AMERY REGIONAL MEDICAL CENTER INC: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization: AMERY REGIONAL MEDICAL CENTER INC (EIN 39-0908320)
Tax period: 2017-01-01 to 2017-12-31
Filed: 2018-11-13
IRS object ID: 201833179349307633
Schema version: 2017v2.2
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule K
Schedule K
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2018-11-13T16:53:33-06:00	ReturnTs
Tax Period End	2017-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	135565207	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	KPMG LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	4200 WELLS FARGO CTR 90 S 7TH	AddressLine1Txt
Address Line2	STREET	AddressLine2Txt
City	MINNEAPOLIS	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	55402	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2017-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	390908320	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	AMERY REGIONAL MEDICAL CENTER INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	AMER	BusinessNameControlTxt
Phone	7152688000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	8170 33RD AVENUE SOUTH PO BOX 1309	AddressLine1Txt
City	MINNEAPOLIS	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	554401309	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	DEBRA RUDQUIST	PersonNm
Person Title	PRESIDENT & CEO	PersonTitleTxt
Phone	7152688000	PhoneNum
Signature	2018-11-13	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

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

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	198.174.110.146	IPv4AddressTxt

Field	Value	IRS element (for citing)
IP	2018-11-13	IPDt
IP Tm	15:43:28	IPTm
IP Timezone	CS	IPTimezoneCd
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	BC53011EDF70B2E1BD72B439C4A42BAD8A5D7AD2	AtSubmissionCreationDeviceId
At Submission Filing Device Id	BC53011EDF70B2E1BD72B439C4A42BAD8A5D7AD2	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2017	TaxYr
Build TS	2019-02-21 02:37:17Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	DEBRA RUDQUIST	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	8170 33RD AVENUE SOUTH PO BOX 1309	AddressLine1Txt
City	MINNEAPOLIS	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	554401309	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$54,241,419	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.AMERYMEDICALCENTER.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1954	FormationYr
Legal Domicile State	WI	LegalDomicileStateCd
Activity Or Mission	SEE SCHEDULE O - PRIMARY EXEMPT PURPOSE AND ACHIEVEMENTS	ActivityOrMissionDesc
Voting Members Governing Body	13	VotingMembersGoverningBodyCnt
Voting Members Independent	7	VotingMembersIndependentCnt
Total Employee	499	TotalEmployeeCnt
Total Volunteers	29	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$298,279	PYContributionsGrantsAmt
CY Contributions Grants	$110,442	CYContributionsGrantsAmt
PY Program Service Revenue	$57,300,642	PYProgramServiceRevenueAmt
CY Program Service Revenue	$53,729,810	CYProgramServiceRevenueAmt
PY Investment Income	$69,771	PYInvestmentIncomeAmt
CY Investment Income	$34,143	CYInvestmentIncomeAmt
PY Other Revenue	$170,590	PYOtherRevenueAmt
CY Other Revenue	$187,010	CYOtherRevenueAmt
PY Total Revenue	$57,839,282	PYTotalRevenueAmt
CY Total Revenue	$54,061,405	CYTotalRevenueAmt
PY Grants And Similar Paid	$71,766	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$43,009	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$36,447,344	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$38,112,863	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$19,614,652	PYOtherExpensesAmt
CY Other Expenses	$19,251,211	CYOtherExpensesAmt
PY Total Expenses	$56,133,762	PYTotalExpensesAmt
CY Total Expenses	$57,407,083	CYTotalExpensesAmt
PY Revenues Less Expenses	$1,705,520	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$3,345,678	CYRevenuesLessExpensesAmt
Total Assets BOY	$58,452,023	TotalAssetsBOYAmt
Total Assets EOY	$55,551,941	TotalAssetsEOYAmt
Total Liabilities BOY	$34,202,433	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$34,648,029	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$24,249,590	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$20,903,912	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	AMERY REGIONAL MEDICAL CENTER IS COMMITTED TO PROVIDEACCESSIBLE, COMPREHENSIVE, QUALITY HEALTHCARE AND TO PROMOTE THEHEALTH AND WELLNESS OF ITS COMMUNITY.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$51,564,867	ExpenseAmt
Grant	$43,009	GrantAmt
Revenue	$53,729,810	RevenueAmt
Desc	SEE SCHEDULE O - EXEMPT PURPOSE AND ACHIEVEMENTS FOR A DESCRIPTION OF PROGRAM SERVICE ACCOMPLISHMENTS	Desc
Total Program Service Expenses	$51,564,867	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	Yes (1)	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Temp Or Permanent Endowments	0	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	0	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (1)	TaxExemptBondsInd
Invest Tax Exempt Bonds	0	InvestTaxExemptBondsInd
Escrow Account	0	EscrowAccountInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	0	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (1)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	Yes (1)	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	499	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	13	GoverningBodyVotingMembersCnt
Independent Voting Member	7	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (1)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (1)	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	WI	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	JASON LUHRS - CFO	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	7152688000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	265 GRIFFIN STREET EAST	AddressLine1Txt
City	AMERY	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54001	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
DAN DRAXLER
DIRECTOR	1.75	0.25	Yes (X)	$1,200	$0	$0
HEIDI ERSPAMER
DIRECTOR & SECRETARY	1.75	0.25	Yes (X)	$1,200	$0	$0	Yes (X)
JAMES A LEADHOLM JR
DIRECTOR & VICE CHAIR	1.75	0.25	Yes (X)	$1,200	$0	$0	Yes (X)
DANIEL LIEN
DIRECTOR & CHAIR	1.75	0.25	Yes (X)	$1,200	$0	$0	Yes (X)
DAVID RASMUSSEN
DIRECTOR	1.75	0.25	Yes (X)	$1,200	$0	$0
CHRIS PETERSON
DIRECTOR	1.75	0.25	Yes (X)	$800	$0	$0
ORALEE SCHOCK
DIRECTOR	1.75	0.25	Yes (X)	$800	$0	$0
ROSS R BULLARD
DIRECTOR & TREASURER	1.00	44.00	Yes (X)	$0	$209,385	$59,571	Yes (X)
DYLAN COE MD
DIRECTOR	0.25	39.75	Yes (X)	$0	$299,925	$83,618
MARTIN E RICHARDS MD
DIRECTOR	0.25	39.75	Yes (X)	$0	$512,084	$53,479
ANN SEAGREN MD
DIRECTOR	0.25	49.75	Yes (X)	$0	$264,867	$68,957
TED WEGLEITNER
DIRECTOR	0.25	52.75	Yes (X)	$0	$555,832	$109,748
MARYANN SCOGLIO CANP
DIRECTOR	0.25	64.75	Yes (X)	$0	$186,318	$41,672
JASON J LUHRS
CFO	0.50	49.50		$0	$209,275	$61,093	Yes (X)
SANDRA M REED
VP - AMBULATORY CARE	50.00			$162,025	$0	$37,052	Yes (X)
DEBRA RUDQUIST
CHIEF EXECUTIVE OFFICER	55.00			$0	$318,572	$78,697	Yes (X)
JESSICA NUUTINEN
VP PATIENT CARE SERVICES	40.00			$129,093	$0	$31,784	Yes (X)
PATRICK SURA MD
CHIEF MEDICAL OFFICER	0.25	59.75		$0	$559,077	$54,160	Yes (X)
MARK A TRYGGESTAD
DIRECTOR OF PHARMACY	48.00			$171,797	$0	$18,075		Yes (X)
MARK T MOIOFFER
PHARMACIST	40.00			$128,204	$0	$36,772		Yes (X)
TRACEY HARRIS
PROVIDER-APNP	44.00			$144,932	$0	$31,577		Yes (X)
VICKI D ZIGLINSKI
DIRECTOR-PATIENT FINANCIAL	48.00			$121,814	$0	$35,874		Yes (X)
BENJAMIN BOGLE
PROVIDER-APNP	40.00			$131,658	$0	$36,846		Yes (X)
JOANNE L JACKSON
FORMER HR, PR AND MKTG DIR	50.00			$142,365	$0	$24,600			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,139,488	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$3,115,335	TotReportableCompRltdOrgAmt
Total Other Compensation	$863,575	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	21	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (1)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
COMPHEALTH INC
PO BOX 972651	DALLAS	TX	753972651	PROFESSIONAL SERVICES	$926,273
RIVER VALLEY ANESTHESIA INC
PO BOX 118	NEW RICHMOND	WI	54017	NURSE ANESTHETISTS	$836,101
MARKET & JOHNSON INC
2350 GALLOWAY ST	EAU CLAIRE	WI	54702	PROFESSIONAL SERVICES	$572,526
KRAUS-ANDERSON CONST CO
525 8TH STREET	MINNEAPOLIS	MN	55404	PROFESSIONAL SERVICES	$489,614
HEALOGICS WOUND CARE
28525 NETWORK PLACE	CHICAGO	IL	60673	WOUND HEALING MANAGEMENT	$425,888

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	13	CntrctRcvdGreaterThan100KCnt
Related Organizations	$56,578	RelatedOrganizationsAmt
Government Grants	$28,382	GovernmentGrantsAmt
All Other Contributions	$25,482	AllOtherContributionsAmt
Total Contributions	$110,442	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE	621110	$52,874,787	$52,874,787
OTHER OPERATING	900099	$527,269	$527,269
SUBSIDIARY REVENUE	900099	$172,706	$172,706
FITNESS CENTER	624110	$155,048	$155,048

Field	Value	IRS element (for citing)
Total Program Service Revenue	$53,729,810	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$95,193	TotalRevenueColumnAmt
Exclusion	$95,193	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$57,875	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$30,724	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$27,151	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$27,151	TotalRevenueColumnAmt
Exclusion	$27,151	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$88,240	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Other	$149,290	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Other	-$61,050	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$61,050	TotalRevenueColumnAmt
Exclusion	-$61,050	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt
CAFETERIA AND OTHER	900099	$145,227	$145,227
GIFT SHOP	900099	$14,632	$14,632

Field	Value	IRS element (for citing)
Other Revenue Total	$159,859	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$54,061,405	TotalRevenueColumnAmt
Related Or Exempt Func Income	$53,729,810	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$221,153	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$43,009	TotalAmt
Program Services	$43,009	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$298,718	TotalAmt
Management And General	$298,718	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$31,735,299	TotalAmt
Program Services	$29,576,672	ProgramServicesAmt
Management And General	$2,158,627	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$551,787	TotalAmt
Program Services	$451,679	ProgramServicesAmt
Management And General	$100,108	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$4,154,667	TotalAmt
Program Services	$3,400,905	ProgramServicesAmt
Management And General	$753,762	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$1,372,392	TotalAmt
Program Services	$1,123,405	ProgramServicesAmt
Management And General	$248,987	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$9,678	TotalAmt
Management And General	$9,678	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$2,669,819	TotalAmt
Program Services	$2,124,943	ProgramServicesAmt
Management And General	$544,876	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$341,801	TotalAmt
Program Services	$10,076	ProgramServicesAmt
Management And General	$331,725	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$485,050	TotalAmt
Program Services	$288,676	ProgramServicesAmt
Management And General	$196,374	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$147,768	TotalAmt
Program Services	$126,038	ProgramServicesAmt
Management And General	$21,730	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$865,627	TotalAmt
Program Services	$825,390	ProgramServicesAmt
Management And General	$40,237	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$111,440	TotalAmt
Program Services	$66,683	ProgramServicesAmt
Management And General	$44,757	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$12,050	TotalAmt
Program Services	$6,785	ProgramServicesAmt
Management And General	$5,265	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$863,121	TotalAmt
Program Services	$863,121	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$3,452,432	TotalAmt
Program Services	$3,340,651	ProgramServicesAmt
Management And General	$111,781	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$157,281	TotalAmt
Management And General	$157,281	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL & DRUG SUPPLIES	$6,021,495	$6,016,230	$5,265
OTHER EXPENSE	$1,879,079	$1,879,079
EQUIP. RENT & REPAIR	$1,551,225	$936,311	$614,914
DIETARY & FOOD SUPPLIES	$388,501	$384,069	$4,432

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$294,844	TotalAmt
Program Services	$101,145	ProgramServicesAmt
Management And General	$193,699	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$57,407,083	TotalAmt
Program Services	$51,564,867	ProgramServicesAmt
Management And General	$5,842,216	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$5,570	BOYAmt
EOY	$7,407	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$15,837,030	BOYAmt
EOY	$11,110,340	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$5,615,195	BOYAmt
EOY	$6,521,958	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$685,849	BOYAmt
EOY	$720,641	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$51,785	BOYAmt
EOY	$62,498	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$59,677,429	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$34,289,240	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$24,990,973	BOYAmt
EOY	$25,388,189	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$8,552,008	BOYAmt
EOY	$9,152,717	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$2,713,613	BOYAmt
EOY	$2,473,135	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$115,056	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$58,452,023	BOYAmt
EOY	$55,551,941	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$7,470,083	BOYAmt
EOY	$8,910,042	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$26,732,350	BOYAmt
EOY	$25,737,987	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$34,202,433	BOYAmt
EOY	$34,648,029	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$24,249,590	BOYAmt
EOY	$20,903,912	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$24,249,590	BOYAmt
EOY	$20,903,912	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$58,452,023	BOYAmt
EOY	$55,551,941	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	-$3,345,678	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	$0	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	VolunteersInd
Paid Staff Or Management	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Total Lobbying Expenditures	$0	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1:	FormAndLineReferenceDesc
Explanation	AMERY REGIONAL MEDICAL CENTER, INC. PAYS FOR CERTAIN CORPORATE AND EMPLOYEE PROFESSIONAL ASSOCIATION MEMBERSHIPS. A PORTION OF SUCH MEMBERSHIP DUES POTENTIALLY COULD BE USED BY THE PROFESSIONAL ASSOCIATIONS FOR LOBBYING ACTIVITIES.	ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,072,735	OtherCostOrOtherBasisAmt
Book Value	$1,072,735	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$27,743,885	OtherCostOrOtherBasisAmt
Depreciation	$13,582,520	DepreciationAmt
Book Value	$14,161,365	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$24,330,458	OtherCostOrOtherBasisAmt
Depreciation	$15,723,776	DepreciationAmt
Book Value	$8,606,682	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$6,530,351	OtherCostOrOtherBasisAmt
Depreciation	$4,982,944	DepreciationAmt
Book Value	$1,547,407	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$25,388,189	TotalBookValueLandBuildingsAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART X, LINE 2:	FormAndLineReferenceDesc
Explanation	AMERY REGIONAL MEDICAL CENTER, INC. IS INCLUDED IN THE HEALTHPARTNERS, INC. (HP) CONSOLIDATED AUDITED FINANCIAL STATEMENT. HP'S ACCOUNTING POLICY PROVIDES THAT A TAX BENEFIT FROM AN UNCERTAIN TAX POSITION MAY BE RECOGNIZED WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING RESOLUTIONS OF ANY RELATED APPEALS OR LITIGATION PROCESSES, BASED ON THE TECHNICAL MERITS. HP RECORDED NO LIABILITIES AT DECEMBER 31, 2017 OR 2016 FOR UNRECOGNIZED TAX BENEFITS.	ExplanationTxt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent300	Yes (X)	Percent300Ind
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	0	ExpensesExceedBudgetInd
Annual Community Bnft Report	0	AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Persons Served	5502	PersonsServedCnt
Total Community Benefit Expns	$353,564	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$353,564	NetCommunityBenefitExpnsAmt
Total Expense	0.00620	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$12,990,970	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$7,820,200	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,170,770	NetCommunityBenefitExpnsAmt
Total Expense	0.09010	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Persons Served	5502	PersonsServedCnt
Total Community Benefit Expns	$13,344,534	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$7,820,200	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,524,334	NetCommunityBenefitExpnsAmt
Total Expense	0.09630	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	20	ActivitiesOrProgramsCnt
Persons Served	2298	PersonsServedCnt
Total Community Benefit Expns	$279,279	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,537	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$276,742	NetCommunityBenefitExpnsAmt
Total Expense	0.00480	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Activities Or Programs	6	ActivitiesOrProgramsCnt
Persons Served	56	PersonsServedCnt
Total Community Benefit Expns	$24,271	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$24,271	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Activities Or Programs	8	ActivitiesOrProgramsCnt
Persons Served	168	PersonsServedCnt
Total Community Benefit Expns	$193,382	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$13,590	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$179,792	NetCommunityBenefitExpnsAmt
Total Expense	0.00310	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	34	ActivitiesOrProgramsCnt
Persons Served	2522	PersonsServedCnt
Total Community Benefit Expns	$496,932	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$16,127	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$480,805	NetCommunityBenefitExpnsAmt
Total Expense	0.00830	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	34	ActivitiesOrProgramsCnt
Persons Served	8024	PersonsServedCnt
Total Community Benefit Expns	$13,841,466	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$7,836,327	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,005,139	NetCommunityBenefitExpnsAmt
Total Expense	0.10460	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$150	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$150	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$7,125	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$7,125	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	158	PersonsServedCnt
Total Community Benefit Expns	$1,291	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,291	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	3	ActivitiesOrProgramsCnt
Persons Served	158	PersonsServedCnt
Total Community Benefit Expns	$8,566	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$8,566	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	0	BadDebtExpenseReportedInd
Bad Debt Expense	$1,915,992	BadDebtExpenseAmt
Bad Debt Expense Attributable	$654,628	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$21,245,100	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$21,508,617	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$263,517	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	AMERY REGIONAL MEDICAL CENTER	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	265 GRIFFIN STREET EAST	AddressLine1Txt
City	AMERY	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54001	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.AMERYMEDICALCENTER.ORG	WebsiteAddressTxt
State License	CAH CERT LICENSE 1010	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Critical Access Hospital	Yes (X)	CriticalAccessHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	AMERY REGIONAL MEDICAL CENTER INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	15	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	0	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	WWW.AMERYMEDICALCENTER.ORG	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	15	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	WWW.AMERYMEDICALCENTER.ORG/COMMUNITY_HEALTH_NEEDS_ASSESSMENT.ASPX	StrategyWebsiteURLTxt
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.000000000000	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	300.000000000000	FPGFamilyIncmLmtDscntCarePct
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	WWW.AMERYMEDICALCENTER.ORG	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	WWW.AMERYMEDICALCENTER.ORG	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	WWW.AMERYMEDICALCENTER.ORG	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr Prvt	Yes (X)	LookBackMedicaidMedcrPrvtInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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 ARMC'S 2015 CHNA AND ANNUAL IMPLEMENTATION PLAN UPDATE IS POSTED ON ARMC'S WEBPAGE AT WWW.AMERYMEDICALCENTER.ORG/COMMUNITY_HEALTH_NEEDS_ASSESSMENT.ASPX

Field	Value	IRS element (for citing)
Facility	6	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
1 - ARMC REHAB SERVICES
220 N KELLER AVENUE	AMERY	WI	54001	REHABILITATION
2 - LUCK MEDICAL CLINIC
137 FIRST AVENUE	LUCK	WI	54853	RURAL HEALTH CLINIC
3 - TURTLE LAKE MEDICAL CLINIC
550 MARTIN AVENUE	TURTLE LAKE	WI	54889	RURAL HEALTH CLINIC
4 - CLEAR LAKE CLINIC
357 THIRD AVENUE	CLEAR LAKE	WI	54005	RURAL HEALTH CLINIC
5 - LUCK PT & FITNESS
2547 STATE ROAD 35 SUITE 5	LUCK	WI	54853	PHYSICAL THERAPY
6 - AMERY REGIONAL MEDICAL CENTER WEST
230 DERONDA STREET	AMERY	WI	54001	10 BED INPATIENT DPU OF AMERY

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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 $654,628 AND $790,642 FOR THE YEARS ENDED 12/31/17 AND 12/31/16 RESPECTIVELY, AND PROVIDED MEDICAL CARE TO PATIENTS WHO WERE DETERMINED TO BE ABLE, BUT UNWILLING TO PAY (DOUBTFUL ACCOUNTS) OF $1,915,992 AND $1,137,485 FOR THE YEARS ENDED 12/31/17 AND 12/31/16 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.

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	AMERY REGIONAL MEDICAL CENTER FOUNDATION	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	8170 33RD AVE S	AddressLine1Txt
City	BLOOMINGTON	CityNm
State Abbreviation	MN	StateAbbreviationCd
ZIP	554401309	ZIPCd

Field	Value	IRS element (for citing)
Recipient EIN	391726539	RecipientEIN
IRC Section	501(C)(3)	IRCSectionDesc
Cash Grant	$10,000	CashGrantAmt
Purpose Of Grant	PROGRAM SUPPORT	PurposeOfGrantTxt

Field	Value	IRS element (for citing)
Total501c3 Org	1	Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

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

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (1)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (17 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
ROSS R BULLARD
DIRECTOR & TREASURER	$0	$184,046	$0	$21,234	$0	$4,105	$0	$31,660	$0	$27,911	$0	$268,956	$0	$0
DYLAN COE MD
DIRECTOR	$0	$195,920	$0	$0	$0	$104,005	$0	$64,743	$0	$18,875	$0	$383,543	$0	$0
MARTIN E RICHARDS MD
DIRECTOR	$0	$369,589	$0	$10,830	$0	$131,665	$0	$20,250	$0	$33,229	$0	$565,563	$0	$0
ANN SEAGREN MD
DIRECTOR	$0	$194,454	$0	$0	$0	$70,413	$0	$40,255	$0	$28,702	$0	$333,824	$0	$0
TED WEGLEITNER
DIRECTOR	$0	$408,444	$0	$110,594	$0	$36,794	$0	$75,885	$0	$33,863	$0	$665,580	$0	$31,729
MARYANN SCOGLIO CANP
DIRECTOR	$0	$162,122	$0	$0	$0	$24,196	$0	$14,362	$0	$27,310	$0	$227,990	$0	$0
JASON J LUHRS
CFO	$0	$182,408	$0	$25,725	$0	$1,142	$0	$34,255	$0	$26,838	$0	$270,368	$0	$0
SANDRA M REED
VP - AMBULATORY CARE	$132,851	$0	$20,950	$0	$8,224	$0	$4,945	$0	$32,107	$0	$199,077	$0	$0	$0
DEBRA RUDQUIST
CHIEF EXECUTIVE OFFICER	$0	$261,858	$0	$54,164	$0	$2,550	$0	$50,076	$0	$28,621	$0	$397,269	$0	$0
JESSICA NUUTINEN
VP PATIENT CARE SERVICES	$128,293	$0	$0	$0	$800	$0	$3,466	$0	$28,318	$0	$160,877	$0	$0	$0
PATRICK SURA MD
CHIEF MEDICAL OFFICER	$0	$363,107	$0	$10,024	$0	$185,946	$0	$20,250	$0	$33,910	$0	$613,237	$0	$0
MARK A TRYGGESTAD
DIRECTOR OF PHARMACY	$160,787	$0	$2,508	$0	$8,502	$0	$4,954	$0	$13,121	$0	$189,872	$0	$0	$0
MARK T MOIOFFER
PHARMACIST	$125,963	$0	$238	$0	$2,003	$0	$4,034	$0	$32,738	$0	$164,976	$0	$0	$0
TRACEY HARRIS
PROVIDER-APNP	$135,525	$0	$4,000	$0	$5,407	$0	$0	$0	$31,577	$0	$176,509	$0	$0	$0
VICKI D ZIGLINSKI
DIRECTOR-PATIENT FINANCIAL	$113,393	$0	$2,508	$0	$5,913	$0	$3,685	$0	$32,189	$0	$157,688	$0	$0	$0
BENJAMIN BOGLE
PROVIDER-APNP	$128,771	$0	$2,000	$0	$887	$0	$4,106	$0	$32,740	$0	$168,504	$0	$0	$0
JOANNE L JACKSON
FORMER HR, PR AND MKTG DIR	$127,814	$0	$9,707	$0	$4,844	$0	$4,279	$0	$20,321	$0	$166,965	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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 $36,634
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 $31,729

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
VILLAGE OF LUCK WISCONSIN
A	396006307	2011-04-28	$8,500,000	REFINANCE EXISTING DEBT	0	0	0
CITY OF AMERY WISCONSIN
B	396005378	2011-04-13	$8,500,000	REFINANCE EXISTING DEBT	0	0	0
VILLAGE OF CLEAR LAKE WISCONSIN
C	396006238	2011-03-29	$8,500,000	REFINANCE EXISTING DEBT	0	0	0
TOWN OF BLACK BROOK POLK COUNTY WISCONSIN
D	391169876	2011-05-13	$6,150,000	REFINANCE EXISTING DEBT	0	0	0

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Total ProceedsTotalProceedsAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Other Spent ProceedsOtherSpentProceedsAmt	Substantial CompletionSubstantialCompletionYr	Current RefundingCurrentRefundingInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$2,710,746	$8,500,000	$170,000	$8,330,000	2007	Yes (1)	Yes (1)	Yes (1)
B	$2,710,746	$8,500,000	$170,000	$8,330,000	2007	Yes (1)	Yes (1)	Yes (1)
C	$2,710,746	$8,500,000	$170,000	$8,330,000	2007	Yes (1)	Yes (1)	Yes (1)
D	$1,964,971	$6,150,000	$123,000	$6,027,000	2007	Yes (1)	Yes (1)	Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCd	Private Bus Use By OthersPrivateBusUseByOthersPct	Total Private Business UseTotalPrivateBusinessUsePct	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd
A	0.00040	0.00040	Yes (1)
B	0.00040	0.00040	Yes (1)
C	0.00040	0.00040	Yes (1)
D	0.00040	0.00040	Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

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

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	0
B	0
C	0
D	0

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	FORM 990, SCHEDULE K, PART IV, LINE 2A THRU 2C	FormAndLineReferenceDesc
Explanation	REBATE CALCULATION IS NOT DUE BUT EVERY 5 YEARS. THERE IS NO REBATE CACLULATION DUE FOR ANY BONDS LISTED IN SCHEDULE K, PART I.	ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	TOWN OF LINCOLN POLK COUNTY WISCONSIN	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Bond Issuer EIN	391406159	BondIssuerEIN
Bond Issued	2011-05-31	BondIssuedDt
Issue Price	$6,150,000	IssuePriceAmt
Purpose	REFINANCE EXISTING DEBT	PurposeDesc
Defeased	0	DefeasedInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Pool Financing	0	PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Retired	$1,964,971	RetiredAmt
Total Proceeds	$6,150,000	TotalProceedsAmt
Issuance Costs From Proceeds	$123,000	IssuanceCostsFromProceedsAmt
Capital Expenditures	$1,709,792	CapitalExpendituresAmt
Other Spent Proceeds	$4,317,208	OtherSpentProceedsAmt
Substantial Completion	2007	SubstantialCompletionYr
Current Refunding	Yes (1)	CurrentRefundingInd
Advance Refunding	0	AdvanceRefundingInd
Final Allocation Made	Yes (1)	FinalAllocationMadeInd
Adequate Books And Rec Maint	Yes (1)	AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Owning Bond Financed Property	0	OwningBondFinancedPropertyInd
Any Lease Arrangements	0	AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop	0	MgmtContractBondFincdPropInd
Any Research Agreements	0	AnyResearchAgreementsInd
Private Bus Use By Others	0.00040	PrivateBusUseByOthersPct
Total Private Business Use	0.00040	TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test	Yes (1)	BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop	0	ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond Remdtd	0	ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	0	Form8038TFiledInd
Rebate Not Due Yet	Yes (1)	RebateNotDueYetInd
Exception To Rebate	0	ExceptionToRebateInd
No Rebate Due	0	NoRebateDueInd
Variable Rate Issue	Yes (1)	VariableRateIssueInd
Hedge Identified In Bks And Rec	0	HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC	0	GrossProceedsInvestedInGICInd
Gross Proceeds Invested	0	GrossProceedsInvestedInd
Written Proc To Monitor Reqs	0	WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Procedures Corrective Action	0	ProceduresCorrectiveActionInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART III, LINE 4A - EXEMPT PURPOSE AND ACHIEVEMENTS	AMERY REGIONAL MEDICAL CENTER (ARMC), A STATE LICENSED 25-BED, LEVEL IV CRITICAL ACCESS HOSPITAL (CAH), IS A WISCONSIN NON-PROFIT CORPORATION RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE ("IRC") SECTION 501(C)(3) AND IS PART OF THE FAMILY OF HEALTHPARTNERS ORGANIZATIONS "HEALTHPARTNERS". FOUNDED IN 1957, HEALTHPARTNERS IS AN INTEGRATED SYSTEM OF HEALTH CARE DELIVERY AND HEALTH CARE FINANCING ORGANIZATIONS, AND IS ONE OF THE LARGEST CONSUMER-GOVERNED ORGANIZATIONS IN THE COUNTRY. HEALTHPARTNERS' MISSION IS TO IMPROVE HEALTH AND WELL-BEING IN PARTNERSHIP WITH OUR MEMBERS, PATIENTS AND COMMUNITY. HEALTHPARTNERS SEEKS TO TRANSFORM HEALTHCARE THROUGH A RELENTLESS FOCUS ON THE TRIPLE AIM - PROVIDING EXCEPTIONAL EXPERIENCE FOR THE INDIVIDUAL, IMPROVING THE HEALTH OF THE POPULATION, AND MAINTAINING AFFORDABILITY, ALL AT THE SAME TIME. HEALTHPARTNERS INCLUDES AN ARRAY OF TAX-EXEMPT AND TAXABLE ORGANIZATIONS WITH HEALTH CARE ACTIVITIES PRIMARILY OPERATING IN MINNESOTA, WESTERN WISCONSIN AND EXPANDING TO SEVERAL 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 PLAN'S SERVE MORE THAN 1.8 MILLION MEDICAL AND DENTAL MEMBERS NATIONWIDE. HEALTHPARTNERS MEDICAL CARE SYSTEM INCLUDES MORE THAN 1,800 PHYSICIANS, SIX HOSPITALS WITH OVER 1,000 ACUTE CARE BEDS, AND 93 PRIMARY AND SPECIALTY CARE MEDICAL FACILITIES WITH PRACTICES IN MINNESOTA AND WESTERN WISCONSIN. IN ADDITION, HEALTHPARTNERS DENTAL CARE SYSTEM HAS MORE THAN 60 DENTISTS AND 25 DENTAL CLINICS. 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 TO SEVERAL OTHER MIDWESTERN STATES. HEALTHPARTNERS ALSO PROVIDES MEDICAL EDUCATION AND TRAINING TO MEDICAL PROFESSIONALS AND CONDUCTS RESEARCH AND FUND RAISING ACTIVITIES THAT SUPPORT THE HEALTH CARE DELIVERY SYSTEM. A COMPLETE LISTING OF ALL ORGANIZATIONS WITHIN THE HEALTHPARTNERS FAMILY, AND THE RELATIONSHIP BETWEEN THEM, CAN BE FOUND ON SCHEDULE R WITHIN THIS 990 RETURN. DETAILED INFORMATION ABOUT THE COMMUNITY BENEFIT ACTIVITIES AND ACCOMPLISHMENTS OF EACH TAX-EXEMPT ORGANIZATION CAN BE FOUND IN THE INDIVIDUAL FORM 990 RETURN FOR THAT ORGANIZATION. HEALTHPARTNERS IS DRIVING CHANGE THAT HELPS OUR MEMBERS AND PATIENTS LIVE HEALTHIER LIVES. HEALTHPARTNERS COLLABORATE WITH OTHER PLANS, CARE PROVIDERS AND OTHER COMMUNITY AND BUSINESS ORGANIZATIONS IN THE REGION AND THROUGHOUT THE NATION TO INCREASE ACCESS, CREATE AND SHARE QUALITY MEASURES AND INITIATIVES, PARTICIPATE IN DEVELOPMENT OF PUBLIC POLICY, AND COLLABORATE IN IMPROVEMENTS THAT SUPPORT THE TRIPLE AIM. AMONG HEALTHPARTNERS' SIGNATURE INITIATIVES CONTINUING IN 2017 ARE TOTAL COST OF CARE MEASUREMENTS (DEVELOPMENT OF A NATIONALLY RECOGNIZED METRIC, ENDORSED BY THE NATIONAL QUALITY FORUM, ENABLING MEASUREMENT AND INCENTIVES BASED ON COORDINATION AND EVIDENCE-BASED PRACTICES), MENTAL HEALTH (REDUCING STIGMA, AND ASSURING ACCESS TO HIGH QUALITY CARE IN THE MOST APPROPRIATE SETTINGS), CHILDREN'S HEALTH (IMPROVING CHILD HEALTH BY PROMOTING EARLY BRAIN DEVELOPMENT, PROVIDING FAMILY CENTERED CARE, AND STRENGTHENING COMMUNITIES), AND SUSTAINABILITY (ENERGY EFFICIENCY, WASTE REDUCTION, AND RESOURCE MANAGEMENT). HEALTHPARTNERS, INC. (HPI) IS THE PARENT ENTITY OF HEALTHPARTNERS AND IS A MINNESOTA NON-PROFIT CORPORATION AND LICENSED HEALTH MAINTENANCE ORGANIZATION (HMO) RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(4). HPI IS THE SOLE CORPORATE MEMBER OF HPI-RAMSEY, A MINNESOTA NON-PROFIT CORPORATION RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). IN TURN, HPI-RAMSEY IS THE SOLE CORPORATE MEMBER OF REGIONS HOSPITAL, REGIONS HOSPITAL FOUNDATION, CAPITOL VIEW TRANSITIONAL CARE CENTER, STILLWATER HEALTH SYSTEM (LAKEVIEW HEALTH), RAMSEY INTEGRATED HEALTH SERVICES AND RH-WISCONSIN, INC., ALL OF WHICH ARE NON-PROFIT CORPORATIONS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). RH-WISCONSIN AND GROUP HEALTH PLAN, INC. (GHI) ARE CORPORATE MEMBERS OF ARMC. GHI IS A MINNESOTA NON-PROFIT CORPORATION AND LICENSED HEALTH MAINTENANCE ORGANIZATION (HMO) RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). IN TURN, ARMC IS THE SOLE CORPORATE MEMBER OF THE AMERY REGIONAL MEDICAL CENTER FOUNDATION, INC. (FOUNDATION) A WISCONSIN NON-STOCK CORPORATION EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C). BENEFIT TO THE COMMUNITY: 1. COMMUNITY HEALTH IMPROVEMENT SERVICES: $ 248,785 A. COMMUNITY HEALTH EDUCATION - ARMC HELPS EDUCATE THE LOCAL COMMUNITIES IN REGARDS TO HEALTH ISSUES BY PROVIDING THE FOLLOWING TYPES OF COMMUNITY EDUCATION: CPR/BLS CLASSES, MONTHLY DIABETES SUPPORT GROUP REACHING OVER 100 INDIVIDUALS, EXPECTANT PARENTS/PRE-NATAL AND BREASTFEEDING CLASSES REACHING OVER 30 PARENTS, 8 HEALTH FAIRS WITH FOCUS ON HEART HEALTH, STROKE PREVENTION, WOUND HEALING, DIABETES EDUCATION, AND NUTRITION, 15 MENTAL HEALTH FOCUSED COMMUNITY EDUCATION CLASSES WITH A REACH OF OVER 350 INDIVIDUALS. CONTINUING IN 2017, ARMC OFFERED AT LEAST ONE FREE COMMUNITY EDUCATION CLASS EVERY MONTH WITH TWO DIFFERENT MEDICAL NUTRITION THERAPY CLASSES TAUGHT BY REGISTERED DIETITIANS WITH A FOCUS ON HEALTHY WEIGHT AND DIABETES PREVENTION, NEWLY OFFERED AT NO COST. ARMC PROVIDES EDUCATION AT OUR SCHOOLS BY HOLDING A 3RD GRADE HEALTH FAIR REACHING 188 STUDENTS FROM AMERY, CLEAR LAKE, CLAYTON, AND TURTLE LAKE, WISCONSIN. 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 SECOND FULL YEAR IN AMERY WITH GREAT SUCCESS. EXAMPLES INCLUDE: 10 FREE KIDS COOKING CLASSES, REACHED 120 KIDS AGES 7-13 YEARS LIEN ELEMENTARY SCHOOL IN AMERY "POWERED UP" SCHOOL CARNIVAL FOOD OPTIONS, REACHED 200+ KIDS AND ADULTS LIEN ELEMENTARY "POWERED UP" SCHOOL STEM EVENT FOOD OPTIONS, REACHED 200+ KIDS AND ADULTS LIEN ELEMENTARY "POWERED UP" SCHOOL READ-IN EVENT SNACK OPTIONS, REACHED 200+ KIDS AND ADULTS POWERUP FAMILY 2K RUN/WALK, REACHED 163 KIDS AND ADULTS CHOMP'S BIRTHDAY PARTY CELEBRATION AT THE LIBRARY, REACHED 70 KIDS AND ADULTS KID'S DANCE OPEN GYM, REACHED 35 KIDS AND ADULTS 72 BAGS OF FRESH VEGGIES (JICAMA, ZUCCHINI, AND CARROTS) GIVEN AWAY AT VEGGIE GIVEAWAY EVENT AMERY INTERMEDIATE SCHOOL "POWERED UP" THEIR FUNDRAISER BY HAVING A WALK-A-THON, WHICH REACHED 314 STUDENTS (ENTIRE SCHOOL PARTICIPATED); IMPACT GOES BEYOND THE STUDENTS WHO ACTUALLY WALKED/RAN IN THE FUNDRAISER THOUGH AND EXTENDS INTO COMMUNITY BY NOT HAVING SOLD JUNK FOOD TO RAISE MONEY PARTNERSHIP WITH SUMMER FOOD PROGRAM HELD AT LIEN ELEMENTARY OVER THE SUMMER - PROVIDED 8 ENGAGEMENT ACTIVITIES RELATED TO FOOD AND PHYSICAL ACTIVITY, REACHING 60 KIDS ABOUT 40 POUNDS OF CANDY WAS BROUGHT IN BY KIDS AT THE CANDY TRADE-IN EVENT AND EXCHANGED FOR POWERUP PRIZES (KIDS ALSO WROTE THANK YOU CARDS TO SOLDIER'S THAT ACCOMPANIED THE CANDY BEING SENT OVERSEAS TO ACTIVE DUTY MILITARY) A TOTAL OF 650, $10 FRUIT AND VEGETABLE "PRESCRIPTIONS" WERE DISTRIBUTED AT ARMC CLINICS TO KIDS AGES 2-17 BETWEEN MAY AND SEPTEMBER; REDEMPTION RATES: LUCK = 19%, CLEAR LAKE = 43%, AMERY = 51.7%, TURTLE LAKE = 51%; TOTAL # REDEEMED = 294; OUR LOCAL REDEMPTION RATES, WITH EXCEPTION OF LUCK CLINIC, EXCEEDED THE 40% AVERAGE REDEMPTION RATE FOR ALL VEGGIERX'S DISTRIBUTED ACROSS THE ST. CROIX RIVER VALLEY AND TWIN CITIES OPEN GYMS (8 TOTAL IN 2017), REACHING 35+ KIDS AND ADULTS AT EACH OPEN GYM AMERY LIBRARY CHILDREN'S BOOK FEST "POWERED UP" SNACK OPTION, REACHING 75+ KIDS AND ADULTS AMERY LIBRARY NOON YEAR'S EVE POWERUP CELEBRATION, REACHING 75+ KIDS AND ADULTS AMERY INTERMEDIATE SCHOOL NUTRITION CURRICULUM + COOKING CLASS WITH AMERY INQUIRING MINDS (AIM) CLASS, REACHING ALL 60 KIDS IN THE CLASS B. COMMUNITY-BASED CLINICAL SERVICES - $ 2,445 ARMC PROVIDED 2 FLU SHOT CLINICS AT SURROUNDING AREA BUSINESSES. BEHAVIORAL HEALTH SCREENED 6 TEENS FOR DEPRESSION, SUICIDAL THOUGHTS AND STRESSORS IN GENERAL AT THE AMERY HIGH SCHOOL.
FORM 990, PART III, LINE 4A	C.- HEALTH CARE SUPPORT SERVICES - $ 120,980 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 $ 58,272 IN STAFF TIME TO ASSIST PATIENTS IN ENROLLING IN PUBLIC MEDICAL PROGRAMS, FREE DRUG PROGRAMS, AND REFER INDIVIDUALS TO COMMUNITY SERVICES/PUBLIC HEALTH ASSISTANCE. ARMC 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 1,300 PATIENTS USED THIS SERVICE IN 2017, WITH REVENUE OF $ 2,537 AND OPERATING COST OF $ 65,245. D.- SOCIAL & ENVIRONMENTAL IMPROVEMENT ACTIVITIES - $ 36,449 DUE THE HEALTH PROFESSIONAL SHORTAGE AREA IN THE ARMC SERVICE AREA, NUMEROUS RESOURCES WERE INVESTED IN PHYSICIAN AND ADVANCED PRACTICE PROVIDER RECRUITMENT, TOTALING AT LEAST $ 20,534. ARMC WELCOMED THREE NEW FAMILY MEDICINE PHYSICIANS AND ONE ADVANCED PRACTICE PROVIDER, AND 3 SOCIAL WORKERS. 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 ARE EXPECTED TO START JULY 2019. OUR PHYSICIANS ARE CURRENTLY UNDERGOING PRECEPTOR TRAINING AND EDUCATION TO BEST PREPARE THESE STUDENTS ON BECOMING RURAL PHYSICIANS. ARMC PARTNERED WITH THE CITY OF AMERY TO OFFER ADDITIONAL GARDENING PLOTS AT THE COMMUNITY GARDEN LOCATED ON ARMC GROUNDS. SIX NEW RAISED GARDEN BEDS WERE ADDED IN 2017, BRINGING THE TOTAL TO 18. THEY WERE FUNDED BY AMERY HEALTH & WELLNESS FOUNDATION AND BUILT BY THE CITY OF AMERY. ARMC EMS CONTINUES TO PARTICIPATE IN COUNTY-WIDE AND REGIONAL EMERGENCY PREPAREDNESS PLANNING ACTIVITIES TO PLAN FOR LARGE SCALE EVENTS THAT WOULD QUICKLY OVERCOME LOCAL RESOURCES. 2. HEALTH PROFESSIONAL EDUCATION: $ 24,271 STUDENTS IN NURSING, DIETETICS, PHYSICIAN ASSISTANT PROGRAMS, PHYSICAL THERAPY, RADIOLOGIC TECHNOLOGY, MEDICAL RECORDS, MEDICAL ASSISTANT, LAB TECHNICIAN, NURSE PRACTITIONERS, AND MEDICAL ADMINISTRATIVE ASSISTANTS, STUDY AT ARMC. ARMC ALSO HAS AN AGREEMENT WITH UNIVERSITY OF MINNESOTA-DULUTH FOR FIRST YEAR AND SECOND YEAR MEDICAL STUDENT ROTATIONS. IN ADDITION, ARMC ACTIVELY COLLABORATES WITH THE WISCONSIN INDIANHEAD TECHNICAL COLLEGE (WITC) TO HELP EDUCATE AND TRAIN NURSES. FOR THE YEAR 2017, ARMC PROVIDED CLINICAL TRAINING FOR 32 NURSES, 2 MEDICAL STUDENTS, 1 PHLEBOTOMY STUDENT, 2 DIETETICS STUDENTS, 4 PHARMACY STUDENTS, AND 2 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: $ 179,792 A.- CASH DONATIONS - ARMC HELPED VARIOUS NON-PROFIT ORGANIZATIONS, COMMUNITY GROUPS, AND SCHOOL PROGRAMS THROUGH CASH DONATIONS TOTALING $ 17,380. B.- 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 2000 HOURS OF ATHLETIC TRAINING AND SUPPORT FOR A MINIMAL FEE TOTALING $ 13,590, WITH THE BENEFIT OF DONATED SERVICES TOTALING $ 74,151. ARMC HOSTED TWO BLOOD DRIVES COLLECTING OVER 40 UNITS OF BLOOD FROM 58 INDIVIDUALS IN SUPPORT OF THE AMERICAN RED CROSS. ARMC PROVIDES MEETING SPACE FOR NON-PROFIT AND COMMUNITY GROUPS WITH A HEALTH FOCUS SUCH AS THE AMERICAN RED CROSS, BABY & ME, PRENATAL & BREASTFEEDING SUPPORT, DAVITA KIDNEY SMART, AND WITC NURSING PROGRAM TOTALING $ 5,000. IN ORDER TO HELP COMBAT POVERTY, ARMC PROVIDES AMERY AREA FOOD SHELF WITH FREE RENT, HEAT AND SHELVING FOR FOOD ITEMS. IN 2017, OVER $ 74,000 WAS PROVIDED TO SUPPORT THIS LOCAL PROGRAM. 4. COMMUNITY BUILDING ACTIVITIES: $ 8,566 A.- COMMUNITY SUPPORT - ARMC PROVIDES MEETING SPACE FOR NON-PROFIT AND COMMUNITY GROUPS WITHOUT A HEALTH FOCUS SUCH AS THE GIRL SCOUTS AND POLK COUNTY EXTENSION TOTALING $ 150. B.- ENVIRONMENTAL IMPROVEMENTS - ARMC HAD 4 REPRESENTATIVES ATTEND THE ANNUAL CLEANMED CONFERENCE WHICH IS A NATIONAL ENVIRONMENTAL CONFERENCE FOR LEADERS IN HEALTH CARE SUSTAINABILITY. ONE REPRESENTATIVE CO-PRESENTED ON OUR LOCAL SUSTAINABILITY INITIATIVES. ARMC CONTINUES TO BE A SUSTAINABILITY CHAMPION AND HOSTS AN ELECTRONICS RECYCLING EVENT. C.- WORKFORCE DEVELOPMENT - ARMC HAS REPRESENTATIVES SERVE ON THE WITC MEDICAL ASSISTANT ADVISORY COMMITTEE, WITC ADVISORY COUNCIL, AND WITC HEALTH INFORMATION TECHNOLOGY ADVISORY COMMITTEE. A MOCK INTERVIEW DAY AT WITC WAS ATTENDED BY 2 ARMC STAFF INTENDED FOR STUDENTS CURRENTLY ENROLLED IN THE NURSING, MEDICAL ASSISTANT AND MEDICAL ADMINISTRATIVE SPECIALIST PROGRAMS. THIS INCLUDED PRACTICE INTERVIEW QUESTIONS AND RESUME REVIEW. 5. COMMUNITY BENEFIT OPERATIONS: $ 27,957 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 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 REQUESTED 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, AND REINFORCES 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 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. 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.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (26 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Direct Controlling NADirectControllingNACd	Controlled OrganizationControlledOrganizationInd	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
HEALTHPARTNERS INC
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	411693838	HYBRID STAFF MODEL/NETWORK MODEL HEALTH MAINTENANCE ORGANIZATION	MN	501(C)(4)	N/A	0
RH-WISCONSIN
8171 33RD AVE S PO BOX 1309	MPLS	MN	554401309	202287016	CORPORATE PLANNING AND OVERSIGHT	WI	501(C)(3)		0	509(A)(3) TYPE I	HPI - RAMSEY
HPI-RAMSEY
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	411793333	CORPORATE PLANNING AND OVERSIGHT	MN	501(C)(3)		0	509(A)(3) TYPE I	HEALTHPARTNERS INC
GROUP HEALTH PLAN INC
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	410797853	STAFF MODEL HEALTH MAINTENANCE ORGANIZATION	MN	501(C)(3)		0	170(B)(1) (A)(III)	HEALTHPARTNERS INC
HEALTHPARTNERS INSTITUTE
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	411670163	HEALTHCARE EDUCATION AND RESEARCH	MN	501(C)(3)		0	509(A)(3) TYPE I	HEALTHPARTNERS INC
CAPITOL VIEW TRANSITIONAL CARE CENTER
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	412011453	TRANSITIONAL CARE SERVICES, STEP DOWN FROM INPATIENT HOSPITAL	MN	501(C)(3)		0	170(B)(1) (A)(III)	HPI - RAMSEY
REGIONS HOSPITAL
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	410956618	HOSPITAL	MN	501(C)(3)		0	170(B)(1) (A)(III)	HPI - RAMSEY
REGIONS HOSPITAL FOUNDATION
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	411888902	PROVIDE SUPPORT TO HOSPITAL AND IMPORVE COMMUNITY HEALTH	MN	501(C)(3)		0	170(B)(1) (A)(VI)	HPI - RAMSEY
RHSC INC
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	411891928	HEALTHCARE STAFFING AND INTENSE REHAB SERVICES	MN	501(C)(3)		0	509(A)(3) TYPE II	HPI - RAMSEY
PHYSICIANS NECK AND BACK CLINICS
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	270684883	SPECIALTY PATIENT CARE	MN	501(C)(3)		0	509(A)(3) TYPE II	GROUP HEALTH PLAN INC
HUDSON HOSPITAL INC
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	390804125	HOSPITAL	WI	501(C)(3)		0	170(B)(1) (A)(III)	RH-WISCONSIN
HUDSON HOSPITAL FOUNDATION INC
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	391279567	PROVIDE SUPPORT TO HOSPITAL AND IMPORVE COMMUNITY HEALTH	WI	501(C)(3)		0	170(B)(1) (A)(VI)	HUDSON HOSPITAL INC
LAKEVIEW MEMORIAL HOSPITAL FOUNDATION
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	411386635	PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT	MN	501(C)(3)		0	509(A)(3) TYPE II	STILLWATER HEALTH SYSTEM
LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION INC
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	410811697	HOSPITAL	MN	501(C)(3)		0	170(B)(1) (A)(III)	STILLWATER HEALTH SYSTEM
STILLWATER MEDICAL GROUP
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	830379473	CLINIC STAFF AND FACILITIES	MN	501(C)(3)		0	509(A)(3) TYPE I	STILLWATER HEALTH SYSTEM
STILLWATER HEALTH SYSTEM
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	300221189	CORPORATE PLANNING AND OVERSIGHT	MN	501(C)(3)		0	509(A)(3) TYPE II	HPI - RAMSEY
WESTFIELDS HOSPITAL INC
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	390808442	HOSPITAL	WI	501(C)(3)		0	170(B)(1) (A)(III)	RH-WISCONSIN
WESTFIELDS HOSPITAL FOUNDATION INC
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	391770913	PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT	WI	501(C)(3)		0	170(B)(1) (A)(VI)	WESTFIELDS HOSPITAL INC
RAMSEY INTEGRATED HEALTH SERVICES
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	411503090	HOME CARE AND HOSPICE	MN	501(C)(3)		0	509(A)(2)	HPI - RAMSEY
PARK NICOLLET HEALTH SERVICES
6500 EXCELSIOR BLVD	ST LOUIS PARK	MN	55426	363465840	CORPORATE PLANNING AND OVERSIGHT	MN	501(C)(3)		0	509(A)(2)	HEALTHPARTNERS INC
PARK NICOLLET FOUNDATION
6500 EXCELSIOR BLVD	ST LOUIS PARK	MN	55426	237346465	SUPPORT TO RELATED ENTITIES AND COMMUNITY TO IMPROVE HEALTH	MN	501(C)(3)		0	170(B)(1) (A)(VI)	PARK NICOLLET HEALTH SERVICES
PARK NICOLLET METHODIST HOSPITAL
6500 EXCELSIOR BLVD	ST LOUIS PARK	MN	55426	410132080	HOSPITAL	MN	501(C)(3)		0	170(B)(1) (A)(III)	PARK NICOLLET HEALTH SERVICES
PARK NICOLLET HEALTH CARE PRODUCTS
6500 EXCELSIOR BLVD	ST LOUIS PARK	MN	55426	010638901	DURABLE MEDICAL EQUIPMENT , PHARMACY AND OTHER HEALTH CARE RETAIL SALES	MN	501(C)(3)		0	509(A)(3) TYPE I	PARK NICOLLET HEALTH SERVICES
PARK NICOLLET CLINIC
6500 EXCELSIOR BLVD	ST LOUIS PARK	MN	55426	410834920	CLINIC SERVICES	MN	501(C)(3)		0	170(B)(1) (A)(III)	PARK NICOLLET HEALTH SERVICES
PNMC HOLDINGS
6500 EXCELSIOR BLVD	ST LOUIS PARK	MN	55426	411741792	HEALTHCARE REAL ESTATE	MN	501(C)(3)		0	509(A)(3) TYPE I	PARK NICOLLET HEALTH SERVICES
AMERY REGIONAL MEDICAL CENTER FOUNDATION INC
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	391726539	PROVIDE SUPPORT TO HOSPITAL AND IMPORVE COMMUNITY HEALTH	WI	501(C)(3)		Yes (1)	170(B)(1) (A)(VI)	AMERY REGIONAL MEDICAL CENTER INC

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	AMERY REGIONAL MEDICAL CENTER PHARMACY LLC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	265 GRIFFIN STREET E	AddressLine1Txt
City	AMERY	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54001	ZIPCd

Field	Value	IRS element (for citing)
EIN	391979705	EIN
Primary Activities	PHARMACEUTICAL	PrimaryActivitiesTxt
Legal Domicile State	WI	LegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	AMERY REGIONAL MEDICAL CENTER	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Predominant Income Type	RELATED	PredominantIncomeTypeTxt
Share Of Total Income	-$69,674	ShareOfTotalIncomeAmt
Share Of EOY Assets	-$52,391	ShareOfEOYAssetsAmt
Disproportionate Allocations	0	DisproportionateAllocationsInd
General Or Managing Partner	Yes (1)	GeneralOrManagingPartnerInd
Ownership	0.50000	OwnershipPct

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd
HEALTHPARTNERS ADMINISTRATORS INC
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	411629390	THIRD PARTY ADMINISTRATOR	MN	HEALTHPARTNERS INC	C	0
HEALTHPARTNERS ASSOCIATES INC
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	522365151	MEDICAL CLINIC STAFFING AND ASSET MANAGEMENT	MN	HEALTHPARTNERS ADMINISTRATORS INC	C	0
HEALTHPARTNERS SERVICES INC
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	411683568	MEDICAL CLINIC STAFFING AND ASSET MANAGEMENT	MN	HEALTHPARTNERS ADMINISTRATORS INC	C	0
HEALTHPARTNERS INSURANCE COMPANY
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	411683523	MEDICAL AND DENTAL INSURANCE	MN	HEALTHPARTNERS ADMINISTRATORS INC	C	0
DENTAL SPECIALTIES INC
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	451297583	PROFESSIONAL DENTAL SERVICES	MN	HEALTHPARTNERS ADMINISTRATORS INC	C	0
HEALTHPARTNERS CENTRAL MINNESOTA CLINICS INC
8170 33RD AVE S PO BOX 1309	MPLS	MN	554401309	411236798	MEDICAL CLINIC STAFFING	MN	HEALTHPARTNERS ADMINISTRATORS INC	C	0
PARK NICOLLET ENTERPRISES
6500 EXCELSIOR BLVD	ST LOUIS PARK	MN	55426	411656735	REAL ESTATE FOR RELATED ORGANIZATIONS	MN	PARK NICOLLET HEALTH SERVICES	C	0

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (1)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (1)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	0	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	0	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (1)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	0	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (1)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	0	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	0	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	0	TransferToOtherOrgInd
Transfer From Other Org	0	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
HEALTHPARTNERS INC - CLAIMSHEALTHCARE SERVICES
L	$305,193	FAIR VALUE
AMERY REGIONAL MEDICAL CENTER FOUNDATION
C	$56,578	FAIR VALUE