Form990
Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
A For the 2019 calendar year, or tax year beginning 07-01-2017 , and ending 06-30-2018
BCheck if applicable:
CName of organization
Wheaton Franciscan Healthcare - Southeast Wisconsin Inc
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
400 W River Woods Pkwy
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Glendale, WI53212
D Employer identification number

39-1568865
E Telephone number

G Gross receipts $ 72,392,450
F Name and address of principal officer:
BERNARD SHERRY
400 W River Woods Pkwy
Glendale,WI53212
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
N/A
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 1986
M State of legal domicile: IL
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: TO IMPROVE THE HEALTH AND WELL-BEING OF ALL PEOPLE IN THE COMMUNITES WE SERVE.
2 Check this box MediumBullet
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 10
5 Total number of individuals employed in calendar year 2019 (Part V, line 2a) ...... 5 1,309
6 Total number of volunteers (estimate if necessary) ............. 6 10
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 39 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 1,130,010 29,017
9 Program service revenue (Part VIII, line 2g) ......... 376,476,254 67,470,776
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... -253,667 -1,485,718
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 6,063,623 4,823,876
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 383,416,220 70,837,951
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 1,268,110 0
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 117,316,763 8,332,642
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 226,072,973 64,829,809
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 344,657,846 73,162,451
19 Revenue less expenses. Subtract line 18 from line 12....... 38,758,374 -2,324,500
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 1,074,764,974 208,882,917
21 Total liabilities (Part X, line 26)............. 1,792,470,565 724,750,487
22 Net assets or fund balances. Subtract line 21 from line 20..... -717,705,591 -515,867,570
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2019)
Form 990 (2019)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: OUR MISSION AS PART OF A CATHOLIC HEALTH CARE SYSTEM IS TO FURTHER THE HEALING MINISTRY OF JESUS BY CONTINUALLY IMPROVING THE HEALTH AND WELL-BEING OF ALL PEOPLE, ESPECIALLY THE POOR, IN THE COMMUNITIES WE SERVE.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 53,869,658 including grants of $ 0 ) (Revenue $ 67,470,776 )
PART OF ASCENSION WISCONSIN, WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN, INC. IS THE REGIONAL PARENT ORGANIZATION FOR WHEATON FRANCISCAN HEALTHCARE ENTITIES LOCATED IN THE SOUTHEAST WISCONSIN REGION. WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN PROVIDES SUPPORT FOR OTHER ORGANIZATIONS BY PROVIDING SERVICES SUCH AS FINANCE, ADMINISTRATIVE, HUMAN RESOURCES, BENEFITS MANAGEMENT, LEGAL, AND ORGANIZATIONAL DEVELOPMENT. MIDWEST ORTHOPEDIC SPECIALTY HOSPITAL (MOSH) IS A LICENSED 16-BED FACILITY IN FRANKLIN, WISCONSIN. THE HOSPITAL, WHICH OPENED IN 2009, IS A JOINT VENTURE BETWEEN 24 INDEPENDENT ORTHOPEDIC PHYSICIANS AND WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN, INC. MOSH OFFERS COMPREHENSIVE ORTHOPEDIC SERVICES AND PAIN MANAGEMENT FROM BOARD CERTIFIED PHYSICIANS IN A HIGH TECHNOLOGY SETTING. ANCILLARY SERVICES, SUCH AS RADIOLOGY, LAB, PHARMACY AND REHABILITATION SERVICES, ARE PROVIDED BY WHEATON FRANCISCAN HEALTHCARE - FRANKLIN. THE GOAL IS TO HELP PATIENTS REACH THEIR HIGHEST LEVELS OF STRENGTH, FUNCTION AND INDEPENDENCE. STAFF INCLUDES MEDICAL SPECIALISTS, AS WELL AS PHYSICAL AND OCCUPATIONAL THERAPISTS. TOGETHER, THEY COMBINE EXPERIENCE, SKILL AND KNOWLEDGE WITH LEADING-EDGE TECHNOLOGY TO PROVIDE EXCEPTIONAL INSTRUCTION, TREATMENT AND FOLLOW-UP CARE. A FULL-SERVICE IMAGING DEPARTMENT IS EQUIPPED WITH ADVANCED DIGITAL IMAGING TECHNOLOGY, INCLUDING A CT SCANNER AND MRI ALONG WITH EXPERIENCED, BOARD-CERTIFIED RADIOLOGISTS TO PROVIDE COMPREHENSIVE ORTHOPEDIC CARE. THE PHYSICIANS FOCUS ON 14 AREAS OF ORTHOPEDIC SERVICES, WITH ONE PATIENT-FOCUSED APPROACH. UPON OPENING THE HOSPITAL, THE PHYSICIANS AND STAFF SIGNED A COMMITMENT STATEMENT THAT PROMISED PATIENTS THREE THINGS: 1) THAT EVERYTHING THEY DO IS FOR THE PATIENT'S HEALTH AND COMFORT; 2) THAT THEY PERFORM ALL CLINICAL AND TECHNICAL REQUIREMENTS TO THE BEST OF THEIR ABILITY; 3) AND THAT THEY ESTABLISH A CULTURE OF MUTUAL RESPECT AMONG PHYSICIANS AND EMPLOYEES TO BUILD THE BEST POSSIBLE PATIENT EXPERIENCE. AS A RESULT, PATIENT SATISFACTION SCORES HAVE ROUTINELY BEEN IN THE 90TH PERCENTILE IN EVERY CATEGORY FOR SEVERAL YEARS, AND FOR THIS MOSH HAS ALSO WON THE PRESTIGIOUS PRESS GANEY SUMMIT AWARD AND GUARDIAN OF EXCELLENCE AWARD FOR BOTH PATIENT SATISFACTION AND CLINICAL QUALITY.
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 expensesMediumBullet53,869,658
Form 990 (2019)
Form 990 (2019)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment.........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C, Part III..
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part I.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part II....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D, Part III..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IV..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part V......
10
 
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D, Part VI. Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VII.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
Yes
 
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII......................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I(see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....
21
 
No
Form 990 (2019)
Form 990 (2019)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I ....
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part II...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part III.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....
28b
 
No
c
A 35% controlled entity of one or more individuals and/or organizations described in lines 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
 
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2.............
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VI
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable ..
1a
41
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2019)
Form 990 (2019)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
1,309
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
Yes
 
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see instructions and file Form 4720, Schedule N.
15
 
 
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
 
Form 990 (2019)
Form 990 (2019)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
11
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
10
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
 
No
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
 
No
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filedMediumBullet
WI
18
Section 6104 requires an organization to make its Form 1023 (or 1024-A if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletSARA OBRIEN11775 BORMAN DRIVE   MARYLAND HEIGHTS,MO63146 (314) 733-8070
Form 990 (2019)
Form 990 (2019)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

See instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(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) 		(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
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) WILLIAM C WERNER
 
CHAIR
 1.0
.................
2.0 		X   X       0 0 0
(2) ROBERT J VENABLE
 
VICE CHAIR
 1.0
.................
2.0 		X   X       0 0 0
(3) RANDALL PERRY
 
SECRETARY
 1.0
.................
2.0 		X   X       0 0 0
(4) KURT D VELDHUIZEN CPA
 
TREASURER
 1.0
.................
2.0 		X   X       0 0 0
(5) BERNARD J SHERRY
 
EX-OFFICIO - SR VP ASCENSION WI
 0.0
.................
50.0 		X   X       0 2,088,531 45,582
(6) SISTER M THERESE GOTTSCHALK
 
BOARD MEMBER
 1.0
.................
4.0 		X           0 0 0
(7) JOHN BYKOWSKI
 
BOARD MEMBER
 1.0
.................
3.0 		X           0 0 0
(8) JOHN SPLUDE
 
BOARD MEMBER
 1.0
.................
2.0 		X           0 0 0
(9) PATRICIA DOLHUN MD
 
BOARD MEMBER
 1.0
.................
2.0 		X           0 0 0
(10) TRACY JOHNSON
 
BOARD MEMBER
 1.0
.................
2.0 		X           0 0 0
(11) SISTER ANDREA LEE
 
BOARD MEMBER
 1.0
.................
2.0 		X           0 0 0
(12) JONATHAN SOHN
 
CFO - ASCENSION, WI
 2.0
.................
48.0 		    X       0 903,904 48,367
(13) JOAN M BACHLEITNER
 
CHIEF STRATEGY OFFICER - ASCENSION WI
 15.0
.................
35.0 		      X     0 446,988 44,242
(14) TIMOTHY L BELEC
 
WI MARKET INFOMATION OFFICER
 10.0
.................
40.0 		      X     0 369,674 17,272
(15) LISA S BENSON MD
 
CHIEF QUAILITY OFFICER - ASCENSION, WI
 10.0
.................
40.0 		      X     0 510,066 20,485
(16) VINCENT GALLUCCI
 
CHIEF MARKETING OFFICER - ASCENSION WI
 10.0
.................
40.0 		      X     0 547,511 19,891
(17) SARAH HERZOG
 
CHIEF LEGAL OFFICER - ASCENSION WI
 5.0
.................
45.0 		      X     0 678,124 43,604
Form 990 (2019)
Form 990 (2019)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(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) 		(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
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) DOUGLAS REDING MD
 
CHIEF MEDICAL OFFICER - ASCENSION WI
 10.0
.......................40.0 		      X     0 647,638 40,758
(19) THERESE M ROCOLE
 
CHIEF MISSION INTEGRATION OFFICER - ASCENSION WI
 15.0
.......................35.0 		      X     0 425,644 19,594
(20) Tracy A Rogers
 
CHIEF OPERATING OFFICER - ASCENSION WI
 14.0
.......................36.0 		      X     0 1,696,876 51,047
(21) LYNN SCHUSTER
 
SR DIRECTOR REGIONAL RISK MANAGEMENT
 10.0
.......................40.0 		      X     0 277,187 39,461
(22) CELIA SHAUGHNESSY
 
VP-HUMAN RESOURCES - WI, MI MARKET
 5.0
.......................45.0 		      X     0 511,669 31,898
(23) DEBRA STANDRIDGE
 
REGIONAL PRESIDENT - ASCENSION WI
 5.0
.......................45.0 		      X     0 825,914 36,007
(24) TOM E VEESER
 
CHIEF NURSING OFFICER - ASCENSION WI
 15.0
.......................35.0 		      X     0 439,962 40,307
(25) TRAVIS D ANDERSEN
 
REGIONAL PRESIDENT - ASCENSION WI
 5.0
.......................45.0 		      X     0 1,367,565 44,454
(26) YATA A NAIGOW
 
WSST RN SPECIALTY
 50.0
.......................0 		        X   229,158 0 26,823
(27) MARY JOANNE WODICKA
 
VP - HUMAN RESOURCES
 50.0
.......................0 		        X   171,013 0 25,668
(28) MARK J CHARBOGIAN
 
VP - LAB SERVICES SE WI
 50.0
.......................0.0 		        X   168,764 0 0
(29) JAY D RICE
 
VP - PHARMACIES
 50.0
.......................0 		        X   164,850 0 0
(30) MICHELLE L JONES
 
DIR PATIENT ACCESS & FIN SVCS
 50.0
.......................0 		        X   156,387 0 11,786
(31) JULIE E SWIDERSKI
 
FORMER KEY EMPLOYEE (END 6/2016)
 0.0
.......................50.0 		          X 0 408,685 36,440
(32) SUSAN BOLAND
 
FORMER OFFICER (END 4/2017)
 0.0
.......................0.0 		          X 557,653 0 14,315
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 1,447,825 12,145,938 658,001
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet22
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
AMPHION MEDICAL SOLUTIONS

8301 EXCELSIOR DRIVE
MADISON,WI53717 		MEDICAL RECORDS TRANSCRIPTION SERVICES 300,933
TRUST HEALTHCARE SERVICES LLC

2305 S BLACKMAN ROAD
SUITE D
SPRINGFIELD,WI658092809 		CONSULTING AND STAFFING SERVICES 257,380
AMERIPATH MILWAUKEE SC

12805 W BURLEIGH ROAD
SUITE 200
BROOKFIELD,WI530053111 		PATHOLOGY SERVICES 255,938
HARMONY HEALTHCARE LLC

2909 W BAY TO BAY BLVD
SUITE 500
TAMPA,FL336298178 		STAFFING AND CONSULTING SERVICES 125,925
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet4
Form 990 (2019)
Form 990 (2019)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a 0
b Membership dues..1b 0
c Fundraising events..1c 0
d Related organizations1d 20,016
e Government grants (contributions)1e 8,736
f All other contributions, gifts, grants, and similar amounts not included above1f 265
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f.......MediumBullet 29,017
Program Service RevenueAmt Business Code
2a MANAGEMENT FEES TO AFFILIATES 561000 50,073,212 50,073,212    
b INCOME FROM JOINT VENTURE 900099 17,098,553 17,098,553    
c ELECTRONIC HEALTH RECORDS 900099 256,043 256,043    
d SERVICES TO AFFILIATES 900099 42,968 42,968    
e
f All other program service revenue. 0 0 0 0
g Total. Add lines 2a–2f .....MediumBullet 67,470,776
OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 54,206     54,206
4 Income from investment of tax-exempt bond proceedsMediumBullet 0     0
5 Royalties...........MediumBullet 0     0
(ii) Personal (i) Real
6a Gross rents 0 472,871 6a
b Less: rental expenses   0 6b
c Rental income or (loss) 0 472,871 6c
d Net rental income or (loss).......MediumBullet 472,871     472,871
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory 14,575 0 7a
b Less: cost or other basis and sales expenses 1,554,499   7b
c Gain or (loss) -1,539,924 0 7c
d Net gain or (loss).........MediumBullet -1,539,924     -1,539,924
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a  
b Less: direct expenses ... 8b  
c Net income or (loss) from fundraising events..MediumBullet 0   0
9a Gross income from gaming activities.
See Part IV, line 19 ...
9a  
b Less: direct expenses ... 9b  
c Net income or (loss) from gaming activities..MediumBullet 0     0
10a Gross sales of inventory, less
returns and allowances ..
10a 0
b Less: cost of goods sold .. 10b 0
c Net income or (loss) from sales of inventory..MediumBullet 0     0
Business Code Miscellaneous Revenue
11a MEDICAL RECORDS FEES 900099 460,575     460,575
b CAFETERIA/VENDING REVENUEQ 722514 199,280     199,280
c ESCHEATMENT REVENUE 900099 384     384
d All other revenue .... 3,690,766 0 0 3,690,766
e Total. Add lines 11a–11d ...... MediumBullet 4,351,005
12 Total revenue. See instructions.....MediumBullet 70,837,951 67,470,776 0 3,338,158
Form 990 (2019)
Form 990 (2019)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....    
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ...........    
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............    
4 Benefits paid to or for members .......    
5 Compensation of current officers, directors, trustees, and key employees ...........        
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........        
7 Other salaries and wages........ 9,119,069 5,861,453 3,257,616  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....        
9 Other employee benefits ....... -1,990,413 -1,279,375 -711,038  
10 Payroll taxes ........... 1,203,986 773,885 430,101  
11 Fees for services (non-employees):        
a Management ...... -114,763 3,677 -118,440  
b Legal .........        
c Accounting ........... -2,245   -2,245  
d Lobbying ........... 4,218   4,218  
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ......        
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 215,967 152,840 63,127 0
12 Advertising and promotion .... 34,358 31,838 2,520  
13 Office expenses ....... 104,326 14,237 90,089  
14 Information technology ...... 31,050 31,050    
15 Royalties ..        
16 Occupancy ........... 1,278,792 1,023,034 255,758  
17 Travel ............ 26,687 15,413 11,274  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 51,263 48,935 2,328  
20 Interest ........... 128,774 103,019 25,755  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 25,671,666 20,537,333 5,134,333  
23 Insurance ...        
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 PURCHASED SERVICES 33,169,902 26,535,922 6,633,980  
b NON RECURRING EXPENSES 2,175,029   2,175,029  
c COLLECTION AGENCY FEES 1,693,520   1,693,520  
d CONTRACT LABOR 216,335   216,335  
e All other expenses 144,930 16,397 128,533 0
25 Total functional expenses. Add lines 1 through 24e 73,162,451 53,869,658 19,292,793 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 MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2019)
Form 990 (2019)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 31,209,491 1 1,852
2 Savings and temporary cash investments ......... 0 2 9,624,560
3 Pledges and grants receivable, net ...... 0 3 0
4 Accounts receivable, net ............. 4,874,555 4 136,073
5 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
0 6 0
7 Notes and loans receivable, net ........... 140,836,628 7 917,331
8 Inventories for sale or use ............ 0 8 0
9 Prepaid expenses and deferred charges ...... 11,647,907 9 3,639,919
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 80,275,309
b Less: accumulated depreciation 10b 30,653,898 60,870,587 10c 49,621,411
11 Investments—publicly traded securities . 0 11 0
12 Investments—other securities. See Part IV, line 11 ..... 0 12  
13 Investments—program-related. See Part IV, line 11 .. 58,454,027 13 56,802,579
14 Intangible assets ............... 70,245,121 14 54,423,774
15 Other assets. See Part IV, line 11 ........... 696,626,658 15 33,715,418
16 Total assets. Add lines 1 through 15 (must equal line 33)... 1,074,764,974 16 208,882,917
Liabilities 17 Accounts payable and accrued expenses ..... 39,675,081 17 16,539,661
18 Grants payable ... 0 18 0
19 Deferred revenue ......... 643,723 19 288,292
20 Tax-exempt bond liabilities ......... 0 20 0
21 Escrow or custodial account liability. Complete Part IV of Schedule D 0 21 0
22 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 0 23 0
24 Unsecured notes and loans payable to unrelated third parties .. 0 24 0
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 1,752,151,761 25 707,922,534
26 Total liabilities. Add lines 17 through 25.. 1,792,470,565 26 724,750,487
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions ..........   27  
28 Net assets with donor restrictions ...........   28  
Organizations that do not follow FASB ASC 958, check here MediumBullet and complete lines 29 through 33.
29 Capital stock or trust principal, or current funds .....   29  
30 Paid-in or capital surplus, or land, building or equipment fund ...   30  
31 Retained earnings, endowment, accumulated income, or other funds   31  
32 Total net assets or fund balances ........... -717,705,591 32 -515,867,570
33 Total liabilities and net assets/fund balances ........ 1,074,764,974 33 208,882,917
Form 990 (2019)
Form 990 (2019)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
70,837,951
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
73,162,451
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-2,324,500
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
-717,705,591
5
Net unrealized gains (losses) on investments ...............
5
 
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
204,162,521
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
-515,867,570
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
 
No
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
 
 
Form 990 (2019)
Form 990 (2019)
Additional Data


Software ID: 17005876
Software Version: 2017v2.2
Form 990, Special Condition Description:
Special Condition Description
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 Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
Wheaton Franciscan Healthcare - Southeast Wisconsin Inc
 
Employer identification number

39-1568865
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 12, check only one box.)
1
2
3
4
5
6
7
8
9
10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................9
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
(A) ASCENSION SE WISCONSIN HOSPITAL INC (FKA WHEATON FRANCISCAN INC)
  		390816857 3   No 3,546,075 0
(B) ASCENSION ALL SAINTS HOSPITAL INC (FKA WHEATON FRANCISCAN HEALTHCARE - ALL
SAINTS INC) 		391264986 3   No 13,084,140 0
(C) ASCENSION ST FRANCIS HOSPITAL INC (FKA WHEATON FRANCISCAN HEALTHCARE - ST F
RANCIS INC) 		390907740 3   No 1,405,852 0
(D) WHEATON FRANCISCAN HEALTHCARE - FRANKLIN INC
  		562592868 3   No 8,494,447 0
(E) ASCENSION WISCONSIN PHARMACY INC (FKA WHEATON FRANCISCAN HEALTHCARE PHARMAC
Y ENTERPRISES AND FRANCISCAN WOODS INC) 		391613624 9   No 2,071,042 0
(F) ASCENSION MEDICAL GROUP-SOUTHEAST WISCONSIN INC (FKA WHEATON FRANCISCAN MED
ICAL GROUP INC) 		391791586 3   No 13,995,999 0
(G) ASCENSION WISCONSIN LABORATORIES INC (FKA WHEATON FRANCISCAN LABORATORIES I
NC) 		391701402 9   No 706,058 0
Total
7
 43,303,613 0
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
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 failed to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..            
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) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (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  
12
12
 
13
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
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (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) right arrow (a) 2015 (b) 2016 (c) 2017 (d) 2018 (e) 2019 (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.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
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.
1
 
No
2
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).
2
 
No
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
No
b
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.
3b
 
 
c
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.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.
4a
 
No
b
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.
4b
 
 
c
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.
4c
 
 
5a
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).
5a
 
No
b
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?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
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.
6
Yes
 
7
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) .
7
 
No
8
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).
8
 
No
9a
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.
9a
 
No
b
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.
9b
 
No
c
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.
9c
 
No
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
 
No
b
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) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
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
 
No
b
A family member of a person described in (a) above?
11b
 
No
c
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
 
No
Section B. Type I Supporting Organizations
Yes
No
1
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.
1
 
 
2
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.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
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).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
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?
1
Yes
 
2
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).
2
Yes
 
3
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.
3
Yes
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
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.
2a
 
 
b
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.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
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.
3a
Yes
 
b
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.
3b
Yes
 
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
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  
7
Schedule A (Form 990 or 990-EZ) 2019

Schedule A (Form 990 or 990-EZ) 2019
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 2019 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-2019 		(iii)
Distributable
Amount for 2019
1 Distributable amount for 2019 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI).
See instructions.		  
3 Excess distributions carryover, if any, to 2019:
a From 2014.......  
b From 2015.......  
c From 2016.......  
d From 2017.......  
e From 2018.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2019 distributable amount  
i Carryover from 2014 not applied (see
instructions) 		 
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2019 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2019 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2019, if any. Subtract lines 3g and 4a from line 2.
If the amount is greater than zero, explain in Part VI.
See instructions.		  
6 Remaining underdistributions for 2019. Subtract
lines 3h and 4b from line 1. If the amount is greater
than zero, explain in Part VI. See instructions.		  
7 Excess distributions carryover to 2020. Add lines
3j and 4c.		  
8 Breakdown of line 7:
a Excess from 2015.....  
b Excess from 2016.....  
c Excess from 2017.....  
d Excess from 2018.....  
e Excess from 2019.....  
Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019
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, Part IV, Section A, Line 1 Supported Orgs Listed By Name OUR SUPPORTED ORGANIZATIONS ARE NOT NORMALLY LISTED BY NAME IN THE GOVERNING DOCUMENTS. WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN, INC. IS A TIER II PARENT ORGANIZATION, AND DUE TO LONG-STANDING HISTORICAL RELATIONSHIPS AS WELL AS RELATIONSHIPS THAT ARE OFFICIALLY DELINEATED IN OUR ORGANIZATIONAL CHART, SUPPORTS ALL ORGANIZATIONS AT THE TIER III LEVEL THAT ARE NOT THEMSELVES SUPPORTING ORGANIZATIONS. WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN, INC. PROVIDES THIS SUPPORT BY WAY OF CORPORATE OVERSIGHT AND RELATED ADMINISTRATIVE AND PROGRAM SERVICES SUCH AS PAYROLL, HUMAN RESOURCES, LEGAL SERVICES, AND MANY OTHERS, WHICH RESULT IN MONETARY EQUITY TRANSFERS AND INTERCOMPANY JOURNAL ENTRIES THAT PROVIDE "SUPPORT".
Schedule A, Part IV, Section A, Line 6 Support to other supported orgs WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN, INC. IS A TIER II PARENT ORGANIZATION THAT IS PART OF A CONTROLLED GROUP OF HEALTHCARE PROVIDER ORGANIZATIONS. AS SUCH, IT IS COMMON TO HAVE INTERCOMPANY JOURNAL ENTRIES THAT RESULT IN SUPPORT BEING PROVIDED TO OTHER SUPPORTING ORGANIZATIONS WITHIN THE GROUP, THAT MAY PROVIDE ADDITIONAL SUPPORT TO ONE OR MORE OF THE SAME SUPPORTED ORGANIZATION. ADDITIONALLY, WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN, INC. PROVIDES CERTAIN SUPPORT TO A 50% OWNED JOINT VENTURE UNDER A PURCHASED SERVICES AGREEMENT.
Schedule A, Part IV, Section D, Line 3 Supp. Org. Have Significant Voice In Investment Policies BY VIRTUE OF OVERLAPPING BOARD MEMBERS, THE SUPPORTED ORGANIZATIONS HAVE A SIGNIFICANT VOICE IN THE SUPPORTING ORGANIZATION'S DAILY OPERATIONS. THE INVESTMENTS ARE HELD AT THE NATIONAL SYSTEM OFFICE BY ASCENSION HEALTH. THE ASCENSION SPONSOR, THROUGH ITS CONTROL OF THE ASCENSION BOARD, CONTROLS THE SYSTEM'S INTEGRATED STRATEGIC OPERATIONAL FINANCIAL PLAN, ANNUAL TARGETS AND INITIATIVES. WITHIN THIS OPERATIONAL FRAMEWORK, CERTAIN EXPENDITURES OF FUNDS, CAPITAL INVESTMENTS, ISSUANCE OF DEBT, ETC. ARE SUBJECT TO ASCENSION-LEVEL APPROVAL.
Schedule A, Part IV, Section E, Line 3a Power To Appoint/Elect Majority of Officer/Director/Trustee WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN, INC. AND ITS SUPPORTED ORGANIZATIONS HAVE SEVERAL MEMBERS OF ITS GOVERNING BODIES THAT SERVE ON COMMON BOARDS. THESE MEMBERS HOLD RESERVED POWERS THAT INCLUDE, BUT ARE NOT LIMITED TO, THE ELECTION OF MEMBERS OF THE GOVERNING BODY AND ELECTION OF OFFICERS.
Schedule A, Part IV, Section E, Line 3b Substantial Direction Over Policies/Programs/Activities WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN, INC. AND ITS SUPPORTED ORGANIZATIONS HAVE SEVERAL MEMBERS OF ITS GOVERNING BODIES THAT SERVE ON COMMON BOARDS. THESE MEMBERS HOLD RESERVED POWERS THAT INCLUDE, BUT ARE NOT LIMITED TO, APPROVAL OF CERTAIN FINANCIAL EXPENDITURES IN ACCORDANCE WITH POLICIES AND PROCEDURES, AND APPROVAL OF BUDGETS AND STRATEGIC PLANS.
Schedule A (Form 990 or 990-EZ) 2019


Additional Data


Software ID: 17005876
Software Version: 2017v2.2
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Name of the organization
Wheaton Franciscan Healthcare - Southeast Wisconsin Inc
 
Employer identification number

39-1568865
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ






Form 990-PF




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
Special Rules
......... Arrow Bullet $  
Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2
Name of organization
Wheaton Franciscan Healthcare - Southeast Wisconsin Inc
  		Employer identification number
39-1568865
Part I
Contributors
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
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Page 3
Name of organization
Wheaton Franciscan Healthcare - Southeast Wisconsin Inc
  		Employer identification number

39-1568865
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) (2019)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)
Page 4
Name of organization
Wheaton Franciscan Healthcare - Southeast Wisconsin Inc
  		Employer identification number

39-1568865
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 $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I		 (b) Purpose of gift (c) Use 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 (c) Use 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 (c) Use 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 (c) Use 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) (2019)

Additional Data


Software ID: 17005876
Software Version: 2017v2.2
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 BulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
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
Wheaton Franciscan Healthcare - Southeast Wisconsin Inc
 
Employer identification number

39-1568865
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

2
Political campaign activity expenditures (see instructions) ....................................................................SchCMd Bullet
$  
3
Volunteer hours for political campaign activities (see instructions) ..................................................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 ................................SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 .......................SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................
4a
Was a correction made? ......................................................................................................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b...........SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
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) 2019

Schedule C (Form 990 or 990-EZ) 2019
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 Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(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? ...................................................................................................................

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) 2016 (b) 2017 (c) 2018 (d) 2019 (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) 2019


Schedule C (Form 990 or 990-EZ) 2019
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|No
(b)
Amount
1
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:
a
Volunteers? ...........................................................................................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
Yes
 
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
 
No
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
Yes
 
42,377
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
4,218
j
Total. Add lines 1c through 1i ....................................................................................................
46,595
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
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
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
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."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
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? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) .........................................
5
 
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 ASCENSION WISCONSIN WAS PART OF A CONTROLLED GROUP OF HEALTHCARE ORGANIZATIONS RELATED THROUGH A COMMON PARENT ORGANIZATION. CERTAIN ENTITIES WITHIN THIS CONTROLLED GROUP ENGAGED IN LIMITED LOBBYING ACTIVITIES THAT BENEFITED EACH ORGANIZATION COLLECTIVELY. FOR CALENDAR YEAR 2017, TWO INDIVIDUALS WERE EMPLOYED WHOSE RESPONSIBILITIES INCLUDED OVERSIGHT AND MANAGEMENT OF LOBBYING ACTIVITIES FOR THESE ORGANIZATIONS - THE VICE PRESIDENT AND CHIEF ADVOCACY OFFICER AND THE DIRECTOR OF GOVERNMENT RELATIONS AND ADVOCACY. THE VICE PRESIDENT PROVIDED STRATEGIC OVERSIGHT FOR THE DEPARTMENT AND PARTICIPATED IN VISITS WITH KEY ELECTED OFFICIALS WHEN APPROPRIATE. THE DIRECTOR PROVIDED ON-THE-GROUND SUPPORT, SERVED AS THE FIRST POINT OF CONTACT FOR ELECTED OFFICIALS, AND EXECUTED ON LEGISLATIVE LOBBYING ACTIVITIES THAT SUPPORTED THE STRATEGIC INTERESTS OF THE ORGANIZATION. WE ESTIMATE THESE LOBBYING ACTIVITIES APPROXIMATED 50% OF TOTAL ANNUAL SALARY FOR THE DIRECTOR AND 25% FOR THE VICE PRESIDENT. A BENEFITS FACTOR OF 25% WAS ADDED, AND THE TOTAL WAS ALLOCATED AMONGST THE ORGANIZATIONS THAT RECEIVED THE BENEFIT OF THESE SERVICES. THE LOBBYING ACTIVITIES INCLUDED ADVOCACY EFFORTS RELATED TO PUBLIC POLICY PROPOSALS SUCH AS: CHANGES TO MEDICARE AND MEDICAID FUNDING; FEDERAL OR STATE LEGISLATION THAT MAY IMPACT THE ORGANIZATIONS IN WISCONSIN; PARTICIPATING IN AND COORDINATING VISITS WITH ELECTED OFFICIALS AT ALL LEVELS OF GOVERNMENT (LOCAL, STATE AND FEDERAL); MOBILIZING GRASSROOTS EFFORTS ON BEHALF OF THE ORGANIZATION ON ISSUES OF IMPORTANCE; COORDINATING ADVOCACY ACTIVITIES IN CONJUNCTION WITH RELEVANT TRADE ASSOCIATIONS; AND PROVIDING INTERNAL AWARENESS ON SPECIFIC STATE-RELATED LEGISLATIVE ISSUES WHEN THE NEED ARISES. FINALLY, ANY TRADE ASSOCIATION DUES CONTAINING A PERCENTAGE PORTION ALLOCABLE TO LOBBYING ACTIVITIES, HAS BEEN IDENTIFIED, AND INCLUDED WHERE APPROPRIATE.
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY ASCENSION WISCONSIN WAS PART OF A CONTROLLED GROUP OF HEALTHCARE ORGANIZATIONS RELATED THROUGH A COMMON PARENT ORGANIZATION. CERTAIN ENTITIES WITHIN THIS CONTROLLED GROUP ENGAGED IN LIMITED LOBBYING ACTIVITIES THAT BENEFITED EACH ORGANIZATION COLLECTIVELY. FOR CALENDAR YEAR 2017, TWO INDIVIDUALS WERE EMPLOYED WHOSE RESPONSIBILITIES INCLUDED OVERSIGHT AND MANAGEMENT OF LOBBYING ACTIVITIES FOR THESE ORGANIZATIONS - THE VICE PRESIDENT AND CHIEF ADVOCACY OFFICER AND THE DIRECTOR OF GOVERNMENT RELATIONS AND ADVOCACY. THE VICE PRESIDENT PROVIDED STRATEGIC OVERSIGHT FOR THE DEPARTMENT AND PARTICIPATED IN VISITS WITH KEY ELECTED OFFICIALS WHEN APPROPRIATE. THE DIRECTOR PROVIDED ON-THE-GROUND SUPPORT, SERVED AS THE FIRST POINT OF CONTACT FOR ELECTED OFFICIALS, AND EXECUTED ON LEGISLATIVE LOBBYING ACTIVITIES THAT SUPPORTED THE STRATEGIC INTERESTS OF THE ORGANIZATION. WE ESTIMATE THESE LOBBYING ACTIVITIES APPROXIMATED 50% OF TOTAL ANNUAL SALARY FOR THE DIRECTOR AND 25% FOR THE VICE PRESIDENT. A BENEFITS FACTOR OF 25% WAS ADDED, AND THE TOTAL WAS ALLOCATED AMONGST THE ORGANIZATIONS THAT RECEIVED THE BENEFIT OF THESE SERVICES. THE LOBBYING ACTIVITIES INCLUDED ADVOCACY EFFORTS RELATED TO PUBLIC POLICY PROPOSALS SUCH AS: CHANGES TO MEDICARE AND MEDICAID FUNDING; FEDERAL OR STATE LEGISLATION THAT MAY IMPACT THE ORGANIZATIONS IN WISCONSIN; PARTICIPATING IN AND COORDINATING VISITS WITH ELECTED OFFICIALS AT ALL LEVELS OF GOVERNMENT (LOCAL, STATE AND FEDERAL); MOBILIZING GRASSROOTS EFFORTS ON BEHALF OF THE ORGANIZATION ON ISSUES OF IMPORTANCE; COORDINATING ADVOCACY ACTIVITIES IN CONJUNCTION WITH RELEVANT TRADE ASSOCIATIONS; AND PROVIDING INTERNAL AWARENESS ON SPECIFIC STATE-RELATED LEGISLATIVE ISSUES WHEN THE NEED ARISES. FINALLY, ANY TRADE ASSOCIATION DUES CONTAINING A PERCENTAGE PORTION ALLOCABLE TO LOBBYING ACTIVITIES, HAS BEEN IDENTIFIED, AND INCLUDED WHERE APPROPRIATE.
Schedule C (Form 990 or 990EZ) 2019


Additional Data


Software ID: 17005876
Software Version: 2017v2.2

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet 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.
SchDMd Bullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
Wheaton Franciscan Healthcare - Southeast Wisconsin Inc
 
Employer identification number

39-1568865
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 ........    
5
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? ............
6
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? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
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.
Held at the End of the 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 7/25/06, and not on a historic structure listed in the National Register ... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
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)? .............................
9
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.
1a
If the organization elected, as permitted under FASB 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.
b
If the organization elected, as permitted under FASB 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 $  
2
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 FASB ASC 958 relating to these items:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
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) 2019

Schedule D (Form 990) 2019
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
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):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
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?...
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.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
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  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
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 ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Term endowment SchDMd Bullet  
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .................
3a(i)
 
 
(ii) Related organizations .................
3a(ii)
 
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
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 .....   6,623,540 6,623,540
b Buildings ....   33,573,899 3,790,472 29,783,427
c Leasehold improvements   11,700 11,700 0
d Equipment ....   37,579,021 26,344,321 11,234,700
e Other .....   2,487,149 507,405 1,979,744
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 49,621,411
Schedule D (Form 990) 2019

Schedule D (Form 990) 2019
Page 3
Part VII
Investments—Other 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
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program 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)INVESTMENT MIDWEST ORTHOPEDIC 56,802,579  
(2)Investment in Cyclotron    
(3)Equity Investment in.    
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet 56,802,579
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)DUE FROM AFFILIATES 28,588,539
(2)OTHER ASSETS  
(3)OTHER RECEIVABLES 5,111,681
(4)SECURITY DEPOSIT 14,244
(5)OTHER MISCELLANEOUS ASSETS 954
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 33,715,418
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 0
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 707,922,534
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) 2019

Schedule D (Form 990) 2019
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 THE SYSTEM ACCOUNTS FOR UNCERTAINTY IN INCOME TAX POSITIONS BY APPLYING A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE SYSTEM HAS DETERMINED THAT NO MATERIAL UNRECOGNIZED TAX BENEFITS OR LIABILITIES EXIST AS OF JUNE 30, 2018.
Schedule D (Form 990) 2019


Additional Data


Software ID: 17005876
Software Version: 2017v2.2




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
Wheaton Franciscan Healthcare - Southeast Wisconsin Inc
 
Employer identification number

39-1568865
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
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.
3
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.
a
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:
3a
Yes
 
b
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: . . . . . . . .
3b
Yes
 
%
c
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.
4
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"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
Yes
 
c
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? . . . . . . . . . . . . .
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
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) . . . 		    42,106 0 42,106 0.21 %
b Medicaid (from Worksheet 3, column a) . . . . .     2,055,720 1,330,689 725,031 3.64 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .         0 0 %
d Total Financial Assistance and Means-Tested Government Programs . . . . . 0 0 2,097,826 1,330,689 767,137 3.85 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).         0 0 %
f Health professions education (from Worksheet 5) . . .     12,679 0 12,679 0.06 %
g Subsidized health services (from Worksheet 6) . . . .         0 0 %
h Research (from Worksheet 7) .         0 0 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .         0 0 %
j Total. Other Benefits . . 0 0 12,679 0 12,679 0.06 %
k Total. Add lines 7d and 7j . 0 0 2,110,505 1,330,689 779,816 3.91 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
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 0 0 0 0 %
2 Economic development 0 0 0 0 0 0 %
3 Community support 0 0 0 0 0 0 %
4 Environmental improvements 0 0 0 0 0 0 %
5 Leadership development and
training for community members		 0 0 0 0 0 0 %
6 Coalition building 0 0 0 0 0 0 %
7 Community health improvement advocacy 0 0 0 0 0 0 %
8 Workforce development 0 0 0 0 0 0 %
9 Other 0 0 0 0 0 0 %
10 Total 0 0 0 0 0 0 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
217,688
3
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. ......
3
4,354
4
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
5
Enter total revenue received from Medicare (including DSH and IME).....
5
8,200,535
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
7,194,002
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
1,006,533
8
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:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
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 .........................

9b

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 %
1MIDWEST ORTHOPEDIC SPECIALTY HOSPITAL LLC
  		ORTHOPEDIC HOSPITAL 50 %   50 %
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
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?1Name, 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) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 MIDWEST ORTHOPEDIC SPECIALTY HOSPITAL
10101 S 27TH STREET 2ND FLOOR
FRANKLIN,WI53132
https://www.mymosh.com/locations/mosh/
1070 (WI) 		X X       X     ORTHOPEDIC ROTATION 1
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
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)
1
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): 		1
Yes No
Community Health Needs Assessment
1 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?........................ 1   No
2 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............... 2   No
3 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...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 15
5 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 ................. 5 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.................................. 6a Yes  
b 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. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 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. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): https://www.mymosh.com/locations/mosh/
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 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   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c 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) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
1
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 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):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
https://www.mymosh.com/your-visit/after-your-visit/#billing
b
https://www.mymosh.com/your-visit/after-your-visit/#billing
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
1
Name of hospital facility or letter of facility reporting group  
Yes No
17 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 nonpayment?.................................. 17 Yes  
18 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:
a
b
c
d
e
f
19 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 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):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
1
Name of hospital facility or letter of facility reporting group  
Yes No
22 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.
a
b
c
d
23 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? ............................... 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 8
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, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 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 3E TO BETTER TARGET COMMUNITY RESOURCES ON THE SERVICE AREA'S MOST PRESSING HEALTH NEEDS, THE HOSPITAL PARTICIPATED IN A GROUP DISCUSSION WITH ORGANIZATIONAL DECISION MAKERS AND COMMUNITY LEADERS TO PRIORITIZE THE SIGNIFICANT COMMUNITY HEALTH NEEDS WHILE CONSIDERING SEVERAL CRITERIA: ALIGNMENT WITH ASCENSION HEALTH STRATEGIES OF HEALTHCARE THAT LEAVES NO ONE BEHIND; CARE FOR THE POOR AND VULNERABLE; OPPORTUNITIES FOR PARTNERSHIP; AVAILABILITY OF EXISTING PROGRAMS AND RESOURCES; ADDRESSING DISPARITIES OF SUBGROUPS; AVAILABILITY OF EVIDENCE-BASED PRACTICES; AND COMMUNITY INPUT. THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AS IDENTIFIED THROUGH THE CHNA. SEE SCHEDULE H, PART V, LINE 7 FOR THE LINK TO THE CHNA AND SCHEDULE H, PART V, LINE 11 FOR HOW THOSE NEEDS ARE BEING ADDRESSED.
Schedule H, Part V, Section B, Line 5 Facility 1, 1 Facility 1, 1 - MIDWEST ORTHOPEDIC SPECIALTY HOSPITAL. WHEATON FRANCISCAN HEALTHCARE PARTNERED WITH THE MILWAUKEE HEALTH CARE PARTNERSHIP WHICH INCLUDES AURORA HEALTH CARE, CHILDREN'S HOSPITAL OF WISCONSIN, COLUMBIA ST. MARY'S HEALTH SYSTEM, FROEDTERT HEALTH AND PUBLIC HEALTH DEPARTMENTS TO COLLABORATIVELY CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT. THIRD-PARTY ORGANIZATIONS, JKV RESEARCH, LLC AND CENTER FOR URBAN POPULATION HEALTH WERE CONTRACTED TO HELP CONDUCT THE ASSESSMENT. THE ASSESSMENT CONSISTED OF 3 KEY PROCESSES IN ORDER TO OBTAIN DATA, A TELEPHONE HEALTH SURVEY, SECONDARY DATA RESEARCH AND KEY INFORMANT INTERVIEWS AND FOCUS GROUPS. A TOTAL OF 1,967 TELEPHONE INTERVIEWS WERE COMPLETED BETWEEN MARCH 16 AND JULY 14, 2015 FOR MILWAUKEE COUNTY INCLUDING 1,200 INTERVIEWS DURING THE SAME TIMEFRAME FOR THE CITY OF MILWAUKEE; 400 TELEPHONE INTERVIEWS WERE COMPLETED BETWEEN FEBRUARY 2 AND FEBRUARY 23, 2015 FOR WAUKESHA COUNTY; AND 1,967 TELEPHONE INTERVIEWS WERE COMPLETED BETWEEN FEBRUARY 2 AND MARCH 3, 2015 FOR RACINE COUNTY INCLUDING 400 INTERVIEWS DURING THE SAME TIMEFRAME FOR THE CITY OF RACINE. THE THIRD PIECE OF THE ASSESSMENT PROCESS WAS CONDUCTING INTERVIEWS AND FOCUS GROUPS WITH KEY STAKEHOLDERS IN THE COMMUNITY IN THE SPRING AND SUMMER OF 2015. A LIST OF THE ORGANIZATIONS THAT PROVIDE INPUT ARE LISTED BELOW. EACH OF THESE ORGANIZATIONS SERVES THE MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS. * UNITED WAY OF GREATER MILWAUKEE * CITY OF MILWAUKEE HEALTH DEPARTMENT * NORTH SHORE HEALTH DEPARTMENT * MILWAUKEE COUNTY OF HEALTH AND HUMAN SERVICES * CHILDREN'S HEALTH ALLIANCE OF WISCONSIN * NORTH SHORE HEALTH DEPARTMENT * UNITED COMMUNITY CENTER * THE FAYE MCBEATH FOUNDATION * AIDS RESOURCE CENTER OF WISCONSIN * COMMUNITY SERVICES FOR CHILDREN'S HOSPITAL AND HEALTH SYSTEM * CHILDREN'S HOSPITAL OF WISCONSIN * WISCONSIN DEPARTMENT OF PUBLIC HEALTH SERVICES * GREATER MILWAUKEE FOUNDATION * MILWAUKEE COMMON COUNCIL * WAUWATOSA HEALTH DEPARTMENT * HELEN BADER FOUNDATION * BLACK HEALTH COALITION OF WISCONSIN * MEDICAL COLLEGE OF WISCONSIN INSTITUTE FOR HEALTH AND SOCIETY * WEST ALLIS AND WEST MILWAUKEE HEALTH DEPARTMENT * SOUTH MILWAUKEE HEALTH DEPARTMENT * UW-MILWAUKEE JOSEPH J. ZILBER SCHOOL OF PUBLIC HEALTH * YWCA MILWAUKEE * HALES CORNERS HEALTH DEPARTMENT * MEDICAL SOCIETY OF MILWAUKEE COUNTY * OAK CREEK HEALTH DEPARTMENT * GREENFIELD HEALTH DEPARTMENT * SAINT FRANCIS HEALTH DEPARTMENT * GREENDALE HEALTH DEPARTMENT * UNCOM (UNITED NEIGHBORHOOD CENTERS OF MILWAUKEE * MILWAUKEE ORAL HEALTH TASK FORCE * COLUMBIA ST. MARY'S * MILWAUKEE HEALTH CARE PARTNERSHIP * LINDSAY HEIGHTS HEALTH ALLIANCE * COMMUNITY ADVOCATES * CUDAHY HEALTH DEPARTMENT * YMCA OF METRO MILWAUKEE * LATINO HEALTH COALITION * BOYS AND GIRLS CLUB OF GREATER MILWAUKEE * STAFF HOUSING AUTHORITY OF THE CITY OF MILWAUKEE * RESIDENTS FROM PARKLAWN AND HIGHLAND GARDENS
Schedule H, Part V, Section B, Line 6a Facility 1, 1 Facility 1, 1 - MIDWEST ORTHOPEDIC SPECIALTY HOSPITAL. AURORA HEALTH CARE CHILDREN'S HOSPITAL OF WISCONSIN COLUMBIA ST. MARY'S HEALTH SYSTEM FROEDTERT HEALTH.
Schedule H, Part V, Section B, Line 7 Facility 1, 1 Facility 1, 1 - MIDWEST ORTHOPEDIC SPECIALTY HOSPITAL. SEVERAL REPORTS APPLICABLE TO OUR WISCONSIN HOSPITAL FACILITIES ARE AVAILABLE AT THE MILWAUKEE HEALTH CARE PARTNERSHIP'S (MHCP) WEBSITE AT HTTP://MKEHCP.ORG/PUBLICATIONS. MHCP IS A PUBLIC / PRIVATE CONSORTIUM DEDICATED TO IMPROVING HEALTH CARE COVERAGE, ACCESS, AND CARE COORDINATION FOR UNDERSERVED POPULATIONS IN MILWAUKEE COUNTY, WITH THE GOALS OF IMPROVING HEALTH OUTCOMES, ELIMINATING DISPARITIES, AND REDUCING THE TOTAL COST OF CARE.
Schedule H, Part V, Section B, Line 11 Facility 1, 1 Facility 1, 1 - MIDWEST ORTHOPEDIC SPECIALTY HOSPITAL. USING THE CHNA COMPLETED IN JUNE 2016, THE HOSPITAL DEVELOPED, ADOPTED, AND WORKED ON EXECUTING A THREE-YEAR IMPLEMENTATION STRATEGY TO ADDRESS PRIORITY COMMUNITY HEALTH NEEDS. IN FISCAL YEAR 2017 (TAX YEAR 2016), THE HOSPITAL IMPLEMENTED THE FOLLOWING PLAN TO ADDRESS THE PRIORITY NEEDS: ACCESS TO CARE -- PARTNERED WITH LOCAL SCHOOLS TO PROVIDE ATHLETIC TRAINING SERVICES AND INJURY PREVENTION EDUCATION. -- PROVIDED EDUCATION ON BONE HEALTH TO COMMUNITY MEMBERS. ------------------------------------------------------------------------------------------------------------------------------------- EXPLANATION ON NEEDS IDENTIFIED IN CHNA THAT ARE NOT BEING ADDRESSED: WHILE OUR ORGANIZATION UNDERSTANDS THE IMPORTANCE OF MEETING ALL OF THE NEEDS OF THE COMMUNITY, AN IN-DEPTH ASSESSMENT WAS COMPLETED IN WHICH THE KEY LEADERS INVOLVED WITH WORK WITHIN MOSH WERE ABLE TO IDENTIFY THE NEEDS THAT WOULD BE MOST IMPACTED BY THE SITE. THE TOP HEALTH NEEDS IDENTIFIED BY MOSH LEADERSHIP TEAM THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT THAT WERE NOT A PART OF THE CURRENT IMPLEMENTATION PLAN WERE AS FOLLOWS: COVERAGE: MOSH FEELS THAT THIS SIGNIFICANT NEED IS OUTSIDE OF OUR SCOPE OF SERVICES. WE ARE COMMITTED TO FOCUSING EFFORTS ON PROVIDING ACCESS TO CARE TO THOSE WITHIN OUR COMMUNITY REGARDLESS OF THEIR COVERAGE. WE WILL CONTINUE TO SUPPORT OTHER INITIATIVES REGARDING THIS NEED IN A SECONDARY CAPACITY WHEN NECESSARY. MENTAL AND BEHAVIORAL HEALTH: WHILE MOSH UNDERSTANDS THIS GROWING CONCERN, AT THE TIME OF ASSESSMENT, THE RESOURCES AND EXPERTISE WERE NOT AVAILABLE TO ADDRESS AND MAKE A MEANINGFUL IMPACT ON MENTAL AND BEHAVIORAL HEALTH. DURING THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS, THE MILWAUKEE HEALTH CARE PARTNERSHIP WAS MADE AWARE OF SEVERAL EXISTING STRATEGIES THROUGH OUR KEY INFORMANTS. KEY INFORMANTS NAMED THE FOLLOWING EXISTING STRATEGIES IN THE COUNTY TO ADDRESS MENTAL HEALTH: INPATIENT AND OUTPATIENT MENTAL HEALTH SERVICES; INCREASED BULLYING AWARENESS; HOUSING FIRST STRATEGY; COMMUNITY BEHAVIORAL HEALTH REDESIGN IS UNDERWAY; MILWAUKEE CENTER FOR INDEPENDENCE PROGRAMMING THAT MANAGES MEDICATION AND RE-INTEGRATES PEOPLE WITH MENTAL HEALTH ISSUES INTO THE COMMUNITY, JOBS, AND HOUSING; CRISIS INTERVENTION TRAINING FOR EMPLOYEES; EFFORTS WITHIN SCHOOLS AND SCHOOL-COMMUNITY PARTNERSHIPS; MENTAL AND BEHAVIORAL HEALTH TASK FORCES; IMPLEMENTING TRAUMA INFORMED CARE; AND MORE MENTAL HEALTH PROVIDERS ARE BEING ADDED IN THE COMMUNITY. ALCOHOL AND DRUG USE: WHILE MOSH UNDERSTANDS THIS GROWING CONCERN, AT THE TIME OF ASSESSMENT, THE RESOURCES AND EXPERTISE WERE NOT AVAILABLE TO ADDRESS AND MAKE A MEANINGFUL IMPACT ON ALCOHOL AND DRUG USE. DURING THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS, THE MILWAUKEE HEALTH CARE PARTNERSHIP WAS MADE AWARE OF SEVERAL EXISTING STRATEGIES THROUGH OUR KEY INFORMANTS. KEY INFORMANTS INDICATED A NUMBER OF ORGANIZATIONS ACROSS SECTORS ARE ALREADY ADDRESSING THESE ISSUES BY PROVIDING SERVICES, AND EDUCATION IS IN PLACE WITHIN THE SCHOOLS. SPECIFIC STRATEGIES NAMED INCLUDE NEEDLE EXCHANGE AND SHARPS COLLECTION PROGRAMS, PUBLIC CAMPAIGNS AND MEDIA COVERAGE OF THE ISSUES, PRESCRIPTION DRUG DROP OFF LOCATIONS, THE WISCONSIN PRESCRIPTION DRUG MONITORING PROGRAM (PDMP), MEDICATION LOCK BOXES SOLD AT COST, THE COMMUNITY HEALTH IMPROVEMENT PLAN, AND COMMUNITY CAPACITY BUILDING. WE ARE COMMITTED TO SUPPORTING THESE EFFORTS IN A SECONDARY CAPACITY AS NECESSARY. INJURY AND VIOLENCE: MOSH FEELS THAT THIS SIGNIFICANT NEED IS OUTSIDE OF OUR SCOPE OF SERVICES. DURING THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS, THE MILWAUKEE HEALTH CARE PARTNERSHIP WAS MADE AWARE OF SEVERAL EXISTING STRATEGIES THROUGH OUR KEY INFORMANTS. EXISTING STRATEGIES TO ADDRESS INJURY PREVENTION INCLUDE HOME ASSESSMENT, INJURY PREVENTION PROGRAMS FOR SENIORS, NEWSLETTERS, CAR SEAT CHECKS AND CAR SAFETY PROGRAMS, BICYCLE RODEOS, MESSAGES IN SCHOOL PLANNERS, PROMOTION OF HELMET USE, AND PEDESTRIAN SAFETY MESSAGING. RELATED TO CRIME, VALIDATED RISK ASSESSMENT TOOLS, ADDRESSING POVERTY, COMMUNITY POLICING, THE COMMUNITY JUSTICE COUNCIL, HOTSPOTTING, PROJECT UJIMA, THE MEDICAL COLLEGE OF WISCONSIN INJURY RESEARCH CENTER, AND THE MILWAUKEE PEACE SUMMIT WERE EXISTING STRATEGIES NAMED. REGARDING FAMILY VIOLENCE AND CHILD ABUSE, SOJOURNER FAMILY PEACE CENTER'S PROGRAMS; THE HMONG AMERICAN WOMEN'S ASSOCIATION'S PROGRAMS, SERVICES, AND SUPPORT WITHIN THE CLAN SYSTEM; THE SAFE AND SOUND COLLABORATIVE; FAMILY SUPPORT SERVICES; IMPLEMENTING TRAUMA INFORMED CARE PRINCIPLES; DENIM DAY AND OTHER AWARENESS CAMPAIGNS; AND MINDFULNESS PROGRAMS WERE NAMED AS EXISTING STRATEGIES TO ADDRESS VIOLENCE. DUE TO THE LACK OF RESOURCES AND EXPERTISE MOSH IN THIS AREA, WE HAVE COMMITTED TO SUPPORTING THIS NEED IN A SECONDARY CAPACITY AS NECESSARY. CHRONIC DISEASE, HIGH BLOOD PRESSURE, NUTRITION AND OBESITY: MOSH FEELS THAT THIS GROWING CONCERN IS OUTSIDE OF THEIR SCOPE OF SERVICES BUT IS AWARE THAT OUR FRANKLIN CAMPUS IS FOCUSING THEIR EFFORTS IN THIS NEED. MOSH IS COMMITTED TO SUPPORTING FRANKLIN IN A SECONDARY CAPACITY AS NECESSARY.
Schedule H, Part V, Section B, Line 16 Facility 1, 1 Facility 1, 1 - MIDWEST ORTHPEDIC SPECIALTY HOSPITAL. THE FILING ORGANIZATION TAKES SEVERAL PROACTIVE APPROACHES TO MAKE PATIENTS AWARE OF OUR FINANCIAL ASSISTANCE POLICY. IN ADDITION TO OUR POLICY BEING POSTED ON OUR WEBSITE AND AVAILABLE TO ANYONE WHO REQUESTS ONE, THERE IS ABUNDANT SIGNAGE THROUGHOUT OUR FACILITY EXPLAINING OUR FINANCIAL ASSISTANCE POLICY AND HOW TO OBTAIN THE ACTUAL POLICY, IF DESIRED. NOTICES REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE ARE DISPLAYED IN HIGHLY VISIBLE LOCATIONS WHERE THERE IS A SIGNIFICANT VOLUME OF INPATIENT OR OUTPATIENT TRAFFIC SUCH AS IN INPATIENT AND OUTPATIENT ADMITTING AND REGISTRATION AREAS, PHYSICIAN OFFICES, AND EMERGENCY DEPARTMENTS. BROCHURES DESCRIBING THE POLICY ARE AVAILABLE IN THE SAME LOCATIONS, AND THE POLICY IS DISCUSSED AT THE TIME OF REGISTRATION OR PRE-REGISTRATION, ADMISSION, DISCHARGE, AND WITH BILLING FOR THOSE IDENTIFIED WITH A NEED. PATIENTS WHO CALL AND EXPRESS A FINANCIAL HARDSHIP WITH PAYING THEIR BILL WILL BE ASSISTED BY A CUSTOMER SERVICE REPRESENTATIVE, WHO WILL ASSIST THE PATIENT IN SETTING UP AN APPOINTMENT TO MEET WITH A FINANCIAL ADVOCATE WHO WILL GO OVER THE FINANCIAL ASSISTANCE POLICY IN DETAIL, GET THE FINANCIAL ASSISTANCE APPLICATION PROCESS STARTED, AND EDUCATE THE PATIENT REGARDING ANY QUESTIONS THEY MAY HAVE. LASTLY, OUR PATIENT STATEMENTS ALSO INCLUDE NOTIFICATIONS ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE AND A PHONE NUMBER TO CALL FOR MORE INFORMATION. ADDITIONALLY, OUR FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATION, AND PLAIN LANGUAGE SUMMARY ARE AVAILABLE ON OUR WEBSITE, HTTPS://WWW.COLUMBIA-STMARYS.ORG/OTH/PAGE.ASP?PAGEID=OTH000609. ALL THREE DOCUMENTS HAVE BEEN TRANSLATED INTO 7 LANGUAGES: ENGLISH, SPANISH, HMONG, LAOTIAN, ARABIC, RUSSIAN, AND SERBIAN/CROATIAN.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 9
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) 2019
Schedule H (Form 990) 2019
Page 10
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 I, Line 7 Costing Methodology used to calculate financial assistance THE COST OF PROVIDING CHARITY CARE, MEANS-TESTED GOVERNMENT PROGRAMS, AND OTHER COMMUNITY BENEFIT PROGRAMS IS ESTIMATED USING INTERNAL COST DATA, AND IS CALCULATED IN COMPLIANCE WITH CATHOLIC HEALTH ASSOCIATION ("CHA") GUIDELINES. THE ORGANIZATION USES A COST ACCOUNTING SYSTEM THAT ADDRESSES ALL PATIENT SEGMENTS (FOR EXAMPLE, INPATIENT, OUTPATIENT, EMERGENCY ROOM, PRIVATE INSURANCE, MEDICAID, MEDICARE, UNINSURED, OR SELF PAY). THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE. FOR THE INFORMATION IN THE TABLE, A COST-TO-CHARGE RATIO WAS CALCULATED AND APPLIED.
Schedule H, Part II Community Building Activities IN THE AREA OF COMMUNITY BUILDING, ASCENSION WF INC PROVIDES HEALTH CARE CAREER EDUCATION AND HEALTH EDUCATION PRESENTATIONS TO HIGH SCHOOLS IN MILWAUKEE COUNTY. THE PRESENTATIONS FOCUS ON PROFESSIONAL ROLES AND WORK RESPONSIBILITIES WITHIN A HEALTH CARE SYSTEM AND CHILD CARE EDUCATION. ACCORDING TO THE COUNTY HEALTH RANKINGS, EMPLOYMENT PROVIDES INCOME AND, OFTEN, BENEFITS THAT CAN SUPPORT HEALTHY LIFESTYLE CHOICES. UNEMPLOYMENT AND UNDER EMPLOYMENT LIMIT THESE CHOICES, AND NEGATIVELY AFFECT BOTH QUALITY OF LIFE AND HEALTH OVERALL.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE AND REASONABLE EFFORTS TO COLLECT FROM THE PATIENT HAVE BEEN EXHAUSTED, THE CORPORATION FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITHIN COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY ASCENSION HEALTH. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE CORPORATION'S POLICIES. AFTER APPLYING THE COST-TO-CHARGE RATIO, THE SHARE OF THE BAD DEBT EXPENSE IN FISCAL YEAR 2018 WAS $989,401 AT CHARGES, ($217,688 AT COST).
Schedule H, Part III, Line 3 Bad Debt Expense Methodology THE PROVISION FOR DOUBTFUL ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL EXPERIENCE, ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY PAYOR CATEGORY, INCLUDING THOSE AMOUNTS NOT COVERED BY INSURANCE. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR DOUBTFUL ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote THE ORGANIZATION IS PART OF THE ASCENSION HEALTH ALLIANCE'S CONSOLIDATED AUDIT IN WHICH THE FOOTNOTE THAT DISCUSSES THE BAD DEBT EXPENSE IS LOCATED ON PAGE 21.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs A COST TO CHARGE RATIO IS APPLIED TO THE ORGANIZATION'S MEDICARE EXPENSE TO DETERMINE THE MEDICARE ALLOWABLE COSTS REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT. ASCENSION HEALTH AND ITS RELATED HEALTH MINISTRIES FOLLOW THE CATHOLIC HEALTH ASSOCIATION (CHA) GUIDELINES FOR DETERMINING COMMUNITY BENEFIT. CHA COMMUNITY BENEFIT REPORTING GUIDELINES SUGGEST THAT MEDICARE SHORTFALL IS NOT TREATED AS COMMUNITY BENEFIT.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance THE ORGANIZATION FOLLOWS THE ASCENSION GUIDELINES FOR COLLECTION PRACTICES RELATED TO PATIENTS QUALIFYING FOR CHARITY OR FINANCIAL ASSISTANCE. A PATIENT CAN APPLY FOR CHARITY OR FINANCIAL ASSISTANCE AT ANY TIME DURING THE COLLECTION CYCLE. ONCE QUALIFYING DOCUMENTATION IS RECEIVED THE PATIENT'S ACCOUNT IS ADJUSTED. PATIENT ACCOUNTS FOR THE QUALIFYING PATIENT IN THE PREVIOUS SIX MONTHS MAY ALSO BE CONSIDERED FOR CHARITY OR FINANCIAL ASSISTANCE. ONCE A PATIENT QUALIFIES FOR CHARITY OR FINANCIAL ASSISTANCE, ALL COLLECTION ACTIVITY IS SUSPENDED.
Schedule H, Part V, Section B, Line 16a FAP website 1 - MIDWEST ORTHOPEDIC SPECIALTY HOSPITAL: Line 16a URL: https://www.mymosh.com/your-visit/after-your-visit/#billing;
Schedule H, Part V, Section B, Line 16b FAP Application website 1 - MIDWEST ORTHOPEDIC SPECIALTY HOSPITAL: Line 16b URL: https://www.mymosh.com/your-visit/after-your-visit/#billing;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website 1 - MIDWEST ORTHOPEDIC SPECIALTY HOSPITAL: Line 16c URL: https://www.mymosh.com/your-visit/after-your-visit/#billing;
Schedule H, Part VI, Line 2 Needs assessment IN ADDITION TO THE CHNA REPORTED IN PART V, SECTION B, WISCONSIN HOSPITALS, INCLUDING THE MIDWEST ORTHOPEDIC & SPECIALTY HOSPITAL USES BOTH HOSPITAL DATA AND RELIABLE, THIRD PARTY REPORTS, INCLUDING DATA FROM GOVERNMENT SOURCES, TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY IT SERVES. THESE REPORTS PROVIDE INFORMATION ABOUT KEY HEALTH, SOCIOECONOMIC, AND DEMOGRAPHIC INDICATORS THAT POINT TO AREAS OF NEED. MIDWEST ORTHOPEDIC & SPECIALTY HOSPITAL UTILIZES THIS INFORMATION TO DETERMINE DEVELOP PROGRAMS AND SERVICES TO BE PROVIDED FOR THE COMMUNITY. THESE NEEDS AND INITIATIVES ARE PRESENTED TO SENIOR LEADERSHIP AND BOARD MEMBERS TO ENSURE THE FINDINGS ARE CONSIDERED IN DEVELOPING THE ORGANIZATION'S STRATEGY, POLICY DEVELOPMENT, AND INTERNAL FINANCIAL AND OPERATIONAL DECISIONS.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance THE FILING ORGANIZATION IS COMMITTED TO DELIVERING EFFECTIVE, SAFE, PERSON-CENTRIC, HEALTH CARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. AS A NONPROFIT HOSPITAL (OR HEALTH SYSTEM), IT IS OUR MISSION AND PRIVILEGE TO PLAY THIS IMPORTANT ROLE IN OUR COMMUNITY. STAFF SCREEN UNINSURED PATIENTS AND IF FOUND POTENTIALLY ELIGIBLE FOR A GOVERNMENT FUNDING SOURCE, PROVIDE ASSISTANCE AND/OR RESOURCES TO THE PATIENT AND THEIR FAMILY. IF A PATIENT IS NOT ELIGIBLE FOR A PAYMENT SOURCE, OUR FINANCIAL ASSISTANCE POLICY COVERS PATIENTS WHO LACK THE FINANCIAL RESOURCES TO PAY FOR ALL OR PART OF THEIR BILLS. ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED UPON THE ANNUAL FEDERAL POVERTY GUIDELINES AND IS PROVIDED FOR THOSE WHO EARN UP TO 400% OF THE FEDERAL POVERTY LEVEL. THE FOLLOWING DOCUMENTS ARE WIDELY PUBLICIZED ON THE ORGANIZATION'S WEBSITE AT: HTTPS://WWW.MYWHEATON.ORG/ABOUT-WHEATON/BILLING-INFORMATION/#POLICY - FINANCIAL ASSISTANCE POLICY - FINANCIAL ASSISTANCE APPLICATION - FINANCIAL ASSISTANCE POLICY SUMMARY - LIST OF PROVIDERS COVERED BY THE FINANCIAL ASSISTANCE POLICY THE ORGANIZATION ALSO MAKES PAPER COPIES OF THE FOLLOWING DOCUMENTS AVAILABLE UPON REQUEST: - FINANCIAL ASSISTANCE POLICY - FINANCIAL ASSISTANCE APPLICATION - FINANCIAL ASSISTANCE POLICY SUMMARY - LIST OF PROVIDERS COVERED BY THE FINANCIAL ASSISTANCE POLICY - AMOUNT GENERALLY BILLED CALCULATION PAPER COPIES ARE MADE READILY AVAILABLE AS PART OF THE INTAKE, DISCHARGE, AND CUSTOMER SERVICE PROCESSES. UPON REQUEST, PAPER COPIES CAN ALSO BE OBTAINED BY MAIL. THE ORGANIZATION INFORMS ITS PATIENTS OF THE FINANCIAL ASSISTANCE POLICY VIA A NOTICE ON PATIENT BILLING STATEMENTS, INCLUDING THE PHONE NUMBER AND WEB ADDRESS WHERE MORE INFORMATION CAN BE OBTAINED. SIGNAGE DISPLAYED IN THE EMERGENCY ROOM AND ADMISSION AREA ALSO INFORMS PATIENTS OF THE FINANCIAL ASSISTANCE POLICY.
Schedule H, Part VI, Line 4 Community information PLEASE SEE DETAILED INFORMATION PROVIDED AT SCHEDULE H PART V SECTION B LINES 1-12 AND PART VI LINE 5.
Schedule H, Part VI, Line 5 Promotion of community health THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS REPRESENTING DIVERSE ASPECTS AND INTERESTS OF THE COMMUNITY. MANY MEMBERS OF the GOVERNING BODY RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA; WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS OR SPECIALTIES. SURPLUS FUNDS ARE PROVIDED TO FUND IMPROVEMENTS IN PATIENT CARE, MEDICAL EDUCATION, AND RESEARCH THROUGH DONATIONS FROM SUPPORTING ORGANIZATIONS. PLEASE ALSO SEE PART III FOR COMMUNITY ACTIVITIES UNDERTAKEN BY THIS ORGANIZATION, AS WELL AS A COMPILATION OF REGIONAL CHARITY CARE INFORMATION.
Schedule H, Part VI, Line 6 Affiliated health care system THE FILING ORGANIZATION IS AN AFFILIATE OF WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN, INC. AND ASCENSION HEALTH. THE HOSPITAL'S AFFILIATES ARE LARGE MULTI-FACETED, INTEGRATED, NOT-FOR-PROFIT MINISTRIES INCLUDING HOSPITAL AND NON-HOSPITAL MINISTRIES (PHYSICIAN GROUP PRACTICES, HOSPITAL ORGANIZATIONS, RESEARCH, HOME HEALTH, DURABLE MEDICAL EQUIPMENT AND SENIOR FACILITIES). THESE MINISTRIES WORK TOGETHER TO CARE FOR PATIENTS, JOINED BY COMMON SYSTEMS AND A PHILOSOPHY OF SERVING AS A HEALING PRESENCE WITH SPECIAL CONCERN FOR OUR NEIGHBORS ESPECIALLY THOSE WHO ARE POOR OR VULNERABLE. THIS COMMUNITY BENEFIT HAPPENS THROUGH ITS FOCUS ON PATIENT CARE, EDUCATION AND RESEARCH. THE ORGANIZATIONS WORK TOGETHER TO SERVE THEIR COMMUNITIES AT THE LOCAL, REGIONAL, STATE AND NATIONAL LEVEL. ASCENSION HEALTH ALLIANCE, D/B/A ASCENSION (ASCENSION), IS A MISSOURI NONPROFIT CORPORATION FORMED ON SEPTEMBER 13, 2011. ASCENSION IS THE SOLE CORPORATE MEMBER AND PARENT ORGANIZATION OF ASCENSION HEALTH, A CATHOLIC NATIONAL HEALTH SYSTEM CONSISTING PRIMARILY OF NONPROFIT CORPORATIONS THAT OWN AND OPERATE LOCAL HEALTHCARE FACILITIES, OR HEALTH MINISTRIES, LOCATED IN 23 OF THE UNITED STATES AND THE DISTRICT OF COLUMBIA. ASCENSION IS SPONSORED BY ASCENSION SPONSOR, A PUBLIC JURIDIC PERSON. THE PARTICIPATING ORGANIZATIONS/ENTITIES OF ASCENSION SPONSOR ARE THE DAUGHTERS OF CHARITY OF ST. VINCENT DE PAUL, ST. LOUISE PROVINCE; THE CONGREGATION OF ST. JOSEPH; THE CONGREGATION OF THE SISTERS OF ST. JOSEPH OF CARONDELET; THE CONGREGATION OF ALEXIAN BROTHERS OF THE IMMACULATE CONCEPTION PROVINCE, INC. - AMERICAN PROVINCE; AND THE SISTERS OF THE SORROWFUL MOTHER OF THE THIRD ORDER OF ST. FRANCIS OF ASSISI - US/CARIBBEAN PROVINCE. THE ORGANIZATION PROMOTES THE HEALTH OF THE COMMUNITY BY PROVIDING HEALTHCARE SERVICES IN THE SOUTHEAST WISCONSIN AREA, REGARDLESS OF THE PERSON'S ABILITY TO PAY, BECAUSE IT IS OUR MISSION TO IMPROVE THE LIVES OF THOSE IN THE COMMUNITIES WE SERVE.
Schedule H (Form 990) 2019
Additional Data


Software ID: 17005876
Software Version: 2017v2.2
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 Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
Wheaton Franciscan Healthcare - Southeast Wisconsin Inc
 
Employer identification number

39-1568865
Part I
Questions Regarding Compensation
Yes
No
1a
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.
b
If any of the boxes on 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 .........
1b
 
 
2
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 on Line 1a? ..
2
 
 
3
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.
4
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:
a
Receive a severance payment or change-of-control payment? .............
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
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.
5
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:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
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:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
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 ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2019

Schedule J (Form 990) 2019
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
(i) Base
compensation 		(ii) Bonus & incentive
compensation 		(iii) Other reportable compensation
1BERNARD J SHERRY
 
EX-OFFICIO - SR VP ASCENSION WI 		(i)

(ii)		 0
-------------
839,075 		0
-------------
950,848 		0
-------------
298,608 		0
-------------
17,550 		0
-------------
28,032 		0
-------------
2,134,113 		0
-------------
0
2SUSAN BOLAND
 
FORMER OFFICER (END 4/2017) 		(i)

(ii)		 167,060
-------------
0 		0
-------------
0 		390,593
-------------
0 		7,867
-------------
0 		6,448
-------------
0 		571,968
-------------
0 		0
-------------
0
3JONATHAN SOHN
 
CFO - ASCENSION, WI 		(i)

(ii)		 0
-------------
505,898 		0
-------------
270,732 		0
-------------
127,274 		0
-------------
14,885 		0
-------------
33,482 		0
-------------
952,271 		0
-------------
0
4JULIE E SWIDERSKI
 
FORMER KEY EMPLOYEE (END 6/2016) 		(i)

(ii)		 0
-------------
158,989 		0
-------------
65,523 		0
-------------
184,173 		0
-------------
12,794 		0
-------------
23,646 		0
-------------
445,125 		0
-------------
0
5JOAN M BACHLEITNER
 
CHIEF STRATEGY OFFICER - ASCENSION WI 		(i)

(ii)		 0
-------------
349,093 		0
-------------
68,508 		0
-------------
29,387 		0
-------------
10,800 		0
-------------
33,442 		0
-------------
491,230 		0
-------------
0
6TIMOTHY L BELEC
 
WI MARKET INFOMATION OFFICER 		(i)

(ii)		 0
-------------
264,076 		0
-------------
103,833 		0
-------------
1,765 		0
-------------
9,450 		0
-------------
7,822 		0
-------------
386,946 		0
-------------
0
7LISA S BENSON MD
 
CHIEF QUAILITY OFFICER - ASCENSION, WI 		(i)

(ii)		 0
-------------
419,726 		0
-------------
87,358 		0
-------------
2,982 		0
-------------
13,500 		0
-------------
6,985 		0
-------------
530,551 		0
-------------
0
8VINCENT GALLUCCI
 
CHIEF MARKETING OFFICER - ASCENSION WI 		(i)

(ii)		 0
-------------
322,646 		0
-------------
196,044 		0
-------------
28,821 		0
-------------
8,100 		0
-------------
11,791 		0
-------------
567,402 		0
-------------
0
9SARAH HERZOG
 
CHIEF LEGAL OFFICER - ASCENSION WI 		(i)

(ii)		 0
-------------
412,615 		0
-------------
210,783 		0
-------------
54,726 		0
-------------
16,200 		0
-------------
27,404 		0
-------------
721,728 		0
-------------
0
10DOUGLAS REDING MD
 
CHIEF MEDICAL OFFICER - ASCENSION WI 		(i)

(ii)		 0
-------------
523,885 		0
-------------
115,749 		0
-------------
8,004 		0
-------------
13,500 		0
-------------
27,258 		0
-------------
688,396 		0
-------------
0
11THERESE M ROCOLE
 
CHIEF MISSION INTEGRATION OFFICER - ASCENSION WI 		(i)

(ii)		 0
-------------
214,600 		0
-------------
122,011 		0
-------------
89,033 		0
-------------
16,837 		0
-------------
2,757 		0
-------------
445,238 		0
-------------
0
12Tracy A Rogers
 
CHIEF OPERATING OFFICER - ASCENSION WI 		(i)

(ii)		 0
-------------
641,898 		0
-------------
611,054 		0
-------------
443,924 		0
-------------
16,200 		0
-------------
34,847 		0
-------------
1,747,923 		0
-------------
0
13LYNN SCHUSTER
 
SR DIRECTOR REGIONAL RISK MANAGEMENT 		(i)

(ii)		 0
-------------
205,961 		0
-------------
44,909 		0
-------------
26,317 		0
-------------
15,041 		0
-------------
24,420 		0
-------------
316,648 		0
-------------
0
14CELIA SHAUGHNESSY
 
VP-HUMAN RESOURCES - WI, MI MARKET 		(i)

(ii)		 0
-------------
299,105 		0
-------------
178,963 		0
-------------
33,601 		0
-------------
8,100 		0
-------------
23,798 		0
-------------
543,567 		0
-------------
0
15DEBRA STANDRIDGE
 
REGIONAL PRESIDENT - ASCENSION WI 		(i)

(ii)		 0
-------------
493,219 		0
-------------
207,295 		0
-------------
125,400 		0
-------------
9,931 		0
-------------
26,076 		0
-------------
861,921 		0
-------------
0
16TOM E VEESER
 
CHIEF NURSING OFFICER - ASCENSION WI 		(i)

(ii)		 0
-------------
340,537 		0
-------------
76,438 		0
-------------
22,987 		0
-------------
12,663 		0
-------------
27,644 		0
-------------
480,269 		0
-------------
0
17TRAVIS D ANDERSEN
 
REGIONAL PRESIDENT - ASCENSION WI 		(i)

(ii)		 0
-------------
563,166 		0
-------------
701,999 		0
-------------
102,400 		0
-------------
13,500 		0
-------------
30,954 		0
-------------
1,412,019 		0
-------------
0
18YATA A NAIGOW
 
WSST RN SPECIALTY 		(i)

(ii)		 229,028
-------------
0 		0
-------------
0 		130
-------------
0 		6,511
-------------
0 		20,312
-------------
0 		255,981
-------------
0 		0
-------------
0
19MARY JOANNE WODICKA
 
VP - HUMAN RESOURCES 		(i)

(ii)		 115,491
-------------
0 		30,290
-------------
0 		25,232
-------------
0 		9,147
-------------
0 		16,521
-------------
0 		196,681
-------------
0 		0
-------------
0
20MARK J CHARBOGIAN
 
VP - LAB SERVICES SE WI 		(i)

(ii)		 6,154
-------------
0 		0
-------------
0 		162,610
-------------
0 		0
-------------
0 		0
-------------
0 		168,764
-------------
0 		0
-------------
0
21JAY D RICE
 
VP - PHARMACIES 		(i)

(ii)		 6,053
-------------
0 		0
-------------
0 		158,797
-------------
0 		0
-------------
0 		0
-------------
0 		164,850
-------------
0 		0
-------------
0
22MICHELLE L JONES
 
DIR PATIENT ACCESS & FIN SVCS 		(i)

(ii)		 138,259
-------------
0 		13,166
-------------
0 		4,962
-------------
0 		2,850
-------------
0 		8,936
-------------
0 		168,173
-------------
0 		0
-------------
0
Schedule J (Form 990) 2019

Schedule J (Form 990) 2019
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 ASCENSION HEALTH, A RELATED ORGANIZATION OF WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN, INC., USES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
Schedule J, Part I, Line 4a Severance or change-of-control payment THE FOLLOWING INDIVIDUAL(S) RECEIVED SEVERANCE PAYMENTS FROM THE ORGANIZATION OR A RELATED ORGANIZATION DURING THE CALENDAR YEAR 2017: SUSAN BOLAND - $380,635 MARK J CHARBOGIAN - $153,840 JAY D RICE - $151,340 MARY JOANNE WODICKA - $16,537
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan Eligible executives participate in a program that provides for supplemental retirement benefits. The payment of benefits under the program, if any, is entirely dependent upon the facts and circumstances under which the executive terminates employment with the organization. Benefits under the program are unfunded and non-vested. Due to the substantial risk of forfeiture provision, there is no guarantee that these executives will ever receive any benefit under the program. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. No payments were made to listed persons in Part VII under the non-qualified retirement plan during the year.
Schedule J (Form 990) 2019

Additional Data


Software ID: 17005876
Software Version: 2017v2.2
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 Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization
Wheaton Franciscan Healthcare - Southeast Wisconsin Inc
 
Employer identification number

39-1568865
Return Reference Explanation
Form 990, Part VI, Line 15a PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL IN DETERMINING THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL, THE PROCESS PERFORMED BY ASCENSION HEALTH, A RELATED ORGANIZATION OF WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN, INC. INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE TOP MANAGEMENT OFFICIAL WAS COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE COMMITTEE MINUTES. THE INDIVIDUAL WAS NOT PRESENT WHEN HIS COMPENSATION WAS DECIDED.
Form 990, Part VI, Line 6 Classes of members or stockholders WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN, INC. HAS A SINGLE CORPORATE MEMBER, ASCENSION HEALTH.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN, INC. HAS A SINGLE CORPORATE MEMBER, ASCENSION HEALTH, WHO HAS THE ABILITY TO ELECT MEMBERS TO THE GOVERNING BODY OF WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST, WISCONSIN, INC.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders ASCENSION HEALTH HAS DESIGNED A SYSTEM AUTHORITY MATRIX WHICH ASSIGNS AUTHORITY FOR KEY DECISIONS THAT ARE NECESSARY IN THE OPERATION OF THE SYSTEM. SPECIFIC AREAS THAT ARE IDENTIFIED IN THE AUTHORITY MATRIX ARE: NEW ORGANIZATIONS AND MAJOR TRANSACTIONS; GOVERNING DOCUMENTS; APPOINTMENTS/REMOVALS; EVALUATION; DEBT LIMITS; STRATEGIC AND FINANCIAL PLANS; ASSETS; SYSTEM POLICIES AND PROCEDURES. THESE AREAS ARE SUBJECT TO CERTAIN LEVELS OF APPROVAL BY ASCENSION PER THE SYSTEM AUTHORITY MATRIX.
Form 990, Part VI, Line 11b Review of form 990 by governing body DURING THE RETURN PREPARATION PROCESS, THE TAX DEPARTMENT WORKS WITH OTHER FUNCTIONAL AREAS INCLUDING FINANCE, ACCOUNTING, TREASURY, LEGAL, HUMAN RESOURCES, AND CORPORATE COMPLIANCE FOR ADVICE, INFORMATION AND ASSISTANCE IN ORDER TO PREPARE A COMPLETE AND ACCURATE RETURN. UPON COMPLETION, THE FORM 990 IS REVIEWED BY THE ORGANIZATION'S INTERNAL TAX DEPARTMENT WHICH CONSISTS OF ATTORNEYS AND CPAS. A COMPLETE FINAL COPY OF THE RETURN IS PROVIDED TO THE ORGANIZATION'S PRESIDENT, FINANCIAL OFFICER, AND/OR OTHER KEY OFFICERS IN LIEU OF THE FULL BOARD.
Form 990, Part VI, Line 12c Conflict of interest policy THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY IN THAT ANY DIRECTOR, PRINCIPAL OFFICER, OR MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS, WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST, MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF THE COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. THE REMAINING INDIVIDUALS ON THE GOVERNING BOARD OR COMMITTEE WILL DECIDE IF CONFLICTS OF INTEREST EXIST. EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH GOVERNING BOARD DELEGATED POWERS ANNUALLY SIGNS A STATEMENT WHICH AFFIRMS SUCH PERSON HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY, HAS READ AND UNDERSTANDS THE POLICY, HAS AGREED TO COMPLY WITH THE POLICY, AND UNDERSTANDS THAT THE ORGANIZATION IS CHARITABLE AND IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ITS TAX-EXEMPT PURPOSE.
Form 990, Part VI, Line 15b Process to establish compensation of other employees IN DETERMINING COMPENSATION OF THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES, THE PROCESS PERFORMED BY THE FILING ORGANIZATION INCLUDED A REVIEW AND APPROVAL BY INDEPENDENT PERSONS, COMPARABILITY DATA, AND CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. THE EXECUTIVE COMPENSATION COMMITTEE REVIEWED AND APPROVED THE COMPENSATION. IN THE REVIEW OF THE COMPENSATION, THE OFFICERS' SALARIES WERE COMPARED TO INDIVIDUALS AT OTHER ORGANIZATIONS IN THE AREA WHO HOLD THE SAME TITLE. DURING THE REVIEW AND APPROVAL OF THE COMPENSATION, DOCUMENTATION OF THE DECISION WAS RECORDED IN THE MINUTES. INDIVIDUALS WERE NOT PRESENT WHEN THEIR COMPENSATION WAS DECIDED.
Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION WILL PROVIDE ANY DOCUMENTS OPEN TO PUBLIC INSPECTION UPON REQUEST.
Form 990, Part VII, Section A Related Entities The organization utilizes an affiliate as the common pay agent. Employees reported in Part VII may have duties that impact multiple related entities. Total average hours worked and compensation and benefits paid are reported. In doing so, if available, a common law employer analysis is used to determine whether the hours and compensation/benefits are reportable as attributable directly to the filing organization or another entity; otherwise, the best available information has been used as the basis for allocations utilized in the reporting.
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Miscellaneous Revenue - Total Revenue: 3690766, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 3690766;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances WRITE OFF OF NOTES RECEIVABLE - -XXX-XX-XXXX; TRANSFERS WITH ALPHA FUND - XXX-XX-XXXX;
Form 990, Part XII, Line 2b AUDITED FINANCIAL STATEMENTS THE ACTIVITY OF WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN, INC. IS REPORTED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF ASCENSION HEALTH ALLIANCE. NO INDIVIDUAL AUDIT OF WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN, INC. IS COMPLETED. THEREFORE, THE ATTACHED AUDITED FINANCIAL STATEMENTS ARE OF ASCENSION HEALTH ALLIANCE AND AFFILIATES, WHICH INCLUDE THE ACTIVITY OF WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN, INC.
Form 990, Part XII, Line 2c AUDIT COMMITTEE WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN, INC. IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF ASCENSION HEALTH ALLIANCE. THE FINANCE AND AUDIT COMMITTEE OF ASCENSION HEALTH ALLIANCE'S BOARD ASSUMES RESPONSIBILITY FOR THE CONSOLIDATED ORGANIZATION AS A WHOLE.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2019


Additional Data


Software ID: 17005876
Software Version: 2017v2.2
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
Wheaton Franciscan Healthcare - Southeast Wisconsin Inc
 
Employer identification number

39-1568865
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) WHEATON FRANCISCAN MEDICAL EQUIPMENT TEAM LLC
3070 NORTH 51ST STREET STE 406
MILWAUKEE,WI53210
39-1906167 		MEDICAL EQUIPMENT WI 0 0 WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN INC
 
(2) WHEATON FRANCISCAN HEALTHCARE NETWORK LLC
400 WEST RIVER WOODS PARKWAY
GLENDALE,WI53209
38-3955660 		PROVIDER CONTRACT WI 0 0 WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN INC
 
(3) FRANKLIN MEDICAL OFFICE BUILDING LLC
7400 WEST RAWSON AVE
FRANKLIN,WI53132
39-1903791 		REAL ESTATE WI 367,511 5,047,341 WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN INC
 






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?
Yes No
(1)AFFINITY HEALTH SYSTEM
1570 MIDWAY PLACE

MENASHA,WI54952
39-1568866 		HEALTH SYSTEM IL 501(c)(3) Type II MINISTRY HEALTH CARE INC
 
Yes
 
(2)AGAPE COMMUNITY CENTER OF MILWAUKEE INC
6100 NORTH 42ND STREET

MILWAUKEE,WI53209
39-1641846 		COMMUNITY CENTER WI 501(c)(3) 7 MINISTRY HEALTH CARE INC
 
Yes
 
(3)ASCENSION ALL SAINTS HOSPITAL INC (FKA WHEATON FRANCISCAN HEALTHCARE-ALL SA
INTS INC)3801 SPRING STREET

RACINE,WI53405
39-1264986 		HOSPITAL WI 501(c)(3) 3 WHEATON FRANCISCAN HEALTHCARE-SOUTHEAST WISCONSIN INC
 
Yes
 
(4)ASCENSION CALUMET HOSPITAL INC
614 MEMORIAL DRIVE

CHILTON,WI53014
39-0905385 		HOSPITAL WI 501(c)(3) 3 MINISTRY HEALTH CARE INC
 
Yes
 
(5)ASCENSION EAGLE RIVER HOSPITAL INC
201 HOSPITAL ROAD

EAGLE RIVER,WI54521
39-0985690 		HOSPITAL WI 501(c)(3) 3 MINISTRY HEALTH CARE INC
 
Yes
 
(6)ASCENSION GOOD SAMARITAN HOSPITAL INC
601 SOUTH CENTER AVENUE

MERRILL,WI54452
39-0808503 		HOSPITAL WI 501(c)(3) 3 MINISTRY HEALTH CARE INC
 
Yes
 
(7)ASCENSION HEALTH ALLIANCE
PO BOX 45998

ST LOUIS,MO63145
45-3358926 		NATIONAL HEALTH MO 501(c)(3) Type I NA
 
 
No
(8)ASCENSION HEALTH
PO BOX 45998

ST LOUIS,MO63145
31-1662309 		NATIONAL HEALTH MO 501(c)(3) Type I ASCENSION HEALTH ALLIANCE
 
 
No
(9)ASCENSION MEDICAL GROUP-FOX VALLEY WISCONSIN INC (FKA NETWORK HEALTH SYSTEM
INC)1570 APPLETON RD

MENASHA,WI54952
39-1127163 		CLINICAL HEALTHCARE SERVICES WI 501(c)(3) 3 AFFINITY HEALTH SYSTEM
 
Yes
 
(10)ASCENSION MEDICAL GROUP-NORTHERN WISCONSIN INC (FKA MINISTRY MEDICAL GROUP
INC)824 ILLINOIS AVENUE

STEVENS POINT,WI54481
39-1965593 		MEDICAL GROUP WI 501(c)(3) Type III-FI MINISTRY HEALTH CARE INC
 
Yes
 
(11)ASCENSION MEDICAL GROUP-SOUTHEAST WISCONSIN INC (FKA WHEATON FRANCISCAN MED
ICAL GROUP INC)400 WEST RIVER WOODS PARKWAY

GLENDALE,WI53212
39-1791586 		MEDICAL GROUP WI 501(c)(3) 3 WHEATON FRANCISCAN HEALTHCARE-SOUTHEAST WISCONSIN INC
 
Yes
 
(12)ASCENSION NE WISCONSIN INC (FKA ST ELIZABETH HOSPITAL INC)
1506 S ONEIDA STREET

APPLETON,WI54915
39-0816818 		HOSPITAL WI 501(c)(3) 3 MINISTRY HEALTH CARE INC
 
Yes
 
(13)ASCENSION OUR LADY OF VICTORY HOSPITAL INC
1120 PINE STREET

STANLEY,WI54768
39-0807065 		HOSPITAL WI 501(c)(3) 3 MINISTRY HEALTH CARE INC
 
Yes
 
(14)ASCENSION SACRED HEART-STMARY'S HOSPITALS INC
PO BOX 347

STEVENS POINT,WI54481
39-1390638 		HOSPITAL WI 501(c)(3) 3 MINISTRY HEALTH CARE INC
 
Yes
 
(15)ASCENSION SE WISCONSIN HOSPITAL INC (FKA WHEATON FRANCISCAN INC)
5000 WEST CHAMBERS STREET

MILWAUKEE,WI53210
39-0816857 		HOSPITAL WI 501(c)(3) 3 WHEATON FRANCISCAN HEALTHCARE-SOUTHEAST WISCONSIN INC
 
Yes
 
(16)ASCENSION ST CLARE'S HOSPITAL INC
3400 MINISTRY PARKWAY

WESTON,WI54476
72-1531917 		HOSPITAL WI 501(c)(3) 3 MINISTRY HEALTH CARE INC
 
Yes
 
(17)ASCENSION ST FRANCIS HOSPITAL INC (FKA WHEATON FRANCISCAN HEALTHCARE-ST FRA
NCIS INC)3237 SOUTH 16TH STREET

MILWAUKEE,WI53215
39-0907740 		HOSPITAL WI 501(c)(3) 3 WHEATON FRANCISCAN HEALTHCARE-SOUTHEAST WISCONSIN INC
 
Yes
 
(18)ASCENSION ST MICHAEL'S HOSPITAL INC
900 ILLINOIS AVENUE

STEVENS POINT,WI54481
39-0808443 		HOSPITAL WI 501(c)(3) 3 MINISTRY HEALTH CARE INC
 
Yes
 
(19)ASCENSION WISCONSIN LABORATORIES INC (FKA WHEATON FRANCISCAN LABORATORIES I
NC)3237 SOUTH 16TH STREET

MILWAUKEE,WI53215
39-1701402 		LABORATORY WI 501(c)(3) 10 WHEATON FRANCISCAN HEALTHCARE-SOUTHEAST WISCONSIN INC
 
Yes
 
(20)ASCENSION WISCONSIN PHARMACYINC (FKA WHEATON FRANCISCAN HEALTHCARE-PHARMACY
ENTERPRISES AND FRANCISCAN WOODS INC)19525 WEST NORTH AVENUE

BROOKFIELD,WI53005
39-1613624 		PHARMACY WI 501(c)(3) 10 WHEATON FRANCISCAN HEALTHCARE-SOUTHEAST WISCONSIN INC
 
Yes
 
(21)CATALPA HEALTH INC
N4642 COUNTY N

APPLETON,WI54914
45-4681563 		BEHAVIORAL HEALTH SERVICES WI 501(c)(3) 3 AFFINITY HEALTH SYSTEM
 
Yes
 
(22)COLUMBIA COLLEGE OF NURSING Inc
4425 NORTH PORT WASHINGTON ROAD

GLENDALE,WI53212
39-1596986 		COLLEGE WI 501(c)(3) 2 COLUMBIA ST MARY'S HOSPITAL MILWAUKEE INC
 
Yes
 
(23)COLUMBIA ST MARY'S HOSPITAL MILWAUKEE INC
4425 NORTH PORT WASHINGTON ROAD

GLENDALE,WI53212
39-0806315 		HOSPITAL WI 501(c)(3) 3 COLUMBIA ST MARY'S INC
 
Yes
 
(24)COLUMBIA ST MARY'S HOSPITAL OZAUKEE INC
4425 NORTH PORT WASHINGTON ROAD

GLENDALE,WI53212
39-0807063 		HOSPITAL WI 501(c)(3) 3 COLUMBIA ST MARY'S INC
 
Yes
 
(25)COLUMBIA ST MARY'S INC
4425 NORTH PORT WASHINGTON ROAD

GLENDALE,WI53212
39-1834639 		PARENT CORPORATION WI 501(c)(3) Type I ASCENSION HEALTH
 
Yes
 
(26)DR KATE NEWCOMB CONVALESCENT CENTER INC
PO BOX 829

WOODRUFF,WI54568
39-1357365 		NURSING/ASSISTED LIVING SERVICES WI 501(c)(3) 10 HOWARD YOUNG HEALTH CARE INC
 
Yes
 
(27)FOUNDATION OF SAINT JOSEPH'S HOSPITAL OF MARSHFIELD Inc
611 SAINT JOSEPH AVENUE

MARSHFIELD,WI54449
39-1684957 		FOUNDATION WI 501(c)(3) Type I SAINT JOSEPH'S HOSPITAL OF MARSHFIELD INC
 
Yes
 
(28)FOUNDATION OF SAINT CLARE'S HOSPITAL OF WESTON INC
3400 MINISTRY PARKWAY

WESTON,WI54476
75-3193633 		FOUNDATION WI 501(c)(3) Type I ASCENSION ST CLARE'S HOSPITAL INC
 
Yes
 
(29)GOOD SAMARITAN HEALTH CENTER FOUNDATION OF MERRILL WISCONSIN INC
601 SOUTH CENTER AVENUE

MERRILL,WI54452
39-1627755 		FOUNDATION WI 501(c)(3) Type I ASCENSION GOOD SAMARITAN HOSPITAL INC
 
Yes
 
(30)HOWARD YOUNG HEALTH CARE INC
240 MAPLE STREET

WOODRUFF,WI54568
39-1499115 		HOME OFFICE WI 501(c)(3) Type II MINISTRY HEALTH CARE INC
 
Yes
 
(31)MERCY HEALTH FOUNDATION INC
PO BOX 3370

OSHKOSH,WI54903
23-7140261 		FOUNDATION WI 501(c)(3) 10 AFFINITY HEALTH SYSTEM
 
Yes
 
(32)MERCY MEDICAL CENTER OF OSHKOSH INC
500 S OAKWOOD ROAD

OSHKOSH,WI54904
39-0806268 		HOSPITAL WI 501(c)(3) 3 MINISTRY HEALTH CARE INC
 
Yes
 
(33)METRO PHYSICIANS INC
400 WEST RIVER WOODS PARKWAY

GLENDALE,WI53212
94-3436893 		Medical Group WI 501(c)(3) 3 ASCENSION MEDICAL GROUP-SOUTHEAST WISCONSIN INC (FKA WHEATON FRANCISCAN MED
ICAL GROUP INC)
Yes
 
(34)MINISTRY HEALTH CARE INC
10925 W LAKE PARK DR STE 100

MILWAUKEE,WI53224
39-1490371 		PARENT CORPORATION WI 501(c)(3) Type II ASCENSION HEALTH
 
Yes
 
(35)MINISTRY WEIGHT MANAGEMENT INC
2251 NORTH SHORE DRIVE

RHINELANDER,WI54501
39-1829015 		SPECIALTY HEALTH SERVICES WI 501(c)(3) 3 ASCENSION SACRED HEART-STMARY'S HOSPITALS INC
 
Yes
 
(36)SACRED HEART REHABILITATION INSTITUTE Inc
4425 NORTH PORT WASHINGTON ROAD

GLENDALE,WI53212
39-0902199 		REHAB SERVICES WI 501(c)(3) 3 COLUMBIA ST MARY'S INC
 
Yes
 
(37)SAINT ELIZABETH'S HOSPITAL OF WABASHA INC
1200 GRANT BLVD WEST

WABASHA,MN55981
41-0693877 		HOSPITAL MN 501(c)(3) 3 MINISTRY HEALTH CARE INC
 
Yes
 
(38)ST JOSEPH'S HOSPITAL OF MARSHFIELD INC
611 SAINT JOSEPH AVENUE

MARSHFIELD,WI54449
39-0847631 		HOSPITAL WI 501(c)(3) 3 MINISTRY HEALTH CARE INC
 
Yes
 
(39)SAINT MICHAEL'S FOUNDATION OF STEVENS POINT INC
900 ILLINOIS AVENUE

STEVENS POINT,WI54481
39-1657410 		FOUNDATION WI 501(c)(3) Type I ASCENSION ST MICHAEL'S HOSPITAL INC
 
Yes
 
(40)ST ELIZABETH HOSPITAL FOUNDATION INC
1506 S ONEIDA STREET

APPLETON,WI54915
39-1256677 		FOUNDATION WI 501(c)(3) 7 AFFINITY HEALTH SYSTEM
 
Yes
 
(41)THE HOWARD YOUNG MEDICAL CENTER INC
240 MAPLE STREET

WOODRUFF,WI54568
39-0873606 		HOSPITAL WI 501(c)(3) 3 MINISTRY HEALTH CARE INC
 
Yes
 
(42)VOLUNTEERS IN PARTNERSHIP WITH WHEATON FRANCISCAN HEALTHCARE-ALL SAINTS INC
3807 SPRING STREET

RACINE,WI53405
93-0838390 		FOUNDATION WI 501(c)(3) 10 ASCENSION ALL SAINTS HOSPITAL INC (FKA WHEATON FRANCISCAN HEALTHCARE-ALL SA
INTS INC)
Yes
 
(43)WHEATON FRANCISCAN - ELMBROOK MEMORIAL FOUNDATION INC
3237 SOUTH 16TH STREET

MILWAUKEE,WI53215
39-2028808 		FOUNDATION WI 501(c)(3) Type I ASCENSION SE WISCONSIN HOSPITAL INC (FKA WHEATON FRANCISCAN INC)
 
Yes
 
(44)WHEATON FRANCISCAN - ST JOSEPH FOUNDATION INC
5000 WEST CHAMBERS STREET

MILWAUKEE,WI53210
39-1636804 		FOUNDATION WI 501(c)(3) Type I ASCENSION SE WISCONSIN HOSPITAL INC (FKA WHEATON FRANCISCAN INC)
 
Yes
 
(45)WHEATON FRANCISCAN HEALTHCARE - ALL SAINTS FOUNDATION INC
3805B SPRING STREET

RACINE,WI53405
39-1570877 		FOUNDATION WI 501(c)(3) 7 ASCENSION ALL SAINTS HOSPITAL INC (FKA WHEATON FRANCISCAN HEALTHCARE-ALL SA
INTS INC)
Yes
 
(46)WHEATON FRANCISCAN HEALTHCARE-CIRCLE OF LIFE FOUNDATION INC
4300 BROWN DEER ROAD
SUITE 250
BROWN DER,WI53223
56-2426294 		FOUNDATION WI 501(c)(3) Type I ASCENSION WISCONSIN PHARMACY INC (FKA WHEATON FRANCISCAN HEALTHCARE-PHARMAC
Y ENTERPRISES & FRANCISCAN WOODS INC)
Yes
 
(47)WHEATON FRANCISCAN HEALTHCARE - ELMBROOK MEMORIAL AUXILIARY
19333 WEST NORTH AVENUE

BROOKFIELD,WI53045
39-6068950 		AUXILIARY WI 501(c)(3) Type III-FI ASCENSION SE WISCONSIN HOSPITAL INC (FKA WHEATON FRANCISCAN INC)
 
Yes
 
(48)WHEATON FRANCISCAN HEALTHCARE - FOUNDATION FOR ST FRANCIS AND FRANKLIN INC
3237 SOUTH 16TH STREET

MILWAUKEE,WI53215
32-0135258 		FOUNDATION WI 501(c)(3) Type I ASCENSION ST FRANCIS HOSPITAL INC (FKA WHEATON FRANCISCAN HEALTHCARE-ST FRA
NCIS INC)
Yes
 
(49)WHEATON FRANCISCAN HEALTHCARE-FRANKLIN INC
10101 SOUTH 27TH STREET

FRANKLIN,WI53132
56-2592868 		HOSPITAL WI 501(c)(3) 3 WHEATON FRANCISCAN HEALTHCARE-SOUTHEAST WISCONSIN INC
 
Yes
 
(50)WISCONSIN PSYCHOANALYTIC FOUNDATION INC
2323 NORTH LAKE DRIVE
1ST FLOOR
MILWAUKEE,WI53211
39-1377923 		FOUNDATION WI 501(c)(3) 7 COLUMBIA ST MARY'S HOSPITAL MILWAUKEE INC
 
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
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
Yes No Yes No
(1) TWINMED LLP

222 W College Ave Suite 3B
Appleton,WI54911
39-1180341 		REAL ESTATE WI NA
  		N/A                












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?
Yes No
(1) PROSPECT MEDICAL COMMONS CONDOMINIUM ASSOCIATION INC

4425 N PORT WASHINGTON RD
GLENDALE,WI53212
20-8042108 		CONDO ASSOCIATION WI NA
  		C Corporation       Yes  
(2) FRANKLIN MEDICAL OFFICE BUILDING CONDOMINIUM ASSOCIATION INC

400 WEST RIVER WOODS PARKWAY
GLENDALE,WI53212
34-1983857 		CONDO ASSOCIATION WI WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN INC
  		C Corporation 0 0 100 % Yes  
(3) WHEATON FRANCISCAN HOLDINGS INC

400 WEST RIVER WOODS PARKWAY
GLENDALE,WI53212
39-1836357 		HOLDING CO WI WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN INC
  		C Corporation 4,025,686 830,958 100 % Yes  
(4) WHEATON FRANCISCAN PROVIDER NETWORK INC

400 WEST RIVER WOODS PARKWAY
GLENDALE,WI53212
39-1952140 		PROVIDER CONTRACT WI WHEATON FRANCISCAN HEALTHCARE - SOUTHEAST WISCONSIN INC
  		C Corporation 28,660 2,540 100 % Yes  
(5) MADISON MEDICAL AFFILIATES INC

4425 N PORT WASHINGTON RD
GLENDALE,WI53212
39-1855720 		HEALTHCARE WI NA
  		C Corporation       Yes  
(6) WHEATON WAY CONDOMINIUM OWNERS ASSOCIATION INC

10101 SOUTH 27TH STREET
FRANKLIN,WI53123
30-0659830 		CONDO ASSOCIATION WI NA
  		C Corporation       Yes  
(7) WHEATON FRANCISCAN ENTERPRISES INC

400 WEST RIVER WOODS PARKWAY
GLENDALE,WI53212
39-1985204 		HOLDING CO WI NA
  		C Corporation       Yes  
(8) WHEATON FRANCISCAN MEDICAL GROUP - SUSSEX INC

400 WEST RIVER WOODS PARKWAY
GLENDALE,WI53212
39-1361100 		HEALTHCARE WI NA
  		C Corporation       Yes  
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
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
No
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 .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
 
No
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
Yes
 
2
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
(1) ASCENSION ALL SAINTS HOSPITAL INC (FKA WHEATON FRANCISCAN HEALTHCARE-ALL SA
INTS INC)
 L 6,661,350 FAIR MARKET VALUE
(2) ASCENSION ALL SAINTS HOSPITAL INC (FKA WHEATON FRANCISCAN HEALTHCARE-ALL SA
INTS INC)
 M 149,714 FAIR MARKET VALUE
(3) ASCENSION ALL SAINTS HOSPITAL INC (FKA WHEATON FRANCISCAN HEALTHCARE-ALL SA
INTS INC)
 Q 12,934,426 FAIR MARKET VALUE
(4) ASCENSION ALL SAINTS HOSPITAL INC (FKA WHEATON FRANCISCAN HEALTHCARE-ALL SA
INTS INC)
 S 298,672,375 FAIR MARKET VALUE
(5) ASCENSION MEDICAL GROUP-SOUTHEAST WISCONSIN INC (FKA WHEATON FRANCISCAN MED
ICAL GROUP INC)
 Q 13,995,999 FAIR MARKET VALUE
(6) ASCENSION SE WISCONSIN HOSPITAL INC (FKA WHEATON FRANCISCAN INC)

 L 1,570,278 FAIR MARKET VALUE
(7) ASCENSION SE WISCONSIN HOSPITAL INC (FKA WHEATON FRANCISCAN INC)

 M 154,377 FAIR MARKET VALUE
(8) ASCENSION SE WISCONSIN HOSPITAL INC (FKA WHEATON FRANCISCAN INC)

 Q 3,391,698 FAIR MARKET VALUE
(9) ASCENSION SE WISCONSIN HOSPITAL INC (FKA WHEATON FRANCISCAN INC)

 S 288,789,006 FAIR MARKET VALUE
(10) ASCENSION ST FRANCIS HOSPITAL INC (FKA WHEATON FRANCISCAN HEALTHCARE-ST FRA
NCIS INC)
 L 286,718 FAIR MARKET VALUE
(11) ASCENSION ST FRANCIS HOSPITAL INC (FKA WHEATON FRANCISCAN HEALTHCARE-ST FRA
NCIS INC)
 M 80,637 FAIR MARKET VALUE
(12) ASCENSION ST FRANCIS HOSPITAL INC (FKA WHEATON FRANCISCAN HEALTHCARE-ST FRA
NCIS INC)
 Q 1,325,215 FAIR MARKET VALUE
(13) ASCENSION ST FRANCIS HOSPITAL INC (FKA WHEATON FRANCISCAN HEALTHCARE-ST FRA
NCIS INC)
 S 153,574,775 FAIR MARKET VALUE
(14) ASCENSION WISCONSIN LABORATORIES INC (FKA WHEATON FRANCISCAN LABORATORIES I
NC)
 L 504,721 FAIR MARKET VALUE
(15) ASCENSION WISCONSIN LABORATORIES INC (FKA WHEATON FRANCISCAN LABORATORIES I
NC)
 Q 706,058 FAIR MARKET VALUE
(16) ASCENSION WISCONSIN LABORATORIES INC (FKA WHEATON FRANCISCAN LABORATORIES I
NC)
 S 6,158,589 FAIR MARKET VALUE
(17) ASCENSION WISCONSIN PHARMACY INC (FKA WHEATON FRANCISCAN HEALTHCARE-PHARMAC
Y ENTERPRISES AND FRANCISCAN WOODS INC)
 L 1,654,097 FAIR MARKET VALUE
(18) ASCENSION WISCONSIN PHARMACY INC (FKA WHEATON FRANCISCAN HEALTHCARE-PHARMAC
Y ENTERPRISES AND FRANCISCAN WOODS INC)
 Q 2,071,042 FAIR MARKET VALUE
(19) ASCENSION WISCONSIN PHARMACY INC (FKA WHEATON FRANCISCAN HEALTHCARE-PHARMAC
Y ENTERPRISES AND FRANCISCAN WOODS INC)
 S 16,275,714 FAIR MARKET VALUE
(20) WHEATON FRANCISCAN - ELMBROOK MEMORIAL FOUNDATION INC

 Q 85,382 FAIR MARKET VALUE
(21) WHEATON FRANCISCAN HEALTHCARE - FRANKLIN INC

 L 5,673,298 FAIR MARKET VALUE
(22) WHEATON FRANCISCAN HEALTHCARE - FRANKLIN INC

 Q 8,494,447 FAIR MARKET VALUE
(23) WHEATON FRANCISCAN HEALTHCARE - FRANKLIN INC

 S 84,716,691 FAIR MARKET VALUE
(24) WHEATON FRANCISCAN HEALTHCARE SUSSEX MEDICAL GROUP

 Q 318,180 FAIR MARKET VALUE
Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
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) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(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? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2019
Schedule R (Form 990) 2019
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2019

Additional Data


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