2019-11-15T09:48:06-06:00 2018-12-31 135565207 KPMG LLP 4200 WELLS FARGO CTR 90 S 7TH STREET MINNEAPOLIS MN 55402 990 2018-01-01 390804125 HUDSON HOSPITAL INC HUDS 7155316000 405 STAGELINE ROAD HUDSON WI 54016 DOUGLAS E JOHNSON CFO 7155316000 2019-11-14 1 MONROE JORDAN GIERL P01413237 6123055000 198.153.9.209 2019-11-14 15:28:38 CS P BC53011EDF70B2E1BD72B439C4A42BAD8A5D7AD2 31AD5F3C55E0BEE4726FCC0867C2B4B74D95884E 2018 2020-04-17 16:48:07Z DOUGLAS E JOHNSON 405 STAGELINE ROAD HUDSON WI 54016 62696036 0 X WWW.HUDSONHOSPITAL.ORG X 1950 WI TO IMPROVE HEALTH AND WELL-BEING IN PARTNERSHIP WITH OUR MEMBERS, PATIENTS AND COMMUNITY. 13 9 473 66 0 27399 97155 156417 55500897 60856557 599965 114033 309948 394652 56507965 61521659 19555 163606 0 0 32353645 32871085 0 0 0 20746465 22229022 53119665 55263713 3388300 6257946 80806157 83735177 26965277 23943765 53840880 59791412 X TO IMPROVE HEALTH AND WELL-BEING IN PARTNERSHIP WITH OUR MEMBERS, PATIENTS AND COMMUNITY 0 0 47149926 163606 61251209 SEE SCHEDULE O - EXEMPT PURPOSE AND ACHIEVEMENTS FOR A DESCRIPTION OF PROGRAM SERVICE ACCOMPLISHMENTS 47149926 1 1 0 1 0 0 0 0 0 1 1 0 1 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 1 0 1 0 0 473 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 13 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 WI X DOUGLAS E JOHNSON - CHIEF FINANCIAL OFFICER 7155316013 405 STAGELINE ROAD HUDSON WI 54016 X RYAN ARMBRUSTER VICE CHAIR (APRIL - DEC) 1.00 X X 0 0 0 ANNETTE COOK CHAIR 1.00 X X 0 0 0 STEVE KIRBY DIRECTOR 1.00 X 0 0 0 KARI CAMPBELL MD DIRECTOR (JAN-FEB) 1.00 X 0 0 0 MIKE SELLMAN VICE CHAIR (JAN - MAR) 1.00 X X 0 0 0 KARRIN STOEHR MD DIRECTOR (JAN) 1.00 X 0 0 0 JONATHAN SUSA MD DIRECTOR 1.00 X 0 0 0 GARY VANDER VORST DIRECTOR 1.00 X 0 0 0 MARVIN KLINGLER MD DIRECTOR 1.00 X 0 0 0 MARK GHERTY DIRECTOR 1.00 X 0 0 0 JEROME SIY MD DIRECTOR 0.50 49.50 X 0 391148 70946 BECKY DURHAM DIRECTOR 1.00 X 0 0 0 KRISTIN TJORNEHOJ DIRECTOR 1.00 X 0 0 0 MEGAN M REMARK DIRECTOR & SECRETARY 0.50 49.50 X X 0 736612 195456 MARK HANSBERRY DIRECTOR 0.50 49.50 X 0 517570 110371 LEVON O'HAODHA MD DIRECTOR 0.50 39.50 X 0 388435 53654 DOUGLAS E JOHNSON VP & CFO 21.30 33.70 X 0 370787 157922 STEVE MUELLERLEILE VP - PLANNING & DEVELOPMEN 39.50 0.50 X 125938 0 29377 THOMAS BOROWSKI PRESIDENT 58.00 2.00 X 0 264574 40292 KRISTY YAEGER VP, PATIENT CARE SERVICES 50.00 X 187996 0 13122 BHAVIN PATEL MD VPMA 40.00 X 0 310326 76611 DANIELLE L FERKINGSTAD NURSE ANESTHETIST 40.00 X 221109 0 28434 DARLA KLEMENTZ DIRECTOR OF PHARMACY 40.00 X 171044 0 17384 HOWARD J GEORGESON NURSE ANESTHETIST 62.00 X 245025 0 35960 KEITH W LARSON NURSE ANESTHETIST 62.00 X 261703 0 35634 JEFFREY L REICHEL NURSE ANESTHETIST 60.00 X 212866 0 14143 MARIAN M FURLONG FORMER PRESIDENT 0.00 0.00 X 0 135570 16913 ROBBIE HAGELBERG FORMER VP & CNO 0.00 40.00 X 0 224472 31443 1425681 3339494 927662 39 1 1 0 SHARED MEDICAL TECHNOLOGY INC 202 W NEWTON ST RICE LAKE WI 54868 RADIOLOGY SERVICES 721968 CANCER CENTER OF WESTERN WISCONSIN 501 HOSPITAL RD NEW RICHMOND WI 54017 MEDICAL SERVICES 421375 HUDSON PHYSICIANS 403 STAGELINE RD HUDSON WI 54016 PHYSICIAN SERVICES 280758 INTERSTATE COMPANIES PO BOX 1028 FOREST LAKE MN MN 554855970 PROPERTY MANAGEMENT 179379 B&B ELECTRIC INC 1303 WESTERN AVE EAU CLAIRE WI 54703 ELECTRIC SERVICES 144448 10 20825 135592 156417 PATIENT SERVICE 623990 60531894 60531894 DIETARY 722210 179657 179657 OTHER PATIENT SERVICES 623990 73359 73359 GIFT SHOP 453220 71647 71647 60856557 114033 114033 1569029 1174377 394652 394652 394652 61521659 61251209 0 114033 163606 163606 611348 611348 27074611 23256078 3818533 777727 672412 105315 2916302 2584460 331842 1491097 1289182 201915 737 737 1000 1000 1760618 1357830 402788 113230 6377 106853 312074 141422 170652 128698 119981 8717 1647012 782442 864570 76568 47111 29457 29157 13108 16049 642325 642325 3029213 2855122 174091 151097 6961 144136 MEDICAL & OTHER SUPPLY 12041479 12006870 34609 EQUIPMENT & MAINTENANCE 1623742 815690 808052 OTHER EXPENSE 415809 135991 279818 TAXES & ASSESSMENTS 204075 204075 0 52188 48883 3305 55263713 47149926 8113787 0 31433357 35558121 242051 285267 5414487 5548455 835602 1095811 100921 157004 77781897 43596314 36067925 34185583 4460157 4633426 2251657 2271510 80806157 83735177 5994295 5861950 12636565 10188732 8334417 7893083 26965277 23943765 X 50284204 55999325 3474986 3710397 81690 81690 53840880 59791412 80806157 83735177 X 6257946 -542824 235410 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 0 0 PART II-B, LINE 1: HUDSON HOSPITAL, INC. PAYS FOR CERTAIN CORPORATE PROFESSIONAL ASSOCIATION MEMBERSHIPS. A PORTION OF SUCH MEMBERSHIP DUES POTENTIALLY COULD BE USED BY THE PROFESSIONAL ASSOCIATIONS FOR LOBBYING ACTIVITIES. 81690 81690 81690 81690 81690 81690 81690 81690 81690 81690 0 1 1 11298942 11298942 40023406 26432106 13591300 5436367 659172 4777195 18389080 14815212 3573868 2634102 1689824 944278 34185583 CANCER CENTER OF WESTERN WISCONSIN 385000 C INVESTMENT IN MYRTLE DIALYSIS 154408 C INTERCOMPANY SHARED ASSETS 117125 C DEBT ISSUANCE COST 184806 C BENEFICIAL INTEREST 3792087 C 4633426 THIRD-PARTY PAYOR SETTLEMENTS 2303000 INTERCOMPANY NOTES PAYABLE 5590083 7893083 X PART V, LINE 4: HUDSON HOSPITAL, INC. HOLDS $81,690 OF PERMANENTLY RESTRICTED ASSETS RELATED TO HUDSON HOSPITAL, INC.'S BENEFICIAL INTEREST IN THE NET ASSETS OF HUDSON HOSPITAL FOUNDATION, INC., A RELATED ORGANIZATION OF HUDSON HOSPITAL, INC. PART X, LINE 2: HUDSON HOSPITAL, 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, 2018 OR 2017 FOR UNRECOGNIZED TAX BENEFITS. 1 1 1 X 1 X 1 1 1 0 1 1 468 372644 372644 0.00670 1742 4982362 4342631 639731 0.01160 2210 5355006 4342631 1012375 0.01830 71 336270 28405 307865 0.00560 8 369385 369385 0.00670 335216 335216 0.00610 4 58130 58130 0.00110 83 1099001 28405 1070596 0.01950 83 2210 6454007 4371036 2082971 0.03780 3 3705 3705 0.00010 19 60726 60726 0.00110 7 14816 14816 0.00030 12 30261 30261 0.00050 1 2858 2858 0.00010 42 84 112366 112366 0.00210 1 1999096 16526499 16488193 38306 X 1 1 1 WESTERN WISCONSIN CANCER CENTER MEDICAL ONCOLOGY AND RADIATION 0.23700 0.00000 0.00000 2 MYRTLE DIALYSIS DIALYSIS 0.10000 0.00000 0.00000 1 1 HUDSON HOSPITAL INC 405 STAGELINE ROAD HUDSON WI 54016 WWW.HUDSONHOSPITAL.ORG STATE OF WI CRITICAL ACCESS # 1039 X X X X HUDSON HOSPITAL INC 1 0 0 1 X X X X X X X X X 18 1 1 1 1 X HTTP://WWW.HUDSONHOSPITAL.ORG/COMMUNITY/ X 1 15 1 HTTP://WWW.HUDSONHOSPITAL.ORG/COMMUNITY/ 0 1 X 200.000000000000 300.000000000000 X X X 1 1 X X X X 1 X WWW.HUDSONHOSPITAL.ORG X WWW.HUDSONHOSPITAL.ORG X WWW.HUDSONHOSPITAL.ORG X X X X X X 1 X 0 X X X X 1 X 0 0 HUDSON HOSPITAL, INC. PART V, SECTION B, LINE 5: HUDSON HOSPITAL (THE HOSPITAL) IS AN INTEGRAL PART OF HEALTHIER TOGETHER - PIERCE & ST. CROIX COUNTIES, AND SERVES AS ONE OF THE SIX PARTNERS IN THE COALITION. AS PART OF THE DATA COLLECTION PROCESS FOR THE MOST RECENT CHNA THAT WAS CONDUCTED IN 2015, THE HOSPITAL COLLABORATED EXTENSIVELY WITH THE COALITION TO CONDUCT: - THE COMMUNITY HEALTH ASSESSMENT AND GROUP EVALUATION (CHANGE) TOOL, DEVELOPED BY CDC'S HEALTHY COMMUNITIES PROGRAM TO HELP ORGANIZE INFORMATION ON INDICATORS RELATED TO ENVIRONMENTS AND POLIES SUPPORTING HEALTH EATING, ACTIVE LIVING, AND CHRONIC DISEASE MANAGEMENT. INTERVIEWS WERE CONDUCTED IN THE COMMUNITY-AT-LARGE, HEALTHCARE, AND SCHOOL SECTORS WITH OVER 25 KEY INFORMANTS. - A PUBLIC OPINION POLL WITH THE HELP OF PUBLIC OPINION STRATEGIES. THE PURPOSE OF THE POLL WAS TO EVALUATE PUBLIC SUPPORT FOR HEALTHIER TOGETHER'S EFFORTS TO PROMOTE HEALTHIER PLACES TO LIVE, WORK AND PLAY. PUBLIC OPINION STRATEGIES COMPLETED THE SURVEY WITH 300 RANDOM ST. CROIX ADULTS. - A COMMUNITY HEALTH NEEDS ASSESSMENT ONLINE AND PAPER SURVEY, HEAVILY PROMOTED WITH PUBLIC HEALTH PROGRAM PARTICIPANTS.FEEDBACK WAS RECEIVED BETWEEN JULY AND DECEMBER 2013 FROM: - STATE, LOCAL, TRIBAL, OR REGIONAL GOVERNMENTAL PUBLIC HEALTH DEPARTMENT (OR EQUIVALENT DEPARTMENT OR AGENCY) WITH KNOWLEDGE, INFORMATION, OR EXPERTISE RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY. - MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS IN THE COMMUNITY, OR INDIVIDUALS OR ORGANIZATIONS SERVING OR REPRESENTING THE INTERESTS OF SUCH POPULATIONS.FOR A FULL DETAILED LIST OF INSTITUTIONS AND PERSONS, PLEASE SEE OUR WEBSITE: HTTP://WWW.HUDSONHOSPITAL.ORG/COMMUNITY/. HUDSON HOSPITAL, INC. PART V, SECTION B, LINE 6A: OTHER HOSPITAL FACILITIES INCLUDED IN THE 2015 HEALTHPARTNERS CHNA WERE: - LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, MN. - PARK NICOLLET METHODIST HOSPITAL, MN. - REGIONS HOSPITAL, MN. - AMERY REGIONAL MEDICAL CENTER, WI. - WESTFIELDS HOSPITAL, INC., WI. HUDSON HOSPITAL, INC. PART V, SECTION B, LINE 6B: THE HOSPITAL'S CHNA WAS CONDUCTED IN PARTNERSHIP WITH HEALTHIER TOGETHER - PIERCE & ST. CROIX COUNTIES. FOR A FULL DETAILED LIST OF PARTNERING ORGANIZATIONS, PLEASE SEE OUR WEBSITE: HTTP://WWW.HUDSONHOSPITAL.ORG/COMMUNITY/. HUDSON HOSPITAL, INC. PART V, SECTION B, LINE 11: THE 2015 HEALTHPARTNERS CHNA CONDUCTED RESULTED IN THE FOLLOWING PRIORITIES:PRIORITY 1: INCREASE ACCESS TO MENTAL HEALTHPRIORITY 2: PROMOTE POSITIVE BEHAVIORS TO REDUCE OBESITY (NUTRITION / PHYSICAL ACTIVITY)PRIORITY 3: INCREASE ACCESS TO PRIMARY AND PREVENTIVE CARE PRIORITY 4: IMPROVE SERVICE INTEGRATIONPRIORITY 5: PROMOTE CHANGE IN UNHEALTHY LIFESTYLES (TOBACCO / ALCOHOL / SUBSTANCE ABUSE)A FULL REPORT OF THE HOSPITAL'S 2015 CHNA AND ANNUAL IMPLEMENTATION PLAN UPDATE IS POSTED ON THEIR WEBPAGE AT HTTP://WWW.HUDSONHOSPITAL.ORG/COMMUNITY/ WHICH PROVIDES A DETAILED DESCRIPTION OF ALL THE ACTIVITIES. HUDSON HOSPITAL, INC. PART V, SECTION B, LINE 13B: THE HOSPITAL OFFERS A STANDARDIZED AND UNIFORM APPROACH TO OFFERING A DISCOUNT FOR THE UNINSURED. THE DISCOUNT IS 50% FOR ALL ELIGIBLE PATIENTS, REGARDLESS OF INCOME. THE HOSPITAL USES FPG FAMILY INCOME LIMIT OF 300% TO DETERMINE ELIGIBILITY FOR ADDITIONAL DISCOUNTED CARE ABOVE AND BEYOND THE 50%. HUDSON HOSPITAL, INC. PART V, SECTION B, LINE 15E: THE HOSPITAL DEFINES FINANCIAL ASSISTANCE AS THE COST OF CARE DELIVERED TO PATIENTS WHO ARE WILLING, BUT UNABLE TO PAY FOR THE SERVICES THEY RECEIVE. THIS INCLUDES PATIENTS WHOSE CHARGES ARE FORGIVEN OR REDUCED BECAUSE OF INABILITY TO PAY, PATIENTS WHO ARE UNABLE TO PAY THE BALANCE LEFT BY ANY PAYER, AND PATIENTS FOR WHOM UNUSUAL CIRCUMSTANCES OR SPECIAL FINANCIAL HARDSHIP WARRANT SPECIAL CONSIDERATION. TO INFORM AND EDUCATE PATIENTS ON ITS FINANCIAL ASSISTANCE PROGRAM, FINANCIAL ASSISTANCE POLICY, AND GOVERNMENT PROGRAMS, THE HOSPITAL HAS DEVELOPED AN EXTENSIVE FINANCIAL COUNSELING PROGRAM. WHEN A PATIENT VISITS THE HOSPITAL'S EMERGENCY DEPARTMENT OR IS ADMITTED TO THE HOSPITAL, BASIC INFORMATION ABOUT INSURANCE STATUS IS REQUESTED. IF A PATIENT DOES NOT HAVE HEALTH INSURANCE, PATIENT FINANCIAL SERVICES IS CONTACTED TO MEET OR FOLLOW-UP WITH THE PATIENT. ALL PATIENTS WITHOUT INSURANCE AUTOMATICALLY QUALIFY FOR A DISCOUNT OF 50%, REGARDLESS OF INCOME. IF THE PATIENT IS INTERESTED IN DETERMINING IF THEY ARE ELIGIBLE FOR FURTHER DISCOUNTS, THEY WILL BE REQUESTED TO PROVIDE ADDITIONAL INFORMATION. ENROLLMENT ASSISTANCE, INFORMATION, AND REFERRAL SERVICES ARE AVAILABLE TO HELP SECURE A PAYMENT SOURCE FOR UNINSURED AND UNDER INSURED PATIENTS. PATIENT FINANCIAL SERVICES REPRESENTATIVES TO OVERSEE ITS FINANCIAL ASSISTANCE PROGRAM AND, ALONG WITH SUPPORT FROM DEPARTMENT STAFF, HELPS PATIENTS ENROLL IN GOVERNMENT PROGRAMS, FIND OTHER SOURCES OF PAYMENT, OR ACCESS SERVICES BEYOND MEDICAL CARE. IN ADDITION TO FINANCIAL COUNSELING, THE HOSPITAL HAS STAFF SOCIAL WORKERS AND CASE MANAGERS TO HANDLE CRISIS INTERVENTIONS, EMERGENCY ROOM NEEDS, AND PATIENT AFTERCARE. PART I, LINE 7: USED WORKSHEETS PROVIDED IN SCHEDULE H INSTRUCTIONS TO CALCULATE COST TO CHARGE RATIOS. PART I, LINE 7G: HUDSON HOSPITAL (THE HOSPITAL) IS COMMITTED TO PROVIDING NEEDED SERVICES EVEN AT A FINANCIAL LOSS. IN 2018, THE HOSPITAL EXPERIENCED LOSS ON SERVICES FOR HOSPITAL OUTPATIENT SERVICES INCLUDING LACTATION, PROGRAMS FOR CHANGE, CHEMOTHERAPY, BLOOD SERVICES, AND PHYSICAL THERAPY. SCH. H - PART I, LINE 3 - ELIGIBILITY FOR DISCOUNTED CARE THE HOSPITAL CALCULATES FINANCIAL ASSISTANCE BASED ON PATIENTS' HOUSEHOLD INCOME COMPARED TO WHAT'S CALL THE FEDERAL POVERTY GUIDELINES (FPG). PATIENT WHOSE INCOME AND FAMILY SIZE PLACE THEM AT OR BELOW 200% OF THE (FPG) WILL RECEIVE A 100% DISCOUNT. PATIENT'S WHOSE INCOME AND FAMILY SIZE PLACE THEM ABOVE 200%, BUT NOT MORE THAN 300% ABOVE THE (FPG) WILL RECEIVE A SLIDING-SCALE PARTIAL DISCOUNT. IF A PATIENT HAS RECEIVED EMERGENCY OR OTHER MEDICALLY NECESSARY CARE AT THE HOSPITAL AND IS ELIGIBLE FOR FINANCIAL ASSISTANCE, THE HOSPITAL WILL NOT CHARGE MORE THAN AMOUNTS GENERALLY BILLED (AGB) TO PATIENTS THAT HAVE HEALTH INSURANCE COVERAGE. THE HOSPITAL CAN DETERMINE PRESUMPTIVE ELIGIBILITY FOR FINANCIAL ASSISTANCE BASED THE PATIENTS' ABILITY TO MEET CERTAIN CIRCUMSTANCES, WHICH INCLUDE BUT ARE NOT LIMITED TO THE FOLLOWING CONDITIONS: HOMELESSNESS, MEDICALLY NECESSARY SERVICES NOT COVERED OR PAYABLE UNDER A MEDICAID PROGRAM OR FEDERAL GRANT RENDERED TO A QUALIFIED RECIPIENT, QUALIFICATION AND EFFECTIVE DATE FOR MEDICAID SUBSEQUENT TO THE SERVICE DATES, INCARCERATION OR MILITARY SPECIAL CIRCUMSTANCES. PART II, COMMUNITY BUILDING ACTIVITIES: THE HOSPITAL IS AN ENERGETIC MEMBER OF THE LOCAL, STATE AND REGIONAL COMMUNITIES. AS THE HOSPITAL SUPPORTS INDIVIDUALS, ORGANIZATIONS, EVENTS AND PROGRAMS, IT LIVES OUT ITS COMMITMENT TO IMPROVE THE HEALTH OF THE COMMUNITY. KNOWING MUCH MORE CAN BE ACCOMPLISHED TOGETHER, THE HOSPITAL CONTINUED ITS LEADERSHIP AND CO-FACILITATION OF HEALTHIER TOGETHER - ST. CROIX COUNTY WITH ST. CROIX COUNTY DEPARTMENT OF HEALTH. THROUGH THIS COUNTY-WIDE, COMMUNITY HEALTH IMPROVEMENT INITIATIVE, THE HOSPITAL BEGAN TO ALIGN ITS COMMUNITY BENEFIT PROGRAM WITH COMMUNITY HEALTH IMPROVEMENT EFFORTS AND CONTINUES TO BUILD VALUABLE CONNECTIONS WITH INDIVIDUALS AND ORGANIZATIONS FROM PUBLIC, PRIVATE AND NONPROFIT SECTORS TO SHARE SKILLS AND ASSETS. THE HOSPITAL PARTICIPATED IN COMMUNITY-BUILDING ACTIVITIES THAT SUPPORTED ECONOMIC DEVELOPMENT, EMERGENCY PREPAREDNESS, LEADERSHIP DEVELOPMENT, COALITION ADVOCACY GROUPS TO IMPROVE HEALTH, AND WORKFORCE DEVELOPMENT. FOR THESE ACTIVITIES, THE HOSPITAL PARTNERED WITH THE ST. CROIX ECONOMIC DEVELOPMENT, WISCONSIN HOSPITAL ASSOCIATION, ST. CROIX EMS, UNIVERSITY OF WISCONSIN - RIVER FALLS CHANCELLOR'S ADVISORY COUNCIL, THE HEALING ARTS PROGRAM, CANCER CENTER OF WESTERN WISCONSIN, HUDSON HIGH SCHOOL, POWERUP, WISCONSIN INDIANHEAD TECHNICAL COLLEGE (WITC) AND HUDSON CHAMBER OF COMMERCE.THE HOSPITAL CONTINUED ON ITS ECO-FRIENDLY JOURNEY "HEALTH CARE WITHOUT HARM" (2008 COMMITMENT) USING SUSTAINABLE BUSINESS PRACTICES AND ESTABLISHING GREEN PURCHASING POLICIES IN ORDER TO PROVIDE HEALTH CARE THAT IS HEALTHY. GREEN INITIATIVES INCLUDED THE RECYCLING PROGRAM, REDUCTION OF PAPER COPIES, AND REDUCTION OF ENERGY AND WATER CONSUMPTION. IMPLEMENTING SUSTAINABLE BUSINESS PRACTICES HAS MADE THE HOSPITAL A MODEL WITHIN THE HEALTHPARTNERS FAMILY OF ORGANIZATIONS. PART III, LINE 2: "BAD DEBT" REPRESENTS THE UNPAID OBLIGATION FOR CARE PROVIDED TO PATIENTS WHO HAVE BEEN DETERMINED TO BE ABLE TO PAY, BUT HAVE NOT DEMONSTRATED A WILLINGNESS TO DO SO. BAD DEBT INCLUDES ANY UNPAID PATIENT RESPONSIBILITY THAT MAY INCLUDE, BUT IS NOT LIMITED TO, DEDUCTIBLES, CO-INSURANCE, CO-PAYMENTS AND NON-COVERED SERVICES. SCH. H - PART I, LINE 6 - COMMUNITY BENEFIT REPORT AS A NOT-FOR-PROFIT ORGANIZATION, THE HOSPITAL NEEDS TO BE ACCOUNTABLE FOR ITS TAX EXEMPTION STATUS - ACCOUNTABLE TO ITS BOARD, STAFF, PHYSICIANS, DONORS, KEY STAKEHOLDERS, COMMUNITY PARTNERS AND MOST OF ALL TO THE COMMUNITIES IT SERVES. THE 2018 REPORT TO COMMUNITY WAS REVIEWED AT BOTH THE BOARD OF DIRECTORS MEETING AND THE MANAGEMENT COUNCIL MEETING. THE REPORT COMMUNICATES THE ACCOMPLISHMENTS AND CHARITABLE WORKS OF THE HOSPITAL IN SUPPORT OF ITS MISSION. PUBLISHING THE REPORT ONLINE SUPPORTS THE HOSPITAL'S GREEN INITIATIVE, AND THE REPORT SHARES HOSPITAL ACCOMPLISHMENTS, SUPPORT EFFORTS OF THE HUDSON HOSPITAL FOUNDATION, AND HEALTHIER TOGETHER UPDATES. PART III, LINE 4: IN JULY 2011, THE FASB ISSUED ASU NO. 2011-07, PRESENTATION AND DISCLOSURE OF PATIENT SERVICE REVENUE, PROVISION FOR DOUBTFUL ACCOUNTS, AND THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR CERTAIN HEALTH CARE ENTITIES, WHICH PROVIDES FINANCIAL STATEMENT USERS WITH GREATER TRANSPARENCY ABOUT A HEALTH CARE ENTITY'S NET PATIENT SERVICE REVENUE AND RELATED ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE AMENDMENTS REQUIRE HEALTH CARE ENTITIES TO PRESENT THE PROVISION FOR DOUBTFUL ACCOUNTS RELATED TO PATIENT SERVICE REVENUE AS A DEDUCTION FROM PATIENT SERVICE REVENUE (NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS) ON THEIR STATEMENT OF OPERATIONS. THIS STANDARD WAS EFFECTIVE BEGINNING WITH THE 2012 FISCAL YEAR.THE FOOTNOTE IN THE HEALTHPARTNERS (HP) AUDIT REPORT, WHICH THE HOSPITAL IS PART OF, READS AS FOLLOWS: "HEALTH SERVICE ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS OR CHARITY CARE BASED ON ESTABLISHED GUIDELINES FOR IDENTIFYING UNCOLLECTIBLE PATIENT ACCOUNTS AND CLASSIFYING THESE ACCOUNTS AS EITHER DOUBTFUL ACCOUNTS FOR CHARITY CARE. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, HP'S MANAGEMENT PERIODICALLY ASSESSES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND CHARITY CARE BY TAKING INTO CONSIDERATION, BY PAYOR CATEGORY, THE EXPECTED NET COLLECTIONS, ACCOUNTS RECEIVABLE AGING, HISTORICAL COLLECTIONS EXPERIENCE, ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. THE PRIMARY SOURCE OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS THE PATIENT RESPONSIBILITY PORTION OF COMMERCIAL ACCOUNTS. THE PRIMARY SOURCE OF THE ALLOWANCE FOR CHARITY CARE IS CHARGES FOR UNINSURED PATIENTS. PATIENTS WHO ARE INSURED ARE ASSESSED SEPARATELY FOR COLLECTABILITY FROM UNINSURED PATIENTS. THE RESULTS OF THESE ASSESSMENTS ARE USED TO ESTABLISH THE NET REALIZABLE VALUE OF PATIENT ACCOUNTS RECEIVABLE AND THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND CHARITY CARE. FOR PREMIUMS AND OTHER RECEIVABLES, HP'S POLICY IS TO SET UP ALLOWANCES FOR ALL RECEIVABLES OVER 90 DAYS OUTSTANDING." PART III, LINE 8: THE HOSPITAL BASES ITS MEDICARE COSTING METHODOLOGY ON THE CMS MEDICARE COST REPORT METHODOLOGY TO GET THE COST TO CHARGE RATIO. SINCE THE HOSPITAL IS A CRITICAL ACCESS HOSPITAL, REIMBURSEMENT FROM MEDICARE IS EQUAL TO THE COST SO THERE IS NO SURPLUS (SHORTFALL). PART III, LINE 9B: THE HOSPITAL DEBT COLLECTION POLICY CONTAINS PROVISIONS ON COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE. THE HOSPITAL BELIEVES THAT DEBT COLLECTION POLICIES, WHETHER IMPLEMENTED BY HOSPITAL STAFF OR AGENTS, SHOULD REFLECT THE HOSPITAL'S MISSION AND VALUES. THE HOSPITAL WILL NOT TOLERATE ABUSIVE, HARASSING, OPPRESSIVE, FALSE, DECEPTIVE, OR MISLEADING LANGUAGE OR COLLECTIONS CONDUCT BY ITS DEBT COLLECTION, ATTORNEY AND AGENCY, AND THEIR AGENTS AND EMPLOYEES, AND THE HOSPITAL EMPLOYEES RESPONSIBLE FOR COLLECTING MEDICAL DEBT FROM PATIENTS. THE HOSPITAL 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. THE HOSPITAL 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 FINANCIAL ASSISTANCE APPLICATION. IF THE PATIENT HAS SUBMITTED AN APPLICATION FOR FINANCIAL ASSISTANCE, ALL COLLECTION ACTIVITY WILL BE SUSPENDED UNTIL THE APPLICATION HAS BEEN PROCESSED. SCHEDULE H - PART I, LINE 7F - HEALTH PROFESSIONS EDUCATION THE HOSPITAL'S STAFF PROVIDED CLINICAL TRAINING FOR NURSES, NURSING STUDENTS AND HEALTH PROFESSIONALS, INCLUDING EMS, FROM SEVENTEEN INSTITUTIONS. IN ADDITION, THE HOSPITAL VOLUNTARILY PARTICIPATED IN THE WISCONSIN NURSE RESIDENCY PROGRAM (WNRP). THE PROGRAM IS A STRUCTURED LEARNING EXPERIENCE FOR NEWLY LICENSED REGISTERED NURSES DESIGNED TO PROMOTE EFFECTIVE TRANSITION INTO PROFESSIONAL PRACTICE. NURSES ARE PAIRED WITH EXPERIENCED HOSPITAL NURSES ACTING AS COACH/SUPPORT PERSON IN THE 12-MONTH PROGRAM. SCH. H - PART V, SECTION B, LINE 14 - FINANCIAL ASSISTANCE POLICY THE HOSPITAL USES THE FEDERAL POVERTY GUIDELINE PRESCRIBED CALCULATION TO DETERMINE THE MAXIMUM CHARGEABLE AMOUNT FOR PATIENTS DETERMINED TO BE FAP ELIGIBLE. THERE IS ALSO AN UNINSURED DISCOUNT AVAILABLE TO ASSIST THOSE INDIVIDUALS WHO DO NOT HAVE HEALTH INSURANCE. THE HOSPITAL OFFERS A STANDARDIZED AND UNIFORM APPROACH TO OFFERING A DISCOUNT FOR THE UNINSURED AT AMOUNTS NO GREATER THAN AMOUNTS BILLED TO MEDICARE PATIENTS. PART VI, LINE 2: IN 2015, A COMPREHENSIVE, SIX-STEP COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) COLLABORATION WAS CONDUCTED FOR HEALTHPARTNERS AND ITS HOSPITALS (REGIONS HOSPITAL, LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, HUDSON HOSPITAL, WESTFIELDS HOSPITAL, AMERY REGIONAL MEDICAL CENTER, AND PARK NICOLLET METHODIST HOSPITAL) BY COMMUNITY HOSPITAL CONSULTING 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. THE HOSPITAL'S SPECIFIC STUDY AREA IS DEFINED AS:- ST. CROIX COUNTYDATA ELEMENTS REGARDING ALL SEVEN COUNTIES IN THE SYSTEM'S STUDY AREA ARE INCLUDED IN THIS REPORT FOR COMPARISON, AND ARE ALSO PROVIDED AS AN OPPORTUNITY FOR THE HOSPITALS TO WORK TOGETHER TO MEET THE NEEDS IDENTIFIED IN THE OVERLAPPING COUNTIES.- DEMOGRAPHICS: CHC CONSULTING ANALYZED THE MOST CURRENT DEMOGRAPHICS OF RESIDENTS IN ST. CROIX COUNTY, INCLUDING: OVERALL POPULATION, POPULATION BY RACE AND ETHNICITY, MEDIAN AGE, MEDIAN HOUSEHOLD INCOME, POVERTY LEVELS, FOOD INSECURITY, AND EDUCATIONAL ATTAINMENT.- HEALTH DATA COLLECTION: THE HOSPITAL PARTICIPATED IN A COUNTY-WIDE INITIATIVE TO ANALYZE THE HEALTH OF RESIDENTS IN THE COMMUNITY, THE ST. CROIX COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPROVEMENT PLAN 2014-2016.- COMMUNITY INPUT: AS A PART OF THE COUNTY-WIDE ASSESSMENT, COMMUNITY INPUT WAS ANALYZED THROUGH THE FOLLOWING METHODS: COMMUNITY HEALTH ASSESSMENT AND GROUP EVALUATION (CHANGE) ASSESSMENT, TRANSFORM WISCONSIN PUBLIC OPINION POLL, AND THE CHNA SURVEY.FINAL PRIORITIZED NEEDS- MENTAL AND BEHAVIORAL HEALTH- ACCESS AND AFFORDABILITY- CHRONIC DISEASE AND ILLNESS PREVENTION- EQUITABLE CAREA FULL REPORT OF HUDSON'S CHNA AND IMPLEMENTATION PLAN IS POSTED ON THE HOSPITAL'S WEBPAGE AT HTTP://WWW.HUDSONHOSPITAL.ORG/COMMUNITY/COMMUNITY-HEALTH-IMPROVEMENT/. PART VI, LINE 3: THE HOSPITAL DEFINES FINANCIAL ASSISTANCE AS THE COST OF CARE DELIVERED TO PATIENTS WHO ARE WILLING, BUT UNABLE, TO PAY FOR THE SERVICES THEY RECEIVE. THIS INCLUDES PATIENTS WHOSE CHARGES ARE FORGIVEN OR REDUCED BECAUSE OF INABILITY TO PAY, PATIENTS WHO ARE UNABLE TO PAY THE BALANCE LEFT BY ANY PAYER, AND PATIENTS FOR WHOM UNUSUAL CIRCUMSTANCES OR SPECIAL FINANCIAL HARDSHIP WARRANT SPECIAL CONSIDERATION. THE HOSPITAL IS COMPLIANT WITH THE 501R FEDERAL REGULATIONS, AND PROVIDES EASY ACCESS TO THE FINANCIAL ASSISTANCE PROGRAM INCLUDING THE FINANCIAL ASSISTANCE POLICY (FAP), APPLICATION, AND PLAIN LANGUAGE SUMMARY. THE FINANCIAL ASSISTANCE PROGRAM AND LISTS OF PROVIDERS COVERED BY THE PROGRAM IS ALSO WIDELY PUBLICIZED AND AVAILABLE ON THE HOSPITAL'S WEBSITE. TO INFORM AND EDUCATE PATIENTS ABOUT THE FINANCIAL ASSISTANCE PROGRAM, FINANCIAL ASSISTANCE POLICY, AND GOVERNMENT PROGRAMS, EACH PATIENT IS OFFERED AND PROVIDED WITH THE FINANCIAL ASSISTANCE PLAIN LANGUAGE SUMMARY AT INTAKE. THIS INFORMATION IS ALSO IS ALSO PROVIDED IN PUBLIC LOCATIONS SUCH AS ADMITTING AND REGISTRATION AND SENT OUT WITH PATIENT STATEMENTS.IN ADDITION TO FINANCIAL COUNSELING, THE HOSPITAL HAS STAFF SOCIAL WORKERS AND CASE MANAGERS TO HANDLE CRISIS INTERVENTIONS, EMERGENCY ROOM NEEDS, AND PATIENT AFTERCARE. PART VI, LINE 4: THE HOSPITAL SERVES RESIDENTS FROM ST. CROIX AND PIERCE COUNTIES IN WESTERN WISCONSIN AND AREAS OF NEIGHBORING MINNESOTA. OUR PRIMARY SERVICE AREA IS HUDSON, WI 54016 (INCLUDES HUDSON, HUDSON TOWNSHIP, TROY, ST. JOSEPH'S AND NORTH HUDSON). OUR SECONDARY SERVICE AREA INCLUDES WI (BALDWIN, HAMMOND, HOULTON, NEW RICHMOND, PRESCOTT, RIVER FALLS, ROBERTS AND SOMERSET) AND MN (BAYPORT, LAKELAND, AND STILLWATER). 2010 CENSUS LISTS THE POPULATION OF ST. CROIX COUNTY AT 84,345, A 33.6% POPULATION GROWTH SINCE 2000. RAPID GROWTH CONTINUES WITHIN ST. CROIX COUNTY, MUCH IN PART DUE TO ITS CLOSE PROXIMITY TO THE TWIN CITIES (MINNEAPOLIS/ST. PAUL) WHERE MANY RESIDENTS COMMUTE TO WORK. ST. CROIX COUNTY'S POPULATION IS COMPRISED OF: 7.4% UNDER 5 YEARS OLD, 26% UNDER 18, 10% 65 YEARS AND OVER, AND 50% FEMALE. THE POPULATION IS 95.9% WHITE, 0.7% BLACK, 0.4% AMERICAN INDIAN, 1.0% ASIAN AND 2.0% HISPANIC OR LATINO. ST. CROIX COUNTY HAS A HIGH MEDIAN INCOME COMPARATIVELY WITHIN THE STATE - $69,682 AND A POVERTY RATE APPROXIMATELY HALF THAT OF THE REST OF THE STATE - 6.3%. PART VI, LINE 5: THE HOSPITAL IS GOVERNED BY A COMMUNITY-BASED BOARD OF DIRECTORS AND THE MEDICAL STAFF IS ORGANIZED IN THE PUBLIC'S INTEREST. WORKING IN PARTNERSHIP WITH OTHER PROVIDER IN THE HEALTHPARTNERS ORGANIZATION, PHYSICIANS IN HUDSON, AND THE COMMUNITY, THE HOSPITAL ACCOMPLISHED A GREAT DEAL IN 2018. ADVANCEMENTS WERE MADE IN SUPPORT OF THE TRIPLE AIM: TO ENSURE BETTER HEALTH FOR ALL, IMPROVED PATIENT EXPERIENCE AND AFFORDABLE HEALTH CARE. MAKE IT OK: MAKE IT OK IS FOCUSED ON REDUCING THE STIGMA OF MENTAL ILLNESS. HUDSON HOSPITAL HAS EXPANDED THE REACH OF THIS HEALTHPARTNERS CAMPAIGN INTO OUR COMMUNITY THROUGH TRAINING LOCAL MAKE IT OK AMBASSADORS, LOCAL PROMOTION AND PARTNERSHIPS WITH LOCAL AGENCIES AND PUBLIC HEALTH. HUDSON HOSPITAL HELD AN AMBASSADOR TRAINING ONSITE AND THE MAKE IT OK CAMPAIGN REACHED MORE THAN 500 PEOPLE IN THE HUDSON AND ST. CROIX COUNTY AREA THROUGH HELD COMMUNITY PRESENTATIONS AND OUTREACH ON MENTAL HEALTH STIGMA. MORE THAN 350 AMBASSADORS ARE NOW TRAINED IN THE ST. CROIX VALLEY AREA. MORE THAN 90% OF PARTICIPANTS REPORTED INCREASED KNOWLEDGE ABOUT MENTAL ILLNESS AND GREATER CONFIDENCE IN TALKING ABOUT MENTAL ILLNESS AS A RESULT OF THE PRESENTATIONS.POWERUP: SINCE 2014, THE HOSPITAL HAS SUPPORTED POWERUP, A COMMUNITY-WIDE HEALTH INITIATIVE THAT INSPIRES AND ENGAGES THE ENTIRE COMMUNITY TO PROMOTE BETTER EATING AND PHYSICAL ACTIVITIES/ACTIVE LIVES SO YOUTH CAN REACH THEIR FULL POTENTIAL. POWERUP WORKS WITH PARTNERS ACROSS THE ST. CROIX VALLEY TO CREATE POSITIVE COMMUNITY CHANGE THROUGH: KIDS COOKING CLASSES; OPEN GYMS AND OUTDOOR ACTIVITIES; STRONGER SCHOOL WELL-BEING GUIDELINES; MORE HEALTHY FOODS AT FOOD SHELVES, COMMUNITY EVENTS AND CONCESSIONS. POWERUP ADDRESSES THE CORE CONTRIBUTORS TO OVERWEIGHT AND OBESITY IN CHILDREN, WHICH HAVE TRIPLED OVER THE PAST 30 YEARS. RESEARCH SHOWS THAT TODAY'S CHILDREN ARE EXPERIENCING WEIGHT ISSUES AT YOUNGER AGES AND WILL LIVE SHORTER, LESS HEALTHY LIVES THAN THEIR PARENTS, UNLESS WE COMMIT TO SIGNIFICANT, WIDE SPREAD CHANGE. OUR COMMUNITIES ARE READY TO MAKE THIS CHANGE AND 94 PERCENT OF THOSE SURVEYED SAY POWERUP IS IMPORTANT IN HELPING OUR KIDS GROW UP HEALTHY. POWERUP ENGAGES WITH KIDS AND FAMILIES AT EVENTS, CLASSES AND ACTIVITIES, AS WELL AS THROUGH ONLINE EFFORTS, SOCIAL MEDIA AND QUARTERLY NEWSLETTERS. POWERUP COMMUNITY ENGAGEMENT HAS GROWN OVER TIME, WITH MORE THAN 130,000 ENGAGED IN THE ST. CROIX VALLEY AREA IN 2018 THROUGH EVENTS, CLASSES, OUTREACH PROGRAMS AND RESOURCES TO PROMOTE BETTER EATING, FAMILY MEALS, PHYSICAL ACTIVITY, REDUCED SCREEN TIME AND FEWER SUGARY DRINKS. POWERUP IS HIGHLY RECOGNIZED BY MORE THAN 75% PERCENT OF FAMILIES IN TARGETED COMMUNITIES. POWERUP PARTNERED WITH THE HEALTHPARTNERS INSTITUTE TO SURVEY FAMILIES WITH CHILDREN AS A WAY TO MEASURE COMMUNITY CHANGE OVER TIME. THE SURVEY RESULTS SHOW THAT CHILDREN ARE MORE PHYSICALLY ACTIVE IN 2018 THAN WHEN SHOW THAT THE PROPORTION OF PHYSICALLY ACTIVE KIDS HAS INCREASED SINCE POWERUP LAUNCHED IN THE ST. CROIX VALLEY AREA.KEY STRATEGIES AND PROGRAMS INCLUDE: THE POWERUP RECIPE GALLERY HAS MORE THAN 300 KID-APPROVED RECIPES AVAILABLE ONLINE. LOCAL CHILDREN SUBMITTED RECIPES FOR THE POWER CHEF RECIPE CONTEST, WITH WINNING RECIPES ACKNOWLEDGED IN PRINT AND IN PERSON.THE POWERUP TRY FOR 5 SCHOOL CHALLENGE IS A FUN-FILLED, THREE-WEEK PROGRAM TO GET ELEMENTARY-AGED STUDENTS EXCITED ABOUT TRYING TO EAT FOR FIVE FRUITS AND VEGGIES EVERY DAY. THE CHALLENGE STARTS WITH AN ENERGY-FILLED CLASSROOM KICKOFF, THEN KIDS, TEACHERS AND FAMILIES ARE EQUIPPED WITH TOOLS AND RESOURCES TO COMPLETE THE PROGRAM. THE POWERUP SCHOOL CHALLENGE IS PROVIDED AT NO COST TO MORE THAN 24 SCHOOLS IN FOUR COMMUNITIES THROUGHOUT THE SERVICE AREA, REACHING MORE THAN 11,000 CHILDREN EACH YEAR. RESULTS INDICATE THAT TEACHERS, FAMILIES AND STUDENTS ARE HIGHLY ENGAGED IN THE PROGRAM, WITH 80 PERCENT OF CHILDREN TRACKING FRUITS AND VEGETABLES. IN ADDITION, A 3-WEEK WINTER WARM-UP CHALLENGE WAS DEVELOPED IN PARTNERSHIP WITH A PASSIONATE POWERUP VOLUNTEER TO INSPIRE KIDS TO STAY ACTIVE OVER THE COLD MONTHS. POWERUP DEVELOPED THE SCHOOL ENVIRONMENT INDEX TO HELP SCHOOLS MEASURE PROGRESS WITH WELLNESS PRACTICES AND POLICIES THAT SUPPORT BETTER EATING AND MOVING MORE. OPEN GYMS, IN PARTNERSHIP WITH LOCAL SCHOOLS, HAVE EXPANDED TO INCLUDE MULTI-SITE OFFERINGS THROUGHOUT THE SCHOOL YEAR. THE REDUCED COST FOR PHYSICAL ACTIVITY RANKED AS ONE OF THE KEY NEEDS IDENTIFIED BY PARENTS OF CHILDREN ON THE FAMILY COMMUNITY SURVEY IN JANUARY 2014. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEMPLEASE SEE SCHEDULE O: DISCUSSION OF EXEMPT PURPOSE AND ACHIEVEMENTS "I. CORPORATE STRUCTURE, PURPOSE, GOVERNANCE." PART VI, LINE 7, REPORTS FILED WITH STATES WI 0 AMERICAN CANCER SOCIETY 250 WILLIAMS STREET NW ATLANTA GA 30303 131788491 501(C)(3) 5000 PROGRAM SUPPORT HUDSON HOSPITAL FOUNDATION 8170 33RD AVE S BLOOMINGTON MN 55404 391279567 501(C)(3) 146056 PROGRAM SUPPORT 2 PART I, LINE 2: THE HOSPITAL'S MANAGEMENT STAFF REVIEWS THE MISSION AND PURPOSE OF POTENTIAL GRANTEE ORGANIZATIONS TO ASSURE CONSISTENCY WITH THE HOSPITAL'S MISSION AND PURPOSE. AMOUNTS SUBSEQUENTLY GRANTED ARE SUBJECT TO THE HOSPITAL'S FORMAL SPENDING APPROVAL AND DOCUMENTATION PROCESS BASED ON AMOUNT OF THE EXPENDITURE. X X X 1 1 0 0 0 1 1 0 0 JEROME SIY MD DIRECTOR 0 355401 0 15580 0 20167 0 50164 0 20782 0 462094 0 0 MEGAN M REMARK DIRECTOR & SECRETARY 0 515709 0 161965 0 58938 0 158389 0 37067 0 932068 0 28720 MARK HANSBERRY DIRECTOR 0 396539 0 119280 0 1751 0 75396 0 34975 0 627941 0 0 LEVON O'HAODHA MD DIRECTOR 0 324865 0 0 0 63570 0 20625 0 33029 0 442089 0 0 DOUGLAS E JOHNSON VP & CFO 0 296904 0 51144 0 22739 0 121094 0 36828 0 528709 0 0 STEVE MUELLERLEILE VP - PLANNING & DEVELOPMEN 111974 0 12200 0 1764 0 3965 0 25412 0 155315 0 0 0 THOMAS BOROWSKI PRESIDENT 0 251216 0 9344 0 4014 0 10523 0 29769 0 304866 0 0 KRISTY YAEGER VP, PATIENT CARE SERVICES 172249 0 14914 0 833 0 2435 0 10687 0 201118 0 0 0 BHAVIN PATEL MD VPMA 0 299546 0 5621 0 5159 0 44715 0 31896 0 386937 0 0 DANIELLE L FERKINGSTAD NURSE ANESTHETIST 175336 0 500 0 45273 0 4580 0 23854 0 249543 0 0 0 DARLA KLEMENTZ DIRECTOR OF PHARMACY 158116 0 11019 0 1909 0 6943 0 10441 0 188428 0 0 0 HOWARD J GEORGESON NURSE ANESTHETIST 203016 0 500 0 41509 0 5101 0 30859 0 280985 0 0 0 KEITH W LARSON NURSE ANESTHETIST 214239 0 0 0 47464 0 4923 0 30711 0 297337 0 0 0 JEFFREY L REICHEL NURSE ANESTHETIST 184443 0 500 0 27923 0 3096 0 11047 0 227009 0 0 0 MARIAN M FURLONG FORMER PRESIDENT 0 0 0 29090 0 106480 0 0 0 16913 0 152483 0 0 ROBBIE HAGELBERG FORMER VP & CNO 0 199393 0 23502 0 1577 0 11649 0 19794 0 255915 0 0 PART I, LINE 3 THE HOSPITAL'S PRESIDENT AND ITS OFFICERS ARE EMPLOYED BY REGIONS HOSPITAL (REGIONS), LAKEVIEW HOSPITAL OR BY GROUP HEALTH PLAN, INC. (GHI), WHICH ARE ALL RELATED ORGANIZATIONS, OR BY HUDSON HOSPITAL (THE HOSPITAL). GHI, REGIONS, LAKEVIEW HOSPITAL AND THE HOSPITAL HAVE AN ANNUAL PROCESS TO REVIEW THE MARKET COMPARABILITY OF THE TOTAL COMPENSATION OF THE HOSPITAL'S CEO PRESIDENT AND OTHER OFFICERS. PART I, LINES 4A-B A SEVERANCE PAYMENT IN COLUMN B(III) OF SCHEDULE J IS INCLUDED FOR THE FOLLOWING OFFICERS AND DIRECTORS: MARIAN M. FURLONG $106,480 DEFERRED COMPENSATION IN COLUMN C OF SCHEDULE J, PART II INCLUDES AMOUNTS FROM A NONQUALIFIED 457(F) PLAN FOR THE FOLLOWING DIRECTORS: MEGAN M. REMARK $ 30,329 MARK HANSBERRY $ 36,398 PART I, LINE 6 HUDSON HOSPITAL, INC. (THE HOSPITAL) OFFICERS, DIRECTORS AND HIGHEST COMPENSATED EMPLOYEES ARE EMPLOYED BY REGIONS HOSPITAL (REGIONS) OR BY GROUP HEALTH PLAN, INC. (GHI), BOTH OF WHICH ARE RELATED ORGANIZATIONS, OR BY THE HOSPITAL. COMPENSATION REPORTED IN FORM 990, PART VIII INCLUDES ANY COMPENSATION DERIVED FROM REGIONS, GHI OR THE HOSPITAL MANAGEMENT INCENTIVE PROGRAMS, WHICH INCENT AND REWARD BUSINESS LEADERS WHO HELP THE ORGANIZATION ACHIEVE STATED BUSINESS AND/OR HEALTH IMPROVEMENT GOALS FOR A SPECIFIC FISCAL YEAR. THE PROGRAMS ARE A KEY ELEMENT OF THE PARTICIPANT'S TOTAL COMPENSATION PACKAGE. THE MANAGEMENT INCENTIVE PROGRAMS' REWARDS ARE BASED ON POSITION IN THE ORGANIZATION (E.G. SENIOR VICE PRESIDENT, VICE PRESIDENT, DIRECTOR, MANAGER, OTHER SPECIFICALLY IDENTIFIED LEADERS) AND THE ACHIEVEMENT OF BUSINESS AND HEALTH IMPROVEMENT GOALS ESTABLISHED IN A VARIETY OF AREAS. GOALS WILL BE RELATED TO THE ORGANIZATION'S STRATEGIC PLAN AND WILL BE BALANCED. THESE AREAS MAY INCLUDE BUT ARE NOT LIMITED TO PATIENT SATISFACTION, EMPLOYEE SATISFACTION, WORK ENVIRONMENT, EMPLOYEE AND/OR LEADERSHIP DEVELOPMENT, CARE DELIVERY, PATIENT EDUCATION, SIX AIMS, MARKET SHARE, STRATEGIC CAPABILITIES, FINANCIAL PERFORMANCE (NET MARGIN), ETC., AND WILL BE DEFINED ANNUALLY FOR EACH YEAR'S PROGRAM. A NET MARGIN THRESHOLD MUST BE MET FOR ANY PAYMENT TO BE MADE FROM THE PROGRAM AND THERE IS A CAP ON THE MAXIMUM INCENTIVE POTENTIALLY AVAILABLE TO EACH PARTICIPANT. 990, SCH. J, PART II - 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, FOR THE FOLLOWING DIRECTORS AND FORMER DIRECTOR: MEGAN M. REMARK $ 28,720 ANY ANALYSIS OF EARNINGS FOR THE CURRENT YEAR, FOR THESE PARTICIPANTS OF THE PLAN, SHOULD EXCLUDE THE AMOUNT IN COLUMN F AS PART OF THE ANALYSIS SINCE THOSE EARNINGS WERE ALREADY REPORTED IN COLUMN (C) OF PREVIOUS YEARS' 990'S. A WISCONSIN HEALTH AND EDUCATION FACILITIES AUTHORITY 391337855 97710B6E7 2012-10-03 20513711 REFUNDING OF SERIES 2002 BONDS 1 0 0 A 10990404 20513711 470664 20513711 2001 1 0 1 1 A 0 0 1 0 0 0.00000 0.00000 0.00000 1 0 1 A 0 1 0 0 0 0 0 0 1 A 1 SCHEDULE K, PART III, LINES 3B, 3C & 3D HUDSON HOSPITAL USES INTERNAL LEGAL COUNSEL TO REVIEW ANY MANAGEMENT OR SERVICE CONTRACTS RELATING TO THE FINANCED PROPERTY. IF IT ENCOUNTERS UNUSUAL OR COMPLEX CONTRACTS IT WILL ENGAGE BOND COUNSEL OR OTHER OUTSIDE COUNSEL. SCHEDULE K, PART V SINCE 12/31/2012 HUDSON HOSPITAL HAS UNDERTAKEN ESTABLISHING SUCH WRITTEN PROCEDURES. SARA ARMBRUSTER SARA ARMBURSTER IS THE WIFE OF DIRECTOR RYAN ARMBRUSTER 210142 EMPLOYMENT 0 990, PART III, LINE 4A: EXEMPT PURPOSE AND ACHIEVEMENTS HUDSON HOSPITAL (HOSPITAL) 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 HEALTHPARTNERS ORGANIZATION ("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 INCLUDES AN ARRAY OF TAX-EXEMPT AND TAXABLE ORGANIZATIONS WITH HEALTH CARE ACTIVITIES PRIMARILY OPERATING IN MINNESOTA, WESTERN WISCONSIN AND EXPANDING INTO OTHER MIDWESTERN STATES. 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 100 OWNED AND LEASED PRIMARY AND SPECIALTY CARE MEDICAL FACILITIES AND 25 DENTAL FACILITIES WITH PRACTICES IN MINNESOTA AND WESTERN WISCONSIN. HEALTHPARTNERS ALSO CONTRACTS WITH OTHER PRIMARY AND SPECIALTY MEDICAL FACILITIES AND DENTAL FACILITIES, PHYSICIAN GROUPS, HOSPITALS AND RELATED HEALTHCARE PROVIDERS LOCATED PRIMARILY IN MINNESOTA, WESTERN WISCONSIN AND EXPANDING INTO OTHER MIDWESTERN STATES. HEALTHPARTNERS ALSO PROVIDES MEDICAL EDUCATION AND TRAINING TO MEDICAL PROFESSIONALS AND CONDUCTS RESEARCH AND FUNDRAISING ACTIVITIES THAT SUPPORT THE HEALTH CARE DELIVERY SYSTEM. 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 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 2018 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 RIHS AND ITS SISTER ORGANIZATIONS, REGIONS HOSPITAL (REGIONS), REGIONS HOSPITAL FOUNDATION, RH-WISCONSIN, INC., STILLWATER HEALTH SYSTEM (LAKEVIEW HEALTH), AND CAPITOL VIEW TRANSITIONAL CARE CENTER, ALL OF WHICH ARE NON-PROFIT CORPORATIONS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). RH-WISCONSIN, INC. AND GROUP HEALTH PLAN, INC. (GHI) ARE THE CORPORATE MEMBERS OF THE HOSPITAL. GHI IS A MINNESOTA NONPROFIT CORPORATION AND LICENSED HEALTH MAINTENANCE ORGANIZATION (HMO) RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). THE HOSPITAL IS THE SOLE CORPORATE MEMBER OF HUDSON HOSPITAL FOUNDATION (HHF) A FOUNDATION WHOSE PURPOSE IS TO SUPPORT THE HOSPITAL. COMMUNITY BENEFIT TO THE COMMUNITY THE CHARITABLE TRADITION OF THE HOSPITAL CONTINUED IN 2018. OUR COLLEAGUES PARTNERED WITH SCHOOLS, BUSINESSES, AGENCIES AND OTHER HEALTH PROVIDERS THAT SHARE IN OUR VISION OF CREATING A CULTURE - THROUGH EDUCATION AND ECONOMIC DEVELOPMENT - OF COMMUNITY HEALTH AND WELL-BEING. OUR COLLABORATION RESULTED IN IMPROVED HEALTH - AT AN AFFORDABLE COST - AND POSITIVE EXPERIENCES FOR OUR PATIENTS AND THEIR FAMILIES. COMMUNITY HEALTH SERVICES AS A COMMUNITY HEALTH CARE PROVIDER, WE BELIEVE OUR MISSION IS TO DELIVER INFORMATION ON HEALTH AND WELL-BEING BEYOND THE CLINICIAN'S OFFICE OR A HOSPITAL DEPARTMENT. WE ARE COMMITTED TO KEEPING OUR COMMUNITY HEALTHY BY SHARING KNOWLEDGE AT HEALTH FAIRS; AT CLASSES AND SEMINARS; THROUGH WEBINARS, SOCIAL MEDIA AND PRINTED MATERIALS. IN 2018, WE HELD EDUCATIONAL SESSIONS ON, AMONG OTHER TOPICS: AGING BREASTFEEDING MEDICATION REVIEWS FALLS PREVENTION CANCER KNEE REPLACEMENT INJURY PREVENTION RESILIENCY DEMENTIA MEDICARE ENROLLMENT NUTRITION AND WEIGHT MANAGEMENT BLOOD PRESSURE MANAGEMENT MENTAL HEALTH CAR SEAT AND BIKE SAFETY SAFE/SMART DRIVING ADVANCED DIRECTIVES WE ALSO PROVIDE VARIOUS HEALTH CARE SUPPORT SERVICES THAT INCLUDE TRANSLATION/INTERPRETER SERVICES; CRISIS INTERVENTION; COUNSELING SERVICES; CHAPLAINCY SERVICES; MEDICATION THERAPY MANAGEMENT; AND LIFE ASSIST HOME MONITORING SYSTEM. SUPPORT GROUPS WE OFFERED AND SUPPORTED SUPPORT GROUPS FOR COMMUNITY MEMBERS AND THEIR FAMILIES EXPERIENCING PARKINSON'S AND CELIAC DISEASES, AS WELL AS GROUPS FOR NEW PARENTS, GUIDANCE FOR FINDING FINANCIAL ASSISTANCE AND THOSE WITH SUBSTANCE ABUSE CONCERNS. TOTAL COMMUNITY HEALTH EDUCATION EXPENSES TOTALED $285,984. SUBSIDIZED HEALTH SERVICES THE HOSPITAL PROVIDES FINANCIAL ASSISTANCE AND HEALTH CARE ACCESS FOR LOW-INCOME INDIVIDUALS. THE HOSPITAL IS COMPLIANT WITH THE IRC SECTION 501(R) FEDERAL REGULATIONS, AND PROVIDES EASY ACCESS TO THE FINANCIAL ASSISTANCE PROGRAM INCLUDING THE FINANCIAL ASSISTANCE POLICY (FAP), APPLICATION, AND PLAIN LANGUAGE SUMMARY. THE FINANCIAL ASSISTANCE PROGRAM, WHICH LISTS PROVIDERS COVERED BY THE PROGRAM, IS WIDELY PUBLICIZED AND AVAILABLE ON THE HOSPITAL'S WEBSITE. TO INFORM AND EDUCATE PATIENTS ABOUT THE FINANCIAL ASSISTANCE PROGRAM, FINANCIAL ASSISTANCE POLICY, AND GOVERNMENT PROGRAMS, EACH PATIENT IS OFFERED AND PROVIDED WITH THE FINANCIAL ASSISTANCE PROGRAM AT INTAKE. THIS INFORMATION IS ALSO PROVIDED IN ADMITTING, REGISTRATION AND VARIES PUBLIC AREAS, AND IS SENT OUT WITH PATIENT STATEMENTS. THE HOSPITAL DEFINES FINANCIAL ASSISTANCE AS THE COST OF CARE DELIVERED TO PATIENTS WHO ARE UNABLE TO PAY FOR THE SERVICES THEY RECEIVE. THIS INCLUDES PATIENTS WHOSE CHARGES ARE FORGIVEN OR REDUCED BECAUSE OF INABILITY TO PAY, PATIENTS WHO ARE UNABLE TO PAY THE BALANCE LEFT BY ANY PAYER, AND PATIENTS FOR WHOM UNUSUAL CIRCUMSTANCES OR SPECIAL FINANCIAL HARDSHIP WARRANT SPECIAL CONSIDERATION. IN 2018, THE HOSPITAL PROVIDED $372,644 IN FINANCIAL ASSISTANCE. THE HOSPITAL PROVIDES INPATIENT AND OUTPATIENT CARE, INCLUDING EMERGENCY DEPARTMENT SERVICES, TO MEDICAID PATIENTS. PAYMENTS RECEIVED FOR THESE SERVICES ARE BELOW THE COST OF CARE PROVIDED. THE EXPENSE TO COVER UNREIMBURSED MEDICAID COSTS FOR PATIENTS TOTALED $639,731. THE HOSPITAL IS COMMITTED TO PROVIDING NEEDED SERVICES EVEN AT A FINANCIAL LOSS. IN 2018, LOSS ON SERVICES FOR HOSPITAL INPATIENT AND OUTPATIENT HEALTH SERVICES TOTALED $335,216. THESE SERVICES INCLUDE LACTATION, PROGRAMS FOR CHANGE (A SUBSTANCE ABUSE TREATMENT PROGRAM), INFUSION, LAB & BLOOD SERVICES, AND PHYSICAL THERAPY. FORM 990, PART III, LINE 4A TRANSPORTATION PUBLIC TRANSPORTATION IS UNAVAILABLE IN THE CITY OF HUDSON; THEREFORE, UPON REQUEST, VAN TRANSPORTATION WAS MADE AVAILABLE TO COMMUNITY RESIDENTS LIVING WITHIN A 15-MILE RADIUS OF THE HOSPITAL CAMPUS. RESIDENTS CAN USE THE VAN SERVICE FOR MEDICAL-RELATED APPOINTMENTS TO THE HOSPITAL CAMPUS, INCLUDING PHARMACY PICK UP. FINANCIAL CONTRIBUTIONS - CASH DONATIONS, GRANTS AND IN-KIND DONATIONS THE HOSPITAL'S FINANCIAL CONTRIBUTION IN THE FORM OF CASH DONATIONS AND GRANTS TO OTHER TAX-EXEMPT COMMUNITY ORGANIZATIONS AND GOVERNMENT ORGANIZATIONS FOR SPONSORSHIPS OR MEMBERSHIP DUES INCLUDING AMERICAN CANCER SOCIETY, YMCA, MAKE A WISH, FREE CLINIC OF PIERCE & ST. CROIX COUNTIES AND ST. CROIX COUNTY HUMAN SERVICES, ETC., TOTALED $58,130. IN-KIND SERVICES PROVIDED INCLUDED STAFF HOURS SPENT IN SUPPORT OF FUNDRAISING, FOOD DRIVES, AND TAXI VOUCHERS FOR LOW-INCOME COMMUNITY MEMBERS. THE HOSPITAL ALSO PROVIDED CRISIS TELEVIDEO SERVICES TO PATIENTS SEEN AT SURROUNDING EMERGENCY ROOMS, INCLUDING ST. CROIX REGIONS MEDICAL CENTER, AMERY HOSPITAL, WESTFIELDS HOSPITAL, WESTERN WISCONSIN HEALTH, RIVER FALLS HOSPITAL, AND OSCEOLA MEDICAL CENTER. COMMUNITY BUILDING ACTIVITIES WITH THE UNDERSTANDING THAT MORE CAN BE ACCOMPLISHED TOGETHER, THE HOSPITAL'S PARTICIPATION IN HEALTHIER TOGETHER - ST. CROIX, HAS CONNECTED INDIVIDUALS AND ORGANIZATIONS FROM PUBLIC, PRIVATE AND NONPROFIT SECTORS TO SHARE SKILLS AND ASSETS. THE HOSPITAL PARTICIPATED IN COMMUNITY-BUILDING ACTIVITIES THAT SUPPORTED ECONOMIC DEVELOPMENT, COALITION ADVOCACY GROUPS TO IMPROVE HEALTH, AND WORKFORCE DEVELOPMENT. FOR THESE ACTIVITIES, THE HOSPITAL PARTNERED WITH ST. CROIX ECONOMIC DEVELOPMENT, WISCONSIN HOSPITAL ASSOCIATION, ST. CROIX EMS, UNIVERSITY OF WISCONSIN - RIVER FALLS CHANCELLOR'S ADVISORY COUNCIL, THE PHIPPS CENTER FOR THE ARTS, CANCER CENTER OF WESTERN WISCONSIN, HUDSON HIGH SCHOOL, POWERUP, WISCONSIN INDIANHEAD TECHNICAL COLLEGE (WITC), HUDSON ROTARY, AND HUDSON CHAMBER OF COMMERCE. WE ALSO WORKED WITH SEVERAL COMMUNITY AGENCIES ON THEIR HEALTH AND WELL-BEING EFFORTS. WE HOSTED BLOOD DRIVES FOR THE AMERICAN RED CROSS; SUPPORTED THE AMERICAN CANCER SOCIETY THROUGH OUR PARTICIPATION IN RELAY FOR LIFE; AND SUPPORTED AND PARTICIPATED IN THE NATIONAL ALLIANCE ON MENTAL ILLNESS (NAMI) ANNUAL WALK EVENT. SUSTAINABILITY THE HOSPITAL CONTINUED ON ITS ECO-FRIENDLY JOURNEY "HEALTH CARE WITHOUT HARM" (2008 COMMITMENT), USING SUSTAINABLE BUSINESS PRACTICES AND ESTABLISHING GREEN PURCHASING POLICIES TO PROVIDE HEALTH CARE. GREEN INITIATIVES INCLUDED THE RECYCLING PROGRAM, REDUCTION OF PAPER COPIES, AND REDUCTION OF ENERGY AND WATER CONSUMPTION. THE HOSPITAL'S GREEN TEAM HAS ACTIVELY PROVIDED COMMUNITY GARDEN PLOTS AND COMPOSTING TO MEMBERS OF THE COMMUNITY; PROMOTED HUDSON AREA BUSINESSES BY BUYING MEAT AT THE LOCAL ST. CROIX COUNTY FAIR; AND HOSTED AN ELECTRONICS RECYCLING EVENT FOR THE COMMUNITY. IMPLEMENTING SUSTAINABLE BUSINESS PRACTICES HAS MADE THE HOSPITAL A MODEL WITHIN THE HEALTHPARTNERS ORGANIZATION. COMMUNITY BENEFIT OPERATIONS A COMBINATION OF FINANCE, MARKETING, COMMUNITY HEALTH AND EDUCATION STAFF DEDICATE TIME TO THE DATA COLLECTION, ANALYSIS AND REPORTING OF ALL OF THE HOSPITAL'S COMMUNITY BENEFIT ACTIVITIES. IN 2018, THE TIME AND EXPENSE SPENT ON THESE ACTIVITIES TOTALED $21,882. COMMUNITY HEALTH NEEDS ASSESSMENT: PLEASE REFER TO FORM 990 SCHEDULE H NARRATIVE. HEALTH PROFESSIONAL EDUCATION THE HOSPITAL'S STAFF PROVIDED CLINICAL TRAINING FOR NURSES, NURSING STUDENTS, PHARMACISTS AND OTHER HEALTH PROFESSIONALS AT A COST OF $369,385. IN ADDITION, THE HOSPITAL VOLUNTARILY PARTICIPATED IN THE WISCONSIN NURSE RESIDENCY PROGRAM. THE PROGRAM IS A STRUCTURED LEARNING EXPERIENCE FOR NEWLY LICENSED REGISTERED NURSES DESIGNED TO PROMOTE EFFECTIVE TRANSITION INTO PROFESSIONAL PRACTICE. ORGANIZATIONAL AWARDS AND ACHIEVEMENTS THE HOSPITAL HAS BEEN A VITAL AND NECESSARY COMMUNITY RESOURCE SINCE 1953. OUR COMMITMENT TO QUALITY AND COMPASSIONATE CARE CONTINUALLY RECEIVES LOCAL, REGIONAL AND NATIONAL RECOGNITION. IN 2018, WE RECEIVED THE FOLLOWING RECOGNITION: NATIONAL RECOGNITION FOR PERFORMANCE LEADERSHIP IN QUALITY AND PATIENT PERSPECTIVE - BY THE CHARTIS CENTER FOR RURAL HEALTH/IVANTAGE HEALTH ANALYTICS AND NATIONAL ORGANIZATION OF STATE OFFICE OF RURAL HEALTH. HUDSON HOSPITAL NAMED IN BECKER'S HOSPITAL REVIEW "66 CRITICAL ACCESS HOSPITALS TO KNOW" BECKER'S HOSPITAL REVIEW NAMES HUDSON HOSPITAL & CLINIC ONE OF ITS 68 GREENEST HOSPITALS IN AMERICA. PRACTICE GREENHEALTH - TOP 25 ENVIRONMENTAL EXCELLENCE AWARD - CIRCLES OF EXCELLENCE - (HEALTHY FOOD TOP 10 RECOGNITION); CIRCLES OF EXCELLENCE (LEADERSHIP TOP 10 RECOGNITION) AND GREENING THE OPERATING ROOM. HUDSON HOSPITAL RECEIVED A 5-STAR RATING FOR TREATING HEART AND RESPIRATORY FAILURE BY HEALTHGRADES, AN ONLINE RESOURCE FOR HEALTH CARE DATA. NATIONAL RECOGNITION FOR OVERALL EXCELLENCE IN OUTCOMES FROM THE CHARTIS CENTER OF RURAL HEALTH AND THE NATIONAL ORGANIZATION OF STATE OFFICES OF RURAL HEALTH. THE HOSPITAL ALSO RECEIVED FOUR OUT OF FIVE STARS FROM THE CENTERS FOR MEDICARE AND MEDICAID SERVICES FOR SEVERAL QUALITY MEASURES, INCLUDING THE LOW HOSPITAL-ACQUIRED INFECTION RATES AND SHORT EMERGENCY WAIT TIMES. THE HOSPITAL WAS ALSO RECOGNIZED FOR BEING ABOVE THE NATIONAL AVERAGE FOR REDUCING READMISSION RATES, INCREASING PATIENT EXPERIENCE SCORES AND PROVIDING TIMELY AND EFFECTIVE CARE. FORM 990, PART VI, SECTION A, LINE 6 AS OF JANUARY 1, 2009, THE CORPORATE MEMBERS OF THE HOSPITAL ARE GROUP HEALTH PLAN, INC. AND RH-WISCONSIN, INC. THESE SAME ENTITIES ARE ALSO THE CORPORATE MEMBERS OF WESTFIELDS HOSPITAL, INC., A CRITICAL ACCESS HOSPITAL IN NEW RICHMOND, WISCONSIN AND AMERY REGIONAL MEDICAL CENTER,INC., A CRITICAL ACCESS HOSPITAL IN AMERY, WISCONSIN. GROUP HEALTH PLAN, INC. AND RH-WISCONSIN, INC. ARE PART OF THE HEALTHPARTNERS FAMILY OF ORGANIZATIONS. FORM 990, PART VI, SECTION A, LINE 7A THE HOSPITAL'S BOARD OF DIRECTORS IS COMPRISED OF NOT MORE THAN THIRTEEN (13) PERSONS APPOINTED AS FOLLOWS (AMENDED BYLAWS, ART. II, SECT. 2): - SEVEN (7) COMMUNITY DIRECTORS NOMINATED BY THE BOARD'S NOMINATING COMMITTEE AND APPOINTED BY RH-WISCONSIN, INC. - THREE (3) DIRECTORS APPOINTED BY GROUP HEALTH PLAN, INC., ONE OF WHOM MAY BE A PHYSICIAN AND ONE OF WHOM MAY BE THE CHIEF EXECUTIVE OFFICER OF REGIONS HOSPITAL - ONE (1) DIRECTOR WHO IS A MEMBER OF THE ACTIVE MEDICAL STAFF OF THE HOSPITAL AND APPOINTED BY WESTERN WISCONSIN MEDCIAL ASSOCIATES, S.C. OR BY THE LARGEST ACTIVE PRIMARY CARE PHYSICIAN GROUP SERVING THE HOSPITAL. - ONE (1) DIRECTOR SHALL BE THE HOSPITAL'S CHIEF OF STAFF - ONE (1) DIRECTOR SHALL BE A PHYSICIAN NOMINATED BY THE BOARD'S NOMINATING COMMITTEE AND APPOINTED BY RH-WISCONSIN, INC. FORM 990, PART VI, SECTION A, LINE 7B THE HOSPITAL'S CORPORATE MEMBERS - RH-WISCONSIN, INC. AND GROUP HEALTH PLAN, INC. - JOINTLY APPROVE THE FOLLOWING ACTIONS OF THE BOARD OF DIRECTORS OR INITIATE THESE ACTIONS DIRECTLY (AMENDED BYLAWS, ART. III, SECT. 1): - AMENDMENT OF THE ARTICLES, BYLAWS OR OTHER GOVERNING DOCUMENTS - APPROVAL OF THE ADDITION OR DELETION OF MAJOR SERVICE LINES - SALE, LEASE, MORTGAGE OR PLEDGE OF ANY REAL ESTATE OR INTEREST THEREIN, OR OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS - ADOPTION OF AMENDMENT OF A STRATEGIC PLAN, AND CAPITAL AND OPERATING BUDGETS - APPROVAL OF UNBUDGETED CAPITAL EXPENDITURES - APPROVAL OF BORROWING OR LENDING OF FUNDS IN EXCESS OF ONE MILLION DOLLARS - MERGER, CONSOLIDATION, AFFILIATION OR JOINT VENTURE WITH ANY OTHER ENTITY AND TRANSFER OR CONTRIBUTION OF ASSETS AND FUNDS TO SEPARATE ENTITIES - ESTABLISHMENT OR DIVESTITURE OF ENTITIES OF WHICH THE HOSPITAL HAS AN EQUITY OR MANAGEMENT INTEREST, OR ESTABLISHMENT OF ANY SIGNIFICANT AND CONTINUING RELATIONSHIP WITH ANY ENTITY - APPOINTMENT AND REMOVAL OF THE HOSPITAL'S PRESIDENT AND CHAIR OF THE BOARD OF DIRECTORS - DISSOLUTION AND DISTRIBUTION OF ASSETS FORM 990, PART VI, SECTION B, LINE 11B THE HOSPITAL'S 990 RETURN HAS A COMPREHENSIVE REVIEW PROCESS THAT IS FOLLOWED BEFORE IT IS PRESENTED TO THE GOVERNING BODY OF THE HOSPITAL. THE REVIEW PROCESS INCLUDES A LAYERED REVIEW BY THE TAX DEPARTMENT OF GROUP HEALTH PLAN, INC. (GHI), THE MANAGEMENT TEAM OF THE HOSPITAL, GHI'S INTERNAL LEGAL DEPARTMENT AND HEALTHPARTNERS, INC.'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 THE HOSPITAL. ONCE THAT REVIEW PROCESS HAS BEEN COMPLETED, IT IS THE POLICY OF THE HOSPITAL TO MAKE AVAILABLE TO THE FINANCE AND AUDIT COMMITTEE OF IT'S BOARD OF DIRECTORS, AND TO IT'S BOARD OF DIRECTORS, A COPY OF THE 990 PRIOR TO THE FILING OF THE 990 RETURN. THIS COPY IS PROVIDED TO THE FINANCE AND AUDIT COMMITTEE AND THE FULL BOARD OF DIRECTORS IN A PRE-MEETING PACKET, AND IS AN AGENDA ITEM AT THE COMMITTEE MEETING. THIS PROCESS IS NOTED AND DOCUMENTED IN THE WRITTEN COMMITTEE MINUTES OF THE MEETING. THESE MINUTES ARE PRESENTED TO THE FULL BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C THE HOSPITAL 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 THE HOSPITAL'S PRESIDENT AND ITS OFFICERS ARE EMPLOYED BY REGIONS HOSPITAL (REGIONS), LAKEVIEW HOSPITAL OR BY GROUP HEALTH PLAN, INC. (GHI), WHICH ARE ALL RELATED ORGANIZATIONS, OR BY HUDSON HOSPITAL (THE HOSPITAL). GHI, REGIONS, LAKEVIEW HOSPITAL AND THE HOSPITAL HAVE AN ANNUAL PROCESS TO REVIEW THE MARKET COMPARABILITY OF THE TOTAL COMPENSATION OF THE HOSPITAL'S CEO 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 COMPENSATION COMMITTEE OF THE LAKEVIEW HEALTH, THE EXECUTIVE COMMITTEE OF REGIONS, THE COMPENSATION COMMITTEE OF GHI OR THE HOSPITAL 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 COMMITTEE 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 THE HOSPITAL'S BOARD OF DIRECTORS INPUT, THE ST CROIX VALLEY EXECUTIVE LEADER CONDUCTS THE ANNUAL PERFORMANCE REVIEW AND, WITH THE HOSPITAL'S BOARD APPROVAL, DETERMINES THE COMPENSATION OF THE HOSPITAL PRESIDENT. THE HOSPITAL BOARD HAS DELEGATED TO THE PRESIDENT THE ACCOUNTABILITY TO CONDUCT ANNUAL PERFORMANCE REVIEWS AND DETERMINE THE COMPENSATION OF ALL THE HOSPITAL-EMPLOYED OFFICERS WITHIN THE COMPENSATION RANGES DETERMINED BY THE COMMITTEE. ANY EXCEPTIONS TO COMPENSATION IN EXCESS OF THE APPROVED RANGES ARE APPROVED BY THE HOSPITAL 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 19 THE HOSPITAL FINANCIAL STATEMENTS AND 990 RETURNS ARE MADE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION FROM THE HOSPITAL. THE HOSPITAL'S ARTICLES OF INCORPORATION ARE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION THROUGH THE WISCONSIN SECRETARY OF STATE'S OFFICE. THE HOSPITAL'S CONFLICT OF INTEREST POLICY CAN BE VIEWED THROUGH THE HUDSON HOSPITAL.ORG WEBSITE. 990, PART VII, SEC. A, LINE 1A, COL. B: AVERAGE HOURS-RELATED ORGANIZATIONS DIRECTORS AND OFFICERS OF THE HOSPITAL ARE EMPLOYED AND COMPENSATED BY GROUP HEALTH PLAN, INC., REGIONS HOSPITAL, OR THE HOSPITAL. REPORTED AVERAGE HOURS WORKED ARE BASED ON THEIR TOTAL COMPENSATION FROM ALL RELATED ORGANIZATIONS. FORM 990, PART XI, LINE 9: INCREASE IN INTEREST IN NET ASSETS OF HUDSON HOSPITAL FOUNDATION, INC. 235,410. 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) 509(A)(3) TYPE I HEALTHPARTNERS INC 0 GROUP HEALTH PLAN INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 410797853 STAFF MODEL HEALTH MAINTENANCE ORGANIZATION MN 501(C)(3) 170(B)(1) (A)(III) HEALTHPARTNERS INC 0 RH WISCONSIN INC 8171 33RD AVE S PO BOX 1309 MPLS MN 554401309 202287016 CORPORATE PLANNING AND OVERSIGHT MN 501(C)(3) 509(A)(3) TYPE I HEALTHPARTNERS INC 0 HEALTHPARTNERS INSTITUTE 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411670163 HEALTHCARE EDUCATION AND RESEARCH MN 501(C)(3) 509(A)(3) TYPE I HEALTHPARTNERS INC 0 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) 170(B)(1) (A)(III) HPI - RAMSEY 0 REGIONS HOSPITAL 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 410956618 HOSPITAL MN 501(C)(3) 170(B)(1) (A)(III) HPI - RAMSEY 0 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) 170(B)(1) (A)(VI) HPI - RAMSEY 0 RHSC INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411891928 HEALTHCARE STAFFING AND INTENSE REHAB SERVICES MN 501(C)(3) 509(A)(3) TYPE II HPI - RAMSEY 0 PHYSICIANS NECK & BACK CLINICS 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 270684883 SPECIALTY PATIENT CARE MN 501(C)(3) 509(A)(3) TYPE II GROUP HEALTH PLAN INC 0 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) 170(B)(1) (A)(VI) HUDSON HOSPITAL INC 1 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) 509(A)(3) TYPE II LAKEVIEW HEALTH 0 LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 410811697 HOSPITAL MN 501(C)(3) 170(B)(1) (A)(VI) LAKEVIEW HEALTH 0 STILLWATER MEDICAL GROUP 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 830379473 CLINIC STAFF AND FACILITIES MN 501(C)(3) 509(A)(3) TYPE I LAKEVIEW HEALTH 0 LAKEVIEW HEALTH 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 300221189 CORPORATE PLANNING AND OVERSIGHT MN 501(C)(3) 509(A)(3) TYPE II HPI - 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CLAIMSHEALTHCARE SERVICES L 1034950 CASH AMOUNT HUDSON HOSPITAL FOUNDATION B 146056 CASH AMOUNT