2017-05-08T09:26:25-05:00 2016-09-30 420714325 RSM US LLP 227 W FIRST ST STE 700 DULUTH MN 558021926 990 2015-10-01 237013497 MEMORIAL MEDICAL CENTER INC MEMO 7156855515 1615 MAPLE LANE ASHLAND WI 54806 KENT DUMONSEAU CFO 7156855515 2017-04-28 1 MARY BETH SANTORI P00023783 2187275025 2015 2021-01-29 14:40:06Z JASON DOUGLAS 1615 MAPLE LANE ASHLAND WI 54806 82454822 0 X WWW.ASHLANDMMC.COM X 1968 WI INPATIENT AND OUTPATIENT MEDICAL SERVICES. 14 13 437 169 26340 4606 56584 129259 67690397 74091124 1139417 917483 106618 56150 68993016 75194016 45605 146606 0 0 29333739 31238271 0 0 0 27083626 33469730 56462970 64854607 12530046 10339409 111198428 130164685 17773076 26195455 93425352 103969230 X MEMORIAL MEDICAL CENTER WILL REACH OUT AS A TRUSTED PARTNER TO IMPROVE THE HEALTH AND WELLNESS FOR PEOPLE OF OUR SOUTH SHORE REGION OF LAKE SUPERIOR. 0 0 54353668 146606 74064784 MEMORIAL MEDICAL CENTER (MMC) IS A CRITICAL ACCESS HOSPITAL WITH OVER 60 FULL-TIME PHYSICIANS ON STAFF AND OVER 400 EMPLOYEES. LOCATED IN THE CITY OF ASHLAND, MMC SERVES AS A REGIONAL MEDICAL REFERRAL CENTER FOR PATIENTS FROM SEVEN NORTHWESTERN WISCONSIN COUNTIES AND THE NEIGHBORING GOGEBIC COUNTY OF MICHIGAN. MMC OFFERS INPATIENT AND OUTPATIENT SERVICES INCLUDING: MEDICAL-SURGICAL; INTENSIVE CARE; OBSTETRICS INCLUDING LABOR, DELIVERY, POSTPARTUM AND RECOVERY (LDPR) SUITES; BEHAVIORAL HEALTH; AND 24-HOUR EMERGENCY CARE. INPATIENT AND OUTPATIENT SURGERIES INCLUDE: ORTHOPEDIC, UROLOGY, OPHTHALMOLOGY, ENT AND OB/GYN IN ADDITION TO GENERAL SURGERY. SUPPORT DIAGNOSTIC SERVICES INCLUDE: LABORATORY; RADIOLOGY WITH MRI, CT AND DIAGNOSTIC ULTRASOUND; NUTRITIONAL SERVICES; PHARMACY; ENDOSCOPY SUITES AND A SLEEP DISORDER CENTER. REHABILITATION SERVICES INCLUDE: CARDIAC REHABILITATION AND CARDIOPULMONARY REHABILITATION; PHYSICAL THERAPY AND SPORTS MEDICINE. LIFELINE EMERGENCY RESPONSE SYSTEM, HOSPICE SERVICES AND SOCIAL SERVICES ARE ALSO AVAILABLE WITHIN MMC. AN ADDITIONAL BUILDING ON THE MMC CAMPUS HOUSES THE BEHAVIORAL HEALTH SERVICES PROVIDING INPATIENT AND OUTPATIENT AODA AND MENTAL HEALTH CARE AND THERAPIES. MMC OPENED AS A PRIVATE, NOT-FOR-PROFIT HOSPITAL IN 1972, COMBINING THE SERVICES PREVIOUSLY PROVIDED BY TRINITY HOSPITAL AND ASHLAND COMMUNITY HOSPITAL, BOTH LOCATED IN ASHLAND. MMC IS THE ONLY HOSPITAL LOCATED IN ASHLAND, BAYFIELD AND IRON COUNTIES. 54353668 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 67 0 1 437 1 1 1 0 0 0 0 0 0 0 0 0 X 14 13 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X ART MERTIG 7156855500 1615 MAPLE LANE ASHLAND WI 54806 X MATTHEW ANICH BOARD MEMBER 1.00 2.00 X 0 0 0 SCOTT WARREN MD BOARD MEMBER 1.00 1.00 X 0 0 0 JOHN OUJIRI MD BOARD MEMBER 1.00 X 0 0 0 ANNE SULLIVAN BOARD MEMBER 1.00 2.00 X 0 0 0 PATRICIA SCHRAUFNAGEL CHAIR 1.00 1.00 X X 0 0 0 THOMAS JOKINEN BOARD MEMBER 1.00 X 0 0 0 CHRISTINE IVERSON VICE CHAIR 1.00 1.00 X X 0 0 0 T JAY JONES TREASURER 1.00 X X 0 0 0 WILLIAM SLOAN BOARD MEMBER 1.00 1.00 X 0 0 0 THOMAS CUNNINGHAM MD BOARD MEMBER 1.00 X 0 0 0 JASON DOUGLAS PRESIDENT/CEO - MMC 37.00 3.00 X X 359333 0 42504 STEVE BITZER SECRETARY 1.00 X X 0 0 0 PEGGY VAN HOLLEN-KMAN BOARD MEMBER 1.00 X 0 0 0 DEBORAH DRYER MD MEDICAL STAFF PRESIDENT 1.00 X X 0 0 0 KAREN HANSEN CHIEF OPERATING OFFICER - 40.00 X 191774 0 32837 KENT DUMONSEAU VICE PRESIDENT/CFO - REI 24.00 16.00 X 0 212602 38990 WILLIAM MATTILA PHARMACY DIRECTOR 40.00 X 158674 0 36941 PATRICK MARSHALL PHARMACIST 40.00 X 136870 0 28207 KATHRYN TUTTLE CLINICAL DIRECTOR OF NURSING 40.00 X 138184 0 32766 CARL BAUER DIRECTOR OF REHABILITATION SERVICES 40.00 X 133544 0 17179 LUKE BEIRL PHARMACIST 40.00 X 135865 0 19997 1254244 212602 249421 18 0 1 0 REGIONAL ENTERPRISES INC 1615 MAPLE LANE ASHLAND WI 54806 IS/ACCTNG/COMPLIANCE 4641320 THE BOLDT COMPANY 1001 TALL PINE LANE CLOQUET MN 557200287 CONTRUCTION COMPANY 2807714 SUPERIOR ANESTHESIA ASSOCIATES 301 ELLIS AVENUE SUITE 3 ASHLAND WI 54806 ANESTHESIA SERVICES 1375330 TAMARACK 1615 MAPLE LANE ASHLAND WI 54806 ER PRO-FEES 1216273 KAHLER SLATER 111 WEST WISCONSIN AVE MILWAUKEE WI 532032501 PROFESSIONAL DESIGN SERVICES 765889 15 17409 111850 129259 PATIENT SERV REV 621500 73376244 73349904 26340 MEDICARE EHR INCENTIVE PAYMENTS 524114 501541 501541 CAFETERIA 722210 182275 182275 OTHER OPERATING REVENUE 900099 31064 31064 74091124 407609 407609 330467 274317 56150 56150 56150 7496006 357 6983163 3326 512843 -2969 509874 509874 75194016 74064784 26340 973633 141606 141606 5000 5000 657848 657848 23225436 21154388 2071048 899607 819017 80590 4749907 4112303 637604 1705473 1515626 189847 190559 190559 328620 328620 3191585 3191585 1844281 1844281 153534 127058 26476 3856096 3136168 719928 144664 144664 UBI TAX 1000 1000 OTHER PROFESSIONAL SERV 12191607 12191607 NURSING SUPPLIES & OTHE 5595156 5595156 PROVISION FOR BAD DEBTS 3485837 3485837 2486791 2069902 416889 64854607 54353668 10500939 0 55749388 37390168 7879106 12184240 2055365 1691437 2191105 2683603 399247 637718 77061833 36451154 26951268 40610679 15782385 32402257 190564 2564583 111198428 130164685 8495675 7126505 8494245 13693950 783156 5375000 17773076 26195455 X 93425352 103969230 93425352 103969230 111198428 130164685 10339409 204469 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 4133 4133 0 PART II-B, LINE 1: MEMORIAL MEDICAL CENTER PAYS DUES TO CERTAIN ORGANIZATIONS RELATED TO THE INDUSTRY WHICH HAVE LOBBYING EXPENSES. THE AMOUNT LISTED IS THE PERCENTAGE OF THE DUES PAID THAT WERE USED FOR LOBBYING. 189441 189441 29900677 13638337 16262340 43256112 21236554 22019558 3715603 1576263 2139340 40610679 COLLABORATIVE AGREEMENT 5375000 5375000 X 72143076 204469 204469 71938607 3255409 3255409 75194016 61599198 277286 277286 61321912 3532695 3532695 64854607 PART X, LINE 2: NOT-FOR-PROFIT ORGANIZATIONS MAY BECOME SUBJECT TO INCOME TAXES IF QUALIFICATION AS A TAX-EXEMPT ENTITY CHANGES, IF UNRELATED BUSINESS INCOME IS GENERATED, AND IN CERTAIN OTHER INSTANCES. NOT-FOR-PROFIT ORGANIZATIONS ARE REQUIRED TO ASSESS THE CERTAINTY OF THEIR TAX POSITIONS RELATED TO THESE MATTERS AND, IN SOME CASES, RECORD LIABILITIES FOR POTENTIAL TAXES, INTEREST AND PENALTIES ACCOMPANIED BY FOOTNOTE DISCLOSURES. THE HOSPITAL HAS NOT IDENTIFIED ANY UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE THE ACCRUAL OF AN INCOME TAX PROVISION. GENERALLY, THE HOSPITAL IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY THE U.S. FEDERAL OR STATE TAX AUTHORITIES FOR YEARS BEFORE 2013. PART XI, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR DOUBTFUL RECEIVABLES 3,485,837. LOSS ON DISPOSAL OF PROPERTY -2,969. RECLASSIFICATION OF DONATIONS 46,858. RECLASSIFICATION OF RENTAL EXPENSES -274,317. PART XII, LINE 2D - OTHER ADJUSTMENTS: LOSS ON DISPOSAL OF PROPERTY 2,969. RECLASSIFICATION OF RENTAL EXPENSES 274,317. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR DOUBTFUL RECEIVABLES 3,485,837. RECLASSIFICATION OF DONATIONS 46,858. 1 1 1 X 1 X 1 1 1 0 1 1 382724 382724 0.00620 14138655 12931796 1206859 0.01970 14521379 12931796 1589583 0.02590 24148 24148 0.00040 65092 65092 0.00110 7039091 5803667 1235424 0.02010 168744 168744 0.00270 7297075 5803667 1493408 0.02430 21818454 18735463 3082991 0.05020 1 3485837 0 20968242 20938020 30222 X 1 1 1 1 MEMORIAL MEDICAL CENTER 1615 MAPLE LANE ASHLAND WI 54806 ASHLANDMMC.COM/ 1065 X X X X MEMORIAL MEDICAL CENTER 1 0 0 1 X X X X X X X X 15 1 0 1 1 X HTTP://ASHLANDMMC.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ X SEE PART V, PAGE 7 X X 1 15 1 HTTP://ASHLANDMMC.COM/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ 0 0 1 X 100.000000000000 200.000000000000 X X X 1 1 X X X 1 X HTTP://ASHLANDMMC.COM/PATIENT-INFORMATION/FINANCIAL-ASSISTANCE-POLICY/ X HTTP://ASHLANDMMC.COM/PATIENT-INFORMATION/FINANCIAL-ASSISTANCE-POLICY/ X HTTP://ASHLANDMMC.COM/PATIENT-INFORMATION/FINANCIAL-ASSISTANCE-POLICY/ X X X X X X 1 X 0 X X X X 1 X 0 0 MEMORIAL MEDICAL CENTER PART V, SECTION B, LINE 5: AS PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS, COMMUNITY INPUT WAS SOUGHT THROUGH SURVEYING 597 RESIDENTS WITHIN THE CHEQUAMEGON BAY REGION IN FALL OF 2015. SURVEY RESPONSES WERE SOUGHT VIA SOCIAL MEDIA, PRESS RELEASES PUBLISHED IN 8 AREA NEWSPAPERS, EMAIL OUTREACH AMONG PUBLIC HEALTH AND HOSPITAL OFFICIALS, COMMUNITY DROP BOXES AROUND THE REGION AND A SURVEYOR GATHERING DATA FROM UNDERSERVED POPULATIONS SUCH AS WORKING WITH SENIORS AT SENIOR MEALS AND THE AREA'S SENIOR CENTER, ATTENDING TRIBAL HEALTH FAIRS, AND CANVASING IN SOME OF OUR OUTLYING COMMUNITIES. AN ADDITIONAL STAKEHOLDER PRIORITIZING SESSION TOOK PLACE IN SEPTEMBER, 2015 WHICH HAS OVER 50 ATTENDEES INCLUDING LOCAL LAW ENFORCEMENT, SOCIAL SERVICES, PUBLIC HEALTH, ELECTED OFFICIALS, SCHOOL PERSONNEL, SOCIAL SERVICES AND CONCERNED CITIZENS. MEMORIAL MEDICAL CENTER PART V, SECTION B, LINE 6B: BAYFIELD COUNTY HEALTH DEPARTMENT AND ASHLAND COUNTY HEALTH & HUMAN SERVICES DEPARTMENT. MEMORIAL MEDICAL CENTER PART V, SECTION B, LINE 7D: FINALIZED REPORTS ARE DISTRIBUTED AT AREA LIBRARIES AND TO THE COUNTY BOARD MEMBERS OF ASHLAND AND BAYFIELD. MEMORIAL MEDICAL CENTER PART V, SECTION B, LINE 11: PART V, SECTION B, LINE 11: THE COORDINATED TEAM OF MEMORIAL MEDICAL CENTER, ASHLAND COUNTY HEALTH AND HUMAN SERVICES DEPARTMENT AND BAYFIELD COUNTY HEALTH DEPARTMENT DETERMINED THAT DUE TO THE MAGNITUDE OF THE NUMBER ONE HEALTH ISSUE IDENTIFIED, IT WAS ESSENTIAL TO FOCUS EFFORTS ON THAT AREA TO MAKE AN IMPACT ON THE OVERALL REGION. THIS DECISION WAS MADE IN PART DUE TO REGIONAL RESOURCE ALLOCATION AND THE SEVERE MAGNITUDE OF THE PROBLEM. IN ADDITION, A NUMBER OF ACTIVITIES WERE CURRENTLY GOING ON IN THE COMMUNITY AROUND MENTAL HEALTH AND NUTRITION/HEALTHY FOODS (ISSUES IDENTIFIED AS NUMBER 2 AND NUMBER 3)-BOTH OF WHICH MMC AND OTHER PARTNERS ARE ACTIVELY INVOLVED IN.THE FOLLOWING THREE GOALS AND ACTIVITY AROUND ALCOHOL AND OTHER DRUG ABUSE (AODA) TOOK PLACE WITHIN THE FIRST 18-MONTHS OF ESTABLISHING THE GOAL. IT INCLUDES: GOAL 1: RESEARCH OPPORTUNITIES TO IMPROVE RECOVERY CAPACITY OF BAYFIELD AND ASHLAND COUNTY RESIDENTS ADDICTED TO METHAMPHETAMINE AND BUILD INTERNAL CAPACITY TO ACHIEVE AND SUSTAIN A SYSTEMS LEVEL LOCAL RESPONSE.THE COMMUNITY HEALTH IMPROVEMENT PLAN STEERING COMMITTEE CONNECTED WITH THE COORDINATOR OF THE CHEQUAMEGON COALITION ON EMERGING DRUGS IN REGARDS TO HOW WE CAN WORK TOGETHER TO ADDRESS METH USE WITHIN OUR COMMUNITY. THIS GROUP IS PRIMARILY MOVING FORWARD ON THIS GOAL, WITH INPUT AND PARTICIPATION FROM CHIP MEMBERS.THE COALITION RECEIVED A FEDERAL FIVE-YEAR PARTNERSHIP FOR SUCCESS GRANT FOR $25,000 PER YEAR. THE FOCUS IS TO REDUCE AVAILABILITY AND ACCESS, INCREASE AWARENESS, FORM COLLABORATIONS AND INCREASE THE AMOUNT OF DATA FOR STATEWIDE USE OF ALL DRUGS, INCLUDING METHAMPHETAMINE. 2016 ACTIVITIES INCLUDE:- COLLABORATION WITH MELLEN POLICE DEPARTMENT AND LA POINTE POLICE DEPARTMENT TO IMPLEMENT A PRESCRIPTION DROP BOX AT EACH LOCATION.- COLLABORATION WITH MMC, DHS, LOCAL LAW ENFORCEMENT AND THE WITC WELDING PROGRAM TO CREATE MULTIPLE COMMUNITY SHARPS DROP BOX LOCATIONS. (MMC WOULD DISPOSE OF SHARPS BROUGHT).- PROVIDE FUNDING FOR LAW ENFORCEMENT OFFICERS MATT ALBERTUS AND MICHAEL ERON TO BECOME DRUG RECOGNITION EXPERTS. THIS PROGRAM TRAINS OFFICERS TO RECOGNIZE THE SIGNS AND SYMPTOMS OF IMPAIRMENT FROM THE SEVEN CATEGORIES OF DRUGS BY UTILIZING A TWELVE-STEP EVALUATION PROGRAM. OFFICERS TRAINED AS DRUG RECOGNITION EXPERTS (DRES) ARE FREQUENTLY CALLED UPON TO DIFFERENTIATE BETWEEN DRUG INFLUENCE AND MEDICAL AND/OR MENTAL DISORDERS, AND THE TRAINING IS AN EXTREMELY VALUABLE TOOL IN COMBATING THE ADVERSE IMPACT OF DRUG AND ALCOHOL-IMPAIRED DRIVING IN OUR COMMUNITIES.- HOSTED TWO REGIONAL COMMUNITY FORUMS AROUND DRUG USE AND ABUSE. THE FIRST WAS HELD AT WITC IN ASHLAND COUNTY. THE SECOND WAS HELD AT THE NORTHERN GREAT LAKES VISITOR CENTER IN BAYFIELD COUNTY TO COINCIDE WITH RECOVERY DAY. MMC WAS A SPONSOR AND PARTICIPATED IN BOTH OF THESE FORUMS.GOAL 2: IMPLEMENT STRATEGIES DESIGNED TO REDUCE ACCESS TO ALCOHOL BY INDIVIDUALS UNDER THE AGE OF 21 IN BAYFIELD AND ASHLAND COUNTIES.ASHLAND AND BAYFIELD COUNTIES WERE AWARDED A 5-YEAR, GRANT OF $100,000 PER YEAR TO ADDRESS ADOLESCENT HEALTH. AS PART OF THIS GRANT, EFFORTS AROUND ALCOHOL ABUSE ARE BEING ADDRESSED. ACTIVITIES TO DATE INCLUDE:- APPROXIMATELY 18 ADOLESCENTS FROM BAYFIELD COUNTY PARTICIPATED IN THE LEAD AND SEED TRAINING, CULTIVATING LEADERSHIP AND IMPROVED DECISION-MAKING SKILLS, IN NOVEMBER 2016. THAT SAME TRAINING WILL TAKE PLACE IN ASHLAND COUNTY IN 2017. ALSO CDC-RECOMMENDED CURRICULUM (WHICH INCLUDES ALCOHOL EDUCATION) TO IMPROVE ADOLESCENT HEALTH OUTCOMES HAS BEEN IMPLEMENTED IN FOUR SCHOOLS IN BAYFIELD COUNTY AND THREE SCHOOLS IN ASHLAND COUNTY.- YOUTH ADVISORY GROUPS HAVE BEEN FORMED IN THREE BAYFIELD COUNTY SCHOOLS AND TWO ASHLAND COUNTY SCHOOLS. THE ADVISORY GROUPS ADDRESS ADOLESCENT HEALTH CONCERNS IN THEIR COMMUNITIES, INCLUDING ALCOHOL AND DRUG ABUSE. THE WELLNESS FOR LIFE COALITION, MADE UP OF ADULTS IN LEADERSHIP ROLES FROM ASHLAND AND BAYFIELD COUNTIES, CONTINUE TO MEET AND SERVE AS THE STEERING COMMITTEE FOR THE ADVISORY GROUPS.RECOVERY SERVICES STAFF IS CURRENTLY INVOLVED IN THE ASHLAND SCHOOL DISTRICT'S AODA COMMITTEE, WHICH IS FOCUSING ON HOW TO BRING INCREASED EDUCATION AND AWARENESS AROUND AODA ISSUES WITHIN THE SCHOOL'S CURRICULUM.RECOVERY SERVICES STAFF IS ATTENDING THE CRIMINAL JUSTICE MEETINGS, WHICH FOCUS AROUND HOW LAW ENFORCEMENT ARE ADDRESSING RECOVERY IN OUR COMMUNITY. I.E EFFORTS UNDERWAY TO REDUCE AUTOMATIC FELONY STATUS FOR DRUG OFFENDERS IF THEY ARE WILLING TO COMPLETE A PROGRAM. ALSO, MANDATORY TEXTING OF UPCOMING COURT DATES ARE NOW REQUIRED FOR CRIMINAL OFFENDERS. ACCORDING TO DA, THIS HELPS DECREASE NO-SHOW RATES. MMC CONTINUES TO BE A PART OF THIS DIALOGUE. RECOVERY SERVICES STAFF IS ALSO PARTICIPATING IN DRUG COURT.CARRIE ALAJOKI, FORMER OB NURSE, IS WORKING WITH BHS TO SCREEN ALL UNDERAGE PATIENTS FOR ALCOHOL USE, AND THEN REFER THE POSITIVES TO COUNSELING SERVICES, AND PROVIDE THEM WITH RESOURCES UPON DISCHARGE. THIS IS PART OF HER DOCTORATE PROJECT AND IS BEING DONE IN COLLABORATION WITH THE DIRECTOR OF RECOVERY SERVICES AND THE IN-PATIENT BHS NURSE MANAGER.GOAL 3: ADVOCATE AND EDUCATE FOR POLICY CHANGE TO DECREASE AODA ABUSE IN ASHLAND AND BAYFIELD COUNTIES.BAYFIELD COUNTY, IN COLLABORATION WITH MMC WAS AWARDED A 2-YEAR COMMUNITY OPPORTUNITY GRANT FOR $25,000 PER YEAR. FUNDS FROM THE COMMUNITY OPPORTUNITY GRANT WILL BE USED TO ADDRESS THE HARMFUL EFFECTS OF ALCOHOL ABUSE AND MISUSE IN NORTHWEST WISCONSIN. MORE SPECIFICALLY, THE PROJECT, WHICH IS IN COORDINATION WITH THE AREA'S LOCAL COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) COALITION, WILL FOCUS ON INCREASING AWARENESS OF ALCOHOL ABUSE IN OUR REGION TO REGIONAL DECISION-MAKERS, AS WELL AS FACILITATE POLICY AND ENVIRONMENTAL CHANGES TO UTILIZE BEST PRACTICES ON ALCOHOL AVAILABILITY VIA OUTLET DENSITY, LICENSING AND SALES. ACTIVITIES TO DATE INCLUDE:- FACT SHEET ON SPECIFIC ALCOHOL STATISTICS/COSTS/IMPACT FOR ASHLAND, BAYFIELD, DOUGLAS AND SAWYER COUNTIES HAS BEEN ESTABLISHED.- INFORMATION SHEETS ON EVIDENCE-BASED RECOMMENDATIONS FOR FESTIVAL LICENSING, SERVER TRAINING AND PLACE OF LAST DRINK. STILL RESEARCHING MOST CURRENT STATISTICS FOR NUMBER OF DEATHS ARRESTS AND MOTOR VEHICLE CRASHES CAUSED BY ALCOHOL IN WISCONSIN BEFORE SHARING BEST PRACTICES AND RECOMMENDATIONS TO LOCALLY ELECTED BOARDS.IN ADDITION, THE FOLLOWING ACTIVITIES HAVE TAKEN PLACE WITHIN MMC SURROUNDING OUR AODA GOALS.VOICES FOR RECOVERY: LEAD BY MMC RECOVERY SERVICES STAFF. HOSTING A COLOR RUN ON JUNE 24. HOSTED A ST. PATTY'S DAY SAFE AND SOBER PARTY AT THE BRETTINGS CENTER. ANOTHER ONE IS SCHEDULED FOR APRIL 7. ADDITIONAL EVENTS ARE STILL BEING SCHEDULED, BUT WILL INCLUDE A FALL RECOVERY SERVICES DAY PICNIC AS PART OF RECOVERY AWARENESS MONTH.BAY AREA HEALTH EDUCATION COALITION: MMC IS A SPONSOR, PARTICIPANT AND CO-PLANNER OF EVENTS. THE MAY 16 EVENT AT WITC FOCUSES AROUND EMERGING DRUGS AND THE RECOVERY PROCESS. JAY GIANCOLA FROM RECOVERY SERVICES WILL BE SPEAKING, AMONG OTHER COMMUNITY LEADERS AND INDIVIDUALS WITHIN RECOVERY.REGIONAL AODA MEETING: MMC CONVENED, WITH THE ASSISTANCE OF MIKE CASHMAN FROM THE ADOLESCENT HEALTH GRANT, THE 5 REGIONAL COALITIONS ADDRESSING AODA (BAD RIVER, RED CLIFF, HAVE YOU HAD ENOUGH/BAYFIELD COUNTY, COALITION ON EMERGING DRUGS AND THE COMMUNITY HEALTH IMPROVEMENT PLAN COALITION) THIS PAST FALL AT THE NORTHERN GREAT LAKES VISITOR CENTER. APPROXIMATELY 65 PEOPLE ATTENDED. WE PROVIDED UPDATES AND FOUND COMMONALITIES WHERE WE MIGHT BE ABLE TO SHARE INFORMATION AND RESOURCES. I.E. PARENTS WHO HOST, LOSE THE MOST. THIS WILL LIKELY BECOME AN ANNUAL SHARING OF INFORMATION EVENT. MEMORIAL MEDICAL CENTER PART V, SECTION B, LINE 16I: THE FINANCIAL ASSISTANCE POLICY IS PUBLISHED IN THE LOCAL NEWSPAPER. MEMORIAL MEDICAL CENTER PART V, SECTION B, LINE 22D: FOLLOWING A DETERMINATION OF FINANCIAL-ASSISTANCE ELIGIBILITY, THE ELIGIBLE INDIVIDUAL WILL NOT BE CHARGED MORE FOR EMERGENCY OR MEDICALLY NECESSARY CARE THAN THE AMOUNTS GENERALLY BILLED (AGB) TO INDIVIDUALS WITH INSURANCE COVERING SUCH CARE.AT MMC THE AGB IS DETERMINED THROUGH THE "LOOK-BACK METHOD" WHICH IS CALCULATED AS FOLLOWS:FOR 2017, MMC IS USING THE "LOOK-BACK METHOD" TO CALCULATE THE AGB. THIS METHOD BASED AGB ON FULLY ALLOWED PAYMENTS AMOUNTS FOR HOSPITAL CLAIMS WITH A PRIMARY PAYER OF EITHER MEDICARE FEE FOR SERVICE OR A COMMERCIAL PAYER DURING THE PERIOD 9/1/15-8/31/16. MMC DIVIDES THE SUM OF TOTAL PAYMENTS ALLOWED BY THOSE PAYERS (INCLUDING COINSURANCE, COPAYMENTS, AND DEDUCTIBLES) BY THE SUM OF TOTAL HOSPITAL CHARGES FOR THOSE CLAIMS TO IDENTIFY THE "AGB PERCENTAGE".MMC WILL NOT CHARGE PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE MORE THAN BELOW-NOTED AGB PERCENTAGE FOR EMERGENCY OR MEDICALLY NECESSARY SERVICES IN 2016-2017.AGB FOR THE PERIOD 10/1/16-9/30/2017 (UNLESS EARLIER UPDATED) WILL BE 60 PERCENT OF TOTAL HOSPITAL CHARGES.MMC WILL RE-CALCULATE ITS AGB AT LEAST ANNUALLY.THE CURRENT DISCOUNT RATES OFFERED TO ELIGIBLE INDIVIDUALS ARE: 55% FOR INDIVIDUALS AT OR BELOW 100% OF THE FEDERAL POVERTY GUIDELINE 45% FOR INDIVIDUALS AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINE PART V, SECTION B, LINE 7B CHNA REPORT, OTHER WEBSITE: HTTP://WWW.ASHLANDCOUNTYWI.GOVOFFICE3.COM/VERTICAL/SITES/%7B215E4EAC-21AA-4D0B-8377-85A847C0D0ED%7D/UPLOADS/2015-2017CHIP.PDF PART I, LINE 7: COSTS ARE CALCULATED USING FINANCIAL DATA AND THE COST TO CHARGE RATIO FROM THE AS FILED 2016 MEDICARE COST REPORT. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES INCLUDE CARDIAC REHABILITATION, PHYSICAL THERAPY, PSYCHIATRIC/PSYCHOLOGICAL SERVICES AND BEHAVIORAL HEALTH INPATIENT, AND OBSERVATION BEDS. PART I, LN 7 COL(F): BAD DEBT EXPENSE FROM FINANCIAL STATEMENTS IS $3,485,837. PART III, LINE 2: IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AS A PERCENTAGE OF SELF-PAY AND OTHER RECEIVABLES HAS DECREASED FROM 30.5 PERCENT FOR THE YEAR ENDED SEPTEMBER 30, 2015 TO 29.9 PERCENT FOR THE YEAR ENDED SEPTEMBER 30, 2016. PART III, LINE 3: AT MEMORIAL MEDICAL CENTER, INC. BAD DEBT IS CONSIDERED THE UNWILLINGNESS TO PAY, WHILE CHARITY CARE AND FREE CARE ARE INABILITY TO PAY. PART III, LINE 4: SEE FOOTNOTE 1 ON PAGE 7 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: MEMORIAL MEDICAL CENTER, INC. IS A CRITICAL ACCESS HOSPITAL THAT IS REIMBURSED AT 101% OF COST (LESS 2% MEDICARE SEQUESTRATION). THE MEDICARE FEES FOR REIMBURSED SERVICES RESULTED IN NET REVENUE OF $694,694 AND ALLOWABLE COSTS OF $1,645,885 RESULTING IN A SHORTFALL OF $951,191. THE SHORTFALL IS THE RESULT OF UNREIMBURSED PROFESSIONAL CARE. THE MEDICARE ADVANTAGE FEES FOR REIMBURSED SERVICES RESULTED IN NET REVENUE OF $3,706,140 AND ALLOWABLE COSTS OF $4,026,440 RESULTING IN A SHORTFALL OF $320,300.THE HOSPITAL FOLLOWED MEDICARE'S PRESCRIBED METHODS OF DETERMINING COSTS PAYABLE UNDER TITLE XVIII (MEDICARE) IN COMPLETING ITS ANNUAL MEDICARE COST REPORT (COST REPORT) USING DATA AVAILABLE FROM THE INSTITUTION'S BASIC ACCOUNTS, AS USUALLY MAINTAINED, TO ARRIVE AT EQUITABLE AND PROPER PAYMENT FOR SERVICES. THE COST REPORT WAS COMPLETED USING THE HOSPITAL'S TRIAL BALANCE OF EXPENSES, AS WELL AS OTHER STATISTICAL AND FINANCIAL RECORDS MAINTAINED BY THE HOSPITAL. AS REQUIRED BY MEDICARE REGULATIONS, CERTAIN RECLASSIFICATIONS AND ADJUSTMENTS TO COSTS WERE INCLUDED IN THE COST REPORT TO DETERMINE MEDICARE ALLOWABLE COSTS.AFTER MEDICARE ALLOWABLE COSTS ARE DETERMINED, THE COST REPORT PROVIDES FOR THE STEP DOWN METHOD OF COST FINDING. THIS METHOD PROVIDES FOR ALLOCATING THE COST OF SERVICES RENDERED BY EACH GENERAL SERVICE COST CENTER TO OTHER COST CENTERS, WHICH UTILIZE THE SERVICES. ONCE THE COSTS OF A GENERAL SERVICE COST CENTER HAVE BEEN ALLOCATED, THAT COST CENTER IS CONSIDERED CLOSED. ONCE CLOSED, IT DOES NOT RECEIVE ANY OF THE COSTS SUBSEQUENTLY ALLOCATED FROM THE REMAINING GENERAL SERVICE COST CENTERS. AFTER ALL COSTS OF THE GENERAL SERVICE COST CENTERS HAVE BEEN ALLOCATED TO THE REMAINING COST CENTERS, THE TOTAL COSTS OF THESE REMAINING COST CENTERS ARE FURTHER DISTRIBUTED TO THE DEPARTMENTAL CLASSIFICATION TO WHICH THEY PERTAIN, E.G., HOSPITAL GENERAL INPATIENT ROUTINE, SUBPROVIDER, ANCILLARY, ETC.AFTER THE STEP-DOWN PROCESS, THE COST REPORT PROVIDES FOR THE APPORTIONMENT OF COSTS TO THE MEDICARE PROGRAM BASED ON A NUMBER OF DIFFERENT METHODOLOGIES INCLUDING PER PATIENT DAY, PER VISIT, AND PERCENTAGE OF CHARGES, AS MOST PREVALENT. MEDICARE COSTS AS DETERMINED BY THE COST REPORT METHODOLOGIES DESCRIBED PREVIOUSLY WERE UTILIZED TO COMPLETE THE APPLICABLE MEDICARE ALLOWABLE COSTS OF CARE FOR SCHEDULE H (FORM 990) PART III SECTION B LINE 6. PART III, LINE 9B: MEMORIAL MEDICAL CENTER'S BILLING AND COLLECTION POLICY STATES:A. SUBJECT TO COMPLIANCE WITH THE PROVISIONS OF THIS POLICY, MMC MAY TAKE ANY AND ALL LEGAL ACTIONS, INCLUDING EXTRAORDINARY COLLECTION ACTIONS (ECAS), TO OBTAIN PAYMENT FOR MEDICAL SERVICES PROVIDED.B. ALL PATIENTS WILL BE OFFERED A PLAIN LANGUAGE SUMMARY (APPENDIX A) AND AN APPLICATION FORM (APPENDIX B) FOR FINANCIAL ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY (FAP) AS PART OF THE DISCHARGE OR INTAKE PROCESS FROM A HOSPITAL.C. AT LEAST THREE SEPARATE STATEMENTS FOR COLLECTION OF SELF-PAY ACCOUNTS SHALL BE MAILED OR EMAILED TO THE LAST KNOWN ADDRESS OF EACH RESPONSIBLE INDIVIDUAL(S); PROVIDED, HOWEVER, THAT NO ADDITIONAL STATEMENTS NEED BE SENT AFTER A RESPONSIBLE INDIVIDUAL(S) SUBMITS A COMPLETE APPLICATION FOR FINANCIAL ASSISTANCE UNDER THE FAP OR HAS PAID IN-FULL. AT LEAST 60 DAYS SHALL HAVE ELAPSED BETWEEN THE FIRST AND LAST OF THE REQUIRED THREE MAILINGS. IT IS THE RESPONSIBLE INDIVIDUAL(S) OBLIGATION TO PROVIDE A CORRECT MAILING ADDRESS AT THE TIME OF SERVICE OR UPON MOVING. IF AN ACCOUNT DOES NOT HAVE A VALID ADDRESS, THE DETERMINATION FOR "REASONABLE EFFORT" WILL HAVE BEEN MADE. ALL SINGLE PATIENT ACCOUNT STATEMENTS OF SELF-PAY ACCOUNTS WILL INCLUDE BUT NOT LIMITED TO:1. AN ACCURATE SUMMARY OF THE HOSPITAL SERVICES COVERED BY THE STATEMENT;2. THE CHARGES FOR SUCH SERVICES;3. THE AMOUNT REQUIRED TO BE PAID BY THE RESPONSIBLE INDIVIDUAL(S) (OR, IF SUCH AMOUNT IS NOT KNOWN, A GOOD FAITH ESTIMATE OF SUCH AMOUNT AS OF THE DATE OF THE INITIAL STATEMENT); AND4. A CONSPICUOUS WRITTEN NOTICE THAT NOTIFIES AND INFORMS THE RESPONSIBLE INDIVIDUAL(S) ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE UNDER THE HOSPITAL FAP INCLUDING THE TELEPHONE NUMBER OF THE DEPARTMENT AND DIRECT WEBSITE ADDRESS WHERE COPIES OF DOCUMENTS MAY BE OBTAINED.D. AT LEAST ONE OF THE STATEMENTS MAILED OR EMAILED WILL INCLUDE WRITTEN NOTICE THAT INFORMS THE RESPONSIBLE INDIVIDUAL(S) ABOUT THE ECAS THAT ARE INTENDED TO BE TAKEN IF THE RESPONSIBLE INDIVIDUAL(S) DOES NOT APPLY FOR FINANCIAL ASSISTANCE UNDER THE FAP OR PAY THE AMOUNT DUE BY THE BILLING DEADLINE. SUCH STATEMENT MUST BE PROVIDED TO THE RESPONSIBLE INDIVIDUAL(S) AT LEAST 30 DAYS BEFORE THE DEADLINE SPECIFIED IN THE STATEMENT. A PLAIN LANGUAGE SUMMARY WILL ACCOMPANY THIS STATEMENT. IT IS THE RESPONSIBLE INDIVIDUAL(S) OBLIGATION TO PROVIDE A CORRECT MAILING ADDRESS AT THE TIME OF SERVICE OR UPON MOVING. IF AN ACCOUNT DOES NOT HAVE A VALID ADDRESS, THE DETERMINATION FOR "REASONABLE EFFORT" WILL HAVE BEEN MADE.E. RESPONSIBLE INDIVIDUAL(S) PROPENSITY TO PAY WILL BE SCORED BASED ON THAT ASSESSMENT OF THE RESPONSIBLE INDIVIDUAL(S) LIKELIHOOD TO PAY AND DOLLAR AMOUNT OF THE SELF-PAY ACCOUNT.F. MMC OFFERS PAYMENT PLANS THAT BEAR NO INTEREST. GENERALLY, BALANCE REQUIRE A MINIMUM PAYMENT OF $25.00 PER MONTH AND MUST BE PAID IN FULL WITHIN 24 MONTHS.G. PRIOR TO INITIATION OF ANY ECAS, AN ORAL ATTEMPT WILL BE MADE TO CONTACT RESPONSIBLE INDIVIDUAL(S) BY TELEPHONE AT THE LAST KNOWN TELEPHONE NUMBER, IF ANY, AT LEAST ONCE DURING THE SERIES OF MAILED OR EMAILED STATEMENTS IF THE ACCOUNT REMAINS UNPAID. DURING ALL CONVERSATIONS, THE PATIENT OR RESPONSIBLE INDIVIDUAL(S) WILL BE INFORMED ABOUT THE FINANCIAL ASSISTANCE THAT MAY BE AVAILABLE UNDER THE FAP.H. ECAS MAY BE COMMENCED AS FOLLOWS:1. IF ANY RESPONSIBLE INDIVIDUAL(S) FAIL TO APPLY FOR FINANCIAL ASSISTANCE UNDER THE FAP BY 120 DAYS AFTER THE FIRST POST DISCHARGE STATEMENT, AND THE RESPONSIBLE PARTIES HAVE RECEIVED A STATEMENT WITH A BILLING DEADLINE DESCRIBED IN SECTION III.E ABOVE, THEN MMC OR COLLECTION AGENCY MAY INITIATE ECAS.2. IF ANY RESPONSIBLE INDIVIDUAL(S) SUBMITS AN INCOMPLETE APPLICATION FOR FINANCIAL ASSISTANCE UNDER THE FAP PRIOR TO THE APPLICATION DEADLINE, THEN ECAS MAY NOT BE INITIATED UNTIL AFTER EACH OF THE FOLLOWING STEPS HAS BEEN COMPLETED:A. PFS PROVIDES THE RESPONSIBLE INDIVIDUAL(S) WITH A WRITTEN NOTICE THAT DESCRIBES THE ADDITIONAL INFORMATION OR DOCUMENTATION REQUIRED UNDER THE FAP IN ORDER TO COMPLETE THE APPLICATION FOR FINANCIAL ASSISTANCE, WHICH NOTICE WILL INCLUDE A COPY OF THE PLAIN LANGUAGE SUMMARY.B. PFS PROVIDES THE RESPONSIBLE INDIVIDUAL(S) WITH AT LEAST 30 DAYS' PRIOR WRITTEN NOTICE OF THE ECAS THAT MMC OR COLLECTION AGENCY MAY INITIATE AGAINST THE RESPONSIBLE INDIVIDUAL(S) IF THE FAP APPLICATION IS NOT COMPLETED OR PAYMENT IS NOT MADE; PROVIDED, HOWEVER, THAT THE COMPLETION DEADLINE FOR PAYMENT MAY NOT BE SET PRIOR TO 120 DAYS AFTER THE FIRST POST DISCHARGE STATEMENT.C. IF THE RESPONSIBLE INDIVIDUAL(S) WHO HAS SUBMITTED THE INCOMPLETE APPLICATION COMPLETES THE APPLICATION FOR FINANCIAL ASSISTANCE, AND PFS DETERMINES DEFINITIVELY THAT THE RESPONSIBLE INDIVIDUAL(S) IS INELIGIBLE FOR ANY FINANCIAL ASSISTANCE UNDER THE FAP, MMC WILL INFORM THE RESPONSIBLE INDIVIDUAL(S) IN WRITING THE DENIAL AND INCLUDE A 30 DAYS' PRIOR WRITTEN NOTICE OF THE ECAS THAT MMC OR COLLECTION AGENCY MAY INITIATE AGAINST THE RESPONSIBLE INDIVIDUAL(S); PROVIDED, HOWEVER, THAT THE BILLING DEADLINE MAY NOT BE SET PRIOR TO 120 DAYS AFTER THE FIRST POST DISCHARGE STATEMENT.D. IF THE RESPONSIBLE INDIVIDUAL(S) WHO HAS SUBMITTED THE INCOMPLETE APPLICATION FAILS TO COMPLETE THE APPLICATION BY THE COMPLETION DEADLINE SET IN THE NOTICE PROVIDED PURSUANT TO SECTION III.G.3.B ABOVE, THEN ECAS MAY BE INITIATED.E. IF AN APPLICATION, COMPLETE OR INCOMPLETE, FOR FINANCIAL ASSISTANCE UNDER THE FAP IS SUBMITTED BY A RESPONSIBLE INDIVIDUAL(S), AT ANY TIME PRIOR TO THE APPLICATION DEADLINE, MMC WILL SUSPEND ECAS WHILE SUCH FINANCIAL ASSISTANCE APPLICATION IS PENDING.I. AFTER THE COMMENCEMENT OF ECAS IS PERMITTED UNDER SECTION III.G ABOVE, COLLECTION AGENCIES SHALL BE AUTHORIZED TO REPORT UNPAID ACCOUNTS TO CREDIT AGENCIES, AND TO FILE JUDICIAL OR LEGAL ACTION, GARNISHMENT, OBTAIN JUDGMENT LIENS AND EXECUTE UPON SUCH JUDGMENT LIENS USING LAWFUL MEANS OF COLLECTION; PROVIDED, HOWEVER, THAT PRIOR APPROVAL OF PFS SHALL BE REQUIRED BEFORE INITIAL LAWSUITS MAY BE INITIATED. MMC AND EXTERNAL COLLECTION AGENCIES MAY ALSO TAKE ANY AND ALL LEGAL OTHER ACTIONS INCLUDING BUT NOT LIMITED TO TELEPHONE CALLS, EMAILS, TEXTS, MAILING NOTICES, AND SKIP TRACING TO OBTAIN PAYMENT FOR MEDICAL SERVICES PROVIDED.IV. POLICY AVAILABILITYCONTACT OUR BUSINESS OFFICE AT 715-934-4267 FOR INFORMATION REGARDING ELIGIBILITY OR THE PROGRAMS THAT MAY BE AVAILABLE TO YOU, TO REQUEST A COPY OF THE FAP, FAP APPLICATION FORM, OR COLLECTION POLICY TO BE MAILED TO YOU, OR IF YOU NEED A COPY OF THE FAP, FAP APPLICATION FORM, OR COLLECTION POLICY TRANSLATED TO SPANISH. FULL DISCLOSURE OF THE FAP, FAP APPLICATION FORM, OR COLLECTION POLICY MAY BE FOUND AT WWW.ASHLANDMMC.COM. A PAPER COPY OF OUR FAP, FAP APPLICATION FORM, OR COLLECTION POLICY CAN BE OBTAINED AT OUR FACILITY LOCATED AT 1615 MAPLE LANE, ASHLAND, WI 54806 AT THE REGISTRATION DESK. PART VI, LINE 2: MEMORIAL MEDICAL CENTER IS WORKING WITH LOCAL ORGANIZATIONS INCLUDING ASHLAND AND BAYFIELD COUNTY AND LOCAL SENIOR CITIZEN GROUPS TO PUT TOGETHER A 3 YEAR COMMUNITY NEEDS ASSESSMENT. THE PROCESS WILL INCLUDE SURVEYS OF AREA GROUPS AND INDIVIDUALS TO GAIN A PERSPECTIVE OF NEEDS THAT LOCAL CITIZENS BELIEVE ARE NECESSARY TO MEET THE HEALTHCARE NEEDS OF THE AREA. PART VI, LINE 3: NOTICES ARE PUBLISHED IN THE LOCAL NEWSPAPER, INTERVIEWS ARE CONDUCTED AT ADMISSION AND FOR THOSE PATIENTS PREADMITTED INFORMATION IS DISTRIBUTED AND INTERVIEWS CONDUCTED TO EXPLORE ALL THE AVENUES AVAILABLE FOR PAYMENT OF THEIR HEALTHCARE SERVICES TO INCLUDE THEIR ELIGIBILITY FOR CHARITY CARE. PART VI, LINE 4: MEMORIAL MEDICAL CENTER SERVES AN AREA THAT EXTENDS 25 MILES WEST, 75 MILES EAST AND 45 MILES SOUTH. OUR PRIMARY SERVICE AREA HAS A POPULATION OF APPROX. 35,000 PEOPLE. THE AVERAGE INCOME OF OUR SERVICE AREA IS WELL BELOW STATE AVERAGES. PART VI, LINE 5: MEMORIAL MEDICAL CENTER DOES HAVE AN OPEN MEDICAL STAFF WITH A BROAD RANGE OF SPECIALTIES. THE MEMBERS OF THE MEDICAL STAFF PROVIDE SERVICES OUT OF TWO LARGER CLINICS AS WELL AS MANY SMALL INDEPENDENT PRACTICES. ALL HAVE EQUAL PRIVILEGES ON THE MEDICAL STAFF. IN ADDITION WE HAVE A BOARD OF DIRECTORS THAT REPRESENT THE LARGER SERVICE AREA. BOARD OF DIRECTORS COME FROM COMMUNITIES 30-40 MILES FROM ASHLAND AS WELL AS REPRESENTATIVES FROM ASHLAND AND WASHBURN (10 MILES AWAY). PART VI, LINE 6: MEMORIAL MEDICAL CENTER IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. PART VI, LINE 7, REPORTS FILED WITH STATES WI 1 ESSENTIA HEALTH FOUNDATION 130 WEST SUPERIOR ST DULUTH MN 55801 271984704 501(C)(3) 32824 GENERAL SUPPORT ASHLAND CARES 301 ELLIS AVENUE ASHLAND WI 54806 473650960 501(C)(3) 20300 GENERAL SUPPORT DRUMMOND AREA SCHOOL DISTRICT 52440 EASTERN AVENUE PO BOX 40 DRUMMOND WI 54832 396001738 BAYFIELD COUNTY 30000 CARDIO EQUIPMENT HOWARD SANDIN SCHOLARSHIP FUND 1615 MAPLE LANE ASHLAND WI 54806 237013497 501(C)(3) 5000 GENERAL SUPPORT MELLEN SCHOOL DISTRICT 420 SOUTH MAIN STREET PO BOX 500 MELLEN WI 54546 396008011 ASHLAND COUNTY 30000 FITNESS EQUIPMENT DULUTH SUPERIOR AREA COMMUNITY 222 EAST SUPERIOR STREET SUITE 302 DULUTH MN 55802 411429402 501(C)(3) 10000 2016 DISASTER 6 0 SCHOLARSHIPS 10 5000 PART I, LINE 2: THE HOSPITAL REQUIRES RECIPIENTS TO PROVIDE DOCUMENTATION SUPPORTING EXPENDITURE OF RELATED GRANT FUNDS RECEIVED. EXPENDITURES ARE REQUIRED TO QUALIFY FOR THE PURPOSE THE GRANT/AWARD WAS GIVEN OR THE FUNDS ARE REQUIRED TO BE RETURNED. X X X X 0 0 0 0 0 0 0 0 0 JASON DOUGLAS PRESIDENT/CEO - MMC 318149 0 23184 0 18000 0 13250 0 29254 0 401837 0 0 0 KAREN HANSEN CHIEF OPERATING OFFICER - 177307 0 14467 0 0 0 6967 0 25870 0 224611 0 0 0 KENT DUMONSEAU VICE PRESIDENT/CFO - REI 0 197118 0 15484 0 0 0 9848 0 29142 0 251592 0 0 WILLIAM MATTILA PHARMACY DIRECTOR 158674 0 0 0 0 0 7891 0 29050 0 195615 0 0 0 PATRICK MARSHALL PHARMACIST 136870 0 0 0 0 0 7176 0 21031 0 165077 0 0 0 KATHRYN TUTTLE CLINICAL DIRECTOR OF NURSING 138184 0 0 0 0 0 6963 0 25803 0 170950 0 0 0 CARL BAUER DIRECTOR OF REHABILITATION SERVICES 133544 0 0 0 0 0 6647 0 10532 0 150723 0 0 0 LUKE BEIRL PHARMACIST 135865 0 0 0 0 0 6361 0 13636 0 155862 0 0 0 A ASHLAND COUNTY WISCONSIN 396005666 2011-09-20 10000000 CONSTRUCT AND EQUIP FACILITY 0 0 0 B BAYFIELD COUNTY WISCONSIN 396005670 2011-10-05 3827785 CONSTRUCT AND EQUIP FACILITY 0 0 0 C ASHLAND COUNTY WISCONSIN 396005666 2014-12-29 7120000 CONSTRUCT AND EQUIP FACILITY 0 0 0 A 5046614 10000000 10000000 2012 0 0 0 0 B 1935753 3827785 3827785 2012 0 0 0 0 C 107670 7120000 123433 6996567 2016 0 0 0 0 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 C 0 0 0 0 0 0 1 A 0 0 1 0 1 0 0 0 1 B 0 0 1 0 1 0 0 0 1 C 0 0 1 0 1 0 0 0 1 A 1 B 1 C 1 FORM 990, PART VI, SECTION A, LINE 6 REGIONAL ENTERPRISES, INC. IS THE SOLE CORPORATE MEMBER OF MEMORIAL MEDICAL CENTER, INC. FORM 990, PART VI, SECTION A, LINE 7A REGIONAL ENTERPRISES, INC. MAY ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B IN ADDITION TO DOING ALL THINGS REQUIRED BY LAW, REI, AS THE SOLE MEMBER OF MMC, SHALL HAVE THE FOLLOWING RESERVE POWERS: A) THE POWER TO MAKE, AMEND, OR REPEAL MMC'S BYLAWS AND ARTICLES OF INCORPORATION. B) TO APPROVE ANY CHANGE IN MMC'S PHILOSOPHY, MISSION OR VISION STATEMENTS, AND APPROVE THE LONG-RANGE GOALS AND STRATEGIC PLAN FOR MMC. C) TO APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGET. D) TO APPROVE ALL BUILDING PROGRAMS THAT EXCEED $1,000,000 IN VALUE. E) TO SELECT AND RETAIN AN INDEPENDENT AUDING FIRM. F) TO APPROVE THE PURCHASE, SALE, LEASE, DISPOSITION, OR ALIENATION OF ANY REAL PROPERTY OWNED BY MMC. G) TO APPROVE ANY PLAN OF DISSOLUTION OR MERGER, CONSOLIDATION, ACQUISITION OR DISPOSITION OF REAL PROPERTY OR RELOCATION OF THE FACILITIES OF MMC. H) BASED ON A RECOMMENDATION FROM THE BOARD OF DIRECTORS OF MMC, TO APPOINT AND MONITOR THE PERFORMANCE OF THE PRESIDENT/CEO OF REI, WHO SHALL ALSO SIMULTANEOUSLY SERVE AS THE PRESIDENT/CEO OF MMC. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 MUST GO THROUGH AN ADMINISTRATIVE REVIEW AND THEN BE APPROVED BY THE BOARD OF DIRECTORS BEFORE IT IS FILED. FORM 990, PART VI, SECTION B, LINE 12C A. DEFINITIONS 1. AN "INTERESTED PERSON" MEANS ANY CURRENT DIRECTOR, PRINCIPAL OFFICER OR MEMBER OF A COMMITTEE THAT REPORTS TO THE BOARD OF DIRECTORS. IF A PERSON MEETS THE DEFINITION OF AN INTERESTED PERSON FOR REI OR ANY OF ITS AFFILIATED CORPORATIONS, THAT PERSON SHALL BE CONSIDERED AN INTERESTED PERSON FOR ALL CORPORATIONS WITH THE REI SYSTEM. 2. AN "INSIDER" MEANS ANY PERSON WHO IS IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF REI. FOR PURPOSES OF APPLYING THE PROCEDURES OF THIS POLICY, THE FOLLOWING WILL BE CONSIDERED INSIDERS: ANY INTERESTED PERSON AS DEFINED HEREIN; THE MANAGERS AT REI AND ITS AFFILIATED CORPORATIONS; AND MEMBERS OF THE VARIOUS MEDICAL STAFFS AT MEMBERS' HOSPITALS. FOR PURPOSES OF THIS PROTOCOL, A "MANAGER" INCLUDES ANY PERSON WHO MANAGES A DISCRETE SEGMENT OR ACTIVITY OF REI, OR ANY OF ITS AFFILIATES, THAT REPRESENTS A SUBSTANTIAL PORTION (I.E., 10% OR MORE) OF THE ACTIVITIES, ASSETS, INCOME, OR EXPENSES OF REI OR SUCH AFFILIATE AS COMPARED TO THE ORGANIZATION AS A WHOLE. FINALLY, ANYONE WHO HAS BEEN AN INTERESTED PERSON AT ANY TIME IN THE PAST FIVE (5) YEARS AND ANYONE WHO WAS A MEMBER OF ANY MEDICAL STAFF OF A MEMBER HOSPITAL AT SOME TIME IN THE PAST FIVE (5) YEARS, SHALL BE CONSIDERED AN INSIDER. 3. FOR PURPOSES OF THIS POLICY, "FAMILY" OF AN INSIDER SHALL MEAN: A. SUCH INDIVIDUAL'S SPOUSE AND THE PARENTS AND SIBLINGS OF THE SPOUSE; B. SUCH INDIVIDUAL'S PARENTS, GRANDPARENTS, SIBLINGS (WHOLE OR HALF BLOOD OR BY ADOPTIONS), CHILDREN, GRANDCHILDREN AND GREAT GRANDCHILDREN; AND C. SPOUSES OF SUCH INDIVIDUAL'S GRANDPARENTS, SIBLINGS, CHILDREN, GRANDCHILDREN, AND GREAT GRANDCHILDREN. B. DISCLOSURE 1. EACH DIRECTOR AND OFFICER SHALL DISCLOSE TO THE BOARD OF DIRECTORS, OR TO THE OTHER MEMBERS OF ANY COMMITTEE CONSIDERING A PROPOSED BUSINESS TRANSACTION OR ARRANGEMENT, THE EXISTENCE AND NATURE OF ANY FINANCIAL INTEREST SUCH PERSON OR A MEMBER OF SUCH PERSON'S FAMILY MAY HAVE WITH RESPECT TO SUCH PROPOSED TRANSACTION OR ARRANGEMENT. EACH DIRECTOR AND PRINCIPAL OFFICER SHALL PROMPTLY MAKE DISCLOSURES AS MAY BE NECESSARY TO KEEP THE BOARD OR COMMITTEE FULLY APPRISED OF SUCH PERSON'S FINANCIAL INTERESTS. DISCLOSURE SHALL ALSO BE ACCOMPLISHED ON AN ANNUAL BASIS BY HAVING EACH DIRECTOR AND PRINCIPAL OFFICER EXECUTE AND DELIVER TO REI A CERTIFICATE REGARDING CONFLICTS OF INTEREST IN SUBSTANTIALLY THE FORM ATTACHED TO THIS POLICY. 2. THE REQUIREMENT THAT INTERESTED PERSONS DISCLOSE THEIR FINANCIAL INTERESTS SUBSTANTIALLY REQUIRES EACH DIRECTOR AND PRINCIPAL OFFICER TO DISCLOSE ANY INSIDER TRANSACTION IN WHICH HE OR SHE, HIS/HER FAMILY MEMBERS OR A CONTROLLED ENTITY ARE INVOLVED. THIS OCCURS BECAUSE THE DEFINITION OF A FINANCIAL INTEREST IS BROADER THAN THE DEFINITION OF AN INSIDER TRANSACTION. HOWEVER, NOT ALL FINANCIAL INTERESTS DISCLOSED WILL RESULT IN A CONFLICT OF INTEREST OR AN INSIDER TRANSACTION. A TRANSACTION INVOLVING A DIRECTOR OR OFFICER WILL FALL INTO ONE OF THE FOLLOWING THREE CATEGORIES: (I) IT NEITHER INVOLVES AN INTERESTED PERSON NOR IS AN INSIDER TRANSACTION, (II) IT INVOLVES AN INTERESTED PERSON, BUT IS NOT AN INSIDER TRANSACTION; OR (III) IT INVOLVES AN INTERESTED PERSON AND IS AN INSIDER TRANSACTION. C. RESPONSE TO DISCLOSURES IF ANY DIRECTOR OR PRINCIPAL OFFICER DISCLOSES A POTENTIAL FINANCIAL INTEREST TO THE BOARD OF DIRECTORS OR ANY COMMITTEE REGARDING A PROPOSED TRANSACTION OR ARRANGEMENT, THE BOARD OR COMMITTEE SHALL FIRST DETERMINE WHETHER THE PROPOSED TRANSACTION OR ARRANGEMENT COULD BE CONSIDERED AN INSIDER TRANSACTION. IF THE BOARD OR COMMITTEE IS CERTAIN THAT THE TRANSACTION OR ARRANGEMENT WILL NOT INVOLVE AN INSIDER, THE BOARD OR COMMITTEE SHALL FOLLOW ONLY THE PROCEDURES SET FORTH IN SECTION III(C)(1) BELOW. IF THE TRANSACTION OR ARRANGEMENT INVOLVES OR MAY INVOLVE AN INSIDER, THE BOARD OR COMMITTEE SHALL FOLLOW THE PROCEDURES IN BOTH SECTION III(C)(1) AND SECTION III(C)(2). 1. PROCEDURES FOR DISCLOSURES OF ANY FINANCIAL INTEREST THAT MAY RESULT IN A CONFLICT OF INTEREST ON THE PART OF AN INTERESTED PERSON THAT DOES NOT MEET THE DEFINITION OF AN INSIDER TRANSACTION A. THE INTERESTED PERSON SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE FINANCIAL INTEREST IS DISCUSSED. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. IF IT IS DETERMINED NO CONFLICT EXISTS, THE INTERESTED PERSON MAY REJOIN THE MEETING AND PARTICIPATE IN THE DISCUSSIONS AND ACTIONS REGARDING THIS AGENDA ITEM. B. THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER REI 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. I. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE, THAT BODY SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN REI'S BEST INTEREST AND WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO REI. II. IF THE BOARD OR COMMITTEE BELIEVES AN ALTERNATE TRANSACTION COULD BE CONSIDERED THAT WOULD BE MORE ADVANTAGEOUS TO REI, THE CHAIRPERSON OF THE BOARD OR COMMITTEE SHALL APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION. FURTHER ACTION BY THE BOARD OR COMMITTEE SHALL BE TABLED UNTIL SUCH TIMES AS THE DISINTERESTED PERSON HAS BEEN ABLE TO REPORT HIS OR HER FINDINGS TO THE APPROPRIATE GOVERNING BODY. C. THE BOARD OR COMMITTEE SHALL NOT APPROVE ANY TRANSACTION OR ARRANGEMENT THAT IS NOT IN THE BEST INTERESTS OF REI AND THAT IS NOT FAIR AND REASONABLE TO REI. D. ONCE DISCUSSION AND/OR ACTION REGARDING THE AGENDA ITEM RELATING TO THE DIRECTOR'S FINANCIAL INTEREST HAS BEEN COMPLETED, THE INTERESTED PERSON MAY REJOIN THE BOARD OR COMMITTEE MEETING. 2. PROCEDURES FOR DISCLOSURE OF ANY FINANCIAL INTEREST THAT MAY RESULT IN A CONFLICT OF INTEREST THAT IS ALSO A POTENTIAL INSIDER TRANSACTION A. THE INSIDER SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE INSIDER TRANSACTION IS DISCUSSED. IN ADDITION, THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL ALSO DECIDE WHETHER THE TRANSACTION OR ARRANGEMENT UNDER CONSIDERATION COULD CONSTITUTE AN INSIDER TRANSACTION. AS A PART OF THIS CONSIDERATION, THE BOARD OR COMMITTEE SHALL ALSO CONSIDER WHETHER THEIR ACTION COULD BE CONSTRUED TO BE AN EXCESS BENEFIT TRANSACTION SUBJECT TO THE INTERMEDIATE SANCTIONS DISCUSSED ABOVE. B. IN DETERMINING WHETHER A TRANSACTION OR ARRANGEMENT IS AN EXCESS BENEFIT TRANSACTION, THE BOARD OR COMMITTEE CONSIDERING THE TRANSACTION OR ARRANGEMENT SHOULD REVIEW APPROPRIATE DATA AS TO COMPARABILITY. THE BOARD OR COMMITTEE MAY RELY ON SUCH INFORMATION OR DATA PROVIDED BY REI'S MANAGEMENT. C. THE BOARD OR COMMITTEE SHALL NOT APPROVE ANY TRANSACTION OR ARRANGEMENT THAT IS AN EXCESS BENEFIT TRANSACTION. D. RECORDS OF PROCEEDINGS 1. THE MINUTES OF THE BOARD AND COMMITTEE MEETINGS SHALL CONTAIN: A. THE NAMES OF PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE A FINANCIAL INTEREST WITH RESPECT TO ANY PROPOSED TRANSACTION OR ARRANGEMENT WITH REI, THE NATURE OF THE FINANCIAL INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION WITH THE BOARD'S OR COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED. B. THE NAMES OF THE PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO BE A PARTY TO AN INSIDER TRANSACTION, THE NATURE OF THE INSIDER'S RELATIONSHIP TO REI, AND A RECORD OF ALL VOTES TAKEN IN CONNECTION WITH THE BOARD'S DECISION AS TO WHETHER THE INSIDER TRANSACTION WAS AN EXCESS BENEFIT TRANSACTION. C. THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO ANY TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSION, INCLUDING ANY ALTERNATIVES TO PROPOSED TRANSACTION OR A ARRANGEMENT, AND A RECORD OF ANY VOTES TAKEN APPROVING OR REJECTING ANY PROPOSED TRANSACTION OR ARRANGEMENT. 2. REI SHALL DOCUMENT THE BASIS FOR ITS DETERMINATION REGARDING WHETHER ANY INSIDER TRANSACTION IS AN EXCESS BENEFIT TRANSACTION. E. VIOLATIONS OF THE PROTOCOL 1. IF THE BOARD OR COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT A DIRECTOR OR PRINCIPAL OFFICER HAS FAILED TO DISCLOSE A FINANCIAL INTEREST, IT SHALL INFORM THE DIRECTOR OR PRINCIPAL OFFICER OF THE BASIS FOR SUCH BELIEF AND AFFORD THE DIRECTOR OR PRINCIPAL OFFICER AN OPPORTUNITY TO EXPLAIN WHY DISCLOSURE WAS NOT MADE. 2. IF, AFTER HEARING THE RESPONSE OF THE DIRECTOR OR PRINCIPAL OFFICER AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED IN THE CIRCUMSTANCES, THE BOARD OR COMMITTEE DETERMINES THAT THE DIRECTOR HAS IN FACT FAILED TO DISCLOSE A FINANCIAL INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND/OR CORRECTIVE ACTION. THE ORGANIZATION MONITORS AND ENFORCES COMPLIANCE WITH THE ABOVE CONFLICT OF INTEREST POLICY BY PROVIDING A QUESTIONNAIRE TO BOARD MEMBERS ANNUALLY AS WELL AS REVIEWING THE POLICY ANNUALLY WITH THE BOARD. FORM 990, PART VI, SECTION B, LINE 15 MMC PARTICIPATES IN SALARY SURVEYS SPECIFIC TO ADMINISTRATOR POSITIONS. THIS INFORMATION IS USED TO DEVELOP SALARY RANGES FOR THE ADMINISTRATIVE STAFF. THE BOARD OF DIRECTORS PARTICIPATES IN DEVELOPMENT OF RANGES AND ESTABLISHMENT OF SALARIES FOR THE THREE SENIOR LEADERS OF THE ORGANIZATION AS DESCRIBED IN CORPORATE BYLAWS AND BOARD POLICIES. ANY CHANGES TO THE BENEFIT PACKAGE MUST BE APPROVED BY THE MMC BOARD OF DIRECTORS. THE BOARD APPROVES ALL COMPENSATION CHANGES FOR THE PRESIDENT AS OUTLINED IN CORPORATE BYLAWS AND BOARD POLICIES. CHANGES IN COMPENSATION FOR THE VICE-PRESIDENTS ARE DETERMINED BY THE PRESIDENT USING RANGES ESTABLISHED AND APPROVED BY THE BOARD, IN CONJUNCTION WITH SALARY SURVEY INFORMATION. FORM 990, PART VI, SECTION C, LINE 19 THE FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST FROM ADMINISTRATION FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D). FORM 990, PART VII, SECTION A JASON DOUGLAS: TIME ALLOCATION: REI MEDICAL CLINICS, INC: 1 HOUR PER WEEK REGIONAL ENTERPRISES, INC: 1 HOUR PER WEEK MEDICAL SERVICES, INC: 1 HOUR PER WEEK MEMORIAL MEDICAL CENTER: 37 HOURS PER WEEK COMPENSATION RELATED TO REI MEDICAL CLINICS, INC: REPORTABLE COMPENSATION = $0 OTHER COMPENSATION = $0 COMPENSATION RELATED TO REGIONAL ENTERPRISES, INC: REPORTABLE COMPENSATION = $0 OTHER COMPENSATION = $0 COMPENSATION RELATED TO MEDICAL SERVICES, INC: REPORTABLE COMPENSATION = $0 OTHER COMPENSATION = $0 COMPENSATION RELATED TO MEMORIAL MEDICAL CENTER: REPORTABLE COMPENSATION = $359,333 OTHER COMPENSATION = $ 42,504 KENT DUMONSEAU: TIME ALLOCATION: REI MEDICAL CLINICS, INC: 1 HOUR PER WEEK REGIONAL ENTERPRISES, INC: 1 HOUR PER WEEK MEDICAL SERVICES, INC: 14 HOUR PER WEEK MEMORIAL MEDICAL CENTER: 24 HOURS PER WEEK COMPENSATION RELATED TO REI MEDICAL CLINICS, INC: REPORTABLE COMPENSATION = $0 OTHER COMPENSATION = $0 COMPENSATION RELATED TO REGIONAL ENTERPRISES, INC: REPORTABLE COMPENSATION = $212,602 OTHER COMPENSATION = $ 38,990 COMPENSATION RELATED TO MEDICAL SERVICES, INC: REPORTABLE COMPENSATION = $0 OTHER COMPENSATION = $0 COMPENSATION RELATED TO MEMORIAL MEDICAL CENTER: REPORTABLE COMPENSATION = $0 OTHER COMPENSATION = $0 MEDICAL SERVICES INC 11040 N STATE ROAD 77 HAYWARD WI 54843 391536207 HEALTH CARE WI 501(C)(3) LINE 3 REGIONAL ENTERPRISES INC 0 REGIONAL ENTERPRISES INC 1615 MAPLE LANE ASHLAND WI 54806 391555837 SUPPORT WI 501(C)(3) LINE 11B, II N/A 0 REI MEDICAL CLINICS INC 1615 MAPLE LANE ASHLAND WI 54806 391701306 SUPPORT WI 501(C)(3) LINE 11B, II REGIONAL ENTERPRISES INC 0 TAMARACK PROFESSIONAL GROUP INC 1615 MAPLE LANE ASHLAND WI 54806 391198085 HEALTH CARE WI 501(C)(3) LINE 11B, II REGIONAL ENTERPRISES INC 0 MMC DEVELOPMENT CORP INC 1615 MAPLE LANE ASHLAND WI 54806 391360035 SUPPORT WI 501(C)(3) LINE 8 N/A 0 0 0 0 1 1 0 0 0 0 0 0 1 1 0 0 0 0 1 0