Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Ministry Health Care Inc
Employer identification number
39-1490371
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization?
................
11g(i)
No
(ii)
a family member of a person described in (i) above?
......................
11g(ii)
No
(iii)
a 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
No
h
Provide the following information about the supported organization(s).
(i) Name of supported organization
(ii) EIN
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions))
(iv) Is the organization in col. (i) listed in your governing document?
(v) Did you notify the organization in col. (i) of your support?
(vi) Is the organization in col. (i) organized in the U.S.?
(vii) Amount of support?
Yes
No
Yes
No
Yes
No
(1)
Dr Kate Newcomb Convalescent Cente
391357365
3
No
0
(2)
Howard Young Health Care Inc
391499115
3
No
5,479,005
(3)
Marian Health System Inc
363659989
Type 1
No
89,024
(4)
Mercy Medical Center
390806268
3
No
5,132,788
(5)
Agape Community Center
391461846
3
No
591,000
(6)
St Clares Hospital of Weston Inc
721531917
3
No
8,887,838
(7)
Eagle River Memorial Hospital
390985690
3
No
403,532
(8)
Howard Young Medical Center
390873606
3
No
2,094,254
(9)
Good Samaritan Health Center
390808503
3
No
2,591,581
(10)
Door County Memorial Hospital
390806324
3
No
2,070,301
(11)
St Elizabeth Hospital
410693877
3
No
1,405,542
(12)
Our Lady of Victory Hospital
390807065
3
No
2,151,674
(13)
Sacred HeartSt Marys Hospitals
391390638
3
No
11,970,011
(14)
St Michaels Hospital
390808443
3
No
13,080,100
(15)
St Josephs Hospital
390847631
3
No
38,382,472
(16)
Ministry Medical Group
391965593
2
No
9,850,411
(17)
Ministry Home Care
391936201
3
No
1,909,519
Total
106,089,052
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3
The value of services or facilities furnished by a governmental unit to the organization without charge..
4
Total. Add lines 1 through 3..
5
The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included
on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6
Public Support. Subtract line 5 from line 4.
Section B. Total Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
7
Amounts from line 4..
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
10
Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11
Total support (Add lines 7 through 10).
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
13
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here..........................................
Section C. Computation of Public Support Percentage
14
Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f))
.........
14
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2010.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
......................
b
33 1/3% support test—2009.
If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2010.
If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization
..................................................
b
10%-facts-and-circumstances test—2009.
If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported organization
..............................................
18
Private Foundation
If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions
...................................................
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2
Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3
Gross receipts from activities that are not an unrelated trade or business under section 513..
4
Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5
The value of services or facilities furnished by a governmental unit to the organization without charge..
6
Total. Add lines 1 through 5.
7a
Amounts included on lines 1, 2, and 3 received from disqualified persons...
b
Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c
Add lines 7a and 7b..
8
Public Support (Subtract line 7c from line 6.)
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2006
(b) 2007
(c) 2008
(d) 2009
(e) 2010
(f) Total
9
Amounts from line 6...
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
11
Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12
Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13
Total support (Add lines 9, 10c, 11 and 12.).
14
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f))
.........
15
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2010.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
..........
b
33 1/3% support tests—2009.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
....
20
Private Foundation
If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information.
Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Line 11h Column (iv): The publicly supported organizations that are supported by Ministry Health Care, Inc. are not specifically identified in Ministry Health Care Inc.'s governing documents. However, there had been a historic and continuing relationship between Ministry Health Care, Inc. and its supported organizations and because of this relationship there exists a substantial commmon identity of interests between such organizations.Line 11h, Column (vii): The amount of support is quantified based upon what the organization provides for such services as management oversight, strategic planning, and other financial services. The organization bills the supported organization for these services.
Schedule A (Form 990 or 990-EZ) 2010
Additional Data
Software ID:
10000105
Software Version:
2010v3.2
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
Ministry Health Care Inc
Employer identification number
39-1490371
Identifier
Return Reference
Explanation
Schedule K Part IV - Arbitrage, Line 2
The bond issue dated June 17, 2010 (Column D) consists of a fixed rate bonds(B Series with $58,755,138 of proceeds) and a variable rate bonds(C Series with $20,000,000 of proceeds) and accordingly is treated as a variable yield issue.
Schedule K - Part III - Private Use
The 2009 Bond Series (Column B) refunded the following Bond Series: 1999A, 1999B and portions of 1993A; portions of 1993C, portions of 1993D, portions of 1993A and 2007A (which effectively refinanced portions of the 1997 Series and the 2003A and 2003B Series issued April 3, 2003 and August 15, 2003, respectively). The 2003A and 2003B Series refunded portions of the 1993 Bond Series. Accordingly, no information on private use is required for the 2009 Bond Series. The 2010A Bond Series (Column C) refunded portions of 1993C and portions of 1993D Bond Series. In accordance with the special rules for the refunding of pre-2003 issues, reporting of private use information is not required. The 2004 Bond Series (Column A) does not have any private business use of property funded by the proceeds.
Schedule K - Part II, line 17
While Ministry's 2002 Bonds are not required to be listed on Schedule K, that bond issue was audited for compliance by the IRS and that examination was closed with no change to the position that interest on those bonds is excludable from gross income under section 103 of the Internal Revenue Code.
Schedule K - Part I
The organization has caused to be filed protective Form 8038s after 2002 with respect to transactions relating to certain of its bonds issued before 2003. In those cases, the organization entered into certain swap transactions with respect to those bond issues that possibly may have resulted in a reissuance of bonds for federal income tax purposes. Such transactions involved no new use of proceeds, and are not reported as refundings on Schedule K.
Schedule K - Part 1, (c) and (f)
The purpose and full listing of CUSIPs for the bonds listed on Schedule K are as follows:(A) 2004 SERIES Purpose: To pay or reimburse for capital expenditures, primarily related to the acquiring, construction and equipping of St. Clare's Hospital, and to pay for issuance expenses. CUSIPs: 97710BAE2, 97710BAF9, 97710BAG7, 97710BAH5, 97710BAJ1, 97710BAK8, 97710BAL6, 97710BAM4, 97710BAN2, 97710BAP7, 97710BAQ5, 97710BAR3, 97710BAS1, 97710BAT9, 97710BAU6, 97710BAV4, 97710BAW2, 97710BAX0, 97710BAY8, 97710BAZ5, 97710BBA9(B) 2009 SERIES Purpose: To refinance Series 1993 and Series 2007 Bonds and to pay for issuance expenses. CUSIPs: 97710BGK2, 97710BGL0(C) 2010A SERIES Purpose: To refund the Series 1993C and Series 1993D Bonds and to pay for issuance expenses. CUSIPs: 97710BSE3, 97710BSF0, 97710BSG8, 97710BSH6, 97710BSJ2, 97710BSK9, 97710BSL7, 97710BSM5, 97710BSN3, 97710BSP8, 97710BSQ6, 97710BSR4, 97710BSS2(D) 2010B and 2010C SERIES Purpose: To fund the acquisition, construction, renovation and equipping of certain health care facilities and to pay for issuance expenses. CUSIPs: 97710BWJ7, 97710BWK4, 97710BWL2, 97710BWM0, 97710BWN8, 97710BWP3, 97710BWQ1, 97710BWV0, 97710BWU2, 97710BWX6
Form 990 - Part 1 - Summary - Response 1
Ministry Health Care, a Catholic sponsored parent corporation of 501(c)(3) tax exempt health provider organizations, is an internally supported, church controlled organization. Ministry Health Care's primary activity is to provide centralized management to those organizations. Ministry Health Care is affiliated with the church or convention or association of churches and it is included within a group exemption letter under Revenue Procedure 80-27, 1980-1 C.B. 677. Ministry Health Care is listed in the Official Catholic Directory covered under the group exemption ruling issued to the United States Catholic Conference. Ministry Health Care is internally supported and does not offer admission, goods, services or facilities for sale other than on an incidental basis, to the general public.
Federal Supporting Detail-Balance Sheet
Variable Rate Demand Obligations (VRDOs) - are investment in tax exempt debt instruments of corporations and governmental entities.
***Voluntary Filing***
990 Form, B - The Form 990 is voluntarily being filed by Ministry Health Care, Inc. Ministry Health Care, Inc. qualifies as an "integrated auxiliary of a church" under Section 1.6033-2(h)(1) of the Income Tax Regulations and therefore, pursuant to Section 6033(a)(2) of the Internal Revenue Code, Ministry Health Care, Inc. is not required to file an annual Form 990. Prior to filing for the fiscal year ended September 30, 2009, Ministry Health Care, Inc. last filed a Form 990 in 1993. Ministry Health Care, Inc. notified the Internal Revenue Service in a letter dated February 11, 1994, regarding its intention to discontinue filing a Form 990 because it qualifies as an integrated auxiliary of a church. Ministry Health Care, Inc. has never been notified by the Internal Revenue Service that it is not eligible for this exemption and that it should instead begin filing the Form 990. Throughout the years Ministry Health Care, Inc. has continued to monitor its eligibility for the integrated auxiliary exemption to ensure that it continues to meet the internal support test. In the interest of public disclosure and acknowledging the policy direction of health care reform calling for greater transparency of health care providers in general, Ministry Health Care, Inc. began voluntarily filing a Form 990 for the fiscal year ended September 30, 2009. This filing, however, should not be interpreted as, and does not constitute, any admission or acknowledgement of any sort that Ministry Health Care, Inc. is other than an integrated auxiliary of a church.
Form 990, Part VI, Line 19
Form 990, Part VI, Line 19: Other Organization Documents Publicly Available
Governing documents are not generally made available to the public with the exception of Form 990 and its related schedules.
Form 990, Part VI, Line 15b
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees
Senior Executives of the Corporation have their salary and benefits reviewed by an outside independent compensation consulting firm to determine that the compensation is fair market value compensation. A Compensation Committee of the Board of Directors meets with the compensation consultant at least annually to approve the executive compensation and benefit levels.
Form 990, Part VI, Line 12c
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts
Officers, directors, trustees, and VPs and above of Ministry Health Care, Inc. and its related organizations are provided the conflict of interest policy and sign off, where any exceptions are noted, on an annual basis. The Corporation's CEO reviews the conflict of interest sign offs and disclosures, addresses potential or actual conflicts and takes appropriate measures to eliminate or otherwise mitigate such potential or actual conflicts of interests including, but not limited to, prohibiting such individuals from voting or influencing the vote on the subject matter.
Form 990, Part VI, Line 11
Form 990, Part VI, Line 11: Form 990 Review Process
The Finance and Audit Committee of the organization is provided a copy of the 990 and related attachments and those materials were reviewed with the Committee. This role was specifically delegated to the Finance and Audit Committee by the Ministry Health Care, Inc. Board of Directors. Management of the organization reviews the 990 to ensure its accuracy and completeness prior to providing to the Finance and Audit Committee and certain portions of the form are reviewed by legal counsel.
Form 990, Part VI, Line 7a
Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body
Marian Health System, Inc. (Marian) is the sole corporate member of Ministry Health Care, Inc. Marian is a 501(c)(3) tax exempt organization. Marian holds various reserved governance powers over Ministry Health Care, including approval of Board members, the Chief Executive Officer, governing documents, the auditing firm, budgets and financial plans.
Form 990, Part VI, Line 6
Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder
Marian Health System, Inc. (Marian) is the sole corporate member of Ministry Health Care, Inc. Marian is a 501(c)(3) tax exempt organization. Marian holds various reserved governance powers over Ministry Health Care, including approval of Board members, the Chief Executive Officer, governing documents, the auditing firm, budgets and financial plans.
Form 990, Part VI, Line 2
Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et
Several officers and key employees of Ministry Health Care, Inc. have business relationships in that they also serve as officers or directors of another organization(s) within the Ministry Health system. This includes the following individuals: Nicholas Desien, Brian Kief, Jeff Martin, Monica Hilt, Michael Kryda, Sr. Lois Bush, Michael Schmidt, Gerald Worrick and James Watson.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.