | 0 | 42068 | 0 | 29989 | 0 | 33659 | 0 | 31045 | 0 | 306262 | 0 | 0 | 0 |
| William Hart | |||||||||||||
| 0 | 256800 | 0 | 58441 | 0 | 5055 | 0 | 21157 | 0 | 22496 | 0 | 363949 | 0 | 0 |
| Constance J Bradley | |||||||||||||
| 0 | 186947 | 0 | 41176 | 0 | 7593 | 0 | 15567 | 0 | 17663 | 0 | 268946 | 0 | 0 |
| Paul Westrick | |||||||||||||
| 180760 | 0 | 40828 | 0 | 7941 | 0 | 57618 | 0 | 39203 | 0 | 326350 | 0 | 0 | 0 |
| Brian Regan | |||||||||||||
| 166422 | 0 | 92185 | 0 | 48733 | 0 | 18436 | 0 | 18352 | 0 | 344128 | 0 | 0 | 0 |
| Therese Pandl | |||||||||||||
| 0 | 192746 | 0 | 37500 | 0 | 544745 | 0 | 51668 | 0 | 20173 | 0 | 846832 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| Part I, Line 4a | PART I, LINE 4B: ELIGIBLE EXECUTIVES PARTICIPATE IN A PROGRAM THAT PROVIDES FOR SUPPLEMENTAL RETIREMENT BENEFITS. THE PAYMENT OF BENEFITS UNDER THE PROGRAM, IF ANY, IS ENTIRELY DEPENDENT UPON THE FACTS AND CIRCUMSTANCES UNDER WHICH THE EXECUTIVE TERMINATES EMPLOYMENT WITH THE ORGANIZATION. BENEFITS UNDER THE PROGRAM ARE UNFUNDED AND NON-VESTED. DUE TO THE SUBSTANTIAL RISK OF FORFEITURE PROVISION, THERE IS NO GUARANTEE THAT THESE EXECUTIVES WILL EVER RECEIVE ANY BENEFIT UNDER THE PROGRAM. ANY AMOUNT ULTIMATELY PAID UNDER THE PROGRAM TO THE EXECUTIVE IS REPORTED AS COMPENSATION ON FORM 990, SCHEDULE J, PART II, COLUMN B IN THE YEAR PAID. THE FILING ORGANIZATION (CSM) DID NOT CONTRIBUTE ANY AMOUNT TO THIS PLAN THIS YEAR. |
| Part I, Line 7 | BOARD MEMBERS, OFFICERS, KEY EMPLOYEES AND HIGHEST COMPENSATED EMPLOYEES WHO ARE EMPLOYED BY THE CSM ORGANIZATIONS AND ARE MEDICAL DOCTORS ARE ELIGIBLE TO RECEIVE A PERCENTAGE OF THE REVENUE GENERATED FROM PATIENTS THEY SERVE, BASED ON ESTABLISHED GUIDELINES. OFFICERS AND KEY EMPLOYEES PARTICIPATE IN A MANAGEMENT INCENTIVE PLAN, WHEREBY CERTAIN FINANCIAL TRIGGERS OF THE CSM SYSTEM AS APPROVED BY THE BOARD MUST BE MET BEFORE ANY ELIGIBLE EMPLOYEE MAY RECEIVE PAYMENT OF THE INCENTIVE. ONCE THE TRIGGER IS MET, THE INCENTIVE IS MEASURED BASED ON VARIOUS ESTABLISHED GOALS, INCLUDING OPERATING MARGIN, PATIENT SATISFACTION, QUALITY, AND PRODUCTIVITY. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (9 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| Form 990, Part VI, Section A, line 4 | CSM AMENDED ITS ARTICLES OF INCORPORATION EFFECTIVE MARCH 2010. A FEW SMALL CHANGES WERE MADE TO THE ARTICLES AND BYLAWS OF COLUMBIA ST. MARY'S, INC. AND COLUMBIA ST. MARY'S HOSPITAL MILWAUKEE, INC. TO BETTER ALIGN WITH CSM'S MAIN SPONSOR, ASCENSION HEALTH. OF SIGNIFICANCE, HOWEVER, IS THE LEGAL NAME CHANGE OF ST. MARY'S HOSPITAL OZAUKEE, INC. TO COLUMBIA ST. MARY'S HOSPITAL OZAUKEE, INC. | |
| Form 990, Part VI, Section A, line 6 | CSM HAS TWO CORPORATE MEMBERS: ASCENSION HEALTH AND COLUMBIA HEALTH SYSTEM. | |
| Form 990, Part VI, Section A, line 7a | ONE OF CSM'S CORPORATE MEMBERS, ASCENSION HEALTH, HAS THE ABILITY TO ELECT MEMBERS TO THE GOVERNING BODY OF CSM. | |
| Form 990, Part VI, Section A, line 7b | Ascension Health has designed a system authority matrix which assigns authority for key decisions that are necessary in the operation of the system. Specific areas that are identified in the authority matrix are: new organizations & major transactions; governing documents; appointments/removals; evaluation; debt limits; strategic & financial plans; assets; system policies & procedures. These areas are subject to certain levels of approval by Ascension per the system authority matrix. Columbia Health System has the authority to approve any changes to the governing documents which would affect its interest or rights in CSM, the mission and vision statements of CSM, and any major corporate structural transactions of CSM. | |
| Form 990, Part VI, Section B, line 11 | Management, including certain officers, works diligently to complete the Form 990 and attached schedules in a thorough manner. Management presents the Form to the Board, or a designated committee, to review and answer any questions. Prior to filing the return, all Board Members are provided the Form 990 and management team members are available to answer any Board Members questions. | |
| Form 990, Part VI, Section B, line 12c | CSM HAS A WRITTEN CONFLICT OF INTEREST POLICY. THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE POLICY IN THAT ANY DIRECTOR, PRINCIPAL OFFICER, OR MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS, WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST, MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF THE COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. THE REMAINING INDIVIDUALS ON THE GOVERNING BOARD OR COMMITTEE MEETING WILL DECIDE IF CONFLICTS OF INTEREST EXIST. EACH DIRECTOR, PRINCIPAL OFFICER, AND MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS ANNUALLY SIGNS A STATEMENT WHICH AFFIRMS SUCH PERSON HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY, AND UNDERSTANDS THAT THE ORGANIZATION IS CHARITABLE AND IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ITS TAX EXEMPT PURPOSE. | |
| Form 990, Part VI, Section B, line 15 | IN DETERMINING COMPENSATION OF THE ORGANIZATION'S CEO, EXECUTIVE DIRECTOR, OR TOP MANAGEMENT OFFICIAL, THE PROCESS INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE AUDIT COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE CEO WAS COMPARED TO OTHER HOSPITALS IN THE AREA THAT HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE BOARD MINUTES. THE CEO WAS NOT PRESENT WHEN HIS COMPENSATION WAS DECIDED. IN DETERMINING COMPENSATION OF OTHER OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION, THE PROCESS INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE AUDIT COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATIONS, THE OTHER OFFICERS OR KEY EMPLOYEES OF THE ORGANIZATION WERE COMPARED TO OTHER HOSPITALS' EMPLOYEES IN THE AREA THAT HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE BOARD MINUTES. | |
| Form 990, Part VI, Section C, line 19 | THE ORGANIZATION WILL PROVIDE ANY DOCUMENTS OPEN TO PUBLIC INSPECTION UPON REQUEST. CSM DOES PUBLISH AN ANNUAL REPORT AND FACT SHEETS ON THE EXTERNAL WEBSITE, WHICH IS AVAILABLE FOR PUBLIC VIEWING. | |
| FORM 990, PART VII | THE KEY EMPLOYEES AND OFFICERS LISTED ON FORM 990, PART VII PROVIDE SERVICES TO THIS ORGANIZATION AS WELL AS OTHER RELATED CSM ORGANIZATIONS. THE HOURS REPORTED IN COLUMN (B) REPRESENT THE ESTIMATED PERCENTAGE OF TIME THESE INDIVIDUALS DEVOTE TO THE REPORTING ORGANIZATION BASED ON A 40-HOUR WEEK. THE TOTAL AVERAGE HOURS PER WEEK THESE INDIVIDUALS SPEND ON ALL CSM ORGANIZATIONS, INCLUDING THIS ORGANIZATION, EXCEED 40 HOURS. | AVERAGE HOURS OF OFFICERS/KEY EMPLOYEES |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (8 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|
| COLUMBIA ST MARY'S HOSPITAL MILWAUKEE INC | ||||||||||
| 4425 NORTH PORT WASHINGTON ROAD | MILWAUKEE | WI | 53212 | 390806315 | HOSPITAL | WI | 501(c)(3) | 3 | COLUMBIA ST MARY'S INC | |
| COLUMBIA ST MARY'S HOSPITAL OZAUKEE INC | ||||||||||
| 4425 NORTH PORT WASHINGTON ROAD | MILWAUKEE | WI | 53212 | 390807063 | HOSPITAL | WI | 501(c)(3) | 3 | COLUMBIA ST MARY'S INC | |
| SACRED HEART REHABILITATION INSTITUTE INC | ||||||||||
| 4425 NORTH PORT WASHINGTON ROAD | MILWAUKEE | WI | 53212 | 390902199 | REHAB FACILITY | WI | 501(c)(3) | 3 | COLUMBIA ST MARY'S HOSPITAL MILWAUKEE INC | |
| COLUMBIA COLLEGE OF NURSING INC | ||||||||||
| 4425 NORTH PORT WASHINGTON ROAD | MILWAUKEE | WI | 53212 | 391596986 | COLLEGE | WI | 501(c)(3) | 2 | COLUMBIA ST MARY'S HOSPITAL MILWAUKEE INC | |
| SETON CHILDREN'S SCHOOL INC | ||||||||||
| 4425 NORTH PORT WASHINGTON ROAD | MILWAUKEE | WI | 53212 | 391391245 | SCHOOL | WI | 501(c)(3) | 9 | COLUMBIA ST MARY'S HOSPITAL MILWAUKEE INC | |
| ASCENSION HEALTH | ||||||||||
| 4600 EDMUNDSON ROAD | ST LOUIS | MO | 63136 | 311662309 | Health System | MO | 501(c)(3) | 11 | N/A | |
| HORIZON HOME CARE & HOSPICE INC | ||||||||||
| 8949 N DEERBROOK TRL | MILWAUKEE | WI | 53223 | 391171298 | HOME CARE/HOSPICE | WI | 501(c)(3) | 3 | COLUMBIA ST MARY'S INC | |
| COLUMBIA HEALTH SYSTEM | ||||||||||
| 4425 NORTH PORT WASHINGTON ROAD | MILWAUKEE | WI | 53212 | 391494977 | Health System | WI | 501(c)(3) | 11 | N/A | |
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ORTHOPAEDIC HOSPITAL OF WISCONSIN LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 575 RIVERWOODS PKWY | AddressLine1 |
| City | GLENDALE | City |
| State | WI | State |
| ZIP Code | 53212 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 392015655 | EIN |
| Primary Activity | HEALTH CARE | PrimaryActivity |
| Legal Domicile State | WI | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COLUMBIA ST MARY'S INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | RELATED | PredominantIncomeType |
| Share Of Total Income | 9406958 | ShareOfTotalIncome |
| Share Of EOY Assets | 13211340 | ShareOfEOYAssets |
| Disproportionate Allocations | 0 | DisproportionateAllocations |
| General Or Managing Partner | 1 | GeneralOrManagingPartner |
Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|
| CSM STRATEGIC ALLIANCE | |||||||||||
| 4425 NORTH PORT Washington Rd | GLENDALE | WI | 53212 | 391871856 | HEALTHCARE | WI | COLUMBIA ST MARY'S INC | C | -1383 | 43395 | 0.50000 |
| MADISON MEDICAL AFFILIATES INC | |||||||||||
| 4425 NORTH PORT Washington Rd | GLENDALE | WI | 53212 | 391855720 | HEALTHCARE | WI | COLUMBIA ST MARY'S HOSPITAL MILWAUKEE INC | C | -7062669 | 13360266 | 1.00000 |
| PROSPECT MEDICAL COMMONS CONDO ASSOCIATION | |||||||||||
| 4425 NORTH PORT Washington Rd | GLENDALE | WI | 53212 | 208042108 | CONDO ASSOC | WI | COLUMBIA ST MARY'S INC | C | 0.70000 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 1 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (12 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|
| ORTHOPAEDIC HOSPITAL OF WISCONSIN | |
| O | 446797 |
| ASCENSION HEALTH | |
| E | 145678466 |
| COLUMBIA ST MARY'S HOSPITAL MILWAUKEE | |
| Q | 9583711 |
| COLUMBIA ST MARY'S HOSPITAL OZAUKEE | |
| Q | 4100225 |
| SACRED HEART REHABILITATION INSTITUTE | |
| Q | 121795 |
| orthOPAEDIC HOSPITAL OF WISCONSIN | |
| Q | 24507000 |
| COLUMBIA COLLEGE OF NURSING | |
| Q | 2845000 |
| SETON CHILDREN'S SCHOOL | |
| Q | 1800000 |
| COLUMBIA ST MARY'S HOSPITAL MILWAUKEE | |
| Q | 524529000 |
| COLUMBIA ST MARY'S HOSPITAL OZAUKEE | |
| Q | 96291000 |
| ascENSION HEALTH | |
| Q | 6703068 |
| asCENSION HEALTH | |
| Q | 4322416 |
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