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        <OtherCompensation>12899</OtherCompensation>
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      <Form990PartVIISectionA>
        <NamePerson>LARRY CROTS</NamePerson>
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        <ReportableCompFromOrganization>137419</ReportableCompFromOrganization>
        <ReportableCompFromRelatedOrgs>0</ReportableCompFromRelatedOrgs>
        <OtherCompensation>7908</OtherCompensation>
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        <NamePerson>DAVID HOFFMAN</NamePerson>
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        <ReportableCompFromOrganization>125941</ReportableCompFromOrganization>
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        <OtherCompensation>90870</OtherCompensation>
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        <NamePerson>MATTHEW NICHOLAS</NamePerson>
        <Title>CLINICAL LEAD PHARMACIST</Title>
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      <NumberIndividualsGT100K>12</NumberIndividualsGT100K>
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      <ContractorCompensation>
        <NameOfContractor>
          <NameBusiness>
            <BusinessNameLine1>Affinity Health System inc</BusinessNameLine1>
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        <AddressOfContractor>
          <AddressUS>
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        <DescriptionOfServices>Salaries, Legal, Consulting, Misc Serv</DescriptionOfServices>
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      <ContractorCompensation>
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          <NameBusiness>
            <BusinessNameLine1>Ministry Health Care inc</BusinessNameLine1>
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        <AddressOfContractor>
          <AddressUS>
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            <City>Milwaukee</City>
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        <DescriptionOfServices>Management</DescriptionOfServices>
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      <ContractorCompensation>
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          <NameBusiness>
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          <AddressUS>
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          <AddressUS>
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            <State>WI</State>
            <ZIPCode>54952</ZIPCode>
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        <DescriptionOfServices>Physician Services, Salaries, Misc Serv</DescriptionOfServices>
        <Compensation>754237</Compensation>
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      <ContractorCompensation>
        <NameOfContractor>
          <NameBusiness>
            <BusinessNameLine1>Marshfield Laboratories</BusinessNameLine1>
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          <AddressUS>
            <AddressLine1>1000 N Oak Ave</AddressLine1>
            <City>Marshfield</City>
            <State>WI</State>
            <ZIPCode>54449</ZIPCode>
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        <DescriptionOfServices>Lab Services</DescriptionOfServices>
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      <AllOtherContributions>184995</AllOtherContributions>
      <TotalContributions>184995</TotalContributions>
      <ProgramServiceRevenue>
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        <BusinessCode>624100</BusinessCode>
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        <RelatedOrExemptFunctionIncome>114399747</RelatedOrExemptFunctionIncome>
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      <ProgramServiceRevenue>
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        <ExclusionAmount>550448</ExclusionAmount>
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      <ProgramServiceRevenue>
        <Description>OUT PATIENT LAB REVENU</Description>
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        <UnrelatedBusinessRevenue>391235</UnrelatedBusinessRevenue>
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      <ProgramServiceRevenue>
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        <ExclusionAmount>349013</ExclusionAmount>
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      <ProgramServiceRevenue>
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        <ExclusionAmount>4649498</ExclusionAmount>
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      <GrossRents>
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      <LessRentalExpenses>
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      <RentalIncomeOrLoss>
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      <NetRentalIncomeOrLoss>
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        <Other>138585</Other>
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      <NetGainOrLossInvestments>
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        <ExclusionAmount>138591</ExclusionAmount>
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      <GrantsToDomesticOrgs>
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        <ProgramServices>590755</ProgramServices>
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      <CompCurrentOfficersDirectors>
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        <ManagementAndGeneral>635787</ManagementAndGeneral>
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        <ProgramServices>29021369</ProgramServices>
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      <PensionPlanContributions>
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      <PayrollTaxes>
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        <ProgramServices>1772440</ProgramServices>
        <ManagementAndGeneral>622082</ManagementAndGeneral>
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      <FeesForServicesLegal>
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        <ManagementAndGeneral>332</ManagementAndGeneral>
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      <FeesForServicesAccounting>
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        <ManagementAndGeneral>8344</ManagementAndGeneral>
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      <OfficeExpenses>
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        <ProgramServices>19501936</ProgramServices>
        <ManagementAndGeneral>908470</ManagementAndGeneral>
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      <InformationTechnology>
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        <ProgramServices>3188</ProgramServices>
        <ManagementAndGeneral>5300</ManagementAndGeneral>
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      <Occupancy>
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        <ManagementAndGeneral>562787</ManagementAndGeneral>
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      <Travel>
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        <ProgramServices>21246</ProgramServices>
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      <Interest>
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        <ProgramServices>1641692</ProgramServices>
        <ManagementAndGeneral>651159</ManagementAndGeneral>
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        <ManagementAndGeneral>545542</ManagementAndGeneral>
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        <ProgramServices>3467234</ProgramServices>
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      <OtherExpenses>
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      <TotalLiabilities>
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      <FollowSFAS117>X</FollowSFAS117>
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      <TotalNetAssetsFundBalances>
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      <TotalLiabNetAssetsFundBalances>
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        <EOY>251577831</EOY>
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      <MethodOfAccountingAccrual>X</MethodOfAccountingAccrual>
      <AccountantCompileOrReview>0</AccountantCompileOrReview>
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          <BusinessNameLine1>Mercy Medical Center</BusinessNameLine1>
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          <AddressLine1>500 S OAKWOOD RAOD</AddressLine1>
          <City>Oshkosh</City>
          <State>WI</State>
          <ZIPCode>54904</ZIPCode>
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      <Form990ScheduleHPartVI>
        <IncomeBasedCriteria>Part I, Line 3c: It is the policy of Mercy Medical Center to provide medically necessary health care services to people in the communities it serves, regardless of their ability to pay. Affinity Care financial assistance is granted based upon the patient's inability to pay and to individuals who are uninsured, underinsured or medically indigent. Affinity Care works in collaboration with other financial (both public and private) assistance programs. This is to ensure holistic wellness of patients by facilitating knowledge of available services and programs for health while practicing good stewardship of funds. Key criteria utilized to determine eligibility for Affinity Care financial assistance includes family size, federal poverty income guidelines and available assets. The available asset test includes consideration of the amount of equity in a home, automobiles, and savings accounts which are considered part of total allowable income when assessing against the federal poverty income guidelines.</IncomeBasedCriteria>
        <CostingMethodUsed>Part I, Line 7: Amounts calculated in Part I, Line 7 are determined both on a cost accounting system and a cost-to-charge ratio. Other Benefits are determined based on the direct and indirect costs (where allocated) associated with a program net of earned revenue. Detail for each program/activity is maintained and determined at the department level. Charity care and means-tested programs are determined based on a cost-to-charge ratio consistent with Worksheet 2, Ratio of Patient Care Cost to Charges. Prior year cost report settlements are excluded from the shortfall calculation in order to get a true fiscal year shortfall amount.</CostingMethodUsed>
        <PercentOfTotalExpenseExpln>Part I, Line 7f: Bad debt expense of $3,467,234 included on Form 990, Part IX, Line 25 was excluded from the denominator per instructions when calculating the percent of total expenses on Schedule H.</PercentOfTotalExpenseExpln>
        <BadDebtFootnote>Part III, Line 4: No footnote exists in Mercy Medical Center's financials statements that describe bad debt expense. Bad debt expense is recorded in a consistent manner with the organization's collection policies. Bad debt expense includes accounts which are written off and estimates made on live accounts based on historical payment trends and account modeling.A number of patients are truly unable to pay their out-of-pocket liability, but do not complete the process required to apply for financial assistance under the hospital's Affinity Care policy. These patients would qualify for Affinity Care if they completed the charity application, so the bad debt expense associated with treating them should be treated as community benefit. The organization does have a presumptive eligibility program in place to help identify indigent patients and minimize the instances of when they become a bad debt. The administrative requirements to determine whether patients who do not cooperate with the financial assistance process would have qualified for charity can be burdensome, particularly for small balances.</BadDebtFootnote>
        <ShortfallAsCommunityBenefit>Part III, Line 8: The shortfall associated with Medicare should be considered a community benefit for several reasons. First, IRS Rev. Rul. 69-545, which established the community benefit standard for non-profit hospitals, states that if a hospital serves patients with government health benefits, including Medicare, then this is an indication that the hospital operates to promote the health of the community. This implies that treating Medicare patients is a community benefit. Second, for-profit specialty hospitals have been carving out certain high-margin services (i.e. cardiac, orthopedics, and oncology), leaving general acute care hospitals with lower-margin Medicare services. This indicates that Medicare losses can be a result of rendering these lower-margin services (which benefit the community) rather than inefficient operations. Lastly, the community which the organization serves has Medicare as the largest payer. The organization must accept these patients regardless of whether they make a surplus or deficit from providing such services. If the Medicare participation is premised on this fact, then providing Medicare services promotes access to healthcare services which is a community benefit. The demographic of the community is also an aging and underserved population who experience issues with access to healthcare services. Without tax-exempt hospitals providing Medicare services, CMS would bear the burden of directly providing services to the elderly.</ShortfallAsCommunityBenefit>
        <DebtCollectionPolicy>Part III, Line 9b: Mercy Medical Center has a debt collection policy which sets forth collection practices for patients who are known to qualify or may qualify for financial assistance under the charity care program. Sufficient financial counseling support is made available to patients so they can easily access patient financial service representatives and have their questions answered, and gain an understanding of the reasons why they owe a balance. Accounts are designated as charity care in the business offices so no additional time is spent on collection efforts.</DebtCollectionPolicy>
        <GeneralExplanation>Part VI, Line 8, list of states receiving community benefit report: WIMercy Medical Center files their community benefit results in the State of Wisconsin. Their data is incorporated into a report for all Affinity Health System that ultimately is published in the area newspapers.</GeneralExplanation>
        <NeedsAssessment>Part VI, Line 2: Mercy Medical Center performs community health needs assessments as needed. Planning workgroups consisting of community partners (e.g. Community Health Improvement Partnership (CHIP)) are formed to define the community and its health needs through review of United Way Life Study results, Healthy People Initiatives, census documents, and local government health and welfare agencies. Considering other community resources/assets, data collection methods are used to identify particular problems or subgroups and areas known to have high poverty rates and to be underserved. The data is analyzed and priorities are set based on trending information which may target a specific need. When a need is identified, the hospital will collaborate through community partnerships (or individually) to address the identified need. Outcomes from the programs are measured and considered in subsequent community health needs assessments. The leadership at Affinity takes their commitment to the health and well-bring of the community it serves very seriously. In fact, it is listed as one of the key strategic goals of the health system. Senior leaders and management are also highly encouraged to provide direct service to the poor in their communities. Mercy Medical Center and the leadership also subscribe to publications like the Advisory Board to compare national trends to local trends to ensure the hospital is resourcing areas to meet patient needs.</NeedsAssessment>
        <PatientEducationAssistance>Part VI, Line 3: Mercy Medical Center goes to great lengths in order to inform and educate patients/persons who may be billed for patient care about their eligibility for assistance under federal, state or local government programs and under the organization's Affinity Care policy. The Affinity Care policy and application is posted on the organization's website. Admissions and other key areas contain summary information of the Affinity Care policy. As part of the intake/discharge process, patients are provided with a copy of the policy and other information for financial assistance. If during the course of the patient registration process, care encounter, treatment, or upon discharge it becomes evident that a patient may need financial assistance, the patient shall be referred to Mercy Medical Center's Affinity Care program. Patients may be identified as needing financial assistance at any time during the course of an encounter. A referral for consideration of Affinity Care financial assistance can be initiated by any member of the hospital's workforce, including medical staff members, who become aware of the patient's potential need for Affinity Care financial assistance. The Affinity Care policy was also translated into dialects prevalent in the community in order to reach out to those that may speak another language (Spanish and Hmong). Patient Registration staff and Financial Counselors are provided with scripts to follow when interacting with patients. As part of the Affinity Care process, patients must register with the county public assistance to see if they may qualify under any other federal or state programs.</PatientEducationAssistance>
        <CommunityInformation>Part VI, Line 4: While there is growing agreement in the United States about what constitutes a non-profit hospital's "community benefit", this is a work in progress. The organization provided significant charity care and other community benefits as defined by the IRS. But in addition, we believe that we provide a critically important community benefit, which is not quantified. Mercy Medical Center, like most community hospitals, was created and is maintained in order to provide care locally-care that without our hospital, may not be available locally.Certain specialized services available include: I/P Adult Behavioral Health services, I/P Rehabiliatation services, I/P Sub-acute(SNF) services.</CommunityInformation>
        <CommunityBuildingActivities>Part VI, Line 5: Community-building activities include programs that, while not directly related to health care, provide opportunities to address the root causes of health problems, such as poverty, homelessness, and environmental problems. These activities support community assets by offering the expertise and resources of the organization. Costs for these activities include cash, in-kind donations, and expenditures for the development of a variety of community health programs and partnerships.</CommunityBuildingActivities>
        <OtherInformation>Part VI, Line 6: Mercy Medical Center's governing board consists primarily of persons who reside within the primary service area. They are not employees of the organization.The organization strives to further its exempt purposes by the following:Mercy Medical Center participates in government-sponsored health programs (Medicare, Medicaid, CHAMPUS, General Relief, Specialized County Programs and Area Prisons).Mercy Medical Center donates food to area shelters.Mercy Heatlh Foundation donated funds to support area organizations that provide services to the following sectors of our population: low-income, physically and mentally challenged and chronically ill. Mercy Medical Center works with local Police departments in the performance of sexual assault exams. The patient does not incur a bill for the exam and the charges are written off. Mercy Medical Center provides community health improvement services through health education lectures, health fairs and support groups.Mercy Medical Center conducts Cardiac &amp; Pulmonary Rehabilitation family education sessions.Discounted care is provided to low income families up to 662% of Federal Poverty Guidelines.Mercy Medical Center is a Disproportionate Share Hospital with a combined Medicaid and SSI utilization of over 20.45%.Mercy Medical Center provides a subsidy to a School of Radiologic Technology Program.Mercy Medical Center serves as a sponsor site for clinical training of college students in various health care programs.Mercy Medical Center helps to subsidize an area community clinic that serves the uninsured and low income members of the community. Support consists of cash donations for operations, use of clinic building and lab and x-ray services.</OtherInformation>
        <AffiliatedHealthCareSystem>Part VI, Line 7: Mercy Medical Center, of Oshkosh, Wisconsin is part of an affiliated health care system called Affinity Health System. Affinity Health System also has two other hospitals, St. Elizabeth Hospital, in Appleton , WI and Calumet Medical Center, in Chilton, WI. The latter hospital qualifies as a Critical Access Hospital. In addition to the hospitals, Affinity Health System also has 25 area clinics under the control of Affinity Medical Group. The mission of Affinity, as a Catholic health care system, is to live out the healing ministry of by providing services that promote the health and well being of the communities we serve, especially the poor. Affinity Health System is sponsored equally by two Catholic health systems, Ministry Health Care, headquartered in Milwaukee, WI and Wheaton Franciscan Health Care, also headquartered in Milwaukee, WI. Mercy Medical Center and St. Elizabeth Hospital both subsidize area community medical clinics as well as community dental clinics. The 3 hospitals and the 25 clinics provide free or minimal cost health education , support and screening services for the populations they serve. Mercy Medical Center and St. Elizabeth Hospital both provide support for educational programs to educate future health care professionals. There is also an expectation that all people in management services at Affinity Health System will provide direct services to the poor. Mercy Medical Center has a foundation which is not included within the operations of the organization. The foundation provides cash donations which help support the mission of the organization and the affiliated health care system. Examples of the donations are included in item #6 above.</AffiliatedHealthCareSystem>
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          <BusinessNameLine1>MINISTRY HEALTH CARE INC</BusinessNameLine1>
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          <AddressLine1>11925 WEST LAKE PARK DR</AddressLine1>
          <City>MILWAUKEE</City>
          <State>WI</State>
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        <PurposeOfGrant>Grant to serve the poor.</PurposeOfGrant>
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        <ReturnReference>Part I, Line 2:</ReturnReference>
        <Explanation>Schedule I, Part I, Line 2: EACH YEAR MERCY MEDICAL CENTER PROVIDES A GRANT BASED ON AN INTEGRATION AGREEMENT. THE INTEGRATION AGREEMENT SUBSTANTIATES THE AMOUNT AND THE RECIPIENT OF THE GRANT.</Explanation>
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        <ReturnReference>Part I, Line 1b</ReturnReference>
        <Explanation>BUSINESS TRAVEL EXPENSES FOR SPOUSES OF EXECUTIVES AND GOLF CLUB MEMBERSHIP FOR EXECUTIVES ARE REIMBURSED AS PART OF THEIR EXECUTIVE FLEX CREDIT ACCOUNT. RECEIPTS ARE PROVIDED TO SR. ADMINISTRATIVE ASSISTANT IN HR WHO REVIEWS FOR ACCURACY, COMPLETES A REIMBURSEMENT FORM WITH SUBSTANTIATION TO PAYROLL FOR REIMBURSEMENT.</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <ReturnReference>Part I, Line 4b:</ReturnReference>
        <Explanation>John Oliverio received a 2009 taxable payout of $346,993 related to a supplemental nonqualified retirement plan known as Wheaton Franciscan Services Benefit Restoration Plan.</Explanation>
      </Form990ScheduleJPartIII>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Section A, line 6</Identifier>
        <Explanation>The corporate members of Mercy Medical Center of Oshkosh, Inc. are Ministry Health Care, Inc. and Affinity Health System, Inc.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Section A, line 7a</Identifier>
        <Explanation>Ministry Health Care has the power to approve and remove directors from Mercy Medical Center of Oshkosh, Inc.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Section A, line 7b</Identifier>
        <Explanation>Amendments of the articles of incorporation and bylaws must be approved by Ministry Health Care, Inc.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Section B, line 11</Identifier>
        <Explanation>THE CONTROLLER AND CFO OF AFFINITY HEALTH SYSTEM PERFORM A DETAIL REVIEW OF THE 990. AFTER MANAGEMENT REVIEW, A COPY OF THE 990 IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Section B, line 12c</Identifier>
        <Explanation>The board of directors receives a conflict of interest questionnaire every year.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Section B, line 15</Identifier>
        <Explanation>Each year the organization engages an independent compensation firm to provide market data for CEO, executives and key employee positions. This study is shared with the compensation committee of the board of directors for their review and recommendations regarding any compensation changes. The compensation committee is comprised of independent members. The CEO reviews each executive and key employee's annual performance appraisal ratings in making his compensation recommendations to the compensation committee. The compensation committee has the final authority to approve any and all amounts of compensation for members of the executive team. The final approval of compensation amounts are documented.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Section C, line 19</Identifier>
        <Explanation>The organization believes the financial statements, governing documents, and policies are the property of the organization and are not available for public inspection.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VII</Identifier>
        <ReturnReference>HOURS WORKED FOR RELATED ORGANIZATIONS</ReturnReference>
        <Explanation>Frank Chybowski, MD worked an average of 40 hours per week for a related organization. Mark Faustich, MD worked an average of 40 hours per week for a related organization. Joseph McCormick, MD worked an average of 40 hours per week for a related organization. Jay Muller, MD worked an average of 40 hours per week for a related organization. David Romond, MD worked an average of 40 hours per week for a related organization. Stacey Sensor, DO worked an average of 40 hours per week for a related organization. Barbara Strand, MD worked an average of 40 hours per week for a related organization. Daniel Neufelder worked an average of 29 hours per week for related organizations. Jeff Badger worked an average of 29 hours per week for related organizations. William Calhoun worked an average of 29 hours per week for related organizations. John Oliverio worked an average of 40 hours per week for a related organization. Nicholas Desien worked an average of 40 hours per week for a related organizaton.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part XI, Line 2B-2C</Identifier>
        <ReturnReference>Process for oversight of audit and selection of an indepedent accountant</ReturnReference>
        <Explanation>Mercy Medical Center of Oshkosh, Inc. (Organization) does not receive separately audited financial statements. The Organization is audited and reported through consolidated financial statements. The audit committee is responsible for the auditor selection. The audit statements are reviewed by the Controller, CFO, Ministry Health CFO, and the audit committee. This process has not changed from the prior year.</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
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        <NameOfDisregardedEntity>
          <BusinessNameLine1>St Elizabeth Hospital Inc</BusinessNameLine1>
        </NameOfDisregardedEntity>
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          <AddressLine1>1506 S Oneida Street</AddressLine1>
          <City>Appleton</City>
          <State>WI</State>
          <ZIPCode>54915</ZIPCode>
        </AddressUS>
        <EIN>390816818</EIN>
        <PrimaryActivities>Health Care Services</PrimaryActivities>
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          <State>WI</State>
          <ZIPCode>54952</ZIPCode>
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        <EIN>391127163</EIN>
        <PrimaryActivities>Clinical Healthcare Services</PrimaryActivities>
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      <ReimbursementPaidByOtherOrg>1</ReimbursementPaidByOtherOrg>
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</Return>