2019-11-15T07:47:40-06:00 2018-12-31 390758449 WIPFLI LLP PO BOX 8010 WAUSAU WI 544028010 990 2018-01-01 391528430 BAY AREA MEDICAL CENTER INC BAYA 7157354200 3003 UNIVERSITY DR MARINETTE WI 54143 RACHEL HALVERSON VP-TAX AND ACCOUNTING SERVICES 4142991862 2019-11-12 0 KIMBERLY HELLER CPA P00766668 7158453111 2019-11-12 50.50.56.238 2019-11-12 16:12:48 CS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 496D980A72CFB4CBC9EECA10FEA715E1BCC06C37 2018 2020-04-17 16:48:07Z JEFFREY DALEN-BARD 750 WEST VIRGINIA STREET PO BOX 341880 MILWAUKEE WI 53234 133480581 0 X WWW.BAMC.ORG X 1985 WI BAY AREA MEDICAL CENTER (BAMC) IS A REGIONAL HEALTH CARE FACILITY PROVIDING A WIDE RANGE OF MEDICAL SERVICES TO THE RESIDENTS OF MARINETTE AND MENOMINEE COUNTIES AND THE SURROUNDING AREAS. BAMC'S PRIMARY EXEMPT PURPOSE IS THE PROVISION OF HEALTH CARE SERVICES. 9 9 771 9 1298599 0 150210 858628 119353583 129023207 3036881 1508986 -319990 384189 122220684 131775010 0 0 0 0 58591538 55665234 145631 0 52466 60388712 78157849 119125881 133823083 3094803 -2048073 234035074 215003263 106215077 105395483 127819997 109607780 WE ARE YOUR MEDICAL CENTER, STRIVING TO EXCEED YOUR EXPECTATIONS BY PROVIDING COMPASSIONATE, COST-EFFECTIVE, QUALITY HEALTHCARE TO ALL. 0 0 109682227 0 122395005 INPATIENT HOSPITAL SERVICES FOR MEDICAL, SURGICAL AND OBSTETRICS/GYNECOLOGY PATIENTS - BAMC PROVIDED CARE FOR 2,961 PATIENTS WHO WERE ADMITTED AS INPATIENTS DURING 2018. THESE SERVICES INCLUDED 24/7 CARE FOR PATIENTS ADMITTED WITH MEDICAL CONDITIONS WARRANTING A HOSPITAL STAY, PATIENTS ADMITTED FOR SURGICAL PROCEDURES EXTENSIVE ENOUGH TO REQUIRE A STAY OVERNIGHT OR FOR SEVERAL DAYS FOLLOWING THE PROCEDURES, AND PATIENTS ADMITTED FOR THE DELIVERY OF NEWBORNS.OUTPATIENT SURGICAL SERVICES - BAMC PERFORMED 3,408 OUTPATIENT SURGICAL PROCEDURES FOR PATIENTS DURING 2018. THESE PROCEDURES INCLUDED ORTHOPEDIC, UROLOGICAL, GENERAL SURGERY, GYNECOLOGY, AND ENT SURGERIES. 109682227 1 0 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 1 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 103 0 771 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X ADVOCATE AURORA HEALTH INC 4142991576 750 WEST VIRGINIA STREET PO BOX MILWAUKEE WI 54234 X PAT KRAH CHAIR 1.00 0.00 X X 0 0 0 JEFFREY BARD VICE CHAIR 0.80 0.00 X X 0 0 0 WILLIAM MALLORY MD SECRETARY/TREASURER 0.80 0.00 X X 0 0 0 DR STEPHEN CASELTON BOARD MEMBER 0.80 0.00 X 0 0 0 SANDY EWALD BOARD MEMBER 0.80 0.00 X 0 0 0 TONY FURTON BOARD MEMBER 0.80 0.00 X 0 0 0 CHUCK HAWKINS BOARD MEMBER 0.80 0.00 X 0 0 0 PATRICK O'HARA BOARD MEMBER 0.80 0.00 X 0 0 0 MARC JAMO BOARD MEMBER 0.80 0.00 X 0 0 0 EDWARD HARDING CEO 55.00 0.00 X 641688 0 52360 ROGER SNEATH CFO 55.00 0.00 X 369923 0 0 BERNADINE VAN COURT COO 55.00 0.00 X 339345 0 31025 FRANCISCO GAMEZ MD PHYSICIAN 55.00 0.00 X 564941 0 37568 MOHAMED EL-JACK PHYSICIAN 55.00 0.00 X 745988 0 55848 MICHAEL KARKKAINEN MD PHYSICIAN 55.00 0.00 X 1123402 0 61112 EDGAR MASSABNI MD PHYSICIAN 55.00 0.00 X 520391 0 41285 ROBERT MACCANI PHYSICIAN 55.00 0.00 X 520509 0 52032 4826187 0 331230 66 0 1 0 ACL 8901 W LINCOLN AVE WEST ALLIS WI 53227 LABORATORY SERVICES (AURORA LAB) 5142264 INFINITY HEALTHCARE PHYSICIANS SC 111 EWISCONSIN AVE SUITE 2100 MILWAUKEE WI 53202 OUTSOURCED ER PHYSICIANS 2013314 SODEXO INC & AFFLILIATES 9801 WASHINGTONIAN BLVD GAITHERSBURG MD 20879 OUTSOURCED ENVIRONMENTAL SERVICES 1600916 AURORA HEALTH CARE PO BOX 343910 MILWAUKEE WI 53234 MANAGEMENT AND SERVICE FEES 1553345 TRIMEDICS LLS 5451 LAKEVIEW PKWY S DRIVE INDIANAPOLIS IN 46268 WARRANTY/SERVICE AGREEMENTS 808175 25 851060 7568 858628 NET PATIENT REVENUE 900099 105671013 105671013 PHYSICIAN SERVICES - ABAMG & AURO 900099 15661843 15661843 OTHER MISCELLANEOUS ACTIVITIES 900099 5967439 229934 5737505 RETAIL PHARMACY 446110 996602 996602 SPACE LEASED FOR MEDICAL PURPOSES 621110 424313 424313 301997 301997 129023207 908671 908671 33088 56801 -23713 -23713 -23713 663517 1585568 0 1648770 663517 -63202 600315 600315 INTEREST RATE SWAP VALUATION ADJU 900099 407902 407902 407902 131775010 122395005 1298599 7222778 X 1426541 1426541 42691894 35837654 6854240 2243467 1738768 504699 6487399 5202424 1284975 2815933 2214503 601430 647240 647240 626398 626398 52466 52466 149482 149482 14757169 10492755 4264414 623321 36249 587072 22364547 21555062 809485 576749 576749 1476413 1199951 276462 90541 63189 27352 762092 762050 42 5727459 2895749 2831710 439673 350089 89584 IMPAIRMENT LOSS ON GOOD 16662000 16662000 REPAIRS AND MAINTENANCE 5695039 3538688 2156351 BAD DEBTS 4532640 4532640 WI HOSPITAL ASSESSMENT 2493364 2493364 481256 107092 374164 133823083 109682227 24088390 52466 2825 3425 27687642 6810523 14853812 15050628 2880951 3044988 1453422 1385914 201378357 40761241 121296313 160617116 45737008 26760381 17147000 464996 2976101 865292 234035074 215003263 10401974 14888433 85307661 83305440 10505442 7201610 106215077 105395483 X 126439276 108702565 1380721 905215 127819997 109607780 234035074 215003263 X -2048073 -1783835 -14380309 X 0 1 X 1 0 X 0 0 0 0 0 1 10153 0 0 0 10153 0 PART II-B, LINE 1: THE WHA AND AHA WORKS WITH, AND ON BEHALF OF, ITS MEMBERS TO REPRESENT AND ADVOCATE POLICY POSITIONS BEFORE THE CONGRESS, THE COURTS, THE WHITE HOUSE AND FEDERAL AGENCIES. THROUGH REPRESENTATION AND ADVOCACY, THE AHA ASSISTS ITS MEMBERS ON INITIATIVES AND CHANGES NEEDED TO FURTHER HOSPITALS' MISSION TO DELIVER HIGH-QUALITY, COST-EFFECIENT HEALTH CARE TO ALL AMERCIANS. PORTION OF AHA ($5,464) AND WHA ($4,690) DUES = $10,153. 13388814 13388814 122951653 4493561 118458092 60753396 36267680 24485716 4284494 4284494 160617116 ACCRUED POSTRETIREMENT BENEFITS 1280576 DEFERRED COMPENSATION 681839 INTEREST RATE SWAP VALUATION 3875809 AMOUNTS PAYABLE TO THIRD-PARTY REIMBURSEMENT PROGRAM 1163386 REC CENTER NAMING RIGHTS 200000 7201610 X X X 1 ACCORDANT PHILANTHROPY 105 TEAL NEST COURT PONTE VEDRA BEACH FL 32082 CAPITAL CAMPAIGN 0 95255 42611 52644 95255 42611 52644 WI 1 1 X 1 X 250.000000000000 0 1 1 0 1 1 1165598 1165598 0.01030 15879920 7983126 7896794 0.07010 17045518 7983126 9062392 0.08040 17045518 7983126 9062392 0.08040 0 1497571 26325483 27103671 -778188 X 1 1 1 1 BAY AREA MEDICAL CENTER INC 3003 UNIVERSITY DR MARINETTE WI 54143 WWW.BAMC.ORG 2419-800 X X X BAY AREA MEDICAL CENTER 1 0 0 1 X X X X X X X X X 16 1 0 0 1 X HTTPS://WWW.BAMC.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS/ X X 1 16 1 HTTPS://WWW.BAMC.ORG/MEDIA/1310/COMMUNITY-NEEDS-UPDATE-2016.PDF 0 1 X 250.000000000000 X X X X X 1 1 X X X 1 X HTTPS://WWW.BAMC.ORG/MEDIA/1013/FINANCIAL_BROCHURE.PDF X HTTPS://WWW.BAMC.ORG/MEDIA/1016/FINANCIAL_ASSISTANCE_APPLICATION_-_BAMC-ABA X HTTPS://WWW.BAMC.ORG/MEDIA/1013/FINANCIAL_BROCHURE.PDF X X X X X X 1 X 0 X X X 1 X 0 0 BAY AREA MEDICAL CENTER PART V, SECTION B, LINE 5: BAMC UTILIZED THE HEALTH YOUTH COALITION, A TWIN COUNTY ORGANIZATION, THAT PROMOTES HEALTHY AND POSITIVE YOUTH DEVELOPMENT. A YOUTH SURVEY WAS CONDUCTED IN 2015 AND WAS DESIGNED TO IDENTIFY THE LEVELS OF RISK AND PROTECTIVE FACTORS THAT PREDICT PROBLEM BEHAVIORS SUCH AS ALCOHOL, TOBACCO, AND OTHER DRUG USE, POOR SCHOOL ACHIEVEMENT, AND DELINQUENCY. THE REPORT IDENTIFIED THE RISK AND PROTECTIVE FACTORS MOST IN NEED OF ATTENTION IN THE COMMUNITY. BAMC WAS A PARTICIPANT IN THE TRI CITY UNITED WAY COMMUNITY CONVERSATIONS AND IN THE MARINETTE COUNTY COMMUNITY HEALTH IMPROVEMENT ASSESSMENT UPDATE. A BRIEF DESCRIPTION OF THESE INITIATIVES AND OTHER AGENCY RESEARCH EFFORTS ARE IN THE BAY AREA COMMUNITY HEALTH NEEDS ASSESSMENT REPORT.THE COUNTY HEALTH RANKINGS DEVELOPED BY THE UNIVERSITY OF WISCONSIN AND THE ROBERT WOOD JOHNSON FOUNDATION MEASURE THE HEALTH OF NEARLY ALL COUNTIES IN THE NATION AND RANK THEM WITHIN STATES. THE RANKINGS ARE COMPILED USING COUNTY-LEVEL MEASURES FROM A VARIETY OF NATIONAL AND STATE DATA SOURCES. THESE MEASURES ARE STANDARDIZED AND COMBINED USING SCIENTIFICALLY-INFORMED WEIGHTS. THIS IS EXTREMELY VALUABLE FOR THE BAMC EFFORT, GIVEN THAT OUR MARKET INVOLVES TWO COUNTIES IN TWO DIFFERENT STATES, WITH OFTENTIMES DIFFERENT DATA COLLECTION PROCESSES. THE COUNTY HEALTH RANKINGS MODEL, IDENTIFIED A SET OF MEASURES THAT AFFECT HEALTH FROM BOTH INSIDE AND OUTSIDE THE DOCTOR'S OFFICE. THE MODEL RECOGNIZES THAT WHERE PEOPLE LIVE, WORK, AND PLAY CAN HAVE A PROFOUND IMPACT ON THEIR HEALTH. BAY AREA MEDICAL CENTER PART V, SECTION B, LINE 7D: AFTER YEAR END (12/31/2018) THE ORGANIZATION CHANGED OWNERSHIP AND STRUCTURE. THE WEBSITE LINKS FOR THE CHNA AND IMPLEMENTATION PLAN MAY NOT BE APPLICABLE IN THE FUTURE AS CHANGES ARE MADE TO THE WEBSITE OR MOVED TO A SEPARATE WEBSITE. BAY AREA MEDICAL CENTER PART V, SECTION B, LINE 11: THE BAY AREA MEDICAL CENTER COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), WHICH WAS CONDUCTED IN 2013 AND THEN AGAIN IN 2016, EVALUATES THE HEALTH NEEDS OF INDIVIDUALS LIVING IN THE MARINETTE/MENOMINEE MARKET AREA. WORK DONE THIS YEAR IN ALL THREE AREAS OF CONCERN THAT WERE IDENTIFIED INCLUDED: ACCESS TO CARE - BAMC IS IN ITS SIXTH YEAR OF A COMMUNITY WIDE EFFORT TO PROVIDE COMMUNITY MEMBERS ASSISTANCE IN SIGNING UP FOR HEALTH INSURANCE THROUGH THE HEALTH EXCHANGE PROGRAM BY PROVIDING FREE CERTIFIED COUNSELORS. MARKETING PARTICIPATED IN THE OUTREACH, PUBLICITY AND CREATING COMMUNICATIONS TOOLS FOR THE INITIATIVE. A NEW PRIMARY CARE CLINIC WAS OPENED IN CRIVITZ AND ANOTHER IS PLANNED FOR MENOMINEE (OPENING IN 2019).BAMC PROVIDES OFFICE SPACE AND VOLUNTEER SUPPORT FOR THE TWIN COUNTIES FREE CLINIC AND IS A MAJOR SPONSOR OF THEIR ANNUAL FUNDRAISING EVENT IN DECEMBER. DRUG ABUSE BAMC IS A MEMBER OF TWO COMMUNITY TASK FORCES THAT FOCUS ON DRUG ABUSE IN GENERAL AND PRESCRIPTION DRUG ABUSE SPECIFICALLY. WE REMAIN A STRONG SUPPORTER OF THE HEALTHY YOUTH COALITION INCLUDING SUPPORT FOR THEIR LOCK IT DROP IT STOP IT DRUG DISPOSAL PROGRAM. BAMC'S COMMUNITY PHARMACY PARTNERED WITH THE MARINETTE SHERIFF'S DEPARTMENT IN THE ANNUAL APRIL TAKE BACK INITIATIVE, AN EFFORT BY THE DEA TO GIVE RESIDENTS A SAFE AND SECURE WAY TO DISPOSE OF EXPIRED OR UNUSED PRESCRIPTION DRUGS. MEDICAL STAFF IS ALSO CLOSELY FOLLOWING OPIOID PRESCRIPTION GUIDELINES AND REPORTING TO BETTER MANAGE NONMEDICAL USE OF THOSE PRESCRIPTIONS.YOUTH OBESITY - BAMC OFFERED FINANCIAL SUPPORT TO COMMUNITY INITIATIVES THAT FOCUSED ON YOUTH HEALTH AND WELLNESS, INCLUDING PHYSICAL EDUCATION GRANTS TO THE MENOMINEE, MARINETTE, STEPHENSON AND CRIVITZ SCHOOLS AS WELL AS SPONSORSHIP OF THE YMCA HEALTHY KIDS DAY WHERE WE PROVIDED INFORMATION ON BIKE SAFETY AND PRIMARY CARE. THE MAJOR BAMC COMMUNITY EVENTS, THE LEOWSTRONG BIKE RIDE AND WATERFRONT RUN HAVE A KIDS RIDE AND RACE COMPONENT. BAMC'S AND THE AURORA BAY AREA MEDICAL GROUP HELD THIRD WOMEN, WINE AND WELLNESS EVENT, RAISED $6,700 FOR MENTAL HEALTH PROGRAMS IN MARINETTE AND MENOMINEE COUNTIES. ON A PLEASANT SEPTEMBER MORNING AT OUR NEW HOSPITAL, NEARLY 100 WALKERS PARTICIPATED IN OUR ANNUAL KAREN VANHEFTY CARING HEARTS WALK. THE WALK, SPONSORED BY THE BAMC CARDIAC REHAB DEPARTMENT, AND IS A WAY TO ENCOURAGE WALKING AS A HEALTHY LIFESTYLE ACTIVITY. A NEW WALKING TRAIL AROUND THE HOSPITAL GROUNDS WAS DEVELOPED FOR THE WALK AND HAS BECOME A STAPLE FOR STAFF WALKING. BAMC CONTINUES TO EMPHASIZE TO THE COMMUNITY THE IMPORTANCE OF HAVING AN ADVANCE DIRECTIVE ON HAND AT THE HOSPITAL. ADVANCE DIRECTIVE INFORMATION IS AVAILABLE AT ALL HEALTH FAIRS THAT BAMC PARTICIPATES IN AND BAMC OFFERS FREE QUARTERLY EDUCATION SESSION TO ASSIST PEOPLE TO COMPLETE THE 5 WISHES LIVING WILL DOCUMENT. IN JULY, BAMC AND ABAMG PROVIDERS AND STAFF CONDUCTED NEARLY 100 SPORTS PHYSICALS FOR STUDENTS FROM MARINETTE, MENOMINEE AND STEPHENSON SCHOOLS. THE MONEY RAISED THROUGH THESE PHYSICALS GOES TO THE RESPECTIVE SCHOOL'S BOOSTER CLUBS. STUDENTS FROM THESE SCHOOLS ALSO RECEIVE AN EDUCATIONAL NEWSLETTER, SIDELINES, THAT FOCUSES ON HEALTH ASPECTS OF BEING A STUDENT ATHLETE. BAMC PARTICIPATED IN HEALTH AND WELLNESS ACTIVITIES FOR AREA EMPLOYERS INCLUDING STEPHENSON NATIONAL BANK, RW FERNSTRUM, THE CITY OF MARINETTE AND MARINETTE COUNTY. CHILDBIRTH CLASSES ARE OFFERED BY BAMC OB NURSING STAFF FOR EXPECTANT MOTHERS AND FATHERS AND MARKETING HELPS BY PUBLICIZING THE CLASSES. BAMC PARTICIPATED IN AND HELP SPONSOR THE MARINETTE COUNTY COMMUNITY HEALTH ASSESSMENT IN 2018. STAFF NOW ARE ALSO ON TWO OF THE STANDING COMMITTEES THAT ARE IMPLEMENTING THE PLAN. BAY AREA MEDICAL CENTER PART V, SECTION B, LINE 16J: A FINANCIAL BROCHURE IS OFFERED TO PATIENTS UPON REGISTRATION AND IS AVAILABLE ONLINE AT HTTPS://WWW.BAMC.ORG/MEDIA/1013/FINANCAIL_BROCHURE.PDF. BILLING STATEMENTS REFERENCE THE FAP POLICY AND INSTRUCTIONS ON WHO TO CONTACT TO RECEIVE FINANCIAL ASSISTANCE INFORMATION BUT DO NOT INCLUDE THE DETAILED POLICY.SECTION B, LINE 16E:THE ORGANIZATION DOES NOT HAVE ANY LEP POPULATIONS IN THEIR IDENTIFIED SERVICES AREA, AND THUS ONLY HAVE MATERIALS IN ENGLISH, THE PRIMARY LANGUAGE SPOKEN. BAY AREA MEDICAL CENTER PART V, SECTION B, LINE 20E: BAY AREA PROCESSED COMPLETE FAP APPLICATIONS REFERRED TO IN LINE 20C. SECTION B, LINE 16, A-C AFTER YEAR END (12/31/2018) THE ORGANIZATION CHANGED OWNERSHIP AND STRUCTURE. THE WEBSITE LINKS FOR THE FAP, FAP APPLICATION, AND PLAIN LANGUAGE SUMMARY NOT BE APPLICABLE IN THE FUTURE AS CHANGES ARE MADE TO THE WEBSITE OR MOVED TO A SEPARATE WEBSITE. 2 1 - BAY AREA MOBILITY CENTER 3117 SHORE DRIVE MARINETTE WI 54143 REHABILITATION SERVICES AND OCCUPATIONAL HEALTH 2 - BAY AREA REHAB SERVICES - CRIVITZ WI 218 S US HWY 141 SUITE 100 CRIVITZ WI 54114 REHABILITATION SERVICES AND OCCUPATIONAL HEALTH PART I, LINE 7: BAY AREA UTILIZES A COST TO CHARGE RATIO. PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $4,532,640 PART III, LINE 2: BAY AREA MEDICAL CENTER UTILIZED A COST TO CHARGE RATIO FOR DETERMINING THE COST OF BAD DEBT EXPENSE. PART III, LINE 4: BAY AREA ANALYZES PAST RESULTS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. SPECIFICALLY, FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, BAY AREA ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THIRD-PARTY PAYORS HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO HAVE FINANCIAL DIFFICULTIES THAT MAKE REALIZATION OF AMOUNTS DUE UNLIKELY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WITH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), BAY AREA RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. PART III, LINE 8: AMOUNTS ABOVE USE STANDARD MEDICARE DETERMINATION OF ALLOWABLE AND UNALLOWABLE DEPARTMENTS, STANDARD/RECOMMENDED MEDICARE ALLOCATION OF ADMINISTRATION AND GENERAL DEPARTMENTS COSTS TO ALLOWABLE AND UNALLOWABLE DEPARTMENTS BY THE USE OF BAY AREA MEDICAL CENTER'S MEDICARE COST REPORT. THE MEDICARE COST REPORT WAS CALCULATED ON A COST TO CHARGE RATIO. THE COST TO CHARGE RATIO FOLLOWS THE REGULATIONS FOR FILING THE MEDICARE COST REPORT. PART III, LINE 9B: BAY AREA MEDICAL CENTER WILL PROVIDE NEEDED HOSPITAL CARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY FOR THESE SERVICES. COMMUNITY CARE IS ALLOCATED TO PATIENTS BASED ON SET GUIDELINES ESTABLISHED BY THE ORGANIZATION. A FULL OR PARTIAL ADJUSTMENT WILL BE DETERMINED BY COMPARING THE PATIENT'S FINANCIAL STATUS TO A SLIDING FEE SCHEDULE BASED ON THE MOST RECENTLY PUBLISHED FEDERAL POVERTY GUIDELINES.IT IS THE POLICY OF BAY AREA MEDICAL CENTER TO WRITE-OFF BOTH PARTIAL AND FULL PATIENT BALANCES FOR ACCOUNTS THAT QUALIFY FOR COMMUNITY CARE. THERE ARE NO FURTHER COLLECTIONS EFFORTS RELATED TO THOSE WHO QUALIFY FOR A FULL COMMUNITY CARE WRITE-OFF. PATIENTS THAT HAVE HAD PARTIAL WRITE-OFFS THAT DO NOT COOPERATE WITH COLLECTION EFFORTS ON THE BALANCES REMAINING WILL BE REFERRED TO A THIRD-PARTY COLLECTION AGENCY. IF STILL UNCOLLECTIBLE, THE PATIENT ACCOUNT WILL BE WRITTEN OFF TO BAD DEBT. PART VI, LINE 2: BAY AREA MEDICAL CENTER USES A BI-ANNUAL COMMUNITY SURVEY AND ALSO PARTICIPATES IN THE MARINETTE & MENOMINEE COUNTY HEALTH ASSESSMENT INITIATIVES. PART VI, LINE 3: - BROCHURES ARE PROVIDED TO EVERY PATIENT.- THE INFORMATION IS AVAILABLE ON THE ORGANIZATION'S WEBSITE.- ONE ON ONE MEETINGS WITH FINANCIAL ADVISORS ARE ALSO AVAILABLE. PART VI, LINE 4: BAY AREA MEDICAL CENTER SERVES MARINETTE COUNTY, WI AND MENOMINEE COUNTY, MI. THERE ARE NO OTHER HOSPITALS LOCATED IN THESE COUNTIES. PART VI, LINE 5: - THE MAJORITY OF THE BAMC BOARD IS MADE UP OF RESIDENTS OF THE TWO COUNTIES IT SERVES. - BAMC HOSTS QUARTERLY MEETINGS WITH LOCAL MENTAL HEALTH PROFESSIONALS TO SUPPORT THIS INITIATIVE. WE ARE ALSO MEMBERS OF THE MICHIGAN HEALTHCARE CONSORTIUM IN THE UPPER PENINSULA.- ANY SURPLUS FUNDS ARE USED FOR IMPROVEMENTS TO THE FACILITY, EQUIPMENT, STAFF DEVELOPMENT AND PATIENT CARE. - BAMC PROVIDES DIRECT FINANCIAL SUPPORT TO THE TWIN COUNTIES FREE CLINIC. - BAMC HAS WORKING ARRANGEMENTS WITH A TWO YEAR TECHNICAL SCHOOL AND TWO YEAR COLLEGE TO OFFER NURSING AND OTHER MEDICAL PROFESSIONAL STUDENTS INTERNSHIPS IN THEIR PREPARATION FOR HEALTH CARE CAREERS. - BAMC PROVIDES SUPPORT TO LOCAL AREA VOLUNTEER RESCUE SQUAD UNITS THAT WORK WITH THE HOSPITAL-BASED AMBULANCE SERVICE.BAY AREA ACTIVELY PROVIDED OR PARTICIPATED IN THE FOLLOWING COMMUNITY-BASED ACTIVITIES AND PROGRAMS DURING 2016:- PROMOTED GENERAL HEALTH EDUCATION SERVICES SUCH AS HEALTH FAIRS, CANCER EDUCATION, HEALTHY HEART EDUCATION, AND HEALTHY EATING.- OFFERED HEALTH INFORMATION ON BAY AREA'S WEBSITE AND THROUGH HEALTH-RELATED PUBLICATIONS DISTRIBUTED AT NO CHARGE.- OFFERED BLOOD PRESSURE SCREENINGS, CHOLESTEROL TESTING, GLUCOSE TESTING, BMD TESTING, AND INCONTINENCE SCREENINGS.- PROVIDED CHOLESTEROL CANCER SCREENINGS AND FREE MAMMOGRAMS.- PROVIDED ADVANCE DIRECTIVES AND LIVING WELL ASSISTANCE.- PROVIDED GUIDANCE, REFERRAL, AND ENROLLMENT ASSISTANCE FOR PUBLIC MEDICAL PROGRAMS, CERTIFIED COUNSELING FOR AFFORDABLE CARE ACT HEALTH EXCHANGE APPLICANTS, AND OTHER FAMILY SUPPORT ASSISTANCE.- PROVIDED SPACE AND FREE LAB TESTING AND DIAGNOSTIC SERVICES TO SUPPORT A FREE COMMUNITY PHYSICIAN CLINIC.- PROVIDED EMERGENCY CAB FARE FOR PATIENTS WITH TRANSPORTATION NEEDS RELATED TO THEIR HEALTH CARE SERVICES.- PROMOTED PARTICIPATION IN BLOOD DRIVES BY EMPLOYEES AND THE GENERAL PUBLIC.- CONTRIBUTED TO THE EDUCATION OF STUDENT NURSES AND OTHER HEALTH CARE PROFESSIONALS.- SPONSORED AND ORGANIZED THE BAMC MENOMINEE RIVER CENTURY BIKE RIDE WHICH ATTRACTS OVER 1,000 RIDERS.- SPONSORED AND SUPPORTED CHAMBER OF COMMERCE AND EDUCATIONAL LEADERSHIP PROGRAMS.- PROVIDED ATHLETIC TRAINING SERVICES, CONCUSSION EVALUATIONS, AND SPORTS PHYSICALS TO AREA SCHOOL SYSTEMS AND SPORTS PROGRAMS.- PROVIDED FINANCIAL AND STAFF SUPPORT FOR COMMUNITY RUNS AND WALKS.-SPONSORED AND ORGANIZED THE BAMC WATERFRONT 5K/10K RUN, WHICH ATTRACTS OVER 400 RUNNERS.WHILE THERE IS A GROWING AGREEMENT IN THE UNITED STATES ABOUT WHAT CONSTITUTES A NON-PROFIT HOSPITAL'S "COMMUNITY BENEFIT," THIS IS A WORK IN PROGRESS. OUR HOSPITAL PROVIDES SIGNIFICANT CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS. BUT IN ADDITION, WE BELIEVE THAT WE PROVIDE A CRITICALLY IMPORTANT COMMUNITY BENEFIT, WHICH IS NOT QUANTIFIED. OUR HOSPITAL, LIKE MOST RURAL HOSPITALS, WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE CARE LOCALLY-CARE THAT WITHOUT OUR HOSPITAL, WOULD NOT BE AVAILABLE LOCALLY.BEYOND INPATIENT HOSPITALIZATIONS, WE PROVIDE LOCAL ACCESS TO MANY HEALTH SERVICES: AMBULANCE SERVICES, BIRTHING CENTER, DIAGNOSTICS, EMERGENCY SERVICES, INPATIENT CARE, LABORATORY SERVICES, OCCUPATIONAL HEALTH & REHABILITATION SERVICES, SURGICAL SERVICES AND WOMENS' SERVICES. PART VI, LINE 6: BAMC'S ROLE HAS NOT CHANGED SINCE IT IS PART OF AN AFFILIATED HEALTH CARE SYSTEM. THE ROLE OF AURORA IS TO SUPPORT BAMC'S MISSION BY PROVIDING STATEGIC AND OPERATIONAL SUPPORT. PART VI, LINE 7, REPORTS FILED WITH STATES WI X X X X X 0 1 0 0 0 0 0 0 0 EDWARD HARDING CEO 634325 0 0 0 7363 0 20625 0 31735 0 694048 0 0 0 ROGER SNEATH CFO 369923 0 0 0 0 0 0 0 0 0 369923 0 0 0 BERNADINE VAN COURT COO 331549 0 0 0 7796 0 20625 0 10400 0 370370 0 0 0 FRANCISCO GAMEZ MD PHYSICIAN 523455 0 39900 0 1586 0 20625 0 16943 0 602509 0 0 0 MOHAMED EL-JACK PHYSICIAN 714056 0 30000 0 1932 0 20625 0 35223 0 801836 0 0 0 MICHAEL KARKKAINEN MD PHYSICIAN 964354 0 155436 0 3612 0 24369 0 36743 0 1184514 0 0 0 EDGAR MASSABNI MD PHYSICIAN 497070 0 20450 0 2871 0 20625 0 20660 0 561676 0 0 0 ROBERT MACCANI PHYSICIAN 493577 0 25000 0 1932 0 20625 0 31407 0 572541 0 0 0 PART I, LINE 4B THE FOLLOWING INDIVIDUALS PARTICIPATED IN AND RECEIVED PAYMENT FROM A NON-QUALIFIED RETIREMENT PLAN: CONTRIBUTIONS TO 457F PLAN: MICHAEL KARKKAINEN, M.D. $13,800; EDGAR MASSABNI, M.D. $26,718; FRANCISCO GAMEZ, M.D. $141,359; EDWARD HARDING $121,044; BERNADINE VAN COURT $48,583 A WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337955 2015-12-17 85600000 NEW HOSPITAL CONSTRUCTION 0 0 0 A 2015000 85600000 2 318000 85281998 2018 0 0 0 1 A 0 0 0 0 0 0 1 A 0 1 0 0 1 0 0 0 1 A 0 FORM 990, PART VI, SECTION A, LINE 4 ON JANUARY 22, 2019, ADVOCATE AURORA HEALTH, INC. ("AURORA"), AURORA MEDICAL GROUP, INC., M&M HEALTH CARE, INC., AND BAMC (COLLECTIVELY THE "PARTIES") ENTERED INTO A MEMBERSHIP AGREEMENT (THE "MEMBERSHIP AGREEMENT"). UNDER THE TERMS OF THE MEMBERSHIP AGREEMENT, THE PARTIES AGREED TO RESTATE THE ARTICLES OF INCORPORATION AND BYLAWS OF BAMC TO REMOVE M&M HEALTH CARE AS A MEMBER OF BAMC AND TO MAKE AURORA THE SOLE MEMBER OF BAMC. THIS CHANGE WAS EFFECTIVE ON APRIL 1, 2019. FORM 990, PART VI, SECTION A, LINE 6 IN 2014, BAMC AND AURORA HEALTH CARE NORTH, INC. NEGOTIATED AN ARRANGEMENT UNDER WHICH M&M AND AURORA BECAME THE SOLE MEMBERS OF BAMC. M&M HOLDS 51% OF THE VOTING INTERESTS IN BAMC AND AURORA HOLDS 49% OF THE VOTING INTERESTS. FORM 990, PART VI, SECTION A, LINE 7A BAY AREA MEDICAL CENTER'S BY-LAWS INDICATE THAT THE BOARD OF DIRECTORS OF THE CORPORATION SHALL BE NINE (9), FIVE OF WHOM SHALL BE APPOINTED BY M&M HEALTH CARE, INC. AND FOUR OF WHOM SHALL BY APPOINTED BY AURORA HEALTH CARE NORTH, INC. FORM 990, PART VI, SECTION A, LINE 7B THE CORPORATE MEMBERS HAVE RETAINED THE FOLLOWING RESERVED POWERS OVER THE CORPORATION SUCH THAT NONE OF SUCH ACTIONS MAY BE TAKEN BY THE CORPORATION WITHOUT THE UNANIMOUS APPROVAL OF ALL CORPORATE MEMBERS, AND THE CORPORATE MEMBERS, ACTING UNANIMOUSLY, MAY INITIATE AND TAKE SUCH ACTIONS: - TO CHANGE THE CORPORATION'S MISSION OR PURPOSE; - TO APPROVE ANY AMENDMENT TO THE ARTICLES OF INCORPORATION, BYLAWS OR OTHER GOVERNING DOCUMENTS OF THE CORPORATION, INCLUDING THE CONFLICT OF INTEREST, INSIDER TRANSACTION, AND CONFIDENTIALITY POLICY ADOPTED BY THE BOARD OF DIRECTORS FROM TIME TO TIME; - TO APPROVE ALL MATTERS RELATING TO THE MEMBERSHIP OF THE CORPORATION OR ANY RIGHTS ARISING FROM SUCH MEMBERSHIP, INCLUDING THE ISSUING OF ADDITIONAL MEMBERSHIPS IN THE CORPORATION, RECLASSIFYING MEMBERSHIPS IN THE CORPORATION, CREATING A NEW CLASS OF MEMBERSHIP IN THE CORPORATION, BRINGING ON A NEW MEMBER OF THE CORPORATION, TRANSFERRING MEMBERSHIPS IN THE CORPORATION OR ANY RIGHTS ARISING THEREFROM OR REDEEMING MEMBERSHIPS IN THE CORPORATION OR ANY RIGHTS ARISING FROM THEREFROM; - TO APPROVE ANY INDEBTEDNESS FOR BORROWED MONEY TO BE INCURRED OR GUARANTEED ON BEHALF OF THE CORPORATION, EXCEPT THAT FINANCING FOR A FACILITY PLAN DEVELOPED IN 2014 OR 2015 AND APPROVED BY SUPER-MAJORITY BOARD APPROVAL DOES NOT REQUIRE THE UNANIMOUS APPROVAL OF ALL CORPORATE MEMBERS; - TO APPROVE CAPITAL LEASES IN EXCESS OF $3,000,000 IN THE AGGREGATE (AS DETERMINED BY TOTAL LEASE AND OTHER PAYMENTS); FORM 990, PART VI, SECTION B, LINE 11B THE DIRECTOR OF FINANCE HAS FORM 990 AVAILABLE ON SITE FOR BOARD MEMBERS TO REVIEW. FORM 990, PART VI, SECTION B, LINE 12C BOARD OF DIRECTORS - PERSONS WITH ACTUAL OR POTENTIAL CONFLICTS OF INTEREST SHALL FILE FORMAL STATEMENTS DISCLOSING ACTUAL OR POTENTIAL CONFLICTS WHENEVER AN ACTUAL OR POTENTIAL CONFLICT ARISES; BEFORE ANY TRANSACTIONS CONSTITUTING A CONFLICT OR POTENTIAL CONFLICT IS CONSUMMATED; AND ONCE EACH CALENDAR YEAR SO LONG AS THE CONFLICT OR POTENTIAL CONFLICT CONTINUES TO EXIST. THE DISCLOSURE STATEMENT SHALL INCLUDE A DESCRIPTION OF THE RELATIONSHIP OR INTEREST CAUSING THE CONFLICT OR POTENTIAL CONFLICT, THE ROLE IN THE RELATIONSHIP OR TRANSACTION PLAYED BY THE PERSON HAVING THE CONFLICT, AND THE BENEFITS AND DETRIMENTS ACCRUING TO THE HOSPITAL AND TO THE PERSON HAVING THE CONFLICT AS A RESULT OF THE CONTRACT, TRANSACTION, OR RELATIONSHIP. ANY MEMBER OF THE BOARD OF DIRECTORS HAVING AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST ON ANY MATTER SHALL NOT VOTE OR USE HIS/HER PERSONAL INFLUENCE ON THE MATTER CONSTITUTING A CONFLICT. THE INTERESTED DIRECTOR MAY, HOWEVER, BE COUNTED FOR THE PURPOSE OF DETERMINING WHETHER A QUORUM OF THE BOARD, OR OF A COMMITTEE OF THE BOARD, EXISTS. THE MATTER CONSTITUTING THE CONFLICT SHALL BE APPROVED IF IT IS APPROVED BY A MAJORITY OF DISINTERESTED DIRECTORS VOTING ON THE MATTER. THE CONFLICT OF INTEREST POLICY SHALL BE REVIEWED ANNUALLY FOR THE INFORMATION AND GUIDANCE OF THE BOARD OF DIRECTORS AND THAT ANY NEW MEMBERS OF THE SAID BOARD OF DIRECTORS BE ADVISED OF THE POLICY UPON ENTERING ON THE DUTIES OF HIS/HER OFFICE. IN ADDITION TO THE BOARD OF DIRECTORS BEING HELD TO THE CONFLICT OF INTEREST POLICY, COPIES OF THE POLICY ARE PROVIDED TO ALL MANAGEMENT EMPLOYEES. CONFLICT OF INTEREST DISCLOSURE FORMS ARE COMPLETED ANNUALLY BY ALL DIRECTORS, OFFICERS AND KEY EMPLOYEES. THE COMPLETED FORMS ARE KEPT ON FILE BY ADMINISTRATION. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTOR'S COMPENSATION COMMITTEE REVIEWS COMPARABLE COMPENSATION INFORMATION ON OTHER HOSPITALS AND ESTABLISHES BAMC'S EXECUTIVE COMPENSATION LEVELS. MEMBERS OF THE COMPENSATION COMMITTEE DO NOT HAVE A CONFLICT OF INTEREST AND THE CONCLUSIONS ARE SUBSTANTIATED. THE REVIEW PROCESS TAKES PLACE AT LEAST ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DEEMS THESE DOCUMENTS PROPRIETARY SO THEY ARE NOT MADE AVAILABLE TO THE PUBLIC, EXCEPT THAT THE AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO THE FORM 990. FORM 990, PART VII, SECTION A, ROGER SNEATH THE ORGANIZATION REPORTED THE AMOUNT PAID TO R SNEATH ASSOCIATES, LLC ON THE LISTING OF OFFICERS AND DIRECTORS OF $362,123 THIS AMOUNT IS FOR MANAGEMENT SERVICES ROGER SNEATH PROVIDED TO THE ORGANIZATION AND $7,800 FOR RENTS PAID. FORM 990, PART IX, LINE 11G EMERGENCY ROOM SERVICES: PROGRAM SERVICE EXPENSES 2,225,571. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,225,571. ACL TESTING: PROGRAM SERVICE EXPENSES 4,418,789. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,418,789. ENVIRONMENT / WASTE SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,712,798. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,712,798. PATIENT FINANCE SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 814,461. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 814,461. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 3,848,395. MANAGEMENT AND GENERAL EXPENSES 1,737,155. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,585,550. FORM 990, PART XI, LINE 9: INCREASE IN BENEFICIAL INTEREST IN BAMC FOUNDATION, INC. 375,251. CHANGE IN POSTRETIREMENT BENEFIT OBLIGATION OTHER THAN EXPENSE 193,413. RECLASSIFICATION OF ACCUMULATED LOSS ON DESIGNATED CASHFLOW HEDGE 38,645. MEMBER EQUITY CONTRIBUTION 532,292. EQUITY TRANSFER FROM ABAMG -15,719,910. GRANTS FOR PP&E 200,000. FORM 990, PART IV, LINE 12 BAY AREA MEDICAL CENTER WAS AUDITED AS PART OF A CONSOLIDATED AUDIT. BAMC ASSETS MADE UP 99% OF TOTAL ASSETS IN THE CONSOLIDATED AUDIT. FORM 990, PART XI, LINE 2B AND 2C BAY AREA MEDICAL CENTER WAS AUDITED AS PART OF A CONSOLIDATED AUDIT. SEE EXPLANATION TO PART IV, LINE 12. BAY AREA MEDICAL CENTER FOUNDATION INC 3100 SHORE DRIVE MARINETTE WI 54143 392020734 FUNDRAISING FOR BAY AREA MEDICAL CENTER, INC. WI 501 (C) 3 LINE 12B, II M & M HEALTH CARE INC 1 M & M HEALTH CARE INC 3100 SHORE DRIVE MARINETTE WI 54143 471540754 OVERSEEING THE ACCOMPLISHMENTS OF BAY AREA MEDICAL CENTER, INC.'S MISSION WI 501 (C) 3 LINE 12B, II 0 AURORA BAY AREA MEDICAL GROUP LLC 3100 SHORE DRIVE MARINETTE WI 54143 473548414 PHYSICIAN SERVICES WI BAY AREA MEDICAL CENTER INC RELATED -15264067 3575883 0 0 0.73000 NORTHSHORE HEALTH NETWORK 3100 SHORE DRIVE MARINETTE WI 54143 271389366 MESSENGER MODEL FOR MANAGED CARE CONTRACTS WI BAY AREA MEDICAL CENTER INC C 17399 457899 1.00000 1 1 0 1 0 0 0 0 1 0 1 0 1 1 1 1 0 1 1 1 AURORA BAY AREA MEDICAL GROUP LLC INC J 20017719 AGREEMENT AURORA BAY AREA MEDICAL GROUP LLC INC R 15719910 CASH BAY AREA MEDICAL CENTER FOUNDATION INC C 851060 CASH