AMERY REGIONAL MEDICAL CENTER INC: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization: AMERY REGIONAL MEDICAL CENTER INC (EIN 39-0908320)
Tax period: 2019-01-01 to 2019-12-31
Filed: 2020-11-15
IRS object ID: 202033209349301528
Schema version: 2019v5.1
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 B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule K
Schedule K
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2020-11-15T19:02:26-06:00	ReturnTs
Tax Period End	2019-12-31	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	2019-01-01	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	2020-11-15	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	MONROE JORDAN GIERL	PreparerPersonNm
PTIN	P01413237	PTIN
Phone	6123055000	PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	198.153.9.194	IPv4AddressTxt

Field	Value	IRS element (for citing)
IP	2020-11-15	IPDt
IP Tm	17:29:07	IPTm
IP Timezone	CS	IPTimezoneCd
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	763097D6A2B3EA9277A508CC789A2C5E6C07E1F2	AtSubmissionCreationDeviceId
At Submission Filing Device Id	763097D6A2B3EA9277A508CC789A2C5E6C07E1F2	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2019	TaxYr
Build TS	2021-01-29 14:40:06Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	DEBRA 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	$63,227,737	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	500	TotalEmployeeCnt
Total Volunteers	26	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$107,300	PYContributionsGrantsAmt
CY Contributions Grants	$282,579	CYContributionsGrantsAmt
PY Program Service Revenue	$60,760,964	PYProgramServiceRevenueAmt
CY Program Service Revenue	$62,357,101	CYProgramServiceRevenueAmt
PY Investment Income	$184,444	PYInvestmentIncomeAmt
CY Investment Income	$390,681	CYInvestmentIncomeAmt
PY Other Revenue	$207,576	PYOtherRevenueAmt
CY Other Revenue	$148,025	CYOtherRevenueAmt
PY Total Revenue	$61,260,284	PYTotalRevenueAmt
CY Total Revenue	$63,178,386	CYTotalRevenueAmt
PY Grants And Similar Paid	$35,749	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$42,401	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$39,932,985	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$40,651,486	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$20,487,659	PYOtherExpensesAmt
CY Other Expenses	$20,789,982	CYOtherExpensesAmt
PY Total Expenses	$60,456,393	PYTotalExpensesAmt
CY Total Expenses	$61,483,869	CYTotalExpensesAmt
PY Revenues Less Expenses	$803,891	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$1,694,517	CYRevenuesLessExpensesAmt
Total Assets BOY	$51,714,878	TotalAssetsBOYAmt
Total Assets EOY	$53,164,869	TotalAssetsEOYAmt
Total Liabilities BOY	$30,089,212	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$29,387,833	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$21,625,666	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$23,777,036	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	$55,479,136	ExpenseAmt
Grant	$42,401	GrantAmt
Revenue	$62,357,101	RevenueAmt
Desc	SEE SCHEDULE O - EXEMPT PURPOSE AND ACHIEVEMENTS FOR A DESCRIPTION OF PROGRAM SERVICE ACCOMPLISHMENTS	Desc
Total Program Service Expenses	$55,479,136	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	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	Yes (1)	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	Yes (1)	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	Yes (1)	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	500	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 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 (24 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)	$700	$0	$0
HEIDI ERSPAMER
DIRECTOR & VICE CHAIR	1.75	0.25	Yes (X)	$1,200	$0	$0	Yes (X)
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)	$800	$0	$0
STEVEN SCHAFFFER
DIRECTOR	1.75	0.25	Yes (X)	$1,500	$0	$0
CHRIS PETERSEN
DIRECTOR	1.75	0.25	Yes (X)	$1,200	$0	$0
ORALEE SCHOCK
DIRECTOR & SECRETARY	1.75	0.25	Yes (X)	$1,200	$0	$0	Yes (X)
ROSS R BULLARD
DIRECTOR & TREASURER	1.00	46.00	Yes (X)	$0	$236,514	$70,370	Yes (X)
DYLAN COE MD
DIRECTOR	0.25	39.75	Yes (X)	$0	$328,646	$91,647
MARTIN E RICHARDS MD
DIRECTOR	0.25	39.75	Yes (X)	$0	$490,399	$57,228
ANN SEAGREN MD
DIRECTOR	0.25	49.75	Yes (X)	$0	$233,514	$72,952
THEODORE WEGLEITNER
DIRECTOR	0.25	52.75	Yes (X)	$0	$548,976	$116,564
MARYANN SCOGLIO CANP
DIRECTOR	0.25	64.75	Yes (X)	$0	$169,933	$43,446
JASON J LUHRS
CFO (JAN-AUG)	0.50	49.50		$0	$231,590	$53,365	Yes (X)
SANDRA M REED
VP - AMBULATORY CARE	50.00	0.00		$184,600	$0	$42,107	Yes (X)
DEBRA RUDQUIST
PRESIDENT	53.00	0.00		$0	$329,096	$61,861	Yes (X)
PATRICK SURA MD
CHIEF MEDICAL OFFICER	0.25	64.75		$0	$457,353	$56,749	Yes (X)
DOUGLAS JOHNSON
CFO (AUG-DEC)	13.75	41.25		$0	$380,795	$153,262	Yes (X)
MARK A TRYGGESTAD
DIRECTOR OF PHARMACY	48.00	0.00		$179,668	$0	$20,019		Yes (X)
JAMES ERICKSON
RN SUPERVISOR	40.00	0.00		$135,508	$0	$39,469		Yes (X)
ANTHONY GOULD
ANCILLARY SERVICES	40.00	0.00		$128,010	$0	$38,516		Yes (X)
ANN SCHILLING
HR SR DIRECTOR	40.00	0.00		$126,969	$0	$38,275		Yes (X)
BENJAMIN BOGLE
PROVIDER-APNP	40.00	0.00		$130,853	$0	$37,663		Yes (X)
JOANNE L JACKSON
FORMER HR, PR AND MKTG DIR	0.00	45.00		$160,894	$0	$27,544			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,054,302	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$3,406,816	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,021,037	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	19	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	$993,561
TWIN CITIES ORTHOPEDICS PA
5803 NEAL AVE N	OAK PARK HEIGHTS	MN	55082	PROFESSIONAL SERVICES	$849,037
SHARED MEDICAL TECHNOLOGY INC
202 W NEWTON ST	RICE LAKE	WI	54868	PROFESSIONAL SERVICES	$383,128
HEALOGICS WOUND CARE
28525 NETWORK PLACE	CHICAGO	IL	60673	WOUND HEALING MANAGEMENT	$339,205
ABBOT VASCULAR DIVISION
PO BOX 91138	CHICAGO	IL	60675	PROFESSIONAL SERVICES	$221,191

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	12	CntrctRcvdGreaterThan100KCnt
Related Organizations	$274,285	RelatedOrganizationsAmt
Government Grants	$6,186	GovernmentGrantsAmt
All Other Contributions	$2,108	AllOtherContributionsAmt
Total Contributions	$282,579	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE	621110	$61,379,378	$61,379,378
OTHER OPERATING	900099	$686,060	$686,060
FITNESS CENTER	624110	$150,421	$150,421
SUBSIDIARY REVENUE	900099	$141,242	$141,242

Field	Value	IRS element (for citing)
Total Program Service Revenue	$62,357,101	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$390,681	TotalRevenueColumnAmt
Exclusion	$390,681	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$54,711	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	$5,360	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$5,360	TotalRevenueColumnAmt
Exclusion	$5,360	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt
CAFETERIA AND OTHER	900099	$135,587	$135,587
GIFT SHOP	453220	$7,078	$7,078

Field	Value	IRS element (for citing)
Other Revenue Total	$142,665	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$63,178,386	TotalRevenueColumnAmt
Related Or Exempt Func Income	$62,357,101	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$538,706	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$42,401	TotalAmt
Program Services	$42,401	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$234,507	TotalAmt
Management And General	$234,507	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$35,801,286	TotalAmt
Program Services	$32,944,874	ProgramServicesAmt
Management And General	$2,856,412	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$661,021	TotalAmt
Program Services	$608,281	ProgramServicesAmt
Management And General	$52,740	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$2,358,186	TotalAmt
Program Services	$2,170,038	ProgramServicesAmt
Management And General	$188,148	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$1,596,486	TotalAmt
Program Services	$1,469,110	ProgramServicesAmt
Management And General	$127,376	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$16,127	TotalAmt
Management And General	$16,127	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$3,254,056	TotalAmt
Program Services	$2,820,353	ProgramServicesAmt
Management And General	$433,703	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$216,118	TotalAmt
Program Services	$38,654	ProgramServicesAmt
Management And General	$177,464	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$707,015	TotalAmt
Program Services	$523,629	ProgramServicesAmt
Management And General	$183,386	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$178,734	TotalAmt
Program Services	$143,779	ProgramServicesAmt
Management And General	$34,955	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$1,006,829	TotalAmt
Program Services	$756,149	ProgramServicesAmt
Management And General	$250,680	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$100,886	TotalAmt
Program Services	$47,533	ProgramServicesAmt
Management And General	$53,353	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$22,309	TotalAmt
Program Services	$11,218	ProgramServicesAmt
Management And General	$11,091	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$788,485	TotalAmt
Program Services	$788,485	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$3,304,096	TotalAmt
Program Services	$3,142,650	ProgramServicesAmt
Management And General	$161,446	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$201,221	TotalAmt
Program Services	$99,532	ProgramServicesAmt
Management And General	$101,689	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL & DRUG SUPPLIES	$7,970,099	$7,951,342	$18,757
EQUIP. RENT & REPAIR	$1,995,726	$1,264,592	$731,134
OTHER EXPENSE	$663,444	$496,131	$167,313
TAXES & ASSESSMENTS	$159,527		$159,527

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$205,310	TotalAmt
Program Services	$160,385	ProgramServicesAmt
Management And General	$44,925	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$61,483,869	TotalAmt
Program Services	$55,479,136	ProgramServicesAmt
Management And General	$6,004,733	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$23,668	BOYAmt
EOY	$15,748	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$8,912,534	BOYAmt
EOY	$8,593,132	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$7,412,905	BOYAmt
EOY	$7,933,690	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$734,425	BOYAmt
EOY	$771,028	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$126,448	BOYAmt
EOY	$150,822	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$61,593,553	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$40,105,511	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$23,503,059	BOYAmt
EOY	$21,488,042	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$8,125,113	BOYAmt
EOY	$10,871,204	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$2,719,280	BOYAmt
EOY	$2,680,017	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$157,446	BOYAmt
EOY	$661,186	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$51,714,878	BOYAmt
EOY	$53,164,869	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$5,581,652	BOYAmt
EOY	$5,499,230	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$24,507,560	BOYAmt
EOY	$23,438,770	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$449,833	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$30,089,212	BOYAmt
EOY	$29,387,833	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	$21,625,666	BOYAmt
EOY	$23,777,036	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$21,625,666	BOYAmt
EOY	$23,777,036	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$51,714,878	BOYAmt
EOY	$53,164,869	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$1,694,517	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$681,194	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$224,341	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 B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

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	$24,300,372	OtherCostOrOtherBasisAmt
Depreciation	$15,578,685	DepreciationAmt
Book Value	$8,721,687	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$3,834,151	OtherCostOrOtherBasisAmt
Depreciation	$178,092	DepreciationAmt
Book Value	$3,656,059	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$30,296,051	OtherCostOrOtherBasisAmt
Depreciation	$23,667,845	DepreciationAmt
Book Value	$6,628,206	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,179,257	OtherCostOrOtherBasisAmt
Depreciation	$680,889	DepreciationAmt
Book Value	$1,498,368	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$21,488,042	TotalBookValueLandBuildingsAmt

Invst Program Related Org InvstProgramRelatedOrgGrp

Field	Value	IRS element (for citing)
Desc	LONG TERM INVESTMENTS	Desc
Book Value	$2,680,017	BookValueAmt
Method Valuation	C	MethodValuationCd

Field	Value	IRS element (for citing)
Total Book Value Program Rltd	$2,680,017	TotalBookValueProgramRltdAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

Field	Value	IRS element (for citing)
Desc	LEASE OBILGATION	Desc
Amt	$449,833	Amt

Field	Value	IRS element (for citing)
Total Liability	$449,833	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, 2019 OR 2018 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	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$697,878	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$697,878	NetCommunityBenefitExpnsAmt
Total Expense	0.01140	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$9,506,988	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$7,118,154	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,388,834	NetCommunityBenefitExpnsAmt
Total Expense	0.03890	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$10,204,866	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$7,118,154	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,086,712	NetCommunityBenefitExpnsAmt
Total Expense	0.05030	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	24	ActivitiesOrProgramsCnt
Persons Served	1807	PersonsServedCnt
Total Community Benefit Expns	$290,635	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,082	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$288,553	NetCommunityBenefitExpnsAmt
Total Expense	0.00470	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Activities Or Programs	9	ActivitiesOrProgramsCnt
Persons Served	137	PersonsServedCnt
Total Community Benefit Expns	$32,172	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$32,172	NetCommunityBenefitExpnsAmt
Total Expense	0.00050	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	10	ActivitiesOrProgramsCnt
Persons Served	72	PersonsServedCnt
Total Community Benefit Expns	$149,377	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$6,230	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$143,147	NetCommunityBenefitExpnsAmt
Total Expense	0.00230	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	43	ActivitiesOrProgramsCnt
Persons Served	2016	PersonsServedCnt
Total Community Benefit Expns	$472,184	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$8,312	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$463,872	NetCommunityBenefitExpnsAmt
Total Expense	0.00750	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	43	ActivitiesOrProgramsCnt
Persons Served	2016	PersonsServedCnt
Total Community Benefit Expns	$10,677,050	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$7,126,466	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,550,584	NetCommunityBenefitExpnsAmt
Total Expense	0.05780	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$1,321	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,321	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$5,677	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$5,677	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$49	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$49	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	3	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$7,047	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$7,047	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	0	BadDebtExpenseReportedInd
Bad Debt Expense	$2,301,601	BadDebtExpenseAmt
Bad Debt Expense Attributable	$1,314,561	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$22,116,989	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$22,116,989	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	WWW.AMERYMEDICALCENTER.ORG/COMMUNITY_HEALTH_NEEDS_ASSESSMENT.ASPX	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	WWW.AMERYMEDICALCENTER.ORG/COMMUNITY_HEALTH_NEEDS_ASSESSMENT.ASPX	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	HTTPS://WWW.AMERYMEDICALCENTER.ORG/MEDICAL_SERVICES/PATIENT_FINANCIAL_SERVI	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	HTTPS://WWW.AMERYMEDICALCENTER.ORG/MEDICAL_SERVICES/PATIENT_FINANCIAL_SERVI	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	HTTPS://WWW.AMERYMEDICALCENTER.ORG/MEDICAL_SERVICES/PATIENT_FINANCIAL_SERVI	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
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: THE 2018 HEALTHPARTNERS CHNA CONDUCTED RESULTED IN THE FOLLOWING PRIORITIES: PRIORITY 1: ACCESS TO CARE PRIORITY 2: ACCESS TO HEALTH PRIORITY 3: MENTAL HEALTH AND WELL-BEING PRIORITY 4: NUTRITION AND PHYSICAL ACTIVITY PRIORITY 5: SUBSTANCE ABUSEPRIORITIES 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. A FULL REPORT OF AMERY'S 2018 CHNA AND ANNUAL IMPLEMENTATION PLAN UPDATE IS POSTED ON AMERY'S WEBPAGE AT WWW.AMERYMEDICALCENTER.ORG/COMMUNITY_HEALTH_NEEDS_ASSESSMENT.ASPX
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 (12 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 II, COMMUNITY BUILDING ACTIVITIES:	COMMUNITY BUILDING ACTIVITIES AT AMERY PRIMARILY INCLUDE ENVIRONMENTAL IMPROVEMENTS AND WORKFORCE DEVELOPMENT. AMERY CONTINUES TO BE A SUSTAINABILITY CHAMPION AND HOSTS AN ANNUAL ELECTRONICS RECYCLING EVENT AND ATTENDS THE ANNUAL CLEANMED CONFERENCE WHICH IS A NATIONAL ENVIRONMENTAL CONFERENCE FOR LEADERS IN HEALTH CARE SUSTAINABILITY. AMERY ALSO HAS REPRESENTATIVES SERVE ON THE WITC MEDICAL ASSISTANT ADVISORY COMMITTEE, WITC ADVISORY COUNCIL, AND WITC HEALTH INFORMATION TECHNOLOGY ADVISORY COMMITTEE.
PART III, LINE 3:	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 PAGES 13 & 14 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 I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	0	GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt
AMERY REGIONAL MEDICAL CENTER FOUNDATION
8170 33RD AVE S	BLOOMINGTON	MN	554401309	391726539	501(C)(3)	$18,100	PROGRAM SUPPORT
AMERICAN CANCER SOCIETY
250 WILLIAMS STREET NW	ATLANTA	GA	30303	131788491	501(C)(3)	$5,000	PROGRAM SUPPORT

Field	Value	IRS element (for citing)
Total501c3 Org	2	Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 2:	FormAndLineReferenceDesc
Explanation	AMERY REGIONAL MEDICAL CENTER, INC. (ARMC) MANAGEMENT STAFF REVIEWS THE MISSION AND PURPOSE OF POTENTIAL GRANTEE ORGANIZATIONS TO ASSURE CONSISTENCY WITH ARMC'S MISSION AND PURPOSE. AMOUNTS SUBSEQUENTLY GRANTED ARE SUBJECT TO ARMC'S FORMAL SPENDING APPROVAL AND DOCUMENTATION PROCESS BASED ON AMOUNT OF THE EXPENDITURE.	ExplanationTxt

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 (17 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
ROSS R BULLARD
DIRECTOR & TREASURER	$0	$194,405	$0	$37,530	$0	$4,579	$0	$37,435	$0	$32,935	$0	$306,884	$0	$0
DYLAN COE MD
DIRECTOR	$0	$169,210	$0	$0	$0	$159,436	$0	$70,917	$0	$20,730	$0	$420,293	$0	$50,770
MARTIN E RICHARDS MD
DIRECTOR	$0	$378,478	$0	$13,300	$0	$98,621	$0	$21,000	$0	$36,228	$0	$547,627	$0	$0
ANN SEAGREN MD
DIRECTOR	$0	$212,661	$0	$0	$0	$20,853	$0	$41,335	$0	$31,617	$0	$306,466	$0	$0
THEODORE WEGLEITNER
DIRECTOR	$0	$434,318	$0	$108,899	$0	$5,759	$0	$79,487	$0	$37,077	$0	$665,540	$0	$0
MARYANN SCOGLIO CANP
DIRECTOR	$0	$133,559	$0	$0	$0	$36,374	$0	$13,194	$0	$30,252	$0	$213,379	$0	$0
JASON J LUHRS
CFO (JAN-AUG)	$0	$191,700	$0	$33,727	$0	$6,163	$0	$23,722	$0	$29,643	$0	$284,955	$0	$0
SANDRA M REED
VP - AMBULATORY CARE	$158,243	$0	$18,133	$0	$8,224	$0	$7,458	$0	$34,649	$0	$226,707	$0	$0	$0
DEBRA RUDQUIST
PRESIDENT	$0	$270,025	$0	$49,041	$0	$10,030	$0	$30,600	$0	$31,261	$0	$390,957	$0	$0
PATRICK SURA MD
CHIEF MEDICAL OFFICER	$0	$351,644	$0	$8,473	$0	$97,236	$0	$21,000	$0	$35,749	$0	$514,102	$0	$0
DOUGLAS JOHNSON
CFO (AUG-DEC)	$0	$299,890	$0	$55,505	$0	$25,400	$0	$121,094	$0	$32,168	$0	$534,057	$0	$0
MARK A TRYGGESTAD
DIRECTOR OF PHARMACY	$169,158	$0	$1,973	$0	$8,537	$0	$6,898	$0	$13,121	$0	$199,687	$0	$0	$0
JAMES ERICKSON
RN SUPERVISOR	$129,625	$0	$714	$0	$5,169	$0	$5,739	$0	$33,730	$0	$174,977	$0	$0	$0
ANTHONY GOULD
ANCILLARY SERVICES	$119,567	$0	$2,301	$0	$6,142	$0	$5,094	$0	$33,422	$0	$166,526	$0	$0	$0
ANN SCHILLING
HR SR DIRECTOR	$118,213	$0	$7,878	$0	$878	$0	$5,429	$0	$32,846	$0	$165,244	$0	$0	$0
BENJAMIN BOGLE
PROVIDER-APNP	$121,258	$0	$6,000	$0	$3,595	$0	$4,044	$0	$33,619	$0	$168,516	$0	$0	$0
JOANNE L JACKSON
FORMER HR, PR AND MKTG DIR	$135,348	$0	$8,617	$0	$16,929	$0	$6,532	$0	$21,012	$0	$188,438	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (3 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: TED WEGLEITNER $38,373
990, SCHEDULE J, PART II COLUMN F: PRIOR REPORTED COMPENSATION	COLUMN (F) INCLUDES AMOUNTS PAID TO PARTICIPANTS IN THE CURRENT YEAR, WHICH WERE PREVIOUSLY REPORTED IN COLUMN (C) OF PRIOR YEARS' 990'S AS RETIREMENT AND DEFERRED COMPENSATION, GOT FOR THE FOLLOWING DIRECTOR: DYLAN COE, MD $50,770

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	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$5,811,558	$8,500,000	$170,000	$8,330,000	2007	Yes (1)	Yes (1)	Yes (1)
B	$5,811,558	$8,500,000	$170,000	$8,330,000	2007	Yes (1)	Yes (1)	Yes (1)
C	$5,811,558	$8,500,000	$170,000	$8,330,000	2007	Yes (1)	Yes (1)	Yes (1)
D	$4,169,069	$6,150,000	$123,000	$6,027,000	2007	Yes (1)	Yes (1)	Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCd	Any Lease ArrangementsAnyLeaseArrangementsInd	Private Bus Use By OthersPrivateBusUseByOthersPct	Total Private Business UseTotalPrivateBusinessUsePct	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd
A	Yes (1)	0.00090	0.00090	Yes (1)
B	Yes (1)	0.00090	0.00090	Yes (1)
C	Yes (1)	0.00090	0.00090	Yes (1)
D	Yes (1)	0.00090	0.00090	Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCd	Rebate Not Due YetRebateNotDueYetInd	Variable Rate IssueVariableRateIssueInd
A	Yes (1)	Yes (1)
B	Yes (1)	Yes (1)
C	Yes (1)	Yes (1)
D	Yes (1)	Yes (1)

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	$4,196,069	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	0.00090	PrivateBusUseByOthersPct
Total Private Business Use	0.00090	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 (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART III, LINE 4A - EXEMPT PURPOSE AND ACHIEVEMENTS	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 NON-PROFIT 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 PHYSICIANS AND DENTISTS, SEVEN OWNED HOSPITALS WITH OVER 1,000 ACUTE CARE BEDS, OVER 125 PRIMARY AND SPECIALTY CARE MEDICAL FACILITIES AND DENTAL FACILITIES WITH PRACTICES IN MINNESOTA AND WESTERN WISCONSIN SERVING MORE THAN 1.2 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 2019 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 IS DRIVING CHANGE THAT HELPS OUR MEMBERS AND PATIENTS LIVE HEALTHIER LIVES. HEALTHPARTNERS COLLABORATE 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 2019 ARE TOTAL COST OF CARE MEASUREMENTS (DEVELOPMENT OF 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). 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, 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: $ 79,175 - COMMUNITY HEALTH EDUCATION - ARMC HELPS EDUCATE THE LOCAL COMMUNITIES IN REGARDS TO HEALTH ISSUES BY PROVIDING THE FOLLOWING TYPES OF COMMUNITY EDUCATION: CPR/BLS CLASSES, MONTHLY DIABETES SUPPORT GROUP REACHING OVER 100 INDIVIDUALS, MONTHLY BREASTFEEDING SUPPORT GROUP, EXPECTANT PARENTS/PRE-NATAL AND BREASTFEEDING CLASSES REACHING 48 PARENTS, 3 HEALTH FAIRS WITH FOCUS ON HEART HEALTH, STROKE PREVENTION, WOUND HEALING, DIABETES EDUCATION, AND NUTRITION, 13 MENTAL HEALTH FOCUSED COMMUNITY EDUCATION CLASSES WITH A REACH OF OVER 230 INDIVIDUALS. CONTINUING IN 2019, ARMC OFFERED AT LEAST ONE FREE COMMUNITY EDUCATION CLASS EVERY MONTH IN ADDITION TO A MEDICAL NUTRITION THERAPY CLASS TAUGHT BY A REGISTERED DIETITIAN WITH A FOCUS ON DIABETES PREVENTION, OFFERED AT NO COST. BEYOND THE MONTHLY CLASS OFFERINGS, OVER FOUR COMMUNITY-FOCUSED MENTAL HEALTH-RELATED CLASSES WERE TAUGHT BY BEHAVIORAL HEALTH STAFF ON TOPICS SUCH AS: DEMENTIA, SUICIDE PREVENTION, REDUCING MENTAL HEALTH STIGMA, AND MENTAL ILLNESS. ARMC PROVIDES EDUCATION AT OUR SCHOOLS BY HOLDING A 3RD GRADE HEALTH FAIR REACHING 189 STUDENTS FROM AMERY, CLEAR LAKE, CLAYTON, AND TURTLE LAKE. POWERUP, A COMMUNITY-WIDE INITIATIVE TO MAKE IT EASY, FUN AND POPULAR TO EAT BETTER AND MOVE MORE SO YOUTH CAN REACH THEIR FULL POTENTIAL, COMPLETED ITS FOURTH FULL YEAR IN AMERY. OUTREACH AND PROGRAM SUCCESSES INCLUDE: ANNUAL CANDLELIGHT NIGHT ON THE STOWER EVENT DONE IN PARTNERSHIP WITH THE FRIENDS OF THE STOWER SEVEN LAKES STATE TRAIL. THIS FREE EVENT FEATURES TWO MILES OF ILLUMINATED TRAILS WHERE KIDS AND ADULTS OF ALL AGES CAN ENJOY A WALK, SNOWSHOE, CROSS-COUNTRY SKI, OR FAT TIRE BIKING. FREE SNOWSHOES WERE AVAILABLE FOR KIDS AND ADULTS TO TRY ALONG WITH VEGGIE CHILI AND HOT CIDER. OVER 120 WERE IN ATTENDANCE. "VEGGIE FARMER MEET & SEED" EVENT AT LIEN ELEMENTARY DONE IN PARTNERSHIP WITH LIEN ELEMENTARY SCHOOL GARDEN COMMITTEE AND A TEAM OF SIX LOCAL VEGETABLE FARMERS INCLUDED MORNING SESSIONS FOR ALL STUDENTS ON HOW TO PLANT A SEED AND NURTURE A PLANT SO IT GROWS INTO A WHOLESOME AND DELICIOUS VEGETABLE OR BEAUTIFUL FLOWER. STUDENTS ALSO LEARNED ABOUT OUR REGION'S VEGETABLE-GROWING FAMILY FARMS. THESE SEEDLINGS WERE THEN RAISED IN THE SCHOOL HALLWAYS UNTIL READY FOR THE SCHOOL GARDEN. APPROXIMATELY 420 STUDENTS RECEIVED A PACK OF BABY CARROTS TO HELP CELEBRATE. POWERUP AT LIEN ELEMENTARY 4K ORIENTATION FEATURING A SINK OR FLOAT GAME AND OUTREACH MATERIALS. OVER 80 KIDS GUESSED WHETHER DIFFERENT FRUITS AND VEGGIES WOULD SINK OR FLOAT IN A BOWL OF WATER. POWERUP AT THE THIRD GRADE HEALTH FAIR FEATURING A VEGGIE VOTE WHERE APPROXIMATELY 250 STUDENTS TASTE TASTED TWO DIFFERENT VEGETABLES. THIS FUN AND PRESSURE-FREE WAY TO EXPLORE VEGGIES GETS KIDS EXCITED TO TRY! POWERUP SPORTS NUTRITION TALK (FUELING FOR PERFORMANCE, RECOVERY AND INJURY PREVENTION) WITH THE AMERY HIGH SCHOOL GIRLS SOCCER TEAM; APPROXIMATELY 35 STUDENTS.
PART III, CONT.	POWERUP WEEK IS A TIME TO HAVE FUN, GET INSPIRED, AND POWERUP WITH ACTIVITIES TO HELP KIDS, FAMILIES AND THE ENTIRE COMMUNITY EAT BETTER AND MOVE MORE. THIS SPECIAL WEEK IS A GREAT WAY FOR COMMUNITIES IN THE ST. CROIX VALLEY TO COME TOGETHER AND DO WHAT'S BEST FOR OUR KIDS, SO THEY CAN GROW UP HEALTHY AND STRONG. THIS YEAR, POWERUP WEEK IN AMERY FEATURED: A 2K RUN/WALK WITH 132 PARTICIPANTS, CHOMP'S BIRTHDAY PARTY AT AMERY PUBLIC LIBRARY WITH OVER 40 KIDS AND ADULTS, FAMILY YOGA WITH 22 KIDS AND ADULTS, AND A DANCE PARTY WITH OVER 50 KIDS AND ADULTS. MOBILE TEACHING KITCHEN KNOWN AS THE CHARLIE CART CONTINUED IN A PARTNERSHIP WITH AMERY PUBLIC LIBRARY AND REACHED 80 KIDS. PART OF THE MISSION OF BOTH THE CHARLIE CART PROGRAM AND POWERUP IS TO GIVE KIDS THE POWER TO MAKE HEALTHY CHOICES FOR LIFE THROUGH HANDS-ON EXPERIENCES WITH "BETTER-FOR-YOU" FOODS. POWERUP COOKING CLASSES AT FARM TABLE CONTINUED IN 2019 AND REACHED OVER 150 STUDENTS. COOKING CLASSES GIVE STUDENTS HANDS-ON EXPERIENCES WITH A VARIETY OF ESSENTIAL COOKING SKILLS, HELP THEM LEARN TO READ RECIPES, ADJUST MEASUREMENTS, AND PRACTICE TEAMWORK AND PRACTICE TEAMWORK AND ORGANIZATION. POWERUP, FARM TABLE, AND THE FITNESS CENTER PARTNERED TO HOST 30 POLK COUNTY SPECIAL OLYMPICS ATHLETES IN A TWO-PART CLASS TO HELP THEM PREPARE FOR THEIR UPCOMING BASKETBALL AND SHOW SHOE SEASON. THE GROUP HAD A POWERUP COOKING CLASS AT FARM TABLE AND THEN THEY TOOK A SHORT WALK DOWN THE STREET TO THE FITNESS CENTER WHERE THEY HAD A FITNESS CLASS. LIEN ELEMENTARY SCHOOL CARNIVAL WITH "POWERED UP" FOOD OPTIONS INCLUDING A TACO BAR, FRUIT CUPS, POPCORN, VEGGIE AND DIP CUPS, AND FRESH MADE SMOOTHIES; APPROXIMATELY 200 IN ATTENDANCE. AMERY INTERMEDIATE SCHOOL WALK-A-THON "POWERED UP" THEIR ANNUAL FUNDRAISER FOR THE SECOND YEAR BY COLLECTING DONATIONS (INSTEAD OF SELLING PROCESSED FOODS) AND EARNING THEM BY WALKING/RUNNING AROUND THE TRACK DURING AN ALLOTTED TIME. CLASSROOMS WITHIN EACH GRADE LEVEL THAT HAVE THE MOST LAPS EARN A POWERUP SMOOTHIE PARTY! OPEN GYMS IN THE WINTER MONTHS GIVE KIDS AND FAMILIES A SAFE PLACE TO MOVE THEIR BODIES. IN 2019, OPEN GYMS TOOK PLACE IN AMERY, CLEAR LAKE, AND TURTLE LAKE. TOTAL REACH BETWEEN ALL COMMUNITIES WAS 731 KIDS AND ADULTS. POWERUP FRUIT AND VEGGIE RX CONTINUED THIS YEAR WITH PROVIDERS ASKING CHILDREN AGES 2-17 YEARS OLD ABOUT FRUITS AND VEGGIES, AND THEN "PRESCRIBING" TRYING MORE FRUIT & VEGGIES WHILE ALSO GIVING OUT A $10 VOUCHER FOR PRODUCE AT THE LOCAL GROCERY STORE. AVERAGE REDEMPTION RATE FOR ALL FOUR AMERY HOSPITAL & CLINIC LOCATIONS WAS 51%. THE POWER OF PRODUCE (POP) CLUB WAS NEW THIS SUMMER AND RAN FOR 11 WEEKS AT THE AMERY FARMERS MARKET. EACH WEEK, CHILDREN RECEIVED A $2 TOKEN TO SPEND ON FRESH FRUITS, VEGETABLES, OR FOOD PLANTS. CHILDREN AND FAMILIES WERE ALSO PROVIDED WITH SEASONAL RECIPES, RESOURCES ON HOW TO BUY, USE, AND STORE VEGETABLES, AND A FRUIT OR VEGGIE-INSPIRED ACTIVITY. IN 11 WEEKS, THERE WERE 85 YOUTH THAT PARTICIPATED. OF THE 168 TOKENS FOR $2 THAT WERE DISTRIBUTED, 137 WERE REDEEMED (81.5% REDEMPTION RATE). FAMILY AND YOUTH FEEDBACK FOR THE PROGRAM WAS OVERWHELMINGLY POSITIVE AND HAD KIDS EXCITED TO PICK OUT THEIR OWN PRODUCE. SOME FAMILIES REPORTED AN INCREASED INTEREST IN THEIR CHILD CONSUMING FRUITS AND VEGETABLES BECAUSE OF THIS. - COMMUNITY-BASED CLINICAL SERVICES - $ 342 BEHAVIORAL HEALTH SCREENED 9TH GRADE TEENS FOR DEPRESSION, SUICIDAL THOUGHTS AND STRESSORS AT THE AMERY HIGH SCHOOL. - HEALTH CARE SUPPORT SERVICES - $ 189,700 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 $66,136 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 $665 TO HELP 27 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 $2.00 PER RIDE. OVER 1,100 PATIENTS USED THIS SERVICE IN 2019, WITH REVENUE OF $2,082 AND OPERATING COST OF $68,633. - SOCIAL & ENVIRONMENTAL IMPROVEMENT ACTIVITIES - $38,918 DUE THE HEALTH PROFESSIONAL SHORTAGE AREA IN THE ARMC SERVICE AREA, NUMEROUS RESOURCES WERE INVESTED IN PHYSICIAN AND ADVANCED PRACTICE PROVIDER RECRUITMENT, TOTALING AT LEAST $33,200. ARMC WELCOMED ONE DOCTOR OF OSTEOPATHIC MEDICINE, ONE ADULT NURSE PRACTITIONER, AND ONE FAMILY NURSE PRACTITIONER. IN 2019, OVER 825 MEDICAL STUDENTS APPLIED AND OVER 24 WERE INTERVIEWED FOR THE NEWLY INITIATED WESTERN WISCONSIN RURAL RESIDENCY PROGRAM AT ARMC. TWO STUDENTS WERE CHOSEN AND WERE EXPECTED TO START JUNE 10, 2020. 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 STUDENTS IN NURSING, PHYSICAL THERAPY, PHARMACY, OCCUPATIONAL THERAPY, RADIOLOGIC TECHNOLOGY, MEDICAL RECORDS, MEDICAL ASSISTANT, LAB TECHNICIAN, NURSE PRACTITIONERS, AND MEDICAL ADMINISTRATIVE ASSISTANTS STUDY AT ARMC. ARMC ALSO HAS AN AGREEMENT WITH THE UNIVERSITY OF MINNESOTA-DULUTH FOR FIRST YEAR AND SECOND YEAR MEDICAL STUDENT ROTATIONS. IN ADDITION, ARMC ACTIVELY COLLABORATES WITH THE WISCONSIN INDIANHEAD TECHNICAL COLLEGE (WITC) TO HELP EDUCATE AND TRAIN NURSES. IN 2019, ARMC PROVIDED CLINICAL TRAINING FOR: 111 NURSES, 3 CERTIFIED REGISTERED NURSE ANESTHETIST STUDENTS, 5 MEDICAL STUDENTS, 1 LAB TECHNICIAN STUDENT, 1 OCCUPATIONAL THERAPIST STUDENT, 3 OCCUPATIONAL THERAPIST ASSISTANT STUDENTS, 5 PHYSICAL THERAPY STUDENTS, 2 PHYSICAL THERAPY ASSISTANTS, 1 PARAMEDIC STUDENT, 4 PHARMACY STUDENTS, 1 RADIOLOGY STUDENT, 2 SOCIAL WORK STUDENTS, 1 PSYCHIATRIST, AND 1 FITNESS CENTER ASSISTANT. 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: NONE 4. FINANCIAL CONTRIBUTIONS: $ 143,147 - CASH DONATIONS - ARMC HELPED VARIOUS NON-PROFIT ORGANIZATIONS, COMMUNITY GROUPS, AND SCHOOL PROGRAMS THROUGH CASH DONATIONS TOTALING $13, 980. - 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 BOTH AMERY AND LUCK SCHOOL DISTRICTS, PROVIDING OVER 2,000 HOURS OF ATHLETIC TRAINING AND SUPPORT FOR A MINIMAL FEE TOTALING $6,230, WITH THE BENEFIT OF DONATED SERVICES TOTALING $43,932. ARMC HOSTED THREE BLOOD DRIVES IN 2019 COLLECTING OVER 65 UNITS OF BLOOD FROM OVER 60 INDIVIDUALS IN SUPPORT OF THE AMERICAN RED CROSS. ARMC PROVIDES MEETING SPACE FOR NON-PROFIT AND COMMUNITY GROUPS WITH A HEALTH FOCUS SUCH AS THE AMERICAN RED CROSS, BABY & ME, PRENATAL & BREASTFEEDING SUPPORT, DAVITA KIDNEY SMART, AND WITC NURSING PROGRAM TOTALING $5,000. IN ORDER TO HELP COMBAT POVERTY, ARMC PROVIDES AMERY AREA FOOD SHELF WITH FREE RENT, HEAT AND SHELVING FOR FOOD ITEMS. IN 2019, OVER $74,829 WAS PROVIDED TO SUPPORT THIS LOCAL PROGRAM.
PART III, CONT.	5. COMMUNITY BUILDING ACTIVITIES: $7,047 - ENVIRONMENTAL IMPROVEMENTS - ARMC HAD REPRESENTATIVES ATTEND THE ANNUAL CLEANMED CONFERENCE WHICH IS A NATIONAL ENVIRONMENTAL CONFERENCE FOR LEADERS IN HEALTH CARE SUSTAINABILITY. ARMC CONTINUES TO BE A SUSTAINABILITY CHAMPION AND HOSTS AN ANNUAL ELECTRONICS RECYCLING EVENT. - WORKFORCE DEVELOPMENT - ARMC HAS REPRESENTATIVES SERVE ON THE WITC MEDICAL ASSISTANT ADVISORY COMMITTEE, WITC ADVISORY COUNCIL, AND WITC HEALTH INFORMATION TECHNOLOGY ADVISORY COMMITTEE. 6. COMMUNITY BENEFIT OPERATIONS: $16,023 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. 7. ORGANIZATION AWARDS AND ACHIEVEMENTS 2019 PRACTICE GREENHEALTH AWARDS: EMERALD AWARD GREENING THE OR RECOGNITION CIRCLES OF EXCELLENCE (TOP 10): WATER
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 HEALTH OR BY GROUP HEALTH PLAN, INC. (GHI), ALL OF WHICH ARE RELATED ORGANIZATIONS, OR BY AMERY. GHI, REGIONS, LAKEVIEW HEALTH 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 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 ANERY 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.
FORM 990, PART XI, LINE 9:	CONTRIBUTION FROM AMERY HOSPITAL FOUNDATION -224,341.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (28 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	HEALTHPARTNERS INC
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	HPI - RAMSEY
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 III	HUTCHINSON HEALTH

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	-$36,941	ShareOfTotalIncomeAmt
Share Of EOY Assets	-$30,168	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	Yes (1)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (1)	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 (2 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
HEALTHPARTNERS INC - CLAIMSHEALTHCARE SERVICES
L	$197,530	FAIR VALUE
AMERY REGIONAL MEDICAL CENTER FOUNDATION
C	$265,113	FAIR VALUE