2019-10-31T11:31:00-05:00 2018-09-30 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2017-10-01 391091432 REEDSBURG AREA MEDICAL CENTER REED 6085246487 2000 NORTH DEWEY AVENUE REEDSBURG WI 53959 ROBERT VAN MEETEREN PRESIDENT/CEO 6085246487 2019-10-31 1 KOREY BOELTER P01469618 6123764500 67.137.57.251 2019-10-31 09:47:55 CD 41812420192260351e51 2019-08-14 P 9E4ACA9A3A5583693B49D79FC84C6D308F7C5743 648BA5686E5CDD146CA310A02774B929465828AB 2017 2019-02-21 02:37:17Z X ROBERT VAN MEETEREN 2000 NORTH DEWEY AVENUE REEDSBURG WI 53959 118329218 0 X WWW.RAMCHEALTH.COM X 1967 WI PROVIDE QUALITY, COMPASSIONATE, & EFFECTIVE HEALTH CARE GOING BEYOND THE EXPECTED IN ALL WE DO. 12 9 732 123 586033 -34626 90681 124492 69794642 70371805 918688 3063820 1060373 846147 71864384 74406264 618021 3037117 0 0 39071696 41589396 0 0 0 29669195 31831819 69358912 76458332 2505472 -2052068 81960325 104334269 27416262 52227287 54544063 52106982 X REEDSBURG AREA MEDICAL CENTER, ALWAYS THERE, GOING BEYOND THE EXPECTED TO PROVIDE COMPASSIONATE, QUALITY, AND EFFICIENT HEALTH CARE. 0 0 65835707 3037117 65725787 INPATIENT SERVICES INCLUDE MULTICARE (MEDICAL/SURGICAL), OBSTETRICS/NURSERY, AND INTENSIVE CARE UNITS AT REEDSBURG AREA MEDICAL CENTER (RAMC). WITHIN THESE UNITS, RAMC PROVIDED SHORT TERM CARE FOR 3,074 PATIENT DAYS (873 DISCHARGED PATIENTS) DURING THE FISCAL YEAR ENDING 9/30/18. THIS INCLUDED 347 SWING BED DAYS FOR 31 PATIENTS, 706 OBSERVATION DAYS AND 225 BIRTHS. THE STAFF AT RAMC IS COMMITTED TO MEETING PATIENTS' PHYSICAL, SOCIAL, EDUCATIONAL, EMOTIONAL, AND SPIRITUAL NEEDS. RAMC'S EMERGENCY AND URGENT CARE IS HERE FOR THE COMMUNITY WHENEVER THEY MAY NEED IT. URGENT CARE HAS HOURS OF AVAILABILITY FOR MINOR MEDICAL NEEDS SEVEN DAYS A WEEK AND THE EMERGENCY ROOM IS OPEN AND PHYSICIAN STAFFED 24 HOURS A DAY. IN THE FISCAL YEAR ENDING 9/30/18, 9,387 PATIENTS WERE SEEN IN THE EMERGENCY ROOM (RESULTING IN 1,132 INPATIENT ADMISSIONS) AND 5,059 PATIENTS VISITED URGENT CARE. WE BELIEVE THAT EVERYONE DESERVES ACCESS TO QUALITY HEALTH CARE, REGARDLESS OF THEIR INCOME LEVEL, AND OUR FOCUS REMAINS ON THE PATIENTS AND COMMUNITIES WE SERVE. WE ALSO BELIEVE THAT BEING A NON-PROFIT MEDICAL CENTER IS BOTH A PRIVILEGE AND AN OBLIGATION. EVERY DAY WE STRIVE TO BE A LEADER IN COMMUNITY HEALTH. BY MEETING, AND OFTEN EXCEEDING, THAT EXPECTATION, RAMC IS STRENGTHENING OUR RELATIONSHIP WITH PATIENTS, VISITORS AND NEIGHBORING COMMUNITIES. BEING A COMMUNITY PARTNER IS AN AWESOME, BUT IMPORTANT TASK; ONE WE FEEL PRIVILEGED TO UPHOLD.AS IDENTIFIED IN OUR MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT, ACCESS TO MENTAL HEALTH CARE, SUBSTANCE ABUSE AND OBESITY ARE THE TOP THREE HEALTH PRIORITIES THAT RAMC IS WORKING TO ADDRESS. WE ARE COMMITTED TO MAKING POSITIVE IMPACTS IN THESE AREAS AND DEMONSTRATE THIS THROUGH COMMUNITY PARTNERSHIPS AND SUPPORT. RAMC HAS COLLABORATED WITH COMMUNITY MEMBERS AND ORGANIZATIONS IN THE FORMATION OF A BOYS & GIRLS CLUB IN REEDSBURG, WHICH OPENED IN THE FALL OF 2017. BOYS AND GIRLS CLUB PROGRAMMING ALIGNS WITH ALL THREE HEALTH PRIORITIES IDENTIFIED BY RAMC, MAKING IT A NATURAL PARTNER. RAMC HAS JOINED FORCES WITH THE SAUK COUNTY DEPARTMENT OF HUMAN SERVICES, WHICH WAS RECENTLY AWARDED A ONE MILLION DOLLAR GRANT TO ADDRESS THE ISSUE OF DRUG ABUSE IN SAUK COUNTY. RAMC CONTINUES TO SERVE AS A MEETING SITE FOR THE REEDSBURG BRANCH OF THE COMMUNITY ACTIVATED RECOVERY ENHANCEMENT (CARE) PROGRAM, WHICH IS A COLLECTIVE GROUP OF AGENCIES AND INDIVIDUALS THAT ASSIST THOSE SUFFERING FROM ADDICTIONS WITH BECOMING CLEAN AND SOBER AND ESTABLISHING LIFESTYLE SKILLS IN ORDER TO BECOME A SUSTAINABLE MEMBER OF THE COMMUNITY. WE ALSO PARTNER WITH SAUK COUNTY IN LOCAL SUICIDE PREVENTION COALITIONS. IN ADDITION, RAMC SUPPORTS MANY LOCAL EVENTS AND ACTIVITIES DESIGNED TO HELP ENCOURAGE HEALTHY LIFESTYLES AND CHOICES, SUCH AS THE PINEVIEW ELEMENTARY SCHOOL GARDEN PROGRAM, REEDSBURG PARKS & RECREATION TRIATHLON, VEST FEST HALF MARATHON/5K/1-MILE RUN, RUN FOR THE BUTTER AND VARIOUS YOUTH SPORTING OPPORTUNITIES. DURING THE FISCAL YEAR ENDING 9/30/18, RAMC HAS DEMONSTRATED OUR COMMITMENT TO ENSURING QUALITY HEALTHCARE IS ALWAYS AVAILABLE CLOSE TO HOME THROUGH THE ADDITION OF PROVIDERS AND CONTINUED SUPPORT OF COMMUNITY WELLNESS PROGRAMS. IN JUNE OF 2018, RAMC OPENED AN ADDITIONAL PHARMACY LOCATION IN A LOCAL GROCERY STORE CALLED RAMC VIKING PHARMACY. ALONG WITH OFFERING TRADITIONAL PHARMACY SERVICES IN A CONVENIENT LOCATION AND WITH EXPANDED HOURS, RAMC VIKING PHARMACY ALSO OFFERS SERVICES SUCH AS IMMUNIZATIONS, BLOOD PRESSURE AND BLOOD SUGAR CHECKS AND MEDICATION REVIEW. OTHER SERVICES AVAILABLE TO MEET THE COMMUNITY'S HEALTH NEEDS INCLUDE, BUT ARE NOT LIMITED TO, LABORATORY, PHYSICAL, CARDIAC AND PULMONARY REHABILITATION, SLEEP MEDICINE, SURGICAL SERVICES, CONSULTING SERVICES, MASSAGE THERAPY, ORTHOPEDICS, OBSTETRICS, PARISH NURSING, CHEMOTHERAPY, AUDIOLOGY, FAMILY PRACTICE CLINIC, COMMUNITY PHARMACY, GYNECOLOGY, DIABETIC EDUCATION, MEDICAL IMAGING, NUTRITION SERVICES, OCCUPATIONAL HEALTH, RESPIRATORY THERAPY, VOLUNTEER SERVICES, COMMUNITY OUTREACH AND WELLNESS. 1083373 0 4646018 REEDSBURG AREA MEDICAL CENTER COMMUNITY PHARMACY IS CONVENIENTLY LOCATED ON THE RAMC CAMPUS WITHIN THE PHYSICIANS GROUP CLINIC WHILE RAMC VIKING PHARMACY IS LOCATED WITHIN A LOCAL GROCERY STORE. TRADITIONALLY KNOWN FOR ITS CONVENIENCE FOR PATIENTS, BOTH RAMC COMMUNITY PHARMACY AND RAMC VIKING PHARMACY ARE OPEN TO ALL MEMBERS OF THE PUBLIC. PATIENTS CAN FILL/REFILL PRESCRIPTIONS AT THEIR CONVENIENCE AND AS IT FITS INTO THEIR SCHEDULES. AUTOMATED SERVICES MAKE IT EASY TO CALL IN AND PICK UP REFILLS. IN ADDITION TO FILLING PRESCRIPTIONS, BOTH PHARMACIES OFFER AN EXTENSIVE ARRAY OF OVER-THE-COUNTER MEDICATIONS, VITAMINS AND SUPPLEMENTS, FIRST AID NEEDS AND PERSONAL ITEMS. 66919080 1 0 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 63 0 732 1 1 1 0 0 0 0 0 0 0 0 0 X 12 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 WI X BARRY BORCHERT 6085246487 2000 NORTH DEWEY AVENUE REEDSBURG WI 53959 DAN KLAHN CHAIRPERSON 0.50 X X 1800 0 0 BOB BASS VICE CHAIR 0.50 X X 2050 0 0 PAMELA WELCH TREASURER 0.50 X X 1800 0 0 KONYA ANTONETTI SECRETARY 0.50 X X 1300 0 0 CHRIS BJORKLUND TRUSTEE 40.00 X 332160 0 48429 KRISTI BROWN TRUSTEE 0.50 X 0 0 0 JOEL GROSKREUTZ TRUSTEE 0.50 X 0 0 0 DEREK HORKAN TRUSTEE 0.50 X 1600 0 0 DON LICHTE JR TRUSTEE 0.50 X 1200 0 0 MARY BETH SHEAR MD TRUSTEE 40.00 X 193856 0 0 RAYNELLE SYFTESTAD TRUSTEE 0.50 X 1000 0 0 THOMAS WOOD MD MEDICAL ADVISOR 0.50 X 644786 0 61804 BOB VAN MEETEREN PRESIDENT/CEO 40.00 X 402937 0 84417 BARRY BORCHERT CFO 40.00 X 244277 0 48011 DEANNA BENISH PHYSICIAN 40.00 X 314292 0 55066 CHRISTOPHER WENNINGER PHYSICIAN 40.00 X 624548 0 57291 KEVIN MCBRIDE ANESTHESIOLOGIST 40.00 X 312696 0 37647 KENNETH OLSON ANESTHESIOLOGIST 40.00 X 311473 0 22630 JOHN ROOS ANESTHESIOLOGIST 40.00 X 293285 0 37468 3685060 0 452763 58 0 1 0 MADISON EMERGENCY PHYSICIANS SC 1221 JOHN Q HAMMONDS DR MADISON WI 53744 PHYSICIAN SERVICES 1945314 WEBER ORTHOPEDICS 922 OTT LANE BARABOO WI 53913 PHYSICIAN SERVICES 1223343 BADGER ENVIRONMENTALEARTHWORK 200 SWIGGUM RD WESTBY WI 54667 CONSTRUCTION SERVICES 1039490 BEAM HEALTHCARE 25 WEST MAIN ST FLOOR 5 MADISON WI 53703 PHYSICIAN SERVICES 970939 SHARED IMAGING SERVICES PO BOX 88450 MILWAUKEE WI 53288 MEDICAL IMAGING SERVICES 966732 20 124492 124492 PATIENT SERVICE REVENUE 621400 65453984 65453984 PHARMACY REVENUE 446110 4646018 4059985 586033 CAFETERIA REVENUE 722310 271803 271803 70371805 290579 290579 263379 0 263379 263379 263379 46695648 547 43922954 0 2772694 547 2773241 2773241 MEAL REVENUE 722310 486521 486521 OTHER REVENUE 900099 96247 96247 582768 74406264 69785772 586033 3909967 2831314 2831314 205803 205803 2071427 2071427 29698081 26578359 3119722 1127678 1139489 -11811 6665103 6051847 613256 2027107 1814164 212943 166218 166218 58782 58782 4682 4682 7600714 6978037 622677 329902 329902 1058982 732549 326433 191565 191565 1016880 989385 27495 221720 151341 70379 551937 551937 2261485 2261485 255198 255198 MEDICAL SUPPLIES 10457199 10456922 277 REPAIRS & MAINTENANCE 4059004 3393962 665042 BAD DEBT EXPENSE 1144533 1144533 FOOD 581597 555950 25647 1871421 1082003 789418 76458332 66919080 9539252 0 57246 59547 3167133 5379574 9916377 9013937 2032174 1721537 883532 841040 73308662 33306423 30629255 40002239 30935905 42084226 89856 87853 1136000 1249137 3112847 3895179 81960325 104334269 7293206 10627050 -198 1861 14203687 37508505 4287657 3017351 298000 0 1333910 1072520 27416262 52227287 X 52852053 50367832 1692010 1739150 54544063 52106982 81960325 104334269 X -2052068 -437516 52503 X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 4682 4682 0 PART II-B, LINE 1: A PORTION OF ANNUAL DUES PAID TO BOTH THE AMERICAN HOSPITAL ASSOCIATION AND THE WISCONSIN HOSPITAL ASSOCIATION ARE USED BY THOSE ORGANIZATIONS FOR LOBBYING PURPOSES. VARIOUS RAMC EMPLOYEES ANNUALLY ATTEND WISCONSIN HOSPITAL ASSOCIATION'S ADVOCACY DAY WHERE THEY HAVE THE OPPORTUNITY TO LEARN ABOUT THE CURRENT LEGISLATIVE CLIMATE AND ISSUES IMPACTING WISCONSIN HEALTHCARE AND THEN MEET WITH STATE LEGISLATORS. 26703 26703 40477878 19073925 21403953 876333 498882 377451 17439513 13733616 3705897 14488235 14488235 40002239 DEFERRED COMPENSATION 1072520 1072520 X PART X, LINE 2: IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE CORPORATIONS ASSESS WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE LIKELY THAN NOT RECOGNITION THRESHOLD, THE BENEFIT OF THE TAX POSITION IS NOT RECOGNIZED IN THE COMBINED FINANCIAL STATEMENTS. THE CORPORATIONS RECORDED NO ASSETS OR LIABILITIES FOR UNCERTAIN TAX POSITIONS OR UNRECOGNIZED BENEFITS IN 2018 AND 2017. 1 1 X 1 X 1 X 1 1 1 0 1 1 1500 1131321 1131321 0.01500 2541984 2521114 20870 0.00030 1500 3673305 2521114 1152191 0.01530 23573 1635446 436794 1198652 0.01590 240 327802 327802 0.00440 15943890 10180905 5762985 0.07650 5570 437467 437467 0.00580 29383 18344605 10617699 7726906 0.10260 30883 22017910 13138813 8879097 0.11790 25 10837 10837 0.00010 200 9870 9870 0.00010 500 28381 28381 0.00040 10 6000 6000 0.00010 4000 15638 15638 0.00020 4735 70726 70726 0.00090 0 1144533 12093721 17697174 -5603453 X 1 1 1 1 REEDSBURG AREA MEDICAL CENTER 2000 NORTH DEWEY AVENUE REEDSBURG WI 53959 WWW.RAMCHEALTH.COM 1057 X X X X PROVIDER BASED CLINIC AND SPECIALTY CLINIC REEDSBURG AREA MEDICAL CENTER 1 0 0 1 X X X X X X X X X 15 1 1 1 1 X SEE LINE 7D X X 1 15 1 SEE LINE 7D 0 1 X 150.000000000000 400.000000000000 X X X X 1 1 X X X X 1 X HTTPS://WWW.RAMCHEALTH.COM/FINANCIALASSISTANCE X HTTPS://WWW.RAMCHEALTH.COM/FINANCIALASSISTANCE X HTTPS://WWW.RAMCHEALTH.COM/FINANCIALASSISTANCE X X X X X X 1 X 0 X X X X X 1 X 0 0 REEDSBURG AREA MEDICAL CENTER PART V, SECTION B, LINE 5: THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS INCLUDED A VARIETY OF DATA COLLECTION METHODS USED TO CREATE AN OVERALL DESCRIPTION OF THE ISSUES FACING THE COMMUNITY. THESE METHODS WERE DEVELOPED TO SEEK INPUT FROM DIVERSE COMMUNITY STAKEHOLDERS AS WELL AS GENERAL COMMUNITY MEMBERS AND INCLUDED:1. HEALTH NEEDS ASSESSMENT SURVEYS: THESE ONLINE SURVEYS WERE CONDUCTED OVER A PERIOD OF 40 DAYS, USING A 107 QUESTION SURVEY, WITH A TOTAL OF 1,324 RESPONSES. THE TOPICS INCLUDED: DEMOGRAPHICS, COMMUNITY HEALTH PERCEPTIONS, HEALTH CARE ACCESS, CHRONIC DISEASE, PHYSICAL ACTIVITY, NUTRITION, ABUSE, SAFETY, ALCOHOL AND DRUG USE, AND COMMUNITY RESILIENCY. SURVEY DATA WAS DISCUSSED WITH THE SAUK COUNTY HEALTH AND WELLNESS COALITION STEERING COMMITTEE AND THE KEY INFORMANTS (EXPLAINED BELOW).2. FOCUS GROUPS: THESE GROUPS TARGETED THE ELDERLY POPULATION AND THE HISPANIC COMMUNITY, AS THESE GROUPS WERE NOT WELL REPRESENTED IN THE SURVEY RESPONDENTS. THERE WAS A LIST OF 14 QUESTIONS REGARDING THEIR PERCEPTION OF THE HEALTH OF THE COMMUNITY, WITH TOPICS COVERING: COMMUNITY HEALTH, ACCESS TO HEALTH CARE, HEALTH LITERACY, HEALTH PROBLEMS, AND FOOD SECURITY. THE ELDERLY POPULATION WAS ASKED AN ADDITIONAL SIX QUESTIONS ABOUT SPECIFIC ISSUES ELDERLY PEOPLE FACE, AVAILABILITY OF RESOURCES, KNOWLEDGE OF THE ADRC, AND VACCINATION RATES.3. KEY INFORMANTS: THERE WERE 208 MEMBERS OF THE SAUK COUNTY COMMUNITY INVITED TO A KEY INFORMANTS MEETING, OF WHICH 40 ATTENDED. DATA FROM THE SURVEYS AND FOCUS GROUPS WAS PRESENTED BASED ON THE FOLLOWING TEN CATEGORIES: ACCESS TO HIGH-QUALITY HEALTH SERVICES (INCLUDING DENTAL AND MENTAL HEALTH); EMERGENCY PREPAREDNESS, RESPONSE, AND RECOVERY; HEALTH LITERACY; ADEQUATE, APPROPRIATE, AND SAFE FOOD, NUTRITION, & PHYSICAL ACTIVITY; ALCOHOL, DRUG, AND TOBACCO USE; CHRONIC DISEASE PREVENTION AND MANAGEMENT; COMMUNICABLE DISEASE PREVENTION AND CONTROL; ENVIRONMENTAL AND OCCUPATIONAL HEALTH; HEALTHY GROWTH/DEVELOPMENT AND REPRODUCTIVE/SEXUAL HEALTH; INJURY AND VIOLENCE. THE KEY INFORMANTS THEN DETERMINED THE TOP 3 TOPICS THAT THEY FELT SHOULD BE A PRIORITY. THE HEALTH DEPARTMENT STAFF THEN USED THAT DATA TO SET THE PRIORITIES. REEDSBURG AREA MEDICAL CENTER PART V, SECTION B, LINE 6A: INCLUDED AS MEMBERS OF THE SAUK COUNTY HEALTH & WELLNESS COALITION ARE ST. CLARE HOSPITAL, BARABOO AND SAUK PRAIRIE HEALTHCARE. REEDSBURG AREA MEDICAL CENTER PART V, SECTION B, LINE 6B: INCLUDED AS MEMBERS OF THE SAUK COUNTY HEALTH & WELLNESS COALITION ARE THE SAUK COUNTY HEALTH DEPARTMENT AND UW-EXTENSION, SAUK COUNTY. REEDSBURG AREA MEDICAL CENTER PART V, SECTION B, LINE 7D: THE HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT REPORT AND IMPLEMENTATION STRATEGY ARE AVAILABLE ONLINE AT:WWW.RAMCHEALTH.COM/COMMUNITY-HEALTH/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. REEDSBURG AREA MEDICAL CENTER PART V, SECTION B, LINE 11: RAMC HAD IDENTIFIED IN ITS 2016 CHNA THESE 3 PRIORITIES FOR OUR HOSPITAL TO ADDRESS. 1. ACCESS TO MENTAL HEALTH: WE HAVE PARTNERED WITH SAUK COUNTY TO ADDRESS THE ISSUE OF SUICIDE IN A SUICIDE PREVENTION COALITION. WE CONDUCTED A 'TEEN SUMMIT', AN ANNUAL DAY CAMP FOR KIDS THAT PROVIDES TOOLS FOR COPING WITH THE EFFECTS OF DRUGS OR ALCOHOL IN THEIR LIVES. RAMC CREATED COMMUNITY AWARENESS OF MENTAL HEALTH ISSUES WITH RADIO, NEWSLETTER & PRINT ARTICLES AND PARTNERED WITH VARIOUS COMMUNITY AGENCIES AND THE REEDSBURG SCHOOL DISTRICT ON EDUCATIONAL OUTREACH DEALING WITH MENTAL HEALTH, SUICIDE AND ALCOHOL & DRUG ABUSE AWARENESS IN STUDENTS. WE WORKED WITH ALL SECTORS OF OUR COMMUNITY TO BRING A BOYS & GIRLS CLUB TO REEDSBURG WHICH PROVIDES RESOURCES AND FOCUSED EFFORTS PERTAINING TO ALL THREE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE CHNA. 2. DRUG USE & ABUSE: CONTINUE TO PARTNER WITH THE SAUK COUNTY HEALTH & WELLNESS COALITION TO BRING SPEAKERS, TREATMENT & RECOVERY INFORMATION TO OUR COMMUNITY, ESPECIALLY OUR SCHOOLS. RAMC HAS PARTNERED WITH THE SAUK COUNTY DEPARTMENT OF HUMAN SERVICES, WHICH WAS RECENTLY AWARDED A ONE MILLION DOLLAR GRANT TO ADDRESS THE ISSUE OF DRUG ABUSE IN SAUK COUNTY. THE GRANT HAS EXPANDED THE CURRENT VIVITROL PROGRAM AND ESSENTIALLY CREATES A MODEL FOR ADDRESSING ALCOHOL AND DRUG PROBLEMS THROUGHOUT THE COUNTY. SEVERAL RAMC EMPLOYEES SERVE ON THE C.A.R.E. (COMMUNITY ACTIVATED RECOVERY ENHANCEMENT) COALITION THAT IS HELD AT RAMC, AND ATTEND MONTHLY MEETINGS. WE ARE ACTIVE WITH THE SAUK COUNTY DEPARTMENT OF HUMAN SERVICES ON THEIR DRUG PREVENTION COALITION AND THE SAUK COUNTY DEPARTMENT OF HUMAN SERVICES ON THEIR PRESCRIPTION DRUG MISUSE COALITION. WE WORKED WITH ALL SECTORS OF OUR COMMUNITY TO BRING A BOYS & GIRLS CLUB TO REEDSBURG. 3. OBESITY: WE HAVE DEVELOPED A COUNTY-WIDE CALENDAR OF EXERCISE AND NUTRITIONAL EVENTS AVAILABLE ON SOCIAL MEDIA OUTLETS OF THE SAUK COUNTY HEALTH AND WELLNESS COALITION STEERING COMMITTEE. IT IS HOUSED ON THE SAUK COUNTY PUBLIC HEALTH WEBSITE. WE PARTICIPATE IN MANY COMMUNITY-BASED AND BUSINESS-SPECIFIC HEALTH FAIRS. WE SPEAK OFTEN AT COMMUNITY ORGANIZATIONS RELATED TO HEALTH LIFESTYLE. WE HOLD MANY CLASSES AND SESSIONS TO COMBAT OBESITY, SUCH AS: HEALTH4U DIABETES & OBESITY PROGRAM (A CDC NAT'L DIABETES PREVENTION PROGRAM), STRONG WOMEN, AND SENIORS ON THE GO. FUND AND PARTNER WITH THE REEDSBURG SCHOOL DISTRICT IN CONTINUING THEIR SCHOOL GARDEN DURING THE SCHOOL YEAR AND SUMMER TIME, AS WELL AS PROVIDING HEALTHY OPTIONS AND RECIPES FOR FAMILIES. CONTINUE TO SUPPORT AND FUND THE SCHOOL DISTRICT'S WALKING PROGRAM TITLED "WALKING CLUB" FOR ALL SCHOOL CHILDREN AT ALL 5 ELEMENTARY SCHOOLS. CONTINUE TO PROVIDE A FREE SUMMER WALKING PROGRAM FOR AREA FAMILIES. CONTINUE TO HOST OUR ANNUAL KIDS FIT & SAFE DAY. REEDSBURG AREA MEDICAL CENTER PART V, SECTION B, LINE 20E: RAMC WILL NOT ENGAGE IN EXTRAORDINARY COLLECTION ACTIONS WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE WHETHER A PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE. SUCH EFFORTS INCLUDE: WAITING 120 DAYS FROM THE FIRST POST-DISCHARGE BILLING STATEMENT; VALIDATION OF THE BALANCE OWED AND THAT ALL SOURCES OF PAYMENT HAVE BEEN IDENTIFIED AND BILLED BY RAMC; DOCUMENTATION OF THE ATTEMPT TO OFFER THE PATIENT THE OPPORTUNITY TO APPLY FOR CHARITY CARE; DOCUMENTATION THE PATIENT DOES NOT QUALIFY FOR FINANCIAL ASSISTANCE; DOCUMENTATION THAT THE PATIENT HAS BEEN OFFERED A PAYMENT PLAN BUT HAS NOT HONORED THE TERMS OF THE AGREEMENT; AND AT LEAST 30 DAYS BEFORE STARTING ANY EXTRAORDINARY ACTION, WILL SEND THE PATIENT A WRITTEN NOTICE STATING THAT RAMC OFFERS FINANCIAL ASSISTANCE, IDENTIFY THE EXTRAORDINARY ACTION(S) THAT MAY BE TAKEN, GIVE A DEADLINE OF WHEN SUCH ACTION(S) WILL TAKE PLACE AND INCLUDE THE PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY. PART I, LINE 3C: ELIGIBLE INDIVIDUALS MUST RESIDE IN OR HAVE A PRIMARY CARE PHYSICIAN IN RAMC'S SERVICE AREA. REVIEW OF THE PATIENT'S ASSETS AND ALL OTHER FINANCIAL RESOURCES AVAILABLE TO THEM WILL BE INCLUDED IN THE APPLICATION PROCESS ALONG WITH REVIEW OF ALL OUTSTANDING ACCOUNTS AND PREVIOUS PAYMENT HISTORY. DOCUMENTS REQUESTED MAY INCLUDE A COPY OF THE APPLICANT'S MOST RECENT FEDERAL INCOME TAX RETURN, W-2 FORM(S), CURRENT PAYSTUB(S) AND A COMPLETED FINANCIAL DISCLOSURE. HOSPITAL PERSONNEL MAY REQUIRE OTHER VERIFICATION OF INCOME OR ASSETS, AS DEEMED NECESSARY. PART I, LINE 6A: REEDSBURG AREA MEDICAL CENTER ("RAMC") PREPARES A COMMUNITY BENEFIT REPORT ANNUALLY AND FILES IT WITH THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THE REPORT IS AVAILABLE TO THE GENERAL PUBLIC ON WHA'S DATABASE AND WEBSITE ALONG WITH RAMC'S WEBSITE. PART I, LINE 7: THE COSTING METHODOLOGY USED ON FORM 990 IS BASED ON A COST-TO-CHARGE RATIO, WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBT DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST VARIOUS REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER IRS SUGGESTED COSTING METHODS FOR THE FORM 990. THE COSTING METHOD FOR SUBSIDIZED HEALTH SERVICES IS BASED ON ALLOCATED EXPENSES FROM THE MEDICARE COST REPORT, WHICH IS SIMILAR TO A DIRECT COST ACCOUNTING SYSTEM. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES AT REEDSBURG AREA MEDICAL CENTER INCLUDE THE OPERATION OF THE HOSPITAL INPATIENT DEPARTMENTS THAT OPERATE AT A LOSS FROM OPERATIONS, BUT ARE CONSIDERED VITAL HOSPITAL AND CLINIC SERVICES SUCH AS THE INTENSIVE CARE UNIT AND MEDICAL/SURGICAL NURSING UNIT. A LARGE PORTION OF THESE SERVICES ARE ACCESSED BY COMMUNITY MEMBERS THROUGH THE HOSPITAL'S EMERGENCY SERVICES DEPARTMENT. IT IS THE GOAL OF REEDSBURG AREA MEDICAL CENTER TO PROVIDE THESE SERVICES TO THE COMMUNITY REGARDLESS OF A PATIENT'S ABILITY TO PAY. SUBSIDIZED HEALTH SERVICES INCLUDE THE REVENUES AND EXPENSES OF ONE CLINIC. PART I, LN 7 COL(F): THE BAD DEBT EXPENSE INCLUDED IN FORM 990, PART IX, LINE 24(B), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $1,144,533. PART II, COMMUNITY BUILDING ACTIVITIES: RAMC IS PROUD TO ENCOURAGE OUR EMPLOYEES TO GIVE BACK TO OUR COMMUNITY ON THEIR STAFF TIME. IN ADDITIONAL TO THEIR JOB RESPONSIBILITIES, THEY TAKE ON ADDITIONAL ROLES IN THE OUR COMMUNITY BY SERVING ON LOCAL BOARDS AND COMMITTEES, SERVING AT FOOD PANTRIES AND COMMUNITY MEALS, AND SO MUCH MORE. OUR COMMUNITY BUILDING ACTIVITIES WORK TO ADDRESS UNDERLYING HEALTH DETERMINANTS AND SUPPORT PROGRAMS MEANT TO IMPROVE HEALTH BEFORE INTERVENTION IS REQUIRED, AS WELL AS PROVIDING RESOURCES FOR THOSE LOOKING TO IMPROVE THEIR CURRENT HEALTH SITUATION. RAMC EMPLOYEES ARE ALSO ACTIVE IN EDUCATING THE COMMUNITY ON A WIDE VARIETY OF HEALTH TOPICS. HEALTH-RELATED BOARD POSITIONS RANGE FROM THOSE FOCUSING ON AREA DENTAL AND EMERGENCY MEDICAL SERVICES TO THE RURAL WISCONSIN HEALTH COOPERATIVE AND SAUK COUNTY HEALTH BOARDS. MANY EMPLOYEES ARE ALSO MEMBERS OF COMMUNITY SERVICE BOARDS AND VOLUNTEER GROUPS. RAMC IS MINDFUL OF AND PROACTIVE IN DEVELOPING OR PARTNERING WITH GROUPS WORKING TO BETTER THE CURRENT ECONOMIC AND ENVIRONMENTAL CONDITIONS OF OUR COMMUNITY. ADDITIONAL EXAMPLES OF COMMUNITY BUILDING ACTIVITIES INCLUDE DEDICATED PATIENT ADVOCATE STAFF TO ASSIST COMMUNITY MEMBERS WITH ANSWERING MEDICARE, MEDICAID AND OTHER INSURANCE QUESTIONS AND NAVIGATING THE HEALTH INSURANCE MARKET PLACE; BEING A KEY MEMBER IN THE DEVELOPMENT OF THE REEDSBURG BOYS & GIRLS CLUB; PRACTICING GOOD STEWARDSHIP THROUGH CONTINUED RECYCLING EFFORTS; AND SUPPORTING LOCAL COMMUNITY DEVELOPMENT AND GROWTH THROUGH SUPPORT OF LOCAL CHAMBERS OF COMMERCE AND OTHER COMMUNITY ORGANIZATIONS AND PROGRAMS. PART III, LINE 2: THE COSTING METHODOLOGY USED ON FORM 990 IS BASED ON A COST-TO-CHARGE RATIO, WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES EXCLUDING THE PROVISION FOR BAD DEBT, DIVIDED BY GROSS PATIENT REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST THE TOTAL CHARGES THAT ARE WRITTEN OFF DURING THE FISCAL YEAR TO ESTIMATE THE COST OF THE CARE OF PATIENTS WHO HAVE ACCOUNTS THAT ARE DEEMED TO BE BAD DEBTS TO THE HOSPITAL. THE HOSPITAL ALSO RECOGNIZES THAT IT PROVIDES A DISCOUNT TO SELF-PAY OR UNINSURED PATIENTS. THESE AMOUNTS ARE INCLUDED IN THE CONTRACTUAL ADJUSTMENTS ON THE FINANCIAL STATEMENTS AND ARE NOT INCLUDED IN THE RATIO AS DESCRIBED ABOVE AND APPROVED BY THE IRS FOR USE ON FORM 990. IF CONSIDERED, THESE ADDITIONAL WRITE-OFF AMOUNTS TO UNINSURED ACCOUNTS WOULD ALSO INCREASE THE ESTIMATED BAD DEBT EXPENSE AMOUNT ASSOCIATED WITH THESE UNCOLLECTIBLE ACCOUNTS TO THE HOSPITAL. PART III, LINE 3: IN EVALUATING THE COLLECTIBILITY OF PATIENT ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES PAST RESULTS AND IDENTIFIES TRENDS FOR EACH OF IT MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL 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 DOUBTFUL ACCOUNTS. SPECIFICALLY, FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL 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 THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS AND PATIENTS WHO ARE KNOWN TO HAVE FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES PATIENTS WITHOUT INSURANCE AND WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF THEIR PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. MANY TIMES PATIENTS DO NOT COMPLETE THE REQUIRED CHARITY CARE APPLICATION AND ARE TRANSFERRED TO COLLECTION SERVICES EVEN THOUGH RAMC PROVIDES THIS INFORMATION TO ALL PATIENTS AND OFFERS ASSISTANCE WITH THE APPLICATIONS. DUE TO NO RESPONSES FROM SOME PATIENTS, A SIGNIFICANT AMOUNT OF BAD DEBTS COULD BE CONSIDERED AS CHARITY CARE. PART III, LINE 4: SEE THE "PATIENT AND RESIDENT ACCOUNTS RECEIVABLE AND CREDIT POLICY NOTE ON PAGES 9 AND 10 OF THE ATTACHED FINANCIAL STATEMENTS. PART III, LINE 8: THE TOTAL MEDICARE REVENUE SHOWN IN SCHEDULE H TO THE FORM 990 IS BASED ON THE IRS 990 INSTRUCTIONS AND INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE OF THE HOSPITAL, AND ALSO DOES NOT CONSIDER ALL CONTRACTUAL ADJUSTMENTS FOR SERVICES REIMBURSED BY THE MEDICARE PROGRAM. AMOUNTS LISTED FOR MEDICARE REVENUES DO NOT INCLUDE PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT AT THE HOSPITAL AS WELL AS ANESTHESIA PROFESSIONAL SERVICES, SURGEON PROFESSIONAL SERVICES, REVENUES FOR ANY PATIENTS COVERED UNDER MEDICARE ADVANTAGE PLAN PROGRAMS, AND REFERENCE LAB SERVICES FOR PATIENTS OF A NEIGHBORING PHYSICIAN CLINIC. PHYSICIAN PROFESSIONAL SERVICES AND REFERENCE LAB SERVICES ARE REIMBURSED PRIMARILY ON FEE SCHEDULE REIMBURSEMENTS AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY, SURGERY, AND PHYSICIAN SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND, AS SUCH, THESE COSTS AND SHORTFALLS SHOULD ALSO BE CONSIDERED AS AN ADDITIONAL BENEFIT THAT RAMC PROVIDES TO ITS COMMUNITY AND SURROUNDING AREAS. THE COSTING METHOD USED ABOVE FOR IRS 990 COMPLIANCE REPORTING IS ALSO BASED ON THE FILED MEDICARE COST REPORT FOR THE YEAR ENDED SEPTEMBER 30, 2018, AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES, AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICE REVENUES (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE). WHETHER THERE IS A SHORTFALL OR SURPLUS ON SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THESE PEOPLE, WHO ARE TYPICALLY ELDERLY OR DISABLED MEMBERS OF THE COMMUNITY, ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE PATIENT SERVICES, THE CENTERS FOR MEDICARE AND MEDICAID (CMS) WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THESE MEMBERS OF THE COMMUNITY. PART III, LINE 9B: UNDER THE HOSPITAL'S COLLECTION AND CHARITY CARE POLICIES, RAMC MAKES EVERY ATTEMPT TO IDENTIFY AND PROMOTE CHARITY CARE TO PATIENTS. INCLUDED IN THE HOSPITAL'S CHARITY CARE POLICY IT IS NOTED THAT PATIENTS MAY QUALIFY FOR CHARITY CARE EITHER PRIOR TO ADMISSION OR FOLLOWING DISCHARGE. DURING THE PATIENT ACCOUNT COLLECTION PROCESS, SELF-PAY PATIENTS ARE ALSO INFORMED OF THE HOSPITAL'S COLLECTION POLICIES AS WELL AS THE CHARITY CARE PROGRAM TO ALLOW PATIENTS THE OPPORTUNITY TO COMPLETE THE APPROPRIATE FORMS AND QUALIFY UNDER THE PROGRAM. ONCE A PATIENT MEETS ALL QUALIFICATIONS FOR FINANCIAL ASSISTANCE, ALL OR PART OF THE ACCOUNT BALANCE IS WRITTEN OFF, AS APPROPRIATE. THE REMAINING BALANCE, IF ANY, IS THE PATIENT'S RESPONSIBILITY AND COLLECTED FOLLOWING THE HOSPITAL'S STANDARD DEBT COLLECTION POLICY. PART VI, LINE 2: RAMC HAS A FEEDBACK SECTION ON THE HOSPITAL'S WEBSITE, WWW.RAMCHEALTH.COM, ALLOWING A FORUM FOR WHICH THE PUBLIC CAN PROVIDE SUGGESTIONS AND COMMENTS. PATIENTS AND COMMUNITY MEMBERS ARE ALSO ABLE TO PROVIDE COMMENTS, FEEDBACK AND RATINGS ON VARIOUS SOCIAL MEDIA SITES SUCH AS FACEBOOK AND INSTAGRAM. RAMC GATHERS DATA FROM THE SAUK COUNTY HEALTH NEEDS ASSESSMENT THAT HAS BEEN SEGMENTED INTO THE HOSPITAL'S PRIMARY SERVICE AREA. IN WORKING WITH A COMMITTEE CONSISTING OF OFFICIALS FROM THE SAUK COUNTY PUBLIC HEALTH DEPARTMENT, REEDSBURG AREA SCHOOL DISTRICT, AND THE CITY OF REEDSBURG (INCLUDING THE CITY'S AMBULANCE, POLICE, AND FIRE DEPARTMENTS), AS WELL AS VARIOUS OTHER COMMUNITY MEMBERS INCLUDING REPRESENTATIVES FROM BUSINESS AND INDUSTRY, THIS INFORMATION HAS BEEN PRIORITIZED AND USED TO DEVELOP IMPLEMENTATION STRATEGIES. PART VI, LINE 3: CHARITY CARE NOTICES ARE POSTED THROUGHOUT THE FACILITY AND APPLICATIONS ARE AVAILABLE THROUGH BUSINESS SERVICES. THE PATIENT, PATIENT'S REPRESENTATIVE, OR HOSPITAL REPRESENTATIVE MAY INITIATE INQUIRIES REGARDING ELIGIBILITY OR APPLICATION FOR ASSISTANCE AT ANY TIME. THE HOSPITAL, WHEN APPROPRIATE, WILL REVIEW THE PATIENT'S FINANCIAL SITUATION TO SEE IF THEY QUALIFY FOR ANY FORM OF ASSISTANCE. A SOCIAL WORKER IS AVAILABLE TO ASSIST IN THIS PROCESS AS WELL, IF NEEDED. PATIENT FINANCIAL ADVISORS ARE ALSO NOTIFIED WHEN PATIENTS (INPATIENT OR OUTPATIENT) ARE TREATED WHO DO NOT HAVE ANY INSURANCE. THEY DISCUSS WITH THE PATIENT AVAILABLE OPTIONS AND PROVIDE INFORMATION/APPLICATIONS FOR BOTH RAMC CHARITY CARE PROGRAMS AND COUNTY, STATE, OR FEDERAL ASSISTANCE PROGRAMS. AT ANY TIME, PATIENTS MAY INQUIRE WITH HOSPITAL PERSONNEL REGARDING QUESTIONS THEY HAVE ON THEIR ABILITY TO PAY. FINANCIAL ADVISORS ARE AVAILABLE TO HELP AS IS A CONSUMER ADVOCATE. THE CONSUMER ADVOCATE OFFERS COMPLIMENTARY PATIENT ASSISTANCE SERVICES, INCLUDING, BUT NOT LIMITED TO, MEDICARE, MEDICAID, PRIVATE INSURANCE, INTERPRETATION OF EXPLANATION OF BENEFITS (EOBS), AND DIRECTIONS TO ADDITIONAL CONSUMER RESOURCES. PART VI, LINE 4: REEDSBURG AREA MEDICAL CENTER IS LOCATED IN THE CITY OF REEDSBURG, WISCONSIN, IN NORTH CENTRAL SAUK COUNTY. THE PRIMARY SERVICE AREA EXTENDS WEST TO CAZENOVIA, EAST TO ROCK SPRINGS, SOUTH TO HILLPOINT AND NORTH FROM WONEWOC TO JUST WEST OF LAKE DELTON. THIS GEOGRAPHIC AREA IS LARGELY RURAL AND CROSSES INTO THREE COUNTIES IN ADDITION TO SAUK COUNTY, COMPRISING APPROXIMATELY THREE QUARTERS OF THE HOSPITAL'S DISCHARGED PATIENTS. SAUK COUNTY HAS SEEN POPULATION GROWTH OF 1% OVER THE PAST YEAR. THE PERCENTAGE OF THE POPULATION AGED 65 AND OLDER HAS RISEN FROM 15.1% IN 2011 TO 17.4% WHILE THE POPULATION AGED 18 AND YOUNGER HAS REMAINED RELATIVELY STABLE. THE POPULATION IS LARGELY RURAL AT 46.1% WITH 91.4% IDENTIFYING AS NON-HISPANIC WHITE, DOWN FROM 97% IN 2008, WHILE 4.9% IDENTIFIES AS HISPANIC, UP FROM 3% IN 2008. THE CURRENT MEDIAN HOUSEHOLD INCOME IN SAUK COUNTY IS APPROXIMATELY $52,000. THE POVERTY RATE HAS RISEN FROM 8% IN 2008 TO 12% IN 2017 WHILE THE PERCENTAGE OF CHILDREN LIVING IN POVERTY CONCURRENTLY ROSE FROM 14.7% TO 17% WITH OVER 40% OF SAUK COUNTY'S CHILDREN ELIGIBLE FOR FREE SCHOOL LUNCH. THE HIGH SCHOOL GRADUATION RATE WAS 93% IN 2017. 12% OF COUNTY ADULTS AND 7% OF COUNTY CHILDREN ARE UNINSURED AND 2% OF COUNTY RESIDENTS REPORTED NOT SEEING A DOCTOR FOR THE PRIOR 12 MONTHS DUE TO COST WHILE 33% HAD NO DENTAL VISIT. BASED ON NUMEROUS DEMOGRAPHIC, BEHAVIORAL, HEALTH AND SOCIAL METRICS, SUCH AS THOSE SHOWN HERE, SAUK COUNTY HAS BEEN RANKED AS THE 36TH HEALTHIEST COUNTY OUT OF ALL 72 WISCONSIN COUNTIES BY THE COUNTY HEALTH RANKINGS AND ROADMAPS PROGRAM IN 2017. REEDSBURG AREA MEDICAL CENTER IS THE ONLY HOSPITAL WITHIN OUR PRIMARY SERVICE AREA; TWO ADDITIONAL HOSPITALS ARE LOCATED WITHIN SAUK COUNTY. SEVERAL TERTIARY CARE HOSPITALS IN MADISON, WISCONSIN, AND THE SURROUNDING AREA PROVIDE ADDITIONAL SPECIALIZED SERVICES NOT AVAILABLE AT REEDSBURG AREA MEDICAL CENTER. PART VI, LINE 5: REEDSBURG AREA MEDICAL CENTER IS COMMITTED TO THE HEALTH OF OUR COMMUNITY AND THE IMPORTANT PART WE PLAY IN MAINTAINING AND IMPROVING THE OVERALL HEALTH OF OUR CONSTITUENTS. WE TAKE AN ACTIVE ROLE IN EQUIPPING OUR COMMUNITY MEMBERS WITH THE SKILLS NEEDED TO CREATE BETTER HEALTH. RAMC PROVIDES HEALTH CARE SERVICES AND OTHER FINANCIAL SUPPORT THROUGH VARIOUS PROGRAMS THAT ARE DESIGNED, AMONG OTHER MATTERS, TO ENHANCE THE HEALTH OF THE COMMUNITY, INCLUDING THE HEALTH OF LOW-INCOME PATIENTS. CONSISTENT WITH OUR MISSION, CARE IS PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY, INCLUDING PROVIDING SERVICES TO THOSE PERSONS WHO CANNOT AFFORD HEALTH INSURANCE BECAUSE OF INADEQUATE RESOURCES OR ARE UNDERINSURED. COMMUNITY BENEFITS ALSO INCLUDE UNPAID COSTS OF TREATING THE ELDERLY AND DISABLED, HEALTH SCREENINGS, COMMUNITY EDUCATION AND OTHER HEALTH-RELATED SERVICES. OUR COMMUNITY BUILDING ACTIVITIES WORK TO ADDRESS UNDERLYING HEALTH DETERMINANTS AND SUPPORT PROGRAMS MEANT TO IMPROVE HEALTH BEFORE INTERVENTION IS REQUIRED AS WELL AS PROVIDING RESOURCES FOR THOSE LOOKING TO IMPROVE THEIR CURRENT HEALTH SITUATION. RAMC EMPLOYEES ARE ACTIVE IN EDUCATING THE COMMUNITY ON A WIDE VARIETY OF HEALTH TOPICS AND PARTICIPATE ON NUMEROUS LOCAL BOARDS. HEALTH-RELATED BOARD POSITIONS RANGE FROM THOSE FOCUSING ON AREA DENTAL AND EMERGENCY MEDICAL SERVICES TO THE RURAL WISCONSIN HEALTH COOPERATIVE AND SAUK COUNTY HEALTH BOARDS. MANY EMPLOYEES ARE ALSO MEMBERS OF COMMUNITY SERVICE BOARDS AND VOLUNTEER GROUPS. RAMC IS MINDFUL OF AND PROACTIVE IN DEVELOPING OR PARTNERING WITH GROUPS WORKING TO BETTER THE CURRENT ECONOMIC AND ENVIRONMENTAL CONDITIONS OF OUR COMMUNITY. RAMC IS OPERATED BY A BOARD COMPRISED OF LOCAL, INDEPENDENT COMMUNITY MEMBERS, A MEDICAL STAFF ORGANIZED IN THE PUBLIC INTEREST AND OPEN TO ALL QUALIFIED PHYSICIANS, AND AN EMERGENCY ROOM AVAILABLE TO ALL, REGARDLESS OF ABILITY TO PAY. THE BOARD TAKES A BALANCED APPROACH WHEN IT SETS POLICY AND STRATEGIC DIRECTION FOR THE HOSPITAL, WORKING TO ALIGN COMMUNITY NEEDS WITH BUSINESS AND FINANCIAL CONCERNS. THE USE OF SURPLUS FUNDS IS LARGELY DETERMINED BY THE BOARD IN EFFORTS TO MEET THIS GOAL. SURPLUS FUNDS ARE USED TO PURCHASE EQUIPMENT AND TO PROVIDE SERVICES THAT WILL MOST EFFECTIVELY MEET THE IDENTIFIED HEALTH NEEDS OF THE COMMUNITY AND ALLOW FOR COMPREHENSIVE CARE CLOSE TO HOME. WHILE THERE IS GROWING AGREEMENT IN THE UNITED STATES ABOUT WHAT CONSTITUTES A NON-PROFIT HOSPITAL'S "COMMUNITY BENEFIT," THESE EFFORTS CONTINUE TO BE A WORK IN PROGRESS. RAMC PROVIDES SIGNIFICANT AMOUNTS OF CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS AND IN ADDITION, WE BELIEVE THAT IT PROVIDES A CRITICALLY IMPORTANT BENEFIT WHICH IS NOT QUANTIFIED. RAMC, LIKE MOST COMMUNITY HOSPITALS, WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE CARE LOCALLY, WHICH WITHOUT THE HOSPITAL, WOULD NOT BE AVAILABLE LOCALLY. BEYOND INPATIENT HOSPITALIZATIONS, RAMC PROVIDES LOCAL ACCESS TO MANY SERVICES INCLUDING: LABORATORY, PHYSICAL, CARDIAC AND PULMONARY REHABILITATION, SLEEP MEDICINE, SURGICAL SERVICES, CONSULTING SERVICES, MASSAGE THERAPY, ORTHOPEDICS, OBSTETRICS, PARISH NURSING, CHEMOTHERAPY, AUDIOLOGY, FAMILY PRACTICE CLINIC, COMMUNITY PHARMACY, GYNECOLOGY, DIABETIC EDUCATION, MEDICAL IMAGING, NUTRITION SERVICES, OCCUPATIONAL HEALTH, RESPIRATORY THERAPY, VOLUNTEER SERVICES, COMMUNITY OUTREACH AND WELLNESS. PART VI, LINE 7, REPORTS FILED WITH STATES WI 1 REEDSBURG AREA SENIOR LIFE CENTER 2350 NORTH DEWEY AVE REEDSBURG WI 54959 760775289 501(C)(3) 2802000 GENERAL OPERATIONS REEDSBURG AREA MEDICAL CENTER FOUNDATION 2090 RIDGEVIEW DR REEDSBURG WI 53959 391243616 501(C)(3) 15000 COMMUNITY CLINIC VOUCHER PROGRAM SAUK COUNTY AGRICULTURAL SOCIETY INC PO BOX 467 BARABOO WI 539130467 390833316 501(C)(5) 14314 ANIMAL MEAT SALE AT THE COUNTY FAIR 2 1 TUITION ASSISTANCE 69 187303 FMV STIPENDS 43 18500 FMV PART I, LINE 2: RAMC HAS (AT LEAST MONTHLY) ACCESS TO THE FINANCIAL RECORDS AND BOARD MEETING MINUTES OF BOTH THE REEDSBURG AREA SENIOR LIFE CENTER AND THE REEDSBURG AREA MEDICAL CENTER FOUNDATION, ALLOWING FOR REVIEW OF HOW FUNDS ARE ALLOCATED. FUNDS PROVIDED TO THE SAUK COUNTY AGRICULTURAL SOCIETY ARE IN CONJUNCTION WITH THE SAUK COUNTY MEAT ANIMAL SALE TO HELP SUPPORT THE YOUTH PARTICIPATING IN THE SALE. RAMC PROVIDES SCHOLARSHIPS AND TUITION ASSISTANCE TO EMPLOYEES PURSUING HEALTH-CARE RELATED HIGHER EDUCATION. THIS ASSISTANCE IS MADE AVAILABLE TO EMPLOYEES FOR STUDIES WHERE PROFESSIONAL STAFF ARE NEEDED AND THE DEMAND FOR THESE POSITIONS IS GREATER THAN THE SUPPLY AVAILABLE. USUALLY, THE SHORTAGE IS NOT ONLY SEEN LOCALLY, BUT ALSO SATE AND NATION WIDE. THE INTENTION IS TO HAVE THESE TRAINED PROFESSIONALS CONTINUE AT RAMC WITHIN THEIR NEW POSITION, ACCOMPLISHING OUR MISSION AND COMMITMENT TO PROVIDING HIGH-QUALITY, LOCAL CARE FOR OUR COMMUNITY. PROOF OF THE COST OF TUITION AND SUCCESSFUL COURSE COMPLETION ARE REQUIRED. X X X X X 0 1 0 0 0 1 0 0 0 CHRIS BJORKLUND TRUSTEE 317109 0 0 0 15051 0 24115 0 24314 0 380589 0 0 0 MARY BETH SHEAR MD TRUSTEE 193856 0 0 0 0 0 0 0 0 0 193856 0 0 0 THOMAS WOOD MD MEDICAL ADVISOR 616919 0 0 0 27867 0 37500 0 24304 0 706590 0 0 0 BOB VAN MEETEREN PRESIDENT/CEO 337146 0 54797 0 10994 0 59494 0 24923 0 487354 0 0 0 BARRY BORCHERT CFO 207160 0 24890 0 12227 0 24453 0 23558 0 292288 0 0 0 DEANNA BENISH PHYSICIAN 291874 0 0 0 22418 0 31482 0 23584 0 369358 0 0 0 CHRISTOPHER WENNINGER PHYSICIAN 602112 0 0 0 22436 0 30462 0 26829 0 681839 0 0 0 KEVIN MCBRIDE ANESTHESIOLOGIST 308260 0 0 0 4436 0 13500 0 24147 0 350343 0 0 0 KENNETH OLSON ANESTHESIOLOGIST 307782 0 0 0 3691 0 17191 0 5439 0 334103 0 0 0 JOHN ROOS ANESTHESIOLOGIST 271740 0 0 0 21545 0 18000 0 19468 0 330753 0 0 0 PART I, LINE 4B ROBERT VAN MEETEREN - CONTRIBUTION TO 457(F) PLAN - $17,000 PART I, LINE 6 THE TOP MANAGEMENT OFFICIAL AND TOP FINANICAL OFFICIAL ARE ELIGIBLE FOR ADDITIONAL COMPENSATION CONTINGENT ON NET EARNINGS, AS DETERMINED ANNUALLY BY THE BOARD OF DIRECTORS. A WISCONSIN HEALTH & EDUCATION FACILITIES 391337855 97710BXP2 2014-02-19 4273300 REFUND SERIES 2010 BONDS 0 0 0 B WISCONSIN HEALTH & EDUCATION FACILITIES 391337855 2015-11-10 6556441 REFUND SERIES 2006 BONDS 0 0 0 C WISCONSIN HEALTH & EDUCATION FACILITIES 391337855 2017-12-29 29600000 CONSTRUCTION & REFUND SERIES 2010 BONDS 0 0 0 D CITY OF REEDSBURG 396005582 2003-06-03 2600000 REFUND SERIES 1992 BONDS 0 0 0 A 687943 4273300 4273300 2006 1 0 1 1 B 2035682 6556441 130120 6556441 2006 0 1 1 1 C 189009 29600000 431179 10720839 4511983 13935999 0 1 1 1 D 2052630 2600000 60955 2600000 1992 1 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 C 0 0 0 0 0 0 1 A 0 1 0 0 1 0 0 0 1 B 0 1 0 0 0 0 0 0 1 C 0 1 0 0 1 0 0 0 1 D 0 0 1 0 1 0 0 0 0 A 0 B 0 C 1 D 0 LINDSEY MUCHOW FAMILY MEMBER OF DIRECTOR 56244 EMPLOYMENT COMPENSATION 0 RYAN SHEAR FAMILY MEMBER OF DIRECTOR 128201 EMPLOYMENT COMPENSATION 0 HALEY STOVEY FAMILY MEMBER OF DIRECTOR 25819 EMPLOYMENT COMPENSATION 0 JIM SHEAR FAMILY MEMBER OF DIRECTOR 121053 EMPLOYMENT COMPENSATION 0 FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE CHAIRMAN, FIRST VICE-CHAIRMAN, MEDICAL ADVISOR, SECRETARY AND TREASURER. THE EXECUTIVE COMMITTEE SHALL HAVE AND MAY EXERCISE, WHEN THE BOARD OF DIRECTORS IS NOT IN SESSION, THE POWERS OF THE BOARD OF DIRECTORS IN THE MANAGEMENT OF THE AFFAIRS OF THE CORPORATION, EXCEPT ACTION IN RESPECT TO AMENDING THE BY-LAWS, MAKING RULES OR REGULATIONS GOVERNING NOMINATIONS OR ELECTIONS, OR DISPOSING OF OR MORTGAGING ASSETS OF THE CORPORATION. THE BOARD OF DIRECTORS MAY SELECT ONE OR MORE OF ITS MEMBERS AS ALTERNATIVE MEMBERS OF SUCH COMMITTEE WHO MAY TAKE THE PLACE OF ANY ABSENT MEMBER OR MEMBERS AT ANY MEETING OF SUCH COMMITTEE, UPON REQUEST BY THE CHAIRMAN OF THE BOARD OR UPON REQUEST BY THE CHAIRMAN OF SUCH MEETING. SUCH COMMITTEE SHALL FIX ITS OWN RULES GOVERNING THE CONDUCT OF ITS ACTIVITIES AND SHALL MAKE SUCH REPORT TO THE BOARD OF DIRECTORS OF ITS ACTIVITIES AS THE BOARD OF DIRECTORS MAY REQUEST. FORM 990, PART VI, SECTION B, LINE 11B UPON COMPLETION OF THE FORM 990, MANAGEMENT REVIEWED FOR ACCURACY AND COMPLETENESS. UPON APPROVAL, THE FORM 990 WAS PRESENTED TO THE BOARD OF DIRECTORS FOR FINAL APPROVAL PRIOR TO SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C THE PURPOSE OF THE CONFLICTS OF INTEREST POLICY IS TO PROTECT THE CORPORATION'S INTEREST WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTEREST OF AN OFFICER OR DIRECTOR OF THE CORPORATION. THIS POLICY IS INTENDED TO SUPPLEMENT BUT NOT REPLACE ANY APPLICABLE WISCONSIN LAWS GOVERNING CONFLICTS OF INTEREST APPLICABLE TO NONPROFIT AND CHARITABLE CORPORATIONS. ANY DIRECTOR, PRINCIPAL OFFICER OR MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST, AS DEFINED BELOW, IS AN INTERESTED PERSON. A PERSON HAS A FINANCIAL INTEREST IF THE PERSON HAS, DIRECTLY OR INDIRECTLY, THROUGH BUSINESS, INVESTMENT OR FAMILY: (I) AN OWNERSHIP OR INVESTMENT INTEREST IN ANY ENTITY WITH WHICH THE CORPORATION HAS A TRANSACTION OR ARRANGEMENT; OR (II) A COMPENSATION ARRANGEMENT WITH THE CORPORATION OR WITH ANY ENTITY OR INDIVIDUAL WITH WHICH THE CORPORATION HAS A TRANSACTION OR ARRANGEMENT; OR (III) A POTENTIAL OWNERSHIP OR INVESTMENT INTEREST IN, OR COMPENSATION ARRANGEMENT WITH, ANY ENTITY OR INDIVIDUAL WITH WHICH THE CORPORATION IS NEGOTIATING A TRANSACTION OR ARRANGEMENT. COMPENSATION INCLUDES DIRECT AND INDIRECT REMUNERATION AS WELL AS GIFTS OR FAVORS THAT ARE SUBSTANTIAL IN NATURE. EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS THAT SUCH PERSON: (A) HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY; (B) HAS READ AND UNDERSTANDS THE POLICY; (C) HAS AGREED TO COMPLY WITH THE POLICY; AND (D) UNDERSTANDS THAT THE CORPORATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF HIS OR HER FINANCIAL INTEREST AND MUST BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH BOARD-DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. AFTER EXERCISING DUE DILIGENCE, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE CORPORATION CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE UNDER CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, THE BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE CORPORATION'S BEST INTEREST AND FOR ITS OWN BENEFIT AND WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO THE CORPORATION AND SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH SUCH DETERMINATION. FORM 990, PART VI, SECTION B, LINE 15A INDEPENDENT WAGE AND SALARY SURVEYS ARE USED FOR ALL KEY EMPLOYEES, INCLUDING PRESIDENT/CEO. VENDORS USED ARE THE RURAL WISCONSIN HEALTH COOPERATIVE AND WISCONSIN HOSPITAL ASSOCIATION. THE BOARD OF DIRECTORS REVIEWS AND APPROVES THE COMPENSATION OF THE CEO. EXECUTIVE COMMITTEE DOES THE EVALUATION AND CHAIR MEETS WITH THE CEO; MINUTES ARE KEPT IN THE RAMC BOARD MINUTE JOURNAL. THE CEO REVIEWS AND APPROVES THE COMPENSATION OF THE OTHER KEY EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 REEDSBURG AREA MEDICAL CENTER'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE REVIEWED AT THE HOSPITAL'S ANNUAL MEETING, WHICH IS OPEN TO THE GENERAL PUBLIC. SUMMARIZED FINANCIAL STATEMENT DATA IS ALSO AVAILABLE THROUGH THE WISCONSIN HOSPITAL ASSOCIATION'S WEBSITE. FORM 990, PART XI, LINE 9: NET CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION 52,503. ATTACHED FINANCIAL STATEMENTS THE 990 IS BEING AMENDED TO INCLUDE THE ISSUED 9/30/2018 FINANCIAL STATEMENTS. REEDSBURG AREA MEDICAL CENTER FOUNDATION 2000 NORTH DEWEY AVE REEDSBURG WI 53959 391243616 FUNDRAISING WI 501(C)(3) LINE 12C, III-FI N/A 0 PARTNERS OF REEDSBURG AREA MEDICAL CENTER 2000 NORTH DEWEY AVE REEDSBURG WI 53959 237373902 FUNDRAISING WI 501(C)(3) LINE 3 N/A 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 0 1 0 0