Ascension Medical Group-Fox Valley Wisconsin Inc.

“The process of determining the amount of compensation paid to the organization's ceo, executive director or top management official is performed by ministry health care, inc. And its subsidiary organizations. Ministry health care, inc. Is the sole corporate member of affinity health system which is the sole corporate member of ascension medical group-fox valley wisconsin, inc. (f/k/a network health system, inc.). The process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The executive compensation committee reviewed and approved the compensation. In the review of the compensation, the organization's ceo, executive director or top management official's salary was compared to individuals at other organizations in the area who hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the minutes. The individual was not present when their compensation was decided.”

“The process of determining the amount of compensation paid to the organization's officers and key employees is performed by ministry health care, inc. And its subsidiary organizations. Ministry health care, inc. Is the sole corporate member of affinity health system which is the sole corporate member of ascension medical group-fox valley wisconsin, inc. (f/k/a network health system, inc.). The process included a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision. The executive compensation committee reviewed and approved the compensation. In the review of the compensation, the officers' salaries were compared to individuals at other organizations in the area who hold the same title. During the review and approval of the compensation, documentation of the decision was recorded in the minutes. Individuals were not present when their compensation was decided.”

“Ascension medical group-fox valley wisconsin, inc. (f/k/a network health system, inc.) has a single corporate member, affinity health system.”

“Ascension medical group-fox valley wisconsin, inc. (f/k/a network health system, inc.) has a single corporate member, affinity health system, who has the ability to elect members to the governing body of network health system, inc.”

“All decisions that have a material impact to the ascension medical group-fox valley wisconsin, inc. (f/k/a network health system, inc.) financial information or corporation as a whole are subject to approval by its sole corporate member, affinity health system.”

“During the return preparation process, the tax department works with other functional areas including finance, accounting, treasury, legal, human resources, and corporate compliance for advice, information and assistance in order to prepare a complete and accurate return. Upon completion, the form 990 is reviewed by the organization's internal tax department which consists of attorneys and cpas. A complete final copy of the return is provided to the organization's president, financial officer, and/or other key officers in lieu of the full board.”

“The organization regularly and consistently monitors and enforces compliance with the conflict of interest policy in that any director, principal officer, or member of a committee with governing board delegated powers, who has a direct or indirect financial interest, must disclose the existence of the financial interest and be given the opportunity to disclose all material facts to the directors and members of the committees with governing board delegated powers considering the proposed transaction or arrangement. The remaining individuals on the governing board or committee will decide if conflicts of interest exist. Each director, principal officer and member of a committee with governing board delegated powers annually signs a statement which affirms such person has received a copy of the conflicts of interest policy, has read and understands the policy, has agreed to comply with the policy, and understands that the organization is charitable and in order to maintain its federal tax exemption it must engage primarily in activities which accomplish its tax-exempt purpose.”

“The organization will provide any documents open to public inspection upon request.”

“Management Fees - Total Revenue: 150, Related or Exempt Function Revenue: 150, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Sports Medicine Revenue - Total Revenue: 1710, Related or Exempt Function Revenue: 1710, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;”

“OTHER MISCELLANEOUS REVENUE - Total Revenue: 379397, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 379397;”

“Transfers with affiliate - -22130641; transfers with alpha fund - 53941545;”

“The activity of ascension medical group-fox valley wisconsin, inc. (f/k/a network health system, inc.) is reported in the consolidated financial statements of ascension health alliance. No individual audit of ascension medical group-fox valley wisconsin, inc. (f/k/a network health system, inc.) is completed. Therefore, the audited financial statements are of ascension health alliance and affiliates, which include the activity of ascension medical group-fox valley wisconsin, inc. (f/k/a network health system, inc.)”

“Ascension medical group-fox valley wisconsin, inc. (f/k/a network health system, inc.) is included in the consolidated financial statements of ascension health alliance. The finance and audit committee of ascension health alliance's board assumes responsibility for the consolidated organization as a whole.”

“Ascension medical group-fox valley wisconsin, inc. (f/k/a network health system, inc.) is exempt as a hospital under internal revenue code section 170(b)(1)(a)(iii); however, it is not a hospital as defined by form 990, schedule h instructions.”