2017-08-09T08:10:24-05:00 2016-09-30 390758449 WIPFLI LLP 3703 OAKWOOD HILLS PARKWAY/PO BOX 690 EAU CLAIRE WI 547020690 990 2015-10-01 260596045 UPLAND HILLS HEALTH FOUNDATION INC UPLA 6089308000 800 Compassion Way Dodgeville WI 53533 ARTHUR K PUSTINA Vice President of Finance 6089308000 2017-07-21 1 PAUL M TRACZEK CPA P01368830 7158323407 2017-07-19 2015 2021-01-29 14:40:06Z LISA SCHNEDLER 800 Compassion Way Dodgeville WI 53533 102347 0 X www.uplandhillshealth.org/Foundation X 2007 WI TO SOLICIT, RECEIVE, AND ACCEPT GIFTS AND BEQUESTS ON BEHALF OF UPLAND HILLS HEALTH, INC. 10 10 0 53 0 0 82490 67736 0 0 5372 21351 2187 11300 90049 100387 59008 40363 0 0 0 0 0 0 0 40 1399 59048 41762 31001 58625 1202951 1325258 269471 312332 933480 1012926 X The primary purpose of Upland Hills Health Foundation, Inc. is to record and facilitate philanthropic giving for Upland Hills Health, Inc. By serving as the gateway for all philanthropy, the Foundation office will maintain a complete giving history for donors to Upland Hills Health, ensuring that contributors are appropriately acknowledged, and that the philanthropy figures presented to external sources are as complete as possible. 0 0 40363 40363 THE UPLAND HILLS HEALTH FOUNDATION, Inc. IS OPERATED TO PROVIDE SUPPORT AND PERFORM FUNCTIONS FOR UPLAND HILLS HEALTH, INC., WHICH PROVIDES HEALTH CARE SERVICES TO THE RESIDENTS OF IOWA COUNTY, WISCONSIN, AND THE SURROUNDING AREAS. 40363 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 0 0 0 0 WI X ARTHUR K PUSTINA 6089308000 800 Compassion Way Dodgeville WI 53533 Dick Josh Director 1.00 X 0 0 0 Brad Laufenberg Director 1.00 1.00 X 0 0 0 Mark Masters Director 1.00 X 0 0 0 Deb Morgan Director 1.00 X 0 0 0 MARTHA BOYER VICE PRESIDENT 1.00 X X 0 0 0 TED GREENHECK Director 1.00 1.00 X 0 0 0 Skip Lee President 1.00 X X 0 0 0 Dave Wilke DIRECTOR 1.00 X 0 0 0 George Stauffer Treasurer 1.00 X X 0 0 0 Andrea Potterton Secretary 1.00 X X 0 0 0 LISA SCHNEDLEr President/Ceo - UHH 1.00 47.00 X X 0 263595 45411 Arthur K Pustina VP of Finance - UHH 1.00 54.00 X 0 154509 33422 0 418104 78833 0 0 1 0 0 67736 4635 67736 21351 21351 13260 1960 11300 11300 100387 0 0 32651 40363 40363 1399 1399 41762 40363 1399 0 1192101 1324308 10850 950 1202951 1325258 269471 312332 269471 312332 X 215059 227328 508039 575216 210382 210382 933480 1012926 1202951 1325258 58625 20821 0 X X 0 1 X 1 0 X 131362 87059 89984 82490 67736 458631 131362 87059 89984 82490 67736 458631 16396 442235 7718 7861 6337 5372 21351 48639 3872 1529 2457 2187 11300 21345 528615 0.83660 0.86730 X 216040 15695 231735 214947 1093 216040 213859 1088 214947 213277 1000 1504 -1922 213859 210220 2000 1057 213277 0.00000 0.90790 0.09210 0 0 0 Due to Upland Hills Health, Inc. 312332 312332 Part V, Line 4: Upland Hills Health Foundation, Inc.'s endowment fund consists of two funds held in the names of the individual donors. These funds were established to provide income for the Foundation to help support specific programs of Upland Hills Health, Inc. 1 UPLAND HILLS HEALTH INC 800 Compassion Way Dodgeville WI 53533 421017512 501(C)(3) 40363 Cash donated N/A TO ASSIST IN THE DELIVERY OF HEALTHCARE SERVICES TO INDIVIDUALS IN THE DODGEVILLE AREA. 1 0 Part I, Line 2: Upland Hills Health Foundation, Inc's Board of Directors reviews requests for donations from or offers to provide assistance to Upland Hills Health, Inc. to further the mission of Upland Hills Health, Inc. These grants are approved by the foundation's board of directors during its regularly scheduled board of directors' meetings throughout the year. 0 0 0 0 0 0 0 0 0 LISA SCHNEDLEr President/Ceo - UHH 0 261726 0 0 0 1869 0 21000 0 24411 0 309006 0 0 Arthur K Pustina VP of Finance - UHH 0 152008 0 0 0 2501 0 12172 0 21250 0 187931 0 0 Part I, Line 3 COMPENSATION PLANS AND POLICIES FOR THE OFFICERS NOTED ARE DETERMINED AND REVIEWED BY Upland Hills Health Foundation, Inc.'S PARENT ORGANIZATION, UPLAND HILLS HEALTH, INC. PROCEDURES OF UPLAND HILLS HEALTH, INC. INCLUDE COMPENSATION SURVEYS, WRITTEN EMPLOYMENT AGREEMENTS, AND APPROVAL BY THE BOARD OF DIRECTORS. Form 990, Part VI, Section A, line 6 Upland Hills Health, Inc. is the sole corporate member of Upland Hills Health Foundation, Inc. Form 990, Part VI, Section A, line 7a Upland Hills Health, Inc., the sole corporate member of Upland Hills Health Foundation, Inc., can appoint or remove members of the governing body and can also determine the number of governing members. Form 990, Part VI, Section A, line 7b CHANGES TO THE GOVERNING DOCUMENTS OF UPLAND HILLS HEALTH FOUNDATION, INC. REQUIRE APPROVAL OF ITS SOLE CORPORATE MEMBER, UPLAND HILLS HEALTH, INC. Form 990, Part VI, Section B, line 11 A COPY OF FORM 990 WAS PROVIDED TO THE ORGANIZATION'S BOARD OF DIRECTORS PRIOR TO FINAL SUBMISSION. RESPONSES ON THE 990 ARE ALSO REVIEWED BY THE VICE PRESIDENT OF FINANCE OF UPLAND HILLS HEALTH, INC. PRIOR TO ITS SUBMISSION TO THE IRS. Form 990, Part VI, Section B, line 12c UPLAND HILLS HEALTH FOUNDATION, INC. REQUIRES OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, AND HIGHEST-COMPENSATED EMPLOYEES TO COMPLETE AN ANNUAL DISCLOSURE STATEMENT. THESE STATEMENTS ARE THEN REVIEWED BY THE BOARD OF DIRECTORS, NOTING ANY RELATIONSHIPS THAT COULD POTENTIALLY CREATE A CONFLICT OF INTEREST. IF BOARD MEMBERS HAVE CONFLICTS OF INTEREST THAT ARE NOTED, THESE MEMBERS ARE ASKED TO ABSTAIN FROM VOTING ON THOSE MATTERS. Form 990, Part VI, Section B, line 15 The two officers of Upland Hills Health Foundation, Inc. are employed by Upland Hills Health, Inc. The compensation listed in form 990, Part VII relates to all the services they perform as an employee of Upland Hills Health, Inc. The board of directors of Upland Hills Health, Inc. has established a process to review the compensation of the officers. COMPARATIVE DATA FROM WAGE SURVEYS, AREA LABOR ADJUSTMENTS, AND MARKET RATES IN OTHER AREA FACILITIES ARE USED IN DETERMINING COMPENSATION. THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS OF UPLAND HILLS HEALTH, INC. REVIEWS AND APPROVES ANY EXCEPTIONS TO ACROSS-THE-BOARD RAISES AND STANDARD NEW HIRE WAGES. DURING THE REVIEW PROCESS, DECISIONS AFFECTING COMPENSATION AND CONTRACTS ARE ONLY REVIEWED AND APPROVED BY INDIVIDUALS WHO DO NOT HAVE NOTED CONFLICTS. THE DECISIONS AND DELIBERATION ARE ALSO DOCUMENTED IN THE MINUTES OF THE BOARD OF DIRECTORS UPON APPROVAL BY THE BOARD. Form 990, Part VI, Section C, line 19 UPLAND HILLS HEALTH FOUNDATION, INC. MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINAnCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT ITS BUSINESS LOCATION DURING NORMAL BUSINESS HOURS. FORM 990, PART XII, LINE 2C, OVERSIGHT OF AUDIT: THE BOARD OF DIRECTORS OF UPLAND HILLS HEALTH, INC. ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE CONSOLIDATED FINANCIAL STATEMENTS BY AN INDEPENDENT ACCOUNTANT. THE BOARD OF DIRECTORS OF UPLAND HILLS HEALTH, INC. ALSO APPROVES THE SELECTION OF THE INDEPENDENT AUDITORS AND HISTORICALLY HAS USED A PROCESS OF SOLICITATION OF SEALED BIDS FROM INDEPENDENT AUDIT FIRMS WITH HEALTHCARE AUDIT EXPERIENCE EVERY FIVE YEARS SO THAT THE AUDIT FIRM REVIEW IS DONE ON A REGULAR BASIS. THESE PROCESSES AND PROCEDURES HAVE NOT CHANGED IN THE CURRENT YEAR. Form 990, Part VI, Line 14, Document Retention and Destruction Policy: UPLAND HILLS HEALTH FOUNDATION, INC. ANSWERED "NO" TO THE QUESTION REGARDING A WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY, BECAUSE THIS SPECIFIC ORGANIZATION DOES NOT HAVE SUCH A POLICY IN PLACE. HOWEVER, UPLAND HILLS HEALTH FOUNDATION, INC. FOLLOWS THE WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY OF UPLAND HILLS HEALTH, INC. Form 990, Part VII, Section A, Related Party OFFICERS: EXPLANATION OF HOURS WORKED: The two officers of Upland Hills Health Foundation, Inc. are employed by Upland Hills Health, Inc. In addition to the hours worked as an officer of Upland Hills Foundation, Inc., they also work a minimum of an average of 40 hours per week performing other services for Upland Hills Health, Inc. The hours listed on the form 990 relate to their role as an officer, while the compensation listed relates to all the services they perform as an employee of Upland Hills Health, Inc. DETAIL OF HOURS WORKED/SERVED: Lisa Schnedler, President & CEO of Upland Hills Health, Inc. Worked approximately 48.00 hours per week as follows: Upland Hills Health, Inc. - 47.00 Hours Upland Hills Health Foundation, Inc. - 1 Hour A. KARL PUSTINA, VICE PRESIDENT OF FINANCE OF UPLAND HILLS HEALTH, INC., WORKED APPROXIMATELY 55 HOURS PER WEEK AS FOLLOWS: UPLAND HILLS HEALTH, INC. - 54 HOURS UPLAND HILLS HEALTH FOUNDATION, INC. - 1 HOUR BRAD LAUFENBERG, BOARD MEMBER, PROVIDED AN AVERAGE OF 2.0 HOURS OF SERVICE PER WEEK AS FOLLOWS: UPLAND HILLS HEALTH, INC. - 1 HOUR UPLAND HILLS HEALTH FOUNDATION, INC. - 1 HOUR TED GREENHECK, BOARD MEMBER, PROVIDED AN AVERAGE OF 2.0 HOURS OF SERVICE PER WEEK AS FOLLOWS: UPLAND HILLS HEALTH, INC. - 1 HOUR UPLAND HILLS HEALTH FOUNDATION, INC. - 1 HOUR Upland Hills Health Holdings LLC 800 Compassion Way Dodgeville WI 53533 800809494 Partnership for durable medical equipment provided to patients WI 0 0 Upland Hills Health Inc Upland Hills Health Inc 800 Compassion Way Dodgeville WI 53533 421017512 Hospital WI 501(c)(3) Line 3 N/A 0 0 1 1 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0