2021-05-13T06:07:54-05:00 2020-06-30 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2019-07-01 390973724 FLAMBEAU HOSPITAL INC FLAM 7157622484 98 SHERRY AVENUE PARK FALLS WI 54552 JEFF EUCLIDE CAO 7157622484 2021-05-11 1 MICHAEL J PETERSON CPA P01833529 2187224705 2021-05-11 2019 2022-09-23 18:48:47Z JEFF EUCLIDE 98 SHERRY AVENUE PARK FALLS WI 54552 27040479 0 X HTTPS://MARSHFIELDCLINIC.ORG X 1961 WI TO PROVIDE HIGH QUALITY, ACCESSIBLE HEALTH CARE SERVICES IN OUR COMMUNITY. 14 14 266 123 0 0 94569 372115 24301148 26632665 10668 -909595 9130 13249 24415515 26108434 24000 24000 0 0 13245570 13715933 0 0 0 11684572 12430178 24954142 26170111 -538627 -61677 14919663 23202731 3858847 12181496 11060816 11021235 X THE FOLLOWING OBJECTIVES PROVIDE THE DIRECTION FOR FLAMBEAU HOSPITAL IN FULFILLING ITS VISION:- TO CONTINUOUSLY IMPROVE QUALITY SERVICES TO CUSTOMERS BY BUILDING EXCELLENCE INTO EVERY ASPECT AND PROCESS OF THE HOSPITAL. CUSTOMERS INCLUDE PATIENTS AND STAFF MEMBERS. THIS EXCELLENCE DEVELOPS FROM TOTAL QUALITY IMPROVEMENT, AN ENVIRONMENT THAT ENCOURAGES EVERYONE TO CONTRIBUTE TO THE HOSPITAL'S MISSION.- TO ENCOURAGE HEALTH PROMOTION AND WELLNESS THROUGH EDUCATIONAL ACTIVITIES. WHEN FEASIBLE, THESE ACTIVITIES WILL BE PURSUED IN CONJUNCTION WITH AREA HEALTH CARE PROVIDERS.- TO COLLABORATE WITH AND PROVIDE REFERRALS TO AGENCIES PROVIDING SERVICES NOT DIRECTLY AVAILABLE AT THE HOSPITAL.- TO MAINTAIN AN OPEN RELATIONSHIP WITH THE MEDICAL AND HOSPITAL STAFF TO ENSURE EFFICIENT AND EFFECTIVE UTILIZATION OF HOSPITAL RESOURCES.- TO PROVIDE IN-SERVICE AND CONTINUING EDUCATIONAL OPPORTUNITIES FOR HEALTH CARE PERSONNEL AS A MEANS OF PROVIDING QUALITY PATIENT CARE. 0 0 21314969 24000 26560430 FLAMBEAU HOSPITAL PROVIDES WELLNESS ACTIVITIES, EDUCATION AND PRIMARY HEALTHCARE SERVICES TO APPROXIMATELY 17,000 RESIDENTS IN OUR SERVICE AREA. HEALTHCARE SERVICE INCLUDES INPATIENT CARE AND SWING BED SERVICES ALONG WITH LABORATORY, RADIOLOGY, PHARMACY, REHABILITATION, SURGERY, AND OTHER OUTPATIENT SERVICES. SERVICES FOR THE YEAR ENDED JUNE 30, 2020 INCLUDED 1,148 INPATIENT DAYS, 57 SWING BED DAYS AND 30,446 OUTPATIENT REGISTRATIONS.FLAMBEAU HOME HEALTH PROVIDES HEALTH CARE SERVICES FOR HOMEBOUND PATIENTS INCLUDING PRIMARY CARE, WOUND AND INFECTION SERVICES, PERSONAL CARE SERVICES, PAIN MANAGEMENT AND OTHER MEDICAL SERVICES THAT CAN BE PROVIDED IN THE HOME. THESE SERVICES ARE PROVIDED TO THE SAME SERVICE AREA AND INCLUDED UNDUPLICATED PATIENT DAYS AND SERVICES TO PATIENTS.FLAMBEAU HOSPICE PROVIDES END OF LIFE CARE TO PATIENTS AND THEIR FAMILIES IN THEIR HOMES OR OTHER APPROPRIATE FACILITIES. ALSO PROVIDED ARE CHAPLAIN, VOLUNTEER AND BEREAVEMENT SERVICES. BEREAVEMENT SERVICES CONTINUE AFTER A PATIENT'S DEATH FOR ONE YEAR OR MORE. THESE SERVICES ARE PROVIDED TO THE SAME SERVICE AREA AND INCLUDED UNDUPLICATED PATIENT DAYS AND SERVICES TO PATIENTS. 21314969 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 51 0 266 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 0 WI X BRANDON BAY 7157622484 98 SHERRY AVE PARK FALLS WI 54552 X JANE EATON-NYMAN CIO 40.00 X 196649 0 43789 SARA BABLICK PHARMACY DIRECTOR 40.00 X 157354 0 39524 ELIZABETH SCHREIBER DIRECTOR OF NURSING 40.00 X 129761 0 38381 ROBERT PFLANZ SNR. DIRECTOR SUPP SVCS 40.00 X 110808 0 40347 JAMES BRAUN CAO 40.00 0.20 X 0 0 0 BRANDON BAY CFO 40.00 X 90439 0 5324 ROGER STRAND CHAIRPERSON 1.00 X X 0 0 0 JULIA RUFF VICE CHAIRPERSON/TREASURER 1.00 X X 0 0 0 DAVID MANNES VICE PRESIDENT, FINANCE 1.00 X X 0 0 0 CAROL MADER SECRETARY 1.00 X X 0 0 0 THOMAS PREBBLE MD DIRECTOR 1.00 X 0 0 0 SCOTT CARPENTER MD DIRECTOR 1.00 X 0 0 0 LOUAY DANIAL MD DIRECTOR 1.00 X 0 0 0 DAVE DEDA DIRECTOR 1.00 X 0 0 0 MOQUIN DOUG DIRECTOR 1.00 X 0 0 0 BECKY MICHELS DIRECTOR 1.00 X 0 0 0 KRISTEN REUKAUF DIRECTOR 1.00 X 0 0 0 GAYLE STANGLE DIRECTOR 1.00 0.20 X 0 0 0 MATTHEW THOMAS MD DIRECTOR 1.00 X 0 0 0 LAURIE WAGNER DIRECTOR 1.00 X 0 0 0 685011 0 167365 11 0 1 0 MARSHFIELD CLINIC INC 100 N OAK AVE MARSHFIELD WI 54449 ADMIN & MEDICAL SERVICES 2226180 MARSHFIELD CLINIC HEALTH SYSTEM INC 100 N OAK AVE MARSHFIELD WI 54449 ADMIN & MEDICAL SERVICES 851554 ALEXANDER KORITTNIG 442 SOUTH THIRD AVE PARK FALLS WI 54552 ANESTHESIA 510231 SHARED MEDICAL TECHNOLOGY 202 W NEWTON ST RICE LAKE WI 54868 MEDICAL SERVICES 427762 FUSION MEDICAL STAFFING PO BOX 82674 LINCOLN NE 68501 AGENCY STAFFING 341960 7 273407 98708 372115 NET PATIENT SERVICE REVENUE 621110 26253565 26253565 AFFILIATED ORG RENT 900099 174865 174865 CAFETERIA REVENUE 900099 72235 72235 132000 132000 26632665 15913 15913 925508 -925508 -925508 -925508 19786 6537 13249 13249 26108434 26560430 0 -824111 X 24000 24000 652632 386310 266322 9354142 7607534 1746608 294360 249021 45339 2719876 2157343 562533 694923 548037 146886 54930 54930 5373815 4737099 636716 71456 71456 1460624 1435905 24719 747028 747028 301113 243504 57609 144834 111613 33221 34315 34315 831194 831194 1235266 1199481 35785 111222 111222 BAD DEBT 891283 891283 EQUIPMENT RENTAL 727800 553631 174169 FOOD 128016 109070 18946 ASSOCIATION DUES 93301 41991 51310 223981 187953 36028 26170111 21314969 4855142 0 172230 351656 1465224 12016067 4750154 3848835 214749 245867 60137 64876 26646306 20397200 7852941 6249106 404228 426324 14919663 23202731 2963141 1685713 0 3931524 653690 480088 242016 6084171 3858847 12181496 X 10100976 10029772 959840 991463 11060816 11021235 14919663 23202731 X -61677 22096 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 5255 5255 0 PART II-B, LINE 1: FLAMBEAU HOSPITAL PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THESE DUES ARE PRIMARILY FOR ACCESS TO EDUCATIONAL MATERIALS AND STAFF TRAINING AND DEVELOPMENT. THE AHA AND WHA HAVE NOTIFIED FLAMBEAU HOSPITAL THAT $5,255 OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT. 73128 73128 13182426 9613017 3569409 13326634 10784183 2542451 64118 64118 6249106 ASSET RETIREMENT OBLIGATION 201213 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 556122 MEDICARE REFUNDABLE ADVANCE 5326836 6084171 25217151 0 25217151 891283 891283 26108434 24447634 0 24447634 1722477 1722477 26170111 PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT NET AGAINST REVENUE 891,283. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT NET AGAINST REVENUE 891,283. PAYMENTS TO AFFILIATES 831,194. GOLF OUTING 15187 15187 500 150 3477 LIGHTS OF LOVE 4599 4599 300 200 1909 19786 19786 500 150 300 200 5386 6536 13250 1 1 X 1 X 250.000000000000 1 X 1 1 1 0 1 0 204479 204479 0.00810 2733949 2779233 0 0.00000 2938428 2779233 204479 0.00810 11155 100369 100369 0.00400 11 20636 20636 0.00080 5933460 2048905 3884555 0.15370 4769 82190 82190 0.00330 15935 6136655 2048905 4087750 0.16180 15935 9075083 4828138 4292229 0.16990 1554 1554 0.00010 130 24531 24531 0.00100 210 3327 3327 0.00010 2505 2505 0.00010 420 420 0.00000 101 1649 1649 0.00010 441 33986 33986 0.00140 0 498148 8922197 8886711 35486 X 1 1 1 1 FLAMBEAU HOSPITAL INC 98 SHERRY AVENUE PARK FALLS WI 54552 521325 X X X X FLAMBEAU HOSPITAL INC 1 0 0 1 X X X X X X X X X 18 1 0 1 1 X SEE SUPPLEMENTAL INFORMATION X X 1 18 1 SEE SUPPLEMENTAL INFORMATION 0 1 X 250.000000000000 400.000000000000 X X X X X X 1 1 X X X X 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X X X 1 X 0 X X X X 1 X 0 0 FLAMBEAU HOSPITAL, INC. PART V, SECTION B, LINE 5: FLAMBEAU HOSPITAL WORKED CLOSELY WITH THE PRICE COUNTY HEALTH DEPARTMENT IN ORDER TO HAVE INPUT FROM A BROAD SPECTRUM OF COMMUNITY PROFESSIONALS. INDIVIDUALS INCLUDED IN THE FOLLOWING ALL PROVIDED VALUABLE INPUT THROUGH THEIR ATTENDANCE AT THE COMMUNITY NEEDS FORUM: PRICE COUNTY BOARD OF SUPERVISORS, PRICE COUNTY AGING AND DISABILITY RESOURCE CENTER UNIT, PRICE COUNTY CHILDREN AND YOUTH UNIT, PRICE COUNTY BEHAVIORAL HEALTH UNIT, PRICE COUNTY PUBLIC HEALTH UNIT, PRICE COUNTY SHERIFF'S DEPARTMENT, PARK FALLS POLICE DEPARTMENT, CHEQUAMEGON SCHOOL DISTRICT, PHILLIPS SCHOOL DISTRICT, EXTENSION PRICE COUNTY, PHILLIPS PUBLIC LIBRARY, NEW HORIZONS NORTH, EMBRACE, FLAMBEAU HOME HEALTH & HOSPICE, FLAMBEAU HOSPITAL, LIMBERG & ASSOCIATES COUNSELING, LLC, MARSHFIELD CLINIC HEALTH SYSTEM AND ASCENSION WISCONSIN. FLAMBEAU HOSPITAL, INC. PART V, SECTION B, LINE 6B: PRICE COUNTY, PRICE COUNTY PUBLIC HEALTH AND FLAMBEAU HOSPITAL FLAMBEAU HOSPITAL, INC. PART V, SECTION B, LINE 7D: HTTPS://WWW.MARSHFIELDCLINIC.ORG/CLINICLOCATIONS/DOCUMENTS/2019%20COMMUNITY%20HEALTH%20NEEDS%20ASSESSMENT.PDFLINE 10A:HTTPS://WWW.MARSHFIELDCLINIC.ORG/CLINICLOCATIONS/DOCUMENTS/2019%20COMMUNITY%20HEALTH%20NEEDS%20ASSESSMENT.PDF FLAMBEAU HOSPITAL, INC. PART V, SECTION B, LINE 11: FLAMBEAU HOSPITAL IMPLEMENTED MANY STRATEGIES COLLABORATIVELY WITH COMMUNITY AND OTHER HEALTHCARE PARTNERS. COMMUNITY CHANGE IS A LONG-TERM PROCESS THAT NO ONE ORGANIZATION CAN ACCOMPLISH ALONE, THEREFORE PARTNERSHIPS ARE ESSENTIAL FOR SUCCESS. THE FOLLOWING WERE IDENTIFIED BY THE FLAMBEAU PRICE COUNTY COMMUNITY HEALTH ASSESSMENT IN 2019: A. MENTAL HEALTHB. YOUTHC. ALCOHOL, OTHER DRUG ABUSE (AODA)D. PARENTINGE. ECONOMIC INSTABILITYF. INJURY/VIOLENCEG. CHRONIC DISEASE PREVENTION DUE TO THE INTERCONNECTED NATURE OF THE TOP IDENTIFIED HEALTH PRIORITIES, FLAMBEAU CHOSE TO COMBINE A NUMBER OF HEALTH PRIORITIES AND ARE AS FOLLOWS ALONG WITH THE GOALS AND STRATEGIES IDENTIFIED TO ACHIEVE THEM:ALCOHOL, OTHER DRUG ABUSE (AODA). STRATEGY 1: ENSURE PROPER DISPOSAL OF MEDICATIONS. BETWEEN JULY 2019- JUNE 2020, 8.5 POUNDS OF UNWANTED MEDICATIONS WERE COLLECTED AND OVER 100 DOTERRA DISPOSAL KITS WERE DISTRIBUTED IN THE COMMUNITY. STRATEGY 2: COMMUNITY AWARENESS OF AODA ISSUES. IN MARCH 2020, TWO COMMUNITY TOWN HALLS WERE HELD COVERING AODA ISSUES. THE THIRD PLANED TOWN HALL WAS CANCELED DUE TO COVID 19. STRATEGY 3: SCREENING BRIEF AND INTERVENTION. MENTAL HEALTH. STRATEGY 1: STRENGTHENING PARENTING SUPPORTS. THROUGH A PARTNERSHIP WITH UW DIVISION OF EXTENSION PRICE COUNTY, PARENT CAF SUPPORT GROUPS WERE PILOTED IN FALL 2019. SEVEN CAFS WERE HELD WITH AN AVERAGE ATTENDANCE OF 10-15 ADULTS AND BETWEEN 8-10 CHILDREN AT A CAF. PRICE COUNTY STRONGLY EMBRACED THE PARENT CAF IN ITS PILOT LOCATION. EVEN THOUGH COVID-19 CAUSED CANCELLATIONS OF MONTHLY MEETINGS IN THE LAST QUARTER, REVIEWS OF THE PROGRAM WERE LARGELY POSITIVE, WITH PARTICIPANTS FEELING THAT THEIR SUPPORT CIRCLE HAD GROWN AND THAT THEY HAD GREATER CONFIDENCE IN THEIR PARENTING SKILLS.STRATEGY 2: IMPROVE SOCIAL CONNECTEDNESS. FLAMBEAU HOSPITAL SUPPORTED A SUMMER EVENT SERIES WAS HELD JUNE- AUGUST 2019 WITH SIX CONCERTS AND ONE MOVIE SCREENING. FURTHER, FLAMBEAU HOSPITAL RECEIVED A BADER PHILANTHROPIES GRANT FOR SIP AND SWIPE. THE PROGRAM RECEIVED 6 DEVICES TO USE FOR THE PROGRAM AIMED AT INCREASING TECHNOLOGY SKILLS AMONG OLDER ADULTS TAUGHT BY YOUTH. HELD 3 EVENTS, ONE AT PHILLIPS LIBRARY (6 PARTICIPANTS), TWO AT PARK FALLS LIBRARY (1 AND 4 PARTICIPANTS).STRATEGY 3: SUPPORT MENTAL HEALTH TRAINING. IN OCTOBER 2019, FLAMBEAU HOSPITAL PROVIDED SPONSORSHIP FUNDING FOR THE SOURCES OF STRENGTH CURRICULUM TRAINING FOR TWO PRICE COUNTY SCHOOL DISTRICTS. AFTER THIS, ALL THREE SCHOOL DISTRICTS IN PRICE COUNTY ARE IMPLEMENTING THIS CURRICULUM IN HIGH SCHOOLS. A TRAINING OF STUDENTS REPRESENTING NUMEROUS SOCIAL CIRCLES KICKED OFF THE SCHOOL YEAR AND THEN THOSE STUDENTS INITIATED A STREAM OF AWARENESS CAMPAIGNS TO INCLUDE THE REST OF THEIR SCHOOL. THE MOST VISIBLE CAMPAIGN WAS CONDUCTED THROUGH THE SOCIAL MEDIA OF ONE OF THE SCHOOLS, HIGHLIGHTING THE STRENGTH OF EVERY SINGLE STUDENT AND STAFF MEMBER IN THE DISTRICT BEFORE CHALLENGING THE NEXT SCHOOL TO DO THE SAME.CHRONIC DISEASE PREVENTION. STRATEGY 1: BUILDING AN ACTIVE PRICE COUNTYSTRATEGY 2: SUPPORTING A HEALTHY FOOD CULTURESTRATEGY 3: SUPPORTING HEALTHY AGING. THE FOLLOWING HEALTH PRIORITIES WILL NOT BE ADDRESSED BY FLAMBEAU HOSPITAL FOR REASONS INDICATED: 1. YOUTH: YOUTH WILL BE AN INTENDED AUDIENCE OF MENTAL HEALTH AND AODA IMPLEMENTATION EFFORTS. 2. PARENTING: PARENTING WILL BE ADDRESSED AS PART OF THE CHOSEN MENTAL HEALTH PRIORITY. 3. INJURY/VIOLENCE: THE IMPLEMENTATION STRATEGY WILL SUPPORT REDUCTION OF INJURY AND VIOLENCE AS IT PERTAINS TO MENTAL HEALTH AND AODA USE. AT THE SAME TIME, FLAMBEAU HOSPITAL AND PRICE COUNTY PUBLIC HEALTH WILL PROVIDE STRONG SUPPORT AND COLLABORATION WITH EXISTING COMMUNITY EFFORTS AND THE NON-PROFIT ORGANIZATION EMBRACE, WHICH SPECIFICALLY ADDRESSES DOMESTIC VIOLENCE IN OUR COMMUNITY. 4. ECONOMIC INSTABILITY: PRICE COUNTY PUBLIC HEALTH'S AND FLAMBEAU HOSPITAL'S CAPACITY TO ADDRESS ECONOMIC INSTABILITY AS A SEPARATE PRIORITY AREA IS LIMITED. SOME ASPECTS OF ECONOMIC INSTABILITY MAY BE ADDRESSED THROUGH THE SELECTED PRIORITIES AND IMPLEMENTATION STRATEGIES. FLAMBEAU HOSPITAL, INC. PART V, SECTION B, LINE 16J: IN ADDITION TO POSTING THE POLICY IN THE ADMISSIONS OFFICE AND WAITING ROOMS, ALL PATIENTS WHO REGISTER AS SELF-PAY ARE CONTACTED AND GIVEN INFORMATION ABOUT THE HOSPITAL'S CHARITY CARE POLICY. PART V, SECTION B, LINE 16A, FAP WEBSITE: HTTPS://MARSHFIELDCLINIC.ORG/PATIENT-RESOURCES/BILLING/FINANCIAL-ASSISTANCE PART V, SECTION B, LINE 16B, FAP APPLICATION WEBSITE: HTTPS://MARSHFIELDCLINIC.ORG/PATIENT-RESOURCES/BILLING/FINANCIAL-ASSISTANCE PART V, SECTION B, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE: HTTPS://MARSHFIELDCLINIC.ORG/PATIENT-RESOURCES/BILLING/FINANCIAL-ASSISTANCE 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 HOSPITALS TOTAL OPERATING EXPENSES, EXCLUDING THE PROVISION FOR BAD DEBTS DIVIDED BY GROSS PATIENT SERVICE REVENUES. 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. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES AT FLAMBEAU HOSPITAL INCLUDE THE OPERATION OF THE EMERGENCY ROOM DEPARTMENT, AND THE COMMUNITY BASED HOSPICE AND HOMECARE PROGRAMS. THE HOSPITAL EMERGENCY DEPARTMENT OPERATES 24 HOURS PER DAY, SEVEN DAYS PER WEEK AND IS STAFFED BY A GROUP OF HIGHLY TRAINED NURSING STAFF INCLUDING REGISTERED NURSES, LICENSED PRACTICED NURSES, AND OTHER SUPPORT STAFF. MANY OF THE ADMISSIONS TO THE HOSPITAL EMERGENCY DEPARTMENT COME FROM THE COMMUNITY AND SURROUNDING AREAS. THE HOSPICE AND HOMECARE PROGRAMS ARE PROVIDED AS COMMUNITY SUPPORT SERVICES TO THE AREA OF PRICE COUNTY, WISCONSIN. ALL OF THESE SUBSIDIZED HEALTH SERVICES WORK IN SUPPORT AND COOPERATION WITH THE COMBINED EFFORTS OF FLAMBEAU HOSPITAL AND SHARE MANY SUPPORT FUNCTIONS OF THE HOSPITAL IN AN EFFORT TO PROVIDE EXCELLENT LOW COST CARE TO PATIENTS IN THEIR LOCAL COMMUNITY AND AREA. A SIGNIFICANT PAYOR FOR THESE PROGRAMS IS THE MEDICARE PROGRAM WHICH DOES NOT REIMBURSE THE HOSPITAL FOR THESE SERVICES IN ALL CASES BASED ON COST SO A SIGNIFICANT LOSS IS ABSORBED BY THE HOSPITAL TO PROVIDE THESE SERVICES TO MEMBERS OF THE COMMUNITY. IT IS THE GOAL OF FLAMBEAU HOSPITAL, INC. TO PROVIDE THESE SERVICES TO THE COMMUNITY REGARDLESS OF A PATIENTS ABILITY TO PAY. PART I, LN 7 COL(F): BAD DEBT EXPENSE IN THE AMOUNT OF $891,283 INCLUDED ON FORM 990, PART IX, LINE 25 WAS NOT INCLUDED IN TOTAL EXPENSES FOR PURPOSES OF CALCULATING COMMUNITY BENEFIT PERCENTAGES. PART II, COMMUNITY BUILDING ACTIVITIES: FLAMBEAU HOSPITAL, INC. PROVIDES SIGNIFICANT CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS AND IN ADDITION, THE HOSPITAL BELIEVES THAT IT PROVIDES A CRITICALLY IMPORTANT COMMUNITY BENEFIT WHICH IS NOT QUANTIFIED. FLAMBEAU HOSPITAL, INC., LIKE MOST RURAL HOSPITALS, WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE CARE LOCALLY WHICH WITHOUT THE HOSPITAL, WOULD NOT BE AVAILABLE LOCALLY. BEYOND INPATIENT HOSPITALIZATIONS, THE HOSPITAL PROVIDES LOCAL ACCESS TO MANY HEALTH SERVICES INCLUDING: BIRTHING SERVICES, DIAGNOSTICS, EMERGENCY SERVICES & URGENT CARE, HOME CARE, HOSPICE, SWING BED SERVICES, LABORATORY SERVICES, OCCUPATIONAL HEALTH, REHABILITATION SERVICES, SLEEP CENTER, SURGICAL SERVICES, AND WOMEN'S SERVICES, TO NAME SOME OF THE MAJOR SERVICES PROVIDED. PART III, LINE 2: THIS COST TO CHARGE RATIO MULTIPLIED BY BAD DEBT EXPENSE REPORTED ON FORM 990, PART IX, LINE 25. PART III, LINE 4: THE CARRYING AMOUNTS OF PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY ALLOWANCES THAT REFLECT MANAGEMENT'S BEST ESTIMATE OF THE AMOUNTS THAT WILL NOT BE COLLECTED. MANAGEMENT PROVIDES FOR CONTRACTUAL ADJUSTMENTS UNDER TERMS OF THIRD-PARTY REIMBURSEMENT AGREEMENTS THROUGH A REDUCTION OF GROSS REVENUE AND A CREDIT TO PATIENT ACCOUNTS RECEIVABLE. IN ADDITION, MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY FROM UNINSURED PATIENTS AND AMOUNTS PATIENTS ARE PERSONALLY RESPONSIBLE FOR, THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO A VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF HISTORICAL COLLECTION LIKELIHOOD AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUTSTANDING AFTER MANAGEMENT HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO PATIENT ACCOUNTS RECEIVABLE. PART III, LINE 8: THE TOTAL MEDICARE REVENUE SHOWN IN SCHEDULE H OF THE FORM 990 IS BASED ON THE IRS 990 INSTRUCTIONS AND INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE OF THE ORGANIZATION AND ALSO DOES NOT CONSIDER CONTRACTUAL ADJUSTMENTS FOR THE REIMBURSEMENT THAT IS ACTUALLY RECEIVED FROM THE MEDICARE PROGRAM. AMOUNTS LISTED FOR MEDICARE REVENUES DO NOT INCLUDE SIGNIFICANT PORTIONS OF LABORATORY, RADIOLOGY, AMBULANCE AND REHABILITATION SERVICES PROVIDED TO MEDICARE BENEFICIARIES AS WELL AS PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT, ANETHESIA PROFESSIONAL SERVICES, CLINICAL PHYSICIAN PROFESSIONAL SERVICES, SURGICAL PHYSICIAN PROFESSIONAL SERVICES AND REVENUES FOR ANY PATIENTS COVERED UNDER MEDICARE ADVANTAGE PLAN PROGRAMS. PHYSICIAN SERVICES ARE REIMBURSED PRIMARILY ON FEE SCHEDULE REIMBURSEMENT AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY, SURGICAL, AND CLINICAL SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND AS SUCH THESE COSTS AND SHORTFALLS SHOULD BE CONSIDERED AS AN ADDITIONAL BENEFIT THAT FLAMBEAU HOSPITAL PROVIDES TO THE COMMUNITY AND SURROUNDING AREASS. THE COSTING METHOD USED ABOVE FOR IRS 990 COMPLIANCE REPORTING IS ALSO BASED ON THE FILED MEDICARE COST REPORT FOR THE YEAR ENDED JUNE 30, 2020 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.) PART III, LINE 9B: ONCE A PERSON IS KNOWN TO QUALIFY FOR CHARITY CARE, THE HOSPITAL WILL KEEP THAT INFORMATION ON FILE AND AUTOMATICALLY GRANT CHARITY CARE FOR UP TO A YEAR. AT THAT POINT, THE PATIENT WOULD NEED TO REAPPLY OR VERIFY THAT THEIR SITUATION HAS NOT CHANGED SIGNIFICANTLY SINCE THEIR LAST APPLICATION.CHARITY CARE IS APPLIED FIRST BEFORE ANY COLLECTION EFFORTS ARE PURSUED. PART VI, LINE 2: THE HOSPITAL COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT REPORT IN FISCAL YEAR 2019 AND USED THE DATA AND FINDINGS OF THIS REPORT TO GUIDE THE ORGANIZATION IN THE FUTURE TO BE ABLE TO RESPOND TO THOSE NEEDS. IN ADDITION, THE HOSPITAL IS PARTICIPATING WITH PRICE COUNTY ON THE COUNTY HEALTH ASSESSMENT AND HEALTH PLAN. PART VI, LINE 3: INFORMATION IS POSTED IN THE FACILITY AND ALL PATIENTS WHO REGISTER AS SELF-PAY ARE CONTACTED FOR ANY ASSISTANCE NEEDS THEY MAY HAVE. THE INFORMATION IS ALSO PROVIDED IN ALL BILLING STATEMENTS AND WITH ANY LETTERS FOR COLLECTIONS. PART VI, LINE 4: FLAMBEAU HOSPITAL, INC. PROVIDES SERVICES TO RESIDENTS OF PRICE COUNTY, WI AND PORTIONS OF THREE OTHER COUNTIES. THE NEXT CLOSEST HOSPITAL IS 45 MILES AWAY, AND FLAMBEAU HOSPITAL IS DESIGNATED AS UNDERSERVED. THE HOSPITAL PROVIDES A SIGNIFICANT PORTION OF ITS PATIENT CARE SERVICES TO BENEFICIARIES OF THE MEDICARE AND MEDICAID PROGRAMS ESPECIALLY THOSE BENEFICIARIES WHO RECEIVE HOME HEALTH SERVICES FROM THE ORGANIZATION. IN THE SHORT PERIOD ENDING JUNE 30, 2020, THESE MEDICARE AND MEDICAID PATIENTS ACCOUNTED FOR APPROXIMATELY 74 PERCENT OF THE PATIENT SERVICES PROVIDED BY THE ORGANIZATION DURING THE YEAR. PART VI, LINE 5: FLAMBEAU HOSPITAL FURTHERS ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY WITH THEFOLLOWING: REPRESENTATIVES ARE MEMBERS OF THE COORDINATED COMMUNITY RESPONSE COMMITTEEORGANIZED BY EMBRACE IN PRICE COUNTY. THIS COMMITTEE EXAMINES COMMUNITY ISSUES RELATED TO DOMESTIC ABUSE ANDSUPPORTS SYSTEMS THAT HELP VICTIMS IMPROVE OVERALL HEALTH AND OVERCOME THEIRSITUATION. REPRESENTATIVES ARE MEMBERS OF THE PRICE COUNTY COMMUNITY BIOETHICS COMMITTEE. REPRESENTATIVES ARE MEMBERS OF THE PRICE COUNTY EMERGENCY MANAGEMENT COMMITTEE. REPRESENTATIVES ARE MEMBERS OF THE BOARD OF DIRECTORS FOR THE ANNMARIE FOUNDATION. REPRESENTATIVES ARE MEMBERS OF THE PRICE COUNTY TRANSPORTATION COORDINATINGCOMMITTEE. REPRESENTATIVES ARE MEMBERS OF PRICE COUNTY PROJECT LIFESAVER. REPRESENTATIVES ARE MEMBERS OF CONNECTING AGING COMMUNITIES COALITION. REPRESENTATIVES ARE MEMBERS OF THE PRICE COUNTY ALCOHOL OTHER DRUG ABUSE/MENTALHEALTH COALITION: EMERGING DRUG SUBCOMMITTEE STRONG FAMILIES STRONG KIDS SUBCOMMITTEE COMMUNITY AWARENESS SUBCOMMITTEEREPRESENTATIVES ARE MEMBERS OF THE PRICE COUNTY HEALTH & WELLNESS COALITION: PHYSICAL ACTIVITY SUBCOMMITTEE HEALTHY AGING SUBCOMMITTEE NUTRITION SUBCOMMITTEE PART VI, LINE 7, REPORTS FILED WITH STATES WI 1 SCHOLARSHIPS 5 24000 PART I, LINE 2: THE ORGANIZATION HAS A PROCESS OF SELECTING, AWARDING AND MONITORING SCHOLARSHIP RECIPIENTS. X 0 0 0 0 0 0 0 0 0 JANE EATON-NYMAN CIO 193601 0 0 0 3048 0 8098 0 35691 0 240438 0 0 0 SARA BABLICK PHARMACY DIRECTOR 157173 0 0 0 181 0 6533 0 32991 0 196878 0 0 0 ELIZABETH SCHREIBER DIRECTOR OF NURSING 128594 0 0 0 1167 0 5390 0 32991 0 168142 0 0 0 ROBERT PFLANZ SNR. DIRECTOR SUPP SVCS 109822 0 0 0 986 0 4747 0 35600 0 151155 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 MARSHFIELD CLINIC AND MINISTRY HEALTH CARE, INC. ("MINISTRY"), BOTH WISCONSIN TAX-EXEMPT CORPORATIONS, ARE JOINT CORPORATE MEMBERS OF THE HOSPITAL. MINISTRY ALSO, VIA CONTRACT, SHARES CERTAIN GOVERNANCE AUTHORITIES WITH MARSHFIELD CLINIC WITH RESPECT TO THE PARK FALLS AND PHILLIPS ("PRICE COUNTY CLINICS") CLINIC OPERATIONS OF MARSHFIELD CLINIC, WITH MARSHFIELD CLINIC RETAINING THE REMAINING AUTHORITIES. MARSHFIELD CLINIC HAS CONTRACTED TO PROVIDE OPERATING MANAGEMENT TO THE HOSPITAL AND PRICE COUNTY CLINICS. THE GOAL OF THE MEMBERSHIP ARRANGEMENTS IS TO PROVIDE FOR THE EFFECTIVE, ECONOMICAL, AND COORDINATED MANAGEMENT AND OPERATION OF HEALTH CARE SERVICES IN PRICE COUNTY. COLLECTIVELY, THE PARTIES HAVE ESTABLISHED AN INTEGRATED HEALTH CARE DELIVERY SYSTEM FOR PRICE COUNTY. FORM 990, PART VI, SECTION A, LINE 7A CORPORATE MEMBERS HAVE APPROVED RIGHT FOR DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B APPROVAL OF BUDGET, ADMINISTRATOR, PROPERTY PURCHASED, AND DIRECTORS. FORM 990, PART VI, SECTION A, LINE 8B NOT APPLICABLE AS THERE ARE NO SUB-COMMITTEES. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE FORM 990 WAS PROVIDED TO ALL MEMBERS OF THE BOARD PRIOR TO FILING. IF THE BOARD MEMBERS WOULD LIKE ANY EXPLANATION OR CHANGES, THEY WOULD HAVE AN OPPORTUNITY TO COMMENT ON THE RETURN BEFORE ITS FILING. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS AND KEY EMPLOYEES OF THE HOSPITAL ANNUALLY SIGN TO ADHERE TO THE CONFLICT OF INTEREST POLICY AT FLAMBEAU HOSPITAL, INC. IT IS ASSUMED THAT THE BOARD OF DIRECTORS AND KEY EMPLOYEES WILL RECOGNIZE CONFLICTS OF INTEREST WITH ANY PERSONS OR FIRMS MENTIONED IN THE POLICY. IT IS THE POLICY OF THE BOARD THAT THE EXISTENCE OF ANY INTEREST DESCRIBED IN THE POLICY SHALL BE DISCLOSED BEFORE ANY TRANSACTION IS CONSUMMATED. IT IS THE BOARD OF DIRECTORS AND KEY EMPLOYEES RESPONSIBILITY TO REVIEW POTENTIAL CONFLICTS OF INTEREST AND IF A CONFLICT EXISTS THE INDIVIDUAL IS PROHIBITED TO VOTE ON TRANSACTIONS WHERE THE POTENTIAL CONFLICT EXISTS. FORM 990, PART VI, SECTION B, LINE 15 THE MARSHFIELD CLINIC PREPARES A COMPENSATION SCHEDULE THAT IS USED TO DETERMINE TOP MANAGEMENT AND KEY EMPLOYEE COMPENSATION. COMPENSATION STUDIES ARE ALSO USED TO PROVIDE COMPARABILITY DATA. THIS DATA IS REVIEWED AND APPROVED BY INDEPENDENT PERSONS AND ALL DECISIONS ARE SUBSTANTIATED. FORM 990, PART VI, SECTION C, LINE 19 THE HOSPITAL DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART VII, SECTION A: THE ORGANIZATION IS ENGAGED IN A MANAGEMENT AGREEMENT WITH MARSHFIELD CLINIC. JAMES BRAUN, WAS CHIEF ADMINISTRATIVE OFFICER FOR FLAMBEAU HOSPITAL DURING THE YEAR. FLAMBEAU HOSPITAL PAID MARSHFIELD CLINIC $263,880 FOR THESE MANAGEMENT SERVICES. FORM 990, PART IX, LINE 11G ER SERVICES: PROGRAM SERVICE EXPENSES 2,243,529. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,243,529. ANESTHESIOLOGY SERVICES: PROGRAM SERVICE EXPENSES 561,530. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 561,530. MED SURG SERVICES: PROGRAM SERVICE EXPENSES 350,986. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 350,986. OTHER SERVICES: PROGRAM SERVICE EXPENSES 1,581,054. MANAGEMENT AND GENERAL EXPENSES 636,716. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,217,770. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST OF FOUNDATION 22,096. FLAMBEAU HOSPITAL FOUNDATION INC PO BOX 310 PARK FALLS WI 54552 205957150 SUPPORT OF FLAMBEAU HOSPITAL WI 501 (C) 3 LINE 12A, I FLAMBEAU HOSPITAL 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0