2024-05-10T17:23:13+00:00 2023-06-30 350921680 CROWE LLP 225 West Wacker Drive Suite 2600 Chicago IL 606061224 990 2022-07-01 390818682 St Mary's Hospital Medical Center of Green Bay Inc - Hospital Sisters STMA 9204330111 1726 SHAWANO AVENUE Green Bay WI 54303 Patricia Allen System CFO for Care Delivery 2024-05-10 true Patricia Allen 999009999 Mallory Fairless P01321579 3128997000 2022 2023-04-26 12:10:37Z Brian Charlier 1726 SHAWANO AVENUE Green Bay WI 54303 147032024 false 0928 X WWW.STMGB.ORG X 1900 WI TO REVEAL AND EMBODY CHRIST'S HEALING LOVE FOR ALL PEOPLE THROUGH OUR HIGH QUALITY FRANCISCAN HEALTH CARE MINISTRY. 11 10 709 69 605662 0 1971319 1007597 139292540 134972983 4833189 2395903 1207931 1747898 147304979 140124381 0 0 36574989 38783323 0 0 102152354 94699707 138727343 133483030 8577636 6641351 220737322 233488877 42014932 38053472 178722390 195435405 X TO CONTINUE CHRIST'S HEALING LOVE THROUGH DELIVERY OF COMPETENT & COMPASSIONATE HEALTHCARE IN AN ENVIRONMENT SENSITIVE TO THE NEEDS OF ALL PEOPLE. THE HOSPITAL IS COMMITTED TO PROVIDING A BROAD RANGE OF QUALITY INPATIENT AND OUTPATIENT SERVICES WITHOUT REGARD TO THE INDIVIDUAL'S RACE, CREED, HANDICAPS, OR FINANCIAL STATUS. false false 50733866 50837636 SURGERY - Surgical services at St Mary's Hospital Medical Center are comprised of central processing, anesthesia, surgery, and pre/post op surgery. This includes nine operating room suites and two minor treatment rooms. Services are available 24/7 and include both inpatient and outpatient procedures. In FY23 over 5,200 surgical procedures were performed. Surgical procedures include general, orthopedic, neuro, urology, gynecology, oral - maxillofacial, organ procurement, dental, Ent, ophthalmology, podiatry, and plastics. Anesthesia and central processing also provide hospital-wide services to inpatient nursing and to the emergency department. 20194596 21216085 CARDIOLOGY - Cardiology services at St Mary's Hospital Medical Center offers a complete array of catheterization laboratory procedures, noninvasive cardiovascular diagnostic procedures, and electrophysiology procedures. There were nearly 16,000 inpatient and outpatient cardiac procedures in FY23. If needed, a state of the art cardiovascular operating center (CVOR) is available nearby at our sister facility St. Vincent Hospital for cutting edge open heart procedures by our highly skilled cardiothoracic surgeon. CVIC (cardiovascular intensive care) suites are also offered there. For those patients who need follow-up cardio-pulmonary rehabilitation, a program is offered on site at St. Mary's. 19822581 16842605 INTERNAL MEDICINE - Internal Medicine services at St Mary's Hospital Medical center are comprised of general medicine, pulmonary, gastroenterology medical, and cardiology medical services. In FY23 a total of 3,164 patients were admitted to the hospital. The majority of these patients, 58%, are admitted through the Emergency Department. 22499993 45917933 Other program services at St. Mary's Hospital Medical Center are comprised of intensive care, emergency, center for digestive health, pharmacy, laboratory, respiratory therapy, rehabilitation, and other services. 22499993 45917933 113251036 true true false true false false false false false true false false true true true false true false false false false false false false false true true false false true false false false false false false false false false false false false true true false false false true X 1200 0 true 709 true true true false false false false false false false false false false false X 11 10 false false true false true true true true true false false true true true true true true true true true true X Linda Dace 6182342120 3051 Hollis Drive Springfield IL 62704 ANDREW J BAGNALL Wisconsin PRESIDENT & Division CEO - Wisconsin (UNTIL 11/1/22) 13.0 47.0 X X 0 842889 32735 BRIAN CHARLIER President/CEO 29.5 30.5 X X 418501 418501 136918 Dennis Langenberg Chair 1.0 1.0 X X 0 0 0 Michael Wickman Secretary 1.0 1.0 X X 0 0 0 Nicole Schneider Vice Chair 1.0 1.0 X X 0 0 0 Jody Boes BOARD MEMBER 1.0 1.0 X 0 0 0 KYLE MCCARTY MD Board Member 1.0 1.0 X 0 0 0 MARCU PEREZ Board Member 1.0 1.0 X 0 0 0 MITCH WECKOP BOARD MEMBER 1.0 1.0 X 0 0 0 PAULA HAFEMAN BOARD MEMBER 1.0 1.0 X 0 0 0 Sr Maureen Fagan OSF BOARD MEMBER 1.0 2.0 X 0 0 0 Stephanie Bakey MD BOARD MEMBER 1.0 1.0 X 0 0 0 Kimberly Hodgkinson CFO/Foundation Treasurer 1.0 59.0 X 0 508183 58066 PATRICIA ALLEN DIVISION CFO - WISCONSIN 3.0 57.0 X 0 541100 154396 TODD Smart Treasurer 0.3 59.8 X 0 329569 81262 Daniel DORAN DIVISIONAL DIRECTOR-CARDIOVASCULAR 40.0 0 X 207588 0 35395 Gregory Laehn Pharmacist 40.0 0 X 153268 0 15697 Jeffrey Jacobs Division Director- Facilities Management 40.0 0 X 176323 0 33240 PAMELA MIELKE Pharmacist 40.0 0 X 139527 0 25197 Sadie Johnsen Pharmacy Manager 40.0 0 X 154058 0 32146 1249265 2640242 605052 29 false true false MEDICAL SOLUTIONS 1010 N 102ND STREET OMAHA NE 68114 CONTRACT LABOR 5971980 SHEARWATER HEALTH INC 20 BURTON HILLS BLVD NASHVILLE TN 37215 CONTRACT LABOR 1828413 COMPASS ONE HEALTHCARE PO BOX 102289 ATLANTA GA 30368 CONTRACTED SERVICES 1144750 GREEN BAY ANESTHESIA ASSOC 225 S EXECUTIVE DRIVE BROOKFIELD WI 53005 MED PHYSICIAN FEES 954828 SUPERIOR HEALTH LINENS 5005 S PACKARD AVE CUDAHY WI 53110 CONTRACTED SERVICES 446584 13 0 0 0 94515 913082 0 1007597 PATIENT SERVICES 622110 134886860 134886860 0 0 Reference Lab 621500 158724 0 158724 0 Prevea Joint Venture 900099 -72601 -72601 0 0 0 0 0 0 134972983 2089573 0 0 2089573 0 0 0 0 0 0 0 0 2390779 0 3078153 0 -687374 0 -687374 0 0 -687374 310367 3825453 0 3829490 310367 -4037 306330 0 0 306330 CHILDCARE REVENUE 624410 1292835 446938 845897 OTHER OPERATING REVENUE 900099 1095637 0 0 1095637 GIFT SHOP REVENUE 453220 46800 0 0 46800 0 0 0 0 2435272 140124381 134814259 605662 3696863 486960 459684 27276 28490307 26894482 1595825 1507025 1422632 84393 6109580 5767444 342136 2189451 2066842 122609 1618311 1618311 4158617 1542345 2616272 0 2582 2582 28268517 28155107 113410 117325 106296 11029 2619458 2310409 309049 28969 23516 5453 63827 61182 2645 426981 426981 3917788 3903608 14180 305441 100562 204879 Purchased Services 49258376 36679902 12578474 MEDICAID TAX ASSESSMENT 2915200 2915200 Equipment Rental 552970 523283 29687 Licenses & Taxes 34478 28026 6452 410867 287934 122933 0 133483030 113251036 20231994 0 2320 1739 -181825 1036991 18870084 18268781 0 0 0 0 322000 304182 2980665 3126279 88289 195940 159517360 97674439 62162235 61842921 120599416 127479088 0 8815331 8128716 7078807 13104240 220737322 233488877 12296217 11931180 1805248 383340 20148151 18592743 0 0 7765316 7146209 42014932 38053472 X 178722390 195435405 178722390 195435405 220737322 233488877 X 6641351 3095555 6976109 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 17496 17496 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY ST. MARY'S HOSPITAL MEDICAL CENTER OF GREEN BAY, INC. ("THE HOSPITAL") IS A MEMBER OF THE CATHOLIC HEALTH ASSOCIATION ("CHA"), THE WISCONSIN HEALTH ASSOCIATION ("WHA"), AND THE AMERICAN HEALTH ASSOCIATION ("AHA"). AS A MEMBER OF THESE ORGANIZATIONS, THE HOSPITAL PAYS DUES, WITH PART OF THESE DUES BEING ATTRIBUTABLE TO LOBBYING FEES PAID BY THE ORGANIZATIONS. THE AMOUNT LISTED IS THE AMOUNT ATTRIBUTABLE TO THE HOSPITAL FROM ITS DUES PAID. THE ASSOCIATIONS THE HOSPITAL PAYS ARE AS FOLLOWS: - AMERICAN HOSPITAL ASSOCIATION ("AHA") AT 27.29% LOBBYING EXPENSE - CATHOLIC HEALTH ASSOCIATION ("CHA") AT 3.00% LOBBYING EXPENSE - WISCONSIN HOSPITAL ASSOCIATION ("WHA") AT 11.10% LOBBYING EXPENSE THE TOTAL AMOUNT OF ANNUAL DUES PAID TO EACH ASSOCIATION IS MULTIPLIED BY THE PERCENTAGE OF DUES ALLOCATED TO LOBBYING EXPENSE TO CALCULATE THE TOTAL LOBBYING EXPENDITURES PAID. 1608681 1608681 71153986 38078797 33075189 464255 377946 86309 39277907 26865029 12412878 47012531 32352667 14659864 61842921 OTHER ASSETS 585732 Accrued pension benefit 7229154 Operating Leases - ROU Asset 5289354 13104240 RETIREMENT OBLIGATION ASBESTOS 273702 Derivative Instrutment - SWAP 1427407 Operating Lease Liability 5445100 7146209 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote HSHS and the Foundation are Illinois not-for-profit organizations as described in Section 501(c) (3) of the Internal Revenue Code (the Code) and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Kiara, Inc. is an Illinois for-profit corporation that recognizes income taxes under the asset-and-liability method. Deferred tax assets and liabilities are recognized for the future tax consequences attributable to differences between the consolidated financial statement carrying amounts of existing assets and liabilities and their respective tax basis and operating loss and tax credit carryforwards. Deferred tax assets and liabilities are measured using the enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. The net operating loss carryforwards result in a deferred tax asset of $3,382 and $3,548 at June 30, 2023 and 2022, respectively. In assessing the realizability of deferred tax assets, management considers whether it is more likely than not that some portion or all the deferred tax assets will not be realized. The ultimate realization of deferred tax assets is dependent upon the generation of future taxable income during the periods in which those temporary differences become deductible. Management considers projected future taxable income and tax planning strategies in making this assessment. Based upon the level of historical taxable losses and projections for future taxable losses over the periods for which the deferred tax assets are deductible, management believes it is more likely Kiara, Inc. will not realize most of the benefits of these deductible differences. Full valuation allowances have been applied against the deferred tax assets attributable to the net operating loss carryforwards not realized as of June 30, 2023 and 2022 in the accompanying consolidated financial statements due to the uncertainty of realization. HSHS recognizes the tax benefit from an uncertain tax position only if it is more likely than not the tax position will be sustained on examination by the taxing authorities, based on the technical merits of the position. As of June 30, 2023 and 2022, HSHS does not have any liabilities for unrecognized tax benefits. true true X true X true X true true true false true true 225625 225625 0.0017 19841773 8846281 10995492 0.0824 4881662 3630137 1251525 0.0094 0 0 24949060 12476418 12472642 0.0934 253467 253467 0.0019 80019 80019 0.0006 0 0.0 0 0.0 10081 10081 0.0001 0 0 343567 0 343567 0.0026 0 0 25292627 12476418 12816209 0.0960 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 true 0 0 46795139 64042798 -17247659 X true true 1 1 ST MARY'S HOSPITAL MEDICAL CENTER 1726 SHAWANO AVENUE GREEN BAY WI 54303 www.stmgb.org 18 X X X ST MARY'S HOSPITAL MEDICAL CENTER 1 false false true X X X X X X X X X 20 true true true true X https://www.hshs.org/HSHSFamily/media/St.Marys-Green-Bay/SMGB_FY2021-CHNA.pdf X X true 21 true https://www.hshs.org/HSHSFamily/media/St.Marys-Green-Bay/About%20us/FY2021-CHNA-Implementation-Plan- false true X 200.0 400.0 X X X X X X true true X X X true X https://www.hshs.org/about-us/patient-financial-services/wisconsin-financial-assistance X https://www.hshs.org/about-us/patient-financial-services/wisconsin-financial-assistance X https://www.hshs.org/about-us/patient-financial-services/wisconsin-financial-assistance X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3E Yes, the significant health needs are a prioritized description of the significant health needs of the community and were identified through the CHNA process. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - HSHS St. Mary's Hospital Medical Center. Provisions in the Affordable Care Act (ACA) require charitable hospitals to conduct a Community Health Needs Assessment (CHNA) and adopt implementation strategies to meet the needs identified. The CHNA is a systematic process involving the identification and prioritization of community health needs, as well as the identification of community assets and resources potentially available to help address those needs. This process involves the solicitation and consideration of input received from persons who represent the broad interests of the community, including individuals or organizations serving or representing the interests of medically underserved, low-income, and minority populations in the community. The resulting CHNA report is used to develop implementation strategies for improving the health status of the community at large and/or specific populations within the community. Triennially, HSHS St. Mary's Hospital Medical Center conducts such an assessment and adopts an implementation plan by an authorized body of the hospital, making those reports widely available to the public via the hospital website and other means. For purposes of this process, HSHS St. Mary's Hospital Medical Center defines the community it serves as Brown County, Wisconsin. Hospital Sisters Health System and HSHS St. Mary's Hospital Medical Center are committed to promoting and defending human dignity, caring for persons living in poverty and other vulnerable persons, promoting the common good, and stewarding resources wisely. Consequently, we strongly believe that the assessment process must be informed by input from the poor and vulnerable populations we seek to serve. During FY2021, HSHS St. Mary's Hospital Medical Center & HSHS St. Vincent Hospital jointly conducted the CHNA for Brown County (WI) in conjunction with Bellin Health, Advocate Aurora, NEW Community Clinic, Brown County Public Health, De Pere Health Department, WI Department of Health Services, Division of Public Health, Brown County United Way. These representatives comprise The Beyond Health Steering Committee. The CHNA partners in turn worked together to gather input from a broad range of sources, ranging from hospital systems and educational institutions to government and service agencies to community groups, as well as from area residents. These efforts included, but were not limited to, outreach to and through the Aging and Disability Resource Center, NEW Community Clinic, Family Services of NEW, Catholic Charities, Connections for Mental Wellness, and Wello, as well as schools, municipalities, and other organizations. All of these organizations serve the under-resourced in our community - such as low-income seniors, children living in poverty, families who struggle with shelter and food insecurity, justice-involved individuals, and other vulnerable populations - and possess extensive knowledge regarding the needs of those they serve. Actively including these organizations in the CHNA process was critical to ensure consideration of diverse needs in the both the assessment itself and the development of related implementation strategies. The FY2021 CHNA process involved several key components. These included a Community Health Survey, feedback from organizations involved in the previous CHIP work of Beyond Health, and many virtual discussions with members of Beyond Health. The feedback collected through these means, in combination with secondary data comparison of local and national health indicators, were used to identify community health needs and priorities. The hospital subsequently used this data to develop a community health implementation plan incorporating health improvement strategies. The health priorities identified in the CHNA report were formally approved by the HSHS St. Mary's Hospital Medical Center Board of Directors on 5/19/2021. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - HSHS St. Mary's Hospital Medical Center. Yes, the hospital conducted its CHNA with Bellin Health, Aurora BayCare Medical Center, and our sister hospital, HSHS St. Vincent Hospital. Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - HSHS St. Mary's Hospital Medical Center. Yes, the hospital conducted its FY2021 CHNA with Brown County Public Health, De Pere Health Department, Brown County United Way, and the Wisconsin Department Division of Public Health. Schedule H, Part V, Section B, Line 7 Facility , 1 Facility , 1 - HSHS St Mary's Hospital Medical Center. The FY2021 CHNA was shared broadly internally including the Hospital Board of Directors, Patient & Family Advisory Advisory Councils, and hospital leaders. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - HSHS St. Mary's Hospital Medical Center. Community Health Needs Prioritization As detailed in the FY21 CHNA Report, HSHS St. Mary's Hospital Medical Center, in collaboration with Beyond Health community partners, identified the top three health priorities in Brown County: * Equitable Access - Access to Mental Health Care * Equitable Access - Access to Healthy Nutrition & Physical Activity * Equitable Access - Access to Treatment and Prevention of Alcohol & Drug Use/Abuse Equitable Access - Access to Mental Health Care Implementation Strategies: Current Situation as identified in FY2021 CHNA Report; Mental Health and well-being consistently arose as the most prominent community health priority in Brown counties during CHNA discussions. Specifically, access to mental health providers in Brown County, especially in vulnerable populations, was discussed. * Health care system subcommittee began meeting to specifically look at access to depression screenings and data collection tools to collect and track that data specifically to increase depression screening rates as a coordinated initiative for clinical partners in Brown County. o The Executive Director of Behavioral Care for HSHS along with Prevea has implemented a strategy to achieve an 80% completion of PHQ-9 by our primary care providers. Work is being done with the ED of Family Medicine to increase that percentage. The format used for this data collection has been shared with the health care subcommittee. Equitable Access -Access to Healthy Nutrition & Physical Activity Implementation Strategies: Current Situation as identified in FY2021 CHNA Report; Nutrition and Physical Activity consistently arose as a significant opportunity to improve health behavior and therefore as a health priority in Brown County during CHNA discussions. Healthy nutrition and physical activity frequently accompanied discussions around Chronic Disease Prevention and Management, as well as Mental Health. Under the equitable access -Access to Healthy Nutrition & Physical Activity implementation strategies for our patients in and around Brown County, HSHS St. Mary's Hospital & HSHS St. Vincent Hospital through collaboration with the Beyond Health social cohesion committee and other community stakeholders began identifying community assets and services available. Two indictors established for this committee are the percentage of Brown County residents living within 15 minutes of a food outlet & percent of Brown County food pantries offering healthy food options. The goal of his committee is to increase the availability and visibility of healthy food options. HSHS St. Mary's Hospital & HSHS St. Vincent Hospital have been partnering with WELLO in support of two local community health initiatives, Farm to School and our Farmers Market Double Your Bucks program. The financial support of both community health initiatives have helped to reach more people with healthy food options. Equitable Access - Access to Treatment and Prevention of Alcohol & Drug Use/Abuse Implementation Strategies: * During FY23 progress was made under the implementation strategy to improve access to prevention and early intervention services by coordinating regular Medication Take Back days to remove unused prescription from the community. o April 2023 Drug Take Back Day: SMGB collected 321 pounds of unused medications. Community Health Needs That Will Not Be Addressed: 1. Dental Care Through our financial support ($25,000 in FY23) of the Oral Health Partnership (OHP), and operating room time for OHP provided much needed hospital services for kids needing advanced care. OHP partners with Hospital Sisters Health System (St. Mary's, St. Vincent, St. Clare) and Bellin Health to provide this oral surgical care. These restricted donations were specifically for; hospital supplies, partial wages of dentists and assistants for procedures performed at HSHS hospitals - St Vincent, St Mary's St Clare Memorial. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - St. Mary's Hospital Medical Center. Presumptive eligibility is presumed under certain circumstances for uninsured patients based on their enrollment in other means-tested programs or other sources of information, not provided directly by the patient. Once determined, presumptive eligibility provides individuals participating in one of the following categories with a 100% write off. These programs are granted by outside organizations based on screening criteria of less than 200% of the FPG. 1. Homelessness 2. Deceased with no estate 3. Mental incapacitation with no one to act on patient's behalf 4. Medicaid eligibility, but not on date of service or for non-covered services 5. Incarceration in a penal institution 6. Enrollment in the following assistance programs for low-income individuals: 6a. Temporary Assistance for Needy Families (TANF) 6b. Illinois Housing Development Authority's Rental Housing Support Program 6c. Wisconsin Department of Health Services Housing Assistance Program 7. Participation in Women, Infants and Children programs (WIC); 8. Supplemental Nutrition Assistance Program (SNAP) eligibility; 9. Low Income Home Energy Assistance Program (LIHEAP); 10. Wisconsin Home Energy Assistance Program (WHEAP); 11. Enrollment in an organized community-based program providing access to medical care that assesses and documents limited low-income financial status as criteria; 12. Receipt of grant assistance for medical services 0 Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED VARY ACCORDING TO INFORMATION REQUESTED AND THE MOST ACCURATE MEANS OF GATHERING THE REQUIRED INFORMATION. THE IRS PROVIDED WORKSHEET 2 WAS USED TO CALCULATE A COST TO CHARGE RATIO USING INFORMATION FROM THE ORGANIZATION'S GENERAL LEDGER AND COST REPORTS. THAT RATIO WAS THEN USED IN CONJUNCTION WITH IRS WORKSHEET 1 TO CALCULATE THE COST OF FINANCIAL ASSISTANCE PROVIDED AND WORKSHEET 3 TO CALCULATE UNREIMBURSED MEDICAID AMOUNTS. THE COMMUNITY HEALTH IMPROVEMENT AND COMMUNITY BENEFIT PROGRAMS, HEALTH PROFESSIONS EDUCATION, SUBSIDIZED HEALTH SERVICES, RESEARCH PROGRAM, AND DONATIONS ARE STATED AT ACTUAL COST (WHEN APPLICABLE). THE COST OF THESE ITEMS ARE TRACKED THROUGH THE GENERAL LEDGER PROCESS AND THROUGH OTHER ACCOUNTING SOFTWARE. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount FOR FINANCIAL STATEMENT PURPOSES, HOSPITAL SISTERS HEALTH SYSTEM HAS ADOPTED ACCOUNTING STANDARDS UPDATE NO. 2014-09 (TOPIC 606). IMPLICIT PRICE CONCESSIONS INCLUDES BAD DEBTS. THEREFORE, BAD DEBTS ARE INCLUDED IN NET PATIENT REVENUE IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15 AND BAD DEBT EXPENSE IS NOT SEPARATELY REPORTED AS AN EXPENSE. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote The text of the footnote to the organization's financial statements that describes bad debt expense can be found on pages 16-19 in the HSHS Consolidated Audit Report. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs The Hospital continually strives to provide excellent patient care in the most cost effective fashion. Nonetheless, the Medicare program, in many cases, does not provide payment that covers the full cost of the care provided. Since it is the mission of the hospital to respond to community need, hospital leadership continually advocates for improved Medicare payment so that the cost of quality care to those patients who are not able to afford it is not compromised and is fairly subsidized by all payers. The IRS does not classify this shortfall in Medicare payments as Community Benefit. However, we believe it is an important contribution made by the hospital to the health and well-being of the community. If the Medicare program did not exist, many Medicare patients would be eligible for financial assistance or other means-tested government programs. Further, by absorbing this shortfall and providing care below cost to these individuals, the Hospital is relieving the burden of the government. Accordingly, this shortfall restricts the Hospital's ability to make funds available to provide for financial assistance and other Community Benefit. The hospital's Medicare shortfall at cost for FY2023 was $17.2 million. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance Every effort is made prior to, during and after provision of medical services to determine whether a patient is eligible for charity/community care and to assist the patient in completing the application and provide adequate documentation. If the patient qualified for charity/community care for the full balance of their account, the entire amount is written off to charity/community care and hence no debt collection is pursued. If the patient qualified for charity/community care for a portion of their account balance, that portion is written off to charity/community care, with the patient being responsible for the remainder of the balance. Additionally, reasonable effort will be made to obtain third-party or government payer reimbursement on behalf of the patient. If those efforts are not fruitful, an offer will be extended to the patient to make installment payments on their balance. Only at such point that the patient defaults on installment payments or refuses to cooperate with the hospital's efforts to be reimbursed will the account be sent to collections. The hospital will make reasonable efforts to determine whether a patient is eligible under the financial assistance policy before it engages in an ECA. To the extent a patient is determined to be eligible for financial assistance under the FAP, the hospital will take all reasonably available measures to reverse any ECA taken against the patient to obtain payment for the care. Schedule H, Part V, Section B, Line 16a FAP website - ST. MARY'S HOSPITAL MEDICAL CENTER: Line 16a URL: https://www.hshs.org/about-us/patient-financial-services/wisconsin-financial-assistance; Schedule H, Part V, Section B, Line 16b FAP Application website - ST. MARY'S HOSPITAL MEDICAL CENTER: Line 16b URL: https://www.hshs.org/about-us/patient-financial-services/wisconsin-financial-assistance; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - ST. MARY'S HOSPITAL MEDICAL CENTER: Line 16c URL: https://www.hshs.org/about-us/patient-financial-services/wisconsin-financial-assistance; Schedule H, Part VI, Line 2 Needs assessment As indicated in Part V, Section B, HSHS St. Mary's Hospital conducted a Community Health Needs Assessment in FY2021 (July 1, 2020 through June 30, 2021). HSHS St. Mary's Hospital is continually assessing the health care needs of the community through several initiatives. - The Hospital Patient & Family Advisory Council (PFAC) meets regularly to discuss hospital services and the ability of the hospital to meet community health care needs. Agendas are purposely organized to include time for feedback from members on what they are hearing in the community. The Community Health Needs Assessment & Community Health Implementation Plans are presented to the Hospital PFAC and discussed. - The HSHS Community Health Department assumes a lead role in working with community organizations to identify and address local health needs. For instance, the department director serves on the Beyond Health Steering Committee, as well as multiple work teams that focus on specific community priorities. - In addition, HSHS St. Mary's Hospital leaders and colleagues represent the hospital on a variety of local boards and organizations, providing additional opportunities to reach and serve the medically underserved, low income, and minority populations within Brown County. This involvement includes but is not limited to Catholic Charities, Ben's Wish, St John's Homeless Shelter, Center for Childhood Safety, NEW Community Clinic and WELLO (a community wellness coalition). Through this representation, the hospital becomes aware of emerging needs and can offer assistance or support to address these needs. - Finally, the hospital maintains a close working relationship with our public health departments, which capture much of the data and work done locally around community health. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance The Registration Department provides brochures to patients upon registration regarding the Financial Assistance Program available to them at the Hospital. The brochures are also supplied in waiting and ancillary areas for easy access by the patient. To better serve our patient population, the Hospital offers information on our financial assistance program in Spanish. This includes the Financial Assistance Policy, Brochure and Application, which allows the hospital to serve populations in its county and the surrounding area for whom Spanish is their primary language. Patients are also provided a Fair Billing Act notification at the point of registration regarding separate physician billing they can expect to receive, plus information about the patient's financial responsibility if their insurance plan is out of network. One-on-one conversations to educate patients about financial assistance often stem from patients receiving a statement or a pre-collection letter. At that point, the customer service representative or cashier, or other qualified staff, will inform/educate the caller about financial assistance options. The first pre-collection letter reminds the patient their account is in delinquent status. It also informs them they may be eligible for financial assistance through the organization's charity care program. The letter provides direct contact information to begin the application process for charity care and lists the Internet address where the policy can be obtained. A third-party vendor also assists individuals in determining their eligibility for state health plans or insurance on the open health insurance marketplace. They can also assist with the application process. Schedule H, Part VI, Line 4 Community information For purposes of the CHNA, the community served is defined as Brown County, Wisconsin, a primarily urban county located in the northeastern part of the state. Overall, HSHS St. Mary's Hospital serves a population of more than 940,000 in 13 counties, which span 9,700 square miles. Brown County Community profile. Brown County is home to more than a quarter of a million residents with a rich heritage of cultural and community traditions. Based on the most recent U.S. Census data (2019), half of the 264,542 residents are male, and half are female. Eighty-six percent Brown County is considered Urban, while 14% is Rural. The median age is 37, and the average life expectancy is 80. In regard to race, 88% of Brown County residents report being White alone; 3% Black or African American alone; 3% American Indian and Alaska Native alone; 3% Asian alone; and 3% two or more races. Meanwhile, 9% of residents report Hispanic ethnicity. The median household income is $62,100. According to the 2018 United Way ALICE report, 9% of households live in poverty. Meanwhile, 12% of children fall within this threshold (source: County Health Rankings). The majority of jobs in the area are service-providing; other jobs are goods-producing and include trade, transportation, and utilities, manufacturing, and government. As of October 2021, 46,902 Brown County residents (nearly 18%) are covered by Medicaid/BadgerCare Plus. Per the 2021 County Health Rankings, 7% of Brown County's population is uninsured. Of the 72 counties in Wisconsin, Brown County ranks 31st in overall health outcomes and 21st in overall health factors. Brown County has been designated a dental, mental health, and primary care HPSA (health professional shortage area) and the metro area is an MUA (medically underserved area) per HRSA. HSHS St. Mary's Hospital does not exclude MUAs, low income or minority populations from its service area. There are three not-for-profit general medical surgical hospitals and one for-profit general medical surgical hospital serving Brown County and the surrounding area. In addition, there is one not-for-profit psychiatric hospital, one for-profit psychiatric hospital and one county operated psychiatric hospital in the area. Since most of the population resides in the Green Bay metro area, plans and services focus on this area. HSHS St. Mary's Hospital does not exclude Medically Underserved Areas (MUAs), low income, or minority populations from its service area. There are three not-for-profit general medical surgical hospitals and one for-profit general medical surgical hospital serving Brown County and the surrounding area. In addition, there is one not-for-profit psychiatric hospital, one for-profit psychiatric hospital, and one county-operated psychiatric hospital in the area. Since most of the population resides in the Green Bay metro area, plans and services focus on this area. Schedule H, Part VI, Line 5 Promotion of community health As a healing ministry of the Catholic Church and an affiliate of Hospital Sisters Health System (HSHS), HSHS St. Mary's Hospital is committed to delivering high quality, compassionate, and cost-effective health care services to all. Founded in 1900, the hospital brings a healing presence and improves the health of our community, especially those persons who are sick, poor, and disadvantaged. Because of the hospital's mission and heritage, the hospital is dedicated to promoting the health of Brown County, Wisconsin and surrounding areas. The hospital is governed by a Board of Directors, most of whom reside in the hospital's primary service area and are neither employees nor independent contractors of the hospital (nor family members thereof). The Board ensures that HSHS St. Mary's Hospital is responding to community need. At every Board of Directors meeting, a written or oral report on community benefit activities was provided. An educational session for the Board is also held to better understand the recent Community Health Needs Assessment (CHNA) and Community Health Improvement Plan (CHIP). Consistent with its exempt purpose, HSHS St. Mary's Hospital has an open medical staff with privileges available to all qualified physicians in the area. The hospital also operates an emergency department that is open 24 hours to all persons regardless of their ability to pay. As a not-for-profit hospital, HSHS St. Mary's Hospital reinvests surplus funds to support the mission of the organization and promote the health of the community rather than distributing surplus funds as profits to shareholders or individuals. Funds not committed to ongoing operations are generally used to upgrade facilities, secure new technologies, improve patient care, and support initiatives designed to promote health and ensure access for all. HSHS St. Mary's Hospital also conducts medical research through the Cancer Research Institute and serves as a site for health professionals' education. HSHS St. Mary's Hospital also devotes significant resources to access for patients who cannot afford care, along with other Community Benefits. In FY2023, HSHS St. Mary's Hospital provided $12,816,209 in Community Benefit, including financial assistance at cost, unpaid costs of Medicaid and other public programs, and a range of diverse programs designed to enhance access and improve community health. Schedule H, Part VI, Line 6 Affiliated health care system Headquartered in Springfield, Illinois, Hospital Sisters Health System (HSHS) is a highly integrated, multi-institutional health care system comprised of 15 hospitals and more than 200 physician practice sites in Illinois and Wisconsin. HSHS is sponsored by Hospital Sisters Ministries (HSM), which is a public juridic person of the Roman Catholic Church. HSHS continues the health care ministries begun by its founders, the Hospital Sisters of St. Francis, more than 140 years ago, in rural and midsized communities throughout Illinois and Wisconsin. HSHS provides compassionate, holistic, high quality, and cost-effective health care through its acute care hospitals, physician practices, home health programs, palliative and hospice programs, and community outreach services. In addition, HSHS affiliated hospitals include critical access facilities that offer essential health services that otherwise would not be available in many communities. Our mission calls us to reveal and embody Christ's healing love for all people, and we extend our high quality Franciscan health care ministry beyond the walls of our hospitals by providing community health improvement services with special emphasis on the poor and vulnerable. In addition to providing community health improvement services to the broader community, HSHS cares for everyone who comes to its facilities, regardless of their ability to pay. In tandem with a variety of cross sector community partners, HSHS's Community Benefit initiatives are strategically planned and professionally implemented to improve access to health care services; enhance the health of the community; advance medical or general health care knowledge; and relieve or reduce the burden of government to improve health. The COVID-19 pandemic caused an unprecedented disruption in healthcare services across the United States. HSHS responded with services that benefited our communities, including free telehealth screenings, free testing, and coordination with other healthcare providers in the communities we serve to best ensure access to needed care. In FY2023, HSHS collectively provided $222.3 million in Community Benefit (8.2% of total hospital expenses). Of the total Community Benefit provided, HSHS spent $5.8 million provided for Financial Assistance (aka Charity Care) and $146.3 million for unreimbursed care provided as part of the Medicaid program. In addition, HSHS hospitals committed significant resources to treat Medicare patients. The cost of providing services to primarily elderly beneficiaries of the Medicare program - in excess of governmental and managed care contract payments - was $304.5 million. HSHS hospitals also recorded $74.3 million in uncollectible accounts. While HSHS does not count the latter two amounts as Community Benefit, they nonetheless reflect our commitment to serving all persons in need of care. In addition to the dollars invested in our Community Benefit programs, HSHS continues to reinvest any surplus revenue from operations and investments into new medical technology, facility infrastructure and health care services in our communities. By doing so, we ensure our ability to meet the ongoing demand for high quality, efficient and easily accessible health care. Schedule H, Part VI, Line 7 State filing of community benefit report WI X X X X X false true false false false false false false false BRIAN CHARLIER President/CEO 303419 303419 51660 51659 63422 63423 55847 55846 12612 12613 486960 486960 0 0 ANDREW J BAGNALL Wisconsin PRESIDENT & Division CEO - Wisconsin (UNTIL 11/1/22) 0 416871 0 146870 0 279148 0 5318 0 27417 0 875624 0 134905 PATRICIA ALLEN DIVISION CFO - WISCONSIN 0 414598 0 44684 0 81818 0 126563 0 27833 0 695496 0 0 Kimberly Hodgkinson CFO/Foundation Treasurer 0 338668 0 40000 0 129515 0 46924 0 11142 0 566249 0 0 TODD Smart Treasurer 0 267686 0 38335 0 23548 0 45254 0 36008 0 410831 0 0 Daniel DORAN DIVISIONAL DIRECTOR-CARDIOVASCULAR 182151 0 291 0 25146 0 6380 0 29015 0 242983 0 0 0 Jeffrey Jacobs Division Director- Facilities Management 149633 0 0 0 26690 0 26685 0 6555 0 209563 0 0 0 Sadie Johnsen Pharmacy Manager 153538 0 0 0 520 0 26301 0 5845 0 186204 0 0 0 Gregory Laehn Pharmacist 147215 0 2677 0 3376 0 3773 0 11924 0 168965 0 0 0 PAMELA MIELKE Pharmacist 139527 0 0 0 0 0 10672 0 14525 0 164724 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation PLEASE SEE RESPONSE TO FORM 990, PART VI, LINE 15A IN SCHEDULE O. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan HSHS EXECUTIVES ELIGIBLE TO PARTICIPATE IN SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) ARE DEFINED IN THE SERP PLAN DOCUMENTS; THE SERP WAS ESTABLISHED TO PROVIDE ADDITIONAL RETIREMENT BENEFITS TO ENSURE REASONABLE MARKET COMPETITIVE BENEFITS IN ACCORDANCE WITH THE HSHS EXECUTIVE COMPENSATION PHILOSOPHY ESTABLISHED BY THE HSHS COMPENSATION COMMITTEE. THE PLAN PROVIDES A DEFINED RETIREMENT CONTRIBUTION TO PARTICIPANTS COMMENCING ON JANUARY 1, 2008, EQUAL TO A PERCENTAGE OF COMPENSATION AS DEFINED IN THE SERP PLAN DOCUMENTS FOR THE PLAN YEAR. PARTICIPANTS CONSTRUCTIVELY RECEIVE A DISTRIBUTION FROM THE PLAN NO LATER THAN MARCH 15TH OF THE CALENDAR YEAR FOLLOWING THE CALENDAR YEAR IN WHICH AN AMOUNT IS VESTED and TAXABLE PURSUANT TO A VESTING SCHEDULE AS SPECIFIED IN THE PLAN DOCUMENT. THE ACTUAL DISTRIBUTION OF THE VESTED BENEFIT UNDER THE PLAN IS PAID IN A SINGLE LUMP SUM TO THE PARTICIPANT OR THE PARTICIPANT'S BENEFICIARY UPON THE EARLIER OF THE PARTICIPANT'S TERMINATION OF EMPLOYMENT, DEATH, OR TOTAL AND PERMANENT DISABILITY. THE FOLLOWING INTERESTED PERSONS CONSTRUCTIVELY RECEIVED DEFERRALS TO THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2022; THESE DEFERRALS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C). Patricia Allen -- $37,240 Brian Charlier -- $69,233 Todd Smart -- $25,135 THE FOLLOWING INTERESTED PERSONS RECEIVED DISTRIBUTIONS FROM THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2022; THESE PAYMENTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III) AND SCHEDULE J, PART II, COLUMN (F), AS APPLICABLE. Andrew Bagnall -- $134,905 Form 990, Part III, Line 4d Description of other program services (Expenses $ 22,499,993 including grants of $)(Revenue $ 45,917,933) Other program services at St. Mary's Hospital Medical Center are comprised of intensive care, emergency, center for digestive health, pharmacy, laboratory, respiratory therapy, rehabilitation, and other services. Form 990, Part IV, Line 24a TAX EXEMPT BONDS ST MARY'S HOSPITAL MEDICAL CENTER OF GREEN BAY, INC. HOLDS A LIABILITY ON ITS BOOKS FOR TAX-EXEMPT BONDS, WHICH IS AN ALLOCATION FROM ITS SOLE CORPORATE MEMBER, HOSPITAL SISTERS SERVICES, INC. AS A RESULT, THIS QUESTION WAS ANSWERED NO, AND SCHEDULE K WILL BE COMPLETED ON THE HOSPITAL SISTERS SERVICES, INC. FORM 990. Form 990, Part IV, Line 10 Endowment Funds The organization maintains net assets with donor restrictions and without donor restrictions on its balance sheet. Such funds are held by Hospital Sisters of St. Francis Foundation, Inc., a related tax-exempt organization. While these funds are held to further one or more exempt purposes of the filing organization, they are not maintained exclusively for the filing organization. The board of directors of Hospital Sisters of St. Francis Foundation, Inc. maintains ownership and ultimately authority and discretion over the use of these funds. Based on the above, the related amounts have not been reported as endowment funds on Part V of Schedule D. Form 990, Part V, Line 1a Number in Box 3 Form 1096 THE FORM 1096, ANNUAL SUMMARY & TRANSMITTAL OF U.S. INFORMATION RETURN IS FILED BY THE ORGANIZATION'S PARENT, HOSPITAL SISTERS HEALTH SYSTEMS (HSHS) ON THE ORGANIZATION'S BEHALF TO TRANSMIT TO THE IRS FORMS 1099, 1098, 5498 AND W-2G. THE ORGANIZATION IS UNABLE TO DETERMINE THE NUMBER OF FORMS 1099, 1098, 5498 AND W-2G FILED BY HSHS ON THEIR BEHALF. AS THE PARENT ORGANIZATION, HSHS ENSURES THAT THE FILING ORGANIZATION COMPLIES WITH ALL INFORMATION RETURN REPORTING REQUIREMENTS AND BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS AND REPORTABLE GAMING WINNINGS TO PRIZE WINNERS, AS APPLICABLE. Accordingly, the number reported on Form 990, Part V, Line 1a reflects the number of reported in box 3, of Form 1096 for the HSHS, the parent organization. Form 990, Part VI, Line 13 WHISTLEBLOWER POLICY PROVISIONS WITHIN THE CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY PROVIDE PROTECTIONS FOR WHISTLEBLOWER TYPE ACTIVITIES. Form 990, Part VI, Line 16b JOINT VENTURES HOSPITAL SISTERS HEALTH SYSTEM ADOPTED A JOINT VENTURE COMPLIANCE PROGRAM POLICY EFFECTIVE ON JANUARY 1, 2012 FOR ALL SYSTEM HOSPITALS, INCLUDING ST. MARY'S MEDICAL CENTER. THE OVERALL PURPOSE OF THE POLICY IS TO PROVIDE PRACTICAL GUIDELINES FOR ETHICAL BUSINESS CONDUCT, TO ACHIEVE COMPLIANCE, AND TO DETECT AND PREVENT VIOLATIONS OF APPLICABLE LAWS. THE POLICY REQUIRES ST. NICHOLAS HOSPITAL, AND ALL HSHS HOSPITALS, TO EVALUATE THEIR PARTICIPATION IN JOINT VENTURE ARRANGEMENTS, INCLUDING UNDER APPLICABLE FEDERAL TAX LAWS, AND TO SAFEGUARD THE ORGANIZATION'S TAX EXEMPT STATUS WITH RESPECT TO ANY JOINT VENTURE ARRANGEMENTS. Form 990, Part VI, Line 1a Delegate broad authority to a committee PER ARTICLE 6.2 OF THE ORGANIZATION'S BY-LAWS, THE GOVERNING BODY DELEGATES BROAD AUTHORITY TO AN EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE SHALL HAVE WITHIN ITS AUTHORITY THE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE CORPORATION AS WELL AS OVERSEE THE FINANCIAL CONDITION OF THE CORPORATION. AS PROVIDED IN THE BY-LAWS, THE EXECUTIVE COMMITTEE SHALL CONSIST OF FOUR TO SIX MEMBERS, INCLUDING THE CHAIRPERSON OF THE BOARD, THE VICE CHAIRPERSON, THE PRESIDENT AND OTHER MEMBERS SELECTED FROM AMONG THE DIRECTORS BY THE BOARD. Form 990, Part VI, Line 4 Significant changes to organizational documents The bylaws were amended with the following significant changes: 1. The member gained one additional reserved power to approve material actions with respect to employee retirement plans sponsored by the Corporation or any Affiliate. 2. The member only fills President vacancies, removing the ability to fill Secretary and Treasurer vacancies. 3. The Division President no longer serves on the board of directors. Form 990, Part VI, Line 6 Classes of members or stockholders THE SOLE CORPORATE MEMBER OF ST. MARY'S HOSPITAL MEDICAL CENTER OF GREEN BAY INC (THE CORPORATION) IS HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body PURSUANT TO SECTION 2.1 OF THE CORPORATION'S BYLAWS, THE ORGANIZATION'S MEMBER, HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, HAS THE RIGHT TO APPOINT AND REMOVE THE CORPORATION'S BOARD OF DIRECTORS. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders RESPONSIBILITY FOR THE POLICY AND OPERATIONS OF ST. MARY'S HOSPITAL MEDICAL CENTER OF GREEN BAY INC. (THE "CORPORATION") IS VESTED IN ITS BOARD OF DIRECTORS, EXCEPT WITH RESPECT TO SPECIFIC POWERS RESERVED IN THE CORPORATION'S BYLAWS TO THE CORPORATION'S MEMBER, HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE MEMBER OF HSSI IS HOSPITAL SISTERS HEALTH SYSTEM ("HSHS"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE GOVERNANCE AND OPERATIONS OF THE CORPORATION ARE SUBJECT TO HSSI'S RIGHT TO EXERCISE THESE RESERVED POWERS WITH RESPECT TO THE CORPORATION AND ORGANIZATIONS OF WHICH THE CORPORATION IS EITHER, DIRECTLY OR INDIRECTLY, A CONTROLLING MEMBER OR A CONTROLLING SHAREHOLDER ("AFFILIATES"). HSSI'S RIGHT TO EXERCISE CERTAIN OF THESE RESERVED POWERS IS, IN TURN, SUBJECT TO THE APPROVAL OF HSHS AND HSHS' MEMBERS. THE RESERVED POWERS INCLUDE ALL RIGHTS GRANTED TO HSSI BY LAW AND THE RIGHT TO: (A) ADOPT, APPROVE AMENDMENTS TO, OR AMEND ANY STATEMENT OF PHILOSOPHY, MISSION, MISSION INTEGRATION OR VALUES, OR ANY NAME, LOGO, OR MARK OF THE CORPORATION OR OF ANY AFFILIATE; (B) ADOPT, APPROVE AMENDMENTS TO, OR AMEND THE ARTICLES OF INCORPORATION OF THE CORPORATION OR OF ANY AFFILIATE; (C) ADOPT, APPROVE AMENDMENTS TO, OR AMEND THE BYLAWS OF THE CORPORATION OR OF ANY AFFILIATE; (D) APPOINT AND REMOVE THE BOARD OF DIRECTORS, ANY ONE OR MORE OF THE DIRECTORS OF THE CORPORATION OR OF ANY AFFILIATE, AND THE PRESIDENT OF THE CORPORATION OR OF ANY AFFILIATE; (E) APPROVE THE RECOMMENDATION OF THE BOARD OF DIRECTORS TO APPOINT OR REMOVE THE BOARD OF DIRECTORS, ANY ONE OR MORE DIRECTORS OF THE CORPORATION OR OF ANY AFFILIATE, OR THE PRESIDENT OF THE CORPORATION OR OF ANY AFFILIATE. (F) WITH RESPECT TO THE CORPORATION OR ANY AFFILIATE, APPROVE THE PURCHASE, SALE, ALIENATION, EXCHANGE, LEASE, OR ENCUMBRANCE OF ANY REAL PROPERTY OF THE CORPORATION OR OF ANY AFFILIATE, WHICH PROPERTY HAS A VALUE IN EXCESS OF LIMITS SET FROM TIME TO TIME BY THE MEMBER; (G) APPROVE DEBT INCURRED BY THE CORPORATION OR ANY AFFILIATE IN AN AMOUNT IN EXCESS OF LIMITS SET FROM TIME TO TIME BY THE MEMBER; (H) APPROVE THE OPERATING AND CAPITAL BUDGETS OF THE CORPORATION OR OF ANY AFFILIATE, AND ANY DEVIATIONS BY THE CORPORATION OR OF ANY AFFILIATE FROM SUCH BUDGETS IN AN AMOUNT OR PERCENTAGE SPECIFIED BY THE MEMBER FROM TIME TO TIME; (I) APPROVE THE STRATEGIC PLAN AND GOALS OF THE CORPORATION OR OF ANY AFFILIATE; (J) APPROVE THE SALE OF SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION OR OF ANY AFFILIATE; (K) APPROVE THE MERGER OR DISSOLUTION OF THE CORPORATION OR OF ANY AFFILIATE; (L) ADOPT OR AMEND THE PLAN FOR MINISTRY EDUCATION AND GOVERNANCE FOR THE CORPORATION AND ITS AFFILIATES; (M) APPROVE THE CORPORATION'S MISSION ACCOUNTABILITY REPORTS AND THOSE OF ANY AFFILIATE; (N) APPROVE THE FINANCIAL POLICIES AND PROCEDURES OF THE CORPORATION OR OF ANY AFFILIATE, AND APPROVE ANY DEVIATIONS FROM SUCH POLICIES AND PROCEDURES BY THE CORPORATION OR ANY AFFILIATE; AND (O) ADOPT POLICIES TO IMPLEMENT THE RESERVED POWERS OF THE MEMBER. Form 990, Part VI, Line 11b Review of form 990 by governing body THE HOSPITAL EMPLOYS CROWE LLP TO ASSIST IN THE OVERALL REVIEW AND ELECTRONIC SUBMISSION OF ITS FORM 990. CROWE LLP PROVIDES GUIDANCE IN IDENTIFYING CRITICAL ERRORS IN THE RETURN SUBMISSION AND FEEDBACK ON QUANTITATIVE AND QUALITATIVE RESPONSES. ADDITIONALLY, THE HOSPITAL CFO PERFORMS A THOROUGH REVIEW OF THE RETURN AND REVIEWS IT WITH THE HOSPITAL CEO AND/OR SENIOR LEADERS BEFORE PRESENTING IT IN ITS ENTIRETY TO THE HOSPITAL BOARD FOR QUESTIONING AND REVIEW PRIOR TO THE RETURN'S SIGNING AND SUBMISSION TO THE IRS. Form 990, Part VI, Line 12c Conflict of interest policy THE ORGANIZATION IS SUBJECT TO THE CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY ("POLICY") OF HOSPITAL SISTERS HEALTH SYSTEM, AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. A REVISED CORPORATE COMPLIANCE PROGRAM AND CONFLICT OF INTEREST POLICY HAVE BEEN IMPLEMENTED SINCE JANUARY, 2009 TO MANAGE CONFLICTS OF INTEREST USING A SYSTEM-WIDE PROTOCOL FOR DISCLOSURE STATEMENTS. IN ACCORDANCE WITH THE ORGANIZATON'S CONFLICT OF INTEREST POLICY, ALL COVERED PERSONS HAVE A DUTY TO COMPLY WITH THE CONFLICT OF INTEREST POLICY FOR ANY CONTRACT, TRANSACTION, RELATIONSHIP, OR ACTIVITY CONTEMPLATED, ENTERED INTO, OR CONDUCTED AT HSHS OR ITS AFFILIATES. THE POLICY DEFINES COVERED PERSONS AS BOARD MEMBERS, BOARD COMMITTEE MEMBERS, OFFICERS, BOARD DESIGNEES, SENIOR MANAGEMENT, MEMBERS OF ANY COMMITTEE THAT OVERSEES THE APPROVAL OF PHARMACEUTICALS AND MEDICAL DEVICES, AND ANY OTHER INDIVIDUAL WHO HOLDS A POSITION OF TRUST. ON AN ANNUAL BASIS, HSHS DISCLOSES A COPY OF THE CONFLICT OF INTEREST POLICY (AND ALL CORRESPONDING PROCEDURES, GUIDELINES, FORMS, AND TOOLS) TO ALL COVERED PERSONS AND ADVISES ALL COVERED PERSONS IN WRITING OF ANY SUBSTANTIVE CHANGES TO THIS POLICY AND SUCH RELATED MATERIALS. COVERED PERSONS ARE REQUIRED TO REVIEW AND COMPLETE THE CORRESPONDING CONFLICT OF INTEREST STATEMENT. THE SYSTEM OFFICE VICE PRESIDENT - SYSTEM RESPONSIBILITY, VICE PRESIDENT - RISK & COMPLIANCE, OR MEMBERS OF THE AUDIT AND INTEGRITY COMMITTEE ("COMMITTEE") ARE AVAILABLE TO ANSWER ANY QUESTIONS A COVERED PERSON MAY HAVE. IN ADDITION, IF, AT ANY TIME AFTER SUBMITTING AN ANNUAL CONFLICT OF INTEREST STATEMENT, A COVERED PERSON BECOMES AWARE OF AN INTEREST THAT HE OR SHE WOULD HAVE HAD TO DISCLOSE AT THE ANNUAL INTERVAL, THE COVERED PERSON IS REQUIRED PROMPTLY TO DISCLOSE THE INTEREST TO THE COMMITTEE USING THE HSHS CONFLICT OF INTEREST DISCLOSURE STATEMENT. COMPLETED CONFLICT OF INTEREST STATEMENTS ARE SUBMITTED TO THE COMMITTEE, WHICH IS RESPONSIBLE FOR IDENTIFYING, ASSESSING, AND MANAGING CONFLICTS OF INTEREST THAT ARISE IN THE COURSE OF CONDUCTING THE AFFAIRS OF HSHS AND ITS AFFILIATES. IF THE COMMITTEE DETERMINES THAT A CONFLICT OF INTEREST EXISTS, THE CONFLICT OF INTEREST POLICY REQUIRES HSHS NOT TO ENGAGE IN, OR ENTER INTO A PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY UNLESS THE COMMITTEE OR, WHERE NECESSARY, THE BOARD OF DIRECTORS (ACTING THROUGH ITS DISINTERESTED MEMBERS), HAS INVESTIGATED ALTERNATIVES TO THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY AND, IN THE ABSENCE OF ALTERNATIVES THAT ARE IN THE BEST INTERESTS OF HSHS, HAS DETERMINED: 1. THAT, REGARDLESS OF WHETHER THE COVERED PERSON PARTICIPATES IN THE IMPLEMENTATION OF THE PROPOSED CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY; 2. THE CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY IS IN THE BEST INTERESTS OF HSHS; 3. THE CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY IS FAIR AND REASONABLE FROM THE PERSPECTIVE OF HSHS; AND 4. HSHS CANNOT OBTAIN A MORE ADVANTAGEOUS CONTRACT, TRANSACTION, ARRANGEMENT, OR ACTIVITY WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES. IN DETERMINING WHETHER A CONTRACT, TRANSACTION OR ARRANGEMENT IS FAIR AND REASONABLE TO HSHS, THE COMMITTEE SHALL CONSIDER, WHERE APPLICABLE: 1. APPRAISALS OR OTHER INDEPENDENT VALUATIONS OF THE FAIR MARKET VALUE OF THE CONTRACT, TRANSACTION, OR ARRANGEMENT; 2. INFORMATION REGARDING COMPARABLE CONTRACTS, TRANSACTIONS, OR ARRANGEMENTS BETWEEN UNRELATED PARTIES; 3. OFFERS FROM COMPARABLE COMPETING ENTITIES; AND/OR 4. STUDIES OF COMPARABLE COMPENSATION ARRANGEMENTS. IN ANY CASE IN WHICH THE COMMITTEE FINDS, AFTER TAKING THE STEPS DESCRIBED ABOVE, THAT HSHS SHOULD PARTICIPATE IN A PROPOSED TRANSACTION OR ARRANGEMENT DESPITE THE EXISTENCE OF A CONFLICT OF INTEREST, THE COMMITTEE SHALL DEVELOP, IMPLEMENT, MONITOR, AND ENFORCE COMPLIANCE WITH A CONFLICT MANAGEMENT PLAN FOR MANAGING THE CONFLICT OF INTEREST AS IT CONSIDERS NECESSARY FOR SUCH FINDINGS TO REMAIN VALID THROUGHOUT THE LIFE OF THE CONTRACT, TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY. ALL CONFLICT MANAGEMENT PLANS SHALL: 1. STATE THAT THE COMMITTEE WILL OVERSEE, MONITOR, AND ENFORCE COMPLIANCE WITH THE PLAN THROUGHOUT THE COURSE OF THE STUDY AND SPECIFY MEANS FOR DOING SO, INCLUDING, WITHOUT LIMITATION, THAT THE APPROPRIATE INDIVIDUALS MUST PROVIDE THE COMMITTEE WITH WRITTEN REPORTS PERTAINING TO COMPLIANCE WITH THE CONFLICT MANAGEMENT PLAN, THAT THE COMMITTEE SHALL HAVE THE RIGHT TO AUDIT THE STUDY FOR SUCH COMPLIANCE AND THE RIGHT TO IMPOSE SANCTIONS FOR NON-COMPLIANCE; 2. STATE THAT THE PLAN MUST BE SHARED WITH COVERED PERSON WHOSE INTERESTS IT WAS DEVELOPED TO MANAGE; 3. STATE THAT THE PLAN MUST BE SHARED WITH, AND PERIODIC REPORTS ON COMPLIANCE WITH THE PLAN MUST BE PROVIDED TO, THE BOARD, SENIOR MANAGEMENT, AND/OR GOVERNMENT AGENCIES; AND 4. PROVIDE FOR SUCH OTHER MANAGEMENT STEPS AND MECHANISMS THE COMMITTEE CONSIDERS NECESSARY AND APPROPRIATE. IN ADDITION TO THE COMMITTEE, THE SYSTEM OFFICE VICE PRESIDENTS OF SYSTEM RESPONSIBILITY AND RISK & COMPLIANCE MAY RETAIN SUCH INDEPENDENT ADVISORS OR EXPERTS AS DEEMED NECESSARY TO ASSIST IN MAKING ITS DETERMINATIONS AND DECISIONS. IF THE COMMITTEE DETERMINES THAT THE CONTEMPLATED TRANSACTION, RELATIONSHIP, ARRANGEMENT, OR ACTIVITY CANNOT PROCEED DUE TO A CONFLICT OF INTEREST, THE COMMITTEE SHALL INFORM THE APPLICABLE COVERED PERSON OR DECISION-MAKING BODY OF SUCH DETERMINATION WITHIN ONE WEEK OF THE COMMITTEE MEETING AT WHICH THE CONTEMPLATED TRANSACTION WAS DISCUSSED. THE COMMITTEE SHALL DOCUMENT ITS REJECTION OF THE CONTEMPLATED TRANSACTION IN THE COMMITTEE'S MEETING MINUTES. Form 990, Part VI, Line 15a Process to establish compensation of top management official THE COMPENSATION COMMITTEE (COMMITTEE) IS COMPRISED OF INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS. THE COMMITTEE DEVELOPS A COMPENSATION PHILOSOPHY FOR THE SYSTEM AND ALL AFFILIATES. THE COMMITTEE SELECTS AND HIRES THE INDEPENDENT COMPENSATION CONSULTANT TO DEVELOP COMPARABILITY DATA AND ADVISE THE COMMITTEE DURING ITS DELIBERATIONS REGARDING ALL ELEMENTS OF TOTAL COMPENSATION FOR ALL HSHS EXECUTIVES, (the top management official, other officers and key employees). SULLIVAN COTTER, THE CONSULTANTS UTILIZED BY THE COMMITTEE, USE DATA FROM MULTIPLE TAX-EXEMPT PEER GROUP SOURCES TO DETERMINE SALARY RANGES, INCENTIVE OPPORTUNITY RANGES AND BENEFITS FOR THE HSHS executives. SULLIVAN COTTER THEN ASSISTS THE COMMITTEE IN PREPARING CONTEMPORANEOUS DOCUMENTATION OF ALL ACTIONS. EACH COMMITTEE MEETING IS CONDUCTED WITH THE INTENT TO CREATE A REBUTTABLE PRESUMPTION OF REASONABLENESS FOR ALL ELEMENTS OF EXECUTIVE TOTAL COMPENSATION. THE CHAIRMAN MAKES THIS DECLARATION AND ALSO INQUIRES IF THERE ARE ANY CONFLICTS OF INTEREST BY ANY ATTENDEES. ANY CONFLICTS ARE DISCLOSED AND THE COMMITTEE THEN ACTS IN A MANNER TO AVOID ANY CONFLICTED INDIVIDUAL PARTICIPATING IN ANY MANNER WHERE A CONFLICT MIGHT EXIST. AT THE END OF THE MEETING, THE COMMITTEE PREPARES CONTEMPORANEOUS MINUTES THAT RECORD ALL ACTIONS TAKEN DURING THE MEETING. Form 990, Part VI, Line 15b Process to establish compensation of other employees PLEASE SEE RESPONSE TO FORM 990, PART VI, LINE 15A. Form 990, Part VI, Line 19 Required documents available to the public BOARD-APPROVED FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE GENERAL PUBLIC AT THIS TIME. Form 990, Part X, Line 11 POOLED INVESTMENT ACCOUNT THE HOSPITAL'S CASH RESERVES ARE INVESTED IN A POOLED INVESTMENT ACCOUNT MAINTAINED BY HOSPITAL SISTERS HEALTH SYSTEM ("HSHS"). PARTICIPATION IN THE POOLED FUND IS LIMITED TO THE 501(C)(3) HOSPITALS AND HEALTH SERVICES ORGANIZATIONS SPONSORED BY HSHS. THE POOLED ACCOUNT CONSISTS OF CASH, EQUITY, AND DEBT SECURITIES THAT ARE PUBLICLY TRADED. IN ACCORDANCE WITH THE PROVISIONS OF STATEMENT OF FINANCIAL ACCOUNTING STANDARDS ("SFAS") NO. 124 "ACCOUNTING FOR CERTAIN INVESTMENTS HELD BY NOT-FOR-PROFIT ORGANIZATIONS", INVESTMENTS IN EQUITY SECURITIES WITH READILY DETERMINABLE FAIR VALUES, AND ALL INVESTMENTS IN DEBT SECURITIES, ARE REPORTED AT FAIR VALUE ON THE BALANCE SHEET. INCOME, REALIZED AND UNREALIZED GAINS AND LOSSES ARE POOLED AND ALLOCATED TO THE PARTICIPANTS. INDIVIDUAL COMPONENTS OF ASSETS AND REVENUE ARE NOT IDENTIFIED TO THE INDIVIDUAL HOSPITAL PARTICIPANTS. Form 990, Part XI, Line 9 Other changes in net assets or fund balances Change in Net Periodic Pension Costs - net of service costs - 7532623; CHANGE IN FAIR VALUE INTEREST RATE SWAPS - 522148; Tranfers to/from affiliates - -1078662; KIARA CLINICAL INTEGRATION NETWORK LLC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 261417684 HEALTHCARE IL -105950 447864 HSSI PHYSICIAN CLINICAL INTEGRATION NETWORK LLC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371668647 HEALTHCARE IL 554315 15980466 KCIN HSHS ACO LLC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 320465666 HEALTHCARE & SOCIAL ASSISTANCE IL 1805698 3189003 KCIN HOSPITAL SISTERS HEALTH SYSTEM 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371058692 HEALTHCARE IL 501(c)(3) Type III-FI NA false HOSPITAL SISTERS HEALTHCARE-WEST INC 2661 COUNTY HIGHWAY 1 CHIPPEWA FALLS WI 54729 510157933 HEALTHCARE WI 501(c)(3) Type I HSSI true HOSPITAL SISTERS MISSION OUTREACH CORPORATION 4936 LAVERNA ROAD SPRINGFIELD IL 62707 352271729 RECYCLING MEDICAL SUPPLIES IL 501(c)(3) HSHS true HOSPITAL SISTERS OF ST FRANCIS FOUNDATION INC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371186514 HEALTHCARE IL 501(c)(3) 7 HSHS true HOSPITAL SISTERS SERVICES INC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371163402 HEALTHCARE IL 501(c)(3) Type III-FI HSHS true HSHS GOOD SHEPHERD HOSPITAL INC 200 SOUTH CEDAR STREET SHELBYVILLE IL 62565 370512290 HEALTHCARE IL 501(c)(3) 3 HSSI true HSHS HOLY FAMILY HOSPITAL 200 HEALTHCARE DRIVE GREENVILLE IL 62246 370792770 HEALTHCARE IL 501(c)(3) 3 HSSI true HSHS MEDICAL GROUP INC 3051 HOLLIS DRIVE SPRINGFIELD IL 62704 263956318 HEALTHCARE IL 501(c)(3) Type III-FI HSSI true HSHS WISCONSIN MEDICAL GROUP INC 3051 HOLLIS DRIVE SPRINGFIELD IL 62704 264515959 HEALTHCARE WI 501(c)(3) Type III-FI HSSI true ORANGE CROSS AMBULANCE INC 919 ASHLAND AVENUE SHEBOYGAN WI 53081 391860942 HEALTHCARE WI 501(c)(3) 10 ST NICHOLAS true PRAIRIE CARDIOVASCULAR CONSULTANTS LTD 3051 HOLLIS DRIVE SPRINGFIELD IL 62704 371071858 HEALTHCARE IL 501(c)(3) 10 HSSI true PRAIRIE EDUCATION & RESEARCH COOPERATIVE 800 E CARPENTER STREET 62 SPRINGFIELD IL 62769 371157915 HEALTHCARE IL 501(c)(3) 4 HSSI true SACRED HEART HOSPITAL OF HOSPITAL SISTERS OF THIRD ORDER OF ST FRANCIS 990 WEST CLAIREMONT AVENUE EAU CLAIRE WI 54701 390807060 HEALTHCARE WI 501(c)(3) 3 HSSI true SHELBY MEMORIAL HOSPITAL EMPLOYEE BENEFIT TRUST 200 SOUTH CEDAR STREET SHELBYVILLE IL 62565 371778753 TRUST IL 501(a) HSSI true SOUTHERN ILLINOIS CARDIOVASCULAR SERVICE INC ONE ST ELIZABETHS BLVD OFALLON IL 62269 371276333 HEALTHCARE IL 501(c)(3) 3 ST ELIZABETH'S HOSPITAL false ST ANTHONY'S MEMORIAL HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER O F ST FRANCIS 503 N MAPLE STREET EFFINGHAM IL 62401 370661233 HEALTHCARE IL 501(c)(3) 3 HSSI true ST FRANCIS HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS 1215 FRANCISCAN DRIVE LITCHFIELD IL 62056 370661236 HEALTHCARE IL 501(c)(3) 3 HSSI true ST JOSEPH'S HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANC IS 9515 HOLY CROSS LANE BREESE IL 62230 371208459 HEALTHCARE IL 501(c)(3) 3 HSSI true ST JOSEPH'S HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANC IS 2661 COUNTY HIGHWAY 1 CHIPPEWA FALLS WI 54729 390810545 HEALTHCARE WI 501(c)(3) 3 HSSI true ST JOSEPH'S HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANC IS 12866 TROXLER AVENUE HIGHLAND IL 62249 370663568 HEALTHCARE IL 501(c)(3) 3 HSSI true ST VINCENT HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCI S 835 S VAN BUREN GREEN BAY WI 51301 390817529 HEALTHCARE WI 501(c)(3) 3 HSSI true ST CLARE MEMORIAL HOSPITAL INC 855 S MAIN STREET OCONTO FALLS WI 54154 390848401 HEALTHCARE WI 501(c)(3) 3 HSSI true ST ELIZABETH'S HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FR ANCIS ONE ST ELIZABETHS BLVD OFALLON IL 62269 370663567 HEALTHCARE IL 501(c)(3) 3 HSSI true ST JOHN'S HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS 800 EAST CARPENTER STREET SPRINGFIELD IL 62769 370661238 HEALTHCARE IL 501(c)(3) 3 HSSI true ST MARY'S HOSPITAL DECATUR OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS 1800 E LAKE SHORE DRIVE DECATUR IL 62521 370661244 HEALTHCARE IL 501(c)(3) 3 HSSI true ST NICHOLAS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANC IS 3100 SUPERIOR AVENUE SHEBOYGAN WI 53081 390808480 HEALTHCARE WI 501(c)(3) 3 HSSI true UNITY LIMITED PARTNERSHIP 2366 OAK RIDGE CIRCLE DE PERE WI 54115 391750729 HEALTHCARE WI 501(c)(3) 10 HSSI true UTLAUT MEMORIAL FOUNDATION INC 200 HEALTHCARE DRIVE GREENVILLE IL 62246 371140166 FUNDRAISING IL 501(c)(3) Type II HSSI true SPRINGFIELD URGENT CARE REAL ESTATE LLC PO BOX 19456 SPRINGFIELD IL 627949456 030413258 RENTAL REAL ESTATE IL LASANTE INC N/A 0 PRAIRIE HEART INSTITUTE MANAGEMENT COMPANY LLC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 261479945 MEDICAL IL HSHS Related -7032 12572 false true 1 SOUTHWEST ILLINOIS HEALTH SERVICES REAL ESTATE LLP 4000 NORTH ILLINOIS STREET SWANSEA IL 62226 823633320 REAL ESTATE IL St John's Related -126650 1434911 false false 0.5 REHABILITATION HOSPITAL OF WESTERN WISCONSIN LLC 9001 Liberty Parkway Birmingham AL 35242 871489748 Medical DE HSHS Related -80505 4187830 false false 0.5 KIARA INC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371163401 HEALTHCARE IL HSHS C Corporation 601904 18670450 1 true LASANTE WISCONSIN INC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 391572196 HEALTHCARE IL KIARA INC C Corporation true LASANTE INC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 371163400 HEALTHCARE IL KIARA INC C Corporation true PREVEA HEALTH SERVICES INC 2710 EXECUTIVE DRIVE GREEN BAY WI 54304 391839351 HEALTHCARE WI HSSI C Corporation -1641640 24425128 0.5 true PREVEA CLINIC INC 2710 EXECUTVE DRIVE GREEN BAY WI 54304 391839349 HEALTHCARE WI PHSI C Corporation true RENAISSANCE QUALITY INSURANCE LTD PO BOX 1159 GRAND CAYMAN CJ KY11102 980669953 INSURANCE CJ HSSI C Corporation 0 156895227 1 true OJV INC 4936 LAVERNA ROAD SPRINGFIELD IL 62707 460873384 HEALTHCARE IL LASANTE INC C Corporation true false false true false false false false false false true true false true true true true true true true Schedule R, Part V, Line 2 TRANSACTIONS WITH RELATED ORGANIZATIONS ANY TRANSACTIONS LISTED ON SCHEDULE R, PART V, LINE 1 AND NOT ON SCHEDULE R, PART V, LINE 2 ARE BETWEEN RELATED 501(C)(3) AND DO NOT REQUIRE REPORTING ON THIS SECTION. Schedule R, Part VII Related Organizations Due to the increasingly complex organization structure of Hospital Sisters Health System and Affiliates, the filing organization has elected to report all organizations within Hospital Sisters Health System as related, regardless of ownership interest or "control" as defined by the instructions to Schedule R. The intent of this reporting is to promote transparency and increase consistency across the numerous Form 990 submissions by Hospital Sisters Health System and Affiliates.