2017-08-01T09:54:14-05:00 2016-09-30 410746749 CLIFTONLARSONALLEN LLP 220 SOUTH SIXTH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2015-10-01 391091432 REEDSBURG AREA MEDICAL CENTER INC REED 6085246487 2000 NORTH DEWEY AVENUE REEDSBURG WI 53959 ROBERT VAN MEETEREN PRESIDENT/CEO 6085246487 2017-07-27 1 KOREY BOELTER P00775161 6123764500 2015 2021-01-29 14:40:06Z ROBERT VAN MEETEREN 2000 NORTH DEWEY AVENUE REEDSBURG WI 53959 77235539 0 X WWW.RAMCHEALTH.COM X 1967 WI PROVIDE QUALITY, COMPASSIONATE, & EFFECTIVE HEALTH CARE GOING BEYOND THE EXPECTED IN ALL WE DO. 12 9 609 160 225731 -79360 392525 799098 63510734 69597620 1035174 590308 979577 957812 65918010 71944838 571349 613660 0 0 32324150 35720498 0 0 0 29100472 31758319 61995971 68092477 3922039 3852361 76894045 79021118 30938693 28088096 45955352 50933022 X REEDSBURG AREA MEDICAL CENTER, ALWAYS THERE, GOING BEYOND THE EXPECTED TO PROVIDE COMPASSIONATE, QUALITY, AND EFFICIENT HEALTH CARE. 0 0 54428310 613660 65226590 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 4,766 PATIENT DAYS (1,590 DISCHARGED PATIENTS) DURING THE FISCAL YEAR ENDING 9/30/16. THIS INCLUDED 144 SWING BED DAYS FOR 24 PATIENTS, 392 OBSERVATION DAYS AND 278 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 9/30/16, 9,565 PATIENTS WERE SEEN IN THE EMERGENCY ROOM (RESULTING IN 972 INPATIENT ADMISSIONS) AND 4,891 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 WILL WORK TO ADDRESS. WE ARE COMMITTED TO MAKING POSITIVE IMPACTS IN THESE AREAS AND SHOW THIS THROUGH OUR COMMUNITY PARTNERSHIPS AND SUPPORT. RAMC IS COLLABORATING WITH COMMUNITY MEMBERS AND ORGANIZATIONS TO BEGIN WORK ON THE FORMATION OF A BOYS & GIRLS CLUB IN REEDSBURG, WHICH IS SET TO OPEN IN THE FALL OF 2017. BOYS AND GIRLS CLUB PROGRAMMING ALIGNS WITH ALL THREE IDENTIFIED HEALTH PRIORITIES, MAKING IT A NATURAL PARTNERSHIP WITH RAMC. WE HAVE JOINED FORCES WITH 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 AND 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 ARE ALSO PARTNERING 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 9/30/16, 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. RAMC EXPANDED AVAILABILITY OF FOOT AND ANKLE SERVICES WITH THE ADDITION OF DR. ELIZABETH BAKER, DPM TO OUR PODIATRY TEAM; DERMATOLOGY SERVICES WITH THE ADDITION OF PHYSICIAN ASSISTANT, SARAH MOTL; AND FAMILY PRACTICE SERVICES WITH THE ADDITION OF GINA DEGIOVANNI, MD TO OUR PHYSICIANS GROUP CLINIC. 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. 3658190 0 4371030 REEDSBURG AREA MEDICAL CENTER COMMUNITY PHARMACY IS CONVENIENTLY LOCATED ON THE RAMC CAMPUS WITHIN THE PHYSICIANS GROUP. TRADITIONALLY KNOWN FOR ITS CONVENIENCE FOR PATIENTS, RAMC COMMUNITY PHARMACY IS OPEN TO ALL MEMBERS OF THE PUBLIC. PATIENTS CAN FILL NEW PRESCRIPTIONS IN THE PHARMACY SO THEY DON'T NEED TO STOP ON THE WAY HOME AND THE CONVENIENT HOURS MAKES IT EASY TO CALL IN AND PICK UP REFILLS. IN ADDITION TO FILLING PRESCRIPTIONS, THE PHARMACY OFFERS AN EXTENSIVE ARRAY OF OVER-THE-COUNTER MEDICATIONS, VITAMINS AND SUPPLEMENTS, FIRST AID NEEDS AND PERSONAL ITEMS. 58086500 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 1 1 0 0 0 0 0 0 1 0 0 0 1 53 0 609 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 KURT MUCHOW CHAIRPERSON 0.50 X X 2100 0 0 DAN KLAHN VICE CHAIR 0.50 X X 2150 0 0 ERIC SAUEY TREASURER 0.50 X X 1750 0 0 KONYA ANTONETTI SECRETARY 0.50 X X 1350 0 0 BOB BASS TRUSTEE 0.50 X 2250 0 0 JAY BRUNKEN TRUSTEE 0.50 X 800 0 0 DEREK HORKAN TRUSTEE 0.50 X 600 0 0 JAMES SEBRANEK TRUSTEE 0.50 X 2050 0 0 MARY BETH SHEAR MD TRUSTEE 0.50 X 5360 0 0 RAYNELLE SYFTESTAD TRUSTEE 0.50 X 650 0 0 PAMELA WELCH TRUSTEE 0.50 X 1700 0 0 CHRIS WENNINGER MD MEDICAL ADVISOR 0.50 X 6080 0 0 BARRY BORCHERT CFO 40.00 X 171676 0 32092 BOB VAN MEETEREN PRESIDENT/CEO 40.00 X 326219 0 80673 DEAN FOCHIOS MD ORTHOPEDIC SURGEON 40.00 X 495934 0 60765 KEVIN HIBBETT MD GENERAL SURGEON 40.00 X 401594 0 41512 CHRISTOPHER ECKERMAN PODIATRIST 40.00 X 427787 0 54179 CHRISTOPHER BJORKLUND CRNA 40.00 X 298418 0 59067 KEVIN MCBRIDE CRNA 40.00 X 300086 0 59081 2448554 0 387369 32 0 1 0 WEBER ORTHOPEDICS 922 OTT LANE BARABOO WI 53913 ORTHOPEDIC SURGEON 841040 CLIFTONLARSONALLEN LLP 220 SOUTH 6TH STREET SUITE 300 MINNEAPOLIS MN 55402 ACCOUNTING / CONSULTING 109509 2 799098 799098 PATIENT SERVICE REVENUE 621400 64990593 64990593 PHARMACY REVENUE 446110 4371030 4145299 225731 CAFETERIA REVENUE 722310 235997 235997 69597620 347421 347421 345896 0 345896 345896 345896 5524572 9016 5283549 7152 241023 1864 242887 242887 MEAL REVENUE 722310 519355 519355 OTHER REVENUE 900099 92561 92561 611916 71944838 69371889 225731 1548120 X 422489 422489 191171 191171 688017 688017 26629494 22707669 3921825 1069644 912476 157168 5523606 4670657 852949 1809737 1509813 299924 196872 196872 61485 61485 4518 4518 11057404 9265161 1792243 350798 350798 1038912 727325 311587 226222 226222 910154 900971 9183 212779 142577 70202 675295 675295 2613631 2613631 261960 261960 MEDICAL SUPPLIES 10775649 10775317 332 REPAIRS & MAINTENANCE 1108871 1066807 42064 BAD DEBT EXPENSE 605580 605580 FOOD 548647 522955 25692 1109542 376606 732936 68092477 58086500 10005977 0 58334 55027 6213281 5449291 10254199 11104408 2453819 2227750 554793 629837 61565735 32723473 29636688 28842262 23574477 26169747 93576 91762 1136000 1136000 2918878 3315034 76894045 79021118 8001833 7309774 -11204 -13135 17835837 15508916 3116110 3568955 894000 596000 1102117 1117586 30938693 28088096 X 44445961 49324497 1509391 1608525 45955352 50933022 76894045 79021118 X 3852361 982013 143296 X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 4518 4518 0 PART II-B, LINE 1: REEDSBURG AREA MEDICAL CENTER(RAMC) PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THESE DUES ARE PRIMARILY TO ACCESS EDUCATIONAL MATERIALS AND FOR STAFF TRAINING. THE AHA AND WHA HAVE NOTIFIED RAMC THAT $4,518 OF THE ANNUAL DUES PAID WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITY WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT. 26703 26703 40346488 17122658 23223830 876333 452788 423545 19505174 15148027 4357147 811037 811037 28842262 DEFERRED COMPENSATION 1117586 1117586 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 2016 AND 2015. 1 1 X 1 X 1 X 1 1 1 0 1 1 150 909466 909466 0.01340 1450 7303493 5382302 1921191 0.02820 1600 8212959 5382302 2830657 0.04160 22735 342184 51057 291127 0.00430 146 218504 218504 0.00320 100 7728342 5574989 2153353 0.03160 4290 451060 451060 0.00660 27271 8740090 5626046 3114044 0.04570 28871 16953049 11008348 5944701 0.08730 1400 16426 16426 0.00020 400 50493 50493 0.00070 200 7876 7876 0.00010 5100 16039 16039 0.00020 7100 90834 90834 0.00120 0 605580 11767967 15809724 -4041757 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 HTTP://RAMCHEALTH.COM/MEDIA/267356/CHNA-16.PDF X 1 15 1 HTTP://RAMCHEALTH.COM/MEDIA/267356/CHNA-16.PDF 0 0 1 X 150.000000000000 400.000000000000 X X X X 1 1 X X X 1 X HTTP://RAMCHEALTH.COM/PATIENTS-VISITORS/PATIENT-RESOURCES/FINANCIAL-ASSISTA X HTTP://RAMCHEALTH.COM/PATIENTS-VISITORS/PATIENT-RESOURCES/FINANCIAL-ASSISTA X HTTP://RAMCHEALTH.COM/PATIENTS-VISITORS/PATIENT-RESOURCES/FINANCIAL-ASSISTA X X X X X 1 X 0 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 11: IN THE MOST RECENTLY COMPLETED CHNA, RAMC IDENTIFIED ACCESS TO MENTAL HEALTH, DRUG USE AND ABUSE, AND OBESITY AS THE TOP THREE PRIORITY AREAS CURRENTLY FACING THE COMMUNITY IT SERVES. MULTIPLE STEPS HAVE BEEN TAKEN AND STRATEGIES IMPLEMENTED TO ADDRESS THESE ISSUES AND IMPROVE THE OVERALL HEALTH OF THE COMMUNITY. PROPOSED ACTION PLAN1. ACCESS TO MENTAL HEALTH:A. PARTNER WITH SAUK COUNTY IN LOCAL SUICIDE PREVENTION COALITIONS.B. PARTICIPATE IN A QUESTION, PERSUADE, AND REFER (QPR) TRAINING PROGRAM IN CONJUNCTION WITH SAUK COUNTY HEALTH DEPARTMENT.C. CONDUCT AN ANNUAL DAY CAMP FOR KIDS THAT PROVIDES TOOLS FOR COPING WITH THE EFFECTS OF DRUGS OR ALCOHOL IN THEIR LIVES, IN EARLY 2017.D. CREATE COMMUNITY AWARENESS OF MENTAL HEALTH ISSUES WITH RADIO, NEWSLETTER & PRINT ARTICLES.E. PARTNER WITH VARIOUS COMMUNITY AGENCIES AND THE REEDSBURG SCHOOL DISTRICT ON EDUCATIONAL OUTREACH DEALING WITH MENTAL HEALTH, SUICIDE AND ALCOHOL & DRUG ABUSE AWARENESS IN STUDENTS.F. WORK COLLABORATIVELY TO BRING A BOYS AND GIRLS CLUB TO REEDSBURG.G. PARTNER WITH THE SAUK COUNTY HEALTH AND WELLNESS COALITION STEERING COMMITTEE TO IDENTIFY LOCAL PARTNERS TO BUILD A MENTOR/ROLE MODEL PROGRAM PROVIDING COACHING ON APPROPRIATE COMMUNICATION AND OTHER SOCIALLY ACCEPTABLE BEHAVIORS AND SKILLS.2. DRUG USE AND ABUSE:A. CONTINUE TO PARTNER WITH THE SAUK COUNTY HEALTH & WELLNESS COALITION TO BRING SPEAKERS, TREATMENT & RECOVERY INFORMATION TO OUR COMMUNITY, ESPECIALLY OUR SCHOOLSB. PARTNER 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 WILL BE EXPANDING THE CURRENT VIVITROL. PROGRAM AND ESSENTIALLY CREATE A MODEL FOR ADDRESSING ALCOHOL AND DRUG PROBLEMS THROUGHOUT THE COUNTY.C. HAVE SEVERAL RAMC EMPLOYEES SERVE ON THE C.A.R.E. (COMMUNITY ACTIVATED RECOVERY ENHANCEMENT) COALITION THAT IS BEING FORMED FOR REEDSBURG, AND ATTEND MONTHLY MEETINGS. - THE MISSION OF C.A.R.E. IS A COLLECTIVE GROUP OF AGENCIES, ORGANIZATIONS 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. - COMMUNITY STAKEHOLDERS INCLUDE PHYSICIANS, ATTORNEYS, PHARMACISTS, SAUK COUNTY HEALTH DEPARTMENT, HUMAN SERVICES DEPARTMENT, AND LAW ENFORCEMENT, STATE LEGISLATORS, PUBLIC DEFENDERS, COUNTY SUPERVISORS, PHARMACISTS, RN'S, ADDICTION RECOVERY ASSOCIATES & UW-EXTENSION.3. OBESITY:A. WORK COLLABORATIVELY TO BRING A BOYS AND GIRLS CLUB TO REEDSBURGB. BY DECEMBER 31, 2016, RAMC WILL PARTNER WITH THE SAUK COUNTY HEALTH AND WELLNESS COALITION STEERING COMMITTEE TO EXPAND THE MEMBERSHIP TO INCLUDE SCHOOLS, CITIZEN MEMBERS, AND PHILANTHROPIC ORGANIZATIONS.C. BY DECEMBER 31, 2017, DEVELOP A COUNTY WIDE CALENDAR OF EXERCISE AND NUTRITIONAL EVENTS AVAILABLE ON SOCIAL MEDIA OUTLETS OF THE SAUK COUNTY HEALTH AND WELLNESS COALITION STEERING COMMITTEE.D. PARTICIPATE IN COMMUNITY-BASED AND BUSINESS-SPECIFIC HEALTH FAIRS.E. HONOR REQUESTS FROM COMMUNITY ORGANIZATIONS FOR SPEAKERS AT HEALTHY LIFESTYLE PRESENTATIONS.F. CREATE COMMUNITY AWARENESS OF RAMC'S HEALTH4U OVERWEIGHT AND OBESITY PROGRAM THROUGH RADIO AND PRINT ADVERTISING.G. 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.H. EDUCATE THE COMMUNITY ON THE BENEFITS OF HEALTHY EATING AT LOCATIONS LIKE HEALTH FAIRS AND GROCERY STORES.I. WRITE ARTICLES PROMOTING FITNESS IN THE COMMUNITY AND IN-HOUSE.J. CONTINUE TO SUPPORT AND FUND THE SCHOOL DISTRICT S WALKING PROGRAM TITLED "WALKING CLUB" FOR ALL SCHOOL CHILDREN AT ALL 5 ELEMENTARY SCHOOLS.K. CONTINUE TO PROVIDE A FREE SUMMER WALKING PROGRAM FOR FAMILIES.L. CONTINUE TO HOST RAMC S ANNUAL KIDS FIT & SAFE DAY.NEEDS NOT BEING ADDRESSEDTHERE IS NO LIMIT TO THE NUMBER OF ISSUES TO WHICH A HEALTHCARE INSTITUTION COULD DEVOTE RESOURCES. TIME, PEOPLE, AND MONEY OFTEN ARE LIMITING FACTORS FOR WHY WE CANNOT DO MORE. HOWEVER, PREVAILING WISDOM SUGGESTS AN ORGANIZATION LIKE RAMC MUST FOCUS ON A FEW HIGH PRIORITY PROJECTS AND MAKE EVERY EFFORT TO AVOID DUPLICATION AND ENCOURAGE COLLABORATION AND COORDINATION WITH OTHER ORGANIZATIONS AND COMMUNITY GROUPS. AS RAMC ASSESSED UNMET HEALTH NEEDS AND DETERMINED ITS PRIORITIES, WE ALSO EVALUATED THOSE ISSUES WE COULD NOT ADDRESS OR WERE BEING ADDRESSED BY OTHERS.A. HIGH RATES OF UNINTENTIONAL INJURY AND TRAFFIC CRASHES ARE BEING ADDRESSED BY OTHERS INCLUDING LAY ENFORCEMENT AND STATE LEVEL EXPERTS THROUGH INITIATIVES SUCH AS MANDATORY SEAT BELT LAWS, SPEED LIMIT ENFORCEMENT, AND "NO TEXTING WHILE DRIVING" LAWS. AS A RURAL COMMUNITY, FARM SAFETY CONTINUES TO BE A PRIORITY WHICH THE HOSPITAL CONTINUES TO ADDRESS BY SUPPORTING ANNUAL EVENTS LIKE RURAL SAFETY DAY.B. SMOKING/TOBACCO USE IS BEING ADDRESSED BY RAMC THROUGH OUR "SIT TO QUIT" MINDFULNESS CESSATION PROGRAM. IT IS ALSO BEING ADDRESSED BY OTHERS WITHIN THE COMMUNITY, INCLUDING HEALTH EXPERTS AT A STATE LEVEL, THROUGH THE IMPLEMENTATION OF A STATEWIDE SMOKING BAN, EFFECTIVE JULY 2010, AND REMEDIATION PROGRAMS. SINCE 2012, THE PERCENTAGE OF ADULT SMOKERS IN SAUK COUNTY HAS DECREASED.C. MALNUTRITION IS AN ISSUE THAT IS ALREADY BEING ADDRESSED IN THE COMMUNITY. SCHOOL DISTRICTS ARE OFFERING MORE PROGRAMS TO BRING FOOD TO CHILDREN YEAR ROUND. FOOD PANTRIES IN THE COMMUNITY ARE CONSTANTLY BEING REFRESHED TO SUPPLY HEALTHY OPTIONS. 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. REEDSBURG AREA MEDICAL CENTER PART V, SECTION B, LINE 22D: PATIENTS WHOSE FAMILY INCOME DOES NOT MAKE THEM ELIGIBLE FOR ALLOWANCES AT 100% WILL RECEIVE SERVICES AT AMOUNTS NO GREATER THAN AMMOUNTS GENERALLY BILLED (AGB). AGB IS CALCULATED ANNUALLY BY DIVIDING THE TOTAL MEDICARE, MEDICAID, COMMERCIAL AND MANAGED CARE PAYMENTS FOR THE PRIOR FISCAL YEAR BY TOTAL CHARGES FOR THOSE SAME PAYORS (LOOK BACK METHOD). THIS PERCENTAGE IS THEN APPLIED TO ALL ACCOUNTS COVERED BY 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 (THE "HOSPITAL") 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. 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. 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 $605,580. PART II, COMMUNITY BUILDING ACTIVITIES: 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. 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 NEW 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 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: MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY UNINSURED PATIENTS AND AMOUNTS PATIENTS ARE PERSONALLY RESPONSIBLE FOR, THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO A VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF HISTORICAL COLLECTION LIKELIHOOD AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUTSTANDING AFTER THE HOSPITAL HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO ACCOUNTS RECEIVABLE. 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 REEDSBURG AREA MEDICAL CENTER PROVIDES TO THE 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, 2015, 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 THE ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY. PART III, LINE 9B: UNDER THE HOSPITAL'S COLLECTION AND CHARITY CARE POLICIES, REEDSBURG AREA MEDICAL CENTER 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: EVERY THREE YEARS, REEDSBURG AREA MEDICAL CENTER CONDUCTS A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), MEASURING AWARENESS, PREFERENCE, IMAGE AND COMMUNITY NEEDS. THE HOSPITAL CONDUCTS THE CHNA WITHIN THE PRIMARY SERVICE AREA, WHICH INCLUDES THE CITY OF REEDSBURG AND THE SURROUNDING COMMUNITIES. IN ADDITION, THERE IS A FEEDBACK SECTION ON THE HOSPITAL'S WEBSITE, WWW.RAMCHEALTH.COM, ALLOWING A FORUM FOR WHICH THE PUBLIC CAN PROVIDE SUGGESTIONS AND COMMENTS. REEDSBURG AREA MEDICAL CENTER ALSO GATHERS DATA FROM THE SAUK COUNTY HEALTH NEEDS ASSESSMENT. THIS INFORMATION HAS BEEN SEGMENTED INTO THE HOSPITAL'S PRIMARY SERVICE AREEA. 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 IMPLENTATION STRATEGIES. PART VI, LINE 3: CHARITY CARE NOTICES ARE POSTED THROUGHOUT THE FACILITY AND APPLICATIONS ARE AVAILABLE AT ALL POINTS OF ADMISSION AND THROUGH BUSINESS SERVICES. NOTICES OF THE COMMUNITY CARE AND FINANCIAL ASSISTANCE POLICY ARE MADE AVAILABLE ON EVERY BILLING STATEMENT AND THE COMMUNITY CARE AND FINANCIAL ASSISTANCE POLICY, PLAIN LANGUAGE SUMMARY AND COMMUNITY CARE APPLICATION ARE ALL AVAILABLE ON THE RAMC WEBSITE AT WWW.RAMCHEALTH.COM/FINANCIALASSISTANCE. THE PATIENT, PATIENT'S REPRESENTATIVE, OR HOSPITAL REPRESENTATIVE MAY INITIATE INQUIRIES REGARDING ELIGIBILTY 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 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. ALONG WITH FINANCIAL ADVISORS AND SOCIAL WORKERS, BOTH A CONSUMER ADVOCATE AND A MARKET PLACE SPECIALIST ARE AVAILABLE, AT NOT COST, AS ADDITIONAL PATIENT RESOURCES. THE CONSUMER ADVOCATE OFFERS COMPLIMENTARY PATIENT ASSISTANCE SERVICES, INCLUDING, BUT NOT LIMITED TO, QUESTIONS/ISSUES PERTAINING TO MEDICARE, MEDICAID, PRIVATE INSURANCE, INTERPRETATION OF EXPLANATION OF BENEFITS (EOBS), AND DIRECTIONS TO ADDITIONAL CONSUMER RESOURCES. THE MARKET PLACE SPECIALIST IS TRAINED TO HELP CONSUMERS ENROLL IN HEALTH COVERAGE THROUGH THE INSURANCE MARKET PLACE EXCHANGE. 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. ACCORDING TO THE MOST RECENT U.S. CENSUS DATA AVAILABLE, SAUK COUNTY HAS SEEN POPULATION GROWTH OF 11% FROM 2000-2010, WHILE THE STATE OF WISCONSIN EXPERIENCED GROWTH OF JUST 6%. THE CITY OF REEDSBURG GREW AT A RATE OF 18% AND ITS MINORITY POPULACE INCREASED FROM 3% TO 7% OF TOTAL POPULATION FOR THE SAME TIME PERIOD COMPARED TO 8% FOR SAUK COUNTY AND 17% FOR THE STATE OF WISCONSIN. 23% OF COUNTY RESIDENTS ARE UNDER THE AGE OF 18 (22% STATE), 17% ARE ABOVE THE AGE OF 65 (16% STATE) AND 46% OF SAUK COUNTY LIVES IN RURAL AREAS (30% STATE). THE MEDIAN HOUSEHOLD INCOME REPORTED FOR SAUK COUNTY IS $52,000 ($55,600 STATE) WHILE UNEMPLOYED IS 4.2% (4.6% STATE). 40% OF COUNTY CHILDREN ARE ELIGIBLE FOR FREE SCHOOL LUNCH (41% STATE) WHILE 17% LIVE IN POVERTY (17% STATE). 12% OF COUNTY ADULTS AND 7% OF COUNTY CHILDREN ARE UNINSURED (10% AND 5% RESPECTIVELY FOR WISCONSIN). 2% OF COUNTY RESIDENTS (2% STATE) REPORTED NOT SEEING A DOCTOR FOR THE PRIOR 12 MONTHS DUE TO COST WHILE 33% (26% STATE) 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. 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. 1 REEDSBURG AREA SENIOR LIFE CENTER 2350 NORTH DEWEY AVE REEDSBURG WI 54959 760775289 501(C)(3) 402000 GENERAL OPERATIONS REEDSBURG AREA MEDICAL CENTER FOUNDATION 2090 RIDGEVIEW DR REEDSBURG WI 53959 391243616 501(C)(3) 14000 COMMUNITY CLINIC VOUCHER PROGRAM 2 0 TUITION ASSISTANCE 55 131378 FMV STIPENDS 41 12500 FMV PART I, LINE 2: GRANTS WERE PROVIDED BY REEDSBURG AREA MEDICAL CENTER (RAMC) TO REEDSBURG AREA SENIOR LIFE CENTER. RAMC HAS (AT LEAST MONTHLY) ACCESS TO THIS ORGANIZATION'S FINANCIAL RECORDS AND BOARD MEETING MINUTES, ALLOWING FOR REVIEW OF HOW FUNDS ARE ALLOCATED. RAMC ALSO 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 0 0 0 0 BARRY BORCHERT CFO 163276 0 8400 0 0 0 10789 0 21303 0 203768 0 0 0 BOB VAN MEETEREN PRESIDENT/CEO 269404 0 44100 0 12715 0 58041 0 22632 0 406892 0 0 0 DEAN FOCHIOS MD ORTHOPEDIC SURGEON 495934 0 0 0 0 0 37250 0 23515 0 556699 0 0 0 KEVIN HIBBETT MD GENERAL SURGEON 357094 0 44500 0 0 0 21639 0 19873 0 443106 0 0 0 CHRISTOPHER ECKERMAN PODIATRIST 413364 0 0 0 14423 0 31250 0 22929 0 481966 0 0 0 CHRISTOPHER BJORKLUND CRNA 290292 0 0 0 8126 0 37250 0 21817 0 357485 0 0 0 KEVIN MCBRIDE CRNA 300086 0 0 0 0 0 37250 0 21831 0 359167 0 0 0 PART I, LINE 4B ROBERT VAN MEETEREN - 457(F)PLAN - $8,833 A CITY OF REEDSBURG 396005582 2003-06-03 2600000 REFUND SERIES 1992 BONDS 0 0 0 B WISCONSIN HEALTH & EDUCATION FACILITIES 391337855 97710BXK3 2010-09-16 5800000 REFUND SERIES 2006 BONDS 0 0 0 C WISCONSIN HEALTH & EDUCATION FACILITIES 391337855 97710BXP2 2014-02-19 4273300 REFUND SERIES 2010 BONDS 0 0 0 D WISCONSIN HEALTH & EDUCATION FACILITIES 391337855 2015-11-10 6556441 REFUND SERIES 2006 BONDS 0 0 0 A 1778946 2600000 60955 2600000 1992 1 0 1 1 B 995000 5800000 713761 116000 5104000 2006 1 0 1 1 C 372175 4273300 4273300 2006 1 0 1 1 D 574704 6556441 130120 6556441 2006 0 1 1 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 D 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 1 0 0 0 0 B 0 1 0 0 0 0 0 0 0 C 0 1 0 0 1 0 0 0 1 D 0 1 0 0 0 0 0 0 1 A 0 B 0 C 0 D 0 LINDSEY MUCHOW FAMILY MEMBER OF DIRECTOR 54643 EMPLOYMENT COMPENSATION 0 JAMES SHEAR FAMILY MEMBER OF DIRECTOR 129252 EMPLOYMENT COMPENSATION 1 RYAN SHEAR FAMILY MEMBER OF DIRECTOR 67699 EMPLOYMENT COMPENSATION 1 HAILEY SYFTESTAD FAMILY MEMBER OF DIRECTOR 13164 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 ELECT 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 COMMITTE 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 11 UPON COMPLETION OF THE FORM 990, MANAGEMENT REVIEWS FOR ACCURACY AND COMPLETENESS. UPON APPROVAL, THE FORM 990 IS 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 M 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. THE CEO REVIEWS AND APPROVES THE COMPENSATION OF THE 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 IX, LINE 11G PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 6,103,194. MANAGEMENT AND GENERAL EXPENSES 203,403. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,306,597. CONTRACTUAL SERVICES: PROGRAM SERVICE EXPENSES 3,161,967. MANAGEMENT AND GENERAL EXPENSES 1,588,840. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,750,807. FORM 990, PART XI, LINE 9: NET CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION 143,296. REEDSBURG AREA MEDICAL CENTER FOUNDATION 2000 NORTH DEWEY AVE REEDSBURG WI 53959 391243616 FUNDRAISING WI 501(C)(3) LINE 11C, 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