AMERY REGIONAL MEDICAL CENTER INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- AMERY REGIONAL MEDICAL CENTER INC (EIN 39-0908320)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-11-15
- IRS object ID
- 202113199349314651
- Schema version
- 2020v4.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-11-15T13:32:06-06:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 135565207 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4200 WELLS FARGO CTR 90 S 7TH | AddressLine1Txt |
| Address Line2 | STREET | AddressLine2Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390908320 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AMERY REGIONAL MEDICAL CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | AMER | BusinessNameControlTxt |
| Phone | 7152688000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8170 33RD AVENUE SOUTH PO BOX 1309 | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 554401309 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DEBRA RUDQUIST | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 7152688000 | PhoneNum |
| Signature | 2021-11-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | DEBRA | PersonFirstNm |
| Person Last | RUDQUIST | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | HOLLY K MOEN | PreparerPersonNm |
| PTIN | P01800653 | PTIN |
| Phone | 6123055000 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DEBRA A RUDQUIST | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8170 33RD AVENUE SOUTH PO BOX 1309 | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 554401309 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $65,105,740 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.AMERYMEDICALCENTER.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1954 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE ACCESSIBLE, COMPREHENSIVE, QUALITY HEALTHCARE | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 469 | TotalEmployeeCnt |
| Total Volunteers | 21 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $282,579 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,090,592 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $62,357,101 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $59,133,527 | CYProgramServiceRevenueAmt |
| PY Investment Income | $390,681 | PYInvestmentIncomeAmt |
| CY Investment Income | $625,543 | CYInvestmentIncomeAmt |
| PY Other Revenue | $148,025 | PYOtherRevenueAmt |
| CY Other Revenue | $206,727 | CYOtherRevenueAmt |
| PY Total Revenue | $63,178,386 | PYTotalRevenueAmt |
| CY Total Revenue | $65,056,389 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $42,401 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $8,519 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $40,651,486 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $41,505,581 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $20,789,982 | PYOtherExpensesAmt |
| CY Other Expenses | $20,349,108 | CYOtherExpensesAmt |
| PY Total Expenses | $61,483,869 | PYTotalExpensesAmt |
| CY Total Expenses | $61,863,208 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,694,517 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,193,181 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $53,164,869 | TotalAssetsBOYAmt |
| Total Assets EOY | $67,160,715 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $29,387,833 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $39,681,628 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $23,777,036 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $27,479,087 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | AMERY REGIONAL MEDICAL CENTER IS COMMITTED TO PROVIDEACCESSIBLE, COMPREHENSIVE, QUALITY HEALTHCARE AND TO PROMOTE THEHEALTH AND WELLNESS OF ITS COMMUNITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $54,450,345 | ExpenseAmt |
| Grant | $8,519 | GrantAmt |
| Revenue | $59,133,527 | RevenueAmt |
| Desc | SEE SCHEDULE O - EXEMPT PURPOSE AND ACHIEVEMENTS FOR A DESCRIPTION OF PROGRAM SERVICE ACCOMPLISHMENTS | Desc |
| Total Program Service Expenses | $54,450,345 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | Yes (1) | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 469 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DOUGLAS E JOHNSON - CFO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7152688000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 265 GRIFFIN STREET EAST | AddressLine1Txt |
| City | AMERY | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54001 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| RICK DADO | |||||||||
| DIRECTOR | 1.75 | 0.25 | Yes (X) | $1,200 | $0 | $0 | |||
| CHUCK WILLIAMSON | |||||||||
| DIRECTOR | 1.75 | 0.25 | Yes (X) | $700 | $0 | $0 | |||
| JAMES A LEADHOLM JR | |||||||||
| DIRECTOR & CHAIR | 1.75 | 0.25 | Yes (X) | $1,200 | $0 | $0 | Yes (X) | ||
| MARGO ROSEN | |||||||||
| DIRECTOR | 1.75 | 0.25 | Yes (X) | $1,200 | $0 | $0 | |||
| STEVEN SCHAFFFER | |||||||||
| DIRECTOR & SECRETARY | 1.75 | 0.25 | Yes (X) | $1,200 | $0 | $0 | Yes (X) | ||
| CHRIS PETERSEN | |||||||||
| DIRECTOR | 1.75 | 0.25 | Yes (X) | $1,200 | $0 | $0 | |||
| ORALEE SCHOCK | |||||||||
| DIRECTOR & VICE CHAIR | 1.75 | 0.25 | Yes (X) | $1,200 | $0 | $0 | Yes (X) | ||
| ROSS R BULLARD | |||||||||
| DIRECTOR & TREASURER | 1.00 | 47.00 | Yes (X) | $0 | $255,923 | $75,972 | Yes (X) | ||
| DYLAN COE MD | |||||||||
| DIRECTOR | 0.25 | 29.25 | Yes (X) | $0 | $206,614 | $80,693 | |||
| MARTIN E RICHARDS MD | |||||||||
| DIRECTOR | 0.25 | 39.75 | Yes (X) | $0 | $512,943 | $59,457 | |||
| ANN R SEAGREN MD | |||||||||
| DIRECTOR | 0.25 | 49.75 | Yes (X) | $0 | $242,337 | $80,053 | |||
| THEODORE T WEGLEITNER | |||||||||
| DIRECTOR | 0.25 | 52.75 | Yes (X) | $0 | $586,980 | $124,602 | |||
| MARYANN SCOGLIO CANP | |||||||||
| DIRECTOR | 0.25 | 64.75 | Yes (X) | $0 | $149,735 | $42,097 | |||
| SANDRA M REED | |||||||||
| VP - AMBULATORY CARE | 55.00 | 0.00 | $194,432 | $0 | $33,025 | Yes (X) | |||
| DEBRA A RUDQUIST | |||||||||
| PRESIDENT | 53.00 | 0.00 | $0 | $338,363 | $55,642 | Yes (X) | |||
| PATRICK D SURA MD | |||||||||
| CHIEF MEDICAL OFFICER | 0.25 | 59.75 | $0 | $423,163 | $58,156 | Yes (X) | |||
| DOUGLAS E JOHNSON | |||||||||
| CFO | 13.75 | 41.25 | $0 | $415,631 | $40,274 | Yes (X) | |||
| MARK A TRYGGESTAD | |||||||||
| DIRECTOR OF PHARMACY | 42.00 | 0.00 | $183,830 | $0 | $20,419 | Yes (X) | |||
| ANTHONY R GOULD | |||||||||
| ANCILLARY SERVICES | 50.00 | 0.00 | $131,482 | $0 | $40,083 | Yes (X) | |||
| JOLLEEN M NICHOLS | |||||||||
| PROVIDER-APNP | 50.00 | 0.00 | $127,705 | $0 | $14,334 | Yes (X) | |||
| ANN M SCHILLING | |||||||||
| HR SR DIRECTOR | 40.00 | 0.00 | $126,719 | $0 | $39,359 | Yes (X) | |||
| BENJAMIN D BOGLE | |||||||||
| PROVIDER-APNP | 40.00 | 0.00 | $123,610 | $0 | $38,037 | Yes (X) | |||
| JASON J LUHRS | |||||||||
| FORMER CFO | 0.00 | 50.00 | $0 | $270,087 | $51,349 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $895,678 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,401,776 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $853,552 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 23 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| RIVER VALLEY ANESTHESIA INC | |||||
| PO BOX 118 | NEW RICHMOND | WI | 54017 | NURSE ANESTHETISTS | $940,573 |
| INFINITE HEALTH COLLABORATIVE | |||||
| 4200 DALBERG DR STE 300 | GOLDEN VALLEY | MN | 55422 | PROFESSIONAL SERVICES | $538,041 |
| SHARED MEDICAL TECHNOLOGY INC | |||||
| 202 W NEWTON ST | RICE LAKE | WI | 54868 | PROFESSIONAL SERVICES | $295,892 |
| TWIN CITIES ORTHOPEDICS PA | |||||
| 5803 NEAL AVE N | OAK PARK HEIGHTS | MN | 55082 | PROFESSIONAL SERVICES | $280,608 |
| HEALOGICS WOUND CARE | |||||
| 28525 NETWORK PLACE | CHICAGO | IL | 60673 | WOUND HEALING MANAGEMENT | $258,825 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 12 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $5,090,592 | GovernmentGrantsAmt |
| Total Contributions | $5,090,592 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE | 621110 | $58,759,393 | $58,759,393 |
| OTHER OPERATING | 900099 | $356,844 | $356,844 |
| FITNESS CENTER | 624110 | $17,290 | $17,290 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $59,133,527 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $625,543 | TotalRevenueColumnAmt |
| Exclusion | $625,543 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $165,141 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $49,351 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $115,790 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $115,790 | TotalRevenueColumnAmt |
| Exclusion | $115,790 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA AND OTHER | 900099 | $76,067 | $76,067 |
| OTHER | 900099 | $14,391 | $14,391 |
| GIFT SHOP | 453220 | $479 | $479 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $90,937 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $65,056,389 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $59,133,527 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $832,270 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,519 | TotalAmt |
| Program Services | $8,519 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $268,382 | TotalAmt |
| Management And General | $268,382 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,837,718 | TotalAmt |
| Program Services | $32,076,150 | ProgramServicesAmt |
| Management And General | $3,761,568 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $619,803 | TotalAmt |
| Program Services | $554,748 | ProgramServicesAmt |
| Management And General | $65,055 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,193,531 | TotalAmt |
| Program Services | $2,858,334 | ProgramServicesAmt |
| Management And General | $335,197 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,586,147 | TotalAmt |
| Program Services | $1,419,663 | ProgramServicesAmt |
| Management And General | $166,484 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $89,881 | TotalAmt |
| Management And General | $89,881 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,447,259 | TotalAmt |
| Program Services | $3,347,481 | ProgramServicesAmt |
| Management And General | $99,778 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $135,857 | TotalAmt |
| Program Services | $24,877 | ProgramServicesAmt |
| Management And General | $110,980 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $638,638 | TotalAmt |
| Program Services | $339,969 | ProgramServicesAmt |
| Management And General | $298,669 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $202,337 | TotalAmt |
| Program Services | $74,053 | ProgramServicesAmt |
| Management And General | $128,284 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,010,859 | TotalAmt |
| Program Services | $705,626 | ProgramServicesAmt |
| Management And General | $305,233 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,634 | TotalAmt |
| Program Services | $11,818 | ProgramServicesAmt |
| Management And General | $7,816 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,007 | TotalAmt |
| Program Services | $1,751 | ProgramServicesAmt |
| Management And General | $3,256 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $754,789 | TotalAmt |
| Program Services | $754,789 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,367,963 | TotalAmt |
| Program Services | $3,086,481 | ProgramServicesAmt |
| Management And General | $281,482 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $245,383 | TotalAmt |
| Program Services | $104,972 | ProgramServicesAmt |
| Management And General | $140,411 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL & DRUG SUPPLIES | $7,844,043 | $7,836,844 | $7,199 |
| EQUIP. RENT & REPAIR | $1,842,390 | $837,983 | $1,004,407 |
| OTHER EXPENSE | $461,676 | $290,657 | $171,019 |
| DUES & FEES | $129,395 | $92,109 | $37,286 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $153,997 | TotalAmt |
| Program Services | $23,521 | ProgramServicesAmt |
| Management And General | $130,476 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,863,208 | TotalAmt |
| Program Services | $54,450,345 | ProgramServicesAmt |
| Management And General | $7,412,863 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,748 | BOYAmt |
| EOY | $6,274 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,593,132 | BOYAmt |
| EOY | $24,591,162 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,933,690 | BOYAmt |
| EOY | $6,940,177 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $771,028 | BOYAmt |
| EOY | $907,073 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $150,822 | BOYAmt |
| EOY | $175,514 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $59,911,593 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $40,418,984 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,488,042 | BOYAmt |
| EOY | $19,492,609 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,871,204 | BOYAmt |
| EOY | $11,932,369 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,680,017 | BOYAmt |
| EOY | $2,630,802 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $661,186 | BOYAmt |
| EOY | $484,735 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,164,869 | BOYAmt |
| EOY | $67,160,715 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,499,230 | BOYAmt |
| EOY | $16,088,308 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $861,492 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,438,770 | BOYAmt |
| EOY | $22,336,378 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $449,833 | BOYAmt |
| EOY | $395,450 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,387,833 | BOYAmt |
| EOY | $39,681,628 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,777,036 | BOYAmt |
| EOY | $27,479,087 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,777,036 | BOYAmt |
| EOY | $27,479,087 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,164,869 | BOYAmt |
| EOY | $67,160,715 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $3,193,181 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $508,870 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Total Lobbying Expenditures | $0 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | AMERY REGIONAL MEDICAL CENTER, INC. PAYS FOR CERTAIN CORPORATE AND EMPLOYEE PROFESSIONAL ASSOCIATION MEMBERSHIPS. A PORTION OF SUCH MEMBERSHIP DUES POTENTIALLY COULD BE USED BY THE PROFESSIONAL ASSOCIATIONS FOR LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $983,722 | OtherCostOrOtherBasisAmt |
| Book Value | $983,722 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $24,719,692 | OtherCostOrOtherBasisAmt |
| Depreciation | $16,709,366 | DepreciationAmt |
| Book Value | $8,010,326 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,997,221 | OtherCostOrOtherBasisAmt |
| Depreciation | $996,334 | DepreciationAmt |
| Book Value | $5,000,887 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $28,210,958 | OtherCostOrOtherBasisAmt |
| Depreciation | $22,713,284 | DepreciationAmt |
| Book Value | $5,497,674 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $19,492,609 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | LEASE OBILGATION | Desc |
| Amt | $395,450 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $395,450 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | AMERY REGIONAL MEDICAL CENTER, INC. IS INCLUDED IN THE HEALTHPARTNERS, INC. (HP) CONSOLIDATED AUDITED FINANCIAL STATEMENT. HP'S ACCOUNTING POLICY PROVIDES THAT A TAX BENEFIT FROM AN UNCERTAIN TAX POSITION MAY BE RECOGNIZED WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING RESOLUTIONS OF ANY RELATED APPEALS OR LITIGATION PROCESSES, BASED ON THE TECHNICAL MERITS. HP RECORDED NO LIABILITIES AT DECEMBER 31, 2020 OR 2019 FOR UNRECOGNIZED TAX BENEFITS. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $342,381 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $342,381 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00550 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,406,805 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,332,102 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,074,703 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03350 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,749,186 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,332,102 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,417,084 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03900 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $187,586 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,082 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $185,504 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00300 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,766 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $18,766 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,534,285 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,534,285 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04100 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $20,615 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $20,615 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,761,252 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,082 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,759,170 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04460 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,510,438 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,334,184 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,176,254 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08360 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,250,386 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $20,273,833 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $20,273,833 | CostOfCareReimbursedByMedcrAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AMERY REGIONAL MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 265 GRIFFIN STREET EAST | AddressLine1Txt |
| City | AMERY | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54001 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.AMERYMEDICALCENTER.ORG | WebsiteAddressTxt |
| State License | CAH CERT LICENSE 1010 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AMERY REGIONAL MEDICAL CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTPS://WWW.HEALTHPARTNERS.COM/CARE/HOSPITALS/AMERY/ABOUT/COMMUNITY | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTPS://WWW.HEALTHPARTNERS.COM/CARE/HOSPITALS/AMERY/ABOUT/COMMUNITY-HE | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE NOTES | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE NOTES | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE NOTES | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| AMERY REGIONAL MEDICAL CENTER, INC. | PART V, SECTION B, LINE 5: THE WAYS WE BRING THE MISSION TO LIFE IS TO WORK WITH COMMUNITY PARTNERS TO BETTER UNDERSTAND WHAT CONTRIBUTES TO AND STANDS IN THE WAY OF GOOD HEALTH AND HOW WE CAN WORK TOGETHER TO IMPROVE HEALTH OUTCOMES. THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS IS AN OPPORTUNITY FOR US TO IDENTIFY THE SIGNIFICANT HEALTH NEEDS OF OUR COMMUNITY AND THE MEASURES AND RESOURCES REQUIRED TO ADDRESS THOSE NEEDS. HEALTHPARTNERS WORKED WITH LOCAL HEALTH DEPARTMENTS, LOCAL COALITIONS, THE CENTER FOR COMMUNITY HEALTH (CCH) AND COMMUNITY PARTNERS TO CONDUCT A COMPREHENSIVE CHNA. IN ADDITION, EACH HOSPITAL ENGAGED WITH LOCAL PUBLIC HEALTH PARTNERS AND OTHER LOCAL HEALTH CARE ORGANIZATIONS ON THE CHNA PROCESS THROUGH PARTICIPATION IN TWO LOCAL COLLABORATIVES: THE CENTER FOR COMMUNITY HEALTH EAST METRO CHA (COMMUNITY HEALTH ASSESSMENT)/CHNA COLLABORATIVE AND THE WEST METRO CHNA COLLABORATION. COMMUNITY INPUT: AS PART OF ITS CHNA PROCESS, AMERY AND ITS PARTNERS WORKED COLLABORATIVELY WITH POLK AND BARRON COUNTIES TO ENGAGE COMMUNITY MEMBERS AND HEALTH CARE PROVIDERS IN THE PROCESS TO GATHER INPUT ON WHAT THEIR TOP HEALTH CONCERNS ARE.THE COMMUNITY INPUT IN THIS REPORT INCLUDES:COUNTY PRIORITY DATA: EACH COUNTY IN THE AMERY SERVICE AREA HAS DETERMINED THE TOP HEALTH PRIORITIES FOR ITS COMMUNITY THROUGH A COUNTY-LEVEL COMMUNITY HEALTH ASSESSMENT PROCESS (CHA). BARRON COUNTY COMMUNITY SURVEY DATA: IN 2018, BARRON COUNTY CONDUCTED A COMMUNITY SURVEY ABOUT HEALTH NEEDS AND BARRIERS TO HEALTH FOR ITS COMMUNITY HEALTH ASSESSMENT. A TOTAL OF 815 COMMUNITY MEMBERS PARTICIPATED IN THE SURVEY.POLK COUNTY COMMUNITY SURVEY DATA: IN 2015, POLK COUNTY CONDUCTED A COMMUNITY HEALTH SURVEY ABOUT HEALTH NEEDS AND BARRIERS TO HEALTH FOR ITS 2016 COMMUNITY HEALTH ASSESSMENT. A TOTAL OF 650 SURVEYS WERE COMPLETED BY COUNTY RESIDENTS.PROVIDER SURVEY: IN 2018, HEALTHPARTNERS SURVEYED HEALTH CARE PROVIDERS TO UNDERSTAND THEIR PERCEPTIONS OF LEADING HEALTH NEEDS AND COMMUNITY RESOURCES AVAILABLE TO HELP THEIR PATIENTS. THE SURVEY ALSO ASKED PROVIDERS TO IDENTIFY BARRIERS THEY FACE IN ADDRESSING HEALTH NEEDS AND RESOURCES TO BETTER SERVE THEIR PATIENTS. TWENTY-THREE HEALTH CARE PROVIDERS COMPLETED THE SURVEY, INCLUDING 11 WHO PRACTICE AT AMERY. |
| AMERY REGIONAL MEDICAL CENTER, INC. | PART V, SECTION B, LINE 6A: HEALTHPARTNERS COLLABORATED ACROSS SIX HOSPITALS WITHIN ITS FAMILY OF CARE FOR THE 2018 CHNA: - AMERY HOSPITAL & CLINIC (AMERY, WI) - HUDSON HOSPITAL & CLINIC (HUDSON, WI) - LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION (STILLWATER, MN) - PARK NICOLLET HEALTH SERVICES INCLUDING PARK NICOLLET METHODIST HOSPITAL (ST. LOUIS PARK, MN)- REGIONS HOSPITAL (ST. PAUL, MN)- WESTFIELDS HOSPITAL & CLINIC (NEW RICHMOND, WI) |
| AMERY REGIONAL MEDICAL CENTER, INC. | PART V, SECTION B, LINE 11: HEALTHPARTNERS CHNA TEAM INCLUDED REPRESENTATIVES FROM EACH HEALTHPARTNERS HOSPITAL AND HEALTHPARTNERS LEADERSHIP. IN SEPTEMBER 2018, THE CHNA TEAM MET TO REVIEW THE DATA AND PRIORITIZE THE COMMUNITY HEALTH NEEDS ACROSS THE SYSTEM. HEALTHPARTNERS COLLECTIVELY PRIORITIZED COMMUNITY HEALTH NEEDS USING A PROCESS INFORMED BY A MODIFIED HANLON METHOD AND OTHER COMMONLY USED PRIORITIZATION METHODS. EACH HOSPITAL SHARED ITS 4-5 PRIORITY TOPIC AREAS AND RATIONALE FOR EACH TOPIC AREA BASED ON: SIZE, SERIOUSNESS, EQUITY, VALUE AND CHANGE. HEALTHPARTNERS HOSPITALS WORKED IN A THOROUGH, FACILITATED LARGE AND SMALL GROUP PROCESS TO REACH CONSENSUS ON TOP PRIORITIES USING BOTH THE CRITERIA DESCRIBED ABOVE AND COMMUNITY INPUT DATA.PRIORITIES NOT SELECTED: HEALTHPARTNERS DISCUSSED AND CONSIDERED ADDITIONAL OR ALTERNATIVE PRIORITIES DURING THE PRIORITIZATION PROCESS, INCLUDING: OLDER ADULT HEALTH/AGING, MATERNAL AND CHILD HEALTH, ENVIRONMENTAL HEALTH AND INJURY AND VIOLENCE. THESE NEEDS WERE NOT SELECTED AS TOP FIVE PRIORITIES IN THE CONSENSUS BUILDING PROCESS; HOWEVER, THE THEMES WILL BE CONSIDERED IN THE IMPLEMENTATION FOR THE SELECTED PRIORITY AREAS. PRIORITY SPECIFIC PROGRESS IN 20201. ACCESS TO CARE - ENSURED THAT EVERY PERSON WHO TOUCHES OUR ORGANIZATION FEELS WELCOMED, INCLUDED, AND VALUED. STRATEGIES: ORGANIZATION-WIDE TRAINING ON DIVERSITY SERVED AS A SPRINGBOARD TO PATIENT & MEMBER BIAS, PATIENT AND DIVERSITY TRAINING AND INTEGRATION INTO ALL-STAFF LEARNING MODULES, WELCOME DAY AND LEADER DEVELOPMENT. INCREASE WEBSIT ACCESS TO PATIENT AND COMMUNITY ACCESS OF CARE THROUGH APPOINTMENT SCHEDULING. SIGNIFICANTLY INCREASED TELEMEDICINE, ARMC SAW 14,736 TELEMEDICINE APPOINTMENTS IN 2020. PROVIDED COMMUNITY DIABETES EDUCATION WITH VIRTUAL OPTIONS AND LAUNCHED COVID 19 VACCINATION CLINICS. 2 ACCESS TO HEALTH-STRENGTHEN EXISTING AND EXPLORE NEW COMMUNITY PARTNERSHIPS TO ADDRESS SOCIAL DETERMINANTS OF HEALTH. STRATEGIES: ESTABLISH NEW PARTNERSHIOPS TO STRENGTHEN SHIFING AND EMERGING COMMUNITY NEEDS. HEALTH AND WELL-BEING ADVISORY COMMITTEE CONTINUED TO GUIDE COMMUNITY HEALTH EFFORTS AND RESPONSE THROUGH CROSS-SECTOR COLLABORATION. UPDATED COMMUNITY RESOURCE LIST TO INCLUDE NEW RESOURCES AND SUPPORT DURING COVID PANDEMIC; AVAILABLE TO PATIENTS, STAFF AND COMMUNITY MEMBERS. CONTINUED TO SERVE ON CORE LEADERSHIP TEAM FOR SUPERSHELF FOOD SHELF TRANSFORMATIONS AND MAKE ADAPTATIONS IN DELIVERY METHODS FOR COVID-19. CONTINUED FOOD INSECURITY SCREENING AND REFERRAL FOR ALL WELL-CHILD AND MEDICARE WELL EXAMS. PROMOTE EARLY CHILDHOOD BRAIN DEVELOPMENT BY OFFERING VIRTUAL TRAINING AND RESOURCES TO CONTINUE MOMENTUM OF COLLABORATION TO PROMOTE EARLY CHILDHOOD BRAIN DEVELOPMENT. PROMOTE SUSTAINABLE OPERATIONS BY INCREASING RECYCLING AND PURCHASING SUSTAINABLE PRODUCED AND LOCAL FOODS AND REDUCE WASTE.3. MENTAL HEALTH AND WELL-BEING - REDUCE THE STIGMA SURROUNDING MENTAL ILLNESS. STRATEGIES: ARMC IS A PARTNER IN MAKE IT OK, A PROGRAM FOCUSED ON REDUCING THE STIGMA OF MENTAL ILLNESS. MAKE IT OK MADE PROGRESS IN REDUCING THE STIGMA OF MENTAL ILLNESS WITH THE FOLLOWING IMPACT FROM MAKE IT OK IN 2020: RECEIVED 81,349 WEBSITE VISITS WITH 62,780 UNIQUE VISITORS WHERE TOOLS AND RESOURCES WERE DOWNLOADED MORE THAN 500 TIMES BY PEOPLE IN 250 U.S. CITIES AND 25 MINNESOTA COUNTIES. HELD 11 AMBASSADOR TRAINING, MOBILIZING AN ADDITIONAL 200 AMBASSADORS. REACHED MORE THAN 2,000 PEOPLE THROUGH COMMUNITY PRESENTATIONS, EVENTS AND TABLING. 4. NTRITUION AND PHYSICAL ACTIVITY - PROMOTE AND SUPPORT PHYSICAL ACTIVITY AND NUTRITION AND SUPPORT AND ENCOURAGE HEALTHY FOOD AND PHYSICAL ACTIVITY ENVIRONMENT CHANGE. SINCE 2015, ARMC HAS SUPPORTED POWERUP, A COMMUNITYWIDE HEALTH INITIATIVE THAT INSPIRES AND ENGAGES THE ENTIRE COMMUNITY TO PROMOTE BETTER EATING AND PHYSICAL ACTIVITIES SO YOUTH CAN REACH THEIR FULL POTENTIAL. OUR WORK WITH HUNDREDS OF PARTNERS ACROSS THE REGION HAS RESULTED IN A HIGH LEVEL OF COMMUNITY AND SCHOOL ENGAGEMENT, STRONGER SCHOOL WELLNESS POLICIES AND PRACTICES; MORE FREE AND LOW-COST OPTIONS FOR PHYSICAL ACTIVITY INCLUDING OPEN GYMS; PARTNERSHIPS WITH STATE AND LOCAL PARKS; TRANSFORMED FOOD PANTRIES, CAFETERIAS AND CONCESSIONS; AND COMMUNITY MOMENTUM TO CREATE CHANGE.POWERUP COMMUNITY ENGAGEMENT HAS GROWN OVER TIME AND ADAPTED DURING COVID 19 COMMUNITY AND SCHOOL VIRTUAL PROGRAMS, RESOURCES AND SOCIAL MEDIA ENGAGEMENT. EVEN WITH THESE LIMITS FOR OUTREACH, MORE THAN 75,000 ENGAGED IN THE ST. CROIX VALLEY AREA IN 2020 THROUGH EVENTS, CLASSES, OUTREACH PROGRAMS AND GROWING ONLINE RESOURCES TO PROMOTE BETTER EATING AND MOVING MORE.5. SUBSTANCE ABUSE - REDUCED OPIOID PRESCRIPTIONS, DOSES AND PATIENTS MEETING CHRONIC OPIOID USE CRITERIA THROUGH EFFORTS WITH PHARMANCY, PRESCRIBERS AND PAIN CLINICS, OUR CARE SYSTEM ACHIEVED SIGNIFICANT REDUCTION IN OPIOID PRESCRIBING. SINCE 2016 THERE HAS BEEN A 68% AND 52% REDUCTION IN OPIOIDS PRESCRIBED AT DISCHARGE IN HOSPITALS AND EMERGENCY DEPARTMENTS, RESPECTIVELY. INCREASED AWARENESS AND ACCESS FOR TREATMENT FOR SUBSTANCE ABUSE, INCLUDING TOBACCO CESSATION CLASSES AND EXPANDED PROGRAMS FOR CHANGE TO INCREASE ACCESS TO ADDICTION COUNCELING AND SERVICES.A FULL REPORT OF ARMC'S 2018 CHNA AND ANNUAL IMPLEMENTATION PLAN UPDATE IS POSTED ON ARMC'S WEBPAGE AT HTTPS://WWW.HEALTHPARTNERS.COM/CONTENT/DAM/BRAND-IDENTITY/PDFS/CARE/2019-AMERY-CHNA-IMPLEMENTATION-PLAN.PDF |
| PART V, SECTION B, LINE 3E | AMERY ADDRESSES THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY THROUGH OUR CHNA. |
| SCHEDULE H, PART V, LINE 20A | AMERY DOES NOT PERFORM ANY ECAS (EXTRAORDINARY COLLECTION ACTIONS), THEREFORE WE WOULD NOT GIVE A PATIENT A WRITTEN NOTICE OF DOING SO. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 6 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - ARMC REHAB SERVICES | ||||
| 220 N KELLER AVENUE | AMERY | WI | 54001 | REHABILITATION |
| 2 - LUCK MEDICAL CLINIC | ||||
| 137 FIRST AVENUE | LUCK | WI | 54853 | RURAL HEALTH CLINIC |
| 3 - TURTLE LAKE MEDICAL CLINIC | ||||
| 550 MARTIN AVENUE | TURTLE LAKE | WI | 54889 | RURAL HEALTH CLINIC |
| 4 - CLEAR LAKE CLINIC | ||||
| 357 THIRD AVENUE | CLEAR LAKE | WI | 54005 | RURAL HEALTH CLINIC |
| 5 - LUCK PT & FITNESS | ||||
| 2547 STATE ROAD 35 SUITE 5 | LUCK | WI | 54853 | PHYSICAL THERAPY |
| 6 - AMERY REGIONAL MEDICAL CENTER WEST | ||||
| 230 DERONDA STREET | AMERY | WI | 54001 | 10 BED INPATIENT DPU OF AMERY |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | AMERY REGIONAL MEDICAL CENTER (AMERY) USES THE COST-TO-CHARGE RATIO METHOD WHEN CALCULATING THE AMOUNTS REPORTED ON PART I. LINE 7. THE COST-TO-CHARGE RATIO WAS DERIVED USING WORKSHEET 2, RATIO OF PATIENT CARE-COST-TO-CHARGE, FROM THE SCHEDULE H INSTRUCTIONS |
| PART III, LINE 2: | AMERY USES THE COST TO CHARGE METHODOLOGY TO DETERMINE AMOUNT REPORTED AS BAD DEBT. AMERY BELIEVES THAT MANY OF THE ACCOUNTS IN BAD DEBT WOULD HAVE QUALIFIED FOR CHARITY IF THE GUARANTORS WOULD HAVE COMPLETED THE FINANCIAL ASSISTANCE PAPERWORK. AMERY IS PROVIDING SERVICES TO INDIVIDUALS/FAMILIES IN ITS SERVICE AREA THAT ARE UNABLE/UNWILLING TO PAY FOR THESE SERVICES. THIS IS COMPARABLE TO PROVIDING CHARITY CARE WHICH AMERY ALSO INCLUDES AS A COMMUNITY BENEFIT. |
| PART III, LINE 4: | SEE THE ORGANIZATION'S FOOTNOTES 1.O AND 1.Q, ON PAGE 25 OF THE ATTACHED CONSOLIDATED FINANCIAL STATEMENT. |
| PART III, LINE 8: | AMERYS MEDICARE COST IS DERIVED BASED ON THE RATIO OF MEDICARE FFS CHARGES TO TOTAL CHARGES MULTIPLIED BY TOTAL EXPENSES (LESS CHARITY CARE & BAD DEBT). NONE OF THE MEDICARE FFS LOSS REPORTED ON SCHEDULE H, PART III, LINE 7 IS TREATED AS COMMUNITY BENEFIT ON SCHEDULE H, PART I, LINE 7A. |
| PART III, LINE 9B: | COLLECTIONS PRACTICESAMERY'S DEBT COLLECTION POLICY CONTAINS PROVISIONS ON COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO BE ELIGIBLE FOR CHARITY CARE OR FINANCIAL ASSISTANCE. AMERY WILL NOT REFER ANY ACCOUNT TO A THIRD PARTY DEBT COLLECTION AGENCY UNLESS IT HAS CONFIRMED THAT:- THERE IS REASONABLE BASIS TO BELIEVE THAT THE PATIENT OWES THE DEBT.- ALL KNOWN THIRD-PARTY PAYERS HAVE BEEN PROPERLY BILLED, AND THE PATIENT IS RESPONSIBLE FOR THE REMAINING DEBT.- IF THE PATIENT HAS INDICATED AN INABILITY TO PAY THE FULL AMOUNT, THE PATIENT HAS BEEN OFFERED A REASONABLE PAYMENT PLAN. AMERY WILL NOT REFER PATIENTS TO DEBT COLLECTION AGENCIES WHO ARE PERFORMING AS SPECIFIED IN THEIR PAYMENT PLANS.- THE PATIENT HAS BEEN GIVEN AN OPPORTUNITY TO SUBMIT A CHARITY CARE (FINANCIAL ASSISTANCE) APPLICATION. IF THE PATIENT HAS SUBMITTED AN APPLICATION FOR CHARITY CARE, ALL COLLECTION ACTIVITY WILL BE SUSPENDED UNTIL THE APPLICATION HAS BEEN PROCESSED. |
| PART VI, LINE 2: | IN 2018, A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) COLLABORATION WAS CONDUCTED FOR HEALTHPARTNERS AND SIX OF ITS HOSPITALS, INCLUDING REGIONS HOSPITAL, LAKEVIEW HOSPITAL, HUDSON HOSPITAL & CLINIC, WESTFIELDS HOSPITAL & CLINIC, AMERY HOSPITAL & CLINIC, AND PARK NICOLLET METHODIST HOSPITAL) BY THE IMPROVEGROUP TO DETERMINE THE GREATEST HEALTH NEEDS IN THE COMMUNITIES THEY SERVE. THESE HOSPITALS SERVE SIMILAR COMMUNITIES AND HAVE OVERLAPPING STUDY AREAS. THE SYSTEM'S STUDY AREA IS DEFINED AS DAKOTA, HENNEPIN, RAMSEY, SCOTT, AND WASHINGTON COUNTIES IN MINNESOTA AND POLK AND ST. CROIX COUNTIES IN WISCONSIN. AMERY'S SPECIFIC STUDY AREA IS DEFINED AS: BARRON COUNTY POLK COUNTYMETHODOLOGYIN 2018, HEALTHPARTNERS AND AMERY CONTRACTED WITH THE IMPROVE GROUP TO ANALYZE AND REPORT ON THE DATA DESCRIBING THE COMMUNITIES WE SERVE. HEALTHPARTNERS PROVIDED THE IMPROVE GROUP WITH THE DEFINITION OF THE HOSPITAL'S SERVICE AREA, THE INDICATORS TO STUDY FOR THE HEALTH AND DEMOGRAPHIC DATA SUMMARIES AND DATA COLLECTED DURING COMMUNITY CONVERSATIONS. COMMUNITY INPUT WAS COLLECTED IN PARTNERSHIP WITH HEALTHPARTNERS AND PARTNER ORGANIZATIONS THROUGH COMMUNITY CONVERSATIONS AND MULTIPLE SURVEYS. THE IMPROVE GROUP THEN GATHERED SECONDARY DATA FROM PUBLIC SOURCES, ANALYZED COMMUNITY INPUT DATA AND DEVELOPED SUMMARY REPORTS TO GUIDE A PRIORITIZATION PROCESS. PRIORITIZED NEEDSTHE HEALTHPARTNERS CHNA TEAM INCLUDED REPRESENTATIVES FROM EACH HEALTHPARTNERS HOSPITAL AND HEALTHPARTNERS LEADERSHIP. ON SEPTEMBER 14, 2018, THE CHNA TEAM MET TO REVIEW THE DATA AND PRIORITIZE THE COMMUNITY HEALTH NEEDS ACROSS THE SYSTEM. HEALTHPARTNERS COLLECTIVELY PRIORITIZED COMMUNITY HEALTH NEEDS USING A PROCESS INFORMED BY THE HANLON METHOD AND OTHER COMMONLY USED PRIORITIZATION METHODS. EACH HOSPITAL SHARED ITS 4 OR 5 PRIORITY TOPIC AREAS AND RATIONALE FOR EACH TOPIC AREA BASED ON: SIZE: NUMBER OF PERSONS AFFECTED, TAKING INTO ACCOUNT VARIANCE FROM BENCHMARK DATA AND TARGETS; SERIOUSNESS: THE DEGREE TO WHICH THE PROBLEM LEADS TO DEATH, DISABILITY AND IMPAIRMENT OF ONE'S QUALITY OF LIFE (MORTALITY AND MORBIDITY); EQUITY: DEGREE TO WHICH SPECIFIC GROUPS ARE AFFECTED BY THE PROBLEM; VALUE: THE IMPORTANCE OF THE PROBLEM TO THE COMMUNITY; AND CHANGE: WHAT IS THE SAME AND WHAT IS DIFFERENT FROM YOUR PREVIOUS CHNA? HEALTHPARTNERS HOSPITALS WORKED IN A THOROUGH, FACILITATED LARGE AND SMALL GROUP PROCESS TO REACH CONSENSUS ON TOP PRIORITIES. THE CHNA TEAM CONSIDERED THE CRITERIA DESCRIBED ABOVE AS WELL AS COMMUNITY INPUT DATA IN THESE DISCUSSIONS. THE FIVE PRIORITIES ARE OF EQUAL IMPORTANCE AND ARE PRESENTED IN ALPHABETICAL ORDER. THE FIVE PRIORITY AREAS ARE:ACCESS TO CAREACCESS TO CARE REFERS TO HAVING EQUITABLE ACCESS TO APPROPRIATE, CONVENIENT AND AFFORDABLE HEALTH CARE. THIS INCLUDES FACTORS SUCH AS PROXIMITY TO CARE, ACCESS TO PROVIDERS, COST, INSURANCE COVERAGE, MEDICAL TRANSPORTATION, CARE COORDINATION WITHIN THE HEALTH CARE SYSTEM AND CULTURAL SENSITIVITY AND RESPONSIVENESS. ACCESS TO HEALTHACCESS TO HEALTH REFERS TO THE SOCIAL AND ENVIRONMENTAL CONDITIONS THAT DIRECTLY AND INDIRECTLY AFFECT PEOPLE'S HEALTH, SUCH AS HOUSING, INCOME, EMPLOYMENT, EDUCATION AND MORE. THESE FACTORS, ALSO REFERRED TO AS SOCIAL DETERMINANTS OF HEALTH, DISPROPORTIONATELY IMPACT LOW INCOME COMMUNITIES AND COMMUNITIES OF COLOR. MENTAL HEALTH AND WELL-BEINGMENTAL HEALTH AND WELL-BEING REFERS TO THE INTERCONNECTION BETWEEN MENTAL ILLNESS, MENTAL HEALTH, MENTAL WELL-BEING AND THE ASSOCIATED STIGMA. POOR MENTAL HEALTH IS ASSOCIATED WITH POOR QUALITY OF LIFE, HIGHER RATES OF CHRONIC DISEASE AND A SHORTER LIFESPAN.NUTRITION AND PHYSICAL ACTIVITYNUTRITION AND PHYSICAL ACTIVITY REFERS TO EQUITABLE ACCESS TO NUTRITION, PHYSICAL ACTIVITY AND FOOD AND FEEDING CHOICES. POOR NUTRITION AND PHYSICAL INACTIVITY ARE MAJOR CONTRIBUTORS TO OBESITY AND CHRONIC DISEASES SUCH AS DIABETES, HEART DISEASE AND STROKE, WHICH DISPROPORTIONALLY IMPACT LOW INCOME COMMUNITIES AND COMMUNITIES OF COLOR. SUBSTANCE ABUSESUBSTANCE ABUSE AND ADDICTION ARE THE EXCESSIVE USE OF SUBSTANCES INCLUDING ALCOHOL, TOBACCO, PRESCRIPTION DRUGS, OPIOIDS AND OTHER DRUGS IN A MANNER THAT IS HARMFUL TO HEALTH AND WELL-BEING. PRIORITIES NOT SELECTED: HEALTHPARTNERS DISCUSSED AND CONSIDERED ADDITIONAL OR ALTERNATIVE PRIORITIES DURING THE PRIORITIZATION PROCESS, INCLUDING: OLDER ADULT HEALTH/AGING, MATERNAL AND CHILD HEALTH, ENVIRONMENTAL HEALTH AND INJURY AND VIOLENCE. THESE NEEDS WERE NOT SELECTED AS TOP FIVE PRIORITIES IN THE CONSENSUS BUILDING PROCESS; HOWEVER, THE THEMES WILL BE CONSIDERED IN THE IMPLEMENTATION FOR THE SELECTED PRIORITY AREAS. |
| PART VI, LINE 3: | AMERY'S PATIENT FINANCIAL SERVICES DEPARTMENT WORKS WITH EACH PATIENT REGARDING ACCOUNT BALANCES LEFT TO PATIENT RESPONSIBILITY. PATIENTS WHO ARE NOT ALREADY ON GOVERNMENT ASSISTANCE OR HAVE LIMITED ASSISTANCE ARE REFERRED TO AMERY'S HEALTH BENEFITS COUNSELOR, WHO WORKS WITH THEM TO EVALUATE ASSISTANCE OPTIONS AND ASSISTS IN GETTING APPLICATIONS OR CONTACTS WITH THE APPROPRIATE PROGRAMS. IF ADDITIONAL ASSISTANCE IS NEEDED, THE COUNSELOR WILL WORK WITH THE PATIENT TO APPLY FOR FINANCIAL ASSISTANCE WITH AMERY AND HELPS THEM THROUGH THE PROCESS. THE FINANCIAL ASSISTANCE PROGRAM AND APPLICATION ARE LOCATED ON AMERY'S INTERNET SITE TO ALLOW PATIENTS DIRECT ACCESS TO THIS INFORMATION. |
| PART VI, LINE 4: | THE AMERY REGIONAL MEDICAL CENTER (AMERY) SERVICE AREA INCLUDED 15 DIFFERENT ZIP CODES IN NORTHWEST WISCONSIN THAT PRIMARILY REPRESENT POLK COUNTY. IT INCLUDES THREE RURAL HEALTH CLINICS IN LUCK, TURTLE LAKE, AND CLEAR LAKE, WHICH ARE ALL MEDICALLY UNDERSERVED AREAS. THE AMERY COMMUNITY IS ALSO CONSIDERED A MENTAL HEALTH MEDICALLY UNDERSERVED AREA. THE WOUND CENTER & INPATIENT PSYCH SERVICE DRAWS FROM OUTSIDE AMERY'S NORMAL SERVICE AREA. |
| PART VI, LINE 5: | TEN OF AMERY'S THIRTEEN BOARD MEMBERS LIVE IN AMERY'S SERVICE AREA. AMERY HAS AN OPEN MEDICAL STAFF WHICH INCLUDES PROVIDERS FROM THE COMMUNITY, AND OTHER COMMUNITIES AS WELL AS THE TWIN CITIES. ANY SURPLUS FUNDS GENERATED ARE USED TO PURCHASE EQUIPMENT, BUILD NEW FACILITIES, AND EXPAND SERVICES AVAILABLE IN AMERY'S COMMUNITY. |
| PART VI, LINE 6: | HEALTHPARTNERS AND AMERY HAVE HAD A LONG-STANDING RELATIONSHIP, WITH HEALTHPARTNERS EMPLOYING AND SOURCING PHYSICIANS AND MID-LEVEL PRACTITIONERS TO AMERY FOR AMERY'S PRIMARY CARE CLINICS. IN 2014, AMERY BECAME PART OF THE HEALTHPARTNERS FAMILY OF MISSION-DRIVEN NON-PROFIT ORGANIZATIONS. AS PART OF HEALTHPARTNERS, AMERY USES HEALTHPARTNERS' INTEGRATED ELECTRONIC HEALTH RECORD SYSTEM, PARTICIPATES IN COORDINATED CHNA PROCESSES AND IMPLEMENTATION STRATEGIES, AND ACCESSES CENTRALIZED SUPPORT SERVICES IN FINANCE, LEGAL, IS&T, AND QUALITY. THE FOUR HEALTHPARTNERS HOSPITALS IN THE ST. CROIX VALLEY - STILLWATER MN AND HUDSON, NEW RICHMOND, AND AMERY WI - WORK TOGETHER TO ESTABLISH ACCESSIBLE AND COORDINATED SPECIALTY SERVICES FOR VALLEY RESIDENTS. EXAMPLES OF THESE SERVICES INCLUDE RADIATION THERAPY ON THE NEW RICHMOND CAMPUS, BREAST DIAGNOSTICS ON THE STILLWATER CAMPUS, AND GERIATRIC BEHAVIORAL HEALTH SERVICES ON THE ARMC CAMPUS. HEALTHPARTNERS INCLUDES INSURANCE AND HMO (HEALTH MAINTENANCE ORGANIZATION) ENTITIES THAT PROVIDE CARE COORDINATION, DISEASE MANAGEMENT, ON-LINE CARE OF BASIC CONDITIONS, A 24-HOUR/7-DAY PER WEEK NURSE LINE, AND OTHER SERVICES THAT ENHANCE CARE OF MEMBERS, PATIENTS AND THE COMMUNITY. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | WI |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (15 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| THEODORE T WEGLEITNER | ||||||||||||||
| DIRECTOR | $0 | $458,276 | $0 | $118,918 | $0 | $9,786 | $0 | $85,446 | $0 | $39,156 | $0 | $711,582 | $0 | $0 |
| MARTIN E RICHARDS MD | ||||||||||||||
| DIRECTOR | $0 | $397,377 | $0 | $8,550 | $0 | $107,016 | $0 | $21,375 | $0 | $38,082 | $0 | $572,400 | $0 | $0 |
| PATRICK D SURA MD | ||||||||||||||
| CHIEF MEDICAL OFFICER | $0 | $372,773 | $0 | $5,425 | $0 | $44,965 | $0 | $21,375 | $0 | $36,781 | $0 | $481,319 | $0 | $0 |
| DOUGLAS E JOHNSON | ||||||||||||||
| CFO | $0 | $325,510 | $0 | $58,036 | $0 | $32,085 | $0 | $5,700 | $0 | $34,574 | $0 | $455,905 | $0 | $0 |
| DEBRA A RUDQUIST | ||||||||||||||
| PRESIDENT | $0 | $297,382 | $0 | $36,834 | $0 | $4,147 | $0 | $22,992 | $0 | $32,650 | $0 | $394,005 | $0 | $0 |
| ROSS R BULLARD | ||||||||||||||
| DIRECTOR & TREASURER | $0 | $223,974 | $0 | $28,229 | $0 | $3,720 | $0 | $41,182 | $0 | $34,790 | $0 | $331,895 | $0 | $0 |
| ANN R SEAGREN MD | ||||||||||||||
| DIRECTOR | $0 | $178,395 | $0 | $0 | $0 | $63,942 | $0 | $46,497 | $0 | $33,556 | $0 | $322,390 | $0 | $0 |
| JASON J LUHRS | ||||||||||||||
| FORMER CFO | $0 | $223,370 | $0 | $33,735 | $0 | $12,982 | $0 | $17,706 | $0 | $33,643 | $0 | $321,436 | $0 | $0 |
| DYLAN COE MD | ||||||||||||||
| DIRECTOR | $0 | $199,513 | $0 | $0 | $0 | $7,101 | $0 | $60,987 | $0 | $19,706 | $0 | $287,307 | $0 | $0 |
| SANDRA M REED | ||||||||||||||
| VP - AMBULATORY CARE | $159,331 | $0 | $14,855 | $0 | $20,246 | $0 | $7,692 | $0 | $25,333 | $0 | $227,457 | $0 | $0 | $0 |
| MARK A TRYGGESTAD | ||||||||||||||
| DIRECTOR OF PHARMACY | $149,742 | $0 | $1,259 | $0 | $32,829 | $0 | $7,019 | $0 | $13,400 | $0 | $204,249 | $0 | $0 | $0 |
| MARYANN SCOGLIO CANP | ||||||||||||||
| DIRECTOR | $0 | $126,740 | $0 | $0 | $0 | $22,995 | $0 | $11,700 | $0 | $30,397 | $0 | $191,832 | $0 | $0 |
| ANTHONY R GOULD | ||||||||||||||
| ANCILLARY SERVICES | $119,922 | $0 | $1,259 | $0 | $10,301 | $0 | $5,247 | $0 | $34,836 | $0 | $171,565 | $0 | $0 | $0 |
| ANN M SCHILLING | ||||||||||||||
| HR SR DIRECTOR | $121,155 | $0 | $4,954 | $0 | $610 | $0 | $5,437 | $0 | $33,922 | $0 | $166,078 | $0 | $0 | $0 |
| BENJAMIN D BOGLE | ||||||||||||||
| PROVIDER-APNP | $109,245 | $0 | $0 | $0 | $14,365 | $0 | $3,832 | $0 | $34,205 | $0 | $161,647 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | AMERY'S PRESIDENT AND ITS OFFICERS ARE EMPLOYED BY REGIONS HOSPITAL (REGIONS) OR BY GROUP HEALTH PLAN, INC. (GHI), BOTH OF WHICH ARE RELATED ORGANIZATIONS, OR BY AMERY. GHI, REGIONS, AND AMERY HAVE AN ANNUAL PROCESS TO REVIEW THE MARKET COMPARABILITY OF THE TOTAL COMPENSATION OF AMERY'S PRESIDENT AND OTHER OFFICERS. |
| PART I, LINE 4B | DEFERRED COMPENSATION IN COLUMN C OF SCHEDULE J, PART II INCLUDES AMOUNTS FROM A NONQUALIFIED 457(F) PLAN FOR THE FOLLOWING DIRECTOR: THEODORE T. WEGLEITNER $41,250 |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|
| VILLAGE OF LUCK WISCONSIN | |||||||
| A | 396006307 | 2011-04-28 | $8,500,000 | REFINANCE EXISTING DEBT | 0 | 0 | 0 |
| CITY OF AMERY WISCONSIN | |||||||
| B | 396005378 | 2011-04-13 | $8,500,000 | REFINANCE EXISTING DEBT | 0 | 0 | 0 |
| VILLAGE OF CLEAR LAKE WISCONSIN | |||||||
| C | 396006238 | 2011-03-29 | $8,500,000 | REFINANCE EXISTING DEBT | 0 | 0 | 0 |
| TOWN OF BLACK BROOK POLK COUNTY WISCONSIN | |||||||
| D | 391169876 | 2011-05-13 | $6,150,000 | REFINANCE EXISTING DEBT | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Other Spent ProceedsOtherSpentProceedsAmt | Substantial CompletionSubstantialCompletionYr | Refunding Tax Exempt BondsRefundingTaxExemptBondsInd | Refunding Taxable BondsRefundingTaxableBondsInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|---|
| A | $6,064,970 | $8,500,000 | $170,000 | $8,330,000 | 2007 | Yes (1) | 0 | Yes (1) | Yes (1) |
| B | $6,057,939 | $8,500,000 | $170,000 | $8,330,000 | 2007 | Yes (1) | 0 | Yes (1) | Yes (1) |
| C | $6,057,939 | $8,500,000 | $170,000 | $8,330,000 | 2007 | Yes (1) | 0 | Yes (1) | Yes (1) |
| D | $4,374,177 | $6,150,000 | $123,000 | $6,027,000 | 2007 | Yes (1) | 0 | Yes (1) | Yes (1) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Private Bus Use By OthersPrivateBusUseByOthersPct | Total Private Business UseTotalPrivateBusinessUsePct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | Yes (1) | 0 | 0 | 0.00090 | 0.00090 | Yes (1) | 0 | 0 |
| B | 0 | Yes (1) | 0 | 0 | 0.00090 | 0.00090 | Yes (1) | 0 | 0 |
| C | 0 | Yes (1) | 0 | 0 | 0.00090 | 0.00090 | Yes (1) | 0 | 0 |
| D | 0 | Yes (1) | 0 | 0 | 0.00090 | 0.00090 | Yes (1) | 0 | 0 |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | Yes (1) | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 |
| B | 0 | Yes (1) | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 |
| C | 0 | Yes (1) | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 |
| D | 0 | Yes (1) | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 |
Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | 0 |
| B | 0 |
| C | 0 |
| D | 0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990, SCHEDULE K, PART IV, LINE 2A THRU 2C | FormAndLineReferenceDesc |
| Explanation | REBATE CALCULATION IS NOT DUE BUT EVERY 5 YEARS. THERE IS NO REBATE CALCULATION DUE FOR ANY BONDS LISTED IN SCHEDULE K, PART I. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TOWN OF LINCOLN POLK COUNTY WISCONSIN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 391406159 | BondIssuerEIN |
| Bond Issued | 2011-05-31 | BondIssuedDt |
| Issue Price | $6,150,000 | IssuePriceAmt |
| Purpose | REFINANCE EXISTING DEBT | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $4,374,177 | RetiredAmt |
| Total Proceeds | $6,150,000 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $123,000 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $1,709,792 | CapitalExpendituresAmt |
| Other Spent Proceeds | $4,317,208 | OtherSpentProceedsAmt |
| Substantial Completion | 2007 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | Yes (1) | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | 0 | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | Yes (1) | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00080 | PrivateBusUseByOthersPct |
| Total Private Business Use | 0.00080 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | Yes (1) | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (1) | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | Yes (1) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 4A - EXEMPT PURPOSE AND ACHIEVEMENTS | CORPORATE STRUCTURE, PURPOSE, GOVERNANCE AMERY REGIONAL MEDICAL CENTER (ARMC), A STATE LICENSED 25-BED, LEVEL IV CRITICAL ACCESS HOSPITAL (CAH), IS A WISCONSIN NON-PROFIT CORPORATION RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE ("IRC") SECTION 501(C)(3) AND IS PART OF THE FAMILY OF HEALTHPARTNERS ORGANIZATIONS ("HEALTHPARTNERS"). FOUNDED IN 1957, HEALTHPARTNERS IS AN INTEGRATED HEALTH CARE ORGANIZATION, PROVIDING HEALTH CARE SERVICES AND HEALTH PLAN FINANCING AND ADMINISTRATION, AND IS THE LARGEST CONSUMER-GOVERNED NONPROFIT HEALTH CARE ORGANIZATION IN THE COUNTRY. HEALTHPARTNERS' MISSION IS TO IMPROVE HEALTH AND WELL-BEING IN PARTNERSHIP WITH OUR MEMBERS, PATIENTS AND COMMUNITY. HEALTHPARTNERS SEEKS TO TRANSFORM HEALTH CARE THROUGH A RELENTLESS FOCUS ON THE TRIPLE AIM - PROVIDING EXCEPTIONAL EXPERIENCE FOR THE INDIVIDUAL, IMPROVING THE HEALTH OF THE POPULATION, AND MAINTAINING AFFORDABILITY. HEALTHPARTNERS, INC. (HPI) IS A MINNESOTA NONPROFIT CORPORATION AND LICENSED HEALTH MAINTENANCE ORGANIZATION (HMO) RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(4) AND IS THE PARENT ENTITY OF HEALTHPARTNERS ORGANIZATIONS REFERRED TO COLLECTIVELY AS "HEALTHPARTNERS". HEALTHPARTNERS INCLUDES AN ARRAY OF TAX-EXEMPT AND TAXABLE ORGANIZATIONS. HEALTHPARTNERS PROVIDES A FULL RANGE OF HEALTH CARE DELIVERY AND HEALTH PLAN SERVICES INCLUDING INSURANCE, PATIENT CARE, ADMINISTRATION AND HEALTH AND WELL-BEING PROGRAMS. HEALTHPARTNERS HEALTH PLANS SERVE MORE THAN 1.8 MILLION MEDICAL AND DENTAL MEMBERS NATIONWIDE. HEALTHPARTNERS MEDICAL CARE SYSTEM INCLUDES MORE THAN 1,800 EMPLOYED PHYSICIANS AND DENTISTS, EIGHT OWNED HOSPITALS WITH OVER 1,000 ACUTE CARE BEDS, OVER 129 PRIMARY AND SPECIALTY CARE MEDICAL FACILITIES AND DENTAL FACILITIES WITH PRACTICES IN MINNESOTA AND WESTERN WISCONSIN SERVING MORE THAN 1.27 MILLION PATIENTS. HEALTHPARTNERS HEALTH PLANS CONTRACT WITH OTHER PRIMARY AND SPECIALTY MEDICAL FACILITIES AND DENTAL FACILITIES, PHYSICIAN GROUPS, HOSPITALS AND RELATED HEALTHCARE PROVIDERS TO SERVE PLAN MEMBERS. HEALTHPARTNERS ALSO PROVIDES MEDICAL EDUCATION AND TRAINING TO MEDICAL PROFESSIONALS AND CONDUCTS RESEARCH AND FUNDRAISING ACTIVITIES THAT SUPPORT THE HEALTH CARE DELIVERY SYSTEM. HEALTHPARTNERS COLLABORATES WITH OTHER PLANS, CARE PROVIDERS AND OTHER COMMUNITY AND BUSINESS ORGANIZATIONS IN THE REGION AND THROUGHOUT THE NATION TO INCREASE ACCESS, CREATE AND SHARE QUALITY MEASURES AND INITIATIVES, PARTICIPATE IN DEVELOPMENT OF PUBLIC POLICY, AND COLLABORATE IN IMPROVEMENTS THAT SUPPORT THE TRIPLE AIM. AMONG HEALTHPARTNERS' SIGNATURE INITIATIVES CONTINUING IN 2020 ARE TOTAL COST OF CARE MEASUREMENTS (A NATIONALLY RECOGNIZED METRIC, ENDORSED BY THE NATIONAL QUALITY FORUM, ENABLING MEASUREMENT AND INCENTIVES BASED ON COORDINATION AND EVIDENCE-BASED PRACTICES), MENTAL HEALTH (REDUCING STIGMA, AND ASSURING ACCESS TO HIGH QUALITY CARE IN THE MOST APPROPRIATE SETTINGS), CHILDREN'S HEALTH (IMPROVING CHILD HEALTH BY PROMOTING EARLY BRAIN DEVELOPMENT, PROVIDING FAMILY CENTERED CARE, AND STRENGTHENING COMMUNITIES), AND SUSTAINABILITY (ENERGY EFFICIENCY, WASTE REDUCTION, AND RESOURCE MANAGEMENT). A COMPLETE LISTING OF ALL ORGANIZATIONS WITHIN HEALTHPARTNERS, AND THE RELATIONSHIP BETWEEN THEM, CAN BE FOUND ON SCHEDULE R WITHIN THIS 990 RETURN. DETAILED INFORMATION ABOUT THE COMMUNITY BENEFIT ACTIVITIES AND ACCOMPLISHMENTS OF EACH TAX-EXEMPT ORGANIZATION CAN BE FOUND IN THE INDIVIDUAL FORM 990 RETURN FOR THAT ORGANIZATION. HEALTHPARTNERS, INC. (HPI) IS THE PARENT ENTITY OF HEALTHPARTNERS AND IS A MINNESOTA NON-PROFIT CORPORATION AND LICENSED HEALTH MAINTENANCE ORGANIZATION (HMO) RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(4). HPI IS THE SOLE CORPORATE MEMBER OF HPI-RAMSEY, A MINNESOTA NON-PROFIT CORPORATION RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). IN TURN, HPI-RAMSEY IS THE SOLE CORPORATE MEMBER OF REGIONS HOSPITAL, REGIONS HOSPITAL FOUNDATION, CAPITOL VIEW TRANSITIONAL CARE CENTER, STILLWATER HEALTH SYSTEM (LAKEVIEW HEALTH), RAMSEY INTEGRATED HEALTH SERVICES AND RH-WISCONSIN, INC., ALL OF WHICH ARE NON-PROFIT CORPORATIONS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). RH-WISCONSIN AND GROUP HEALTH PLAN, INC. (GHI) ARE CORPORATE MEMBERS OF ARMC. GHI IS A MINNESOTA NON-PROFIT CORPORATION AND LICENSED HEALTH MAINTENANCE ORGANIZATION (HMO) RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). IN TURN, ARMC IS THE SOLE CORPORATE MEMBER OF THE AMERY REGIONAL MEDICAL CENTER FOUNDATION (FOUNDATION) A WISCONSIN NON-STOCK CORPORATION EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3). BENEFIT TO THE COMMUNITY: 1. COMMUNITY HEALTH IMPROVEMENT SERVICES: $ 164,088 - COMMUNITY HEALTH EDUCATION EACH YEAR, ARMC HELPS EDUCATE THE LOCAL COMMUNITIES IN REGARD TO HEALTH ISSUES BY PROVIDING THEM A VARIETY OF COMMUNITY EDUCATION. THE COVID-19 PANDEMIC EMERGED IN OUR COMMUNITY EARLY IN 2020 AND A RAPID MITIGATION RESPONSE FOLLOWED, WHICH INCLUDED THE PAUSE OF ALL IN-PERSON ACTIVITIES, CLASSES AND EVENTS. THIS DRASTICALLY IMPACTED OUR COMMUNITY REACH COMPARED TO PREVIOUS YEARS AND REDUCED ABILITY AND CAPACITY FOR MANY COMMUNITY BENEFIT ACTIVITIES. OUR ORGANIZATION WAS ABLE TO SHIFT AND SERVE OUR COMMUNITY IN NEW AND DIFFERENT WAYS, INCLUDING SOME DIGITAL/VIRTUAL FORMATS, INCLUDING PODCASTS. SIX PODCASTS WERE RECORDED IN 2020, PRIMARILY WITH A MENTAL HEALTH FOCUS ON TOPICS SUCH AS DEPRESSION, ANXIETY AND STRESS RELIEF. IN TOTAL, THESE HAVE BEEN ACCESSED OVER 400 TIMES. PRIOR TO THE PAUSE OF IN-PERSON ACTIVITIES, THERE WERE CLASSES INCLUDING: ADVANCED CARE PLANNING, MENTAL HEALTH FIRST AID, AND FITNESS FOR WEIGHT MANAGEMENT. MAKE IT OK: ARMC IS A PARTNER IN MAKE IT OK, A PROGRAM FOCUSED ON REDUCING THE STIGMA OF MENTAL ILLNESS. ARMC HAS EXPANDED THE REACH OF THIS HEALTHPARTNERS CAMPAIGN INTO OUR COMMUNITY THROUGH TRAINING LOCAL MAKE IT OK AMBASSADORS, LOCAL PROMOTION, AND PARTNERSHIPS WITH LOCAL AGENCIES AND PUBLIC HEALTH. THERE WERE 81,349 WEBSITE VISITS WITH 62,780 UNIQUE VISITORS TO MAKEITOK.ORG IN 2020. IN 2020, THE REACH OF THE MAKE IT OK CAMPAIGN EXPANDED THROUGH TRAINING LOCAL AMBASSADORS, PROMOTION, AND PARTNERSHIPS WITH LOCAL AGENCIES AND PUBLIC HEALTH. DESPITE THE CHALLENGE OF COVID 19, MAKE IT OK MADE PROGRESS IN REDUCING THE STIGMA OF MENTAL ILLNESS WITH THE FOLLOWING IMPACT IN 2020: MAKE IT OK HELD 11 AMBASSADOR TRAININGS BOTH IN PERSON AND VIRTUALLY, MOBILIZING AN ADDITIONAL 200 AMBASSADORS. MAKE IT OK REACHED MORE THAN 2,000 PEOPLE THROUGH COMMUNITY PRESENTATIONS, EVENTS AND TABLING. MORE THAN 90 PERCENT OF PARTICIPANTS REPORTED INCREASED KNOWLEDGE ABOUT MENTAL ILLNESS AND GREATER CONFIDENCE IN TALKING ABOUT MENTAL ILLNESS AS A RESULT OF THE PRESENTATIONS. MAKE IT OK HAS BEEN A KEY PARTNER IN A COMPREHENSIVE APPROACH TO MENTAL HEALTH FOR STUDENTS IN THE LOCAL SCHOOLS. IN A SURVEY OF MAKE IT OK AMBASSADORS IN OCTOBER 2020, 88% SAID THAT MAKE IT OK WAS MORE IMPORTANT THAN EVER IN A TIME OF SOCIAL ISOLATION AND EMOTIONAL STRESS FOR MANY IN OUR COMMUNITIES. MORE THAN 500 AMBASSADORS ARE NOW TRAINED IN THE ST. CROIX VALLEY AREA. MORE THAN 90 PERCENT OF PARTICIPANTS REPORTED INCREASED KNOWLEDGE ABOUT MENTAL ILLNESS AND GREATER CONFIDENCE IN TALKING ABOUT MENTAL ILLNESS AS A RESULT OF THE PRESENTATIONS. |
| PART III, CONT. | POWERUP: SINCE 2015, ARMC HAS SUPPORTED POWERUP, A COMMUNITYWIDE HEALTH INITIATIVE THAT INSPIRES AND ENGAGES THE ENTIRE COMMUNITY TO PROMOTE BETTER EATING AND PHYSICAL ACTIVITIES SO YOUTH CAN REACH THEIR FULL POTENTIAL. OUR WORK WITH HUNDREDS OF PARTNERS ACROSS THE REGION HAS RESULTED IN A HIGH LEVEL OF COMMUNITY AND SCHOOL ENGAGEMENT, STRONGER SCHOOL WELLNESS POLICIES AND PRACTICES; MORE FREE AND LOW-COST OPTIONS FOR PHYSICAL ACTIVITY INCLUDING OPEN GYMS; PARTNERSHIPS WITH STATE AND LOCAL PARKS; TRANSFORMED FOOD PANTRIES, CAFETERIAS AND CONCESSIONS; AND COMMUNITY MOMENTUM TO CREATE CHANGE. POWERUP COMMUNITY ENGAGEMENT HAS GROWN OVER TIME AND ADAPTED DURING COVID-19 COMMUNITY AND SCHOOL VIRTUAL PROGRAMS, RESOURCES AND SOCIAL MEDIA ENGAGEMENT. EVEN WITH THESE LIMITS FOR OUTREACH, MORE THAN 75,000 ENGAGED IN THE ST. CROIX VALLEY AREA IN 2020 THROUGH EVENTS, CLASSES, OUTREACH PROGRAMS AND GROWING ONLINE RESOURCES TO PROMOTE BETTER EATING AND MOVING MORE. KEY STRATEGIES AND RESOURCES INCLUDE: NEW POWERUP4KIDS.ORG WEB PLATFORM WITH IMPROVED NAVIGATION, NEW RESOURCES FOR AT-HOME FAMILY ACTIVITIES AND SCHOOL RESOURCES FOR VIRTUAL AND IN-PERSON LEARNING ENVIRONMENTS. POWERUP ONLINE RECIPE GALLERY, WITH MORE THAN 300 KIDAPPROVED RECIPES. POWERUP VIDEO GALLERY FOR SCHOOLS AND FAMILIES WITH PHYSICAL ACTIVITY AND FOOD IDEAS FOR KIDS, CLASSROOMS AND FAMILIES. POWERUP SCHOOL CHALLENGE PROGRAM WAS COMPLETELY REVISED TO PROVIDE SCHOOLS AND YOUTH SERVING ORGANIZATIONS TO COMPLETE THE CHALLENGE IN A FLEXIBLE WAY, ONLINE OR IN PERSON. THE PROGRAM INSPIRES STUDENTS TO EAT BETTER AND MOVE MORE, AND IN 2020 REACHED ELEMENTARY AGE STUDENTS IN 476 CLASSROOMS IN 23 ST. CROIX VALLEY AREA SCHOOLS. THE TOTAL PROGRAM REACHED STUDENTS IN 54 SCHOOLS AND MORE THAN 900 CLASSROOMS THROUGHOUT MINNESOTA AND WISCONSIN. THE THREE WEEK WINTER WARMUP CHALLENGE INSPIRED KIDS TO STAY ACTIVE DURING THE COLD MONTHS AND WAS IMPLEMENTED IN LOCAL SCHOOLS IN A VIRTUAL FORMAT, REACHING 70 ELEMENTARY CLASSROOMS IN FOUR VALLEY SCHOOL DISTRICTS. POWERUP WORKED WITH PARTNERS TO HELP INSPIRE AND INFLUENCE THEIR COMMUNITIES, INCLUDING 19 OPEN GYMS IN JANUARY AND FEBRUARY 2020 PRIOR TO RESTRICTIONS. POWERUP COLLABORATES WITH OTHER PARTNERS TO DISSEMINATE BEST PRACTICES FOR CREATING COMMUNITY CHANGE. POWERUP CONCEIVED AND PILOTED METHODS TO TRANSFORM FOOD SHELVES AND IS A FOUNDING PARTNER OF THE SUPERSHELF PROJECT, TRANSFORMING FOOD SHELVES TO MAKE HEALTHY FOOD APPEALING AND ACCESSIBLE FOR ALL. STARTING AS A PILOT IN ONE COMMUNITY, SUPERSHELF IS NOW A ROBUST NIH RESEARCH STUDY WITH 30 FOOD SHELVES TRANSFORMED IN THE REGION AND DEMONSTRATING NATIONAL INFLUENCE TO IMPROVE THE QUALITY OF FOOD FOR THOSE WHO ARE FOOD INSECURE. RESULTS HAVE BEEN PUBLISHED IN PEER REVIEWED JOURNALS (SUPERSHELFMN.ORG). POWERUP HAS A LONG-TERM EVALUATION PLAN TO MONITOR RESULTS. KEY RESULTS INCLUDE: COMMUNITY-WIDE SURVEYS OF RESIDENT FAMILIES WITH CHILDREN HAVE SHOWN STATISTICALLY SIGNIFICANT INCREASES IN PHYSICAL ACTIVITY LEVELS AMONG YOUTH OVER TIME IN TARGETED COMMUNITIES. A REVIEW OF BMI DATA FOR CHILDREN 6-10 YEARS OLD SHOWED A STATISTICALLY SIGNIFICANT POSITIVE DOWNWARD TREND IN THE BMIS OF CHILDREN IN SPECIFIC POWERUP COMMUNITIES COMPARED TO OTHER PATIENTS IN THE BROADER CARE SYSTEM. THESE ARE EXCITING RESULTS, SINCE PAST INITIATIVES NATIONWIDE HAVE SHOWN THAT IT IS DIFFICULT TO DEMONSTRATE COMMUNITY-LEVEL CHANGE IN BEHAVIORS OR HEALTH OUTCOMES. TO DEEPEN THE POWERUP STRATEGY WITH OLDER STUDENTS, IN 2020 POWERUP CONTINUED WITH YEAR TWO OF THE POWERUP TEEN LEADERSHIP COUNCIL, WHICH ENCOURAGES MIDDLE AND HIGH SCHOOL STUDENTS TO BECOME CHAMPIONS FOR HEALTHIER LIFESTYLES AMONG THEIR PEERS AND COMMUNITIES. THESE YOUNG ROLE MODELS DESIGN AND IMPLEMENT PROJECTS THAT MAKE IT EASIER FOR THEIR FELLOW STUDENTS TO ENJOY BETTER EATING AND PHYSICAL ACTIVITY. IN 2020, 24 LOCAL YOUTHS FROM DIVERSE BACKGROUNDS WERE RECRUITED AND WERE HIGHLY ENGAGED IN DEVELOPING PROGRAMS FOR THEIR PEERS. THE TEENS ALSO PROVIDE CONSULTATION TO OTHER YOUTH PROGRAMS AND PROJECTS, LOCAL PUBLIC HEALTH AND HEALTHPARTNERS DEPARTMENT OF PEDIATRICS. THEIR INSIGHTS ARE IMPROVING TEEN SERVICES AND PROGRAMS THROUGHOUT THE REGION. - HEALTH CARE SUPPORT SERVICES - $ 81,172 SOCIAL WORKER, HEALTH BENEFIT COUNSELORS, AND PATIENT FINANCIAL SERVICES REPRESENTATIVES PROVIDE HEALTH CARE SUPPORT SERVICES TO INDIVIDUALS ON A ONE-ON-ONE BASIS. THESE STAFF MEMBERS HELP EDUCATE AND ASSIST INDIVIDUALS WITH ADVANCE DIRECTIVE SUPPORT, INFORMATION AND REFERRAL SERVICES, ENROLLMENT ASSISTANCE IN GOVERNMENT PROGRAMS, FINDING OTHER SOURCES OF PAYMENT, AND ACCESSING SERVICES BEYOND MEDICAL CARE. ARMC SPENT $34,341 IN STAFF TIME TO ASSIST PATIENTS IN ENROLLING IN PUBLIC MEDICAL PROGRAMS, FREE DRUG PROGRAMS, AND REFER INDIVIDUALS TO COMMUNITY SERVICES/PUBLIC HEALTH ASSISTANCE. ARMC'S PATIENT EMERGENCY FUND, SUPPORTED BY EMPLOYEES AND STAFF, DONATED OVER $350 TO HELP 20 INDIVIDUALS IN NEED RECEIVE CARE AT ARMC. FUNDS PROVIDED TO INDIVIDUALS WERE FOR EMERGENT NEEDS RELATED TO THEIR HEALTH, INCLUDING EMERGENCY MEDICATIONS AND GAS CARDS. ARMC OPERATES A VAN TRANSPORTATION SERVICE FOR ITS RURAL PATIENT POPULATION. PATIENTS WHO ARE UNABLE TO ARRANGE THEIR OWN TRANSPORTATION TO ARMC FOR CARE AND TREATMENT MAY SCHEDULE A TRANSPORT. PERSONS WHO USE THE SERVICE ARE ASKED TO PAY $2 PER RIDE. OVER 400 PATIENTS USED THIS SERVICE IN 2020, WITH REVENUE OF $2,082 AND OPERATING COSTS OF $48,913. - SOCIAL & ENVIRONMENTAL IMPROVEMENT ACTIVITIES - $60,674 DUE TO THE HEALTH PROFESSIONAL SHORTAGE IN THE ARMC SERVICE AREA, NUMEROUS RESOURCES WERE INVESTED IN PHYSICIAN AND ADVANCED PRACTICE PROVIDER RECRUITMENT, TOTALING AT LEAST $51,000. ARMC WELCOMED TWO FAMILY PRACTICE PHYSICIANS AND ONE NURSE PRACTITIONER WITH OBSTETRICS. ARMC CONTINUES TO PARTNER WITH THE CITY OF AMERY TO OFFER 18 GARDENING PLOTS AT THE COMMUNITY GARDEN LOCATED ON ARMC GROUNDS. 2. HEALTH PROFESSIONAL EDUCATION: $32,712 IN 2020, ARMC PROVIDED CLINICAL TRAINING FOR 86 NURSES, TWO CERTIFIED REGISTERED NURSE ANESTHETIST STUDENTS, AND THREE PHARMACY STUDENTS. EACH YEAR, ARMC AND THE FOUNDATION PROVIDE SEVEN $1,000 SCHOLARSHIPS TO LOCAL HIGH SCHOOL SENIORS PURSUING A CAREER IN A HEALTH-RELATED FIELD. ARMC'S SHARE OF THE COST WAS $3,500. 3. SUBSIDIZED HEALTH SERVICES: ARMC IS COMMITTED TO PROVIDING NEEDED SERVICES EVEN AT A FINANCIAL LOSS. IN 2020, LOSS ON OUTPATIENT HEALTH SERVICES INCLUDING PRIMARY CLINIC, SPECIALTY CLINIC, AND SATELLITE CLINICS IN LUCK, TURTLE LAKE, AND CLEAR LAKE TOTALED $2,534,285. 4. FINANCIAL CONTRIBUTIONS: $ 8,519 - CASH DONATIONS - ARMC HELPED VARIOUS NON-PROFIT ORGANIZATIONS, COMMUNITY GROUPS, AND SCHOOL PROGRAMS THROUGH CASH DONATIONS TOTALING $5,819. - IN-KIND DONATIONS - IN-KIND SERVICES DONATED INCLUDED STAFF HOURS SPENT IN SUPPORT OF LOCAL COMMUNITY BOARDS OR COMMITTEE WORK SUCH AS: VALLEY BEHAVIORAL HEALTH STEERING COMMITTEE, NORTHWESTERN WISCONSIN HEALTHCARE COALITION, MENTAL HEALTH TASK FORCE OF POLK COUNTY, AND THE POLK COUNTY NUTRITION & PHYSICAL ACTIVITY WORKGROUP. ARMC ATHLETIC TRAINERS ARE IN THE AMERY SCHOOL DISTRICT, PROVIDING ATHLETIC TRAINING AND SUPPORT FOR A MINIMAL FEE AND THE BENEFIT OF DONATED SERVICES TOTALING 2,700. ARMC HOSTED ONE BLOOD DRIVE IN 2020, COLLECTING 34 UNITS OF BLOOD FROM 35 INDIVIDUALS IN SUPPORT OF THE AMERICAN RED CROSS. TO HELP COMBAT POVERTY, ARMC PROVIDES AMERY AREA FOOD SHELF WITH FREE RENT, HEAT AND SHELVING FOR FOOD ITEMS. IN 2020, OVER $74,829 WAS PROVIDED TO SUPPORT THIS LOCAL PROGRAM. |
| PART III, CONT. | 5. COMMUNITY BUILDING ACTIVITIES: NONE 6. COMMUNITY BENEFIT OPERATIONS: $20,816 A COMMUNITY HEALTH SPECIALIST HAS TIME ALLOTTED TO THE TRAINING, MANAGEMENT, AND REPORTING OF COMMUNITY BENEFITS TO BEST CAPTURE ARMC'S COMMITMENT TO COMMUNITY HEALTH IMPROVEMENT. PANDEMIC RESPONSE HOSPITALS SERVE AS A CENTER OF STRENGTH FOR A COMMUNITY, EVEN IN THE BEST OF TIMES. DURING DISASTERS AND COMMUNITY HEALTH CRISES LIKE THE COVID-19 PANDEMIC, COMMUNITIES EXPECT HEALTH CARE FACILITIES TO NOT ONLY PROVIDE THE ADDITIONAL CARE THAT'S NEEDED, BUT ALSO CONTINUE THE COMMUNITY SUPPORT THAT INDIVIDUALS AND SOCIAL ENTITIES HAVE COME TO RELY ON. IN 2020 AMERY HOSPITAL & CLINICS DIRECTLY SUPPORTED COMMUNITY NEEDS THAT AROSE BECAUSE OF THE COVID-19 PANDEMIC, INCLUDING: ESTABLISHED AND STAFFED A DRIVE THROUGH COVID-19 PCR TESTING SERVICE TO SUPPORT EFFICIENT ADMINISTRATION AND RESULTING OF COVID-19 TESTS. IMPLEMENTED VIRTUAL VISIT CAPABILITIES FOR CLINIC APPOINTMENTS, DIABETIC EDUCATION CLASSES, AND PULMONOLOGY AND CARDIOLOGY CONSULTATIONS. OFFERED PERSONAL PROTECTIVE EQUIPMENT (PPE) TO PATIENTS AND VISITORS ENTERING FACILITIES TO AID IN PROTECTIVE MEASURES. STAFFED DOOR SCREENERS AT ENTRANCES TO AID IN PROTECTIVE MEASURES (I.E. VISITOR TRACKING, PPE PLACEMENT, AND SECURITY SUPPORT). PARTICIPATED IN COMMUNITY MESSAGING ON MULTIPLE PLATFORMS BY HAVING PROVIDERS SHARE INSIGHTS AND RECOMMENDATIONS ABOUT HOW TO PREVENT OR MITIGATE THE SPREAD OF COVID-19. PROVIDED COMMUNITY MASS COVID-19 VACCINATION PODS (AND THOSE PODS ARE ONGOING AS COVID-19 VACCINATIONS CONTINUE TO BE NEEDED). PROVIDED SIMULTANEOUS INFLUENZA VACCINATION. PROVIDED IPADS FOR PATIENT USE TO MORE MEANINGFULLY COMMUNICATE WITH FAMILY AND FRIENDS WHILE HOSPITALIZED. ADDITIONALLY, AMERY HOSPITAL & CLINIC WAS ABLE TO CONTINUE ITS ONGOING COMMUNITYBASED PARTNERSHIPS BY MAKING THE NECESSARY ADAPTATIONS. WITH THE PANDEMIC REQUIRING SOCIAL DISTANCING, OUTREACH AND ACCESS WERE SEVERELY LIMITED, BUT ADJUSTMENTS ALLOWED THE PROGRAMS TO CONTINUE. FOR INSTANCE: SHIFTED CARE AS NEEDED FOR PRIMARY CARE, SPECIALTY CARE, AND BEHAVIORAL HEALTH CARE TO VIRTUAL PLATFORMS. SHIFTED SOME NURSE VISITS TO TELEPHONE VISITS. ADJUSTED OUR STANDING ORDER FOR PRESCRIPTION REFILL MANAGEMENT TO ALLOW FOR EXTENDED REFILLS. ALL REHAB OUTPATIENTS, BOTH PEDIATRICS AND ADULTS, WERE OFFERED THE OPTION OF TELEHEALTH VISITS. CONTINUED TO OFFER SOCIALLY DISTANCED GROUP THERAPIES AND CHEMICAL DEPENDENCY TREATMENT TO SUPPORT INDIVIDUALS DURING THE PANDEMIC. POWERUP SCHOOL CHALLENGE WAS MOVED TO AN ONLINE PROGRAM. MAKE IT OK AMBASSADOR TRAINING WAS PROVIDED VIRTUALLY. IMPLEMENTED VIRTUAL INTERVIEWS. OFFERED DIABETIC EDUCATION VIA VIDEO OR PHONE VISIT. OFFERED DIABETIC GROUP EDUCATION CLASSES VIRTUALLY. WITH CARE DELIVERY MODELS BEING FORCED TO CHANGE DUE TO COVID-19, THE HOSPITAL CONVENED AND PARTICIPATED IN SEVERAL COMMUNITYBASED COLLABORATIVE EFFORTS TO IMPROVE ACCESS TO COMMUNITY AND MENTAL HEALTH SERVICES, INCLUDING: PROVIDED MENTAL HEALTH TELEHEALTH SERVICES WHICH EXPANDED THE TYPICAL GEOGRAPHIC MARKET TO RURAL AREAS. VIRTUAL APPOINTMENTS FOR PATIENT CARE IN OUR CLINICS. PROVIDED VACCINATION CLINICS. PARTICIPATED IN EMERGENCY MANAGEMENT PLANNING. PARTNERED WITH LOCAL PUBLIC HEALTH OFFICIALS TO SHARE VACCINE RESOURCES AND OFFER VACCINES TO COMMUNITY MEMBERS. PARTNERED WITH AND ADVISED OUR LOCAL SCHOOL DISTRICT ON THEIR COVID-19 RESPONSE PLAN. AFTER TEMPORARILY CLOSING PUBLIC ACCESS AMERY HOSPITAL & CLINIC'S FITNESS CENTER, IT WAS REOPENED WITH MITIGATION MEASURES TO LIMIT EXPOSURES. ADDITIONALLY, AMERY HOSPITAL & CLINIC WAS ABLE TO MAKE THE MOST OF THE COVID FUNDS IT RECEIVED, USING THOSE DOLLARS TO: SUPPORT ONGOING PPE NEEDS. SUPPORT STAFFING FOR THE DOOR SCREENING POSITIONS. SUPPORT STAFFING AND RESOURCES FOR COVID VACCINATION CLINICS. SUPPORT ADDITIONAL STAFFING COSTS REQUIRED TO CARE FOR COVID-19 PATIENTS. PROVIDE TEMPORARY AND PERMANENT STRUCTURES FOR DRIVE-UP COVID TESTING. 7. ORGANIZATION AWARDS AND ACHIEVEMENTS FOUR-STAR RATING FOR ITS QUALITY OF PATIENT CARE, PLACING IT IN THE TOP 24.82 PERCENT OF HOSPITALS IN THE U.S. FROM CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) HOSPITAL COMPARE. TREE CAMPUS HEALTHCARE FACILITY - AMERY HOSPITAL & CLINIC IS AMONG THE FIRST 16 PARTICIPANTS TO EARN RECOGNITION IN THE ARBOR DAY FOUNDATION'S FIRST YEAR OF THE PROGRAM. ROBERT A. WARRINER III, M.D., CENTER OF EXCELLENCE AWARD WOUND HEALING EXCELLENCE - AWARDED TO THE WOUND HEALING CENTER OF AMERY HOSPITAL & CLINIC IN MARCH 2020 FOR CLINICAL/PATIENT EXCELLENCE PERFORMED IN 2019. EMERALD AWARD (TOP 20%); CIRCLE OF EXCELLENCE AWARD WATER CIRCLE (TOP 10); AND GREENING THE OR RECOGNITION FROM PRACTICE GREENHEALTH FOUNDATION MEET STANDARDS ACHIEVEMENT - AMERY HOSPITAL & CLINIC FOUNDATION IS A MEETS STANDARDS ORGANIZATION WITH CHARITIES REVIEW COUNCIL. ENVIRONMENTAL EXCELLENCE DESIGNATED AS A "CERTIFIED AUDUBON COOPERATIVE SANCTUARY" THROUGH THE AUDUBON COOPERATIVE SANCTUARY PROGRAM (ACSP), AN AUDUBON INTERNATIONAL PROGRAM. - RECERTIFICATION IS EVERY THREE YEARS. AMERY HOSPITAL & CLINIC BECAME THE FIRST HOSPITAL, THE FIRST LOCATION IN WISCONSIN, AND ONLY THE 34TH LOCATION IN THE WORLD TO BE CERTIFIED IN THE AUDUBON COOPERATIVE SANCTUARY PROGRAM BACK IN 2017. PERFORMANCE LEADERSHIP AWARDS FOR THE TOP-QUARTILE PERFORMING RURAL HOSPITALS: OUTCOMES & QUALITY FROM THE CHARTIS CENTER FOR RURAL HEALTH AND THE NATIONAL ORGANIZATION OF STATE OFFICES OF RURAL HEALTH (NOSORH) CMS AWARDED AMERY HOSPITAL & CLINIC FOUR-STAR RATINGS ON ITS CARE COMPARE WEBSITE, FOR OVERALL RATING AND PATIENT SURVEYS. |
| FORM 990, PART VI, SECTION A, LINE 6 | RH WISCONSIN, INC. IS THE CLASS A MEMBER AND GHI IS THE CLASS B MEMBER OF ARMC. |
| FORM 990, PART VI, SECTION A, LINE 7A | ARMC'S BOARD OF DIRECTORS IS COMPRISED OF NOT MORE THAN 13 PERSONS APPOINTED AS FOLLOWS: - 7 COMMUNITY REPRESENTATIVES APPOINTED BY THE CLASS A MEMBER (RH-WISCONSIN), FROM RECOMMENDATIONS BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. - 3 REPRESENTATIVES APPOINTED BY THE CLASS B MEMBER (GHI). - 3 HEALTH CARE PROVIDERS NOMINATED BY THE PHYSICIAN GROUP STAFFING ARMC'S PRIMARY CARE CLINIC, AND APPOINTED BY THE CLASS B MEMBER (GHI). - THE PRESIDENT AND CHIEF MEDICAL OFFICER OF ARMC SIT IN EX-OFFICIO CAPACITIES, WITHOUT THE RIGHT TO VOTE. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE CLASS A AND CLASS B MEMBERS (RH WISCONSIN, INC. AND GHI RESPECTIVELY) BOTH MUST APPROVE THE DECISIONS OF THE BOARD OF DIRECTORS AS FOLLOWS: - AMENDMENT OF ARTICLES OR BYLAWS IMPACTING MEMBERSHIP - RESIGNATION OF A MEMBER - DISSOLUTION - ANY CHANGE IN THE FUNDAMENTAL NATURE OR PURPOSE - MERGER OR CONSOLIDATION WITH ANOTHER CORPORATION - DISPOSITION OF SUBSTANTIALLY ALL ASSETS. ONLY THE CLASS A MEMBER MUST APPROVE THE DECISIONS OF THE BOARD OF DIRECTORS AS FOLLOWS: - AMENDMENT OF ARTICLES OR BYLAWS NOT IMPACTING MEMBERSHIP - ANNUAL OPERATING AND CAPITAL BUDGETS AND STRATEGIC PLANS - ESTABLISHMENT OF NEW ENTITIES OR SIGNIFICANT RELATIONSHIPS WITH OTHER ENTITIES - UNBUDGETED EXPENDITURES IN EXCESS OF AMOUNTS ESTABLISHED BY THE MEMBER - GUARANTEEING THE DEBT OF ANY OTHER PERSON OR ENTITY - A LOAN OR OTHER INDEBTEDNESS IN EXCESS OF AMOUNTS ESTABLISHED BY THE MEMBER - TRANSFER OF ASSETS TO ANOTHER ENTITY - APPOINTMENT OF THE PRESIDENT AND THE BOARD CHAIR. |
| FORM 990, PART VI, SECTION B, LINE 11B | ARMC'S 990 RETURN HAS A COMPREHENSIVE REVIEW PROCESS THAT IS FOLLOWED BEFORE IT IS PRESENTED TO THE GOVERNING BODY OF ARMC. THE REVIEW PROCESS INCLUDES A LAYERED REVIEW BY THE TAX DEPARTMENT OF GROUP HEALTH PLAN, INC. (GHI), THE MANAGEMENT TEAM OF ARMC, GHI'S INTERNAL LEGAL DEPARTMENT AND ARMC'S OUTSIDE INDEPENDENT ACCOUNTANTS. EACH ONE OF THOSE AREAS HAS AN OPPORTUNITY TO REVIEW, ASK QUESTIONS AND MAKE COMMENTS BACK TO THE TAX DEPARTMENT OF GHI BEFORE THE FORM 990 IS COMPLETED AND PRESENTED TO THE GOVERNING BODY OF ARMC. ARMC MAKES AVAILABLE TO THE GOVERNING BODY (BOARD OF DIRECTORS) A COPY OF THE 990 FOR REVIEW AND COMMENT PRIOR TO THE FILING OF THE 990 RETURN. THIS COPY IS PROVIDED IN A PRE-MEETING PACKET, AND IS AN AGENDA ITEM AT A MEETING OF THE FULL BOARD OF DIRECTORS. THIS PROCESS IS NOTED AND DOCUMENTED IN THE WRITTEN MINUTES OF THE MEETING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE AMERY BOARD MONITORS POTENTIAL CONFLICTS OF INTEREST ON THE PART OF ITS BOARD MEMBERS, PRINCIPAL OFFICERS, MEMBERS OF COMMITTEES WITH BOARD DELEGATED POWERS, AND KEY EMPLOYEES ("COVERED PERSONS") BY MAINTAINING A CONFLICT OF INTEREST POLICY. UNDER THE POLICY, COVERED PERSONS ANNUALLY ARE PROVIDED WITH A COPY OF THE POLICY AND ASKED TO COMPLETE A QUESTIONNAIRE IDENTIFYING ANY POTENTIAL CONFLICTS OF INTERESTS. THE LEGAL DEPARTMENT OF HEALTHPARTNERS REVIEWS THE QUESTIONNAIRE RESPONSES AND DEVELOPS A REPORT DETAILING ANY POTENTIALLY MATERIAL CONFLICTS FOR THE PRESIDENT AND CHAIR OF THE BOARD. A VERBAL SUMMARY IS ALSO GIVEN TO THE FULL BOARD OR APPROPRIATE COMMITTEE ENDING WITH A REMINDER TO COVERED PERSONS OF THE POLICY'S MANDATE THAT EACH PERSON IS OBLIGATED TO DISCLOSE ANY NEW POTENTIAL CONFLICTS AS THEY MAY ARISE THROUGHOUT THE YEAR. BOARD AGENDAS AND EXECUTIVE DECISIONS ARE MONITORED IN RELATION TO THIS POLICY. |
| FORM 990, PART VI, SECTION B, LINE 15 | AMERY'S PRESIDENT AND ITS OFFICERS ARE EMPLOYED BY REGIONS HOSPITAL (REGIONS), LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, INC (LAKEVIEW) OR BY GROUP HEALTH PLAN, INC. (GHI), ALL OF WHICH ARE RELATED ORGANIZATIONS, OR BY AMERY. GHI, REGIONS, LAKEVIEW AND AMERY HAVE AN ANNUAL PROCESS TO REVIEW THE MARKET COMPARABILITY OF THE TOTAL COMPENSATION OF AMERY'S PRESIDENT AND OTHER OFFICERS. EVERY THREE YEARS, THE INDEPENDENT COMPENSATION COMMITTEE OF THE GHI BOARD OF DIRECTORS (THE "COMMITTEE"), RETAINS AN EXTERNAL COMPENSATION EXPERT TO CONDUCT AN EXTENSIVE MARKET COMPARABILITY REVIEW FOR ALL OFFICERS OF THE ORGANIZATION. THE REVIEW INCLUDES ALL COMPONENTS OF TOTAL COMPENSATION: BASE SALARY, ANNUAL INCENTIVES, BENEFITS AND PERQUISITES. THE MARKET SURVEY RESULTS ARE PRESENTED TO, REVIEWED BY AND APPROVED BY THE APPROPRIATE COMMITTEE. BASED ON THIS DATA, EITHER THE EXECUTIVE COMMITTEE OF REGIONS, THE COMPENSATION COMMITTEE OF GHI,THE COMPENSATION COMMITTEE OF THE LAKEVIEW, OR THE AMERY EXECUTIVE COMMITTEE (THE "COMMITTEES") DETERMINE MINIMUM AND MAXIMUM TOTAL COMPENSATION RANGES FOR EACH EMPLOYED OFFICER. IN INTERIM YEARS, GHI'S HUMAN RESOURCES STAFF, UNDER THE COMMITTEES' DIRECTION, UPDATES CHANGES IN THE SALARY STRUCTURE BASED ON THE SAME INDEPENDENT STUDIES PERFORMED BY THE COMPENSATION CONSULTANT FOR THE COMMITTEE. FOR CERTAIN POSITIONS FULL INDEPENDENT REVIEWS ARE PERFORMED TO SET SALARY RANGES BASED ON THE COMPETITIVE MARKET DATA SPECIFIC TO THOSE POSITIONS. THE COMMITTEES REVIEW AND APPROVE EACH YEAR'S COMPENSATION RESULTS. IN ALL CASES, THE COMMITTEES' MEMBERS COMPLETE AN ANNUAL CONFLICT OF INTEREST SURVEY TO ASSURE THE COMMITTEES MEMBERS' INDEPENDENCE AND THIS IS UPDATED AT ANY MEETING AT WHICH DECISIONS ARE BEING MADE. STAFF (OTHER THAN THE SECRETARY TO THE BOARD) IS NOT IN THE ROOM DURING DELIBERATIONS OR VOTE INCLUDING EXECUTIVE SESSIONS, AND CONTEMPORANEOUS MINUTES ARE KEPT. WITH AMERY'S BOARD OF DIRECTORS INPUT, THE ST CROIX VALLEY EXECUTIVE LEADER CONDUCTS THE ANNUAL PERFORMANCE REVIEW AND, WITH AMERY'S BOARD APPROVAL, DETERMINES THE COMPENSATION OF THE ARMC CEO. THE AMERY'S BOARD HAS DELEGATED TO THE PRESIDENT THE ACCOUNTABILITY TO CONDUCT ANNUAL PERFORMANCE REVIEWS AND DETERMINE THE COMPENSATION OF ALL ARMC-EMPLOYED OFFICERS WITHIN THE COMPENSATION RANGES DETERMINED BY THE COMMITTEE. ANY EXCEPTIONS TO COMPENSATION IN EXCESS OF THE APPROVED RANGES ARE APPROVED BY THE AMERY EXECUTIVE COMMITTEE. TOTAL COMPENSATION IS APPROPRIATELY DOCUMENTED ON THE FORM 990 AND ON THE EMPLOYEE'S W-2. |
| FORM 990, PART VI, SECTION C, LINE 18 | AMERY'S 990 RETURNS ARE MADE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION FROM AMERY OR HEALTHPARTNERS, INC. |
| FORM 990, PART VI, SECTION C, LINE 19 | AMERY MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| 990, PART VII, SEC A, LN 1A, COL (B) - RELATED ORGANIZATION AVERAGE HOURS | DIRECTORS AND OFFICERS OF ARMC ARE EMPLOYED AND COMPENSATED BY GHI, INC., REGIONS HOSPITAL OR ARMC. REPORTED AVERAGE HOURS WORKED ARE BASED ON THEIR TOTAL COMPENSATION FROM ALL RELATED ORGANIZATIONS. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (30 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| HEALTHPARTNERS INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411693838 | HYBRID STAFF MODEL/NETWORK MODEL HEALTH MAINTENANCE ORGANIZATION | MN | 501(C)(4) | N/A | 0 | ||
| HPI-RAMSEY | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411793333 | CORPORATE PLANNING AND OVERSIGHT | MN | 501(C)(3) | 0 | 509(A)(3) TYPE I | HEALTHPARTNERS INC | |
| GROUP HEALTH PLAN INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 410797853 | STAFF MODEL HEALTH MAINTENANCE ORGANIZATION | MN | 501(C)(3) | 0 | 170(B)(1) (A)(III) | HEALTHPARTNERS INC | |
| RH WISCONSIN INC | |||||||||||
| 8171 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 202287016 | CORPORATE PLANNING AND OVERSIGHT | MN | 501(C)(3) | 0 | 509(A)(3) TYPE I | HPI - RAMSEY | |
| HEALTHPARTNERS INSTITUTE | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411670163 | HEALTHCARE EDUCATION AND RESEARCH | MN | 501(C)(3) | 0 | 509(A)(3) TYPE I | HEALTHPARTNERS INC | |
| CAPITOL VIEW TRANSITIONAL CARE CENTER | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 412011453 | TRANSITIONAL CARE SERVICES, STEP DOWN FROM INPATIENT HOSPITAL | MN | 501(C)(3) | 0 | 170(B)(1) (A)(III) | HPI - RAMSEY | |
| REGIONS HOSPITAL | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 410956618 | HOSPITAL | MN | 501(C)(3) | 0 | 170(B)(1) (A)(III) | HPI - RAMSEY | |
| REGIONS HOSPITAL FOUNDATION | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411888902 | PROVIDE SUPPORT TO HOSPITAL AND COMMUNITY HEALTH | MN | 501(C)(3) | 0 | 170(B)(1) (A)(VI) | HPI - RAMSEY | |
| RHSC INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411891928 | HEALTHCARE STAFFING AND INTENSE REHAB SERVICES | MN | 501(C)(3) | 0 | 509(A)(3) TYPE II | HEALTHPARTNERS INC | |
| PHYSICIANS NECK & BACK CLINICS | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 270684883 | SPECIALTY PATIENT CARE | MN | 501(C)(3) | 0 | 509(A)(3) TYPE II | GROUP HEALTH PLAN INC | |
| HUDSON HOSPITAL INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 390804125 | HOSPITAL | WI | 501(C)(3) | 0 | 170(B)(1) (A)(III) | RH-WISCONSIN INC | |
| HUDSON HOSPITAL FOUNDATION INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 391279567 | PROVIDE SUPPORT TO HOSPITAL AND COMMUNITY HEALTH | WI | 501(C)(3) | 0 | 170(B)(1) (A)(VI) | HUDSON HOSPITAL INC | |
| LAKEVIEW HEALTH FOUNDATION | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411386635 | PROVIDE SUPPORT TO HOSPITAL AND COMMUNITY HEALTH | MN | 501(C)(3) | 0 | 170(B)(1) (A)(VI) | LAKEVIEW HEALTH | |
| LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 410811697 | HOSPITAL | MN | 501(C)(3) | 0 | 170(B)(1) (A)(III) | LAKEVIEW HEALTH | |
| STILLWATER MEDICAL GROUP | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 830379473 | CLINIC STAFF AND FACILITIES | MN | 501(C)(3) | 0 | 509(A)(3) TYPE I | LAKEVIEW HEALTH | |
| LAKEVIEW HEALTH | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 300221189 | CORPORATE PLANNING AND OVERSIGHT | MN | 501(C)(3) | 0 | 509(A)(3) TYPE II | HPI - RAMSEY | |
| WESTFIELDS HOSPITAL INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 390808442 | HOSPITAL | WI | 501(C)(3) | 0 | 170(B)(1) (A)(III) | RH-WISCONSIN INC | |
| WESTFIELDS HOSPITAL FOUNDATION INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 391770913 | PROVIDE SUPPORT TO HOSPITAL AND COMMUNITY HEALTH | WI | 501(C)(3) | 0 | 170(B)(1) (A)(VI) | WESTFIELDS HOSPITAL INC | |
| RAMSEY INTEGRATED HEALTH SERVICES | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411503090 | HOME CARE AND HOSPICE | MN | 501(C)(3) | 0 | 509(A)(2) | HPI - RAMSEY | |
| PARK NICOLLET HEALTH SERVICES | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 363465840 | CORPORATE PLANNING AND OVERSIGHT | MN | 501(C)(3) | 0 | 509(A)(2) | HEALTHPARTNERS INC | |
| PARK NICOLLET FOUNDATION | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 237346465 | SUPPORT TO RELATED ENTITIES AND COMMUNITY HEALTH | MN | 501(C)(3) | 0 | 170(B)(1) (A)(VI) | PARK NICOLLET HEALTH SERVICES | |
| PARK NICOLLET METHODIST HOSPITAL | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 410132080 | HOSPITAL | MN | 501(C)(3) | 0 | 170(B)(1) (A)(III) | PARK NICOLLET HEALTH SERVICES | |
| PARK NICOLLET HEALTH CARE PRODUCTS | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 010638901 | DURABLE MEDICAL EQUIPMENT , PHARMACY AND OTHER HEALTH CARE RETAIL SALES | MN | 501(C)(3) | 0 | 509(A)(3) TYPE I | PARK NICOLLET HEALTH SERVICES | |
| PARK NICOLLET CLINIC | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 410834920 | CLINIC SERVICES | MN | 501(C)(3) | 0 | 170(B)(1) (A)(III) | PARK NICOLLET HEALTH SERVICES | |
| PNMC HOLDINGS | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 411741792 | HEALTHCARE REAL ESTATE | MN | 501(C)(3) | 0 | 509(A)(3) TYPE I | PARK NICOLLET HEALTH SERVICES | |
| AMERY REGIONAL MEDICAL CENTER FOUNDATION INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 391726539 | PROVIDE SUPPORT TO HOSPITAL AND COMMUNITY HEALTH | WI | 501(C)(3) | Yes (1) | 170(B)(1) (A)(VI) | AMERY REGIONAL MEDICAL CENTER INC | |
| HUTCHINSON HEALTH | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 841715908 | HOSPITAL | MN | 501(C)(3) | 0 | 170(B)(1) (A)(III) | PARK NICOLLET HEALTH SERVICES | |
| HUTCHINSON HEALTH FOUNDATION | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 363317820 | PROVIDE SUPPORT TO HOSPITAL | MN | 501(C)(3) | 0 | 509(A)(3) TYPE I | HUTCHINSON HEALTH | |
| HEALTHPARTNERS RC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 844261122 | HOSPITAL | MN | 501(C)(3) | 0 | 170(B)(1)(A)(III) | PARK NICOLLET HEALTH SERVICES | |
| OLIVIA HOSPITAL & CLINIC FOUNDATION | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411839619 | PROVIDE SUPPORT TO HOSPITAL | MN | 501(C)(3) | 0 | 509(A)(3) TYPE I | HEALTHPARTNERS RC | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AMERY REGIONAL MEDICAL CENTER PHARMACY LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 265 GRIFFIN STREET E | AddressLine1Txt |
| City | AMERY | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54001 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391979705 | EIN |
| Primary Activities | PHARMACEUTICAL | PrimaryActivitiesTxt |
| Legal Domicile State | WI | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AMERY REGIONAL MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Share Of Total Income | -$87,393 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $133,127 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | Yes (1) | GeneralOrManagingPartnerInd |
| Ownership | 0.50000 | OwnershipPct |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| HEALTHPARTNERS ADMINISTRATORS INC | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411629390 | THIRD PARTY ADMINISTRATOR | MN | HEALTHPARTNERS INC | C | 0 |
| HEALTHPARTNERS ASSOCIATES INC | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 522365151 | MEDICAL CLINIC STAFFING AND ASSET MANAGEMENT | MN | HEALTHPARTNERS ADMINISTRATORS INC | C | 0 |
| HEALTHPARTNERS SERVICES INC | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411683568 | MEDICAL CLINIC STAFFING AND ASSET MANAGEMENT | MN | HEALTHPARTNERS ADMINISTRATORS INC | C | 0 |
| HEALTHPARTNERS INSURANCE COMPANY | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411683523 | MEDICAL AND DENTAL INSURANCE | MN | HEALTHPARTNERS ADMINISTRATORS INC | C | 0 |
| DENTAL SPECIALTIES INC | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 451297583 | PROFESSIONAL DENTAL SERVICES | MN | HEALTHPARTNERS ADMINISTRATORS INC | C | 0 |
| HEALTHPARTNERS CENTRAL MINNESOTA CLINICS INC | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411236798 | MEDICAL CLINIC STAFFING | MN | HEALTHPARTNERS ADMINISTRATORS INC | C | 0 |
| PARK NICOLLET ENTERPRISES | |||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 411656735 | REAL ESTATE FOR RELATED ORGANIZATIONS | MN | PARK NICOLLET HEALTH SERVICES | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTHPARTNERS INC - CLAIMSHEALTHCARE SERVICES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | L | TransactionTypeTxt |
| Involved | $241,482 | InvolvedAmt |
| Method Of Amount Determination | FAIR VALUE | MethodOfAmountDeterminationTxt |
Comments