TY 2015 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) JOAN COFFMAN CEO/PRESIDENT	60.0 ................. 2.0	X	X			0	403,420	131,871
(2) JAMES E DOCKSEY Vice Chair - Part Year	1.0 ................. 1.0	X	X			0	0	0
(3) KAREN HEBERT Vice Chairperson (Partial Year)	1.0 ................. 1.0	X	X			0	0	0
(4) GERALD JACOBSON Secretary	1.0 ................. 1.0	X	X			0	0	0
(5) DAVID KIEFER CHAIRPERSON	1.0 ................. 1.0	X	X			0	0	0
(6) JULIE MANAS DIVISION PRES/CEO	1.0 ................. 61.0	X	X			0	566,384	180,366
(7) BRUCE BARKER Director	1.0 ................. 1.0	X				0	0	0
(8) LON BLASER DO Director	1.0 ................. 3.0	X				0	0	0
(9) GREG HEILER MD Director	1.0 ................. 1.0	X				0	0	0
(10) PETER MANNIX Board Member	1.0 ................. 61.0	X				0	469,517	170,262
(11) Patti Darley Director	1.0 ................. 1.0	X				0	0	0
(12) Jeff Halloin Director	1.0 ................. 1.0	X				0	0	0
(13) ANN M CARR TREASURER	0.3 ................. 59.8		X			0	354,305	222,661
(14) DAVE NELSON DIVISION CHIEF FINANCIAL OFFICER	28.0 ................. 32.0		X			0	312,770	77,831
(15) Estella Clark Chief Nursing Officer	40.0 ................. 0			X		172,140	0	47,500
(16) RONDA ADLER PHARMACIST	40.0 ................. 0				X	170,235	0	47,717
(17) SARA JORGENSON PHARMACIST	40.0 ................. 0				X	160,531	0	50,113

(A) Name and business address	(B) Description of services	(C) Compensation
INFINITY HEALTHCARE 111 E WISCONSIN AVE MILWAUKEE,WI53202	PROVIDER COVERAGE	2,580,927
MARSHFIELD CLINIC 1000 N OAK AVE MARSHFIELD,WI54449	PROFESSIONAL SERVICES	826,423
DIVERSIFIED CLINICAL SVC INC PO BOX 636981 CINCINNATI,OH45263	PROFESSIONAL SERVICES	735,347
SODEXO INC & AFFILIATES 4880 PAYSPHERE CIRCLE CHICAGO,IL60674	CONTRACTED LABOR	689,941
Eau Claire Anesthesiologists 1101 W Clairemont Avenue Eau Claire,WI54701	Professional Services	533,333
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 16

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

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.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

St Joseph's Hospital of the Hospital Sisters of the Third Order of St Franc
is

Employer identification number

39-0810545

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.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ))

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross 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.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 11a through 11d that describes the type of supporting organization and complete lines 11e, 11f, and 11g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ..............

Provide the following information about the supported organization(s).

(i)Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i)Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2015

Page 2

Part II

Support Schedule for Organizations Described in Sections 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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10.

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2014 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2015. 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 ....................... right arrow

33 1/3% support test—2014. If the organization did not check a 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 ..................... right arrow

17a

10%-facts-and-circumstances test—2015. 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 VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2014. 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 VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2015

Page 3

Part III

Support Schedule for Organizations Described in Section 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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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 VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2014 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2015 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2014 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2015. 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 ....... right arrow

33 1/3% support tests—2014. 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 .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2015

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2015

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2015

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2015

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2015 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2015	(iii) Distributable Amount for 2015
1 Distributable amount for 2015 from Section C, line 6
2 Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions)
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013.......
e From 2014.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2015 distributable amount
i Carryover from 2010 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2015 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2015 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions)
6 Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions)
7 Excess distributions carryover to 2016. Add lines 3j and 4c.
8 Breakdown of line 7:
a
b
c Excess from 2013.......
d From 2014.......
e From 2015.......

Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Name of the organization

St Joseph's Hospital of the Hospital Sisters of the Third Order of St Franc
is

Employer identification number

39-0810545

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015) Page 2

Name of organization St Joseph's Hospital of the Hospital Sisters of the Third Order of St Franc is

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Page 3

Name of organization St Joseph's Hospital of the Hospital Sisters of the Third Order of St Franc is		Employer identification number 39-0810545

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Page 4


Name of organization St Joseph's Hospital of the Hospital Sisters of the Third Order of St Franc is			Employer identification number 39-0810545
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

St Joseph's Hospital of the Hospital Sisters of the Third Order of St Franc
is

Employer identification number

39-0810545

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

Political expenditures ...................................................................................................................... SchCMd Bullet

Volunteer hours .............................................................................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2015

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ...............................................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ...........................................
c	Total lobbying expenditures (add lines 1a and 1b) .......................................................................
d	Other exempt purpose expenditures .........................................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ....................................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) ..........................................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ..........................................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ...........................................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ..............................................................................................................	Yes No

4-Year Averaging Period Under section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2012	(b) 2013	(c) 2014	(d) 2015	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2015

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

4,543

Total. Add lines 1c through 1i ....................................................................................................

4,543

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures (see instructions) .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	ST. JOSEPH'S HOSPITAL (THE HOSPITAL) IS A MEMBER OF THE CATHOLIC HEALTH ASSOCIATION ("CHA"), WISCONSIN HEALTH ASSOCIATION ("WHA"), THE NATIONAL ASSOCIATION FOR HOME CARE AND HOSPICE, AND THE AMERICAN HEALTH ASSOCIATION ("AHA"). AS A MEMBER OF THESE ORGANIZATIONS, THE HOSPITAL PAYS DUES, PART OF WHICH ARE ATTRIBUTABLE TO LOBBYING FEES PAID BY THE ORGANIZATIONS. THE AMOUNT LISTED IS THE AMOUNT ATTRIBUTABLE TO THE HOSPITAL FROM ITS DUES PAID.
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	ST. JOSEPH'S HOSPITAL (THE HOSPITAL) IS A MEMBER OF THE CATHOLIC HEALTH ASSOCIATION ("CHA"), WISCONSIN HEALTH ASSOCIATION ("WHA"), THE NATIONAL ASSOCIATION FOR HOME CARE AND HOSPICE, AND THE AMERICAN HEALTH ASSOCIATION ("AHA"). AS A MEMBER OF THESE ORGANIZATIONS, THE HOSPITAL PAYS DUES, PART OF WHICH ARE ATTRIBUTABLE TO LOBBYING FEES PAID BY THE ORGANIZATIONS. THE AMOUNT LISTED IS THE AMOUNT ATTRIBUTABLE TO THE HOSPITAL FROM ITS DUES PAID.

Return Reference

Explanation

Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY

ST. JOSEPH'S HOSPITAL (THE HOSPITAL) IS A MEMBER OF THE CATHOLIC HEALTH ASSOCIATION ("CHA"), WISCONSIN HEALTH ASSOCIATION ("WHA"), THE NATIONAL ASSOCIATION FOR HOME CARE AND HOSPICE, AND THE AMERICAN HEALTH ASSOCIATION ("AHA"). AS A MEMBER OF THESE ORGANIZATIONS, THE HOSPITAL PAYS DUES, PART OF WHICH ARE ATTRIBUTABLE TO LOBBYING FEES PAID BY THE ORGANIZATIONS. THE AMOUNT LISTED IS THE AMOUNT ATTRIBUTABLE TO THE HOSPITAL FROM ITS DUES PAID.

Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY

Schedule C (Form 990 or 990EZ) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

St Joseph's Hospital of the Hospital Sisters of the Third Order of St Franc
is

Employer identification number

39-0810545

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

			(a) Donor advised funds	(b) Funds and other accounts

1	Total number at end of year ....
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ....

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ...........

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ............................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2015

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........

Part V

Endowment Funds. Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations .................

3a(i)

(ii) related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land ...	383,686		383,686
b	Buildings	40,865,382	19,540,653	21,324,729
c	Leasehold improvements	2,226,687	748,938	1,477,749
d	Equipment ...	21,765,853	15,200,976	6,564,877
e	Other ...	141,072		141,072
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				29,892,113

Schedule D (Form 990) 2015

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b)Book value	(c)Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
RATE SWAP AGREEMENTS	3,896,020
MINIMUM PENSION LIABILITY	24,418,364
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	28,314,384
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2015

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference

Explanation

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. In assessing the realizability of deferred tax assets, management considers whether it is more likely than not that some portion or all of 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 than not Kiara, Inc. will not realize the majority 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, 2016 and 2015 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, 2016 and 2015, HSHS does not have any liabilities for unrecognized tax benefits.

Schedule D (Form 990) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

St Joseph's Hospital of the Hospital Sisters of the Third Order of St Franc
is

Employer identification number

39-0810545

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other 60000 %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .		7,671	1,538,647	0	1,538,647	2.50 %
b	Medicaid (from Worksheet 3, column a) . . . . .		11,405	15,439,224	8,706,144	6,733,080	10.94 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .		925	1,228,318	883,799	344,519	0.56 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	0	20,001	18,206,189	9,589,943	8,616,246	14.00 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).		113,908	372,572	2,944	369,628	0.60 %
f	Health professions education (from Worksheet 5) . . .		995	5,589	0	5,589	0.01 %
g	Subsidized health services (from Worksheet 6) . . . .			3,803,058	3,184,393	618,665	1.01 %
h	Research (from Worksheet 7) .					0	0 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .		5,804	30,041		30,041	0.05 %
j	Total. Other Benefits . .	0	120,707	4,211,260	3,187,337	1,023,923	1.66 %
k	Total. Add lines 7d and 7j .	0	140,708	22,417,449	12,777,280	9,640,169	15.66 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2015

Schedule H (Form 990) 2015

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing					0	0 %
2	Economic development					0	0 %
3	Community support					0	0 %
4	Environmental improvements					0	0 %
5	Leadership development and training for community members					0	0 %
6	Coalition building					0	0 %
7	Community health improvement advocacy					0	0 %
8	Workforce development					0	0 %
9	Other		30,649	281,937	87,206	194,731	0.32 %
10	Total	0	30,649	281,937	87,206	194,731	0.32 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

189,601

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

13,678,416

Enter Medicare allowable costs of care relating to payments on line 5.....

20,889,774

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-7,211,358

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2015

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?1 Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	ST JOSEPH'S HOSPITAL 2661 COUNTY HIGHWAY I CHIPPEWA FALLS,WI54729 http://www.stjoeschipfalls.com/ 15	X	X	X

Schedule H (Form 990) 2015

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	ST JOSEPH'S HOSPITAL
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 14

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): * HTTP://WWW.STJOESCHIPFALLS.ORG/COMMUNITY-REPORT

Other website (list url): HTTP://WWW.CHIPPEWHEALTH.ORG/

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 14

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): HTTP://WWW.STJOESCHIPFALLS.ORG/COMMUNITY-CARE

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2015

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	ST JOSEPH'S HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.0% and FPG family income limit for eligibility for discounted care of 600.0%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Included measures to publicize the policy within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

http://www.stjoeschipfalls.com/Patients-Guests/Financial-Assistance

The FAP application form was widely available on a website (list url):

http://www.stjoeschipfalls.com/Patients-Guests/Financial-Assistance

A plain language summary of the FAP was widely available on a website (list url):
http://www.stjoeschipfalls.com/Patients-Guests/Financial-Assistance

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notice of availability of the FAP was conspicuously displayed throughout the hospital facility

Notified members of the community who are most likely to require financial assistance about availability of the FAP

Other (describe in Section C)

Billing and Collections

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2015

Page 6

Part VFacility Information (continued)

	ST JOSEPH'S HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that
can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Section C)

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2015

Page 7

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - HSHS St. Joseph's Hospital, Chippewa Falls. Hshs st. Joseph's hospital (sjcf) undertook a twelve month planning and implementation effort to develop the chna, identify and prioritize community health needs for its service area and formulate an implementation plan to guide ongoing population health initiatives with like-missioned partners and collaborators. These planning and development activities included the following internal and external steps: Internal Sjcf utilized the expertise of the hospital's division director of 3d community health and her team of colleagues to lead the chna process. One of the hospital's marketing specialists participated in the planning and implementation of the chna from start to finish. She and the division director of 3d community health served as liaisons between the hospital, the chna planning committee partners, other community members as well as the hospital's local and health system leaders. She also facilitated a large community health improvement event where community members were asked to provide feedback on preliminary chna results and to engage the public in detailed discussion related to the top need priority areas, highlight related initiatives of the area community health initiatives, and encourage community participation in local health improvement efforts through membership in healthy community action teams and engagement in collaborative action plans. The division director of 3d community health and her team provided education around community benefit and the chna to hospital leaders and colleagues encouraging documentation of the hospital's many community benefit programs and events. An internal team was developed that included the community health director (the hospital's community benefit lead), the hospital's community benefit specialist, the hospital's fiscal controller, colleagues from fiscal services, the director of marketing and a marketing specialist who met on a quarterly basis to review and approve the hospital's community benefit programs/events prior to the programs/events being entered into cbisa. The hospital's and health system's leaders and local governance were kept abreast of the hospital's community health outreach activities, community benefit programs/events and the chna process through reports to the hospital's board of directors. External Sjcf also leveraged existing relationships that provided diverse input for a comprehensive review and analysis of community health needs in the hospital's service area. These external components steps began with forming an external chna planning partnership committee of community partners including: chippewa county department of public health, health officer chippewa health improvement partnership (chip) steering committee and action team members eau claire city-county health department health officer; health educator; community health needs assessment program manager eau claire healthy communities council and action team members marshfield clinic, clinic director mayo clinic health system division director of community engagement and wellness hshs st. Joseph's hospital, chippewa falls director of marketing; marketing specialist who was also chair of chip steering committee united way of the greater chippewa valley, executive director and director of community engagement The eau claire city-county health department served as the fiscal agent for the partnership, and each organization signed a memorandum of understanding prior to the chna process. Contributions from each of the partner organizations totaled $55,000. The otto bremer foundation also awarded a $19,000 grant to the chna committee to increase outreach into rural communities during the chna process. Representatives from the partner organizations met bimonthly from may 2014 through april 2015 to plan and implement the chna. This joint chna process, the first of its kind for chippewa and eau claire counties, demonstrates the commitment each of the partners has to working toward a healthier community through collaborative action across county lines. This collaboration also allows the community to participate in one comprehensive assessment rather than several chnas conducted each year by different organizations. The chna committee believes that no one organization alone can "move the needle" on community health. Rather, only through working together and engaging the community will we truly begin to inspire and realize community health improvement. Analysis of the survey respondent demographics indicated that a low number of surveys were received from the population in chippewa county over age 70 and those residents who's highest Education level is high school or some college. Therefore, targeted listening sessions were held to engage these groups and gather information on barriers to and resources for making Healthy choices in the community. These sessions were held in november 2014 at the chippewa falls community meal site agnes' table and the chippewa falls area senior center. Each listening Session was conducted by at least one chna partner organization representative. After the survey results were analyzed, local quantitative health data was compiled from a variety of data sources based on the measures. The primary and secondary data were presented at five community conversations that took place throughout chippewa county in february 2015. Sessions were held in chippewa falls (two sessions), cornell, cadott, and bloomer. The purpose of these sessions was to allow the public to give input on how to prioritize the 14 health focus areas that were initially presented in the survey. Identical to the survey, the community conversations were widely publicized through the professional networks of each of the chna partner organizations, through community organizations that assisted in survey distribution, and through local print, broadcast, and social media. Community conversations were held on weeknight evenings and in a public location (e.g. local public library or school). Overall, 78 people attended the five community conversations in chippewa county. Community representation was diverse attendees represented health care, public schools, university students and faculty, local government, and the general public. Each community conversation consisted of a data presentation that highlighted survey results and local health data for each of the 14 focus areas. Next, participants discussed the survey results and data in small groups with the goal of each individual selecting their top three priority areas. Prioritization criteria were provided to participants and are shown below. These facilitated group discussions were important for presenting and allowing the public to analyze data from multiple sources, which lends to a more complete picture of community health. Participants were able to develop a more comprehensive picture of health in chippewa county through consideration of the public perception of health and the data that had been collected by local and national agencies. Data was presented orally and also on clear, concise factsheets to allow thorough understanding of the data sources during group discussion.
Schedule H, Part V, Section B, Line 6a Facility , 1	Facility , 1 - HSHS St. Joseph's Hospital, Chippewa Falls. HSHS ST. JOSEPH'S HOSPITAL, CHIPPEWA FALLS, WI AND MAYO CLINIC HEALTH SYSTEMS, EAU CLAIRE, WI ALSO PARTICIPATED IN THE CHNA.
Schedule H, Part V, Section B, Line 6b Facility , 1	Facility , 1 - HSHS St. Joseph's Hospital, Chippewa Falls. HSHS ST. JOSEPH'S HOSPITAL'S CHNA WAS CONDUCTED WITH THE FOLLOWING NON-HOSPITAL ORGANIZATIONS: CHIPPEWA COUNTY DEPARTMENT OF PUBLIC HEALTH, CHIPPEWA COUNTY, WISCONSIN; CHIPPEWA HEALTH IMPROVEMENT PARTNERSHIP, CHIPPEWA COUNTY, WISCONSIN; EAU CLAIRE CITY-COUNTY HEALTH DEPARTMENT, EAU CLAIRE, WISCONSIN; EAU CLAIRE HEALTHY COMMUNITIES, EAU CLAIRE, WISCONSIN; MARSHFIELD CLINIC, CHIPPEWA FALLS AND EAU CLAIRE, WISCONSIN; AND UNITED WAY OF THE GREATER CHIPPEWA VALLEY, CHIPPEWA AND EAU CLAIRE COUNTY, WISCONSIN.
Schedule H, Part V, Section B, Line 7 Facility , 1	Facility , 1 - HSHS St. Joseph's Hospital, Chippewa Falls. Following the community conversations and prioritization of the top health issues for chippewa county, one final event was held in march 2015 in chippewa county to get public feedback on the preliminary chna results and to enhance the focus and understanding of the top three priority areas of mental health, alcohol misuse, and substance use. The purpose of this event was to engage the public in detailed discussion related to these priority areas, highlight related initiatives of the chippewa health improvement partnership (chip), and encourage community participation in local health improvement efforts through membership in a chip action team and engagement in collaborative action plans. A total of 36 community members representing sectors as broad as faith communities, local and regional government, school districts, healthcare providers, university students, and retired citizens participated in this event. The structure included a presentation of recent chip initiatives as well as additional quantitative health data related to the three focus areas. Participants were then guided through three rounds of facilitated small-group discussion to better identify the root causes, existing community resources, and community gaps in services for the top three priority areas. The world cafe model (small facilitated discussion groups that rotate through multiple discussion topics) was utilized to inspire creative thinking and create a comfortable atmosphere in which participants could openly share their ideas on each of the three topic areas during the facilitated discussion. During three rounds of discussion, participants were given the opportunity to provide their thoughts on the top three priority areas. Facilitators guided participants to consider root causes for each focus area. After the discussion period, facilitators reported out to the large group about root causes, resources, and gaps in services that participants identified. Key themes were recorded by note takers and the facilitators for inclusion in this report. The chna was then presented at the hospital's board of directors' meeting as well as at the steering committee meetings of the eau claire healthy communities and chippewa health improvement partnership. A press release/media alert was sent to all area news outlets including tv, radio, newspaper as well as the information being distributed at to churches, serviced clubs, schools and at numerous area events for the general public.
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - HSHS St. Joseph's Hospital, Chippewa Falls. Based on the fy2015 chna planning and development process, the following top three community health needs were identified as the primary focus areas for hshs st. Joseph's hospital community benefit: 1). Mental health 2). Substance use 3). Alcohol misuse As an outcome of the prioritization process, the following community health needs were also identified and will be incorporated into the hopsital's implementation plan as part of one of the top three identified needs : healthy growth and development; healthy nutrition; obesity and physical activity; chronic disease; and access to health care. 1). Mental health - hshs st. Joseph's hospital is involved in the implementation and/or continuation of the following efforts to improve mental health services. A. Suicide prevention initiative - hshs st. Joseph's hospital's (sjcf) 3d community health department is leading suicide prevention activities across multiple sectors and settings in collaboration with chippewa health improvement partnership, eau claire healthy communities, and multiple other community partners to promote awareness that suicide is a public health problem that is preventable. Strategies include community trainings of an evidence-based suicide prevention program, qpr (question, persuade & refer), as well as a variety of events, activities and displays pertaining to suicide prevention. Efforts are measured by the county suicide rate, inventory of change in community knowledge, stigma and behaviors, as well as participation in the county suicide death review team to monitor for potential trends and respond accordingly. B. Suicide community awareness campaign - sjcf's 3d community health department is working to increase community awareness and knowledge of the factors that offer protection from suicidal behaviors and that promote wellness and recovery. Collaboration with multiple community partners is occurring on an ongoing basis. One objective is to promote effective programs and practices i.e. adverse childhood experiences (aces) that increase protection from suicidal risk and promote connectedness among residents of chippewa and eau claire counties. Success is measured by an inventory of community attitudes and behaviors, county suicide statistics and evidence of increased community knowledge of suicide and the connection between mental and physical health and wellbeing based on survey data that the hospital collects. C. Mental health community awareness campaign - sjcf's 3d community health department, in collaboration with the hospital's marketing department will implement research-informed communication efforts designed to reduce the stigma around mental illness by changing knowledge, attitudes and behaviors in defined segments of the population. We will work to increase communication efforts conducted online (utilizing social media and other mediums) that promote positive messages and promote public awareness that mental health and physical health are equal and inseparable components of overall health. Success will be measured utilizing online data collection tools, such as google analytics and insights for face book, for increased site usage, surveys of community members' increase in knowledge, positive changes in behavior risk surveys, and others. D. State behavioral health alignment - sjcf will continue support and participation in a collaborative effort between hshs western and eastern wisconsin to align behavioral health services between the six hospitals and other behavioral health partners. Alignment and coordination of services within the state will demonstrate success. E. Sjcf's 3d community health department will continue to work collaboratively with the hospital's behavioral health department to provide community education. Events/sessions will be evaluated for effectiveness and measurements of success will be developed. 2) substance use - sjcf is supportive of the implementation and/or continuation of the following efforts to address substance abuse. A. Voices in prevention action team - sjcf will continue its current position as lead for this action team of the chippewa health improvement partnership (chip) to further community education and awareness regarding substance abuse, particularly the dangers of opiate use. B. Promote effective programs and practices, i.e. adverse childhood experiences (aces) that increase protection from substance abuse and prmote connectedness among residents of chippewa and eau claire counties. Increased community knowledge of aces will be tracked and be used as a measure of success. C. L.e. phillips libertas treatment center will continue to provide high quality assessment, intervention and residential alcohol and other drug abuse (aoda) treatment for our community and surrounding areas. 3). Alcohol misuse - sjcf is supportive of the implementation and/or continuation of the following efforts to address alcohol misuse. A. L.e. phillips libertas treatment center will continue to provide high quality assessment, intervention, and residential alcohol and other drug abuse (aoda) treatment for persons in our community and surrounding areas. B. L.e. phillips libertas treatment center will continue to provide aoda education through bi-monthly community seminars, and a variety of other community venues. C. Sjcf will continue support of the voices in prevention action team of chippewa health improvement partnership (chip) and the high-risk drinking prevention action team of eau claire healthy communities to further community education and awareness around aoda issues in the Chippewa and eau claire areas. Evaluations of events/programs will be developed and used to track any changes in community knowledge and/or behaviors. County health rankings will be tracked as well. The following community health needs were also identified and will be incorporated into the hospital's implementation plan as part of the strategies to address one of the top three identified need of mental health, alcohol misuse or obesity. The following health needs are impacted by the top three identified community health needs : Healthy growth & development: the hospital supports the infant mental health action team of chippewa health improvement partnership (chip) whose work impacts this focus area. Sjcf will continue its coordination and support of its first connections program which is a partnership between sjcf and the family support center, chippewa falls that provides a visit by a case worker to all parents in sjcf's birth center to evaluate risk factors and provide information/referral. Obesity and physical activity - sjcf is involved in the implementation and/or continuation of the following efforts to address obesity. A. Obesity and physical activity: the hospital will be incorporating obesity into its work on mental health with attention to body image issues and the positive effect that exercise and healthy weight have on mental health. B. Sjcf will continue community education and awareness of the potential risk factors of obesity via the use and promotion of healthaware on-line risk assessment. Assessments that will be promoted include, but are not limited to, heartaware, sleepaware, strokeaware, breastcanceraware, and coloncanceraware. On-line data collection will be used to track number of visits to sites and other measurement tools will be developed to evaluate success. County health rankings will be tracked as well. C. Sjcf will continue to partner with hshs sacred heart hospital to promote their on-line health assessment tool, "go" chippewa valley. This site encourages people to move at least 15 minutes per day and provides health information, an on-line exercise and diet tracking tool called go my way and information about upcoming classes/events that the hospital's community health department coordinates/hosts. Multiple methods of evaluation will be used including google analytics, event program surveys, number of site visits, etc. D. The hospital supports the chip action team, challenge chippewa, which works to impact physical fitness and overall wellbeing. The health educator for sjcf's 3d community health was instrumental in securing a partnership between challenge chippewa and eau claire county's healthy communities action team to collaborate with gordy's county markets in chippewa and eau claire and the university of new mexico to provide a program that the university has developed to encourage customers to purchase fresh produce at the stores. Chronic disease: as a hospital, sjcf is always concerned with the prevention and management of chronic disease and will continue to incorporate this focus area into community awareness and education events/activities even when those events/activities have a primary focus on mental health.
Schedule H, Part V, Section B, Line 11 Facility , 2	Facility , 2 - HSHS St. Joseph's Hospital, Chippewa Falls. Access to health care -this was not one of the 14 needs that was identified/addressed in our chna but sjcf will continue to work closely with community partners, including the chippewa county department of human services and the health department, insurance agencies/brokers, churches and many more, to advance community awareness around the affordable care act (aca) and encourage enrollment in the health insurance marketplace or other insurance assistance programs. The hospital will collaborate with the other members of the chippewa county aca team that the hospital was instrumental in founding three years ago. As an outcome of the prioritization process, the following community health needs were also identified to a lesser degree and will not be addressed directly by the hospital for the reasons indicated: Adequate, appropriate and safe food and nutrition: the hospital did not take the lead on this issue as we have done in the past. It is addressed by groups including the 18 food assistance services in chippewa county, local school districts, and the county health departments. The hospital supports these efforts by donating community garden proceeds to the local food pantries, providing meals through the local meals on wheels program and hospital colleagues volunteering at the local community meal site and by financial contributions. Injury & violence: the community has a well-established, well- respected community sexual assault and domestic violence agency that is the lead on this area. The hospital does provide financial support during the agency's annual fundraising drive as well as senior leadership serving on agency board of directors. Sjcf will have a primary focus of suicide prevention (self-injury area) and awareness which the hospital is including in the mental health focus area. Reproductive/sexual health: the hospital is not taking the lead in this area as it is best served by the county health department and other agencies with expertise in the area. Environmental/occupational health: while sjcf does have a vibrant occupational health department, the hospital will not take the lead; the county health department will lead and has expertise in. Tobacco use and exposure: sjcf is a smoke-free campus and advocates for smoking cessation but will not lead efforts in the community as it is best addressed through the county health department and to community agencies with expertise in this area.

Schedule H (Form 990) 2015

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Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?0
Name and address		Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2015

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Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
Schedule H, Part VI, Line 5 PROMOTION OF COMMUNITY HEALTH (CONTINUED A)	(continuation of Part VI Line 5) FROM JULY 1, 2015- JUNE 30, 2016 3D PROVIDED 37 ADULT QPR PROGRAMS AND REACHED 1046 COMMUNITY MEMBERS AND 44 YOUTH QPR PROGRAMS THAT REACHED 1161 HIGH SCHOOL STUDENTS. 3D ALSO PROVIDED A PROGRAM DISCUSSING THE COMMUNITY HEALTH NEEDS ASSESSMENT AND AN INTRODUCTION TO THE QPR PROGRAM TO 192 COMMUNITY MEMBERS; EVALUATION RESPONSES INCLUDED: AFTER ATTENDING THE QPR PROGRAM DO YOU FEEL YOU ARE NOW ABLE TO ASK SOMEONE YOU ARE CONCERNED ABOUT IF THEY ARE SUICIDAL? YES-83.64% NO-.5% MAYBE-15.97% AFTER ATTENDING THIS TRAINING HAS YOUR KNOWLEDGE OF AVAILABLE MENTAL HEALTH RESOURCES INCREASED? YES-92.83% NO-.3% MAYBE 3.89% *IT'S FAIR TO NOTE THAT IN OUR INITIAL TRAININGS MANY WHO ATTENDED WERE PEOPLE "IN THE FIELD" THUS THE QUESTION OF INCREASED KNOWLEDGE MAY BE A LITTLE SKEWED AS MANY OF THEM ARE ALREADY VERY AWARE OF RESOURCES. SJCF'S 3D COMMUNITY HEALTH DEPARTMENT LOGGED 651 HOURS PROVIDING QPR TO THE COMMUNITY WITH 1938 PEOPLE TOUCHED AT AN EXPENSE OF $66,054.00. IN ADDITION TO TAKING A LEAD ROLE WITH BRINGING QPR TO THE CHIPPEWA COUNTY AND SURROUNDING AREA SJCF IS COORDINATING EFFORTS WITH EAU CLAIRE HEALTHY COMMUNITIES MENTAL HEALTH ACTION TEAM, THAT IS ALSO PROVIDING QPR IN THE COMMUNITY, TO MAKE SURE THAT EFFORTS ARE NOT DUPLICATIVE OR COMPETING FOR SAME DAY OR SAME AUDIENCES AND TO ENSURE SIMILAR MESSAGING IS USED. IN A DIRECT RESPONSE TO THE COMMUNITIES' REQUEST FOR MORE INFORMATION AROUND SPECIFIC MENTAL ILLNESSES AND HOW TO BETTER RESPOND TO THOSE STRUGGLING WITH MENTAL HEALTH DISORDERS, SJCF'S 3D COMMUNITY HEALTH HAS ALSO TAKEN THE SUICIDE PREVENTION EFFORT A STEP FURTHER. A HEALTH EDUCATOR FROM 3D HAS BECOME A CERTIFIED TRAINER IN MENTAL HEALTH FIRST AID, A NATIONALLY RECOGNIZED 8-HOUR COURSE THAT TEACHES ATTENDEES HOW TO IDENTIFY, UNDERSTAND AND RESPOND TO SIGNS OF MENTAL ILLNESS AND SUBSTANCE USE DISORDERS. THIS SAME HEALTH EDUCATOR AND THE DIVISION DIRECTOR OF 3D COMMUNITY HEALTH WILL BE TRAINED ON YOUTH MENTAL HEALTH FIRST AIDE IN FY17. THESE 8-HOUR PROGRAMS WILL BE DEPLOYED TO COMMUNITY MEMBERS DURING THE UPCOMING YEAR. 3D COMMUNITY HEALTH HAS COLLABORATED WITH AREA AGENCIES TO FORM A SUICIDE REVIEW TEAM IN BOTH EAU CLAIRE AND CHIPPEWA COUNTIES. THESE TEAMS WILL REVIEW DETAILS OF EACH SUICIDE TO LOOK FOR POSSIBLE TRENDS AND KEY PIECES OF INFORMATION THAT MAY GUIDE 3D'S EFFORTS IN TARGETING CERTAIN GEOGRAPHIC AREAS, CERTAIN AGE OR GENDER, ETC. FOR THE MOST EFFECTIVE PROGRAMMING. SUICIDE COMMUNITY AWARENESS CAMPAIGN - SJCF'S 3D COMMUNITY HEALTH AND MARKETING DEPARTMENTS ARE WORKING TO INCREASE COMMUNITY AWARENESS AND KNOWLEDGE OF THE FACTORS THAT OFFER PROTECTION FROM SUICIDAL BEHAVIORS AND THAT PROMOTE WELLNESS AND RECOVERY. COLLABORATION WITH MULTIPLE COMMUNITY PARTNERS IS OCCURRING ON AN ONGOING BASIS. ONE OBJECTIVE IS TO PROMOTE EFFECTIVE PROGRAMS AND PRACTICES I.E. ADVERSE CHILDHOOD EXPERIENCES (ACES) THAT INCREASE PROTECTION FROM SUICIDAL RISK AND PROMOTE CONNECTEDNESS AMONG RESIDENTS OF CHIPPEWA AND EAU CLAIRE COUNTIES. SUCCESS IS MEASURED BY AN INVENTORY OF COMMUNITY ATTITUDES AND BEHAVIORS, COUNTY SUICIDE STATISTICS AND EVIDENCE OF INCREASED COMMUNITY KNOWLEDGE OF SUICIDE AND THE CONNECTION BETWEEN MENTAL AND PHYSICAL HEALTH AND WELLBEING BASED ON SURVEY DATA THAT THE HOSPITAL COLLECTS. AT THE CHILDREN, HEALTH AND FAMILY SUMMIT THAT 3D COMMUNITY HEALTH COORDINATED IN PARTNERSHIP WITH THE COUNTY DEPARTMENT OF HUMAN SERVICES 99 OF THE 190 ATTENDEES TOOK A PRE AND POST EVENT SURVEY ABOUT ACES AND BRAIN DEVELOPMENT. THERE WAS A 24% INCREASE IN THE PERCENTAGE THAT STRONGLY AGREED THAT EXPOSING INFANTS TO STRESS CAN ACTUALLY CAUSE THEM TO DEVELOP A SMALLER BRAIN POST EVENT COMPARED TO PRE EVENT. OTHER QUESTIONS SHOWED SIMILAR POSITIVE RESULTS DEMONSTRATING THE SUCCESS OF THE EVENT IN INCREASING EVENT ATTENDEE'S KNOWLEDGE OF THE ACES. SUBSTANCE USE SJCF WILL CONTINUE ITS CURRENT POISTION AS LEAD FOR "VOICES IN PREVENTION ACTION TEAM" OF THE CHIPPEWA HEALTH IMPROVEMENT PARTNERSHIP (CHIP) TO FURTHER COMMUNITY EDUCATION AND AWARENESS REGARDING SUBSTANCE ABUSE, PARTICULARLY THE DANGERS OF OPIATE USE. IN ADDITION, THE HOSPITAL WILL PROMOTE EFFECTIVE PROGRAMS AND PRACTICES, ALCOHOL MISUSE L.E. PHILLIPS LIBERTAS TREATMENT CENTER CONTINUES TO PROVIDE HIGH QUALITY ASSESSMENT, INTERVENTION, AND RESIDENTIAL ALCOHOL AND OTHER DRUG ABUSE (AODA) TREATMENT FOR PERSONS IN OUR COMMUNITY AND SURROUNDING AREAS. L.E. PHILLIPS LIBERTAS TREATMENT CENTER CONTINUES TO PROVIDE AODA EDUCATION THROUGH BI-MONTHLY COMMUNITY SEMINARS, AND A VARIETY OF OTHER COMMUNITY VENUES. THERE WERE 118 PARTICIPANTS IN FY16. SJCF CONTINUES SUPPORT OF THE CHIPPEWA HEALTH IMPROVEMENT PARTNERSHIP (CHIP) ACTION TEAM, VOICES IN PREVENTION, TO FURTHER COMMUNITY EDUCATION AND AWARENESS AROUND AODA ISSUES IN THE CHIPPEWA AND EAU CLAIRE AREAS. EVALUATIONS OF EVENTS/PROGRAMS WILL BE DEVELOPED AND USED TO TRACK ANY CHANGES IN COMMUNITY KNOWLEDGE AND/OR BEHAVIORS. COUNTY HEALTH RANKINGS WILL BE TRACKED AS WELL. THIS TEAM IS CURRENTLY COLLECTING COUNTY-WIDE DATA TO ENABLE THEM TO APPLY FOR A DRUG-FREE COMMUNITIES GRANT. ST. JOSEPH'S HOSPITAL HOSTED AN AWARENESS WALK AND BELL CONCORDANCE ON INTERNATIONAL FETAL ALCOHOL SPECTRUM DISORDER AWARENESS DAY, SEPTEMBER 9, 2015. THE BELL CONCORDANCE; IN WHICH THE AREA CHURCHES RANG THE CHURCH BELLS AT 9:09 AM FOR A MINUTE OF REFLECTION WAS FOLLOWED BY A BRIEF EDUCATIONAL PROGRAM ON FASD AND WALK THROUGH THE PARK. BELLS WERE DISTRIBUTED TO PARTICIPANTS. WE WANTED TO DRAW AWARENESS THAT ACCORDING TO THE CDC, AS WELL AS THE U.S. SURGEON GENERAL THERE IS NO SAFE TIME DURING PREGNANCY TO DRINK AND NO SAFE AMOUNT OF ALCOHOL WHEN A WOMAN IS PREGNANT. SEPTEMBER 9TH, 2015 IS INTERNATIONAL FASD AWARENESS DAY, IN COMMEMORATION OF THE NINE MONTHS OF PREGNANCY. FASD (FETAL ALCOHOL SPECTRUM DISORDERS) IS 100% PREVENTABLE WHEN A PREGNANT WOMAN ABSTAINS FROM ALCOHOL. EDUCATIONAL MATERIALS WERE DISPLAYED IN MEDICAL CLINICS, THE YMCA, SUBSTANCE ABUSE TREATMENT CENTER, GOVERNMENT BUILDINGS AND CHILD CENTERS. AN ARTICLE ABOUT NOT DRINKING DURING PREGNANCY WAS FEATURED IN A LOCAL WOMEN'S MAGAZINE WITH A 10,000 + PRINTED CIRCULATION. ANOTHER ARTICLE APPEARED IN THE WESTERN WISCONSIN DIVISION INSPIRING HEALTH MAGAZINE WITH PRINTED CIRCULATION OF 20,000 HOMES. SHEC/SJCF ALSO CO-HOSTED EDUCATION PROGRAM AT L.E. PHILLIPS LIBERTAS TREATMENT CENTER ON FETAL ALCOHOL SPECTRUM DISORDER. 21 PEOPLE ATTENDED THE PROGRAM. 45% INDICATED AN INCREASE IN KNOWLEDGE OF FASD AND 85% INDICATED AN INCREASE IN KNOWLEDGE OF RESOURCES AVAILABLE FOR FASD. OBESITY- CHRONIC DISEASE PREVENTION AND MANAGEMENT GO15 IS A COMMUNITY INITIATIVE DEVELOPED BY SJCF'S MARKETING DEPARTMENT AND IS UTILIZED BY 3D COMMUNITY HEALTH TO ENCOURAGE HEALTHY LIFESTYLE CHOICES. A GOAL OF 3D COMMUNITY HEALTH IS FOR AREA RESIDENTS TO BECOME MORE PHYSICALLY ACTIVE AND LESS OBESE, WHICH HAS BEEN PROVEN TO REDUCE INCIDENCES OF CHRONIC DISEASE. THE STRATEGY UTILIZED TO ACHIEVE THIS GOAL WAS TO AUGMENT THE GO15 INITIATIVE WITH TWO CHALLENGES FOCUSING ON CHRONIC DISEASE ISSUES IDENTIFIED IN OUR 2015 CHNA: OBESITY AND SEDENTARY LIFESTYLES. THE FIRST CHALLENGE WAS A TWO-WEEK NUTRITION-BASED CHALLENGE, STRIVE FOR 5 FRUITS AND VEGETABLES, THAT ENCOURAGED CONSUMPTION OF FRUITS AND VEGETABLES FOR FIVE DAYS EACH WEEK. TWENTY PARTICIPANTS CONSUMED MORE THAN 350 SERVINGS OF FRUITS/VEGETABLES IN THE TWO WEEK TIMEFRAME. THE SECOND CHALLENGE ENCOURAGED PHYSICAL ACTIVITY WITH A FOCUS ON CARDIO PER MINUTE OF EXERCISE. DURING THE 42-DAY CHALLENGE, 83 PARTICIPANTS LOGGED 47,490 MINUTES OF ACTIVITY. 67.3% OF MEMBERS SUCCESSFULLY MET 100% OF THE CHALLENGE GOAL FOR THE NEXT CHALLENGE SJCF HELD. SJCF'S OFFERS AN ONGOING COMMUNITY HEALTH EDUCATION SERIES TO PROMOTE AWARENESS AND EARLY DETECTION IN AN EFFORT TO MINIMIZE THE DEVELOPMENT OF CHRONIC CONDITIONS. A SERIES OF SEVEN COMMUNITY HEALTH EDUCATION PROGRAMS WERE HELD THROUGHOUT FISCAL YEAR 2016 WITH A TOTAL ATTENDANCE OF 2225 (UP FROM 745 IN FY15) COVERING A MULTITUDE OF TOPICS INCLUDING: MINDFULNESS; SLEEP/BREATH/EAT; DIABETES; MENTAL HEALTH AND SUBSTANCE ABUSE AND DEMENTIA AND MUSIC. EVALUATION SUMMARIES INDICATED 95.8% OF ATTENDEES SAID THAT THEY WOULD MAKE A POSITIVE LIFESTYLE CHANGE AFTER THE PROGRAM. (continued below)
Schedule H, Part VI, Line 5 PROMOTION OF COMMUNITY HEALTH (CONTINUED B)	(Continuation narrative from Part VI Line 5) SJCF'S CONTINUES TO ENHANCE COMMUNITY EDUCATION ABOUT THE WARNING SIGNS OF STROKE, AS EARLY IDENTIFICATION AND INTERVENTION IS CRITICAL TO IMPROVING OUTCOMES AND SURVIVAL RATES. AN ONLINE SCREENING TOOL, STROKEAWARE, WAS IMPLEMENTED, AND 86 ( AN INCREASE OF 27 FROM FY15) STROKE SCREENINGS WERE COMPLETED FROM JULY 1, 2015- JUNE 30, 2016 WITH 4 CONSULTS OCCURRING. 270 HEART SCREENINGS WERE COMPLETED ( AN INCREASE OF 143) IN THAT SAME TIME PERIOD THROUGH SJCF'S HEARTAWARE ONLINE SCREENING TOOL WITH 4 CONSULTS OCCURRING, AS WELL AS 100 SLEEP SCREENINGS THROUGH SJCF'S SLEEPAWARE. AN ONLINE SCREENING COLON CANCER SCREENING TOOL WAS IMPLEMENTED JANUARY 1, 2015, IN CONJUNCTION WITH AN EDUCATIONAL MARKETING CAMPAIGN, WHICH RESULTED IN 77 COLON CANCER SCREENINGS BEING DONE FROM JANUARY 1- JUNE 30, 2015 WITH A TOTAL OF 114 COMPLETED IN FY16. TWO OTHER ONLINE SCREENING TOOLS WERE IMPLEMENTED AS WELL; BREASTCANCERAWARE (32 COMLETED) AND PROSTATECANCERAWARE (17 COMPLETED) IN FY16. SJCF COORDINATES AND HOSTS AN ANNUAL COMMUNITY EDUCATION EVENT AROUND DIABETES WITH. 81 ATTENDEES IN FY2016. OTHER COMMUNITY BENEFIT ACTIVITIES AND PROGRAMS PROVIDES MULTIPLE EDUCATIONAL CLASSES, PROGRAMS, AND RESOURCES INCLUDING: * PREPARED CHILDBIRTH (EXPECTANT PARENT CLASSES, SIBLING CLASSES, BREASTFEEDING CLASSES, AND LACTATION CONSULTING) WITH 519 ATTENDEES * CPR KITS FOR CLASSES * BABYSITTING SEMINARS WERE PROVIDED TO 50 ADOLESCENTS * SJCF COLLEAGUES ASSISTED WITH THE PLANNING AND IMPLEMENTATION OF A PEDIATRIC HEALTH FAIR WITH HANDS-ON ACTIVITIES IN HEALTH, WELLNESS AND SAFETY FOR SECOND GRADE STUDENTS IN EAU CLAIRE COUNTY. 850 ATTENDEES. * WELLNESS PROGRAMS, SERVICES AND RETREATS * PARTICIPATION IN COMMUNITY AND LOCAL BUSINESS HEALTH FAIRS * ASSISTED IN COORDINATING THE 11TH ANNUAL INDOOR SPORTS CENTER "GET HOOKED ON HEALTH" KIDS EXPO (SAFETY EDUCATION, HEALTH & WELLNESS) WITH OVER 3000 ATTENDEES * 3D COMMUNITY HEALTH EDUCATIONAL SERIES AND OTHER EDUCATION PROGRAMS, SPEAKERS AND FREE SCREENINGS * SAFETY TOWN PROGRAM FOR 225 PRE K-K STUDENTS TO TEACH BASIC SAFETY (TAUGHT IN BLOOMER AND EAU CLAIRE) * ANNUAL COAT DRIVE COLLECTS AND DISTRIBUTES MORE THAN 6,000 COATS TO THOSE IN NEED * SUMMER SAFETY POOL DAY-3D COMMUNITY HEALTH TEAM EDUCATE 520 COMMUNITY MEMBERS ABOUT WEARING SUNSCREEN/SUNGLASSES, AND MAKING SURE THEY ARE STAYING HYDRATED WITH ENOUGH WATER, AND GENERAL SUMMER SUN SAFETY AT AREA PUBLIC POOLS. * MEAL PROGRAMS AND SUPPORT INCLUDING: MEALS FOR SENIOR CITIZENS AND CONGREGATE SITE MEALS * 11 HEALTH SCREENING EVENTS HELD INCLUDING BLOOD PRESSURE SCREENINGS AT HEALTH FAIRS TOUCHING 2489 PEOPLE OTHER SERVICES TO THE COMMUNITY, INCLUDING: * SJCF'S CENTER FOR SPIRITUAL CARE PROVIDED ASSISTANCE WITH 688 POWER OF ATTORNEY FOR HEALTH CARE (ADVANCE DIRECTIVE) FORMS AND NUMEROUS PRESENTATIONS AROUND SPIRITUAL CARE ISSUES. * A VARIETY OF STUDENT INTERN PROGRAMS, WORK SHADOWING, AND TOUR * DISASTER PREPAREDNESS PLANNING * "GOT RED?" EVENT AT OAKWOOD MALL IN FEBRUARY, IN CELEBRATION OF AMERICAN HEART MONTH, INCLUDES HEART HEALTH PRESENTATIONS, PRESENTATION ON WARNING SIGNS OF STROKE, EXERCISE DEMONSTRATIONS, HEART HEALTHY COOKING DEMONSTRATIONS, INCLUDING RECIPES AND COOKBOOKS, AND FREE BLOOD PRESSURE SCREENINGS. OVER 506 PEOPLE ATTENDED THIS EVENT. * PARTICIPATION IN FARM EXPO, INCLUDING FREE BLOOD PRESSURE SCREENINGS * SPONSORSHIP OF MULTIPLE HEALTH WALKS AND FUNDRAISERS FOR VARIOUS NON-PROFIT AGENCIES THAT SHARE SIMILAR MISSIONS AS SJCF. * PARTICIPATION AND SUPPORT OF MULTIPLE COMMUNITY ORGANIZATIONS COMMITTEES AND COUNCILS. * SJCF'S PEDIATRIC THERAPY AND MARKETING DEPARTMENTS COORDINATE AND HOST A FUN-FILLED, FREE EVENING AT THE LOCAL CHILDREN'S MUSEUM FOR DISABLED CHILDREN AS WELL AS AN EASTER EVENT FOR ALL CHILDREN. * SJCF'S PEDIATRIC THERAPY HELD 3 COMMUNITY EDUCATION EVENTS TOUCHING 543 PEOPLE. * JOINT RENEW CAMP- PATIENT SERVICES TO 271 PEOPLE. * FINAL AFFAIRS COMMUNITY EVENT HELD IN PARTNERSHIP WITH AREA NURSING HOME. 68 ATTENDEES. * ANNUAL REMEMBRANCE WALK WAS HELD IN THE CITY'S COMMUNITY PARK TO HONOR BABIES WHO DIED DURING PREGNANCY OR SHORTLY AFTER BIRTH RECENTLY OR PREVIOUSLY TO A FAMILY. A SHORT PRAYER SERVICE AND WALK PROVIDES COMFORT TO THOSE WHO WALK TO REMEMBER THE STEPS THEIR CHILD WILL NEVER TAKE. THE WALK IS SPONSORED FREE OF CHARGE BY THE HOSPITAL'S BIRTH CENTER AND SPIRITUAL CARE SERVICES. * FARM FAMILIES WERE ALSO RECOGNIZED DURING THE YEAR WITH A LUNCHEON, SPEAKER AND HEALTH SCREENINGS TO THANK THEM FOR THEIR MANY CONTRIBUTIONS TO OUR LOCAL COMMUNITIES AND TO ALSO MAKE THEM AWARE OF PRECAUTIONS THEY CAN TAKE TO REMAIN HEALTHY AND SAFE. "GREEN" ENVIRONMENTAL STEWARDSHIP AND SUSTAINABILITY EFFORTS (RECYCLING AND REUSING) INCLUDING: * SJCF'S FOOD AND NUTRITION SERVICES (FANS) CONTINUES TO SEPARATE FOOD WASTE FROM OTHER WASTE STREAMS TO BE COMMERCIALLY COMPOSTED AND ARE IMPLEMENTING RENEWABLE RESOURCE DISPOSABLES WHERE APPLICABLE. * FANS ALSO DONATES TO FEED MY PEOPLE FOOD BANK IN SUPPORT OF THE WEEKEND'S KIDS MEAL PROGRAM TO REDUCE HUNGER. * THE HOSPITAL DONATED LEFTOVER FOOD TO AREA FOOD PANTRIES. * DONATED USED MEDICAL EQUIPMENT TO THIRD WORLD COUNTRIES VIA THE HOSPITAL SISTERS MISSION OUTREACH. * AS AN ORGANIZATION DEDICATED TO CREATING INNOVATIVE METHODS TO REDUCE, REUSE, AND RECYCLE FOR THE BETTERMENT OF OUR COMMUNITY AND PLANET, SEVERAL DEPARTMENTS THROUGHOUT SJCF HAVE DEVELOPED NEW WAYS TO REDUCE WASTE TO OUR LOCAL LANDFILLS. INCLUDED IN THESE EFFORTS IS A UNIQUE PARTNERSHIP WITH A LOCAL BUSINESS, EAU CLAIRE MOVING AND STORAGE, TO REUSE THE CLEAN BLUE WRAPS THAT ARE ON INSTRUMENTS AND INSTRUMENT PANS IN THE STERILE PROCESSING DEPARTMENT AND THE OPERATING ROOM. CURRENTLY THE WRAP IS NOT RECYCLABLE AND EC MOVING IS HELPING BY REUSING THE PRODUCT TO ASSIST WITH PACKING AND MOVING. THIS WAY THE BLUE WRAP PRODUCT WILL BE UTILIZED TWICE PRIOR TO IT REACHING OUR LANDFILLS AND WILL ELIMINATE A SECOND PRODUCT THAT THE MOVERS WOULD NORMALLY USE. THIS IDEA CAME FROM SACRED HEART'S SUSTAINABILITY TEAM AND IS BEING CARRIED OUT BY OR AND SPD COLLEAGUES.
Schedule H, Part VI, Line 6 DESCRIPTION OF AFFILIATED GROUP (CONTINUED A)	In southwest Illinois, HSHS St. Joseph's Hospital in Highland enhanced their offerings to their senior population based on their CHNA. "Senior Renewal" is an outpatient counseling program for senior adults who may be facing emotional and physical problems unique to the aging process such as feelings of loneliness, isolation and anxiety. Clients receive a comprehensive level of treatment without inpatient hospitalization through counseling strategies and education. In addition, St. Joseph's Hospital in collaboration with the Illinois Department of Insurance participates in the Senior Health Insurance Program (SHIP), a free health insurance counseling service for Medicare beneficiaries and their caregivers. In addition to programs designed to increase access to care, HSHS makes sure that those who need financial assistance receive it. HSHS's Financial Assistance (Charity Care) policy was modified effective January 1, 2014 to offer a 25 percent self-pay discount to all patients who register without insurance. HSHS Financial Assistance programs have a sliding scale, in some instances providing up to a 55 percent reduction off billed charges if an uninsured patient's family income level is determined to be above 500 percent but equal to our less than 600 percent of the current Federal Poverty Guidelines. HSHS hospitals waive all charges for patients below 200 percent of the Federal Poverty Levels. Counselors are available in our hospitals to explain our financial assistance policy to patients, provide them with assistance in filling out a simple application form, or help them enroll in publicly funded health care programs. Enhance community health As part of our mission to embody Christ's healing love for all people, we understand that we have a responsibility to improve the overall quality of life in our communities by supporting initiatives that promote health and wellness. We recognize we are most successful when we work together with a wide array of public and private organizations that share our commitment to improving lives. By doing so, we maximize our efforts and reduce the duplication of services. To ensure the health care needs of all are being met, HSHS hospitals also understand we need to listen closely to the residents of the communities we serve. In turn, 13 of our 15 hospitals completed Community Health Needs Assessments (CHNAs) in FY2015. HSHS St. Clare Memorial Hospital in Oconto Falls, Wisconsin, who affiliated with HSHS in September 2015, and HSHS Holy Family Hospital in Greenville, Illinois, who affiliated with HSHS in May 2016, both completed their CHNAs in FY2014. HSHS hospitals are using the information gathered from their most recent CHNAs to develop new, and enhance existing, programs and services that best address the needs of the community. Several priority areas were identified in the FY2015 CHNAs including access to health care services; alcohol, tobacco, and other drug abuse; chronic disease prevention and management; nutrition/wellness; mental health; and oral health. HSHS hospitals are addressing these and other needs by proactively offering educational opportunities, preventative screenings, and new or enhanced clinical services. In many cases, the hospitals collaborate with other hospital facilities, local departments of public health and community organizations to address identified needs. In western Wisconsin, HSHS Sacred Heart Hospital in Eau Claire and HSHS St. Joseph's Hospital in Chippewa Falls are taking the lead on programming to educate the public about mental health issues and treatment, the stigma associated with mental health, and the recognition of mental health issues. To combat the rising rate of suicides in the area, both hospitals under the umbrella of 3D Community Health are providing community education on QPR (Question, Persuade and Refer), an evidence-based suicide prevention program. In FY2016, 3D Community Health provided 37 adult QPR programs for 1,046 persons and 44 youth QPR programs for 1,161 high school students. In addition, 3D Community Health hosted a community forum to discuss the CHNA results and introduce QPR to 192 community members. HSHS St. Vincent Hospital in Green Bay collaborated with Prevea Health to implement the TIPS program, a program for non-violent opioid abusers that provides treatment and deferred/dismissed prosecution upon successful completion of the treatment program. St. Vincent Hospital also subsidized scholarships for a residential treatment program and arranged to have the first dose of Vivitrol donated; Vivitrol prevents relapse to opioid dependence after opioid detox by attaching to opioid receptors and blocking feelings of pain relief and wellbeing. HSHS St. Mary's Hospital in Decatur, Illinois joined the Macon County Mental Health Board to collaborate on existing programs and to provide resources to meet identified gaps. While other communities are cutting back on mental health services, St. Mary's Hospital remains committed to providing a full spectrum of behavioral health services for adolescents, adults and senior. For example, the hospital collaborates with the Decatur Public School District to provide school teachers for two hours per day for children in the adolescent behavioral health unit. The partnership limits the amount of schoolwork missed during hospitalization. The hospital also has substance abuse counselors who provide educational programs on alcohol and other drug abuse in county schools for students and faculty. HSHS St. Nicholas Hospital in Sheboygan identified nutrition and physical activity as a priority health need in its FY2015 CHNA. In response, St. Nicholas Hospital coordinated and supported the development of the "Double Your Bucks" program at the Sheboygan Farmers Market in FY2016 to enable EBT recipients to double the amount of fresh fruits and vegetables they can purchase. The hospital is also a sponsor of the Sheboygan Farmers Market to promote healthy eating in the community. Additionally, St. Nicholas subsidized the cost of additional bike helmets at the Early Learning Center to increase the physical activity levels of Head Start students and purchased culinary equipment for South High School nutrition and fitness classes to increase opportunities for students to learn how to prepare healthy food. HSHS St. Mary's Hospital in Streator, Illinois collaborated with two local schools to establish community gardens on each of their campuses to address childhood obesity in addition to the community garden on the hospital campus. Students, their families, and hospital colleagues planted, tended and harvested the gardens. Math and science teachers incorporated the gardens into their curricula. Neither school offered Home Economics classes, so St. Mary's Hospital provided the produce and colleagues to offer cooking demonstrations in the classrooms to encourage students to prepare fresh fruit and vegetables snacks. The three gardens produced more than 1,713 pounds of produce in three years, which was donated to the local food pantry, Salvation Army, students and local churches providing healthy food to the poor and vulnerable. Advance medical knowledge HSHS works to advance medical knowledge by supporting research initiatives and educational opportunities. In FY2016, HSHS hospitals and affiliated physician groups contributed more than $19.1 million toward research and education. Highlights of this commitment include subsidizing medical school residency programs, offering ongoing medical education to physicians and clinicians, and providing job shadowing programs for high school students. In southern Illinois, HSHS St. Joseph's Hospital in Breese, hosted members of the Health Occupations Students of America onsite to learn about job opportunities in health care from health care professionals. St. Joseph's also provided clinical experience for Kaskaskia College students enrolled in nursing, physical therapy and radiology programs. Pharmacy students have also completed their clinical training at St. Joseph's Hospital. In FY2016, the program served more than 100 students. In FY2016, HSHS St. Mary's Hospital Medical Center and HSHS St. Vincent Hospital in Green Bay invested more than $311,000 to provide onsite training and education of nurses and allied health professionals. In addition, the hospitals have been collaborating with the Medical College of Wisconsin to establish a community medical education program in Green Bay and to provide financial support to offset operating costs in FY2016. Also in eastern Wisconsin, HSHS St. Clare Memorial Hospital in Oconto Falls provided training for local paramedics and emergency response personnel through the hospital's EMS liaison program.
Schedule H, Part VI, Line 6 DESCRIPTION OF AFFILIATED GROUP (CONTINUED B)	Mission-driven and strategically implemented Community Benefit is an integral part of Hospital Sisters Health System's Mission. Our commitment to Community Benefit arises from our Catholic identity, Mission and Core Values shared by 14,000 colleagues across Illinois and Wisconsin. Through our work to improve access to health care services, enhance community health, advance medical knowledge, and relieve or reduce the burden of government, we believe we have made a positive difference in the quality of lives of tens of thousands of people in Illinois and Wisconsin in FY2016. As a Catholic health care ministry, HSHS is concerned with the dignity of all persons, the common good, and the stewardship of resources. We advocate for health care for all and work to improve social conditions that lead to improved health and well-being. We engage partners in our communities to improve health and quality of life and to reduce duplication. Working side by side with many faith communities, HSHS remains dedicated to our common purpose of compassionate care for all people.
Schedule H, Part I, Line 7f Bad Debt	The bad debt expense included on Form 990, Part IX, Line 25, column (A) was subtracted prior to and for the purpose of calculating the percentage in Part I, Line 7, column (f) is $189,601.
Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation	189601
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance	THE HOSPITAL USES LYON SOFTWARE (CBISA: COMMUNITY BENEFIT INVENTORY FOR SOCIAL ACCOUNTABILITY) TO DETERMINE SUBSIDIZED SERVICES. PHYSICIAN CLINICS WERE NOT INCLUDED IN THE SUBSIDIZED HEALTH SERVICES. TO DETERMINE THE ACTUAL COST OF THESE SERVICES, THE HOSPITAL USES A COST-TO-CHARGE RATIO BASED ON OUR AUDITED FINANCIAL STATEMENTS TO CALCULATE THE AMOUNTS REPORTED ON LINES 7A THROUGH 7I.
Schedule H, Part II Community Building Activities	SJCF HAS A 137 YEAR HISTORY OF GIVING BACK TO THE COMMUNITY AND IN ADDRESSING COMMUNITY NEED, AT THE MOST BASIC LEVEL. THE HOSPITAL WAS FOUNDED ON THE FRANCISCAN PRINCIPLES OF CARING FOR THE POOR AND MOST VULNERABLE AND WORKING TIRELESSLY TO IMPROVE THE HEALTH OF THE COMMUNITIES IT SERVES. SJCF ENHANCES THE QUALITY OF LIFE AND OVERALL WELLBEING OF ITS COMMUNITY MEMBERS BY EXAMINING THE ROOT CAUSES OF HEALTH PROBLEMS AND TACKLING THOSE ISSUES HEAD ON. SJCF ALSO BELIEVES IN UTILIZING THE EXPERTISE OF OTHERS IN THE COMMUNITY TO WORK TOGETHER TO SOLVE COMMUNITY PROBLEMS. A FEW EXAMPLES OF HOW SJCF HAS DONE THIS IS AS FOLLOWS: F7-COMMUNITY SUPPORT *COMMUNITY CONNECT DINNER: HSHS ST. JOSEPH'S AND SACRED HEART HOSPITALS PARTNERED WITH LOCAL AGENCIES THAT MAKE UP THE CHIPPEWA COUNTY HUNGER AND HOMELESSNESS COALITION TO HOST A COMMUNITY CONNECT DINNER THAT REACHED 100 COMMUNITY MEMBERS. THE EVENT WAS HELD AT AGNES'S TABLE, WHICH IS A FREE MEAL SITE IN CHIPPEWA FALLS. DINERS AT THE JANUARY 28 EVENT WERE TREATED TO A GOURMET ITALIAN MEAL PREPARED BY A LOCAL CHEF. A MUSICAL TRIO DONATED THEIR TIME AND TALENT TO PROVIDE MUSIC AND ENTERTAINMENT. THE TABLES WERE SET WITH CHINA, STEMWARE, LINENS AND THE MEALS WERE SERVED WAITRESS STYLE TO GUESTS. ALL THE FOOD, DECORATIONS AND STAFF TIME WERE DONATED BY LOCAL AGENCIES AND YOUTH GROUPS. PRIOR TO THE DINNER, LOCAL RESOURCE AGENCIES HAD INFORMATIONAL BOOTHS SET UP FOR GUESTS TO LEARN ABOUT RESOURCES AVAILABLE IN THE COMMUNITY. THE PURPOSE OF THE DINNER WAS THREE-FOLD: TO LINK FOLKS IN POVERTY TO LOCAL RESOURCES; TO ADMINISTER THE SEMI-ANNUAL UNSHELTERED POINT-IN-TIME COUNT SURVEY; AND TO GIVE THE DINERS A MEMORABLE AND PLEASURABLE DINING EXPERIENCE. 3D COMMUNITY HEALTH COLLEAGUES SERVE ON THE LEGACY COMMUNITY CENTER BOARD OF DIRECTORS. GOALS OF THE LEGACY COMMUNITY CENTER ARE TO IMPROVE THE HEALTH, WELLNESS AND SELF-SUFFICIENCY OF CITIZENS, REDUCE POVERTY TO POSITIVELY IMPACT THE NEED FOR PUBLIC FINANCIAL SERVICES AND INCREASE THE NUMBER OF INDIVIDUALS AND FAMILIES ABLE TO MEET THEIR BASIC NEEDS AND INCREASE THEIR DISPOSABLE INCOME. AMONG OUR COMMUNITY BUILDING EFFORTS WAS THE SJCF'S HOSPITAL REVERENCE FOR THE EARTH "GREEN TEAM" AND HOSPITAL SISTERS HEALTHCARE-WEST OFFERED GARDENING PLOTS FOR THE 2015 GROWING SEASON. THIS SUCCESSFUL INITIATIVE CONTINUED IN FY16. THE GARDEN PLOTS ARE AVAILABLE FOR LEASE BY INDIVIDUALS, HOUSEHOLDS OR ORGANIZATIONS FOR THE SOLE PURPOSE OF PROVIDING FOOD FOR THOSE IN NEED. INDIVIDUALS AND FAMILIES IN THE CHIPPEWA VALLEY EXPERIENCE HUNGER ON A DAILY BASIS AND SJCF'S COMMUNITY GARDEN HAS BEEN ESTABLISHED TO OFFER PEOPLE AN OPPORTUNITY TO GROW THEIR OWN VEGETABLES TO SUPPLEMENT THEIR DIET. OTHERS, SUCH AS FAMILIES, CLUBS, YOUTH GROUPS, CHURCHES AND SERVICE ORGANIZATIONS WERE ALSO ENCOURAGED TO RESERVE GARDEN SPACE TO GROW VEGETABLES FOR DONATION TO LOCAL FOOD PANTRIES. THE COMMUNITY GARDEN ALSO ACCEPTS DONATIONS OF SURPLUS VEGETABLES FROM HOME GARDENS. THE GARDEN IS COMPLETELY IRRIGATED AND SURROUNDED BY AN 8' TALL DEER FENCE AND LOCKED GATES, SO GARDENERS DO NOT HAVE TO WORRY ABOUT BRINGING WATER TO THEIR GARDEN PLOT OR BE CONCERNED ABOUT DEER PREDATION OR VANDALISM, WHICH REDUCED YIELDS IN PREVIOUS YEARS. THIS GARDEN YIELDED 2000 LBS. OF FRESH PRODUCE WHICH WAS DONATED TO AREA NEEDY FAMILIES. F6-COALITION BUILDING SJCF SUPPORTS THE HEALTHY COMMUNITIES INITIATIVES OF THE AREA (CHIPPEWA HEALTH IMPROVEMENT PARTNERSHIP AND EAU CLAIRE HEALTHY COMMUNITIES) FINANCIALLY AND BY HOSPITAL COLLEAGUES SERVING ON THE STEERING COMMITTEES AND ACTION TEAMS AND ASSISTING AT EVENTS/ACTIVITIES AS WELL AS PROVIDING IN-KIND DONATIONS OF PRINTING, VENUE AND REFRESHMENTS FOR MEETINGS AND MUCH MORE. ANOTHER EXAMPLE OF SJCF'S COMMUNITY BUILDING EFFORTS WAS ST. JOSEPH'S COLLABORATION TO MAKE CHIPPEWA FALLS A DEMENTIA FRIENDLY BUSINESS COMMUNITY. SJCF, THE CHIPPEWA COUNTY'S AGING AND DISABILITY RESOURCE CENTER, THE ALZHEIMER'S ASSOCIATION, AND THE MAIN STREET ASSOCIATION IN A COORDINATED EFFORT, WORKED TOGETHER TO MAKE DOWNTOWN BUSINESSES DEMENTIA FRIENDLY. SJCF PROVIDED BUSINESS CARDS FOR DEMENTIA PATIENTS TO HAND TO LOCAL BUSINESSES WHEN SHOPPING IN THEIR STORE TO MAKE STORE CLERKS AWARE OF THEIR DIFFICULTY. THE HOSPITAL'S MARKETING DEPARTMENT ALSO DESIGNED AND PROVIDED WINDOW STICKERS FOR BUSINESSES TO PUT IN THEIR DOORWAYS ADVISING DEMENTIA PATIENTS THAT THEIR BUSINESS WAS DEMENTIA FRIENDLY. SJCF IS READILY SHARING ITS MATERIALS WITH OTHER COMMUNITIES THAT ALSO WISH TO BEGIN INITIATIVES. THE MAIN STREET ASSOCIATION RECEIVED 100% SUPPORT FROM DOWNTOWN BUSINESSES FOR THIS PROJECT AND LOCAL BUSINESSES WERE TRAINED BY VOLUNTEERS TO LEARN HOW TO MORE EFFECTIVELY INTERACT WITH DEMENTIA PATIENTS. F5-LEADERSHIP DEVELOPMENT AND LEADERSHIP TRAINING FOR COMMUNITY MEMBERS SJCF PROVIDED SUICIDE PREVENTION QPR TRAIN THE TRAINER TRAINING FOR 14 PROFESSIONALS IN THE COMMUNITY. SJCF'S 3D COMMUNITY HEALTH STAFF CONDUCTED A SERIES OF LEADERSHIP DEVELOPMENT CLASSES FOR NEW LEADERS AT THE CHIPPEWA COUNTY DHS. INCLUDED IN THE TRAINING WERE A BEHAVIORAL ASSESSMENT TOOL AND A 360 DEGREE LEADERSHIP DEVELOPMENT PROFILE.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	Self-pay patients are screened for verification of no insurance coverage. Once verification of no coverage has been completed, the guarantors will be screened for charity or uninsured discounts based on income levels. Those guarantors who do not qualify for charity through the screening process will be asked to provide proof of income in the form of a recent pay stub and/or recent tax return to determine the level of uninsured discounting. If no proof of income is provided or a guarantor's income is greater than 201% of the federal poverty level, the appropriate discount according to the established criteria up to 600% of the federal poverty level will be applied. The amount of money not collected from those self-pay patients who are not eligible for charity care is reported as bad debt. Allowances for Doubtful Accounts have been recorded based on an historical matrix, using collectability percentages by payor and aging category in accordance with HSHS Executive Policy #F-23, Valuation of Net Accounts Receivable. Percentages are based on historical experience at the hospital and adjusted for known limitations. The hospital reports bad debt in accordance with Generally Accepted Accounting Principles (GAAP).
Schedule H, Part III, Line 3 Bad Debt Expense Methodology	The hospital strongly believes that its charity care, and the related community benefit obtained from such care, is understated because of those patients who potentially qualify for charity care but do not wish to apply for it. In addition, some care is not classified as charity because of missing documentation on patient resources. Thus, the hospital's bad debt includes a portion that could be classified as charity care if application for such care was sought and/or completed. Currently, the hospital is implementing processes, procedures and systems to more effectively determine charity care that will reduce a patient's documentation requirements and ease the patient's emotional burden in applying for charity care. This will provide a more accurate reporting of charity care services provided by the hospital.
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 page 21 of 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 MANAGEMENT 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. WHILE THIS SHORTFALL IN MEDICARE PAYMENTS IS NOT CLASSIFIED AS COMMUNITY BENEFIT BY THE IRS, WE NONETHELESS BELIEVE IT IS AN IMPORTANT CONTRIBUTION MADE BY THE HOSPITAL TO THE HEALTH AND WELL-BEING OF THE COMMUNITY. IF THE MEDICARE PROGRAM DID NOT EXIST, MANY MEDICARE PATIENTS WOULD BE ELIGIBLE FOR CHARITY CARE OR OTHER MEANS-TESTED GOVERNMENT PROGRAMS. FURTHER, BY ABSORBING THIS PAYMENT SHORTFALL AND PROVIDING CARE BELOW COST TO THESE INDIVIDUALS, HSHS ST. JOSEPH'S HOSPITAL IS RELIEVING THE BURDENS OF THE GOVERNMENT. ACCORDINGLY, THIS SHORTFALL RESTRICTS HSHS ST. JOSEPH'S HOSPITAL'S ABILITY TO MAKE FUNDS AVAILABLE TO PROVIDE FOR CHARITY CARE AND OTHER COMMUNITY BENEFITS. THE HOSPITAL MEDICARE SHORTFALL AT COST FOR FISCAL YEAR 2016 WAS $7,211,358.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	EVERY EFFORT IS MADE PRIOR TO, DURING AND AFTER THE PROVISION OF MEDICAL CARE SERVICES TO DETERMINE IF A PATIENT IS ELIGIBLE FOR CHARITY/COMMUNITY CARE AND TO ASSIST THE PATIENT IN COMPLETING THE APPLICATION AND PROVIDING ADEQUATE DOCUMENTATION. IF THE PATIENT QUALIFIES 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 PAYMENT ON THEIR BALANCE. ONLY AT SUCH POINT THAT THE PATIENT DEFAULTS ON INSTALLMENT PAYMENTS OR REFUSES TO COOPERATE WITH THE HOSPITAL EFFORTS TO BE REIMBURSED WILL THE ACCOUNT BE SENT TO COLLECTIONS.
Schedule H, Part V, Section B, Line 16a FAP website	- ST JOSEPH'S HOSPITAL: Line 16a URL: http://www.stjoeschipfalls.com/Patients-Guests/Financial-Assistance;
Schedule H, Part V, Section B, Line 16b FAP Application website	- ST JOSEPH'S HOSPITAL: Line 16b URL: http://www.stjoeschipfalls.com/Patients-Guests/Financial-Assistance;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- ST JOSEPH'S HOSPITAL: Line 16c URL: http://www.stjoeschipfalls.com/Patients-Guests/Financial-Assistance;
Schedule H, Part VI, Line 2 Needs assessment	As indicated in Part V, Section C, HSHS St. Joseph's Hospital in Chippewa Falls conducted a Community Health Needs Assessment in FY2015 (July 1, 2014 through June 30, 2015). In previous years, the hospital assessed community need by IDENTIFYING UNMET COMMUNITY HEALTH NEEDS AND DEVELOPING A PLAN TO HELP IMPROVE THE HEALTH OF OUR COMMUNITY. AN EXAMPLE OF THIS IS THE UNIQUE APPROACH UTILIZED BY SJCF AND SISTER HOSPITAL SACRED HEART IN FY2012 WHEN THE TWO HOSPITALS CONDUCTED TWO "TOWN HALL" MEETINGS WITH MORE THAN 800 INDIVIDUALS PARTICIPATING AND GIVING VOICE TO WHAT THEY BELIEVED COULD ENHANCE THE HEALTH OF THEIR COMMUNITY. IN ADDITION, 30 COMMUNITY "VISIONING" SESSIONS WERE HELD TO REACH DIVERSE GROUPS OF INDIVIDUALS BEYOND THE BORDERS OF EAU CLAIRE COUNTY, MOST OF WHICH ARE DESIGNATED AS RURAL. PEOPLE OF ALL AGES, ECONOMIC STATUS, THE UNDERSERVED, AND THOSE EXPERIENCING ACCESS BARRIERS PARTICIPATED. GROUPS THAT PARTICIPATED IN THE "VISIONING" SESSIONS INCLUDED LOCAL SCHOOL CHILDREN, MEMBERS OF THE AMISH COMMUNITY, PATIENTS OF THE CHIPPEWA VALLEY FREE CLINIC, LOCAL COLLEGE STUDENTS, PATRONS AND STAFF OF THE ST. FRANCIS FOOD PANTRY AND ELDERLY ASSISTED LIVING CENTER PATIENTS AND STAFF, TO NAME A FEW. THE HOSPITAL'S PLAN CONTINUES TO BE FOCUSED ON ENHANCING THE HEALTH AND WELLNESS OF THE COMMUNITY WE SERVE THROUGH CLINICAL PROGRAMS AND SERVICES, COMMUNITY EDUCATION AND OUTREACH, AND CONTINUED COLLABORATION AND PARTNERSHIPS WITH OTHER LOCAL ORGANIZATIONS. Provisions in the Affordable Care Act require charitable hospitals to conduct a CHNA and adopt implementation strategies to meet the needs identified. To comply with these requirements, HSHS St. Joseph's Hospital led a collaborative approach to conduct its CHNA and adopt an Implementation Plan in FY2015 (July 1, 2014 through June 30, 2015), a process we undertake every three years.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	THE REGISTRATION DEPARTMENT PROVIDES BROCHURES TO PATIENTS UPON REGISTRATION REGARDING THE PAYMENT ASSISTANCE PROGRAM AVAILABLE TO THEM AT HSHS ST. JOSEPH'S HOSPITAL. BROCHURES ARE ALSO SUPPLIED IN WAITING AND ANCILLARY AREAS FOR EASY ACCESS BY THE PATIENT. IF THE PATIENT EXPRESSES FINANCIAL CONCERNS, THEY MEET WITH HOSPITAL STAFF TO REVIEW ELIGIBILITY FOR INSURANCE OPTIONS AS WELL AS A REVIEW OF OUR COMMUNITY CARE POLICY. IF NEEDED LANGUAGE TRANSLATORS ARE AVAILABLE TO TRANSLATE BOTH WRITTEN AND VERBAL COMMUNICATION FOR ALL LANGUAGES THAT ARE PRESENT IN OUR MARKET. THE ORGANIZATION HAS A REPRESENTATIVE ON SITE TO ASSIST PATIENTS WHO MAY BE ELIGIBLE FOR MEDICAID ASSISTANCE THROUGH THE WISCONSIN DEPARTMENT OF PUBLIC ASSISTANCE. THEY WORK WITH PATIENTS TO DETERMINE IF THEY MAY BE ELIGIBLE, AND IF SO, ASSIST IN COMPLETING THE NECESSARY APPLICATION FOR SUBMISSION. 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 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 SYSTEM CALLED PASSPORT PAYNAV IS NOW BEING UTILIZED AFTER FAILED ATTEMPTS MADE BY THE HOSPITAL AND OUR LAW FIRM TO WORK OUT PAYMENT ARRANGEMENTS. THAT SYSTEM REVIEWS CREDIT AND OTHER PUBLICLY AVAILABLE FINANCIAL INFORMATION TO DISCERN THE PROBABILITY OF A PATIENT BEING ABLE TO PAY THEIR BILL. AFTER ASSESSING THAT INFORMATION, THE HOSPITAL MAKES A DETERMINATION WHETHER TO GRANT CHARITY CARE OR CONTINUE COLLECTION EFFORTS.
Schedule H, Part VI, Line 4 Community information	HSHS ST. JOSEPH'S HOSPITAL (SJCF) IS AN ACUTE CARE COMMUNITY HOSPITAL LOCATED IN CHIPPEWA FALLS, WISCONSIN. CHIPPEWA FALLS HAS A POPULATION OF 13,718 (2013) AND IS THE COUNTY SEAT OF CHIPPEWA COUNTY, WITH A POPULATION OF 63,132 (54 PERCENT URBAN, 46 PERCENT RURAL) IN 2013. CHIPPEWA COUNTY IS ST. JOSEPH'S HOSPITAL PRIMARY SERVICE AREA. ITS SECONDARY SERVICE AREA INCLUDES SURROUNDING COUNTIES: PORTIONS OF BARRON, CLARK, DUNN, RUSK AND TAYLOR COUNTIES. CHIPPEWA COUNTY IS THE LARGEST OF THE SIX COUNTIES. FIVE OUT OF SIX SERVICE AREA COUNTIES ARE CONSIDERED RURAL BY THE U.S. DEPARTMENT OF AGRICULTURE. EVIDENCE CONTINUES TO SUGGEST THAT RURAL SETTINGS IN THE U.S. EXHIBIT PRONOUNCED NEEDS IN THE AREAS OF HEALTH, EDUCATION, AND ECONOMIC SECURITY. IT IS IMPORTANT TO BE MINDFUL OF THE RURAL DISTINCTION TO BETTER ADDRESS THESE DISPARITIES BY FOCUSING PROGRAMS AND SERVICES APPROPRIATELY TO THESE COMMUNITIES. THE SERVICE AREA POPULATION IS AGING, MUCH LIKE THE REST OF THE NATION. THE LARGEST SEGMENT OF GROWTH FROM 2000 TO 2010 OCCURRED IN THE 18 TO 64 YEAR OLD AGE CATEGORY WITH A GROWTH RATE OF 16.9 PERCENT FOLLOWED BY A 10.3 PERCENT GROWTH RATE IN THE 65+ YEAR OLD AGE CATEGORY. THE NUMBER OF 0 TO 18 YEARS OLDS IS DECLINING. COMBINED POPULATION GROWTH FOR THESE SIX COUNTIES WAS APPROXIMATELY 6.6 PERCENT BETWEEN 2000 AND 2010. ALONG WITH THE AGING POPULATION COME INCREASED HEALTH CARE COSTS WITH CHRONIC DISEASE. STUDIES INDICATE THAT THE HEALTH OF THE AGING POPULATION CAN BE MAINTAINED AND CHRONIC DISEASES CAN BE REDUCED BY PROMOTING HEALTHY BEHAVIORS AND EXPANDING PREVENTIVE HEALTH SERVICES. THE SERVICE AREA'S RACIAL PROFILE IS PRIMARILY WHITE (95.2 PERCENT), HIGHER THAN THE STATE (86.2 PERCENT) AND NATION (72.4 PERCENT). THE LARGEST MINORITY POPULATION IN THE SERVICE AREA IS HISPANIC OR LATINO (1.8 PERCENT), WITH OTHER RACES MAKING UP THE REMAINING 3 PERCENT OF THE POPULATION. SEVERAL UNIQUE MINORITY POPULATIONS ARE FOUND IN WESTERN WISCONSIN, INCLUDING THE AMISH, MENNONITES AND HMONG. WISCONSIN HAS THE FOURTH HIGHEST AMISH POPULATION IN THE NATION. SEVERAL COMMUNITIES OF AMISH ARE SPRINKLED THROUGHOUT CHIPPEWA AND THE SURROUNDING COUNTIES WITH SIGNIFICANT SETTLEMENTS IN BARRON, BUFFALO AND CLARK COUNTIES. DETERMINING AN ACCURATE NUMBER OF AMISH AND MENNONITES LIVING IN THE STATE IS NOT EASY, AS THE CENSUS BUREAU AND OTHER STATISTICAL AGENCIES DO NOT HAVE DATA ON RELIGIOUS AFFILIATION. WHILE THE 2009 MEDIAN HOUSEHOLD INCOME OF THE U.S. AND WISCONSIN ARE BOTH APPROXIMATELY $50,000 PER YEAR, SJCF'S SERVICE AREA AVERAGE MEDIAN HOUSEHOLD INCOME IS ABOUT $7,000 LOWER. EVEN THOUGH EVERY COUNTY IS BELOW THE STATE AND NATIONAL MEAN, SOME COUNTIES ARE SIGNIFICANTLY BELOW. FOR EXAMPLE, WHILE CHIPPEWA COUNTY HAS THE HIGHEST MEAN AT $50,327 PER YEAR, RUSK COUNTY HAS THE LOWEST MEAN AT $38,000 PER YEAR. SOCIOECONOMICS IS ONE OF THE MOST INFLUENTIAL DETERMINANTS IN AN INDIVIDUAL'S LEVEL OF ACCESS TO HEALTH CARE (I.E., INDIVIDUALS WITH A LOWER SOCIOECONOMIC STATUS IN THE U.S. HAVE LOWER LEVELS OF GENERAL HEALTH, INSURANCE COVERAGE, IN ADDITION TO LESS ACCESS TO CARE) (AMERICAN JOURNAL OF PUBLIC HEALTH, 2000). INSURANCE COVERAGE IN THE COUNTIES OF SJCF'S SERVICE AREA FAR EXCEEDS THAT OF THE U.S. IN GENERAL. HOWEVER, WHEN COMPARED TO WISCONSIN, ALL SIX COUNTIES HAVE UNINSURED RATES THAT ARE EQUIVALENT TO OR EXCEED THE STATE AVERAGE. INSURANCE COVERAGE IS STRONGLY RELATED TO BETTER HEALTH OUTCOMES FOR BOTH CHILDREN AND ADULTS WHEN IT MAKES HEALTH CARE SERVICES AFFORDABLE AND HELPS INDIVIDUALS AND FAMILIES USE CARE APPROPRIATELY. UNINSURED INDIVIDUALS GENERALLY RECEIVE MUCH LESS CARE, EITHER PREVENTIVE OR FOR ACUTE AND CHRONIC CONDITIONS, THAN INSURED INDIVIDUALS. IN PARTICULAR, UNINSURED ADULTS REPORT LOWER LEVELS OF SELF-PERCEIVED WELLNESS AND FUNCTIONING. THERE ARE TWO ACUTE-CARE HOSPITALS OFFERING TERTIARY LEVEL SERVICES INCLUDING CARDIOVASCULAR SURGERY, NEUROSURGERY, ONCOLOGY AND TRAUMA LEVEL II IN NEARBY EAU CLAIRE: HSHS SACRED HEART HOSPITAL (SHEC) AND MAYO CLINIC HEALTH SYSTEM - EAU CLAIRE, AS WELL AS OAKLEAF SURGICAL HOSPITAL. THE HOSPITAL SISTERS HEALTH SYSTEM AND MAYO HEALTH SYSTEM HAVE EXTENSIVE PENETRATION IN EAU CLAIRE COUNTY. LIKEWISE, THE OAKLEAF MEDICAL NETWORK AND MARSHFIELD CLINIC OFFER SERVICES AT SEVERAL SITES THROUGHOUT THE COUNTY. RESIDENTS LOCATED ON THE PERIPHERY OF SJCF'S SERVICE AREA HAVE ACCESS TO EQUIVALENT AND EVEN GREATER LEVELS OF ACUTE CARE. TO THE WEST, THE TWIN CITIES MARKET BOASTS SEVERAL LARGE COMMUNITY HOSPITALS WITH TRAUMA LEVEL 1 AND AN ACADEMIC MEDICAL CENTER. A COMPREHENSIVE HEALTH CARE NETWORK, INCLUDING TWO HOSPITALS, A LARGE MULTI-SPECIALTY GROUP PRACTICE, AND A REGIONAL COMMUNITY CLINIC, EXISTS TO THE SOUTH IN LA CROSSE. TO THE EAST, MINISTRY HEALTHCARE, ST. JOSEPH'S HOSPITAL, MARSHFIELD AND THE MARSHFIELD CLINIC PHYSICIAN GROUP PROVIDE BOTH ACUTE CARE AND PRIMARY CARE SERVICES.
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. Joseph's hospital (sjcf) is committed to delivering high quality, compassionate, and cost-effective health care services to all. The hospital was founded more than 137 years ago to bring a healing presence and improve the health of our community, especially for those persons who are sick, poor, and disadvantaged. Because of the hospital's purpose and tradition, it is organized to promote the health of eau claire, wisconsin and surrounding areas. The hospital is governed by a board of directors, at least a majority of who reside in the hospital's primary service area and who are neither employees nor independent contractors of the hospital (nor family members thereof). The board ensures that sjcf is responding to community need. In fy2015, for example, the board reviewed the community health needs assessment and approved an implementation plan for addressing the selected health focus areas of mental health, alcohol misuse and obesity. The chna was also reviewed and approved by the chippewa health improvement partnership (chip) steering committee. Chip is the healthy communities' initiative that is hosted by sjcf. The chip steering committee is comprised of concerned individuals representing area schools, churches, businesses, health & medical facilities, senior citizens, government & legal agencies and the public at large who are interested in creating a healthier community. The division director of sjcf's 3d community health provides written and verbal updates to the hospital board throughout the year on the various community benefit initiatives the hospital is involved in and regarding any new needs that may arise. Multiple board members routinely seek out and engage in conversation with the 3d division director about community need and how the hospital board might best serve the hospital and meet community need. There are also other bodies that assist sjcf's connection's with the community, such as our advisory council, the patient and family advisory council, the st. Joseph's foundation, and our volunteer partners board. Also consistent with its exempt purpose, sjcf 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, sjcf reinvests surplus funds to support the mission of the organization and 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. Sjcf is currently working with its parent organization, hospital sisters health system, to continuously enhance quality and improve coordination of care both inside the hospital and with a growing number of physician partners. Supported by investments in information technology, this "care integration" strategy is designed to better coordinate care, improve health outcomes, create new efficiencies, and help ensure that patients (especially those with chronic conditions) get well and stay well. Sjcf also devotes significant resources to access for patients who cannot afford care, along with other community benefits. In fiscal year 2016, sjcf provided more than $9.6 million in community benefit services, including charity care at cost, unpaid costs of medicaid and other public programs, and a range of diverse programs designed to enhance access and improve community health. Additionally, in fiscal year 2016, sjcf provided $59,506 (at cost) in uncompensated care to patients who did not qualify for charity care or public assistance and more than $7.2 million (at cost) in excess of medicare payment for health care services. Sjcf provides a range of community benefit activities and programs that furthers our mission and long-standing commitment to our community. In many cases, these community benefit initiatives would not exist without the leadership role played by sjcf and they often relieve a burden that would otherwise be carried by government. In fy2016, sjcf continued its involvement in community building activities that addressed laying a foundation for a healthier, safer and better educated community. The hospital continues to draw from the fy15 community health needs assessment (chna) which surfaced the following health focus areas to be addressed by the hospital in collaboration with other hospitals and community organizations: 1) mental health; 2) substance use; and 3) alcohol misuse. Hshs st. Joseph's hospital's board of directors approved implementation strategies for each health priority identified through the chna fy2015 process. The development and expansion of services and programs targeted to meet the three top health needs, in particular meeting fundamental behavioral health needs, creates an explicit link to improving community health status. Coordination of these preventative and treatment services and programs among local health care providers, community health and social service providers, and other health promotion agencies is necessary so that western wisconsin residents get the appropriate prevention, diagnostic and treatment services needed. Though socioeconomic challenges are difficult to eliminate, western wisconsin residents will benefit from sjcf's efforts to improve access to mental health services, information and education pertaining to alcohol and other drug abuse issues, chronic disease preventative health and management services, and health education programming. Mental health Access to mental health care services for the uninsured and underinsured. Hshs st. Joseph's hospital (sjcf) expanded access to mental healthcare for children and adolescents by partnering with their sister hospital, sacred heart in eau claire to open an outpatient behavioral health clinic in eau claire in fy2012. This service is incredibly important as it increases outpatient coverage for mental health services that are lacking in the community. Sjcf/shec will continue to expand the program by recruiting additional physician providers to serve this location. In tandem, the use of screening tools for behavioral and mental health risk will be promoted among hospital-affiliated clinics for improved identification of mental health issues and earlier intervention. Sjcf also partners with the open door clinic (a free community medical care clinic that sjcf was instrumental in founding and continues to support) to expand provider coverage for odc patients who require mental health care services. Sjcf is also actively involved in a collaboration between its sister hospitals to the north and on the eastern side of the state along with area primary care clinicians in which the partners are exploring ways to better align behavioral health services between these locations in the hope expanding access to mental health services and filling identified gaps that currently exist. Education and awareness of mental health. Sjcf's 3d community health works closely with the hospital's behavioral health department to provide community education and events that bring research-based information to the public, drawing on the expertise of the behavioral health colleagues. Suicide prevention initiative - sjcf's 3d community health department is leading suicide prevention activities across multiple sectors and settings in collaboration with chippewa health improvement partnership, eau claire healthy communities, and multiple other community partners to promote awareness that suicide is a public health problem that is preventable. Strategies include community trainings of an evidence-based suicide prevention program, qpr (question, persuade & refer), as well as a variety of events, activities and displays pertaining to suicide prevention. Efforts are measured by the county suicide rate, inventory of change in community knowledge, stigma and behaviors, as well as participation in the county suicide death review team to monitor for potential trends and respond accordingly. In an effort to combat the rising rate of suicides in eau claire county sjcf's 3d community health has taken the lead in the area on suicide prevention by coordinating train the trainer sessions as well as community education sessions on qpr (question, persuade, and refer), an evidence-based suicide prevention program. (continued below)
Schedule H, Part VI, Line 6 Affiliated health care system	HSHS St. Joseph's Hospital in Chippewa Falls is an affiliate of Hospital Sisters Health System (HSHS), a health care ministry that includes 15 hospitals, numerous community-based health centers and clinics, and hundreds of physician partners across Illinois and Wisconsin. The mission of HSHS is "to reveal and embody Christ's healing love for all people through our high quality Franciscan health care ministry." We live our mission by providing holistic healing to all who seek our care, as well as through Community Benefit. In tandem with others in the communities we serve, our Community Benefit initiatives are strategically increasing access to care, improving the health status of residents, and increasing medical education and knowledge. In FY2016, our hospitals responded to the top needs identified in each of their most recent Community Health Needs Assessments (CHNAs). The information gathered from these assessments was used to develop or enhance Community Benefit programs and services to best address community health needs. Among the priority needs identified in the most recent CHNA process were access to care; alcohol, tobacco, and other drug abuse; chronic disease prevention and management; nutrition/wellness; mental health; and oral health. HSHS hospitals are proactively addressing these and other needs through patient, provider and community education, preventative screenings, self-management classes, and new or enhanced clinical services. In FY2016, HSHS collectively provided $203.8 million in Community Benefit (10.0% of total hospital expenses). This amount included $28.1 million provided for Financial Assistance (i.e. Charity Care) and $134.3 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 $221.3 million. HSHS hospitals also recorded $31.4 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. Improve access to health services As a Franciscan health care ministry, HSHS is deeply committed to serving those who are most in need with a special focus on the poor and vulnerable. We not only provide care to every patient who walks through our doors, but also reach out beyond the walls of our hospitals and clinics to care for those in our communities. Our efforts to ensure residents in the communities we serve receive the right care, at the right time, and in the right setting involve collaborating with others to achieve this goal. Across our two-state System, there are numerous examples of partnerships with departments of public health, other health care facilities and community and social service organizations to enhance access to care for those in need. In FY2016, HSHS and our 15 hospitals invested Community Benefit resources to educate the uninsured about new enrollment opportunities in affordable health care coverage and to facilitate the process. Studies have shown that people without insurance are more likely to postpone care and develop more severe and expensive conditions than their insured counterparts. It is for this reason that the Catholic Church, Catholic health care and HSHS have long promoted "coverage and access for all." HSHS and our 15 hospitals in partnership with local health departments, social service agencies and other health care providers played a vital role in educating eligible people in their local communities, by referring people to Certified Application Counselors and/or in enrolling them in the health insurance exchanges, or in securing coverage through Medicaid expansion. In southern Illinois, HSHS St. Elizabeth's Hospital in Belleville identified an education gap among newly insured patients. Although these patients now had health insurance, they did not know how to use insurance nor did they understand the many benefits that come with different plans. To bridge the gap, St. Elizabeth's Hospital hosted quarterly resource fairs in collaboration with other social service agencies in the community to not only educate the public about their health insurance benefits but also about other resources in the community that can improve their overall health and quality of life. More than 100 persons participated in the resource fairs and each received a healthy snack or hygiene kit. In response to its FY2015 CHNA, HSHS St. John's Hospital in Springfield, Illinois established a community health worker program to increase access to health care and coordination of care for residents of the Enos Park Neighborhood. The hospital also helped establish an Enos Park Neighborhood Advisory Council and Providers Alliance as part of the access collaborative to drive behavior changes and improve health outcomes. In the first year of the program, 103 clients were 100% engaged. Services provided included basic needs (70%) and health care access (30%). The access collaborative also placed 12 homeless individuals or families in affordable, safe housing in Enos Park. Of the 27 parolees we worked with, we realized an 18% recidivism rate compared to the national rate of 60% due to lack of housing or employment. One hundred percent of our clients visited a primary care provider and 84% connected to a medical home. Due to the program's initial success, it is being replicated in Sangamon County's eastside where our most poor and vulnerable populations live. HSHS St. Mary's Hospital Medical Center in Green Bay led the activities of the community Oral Health Task Force, which focuses on prevention, intervention and policy modification strategies to improve oral health in Brown County. In FY2016, St. Mary's Hospital helped to expand the services at NEW Community Clinic dental clinic by supporting their efforts to secure a HRSA grant for expansion by subsidizing the rent guarantee necessary and by assisting with the design cost for the center. The hospital also subsidized the cost of a staff person to obtain the necessary medical clearances and consent forms for patients, many of whom are elderly and/or disabled and need consent from guardians - thus supporting the oral surgeons who are providing their services free of charge. St. Mary's Hospital expanded oral health services for children by covering the costs of a dental hygienist employed by the Brown County Oral Health Partnership to offer oral health services in the Ashwaubenon school district. Through this new alliance, 79 students received oral health care that otherwise would have been difficult to obtain, including care for dental caries and abscesses. HSHS St. Francis Hospital in Litchfield, Illinois collaborated with Lewis & Clark Community College and local dental providers to bring the College's mobile dental health unit to the Litchfield area; the unit provides free or low cost dental exams and screenings, x-rays and hygiene services. In addition, three local dental providers also participated by opening their offices and donating time, staff and supplies to provide either a free filling, extraction or hygiene services. Beginning in 2015, the hospital collaborated with Catholic Charities to launch a dental voucher program. Five dentists in Macoupin and Montgomery counties participate in the program, which covers an initial exam and x-rays, one tooth extraction and up to three fillings per year per individual. The percentage of total emergency department visits related to dental issues decreased from 2.2 percent in 2011 to 1.27 percent in 2014 because of this collaboration. In southeast Illinois, area residents can get help filling a prescription through the long-term collaboration between HSHS St. Anthony's Memorial Hospital in Effingham and Catholic Charities. In FY2016, St. Anthony's Memorial Hospital helped to underwrite the cost of prescription medications for 518 residents. St. Anthony's Memorial Hospital and Catholic Charities believe no one should be without prescriptions because of the inability to pay.
Schedule H, Part VI, Line 7 State filing of community benefit report	WI

Schedule H (Form 990) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

St Joseph's Hospital of the Hospital Sisters of the Third Order of St Franc
is

Employer identification number

39-0810545

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ................

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization?

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization?

Any related organization? .........................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2015

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column(B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1JOAN COFFMAN CEO/PRESIDENT	(i) (ii)	0 ------------- 290,250	0 ------------- 51,918	0 ------------- 61,252	0 ------------- 109,792	0 ------------- 22,079	0 ------------- 535,291	0 ------------- 31,552
2JULIE MANAS DIVISION PRES/CEO	(i) (ii)	0 ------------- 466,432	0 ------------- 78,843	0 ------------- 21,109	0 ------------- 155,297	0 ------------- 25,069	0 ------------- 746,750	0 ------------- 0
3LAWRENCE SCHUMACHER Former DIRECTOR	(i) (ii)	0 ------------- 255,552	0 ------------- 152,120	0 ------------- 1,052,448	0 ------------- 63,423	0 ------------- 9,282	0 ------------- 1,532,825	0 ------------- 342,101
4PETER MANNIX Board Member	(i) (ii)	0 ------------- 346,185	0 ------------- 58,018	0 ------------- 65,314	0 ------------- 135,165	0 ------------- 35,097	0 ------------- 639,779	0 ------------- 49,945
5ANN M CARR TREASURER	(i) (ii)	0 ------------- 253,980	0 ------------- 36,527	0 ------------- 63,798	0 ------------- 201,780	0 ------------- 20,881	0 ------------- 576,966	0 ------------- 29,789
6DAVE NELSON DIVISION CHIEF FINANCIAL OFFICER	(i) (ii)	0 ------------- 278,910	0 ------------- 30,580	0 ------------- 3,280	0 ------------- 55,031	0 ------------- 22,800	0 ------------- 390,601	0 ------------- 0
7Estella Clark Chief Nursing Officer	(i) (ii)	159,874 ------------- 0	11,486 ------------- 0	780 ------------- 0	31,442 ------------- 0	16,058 ------------- 0	219,640 ------------- 0	0 ------------- 0
8RONDA ADLER PHARMACIST	(i) (ii)	169,681 ------------- 0	0 ------------- 0	554 ------------- 0	39,404 ------------- 0	8,313 ------------- 0	217,952 ------------- 0	0 ------------- 0
9SARA JORGENSON PHARMACIST	(i) (ii)	160,531 ------------- 0	0 ------------- 0	0 ------------- 0	39,978 ------------- 0	10,135 ------------- 0	210,644 ------------- 0	0 ------------- 0
10Lois Klay Vice President (Partial Year)	(i) (ii)	135,147 ------------- 0	0 ------------- 0	55,274 ------------- 0	103,550 ------------- 0	7,970 ------------- 0	301,941 ------------- 0	0 ------------- 0
11Chris Klay Division Director	(i) (ii)	143,838 ------------- 0	0 ------------- 0	7,330 ------------- 0	16,439 ------------- 0	22,435 ------------- 0	190,042 ------------- 0	0 ------------- 0
12LARRY STUDT PHYSICIAN	(i) (ii)	232,579 ------------- 0	9,568 ------------- 0	780 ------------- 0	31,676 ------------- 0	22,800 ------------- 0	297,403 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2015

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
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 4a Severance or change-of-control payment	Organization: Hospital Sisters Health System, Inc. EIN: 37-1058692 Interested Person: Lawrence Schumacher Amount: $476,419 Terms: Compensation paid as a result of a severance from the position of COO. Organization: St. Joseph's Hospital of the Hospital Sisters of St Francis, Inc. EIN: 39-0810545 Interested Person: Lois Klay Amount: $16,536 Terms: Compensation paid as a result of a severance from the position of Vice President.
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 DOCUENTS 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 2015; THESE DEFERRALS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C). ANN M. CARR -- $31,485 PETER MANNIX -- $41,432 JOAN COFFMAN -- $36,356 JULIE MANAS -- $55,012 THE FOLLOWING INTERESTED PERSONS RECEIVED DISTRIBUTIONS FROM THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) IN 2015; THESE PAYMENTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III) AND SCHEDULE J, PART II, COLUMN (F), AS APPLICABLE. ANN M. CARR -- $29,789 PETER MANNIX -- $49,945 JOAN COFFMAN -- $31,552 LARRY SCHUMACHER --$342,101

Schedule J (Form 990) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

Information about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

St Joseph's Hospital of the Hospital Sisters of the Third Order of St Franc
is

Employer identification number

39-0810545

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No










Total ............... $

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2015

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) Pathology Service Corporation	Director	102,252	Hospital Based Pathology Services		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- 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 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

St Joseph's Hospital of the Hospital Sisters of the Third Order of St Franc
is

Employer identification number

39-0810545

Return Reference	Explanation
Form 990, Part III, Line 4a PROGRAM SERVICE ACCOMPLISHMENTS	ST. JOSEPH'S HOSPITAL PROVIDES QUALITY MEDICAL HEALTHCARE TO THE SURROUNDING COMMUNITY REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND FINANCIAL STABILITY OF ST. JOSEPH'S HOSPITAL, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES. AND, FURTHER THAT OUR MISSION IS TO SERVE THE COMMUNITY BY PROVIDING HEALTHCARE SERVICES AND HEALTHCARE EDUCATION. INHERENT IN OUR MISSION, WE PROVIDE CARE TO THE POOR, THE ELDERLY, AND THE NEEDY OF THE COMMUNITY THROUGH VARIOUS PROGRAMS AND SERVICES. THESE ACTIVITIES INCLUDE WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, AND SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED, MEDICALLY UNDER SERVED, AND VARIETY OF COMMUNITY SUPPORT ENDEAVORS. ST. JOSEPH'S HOSPITAL PROVIDED THE FOLLOWING SERVICES IN FISCAL YEAR 06/30/16: 4,038 ADULT AND PEDIATRIC INPATIENT DAYS OF CARE 10,323 ALCOHOL AND DRUG ABUSE INPATIENT DAYS OF CARE 78,923 OUTPATIENT HOSPITAL VISITS 11,054 OUTPATIENT ALCOHOL AND DRUG ABUSE VISITS 15,263 HOME HEALTH VISITS 18,243 HOSPICE DAYS ST. JOSEPH'S HOSPITAL PROVIDES BOTH BENEFITS TO THE POOR AND FOR THE BROADER COMMUNITY. BENEFITS TO THE POOR ARE PROVIDED IN THE FORM OF TRADITIONAL CHARITY CARE, FOR THOSE WHO CANNOT AFFORD TO PAY, AS WELL AS UNPAID COSTS OF PUBLIC PROGRAMS SUCH AS MEDICAID AND GENERAL RELIEF. TOTAL VALUE OF THESE NON-REIMBURSED BENEFITS FOR THE POOR WERE $8,658,684 IN FISCAL YEAR 06/30/16. ST. JOSEPH'S HOSPITAL ALSO PROVIDES NUMEROUS BENEFITS TO THE BROADER CHIPPEWA VALLEY AREA. THESE BENEFITS ARE PROVIDED BY OUR PARTICIPATION IN THE MEDICARE PROGRAM, PROVIDING MANY PROGRAMS AND SERVICES FREE OR AT A REDUCED PRICE AND PROVIDING SERVICES THAT BENEFIT THE COMMUNITY BUT HAVE A NEGATIVE MARGIN. THE UNPAID OR NON-REIMBURSED COST OF PARTICIPATION IN THE MEDICARE PROGRAM WAS $7,211,358 IN FISCAL YEAR 06/30/16. TOTAL QUANTIFIABLE BENEFITS FOR THE BROADER COMMUNITY WERE $1,176,216 IN FISCAL YEAR 06/30/16. THE FOLLOWING IS A LISTING OF SPECIFIC EXAMPLES OF SERVICES INCLUDED IN THE ABOVE FIGURES: MEALS REIMBURSED AT LESS THAN COST TO ELDERLY OF THE COMMUNITY. ORGAN AND TISSUE DONATION PROGRAM COORDINATED WITH PASTORAL CARE, NURSING SERVICES, AND THE WISCONSIN EYE BANK AND ORGAN PROCUREMENT SERVICE IN MADISON, WISCONSIN. PASTORAL CARE SERVICES PROVIDED 24 HOURS PER DAY. PHYSICIAN REFERRAL SERVICE FOR NEW RESIDENTS OF THE AREA. PARTICIPANT IN THE PROJECT CARE SEAT PROGRAM OFFERING INFANT CAR SEATS AT A MINIMAL RENTAL RATE. SHARPS DISPOSAL PROGRAM FOR THOSE IN THE COMMUNITY WHO MUST DISPOSE OF NEEDLES AND SYRINGES. SOCIAL SERVICE DEPARTMENT TO ASSIST FAMILIES WITH EMOTIONAL AND SOCIAL PROBLEMS. HOSPICE GRIEF SUPPORT PROGRAM TO HELP THOSE WHO HAVE LOST LOVED ONES DEAL WITH THE GRIEVING PROCESS. SHARE PROGRAM TO HELP THOSE WHO HAVE LOST INFANTS TO MISCARRIAGE, ECTOPIC PREGNANCY, STILLBIRTH OR NEWBORN DEATH. BABY-SITTERS CLINIC. BACK IN BALANCE SPONSORED BY PHYSICAL THERAPY DEPARTMENT FOR PEOPLE WITH CHRONIC BACK PAIN. BIG KID/LITTLE KID PROGRAM TO PREPARE EXPECTANT PARENTS AND BIGGER BROTHERS AND SISTERS FOR THE NEW ADDITION TO THE FAMILY. FREE BLOOD PRESSURE SCREENING OFFERED IN THE HOSPITAL EMERGENCY ROOM. CHILDREN'S HEALTH FAIR FOR AREA FIRST GRADERS THAT ALLOWS THEM TO SEE A HOSPITAL BEFORE THEY NEED TO USE ONE. DIABETES CONSULTATION AND DIABETES EDUCATION OFFERED AT NOMINAL FEES TO NEW DIABETICS AND THEIR FAMILIES. EMERGENCY NURSES C.A.R.E. (CANCEL ALCOHOL-RELATED EMERGENCIES) PROGRAM TO EDUCATE THE YOUTH OF THE COMMUNITY ABOUT THE DANGERS OF DRINKING AND DRIVING. FIRST CARE PROGRAM IS A RESPONDER/FIRST AID PROGRAM FOR FARM FAMILIES. FRESH START QUIT SMOKING CLINIC OFFERED AT A NOMINAL FEE FOR THOSE WISHING TO QUIT SMOKING. HOSPICE VOLUNTEER TRAINING PROGRAM TO TRAIN PEOPLE TO HELP SUPPORT HOSPICE PATIENTS AND FAMILIES. NATURAL FAMILY PLANNING PROGRAM TO HELP THOSE WISHING TO PRACTICE BIRTH CONTROL WITHOUT THE USE OF CHEMICALS OR OTHER MEDICAL DEVICES. PRENATAL CLASSES FOR FIRST TIME PARENTS AND REFRESHER CLASSES FOR PARENTS EXPECTING ANOTHER CHILD OFFERED AT NO COST. SPEAKERS' BUREAU FOR CLUBS AND ORGANIZATIONS OFFERED AT NO CHARGE ON MANY DIFFERENT HEALTH CARE TOPICS. THE MOBILE HEALTH UNIT OFFERS DIAGNOSTIC HEALTH TESTS AND SCREENINGS, HEALTH EDUCATION, WELLNESS AND PREVENTION INFORMATION TO THE COMMUNITY AT REDUCED FEES. FREE SCREENING TO DETERMINE IF SOMEONE HAS A DEPENDENCY ON ALCOHOL/DRUGS. FREE PROGRAMS FOCUSING ON VARIOUS ASPECTS AND OUTCOMES OF CHEMICAL DEPENDENCY. INFANT MASSAGE CLASSES OFFERED AT A MINIMAL FEE. PARENTS LEARN TECHNIQUES OF MASSAGE FROM A PHYSICAL THERAPIST THAT WILL HELP TO COMFORT THEIR INFANT AND HELP THEIR CHILD RELAX AND SLEEP. WOMEN'S HEALTH CENTER OFFERED SEVERAL FREE EDUCATIONAL PROGRAMS TO THE PUBLIC FOCUSING ON SUCH TOPICS AS BREAST DISEASE AND OSTEOPOROSIS. FREE STROKE PREVENTION SCREEN CLINIC PROVIDED. BLOOD PRESSURE, PULSE, AND CHOLESTEROL CHECK ALONG WITH FAMILY HISTORY. FREE DEPRESSION SCREENING CLINIC OFFERED TO HELP PEOPLE DETERMINE IF THEY HAVE DEPRESSION. CLASSES FOR PARENTS AND YOUTHS TO PREPARE FOR THE TIME THE YOUTHS BECOME ADOLESCENTS. FREE PUBLIC/COMMUNITY FORUM FOCUSING ON THE SOCIETAL PROBLEMS ASSOCIATED WITH CHEMICAL DEPENDENCY. CO-SPONSORED TWO SENIOR FUN DAYS FOR AREA SENIORS TO LEARN ABOUT HEALTH, HEALTH SCREENINGS OFFERED. *CO-SPONSORED CHILDCARE WORKSHOPS AS A RESOURCE OF CONTINUING EDUCATION FOR CHILDCARE PROVIDERS.
Form 990, Part IV, Line 24a TAX EXEMPT BONDS	ST JOSEPHS HOSPITAL 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 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. JOSEPH'S HOSPITAL. 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. JOSEPH'S HOSPITAL, AND ALL HSHS HOSPITALS, TO EVALUATE THEIR PARTICIPATION IN JOINT VENTURE ARRANGEMENTS, INCLUDING UNDER APPLICABLE FEDERAL TAX LAWS, AND TO SAFEGUARD ST. JOSEPH'S HOSPITAL'S TAX EXEMPT STATUS WITH RESPECT TO ANY JOINT VENTURE ARRANGEMENTS.
Form 990, Part VI, Line 6 Classes of members or stockholders	THE SENIOR GOVERNING BODY OF ST. JOSEPH'S HOSPITAL CHIPPEWA FALLS (THE "CORPORATION") IS THE MEMBER OF THE CORPORATION, WHICH IS HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. PURSUANT TO SECTION 2.3 OF THE CORPORATION'S BYLAWS,
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	PURSUANT TO SECTION 2.3 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, CHAIRPERSON OF THE BOARD AND PRESIDENT. HSSI HAS THE RIGHT TO APPOINT AND REMOVE THE CORPORATION'S BOARD OF DIRECTORS, CHAIRPERSON OF THE BOARD AND PRESIDENT
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	RESPONSIBILITY FOR THE POLICY AND OPERATIONS OF ST. JOSEPH'S HOSPITAL CHIPPEWA FALLS (THE "CORPORATION") IS VESTED IN ITS BOARD OF DIRECTORS, EXCEPT WITH RESPECT TO SPECIFIC POWERS RESERVED IN THE CORPORATION'S BYLAWS TO THE CORPORATION'S MEMBER, HOSPITAL SISTERS SERVICES, INC. ("HSSI"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE MEMBER OF HSSI IS HOSPITAL SISTERS HEALTH SYSTEM ("HSHS"), AN ILLINOIS NOT FOR PROFIT CORPORATION EXEMPT FROM FEDERAL TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE MEMBERS OF HSHS ARE THE INDIVIDUAL SISTERS WHO, FROM TIME TO TIME, ARE THE DULY ELECTED PROVINCIAL SUPERIOR AND PROVINCIAL COUNCILORS, RESPECTIVELY OF THE AMERICAN PROVINCE OF THE HOSPITAL SISTERS OF ST. FRANCIS ("AMERICAN PROVINCE"). THE AMERICAN PROVINCE IS THE UNITED STATES ORGANIZATION OF THE CONGREGATION OF THE HOSPITAL SISTERS OF THE THIRD ORDER REGULAR OF ST. FRANCIS, A RELIGIOUS INSTITUTE OF THE ROMAN CATHOLIC CHURCH. THE GOVERNANCE AND OPERATIONS OF THE CORPORATION ARE SUBJECT TO HSSI'S RIGHT TO EXERCISE THESE RESERVED POWERS WITH RESPECT TO THE CORPORATION AND ORGANIZATIONS OF WHICH THE CORPORATION IS EITHER, DIRECTLY OR INDIRECTLY, A CONTROLLING MEMBER OR A CONTROLLING SHAREHOLDER ("AFFILIATES"). HSSI'S RIGHT TO EXERCISE CERTAIN OF THESE RESERVED POWERS IS, IN TURN, SUBJECT TO THE APPROVAL OF HSHS AND HSHS' MEMBERS. THE RESERVED POWERS INCLUDE ALL RIGHTS GRANTED TO HSSI BY LAW, AND THE RIGHT TO: (A) ADOPT, APPROVE AMENDMENTS TO, OR AMEND ANY STATEMENT OF PHILOSOPHY, MISSION, MISSION INTEGRATION OR VALUES, OR ANY NAME, LOGO, OR MARK OF THE CORPORATION OR OF ANY AFFILIATE; (B) ADOPT, APPROVE AMENDMENTS TO, OR AMEND THE ARTICLES OF INCORPORATION OF THE CORPORATION OR OF ANY AFFILIATE; (C) ADOPT, APPROVE AMENDMENTS TO, OR AMEND THE BYLAWS OF THE CORPORATION OR OF ANY AFFILIATE; (D) APPOINT AND REMOVE THE BOARD OF DIRECTORS, ANY ONE OR MORE OF THE DIRECTORS OF THE CORPORATION OR OF ANY AFFILIATE, AND THE CHAIRPERSON AND PRESIDENT OF THE CORPORATION OR OF ANY AFFILIATE; (E) APPROVE THE RECOMMENDATION OF THE BOARD OF DIRECTORS TO APPOINT OR REMOVE THE BOARD OF DIRECTORS, ANY ONE OR MORE DIRECTORS OF THE CORPORATION OR OF ANY AFFILIATE, OR THE CHAIRPERSON AND PRESIDENT OF THE CORPORATION OR OF ANY AFFILIATE. (F) WITH RESPECT TO THE CORPORATION OR ANY AFFILIATE, APPROVE THE PURCHASE, SALE, ALIENATION, EXCHANGE, LEASE, OR ENCUMBRANCE OF ANY REAL PROPERTY OF THE CORPORATION OR OF ANY AFFILIATE, WHICH PROPERTY HAS A VALUE IN EXCESS OF LIMITS SET FROM TIME TO TIME BY HSSI; (G) APPROVE THE OPERATING AND CAPITAL BUDGETS OF THE CORPORATION OR OF ANY AFFILIATE, AND ANY DEVIATIONS BY THE CORPORATION OR OF ANY AFFILIATE FROM SUCH BUDGETS IN AN AMOUNT OR PERCENTAGE SPECIFIED BY HSSI FROM TIME TO TIME; (H) APPROVE THE STRATEGIC PLAN AND GOALS OF THE CORPORATION OR OF ANY AFFILIATE; (I) APPROVE THE SALE OF SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION OR OF ANY AFFILIATE; (J) APPROVE THE MERGER OR DISSOLUTION OF THE CORPORATION OR OF ANY AFFILIATE; (K) ADOPT OR AMEND THE PLAN FOR MINISTRY EDUCATION AND GOVERNANCE FOR THE CORPORATION AND ITS AFFILIATES; (L) APPROVE THE CORPORATION'S MISSION ACCOUNTABILITY REPORTS AND THOSE OF ANY AFFILIATE; (M) APPROVE THE FINANCIAL POLICIES AND PROCEDURES OF THE CORPORATION OR OF ANY AFFILIATE, AND APPROVE ANY DEVIATIONS FROM SUCH POLICIES AND PROCEDURES BY THE CORPORATION OR ANY AFFILIATE; AND (N) ADOPT POLICIES TO IMPLEMENT THE RESERVED POWERS OF HSSI.
Form 990, Part VI, Line 11b Review of form 990 by governing body	THE HOSPITAL EMPLOYS CROWE HORWATH TO ASSIST IN THE OVERALL PREPARATION, REVIEW AND ELECTRONIC SUBMISSION OF ITS FORM 990. CROWE HORWATH 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 DISQUALIFIED INDIVIDUALS. INTEGRATED HEALTHCARE STRATEGIES ("IHS"), THE CONSULTANTS UTILIZED BY THE COMMITTEE, USE DATA FROM MULTIPLE TAX-EXEMPT PEER GROUP SOURCES TO DETERMINE SALARY RANGES, INCENTIVE OPPORTUNITY RANGES, AND BENEFITS FOR THE DISQUALIFIED INDIVIDUALS. IHS THEN ASSISTS THE COMMITTEE IN PREPARING CONTEMPORANEOUS DOCUMENTATION OF ALL ACTIONS. EACH COMMITTEE MEETING IS CONDUCTED WITH THE INTENT TO CREATE A REBUTTABLE PRESUMPTION OF REASONABLENESS FOR ALL ELEMENTS OF EXECUTIVE TOTAL COMPENSATION FOR THE DISQUALIFIED INDIVIDUALS. THE CHAIRMAN MAKES THIS DECLARATION AND ALSO INQUIRES IF THERE ARE ANY CONFLICTS OF INTEREST BY ANY ATTENDEES. ANY CONFLICTS ARE DISCLOSED AND THE COMMITTEE THEN ACTS IN A MANNER TO AVOID ANY CONFLICTED INDIVIDUAL PARTICIPATING IN ANY MANNER WHERE A CONFLICT MIGHT EXIST. AT THE END OF THE MEETING, THE COMMITTEE PREPARES CONTEMPORANEOUS MINUTES THAT RECORD ALL ACTIONS TAKEN DURING THE MEETING.
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 IX, Line 11g Other Fees	Purchased professional services - Total Expense: 4693406, Program Service Expense: 4526403, Management and General Expenses: 167003, Fundraising Expenses: 0; Purchased Medical Services - Total Expense: 751121, Program Service Expense: 751121, Management and General Expenses: 0, Fundraising Expenses: 0; Other - Total Expense: 2859466, Program Service Expense: 2324196, Management and General Expenses: 535270, Fundraising Expenses: 0;
Form 990, Part X, Line 11 POOLED INVESTMENT ACCOUNT	ST. JOSEPH'S HOSPITAL'S CASH RESERVES ARE INVESTED IN A POOLED INVESTMENT ACCOUNT. PARTICIPATION IN THE POOLED FUND IS LIMITED TO THE 501(C)(3) HOSPITALS AND RELATED HEALTH SERVICES ORGANIZATIONS SPONSORED BY THE HOSPITAL SISTERS HEALTH SYSTEM. THE POOLED ACCOUNT CONSISTS OF CASH, AND EQUITY AND DEBT SECURITIES THAT ARE PUBLICLY TRADED. IN ACCORDANCE WITH THE PROVISIONS OF SFAS NO. 124 "ACCOUNTING FOR CERTAIN INVESTMENTS HELD BY NOT-FOR-PROFIT ORGANIZATIONS," INVESTMENTS IN EQUITY SECURITIES WITH READILY DETERMINABLE VALUES, AND ALL INVESTMENTS IN DEBT SECURITIES, ARE REPORTED AT FAIR VALUE ON THE BALANCE SHEET. INCOME, REALIZED AND UNREALIZED GAINS AND LOSSES ARE POOLED AND ALLOCATED TO THE PARTICIPANTS. INDIVIDUAL COMPONENTS OF ASSETS AND REVENUE ARE NOT IDENTIFIED TO THE PARTICIPANTS.
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	Change in fair value of the interest rate swaps - -1262409; Swap payments - -350633; Change in Temporarily Restricted Net Assets - 835050; Change in Permanently Restricted Net Assets - -3518094; Transfer to Affiliates - -3598686; Pension-related changes other than net periodic pension costs - -9818035;

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

St Joseph's Hospital of the Hospital Sisters of the Third Order of St Franc
is

Employer identification number

39-0810545

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) KIARA CLINICAL INTEGRATION NETWORK LLC 4936 LAVERNA ROAD SPRINGFIELD,IL62707 26-1417684	HEALTHCARE	IL	-3,126,361	6,209,010	HSSI
(2) PHYSICIAN CLINICAL INTEGRATION NETWORK LLC 4936 LAVERNA ROAD SPRINGFIELD,IL62707 37-1668647	HEALTHCARE	IL	-127,884	6,099,730	KCIN
(3) HSHS ACO LLC 4937 LAVERNA ROAD SPRINGFIELD,IL62707 32-0465666	HEALTHCARE & SOCIAL ASSISTANCE	IL	-35	0	KCIN

Part II

Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)HOSPITAL SISTERS HEALTH SYSTEM 4936 LAVERNA ROAD SPRINGFIELD,IL62707 37-1058692	HEALTHCARE	IL	501(c)(3	Type III-FI	NA		No
(2)HOSPITAL SISTERS OF ST FRANCIS FOUNDATION 4936 LAVERNA ROAD SPRINGFIELD,IL62707 37-1186514	HEALTHCARE	IL	501(c)(3	7	HSHS	Yes
(3)HSHS HEALTHCARE PLAN TRUST FUND 4936 LAVERNA ROAD SPRINGFIELD,IL62707 37-1137724	HEALTHCARE	IL	501(c)(9		HSHS	Yes
(4)HSHS SELF INSURANCE TRUST 4936 LAVERNA ROAD SPRINGFIELD,IL62707 37-1120626	INSURANCE	IL	501(c)(3	Type I	HSHS	Yes
(5)HOSPITAL SISTERS HEALTHCARE WEST INC 2661 COUNTY HIGHWAY 1 CHIPPEWA FALLS,WI54729 51-0157933	HEALTHCARE	WI	501(c)(3	Type I	HSSI	Yes
(6)SACRED HEART HOSPITAL 990 WEST CLAIREMONT AVENUE EAU CLAIRE,WI54701 39-0807060	HEALTHCARE	WI	501(c)(3	3	HSSI	Yes
(7)ST ANTHONY'S HOSPITAL 503 N MAPLE STREET EFFINGHAM,IL62401 37-0661233	HEALTHCARE	IL	501(c)(3	3	HSSI	Yes
(8)ST ELIZABETH'S HOSPITAL 211 SOUTH THIRD STREET BELLEVILLE,IL62220 37-0663567	HEALTHCARE	IL	501(c)(3	3	HSSI	Yes
(9)ST NICHOLAS HOSPITAL 3100 SUPERIOR AVENUE SHEBOYGAN,WI53081 39-0808480	HEALTHCARE	WI	501(c)(3	3	HSSI	Yes
(10)ST JOHN'S HOSPITAL 800 EAST CARPENTER STREET SPRINGFIELD,IL62769 37-0661238	HEALTHCARE	IL	501(c)(3	3	HSSI	Yes
(11)ST JOSEPH'S HOSPITAL 9515 HOLY CROSS LANE BREESE,IL62230 37-1208459	HEALTHCARE	IL	501(c)(3	3	HSSI	Yes
(12)ST MARY'S HOSPITAL 1800 E LAKE SHORE DRIVE DECATUR,IL62521 37-0661244	HEALTHCARE	IL	501(c)(3	3	HSSI	Yes
(13)ST MARY'S HOSPITAL 111 Spring Street Streator,IL61364 36-2169181	HEALTHCARE	IL	501(c)(3	3	HSSI	Yes
(14)ST MARY'S MEDICAL CENTER 1762 SHAWANO AVENUE GREEN BAY,WI54303 39-0818682	HEALTHCARE	WI	501(c)(3	3	HSSI	Yes
(15)ST VINCENT HOSPITAL 835 S VAN BUREN GREEN BAY,WI51301 39-0817529	HEALTHCARE	WI	501(c)(3	3	HSSI	Yes
(16)ST JOSEPH'S HOSPITAL 12866 TROXLER AVENUE HIGHLAND,IL62249 37-0663568	HEALTHCARE	IL	501(c)(3	3	HSSI	Yes
(17)ST FRANCIS HOSPITAL 1215 FRANCISCAN DRIVE LITCHFIELD,IL62056 37-0661236	HEALTHCARE	IL	501(c)(3	3	HSSI	Yes
(18)HOSPITAL SISTERS SERVICES INC 4936 LAVERNA ROAD SPRINGFIELD,IL62707 37-1163402	HEALTHCARE	IL	501(c)(3	Type III-FI	HSHS	Yes
(19)HSHS MEDICAL GROUP INC 3215 EXECUTIVE PARK DRIVE SPRINGFIELD,IL62703 26-3956318	HEALTHCARE	IL	501(c)(3	Type III-FI	HSSI	Yes
(20)HSHS WISCONSIN MEDICAL GROUP INC 3215 EXECUTIVE PARK DRIVE SPRINGFIELD,IL62703 26-4515959	HEALTHCARE	WI	501(c)(3	Type III-FI	HSSI	Yes
(21)ORANGE CROSS AMBULANCE INC 919 ASHLAND AVENUE SHEBOYGAN,WI53081 39-1860942	HEALTHCARE	WI	501(c)(3	9	ST NICHOLAS	Yes
(22)UNITY LIMITED PARTNERSHIP 2366 OAK RIDGE CIRCLE DE PERE,WI54115 39-1750729	HEALTHCARE	WI	501(c)(3	9	HSSI	Yes
(23)PRAIRIE EDUCATION & RESEARCH COOPERATIVE 317 NORTH 5TH STREET SPRINGFIELD,IL62701 37-1157915	HEALTHCARE	IL	501(c)(3	4	HSSI	Yes
(24)ST CLARE MEMORIAL HOSPITAL 855 S MAIN STREET OCONTO FALLS,WI54154 39-0848401	HEALTHCARE	WI	501(c)(3	3	HSSI	Yes
(25)HSHS HOLY FAMILY HOSPITAL 200 HEALTHCARE DRIVE GREENVILLE,IL62246 37-0792770	HEALTHCARE	IL	501(c)(3	3	HSSI	Yes
(26)UTLAUT MEMORIAL FOUNDATION 200 HEALTHCARE DRIVE GREENVILLE,IL62246 37-1140166	FUNDRAISING	IL	501(c)(3	Type II	HSSI	Yes
(27)GREENVILLE REGIONAL HEALTHCARE 200 HEALTHCARE DRIVE GREENVILLE,IL62246 37-1139987	HEALTHCARE	IL	501(c)(3	Type II	HSSI	Yes

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2015

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) MEMORIAL AND ST ELIZABETH'S HEALTHCARE CANCER TREATMENT CENTER 4000 NORTH ILLINOIS STREET SWANSEA,IL62226 37-1312961	HEALTHCARE	IL	ST ELIZABETH'S	Related	848,922	4,789,579		No			No	50 %
(2) PRAIRIE HEART INSTITUTE ST JOHN'S 800 EAST CARPENTER STREET SPRINGFIELD,IL62769 37-1321197	HEALTHCARE	IL	HSHS	Related	-596	8,000		No			No	100 %
(3) PAIN CENTER OF WISCONSIN 4131 W LOOMIS ROAD SUITE 300 GREENFIELD,WI53221 26-3155343	HEALTHCARE	WI	ST VINCENT	Related	606,068	807,898		No			No	50 %
(4) PAIN CENTER OF WISCONSIN - OCONTO FALLS LLC 4131 W LOOMIS ROAD SUITE 300 GREENFIELD,WI53221 36-4717036	HEALTHCARE	WI	ST CLARE	Related	-79,535	206,472		No			No	50 %
(5) CARPENTER STREET HOTEL LLC 525 NORTH SIXTH STREET SPRINGFIELD,IL62702 36-4128127	HOTEL	IL	LASANTE INC	N/A								0 %
(6) SPRINGFIELD URGENT CARE REAL ESTATE LLC PO BOX 19456 SPRINGFIELD,IL727949456 03-0413258	RENTAL REAL ESTATE	IL	LASANTE INC	N/A								0 %
(7) PRAIRIE HEART INSTITUTE MANAGEMENT COMPANY LLC 4936 LAVERNA ROAD SPRINGFIELD,IL62707 26-1479945	MEDICAL	IL	HSHS	Related	-7,435	17,725		No		Yes		100 %

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets		Yes	No
(1) KIARA INC 4936 LAVERNA ROAD SPRINGFIELD,IL62707 37-1163401	HEALTHCARE	IL	HSHS	C Corporation	-36,664,461	46,374,438	1 %	Yes
(2) LASANTE WISCONSIN INC 4936 LAVERNA ROAD SPRINGFIELD,IL62707 39-1572196	HEALTHCARE	IL	KIARA INC	C Corporation				Yes
(3) LASANTE INC 4936 LAVERNA ROAD SPRINGFIELD,IL62707 37-1163400	HEALTHCARE	IL	KIARA INC	C Corporation				Yes
(4) PRAIRIE CARDIOVASCULAR 619 EAST MASON SUITE 4P57 SPRINGFIELD,IL62701 37-1071858	HEALTHCARE	IL	KIARA INC	C Corporation				Yes
(5) PREVEA HEALTH SERVICES INC 2710 EXECUTIVE DRIVE GREEN BAY,WI54304 39-1839351	HEALTHCARE	WI	HSSI	C Corporation	174,464	47,208,492	0.5 %	Yes
(6) PREVEA CLINIC INC 2710 EXECUTVE DRIVE GREEN BAY,WI54304 39-1839349	HEALTHCARE	WI	PHSI	C Corporation				Yes
(7) RENAISSANCE QUALITY INSURANCE LTD PO BOX 1159 GRAND CAYMANKY11102 CJ 98-0669953	INSURANCE	CJ	HSSI	C Corporation	0	105,014,533	1 %	Yes
(8) OJV INC 4936 LAVERNA ROAD SPRINGFIELD,IL62707 46-0873384	HEALTHCARE	IL	LASANTE INC	C Corporation				Yes

Schedule R (Form 990) 2015

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

Yes

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

Yes

k Lease of facilities, equipment, or other assets from related organization(s) ......................

Yes

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2015

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2015

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation
Schedule R, Part V, Line 2 TRANSACTIONS WITH RELATED ENTITIES	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 (Form 990) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v3.0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	1,454,498	429,252
9	Program service revenue (Part VIII, line 2g) .........	71,211,942	67,870,891
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	3,302,159	1,958,538
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	192,761	228,455
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	76,161,360	70,487,136
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...		0
14	Benefits paid to or for members (Part IX, column (A), line 4).....		0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	37,038,343	34,115,396
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	30,002,318	27,626,758
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	67,040,661	61,742,154
19	Revenue less expenses. Subtract line 18 from line 12.......	9,120,699	8,744,982
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	151,101,856	143,907,389
21	Total liabilities (Part X, line 26).............	46,373,200	52,799,890
22	Net assets or fund balances. Subtract line 21 from line 20.....	104,728,656	91,107,499

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 55,623,144 including grants of $ ) (Revenue $ 67,948,870 )
	SEE SCHEDULE O - PROGRAM SERVICE ACCOMPLISHMENTS

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses55,623,144

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)			(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) Lois Klay Vice President (Partial Year)	40.0 .......................0	X		190,421	0	111,520
(19) Chris Klay Division Director	40.0 .......................0	X		151,168	0	38,874
(20) LARRY STUDT PHYSICIAN	40.0 .......................0	X		242,927	0	54,476
(21) LAWRENCE SCHUMACHER Former DIRECTOR	.......................0.0		X	0	1,460,120	72,705

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	1,087,422	3,566,516	1,205,896

1	Briefly describe the organization’s mission or most significant activities: ST. JOSEPH'S MISSION IS TO DELIVER COMPASSIONATE HEALTH CARE TO PEOPLE IN NEED AND TO BE THE PREFERRED CHOICE FOR HEALTH CARE IN THE CHIPPEWA VALLEY.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	11
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	8
5	Total number of individuals employed in calendar year 2015 (Part V, line 2a) ......	5	603
6	Total number of volunteers (estimate if necessary) .............	6	432
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	0

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	187,784
e	Government grants (contributions)		1e	238,468

f	All other contributions, gifts, grants, and similar amounts not included above		1f	3,000

g	Noncash contributions included in lines 1a-1f:$
h Total.Add lines 1a-1f.......		429,252

			Business Code
2a	PATIENT SERVICE REVENUE	900099	67,209,389	67,209,389
b	OTHER DEPARTMENT REVENUE	900099	661,502	661,502
c
d
e
f	All other program service revenue.			0	0	0	0
g Total.Add lines 2a–2f.....			67,870,891

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			548,928			548,928
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		150,476
b	Less: rental expenses
c	Rental income or (loss)	0	150,476
d	Net rental income or (loss)......			150,476			150,476
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory		1,409,610
b	Less: cost or other basis and sales expenses
c	Gain or (loss)	0	1,409,610
d	Net gain or (loss).....			1,409,610			1,409,610
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	GIFT SHOP REVENUE		453220	51,701	51,701
b	CAFETERIA REVENUE		722514	26,278	26,278
c
d	All other revenue ....			0	0	0	0
e	Total. Add lines 11a–11d ......			77,979
12	Total revenue. See Instructions......			70,487,136	67,948,870	0	2,109,014

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	0	0
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	0	0
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16	0	0
4	Benefits paid to or for members	0	0
5	Compensation of current officers, directors, trustees, and key employees ....	219,640	0	219,640	0
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0	0	0	0
7	Other salaries and wages	25,955,527	23,240,273	2,715,254	0
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	1,402,371	1,245,130	157,241	0
9	Other employee benefits .......	4,738,048	4,206,794	531,254	0
10	Payroll taxes ...........	1,799,810	1,598,006	201,804	0
11	Fees for services (non-employees):
a	Management ......	1,059,941	0	1,059,941	0
b	Legal .........	7,197	0	7,197	0
c	Accounting ...........	0	0	0	0
d	Lobbying ...........	0	0		0
e	Professional fundraising services. See Part IV, line 17	0			0
f	Investment management fees ......	0	0	0	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	8,303,993	7,601,720	702,273	0
12	Advertising and promotion ....	266,977	0	266,977	0
13	Office expenses .......	679,694	678,511	1,183	0
14	Information technology ......	4,181,090	4,181,090	0	0
15	Royalties ..	0	0	0	0
16	Occupancy ...........	883,230	883,230	0	0
17	Travel ............	279,888	279,761	127	0
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0	0	0	0
19	Conferences, conventions, and meetings ....	111,859	69,341	42,518	0
20	Interest ...........	224,475	224,475	0	0
21	Payments to affiliates .......	0	0	0	0
22	Depreciation, depletion, and amortization ..	3,409,253	3,362,347	46,906	0
23	Insurance ...	276,757	276,757	0	0
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	CLINICAL SUPPLIES	4,534,099	4,503,941	30,158	0
b	WISCONSIN MEDICAID ASSESSMENT	1,377,256	1,377,256	0	0
c	MAINTENANCE SERVICE	697,189	694,262	2,927	0
d	PROVISION FOR BAD DEBT	189,601	189,601	0	0
e	All other expenses	1,144,259	1,010,649	133,610	0
25	Total functional expenses. Add lines 1 through 24e	61,742,154	55,623,144	6,119,010	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			772,528	1	2,323,113
2	Savings and temporary cash investments .........				2
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			9,513,001	4	9,254,585
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
					5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
					6	0
7	Notes and loans receivable, net ....				7
8	Inventories for sale or use ........			350,195	8	363,220
9	Prepaid expenses and deferred charges ......			111,518	9	0
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	65,382,680
b	Less: accumulated depreciation	10b	35,490,567	31,332,376	10c	29,892,113
11	Investments—publicly traded securities .			108,924,862	11	101,985,930
12	Investments—other securities. See Part IV, line 11 .....			0	12
13	Investments—program-related. See Part IV, line 11 ..			0	13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			97,376	15	88,428
16	Total assets. Add lines 1 through 15 (must equal line 34)...			151,101,856	16	143,907,389

17	Accounts payable and accrued expenses .....	7,546,803	17	6,476,699
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........	18,770,743	20	18,008,807
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..		22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D	20,055,654	25	28,314,384
26	Total liabilities. Add lines 17 through 25..	46,373,200	26	52,799,890

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	94,568,397	27	86,050,074
28	Temporarily restricted net assets ...........	3,731,468	28	2,146,728
29	Permanently restricted net assets	6,428,791	29	2,910,697
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	104,728,656	33	91,107,499
34	Total liabilities and net assets/fund balances ........	151,101,856	34	143,907,389