2022-08-15T11:49:45-05:00 2021-09-30 410746749 CLIFTONLARSONALLEN LLP 220 S 6TH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2020-10-01 391091432 REEDSBURG AREA MEDICAL CENTER REED 6085246487 2000 NORTH DEWEY AVENUE REEDSBURG WI 53959 ROBERT VAN MEETEREN PRESIDENT/CEO 6085246487 2022-08-12 1 ROBERT VAN MEETEREN 999009999 KOREY BOELTER P00775161 6123764500 2022-08-12 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z ROBERT VAN MEETEREN 2000 NORTH DEWEY AVENUE REEDSBURG WI 53959 100158884 0 X WWW.RAMCHEALTH.COM X 1967 WI PROVIDE QUALITY, COMPASSIONATE, & EFFECTIVE HEALTH CARE GOING BEYOND THE EXPECTED IN ALL WE DO. 11 9 728 48 3071527 989433 7336697 6011931 76984496 91960140 557402 1117425 1106558 1033739 85985153 100123235 2239477 2032681 0 0 46755148 50135396 0 0 0 36317514 40386219 85312139 92554296 673014 7568939 115043817 119002256 63800984 57863781 51242833 61138475 X REEDSBURG AREA MEDICAL CENTER, ALWAYS THERE, GOING BEYOND THE EXPECTED TO PROVIDE COMPASSIONATE, QUALITY, AND EFFICIENT HEALTH CARE. 0 0 75712660 2032681 83514633 'INPATIENT SERVICES INCLUDE MULTICARE (MEDICAL/SURGICAL), OBSTETRICS/NURSERY, AND INTENSIVE CARE UNITS AT REEDSBURG AREA MEDICAL CENTER (RAMC). WITHIN THESE UNITS, RAMC PROVIDED SHORT TERM CARE FOR 3,267 PATIENT DAYS (1,065 DISCHARGED PATIENTS) DURING THE FISCAL YEAR ENDING 9/30/21. THIS INCLUDED 357 SWING BED DAYS FOR 31 PATIENTS, 768 OBSERVATION DAYS AND 198 BIRTHS. THE STAFF AT RAMC IS COMMITTED TO MEETING PATIENTS' PHYSICAL, SOCIAL, EDUCATIONAL, EMOTIONAL, AND SPIRITUAL NEEDS. RAMC'S EMERGENCY AND WALK-IN CLINIC IS HERE FOR THE COMMUNITY WHENEVER THEY MAY NEED IT. WALK-IN CLINIC HAS HOURS OF AVAILABILITY FOR MINOR MEDICAL NEEDS SEVEN DAYS A WEEK AND THE EMERGENCY ROOM IS OPEN AND PHYSICIAN STAFFED 24 HOURS A DAY. IN THE FISCAL YEAR ENDING 9/30/21, 8,596 PATIENTS WERE SEEN IN THE EMERGENCY ROOM (RESULTING IN 1,107 INPATIENT ADMISSIONS) AND 9,795 PATIENTS VISITED THE WALK-IN CLINIC. WE BELIEVE THAT EVERYONE DESERVES ACCESS TO QUALITY HEALTH CARE, REGARDLESS OF THEIR INCOME LEVEL, AND OUR FOCUS REMAINS ON THE PATIENTS AND COMMUNITIES WE SERVE. WE ALSO BELIEVE THAT BEING A NON-PROFIT MEDICAL CENTER IS A PRIVILEGE AND AN OBLIGATION. EVERY DAY WE STRIVE TO BE A LEADER IN COMMUNITY HEALTH. BY MEETING, AND OFTEN EXCEEDING THAT EXPECTATION, RAMC IS STRENGTHENING OUR RELATIONSHIP WITH PATIENTS, VISITORS AND NEIGHBORING COMMUNITIES. BEING A COMMUNITY PARTNER IS AN AWESOME, BUT IMPORTANT TASK, ONE WE FEEL PRIVILEGED TO UPHOLD. AS IDENTIFIED IN OUR MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT, MENTAL HEALTH, CHRONIC DISEASE AND NUTRITION & PHYSICAL ACTIVITY ARE THE TOP PRIORITIES THAT RAMC WILL WORK TO ADDRESS. WE ARE COMMITTED TO MAKING POSITIVE IMPACTS IN THESE AREAS AND SHOW THIS THROUGH OUR COMMUNITY PARTNERSHIPS AND SUPPORT. RAMC HAS COLLABORATED WITH COMMUNITY PARTNERS ON SEVERAL INITIATIVES, INCLUDED, BUT NOT LIMITED TO, ORGANIZING A TEEN SUMMIT FOCUSED ON TEEN MENTAL WELL-BEING AND CURRENT ISSUES WITH OVER 100 TEENS IN ATTENDANCE, WORKING WITH SAUK COUNTY HEALTH DEPARTMENT TO COMBAT SUICIDE, IS A MEMBER OF THE SAUK COUNTY PARTNERSHIP FOR PREVENTION & RECOVERY, SUPPORT LOCAL BOYS & GIRLS CLUB, HOLD COMMUNITY DIABETES PREVENTION PROGRAMMING AND HEALTHY LIVING CLASSES (HEALTH4U) AND HOST KIDS FIT & SAFETY DAY FOR ALL 4TH & 5TH GRADERS IN THE REEDSBURG SCHOOL DISTRICT. IN ADDITION, RAMC SUPPORTS MANY LOCAL EVENTS AND ACTIVITIES DESIGNED TO HELP ENCOURAGE HEALTHY LIFESTYLES AND CHOICES. DURING THE FISCAL YEAR ENDING 9/30/21, RAMC HAS DEMONSTRATED OUR COMMITMENT TO ENSURING QUALITY HEALTHCARE IS ALWAYS AVAILABLE CLOSE TO HOME THROUGH THE ADDITION OF PROVIDERS AND CONTINUED SUPPORT OF COMMUNITY WELLNESS PROGRAMS. OUR TWO PHARMACIES OFFERS SERVICES SUCH AS IMMUNIZATIONS, BLOOD PRESSURE AND BLOOD SUGAR CHECKS AND MEDICATION REVIEW. OTHER SERVICES AVAILABLE TO MEET THE COMMUNITY'S HEALTH NEEDS INCLUDE, BUT ARE NOT LIMITED TO, LABORATORY, PHYSICAL, CARDIAC AND PULMONARY REHABILITATION, SLEEP MEDICINE, SURGICAL SERVICES, CONSULTING SERVICES, MASSAGE THERAPY, ORTHOPEDICS, OBSTETRICS, PARISH NURSING , CHEMOTHERAPY, AUDIOLOGY, FAMILY PRACTICE CLINIC, COMMUNITY PHARMACY, GYNECOLOGY, DIABETIC EDUCATION, MEDICAL IMAGING, NUTRITION SERVICES, OCCUPATIONAL HEALTH, RESPIRATORY THERAPY, VOLUNTEER SERVICES, COMMUNITY OUTREACH AND WELLNESS. 5296214 0 8445507 REEDSBURG AREA MEDICAL CENTER COMMUNITY PHARMACY IS CONVENIENTLY LOCATED ON THE RAMC CAMPUS WITHIN THE PHYSICIAN'S GROUP WHILE RAMC VIKING PHARMACY IS LOCATED WITHIN A LOCAL GROCERY STORE. BOTH PHARMACIES ARE OPEN TO ALL MEMBERS OF THE PUBLIC. PATIENTS CAN FILL/REFILL PRESCRIPTIONS AT THEIR CONVENIENCE AND AS IT FITS INTO THEIR SCHEDULES. AUTOMATED SERVICES MAKE IT EASY TO CALL IN AND PICK UP REFILLS. IN ADDITION TO FILLING PRESCRIPTIONS, BOTH PHARMACIES OFFER AN EXTENSIVE ARRAY OF OVER-THE-COUNTER MEDICATIONS, VITAMINS AND SUPPLEMENTS, FIRST AID NEEDS AND PERSONAL ITEMS. 81008874 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 37 0 728 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 11 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 WI X BARRY BORCHERT 6085246487 2000 NORTH DEWEY AVENUE REEDSBURG WI 53959 CHRISTOPHER DALE MD PHYSICIAN 40.00 0.00 X 861831 0 30700 THOMAS WOOD MD TRUSTEE/PHYSICIAN 40.00 0.00 X 644777 0 73463 CHRISTOPHER WENNINGER MD PHYSICIAN 40.00 0.00 X 609416 0 52335 ROBERT VAN MEETEREN CEO / PRESIDENT 40.00 0.00 X 440071 0 81589 BENJAMIN NESSEIM MD PHYSICIAN 40.00 0.00 X 370008 0 45762 CHRISTOPHER ECKERMAN DPM PHYSICIAN 40.00 0.00 X 372066 0 43240 CHRISTOPHER BJORKLUND CRNA ANESTHESIOLOGIST/FOUNDATION LIAISON 40.00 0.00 X 325184 0 50610 BARRY BORCHERT CFO 40.00 0.00 X 275549 0 54140 MARY BETH SHEAR MD MEDICAL ADVISOR/TRUSTEE 40.00 0.00 X 181786 0 33206 KRISTI BROWN TREASURER 0.50 0.00 X X 1950 0 0 BOB BASS CHAIRPERSON 0.50 0.00 X X 0 0 0 DEREK HORKAN VICE CHAIRPERSON 0.50 0.00 X X 0 0 0 KONYA ANTONETTI SECRETARY 0.50 0.00 X X 0 0 0 JULIE ADELMAN TRUSTEE 0.50 0.00 X 0 0 0 JOEL GROSKREUTZ TRUSTEE 0.50 0.00 X 0 0 0 DAN KLAHN TRUSTEE 0.50 0.00 X 0 0 0 DON LICHTE JR TRUSTEE 0.50 0.00 X 0 0 0 RAYNELLE SYFTESTAD TRUSTEE 0.50 0.00 X 0 0 0 PAMELA WELCH TRUSTEE (THROUGH OCTOBER 2020) 0.50 0.00 X 0 0 0 4082638 0 465045 69 0 1 0 MADISON EMERGENCY PHYSICIANS SC 1221 JOHN Q HAMMONDS DR MADISON WI 53744 PHYSICIAN SERVICES 3888314 BEAM HEALTHCARE 25 WEST MAIN ST FLOOR 5 MADISON WI 53703 PHYSICIAN SERVICES 1558984 SHARED IMAGING SERVICES PO BOX 88450 MILWAUKEE WI 53288 MEDICAL IMAGING SERVICES 1009774 UNITYPOINT HEALTH PO BOX 83381 CHICAGO IL 60691 EPIC SOFTWARE 986546 MARSHFIELD LABORATORIES 1000 NORTH OAK AVE MARSHFIELD WI 54449 LAB ANALYSIS 895258 20 5998821 13110 22380 6011931 PATIENT SERVICE REVENUE 621400 83289664 83289664 PHARMACY REVENUE 446110 8445507 5373980 3071527 CAFETERIA REVENUE 722310 224969 224969 91960140 466173 466173 156049 0 156049 156049 156049 686901 0 35649 686901 -35649 651252 651252 MEAL REVENUE 722310 329614 329614 JOINT VENTURE GAIN/(LOSS) 900099 283865 283865 MISCELLANEOUS REVENUE 900099 264211 264211 877690 100123235 88888613 3071527 2151164 X 1852457 1852457 180224 180224 1429764 619543 810221 37603226 32617371 4985855 1656194 1409147 247047 6884296 5808223 1076073 2561916 2148557 413359 166807 166807 51724 51724 7765 7765 12629798 10604896 2024902 212159 212159 1309586 958304 351282 1173461 1152110 21351 148070 113634 34436 1593001 1593001 4286863 4286863 330846 330846 INCOME TAX EXPENSE 328502 328502 MEDICAL SUPPLIES 16039509 16039174 335 OTHER EXPENSES 459705 416469 43236 DUES & LICENSES 413362 135467 277895 1235061 1073434 161627 92554296 81008874 11545422 0 5099 6409 14749798 11438982 8933328 9690023 2325386 2591779 379070 521941 86108886 35530548 52022121 50578338 31540079 38380466 408862 666260 1135537 1021939 3544537 4106119 115043817 119002256 25416077 20924090 8369 6986 34960822 33693674 2263111 2035071 1152605 1203960 63800984 57863781 X 50602440 60427117 640393 711358 51242833 61138475 115043817 119002256 X 7568939 2166984 159719 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 2620 0 1 5145 7765 0 PART II-B, LINE 1: A PORTION OF ANNUAL DUES PAID TO BOTH THE AMERICAN HOSPITAL ASSOCIATION AND THE WISCONSIN HOSPITAL ASSOCIATION ARE USED BY THOSE ORGANIZATIONS FOR LOBBYING PURPOSES. VARIOUS RAMC EMPLOYEES ANNUALLY ATTEND WISCONSIN HOSPITAL ASSOCIATION'S ADVOCACY DAY WHERE THEY HAVE THE OPPORTUNITY TO LEARN ABOUT THE CURRENT LEGISLATIVE CLIMATE AND ISSUES IMPACTING WISCONSIN HEALTHCARE AND THEN MEET WITH STATE LEGISLATORS. 2334169 217576 2551745 2234116 100053 2334169 2537304 116219 419407 2234116 1.00000 0.00000 0.00000 0 0 26703 26703 62616970 23175200 39441770 20912914 11429245 9483669 2552299 926103 1626196 50578338 DEFERRED COMPENSATION 1203960 1203960 X PART V, LINE 4: THE EARNINGS OF THE ENDOWMENT WERE USED FOR CAPITAL EXPENDITURES. PART X, LINE 2: THE CORPORATION IS A NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE IRC. THE CORPORATION IS ALSO EXEMPT FROM STATE INCOME TAXES ON RELATED INCOME. IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE CORPORATION ASSESS WHETHER IT ISMORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE LIKELY THAN NOT RECOGNITION THRESHOLD, THE BENEFIT OFTHE TAX POSITION IS NOT RECOGNIZED IN THE COMBINED FINANCIAL STATEMENTS. THE CORPORATION RECORDED NO ASSETS OR LIABILITIES FOR UNCERTAIN TAX POSITIONS OR UNRECOGNIZED BENEFITS IN 2021 AND 2020. 1 1 X 1 X 1 X 1 1 1 0 1 1 862031 233219 628812 0.00680 9721097 8770658 950439 0.01030 10583128 9003877 1579251 0.01710 536570 50 536520 0.00580 183937 183937 0.00200 4112611 2066512 2046099 0.02220 1864200 1864200 0.02020 6697318 2066562 4630756 0.05020 17280446 11070439 6210007 0.06730 1610 1610 0.00000 212 212 0.00000 31479 31479 0.00030 5000 5000 0.00010 11396 11396 0.00010 49697 49697 0.00050 0 242133 242133 11549152 16999774 -5450622 X 1 1 1 1 REEDSBURG AREA MEDICAL CENTER 2000 NORTH DEWEY AVENUE REEDSBURG WI 53959 WWW.RAMCHEALTH.COM 1057 X X X X PROVIDER-BASED CLINIC AND SPECIALTY CLINIC REEDSBURG AREA MEDICAL CENTER 1 0 0 1 X X X X X X X X X 18 1 1 1 1 X SEE PART V, SECTION B, LINE 7D X X 1 18 1 SEE PART V, SECTION B, LINE 7D 0 1 X 150.000000000000 400.000000000000 X X X X X 1 1 X X X X 1 X WWW.RAMCHEALTH.COM/PATIENTS-VISITORS/BILLING-FINANCIAL-SERVICES X WWW.RAMCHEALTH.COM/PATIENTS-VISITORS/BILLING-FINANCIAL-SERVICES X WWW.RAMCHEALTH.COM/PATIENTS-VISITORS/BILLING-FINANCIAL-SERVICES X X X X X X 1 X 0 X X X X X 1 X 0 0 REEDSBURG AREA MEDICAL CENTER PART V, SECTION B, LINE 5: THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS INCLUDED A VARIETY OF DATA COLLECTION METHODS USED TO CREATE AN OVERALL DESCRIPTION OF THE ISSUES FACING THE COMMUNITY. THESE METHODS WERE DEVELOPED TO SEEK INPUT FROM DIVERSE COMMUNITY STAKEHOLDERS AS WELL AS GENERAL COMMUNITY MEMBERS AND INCLUDED: 1. CONVENIENCE SURVEY: THESE SURVEYS WERE CONDUCTED WITH OVER 1,600 AREA RESIDENTS VIA A PAPER AND AN ONLINE METHOD. INDIVIDUALS PARTICIPATED FROM A VARIETY OF PROFESSIONS INCLUDING HOSPITALS, SCHOOLS, LAW ENFORCEMENT, MENTAL HEALTH, ENVIRONMENTAL HEALTH, BUSINESSES, PUBLIC HEALTH, DISABILITY AND AGING ADVOCATES, ABUSE VICTIM ADVOCATES, AND LONG-TERM CARE PROVIDERS. 2. COMMUNITY CONVERSATIONS (FOCUS GROUPS): THE ELDERLY, HISPANIC AND AMISH POPULATIONS WERE TARGETED FOR THE FOCUS GROUPS AS THEY WERE NOT WELL REPRESENTED IN OUR SURVEY. TOPICS INCLUDED COMMUNITY HEALTH, ACCESS TO CARE, HEALTH LITERACY, HEALTH PROBLEMS, TRANSPORTATION AND FOOD SECURITY ALONG WITH QUESTIONS SPECIFIC TO EACH POPULATION. FOCUS GROUPS WERE CONDUCTED AT SAUK COUNTY FOOT CLINICS, AGING AND DISABILITY RESOURCE CENTER DINING CENTERS, SERVICE CLUB MEETINGS, LAKE DELTON, WISCONSIN DELLS AND SAUK PRAIRIE COMMUNITIES. 3. KEY INFORMANT CONVERSATIONS (INTERVIEWS): 50 KEY INFORMANTS WERE INTERVIEWED ON HEALTH CARE ISSUES IN SAUK COUNTY THAT WERE SELECTED BASED ON THE HEALTHY WISCONSIN 2020 INITIATIVES. IN ADDITION TO THE DATA GATHERING STRATEGIES NOTED ABOVE, SECONDARY HEALTH DATA WAS GATHERED FROM VARIOUS CREDIBLE SOURCES TO PROVIDE ACTUAL COMPARATIVE RISKS FOR MORBIDITY AND MORTALITY ON A WIDE RANGE OF HEALTH ISSUES. SOURCES INCLUDE: COUNTY HEALTH RANKINGS & ROADMAPS, COMMUNITY COMMONS, WISCONSIN DEPARTMENT OF HEALTH SERVICES, CDC BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM, CDC WONDER, WISCONSIN BEHAVIORAL RISK FACTOR SURVEY, NATIONAL CENTER FOR CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION, CDC NATIONAL VITAL STATISTICS SYSTEM, DARTMOUTH COLLEGE INSTITUTE FOR HEALTH POLICY & CLINICAL PRACTICE, SAUK COUNTY CHILD DEATH REVIEW TEAM, WISCONSIN IMMUNIZATION REGISTRY, WISCONSIN INTERACTIVE STATISTICS ON HEALTH (WISH) QUERY SYSTEM, US DEPARTMENT OF HEALTH & HUMAN SERVICES. REEDSBURG AREA MEDICAL CENTER PART V, SECTION B, LINE 6A: INCLUDED AS MEMBERS OF THE SAUK COUNTY HEALTH & WELLNESS COALITION ARE ST. CLARE HOSPITAL, BARABOO AND SAUK PRAIRIE HEALTHCARE. REEDSBURG AREA MEDICAL CENTER PART V, SECTION B, LINE 6B: INCLUDED AS MEMBERS OF THE SAUK COUNTY HEALTH & WELLNESS COALITION ARE THE SAUK COUNTY PUBLIC HEALTH DEPARTMENT, SAUK COUNTY HEALTH & WELLNESS COALITION, BARABOO DISTRICT EMS, MADISON EMERGENCY PHYSICIANS, REEDSBURG EMS, BARABOO FIRE DEPARTMENT, DELLS-DELTON EMS, SAUK COUNTY SHERIFF'S DEPARTMENT, LAKE DELTON POLICE DEPARTMENT, FIRE & EMS, SSM HEALTH AT HOME, SAUK COUNTY AGING & DISABILITY RESOURCE CENTER, YOGI BEAR RESORT, SCHOOL DISTRICT OF WISCONSIN DELLS, EDGEWOOD COLLEGE, LANDS' END, THRIVENT FINANCIAL, BOYS & GIRLS CLUB OF WEST CENTRAL WISCONSIN, AGRACE, REEDSBURG SCHOOL DISTRICT, HO-CHUNK NATION EMERGENCY MANAGEMENT, SECOND HARVEST FOODBANK, CITY OF BARABOO, MEADOW RIDGE/MEADOW VIEW, OUR HOUSE, WISCONSIN DELLS HEALTH SERVICES, BARABOO SCHOOL DISTRICT, REEDSBURG AREA AMBULANCE, SAUK COUNTY BOARD OF SUPERVISORS, PLAIN EMS & FIRE, BASCO, UPLAND HILLS HEALTH CLINIC, MADISON COLLEGE, THERAPY WITHOUT WALLS, HEALTHFIRST NETWORK, BARABOO FIRE DEPARTMENT REEDSBURG AREA MEDICAL CENTER PART V, SECTION B, LINE 7D: RAMC'S COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND IMPLEMENTATION STRATEGY ARE AVAILABLE ONLINE AT WWW.RAMCHEALTH.COM/COMMUNITY-HEALTH/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. REEDSBURG AREA MEDICAL CENTER PART V, SECTION B, LINE 11: RAMC HAD IDENTIFIED IN ITS 2019 CHNA THREE PRIORITIES FOR OUR HOSPITAL TO ADDRESS: 1) MENTAL HEALTH, 2) CHRONIC DISEASE AND 3) NUTRITION & PHYSICAL ACTIVITY. WE ARE COMMITTED TO MAKING POSITIVE IMPACTS IN THESE AREAS AND SHOW THIS THROUGH OUR COMMUNITY PARTNERSHIPS AND SUPPORT. RAMC HAD IDENTIFIED IN ITS 2019 CHNA THESE THREE PRIORITIES FOR OUR HOSPITAL TO ADDRESS AS IDENTIFIED IN OUR MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT - MENTAL HEALTH, CHRONIC DISEASE AND NUTRITION & PHYSICAL ACTIVITY. WE ARE COMMITTED TO MAKING POSITIVE IMPACTS IN THESE AREAS AND SHOW THIS THROUGH OUR COMMUNITY PARTNERSHIPS AND SUPPORT. RAMC HAS COLLABORATED WITH COMMUNITY PARTNERS ON SEVERAL INITIATIVES, INCLUDED, BUT NOT LIMITED TO, ORGANIZING A TEEN SUMMIT FOCUSED ON TEEN MENTAL WELL-BEING AND CURRENT ISSUES WITH OVER 100 TEENS IN ATTENDANCE, WORKING WITH SAUK COUNTY HEALTH DEPARTMENT TO COMBAT SUICIDE, IS A MEMBER OF THE SAUK COUNTY PARTNERSHIP FOR PREVENTION & RECOVERY, SUPPORT LOCAL BOYS & GIRLS CLUB, HOLD COMMUNITY DIABETES PREVENTION PROGRAMMING AND HEALTHY LIVING CLASSES (HEALTH4U) AND HOST KIDS FIT & SAFETY DAY FOR ALL 4TH & 5TH GRADERS IN THE REEDSBURG SCHOOL DISTRICT. IN ADDITION, RAMC SUPPORTS MANY LOCAL EVENTS AND ACTIVITIES DESIGNED TO HELP ENCOURAGE HEALTHY LIFESTYLES AND CHOICES. DURING THE FISCAL YEAR ENDING 9/30/21, RAMC HAS DEMONSTRATED OUR COMMITMENT TO ENSURING QUALITY HEALTHCARE IS ALWAYS AVAILABLE CLOSE TO HOME THROUGH THE ADDITION OF PROVIDERS AND CONTINUED SUPPORT OF COMMUNITY WELLNESS PROGRAMS. OUR TWO PHARMACIES OFFERS SERVICES SUCH AS IMMUNIZATIONS, BLOOD PRESSURE AND BLOOD SUGAR CHECKS AND MEDICATION REVIEW. OTHER SERVICES AVAILABLE TO MEET THE COMMUNITY'S HEALTH NEEDS INCLUDE, BUT ARE NOT LIMITED TO, LABORATORY, PHYSICAL, CARDIAC AND PULMONARY REHABILITATION, SLEEP MEDICINE, SURGICAL SERVICES, CONSULTING SERVICES, MASSAGE THERAPY, ORTHOPEDICS, OBSTETRICS, CHEMOTHERAPY, AUDIOLOGY, FAMILY PRACTICE CLINIC, COMMUNITY PHARMACY, GYNECOLOGY, DIABETIC EDUCATION, MEDICAL IMAGING, NUTRITION SERVICES, OCCUPATIONAL HEALTH, RESPIRATORY THERAPY, VOLUNTEER SERVICES, COMMUNITY OUTREACH AND WELLNESS.THERE IS NO LIMIT TO THE NUMBER OF ISSUES TO WHICH A HEALTHCARE INSTITUTION COULD DEVOTE RESOURCES. TIME, PEOPLE AND MONEY ARE OFTEN LIMITING FACTORS IN WHY WE CANNOT DO MORE. HOWEVER, PREVAILING WISDOM SUGGESTS AN ORGANIZATION LIKE RAMC MUST FOCUS ON A FEW HIGH-PRIORITY PROJECTS AND MAKE EVERY EFFORT TO AVOID DUPLICATION AND ENCOURAGE COLLABORATION AND COORDINATION WITH OTHER ORGANIZATIONS AND COMMUNITY GROUPS. AS RAMC ASSESSED UNMET HEALTH NEEDS AND DETERMINED ITS PRIORITIES, WE ALSO EVALUATED THOSE ISSUES WE COULD NOT ADDRESS OR THAT WERE BEING ADDRESSED BY OTHERS. DENTAL HEALTH CONTINUES TO BE A PREVAILING ISSUE. UNFORTUNATELY, POOR DENTAL HEALTH LEADS TO SO MANY HEALTH ISSUES WE HAVE IDENTIFIED. WE WILL CONTINUE TO SUPPORT THE SAUK COUNTY HEALTH DEPARTMENT WITH THEIR SEAL-A-SMILE PROGRAMS, AS WELL AS OUR OWN "BRIGHT SMILES" PROGRAM, WHICH SUPPLIES FREE TOOTHPASTE AND BRUSHES, ALONG WITH BRUSHING EDUCATION, IN AREA SCHOOLS. RATES OF UNINTENTIONAL INJURY AND TRAFFIC CRASHES ARE BEING ADDRESSED BY OTHERS, INCLUDING LAW ENFORCEMENT AND STATE LEVEL EXPERTS THROUGH INITIATIVES SUCH AS MANDATORY SEAT BELT LAWS, SPEED LIMIT ENFORCEMENT, AND "NO TEXTING WHILE DRIVING" LEGISLATION. AS A RURAL COMMUNITY, FARM SAFETY CONTINUES TO BE A PRIORITY WHICH THE HOSPITAL ADDRESSES BY SUPPORTING ANNUAL EVENTS LIKE RURAL FARM SAFETY DAY FOR AREA SCHOOL CHILDREN. SMOKING/TOBACCO USE IS BEING ADDRESSES BY RAMC THROUGH OUR "SIT TO QUIT" MINDFULNESS CESSATION PROGRAM. IT IS ALSO ADDRESSED BY OTHERS WITHIN THE COMMUNITY, INCLUDING HEALTH EXPERTS AT A STATE LEVEL, THROUGH THE IMPLEMENTATION OF A STATEWIDE SMOKING BAN AND REMEDIATION PROGRAMS. MALNUTRITION IS ANOTHER ISSUE ALREADY BEING ADDRESSED WITHIN THE COMMUNITY. SCHOOL DISTRICTS ARE OFFERING MORE PROGRAMS TO BRING FOOD TO CHILDREN YEAR-ROUND AND FOOD PANTRIES IN THE COMMUNITY ARE CONSTANTLY BEING REFRESHED TO SUPPLY HEALTHY OPTIONS. DRUG USE CONTINUES TO RISE IN OUR AREA, CONTRIBUTING TO POOR HEALTH, HOMELESSNESS AND DEATH. WE CONTINUE TO WORK AS A COALITION IN ADDRESSING THIS ISSUE WITH GRANTS AND INNOVATIVE PRACTICES. TRANSPORTATION WAS AN ISSUE BROUGHT UP AT EVERY LISTENING SESSION. THIS IS AN ISSUE WE SEE OFTEN THROUGH OUR EMERGENCY ROOM. WE ARE AWARE OF THIS NEED AND WILL CONTINUE TO MONITOR IT. REEDSBURG AREA MEDICAL CENTER PART V, SECTION B, LINE 20E: RAMC WILL NOT ENGAGE IN EXTRAORDINARY COLLECTION ACTIONS WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE WHETHER A PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE. SUCH EFFORTS INCLUDE: WAITING 120 DAYS FROM THE FIRST POST-DISCHARGE BILLING STATEMENT; VALIDATION OF THE BALANCE OWED AND THAT ALL SOURCES OF PAYMENT HAVE BEEN IDENTIFIED AND BILLED BY RAMC; DOCUMENTATION OF THE ATTEMPT TO OFFER THE PATIENT THE OPPORTUNITY TO APPLY FOR CHARITY CARE; DOCUMENTATION THE PATIENT DOES NOT QUALIFY FOR FINANCIAL ASSISTANCE; DOCUMENTATION THAT THE PATIENT HAS BEEN OFFERED A PAYMENT PLAN BUT HAS NOT HONORED THE TERMS OF THE AGREEMENT; AND AT LEAST 30 DAYS BEFORE STARTING ANY EXTRAORDINARY ACTION, WILL SEND THE PATIENT A WRITTEN NOTICE STATING THAT RAMC OFFERS FINANCIAL ASSISTANCE, IDENTIFY THE EXTRAORDINARY ACTION(S) THAT MAY BE TAKEN, GIVE A DEADLINE OF WHEN SUCH ACTION(S) WILL TAKE PLACE AND INCLUDE THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY. PART I, LINE 3C: ELIGIBLE INDIVIDUALS MUST RESIDE IN OR HAVE A PRIMARY CARE PHYSICIAN IN RAMC'S SERVICE AREA. REVIEW OF THE PATIENT'S ASSETS AND ALL OTHER FINANCIAL RESOURCES AVAILABLE TO THEM WILL BE INCLUDED IN THE APPLICATION PROCESS ALONG WITH REVIEW OF ALL OUTSTANDING ACCOUNTS AND PREVIOUS PAYMENT HISTORY. DOCUMENTS REQUESTED MAY INCLUDE A COPY OF THE APPLICANT'S MOST RECENT FEDERAL INCOME TAX RETURN, W-2 FORM(S), CURRENT PAYSTUB(S) AND A COMPLETED FINANCIAL DISCLOSURE. HOSPITAL PERSONNEL MAY REQUIRE OTHER VERIFICATION OF INCOME OR ASSETS, AS DEEMED NECESSARY. PART I, LINE 6A: REEDSBURG AREA MEDICAL CENTER ("RAMC") PREPARES A COMMUNITY BENEFIT REPORT ANNUALLY AND FILES IT WITH THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THE REPORT IS AVAILABLE TO THE GENERAL PUBLIC ON WHA'S DATABASE AND WEBSITE ALONG WITH RAMC'S WEBSITE. PART I, LINE 7: THE COSTING METHODOLOGY USED ON FORM 990 IS BASED ON A COST-TO-CHARGE RATIO, WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBT DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST VARIOUS REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER IRS SUGGESTED COSTING METHODS FOR THE FORM 990. THE COSTING METHOD FOR SUBSIDIZED HEALTH SERVICES IS BASED ON ALLOCATED EXPENSES FROM THE MEDICARE COST REPORT, WHICH IS SIMILAR TO A DIRECT COST ACCOUNTING SYSTEM. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES AT REEDSBURG AREA MEDICAL CENTER INCLUDE MASSAGE THERAPY, OCCUPATIONAL HEALTH, DIETARY SERVICES, EDUCATION, CONSULTING, THE PG LAB AND HOSPITALIST SERVICES. IT IS THE GOAL OF REEDSBURG AREA MEDICAL CENTER TO PROVIDE THESE SERVICES TO THE COMMUNITY REGARDLESS OF A PATIENT'S ABILITY TO PAY. PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED IN FORM 990, PART IX, LINE 24(B), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $242,133. PART II, COMMUNITY BUILDING ACTIVITIES: RAMC IS PROUD TO ENCOURAGE OUR EMPLOYEES TO GIVE BACK TO OUR COMMUNITY ON THEIR STAFF TIME. IN ADDITION TO THEIR JOB RESPONSIBILITIES, THEY TAKE ON ADDITIONAL ROLES IN THE OUR COMMUNITY BY SERVING ON LOCAL BOARDS AND COMMITTEES, SERVING AT FOOD PANTRIES AND COMMUNITY MEALS, AND SO MUCH MORE. OUR COMMUNITY BUILDING ACTIVITIES WORK TO ADDRESS UNDERLYING HEALTH DETERMINANTS AND SUPPORT PROGRAMS MEANT TO IMPROVE HEALTH BEFORE INTERVENTION IS REQUIRED AS WELL AS PROVIDING RESOURCES FOR THOSE LOOKING TO IMPROVE THEIR CURRENT HEALTH SITUATION. RAMC EMPLOYEES ARE ALSO ACTIVE IN EDUCATING THE COMMUNITY ON A WIDE VARIETY OF HEALTH TOPICS. HEALTH-RELATED BOARD POSITIONS RANGE FROM THOSE FOCUSING ON AREA DENTAL AND EMERGENCY MEDICAL SERVICES TO THE RURAL WISCONSIN HEALTH COOPERATIVE AND SAUK COUNTY HEALTH BOARDS. MANY EMPLOYEES ARE ALSO MEMBERS OF COMMUNITY SERVICE BOARDS AND VOLUNTEER GROUPS. RAMC IS MINDFUL OF AND PROACTIVE IN DEVELOPING OR PARTNERING WITH GROUPS WORKING TO BETTER THE CURRENT ECONOMIC AND ENVIRONMENTAL CONDITIONS OF OUR COMMUNITY. ADDITIONAL EXAMPLES OF COMMUNITY BUILDING ACTIVITIES INCLUDE DEDICATED PATIENT ADVOCATE STAFF TO ASSIST COMMUNITY MEMBERS WITH ANSWERING MEDICARE, MEDICAID AND OTHER INSURANCE QUESTIONS AND NAVIGATING THE HEALTH INSURANCE MARKET PLACE; BEING A KEY MEMBER IN THE DEVELOPMENT OF THE REEDSBURG BOYS & GIRLS CLUB; PRACTICING GOOD STEWARDSHIP THROUGH CONTINUED RECYCLING EFFORTS; AND SUPPORTING LOCAL COMMUNITY DEVELOPMENT AND GROWTH THROUGH SUPPORT OF LOCAL CHAMBERS OF COMMERCE AND OTHER COMMUNITY ORGANIZATIONS AND PROGRAMS. PART III, LINE 2: THE BAD DEBT EXPENSE REPORTED ON LINE 2 IS REPORTED AT CHARGES PRESENTED ON THE AUDITED FINANCIAL STATEMENTS. PART III, LINE 3: IN EVALUATING THE COLLECTIBILITY OF PATIENT ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES PAST RESULTS AND IDENTIFIES TRENDS FOR EACH OF IT MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL 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. SPECIFICALLY, FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS AND PATIENTS WHO ARE KNOWN TO HAVE FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES PATIENTS WITHOUT INSURANCE AND WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF THEIR 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 AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. MANY TIMES PATIENTS DO NOT COMPLETE THE REQUIRED CHARITY CARE APPLICATION AND ARE TRANSFERRED TO COLLECTION SERVICES EVEN THOUGH RAMC PROVIDES THIS INFORMATION TO ALL PATIENTS AND OFFERS ASSISTANCE WITH THE APPLICATIONS. DUE TO NO RESPONSES FROM SOME PATIENTS, A SIGNIFICANT AMOUNT OF BAD DEBTS COULD BE CONSIDERED AS CHARITY CARE. PART III, LINE 4: SEE THE "PATIENT AND RESIDENT ACCOUNTS RECEIVABLE AND CREDIT POLICY NOTE ON PAGES 9 AND 10 OF THE ATTACHED FINANCIAL STATEMENTS. PART III, LINE 8: THE TOTAL MEDICARE REVENUE SHOWN IN SCHEDULE H TO THE FORM 990 IS BASED ON THE IRS 990 INSTRUCTIONS AND INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE OF THE HOSPITAL, AND ALSO DOES NOT CONSIDER ALL CONTRACTUAL ADJUSTMENTS FOR SERVICES REIMBURSED BY THE MEDICARE PROGRAM. AMOUNTS LISTED FOR MEDICARE REVENUES DO NOT INCLUDE PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT AT THE HOSPITAL AS WELL AS ANESTHESIA PROFESSIONAL SERVICES, SURGEON PROFESSIONAL SERVICES, REVENUES FOR ANY PATIENTS COVERED UNDER MEDICARE ADVANTAGE PLAN PROGRAMS, AND REFERENCE LAB SERVICES FOR PATIENTS OF A NEIGHBORING PHYSICIAN CLINIC. PHYSICIAN PROFESSIONAL SERVICES AND REFERENCE LAB SERVICES ARE REIMBURSED PRIMARILY ON FEE SCHEDULE REIMBURSEMENTS AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY, SURGERY, AND PHYSICIAN SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND, AS SUCH, THESE COSTS AND SHORTFALLS SHOULD ALSO BE CONSIDERED AS AN ADDITIONAL BENEFIT THAT RAMC PROVIDES TO ITS COMMUNITY AND SURROUNDING AREAS. THE COSTING METHOD USED ABOVE FOR IRS 990 COMPLIANCE REPORTING IS ALSO BASED ON THE FILED MEDICARE COST REPORT FOR THE YEAR ENDED SEPTEMBER 30, 2021, AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES, AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICE REVENUES (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE). WHETHER THERE IS A SHORTFALL OR SURPLUS ON SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THESE PEOPLE, WHO ARE TYPICALLY ELDERLY OR DISABLED MEMBERS OF THE COMMUNITY, ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE PATIENT SERVICES, THE CENTERS FOR MEDICARE AND MEDICAID (CMS) WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THESE MEMBERS OF THE COMMUNITY. PART III, LINE 9B: UNDER THE HOSPITAL'S COLLECTION AND CHARITY CARE POLICIES, RAMC MAKES EVERY ATTEMPT TO IDENTIFY AND PROMOTE CHARITY CARE TO PATIENTS. INCLUDED IN THE HOSPITAL'S CHARITY CARE POLICY IT IS NOTED THAT PATIENTS MAY QUALIFY FOR CHARITY CARE EITHER PRIOR TO ADMISSION OR FOLLOWING DISCHARGE. DURING THE PATIENT ACCOUNT COLLECTION PROCESS, SELF-PAY PATIENTS ARE ALSO INFORMED OF THE HOSPITAL'S COLLECTION POLICIES AS WELL AS THE CHARITY CARE PROGRAM TO ALLOW PATIENTS THE OPPORTUNITY TO COMPLETE THE APPROPRIATE FORMS AND QUALIFY UNDER THE PROGRAM. ONCE A PATIENT MEETS ALL QUALIFICATIONS FOR FINANCIAL ASSISTANCE, ALL OR PART OF THE ACCOUNT BALANCE IS WRITTEN OFF, AS APPROPRIATE. THE REMAINING BALANCE, IF ANY, IS THE PATIENT'S RESPONSIBILITY AND COLLECTED FOLLOWING THE HOSPITAL'S STANDARD DEBT COLLECTION POLICY. PART VI, LINE 2: RAMC HAS A FEEDBACK SECTION ON THE HOSPITAL'S WEBSITE, WWW.RAMCHEALTH.COM, ALLOWING A FORUM FOR WHICH THE PUBLIC CAN PROVIDE SUGGESTIONS AND COMMENTS. PATIENTS AND COMMUNITY MEMBERS ARE ALSO ABLE TO PROVIDE COMMENTS, FEEDBACK AND RATINGS ON VARIOUS SOCIAL MEDIA SITES SUCH AS FACEBOOK AND INSTAGRAM. RAMC GATHERS DATA FROM THE SAUK COUNTY HEALTH NEEDS ASSESSMENT THAT HAS BEEN SEGMENTED INTO THE HOSPITAL'S PRIMARY SERVICE AREA. IN WORKING WITH A COMMITTEE CONSISTING OF OFFICIALS FROM THE SAUK COUNTY PUBLIC HEALTH DEPARTMENT, REEDSBURG AREA SCHOOL DISTRICT, AND THE CITY OF REEDSBURG (INCLUDING THE CITY'S AMBULANCE, POLICE, AND FIRE DEPARTMENTS), AS WELL AS VARIOUS OTHER COMMUNITY MEMBERS INCLUDING REPRESENTATIVES FROM BUSINESS AND INDUSTRY, THIS INFORMATION HAS BEEN PRIORITIZED AND USED TO DEVELOP IMPLEMENTATION STRATEGIES. PART VI, LINE 3: CHARITY CARE NOTICES ARE POSTED THROUGHOUT THE FACILITY AND APPLICATIONS ARE AVAILABLE THROUGH BUSINESS SERVICES. THE PATIENT, PATIENT'S REPRESENTATIVE, OR HOSPITAL REPRESENTATIVE MAY INITIATE INQUIRIES REGARDING ELIGIBILITY OR APPLICATION FOR ASSISTANCE AT ANY TIME. THE HOSPITAL, WHEN APPROPRIATE, WILL REVIEW THE PATIENT'S FINANCIAL SITUATION TO SEE IF THEY QUALIFY FOR ANY FORM OF ASSISTANCE. A SOCIAL WORKER IS AVAILABLE TO ASSIST IN THIS PROCESS AS WELL, IF NEEDED. PATIENT FINANCIAL ADVISORS ARE ALSO NOTIFIED WHEN PATIENTS (INPATIENT OR OUTPATIENT) ARE TREATED WHO DO NOT HAVE ANY INSURANCE. THEY DISCUSS WITH THE PATIENT AVAILABLE OPTIONS AND PROVIDE INFORMATION/APPLICATIONS FOR BOTH RAMC CHARITY CARE PROGRAMS AND COUNTY, STATE, OR FEDERAL ASSISTANCE PROGRAMS. AT ANY TIME, PATIENTS MAY INQUIRE WITH HOSPITAL PERSONNEL REGARDING QUESTIONS THEY HAVE ON THEIR ABILITY TO PAY. FINANCIAL ADVISORS ARE AVAILABLE TO HELP AS IS A CONSUMER ADVOCATE. THE CONSUMER ADVOCATE OFFERS COMPLIMENTARY PATIENT ASSISTANCE SERVICES, INCLUDING, BUT NOT LIMITED TO, MEDICARE, MEDICAID, PRIVATE INSURANCE, INTERPRETATION OF EXPLANATION OF BENEFITS (EOBS), AND DIRECTIONS TO ADDITIONAL CONSUMER RESOURCES. PART VI, LINE 4: REEDSBURG AREA MEDICAL CENTER IS LOCATED IN THE CITY OF REEDSBURG, WISCONSIN, IN NORTH CENTRAL SAUK COUNTY. THE PRIMARY SERVICE AREA EXTENDS WEST TO CAZENOVIA, EAST TO ROCK SPRINGS, SOUTH TO HILLPOINT AND NORTH FROM WONEWOC TO JUST WEST OF LAKE DELTON. THIS GEOGRAPHIC AREA IS LARGELY RURAL AND CROSSES INTO THREE COUNTIES IN ADDITION TO SAUK COUNTY, COMPRISING APPROXIMATELY THREE QUARTERS OF THE HOSPITAL'S DISCHARGED PATIENTS. SAUK COUNTY HAS SEEN POPULATION GROWTH OF .3% OVER THE PAST YEAR. THE PERCENTAGE OF THE POPULATION AGED 65 AND OLDER HAS RISEN FROM 17.4% IN 2017 TO 19.1% WHILE THE POPULATION AGED 18 AND YOUNGER HAS REMAINED RELATIVELY STABLE. THE RURAL POPULATION IS AT 46.1% WITH 90.4% IDENTIFYING AS NON-HISPANIC WHITE, WHILE 5.4% IDENTIFIES AS HISPANIC. THE CURRENT MEDIAN HOUSEHOLD INCOME IN SAUK COUNTY IS APPROXIMATELY $63,800. THE POVERTY RATE IS AT 10.2% WHILE THE PERCENTAGE OF CHILDREN LIVING IN POVERTY IS AT 15%, WITH 40% OF SAUK COUNTY'S CHILDREN ELIGIBLE FOR FREE SCHOOL LUNCH. THE HIGH SCHOOL GRADUATION RATE WAS 91% IN 2021. 8% OF COUNTY ADULTS AND 5% OF COUNTY CHILDREN ARE UNINSURED. BASED ON NUMEROUS DEMOGRAPHIC, BEHAVIORAL, HEALTH AND SOCIAL METRICS, SUCH AS THOSE SHOWN HERE, SAUK COUNTY HAS BEEN RANKED AS THE 33RD HEALTHIEST COUNTY OUT OF ALL 72 WISCONSIN COUNTIES BY THE COUNTY HEALTH RANKINGS AND ROADMAPS PROGRAM IN 2021. REEDSBURG AREA MEDICAL CENTER IS THE ONLY HOSPITAL WITHIN OUR PRIMARY SERVICE AREA; TWO ADDITIONAL HOSPITALS ARE LOCATED WITHIN SAUK COUNTY. SEVERAL TERTIARY CARE HOSPITALS IN MADISON, WISCONSIN, AND THE SURROUNDING AREA PROVIDE ADDITIONAL SPECIALIZED SERVICES NOT AVAILABLE AT REEDSBURG AREA MEDICAL CENTER. PART VI, LINE 5: REEDSBURG AREA MEDICAL CENTER IS COMMITTED TO THE HEALTH OF OUR COMMUNITY AND THE IMPORTANT PART WE PLAY IN MAINTAINING AND IMPROVING THE OVERALL HEALTH OF OUR CONSTITUENTS. WE TAKE AN ACTIVE ROLE IN EQUIPPING OUR COMMUNITY MEMBERS WITH THE SKILLS NEEDED TO CREATE BETTER HEALTH. RAMC PROVIDES HEALTH CARE SERVICES AND OTHER FINANCIAL SUPPORT THROUGH VARIOUS PROGRAMS THAT ARE DESIGNED, AMONG OTHER MATTERS, TO ENHANCE THE HEALTH OF THE COMMUNITY, INCLUDING THE HEALTH OF LOW-INCOME PATIENTS. CONSISTENT WITH OUR MISSION, CARE IS PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY, INCLUDING PROVIDING SERVICES TO THOSE PERSONS WHO CANNOT AFFORD HEALTH INSURANCE BECAUSE OF INADEQUATE RESOURCES OR ARE UNDERINSURED. COMMUNITY BENEFITS ALSO INCLUDE UNPAID COSTS OF TREATING THE ELDERLY AND DISABLED, HEALTH SCREENINGS, COMMUNITY EDUCATION AND OTHER HEALTH-RELATED SERVICES. OUR COMMUNITY BUILDING ACTIVITIES WORK TO ADDRESS UNDERLYING HEALTH DETERMINANTS AND SUPPORT PROGRAMS MEANT TO IMPROVE HEALTH BEFORE INTERVENTION IS REQUIRED AS WELL AS PROVIDING RESOURCES FOR THOSE LOOKING TO IMPROVE THEIR CURRENT HEALTH SITUATION. RAMC EMPLOYEES ARE ACTIVE IN EDUCATING THE COMMUNITY ON A WIDE VARIETY OF HEALTH TOPICS AND PARTICIPATE ON NUMEROUS LOCAL BOARDS. HEALTH-RELATED BOARD POSITIONS RANGE FROM THOSE FOCUSING ON AREA DENTAL AND EMERGENCY MEDICAL SERVICES TO THE RURAL WISCONSIN HEALTH COOPERATIVE AND SAUK COUNTY HEALTH BOARDS. MANY EMPLOYEES ARE ALSO MEMBERS OF COMMUNITY SERVICE BOARDS AND VOLUNTEER GROUPS. RAMC IS MINDFUL OF AND PROACTIVE IN DEVELOPING OR PARTNERING WITH GROUPS WORKING TO BETTER THE CURRENT ECONOMIC AND ENVIRONMENTAL CONDITIONS OF OUR COMMUNITY. RAMC IS OPERATED BY A BOARD COMPRISED OF LOCAL, INDEPENDENT COMMUNITY MEMBERS, A MEDICAL STAFF ORGANIZED IN THE PUBLIC INTEREST AND OPEN TO ALL QUALIFIED PHYSICIANS, AND AN EMERGENCY ROOM AVAILABLE TO ALL, REGARDLESS OF ABILITY TO PAY. THE BOARD TAKES A BALANCED APPROACH WHEN IT SETS POLICY AND STRATEGIC DIRECTION FOR THE HOSPITAL, WORKING TO ALIGN COMMUNITY NEEDS WITH BUSINESS AND FINANCIAL CONCERNS. THE USE OF SURPLUS FUNDS IS LARGELY DETERMINED BY THE BOARD IN EFFORTS TO MEET THIS GOAL. SURPLUS FUNDS ARE USED TO PURCHASE EQUIPMENT AND TO PROVIDE SERVICES THAT WILL MOST EFFECTIVELY MEET THE IDENTIFIED HEALTH NEEDS OF THE COMMUNITY AND ALLOW FOR COMPREHENSIVE CARE CLOSE TO HOME. WHILE THERE IS GROWING AGREEMENT IN THE UNITED STATES ABOUT WHAT CONSTITUTES A NON-PROFIT HOSPITAL'S "COMMUNITY BENEFIT," THESE EFFORTS CONTINUE TO BE A WORK IN PROGRESS. RAMC PROVIDES SIGNIFICANT AMOUNTS OF CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS AND IN ADDITION, WE BELIEVE THAT IT PROVIDES A CRITICALLY IMPORTANT BENEFIT WHICH IS NOT QUANTIFIED. RAMC, LIKE MOST COMMUNITY HOSPITALS, WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE CARE LOCALLY, WHICH WITHOUT THE HOSPITAL, WOULD NOT BE AVAILABLE LOCALLY. BEYOND INPATIENT HOSPITALIZATIONS, RAMC PROVIDES LOCAL ACCESS TO MANY SERVICES INCLUDING: LABORATORY, PHYSICAL, CARDIAC AND PULMONARY REHABILITATION, SLEEP MEDICINE, SURGICAL SERVICES, CONSULTING SERVICES, MASSAGE THERAPY, ORTHOPEDICS, OBSTETRICS, CHEMOTHERAPY, AUDIOLOGY, FAMILY PRACTICE CLINIC, COMMUNITY PHARMACY, GYNECOLOGY, DIABETIC EDUCATION, MEDICAL IMAGING, NUTRITION SERVICES, OCCUPATIONAL HEALTH, RESPIRATORY THERAPY, VOLUNTEER SERVICES, COMMUNITY OUTREACH AND WELLNESS. PART VI, LINE 7, REPORTS FILED WITH STATES WI 1 REEDSBURG AREA SENIOR LIFE CENTER 2350 NORTH DEWEY AVENUE REEDSBURG WI 54959 760775289 501(C)(3) 1852457 GENERAL OPERATIONS 1 0 TUITION ASSISTANCE 57 147866 STIPENDS 35 32358 PART I, LINE 2: RAMC HAS (AT LEAST MONTHLY) ACCESS TO THE FINANCIAL RECORDS AND BOARD MEETING MINUTES OF BOTH THE REEDSBURG AREA SENIOR LIFE CENTER AND THE REEDSBURG AREA MEDICAL CENTER FOUNDATION, ALLOWING FOR REVIEW OF HOW FUNDS ARE ALLOCATED. RAMC PROVIDES SCHOLARSHIPS AND TUITION ASSISTANCE TO EMPLOYEES PURSUING HEALTH-CARE RELATED HIGHER EDUCATION. THIS ASSISTANCE IS MADE AVAILABLE TO EMPLOYEES FOR STUDIES WHERE PROFESSIONAL STAFF ARE NEEDED AND THE DEMAND FOR THESE POSITIONS IS GREATER THAN THE SUPPLY AVAILABLE. USUALLY, THE SHORTAGE IS NOT ONLY SEEN LOCALLY, BUT ALSO STATE AND NATION WIDE. THE INTENTION IS TO HAVE THESE TRAINED PROFESSIONALS CONTINUE AT RAMC WITHIN THEIR NEW POSITION, ACCOMPLISHING OUR MISSION AND COMMITMENT TO PROVIDING HIGH-QUALITY, LOCAL CARE FOR OUR COMMUNITY. PROOF OF THE COST OF TUITION AND SUCCESSFUL COURSE COMPLETION ARE REQUIRED. X X X X X 0 1 0 0 0 1 0 0 0 CHRISTOPHER DALE MD PHYSICIAN 861831 0 0 0 0 0 20528 0 10172 0 892531 0 0 0 THOMAS WOOD MD TRUSTEE/PHYSICIAN 640099 0 0 0 4678 0 47526 0 25937 0 718240 0 0 0 CHRISTOPHER WENNINGER MD PHYSICIAN 604129 0 0 0 5287 0 23811 0 28524 0 661751 0 0 0 ROBERT VAN MEETEREN CEO / PRESIDENT 365444 0 65445 0 9182 0 55098 0 26491 0 521660 0 0 0 BENJAMIN NESSEIM MD PHYSICIAN 364721 0 0 0 5287 0 19297 0 26465 0 415770 0 0 0 CHRISTOPHER ECKERMAN DPM PHYSICIAN 366779 0 0 0 5287 0 17156 0 26084 0 415306 0 0 0 CHRISTOPHER BJORKLUND CRNA ANESTHESIOLOGIST/FOUNDATION LIAISON 319897 0 0 0 5287 0 25764 0 24846 0 375794 0 0 0 BARRY BORCHERT CFO 245124 0 30425 0 0 0 31473 0 22667 0 329689 0 0 0 MARY BETH SHEAR MD MEDICAL ADVISOR/TRUSTEE 177108 0 0 0 4678 0 9614 0 23592 0 214992 0 0 0 PART I, LINE 4B ROBERT VAN MEETEREN - CONTRIBUTION TO 457(F) PLAN - $19,121 PART I, LINE 6 THE TOP MANAGEMENT OFFICIAL AND TOP FINANCIAL OFFICIAL ARE ELIGIBLE FOR ADDITIONAL COMPENSATION CONTINGENT ON NET EARNINGS, AS DETERMINED ANNUALLY BY THE BOARD OF DIRECTORS. A WISCONSIN HEALTH & EDUCATION FACILITIES 391337855 97710BXP2 2014-02-19 7500000 REFUND SERIES 2010 BONDS 0 0 0 B WISCONSIN HEALTH & EDUCATION FACILITIES 391337855 2015-11-10 6556441 REFUND SERIES 2006 BONDS 0 0 0 C WISCONSIN HEALTH & EDUCATION FACILITIES 391337855 2017-12-29 29600000 CONSTRUCTION & REFUND SERIES 2010 BONDS 0 0 0 D CITY OF REEDSBURG 396005582 2003-06-03 2600000 REFUND SERIES 1992 BONDS 0 0 0 A 2029983 7500000 7500000 2006 1 0 1 1 B 4333017 6556441 130120 6426321 2006 0 1 1 1 C 971195 4511983 29600000 431179 25118110 4050711 0 1 1 1 D 2463156 2600000 2600000 1992 1 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 C 0 0 0 0 0 0 1 A 0 0 0 1 1 0 0 0 1 B 0 1 0 0 0 0 0 0 1 C 0 0 0 1 1 0 0 0 1 D 0 0 1 0 1 0 0 0 0 A 1 B 1 C 1 D 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: WISCONSIN HEALTH & EDUCATION FACILITIES DATE THE REBATE COMPUTATION WAS PERFORMED: 02/08/2019 ISSUER NAME: WISCONSIN HEALTH & EDUCATION FACILITIES DATE THE REBATE COMPUTATION WAS PERFORMED: 12/06/2019 RYAN SHEAR FAMILY MEMBER OF DIRECTOR 147169 EMPLOYMENT COMPENSATION 0 HALEY STOVEY FAMILY MEMBER OF DIRECTOR 36005 EMPLOYMENT COMPENSATION 0 TYSON BORCHERT FAMILY MEMBER OF OFFICER 59518 EMPLOYMENT COMPENSATION 0 MARY BETH SHEAR MD EMPLOYEE & DIRECTOR 189838 EMPLOYMENT COMPENSATION 0 THOMAS WOOD MD EMPLOYEE & DIRECTOR 652854 EMPLOYMENT COMPENSATION 0 FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE CHAIRMAN, FIRST VICE-CHAIRMAN, MEDICAL ADVISOR, SECRETARY AND TREASURER. THE EXECUTIVE COMMITTEE SHALL HAVE AND MAY EXERCISE, WHEN THE BOARD OF DIRECTORS IS NOT IN SESSION, THE POWERS OF THE BOARD OF DIRECTORS IN THE MANAGEMENT OF THE AFFAIRS OF THE CORPORATION, EXCEPT ACTION IN RESPECT TO AMENDING THE BY-LAWS, MAKING RULES OR REGULATIONS GOVERNING NOMINATIONS OR ELECTIONS, OR DISPOSING OF OR MORTGAGING ASSETS OF THE CORPORATION. THE BOARD OF DIRECTORS MAY SELECT ONE OR MORE OF ITS MEMBERS AS ALTERNATIVE MEMBERS OF SUCH COMMITTEE WHO MAY TAKE THE PLACE OF ANY ABSENT MEMBER OR MEMBERS AT ANY MEETING OF SUCH COMMITTEE, UPON REQUEST BY THE CHAIRMAN OF THE BOARD OR UPON REQUEST BY THE CHAIRMAN OF SUCH MEETING. SUCH COMMITTEE SHALL FIX ITS OWN RULES GOVERNING THE CONDUCT OF ITS ACTIVITIES AND SHALL MAKE SUCH REPORT TO THE BOARD OF DIRECTORS OF ITS ACTIVITIES AS THE BOARD OF DIRECTORS MAY REQUEST. FORM 990, PART VI, SECTION B, LINE 11B UPON COMPLETION OF THE FORM 990, MANAGEMENT REVIEWED FOR ACCURACY AND COMPLETENESS. UPON APPROVAL, THE FORM 990 WAS PRESENTED TO THE BOARD OF DIRECTORS FOR FINAL APPROVAL PRIOR TO SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C THE PURPOSE OF THE CONFLICT OF INTEREST POLICY IS TO PROTECT THE CORPORATION'S INTEREST WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTEREST OF ANY GOVERNING BOARD MEMBER, SENIOR LEADERSHIP STAFF, PROVIDER OR EMPLOYEE. THIS POLICY IS INTENDED TO SUPPLEMENT BUT NOT REPLACE ANY APPLICABLE WISCONSIN LAWS GOVERNING CONFLICTS OF INTEREST APPLICABLE TO NONPROFIT AND CHARITABLE CORPORATIONS. ANY DIRECTOR, PRINCIPAL OFFICER, EMPLOYEE OR MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST, THROUGH BUSINESS, INVESTMENT OR FAMILY: (I) AN OWNERSHIP OR INVESTMENT INTEREST IN ANY ENTITY WITH WHICH THE CORPORATION HAS A TRANSACTION OR ARRANGEMENT; OR (II) A COMPENSATION ARRANGEMENT WITH THE CORPORATION OR WITH ANY ENTITY OR INDIVIDUAL WITH WHICH THE CORPORATION HAS A TRANSACTION OR ARRANGEMENT; OR (III) A POTENTIAL OWNERSHIP OR INVESTMENT INTEREST IN, OR COMPENSATION ARRANGEMENT WITH, ANY ENTITY OR INDIVIDUAL WITH WHCIH THE CORPORATION IS NEGOTIATING A TRANSACTION OR ARRANGEMENT. COMPENSATION INCLUDES DIRECT AND INDIRECT REMUNERATION AS WELL AS GIFTS OR FAVORS THAT ARE SUBSTANTIAL IN NATURE. EACH DIRECTOR, PRINCIPAL OFFICER, EMPLOYEE AND MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON: (A) HAS RECIEVED A COPY OF THE CONFLICTS OF INTERST POLICY; (B) HAS READ AND UNDERSTANDS THE POLICY; (C) HAS AGREED TO COMPLY WITH THE POLICY; AND (D) UNDERSTANDS THAT THE CORPORATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF HIS OR HER FINANCIAL INTEREST AND MUST BE GIVEN THE OPPORTUNITY TO DISLCOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OR COMMITTEES WITH BOARD-DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. AFTER EXCERCISING DUE DILLIGENCE, THE BOARD OR COMMITTEE SHALL DETERMINE WHETTHER THE CORPORATION CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE UNDER CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, THE BOARD OR COMMITTEE SHALL DETERMINE BY A THREE-FOURTHS (3/4) VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE CORPORATION'S BEST INTEREST AND FOR ITS OWN BENEFIT AND WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO THE CORPORATION AND SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH SUCH DETERMINATION. FORM 990, PART VI, SECTION B, LINE 15A INDEPENDENT WAGE AND SALARY SURVEYS ARE USED FOR ALL KEY EMPLOYEES, INCLUDING PRESIDENT/CEO. VENDORS USED ARE THE RURAL WISCONSIN HEALTH COOPERATIVE AND WISCONSIN HOSPITAL ASSOCIATION. THE BOARD OF DIRECTORS REVIEWS AND APPROVES THE COMPENSATION OF THE CEO. THE EXECUTIVE COMMITTEE DOES THE EVALUATION AND THE CHAIR MEETS WITH THE CEO; MINUTES ARE KEPT IN THE RAMC BOARD MINUTE JOURNAL. THE CEO REVIEWS AND APPROVES THE COMPENSATION OF THE OTHER KEY EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 REEDSBURG AREA MEDICAL CENTER'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE REVIEWED AT THE HOSPITAL'S ANNUAL MEETING, WHICH IS OPEN TO THE GENERAL PUBLIC. SUMMARIZED FINANCIAL STATEMENT DATA IS ALSO AVAILABLE THROUGH THE WISCONSIN HOSPITAL ASSOCIATION'S WEBSITE. FORM 990, PART IX, LINE 11G CONTRACTUAL SERVICES: PROGRAM SERVICE EXPENSES 3,954,499. MANAGEMENT AND GENERAL EXPENSES 659,091. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,613,590. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 6,650,397. MANAGEMENT AND GENERAL EXPENSES 957,863. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,608,260. COLLECTION FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 407,948. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 407,948. FORM 990, PART XI, LINE 9: NET CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION 159,719. FORM 990, PART XII, LINE 2C: THE PROCESS FOR SELECTION AND OVERSIGHT OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. REEDSBURG AREA MEDICAL CENTER FOUNDATION 2000 NORTH DEWEY AVE REEDSBURG WI 53959 391243616 FUNDRAISING WI 501(C)(3) LINE 12C, III-FI N/A 0 PARTNERS OF REEDSBURG AREA MEDICAL CENTER 2000 NORTH DEWEY AVE REEDSBURG WI 53959 237373902 FUNDRAISING WI 501(C)(3) LINE 3 N/A 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 0 1 0 0