2016-11-14T10:27:28-06:00 2015-12-31 390758449 Wipfli LLP PO Box 8010 Wausau WI 544028010 990 2015-01-01 391528430 Bay Area Medical Center Inc BAYA 7157354200 3100 Shore Drive Marinette WI 54143 MATTHEW HUFF CFO 7157354200 2016-11-11 1 Kimberly Heller CPA P00766668 7158453111 2016-11-10 2015 2017-02-10 21:41:12Z MATTHEW HUFF 3100 Shore Drive Marinette WI 54143 116806419 0 X www.bamc.org X 1985 WI BAY AREA MEDICAL CENTER (BAMC) IS A REGIONAL HEALTH CARE FACILITY PROVIDING A WIDE RANGE OF MEDICAL SERVICES TO THE RESIDENTS OF MARINETTE AND MENOMINEE COUNTIES AND THE SURROUNDING AREAS. BAMC'S PRIMARY EXEMPT PURPOSE IS THE PROVISION OF HEALTH CARE SERVICES. 9 9 792 0 2206960 -924302 42751 66230 109347863 102069161 3851864 7421982 -2655510 6936096 110586968 116493469 0 0 0 0 51114212 52432346 0 0 0 54134257 53256650 105248469 105688996 5338499 10804473 217937336 219395893 59810739 63903800 158126597 155492093 We are your Medical Center, striving to exceed your expectations by providing compassionate, cost-effective, quality healthcare to all. 0 0 80485816 88596809 INPATIENT HOSPITAL SERVICES FOR MEDICAL, SURGICAL AND OBSTETRICS/GYNECOLOGY PATIENTS - BAMC PROVIDED CARE FOR 3,036 PATIENTS WHO WERE ADMITTED AS INPATIENTS DURING 2015. THESE SERVICES INCLUDED 24/7 CARE FOR PATIENTS ADMITTED WITH MEDICAL CONDITIONS WARRANTING A HOSPITAL STAY, PATIENTS ADMITTED FOR SURGICAL PROCEDURES EXTENSIVE ENOUGH TO REQUIRE A STAY OVERNIGHT OR FOR SEVERAL DAYS FOLLOWING THE PROCEDURES, AND PATIENTS ADMITTED FOR THE DELIVERY OF NEWBORNS.OUTPATIENT SURGICAL SERVICES - BAMC PERFORMED 1,998 OUTPATIENT SURGICAL PROCEDURES FOR PATIENTS DURING 2015. THESE PROCEDURES INCLUDED ORTHOPEDIC, UROLOGICAL, GENERAL SURGERY, GYNECOLOGY, AND ENT SURGERIES. 80485816 1 0 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 78 0 1 792 1 1 1 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X MATTHEW HUFF CFO 7157354200 3100 SHORE DR MARINETTE WI 54143 TONY FURTON Chair 1.00 X X 0 0 0 Pat Krah VICE CHAIR 0.80 X X 0 0 0 WiLLIAM MALLORY MD Secretary/Treasurer 0.80 X X 0 0 0 SANDY EWALD BOARD MEMBER 0.80 X 0 0 0 MARC JAMO BOARD MEMBER 0.80 X 0 0 0 JEFF BARD BOARD MEMBER 0.80 X 0 0 0 OSAMA HALAWEH MD BOARD MEMBER 0.80 X 0 0 0 TIM RENNES BOARD MEMBER 0.80 X 0 0 0 PATRICK O'HARA BOARD MEMBER 0.80 X 0 0 0 EDWARD HARDING CEO 40.00 X 807964 0 42611 C Daniel Carlson CFO (RETIRED MARCH 2016) 40.00 X 358264 0 44691 MATTHEW HUFF CFO (Hired March 2016) 40.00 X 0 0 0 Bernadine Van Court COO 40.00 X 362917 0 21580 Michael Karkkainen MD Physician 40.00 X 1419092 0 46825 Edgar Massabni MD Physician 40.00 X 878320 0 45161 Qefli Neziri MD Physician 40.00 X 574974 0 8576 Francisco Gamez MD Physician 40.00 X 520909 0 31417 Robert Maccani DO Physician 40.00 X 489025 0 34661 5411465 0 275522 67 0 1 0 ACL B05854 6901 W Lincoln Ave West Allis WI 53227 Laboratory Services (Aurora Lab) 1602216 SODEXO INC &AFFLILIATESB05757 9801 Washingtonian Blvd Gaithersburg MD 20879 Outsourced Environmental Services 1505047 INFINITY HEALTHCARE SCB02593 111 E Wisconsin Ave - Suite 2100 Milwaukee WI 53202 Occupational Health Service Physician Fe 1079453 COMPHEALTHB00221 PO Box 972651 Dallas TX 753972651 Physician Services 868739 AHSA LLC B04890 PO Box 945 Traverse City MI 49685 Medical Staffing - Purchased Services 821416 36 66230 66230 NET PATIENT REVENUE 900099 87865560 87865560 Physician Services - ABAMG & Auro 900099 9683858 9683858 SPACE LEASED FOR MEDICAL PURPOSES 621110 1671586 1671586 REFERENCE LAB 621500 1266832 1266832 RETAIL PHARMACY 446110 940128 940128 641197 128771 512426 102069161 1238667 1238667 64509 79305 -14796 -14796 -14796 6169309 247651 0 233645 6169309 14006 6183315 6183315 Acquisition of Ancillary Business 900099 8020000 8020000 Interest Rate Swap Valuation Adju 900099 -1069108 -1069108 6950892 116493469 106300667 2206960 7919612 1638027 1638027 40978538 33399146 7579392 1213063 950103 262960 8602718 6516883 2085835 876081 876081 107093 107093 13243638 7597009 5646629 311742 69960 241782 18709380 17469299 1240081 1414249 910824 503425 5481 5306 175 227402 177087 50315 307557 307557 6747815 5069043 1678772 865627 657577 208050 REPAIRS AND MAINTENANCE 4746119 1775915 2970204 BAD DEBTS 3036411 3036411 WI Hospital Assessment 2498852 2498852 159203 44844 114359 105688996 80485816 25203180 0 3545 2745 33043729 16555504 26298368 27309737 2868438 2951832 1527363 1691992 125682170 76762505 46597461 48919665 107016479 104732129 581953 17232289 217937336 219395893 9752005 9280028 34345000 40000000 15713734 14623772 59810739 63903800 X 157807250 155156665 319347 335428 158126597 155492093 217937336 219395893 X 10804473 -5722345 -7716632 X X 0 1 X 1 0 X 0 0 0 0 0 1 9281 0 0 0 9281 0 Part II-B, Line 1: PORTION OF AHA ($5,312) AND WHA (3,969) DUES = $9,281. 1644987 1644987 74487904 43268632 31219272 1535045 1939354 -404309 46743173 31554519 15188654 1271061 1271061 48919665 OTHER 308911 INTEREST IN NET ASSETS OF BAMC FOUNDATION 261378 GOODWILL 16662000 17232289 ACCRUED POSTRETIREMENT BENEFITS 2064846 DEFERRED COMPENSATION 589674 INTEREST RATE SWAP VALUATION 6185050 Capital Lease Obligation 338864 Amounts Payable to third-party reimbursement program 1795338 CONTINGENT MEMBER EQUITY CONTRIBUTION 3650000 14623772 X 116572774 79305 79305 116493469 0 116493469 105768301 79305 79305 105688996 0 105688996 Part X, Line 2: BAY AREA IS A NONPROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND IS EXEMPT FROM FEDERAL INCOME TAX ON RELATED INCOME PURSUANT TO SECTION 509(A)(2) OF THE CODE. IT IS ALSO EXEMPT FROM STATE INCOME TAX ON RELATED INCOME. BAY AREA IS ALSO ENGAGED, TO A LIMITED EXTENT, IN CERTAIN ACTIVITIES SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME (UBI). INCOME TAXES ON UBI ARE NOT SIGNIFICANT. Part XI, Line 2d - Other Adjustments: Rent Expense 79,305. Part XII, Line 2d - Other Adjustments: Rental Expenses 79,305. 1 1 1 X 1 X 1 1 0 1 1 566316 566316 0.00550 16640527 10359865 6280662 0.06120 17206843 10359865 6846978 0.06670 98400 98400 0.00100 98400 98400 0.00100 17305243 10359865 6945378 0.06770 1 1246752 19785967 23153160 -3367193 X 1 1 1 1 BAY AREA MEDICAL CENTER INC 3100 SHORE DRIVE MARINETTE WI 54143 www.bamc.org 2419-800 X X X BAY AREA MEDICAL CENTER 1 0 0 1 X X X X X X X X X 13 1 0 0 1 X www.bamc.org X 1 13 1 HTTP://WWW.BAMC.ORG/PDFS/COMMUNITYHEALTHNEEDS.PDF 0 0 1 X 100.000000000000 200.000000000000 X X X 1 1 X X X 1 X http://www.bamc.org/patients-financial-information.html X http://www.bamc.org/patients-financial-information.html X X X X X 1 0 X X X X 1 X 0 0 BAY AREA MEDICAL CENTER Part V, Section B, Line 5: BAMC HELD TWO HEALTH CARE ROUND TABLES THAT BROUGHT COMMUNITY GROUPS TOGETHER TO NOT ONLY SHARE THEIR RESEARCH BUT BEGIN THE PROCESS OF GREATER COLLABORATION TO ACCOMPLISH SIMILAR GOALS. BAMC ALSO PARTICIPATED IN THREE OF THE INITIATIVES AS A PARTICIPANT GROUP FACILITATOR FOR THE TRI CITY UNITED WAY STUDY AND AS A PARTICIPANT IN THE MARINETTE COUNTY ASSESSMENT. A BRIEF DESCRIPTION OF THESE OTHER AGENCY RESEARCH EFFORTS ARE IN THE BAY AREA COMMUNITY HEALTH NEEDS ASSESSMENT REPORT. BAY AREA MEDICAL CENTER Part V, Section B, Line 11: THE BAY AREA MEDICAL CENTER COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), CONDUCTED IN 2013 TO EVALUATE THE HEALTH NEEDS OF INDIVIDUALS LIVING IN THE MARINETTE/MENOMINEE MARKET AREA, HAD CONSIDERABLE WORK DONE THIS YEAR IN ALL THREE AREAS OF CONCERN THAT WERE IDENTIFIED. 1. ACCESS TO CARE - BAMC IS IN ITS THIRD YEAR OF A COMMUNITY-WIDE EFFORT TO PROVIDE COMMUNITY MEMBERS ASSISTANCE IN SIGNING UP FOR HEALTH INSURANCE THROUGH THE HEALTH EXCHANGE PROGRAM THROUGH CERTIFIED COUNSELORS. BAMC OFFERED FREE CONSULTATION TO COMMUNITY MEMBERS LOOKING TO BECOME INSURED THROUGH THE FEDERAL EXCHANGES. THIS INVOLVED WORKING WITH OTHER COMMUNITY GROUPS TO IDENTIFY INDIVIDUALS AND OFFER THEM ACCESS TO OUR COUNSELORS AT NO CHARGE TO IDENTIFY COVERAGE OR MAINTAIN THEIR PREVIOUSLY ESTABLISHED OVERAGE. IT ALSO ASSISTS BOTH MI AND WI RESIDENTS IN DETERMINING IF THEY ARE ELIGIBLE FOR STATE PROGRAMS SUCH AS MEDICAID OR BADGERCARE.2. DRUG ABUSE - BAMC IS A FOUNDING MEMBER OF TWO COMMUNITY TASK FORCES THAT FOCUS ON DRUG ABUSE IN GENERAL AND PRESCRIPTION DRUG ABUSE SPECIFICALLY. IN 2015, BAMC CONDUCTED AN INVENTORY OF LOCAL ALTERNATIVES TO PAIN MANAGEMENT AND ORGANIZED THE INFORMATION IN A RESOURCE GUIDE FOR LOCAL PROVIDERS. IT WAS PRESENTED AT A PHYSICIAN ROUNDTABLE EVENT THAT BAMC WAS A MAJOR SPONSOR. THE REPORT WAS ALSO MADE AVAILABLE ELECTRONICALLY THROUGH OUR WEB SITE. WE REMAIN A STRONG SUPPORTER OF THE HEALTHY YOUTH COALITION, A LOCAL NONPROFIT ORGANIZATION THAT PROMOTES HEALTHY LIFESTYLES AND CHOICES THROUGH SCHOOL EDUCATION AND LIAISON PROGRAMS. BAMC PARTNERS WITH LOCAL LAW ENFORCEMENT AGENCIES IN THE ANNUAL APRIL TAKE BACK INITIATIVE, AN EFFORT BY THE DEA TO GIVE RESIDENTS A SAFE AND SECURE WAY TO DISPOSE OF EXPIRED OR UNUSED PRESCRIPTION DRUGS. 3. OBESITY - BAMC OFFERED FINANCIAL SUPPORT TO COMMUNITY INITIATIVES THAT FOCUSED ON YOUTH HEALTH AND WELLNESS INCLUDING PHYSICAL EDUCATION GRANTS TO THE MENOMINEE, MARINETTE, STEPHENSON AND CRIVITZ SCHOOLS AS WELL AS SPONSORSHIP OF THE YMCA HEALTHY KIDS DAY. BAMC IS A MAJOR SPONSOR FOR TWO OF THE LARGEST WELLNESS EVENTS IN THE COMMUNITY; THE BAMC MENOMINEE RIVER CENTURY BIKE RIDE INVOLVES NEARLY 1,000 RIDERS AND THE BAMC WATERFRONT FESTIVAL RUN, THE LARGEST 5K/10K RUN IN THE COMMUNITY, NOW HAS OVER 300 PARTICIPANTS INCLUDING A SEPARATE RACE FOR CHILDREN. BAY AREA MEDICAL CENTER Part V, Section B, Line 16i: A FINANCIAL BROCHURE IS OFFERED TO PATIENTS UPON REGISTRATION AND BILLING STATEMENTS REFERENCE THE POLICY BUT DO NOT INCLUDE DETAIL. BAY AREA MEDICAL CENTER Part V, Section B, Line 22d: BAMC DETERMINES THE AGB BY USING A LOOK-BACK METHOD. AT LEAST ANNUALLY, BAMC WILL DIVIDE THE SUM OF ALL OF ITS CLAIMS FOR EMERGENCY AND OTHER MEDICALLY NECESSARY CARE THAT HAVE BEEN ALLOWED BY MEDICARE FEE-FOR-SERVICE AND ALL PRIVATE HEALTH INSURERS THAT PAY CLAIMS TO BAMC DURING A PRIOR 12-MONTH PERIOD BY THE SUM OF THE ASSOCIATED GROSS CHARGES FOR THOSE CLAIMS. IF THE AMOUNT A HEALTH INSURER WILL ALLOW FOR A CLAIM HAS NOT BEEN FINALLY DETERMINED AS OF THE LAST DAY OF THE 12-MONTH PERIOD USED TO CALCULATE THE AGB PERCENTAGE(S), BAMC WILL EXCLUDE THE AMOUNT OF THE CLAIM FROM THAT CALCULATION AND INCLUDE IT IN THE SUBSEQUENT 12-MONTH PERIOD DURING WHICH THE AMOUNT ALLOWED IS FINALLY DETERMINED. WHEN INCLUDING ALLOWED CLAIMS IN CALCULATING ITS AGB PERCENTAGE(S), BAMC WILL INCLUDE THE FULL AMOUNT THAT HAS BEEN ALLOWED BY THE HEALTH INSURER, INCLUDING BOTH THE AMOUNT THE INSURER WILL PAY OR REIMBURSE AND THE AMOUNT (IF ANY) THE INDIVIDUAL IS PERSONALLY RESPONSIBLE FOR PAYING IN THE FORM OF CO-PAYMENTS, COINSURANCE, AND DEDUCTIBLES, REGARDLESS OF WHETHER OR WHEN THE FULL AMOUNT ALLOWED IS ACTUALLY PAID AND DISREGARDING ANY DISCOUNTS APPLIED TO THE INDIVIDUAL'S PORTION. BAMC WILL APPLY THE AGB PERCENTAGES IT CALCULATES UNDER THIS SECTION BY THE 120TH DAY AFTER THE END OF THE 12-MONTH PERIOD BAMC USED TO CALCULATE THE ABG PERCENTAGE. 2 1 - BAY AREA MOBILITY CENTER 3117 SHORE DRIVE MARINETTE WI 54143 REHABILITATION SERVICES AND OCCUPATIONAL HEALTH 2 - BAY AREA REHAB SERVICES - CRIVITZ WI 218 S US HWY 141 SUITE 100 CRIVITZ WI 54114 REHABILITATION SERVICES AND OCCUPATIONAL HEALTH Part I, Line 7: Bay Area utilizes a cost to charge ratio. Part I, Line 7g: Twin Counties Free Clinic Part I, Ln 7 Col(f): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $3,036,411 Part III, Line 2: BAY AREA MEDICAL CENTER UTILIZED A COST TO CHARGE RATIO FOR DETERMINING THE COST OF BAD DEBT EXPENSE. Part III, Line 4: Bay Area analyzes past results and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for uncollectible 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 uncollectible accounts. Specifically, for receivables associated with services provided to patients who have third-party coverage, Bay Area analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for bad debts for expected uncollectible deductibles and copayments on accounts for which third-party payors has not yet paid, or for payors who are known to have financial difficulties that make 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 with third-party coverage exists for part of the bill), Bay Area records a significant 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. Part III, Line 8: Amounts above use standard Medicare determination of allowable and unallowable departments, standard/recommended Medicare allocation of Administration and General departments costs to allowable and unallowable departments by the use of Bay Area Medical Center's Medicare Cost Report. The Medicare Cost Report was caLculated on a cost to charge ratio. The cost to charge ratio follows the regulations for filing the Medicare Cost Report. Part III, Line 9b: BAY AREA MEDICAL CENTER WILL PROVIDE NEEDED HOSPITAL CARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY FOR THESE SERVICES. COMMUNITY CARE IS ALLOCATED TO PATIENTS BASED ON SET GUIDELINES ESTABLISHED BY THE ORGANIZATION. A FULL OR PARTIAL ADJUSTMENT WILL BE DETERMINED BY COMPARING THE PATIENT'S FINANCIAL STATUS TO A SLIDING FEE SCHEDULE BASED ON THE MOST RECENTLY PUBLISHED FEDERAL POVERTY GUIDELINES.IT IS THE POLICY OF BAY AREA MEDICAL CENTER TO WRITE-OFF BOTH PARTIAL AND FULL PATIENT BALANCES FOR ACCOUNTS THAT QUALIFY FOR COMMUNITY CARE. THERE ARE NO FURTHER COLLECTIONS EFFORTS RELATED TO THOSE WHO QUALIFY FOR A FULL COMMUNITY CARE WRITE-OFF. PATIENTS THAT HAVE HAD PARTIAL WRITE-OFFS THAT DO NOT COOPERATE WITH COLLECTION EFFORTS ON THE BALANCES REMAINING WILL BE REFERRED TO A THIRD-PARTY COLLECTION AGENCY. IF STILL UNCOLLECTIBLE, THE PATIENT ACCOUNT WILL BE WRITTEN OFF TO BAD DEBT. Part VI, Line 2: Bay Area Medical Center uses a Bi-annual community survey and also participates in the Marinette & Menominee County Health Assessment Initiatives. Part VI, Line 3: - Brochures are provided to every patient.- The information is available on the organization's website.- One on one meetings with Finacial Advisors are also available. Part VI, Line 4: Bay Area Medical Center serves Marinette County, WI and Menominee County, MI. There are no other hospitals located in these counties. Part VI, Line 5: - THE MAJORITY OF THE BAMC BOARD IS MADE UP OF RESIDENTS OF THE TWO COUNTIES IT SERVES. - BAMC HOSTS QUARTERLY MEETINGS WITH LOCAL MENTAL HEALTH PROFESSIONALS TO SUPPORT THIS INITIATIVE. WE ARE ALSO MEMBERS OF THE MICHIGAN HEALTHCARE CONSORTIUM IN THE UPPER PENINSULA.- ANY SURPLUS FUNDS ARE USED FOR IMPROVEMENTS TO THE FACILITY, EQUIPMENT, STAFF DEVELOPMENT AND PATIENT CARE. - BAMC PROVIDES DIRECT FINANCIAL SUPPORT TO THE TWIN COUNTIES FREE CLINIC. - BAMC HAS WORKING ARRANGEMENTS WITH A TWO YEAR TECHNICAL SCHOOL AND TWO YEAR COLLEGE TO OFFER NURSING AND OTHER MEDICAL PROFESSIONAL STUDENTS INTERNSHIPS IN THEIR PREPARATION FOR HEALTH CARE CAREERS. - BAMC PROVIDES SUPPORT TO LOCAL AREA VOLUNTEER RESCUE SQUAD UNITS THAT WORK WITH THE HOSPITAL-BASED AMBULANCE SERVICE.BAY AREA ACTIVELY PROVIDED OR PARTICIPATED IN THE FOLLOWING COMMUNITY-BASED ACTIVITIES AND PROGRAMS DURING 2015 AND 2014:- PROMOTED GENERAL HEALTH EDUCATION SERVICES SUCH AS HEALTH FAIRS, CANCER EDUCATION, HEALTHY HEART EDUCATION, AND HEALTHY EATING.- OFFERED HEALTH INFORMATION ON BAY AREA'S WEBSITE AND THROUGH HEALTH-RELATED PUBLICATIONS DISTRIBUTED AT NO CHARGE.- OFFERED BLOOD PRESSURE SCREENINGS, CHOLESTROL TESTING, GLUCOSE TESTING, BMD TESTING, AND INCONTINENCE SCREENINGS.- PROVIDED COLESTERAL CANCER SCREENINGS AND FREE MAMMOGRAMS.- PROVIDED ADVANCE DIRECTIVES AND LIVING WELL ASSISTANCE.- PROVIDED GUIDANCE, REFERRAL, AND ENROLLMENT ASSISTANCE FOR PUBLIC MEDICAL PROGRAMS, CERTIFIED COUNSELING FOR AFFORDABLE CARE ACT HEALTH EXCHANGE APPLICANTS, AND OTHER FAMILY SUPPORT ASSISTANCE.- PROVIDED SPACE AND FREE LAB TESTING AND DIAGONSTIC SERVICES TO SUPPORT A FREE COMMUNITY PHYSICIAN CLINIC.- PROVIDED EMERGENCY CAB FARE FOR PATIENTS WITH TRANSPORTATION NEEDS RELATED TO THEIR HEALTH CARE SERVICES.- PROMOTED PARTICIPATION IN BLOOD DRIVES BY EMPLOYEES AND THE GENERAL PUBLIC.- CONTRIBUTED TO THE EDUCATION OF STUDENT NURSES AND OTHER HEALTH CARE PROFESSIONALS.- SPONSORED AND ORGANIZED THE BAMC MENOMINEE RIVER CENTURY BIKE RIDE WHICH ATTRACTS OVER 1,000 RIDERS.- SPONSORED AND SUPPORTED CHAMBER OF COMMERCE AND EDUCATIONAL LEADERSHIP PROGRAMS.- PROVIDED ATHLETIC TRAINING SERVICES, CONCUSSION EVALUATIONS, AND SPORTS PHYSICALS TO AREA SCHOOL SYSTEMS AND SPORTS PROGRAMS.- PROVIDED FINANCIAL AND STAFF SUPPORT FOR COMMUNITY RUNS AND WALKS.-SPONSORED AND ORGANIZED THE BAMC WATERFRONT 5K/10K RUN, WHICH ATTRACTS OVER 400 RUNNERS.WHILE THERE IS A GROWING AGREEMENT IN THE UNITED STATES ABOUT WHAT CONSTITUTES A NON-PROFIT HOSPITAL'S "COMMUNITY BENEFIT," THIS IS A WORK IN PROGRESS. OUR HOSPITAL PROVIDES SIGNIFICANT CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS. BUT IN ADDITION, WE BELIEVE THAT WE PROVIDE A CRITICALLY IMPORTANT COMMUNITY BENEFIT, WHICH IS NOT QUANTIFIED. OUR HOSPITAL, LIKE MOST RURAL HOSPITALS, WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE CARE LOCALLY-CARE THAT WITHOUT OUR HOSPITAL, WOULD NOT BE AVAILABLE LOCALLY.BEYOND INPATIENT HOSPITALIZATIONS, WE PROVIDE LOCAL ACCESS TO MANY HEALTH SERVICES: AMBULANCE SERVICES, BIRTHING CENTER, DIAGNOSTICS, EMERGENCY SERVICES, INPATIENT CARE, LABORATORY SERVICES, OCCUPATIONAL HEALTH & REHABILITATION SERVICES, SURGICAL SERVICES AND WOMENS' SERVICES. Part VI, Line 6: BAMC'S ROLE HAS NOT CHANGED SINCE IT IS PART OF AN AFFILIATED HEALTH CARE SYSTEM. THE ROLE OF AURORA IS TO SUPPORT BAMC'S MISSION BY PROVIDING STATEGIC AND OPERATIONAL SUPPORT. Part VI, Line 7, Reports Filed With States WI X X X X X 0 1 0 0 0 0 0 0 0 EDWARD HARDING CEO 476804 0 238692 0 92468 0 7950 0 34661 0 850575 0 0 0 C Daniel Carlson CFO (RETIRED MARCH 2016) 264806 0 53012 0 40446 0 7950 0 36741 0 402955 0 0 0 Bernadine Van Court COO 282359 0 55822 0 24736 0 7950 0 13630 0 384497 0 0 0 Michael Karkkainen MD Physician 404044 0 671858 0 343190 0 7950 0 38875 0 1465917 0 0 0 Edgar Massabni MD Physician 634005 0 35850 0 208465 0 7950 0 37211 0 923481 0 0 0 Qefli Neziri MD Physician 252553 0 238692 0 83729 0 7950 0 626 0 583550 0 0 0 Francisco Gamez MD Physician 401904 0 35276 0 83729 0 7950 0 23467 0 552326 0 0 0 Robert Maccani DO Physician 436649 0 25030 0 27346 0 0 0 34661 0 523686 0 0 0 Part I, Line 4b THE FOLLOWING INDIVIDUALS PARTICIPATED IN AND RECEIVED PAYMENT FROM A NON-QUALIFIED RETIREMENT PLAN: CONTRIBUTIONS TO 457F PLAN: MICHAEL KARKKAINEN, M.D. $120,756; EDGAR MASSABNI, M.D. $46,000; QEFLI NEZIRI, M.D. $10,750; FRANCISCO GAMEZ, M.D. $27,425; BERNADINE VAN COURT $14,464; DANIEL CARLSON $33,028; EDWARD HARDING $85,270. A WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337955 2015-12-17 85600000 New hospital construction 0 0 0 A 85600000 84761060 310000 528940 0 0 0 1 A 0 0 0 0 0 0 1 A 0 0 0 0 1 0 0 0 1 A 0 FORM 990, SCHEDULE K, PART IV, LINE 3 IN DECEMBER 2015, THE WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY (THE "AUTHORITY") ISSUED FOR BAY AREA'S BENEFIT, $40,000,000 OF 2.565% FIXED RATE DEMAND REVENUE BONDS ("SERIES 2015A BONDS"), AND $45,600,000 OF VARIABLE INTEREST RATE DEMAND REVENUE BONDS ("SERIES 2015B BONDS") WHICH COLLECTIVELY REPRESENT THE SERIES 2015 BONDS. THE SERIES 2015 BONDS WILL BE USED TO FUND THE NEW HOSPITAL CONSTRUCTION. THE SERIES 2015 BONDS ARE PAYABLE SOLELY FROM LOAN PAYMENTS TO BE MADE BY BAY AREA PURSUANT TO THE LOAN AGREEMENT BETWEEN THE AUTHORITY AND BAY AREA. THE SERIES 2015A BONDS WERE FULLY DRAWN ON THE DATE OF ISSUANCE. PER THE DEBT AGREEMENT, THE SERIES 2015B BONDS WERE STRUCTURED AS A "DRAW-DOWN LOAN." THERE WERE NO AMOUNTS DRAWN ON THE SERIES 2015B BONDS AT DECEMBER 31, 2015. THE SERIES 2015B BONDS PROCEEDS MUST BE FULLY DRAWN WITHIN 36 MONTHS OF ISSUANCE. Form 990, Part VI, Section A, line 6 IN 2014, BAMC AND AURORA HEALTH CARE NORTH, INC. NEGOTIATED AN ARRANGEMENT UNDER WHICH M&M AND AURORA BECAME THE SOLE MEMBERS OF BAMC. M&M HOLDS 51% OF THE VOTING INTERESTS IN BAMC AND AURORA HOLDS 49% OF THE VOTING INTERESTS. Form 990, Part VI, Section A, line 7a BAY AREA MEDICAL CENTER'S BY-LAWS INDICATE THAT THE BOARD OF DIRECTORS OF THE CORPORATION SHALL BE NINE (9), FIVE OF WHOM SHALL BE APPOINTED BY M&M HEALTH CARE, INC. AND FOUR OF WHOM SHALL BY APPOINTED BY AURORA HEALTH CARE NORTH, INC. Form 990, Part VI, Section A, line 7b THE CORPORATE MEMBERS HAVE RETAINED THE FOLLOWING RESERVED POWERS OVER THE CORPORATION SUCH THAT NONE OF SUCH ACTIONS MAY BE TAKEN BY THE CORPORATION WITHOUT THE UNANIMOUS APPROVAL OF ALL CORPORATE MEMBERS, AND THE CORPORATE MEMBERS, ACTING UNANIMOUSLY, MAY INITIATE AND TAKE SUCH ACTIONS: - TO CHANGE THE CORPORATION'S MISSION OR PURPOSE; - TO APPROVE ANY AMENDMENT TO THE ARTICLES OF INCORPORATION, BYLAWS OR OTHER GOVERNING DOCUMENTS OF THE CORPORATION, INCLUDING THE CONFLICT OF INTEREST, INSIDER TRASACTION, AND CONFIDENTIALITY POLICY ADOPTED BY THE THE BOARD OF DIRECTORS FROM TIME TO TIME; - TO APPROVE ALL MATTERS RELATING TO THE MEMBERSHIP OF THE CORPORATION OR ANY RIGHTS ARISING FROM SUCH MEMBERSHIP, INCLUDING THE ISSUING OF ADDITIONAL MEMBERSHIPS IN THE CORPORATION, RECLASSIFYING MEMBERSHIPS IN THE CORPORATION, CREATING A NEW CLASS OF MEMBERSHIP IN THE CORPORATION, BRINGING ON A NEW MEMBER OF THE CORPORATION, TRANSFERRING MEMBERSHIPS IN THE CORPORATION OR ANY RIGHTS ARISING THEREFROM OR REDEEMING MEMBERSHIPS IN THE CORPORATION OR ANY RIGHTS ARISING FROM THEREFROM; - TO APPROVE ANY INDEBTNESS FOR BORROWED MONEY TO BE INCURRED OR GUARANTEED ON BEHALF OF THE CORPORATION, EXCEPT THAT FINANCING FOR A FACILITY PLAN DEVELOPED IN 2014 OR 2015 AND APPROVED BY SUPER-MAJORITY BOARD APPROVAL DOES NOT REQUIRE THE UNANIMOUS APPROVAL OF ALL CORPORATE MEMBERS; - TO APPROVE CAPITAL LEASES IN EXCESS OF $3,000,000 IN THE AGGREGATE (AS DETERMINED BY TOTAL LEASE AND OTHER PAYMENTS); Form 990, Part VI, Section B, line 11 THE CFO MAKES THE FORM 990 AVAILABLE ON SITE FOR ALL BOARD MEMBERS TO REVIEW PIOR TO WHEN THE FORM 990 IS FILED. Form 990, Part VI, Section B, line 12c Board of Directors - Persons with actual or potential conflicts of interest shall file formal statements disclosing actual or potential conflicts whenever an actual or potential conflict arises; before any transactions constituting a conflict or potential conflict is consummated; and once each calendar year so long as the conflict or potential conflict continues to exist. The disclosure statement shall include a description of the relationship or interest causing the conflict or potential conflict, the role in the relationship or transaction played by the person having the conflict, and the benefits and detriments accruing to the Hospital and to the person having the conflict as a result of the contract, transaction, or relationship. Any member of the Board of Directors having an actual or potential conflict of interest on any matter shall not vote or use his/her personal influence on the matter consituting a conflict. The interested Director may, however, be counted for the purpose of determing whether a quorum of the Board, or of a committee of the Board, exists. The matter consituting the conflict shall be approved if it is approved by a majority of disinterested Directors voting on the matter. The Conflict of Interest Policy shall be reviewed annually for the information and guidance of the Board of Directors and that any new members of the said Board of Directors be advised of the policy upon entering on the duties of his/her office. In addition to the Board of Directors being held to the Conflict of Interest Policy, copies of the policy are provided to all management employees. Conflict of Interest disclosure forms are completed annually by all directors, officers and key employees. The completed forms are kept on file by Administration. Form 990, Part VI, Section B, line 15 The Board of Director's compensation committee reviews comparable compensation information on other hospitals and establishes BAMC's executive compensation levels. Members of the compensation committee do not have a conflict of interest and the conclusions are substantiated. The review process takes place at least annually. Form 990, Part VI, Section C, line 19 THE ORGANIZATION DEEMS THESE DOCUMENTS PROPRIETARY SO THEY ARE NOT MADE AVAILABLE TO THE PUBLIC, EXCEPT THAT THE AUDITED FINANCIAL STATEMENTS ARE ATTACHED TO THE FORM 990. Form 990, Part XI, line 9: INCREASE IN BENEFICIAL INTEREST IN BAMC FOUNDATION, INC. 54,747. ASSETS RELEASED FROM RESTRICTIONS -45,807. CHANGE IN POSTRETIREMENT BENEFIT OBLIGATION OTHER THAN EXPENSE -99,217. RECLASSIFICATION OF ACCUMULATED LOSS ON DESIGNATED CASHFLOW HEDGE 38,645. MEMBER EQUITY CONTRIBUTION -7,665,000. Form 990, Part XI, Line 2C THE PROCESS OF OVERSIGHT AND SELECTION OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. Form 990, Part IV, Line 12 Bay Area Medical Center was audited as part of a consolidated audit. BAMC assets made up 99% of total assets in the consolidated audit. Form 990, Part XI, Line 2B and 2C Bay Area Medical Center was audited as part of a consolidated audit. See explanation to Part IV, Line 12. BAY AREA MEDICAL CENTER FOUNDATION INC 3100 SHORE DRIVE MARINETTE WI 54143 392020734 FUNDRAISING FOR BAMC, INC. WI 501 (C) 3 Line 11a, I M & M HEALTH CARE INC 1 WISCONSIN UPPER PENINSULA ONCOLOGY MANAGEMENT SERVICES INC 3100 SHORE DRIVE MARINETTE WI 54143 391677100 PROVIDING RADIATION ONCOLOGY SERVICES WI 501 (C) 3 Line 11a, I Bay AREA MEDICAL CENTER INC 1 M & M HEALTH CARE INC 3100 SHORE DRIVE MARINETTE WI 54143 471540754 OVERSEEING THE ACCOMPLISHMENTS OF BAMC'S MISSION WI 501 (C) 3 Line 11a, I 0 AURORA BAY AREA MEDICAL GROUP LLC 3100 Shore Drive Marinette WI 54143 473548414 Physician services WI BAY AREA MEDICAL CENTER INC -5753611 4465365 0 0 0.73000 1 0 1 0 0 0 0 0 0 1 0 1 1 1 1 0 1 1 1 BAY AREA MEDICAL CENTER FOUNDATION INC C 51902 CASH WISCONSIN UPPER PENINSULA ONCOLOGY MANAGEMENT SERVICES INC I 317534 LEASE AGREEMENT WISCONSIN UPPER PENINSULA ONCOLOGY MANAGEMENT SERVICES INC N 178493 LEASED EMPLOYEE AGREEMENT WISCONSIN UPPER PENINSULA ONCOLOGY MANAGEMENT SERVICES INC R 276282 CASH AURORA BAY AREA MEDICAL GROUP LLC I 4172193 LEASE AGREEMENT AURORA BAY AREA MEDICAL GROUP LLC Q 7665000 ORIGINAL INVESTMENT M & M Health Care Inc R 96078 CASH