TY 2021 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(1) MARK BEHL...................................................................... DIRECTOR & EVP/FH COO	1.00 ................. 49.00	X			0	1,424,699	200,708
(2) MICHELLE L BIRSCHBACH...................................................................... CO-CHAIR	1.00 ................. 0.00	X	X		0	0	0
(3) MATTHEW L CAMPBELL MD...................................................................... DIRECTOR	50.00 ................. 0.00	X			63,629	366,187	42,682
(4) CANDICE GIESEN...................................................................... DIRECTOR	1.00 ................. 0.00	X			0	0	0
(5) MILAN JORDAN MD...................................................................... DIRECTOR	50.00 ................. 0.00	X			64,038	352,741	45,073
(6) MARILYN A KAUFMANN PHD RN...................................................................... CHAIR	1.00 ................. 0.00	X	X		0	0	0
(7) SISTER NANCY KINATE...................................................................... SECRETARY	1.00 ................. 0.00	X	X		0	0	0
(8) CHARLES KRUEGER...................................................................... DIRECTOR	1.00 ................. 0.00	X			0	0	0
(9) STEVEN LITTLE...................................................................... SR. VP & PRESIDENT	50.00 ................. 0.00	X	X		0	602,003	71,713
(10) SISTER MARY FRANCES MAHER...................................................................... DIRECTOR	1.00 ................. 0.00	X			0	0	0
(11) GENEVIEVE SHIELDS...................................................................... DIRECTOR	1.00 ................. 0.00	X			0	0	0
(12) THOMAS VEESER...................................................................... CHIEF NURSING OFFICER	50.00 ................. 0.00	X			34,841	186,095	69,612
(13) KENLYN T GRETZ...................................................................... DIRECTOR (TERMED 2-2022)	1.00 ................. 0.00	X			0	0	0
(14) JEFFREY VAN DE KREEKE...................................................................... TREASURER	1.00 ................. 49.00		X		0	594,531	34,997
(15) RYAN M DOPIRAK MD...................................................................... PHYSICIAN PROVIDER	50.00 ................. 0.00			X	116,042	716,820	50,799
(16) RICHARD MANOS MD...................................................................... PHYSICIAN PROVIDER	50.00 ................. 0.00			X	118,874	653,583	28,870
(17) EDWARD L SMITH MD...................................................................... PHYSICIAN PROVIDER	50.00 ................. 0.00			X	101,693	604,774	48,998

(A) Name and business address	(B) Description of services	(C) Compensation
XTEND HEALTHCARE LLC 90 VOLUNTEER DR STE 200 HENDERSONVILLE,TN37075	BILLING SERVICES	3,907,054
RIGHTSOURCING INC PO BOX 515743 LOS ANGELES,CA900515118	STAFFING SERVICES	1,906,861
MEDICAL SOLUTIONS LLC 1010 N 102ND ST STE 300 OMAHA,NE68114	STAFFING SERVICES	1,781,224
BELLIN MEMORIAL HOSPITAL INC 1630 COMMANCHE AVE GREEN BAY,WI54313	PROFESSIONAL SVCS	902,295
COMPLETERX LTD 3200 WILCREST DR STE 250 HOUSTON,TX77042	PHARMACY SERVICES	849,167
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 23

- TIN:

SCHEDULE A
(Form 990)

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

2021

Open to Public
Inspection

Name of the organization

HOLY FAMILY MEMORIAL INC

Employer identification number

39-0806395

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.)

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

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

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

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

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

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

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

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

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

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

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

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

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

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

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

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

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

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

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


Total

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

Cat. No. 11285F

Schedule A (Form 990) 2021

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)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

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

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2021 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2021. If the organization did not check the box on line 13, and line 14 is 33 1/3 % or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2020. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2021. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2020. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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

Schedule A (Form 990) 2021

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)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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 on line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2021 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2020 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2021 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2020 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2021. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2020. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

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

Schedule A (Form 990) 2021

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

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

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

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

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

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

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

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

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

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

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

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

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

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

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

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

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

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

10a

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

10a

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

10b

Schedule A (Form 990) 2021

Page 5

Part IV

Supporting Organizations (continued)

Yes

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

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

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

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

Section C. Type II Supporting Organizations

Yes

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

Section D. All Type III Supporting Organizations

Yes

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

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

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

Section E. Type III Functionally-Integrated Supporting Organizations

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

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

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

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

Activities Test. Answer lines 2a and 2b below.

Yes

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

Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

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

Schedule A (Form 990) 2021

Page 6

Part V

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

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

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

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 0.015 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 0.035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

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

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

Schedule A (Form 990) 2021

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	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2021 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2021	(iii) Distributable Amount for 2021
1 Distributable amount for 2021 from Section C, line 6
2 Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2021:
a From 2016.......
b From 2017.......
c From 2018.......
d From 2019.......
e From 2020.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2021 distributable amount
i Carryover from 2016 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2021 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2021 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2021, 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 2021. 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 2022. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2017.....
b Excess from 2018.....
c Excess from 2019.....
d Excess from 2020.....
e Excess from 2021.....

Schedule A (Form 990) (2021)

Schedule A (Form 990) 2021

Page 8

Part VI

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

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

Name of the organization

HOLY FAMILY MEMORIAL INC

Employer identification number

39-0806395

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

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

General Rule

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

Special Rules

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

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

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

Caution: An organization that 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) (2021)

Schedule B (Form 990) (2021) Page 2

Name of organization HOLY FAMILY MEMORIAL INC

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
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2021)

Schedule B (Form 990) (2021)

Page 3

Name of organization HOLY FAMILY MEMORIAL INC		Employer identification number 39-0806395

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) (2021)

Schedule B (Form 990) (2021)

Page 4


Name of organization HOLY FAMILY MEMORIAL INC			Employer identification number 39-0806395
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

Schedule B (Form 990) (2021)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

HOLY FAMILY MEMORIAL INC

Employer identification number

39-0806395

Part I

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

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

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

Yes No

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

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

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

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

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

Yes No

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

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

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

Yes No

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

Part III

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

If the organization elected, as permitted under 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.

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

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:

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

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

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

Cat. No. 52283D

Schedule D (Form 990) 2021

Page 2

Part III

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

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

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

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

Yes No

Part IV

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

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

Yes No


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

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

Yes No

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

Part V

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

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

1a	Beginning of year balance ....	3,974,887	3,888,220	3,792,351	3,157,405	3,160,846
b	Contributions ...	70,890	14,813	170,642	726,675	203,946
c	Net investment earnings, gains, and losses	-487,031	111,690	265,013	264,841	-91,795
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	59,513	39,836	339,786	356,570	115,592
f	Administrative expenses ....
g	End of year balance ......	3,499,233	3,974,887	3,888,220	3,792,351	3,157,405

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

Board designated or quasi-endowment SchDMd Bullet

87.400 %

Permanent endowment SchDMd Bullet

9.700 %

Term endowment SchDMd Bullet

2.900 %

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

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

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

Yes

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

Yes

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 .....	7,420,931		7,420,931
b	Buildings ....	5,476,460	262,399	5,214,061
c	Leasehold improvements
d	Equipment ....	17,462,634	4,726,099	12,736,535
e	Other .....	1,474,405	65,246	1,409,159
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				26,780,686

Schedule D (Form 990) 2021

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
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

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

Part IX

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

(a) Description				(b) Book value
(1)BOARD DESIGNATED - OTHER				4,042,846
(2)MISCELLANEOUS A/R				1,792,381
(3)DUE FROM AFFILIATES				572,531
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				6,407,758

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
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	350,207
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) 2021

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

PART V, LINE 4:

HOLY FAMILY MEMORIAL'S ENDOWMENT FUNDS WERE ESTABLISHED TO PROVIDE FINANCIAL SUPPORT ON AN ONGOING BASIS TO MEET THE CURRENT AND FUTURE NEEDS OF HOLY FAMILY MEMORIAL AND THE PEOPLE IT SERVES. FUNDS ARE USED FOR CAPITAL EQUIPMENT, MAJOR BUILDING IMPROVEMENTS, PROGRAM DEVELOPMENT, AND OPERATIONS.

PART X, LINE 2:

THE SYSTEM APPLIES ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740, INCOME TAXES. ASC TOPIC 740 PRESCRIBES A MORE-LIKELY THAN-NOT RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN. UNDER ASC TOPIC 740, TAX POSITIONS ARE EVALUATED FOR RECOGNITION, DERECOGNITION, AND MEASUREMENT USING CONSISTENT CRITERIA AND PROVIDE MORE INFORMATION ABOUT THE UNCERTAINTY IN INCOME TAX ASSETS AND LIABILITIES. AS OF JUNE 30, 2022 AND 2021, THE SYSTEM DOES NOT HAVE AN ASSET OR LIABILITY RECORDED FOR UNRECOGNIZED TAX POSITIONS.

Schedule D (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G (Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" on Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. 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

2021

Open to Public Inspection

Name of the organization
HOLY FAMILY MEMORIAL INC

Employer identification number

39-0806395

Part I

Fundraising Activities.Complete if the organization answered "Yes" on Form 990, Part IV, line 17.

Form 990-EZ filers are not required to complete this part.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

YesNo

If "Yes," list the 10 highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

(i) Name and address of individual or entity (fundraiser)	(iii) Did fundraiser have custody or control of contributions?
	Yes	No










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

List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.

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

Cat. No. 50083H

Schedule G (Form 990) 2021

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.

		(a) Event #1 SAMARITAN DAY (event type)	(b) Event #2 LOVE LIGHTS (event type)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	23,325	8,585	31,910
2	Less: Contributions . . . .	3,720		3,720
3	Gross income (line 1 minus line 2) . . . . . .	19,605	8,585	28,190

4	Cash prizes . . . . .
5	Noncash prizes . . . .
6	Rent/facility costs . . . .
7	Food and beverages . . .
8	Entertainment . . . .
9	Other direct expenses . . .	7,587	135	7,722
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .			7,722
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .			20,468

Part III

Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

		(a) Bingo	(b) Pull tabs/Instant bingo/progressive bingo	(c) Other gaming	(d) Total gaming (add col.(a) through col.(c))
1	Gross revenue . . . . .

2	Cash prizes . . . . .
3	Noncash prizes . . . .
4	Rent/facility costs . . . .
5	Other direct expenses . . .

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow

Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow

Enter the state(s) in which the organization conducts gaming activities:

Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .

YesNo

If "No," explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .

YesNo

If "Yes," explain:

Schedule G (Form 990) 2021

Page 3

Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? . . . . . . . . . . . . . . . . .

YesNo

Indicate the percentage of gaming activity conducted in:

The organization's facility . . . . . . . . . . . . . . . . . .

13a

An outside facility . . . . . . . . . . . . . . . . . . . .

13b

Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? . . . . . . . . . . . . . . . . . . . . . . . .

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? . . . . . . . . . . . . . . . . . . .

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also provide any additional information. See instructions.

Return Reference	Explanation

Schedule G (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

HOLY FAMILY MEMORIAL INC

Employer identification number

39-0806395

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

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

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

Yes

100% 150% 200% Other 25000.0000000000 %

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

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

Yes

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

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

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

Yes

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

Yes

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

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .			276,471	0	276,471	0.190 %
b	Medicaid (from Worksheet 3, column a) . . . . .			17,523,014	6,587,332	10,935,682	7.470 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .			0	0		0 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .			17,799,485	6,587,332	11,212,153	7.660 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	17	6,950	192,071	0	192,071	0.130 %
f	Health professions education (from Worksheet 5) . . .	4	113	117,214	0	117,214	0.080 %
g	Subsidized health services (from Worksheet 6) . . . .	0	0	0	0		0 %
h	Research (from Worksheet 7) .	0	0	0	0		0 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	10	3,122	144,652	0	144,652	0.100 %
j	Total. Other Benefits . .	31	10,185	453,937		453,937	0.310 %
k	Total. Add lines 7d and 7j .	31	10,185	18,253,422	6,587,332	11,666,090	7.970 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2021

Schedule H (Form 990) 2021

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
2	Economic development	1	75	9,760	0	9,760	0.010 %
3	Community support	1	0	2,327	0	2,327	0 %
4	Environmental improvements	0	0	0	0
5	Leadership development and training for community members	0	0	0	0
6	Coalition building	0	0	0	0
7	Community health improvement advocacy	0	0	0	0
8	Workforce development	2	6	961	0	961	0 %
9	Other	0	0	0	0
10	Total	4	81	13,048		13,048	0.010 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

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

4,959,532

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

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

Section B. Medicare

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

16,741,196

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

23,285,130

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

-6,543,934

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

Yes

Part IV

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

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
11 NONE
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2021

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)
1	HOLY FAMILY MEMORIAL INC 2300 WESTERN AVENUE PO BOX 1450 MANITOWOC,WI542211450 WWW.HFMHEALTH.ORG	X	X	X

Schedule H (Form 990) 2021

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)

	HOLY FAMILY MEMORIAL INC
Name of hospital facility or letter of facility reporting group

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

Yes

Community Health Needs Assessment

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

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 22

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

Yes

6 a

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

Yes

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

Yes

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

Yes

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

Hospital facility’s website (list url): WWW.HFMHEALTH.ORG/ABOUT/COMMUNITY-IMPACT

Other website (list url): HEALTHIESTMC.ORG; MANITOWOCCOUNTYWI.GOV/

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

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 22

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

Yes

If "Yes" (list url): WWW.HFMHEALTH.ORG/ABOUT/COMMUNITY-IMPACT

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

10b

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

12a

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

12a

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

12b

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

Schedule H (Form 990) 2021

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	HOLY FAMILY MEMORIAL INC
Name of hospital facility or letter of facility reporting group

Yes

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

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

Yes

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

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 250.000000000000%
and FPG family income limit for eligibility for discounted care of 400.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

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

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

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

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

WWW.HFMHEALTH.ORG/COMMUNITY-CARE/

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

SEE PART V

A plain language summary of the FAP was widely available on a website (list url):
SAME AS 16B

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

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

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

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

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

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2021

Page 6

Part VFacility Information (continued)

Billing and Collections

	HOLY FAMILY MEMORIAL INC
Name of hospital facility or letter of facility reporting group

Yes

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?..................................

Yes

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

Schedule H (Form 990) 2021

Page 7

Part VFacility Information (continued)

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

	HOLY FAMILY MEMORIAL INC
Name of hospital facility or letter of facility reporting group

Yes

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

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 2021

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
PART V, LINE 5	COMMUNITY HEALTH NEEDS ASSESSMENT:IN 2022, A CHNA WAS CONDUCTED TO 1) DETERMINE CURRENT COMMUNITY HEALTH NEEDS IN MANITOWOC COUNTY, 2) GATHER INPUT FROM PERSONS WHO REPRESENT THE BROAD INTEREST OF THE COMMUNITY AND IDENTIFY COMMUNITY ASSETS, 3) IDENTIFY AND PRIORITIZE SIGNIFICANT HEALTH NEEDS, AND 4) DEVELOP IMPLEMENTATION STRATEGIES TO ADDRESS THE PRIORITIZED HEALTH NEEDS. HOLY FAMILY MEMORIAL ASSESSED THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES THROUGH A COMPREHENSIVE DATA COLLECTION PROCESS FROM A NUMBER OF KEY SOURCES. DATA AND RESEARCH INCLUDED INFORMATION FROM COMMUNITY MEMBERS, PUBLIC HEALTH OFFICIALS, COMMUNITY LEADERS/EXPERTS, AND NON-PROFIT ORGANIZATIONS REPRESENTING VULNERABLE POPULATIONS IN OUR SERVICE AREA. INFORMATION/DATA SOURCES WERE COLLECTED AND TAKEN INTO CONSIDERATION FOR ASSESSING AND ADDRESSING COMMUNITY HEALTH NEEDS. THESE INCLUDED A COMMUNITY HEALTH SURVEY, KEY STAKEHOLDER INTERVIEWS, SECONDARY DATA ANALYSIS AND INTERNAL HOSPITAL DATA ANALYSIS. FOR THE TAX YEAR ENDED JUNE 30, 2022, THIS INCLUDES THE TIME PERIOD REPORTED IN THIS FORM 990, HOLY FAMILY MEMORIAL ADDRESSED THE SIGNIFICANT HEALTH NEEDS THAT WERE IDENTIFIED IN ITS 2019 CHNA AND IN WHICH THE IMPLEMENTATION STRATEGY WAS ADOPTED FOR FISCAL YEARS 2020, 2021, AND 2022. AS OF MARCH 1, 2021, BFHFM, LLC OWNS 80% OF HFM AS A CORPORATE MEMBER. FROEDTERT HEALTH INC OWNS 100% OF BFHFM, LLC. FROEDTERT HEALTH HAS UNTIL JUNE, 30, 2023 TO BE IN FULL COMPLIANCE WITH IRC 501(R)(3).IN 2019, A CHNA WAS CONDUCTED TO 1) DETERMINE CURRENT COMMUNITY HEALTH NEEDS IN MANITOWOC COUNTY, 2) GATHER INPUT FROM PERSONS WHO REPRESENT THE BROAD INTEREST OF THE COMMUNITY AND IDENTIFY COMMUNITY ASSETS, 3) IDENTIFY AND PRIORITIZE SIGNIFICANT HEALTH NEEDS, AND 4) DEVELOP IMPLEMENTATION STRATEGIES TO ADDRESS THE PRIORITIZED HEALTH NEEDS. HOLY FAMILY MEMORIAL ASSESSED THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES THROUGH A COMPREHENSIVE DATA COLLECTION PROCESS FROM A NUMBER OF KEY SOURCES. DATA AND RESEARCH INCLUDED INFORMATION FROM COMMUNITY MEMBERS, PUBLIC HEALTH OFFICIALS, COMMUNITY LEADERS/EXPERTS, AND NON-PROFIT ORGANIZATIONS REPRESENTING VULNERABLE POPULATIONS IN OUR SERVICE AREA. THE FOLLOWING INFORMATION/DATA SOURCES WAS COLLECTED AND TAKEN INTO CONSIDERATION FOR ASSESSING AND ADDRESSING COMMUNITY HEALTH NEEDS:COMMUNITY HEALTH SURVEY: USING THE CENTER FOR DISEASE CONTROL'S BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS), A TELEPHONE-BASED SURVEY OF 400 RESIDENTS WAS CONDUCTED BY HOLY FAMILY MEMORIAL IN COLLABORATION WITH AURORA HEALTH CARE, LAKESHORE CAP, LAKESHORE COMMUNITY HEALTH CENTER, UNITED WAY MANITOWOC COUNTY AND THE MANITOWOC COUNTY HEALTH DEPARTMENT. THE FULL REPORT OF THIS SURVEY CAN BE FOUND AT HTTPS://WWW.HFMHEALTH.ORG/ABOUT/COMMUNITY-IMPACT/. KEY INFORMANT INTERVIEWS: HOLY FAMILY MEMORIAL LEADERS CONDUCTED 31 IN-PERSON INTERVIEWS WITH 32 COMMUNITY LEADERS OF VARIOUS SCHOOL DISTRICTS, NON-PROFIT ORGANIZATIONS, HEALTH & HUMAN SERVICE DEPARTMENT AND BUSINESS LEADERS. THE FULL KEY INFORMANT RESULTS CAN BE FOUND AT HTTPS://WWW.HFMHEALTH.ORG/ABOUT/COMMUNITY-IMPACT/. COMMUNITY PARTNER/AGENCY REPORTS: TO BETTER UNDERSTAND THE NEEDS OF OUR UNDERSERVED POPULATIONS, HOLY FAMILY MEMORIAL OBTAINED IMPORTANT DATA AND TRENDS FROM PARTNER ORGANIZATIONS SUCH AS LAKESHORE COMMUNITY HEALTH CENTER, UNITED WAY MANITOWOC COUNTY ALICE REPORT, AND OTHERS TO SEEK IMPORTANT TRENDS, DEMOGRAPHIC DATA AND SERVICES TO PROVIDE AN INCLUSIVE VIEWPOINT OF COMMUNITY NEEDS FOR THESE UNREPRESENTED POPULATIONS.SECONDARY DATA REPORTS: UTILIZING MULTIPLE COUNTY AND COMMUNITY-BASED PUBLICLY AVAILABLE REPORTS, INFORMATION WAS GATHERED REGARDING: MORTALITY/MORBIDITY DATA, INJURY HOSPITALIZATIONS, EMERGENCY DEPARTMENT VISITS, MANITOWOC COUNTY HEALTH RANKINGS, PUBLIC SAFETY/CRIME REPORTS AND SOCIO-ECONOMIC DATA. A FULL SUMMARY OF SECONDARY DATA INFORMATION CAN BE FOUND AT HTTPS://WWW.HFMHEALTH.ORG/ABOUT/COMMUNITY-IMPACT/. HOLY FAMILY MEMORIAL IS COMMITTED TO ADDRESSING COMMUNITY HEALTH NEEDS COLLABORATIVELY WITH LOCAL PARTNERS. HOLY FAMILY MEMORIAL USED THE FOLLOWING METHODS TO GAIN COMMUNITY INPUT FROM FEBRUARY THROUGH MARCH 2019 ON THE SIGNIFICANT HEALTH NEEDS OF THE HOLY FAMILY MEMORIAL'S COMMUNITY. THESE METHODS PROVIDED ADDITIONAL PERSPECTIVES ON HOW TO SELECT AND ADDRESS TOP HEALTH ISSUES FACING HOLY FAMILY MEMORIAL'S COMMUNITY.INPUT FROM COMMUNITY MEMBERS:KEY INFORMANT INTERVIEWS: KEY ORGANIZATIONS WITH SPECIFIC KNOWLEDGE AND INFORMATION RELEVANT TO THE SCOPE OF THE IDENTIFIED SIGNIFICANT HEALTH NEEDS ("INFORMANTS") IN HOLY FAMILY MEMORIAL'S COMMUNITY, INCLUDING MANITOWOC COUNTY, WERE IDENTIFIED BY ORGANIZATIONS AND PROFESSIONALS THAT REPRESENT THE BROAD NEEDS OF THE COMMUNITY AS WELL AS ORGANIZATIONS THAT SERVE LOW-INCOME AND UNDERSERVED POPULATIONS. THESE LOCAL PARTNERING ORGANIZATIONS ALSO INVITED THE INFORMANTS TO PARTICIPATE IN AND CONDUCT THE INTERVIEWS. THE INTERVIEWERS USED A STANDARD INTERVIEW SCRIPT THAT INCLUDED THE FOLLOWING ELEMENTS:RANKING OF UP TO FIVE PUBLIC HEALTH ISSUES, BASED ON THE FOCUS AREAS PRESENTED IN WISCONSIN'S STATE HEALTH PLAN, THAT ARE THE MOST IMPORTANT ISSUES FOR THE COUNTY; ANDFOR THOSE FIVE PUBLIC HEALTH ISSUES:-EXISTING STRATEGIES TO ADDRESS THE ISSUE,-BARRIERS AND CHALLENGES TO ADDRESSING THE ISSUE,-ADDITIONAL STRATEGIES NEEDED,-KEY GROUPS IN THE COMMUNITY THAT HOSPITALS SHOULD PARTNER WITH TO IMPROVE COMMUNITY HEALTH,-IDENTIFICATION OF SUBGROUPS OR SUBPOPULATIONS WHERE EFFORTS COULD BE TARGETED, AND-WAYS EFFORTS CAN BE TARGETED TOWARD EACH SUBGROUP OR SUBPOPULATION.UNDERSERVED POPULATION INPUT: HOLY FAMILY MEMORIAL IS DEDICATED TO REDUCING HEALTH DISPARITIES AND INPUT FROM COMMUNITY MEMBERS WHO ARE MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS AND/OR ORGANIZATIONS THAT REPRESENT THOSE POPULATIONS ARE IMPORTANT IN ADDRESSING COMMUNITY HEALTH NEEDS. WITH THAT IN MIND, HOLY FAMILY MEMORIAL TOOK THE FOLLOWING STEPS TO GAIN INPUT:-COMMUNITY HEALTH SURVEY: WHEN APPROPRIATE, DATA WAS STRATIFIED BY GENDER, AGE, EDUCATION HOUSEHOLD INCOME LEVEL AND MARITAL STATUS.-KEY INFORMANT INTERVIEWS: THE KEY INFORMANT INTERVIEWS INCLUDED INPUT FROM MEMBERS OF ORGANIZATIONS REPRESENTING MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS.SUMMARY OF COMMUNITY MEMBER INPUT:TOP FIVE HEALTH ISSUES RANKED MOST CONSISTENTLY OR MOST OFTEN CITED FOR MANITOWOC COUNTY WERE: KEY INFORMANT INTERVIEWS FOR-MENTAL HEALTH,-SUBSTANCE USE AND ABUSE,-ALCOHOL ABUSE,-ADVERSE CHILDHOOD EXPERIENCES, AND-ACCESS TO HEALTH CARE.COMMUNITY HEALTH SURVEY:-ILLEGAL DRUG USE,-ALCOHOL USE OR ABUSE,-PRESCRIPTION OR OTC DRUG ABUSE,-ACCESS TO HEALTH CARE, AND-CHRONIC DISEASES.AFTER ADOPTION OF THE CHNA REPORT AND IMPLEMENTATION STRATEGY, HOLY FAMILY MEMORIAL PUBLICLY SHARES BOTH DOCUMENTS WITH COMMUNITY PARTNERS, KEY INFORMANTS, HOSPITAL BOARD MEMBERS, PUBLIC SCHOOLS, NON-PROFITS, HOSPITAL COALITION MEMBERS, THE MANITOWOC COUNTY HEALTH DEPARTMENT, AND THE GENERAL PUBLIC. DOCUMENTS ARE MADE AVAILABLE VIA EMAIL, HARD COPIES ARE MADE AVAILABLE AT APPLICABLE MEETINGS, AND ELECTRONIC COPIES ARE MADE AVAILABLE BY PDF FOR DOWNLOAD ON HTTPS://WWW.HFMHEALTH.ORG/ABOUT/COMMUNITY-IMPACT/. FEEDBACK AND PUBLIC COMMENTS ARE ALWAYS WELCOMED AND ENCOURAGED, AND CAN BE PROVIDED THROUGH THE CONTACT FORM ON THE FROEDTERT & THE MEDICAL COLLEGE OF WISCONSIN WEBSITE AT HTTPS://WWW.FROEDTERT.COM/CONTACT, OR CONTACTING FROEDTERT HEALTH, INC.'S COMMUNITY ENGAGEMENT LEADERSHIP/STAFF WITH QUESTIONS AND CONCERNS BY CALLING 414-777-1926. HOLY FAMILY MEMORIAL RECEIVED NO COMMENTS OR ISSUES WITH THE PREVIOUS COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND IMPLEMENTATION STRATEGY.
PART V, LINE 5(CONT)	MANITOWOC COUNTY KEY INFORMANT INTERVIEW ORGANIZATIONS:AGING AND DISABILITY RESOURCE CENTER OF THE LAKESHORE- PROVIDES INFORMATION, ASSISTANCE, AND ACCESS TO SERVICES AND COMMUNITY RESOURCES FOR SENIORS AND ADULTS WITH DISABILITIES;ASCEND SERVICES, INC- NONPROFIT THAT PROVIDES SERVICES TO INDIVIDUALS WITH EXCEPTION ABILITIES THROUGH COMMUNITY EXPERIENCES, EDUCATION AND EMPLOYMENT OPPORTUNITIES;CITY OF MANITOWOC- LOCAL GOVERNMENT;FIRST PRESBYTERIAN CHURCH- FAITH-BASED ORGANIZATION;UW-EXTENSION MANITOWOC COUNTY- DESIGNS EDUCATIONAL PROGRAMS FOCUSED ON AGRICULTURE, COMMUNITY DEVELOPMENT, HUMAN DEVELOPMENT & RELATIONSHIPS, NUTRITION EDUCATION, 4-H YOUTH DEVELOPMENT, AND POSITIVE YOUTH DEVELOPMENT;HOLY FAMILY MEMORIAL- HEALTH CARE ORGANIZATION;HOLY FAMILY MEMORIAL BEHAVIORAL HEALTH- DEPARTMENT THAT PROVIDES CARE TO INDIVIDUALS SEEKING BEHAVIORAL HEALTH SERVICES;HOPE HOUSE OF MANITOWOC COUNTY- NONPROFIT THAT PROVIDES SHELTER AND SUPPORTIVE SERVICES TO INDIVIDUALS AND FAMILIES EXPERIENCING HOMELESSNESS;IN COURAGE- NONPROFIT PROVIDING SERVICES FOR PEOPLE DEALING WITH DOMESTIC ABUSE;MANITOWOC COUNTY VETERANS SERVICES OFFICE- DEPARTMENT THAT PROVIDES SERVICES TO VETERANS;MANITOWOC COUNTY HEALTH DEPARTMENT- GOVERNMENT DEPARTMENT THAT PREVENTS DISEASE AND PROMOTES HEALTH;MANITOWOC COUNTY HUMAN SERVICES DEPARTMENT- PROVIDES COMMUNITY PROGRAMS AND SERVICES TO INDIVIDUALS AND FAMILIES CHALLENGED BY MENTAL HEALTH AND SUBSTANCE USE AND ABUSE;MANITOWOC PUBLIC SCHOOL DISTRICT- PROVIDES SERVICES FOR YOUTH;MANITOWOC-TWO RIVERS YMCA- NONPROFIT PROVIDING SERVICES THAT HELP PEOPLE IMPROVE THEIR HEALTH AND WELL-BEING;MARIBEL FOOD PANTRY- PROVIDES FOOD FOR LOW INCOME INDIVIDUALS & FAMILIES;LAKESHORE CAP- PROVIDES SERVICES TO HELP INDIVIDUALS AND FAMILIES ACHIEVE ECONOMIC SELF-SUFFICIENCY AND WELL-BEING;LAKESHORE TECHNICAL COLLEGE- HIGHER EDUCATION INSTITUTE;REEDSVILLE SCHOOL DISTRICT- PROVIDES SERVICES FOR YOUTH;ST. THOMAS THE APOSTLE- FAITH-BASED ORGANIZATION;THE CHAMBER OF MANITOWOC COUNTY- NONPROFIT SUPPORTING LOCAL BUSINESSES IN MANITOWOC COUNTY;THE CROSSING OF MANITOWOC COUNTY- NONPROFIT PROVIDING SUPPORT FOR INDIVIDUALS EXPERIENCING UNPLANNED PREGNANCIES;THE HAVEN OF MANITOWOC COUNTY, INC- NONPROFIT THAT PROVIDES SHELTER AND SUPPORTIVE SERVICES TO MEN EXPERIENCING HOMELESSNESS; ANDUNITED WAY MANITOWOC COUNTY- ENGAGES, CONVENES, AND MOBILIZES COMMUNITY RESOURCES TO ADDRESS ROOT CAUSES OF LOCAL HEALTH AND HUMAN SERVICES NEEDS.
PART V, SECTION B, LINE 6A	HOLY FAMILY MEMORIAL COLLABORATES WITH THE OTHER HOSPITAL SYSTEMS AND ORGANIZATIONS TO ASSESS THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES THROUGH A COMPREHENSIVE DATA COLLECTION PROCESS FROM A NUMBER OF KEY SOURCES. THIS SHARED CHNA SERVES AS THE FOUNDATION FOR HOLY FAMILY MEMORIAL AND IS THE BASIS FOR CREATION OF AN IMPLEMENTATION STRATEGY TO IMPROVE HEALTH OUTCOMES AND REDUCE DISPARITIES IN MANITOWOC COUNTY AND THE HOSPITAL'S PRIMARY SERVICE AREA.MANITOWOC COUNTY COLLABORATIVE PARTNERS:HOLY FAMILY MEMORIAL IN AFFILIATION WITH FROEDTERT & THE MEDICAL COLLEGE OF WISCONSIN;AURORA HEALTH CARE.AFTER COMPLETION OF THE SHARED CHNA, THE DATA WAS TAKEN INTO CONSIDERATION IN ORDER FOR HOLY FAMILY MEMORIAL TO CREATE AN INDEPENDENT CHNA AND IMPLEMENTATION STRATEGY SPECIFIC TO THE HOSPITAL'S SERVICE AREA AND COMMUNITY HEALTH NEEDS.
PART V, SECTION B, LINE 6B	HOLY FAMILY MEMORIAL COLLABORATES WITH THE OTHER HOSPITAL SYSTEMS AND ORGANIZATIONS TO ASSESS THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES THROUGH A COMPREHENSIVE DATA COLLECTION PROCESS FROM A NUMBER OF KEY SOURCES. THIS SHARED CHNA SERVES AS THE FOUNDATION FOR HOLY FAMILY MEMORIAL AND IS THE BASIS FOR CREATION OF AN IMPLEMENTATION STRATEGY TO IMPROVE HEALTH OUTCOMES AND REDUCE DISPARITIES IN MANITOWOC COUNTY AND THE HOSPITAL'S PRIMARY SERVICE AREA.MANITOWOC COUNTY ORGANIZATIONS:LAKESHORE CAP,LAKESHORE COMMUNITY HEALTH CENTER,UNITED WAY MANITOWOC COUNTY,MANITOWOC COUNTY HEALTH DEPARTMENT,JKV RESEARCH, ANDCENTER FOR URBAN POPULATION HEALTH.AFTER COMPLETION OF THE SHARED CHNA, THE DATA WAS TAKEN INTO CONSIDERATION IN ORDER FOR HOLY FAMILY MEMORIAL TO CREATE AN INDEPENDENT CHNA AND IMPLEMENTATION STRATEGY SPECIFIC TO THE HOSPITAL'S SERVICE AREA AND COMMUNITY HEALTH NEEDS.
PART V, SECTION B, LINE 7D	THE FULL VERSION OF THE MOST RECENT AND PAST CHNA SUMMARIES, REPORTS AND OTHER SUPPORTING DOCUMENTS CAN BE FOUND ON HOLY FAMILY MEMORIAL WEBSITE: HTTPS://WWW.HFMHEALTH.ORG/ABOUT/COMMUNITY-IMPACT/.
PART V, LINE 10A	HOLY FAMILY MEMORIAL'S IMPLEMENTATION STRATEGY IS POSTED ON OUR INTRANET SITE FOR STAFF, PHYSICIANS AND LEADERS AS WELL AS THE GENERAL PUBLIC THROUGH OUR EXTERNAL WEBSITE FROEDTERT.COM. TO ACCESS THE IMPLEMENTATION STRATEGY, PLEASE GO TO: HTTPS://WWW.HFMHEALTH.ORG/ABOUT/COMMUNITY-IMPACT/.
PART V, LINE 11	COMMUNITY HEALTH IMPROVEMENT PLAN FOR HOLY FAMILY MEMORIAL IS AVAILABLE ONLINE AT: HTTPS://WWW.HFMHEALTH.ORG/ABOUT/COMMUNITY-IMPACT/. FOR THE TAX YEAR ENDED JUNE 30, 2022, THIS INCLUDES THE TIME PERIOD REPORTED IN THIS FORM 990, HOLY FAMILY MEMORIAL ADDRESSED THE SIGNIFICANT HEALTH NEEDS THAT WERE IDENTIFIED IN ITS 2019 CHNA AND IN WHICH THE IMPLEMENTATION STRATEGY WAS ADOPTED FOR FISCAL YEARS 2020, 2021 AND 2022. THE 2022 CHNA WILL BE EFFECTIVE FOR FISCAL YEARS 2023, 2024 AND 2025 AND THE STRATEGY WAS IMPLEMENTED 11/30/2022.THE FISCAL YEAR 2020 - 2022 IMPLEMENTATION STRATEGY/COMMUNITY HEALTH IMPROVEMENT PLAN WAS REVIEWED AND ADOPTED BY THE HOLY FAMILY MEMORIAL BOARD OF DIRECTORS ON 12/4/2019.TO IDENTIFY THE STRATEGIES, HOLY FAMILY MEMORIAL STAFF REVIEWED THE COMMUNITY NEEDS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT AND SELECTED THREE WHERE HOLY FAMILY MEMORIAL COULD MAKE THE MOST IMPACT AND WHICH THE ORGANIZATION HAD THE ABILITY TO EXECUTE. THE SELECTION WAS REVIEWED AND APPROVED BY HOLY FAMILY MEMORIAL EXECUTIVE LEADERSHIP, HOLY FAMILY MEMORIAL'S COMMUNITY ENGAGEMENT COMMITTEE, AND FINALLY THE HOLY FAMILY MEMORIAL BOARD OF DIRECTORS.THESE THREE OVERARCHING THEMES WERE IDENTIFIED AS PRIORITIES FOR HOLY FAMILY MEMORIAL'S FISCAL YEARS 2020 - 2022:-ALCOHOL USE OR ABUSE;-PRESCRIPTION OR OVER-THE-COUNTER DRUG ABUSE; AND-OVERWEIGHT OR OBESITY.SIGNIFICANT HEALTH NEEDS NOT ADDRESSED:BEHAVIORAL HEALTH: THIS IS INTEGRAL IN EVERY ASPECT OF HEALTH CARE AND HFM ADDRESSES IT THROUGHOUT THE SPECTRUM AS DO OTHER COMMUNITY ORGANIZATIONS;ADVERSE CHILDHOOD EXPERIENCES: THIS IS ADDRESSED BY HEALTHIEST MANITOWOC COUNTY, HUMAN SERVICES, AND THE COUNTY HEALTH DEPARTMENT;ACCESS TO HEALTH CARE: THIS IS ADDRESSED BY HEALTHIEST MANITOWOC COUNTY (HFM HAS STAFF ON THE COMMITTEE) LAKESHORE COMMUNITY HEALTH, AND PUBLIC HEALTH;CHRONIC DISEASE: HEALTHIEST MANITOWOC COUNTY (HFM HAS STAFF ON COMMITTEES), LAKESHORE COMMUNITY HEALTH CARE, AND THE HEALTH DEPARTMENT ARE LEADING THIS INITIATIVE;INJURY AND VIOLENCE: LEADERS IN THIS EFFORT ARE LOCAL COUNSELORS, MANITOWOC HEALTH DEPARTMENT, INCOURAGE, LAW ENFORCEMENT AND LOCAL GOVERNMENTS LEAD THE EFFORT. HFM SANE PROGRAM DOES PARTICIPATE;ORAL HEALTH: THIS IS LED PRIMARILY THROUGH DENTAL SERVICES AND LAKESHORE COMMUNITY HEALTH;ENVIRONMENTAL AND OCCUPATIONAL HEALTH: THE UW EXTENSION, FARM WISCONSIN DISCOVERY CENTER, FARM BUREAU, AND TECH COLLEGES FIGURE PROMINENTLY IN THIS EFFORT;COMMUNICABLE DISEASE: CHURCHES AND SCHOOLS ARE KEY PARTNERS WITH HEALTHIEST MANITOWOC COUNTY;HEALTHY GROWTH AND DEVELOPMENT: SCHOOLS, RETIREMENT COMMUNITIES, ADRC AND SENIOR CENTERS WORK WITH HEALTHIEST MANITOWOC COUNTY;REPRODUCTIVE AND SEXUAL HEALTH: PLANNED PARENTHOOD, LAKESHORE COMMUNITY HEALTH AND SOCIAL SERVICE AGENCIES ARE KEY PARTICIPANTS; ANDTOBACCO USE AND EXPOSURE: POLICE, PARENTS AND SCHOOLS WORK WITH HEALTHIEST MANITOWOC COUNTY ON THIS.HOLY FAMILY MEMORIAL SUMMARY OF IMPLEMENTATION STRATEGY:HOLY FAMILY MEMORIAL HAS COMPLETED AN IMPLEMENTATION STRATEGY THAT ADDRESSES THE HOSPITAL'S IMPLEMENTATION STRATEGY TO MEET THE COMMUNITY HEALTH NEEDS IDENTIFIED IN THIS CHNA. THE FOLLOWING IS A SUMMARY OF THAT SEPARATE, MORE COMPREHENSIVE IMPLEMENTATION STRATEGY REPORT.THE KEY PROGRAMS, STRATEGIES AND DEDICATED HOSPITAL RESOURCES INTENDED TO ADDRESS IDENTIFIED SIGNIFICANT COMMUNITY HEALTH NEEDS ARE ADDRESSED BELOW. COMMUNITY ENGAGEMENT AND HOLY FAMILY MEMORIAL HAVE DEDICATED EMPLOYEES AND BUDGETED FUNDS TOWARD SERVING THE NEEDS OF THE HOLY FAMILY MEMORIAL COMMUNITIES. TO ACCESS A COPY OF THE FULL IMPLEMENTATION STRATEGY, PLEASE GO TO HTTPS://WWW.HFMHEALTH.ORG/ABOUT/COMMUNITY-IMPACT/.TREATMENT, COMMUNITY COALITIONS AND EDUCATIONCHNA SIGNIFICANT HEALTH NEED: ALCOHOL USE OR ABUSEGOAL: IMPROVE SUBSTANCE ABUSE AND CARE SERVICES FOR OUR COMMUNITY.HOLY FAMILY MEMORIAL AVAILABLE RESOURCES:-PARTNER WITH CORE TREATMENT SERVICES TO OPEN RESIDENTIAL AODA TREATMENT BEDS AND ADDITIONAL OUTPATIENT SERVICES IN A FACILITY ON HOLY FAMILY MEMORIAL'S CAMPUS IN 2020;-PARTICIPATE IN HEALTHIEST MANITOWOC COUNTY AODA INITIATIVES TO ASSIST WITH COMMUNITY-WIDE EDUCATION AND OUTREACH;-PROVIDE AODA EDUCATION TO AREA VETERANS THROUGH OUTREACH/COMMUNITY EDUCATION INITIATIVESHOLY FAMILY MEMORIAL COLLABORATIVE PARTNERS:-CORE TREATMENT SERVICES,-HEALTHIEST MANITOWOC COUNTY, AND-VETERANS SERVICES.CORE TREATMENT SERVICES:FY 2020 OUTCOMES/PROGRESS:-CORE TREATMENT SERVICES OPENED IN MARCH 2020FY 2021 OUTCOMES/PROGRESS:-CORE TREATMENT SERVICES IN MARCH 2020;-IN FY21, CORE TREATMENT SERVICES ADDED TWO CRISIS BEDSFY 2022 OUTCOMES/PROGRESS:-NO OTHER SUPPORT WAS PROVIDED AFTER CORE OPENED IN MARCH 2020.HEALTHIEST MANITOWOC COUNTY:FY 2020 OUTCOMES/PROGRESS:-DID NOT HAPPEN IN FY20 DUE TO COVID-19FY 2021 OUTCOMES/PROGRESS:-DID NOT HAPPEN IN FY21 DUE TO COVID-19FY 2022 OUTCOMES/PROGRESS:-DID NOT HAPPEN IN FY22 DUE TO COVID-19.VETERANS SERVICES:FY 2020 OUTCOMES/PROGRESS:-PROVIDED MONTHLY COFFEE EVENTS FOR 2-3 VETERANSFY 2021 OUTCOMES/PROGRESS:-HOLY FAMILY MEMORIAL DID NOT PROVIDE EDUCATION AND OUTREACH DUE TO COVID-19 BUT CORE TREATMENT SERVICES ADDRESSED A PORTION OF NEEDS DUE TO THE HIGH NUMBER OF VETERANS SEEKING AODA SERVICESFY 2022 OUTCOMES/PROGRESS:-HOLY FAMILY MEMORIAL DID NOT PROVIDE EDUCATION AND OUTREACH DUE TO COVID-19 BUT CORE TREATMENT SERVICES ADDRESSED A PORTION OF NEEDS DUE TO THE HIGH NUMBER OF VETERANS SEEKING AODA SERVICES.EDUCATION, TRACKING, COMMUNITY COALITIONS AND TREATMENTCHNA SIGNIFICANT HEALTH NEED: PRESCRIPTION OR OVER-THE-COUNTER DRUG ABUSEGOAL: REDUCE PRESCRIPTION AND OVER-THE-COUNTER DRUG ABUSE IN MANITOWOC COUNTY.HOLY FAMILY MEMORIAL AVAILABLE RESOURCES:-PROVIDE PROVIDER EDUCATION ON OPIOID AND OTHER DRUG ABUSE;-IMPLEMENT EMR OPIOID TRACKING;-PARTICIPATE IN HEALTHIEST MANITOWOC COUNTY AODA COMMITTEES AND INITIATIVES;-PROVIDERS OFFER MEDICATION-ASSISTED-TREATMENT IN COLLABORATION WITH HOLY FAMILY MEMORIAL BEHAVIORAL HEALTHHOLY FAMILY MEMORIAL COLLABORATIVE PARTNERS:-HEALTHIEST MANITOWOC COUNTY,-AURORA HEALTHCARE, AND-LOCAL PHARMACIES. PROVIDER EDUCATION:FY 2020 OUTCOMES/PROGRESS:-THERE IS CONTINUED EDUCATION AROUND PRESCRIPTION OR OVER-THE-COUNTER DRUG ABUSE AT PROVIDER OPERATIONS COUNCIL MEETINGSFY 2021 OUTCOMES/PROGRESS:-THERE IS CONTINUED EDUCATION AROUND PRESCRIPTION OR OVER-THE-COUNTER DRUG ABUSE AT PROVIDER OPERATIONS COUNCIL MEETINGSFY 2022 OUTCOMES/PROGRESS:-THERE IS CONTINUED EDUCATION AROUND PRESCRIPTION OR OVER-THE-COUNTER DRUG ABUSE AT PROVIDER OPERATIONS COUNCIL MEETINGS.
PART V, LINE 11 (CONT)	EMR TRACKING:FY 2020 OUTCOMES/PROGRESS:-EMR TRACKING WAS ROLLED IN LATE 2020 WITH PROVIDER EDUCATION HAPPENING IN FY21;FY 2021 OUTCOMES/PROGRESS:-NO FURTHER SUPPORT WAS PROVIDED;FY 2022 OUTCOMES/PROGRESS:-NO FURTHER SUPPORT WAS PROVIDED.HEALTHIEST MANITOWOC COUNTY:FY 2020 OUTCOMES/PROGRESS:-DID NOT HAPPEN IN FY20 DUE TO COVID-19;FY 2021 OUTCOMES/PROGRESS:-DID NOT HAPPEN IN FY21 DUE TO COVID-19;FY 2022 OUTCOMES/PROGRESS:-DID NOT HAPPEN IN FY22 DUE TO COVID-19.MAT COLLABORATION:FY 2020 OUTCOMES/PROGRESS:-THERE ARE TWO PROVIDERS WHO OFFER MAT SERVICES;-100 PATIENTS WERE PRESCRIBED MEDICATIONS IN FY20;FY 2021 OUTCOMES/PROGRESS:-THERE ARE TWO PROVIDERS WHO OFFER MAT SERVICES;-144 PATIENTS WERE PRESCRIBED MEDICATIONS IN FY21;FY 2022 OUTCOMES/PROGRESS:-THERE ARE TWO PROVIDERS WHO OFFER MAT SERVICES;-92 PATIENTS WERE PRESCRIBED MEDICATIONS IN FY22.EDUCATION AND OUTREACHCHNA SIGNIFICANT HEALTH NEED: OVERWEIGHT OR OBESITYGOAL: MODEL AND INSPIRE HEALTHY NUTRITION AND EXERCISE TO ADDRESS OVERWEIGHT AND OBESITY.HOLY FAMILY MEMORIAL AVAILABLE RESOURCES:-ENHANCE EXISTING HOLY FAMILY MEMORIAL LEAN ON THE LAKESHORE EVENT TO KEEP FOCUS ON WEIGHT LOSS;-EXPAND MOVE MANITOWOC EFFORTS TO INCLUDE MORE BUSINESSES AND SHARE THE HEALTH BENEFITS OF BEING ACTIVE;-INCREASE UTILIZATION OF PRESCRIPTIONS FOR SERVICES THROUGH THE WELLNESS CENTERHOLY FAMILY MEMORIAL COLLABORATIVE PARTNERS:-AURORA HEALTHCARE,-LIGHTHOUSE RECOVERY,-FESTIVAL FOODS, AND-MANITOWOC PUBLIC WORKS DEPARTMENT.LEAN ON THE LAKESHORE:FY 2020 OUTCOMES/PROGRESS:-EVENT WAS CANCELLED DUE TO COVID-19 ISSUES;FY 2021 OUTCOMES/PROGRESS:-EVENT WAS CANCELLED PERMANENTLY DUE TO LACK OF INTEREST;FY 2022 OUTCOMES/PROGRESS:-EVENT WAS CANCELLED PERMANENTLY DUE TO LACK OF INTEREST.MOVE MANITOWOC:FY 2020 OUTCOMES/PROGRESS:-EFFORT HAS BEEN CANCELLED PERMANENTLY DUE TO COVID-19 ISSUES;FY 2021 OUTCOMES/PROGRESS:-EFFORT HAS BEEN CANCELLED PERMANENTLY DUE TO COVID-19 ISSUES;FY 2022 OUTCOMES/PROGRESS:-EFFORT HAS BEEN CANCELLED PERMANENTLY DUE TO COVID-19 ISSUES.PRESCRIPTIONS FOR WELLNESS CENTER SERVICES:FY 2020 OUTCOMES/PROGRESS:-58 INDIVIDUALS RECEIVED A PRESCRIPTION OR A FREE VOUCHER FOR WELLNESS CENTER SERVICES;FY 2021 OUTCOMES/PROGRESS:-95 INDIVIDUALS RECEIVED A PRESCRIPTION OR A FREE VOUCHER FOR WELLNESS CENTER SERVICES;FY 2022 OUTCOMES/PROGRESS:-51 INDIVIDUALS RECEIVED A PRESCRIPTION OR A FREE VOUCHER FOR WELLNESS CENTER SERVICES.OTHER ENGAGEMENT PROGRAMS AND INITIATIVESCOMMUNITY ENGAGEMENT PROACTIVELY ADDRESSES THE SOCIAL, CULTURAL AND ECONOMIC DETERMINANTS THAT UNDERPIN HEALTH AND SEEKS TO BUILD PARTNERSHIPS WITH OTHERS TO FIND SOLUTIONS. FROEDTERT & THE MEDICAL COLLEGE OF WISCONSIN ARE COMMITTED TO MAKING A POSITIVE, SUSTAINED DIFFERENCE IN OUR COMMUNITY. COMMUNITY ENGAGEMENT WILL STRENGTHEN THE ECONOMIC VITALITY AND QUALITY OF LIFE OF THOSE COMMUNITIES WE SERVE. HOLY FAMILY MEMORIAL COMMUNITY ENGAGEMENT PROGRAMMING AND HEALTH IMPROVEMENT ACTIVITIES ARE SUPPORTED THROUGH STAFF RESOURCES, BUDGETED DOLLARS FOR PROGRAMMING AND COMMUNITY PARTNERSHIPS. SEXUAL ASSAULT NURSE EXAMINER (SANE) AVAILABLE 24 HOURS A DAY (ACCESS TO CARE AND NAVIGATION)WHEN EMERGENCIES TAKE ON THE EVEN MORE TRAUMATIC ELEMENT OF SEXUAL ASSAULT, THE SPECIALLY TRAINED SANE PROGRAM STAFF HAS CREATED A SAFE HAVEN AT HOLY FAMILY MEMORIAL FOR COMPREHENSIVE, COMPASSIONATE CARE. SANE STAFF ARE REGISTERED NURSES WITH ADVANCED TRAINING IN MEDICAL-FORENSIC EXAMINATION AND IN THE PSYCHOLOGICAL AND EMOTIONAL TRAUMA PATIENT'S EXPERIENCE. THEY CARE FOR VICTIMS OF ALL AGES, RACES, AND POPULATIONS TO PROVIDE TIMELY EMOTIONAL SUPPORT. SANE NURSES ARE AVAILABLE TO SPEAK TO GROUPS AND ORGANIZATIONS. THEY ARE ALSO ABLE TO SERVE AS EXPERT WITNESSES IF CALLED TO TESTIFY AT A TRIAL. SERVICES PROVIDED:-PHYSICAL EXAMINATION AND WELLNESS CHECK,-COLLECTION OF MEDICAL-FORENSIC EVIDENCE,-ASSISTANCE WITH REPORTING THE CRIME TO POLICE, WHEN REQUESTED (MANDATORY REPORTING FOR CHILDREN),-ASSISTANCE WITH CONCERNS ABOUT SEXUALLY TRANSMITTED INFECTION AND PREGNANCY,-ASSISTANCE WITH SAFETY PLANNING, AND-DEVELOPMENT OF A MEDICAL FOLLOW-UP PLAN. LEADERSHIP VOLUNTEERISM/COMMUNITY SUPPORT (FROEDTERT IN ACTION) (COMMUNITY BUILDING)HOLY FAMILY MEMORIAL ENCOURAGES ITS LEADERS TO PARTICIPATE IN COMMUNITY ACTIVITIES SUPPORTING LOCAL NONPROFIT ORGANIZATIONS. LEADERS ARE ACTIVE WITH GROUPS SUCH AS AREA VOLUNTEER FIRE DEPARTMENTS AND FIRST RESPONDER GROUPS, HEALTHIEST MANITOWOC COUNTY, LOCAL CHURCHES, THE CHAMBER OF MANITOWOC COUNTY, PROGRESS LAKESHORE, BIG BROTHERS BIG SISTERS, BOYS AND GIRLS CLUB, THE HAVEN HOMELESS SHELTER, VARIOUS FOOD PANTRIES AND MORE. ALL OF THESE ACTIVITIES ARE VOLUNTEER.FOR MORE INFORMATION ON HOLY FAMILY MEMORIAL COMMUNITY BENEFIT PROGRAMS, PLEASE VISIT HTTPS://WWW.HFMHEALTH.ORG/ABOUT/COMMUNITY-IMPACT/.
PART V, SECTION B, LINE 13B	IN ALIGNMENT WITH THE FH FINANCIAL ASSISTANCE POLICY, HFM RESERVES THE RIGHT TO REVIEW EACH APPLICATION FOR FINANCIAL ASSISTANCE ON ITS OWN MERITS AND TO CONSIDER OTHER EXTENUATING CIRCUMSTANCES IN THE DECISION TO APPROVE OR DENY A PATIENT'S APPLICATION FOR FINANCIAL ASSISTANCE. THE APPLICANT'S GROSS FAMILY INCOME WILL BE DETERMINED USING MODIFIED ADJUSTED GROSS INCOME (MAGI). MODIFIED ADJUSTED GROSS INCOME INCLUDES BOTH EARNED INCOME AND PASSIVE INCOME RECEIVED AND COMPARED TO THE ANNUAL FEDERAL POVERTY GUIDELINES SET FORTH BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. A PATIENT WHO HAS AN ANNUAL GROSS INCOME EQUAL TO OR LESS THAN 400% OF THE CURRENT YEAR'S POVERTY GUIDELINES WILL NOT PAY MORE THAN 15% OF THEIR ANNUAL GROSS INCOME ON ANY SINGLE ACCOUNT DURING THE APPROVED ELIGIBILITY TIMEFRAME. PATIENTS WHO MEET THE REQUIREMENTS AND HAVE A GROSS INCOME EQUAL OR LESS THAN 250% OF THE FPL MAY QUALIFY FOR A 100% DISCOUNT. PATIENTS WHO MEET THE REQUIREMENTS AND HAVE A GROSS INCOME BETWEEN 250% AND 400% OF THE FPL MAY QUALIFY FOR A DISCOUNT ON A SLIDING SCALE. IN ADDITION TO INCOME, HFM ALSO TAKES CERTAIN ASSETS INTO CONSIDERATION. ASSETS PROTECTED FROM FINANCIAL EVALUATION INCLUDE A HOUSEHOLD'S RETIREMENT ASSETS, HOME EQUITY, AND A PORTION OF CASH AND SAVINGS ASSETS.
PART V, SECTION B, LINE 13H	OUT OF POCKET MAXIMUM DISCOUNT.
PART V, LINE 16B, FAP APPLICATION WEBSITE	WWW.FROEDTERT.COM/FINANCIAL-SERVICES
PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE	WWW.HFMHEALTH.ORG/WP-CONTENT/UPLOADS/
PART V, SECTION B, LINE 20E	WE REQUEST ADDITIONAL DOCUMENTATION WHEN AN INDIVIDUAL HAS SUBMITTED AN INCOMPLETE FINANCIAL ASSISTANCE APPLICATION.

Schedule H (Form 990) 2021

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?2
Name and address		Type of Facility (describe)
1	1 - FROEDTERT MANITOWOC MEDICAL GROUP 1650 S 41ST ST MANITOWOC,WI54220	PHYSICIAN MEDICAL GROUP
2	2 - HOLY FAMILY HEALTH SERVICES INC 1650 S 41ST ST MANITOWOC,WI54220	RETAIL PHARMACY
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2021

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
PART I, LINE 3C	IN ALIGNMENT WITH THE FROEDTERT HEALTH, INC. FINANCIAL ASSISTANCE POLICY HFM RESERVES THE RIGHT TO REVIEW EACH APPLICATION FOR FINANCIAL ASSISTANCE ON ITS OWN MERITS AND TO CONSIDER OTHER EXTENUATING CIRCUMSTANCES IN THE DECISION TO APPROVE OR DENY A PATIENT'S APPLICATION FOR FINANCIAL ASSISTANCE. THE APPLICANT'S GROSS FAMILY INCOME WILL BE COMPARED TO THE ANNUAL FEDERAL POVERTY GUIDELINES SET FORTH BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. A PATIENT WHO HAS AN ANNUAL GROSS INCOME EQUAL TO OR LESS THAN 400% OF THE CURRENT YEAR'S POVERTY GUIDELINES WILL NOT PAY MORE THAN 15% OF THEIR ANNUAL GROSS INCOME ON ANY SINGLE ACCOUNT DURING THE APPROVED ELIGIBILITY TIMEFRAME. PATIENTS WHO MEET THE REQUIREMENTS AND HAVE A GROSS INCOME EQUAL OR LESS THAN 250% OF THE FPG MAY QUALIFY FOR A 100% DISCOUNT. PATIENTS WHO MEET THE REQUIREMENTS AND HAVE A GROSS INCOME BETWEEN 250% AND 400% OF THE FPG MAY QUALIFY FOR A DISCOUNT ON A SLIDING SCALE. IN ADDITION TO INCOME, HFM ALSO TAKES CERTAIN ASSETS INTO CONSIDERATION. ASSETS PROTECTED FROM FINANCIAL EVALUATION INCLUDE A PORTION OF A HOUSEHOLD'S RETIREMENT ASSETS, CASH, SAVINGS ASSETS AND HOME EQUITY.
PART I, LINE 6A	EVERY YEAR, HOLY FAMILY MEMORIAL PRODUCES AN ANNUAL REPORT TO THE COMMUNITY HIGHLIGHTING ALL OF THE HOSPITALS AND CLINICS EFFORTS IN COMMUNITY OUTREACH PROGRAMS, PATIENT IMPACT STORIES AND INVESTMENTS IN THE COMMUNITIES WE SERVE. THE REPORT IS POSTED ON THE HOLY FAMILY MEMORIAL WEBSITE AND SOCIAL MEDIA PLATFORMS, HOLY FAMILY MEMORIAL BOARD OF DIRECTORS, HOLY FAMILY MEMORIAL LEADERS AND STAFF, GOVERNMENT OFFICIALS, BUSINESS LEADERS AND OTHER COMMUNITY MEMBERS. A COPY OF THE MOST RECENT REPORT CAN BE FOUND AT HTTPS://WWW.HFMHEALTH.ORG/ABOUT/COMMUNITY-IMPACT/.
PART I, LINE 7	COMMUNITY BENEFITS ARE PROGRAMS OR ACTIVITIES THAT PROVIDE CARE AND/OR PROMOTE HEALTH AND HEALING AS A RESPONSE TO IDENTIFIED COMMUNITY NEEDS. HFM'S COMMUNITY BENEFIT PROGRAMS INCLUDE SERVICES FOR THOSE WHO CANNOT AFFORD HEALTH CARE AND INITIATIVES FOR IMPROVING HEALTH IN THE BROADER COMMUNITY. PROVIDING COMMUNITY BENEFITS DEMONSTRATES THAT HOLY FAMILY MEMORIAL IS FULFILLING ITS CHARITABLE MISSION AND DEMONSTRATES THAT ITS PREFERENTIAL TAX STATUS IS DESERVED.
PART I, LINE 7, COLUMN (F)	THE PERCENTAGE OF COMMUNITY BENEFIT EXPENSE TO OVERALL EXPENSES REPORTED ON FORM 990 FOR HFM.
PART II	TO PROMOTE THE HEALTH OF OUR COMMUNITIES, HOLY FAMILY MEMORIAL PARTICIPATES IN NUMEROUS COMMUNITY-BUILDING ACTIVITIES, WHICH ARE NOT INCLUDED ELSEWHERE ON SCHEDULE H. THESE ACTIVITIES INCLUDE:1. COALITION BUILDING: COLLABORATION WITH COUNTY SERVICE AGENCIES INCLUDES WORK WITH THE MANITOWOC COUNTY COMMUNITY COALITION TO ADDRESS SUBSTANCE USE AND ABUSE, OBESITY AND MENTAL HEALTH ISSUES. HOLY FAMILY MEMORIAL'S SANE (SEXUAL ASSAULT NURSE EXAMINER PROGRAM) WORKS CLOSELY WITH VOLUNTEERS FROM THE INCOURAGE TO CARE FOR VICTIMS OF SEXUAL ASSAULT.2. COMMUNITY SUPPORT: PARTICIPATION IN LOCAL EMERGENCY PREPAREDNESS AND YOUTH FOCUSED COALITIONS TO IMPROVE THE COMMUNITIES' ABILITY TO RESPOND TO AN EMERGENCY AND TO IMPROVE THE COMMUNITY ENVIRONMENT FOR YOUTH TO SET THEM UP FOR GREATER SUCCESS.3. ECONOMIC DEVELOPMENT: LEADERSHIP PARTICIPATES IN LOCAL CHAMBER OF COMMERCE BOARDS FOCUSING ON ECONOMIC DEVELOPMENT.4. DIVERSITY: TRAINING THAT RECRUITS HEALTH PROFESSIONALS IN OUR TRADITIONALLY UNDERSERVED COMMUNITY.5. WORKFORCE DEVELOPMENT: DIVERSITY TRAINING AND MINORITY INTERNSHIP PROGRAMS THAT RECRUIT HEALTH PROFESSIONALS IN OUR TRADITIONALLY UNDERSERVED COMMUNITIES TO DIVERSIFY OUR WORKFORCE POPULATION TO BETTER SERVE OUR COMMUNITIES.
PART III, LINE 2	THE HOSPITAL PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION, AND EXISTING ECONOMIC CONDITIONS AND TRENDS. THE RATIO OF PATIENT CARE COST TO CHARGES IS APPLIED TO THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS TO CALCULATE THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS THAT IS REPORTED ON LINE 2. DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS ARE RECORDED AS AN ADJUSTMENT TO REVENUE, NOT BAD DEBT EXPENSE.
PART III, LINE 3	THE FINANCIAL ASSISTANCE POLICY ALLOWS FOR ACCOUNTS IN BAD DEBT TO BE APPROVED FOR FINANCIAL ASSISTANCE IF THE PATIENT MEETS THE CRITERIA. THERE ARE POSSIBLE FINANCIAL ASSISTANCE ACCOUNTS IN BAD DEBT, ALTHOUGH THE EXACT PERCENTAGE IS UNKNOWN AS WE DO NOT HAVE THE APPROPRIATE TOOLS TO DETERMINE THIS PERCENTAGE ACCURATELY.
PART III, LINE 4	PATIENTS' ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF PATIENTS' ACCOUNTS RECEIVABLE, FROEDTERT HEALTH, INC. (FH) ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD PARTY COVERAGE, FH ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AS WELL AS PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD PARTY COVERAGE EXISTS FOR PART OF THE BILL), FROEDTERT HEALTH, INC. RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED, IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FH RECOGNIZES PATIENT SERVICE REVENUE ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD PARTY PAYOR COVERAGE ON THE BASIS OF CONTRACTUAL RATES FOR THE SERVICES RENDERED. FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, FROEDTERT HEALTH, INC. RECOGNIZES REVENUE ON THE BASIS OF ITS STANDARD RATES FOR SERVICES PROVIDED (OR ON THE BASIS OF DISCOUNTED RATES, IF NEGOTIATED OR PROVIDED BY POLICY). ON THE BASIS OF HISTORICAL EXPERIENCE, A SIGNIFICANT PORTION OF FH'S UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, FH RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED.SEE ALSO PAGE 29-31 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS.
PART III, LINE 8	HFM BELIEVES THAT ALL OF THE SHORTFALL SHOULD BE CONSIDERED AS COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE TO THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORBED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. THE HOSPITAL PROVIDES EMERGENCY MEDICAL CARE OR OTHER MEDICALLY NECESSARY CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVES THE FEDERAL GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST FOR MEDICARE BENEFICIARIES.THE COSTING METHODOLOGY USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS IS BASED ON A CALCULATION DEVELOPED BY THE AMERICAN HOSPITAL ASSOCIATION IN WHICH THE DATA IS DERIVED FROM THE ANNUAL FILED MEDICARE COST REPORT.
PART III, LINE 9B	IN ALIGNMENT WITH THE FH FINANCIAL ASSISTANCE POLICY AND CREDIT AND COLLECTIONS POLICY REGARDING THE BILLING, COLLECTION, AND SUPPORT FOR PATIENTS WITH PAYMENT OBLIGATIONS, HFM MAKES EVERY EFFORT TO ADHERE TO THE POLICY AND IS COMMITTED TO IMPLEMENTING AND APPLYING THE POLICIES FOR ASSISTING THOSE PATIENTS WHO MAY QUALIFY FOR FINANCIAL ASSISTANCE IN A PROFESSIONAL AND CONSISTENT MANNER. STAFF MEMBERS WHO WORK CLOSELY WITH PATIENTS SUCH AS PATIENT FINANCIAL SERVICES CUSTOMER SERVICE AND FINANCIAL COUNSELING STAFF, AS WELL AS THOSE INVOLVED IN BILLING AND COLLECTIONS, ARE TRAINED ABOUT THESE POLICIES WITH AN EMPHASIS ON TREATING ALL PATIENTS WITH DIGNITY AND RESPECT REGARDLESS OF THEIR INSURANCE OR THEIR ABILITY TO PAY FOR SERVICES. OTHER STAFF WHO MAY HAVE INTERACTIONS WITH PATIENTS, SUCH AS ADMITTING STAFF, ARE ALSO AWARE OF THE POLICY AND ARE ABLE TO PROVIDE PATIENTS A COPY OF AN APPLICATION UPON REQUEST AND ALSO ARE COMMITTED TO TREATING PATIENTS WITH DIGNITY AND RESPECT REGARDLESS OF THEIR INSURANCE OR THEIR ABILITY TO PAY FOR SERVICES.
PART VI, LINE 2	IN 2019, A CHNA WAS CONDUCTED TO 1) DETERMINE CURRENT COMMUNITY HEALTH NEEDS IN MANITOWOC COUNTY, 2) GATHER INPUT FROM PERSONS WHO REPRESENT THE BROAD INTEREST OF THE COMMUNITY AND IDENTIFY COMMUNITY ASSETS, 3) IDENTIFY AND PRIORITIZE SIGNIFICANT HEALTH NEEDS, AND 4) DEVELOP IMPLEMENTATION STRATEGIES TO ADDRESS THE PRIORITIZED HEALTH NEEDS. HOLY FAMILY MEMORIAL ASSESSED THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES THROUGH A COMPREHENSIVE DATA COLLECTION PROCESS FROM A NUMBER OF KEY SOURCES. DATA AND RESEARCH INCLUDED INFORMATION FROM COMMUNITY MEMBERS, PUBLIC HEALTH OFFICIALS, COMMUNITY LEADERS/EXPERTS, AND NON-PROFIT ORGANIZATIONS REPRESENTING VULNERABLE POPULATIONS IN OUR SERVICE AREA. THE FOLLOWING INFORMATION/DATA SOURCES WAS COLLECTED AND TAKEN INTO CONSIDERATION FOR ASSESSING AND ADDRESSING COMMUNITY HEALTH NEEDS:COMMUNITY HEALTH SURVEY: USING THE CENTER FOR DISEASE CONTROL'S BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS), A TELEPHONE-BASED SURVEY OF 400 RESIDENTS WAS CONDUCTED BY HOLY FAMILY MEMORIAL IN COLLABORATION WITH AURORA HEALTH CARE, LAKESHORE CAP, LAKESHORE COMMUNITY HEALTH CENTER, UNITED WAY MANITOWOC COUNTY AND THE MANITOWOC COUNTY HEALTH DEPARTMENT. THE FULL REPORT OF THIS SURVEY CAN BE FOUND AT HTTPS://WWW.HFMHEALTH.ORG/ABOUT/COMMUNITY-IMPACT/. KEY INFORMANT INTERVIEWS: HOLY FAMILY MEMORIAL LEADERS CONDUCTED 31 IN-PERSON INTERVIEWS WITH 32 COMMUNITY LEADERS OF VARIOUS SCHOOL DISTRICTS, NON-PROFIT ORGANIZATIONS, HEALTH & HUMAN SERVICE DEPARTMENT AND BUSINESS LEADERS. THE FULL KEY INFORMANT RESULTS CAN BE FOUND AT HTTPS://WWW.HFMHEALTH.ORG/ABOUT/COMMUNITY-IMPACT/. COMMUNITY PARTNER/AGENCY REPORTS: TO BETTER UNDERSTAND THE NEEDS OF OUR UNDERSERVED POPULATIONS; HOLY FAMILY MEMORIAL OBTAINED IMPORTANT DATA AND TRENDS FROM PARTNER ORGANIZATIONS SUCH AS LAKESHORE COMMUNITY HEALTH CENTER, UNITED WAY MANITOWOC COUNTY ALICE REPORT AND OTHERS TO SEEK IMPORTANT TRENDS, DEMOGRAPHIC DATA AND SERVICES TO PROVIDE AN INCLUSIVE VIEWPOINT OF COMMUNITY NEEDS FOR THESE UNREPRESENTED POPULATIONS.SECONDARY DATA REPORTS: UTILIZING MULTIPLE COUNTY AND COMMUNITY-BASED PUBLICLY AVAILABLE REPORTS, INFORMATION WAS GATHERED REGARDING: MORTALITY/MORBIDITY DATA, INJURY HOSPITALIZATIONS, EMERGENCY DEPARTMENT VISITS, MANITOWOC COUNTY HEALTH RANKINGS, PUBLIC SAFETY/CRIME REPORTS AND SOCIO-ECONOMIC DATA. A FULL SUMMARY OF SECONDARY DATA INFORMATION CAN BE FOUND AT HTTPS://WWW.HFMHEALTH.ORG/ABOUT/COMMUNITY-IMPACT/. HOLY FAMILY MEMORIAL IS COMMITTED TO ADDRESSING COMMUNITY HEALTH NEEDS COLLABORATIVELY WITH LOCAL PARTNERS. HOLY FAMILY MEMORIAL USED THE FOLLOWING METHODS TO GAIN COMMUNITY INPUT FROM FEBRUARY-MARCH 2019 ON THE SIGNIFICANT HEALTH NEEDS OF THE HOLY FAMILY MEMORIAL'S COMMUNITY. THESE METHODS PROVIDED ADDITIONAL PERSPECTIVES ON HOW TO SELECT AND ADDRESS TOP HEALTH ISSUES FACING HOLY FAMILY MEMORIAL'S COMMUNITY.INPUT FROM COMMUNITY MEMBERSKEY INFORMANT INTERVIEWS: KEY ORGANIZATIONS WITH SPECIFIC KNOWLEDGE AND INFORMATION RELEVANT TO THE SCOPE OF THE IDENTIFIED SIGNIFICANT HEALTH NEEDS ("INFORMANTS") IN HOLY FAMILY MEMORIAL'S COMMUNITY, INCLUDING MANITOWOC COUNTY, WERE IDENTIFIED BY ORGANIZATIONS AND PROFESSIONALS THAT REPRESENT THE BROAD NEEDS OF THE COMMUNITY AS WELL AS ORGANIZATIONS THAT SERVE LOW-INCOME AND UNDERSERVED POPULATIONS. THESE LOCAL PARTNERING ORGANIZATIONS ALSO INVITED THE INFORMANTS TO PARTICIPATE IN AND CONDUCT THE INTERVIEWS. THE INTERVIEWERS USED A STANDARD INTERVIEW SCRIPT THAT INCLUDED THE FOLLOWING ELEMENTS:RANKING OF UP TO FIVE PUBLIC HEALTH ISSUES, BASED ON THE FOCUS AREAS PRESENTED IN WISCONSIN'S STATE HEALTH PLAN, THAT ARE THE MOST IMPORTANT ISSUES FOR THE COUNTY; AND FOR THOSE FIVE PUBLIC HEALTH ISSUES: -EXISTING STRATEGIES TO ADDRESS THE ISSUE -BARRIERS AND CHALLENGES TO ADDRESSING THE ISSUE -ADDITIONAL STRATEGIES NEEDED -KEY GROUPS IN THE COMMUNITY THAT HOSPITALS SHOULD PARTNER WITH TO IMPROVE COMMUNITY HEALTH -IDENTIFICATION OF SUBGROUPS OR SUBPOPULATIONS WHERE EFFORTS COULD BE TARGETED -WAYS EFFORTS CAN BE TARGETED TOWARD EACH SUBGROUP OR SUBPOPULATION UNDERSERVED POPULATION INPUT: HOLY FAMILY MEMORIAL IS DEDICATED TO REDUCING HEALTH DISPARITIES AND INPUT FROM COMMUNITY MEMBERS WHO ARE MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS AND/OR ORGANIZATIONS THAT REPRESENT THOSE POPULATIONS ARE IMPORTANT IN ADDRESSING COMMUNITY HEALTH NEEDS. WITH THAT IN MIND, HOLY FAMILY MEMORIAL TOOK THE FOLLOWING STEPS TO GAIN INPUT:-COMMUNITY HEALTH SURVEY: WHEN APPROPRIATE, DATA WAS STRATIFIED BY GENDER, AGE, EDUCATION HOUSEHOLD INCOME LEVEL AND MARITAL STATUS.-KEY INFORMANT INTERVIEWS: THE KEY INFORMANT INTERVIEWS INCLUDED INPUT FROM MEMBERS OF ORGANIZATIONS REPRESENTING MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS.SUMMARY OF COMMUNITY MEMBER INPUTTOP FIVE HEALTH ISSUES RANKED MOST CONSISTENTLY OR MOST OFTEN CITED FOR MANITOWOC COUNTY WERE:KEY INFORMANT INTERVIEWS:-MENTAL HEALTH-SUBSTANCE USE AND ABUSE-ALCOHOL ABUSE-ADVERSE CHILDHOOD EXPERIENCES-ACCESS TO HEALTH CARECOMMUNITY HEALTH SURVEY:-ILLEGAL DRUG USE-ALCOHOL USE OR ABUSE-PRESCRIPTION OR OTC DRUG ABUSE-ACCESS TO HEALTH CARE-CHRONIC DISEASESAFTER ADOPTION OF THE CHNA REPORT AND IMPLEMENTATION STRATEGY, HOLY FAMILY MEMORIAL PUBLICLY SHARES BOTH DOCUMENTS WITH COMMUNITY PARTNERS, KEY INFORMANTS, HOSPITAL BOARD MEMBERS, PUBLIC SCHOOLS, NON-PROFITS, HOSPITAL COALITION MEMBERS, THE MANITOWOC COUNTY HEALTH DEPARTMENT, AND THE GENERAL PUBLIC. DOCUMENTS ARE MADE AVAILABLE VIA EMAIL, HARD COPIES ARE MADE AVAILABLE AT APPLICABLE MEETINGS, AND ELECTRONIC COPIES ARE MADE AVAILABLE BY PDF FOR DOWNLOAD ON HTTPS://WWW.HFMHEALTH.ORG/ABOUT/COMMUNITY-IMPACT/.FEEDBACK AND PUBLIC COMMENTS ARE ALWAYS WELCOMED AND ENCOURAGED, AND CAN BE PROVIDED THROUGH THE CONTACT FORM ON THE FROEDTERT & THE MEDICAL COLLEGE OF WISCONSIN WEBSITE AT HTTPS://WWW.FROEDTERT.COM/CONTACT, OR CONTACTING FROEDTERT HEALTH, INC.'S COMMUNITY ENGAGEMENT LEADERSHIP/STAFF WITH QUESTIONS AND CONCERNS BY CALLING 414-777-1926. HOLY FAMILY MEMORIAL RECEIVED NO COMMENTS OR ISSUES WITH THE PREVIOUS COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND/IMPLEMENTATION STRATEGY.
PART VI, LINE 3	INFORMATION ON ELIGIBILITY FOR ASSISTANCE IS AVAILABLE FROM HFM'S WEBSITE, BROCHURES, ADMISSIONS STAFF, COLLECTION CORRESPONDENTS, AS WELL AS INSURANCE BENEFIT PAPERWORK THAT IS SENT TO PATIENTS FOR INPATIENT, SAME DAY SURGERY, MRI, AND CT SCANS. A PATIENT FINANCIAL ADVISOR AND/OR ELIGIBILITY SPECIALIST COMMUNICATES TO SELF PAY INPATIENTS TO INTERVIEW AND ADVISE PATIENTS OF ANY PROGRAMS THEY MAY QUALIFY FOR, INCLUDING, BUT NOT LIMITED TO, MEDICAID, VETERANS ADMINISTRATION, OR OUR OWN CHARITY PROGRAM. IF THEY QUALIFY FOR MEDICAID OR VETERANS ADMINISTRATION, WE ASSIST THEM IN COMPLETING THE APPLICATION AND FOLLOW UP ON THE APPLICATION THROUGH APPROVAL. FOR THE NETWORK CHARITY PROGRAM, AN APPLICATION IS PROVIDED AND THE PATIENT IS INSTRUCTED ON WHOM TO CONTACT FOR ASSISTANCE FOR APPLYING. WHEN CONTACTING PATIENTS BY PHONE, THE PATIENT FINANCIAL ADVISOR OR ELIGIBILITY SPECIALIST IS TRAINED TO IDENTIFY PATIENTS WHO MAY QUALIFY FOR OUTSIDE STATE OR FEDERAL ASSISTANCE AND WILL ASSIST THOSE PATIENTS TO APPLY FOR THOSE PROGRAMS.
PART VI, LINE 4	OVERVIEWHOLY FAMILY MEMORIAL, IN AFFILIATION WITH THE FROEDTERT & THE MEDICAL COLLEGE OF WISCONSIN HEALTH NETWORK, IS THE RECOGNIZED LEADER AND LARGEST PROVIDER OF COMPREHENSIVE HEALTH CARE SERVICES IN MANITOWOC COUNTY. FOUNDED BY THE FRANCISCAN SISTERS OF CHRISTIAN CHARITY, HOLY FAMILY MEMORIAL, ROOTED IN THE HEALING MINISTRY OF JESUS CHRIST, IS COMMITTED TO PROVIDING HIGH QUALITY MEDICAL CARE AND DEDICATED TO HELPING INDIVIDUALS IN THE COMMUNITIES HOLY FAMILY MEMORIAL SERVES ACHIEVE HEALTHIER LIVES. THE FROEDTERT & MCW HEALTH NETWORK OPERATES EASTERN WISCONSIN'S ONLY ACADEMIC MEDICAL CENTER AND ADULT LEVEL I TRAUMA CENTER AT FROEDTERT HOSPITAL, MILWAUKEE. IT ALSO INCLUDES EIGHT HOSPITAL LOCATIONS, NEARLY 2,000 PHYSICIANS AND MORE THAN 45 HEALTH CENTERS AND CLINICS.MISSION STATEMENTFROEDTERT & THE MEDICAL COLLEGE OF WISCONSIN ADVANCE THE HEALTH OF THE PEOPLE OF THE DIVERSE COMMUNITIES WE SERVE THROUGH EXCEPTIONAL CARE ENHANCED BY INNOVATION AND DISCOVERY.SERVICE AREA AND DEMOGRAPHICSFOR THE PURPOSE OF THE COMMUNITY HEALTH NEEDS ASSESSMENT, THE COMMUNITY IS DEFINED AS MANITOWOC COUNTY, BECAUSE 86.7% OF DISCHARGES OCCUR FROM THIS GEOGRAPHY. ALL PROGRAMS, ACTIVITIES, AND PARTNERSHIPS UNDER THE CHNA WILL BE DELIVERED IN MANITOWOC COUNTY. FROEDTERT HOLY FAMILY MEMORIAL HOSPITAL DETERMINES ITS PRIMARY SERVICE AREA BY COMPLETING AN ANNUAL REVIEW AND ANALYSIS OF HOSPITAL DISCHARGES AND MARKET SHARE ACCORDING TO VARIOUS DETERMINANTS.THE FROEDTERT HOLY FAMILY MEMORIAL HOSPITAL TOTAL SERVICE AREA IN MANITOWOC COUNTY CONSISTS OF 14 ZIP CODES. 53015 (CLEVELAND), 53042 (KIEL), 53063 (NEWTON), 54207 (COLLINS), 54214 (FRANCIS CREEK), 54215 (KELLNERSVILLE), 54220 (MANITOWOC), 54227 (MARIBEL), 54228 (MISHICOT), 54230 (REEDSVILLE), 54232 (SAINT NAZIANZ), 54241 (TWO RIVERS), 54245 (VALDERS), 54247 (WHITELAW).FROEDTERT HOLY FAMILY MEMORIAL HOSPITALHOUSEHOLD INCOME CY20 PRIMARY SERVICE AREAUNDER $24,999..................18.59%$25,000-$49,999..................25.20%$50,000-$99,999..................37.77%$100,000 AND UP................18.44%TOTAL HOUSEHOLDS..............32,983PAYER SOURCE FY21 PRIMARY SERVICE AREACOMMERCIAL/MANAGED CARE........... 28.7%MEDICAID...........................12.4%MEDICARE...........................54.8%OTHER GOVERNMENT....................2.2%OTHER/SELF PAY......................1.8%SOURCE: WHARACE CY20 PRIMARY SERVICE AREAWHITE..............................92.13%AFRICAN AMERICAN....................1.04% ASIAN/HAWAIIAN/PACIFIC ISLANDER......0.03%NATIVE AMERICAN.....................0.61%TWO OR MORE RACES....................1.71%OTHER................................1.70%HISPANIC.............................4.15%TOTAL POPULATION.....................79,294PAYER SOURCE FY22Q3 PRIMARY SERVICE AREACOMMERCIAL/MANAGED CARE...................27.5%MEDICAID..................................12.6%MEDICARE..................................53.4%OTHER GOVERNMENT...........................3.0%OTHER/SELF PAY.............................3.5%SOURCE: WHA
PART VI, LINE 5	THE BOARD OF DIRECTORS AT HOLY FAMILY MEMORIAL IS MADE UP OF MEDICAL AND BUSINESS PROFESSIONALS. THEY ARE DEDICATED TO LEVERAGING THE BENEFITS OF OUR COMMUNITY THROUGH OUR HOSPITAL'S MISSION. THEY VALUE THE UNIQUE CHARACTER AND NEEDS OF THE PATIENTS AND COMMUNITIES WE SERVE AND THE PHYSICIANS WHO PROVIDE SPECIALTY CARE. HOLY FAMILY MEMORIAL'S COMMUNITY BOARD DEMONSTRATES OUR COMMITMENT TO QUALITY AND SERVICE. ANNUALLY, THE BOARD REVIEWS AND APPROVES THE HOSPITAL'S COMMUNITY HEALTH IMPROVEMENT PLAN.ADDRESSING NEEDS THROUGH TARGETED OUTREACH:HOLY FAMILY MEMORIAL DEVELOPS AND EXECUTES COMMUNITY OUTREACH PROGRAMMING AND ACTIVITIES BASED ON IDENTIFIED COMMUNITY HEALTH NEEDS. EVERY NEEDS ASSESSMENT CYCLE, HOLY FAMILY MEMORIAL COMMUNITY ENGAGEMENT STAFF ALONG WITH THE HOSPITAL'S COMMUNITY PARTNERS AND OTHER LEADERS DEVELOPS A COMMUNITY HEALTH IMPROVEMENT PLAN THAT IS INCORPORATED INTO THE HOSPITAL'S OVERALL STRATEGIC PLAN TO ADDRESS THE MOST CRITICAL NEEDS IN THE COMMUNITIES WE SERVE. THE PLAN IS REVIEWED ANNUALLY BY THE HOLY FAMILY MEMORIAL BOARD OF DIRECTORS. HOLY FAMILY MEMORIAL COMMUNITY ENGAGEMENT STAFF, LEADERS AND EXTERNAL COMMUNITY PARTNERS WORK COLLABORATIVELY TO DEVELOP KEY GOALS AND STRATEGIES TO ADDRESS COMMUNITY HEALTH NEEDS. PROGRESS TOWARDS COMMUNITY OUTREACH PROGRAMS/ACTIVITIES AND GOALS ARE REPORTED ANNUALLY TO THE HOLY FAMILY MEMORIAL BOARD OF DIRECTORS, MISSION INTEGRATION COMMITTEE, AND AT LEADERSHIP MEETINGS. BASED ON THE RESULTS FROM THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT, PROGRAMS AND ACTIVITIES ARE FOCUSED AROUND THE FOLLOWING IDENTIFIED HEALTH NEEDS:-ALCOHOL USE OR ABUSE-PRESCRIPTION OR OVER-THE-COUNTER DRUG ABUSE-OVERWEIGHT OR OBESITYFOR MORE INFORMATION ON SPECIFIC COMMUNITY OUTREACH EFFORTS, IMPLEMENTATION STRATEGY AND COMMUNITY HEALTH NEEDS ASSESSMENTS, PLEASE GO TO HOLY FAMILY MEMORIAL'S WEBSITE AT HTTPS://WWW.HFMHEALTH.ORG/ABOUT/COMMUNITY-IMPACT/.
PART VI, LINE 6	HOLY FAMILY MEMORIAL, IN AFFILIATION WITH THE FROEDTERT & THE MEDICAL COLLEGE OF WISCONSIN HEALTH NETWORK, IS THE RECOGNIZED LEADER AND LARGEST PROVIDER OF COMPREHENSIVE HEALTH CARE SERVICES IN MANITOWOC COUNTY. FOUNDED BY THE FRANCISCAN SISTERS OF CHRISTIAN CHARITY, HOLY FAMILY MEMORIAL, ROOTED IN THE HEALING MINISTRY OF JESUS CHRIST, IS COMMITTED TO PROVIDING HIGH QUALITY MEDICAL CARE AND DEDICATED TO HELPING INDIVIDUALS IN THE COMMUNITIES HOLY FAMILY MEMORIAL SERVES ACHIEVE HEALTHIER LIVES. THE FROEDTERT & MCW HEALTH NETWORK OPERATES EASTERN WISCONSIN'S ONLY ACADEMIC MEDICAL CENTER AND ADULT LEVEL I TRAUMA CENTER AT FROEDTERT HOSPITAL, MILWAUKEE. IT ALSO INCLUDES EIGHT HOSPITAL LOCATIONS, NEARLY 2,000 PHYSICIANS AND MORE THAN 45 HEALTH CENTERS AND CLINICS.FROEDTERT MEMORIAL LUTHERAN HOSPITAL, FROEDTERT MENOMONEE FALLS, FROEDTERT WEST BEND HOSPITALS, FROEDTERT HEALTH NEIGHBORHOOD HOSPITAL, LLC, AND HOLY FAMILY MEMORIAL MADE SIGNIFICANT INVESTMENTS IN THE HEALTH OF THEIR COMMUNITIES. PATIENTS WHO COULDN'T PAY FOR THEIR MEDICAL CARE RECEIVED MORE THAN $183 MILLION IN UNCOMPENSATED SERVICES. BEYOND PROVIDING CARE FOR THE UNINSURED/UNDERINSURED PATIENTS, WE CONTRIBUTED $129 MILLION TO IMPROVE ACCESS TO CARE, TEACH FUTURE HEALTHCARE PROFESSIONALS, DEVELOP NEW MEDICAL THERAPIES AND PARTICIPATE IN LOCAL PARTNERSHIPS AIMED AT REDUCING HEALTH DISPARITIES.FROEDTERT HEALTH MEMBERS DEVELOP COMMUNITY BENEFIT STRATEGIES AND GOALS BASED ON THE UNIQUE NEEDS OF EACH OF THEIR COMMUNITIES. BY CONDUCTING REGULAR COMMUNITY NEEDS ASSESSMENTS THAT MONITOR CRITICAL PUBLIC HEALTH ISSUES, AND ACTIVELY SEEKING COMMUNITY INPUT, THE HOSPITALS HAVE BUILT IMPORTANT LOCAL RELATIONSHIPS THAT PROVIDE MEANINGFUL OUTREACH PROGRAMS THAT LINK EACH HOSPITAL TO THEIR NEIGHBORS AND PATIENTS. AS A NOT-FOR-PROFIT HEALTH SYSTEM, FROEDTERT HEALTH REINVESTS ITS SURPLUS FUNDS BACK INTO THE COMMUNITY THROUGH PROGRAMS TO SERVE THE POOR AND UNINSURED, TEACH FUTURE HEALTHCARE PROFESSIONALS, DEVELOP NEW MEDICAL THERAPIES, MANAGE CHRONIC CONDITIONS LIKE DIABETES, HEALTH EDUCATION AND PROMOTION INITIATIVES, AND PARTICIPATE IN LOCAL PARTNERSHIPS AIMED AT REDUCING HEALTH DISPARITIES. FOR MORE INFORMATION ABOUT HOLY FAMILY MEMORIAL, VISIT HTTPS://WWW.HFMHEALTH.ORG/ AND FOR FROEDTERT HEALTH, VISIT WWW.FROEDTERT.COM
PART VI, LINE 7	COMMUNITY BENEFIT DATA IS REPORTED ANNUALLY TO THE WISCONSIN HOSPITAL ASSOCIATION.

Schedule H (Form 990) 2021

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Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
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Attach to Form 990.
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Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization
HOLY FAMILY MEMORIAL INC

Employer identification number
39-0806395

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1) BOYS & GIRLS CLUBS OF THE FOX VALLEY INC PO BOX 756 MANITOWOC,WI54221	39-1225709	501C(3)	25,000	FMV	N/A	PAYMENT FOR BENEFIT OF YOUNG PEOPLE BETWEEN AGES 6 - 12
(2) CAPITOL CIVIC CENTRE INC PO BOX 399 MANITOWOC,WI54221	39-1569595	501C(3)	21,000	FMV	N/A	ACT II CAMPAIGN - PAYMENT TO IMPROVE THE CENTRE'S BUILDING
(3) PROGRESS LAKESHORE 202 N 8TH ST SUITE 101 MANITOWOC,WI54220	20-0419691	501C(6)	13,000	FMV	N/A	GENERAL SUPPORT
(4) THE CHAMBER OF MANITOWOC COUNTY 1515 MEMORIAL DRIVE MANITOWOC,WI54220	39-0465570	501C(6)	6,187	FMV	N/A	HOLE SPONSORSHIP OF GOLF OUTING; SPONSORSHIP OF AWARDS OF DISTINCTION; TITLE SPONSOR OF FALL CONFERENCE
(5) CITY OF MANITOWOC 900 QUAY ST MANITOWOC,WI54220	39-6005511		5,500	FMV	N/A	HOLIDAY PARADE SPONSORSHIP; PAYMENT FOR MANITOWOC FAMILY AQUATIC CENTER CAPITAL CAMPAIGN

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

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

Cat. No. 50055P

Schedule I (Form 990) 2021

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1) MEDICAL ITEMS/SUPPLIES FOR THE NEEDY	31		2,821	FMV	MED ITEMS
(2) TRANSPORTATION FOR THE NEEDY	82		2,027	FMV	TAXI/OTHER TRANSPORT
(3) SCHOLARSHIPS	6	12,000		FMV
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference	Explanation
PART I, LINE 2:	FOR GRANTS TO ORGANIZATIONS FOR PART II, GRANT REQUESTS FROM ORGANIZATIONS ARE MADE AND EVALUATED BASED ON THE BENEFIT PROVIDED TO A WIDE GROUP OF PEOPLE LIVING IN THE SERVICE AREA WHERE WE PROVIDE SERVICES AS WELL AS BEING OF A CHARITABLE OR PUBLIC BENEFIT TYPE NATURE.
PART III	HOLY FAMILY MEMORIAL MAINTAINS FILES OF THE GRANTS AWARDED ALONG WITH THE AMOUNT. AN APPLICATION FORM IS USED (IF APPLICABLE) FOR THE AWARD, WHICH INCLUDES A REVIEW OF INSURANCE AND EMPLOYMENT STATUS. PROVIDENCE FUNDS MAY ALSO BE USED IN EMERGENCY SITUATIONS TO PROVIDE FOOD, HOUSING, CLOTHING, AND MEDICAL SUPPLIES FOR SOMEONE STRANDED DUE TO AN ACCIDENT. GRANTS ARE AWARDED BASED ON MEDICAL AND FINANCIAL NEED.
PART-III LINE-(B)	THE RATIO OF A KNOWN COST TO A KNOWN RECIPIENT COUNT FOR EACH TYPE OF ASSISTANCE WAS APPLIED TO THE COSTS THAT DID NOT HAVE A SPECIFIC RECIPIENT NUMBER ASSIGNED FOR THAT ASSISTANCE TYPE TO ARRIVE AT AN ESTIMATED RECIPIENT VALUE FOR EACH ASSISTANCE TYPE.

Schedule I (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

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

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

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

HOLY FAMILY MEMORIAL INC

Employer identification number

39-0806395

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

If any of the boxes 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 .....

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? ....

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

Yes

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 2021

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, 1099-MISC compensation, and/or 1099-NEC			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1MARK BEHL DIRECTOR & EVP/FH COO	(i) (ii)	0 ------------- 752,801	0 ------------- 649,880	0 ------------- 22,018	0 ------------- 170,238	0 ------------- 30,470	0 ------------- 1,625,407	0 ------------- 0
2RYAN M DOPIRAK MD PHYSICIAN PROVIDER	(i) (ii)	115,870 ------------- 637,284	0 ------------- 78,681	172 ------------- 855	3,000 ------------- 15,750	4,931 ------------- 27,118	123,973 ------------- 759,688	0 ------------- 0
3RICHARD MANOS MD PHYSICIAN PROVIDER	(i) (ii)	118,470 ------------- 651,476	0 ------------- 0	404 ------------- 2,107	0 ------------- 3,588	3,889 ------------- 21,393	122,763 ------------- 678,564	0 ------------- 0
4EDWARD L SMITH MD PHYSICIAN PROVIDER	(i) (ii)	101,568 ------------- 604,120	0 ------------- 0	125 ------------- 654	13,373 ------------- 10,343	3,889 ------------- 21,393	118,955 ------------- 636,510	0 ------------- 0
5BRETT W NORELL FORMER OFFICER	(i) (ii)	73,831 ------------- 9,322	0 ------------- 135,132	2,109 ------------- 435,024	23,151 ------------- 11,186	3,890 ------------- 0	102,981 ------------- 590,664	0 ------------- 135,132
6STEVEN LITTLE SR. VP & PRESIDENT	(i) (ii)	0 ------------- 411,622	0 ------------- 187,602	0 ------------- 2,779	0 ------------- 55,224	0 ------------- 16,489	0 ------------- 673,716	0 ------------- 0
7JEFFREY VAN DE KREEKE TREASURER	(i) (ii)	0 ------------- 332,666	0 ------------- 181,985	0 ------------- 79,880	0 ------------- 18,675	0 ------------- 16,322	0 ------------- 629,528	0 ------------- 0
8TROY D DAY FORMER OFFICER	(i) (ii)	44,576 ------------- 177,190	0 ------------- 162,648	191 ------------- 104,359	13,535 ------------- 36,125	180 ------------- 720	58,482 ------------- 481,042	0 ------------- 116,335
9MATTHEW L CAMPBELL MD DIRECTOR	(i) (ii)	62,505 ------------- 355,775	1,000 ------------- 9,726	124 ------------- 686	1,949 ------------- 11,551	4,490 ------------- 24,692	70,068 ------------- 402,430	0 ------------- 0
10MILAN JORDAN MD DIRECTOR	(i) (ii)	63,429 ------------- 273,775	0 ------------- 0	609 ------------- 78,966	1,978 ------------- 10,078	5,080 ------------- 27,937	71,096 ------------- 390,756	0 ------------- 0
11THOMAS VEESER CHIEF NURSING OFFICER	(i) (ii)	34,513 ------------- 170,989	0 ------------- 0	328 ------------- 15,106	11,057 ------------- 30,757	4,277 ------------- 23,521	50,175 ------------- 240,373	0 ------------- 0

Schedule J (Form 990) 2021

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

PART I, LINE 3

COMPENSATION OF CEO/EXECUTIVE DIRECTOR ESTABLISHED BY RELATED ORGANIZATION, FROEDTERT HEALTH, THROUGH USE OF COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.

PART I, LINES 4A-B

SEVERANCE PAYMENTS: DAY, TROY - $60,178 NORELL, BRETT - $389,639 457(F) PARTICIPANTS: BEHL, MARK DAY, TROY LITTLE, STEVEN NORELL, BRETT VAN DE KREEKE, JEFFREY VEESER, TOM 457(F) DISTRIBUTIONS: DAY, TROY - $116,335 NORELL, BRETT - $135,132 NON-QUALIFIED DISTRIBUTIONS: VAN DE KREEKE, JEFFREY - $44,967 (OF WHICH $0 WAS REPORTED AS DEFERRED ON A PRIOR FORM 990) NON-QUALIFIED PARTICIPANTS: VAN DE KREEKE, JEFFREY

Schedule J (Form 990) 2021

Additional Data

Software ID:
Software Version:

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Schedule L
(Form 990)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

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

Attach to Form 990 or Form 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

HOLY FAMILY MEMORIAL INC

Employer identification number

39-0806395

Part I

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

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

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

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

Part II

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

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






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

Part III

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

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

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

Cat. No. 50056A

Schedule L (Form 990) 2021

Page 2

Part IV

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

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) CLAIRE JORDAN	SPOUSE OF DIRECTOR	37,537	EMPLOYMENT		No
(2) DAWN KRUEGER	SPOUSE OF DIRECTOR	114,239	EMPLOYMENT		No
(3) AMERICOLLECT INC	SEE PART V	175,364	SEE PART V		No

Part V

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

Return Reference	Explanation
PART IV	KENLYN T. GRETZ, DIRECTOR, WAS THE OWNER (80%) OF AMERICOLLECT, INC., WHICH PROVIDED SERVICES TO HFM IN THE AMOUNT OF $175,364.

Schedule L (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990)

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

2021

Open to Public
Inspection

Name of the organization

HOLY FAMILY MEMORIAL INC

Employer identification number

39-0806395

Return Reference	Explanation
FORM 990, PART III, LINE 4A	OUTPATIENT SERVICES: HOLY FAMILY MEMORIAL HAD 209,764 OUTPATIENT VISITS DURING THIS PERIOD. OUTPATIENT SURGERIES TOTALLED 2,110. CARDIOLOGY ENCOUNTERS WERE 1,818. ORTHO NOW PROVIDES SAME-DAY CARE FOR ORTHOPAEDIC AND SPORTS-RELATED INJURIES AT THE COST OF A CLINIC VISIT. FOOT AND ANKLE CLINIC: OUR TEAM INTEGRATES ALL ASPECTS OF SPECIALIZED CARE BY COLLECTIVELY COMBINING THEIR KNOWLEDGE, EXPERIENCE, AND EXPERTISE. WE BELIEVE THAT NO ONE SHOULD HAVE TO LIVE WITH ANKLE PAIN OR FOOT PAIN. WE WILL HELP YOU THROUGH EVERY STEP OF YOUR TREATMENT, WHETHER IT BE ORTHOTIC THERAPY OR CORRECTIVE SURGERY. FOOT AND ANKLE PAIN IS A COMMON DISORDER. ALMOST 80% OF THE POPULATION WILL EXPERIENCE FOOT PAIN IN THEIR LIVES. OUR TEAM IS TRAINED AND EQUIPPED TO DIAGNOSE AND TREAT ALL PROBLEMS INVOLVING THE FOOT AND ANKLE. WE TREAT PEOPLE OF ALL AGES, FOR PROBLEMS SUCH AS PLANTAR FASCIITIS, TENDONITIS AND BUNIONS, AS WELL AS SERIOUS INJURIES AND DISORDERS. MANY FOOT AND ANKLE PROBLEMS CAN BE REMEDIED WITH CONSERVATIVE CARE, INCLUDING CORRECTIVE ORTHOTIC DEVICES. FOR PATIENTS WITH CONDITIONS THAT FAIL TO RESPOND TO CONSERVATIVE CARE, SURGICAL INTERVENTION MAY BE NECESSARY. FOOT AND ANKLE SURGERY INCLUDES THE TREATMENT OF FRACTURES, REPAIR OF TENDON INJURIES, CORRECTION OF DEFORMITY, MANAGEMENT OF ANKLE INSTABILITY AND BONE/CARTILAGE FROM SPORTS-RELATED INJURIES, AND COMPREHENSIVE MANAGEMENT OF HEEL PAIN. WE ARE DEDICATED TO KEEPING OUR PATIENTS' FEET AND ANKLES IN THE HEALTHIEST CONDITIONS. IT IS OUR GOAL TO RELIEVE PATIENTS OF CHRONIC PAIN AND TO RETURN FUNCTION AND ENJOYMENT TO EVERYDAY ACTIVITY. BEHAVIORAL HEALTH SERVICES: FROM ALCOHOLISM AND OTHER DRUG ABUSE, TO ANXIETY, DEPRESSION, AND A RANGE OF OTHER MENTAL HEALTH ISSUES, OUR BEHAVIORAL HEALTH EXPERTS ARE HERE TO HELP YOU DEVELOP EFFECTIVE SKILLS TO: CHANGE UNHEALTHY OR ADDICTIVE BEHAVIORS, CONFRONT AND OVERCOME THE STRUGGLES OF GROWING UP, DEAL WITH THE EFFECTS OF SUBSTANCE ABUSE, FACE A TRAUMA AND THE STRESS AND ANXIETY IT MAY CAUSE, HANDLE LIFE CHANGES BROUGHT ON BY MARRIAGE, DIVORCE, OR THE DEATH OF A LOVED ONE, MANAGE DISRUPTIVE BEHAVIORAL PROBLEMS IN CHILDREN, INCLUDING ATTENTION-DEFICIT/HYPERACTIVITY DISORDER (ADHD), SUCCESSFULLY COPE WITH ANXIETY, DEPRESSION, LOW ENERGY, LOW SELF-ESTEEM, AND LONELINESS, AND TAKE ON THE CHALLENGES OF RAISING A FAMILY. BEHAVIORAL HEALTH PROVIDES THE HIGHEST QUALITY CARE COMBINED WITH UNMATCHED COMPASSION AND SENSITIVITY. WE'RE PROUD TO OFFER A VARIETY OF PROVEN SERVICES AND TREATMENT OPTIONS FOR YOUR SPECIFIC NEEDS, INCLUDING: ALCOHOL AND OTHER DRUG ABUSE TREATMENTS; DEMENTIA/MEMORY ASSESSMENTS; DIALECTIC BEHAVIOR THERAPY (DBT) FOR PATIENTS WITH DIFFICULTY MANAGING THEIR EMOTIONS AND POTENTIALLY ENGAGING IN SELF-HARM; EYE MOVEMENT DESENSITIZATION AND REPROCESSING (EMDR) AND BRAINSPOTTING FOR TREATING TRAUMA-RELATED SYMPTOMS; INDIVIDUAL, FAMILY, AND GROUP COUNSELING; PSYCHIATRIC EVALUATIONS AND MEDICATION MANAGEMENT; AND SPECIFIC SERVICES AND TREATMENTS FOR CHILDREN AND ADOLESCENTS. ALCOHOLISM AND SUBSTANCE ABUSE ARE DISEASES. THEY DEVASTATE FAMILIES AND DESTROY LIVES EVERY DAY. AT BEHAVIORAL HEALTH, WE OFFER THE MOST COMPREHENSIVE OUTPATIENT SUBSTANCE ABUSE DISORDER TREATMENT SERVICES IN THE AREA PROVIDING EVERYTHING FROM ASSESSMENT AND OUTPATIENT COUNSELING, TO SPECIALIZED MEDICATION-ASSISTED TREATMENT (MAT). WE'RE EXPERTS IN WHAT WE DO, AND UNLIKE MANY PROVIDERS, ARE CERTIFIED TO PROVIDE MEDICATIONS TO ASSIST YOU BOTH IN REDUCING YOUR CRAVINGS AND URGES, AS WELL AS PREVENTING WITHDRAWAL SYMPTOMS. BECAUSE WE KNOW ADDICTION IS NOT WEAKNESS. IT'S NOT WILLFULNESS OR STUBBORNNESS. IT'S A CHRONIC AND RELAPSING BRAIN DISEASE, AND WE'RE HERE TO HELP YOU WITH EVERYTHING FROM TAKING THE FIRST STEP, TO DEVELOPING A LONG-TERM RECOVERY PLAN. DIAGNOSTIC IMAGING SERVICES: WHEN IT COMES TO DIAGNOSING AND TREATING DISEASES, THE RIGHT TECHNOLOGY MAKES A DIFFERENCE. HOLY FAMILY MEMORIAL IS TAKING THE LEAD IN BRINGING CUTTING-EDGE DIAGNOSTIC TECHNOLOGY TO YOU. OUR DIAGNOSTIC IMAGING SERVICES INCLUDE: CT SCAN (MANITOWOC COUNTY'S ONLY 64-SLICE CT SCANNER AND ONE OF THE FEW IN WISCONSIN TO PERFORM CT HEART SCANS); 3D MAMMOGRAPHY; SHORT-BORE MRI FEATURING MUSIC, AROMATHERAPY, AND OTHER CLAUSTROPHOBIA-REDUCING AMENITIES; ECHO-VASCULAR ULTRASOUND; PET/CT; AND NUCLEAR MEDICINE. EAR, NOSE, AND THROAT (ENT): AT EAR, NOSE, AND THROAT, OUR EXPERT TEAM SPECIALIZES IN QUICKLY DIAGNOSING AND EFFECTIVELY TREATING DISEASES AND DISORDERS AFFECTING THE HEAD AND NECK, FOR PATIENTS OF ALL AGES. FROM ALLERGIES TO EAR INFECTIONS, TO THYROIDS, TONSILS, AND SINUSES, WE'VE GOT YOU COVERED WITH THE RIGHT CARE FOR YOUR SPECIFIC NEEDS. HEARING AND BALANCE: AT HEARING AND BALANCE, WE KNOW THAT HEARING WELL IS VITAL TO THE WAY YOU EXPERIENCE LIFE. OUR EXPERT TEAM OF AUDIOLOGISTS SPECIALIZE IN EVALUATING YOUR HEARING AND HELPING YOU IMPROVE IT. AND IN ADDITION TO YOUR HEARING, WE ALSO OFFER BALANCE ASSESSMENTS TO ADDRESS ANY HEARING-RELATED BALANCE ISSUES YOU MAY BE EXPERIENCING. WE'RE PROUD TO OFFER COMPREHENSIVE HEARING AND BALANCE CARE, BECAUSE WE WANT YOU LIVING YOUR LIFE TO ITS FULLEST, NOT HINDERED BY HEARING OR BALANCE ISSUES. OUR COMPREHENSIVE AUDIOLOGY AND BALANCE SERVICES INCLUDE: ASSISTIVE LISTENING DEVICES; BALANCE/DIZZINESS EVALUATIONS; COMPREHENSIVE HEARING EVALUATIONS FOR ADULTS AND CHILDREN; HEARING AID FITTINGS; AND PROTECTIVE HEARING DEVICES. HOME HEALTH CARE: SKILLED NURSING SERVICES INCLUDE: INFUSION THERAPY; PHYSICAL, OCCUPATIONAL AND SPEECH THERAPIES; CARE AFTER SURGERY; COMPLEX WOUND CARE; MEDICATION MANAGEMENT; TELEMONITORING PROGRAM; MEDICAL SOCIAL WORK; AND HOME HEALTH AIDE. OTHER HOME CARE SERVICES INCLUDE: PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPIES; MEDICAL SOCIAL WORK; HOME HEALTH AID; AND CARE TAILORED TO THE NEEDS OF EACH PATIENT AND HIS/HER FAMILY. LABORATORY: OUR LEADING-EDGE HFM LABORATORY PROUDLY SERVES THE ENTIRE HFM NETWORK, AS WELL AS PROVIDING TESTING FOR MANY OUT-OF-NETWORK PROVIDERS AND HEALTHCARE ORGANIZATIONS. BECAUSE OUR PATIENTS AS WELL AS OTHER HEALTHCARE PROFESSIONALS KNOW THEY CAN PLACE THEIR TRUST IN US TO PROVIDE ACCURATE, RELIABLE RESULTS FAST. WE'RE CLINICAL LABORATORY IMPROVEMENT AMENDMENTS (CLIA) CERTIFIED, AND COLLEGE OF AMERICAN PATHOLOGISTS (CAP) ACCREDITED, AND OUR HIGHLY SPECIALIZED TEAM UTILIZES INNOVATIVE TECHNOLOGY TO PROVIDE YOU WITH THE RIGHT LABORATORY SERVICES AND THE RIGHT RESULTS. REHAB SERVICES: AT REHAB PLUS, WE'RE COMMITTED TO COLLABORATING WITH OUR PATIENTS AND PROVIDING THE RIGHT REHABILITATION CARE THROUGHOUT THEIR RECOVERY. OUR EXPERT TEAM OF HIGHLY SKILLED PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPISTS IS HERE TO WORK WITH YOU TO BUILD A PERSONALIZED PLAN TO MAXIMIZE YOUR FUNCTION AND MEET YOUR GOALS, WHETHER IT'S GETTING BACK TO COMPETITIVE ATHLETICS OR SIMPLY BUILDING STRENGTH TO GET OFF THE COUCH. WHILE THE ISSUES WE TREAT VARY GREATLY, OUR APPROACH REMAINS THE SAME. WE PROVIDE THE RIGHT CARE, IN THE RIGHT SETTING, FOR THE RIGHT OUTCOMES. PHYSICAL THERAPY: WITH A FOCUS ON RESTORING FUNCTION OF THE BODY FROM INJURY, SURGERY, OR SIMPLY PAIN, OUR LICENSED PHYSICAL THERAPY EXPERTS AT REHAB PLUS ARE HERE TO IDENTIFY THE CAUSE OF YOUR SYMPTOMS, EDUCATE YOU ON HOW TO BEST MANAGE THEM, AND WORK WITH YOU TO CREATE AN INDIVIDUALIZED PLAN TO IMPROVE YOUR FUNCTION AND QUALITY OF LIFE. STAFF ARE WELL TRAINED TO WORK WITH ALL POPULATIONS AND WILL CUSTOMIZE TREATMENT BASED UPON THE PATIENTS' EVALUATION. OUR TEAM HAS EXPERTISE IN TREATING A WIDE RANGE OF INJURIES AND ISSUES, INCLUDING: ARTHRITIS DISORDERS, CONCUSSIONS, CUMULATIVE TRAUMA DISORDERS, FOOT PAIN, GAIT AND BALANCE DISORDERS, HEADACHES, IMPROVING ATHLETIC PERFORMANCE, LOW BACK AND NECK PAIN, MUSCLE AND JOINT STRAINS AND SPRAINS, NEUROLOGICAL DISORDERS, PRE AND POSTOPERATIVE ORTHOPAEDIC CONDITIONS, SPORTS AND RECREATIONAL INJURIES, STROKE/CVA, TMJ DISORDERS, VESTIBULAR DISORDERS, AND WORK-RELATED INJURIES.
PART III, LINE 4A (CONT)	OUR PROVEN, EVIDENCE-BASED TREATMENT OPTIONS INCLUDE: AQUATIC POOL THERAPY, AUGMENTED SOFT TISSUE MOBILIZATION, MANUAL THERAPY TECHNIQUES TO ADDRESS MUSCLE AND JOINT ISSUES, MODALITIES INCLUDING ULTRASOUNDS AND IONTOPHORESIS, AND SPECIFIC EXERCISES TO REDUCE PAIN AND IMPROVE FUNCTION. AND BECAUSE WE'RE COMMITTED TO PROVIDING THE RIGHT CARE TO ANY PATIENT IN NEED, OUR PHYSICAL THERAPY SERVICES ARE AVAILABLE WITHOUT A PHYSICIAN'S REFERRAL THROUGH OUR DIRECT ACCESS THERAPY PROGRAM. OCCUPATIONAL THERAPY: AT REHAB PLUS, WE ALSO OFFER COMPREHENSIVE OUTPATIENT OCCUPATIONAL THERAPY IF YOU'RE EXPERIENCING A PHYSICAL DISABILITY OR DYSFUNCTION OF YOUR HAND, WRIST, OR ARM. OUR LICENSED OCCUPATIONAL THERAPISTS, CERTIFIED HAND THERAPISTS, AND CERTIFIED OCCUPATIONAL THERAPY ASSISTANTS ARE EXPERTS IN THE EVALUATION AND TREATMENT OF: ANKLE AND LEG SWELLING, ARTHRITIS DISORDERS OF THE HAND, WRIST, AND ARM, COGNITIVE DISABILITIES RESULTING FROM A HEAD INJURY, HAND, WRIST AND ELBOW INJURIES, STROKE/CVA, AND UPPER BODY, WORK-RELATED INJURIES AND CUMULATIVE TRAUMA DISORDERS. BASED ON YOUR SPECIFIC DIAGNOSIS AND NEEDS, OUR TEAM IS EXPERIENCED IN A VARIETY OF PROCEDURES AND TREATMENTS, INCLUDING: CUSTOM HAND, WRIST AND ARM SPLINTING, LYMPHEDEMA MANAGEMENT, AND MANUAL THERAPY AND PERSONALIZED EXERCISE TECHNIQUES. SPEECH THERAPY: OUR LICENSED SPEECH PATHOLOGISTS ARE SPECIALLY TRAINED TO EVALUATE AND TREAT CHILDREN AND ADULTS WITH SPEECH, LANGUAGE, AND SWALLOWING PROBLEMS. WE'RE HERE TO PROVIDE EXPERT CARE FOR: COGNITIVE DISORDERS FOLLOWING TBI, DEVELOPING AUGMENTATIVE COMMUNICATION SYSTEMS, FLUENCY (STUTTERING) THERAPY, SPEECH AND SWALLOWING ISSUES ASSOCIATED WITH EVERYTHING FROM A STROKE/CVA TO NEUROLOGICAL DISEASE, TREATMENT FOLLOWING HEAD/NECK CANCER, VOCAL DISORDERS ASSOCIATED WITH GERD, AND VOICE DISORDER TREATMENT. OUR SPEECH THERAPY TEAM ALSO OFFERS SPECIALTY SERVICES WHEN REQUIRED, INCLUDING MODIFIED BARIUM SWALLOW STUDIES. SPECIALTY REHAB SERVICES: AT HFM REHAB PLUS, WE'RE COMMITTED TO STAYING ON THE LEADING-EDGE OF REHAB TREATMENTS AND SERVICES. WE'RE PROUD TO OFFER AN ARRAY OF SPECIALTY REHAB SERVICES, INCLUDING: AQUATIC THERAPY, ASTYM THERAPY, BLOOD FLOW RESTRICTION, CONCUSSION CARE, DRY NEEDLING, FUNCTIONAL CAPACITY EVALUATIONS, HFM SURVIVORSHIP AND REHAB PROGRAM, HOME CARE SERVICES, LYMPHEDEMA THERAPY, MODIFIED BARIUM SWALLOW STUDIES, PEDIATRIC THERAPY, PELVIC FLOOR AND INCONTINENCE REHABILITATION, SELF-PAY THERAPY SERVICES, VESTIBULAR REHABILITATION, AND WORK CONDITIONING. SLEEP CLINIC: AT HOLY FAMILY MEMORIAL, WE OFFER A VARIETY OF SLEEP STUDIES AND SCREENINGS FOR THE SPECTRUM OF SLEEP DISORDERS. FROM SIMPLE, AT-HOME SCREENINGS TO IN-DEPTH DIAGNOSTIC SLEEP STUDIES, WE'VE GOT YOU COVERED. AND YOU HAVE OPTIONS. MOST DIAGNOSTIC SLEEP STUDIES CAN BE PERFORMED EITHER OVERNIGHT AT OUR FROEDTERT HOLY FAMILY MEMORIAL HOSPITAL, OR AS A HOME SLEEP STUDY. WOUND CARE: AT WOUND CLINIC, WE'RE COMMITTED TO PROVIDING YOU WITH THE RIGHT CARE, TAILORED TO YOUR SPECIFIC CONDITION. YOUR INDIVIDUALIZED WOUND CARE TREATMENT PLAN MAY INCLUDE SOME OR ALL OF THESE TREATMENTS AND TECHNIQUES: ANTIBIOTIC THERAPY, APPLICATION OF SPECIALTY DRESSINGS AND/OR OINTMENTS, LABORATORY STUDIES, NUTRITIONAL COUNSELING AND/OR SUPPLEMENTS, PHYSICAL THERAPY, SURGICAL DEBRIDEMENT TO REMOVE INFECTED TISSUE AND/OR BONE, USE OF CRUTCHES, WHEELCHAIR, OR OTHER OFF-LOADING TECHNIQUES, VASCULAR STUDIES, AND X-RAYS. OUR WOUND CLINIC IS ALSO PROUD TO OFFER ADDITIONAL CARE SERVICES, INCLUDING: GENERAL OSTOMY CARE, HOSPITAL DISCHARGE FOLLOW-UP FOR NEW OR REVISED OSTOMIES, PREOPERATIVE OSTOMY SITE MARKING AND EDUCATION, AND POSTOPERATIVE OSTOMY EDUCATION AND CARE.
FORM 990, PART III, LINE 4B, DESCRIPTION OF PROGRAM SERVICE:	INPATIENT SERVICES: HOLY FAMILY MEMORIAL IS AN INTEGRATED NETWORK PROVIDING HEALTH CARE SERVICES INTENDED TO BENEFIT THE HEALTH AND WELLBEING OF THE COMMUNITIES IT SERVES. THESE SERVICES INCLUDE PRIMARY AND SPECIALTY CLINIC CARE, PREVENTIVE CARE SUCH AS HEALTH SCREENINGS, VACCINATION CLINICS AND HEALTH EDUCATION CLASSES, 24/7 EMERGENCY CARE, WALK-IN, INPATIENT ACUTE CARE, OUTPATIENT CARE, HOME CARE AND HOSPICE, PRESCRIPTIONS, OCCUPATIONAL HEALTH SERVICES, AND MEDICALLY BASED FITNESS AND WELLNESS. HOLY FAMILY MEMORIAL HAS BEEN ABLE TO ACHIEVE A GREATER IMPACT IN THE COMMUNITY BY PARTNERING FINANCIAL, HUMAN AND PROGRAMMATIC RESOURCES WITH OTHER ORGANIZATIONS. THESE PARTNERSHIPS INCLUDE A COMMITMENT TO COLLABORATE WITH OTHER HEALTH AND SOCIAL SERVICE AGENCIES TO IMPROVE ACCESS TO CARE, FOCUS ON PREVENTIVE SERVICES, REDUCE COMMUNITY HEALTH RISKS, AND CONTRIBUTE TO A HEALTHIER, VIBRANT COMMUNITY. HOLY FAMILY MEMORIAL PROVIDES MEDICALLY NECESSARY SERVICES WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICIES. IN ASSESSING A PATIENT'S ABILITY TO PAY, HFM UTILIZES GENERALLY RECOGNIZED POVERTY INCOME LEVELS OF THE COMMUNITIES IT SERVES, AND CONSIDERS SITUATIONS WHERE INCURRED CHARGES ARE SIGNIFICANT WHEN COMPARED TO THE PATIENT'S FINANCIAL RESOURCES. BECAUSE HFM DOES NOT EXPECT TO RECEIVE PAYMENT OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THESE AMOUNTS ARE NOT INCLUDED IN NET PATIENT SERVICE REVENUES. HOLY FAMILY MEMORIAL'S TOTAL COMMUNITY BENEFIT INCLUDES THE COST OF CHARITY CARE AND UNPAID COST OF PUBLIC PROGRAMS (MEDICARE AND MEDICAID) AS WELL AS THOSE DISCUSSED ABOVE. HOLY FAMILY MEMORIAL'S COMMUNITY BENEFIT WAS APPROXIMATELY $18,223,000 FOR THE PERIOD ENDED JUNE 30, 2022. THIS AMOUNT INCLUDES THE NET COST OF CHARITY CARE OF APPROXIMATELY $276,000. MORE INFORMATION IS AVAILABLE FROM OUR COMMUNITY BENEFIT REPORT WHICH IS LOCATED ON OUR WEBSITE AT WWW.HFMHEALTH.ORG WHEN THE FRANCISCAN SISTERS OF CHRISTIAN CHARITY WAS APPROACHED BY LOCAL CLERGY AND COMMUNITY LEADERS OVER A CENTURY AGO TO CARE FOR THE HEALTH NEEDS OF OUR GROWING COMMUNITY IN THE MANITOWOC AREA, THEY ANSWERED THE CALL. HOLY FAMILY MEMORIAL WAS FOUNDED IN 1899 WITH A MISSION TO SERVE OUR COMMUNITY'S UNIQUE NEEDS. AS HEALTHCARE HAS EVOLVED AND AS OUR COMMUNITY HAS GROWN, SO HAVE WE. BUT OUR MISSION REMAINS THE SAME. AND WE'VE BEEN PROUDLY SERVING OUR COMMUNITY EVER SINCE. ROOTED IN THE FRANCISCAN TRADITION OF HOSPITALITY AND THE HEALING MINISTRY OF JESUS CHRIST, HOLY FAMILY MEMORIAL HAS A RICH HERITAGE OF PUTTING OUR COMMUNITY FIRST. WE'RE COMMITTED TO PROVIDING THE RIGHT CARE, IN THE RIGHT SETTING, FOR THE RIGHT OUTCOMES. TODAY, WE'RE RECOGNIZED AS THE LEADER AND LARGEST PROVIDER OF HEALTHCARE SERVICES IN MANITOWOC COUNTY. OUR NETWORK OF MORE THAN 830 HEALTHCARE PROFESSIONALS PROUDLY PROVIDES OUR COMMUNITY WITH TOP QUALITY, PERSONALIZED CARE. HOLY FAMILY MEMORIAL INCLUDES AN INPATIENT AND OUTPATIENT MEDICAL CENTER, SPECIALTY AND WALK-IN CARE, AND MORE THAN 10 CLINICS. CANCER CAN BE A LIFE-CHANGING DIAGNOSIS. BUT LIFE DOESN'T STOP. AND NEITHER DO WE. OUR CANCER CENTER TEAM IS HERE AND READY TO WALK WITH YOU THROUGH YOUR JOURNEY, ALWAYS FOCUSED ON YOU AND THE RIGHT OUTCOME. THROUGH OUR CANCER CENTER, WE OFFER INNOVATIVE, COLLABORATIVE, COMPREHENSIVE CANCER SERVICES TO CARE FOR YOUR PHYSICAL, SPIRITUAL, AND EMOTIONAL NEEDS. AT ORTHOPAEDICS, WE'RE HERE TO HELP YOU GET BACK TO DOING WHAT YOU LOVE. OUR DEDICATED TEAM OF ORTHOPAEDIC EXPERTS DELIVERS ORTHOPAEDIC EXCELLENCE TO EACH OF OUR PATIENTS. WE'RE PROUD TO BE RECOGNIZED AS THE REGION'S PREMIER ORTHOPAEDIC PROVIDER, A DISTINCTION WE'VE HELD FOR MORE THAN A DECADE. AT WOMEN'S HEALTH, WE'RE DEDICATED TO PROVIDING COMPREHENSIVE HEALTHCARE FOR WOMEN THROUGHOUT EVERY LIFE STAGE. WHETHER YOU'RE WELCOMING YOUR FIRST BABY INTO THE WORLD, SCHEDULING YOUR FIRST MAMMOGRAM, APPROACHING MENOPAUSE, OR JUST TRYING TO IMPROVE YOUR HEALTH AND WELL-BEING, WE'RE HERE TO PROVIDE YOU WITH SERVICES AND SUPPORT FOR ALL OF YOUR UNIQUE HEALTHCARE NEEDS. WHILE THE SPECIFIC TYPE OF CARE YOU NEED MAY CHANGE AS YOU GO THROUGH DIFFERENT LIFE STAGES, THE NEED FOR EXPERT, COMPASSIONATE, AND SPECIALIZED CARE DOESN'T. HEART AND VASCULAR CENTER PROVIDES TOP-QUALITY, COMPREHENSIVE CARDIAC CARE TO OUR COMMUNITY. FEATURING AN AWARD-WINNING CARDIAC CATH LAB, THE ONLY ONE OF ITS KIND IN MANITOWOC AND SHEBOYGAN COUNTIES, OUR TEAM QUICKLY AND EXPERTLY DIAGNOSES, TREATS, AND MANAGES EVERYTHING FROM CHEST PAIN, HEART ATTACKS, AND CONGESTIVE HEART FAILURE, TO CORONARY ARTERY DISEASE, MYOCARDIAL INFARCTION, ARRHYTHMIAS, AND HYPERTENSION. AT HOLY FAMILY MEMORIAL, YOU RECEIVE WORLD-CLASS, FAITH-BASED HEALTHCARE RIGHT IN YOUR OWN COMMUNITY. YOU DON'T HAVE TO TRAVEL TO A LARGER MARKET NETWORK TO GET BETTER QUALITY OF CARE SINCE WE'RE RIGHT HERE, JUST MINUTES FROM YOUR HOME, WORKING HARD TO EXCEED REGIONAL AND NATIONAL STANDARDS EVERY DAY. IT'S OUR PROMISE TO YOU TOO, TO PROVIDE THE RIGHT CARE, IN THE RIGHT SETTING, FOR THE RIGHT OUTCOMES. OUR EVER-GROWING LIST OF AWARDS, ACCOLADES, ACCREDITATIONS, AND RECOGNITION DEMONSTRATE OUR COMMITMENT TO EXCELLENCE AND OUR DEDICATION TO OUR PATIENTS AND OUR COMMUNITY. IN MARCH 2021, HFM FINALIZED AN AFFILIATION AGREEMENT WITH FROEDTERT AND THE MEDICAL COLLEGE OF WISCONSIN, STARTING THE NEXT CHAPTER IN CONTINUING TO IMPROVE OUR OFFERING OF HEALTHCARE TO THE MANITOWOC AREA. WORKING TOGETHER, WE'RE MAKING MORE OF WHAT IS HUMANLY POSSIBLE FOR YOUR HEALTH CARE AVAILABLE CLOSER TO HOME IN MANITOWOC COUNTY. IT'S A PARTNERSHIP THAT BUILDS ON THE RICH LEGACY OF HOLY FAMILY MEMORIAL AND SECURES IT FOR YEARS TO COME BY ADDING THE BROAD RESOURCES OF THE FROEDTERT AND MCW ACADEMIC HEALTH NETWORK TO BRING MORE HEALTH CARE OPTIONS TO THE COMMUNITY. IT'S A BEST-OF-BOTH-WORLDS SCENARIO FOR LOCAL RESIDENTS, AS MANITOWOC COUNTY'S TRUSTED HEALTH CARE PROVIDER PARTNERS WITH EASTERN WISCONSIN'S ONLY ACADEMIC HEALTH NETWORK TO OFFER EASY, LOCAL CONNECTIONS TO HIGH-CALIBER COMPLEX AND SPECIALTY CARE. BY WORKING TOGETHER, THE ENTIRE COMMUNITY BENEFITS, TOO. AS NONPROFIT ORGANIZATIONS, WE REMAIN COMMITTED TO REINVESTING ALL REVENUE OVER EXPENSES INTO OUR PEOPLE, FACILITIES, TECHNOLOGY, AND STRATEGIES TO SUPPORT OUR SHARED MISSION TO ADVANCE THE HEALTH OF THOSE WE SERVE NOW AND IN THE FUTURE. IT'S A MISSION STARTED WHEN THE FRANCISCAN SISTERS OF CHRISTIAN CHARITY MINISTRY FOUNDED HOLY FAMILY MEMORIAL AND ONE THAT REFLECTS THE VALUES LONG SUPPORTED BY THE FROEDTERT AND THE MEDICAL COLLEGE OF WISCONSIN HEALTH NETWORK. INPATIENT SERVICES: HOLY FAMILY MEMORIAL HAS 58 INPATIENT BEDS. FOR THE 12 MONTHS ENDED JUNE 30, 2022 WE HAD 1,502 ADMISSIONS WITH 8,379 PATIENT DAYS OF CARE. INPATIENT SURGERIES WERE 387. DURING FISCAL YEAR 2022, THE HOSPITAL HAD 215 CANCER REGISTRY CASES. SURGICAL SERVICES: WE HAVE SURGICAL SPECIALISTS IN A VARIETY OF FIELDS TO MEET ALL OF THE SURGICAL NEEDS OF OUR COMMUNITY, INCLUDING: CANCER TREATMENT - SCREENINGS AND SURGICAL PROCEDURES FOR COMMON CANCERS, INCLUDING: COLORECTAL, BREAST, ESOPHAGUS, STOMACH, LUNG, LIVER, SKIN, OVARIAN, THYROID AND OTHERS; EAR, NOSE, AND THROAT (ENT) SURGERY - TUBES IN EARS, REMOVE TONSILS, SEPTUM REPAIR OR REPOSITION, TURBINATE REDUCTION SURGERY, AND ENDOSCOPIC SINUS SURGERY; GENERAL SURGERY - HERNIA REPAIR, GALL BLADDER REMOVAL, VARICOSE VEIN REPAIR; GYNECOLOGICAL SURGERY - HYSTERECTOMIES, INCONTINENCE TREATMENT, ENDOMETRIAL ABLATION; ORTHOPAEDIC SURGERY - JOINT REPLACEMENTS, SPORTS MEDICINE INJURY REPAIR; AND UROLOGICAL SURGERY - INCONTINENCE TREATMENT, ENLARGED PROSTATE TREATMENT. THE HEART AND VASCULAR CENTER IS A PROVIDER OF TOP-QUALITY, COMPREHENSIVE CARDIAC CARE IN MANITOWOC COUNTY. FEATURING AN AWARD-WINNING CARDIAC CATH LAB, OUR TEAM QUICKLY AND EXPERTLY DIAGNOSES, TREATS, AND MANAGES EVERYTHING FROM CHEST PAIN, HEART ATTACKS, AND CONGESTIVE HEART FAILURE, TO CORONARY ARTERY DISEASE, MYOCARDIAL INFARCTION, ARRHYTHMIAS, AND HYPERTENSION. AT HOLY FAMILY MEMORIAL, OUR AWARD-WINNING, NATIONALLY RECOGNIZED CARDIAC CATH LAB IS HERE AND READY WHEN YOU NEED US WITH THE RAPID RESPONSE AND EXPERTISE YOU CAN DEPEND ON. OUR INNOVATIVE X-RAY SYSTEM AT HFM IS ONE OF THE MOST ADVANCED IN THE NATION. IT CUTS RADIATION EXPOSURE TO PATIENTS BY 73% WHILE MAINTAINING IMAGE QUALITY AND IS ABLE TO ADJUST IN REAL-TIME TO THE DEPTH AND AREA BEING VIEWED.
PART III, LINE 4B (CONT)	WHEN IT COMES TO A HEART ATTACK, EVERY MINUTE MATTERS. WHEN DEALING WITH HEART ATTACKS, YOU OFTEN HEAR THE TERM, "DOOR-TO-BALLOON TIME." THIS REFERS TO THE AMOUNT OF TIME BETWEEN WHEN A PATIENT ARRIVES AT THE HOSPITAL TO THE TIME THEY RECEIVE NECESSARY TREATMENT TO OPEN A BLOCKED HEART VESSEL. HFM'S DOOR-TO-BALLOON TIME CONSISTENTLY BEATS NATIONAL AVERAGES. OUR AVERAGE TIME IS 30 MINUTES, AND WE OFTENTIMES CLOCK IN UNDER 15 MINUTES. IT'S THIS COMMITMENT TO SPEED AND EXCELLENCE THAT'S LED US TO RECEIVING NATIONAL AWARDS AND RECOGNITION. THE AMERICAN HEART ASSOCIATION HAS HONORED HOLY FAMILY MEMORIAL WITH TWO MISSION: LIFELINE AWARDS, FOR EXCELLENCE IN IMPROVING QUALITY OF CARE FOR HEART ATTACK PATIENTS. HFM HAS ALSO BEEN AWARDED THE PLATINUM PERFORMANCE ACHIEVEMENT AWARD FROM THE AMERICAN COLLEGE OF CARDIOLOGY AND IS ACCREDITED BY THE AMERICAN HEART ASSOCIATION AND THE SOCIETY OF CARDIOVASCULAR PATIENT CARE. HFM'S LEADING-EDGE CARDIODIAGNOSTICS DEPARTMENT PROVIDES A NUMBER OF SERVICES TO DIAGNOSE HEART CONDITIONS, INCLUDING: ECHOCARDIOGRAPHY (INCLUDING TRANSESOPHAGEAL ECHOCARDIOGRAPHY); EKG; EVENT MONITORING; STRESS TESTING; HOLTER MONITORING; AND NUCLEAR MEDICINE CARDIAC IMAGING. TOTAL JOINT REPLACEMENT CLINIC: WE WORK WITH PATIENTS TO IDENTIFY AND DIAGNOSE THEIR BONE OR JOINT PROBLEM, LISTEN TO THEIR CONCERNS, IDENTIFY THEIR GOALS, AND CREATE AN INDIVIDUALIZED TREATMENT PLAN. OFTENTIMES, SURGERY IS NOT REQUIRED, AND PATIENTS CAN BE TREATED WITH THE FOLLOWING THERAPIES AND RECOMMENDATIONS: ANTI-INFLAMMATORY MEDICATIONS; KNEE BRACES; WALKING DEVICES; EXERCISE AND/OR PHYSICAL THERAPY; ICE FOLLOWING CERTAIN ACTIVITIES; WEIGHT REDUCTION FOR THOSE OVERWEIGHT; HYALURONIC ACID THERAPY; AND REST OR ACTIVITY MODIFICATION, OUR ADVANCED DIAGNOSTIC CAPABILITIES AND STATE-OF-THE-ART TECHNOLOGY HELP US MAKE AN ACCURATE DIAGNOSIS FOR EACH PATIENT. WE USE RESOURCES SUCH AS MAGNETIC RESONANCE IMAGING (MRI), CT SCANS, ELECTROMYOGRAPHY (EMG), MOTION AND GAIT ANALYSIS. WE ARE THE ONLY PROVIDER IN NORTHEASTERN WISCONSIN OFFERING KNEEKG TO HELP ASSESS CONDITIONS THAT MAY REQUIRE JOINT REPLACEMENT. JOINT REPLACEMENT SURGERY CAN BE AN EFFECTIVE WAY TO ELIMINATE PAIN AND DRAMATICALLY IMPROVE A PATIENT'S QUALITY OF LIFE. JOINT REPLACEMENT SURGERY IS GENERALLY CONSIDERED ONLY AFTER OTHER TREATMENTS HAVE BEEN TRIED FIRST. A VARIETY OF SURGERIES ARE OFFERED INCLUDING: ANTERIOR HIP REPLACEMENT; REVISION HIP AND KNEE REPLACEMENT; MUSCLE SPARING JOINT REPLACEMENT; RAPID RECOVERY JOINT REPLACEMENT; NARCOTIC-FREE AND MINIMALLY INVASIVE TOTAL KNEE REPLACEMENT; GENDER-SPECIFIC KNEE REPLACEMENT; NO PRECAUTION TOTAL HIP REPLACEMENT; AND VISCOSUPPLEMENTATION. CANCER SERVICES: MEDICAL ONCOLOGY AND HEMATOLOGY TREATS THE FULL SPECTRUM OF CANCER DIAGNOSES USING CHEMOTHERAPY, BIOLOGIC RESPONSE MODIFIERS, TARGETED THERAPIES, AND IMMUNOTHERAPY. SUPPORTIVE SERVICES PROVIDED FOR THESE TREATMENTS MAY INCLUDE BONE MARROW BIOPSY, BLOOD TRANSFUSIONS, HYDRATION, AND NAUSEA OR PAIN MANAGEMENT THERAPIES. RADIATION ONCOLOGY PROVIDES A FULL RANGE OF EXTERNAL BEAM RADIATION FOR ALL ADULT MALIGNANCIES, SOME ADOLESCENT MALIGNANCIES, AND SELECT BENIGN CONDITIONS. THE CANCER CENTER IS HOME TO THE ONLY TOMOTHERAPY UNIT IN BROWN, CALUMET, MANITOWOC, AND SHEBOYGAN COUNTIES. TOMOTHERAPY IS A CUTTING-EDGE TECHNOLOGY DESIGNED TO EFFECTIVELY TREAT HARD-TO-REACH AND COMPLEX TUMORS BY DELIVERING EXACT, INTENSE RADIATION. IT PRECISELY TARGETS THE TUMOR FROM ALL ANGLES ALLOWING HIGHER DOSES OF RADIATION TO BE GIVEN TO THE TUMOR, WHILE REDUCING THE RADIATION EXPOSURE OF HEALTHY TISSUE. CT IMAGING IS USED TO GUIDE TREATMENT. SURGICAL SERVICES ARE ONE OF THE PRIMARY METHODS USED IN CANCER DIAGNOSIS AND TREATMENT. HFM HAS A COMPREHENSIVE SURGICAL DEPARTMENT THAT IS EQUIPPED TO PERFORM NEWER CANCER PROCEDURES, INCLUDING SENTINEL NODE MAPPING AND BIOPSY AND STEREOTACTIC BREAST BIOPSIES. GASTROENTEROLOGY: AT GASTROENTEROLOGY, WE'RE HERE TO PROVIDE YOU WITH ANSWERS FOR ALL OF YOUR GASTROINTESTINAL CONCERNS IN TERMS YOU'LL UNDERSTAND, ALONG WITH THE EXPERT CARE YOU DESERVE. OUR TEAM OF INDUSTRY-LEADING GASTROENTEROLOGISTS COMBINE YEARS OF EXPERIENCE WITH CUTTING-EDGE TECHNOLOGY TO QUICKLY DIAGNOSE AND EFFECTIVELY TREAT ANY DIGESTIVE SYSTEM DISORDER. HERE ARE JUST SOME OF THE DIGESTIVE CONDITIONS WE TREAT: ACID REFLUX; BARRETT'S ESOPHAGUS; BILE DUCT DISORDERS; CELIAC DISEASE; CIRRHOSIS; COLON CANCER SCREENING (COLONOSCOPY); COMMON BILE DUCT STONES; CONSTIPATION; CROHN'S DISEASE; DIARRHEA; DIVERTICULITIS; DYSPHAGIA; ESOPHAGITIS; GALLBLADDER DISORDERS; GASTROESOPHAGEAL REFLUX DISEASE (GERD); GASTROINTESTINAL BLEEDING; GASTRITIS; HEPATITIS B AND C; IRRITABLE BOWEL SYNDROME (IBS); INFLAMMATORY BOWEL DISEASE (IBD); LIVER DISEASES (BOTH VIRAL AND INHERITABLE); PANCREATITIS; PEPTIC ULCER DISEASE; AND ULCERATIVE COLITIS. BIRTHING SERVICES: THE BIRTH OF A CHILD IS ONE OF THE MOST EXCITING, JOYOUS EVENTS LIFE HAS TO OFFER. OUR EXPERIENCED, BOARD-CERTIFIED DOCTORS AND CARING STAFF LOOK FORWARD TO HELPING PATIENTS AND THEIR FAMILY TO HAVE THE MOST MEMORABLE AND POSITIVE BIRTH EXPERIENCE. EVERY PREGNANCY IS UNIQUE. THAT'S WHY WE WORK CLOSELY WITH OUR PATIENTS TO PERSONALIZE EACH BIRTH PLAN AND PROVIDE ADDITIONAL SERVICES THAT MAY BE NEEDED TO PREPARE FOR PREGNANCY, LABOR, DELIVERY, AND POSTPARTUM CARE. DURING THIS REPORTING PERIOD, HFM HAD 70 BIRTHS.
FORM 990, PART III, LINE 4C	EMERGENCY SERVICES: DURING THE 12 MONTHS ENDED JUNE 30, 2022, WE HAD 10,375 EMERGENCY VISITS. THE EMERGENCY DEPARTMENT OFFERS MANITOWOC COUNTY THE MOST COMPREHENSIVE EMERGENCY SERVICES IN THE AREA. WE ARE A LEVEL III TRAUMA CENTER. WITH A TEAM OF FULL-TIME, EMERGENCY MEDICINE PHYSICIANS AND SPECIALLY TRAINED ACLS-CERTIFIED NURSES, PATIENTS WILL RECEIVE THE HIGHEST LEVEL OF CARE. HFM ALSO OFFERS A 10-BED INTENSIVE CARE UNIT STAFFED BY HIGHLY TRAINED NURSES AND MONITOR TECHNICIANS. IN OUR INTENSIVE CARE UNIT: RNS ARE CERTIFIED IN ADVANCED CARDIAC LIFE SUPPORT; CHEST PAIN PROTOCOLS INITIATED IN THE EMERGENCY ROOM ARE CONTINUED AND A WORK UP FOR CARDIAC DISEASE CAN OFTEN BE COMPLETED IN 12-24 HOURS; STATE-OF-THE-ART MONITORING EQUIPMENT IS USED, INCLUDING INTRA-AORTIC BALLOON PUMPS; AND WE BRING THE ELEMENT OF HUMAN CARING TO A HIGHLY TECHNICAL AREA.
FORM 990, PART I, LINE 5 AND PART V, LINE 2	FROEDTERT HEALTH, INC. IS THE COMMON LAW EMPLOYER FOR THE FROEDTERT HEALTH SYSTEM WHICH INCLUDES HOLY FAMILY MEMORIAL, INC.
FORM 990, PART VI, SECTION A, LINE 2	JEFFREY VAN DE KREEKE, STEVE LITTLE, AND THOMAS VEESER HAVE A BUSINESS RELATIONSHIP WITH MARK BEHL.
FORM 990, PART VI, SECTION A, LINE 6	AS OF MARCH 1, 2021, BFHFM, LLC OWNS 80% OF HFM AS A CORPORATE MEMBER. PRIOR TO MARCH 1, 2021, HOLY FAMILY MEMORIAL WAS SPONSORED BY FRANCISCAN SISTERS OF CHRISTIAN CHARITY SPONSORED MINISTRIES, INC. (FSCCSM). AS OF MARCH 1, 2021, FSCCSM RETAINS A 20% INTEREST IN HFM. BFHFM, LLC AND FSCCSM, INC. ARE THE TWO CORPORATE MEMBERS OF HFM. FROEDTERT HEALTH INC. OWNS 100% OF BFHFM, LLC.
FORM 990, PART VI, SECTION A, LINE 7A	HOLY FAMILY MEMORIAL OPERATES AN INTEGRATED HEALTHCARE DELIVERY SYSTEM, PRIMARILY TO THE RESIDENTS OF MANITOWOC COUNTY, WISCONSIN. HOLY FAMILY MEMORIAL'S BOARD OF DIRECTORS SHALL CONSIST OF NO MORE THAN SEVENTEEN INDIVIDUALS. THE PRESIDENT OF THE CORPORATION, THE CHIEF OF THE CORPORATION'S MEDICAL STAFF, AND THE CHIEF NURSING OFFICER SHALL BE EX-OFFICIO MEMBERS WITH FULL VOTING PRIVILEGES. IN ADDITION TO THE EX-OFFICIO BOARD POSITIONS, THE BOARD OF DIRECTORS SHALL INCLUDE TWO MEMBERS OF FRANCISCAN SISTERS OF CHRISTIAN CHARITY, EIGHT TO TEN INDEPENDENT MEMBERS FROM THE COMMUNITIES SERVED BY THE CORPORATION, AND TWO OTHERS APPOINTED BY BFHFM, LLC. BFHFM, LLC. HAS THE RIGHT TO APPOINT THE INDEPENDENT COMMUNITY BOARD MEMBERS.
FORM 990, PART VI, SECTION A, LINE 7B	BFHFM, LLC, WHICH IS 100% OWNED BY FROEDTERT HEALTH, INC., AS THE MAJORITY CORPORATE MEMBER OF HFM, HAS CERTAIN POWERS AND AUTHORITIES WITH RESPECT TO THE OPERATIONS AND MANAGEMENT OF HFM AS SET FORTH IN THE HFM BYLAWS. IN ADDITION, BFHFM, LLC AND FRANCISCAN SISTERS OF CHRISTIAN CHARITY SPONSORED MINISTRIES, INC JOINTLY EXERCISE CERTAIN RETAINED AUTHORITIES AS DEFINED IN HFM'S BYLAWS.
FORM 990, PART VI, SECTION B, LINE 11B	FROEDTERT HEALTH, INC. ACCOUNTING STAFF PREPARE FORM 990 WHICH IS REVIEWED BY FROEDTERT HEALTH, INC.'S FINANCIAL LEADERS. THE 990 IS THEN REVIEWED BY KPMG, FROEDTERT HEALTH INC.'S OUTSIDE ACCOUNTING FIRM. NEXT, THE 990 IS PROVIDED TO THE FROEDTERT HEALTH INC. AUDIT COMMITTEE AND BOARD OF DIRECTORS. AND FINALLY, THE 990 IS FILED AS REQUIRED.
FORM 990, PART VI, SECTION B, LINE 12C	ON AN ANNUAL BASIS ALL OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT. THE DATA IS COMPILED, AND THE FH VICE PRESIDENT-CHIEF COMPLIANCE OFFICER (CCO), THE SENIOR VICE-PRESIDENT-GENERAL COUNSEL AND/OR DELEGATE WILL REVIEW ALL FORMS AND NOTIFICATIONS TO DETERMINE IF ANY CONFLICTS OF INTEREST EXIST IN THE DISCLOSURE DOCUMENTS. IF IT IS DETERMINED THAT A CONFLICTS OF INTEREST EXISTS, THEN THE PERSON MAKING THE DISCLOSURE SHALL BE RELIEVED OF HIS/HER OBLIGATIONS ON BEHALF OF HFM WITH RESPECT TO THE TRANSACTION OR ARRANGEMENT THAT CREATES THE CONFLICT OF INTEREST. A REPORT OF ALL CONFLICTS OF INTEREST WILL BE MADE BY THE CCO AT LEAST ANNUALLY TO THE FH FINANCE COMMITTEE OF THE FH BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 15	COMPENSATION REVIEW AND APPROVAL PROCESS CEO AND TOP MANAGEMENT: IN ESTABLISHING THE COMPENSATION OF THE ORGANIZATION'S CEO AND TOP MANAGEMENT, INDEPENDENT COMPENSATION CONSULTANTS ARE UTILIZED. COMPENSATION STUDIES ARE COMPLETED TO GATHER COMPARATIVE DATA. PERSONS WITH A CONFLICT OF INTEREST REGARDING THE COMPENSATION ARRANGEMENTS AT ISSUE ARE NOT INVOLVED IN THE DECISION MAKING PROCESS, AND AMOUNTS ARE REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. IN ADDITION, THERE IS CONTEMPORANEOUS DOCUMENTATION AND RECORD KEEPING FOR DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENTS. COMPENSATION REVIEW AND APPROVAL PROCESS OFFICERS AND KEY EMPLOYEES: IN ESTABLISHING THE COMPENSATION OF THE ORGANIZATION'S OFFICERS, INDEPENDENT COMPENSATION CONSULTANTS ARE UTILIZED. COMPENSATION STUDIES ARE COMPLETED TO GATHER COMPARATIVE DATA. PERSONS WITH A CONFLICT OF INTEREST REGARDING THE COMPENSATION ARRANGEMENTS AT ISSUE ARE NOT INVOLVED IN THE DECISION MAKING PROCESS, AND AMOUNTS ARE REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF FROEDTERT HEALTH, INC. (A RELATED ORGANIZATION) IN ADDITION, THERE IS CONTEMPORANEOUS DOCUMENTATION AND RECORD KEEPING FOR DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION ARRANGEMENTS.
FORM 990, PART VI, SECTION C, LINE 19	DISCLOSURE: FROEDTERT HEALTH, INC'S QUARTERLY FINANCIAL INFORMATON IS MADE AVAILABLE TO THE PUBLIC ONLINE THROUGH THE DIGITAL ASSURANCE CORPORATION, INC. WEBSITE. ANYONE CAN REGISTER TO RECEIVE ONGOING ACCESS TO AND NOTIFICATIONS REGARDING FINANCIAL STATEMENTS AT THE ONLINE WEBSITE. ADDITIONALLY, GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE TO THE PUBLIC THROUGH THE CORPORATE OFFICE UPON REQUEST.
FORM 990, PART VII, SECTION A	ON MARCH 1, 2021, FROEDTERT HEALTH INC. BECAME THE COMMON LAW EMPLOYER OF HOLY FAMILY MEMORIAL. THEREFORE, PART VII, SECTION A COLUMN D SHOWS REPORTABLE COMPENSATION PAID BY THE ORGANIZATION FOR THE TIME PERIOD 1/1/2021 - 2/28/2021 FOR THE APPLICABLE INDIVIDUAL AND PART VII, SECTION A COLUMN E SHOWS REPORTABLE COMPENSATION PAID BY FROEDTERT HEALTH, THE COMMON LAW EMPLOYER FOR THE TIME PERIOD 3/1/2021 - 12/31/2021. THE TOTAL OF COLUMNS D AND COLUMNS E TIE TO BOX 5 OF THE 2021 W-2 FOR EACH INDIVIDUAL LISTED. MARK BEHL, STEVEN LITTLE AND JEFFREY VAN DE KREEKE WERE EMPLOYEES OF FROEDTERT HEALTH FOR ALL OF TAX YEAR 2021. PART VII, SECTION A, COLUMN (E) AND SCHEDULE J, PART II, COLUMNS (B)(I)-(III) REFLECT THE COMPENSATION FOR THESE EMPLOYEES FOR ALL OF 2021 THAT TIES TO THEIR 2021 W-2S EVEN THOUGH THEY WERE ONLY OFFICERS OF THE FILING ORGANIZATION FROM 3/1/2021 - 12/31/2021.
FORM 990, PART IX, LINE 11G	GENERAL SERVICES: PROGRAM SERVICE EXPENSES 3,032,030. MANAGEMENT AND GENERAL EXPENSES 10,924,954. FUNDRAISING EXPENSES 148. TOTAL EXPENSES 13,957,132. STAFFING SERVICES: PROGRAM SERVICE EXPENSES 8,833,104. MANAGEMENT AND GENERAL EXPENSES 3,516,760. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,349,864. REPAIR & MAINTENANCE SERVICES: PROGRAM SERVICE EXPENSES 2,348,209. MANAGEMENT AND GENERAL EXPENSES 827,189. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,175,398. OTHER PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 163,430. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 163,430. CONSULTING FEES: PROGRAM SERVICE EXPENSES 22,407. MANAGEMENT AND GENERAL EXPENSES 136,638. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 159,045. LANDSCAPE & GROUNDS SERVICES: PROGRAM SERVICE EXPENSES 74,954. MANAGEMENT AND GENERAL EXPENSES 57,469. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 132,423.
FORM 990, PART XI, LINE 9:	CONTRIBUTED CAPITAL 32,500,000. INVESTMENT RETURN ON RESTRICTED ASSETS -481,467. OTHER CHANGES TO RESTRICTED NET ASSETS 5,813. ADJUSTMENTS TO FIXED ASSETS 677,789.

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

Cat. No. 51056K

Schedule O (Form 990) 2021

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: HOLY FAMILY MEMORIAL IS A NETWORK OF PROFESSIONALS WHO, ROOTED IN THE HEALING MINISTRY OF JESUS CHRIST, PROVIDE SERVICES TO HELP INDIVIDUALS ACHIEVE HEALTHIER LIVES.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	12
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	6
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6	180
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	93,262
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	16,697

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	46,893	87,320
9	Program service revenue (Part VIII, line 2g) .........	48,806,173	101,866,434
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	2,864,092	113,981
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	111,450	8,846,407
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	51,828,608	110,914,142
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	6,309	127,113
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)	33,466,946	77,882,350
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 235
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	28,423,236	68,476,115
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	61,896,491	146,485,578
19	Revenue less expenses. Subtract line 18 from line 12.......	-10,067,883	-35,571,436
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	64,042,070	47,324,620
21	Total liabilities (Part X, line 26).............	22,964,988	10,191,501
22	Net assets or fund balances. Subtract line 21 from line 20.....	41,077,082	37,133,119

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 73,604,210 including grants of $ 0 ) (Revenue $ 73,785,306 )
	SEE SCHEDULE O - OUTPATIENT SERVICES

4b	(Code: ) (Expenses $ 23,051,238 including grants of $ 0 ) (Revenue $ 23,131,117 )
	SEE SCHEDULE O - INPATIENT SERVICES

4c	(Code: ) (Expenses $ 4,839,977 including grants of $ 0 ) (Revenue $ 4,856,749 )
	SEE SCHEDULE O - EMERGENCY SERVICES

	(Code: ) (Expenses $ 8,762,714 including grants of $ 127,113 ) (Revenue $ 8,682,432 )
	ALL OTHER REVENUE:INTERCOMPANY REVENUE: REVENUE THAT ORIGINALLY CAME FROM PATIENT ACTIVITY THAT WAS MOVED BETWEEN RELATED FROEDTERT COMPANIES DUE TO COMPANY RESTRUCTURING;OTHER DEPARTMENT REVENUE: REVENUE DERIVED FROM A VARIETY OF SERVICES AND ACTIVITY THAT SUPPORTS DIRECTLY OR INDIRECTLY THE PROVISION OF PATIENT CARE WITHIN THE FACILITY. INCLUDED IN THIS CATEGORY ARE ATHLETIC TRAINER SERVICES, FITNESS DEVELOPMENT, WORKFORCE HEALTH, AND NUTRITION SERVICES;CAFETERIA: CAFETERIA RECEIPTS;ALL OTHER REVENUE: CONTAINS REBATES AND INVENTORY DISCOUNTS.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 8,762,714 including grants of $ 127,113 ) (Revenue $ 8,682,432 )
4e	Total program service expenses110,258,139

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)		(D) Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(18) BRETT W NORELL........................................................................ FORMER OFFICER	50.00 .......................0.00	X	75,940	579,478	38,227
(19) TROY D DAY........................................................................ FORMER OFFICER	50.00 .......................0.00	X	44,767	444,197	50,560

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	619,824	6,525,108	682,239

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c	3,720
d	Related organizations		1d
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f	83,600

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		87,320

		Business Code
2a	OUTPATIENT REVENUE	900099	73,785,306	73,785,306
b	INPATIENT REVENUE	900099	23,131,117	23,131,117
c	EMERGENCY/TRAUMA REVENUE	900099	4,856,749	4,856,749
d	LAB REFERRAL	621500	93,262		93,262
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		101,866,434

3 Investment income (including dividends, interest, and othersimilar amounts) ......			88,103			88,103
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		143,507	6a
b	Less: rental expenses		0	6b
c	Rental income or (loss)		143,507	6c
d	Net rental income or (loss).......			143,507			143,507
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	1,060	1,163,715	7a
b	Less: cost or other basis and sales expenses	32,103	1,106,794	7b
c	Gain or (loss)	-31,043	56,921	7c
d	Net gain or (loss).........			25,878			25,878
8a	Gross income from fundraising events (not including $ 3,720of contributions reported on line 1c). See Part IV, line 18 ....
			8a	28,190
b	Less: direct expenses ...		8b	7,722
c	Net income or (loss) from fundraising events..			20,468			20,468
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..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	INTERCOMPANY REVENUE		900099	7,089,442	7,089,442
b	OTHER DEPARTMENT REVENUE		900099	1,201,637	1,201,637
c	CAFETERIA		722514	297,643	297,643
d	All other revenue ....			93,710	93,710
e	Total. Add lines 11a–11d ......			8,682,432
12	Total revenue. See instructions.....			110,914,142	110,455,604	93,262	277,956

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	110,265	110,265
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	16,848	16,848
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........	62,388,362	56,982,231	5,406,131
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	731,987	589,945	142,042
9	Other employee benefits .......	10,809,064	6,812,888	3,996,176
10	Payroll taxes ...........	3,952,937	3,558,551	394,386
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	151,656		151,656
c	Accounting ...........
d	Lobbying ...........
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)	29,937,292	14,310,704	15,626,440	148
12	Advertising and promotion ....	316,514	27,903	288,611
13	Office expenses .......	712,961	325,533	387,428
14	Information technology ......	7,377,823	1,543,865	5,833,884	74
15	Royalties ..
16	Occupancy ...........	2,112,571	1,013,833	1,098,738
17	Travel ............	70,227	28,586	41,641
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	228,109	153,175	74,934
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	4,030,670	2,548,564	1,482,093	13
23	Insurance ...	92,130	78,095	14,035
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	SUPPLIES	19,535,838	19,230,813	305,025
b	STATE ASSESSMENT	2,025,324	2,025,324
c	DUES & LICENSES	1,107,046	519,099	587,947
d	RECRUITMENT, OTHER DIRE	698,780	334,512	364,268
e	All other expenses	79,174	47,405	31,769
25	Total functional expenses. Add lines 1 through 24e	146,485,578	110,258,139	36,227,204	235
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			10,625,058	1	-4,917,209
2	Savings and temporary cash investments .........			0	2	0
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			8,386,170	4	10,502,367
5	Loans and other receivables from 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 ...........			0	7	0
8	Inventories for sale or use ............			1,983,857	8	1,444,574
9	Prepaid expenses and deferred charges ......			5,652,295	9	1,174,925
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	31,834,430
b	Less: accumulated depreciation	10b	5,053,744	20,997,630	10c	26,780,686
11	Investments—publicly traded securities .			16,222,060	11	5,931,519
12	Investments—other securities. See Part IV, line 11 .....			0	12	0
13	Investments—program-related. See Part IV, line 11 ..			0	13	0
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			175,000	15	6,407,758
16	Total assets. Add lines 1 through 15 (must equal line 33)...			64,042,070	16	47,324,620

17	Accounts payable and accrued expenses .....	13,578,384	17	9,772,058
18	Grants payable ...	0	18	0
19	Deferred revenue .........	76,192	19	69,236
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	9,310,412	25	350,207
26	Total liabilities. Add lines 17 through 25..	22,964,988	26	10,191,501

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	37,102,195	27	33,633,887
28	Net assets with donor restrictions ...........	3,974,887	28	3,499,232
	Organizations that do not follow FASB ASC 958, check here 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 ...........	41,077,082	32	37,133,119
33	Total liabilities and net assets/fund balances ........	64,042,070	33	47,324,620

(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) FROEDTERT MANITOWOC MEDICAL GROUP LLC 9200 W WISCONSIN AVE MILWAUKEE,WI53226 87-1785388	HLTHCARE SVCS	WI	5,075,524	3,488,380	HFM INC

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)FROEDTERT HEALTH INC 9200 W WISCONSIN AVE MILWAUKEE,WI53226 39-2014409	MGMT SVCS	WI	501(C)3	12 TYPE III	N/A		No
(2)ST JOSEPH'S COMMUNITY HOSP OF WEST BEND 3200 PLEASANT VALLEY RD WEST BEND,WI53095 39-0806302	HOSPITAL	WI	501(C)3	3	FH INC		No
(3)ST JOSEPH'S COMMUNITY FOUNDATION INC 3200 PLEASANT VALLEY RD WEST BEND,WI53095 39-2034296	HLTH/WELFARE	WI	501(C)3	LN 7	SJH		No
(4)COMMUNITY MEMORIAL HOSPITAL OF MF W180 N8085 TOWN HALL RD MENOMONEE FALLS,WI53051 39-0987025	HOSPITAL	WI	501(C)3	3	FH INC		No
(5)FROEDTERT MEMORIAL LUTHERAN HOSPITAL 9200 W WISCONSIN AVE MILWAUKEE,WI53226 39-6105970	HOSPITAL	WI	501(C)3	3	FH INC		No
(6)QHS 1 INC 9200 W WISCONSIN AVE MILWAUKEE,WI53226 20-2636686	HLTHCARE SVCS	WI	501(C)3	12 TYPE III	FH INC		No
(7)COMMUNITY MEMORIAL FOUNDATION OF MF W180 N8085 TOWN HALL RD MENOMONEE FALLS,WI53051 39-1635057	HLTH/WELFARE	WI	501(C)3	LN 10	CMH		No
(8)COMMUNITY OUTPATIENT HEALTH SERVICES W180 N8085 TOWN HALL RD MENOMONEE FALLS,WI53051 39-1743056	MED/DENT SVCS	WI	501(C)3	3	CMH		No
(9)FROEDTERT HOSPITAL FOUNDATION INC 9200 W WISCONSIN AVE MILWAUKEE,WI53226 39-1431192	HLTH/WELFARE	WI	501(C)3	LN 7	FMLH		No

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership
(1) FMLH MCW REAL ESTATE VENTURES LLC 9200 W WISCONSIN AVE MILWAUKEE,WI53226 26-0629591	REAL ESTATE	WI	N/A	N/A				No			No
(2) WISCONSIN DIAGNOSTIC LABORATORIES LLC 9200 W WISCONSIN AVE MILWAUKEE,WI53226 39-1896819	LAB SERVICES	WI	N/A	N/A				No			No
(3) D1 SPORTS TRAINING OF MILWAUKEE LLC 9200 W WISCONSIN AVE MILWAUKEE,WI53226 47-3322294	SPORTS MEDICINE	WI	N/A	N/A				No			No
(4) DREXEL TOWN SQUARE SURGERY CENTER LLC 7901 S 6TH ST OAK CREEK,WI53154 81-4904300	SURGERY CENTER	WI	N/A	N/A				No			No
(5) FROEDTERT SURGERY CENTER LLC 9200 W WISCONSIN AVE MILWAUKEE,WI53226 20-1499345	SURGERY CENTER	WI	N/A	N/A				No			No
(6) MENOMONEE FALLS AMBULATORY SURGERY CTR W180 N8045 TOWN HALL RD MENOMONEE FALLS,WI53051 39-1745697	SURGERY CENTER	WI	N/A	N/A				No			No
(7) THP-FROEDTERT HEALTH VENTURES LLC 1415 LOUISIANA ST HOUSTON,TX77002 82-3559342	HEALTH CARE	TX	N/A	N/A				No			No
(8) FROEDTERT & THE MCW NETWORK LLC 9200 W WISCONSIN AVE MILWAUKEE,WI53226 81-4382585	HEALTH CARE	WI	N/A	N/A				No			No
(9) FROEDTERT & MEDICAL COLLEGE OF WI ACO 8710 WATERTOWN PLANK RD MILWAUKEE,WI53226 83-3159534	HEALTH CARE	WI	N/A	N/A				No			No

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) HOLY FAMILY HEALTH SERVICES	Q	788,409	FMV
(2) HOLY FAMILY HEALTH SERVICES	P	52,083	FMV

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