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 390908320 AMERY REGIONAL MEDICAL CENTER INC AMER 7152688000 8170 33RD AVENUE SOUTH PO BOX 1309 MINNEAPOLIS MN 554401309 DEBRA RUDQUIST PRESIDENT & CEO 7152688000 2019-11-14 1 MONROE JORDAN GIERL P01413237 6123055000 198.153.9.209 2019-11-14 11:43:01 CS P BC53011EDF70B2E1BD72B439C4A42BAD8A5D7AD2 31AD5F3C55E0BEE4726FCC0867C2B4B74D95884E 2018 2020-03-31 21:24:44Z DEBRA RUDQUIST 8170 33RD AVENUE SOUTH PO BOX 1309 MINNEAPOLIS MN 554401309 61291008 0 X WWW.AMERYMEDICALCENTER.ORG X 1954 WI TO PROVIDE ACCESSIBLE, COMPREHENSIVE, QUALITY HEALTHCARE 12 6 511 27 0 10322 110442 107300 53729810 60760964 34143 184444 187010 207576 54061405 61260284 43009 35749 0 0 38112863 39932985 0 0 0 19251211 20487659 57407083 60456393 -3345678 803891 55551941 51714878 34648029 30089212 20903912 21625666 X AMERY REGIONAL MEDICAL CENTER IS COMMITTED TO PROVIDEACCESSIBLE, COMPREHENSIVE, QUALITY HEALTHCARE AND TO PROMOTE THEHEALTH AND WELLNESS OF ITS COMMUNITY. 0 0 53723552 35749 60760964 SEE SCHEDULE O - EXEMPT PURPOSE AND ACHIEVEMENTS FOR A DESCRIPTION OF PROGRAM SERVICE ACCOMPLISHMENTS 53723552 1 1 0 1 0 0 0 0 0 0 1 0 1 0 0 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 0 0 0 0 0 0 0 1 1 1 1 0 1 0 0 511 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 12 6 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 WI X DOUGLAS JOHNSON - CFO 7152688000 265 GRIFFIN STREET EAST AMERY WI 54001 X DAN DRAXLER DIRECTOR 1.75 0.25 X 1200 0 0 HEIDI ERSPAMER DIRECTOR & SECRETARY 1.75 0.25 X X 1200 0 0 JAMES A LEADHOLM JR DIRECTOR & VICE CHAIR 1.75 0.25 X X 1200 0 0 DANIEL LIEN DIRECTOR & CHAIR (UNTIL 10/29/2018) 1.75 0.25 X X 1000 0 0 STEVEN SCHAFFFER DIRECTOR (FROM 10/8/2018) 1.75 0.25 X 300 0 0 CHRIS PETERSON DIRECTOR 1.75 0.25 X 1200 0 0 ORALEE SCHOCK DIRECTOR 1.75 0.25 X 1200 0 0 ROSS R BULLARD DIRECTOR & TREASURER 1.00 46.00 X X 0 224922 64991 DYLAN COE MD DIRECTOR 0.25 39.75 X 0 243305 81672 MARTIN E RICHARDS MD DIRECTOR 0.25 39.75 X 0 483655 55035 ANN SEAGREN MD DIRECTOR 0.25 49.75 X 0 269275 72512 TED WEGLEITNER DIRECTOR 0.25 52.75 X 0 568002 112133 MARYANN SCOGLIO CANP DIRECTOR 0.25 64.75 X 0 168822 41613 JASON J LUHRS CFO 0.50 49.50 X 0 205235 62557 SANDRA M REED VP - AMBULATORY CARE 55.00 X 184220 0 39802 DEBRA RUDQUIST CHIEF EXECUTIVE OFFICER 40.00 X 0 308982 77721 JESSICA NUUTINEN VP PATIENT CARE SERVICES 40.00 X 155853 0 35712 PATRICK SURA MD CHIEF MEDICAL OFFICER 0.25 64.75 X 0 497314 55233 MARK A TRYGGESTAD DIRECTOR OF PHARMACY 48.00 X 205856 0 20341 MARK T MOIOFFER PHARMACIST 40.00 X 123894 0 37262 TRACEY HARRIS PROVIDER-APNP 44.00 X 141997 0 12575 KENNETH GILLESPIE PROVIDER-APNP 40.00 X 144643 0 15364 BENJAMIN BOGLE PROVIDER-APNP 40.00 X 124331 0 37150 JOANNE L JACKSON FORMER HR, PR AND MKTG DIR 0.00 45.00 X 0 158591 25265 1088094 3128103 846938 25 1 1 0 RIVER VALLEY ANESTHESIA INC PO BOX 118 NEW RICHMOND WI 54017 NURSE ANESTHETISTS 939174 TOTALMED STAFFING INC 221 W COLLEGE AVE 2ND FL APPLETON WI 54911 PROFESSIONAL STAFFING SERVICES 449511 HEALOGICS WOUND CARE 28525 NETWORK PLACE CHICAGO IL 60673 WOUND HEALING MANAGEMENT 427920 TWIN CITIES ORTHOPEDICS PA 5803 NEAL AVE N OAK PARK HEIGHTS MN 55082 PROFESSIONAL SERVICES 389252 SHARED MEDICAL TECHNOLOGY INC 202 W NEWTON ST RICE LAKE WI 54868 PROFESSIONAL SERVICES 356917 17 87500 19800 107300 NET PATIENT SERVICE 621110 56021854 56021854 OTHER OPERATING 900099 4252841 4252841 SUBSIDIARY REVENUE 900099 319157 319157 FITNESS CENTER 624110 167112 167112 60760964 184444 184444 43898 30724 13174 13174 13174 CAFETERIA AND OTHER 900099 185164 185164 GIFT SHOP 453220 9238 9238 194402 61260284 60760964 0 392020 35749 35749 347073 347073 33621509 29906525 3714984 1634843 1476009 158834 1259077 1136751 122326 3070483 2772169 298314 10564 10564 3995469 3647667 347802 304957 13562 291395 598052 422798 175254 182564 156291 26273 983474 899517 83957 85100 48961 36139 16035 5535 10500 826397 826397 3152918 2982368 170550 194447 104945 89502 MEDICAL & DRUG SUPPLIES 7381825 7370372 11453 EQUIP. RENT & REPAIR 1634303 994241 640062 OTHER EXPENSE 785093 785093 TAXES & ASSESSMENTS 141635 141635 194826 138602 56224 60456393 53723552 6732841 0 7407 23668 11110340 8912534 6521958 7412905 720641 734425 62498 126448 60628109 37125050 25388189 23503059 9152717 8125113 2473135 2719280 115056 157446 55551941 51714878 8910042 5581652 25737987 24507560 34648029 30089212 X 20903912 21625666 20903912 21625666 55551941 51714878 803891 -82137 0 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: 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. 983722 983722 24300372 15100199 9200173 3574794 89046 3485748 27283285 17486579 9796706 4485936 4449226 36710 23503059 LONG TERM INVESTMENTS 2719280 C 2719280 X PART X, LINE 2: 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, 2018 OR 2017 FOR UNRECOGNIZED TAX BENEFITS. 1 1 X 1 X 1 X 1 1 0 0 385940 385940 0.00640 8089084 5146401 2942683 0.04870 8475024 5146401 3328623 0.05510 25 5226 248419 2082 246337 0.00410 9 80 49659 49659 0.00080 34 5306 298078 2082 295996 0.00490 34 5306 8773102 5148483 3624619 0.06000 1 1468 1468 0.00000 1 4467 4467 0.00010 1 325 506 506 0.00000 3 325 6441 6441 0.00010 0 1985818 734357 20915356 20915356 X 1 1 1 1 AMERY REGIONAL MEDICAL CENTER 265 GRIFFIN STREET EAST AMERY WI 54001 WWW.AMERYMEDICALCENTER.ORG CAH CERT LICENSE 1010 X X X X AMERY REGIONAL MEDICAL CENTER INC 1 0 0 1 X X X X X X X X X 18 1 1 0 1 X WWW.AMERYMEDICALCENTER.ORG/COMMUNITY_HEALTH_NEEDS_ASSESSMENT.ASPX X 1 15 1 WWW.AMERYMEDICALCENTER.ORG/COMMUNITY_HEALTH_NEEDS_ASSESSMENT.ASPX 0 1 X 200.000000000000 300.000000000000 X X X X 1 1 X X X X 1 X WWW.AMERYMEDICALCENTER.ORG X WWW.AMERYMEDICALCENTER.ORG X WWW.AMERYMEDICALCENTER.ORG X X X X X X 1 X 0 X X X 1 X 0 0 AMERY REGIONAL MEDICAL CENTER, INC. PART V, SECTION B, LINE 5: AS A PART OF COUNTY-WIDE ASSESSMENTS, SURVEYS AND LISTENING SESSIONS INCLUDED:1. STATE, LOCAL, TRIBAL, OR REGIONAL GOVERNMENTAL PUBLIC HEALTH DEPARTMENT(OR EQUIVALENT DEPARTMENT OR AGENCY) WITH KNOWLEDGE, INFORMATION, OREXPERTISE RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY (THE POLK COUNTY 2020 COMMUNITY HEALTH IMPROVEMENT PLAN, CONDUCTED IN COLLABORATION WITH THE POLK COUNTY HEALTH DEPARTMENT).2. MEMBERS OF MEDICALLY UNDERSERVED, LOW INCOME, AND MINORITYPOPULATIONS IN THE COMMUNITY, OR INDIVIDUALS OR ORGANIZATIONS SERVING ORREPRESENTING THE INTERESTS OF SUCH POPULATIONS (COMMUNITY SURVEYS). AMERY REGIONAL MEDICAL CENTER, INC. PART V, SECTION B, LINE 6A: OTHER HOSPITAL FACILITIES INCLUDED IN THE 2015 HEALTHPARTNERS CHNA WERE:- HUDSON HOSPITAL, HUDSON, WI.- WESTFIELDS HOSPITAL, NEW RICHMOND, WI.- LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, STILLWATER, MN.- PARK NICOLLET METHODIST HOSPITAL, ST. LOUIS PARK, MN- REGIONS HOSPITAL, ST. PAUL, MN AMERY REGIONAL MEDICAL CENTER, INC. PART V, SECTION B, LINE 11: THE 2015 HEALTHPARTNERS CHNA CONDUCTED RESULTED IN THE FOLLOWING PRIORITIES:PRIORITY 1: MENTAL AND BEHAVIORAL HEALTHPRIORITY 2: INCREASE ACCESS AND AFFORDABILITYPRIORITY 3: CRONIC DISEASE AND ILLNESS PREVENTIONPRIORITY 4: EQUITABLE CAREA FULL REPORT OF AMERY REGIONAL MEDICAL CENTER'S 2015 CHNA AND ANNUAL IMPLEMENTATION PLAN UPDATE IS POSTED ON ARMC'S WEBPAGE AT WWW.AMERYMEDICALCENTER.ORG/COMMUNITY_HEALTH_NEEDS_ASSESSMENT.ASPX 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. 6 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 PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY BUILDING ACTIVITIES AT ARMC PRIMARILY INCLUDE ENVIRONMENTAL IMPROVEMENTS AND WORKFORCE DEVELOPMENT. ARMC 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. ARMC ALSO HAS REPRESENTATIVES SERVE ON THE WITC MEDICAL ASSISTANT ADVISORY COMMITTEE, WITC ADVISORY COUNCIL, AND WITC HEALTH INFORMATION TECHNOLOGY ADVISORY COMMITTEE. PART III, LINE 2: AMERY REGIONAL MEDICAL CENTER (ARMC) USES A COST TO CHARGE METHODOLOGY. PART III, LINE 3: ARMC USES THE COST TO CHARGE METHODOLOGY TO DETERMINE AMOUNT REPORTED AS BAD DEBT. ARMC BELIEVES THAT MANY OF THE ACCOUNTS IN BAD DEBT WOULD HAVE QUALIFIED FOR CHARITY IF THE GUARANTORS WOULD HAVE COMPLETED THE FINANCIAL ASSISTANCE PAPERWORK. ARMC 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 ARMC ALSO INCLUDES AS A COMMUNITY BENEFIT. PART III, LINE 4: ALLOWANCE FOR DOUBTFUL ACCOUNTS AND CHARITY CARE: THE FINANCIAL STATEMENTS DO NOT HAVE A SEPARATE BAD DEBT FOOTNOTE. THE FOLLOWING IS PART OF ARMC'S PATIENT ACCOUNTS RECEIVABLE AND CREDIT POLICY:ACCOUNTS RECEIVABLE ARE REDUCED BY AN ANNUAL ALLOWANCE FOR DOUBTFUL ACCOUNTS OR CHARITY CARE, BASED ON ESTABLISHED GUIDELINES FOR IDENTIFYING UNCOLLECTIBLE PATIENT ACCOUNTS AND CLASSIFYING THESE ACCOUNTS AS EITHER DOUBTFUL ACCOUNTS OR CHARITY. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, ARMC'S MANAGEMENT PERIODICALLY ASSESSES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND CHARITY CARE BY TAKING INTO CONSIDERATION BY PAYER 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 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. ARMC PROVIDED MEDICAL CARE WITHOUT CHARGE OR A REDUCED COST TO PATIENTS WHO WERE DETERMINED TO BE UNABLE TO PAY (CHARITY CARE) OF $734,357 AND $654,628 FOR THE YEARS ENDED 12/31/18 AND 12/31/17 RESPECTIVELY, AND PROVIDED MEDICAL CARE TO PATIENTS WHO WERE DETERMINED TO BE ABLE, BUT UNWILLING TO PAY (DOUBTFUL ACCOUNTS) OF $1,985,818 AND $1,915,992 FOR THE YEARS ENDED 12/31/18 AND 12/31/17 RESPECTIVELY. ACCORDINGLY, ARMC DOES NOT SEPARATE ALLOWANCE ACCOUNTS FOR DOUBTFUL ACCOUNTS AND CHARITY CARE. PART III, LINE 8: THE COSTING METHODOLOGY USED IS COST TO CHARGE RATIO AS REQUIRED BY MEDICARE. THE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT BECAUSE ARMC IS INCURRING THE COST OF PROVIDING SERVICES TO MEDICARE PATIENTS AND NOT GETTING PAID COMPLETELY BY MEDICARE FOR THE COST OF PROVIDING THESE SERVICES. PART III, LINE 9B: ARMC IS COMMITTED TO PROVIDING QUALITY MEDICAL CARE TO OUR PATIENTS, INCLUDING THOSE IN NEED OF FINANCIAL ASSISTANCE. AS A RESULT, OUR FINANCIAL ASSISTANCE POLICY (REFERRED TO HEREIN AS "FAP OR "POLICY") IS AVAILABLE TO UNINSURED OR UNDERINSURED PATIENTS BASED ON THE PATIENT'S ABILITY TO PAY FOR EMERGENCY AND OTHER MEDICALLY NECESSARY CARE. OUR POLICY IS AVAILABLE TO PROVIDE EPISODIC HELP; IT IS NOT MEANT TO PROVIDE LONG-TERM, FREE OR DISCOUNTED CARE. OUR POLICY SETS FORTH AND DESCRIBES ELIGIBILITY CRITERIA, HOW WE CALCULATE DISCOUNTS, HOW TO APPLY FOR FINANCIAL ASSISTANCE, THE PROVIDERS DELIVERING CARE IN OUR HOSPITAL AND OUR EMERGENCY MEDICAL CARE POLICY.PATIENTS CAN OBTAIN FREE COPIES OF THIS POLICY AT ALL PATIENT REGISTRATION LOCATIONS AT AMERY. FOR ADDITIONAL INFORMATION OR QUESTIONS ABOUT THE APPLICATION PROCESS, OR TO REQUEST COPIES BY MAIL, PATIENTS CAN CONTACT OUR PATIENT FINANCIAL SERVICES DEPARTMENT AT 1-715-268-8000. FREE COPIES OF THIS POLICY AND THE FINANCIAL ASSISTANCE APPLICATION FORM ARE ALSO AVAILABLE AT HTTP://WWW.AMERYMEDICALCENTER.ORG. PART VI, LINE 7, REPORTS FILED WITH STATES WI 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, ARMC, 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 STUDY AREA IS DEFINED AS DAKOTA, HENNEPIN, RAMSEY, SCOTT, AND WASHINGTON COUNTIES IN MINNESOTA AND POLK AND ST. CROIX COUNTIES IN WISCONSIN. ARMC'S SPECIFIC STUDY AREA IS DEFINED AS:- POLK COUNTYDATA ELEMENTS REGARDING ALL SEVEN COUNTIES IN THE STUDY AREA WERE INCLUDED IN THE REPORT FOR COMPARISON, AND WERE 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 POLK COUNTY, INCLUDING: OVERALL POPULATION, POPULATION BY RACE AND ETHNICITY, MEDIAN AGE, MEDIAN HOUSEHOLD INCOME, POVERTY LEVELS, FOOD INSECURITY, AND EDUCATIONAL ATTAINMENT.- HEALTH DATA COLLECTION: ARMC PARTICIPATED IN A COUNTY-WIDE INITIATIVE TO ANALYZE THE HEALTH OF RESIDENTS IN THE COMMUNITY, THE POLK COUNTY 2020 COMMUNITY HEALTH IMPROVEMENT PLAN VERSION 2014-2016.- COMMUNITY INPUT: AS A PART OF THE COUNTY-WIDE ASSESSMENT, SURVEYS WERE CONDUCTED TO GATHER INPUT FROM COMMUNITY RESIDENTS. IN ADDITION, ARMC CONDUCTED A COMMUNITY CONVERSATION ON AUGUST 20, 2015 TO GAIN INSIGHT SURROUNDING SIGNIFICANT HEALTH NEEDS.FINAL PRIORITIZED NEEDS - MENTAL AND BEHAVIORAL HEALTH - ACCESS AND AFFORDABILITY - CHRONIC DISEASE AND ILLNESS PREVENTION - EQUITABLE CAREA FULL REPORT OF ARMC'S CHNA AND IMPLEMENTATION PLAN IS POSTED ON ARMC'S WEBPAGE AT HTTP://WWW.AMERYMEDICALCENTER.ORG/COMMUNITY_HEALTH_NEEDS_ASSESSMENT.ASPX. PART VI, LINE 3 ARMC'S PATIENT FINANCIAL SERVICES DEPARTMENT WORKS WITH EACH PATIENT REGARDING ACCOUNT BALANCES LEFT TO PATIENT RESPONSIBILITY. PATIENTS THAT ARE NOT ALREADY ON GOVERNMENT ASSISTANCE OR HAVE LIMITED ASSISTANCE, ARE REFERRED TO ARMC'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 ARMC AND HELPS THEM THROUGH THE PROCESS. THE FINANCIAL ASSISTANCE PROGRAM AND APPLICATION ARE LOCATED ON THE ARMC'S INTERNET SITE TO ALLOW PATIENTS DIRECT ACCESS TO THIS INFORMATION. PART VI, LINE 4 ARMC SERVICE AREA INCLUDES FIFTEEN DIFFERENT ZIP CODES IN NORTHWEST WISCONSIN THAT PRIMARILY REPRESENT POLK COUNTY. IT INCLUDES THREE RURAL HEALTH CLINICS IN LUCK, TURTLE LAKE, & CLEAR LAKE WHICH ARE ALL MEDICALLY UNDERSERVED AREAS. THE ARMC COMMUNITY IS ALSO CONSIDERED A MENTAL HEALTH MEDICALLY UNDERSERVED AREA. THE WOUND CENTER & INPATIENT PSYCH SERVICE DRAWS PATIENTS FROM OUTSIDE ARMC'S NORMAL SERVICE AREA. PART VI, LINE 5 TEN OF ARMC'S THIRTEEN BOARD MEMBERS LIVE IN ARMC'S SERVICE AREA. ARMC 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 ARMC'S COMMUNITY. PART VI, LINE 6 HEALTHPARTNERS AND ARMC HAVE HAD A LONG-STANDING RELATIONSHIP, WITH HEALTHPARTNERS EMPLOYING AND SOURCING PHYSICIANS AND MID-LEVEL PRACTITIONERS TO ARMC FOR ARMC'S PRIMARY CARE CLINICS. AS OF 2014, ARMC BECAME PART OF THE HEALTHPARTNERS FAMILY OF MISSION-DRIVEN NON-PROFIT ORGANIZATIONS. AS PART OF THE HEALTHPARTNERS FAMILY, ARMC USES HEALTHPARTNERS' INTEGRATED ELECTRONIC HEALTH RECORD SYSTEM, PARTICIPATES IN COORDINATED CHNA PROCESSES AND IMPLEMENTATION STRATEGIES, 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 IN THE VALLEY FOR THE BENEFIT OF 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 FOR BASIC CONDITIONS, A 24 HOUR/7 DAY PER WEEK NURSE LINE, AND OTHER SERVICES THAT ENHANCE CARE FOR MEMBERS, PATIENTS AND THE COMMUNITY. 0 AMERY REGIONAL MEDICAL CENTER FOUNDATION 8170 33RD AVE S BLOOMINGTON MN 554401309 391726539 501(C)(3) 10000 PROGRAM SUPPORT AMERICAN CANCER SOCIETY 250 WILLIAMS STREET NW ATLANTA GA 30303 131788491 501(C)(3) 5000 PROGRAM SUPPORT 2 0 PART I, LINE 2: 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. 0 1 0 0 0 0 0 0 0 ROSS R BULLARD DIRECTOR & TREASURER 0 189198 0 31310 0 4414 0 34807 0 30184 0 289913 0 0 DYLAN COE MD DIRECTOR 0 191970 0 0 0 51335 0 62988 0 18684 0 324977 0 0 MARTIN E RICHARDS MD DIRECTOR 0 385617 0 15580 0 82458 0 20625 0 34410 0 538690 0 0 ANN SEAGREN MD DIRECTOR 0 192000 0 0 0 77275 0 42221 0 30291 0 341787 0 0 TED WEGLEITNER DIRECTOR 0 421844 0 101090 0 45068 0 76500 0 35633 0 680135 0 40735 MARYANN SCOGLIO CANP DIRECTOR 0 160014 0 0 0 8808 0 13063 0 28550 0 210435 0 0 JASON J LUHRS CFO 0 186683 0 17473 0 1079 0 34342 0 28215 0 267792 0 0 SANDRA M REED VP - AMBULATORY CARE 136928 0 38884 0 8408 0 6495 0 33307 0 224022 0 0 0 DEBRA RUDQUIST CHIEF EXECUTIVE OFFICER 0 268899 0 37543 0 2540 0 46864 0 30857 0 386703 0 0 JESSICA NUUTINEN VP PATIENT CARE SERVICES 138725 0 12649 0 4479 0 4621 0 31091 0 191565 0 0 0 PATRICK SURA MD CHIEF MEDICAL OFFICER 0 364500 0 6681 0 126133 0 20625 0 34608 0 552547 0 0 MARK A TRYGGESTAD DIRECTOR OF PHARMACY 165831 0 32272 0 7753 0 6690 0 13651 0 226197 0 0 0 MARK T MOIOFFER PHARMACIST 120127 0 135 0 3632 0 3938 0 33324 0 161156 0 0 0 TRACEY HARRIS PROVIDER-APNP 114274 0 650 0 27073 0 1473 0 11102 0 154572 0 0 0 KENNETH GILLESPIE PROVIDER-APNP 124581 0 5150 0 14912 0 4166 0 11198 0 160007 0 0 0 BENJAMIN BOGLE PROVIDER-APNP 109719 0 150 0 14462 0 3882 0 33268 0 161481 0 0 0 JOANNE L JACKSON FORMER HR, PR AND MKTG DIR 0 131832 0 24490 0 2269 0 5519 0 19746 0 183856 0 0 PART I, LINE 3 ARMC'S CEO AND ITS OFFICERS ARE EMPLOYED BY REGIONS HOSPITAL (REGIONS) OR BY GROUP HEALTH PLAN, INC. (GHI), BOTH OF WHICH ARE RELATED ORGANIZATIONS, OR BY ARMC. GHI, REGIONS, AND ARMC HAVE AN ANNUAL PROCESS TO REVIEW THE MARKET COMPARABILITY OF THE TOTAL COMPENSATION OF ARMC'S CEO 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 $36,931 990, 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: TED WEGLEITNER $40,735 A VILLAGE OF LUCK WISCONSIN 396006307 2011-04-28 8500000 REFINANCE EXISTING DEBT 0 0 0 B CITY OF AMERY WISCONSIN 396005378 2011-04-13 8500000 REFINANCE EXISTING DEBT 0 0 0 C VILLAGE OF CLEAR LAKE WISCONSIN 396006238 2011-03-29 8500000 REFINANCE EXISTING DEBT 0 0 0 D TOWN OF BLACK BROOK POLK COUNTY WISCONSIN 391169876 2011-05-13 6150000 REFINANCE EXISTING DEBT 0 0 0 A 5558146 8500000 170000 8330000 2007 1 0 1 1 B 5558146 8500000 170000 8330000 2007 1 0 1 1 C 5558146 8500000 170000 8330000 2007 1 0 1 1 D 4017961 6150000 123000 6027000 2007 1 0 1 1 A 0 1 0 0 0.00090 0.00090 1 0 0 B 0 1 0 0 0.00090 0.00090 1 0 0 C 0 1 0 0 0.00090 0.00090 1 0 0 D 0 1 0 0 0.00090 0.00090 1 0 0 A 0 1 0 0 1 0 0 0 0 B 0 1 0 0 1 0 0 0 0 C 0 1 0 0 1 0 0 0 0 D 0 1 0 0 1 0 0 0 0 A 0 B 0 C 0 D 0 FORM 990, SCHEDULE K, PART IV, LINE 2A THRU 2C REBATE CALCULATION IS NOT DUE BUT EVERY 5 YEARS. THERE IS NO REBATE CACLULATION DUE FOR ANY BONDS LISTED IN SCHEDULE K, PART I. A TOWN OF LINCOLN POLK COUNTY WISCONSIN 391406159 2011-05-31 6150000 REFINANCE EXISTING DEBT 0 0 0 A 4017961 6150000 123000 1709792 4317208 2007 1 0 1 1 A 0 1 0 0 0.00090 0.00090 1 0 0 A 0 1 0 0 1 0 0 0 0 A 0 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 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). BENEFIT TO THE COMMUNITY: 1. COMMUNITY HEALTH IMPROVEMENT SERVICES: $ 207,770 COMMUNITY HEALTH EDUCATION - ARMC HELPS EDUCATE THE LOCAL COMMUNITIES ABOUT HEALTH ISSUES BY PROVIDING THE FOLLOWING TYPES OF COMMUNITY EDUCATION: CPR/BLS CLASSES, MONTHLY DIABETES SUPPORT GROUPS REACHING OVER 100 INDIVIDUALS, MONTHLY BREASTFEEDING SUPPORT GROUPS REACHING OVER 50 INDIVIDUALS, EXPECTANT PARENTS/PRE-NATAL AND BREASTFEEDING CLASSES REACHING 30 PARENTS, FIVE HEALTH FAIRS WITH FOCUS ON HEART HEALTH, STROKE PREVENTION, WOUND HEALING, DIABETES EDUCATION, AND NUTRITION, AND 15 MENTAL HEALTH FOCUSED COMMUNITY EDUCATION CLASSES WITH A REACH OF OVER 450 INDIVIDUALS. CONTINUING IN 2018, ARMC OFFERED AT LEAST ONE FREE COMMUNITY EDUCATION CLASS EVERY MONTH IN ADDITION TO FREE MEDICAL NUTRITION THERAPY CLASSES TAUGHT BY REGISTERED DIETITIANS WITH A FOCUS ON HEALTHY WEIGHT AND DIABETES PREVENTION. BEYOND THE MONTHLY CLASS OFFERINGS, OVER 20 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 198 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 THIRD FULL YEAR IN AMERY WITH GREAT SUCCESS. EXAMPLES INCLUDE: AMERY INQUIRING MINDS COLLABORATION WITH FARM TABLE AND POWERUP, WHICH CONSISTED OF FOUR COOKING CLASSES (15 STUDENTS EACH CLASS/60 STUDENTS TOTAL) WITH A CURRICULUM FOCUSED ON PREPARING SNACKS, COOKING SKILLS, RECIPE READING, AND TEAMWORK. THE CULMINATION OF THE COLLABORATION WAS A GALLERY NIGHT AT FARM TABLE FOR STUDENTS TO EXHIBIT THEIR ART, A PROJECT LED BY FARM TABLE. HERE, SNACKS THAT THE STUDENTS HAD BEEN MAKING AT EACH OF THE CLASSES WERE FEATURED AS THE HORS D'OEUVRES. OVER 200 WERE IN ATTENDANCE. ANNUAL CANDLELIGHT SKI/SNOWSHOE/HIKE/FAT TIRE BIKE ON THE STOWER EVENT IN PARTNERSHIP WITH THE FRIENDS OF THE STOWER SEVEN LAKES STATE TRAIL. THIS WAS A FREE EVENT WITH POWERUP SNACKS AND SNOWSHOES AVAILABLE FOR USE. OVER 200 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 INTO A WHOLESOME AND DELICIOUS VEGETABLE OR BEAUTIFUL FLOWER. STUDENTS ALSO LEARNED ABOUT OUR REGION'S VEGETABLE-GROWING FAMILY FARMS. THEIR SEEDLINGS WERE THEN RAISED IN THE SCHOOL HALLWAYS UNTIL READY FOR THE SCHOOL GARDEN. THE CHARACTER "CHOMP" MADE AN APPEARANCE AT THE END OF THE DAY TO CELEBRATE THIS EVENT AND HANDED OUT BABY CARROTS TO APPROXIMATELY 400 STUDENTS. POWERUP AT LIEN ELEMENTARY 4K ORIENTATION FEATURING A VEGGIE VOTE AND OUTREACH MATERIALS. OVER 70 KIDS AND ADULTS TASTE TESTED RED PEPPER AND JICAMA! AREA LIBRARY (OSCEOLA, ST. CROIX, AMERY) KAYAKING TRIP DOWN THE ST. CROIX RIVER WITH POWERUP COOKOUT COOKING AT THE END OF THE TRIP. A GROUP OF 17 TEENS AND 5 ADULTS PREPARED THEIR OWN CAMPFIRE MEALS. SHARED PLAN OF CARE GRANT FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS FAMILY ENGAGEMENT NIGHT WITH A POWERUP COOKING ACTIVITY IN JUNE AND OCTOBER; TOTAL REACH 15 KIDS. POWERUP AT THE THIRD GRADE HEALTH FAIR FEATURING A VEGGIE VOTE WHERE APPROXIMATELY 250 STUDENTS TASTE TASTED TWO DIFFERENT VEGETABLES. POWERUP SPORTS NUTRITION TALK (FUELING FOR PERFORMANCE, RECOVERY AND INJURY PREVENTION) WITH THE AMERY HIGH SCHOOL GIRLS SOCCER TEAM AND TRACK TEAM; TOTAL REACH OF APPROXIMATELY 90 STUDENTS. POWERUP WEEK FEATURING A 2K AND 5K RUN/WALK WITH 107 PARTICIPANTS, CHOMP'S BIRTHDAY PARTY AT AMERY PUBLIC LIBRARY WITH OVER 30 KIDS AND ADULTS, AND A SPECIAL POWERUP PLAY DAY OPEN GYM FEATURING PE TEACHERS LEADING GAMES AND ACTIVITIES TO 25 KIDS AND ADULTS. MOBILE TEACHING KITCHEN KNOWN AS THE CHARLIE CART LAUNCHED IN A PARTNERSHIP WITH AMERY PUBLIC LIBRARY IN JUNE, JULY, AND AUGUST WITH CLASSES OF 30 KIDS EACH, A TOTAL REACH OF 90 OVER THREE MONTHS. POWERUP RECIPE CONTEST TASTE TESTING AT AMERY HOSPITAL, THE LAST STEP IN THE CONTEST TO DETERMINE FINAL RANK OF THE TOP 5 RECIPES. THE TASTE TESTING ENGAGED APPROXIMATELY 50 ARMC EMPLOYEES AND VISITORS. IN THE END, THE TOP 2 RECIPES WERE BOTH FROM AMERY: PAUL J. WITH HIS RECIPE "UNROLLED EGG ROLL" WAS FIRST PLACE AND LILA S. WITH HER RECIPE "RAINBOW ROLL-UPS" WAS SECOND PLACE. IN OCTOBER, POWERUP HELD AN ALL-SCHOOL ASSEMBLY TO ANNOUNCE THE WINNERS AT LIEN ELEMENTARY. FORM 990, PART III, LINE 4A POWERUP COOKING CLASSES AT FARM TABLE CONTINUED IN 2018, WITH A PROGRAM CHANGE IN THE FALL TO AN AFTER-SCHOOL CLASS WHERE STUDENTS COULD RIDE THE BUS STRAIGHT TO FARM TABLE. A TOTAL OF 66 STUDENTS ATTENDED OVER THE COURSE OF FIVE CLASSES. 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 ORGANIZATION. LIEN ELEMENTARY SCHOOL CARNIVAL WITH "POWERED UP" FOOD OPTIONS INCLUDING A TACO BAR, FRUIT CUPS, POPCORN, CELERY AND PEANUT BUTTER CUPS, AND FRESH MADE SMOOTHIES; APPROXIMATELY 200 WERE IN ATTENDANCE. AMERY INTERMEDIATE SCHOOL WALK-A-THON "POWERED UP" ITS 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 HAD THE MOST LAPS EARNED A POWERUP SMOOTHIE PARTY! EIGHT OPEN GYMS FOR FAMILIES TOOK PLACE FOR THE WINTER MONTHS IN THE SCHOOL YEAR OF 2017- 2018 IN PARTNERSHIP WITH AMERY SCHOOL DISTRICT AND AMERY COMMUNITY ED. AVERAGE ATTENDANCE WAS 30-40 KIDS AND PARENTS. THREE POWERUP SPONSORED OPEN SKATES IN PARTNERSHIP WITH AMERY YOUTH HOCKEY ASSOCIATION. EVENTS WERE FREE AND INCLUDED FREE SKATES TO USE. IN ADDITION, CONCESSIONS WERE "POWERED UP" DURING POWER UP SPONSORED OPEN SKATES. 15 OPEN GYMS FOR FAMILIES WERE PLANNED FOR THE WINTER MONTHS IN THE SCHOOL YEAR OF 2018-2019 (FIVE OCCURRING IN 2018) IN PARTNERSHIP WITH CLEAR LAKE SCHOOL DISTRICT AND CLEAR LAKE COMMUNITY EDUCATION. POWERUP CANDY TRADE-IN ACROSS THE ST. CROIX VALLEY AND TWIN CITIES METRO. KIDS BROUGHT IN HALLOWEEN CANDY TO DONATE TO SOLDIERS AND WRITE THEM A THANK YOU CARD; IN RETURN THEY GOT TO PICK A POWERUP PRIZE. (TOTAL POUNDS OF CANDY COLLECTED: AMERY HOSPITAL = 45 LBS; CLEAR LAKE ELEMENTARY = 50 LBS; THE VALLEY = 1,171 LBS). POWERUP FRUIT AND VEGGIE RX CONTINUED THIS YEAR WITH PROVIDERS ASKING CHILDREN AGES 2-17 YEARS OLD ABOUT FRUITS AND VEGGIES, AND THEN "PRESCRIBING" THAT THEY TRY MORE FRUIT AND 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 PERCENT. COMMUNITY-BASED CLINICAL SERVICES - $543 ARMC PROVIDED TWO FLU SHOT CLINICS AT A LOCAL AREA BUSINESS. BEHAVIORAL HEALTH SCREENED THREE TEENS FOR DEPRESSION, SUICIDAL THOUGHTS AND STRESSORS AT THE AMERY HIGH SCHOOL. HEALTH CARE SUPPORT SERVICES - $92,374 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 $54,925 IN STAFF TIME TO ASSIST PATIENTS IN ENROLLING IN PUBLIC MEDICAL PROGRAMS, FREE DRUG PROGRAMS, AND TO REFER INDIVIDUALS TO COMMUNITY SERVICES/PUBLIC HEALTH ASSISTANCE. ARMC'S PATIENT EMERGENCY FUND, SUPPORTED BY EMPLOYEES AND STAFF, DONATED OVER $300 TO HELP 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 2018, WITH REVENUE OF $2,082 AND AN OPERATING COST OF $49,736. SOCIAL & ENVIRONMENTAL IMPROVEMENT ACTIVITIES - $48,930 DUE TO THE HEALTH PROFESSIONAL SHORTAGE AREA IN THE ARMC SERVICE AREA, NUMEROUS RESOURCES WERE INVESTED IN PHYSICIAN AND ADVANCED PRACTICE PROVIDER RECRUITMENT, TOTALING AT LEAST $38,725. ARMC WELCOMED ONE NEW FAMILY MEDICINE PHYSICIAN, ONE DERMATOLOGIST, AND ONE RHEUMATOLOGIST. IN 2017, OVER 200 MEDICAL STUDENTS APPLIED AND OVER 20 WERE INTERVIEWED FOR THE NEWLY INITIATED WESTERN WISCONSIN RURAL RESIDENCY PROGRAM AT ARMC. TWO STUDENTS WERE CHOSEN AND ONE IS EXPECTED TO START IN JULY 2019. 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: $57,131 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 AND SECOND YEAR MEDICAL STUDENT ROTATIONS. IN ADDITION, ARMC ACTIVELY COLLABORATES WITH THE WISCONSIN INDIANHEAD TECHNICAL COLLEGE (WITC) TO HELP EDUCATE AND TRAIN NURSES. FOR 2018, ARMC PROVIDED CLINICAL TRAINING FOR: 40 NURSES, SEVEN CERTIFIED REGISTERED NURSE ANESTHETIST STUDENTS, ONE MEDICAL STUDENT, ONE PHLEBOTOMY STUDENT, TWO LAB TECHNICIAN STUDENTS, ONE OCCUPATIONAL THERAPIST STUDENT, ONE OCCUPATIONAL THERAPIST ASSISTANT STUDENT, ONE PHYSICAL THERAPY STUDENT, FOUR PARAMEDIC STUDENTS, TWO HEALTH INFORMATION MANAGEMENT STUDENTS, THREE PHARMACY STUDENTS, FIVE RADIOLOGY STUDENTS, ONE SOCIAL WORK STUDENT, AND TWO MEDICAL ASSISTANTS. 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. FINANCIAL CONTRIBUTIONS: $143, 833 CASH DONATIONS - ARMC HELPED VARIOUS NON-PROFIT ORGANIZATIONS, COMMUNITY GROUPS, AND SCHOOL PROGRAMS THROUGH CASH DONATIONS TOTALING $16,529. 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 OBESITY PREVENTION GROUP. 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 $7,959, WITH THE BENEFIT OF DONATED SERVICES TOTALING $36, 761. ARMC HOSTED TWO BLOOD DRIVES COLLECTING 90 UNITS OF BLOOD FROM 92 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. TO HELP COMBAT POVERTY, ARMC PROVIDES AMERY AREA FOOD SHELF WITH FREE RENT, HEAT AND SHELVING FOR FOOD ITEMS. IN 2018, OVER $74,000 WAS PROVIDED TO SUPPORT THIS LOCAL PROGRAM. 4. COMMUNITY BUILDING ACTIVITIES: $6,441 ENVIRONMENTAL IMPROVEMENTS - ARMC HAD A REPRESENTATIVE ATTEND THE ANNUAL CLEANMED CONFERENCE, 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. 5. COMMUNITY BENEFIT OPERATIONS: $30,578 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. 6. ORGANIZATION AWARDS AND ACHIEVEMENTS 2018 PRACTICE GREENHEALTH AWARDS: EMERALD AWARD GREENING THE OR RECOGNITION CIRCLES OF EXCELLENCE: 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 ARMC'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 ARMC. GHI, REGIONS, AND ARMC HAVE AN ANNUAL PROCESS TO REVIEW THE MARKET COMPARABILITY OF THE TOTAL COMPENSATION OF ARMC'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 ARMC 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 ARMC'S BOARD OF DIRECTORS INPUT, THE ST CROIX VALLEY EXECUTIVE LEADER CONDUCTS THE ANNUAL PERFORMANCE REVIEW AND, WITH ARMC'S BOARD APPROVAL, DETERMINES THE COMPENSATION OF THE ARMC CEO. THE ARMC BOARD HAS DELEGATED TO THE CEO 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 ARMC 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 ARMC 990 RETURNS ARE MADE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION FROM ARMC OR HEALTHPARTNERS, INC. FORM 990, PART VI, SECTION C, LINE 19 ARMC 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. 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 - 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CLAIMSHEALTHCARE SERVICES L 245865 FAIR VALUE AMERY REGIONAL MEDICAL CENTER FOUNDATION C 87500 FAIR VALUE