2016-11-14T09:41:15-06:00 2015-12-31 135665207 KPMG LLP 4200 WELLS FARGO CENTER 90 SOUTH 7TH ST MINNEAPOLIS MN 55402 990 2015-01-01 391279567 HUDSON HOSPITAL FOUNDATION INC HUDS 7155316000 405 STAGELINE ROAD HUDSON WI 54016 DOUGLAS E JOHNSON CFO 7155316000 2016-11-14 1 ANN LAMOUREUX P00691316 6123055000 2015 2017-02-10 21:41:12Z DOUGLAS E JOHNSON 405 STAGELINE ROAD HUDSON WI 54016 276914 0 X WWW.HUDSONHOSPITAL.ORG X 1977 WI SEE SCHEDULE O - EXEMPT PURPOSE AND ACHIEVEMENTS 11 10 0 31 0 0 357607 229404 0 0 96717 -60309 63969 77962 518293 247057 181086 158589 0 0 0 0 0 0 111388 114107 125080 295193 283669 223100 -36612 2829545 2777548 117890 4404 2711655 2773144 X TO SUPPORT, ACT FOR THE BENEFIT OF, AND CARRY OUT THE CHARITABLE PURPOSE OF HUDSON HOSPITAL, INC. BY SUPPORTING COMMUNITY HEALTH EDUCATION, PROVIDING HOME CARE ASSISTANCE, AND CONTRIBUTING TO OTHER HEALTH RELATED CHARITABLE ENDEAVORS. 0 0 159412 158589 14838 SEE SCHEDULE O - EXEMPT PURPOSE AND ACHIEVEMENTS FOR A DESCRIPTION OF PROGRAM SERVICE ACCOMPLISHMENTS 159412 1 1 0 0 0 1 0 0 0 1 0 0 0 0 0 1 0 1 0 0 0 0 0 0 1 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 0 0 0 X 11 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X DOUGLAS E JOHNSON 6514304581 405 STAGELINE ROAD HUDSON WI 54016 X RYAN CARI DIRECTOR 0.50 X 0 0 0 MATT CARON DIRECTOR 0.50 X 0 0 0 MARY GABOURY DIRECTOR 0.50 X 0 0 0 DAVE GRAMBOW DIRECTOR & VICE CHAIR 1.00 X 0 0 0 JENNIFER HAASE DIRECTOR 0.50 X 0 0 0 NICK HACKWORTHY DIRECTOR & TREASURER 0.50 X 0 0 0 CHUCK JERRICK DIRECTOR 0.50 X 0 0 0 ALAN KIECKER DIRECTOR 0.50 X 0 0 0 STEPHEN LINES DIRECTOR & SECRETARY 0.50 X 0 0 0 RICHARD O'CONNOR DIRECTOR & CHAIR 1.00 X 0 0 0 ROBERT PETERSON DIRECTOR 0.50 X 0 0 0 LINDA ROBERTSON DIRECTOR 0.50 X 0 0 0 KARRIN STOEHR MD DIRECTOR 0.50 X 0 0 0 MARIAN M FURLONG DIRECTOR 0.50 49.50 X 0 316924 54762 KAREN K RAMBO PRESIDENT 40.00 X 0 120454 21043 0 437378 75805 0 0 1 0 0 49510 22169 157725 229404 -60309 -60309 22543 7705 14838 14838 14838 85276 49510 22152 63124 63124 247057 14838 0 2815 158589 158589 100782 782 100000 4386 4386 4482 285 4197 7002 7002 ADMINISTRATIVE EXPENSE 7622 7622 MISCELLANEOUS EXPENSE 806 538 268 283669 159412 12869 111388 282647 203038 36746 36778 38350 6228 17372 107068 5500 2454430 2418936 2829545 2777548 117890 4404 117890 4404 X 2165561 2176155 464404 515299 81690 81690 2711655 2773144 2829545 2777548 X -36612 98101 X 0 1 X 1 0 X 141422 182806 241660 357607 229404 1152899 141422 182806 241660 357607 229404 1152899 366465 786434 1407 209510 339271 120990 -34766 636412 1789311 313539 0.43950 0.56470 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 19 84535 33641 515299 1 1 81690 81690 81690 81690 81690 81690 81690 81690 81690 81690 0.00000 1.00000 0.00000 0 0 0 X 276914 0 276914 -29857 -29857 247057 313526 29857 29857 283669 0 283669 PART V, LINE 4: TO SUPPORT THE MISSION OF HUDSON HEALTH FOUNDATION, INC. (HHF) PART X, LINE 2: HHF IS INCLUDED IN THE HEALTHPARTNERS, INC. (HP) CONSOLIDATED AUDITED FINANCIAL STATEMENT. HP'S ACCOUNTING POLICY PROVIDES THAT A TAX BENEFIT FROM AN UNCERTAIN TAX POSITION MAY BE RECOGNIZED WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING RESOLUTIONS OF ANY RELATED APPEALS OR LITIGATION PROCESSES, BASED ON THE TECHNICAL MERITS. HP RECORDED NO LIABILITIES AT DECEMBER 31, 2015 OR 2014 FOR UNRECOGNIZED TAX BENEFITS. PART XI, LINE 4B - OTHER ADJUSTMENTS: GOLF TOURNAMENT EXPENSE -12,713. WINE TASTING EVENT EXPENSE -9,439. LIFELINE UNIT EXPENSE -7,705. PART XII, LINE 2D - OTHER ADJUSTMENTS: GOLF TOURNAMENT EXPENSE 12,713. WINE TASTING EVENT EXPENSE 9,439. LIFELINE UNIT EXPENSE 7,705. GOLF TOURNAMENT 60745 41590 19155 1250 6578 3288 1597 WINE TASTING 74041 7920 66121 3945 5494 134786 49510 85276 1250 6578 7233 7091 22152 63124 1 HUDSON HOSPITAL INC 405 STAGELINE ROAD HUDSON WI 54016 23389 COST OFFICE BUILDING SCULPTURE & CPR TRAINING KITS HOSPITAL USE HUDSON SCHOOL DISTRICT 644 BRAKKE DRIVE HUDSON WI 54016 12550 BIOMEDICAL ACADEMY EQUIPMENT CITY OF HUDSON 505 3RD STREET HUDSON WI 540161694 96831 FMV PLAYGROUND EQUIPMENT COMMUNITY YOUTH PROGRAM SUPPORT 3 PART I, LINE 2: HUDSON HOSPITAL FOUNDATION, INC. (HHF) MANAGEMENT STAFF REVIEW THE MISSION AND PURPOSE OF POTENTIAL GRANTEE ORGANIZATIONS TO ASSURE CONSISTENCY WITH HHF'S MISSION AND PURPOSE. AMOUNTS SUBSEQUENTLY GRANTED ARE SUBJECT TO HHF'S FORMAL SPENDING APPROVAL AND DOCUMENTATION PROCESS BASED ON AMOUNT OF THE EXPENDITURE. X X 0 0 0 0 0 0 0 0 0 MARIAN M FURLONG DIRECTOR 0 262012 0 54912 0 0 0 21760 0 33002 0 371686 0 0 PART I, LINE 6 HUDSON HOSPITAL FOUNDATION, INC. (HHF) HAS NO EMPLOYEES. HHF'S PRESIDENT IS EMPLOYED BY HUDSON HOSPITAL, INC. (HOSPITAL), WHICH HAS AN INCENTIVE PROGRAM WHICH INCENTS AND REWARDS THE HOSPITAL'S EMPLOYEES WHO HELP THE ORGANIZATION ACHIEVE STATED BUSINESS AND/OR HEALTH IMPROVEMENT GOALS FOR A SPECIFIC YEAR. HOW THE PROGRAM WORKS: THE HOSPITAL BOARD OF DIRECTORS HAVE AUTHORITY FOR THE PROGRAM AND APPROVE EACH LEVEL OF THE PROGRAM ON AN ANNUAL BASIS. THE HOSPITAL INCENTIVE PROGRAM REWARDS ARE BASED ON POSITION IN THE ORGANIZATION AND THE ACHIEVEMENT OF BUSINESS AND HEALTH IMPROVEMENT GOALS ESTABLISHED IN A VARIETY OF AREAS. GOALS WILL BE RELATED TO THE ORGANIZATIONS STRATEGIC PLAN. THESE AREAS MAY INCLUDE BUT ARE NOT LIMITED TO PATIENT SATISFACTION, EMPLOYEE SATISFACTION, WORK ENVIRONMENT, EMPLOYEE AND/OR LEADERSHIP DEVELOPMENT, CARE DELIVERY, STRATEGIC CAPABILITIES, FINANCIAL PERFORMANCE, ETC., AND WILL BE DEFINED ANNUALLY FOR EACH YEAR'S PROGRAM. INCENTIVE PROGRAM GOALS FOR EACH YEAR WILL TYPICALLY BE DETERMINED BY OCTOBER OF THE PREVIOUS YEAR. SPECIFIC MEASURES FOR THE SELECTED GOAL AREAS WILL BE OUTLINED EACH YEAR IN A SUPPLEMENTAL DOCUMENT AND WILL BE COMMUNICATED TO PARTICIPANTS DURING THE FIRST QUARTER OF THE EACH YEAR. THE ACTUAL ANNUAL PAYMENT IS DETERMINED BY THE LEVEL OF GOAL ATTAINMENT. STEWARDSHIP GOALS ARE TIED TO BUDGET. A NET MARGIN THRESHOLD MUST BE MET FOR ANY PAYMENT TO BE MADE FROM THE HOSPITAL. ADDITIONALLY, THERE IS A CAP ON THE AMOUNT OF NET MARGIN USED UNDER THE PROGRAM AND THERE IS A CAP ON THE MAXIMUM INCENTIVE POTENTIALLY AVAILABLE TO EACH PARTICIPANT. 990, PART III, LINE 4A: EXEMPT PURPOSE AND ACHIEVEMENTS I. ORGANIZATION AND GOVERNANCE HHF IS A WISCONSIN NON-PROFIT CORPORATION RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND IS PART OF THE FAMILY OF HEALTHPARTNERS ORGANIZATIONS "HEALTHPARTNERS". FOUNDED IN 1957, HEALTHPARTNERS IS AN INTEGRATED SYSTEM OF HEALTH CARE DELIVERY AND HEALTH CARE FINANCING ORGANIZATIONS, AND IS ONE OF THE LARGEST CONSUMER-GOVERNED ORGANIZATIONS IN THE COUNTRY. HEALTHPARTNERS' MISSION IS TO IMPROVE HEALTH AND WELL-BEING IN PARTNERSHIP WITH OUR MEMBERS, PATIENTS AND COMMUNITY. HEALTHPARTNERS SEEKS TO TRANSFORM HEALTHCARE THROUGH A RELENTLESS FOCUS ON THE TRIPLE AIM - PROVIDING EXCEPTIONAL EXPERIENCE FOR THE INDIVIDUAL, IMPROVING THE HEALTH OF THE POPULATION, AND MAINTAINING AFFORDABILITY, ALL AT THE SAME TIME. HEALTHPARTNERS INCLUDES AN ARRAY OF TAX-EXEMPT AND TAXABLE ORGANIZATIONS WITH HEALTH CARE ACTIVITIES PRIMARILY OPERATING IN MINNESOTA AND WESTERN WISCONSIN. HEALTHPARTNERS PROVIDES A FULL-RANGE OF HEALTH CARE DELIVERY AND HEALTH PLAN SERVICES INCLUDING INSURANCE, PATIENT CARE, ADMINISTRATION AND HEALTH AND WELL-BEING PROGRAMS. HEALTHPARTNERS HEALTH PLAN'S SERVE MORE THAN 1.5 MILLION MEDICAL AND DENTAL MEMBERS NATIONWIDE, AND IS THE TOP-RANKED COMMERCIAL PLAN IN MINNESOTA. HEALTHPARTNERS MEDICAL CARE SYSTEM INCLUDES MORE THAN 1,700 PHYSICIANS, SIX HOSPITALS WITH OVER 1,000 ACUTE CARE BEDS, AND 93 PRIMARY AND SPECIALTY CARE MEDICAL FACILITIES WITH PRACTICES IN MINNESOTA AND WESTERN WISCONSIN. IN ADDITION, HEALTHPARTNERS DENTAL CARE SYSTEM HAS MORE THAN 60 DENTISTS AND 24 DENTAL CLINICS. HEALTHPARTNERS ALSO CONTRACTS WITH OTHER PRIMARY AND SPECIALTY MEDICAL FACILITIES AND DENTAL FACILITIES, PHYSICIAN GROUPS, HOSPITALS AND RELATED HEALTHCARE PROVIDERS LOCATED PRIMARILY IN MINNESOTA AND WESTERN WISCONSIN. HEALTHPARTNERS ALSO PROVIDES MEDICAL EDUCATION AND TRAINING TO MEDICAL PROFESSIONALS AND CONDUCTS RESEARCH AND FUND RAISING ACTIVITIES THAT SUPPORT THE HEALTH CARE DELIVERY SYSTEM. A COMPLETE LISTING OF ALL ORGANIZATIONS WITHIN THE HEALTHPARTNERS FAMILY, AND THE RELATIONSHIP BETWEEN THEM, CAN BE FOUND ON SCHEDULE R WITHIN THIS 990 RETURN. DETAILED INFORMATION ABOUT THE COMMUNITY BENEFIT ACTIVITIES AND ACCOMPLISHMENTS OF EACH TAX-EXEMPT ORGANIZATION CAN BE FOUND IN THE INDIVIDUAL FORM 990 RETURN FOR THAT ORGANIZATION. HEALTHPARTNERS IS DRIVING CHANGE THAT HELPS OUR MEMBERS AND PATIENTS LIVE HEALTHIER LIVES. HEALTHPARTNERS COLLABORATE WITH OTHER PLANS, CARE PROVIDERS AND OTHER COMMUNITY AND BUSINESS ORGANIZATIONS IN THE REGION AND THROUGHOUT THE NATION TO INCREASE ACCESS, CREATE AND SHARE QUALITY MEASURES AND INITIATIVES, PARTICIPATE IN DEVELOPMENT OF PUBLIC POLICY, AND COLLABORATE IN IMPROVEMENTS THAT SUPPORT THE TRIPLE AIM. AMONG HEALTHPARTNERS' SIGNATURE INITIATIVES CONTINUING IN 2015 ARE TOTAL COST OF CARE MEASUREMENTS (DEVELOPMENT OF A NATIONALLY RECOGNIZED METRIC, ENDORSED BY THE NATIONAL QUALITY FORUM, ENABLING MEASUREMENT AND INCENTIVES BASED ON COORDINATION AND EVIDENCE-BASED PRACTICES), MENTAL HEALTH (REDUCING STIGMA, AND ASSURING ACCESS TO HIGH QUALITY CARE IN THE MOST APPROPRIATE SETTINGS), CHILDREN'S HEALTH (IMPROVING CHILD HEALTH BY PROMOTING EARLY BRAIN DEVELOPMENT, PROVIDING FAMILY CENTERED CARE, AND STRENGTHENING COMMUNITIES), AND SUSTAINABILITY (ENERGY EFFICIENCY, WASTE REDUCTION, AND RESOURCE MANAGEMENT). HEALTHPARTNERS, INC. (HPI) IS THE PARENT ENTITY OF HEALTHPARTNERS AND IS A MINNESOTA NON-PROFIT CORPORATION AND LICENSED HEALTH MAINTENANCE ORGANIZATION (HMO) RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(4). HPI IS THE SOLE CORPORATE MEMBER OF HPI-RAMSEY, A MINNESOTA NON-PROFIT CORPORATION RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). IN TURN, HPI-RAMSEY IS THE SOLE CORPORATE MEMBER OF REGIONS HOSPITAL, REGIONS HOSPITAL FOUNDATION, CAPITOL VIEW TRANSITIONAL CARE CENTER, STILLWATER HEALTH SYSTEM (LAKEVIEW HEALTH), RAMSEY INTEGRATED HEALTH SERVICES AND RH-WISCONSIN, INC., ALL OF WHICH ARE NON-PROFIT CORPORATIONS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). RH-WISCONSIN, INC., AND GROUP HEALTH PLAN, INC. ARE THE SOLE CORPORATE MEMBERS OF HUDSON HOSPITAL, INC. ( HUDSON HOSPITAL), A WISCONSIN STATE LICENSED 25-BED, LEVEL IV CRITICAL ACCESS HOSPITAL AND IS A WISCONSIN NON-PROFIT ORGANIZATION EXEMPT FROM FEDERAL INCOME TAX UNDER IRC 501(C)(3). HUDSON HOSPITAL IS THE SOLE CORPORATE MEMBER OF HHF. THE CHARITABLE PURPOSE OF HHF IS TO RAISE PHILANTHROPIC FUNDS FROM ITS CONSTITUENCY IN ORDER TO ADVANCE THE MISSION, VISION, AND VALUES OF HUDSON HOSPITAL. ESTABLISHED IN 1977, HHF RAISES FUNDS TO PROVIDE SIGNIFICANT FINANCIAL SUPPORT FOR PROGRAMS AND CAPITAL NEEDS THAT ASSIST HUDSON HOSPITAL WITH PROVIDING EXCEPTIONAL CARE CLOSE TO HOME. HHF IS GOVERNED BY A VOLUNTEER BOARD OF DIRECTORS COMPRISED OF UP TO 13 MEMBERS WHO INCLUDE COMMUNITY REPRESENTATIVES, MEDICAL STAFF AND THE PRESIDENT & CEO OF THE HUDSON HOSPITAL. II. ACTIVITIES PROGRAM SUPPORT HHF STRATEGICALLY PARTNERED WITH MANY ORGANIZATIONS TO IMPROVE CARE LOCALLY AND REGIONALLY IN WESTERN WISCONSIN. - ALL-INCLUSIVE UNIVERSAL PLAYGROUND: HHF PROVIDED A GRANT TO THE CITY OF HUDSON, WISCONSIN, TO SUPPORT THE CITY'S INSTALLATION OF THE CITY'S FIRST ALL-INCLUSIVE UNIVERSAL PLAYGROUND WHICH PROMOTES SOCIAL, EMOTIONAL, AND PHYSICAL PLAY FOR ALL OUR CHILDREN REGARDLESS OF ABILITY OR DISABILITY. HHF FUNDED NEARLY $100,000 TOWARD THE ENTIRE PROJECT. PLAYGROUND INSTALL IS PROJECTED FOR SPRING 2016. - HEALING ARTS: HHF CONTINUES TO RAISE FUNDS LOCALLY FOR THIS PROGRAM WHICH GIVES PATIENTS, FAMILIES AND VISITORS A DIFFERENT PERSPECTIVE ON WHAT A HEALTH CARE INSTITUTION LOOKS LIKE. HEALING ARTS IS A UNIQUE PARTNERSHIP WITH THE PHIPPS CENTER FOR THE ARTS, WHICH INCLUDES ORIGINAL ARTWORK, MUSIC THERAPY, HEALING TOUCH, AROMATHERAPY, AND PET THERAPY. IN 2015, THROUGH THE GENEROSITY OF EMPLOYEE DONORS, THE PROGRAM COMMISSIONED AND INSTALLED ITS FIRST ROOF-TOP SCULPTURE. - HOME MONITORING: IN PARTNERSHIP WITH LIFEASSIST USA, HHF CONTINUES ITS HOME MONITORING PROGRAM FOR SENIORS. THE ELECTRONIC HOME MONITORING SYSTEM WORKS IN CONJUNCTION WITH THE USER'S TELEPHONE SERVICE. IF THE USER NEEDS HELP, HE OR SHE WOULD SIMPLY PUSH A BUTTON (WORN ON A WRISTBAND OR NECKLACE) TO CONTACT THE HOSPITAL OR CARE CENTER, 24 HOURS A DAY, SEVEN DAYS A WEEK. THE SERVICE IS AVAILABLE FOR A NOMINAL MONTHLY FEE. - HEART CARE: HHF SPONSORED THE CPR/AED EDUCATION OF 430 SIXTH GRADERS ATTENDING THE HUDSON SCHOOL MIDDLE SCHOOL, TRINITY LUTHERAN AND HUDSON HOME-SCHOOLED IN EFFORT FOR EACH STUDENT TO THEN TRAIN UP TO FOUR FAMILY MEMBERS. STUDENTS RECEIVED COURSE CREDIT FOR THIS EFFORT. THE GOAL OF THIS PROGRAM IS TO REDUCE THE TIME TO DEFIBRILLATION AND INCREASE THE CHANCE OF SURVIVAL FOR PEOPLE WITH HEART-RELATED EMERGENCIES IN AND AROUND HUDSON. COMMUNITY GIVING HHF PARTNERED WITH THREE LOCAL NOT FOR PROFITS: HUDSON SCHOOL DISTRICT, PROACT, INC., AND SEXUAL ASSAULT RESPONSE TEAM OF ST. CROIX VALLEY, (S.A.R.T). A $12,550 GRANT WAS AWARDED TO THE HUDSON SCHOOL DISTRICT FOR PROJECT LEAD THE WAY FOR BIOMEDICAL SCIENCE CURRICULUM EQUIPMENT. HHF ALSO AWARDED $5,000 TO PROACT, INC., OF HUDSON IN SUPPORT OF TEACHING HEALTHY LIVING TO ADULTS WITH DISABILITIES. PROACT WILL PURCHASE ITS FIRST SMARTBOARD AND SHED TO ENHANCE ITS NEW OUTDOOR HEALTHY LIVING CURRICULUM. S.A.R.T WAS AWARDED $2,250 OF CHARITABLE FUNDING TO BEGIN A SECONDARY VICTIM SUPPORT GROUP PILOT FOR FAMILIES WHO HAVE SUFFERED THROUGH A DOMESTIC INCIDENT. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE CORPORATE MEMBER OF HHF IS HUDSON HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A PURSUANT TO BYLAWS, HHF'S BOARD OF DIRECTORS IS COMPRISED OF NOT LESS THAN SEVEN (7) AND NOT MORE THAN FIFTEEN (15) PERSONS APPOINTED BY HUDSON HOSPITAL AS THE SOLE CORPORATE MEMBER OF HHF. FORM 990, PART VI, SECTION A, LINE 7B HHF'S CORPORATE MEMBER, HUDSON HOSPITAL, MUST APPROVE THE FOLLOWING ACTIONS OF HHF'S BOARD OF DIRECTORS OR INITIATE THESE ACTIONS DIRECTLY: - AMENDMENTS OF THE ARTICLES, BYLAWS OR OTHER GOVERNING DOCUMENTS - SALE, LEASE, MORTGAGE OR PLEDGE OF ANY REAL ESTATE OR INTEREST THEREIN, OR OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS - ADOPTION OF AMMENDMENT OF A STRATEGIC PLAN, AND CAPITAL AND OPERATING BUDGETS - APPROVAL OF UNBUDGETED CAPITAL EXPENDITURES - APPROVAL OF BORROWING OR LENDING OF FUNDS OF THE FOUNDATION - MERGER, CONSOLIDATION, AFFILIATION OR JOINT VENTURE WITH ANY OTHER ENTITY AND TRANSFER OR CONTRIBUTION OF ASSETS AND FUNDS TO SEPERATE ENTITIES - ESTABLISHMNENT OR DIVESTITURE OF ENTITIES OF WHICH HHF HAS AN EQUITY OR MANAGEMENT INTEREST, OR ESTABLISHMENT OF ANY SIGNIFICANT AND CONTINUING RELATIONSHIP WITH ANY ENTITY - DISSOLUTION AND DISTRIBUTION OF ASSETS FORM 990, PART VI, SECTION B, LINE 11 HHF'S 990 RETURN HAS A COMPREHENSIVE REVIEW PROCESS THAT IS FOLLOWED BEFORE IT IS PRESENTED TO THE GOVERNING BODY OF HHF. THE REVIEW PROCESS INCLUDES A LAYERED REVIEW BY THE TAX DEPARTMENT OF GHI, THE MANAGEMENT TEAM OF HHF, GHI'S INTERNAL LEGAL DEPARTMENT AND HHF'S OUTSIDE INDEPENDENT ACCOUNTANTS. EACH ONE OF THOSE AREAS HAS AN OPPORTUNITY TO REVIEW, ASK QUESTIONS AND MAKE COMMENTS BACK TO THE TAX DEPARTMENT OF GHI BEFORE THE FORM 990 IS COMPLETED AND PRESENTED TO THE GOVERNING BODY OF HHF. HHF MAKES AVAILABLE TO THE GOVERNING BODY (BOARD OF DIRECTORS) A COPY OF THE 990 FOR REVIEW AND COMMENT PRIOR TO THE FILING OF THE 990 RETURN. THIS COPY IS PROVIDED IN A PRE-MEETING PACKET, AND IS AN AGENDA ITEM AT A MEETING OF THE FULL BOARD OF DIRECTORS. THIS PROCESS IS NOTED AND DOCUMENTED IN THE WRITTEN MINUTES OF THE MEETING. FORM 990, PART VI, SECTION B, LINE 12C AS REQUIRED BY THE BYLAWS OF HHF, THE BOARD MONITORS POTENTIAL CONFLICTS OF INTEREST ON THE PART OF ITS BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES BY MAINTAINING A CONFLICT OF INTEREST POLICY. UNDER THE POLICY, ALL BOARD MEMBERS, PRINCIPAL OFFICERS, MEMBERS OF A COMMITTEE WITH BOARD DELEGATED POWERS AND KEY EMPLOYEES ANNUALLY ARE PROVIDED WITH A COPY OF THE POLICY AND REQUESTED TO COMPLETE A QUESTIONNAIRE IDENTIFYING ANY POTENTIAL CONFLICTS OF INTEREST. THE GENERAL COUNSEL WILL SUMMARIZE THE FINDINGS FOLLOWING REVIEW OF THE QUESTIONNAIRE AND SUBMIT A REPORT TO THE CHAIR, HUDSON HOSPITAL'S PRESIDENT AND HHF'S PRESIDENT. BOARD AGENDAS AND EXECUTIVE DECISIONS ARE MONITORED IN RELATION TO THIS POLICY. FORM 990, PART VI, SECTION B, LINE 15 HHF HAS NO EMPLOYEES. HHF'S PRESIDENT IS EMPLOYED BY HUDSON HOSPITAL, A RELATED ORGANIZATION. HOSPITAL COMPENSATION PROGRAM: KEY POINTS: - SALARY RANGES ARE DETERMINED BY UTILIZING PUBLISHED SALARY SURVEY DATA AND LOCAL JOB MARKET INFORMATION (TYPICALLY HRRAM'S ANNUAL SURVEY). - RANGES ARE UPDATED ANNUALLY DURING MAY BY HUDSON HOSPITAL'S HR DEPARTMENT. - RANGES ARE POSITION SPECIFIC AND ARE 95-100% OF THE TWIN CITY MARKET OR 100% OF THE WISCONSIN DATA (THE HIGHER OF THE TWO). - HUDSON HOSPITAL COMPENSATION DEPARTMENT IS REFERENCED FOR NON-MATCHING POSITIONS WITH HRRAM DATA. - WISCONSIN HOSPITAL ASSOCIATION SALARY SURVEY IS ALSO REFERENCED FOR SENIOR LEADERS AND EXECUTIVE POSITIONS. - PLACEMENT IN THE RANGE IS DETERMINED BY JOB DESCRIPTION REQUIREMENTS, INCLUDING EDUCATION, TRAINING, EXPERIENCE, LENGTH OF TIME IN THE POSITION, AND PERFORMANCE IN THE POSITION. FORM 990, PART VI, SECTION C, LINE 19 HHF'S FINANCIAL STATEMENTS AND 990 RETURNS ARE MADE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION FROM HHF. HHF'S ARTICLES OF INCORPORATION ARE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION THROUGH THE WISCONSIN SECRETARY OF STATE'S OFFICE. HHF'S CONFLICT OF INTEREST POLICY THROUGH IT'S RELATED ORGANIZATION, HUDSON HOSPITAL, CAN BE VIEWED THROUGH THE HUDSONHOSPITAL.ORG WEBSITE. 990, PART VII, SECT A, LN 1A, COL (B): AVERAGE HRS-RELATED ORGANIZATIONS DIRECTORS AND OFFICERS OF HHF ARE EMPLOYED AND COMPENSATED BY REGIONS HOSPITAL OR HUDSON HOSPITAL. REPORTED AVERAGE HOURS WORKED ARE BASED ON THEIR TOTAL COMPENSATION FROM ALL RELATED ORGANIZATIONS. FORM 990, PART XI, LINE 9: HUDSON HOSPITAL NET ASSET TRANSFERS 98,101. HEALTHPARTNERS INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411693838 HYBRID STAFF MODEL/NETWORK MODEL HEALTH MAINTENANCE ORGANIZATION MN 501(C)(4) N/A 0 HPI - RAMSEY 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411793333 CORPORATE PLANNING AND OVERSIGHT MN 501(C)(3) 509(A)(3) TYPE I HEALTHPARTNERS INC 0 GROUP HEALTH PLAN INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 410797853 STAFF MODEL HEALTH MAINTENANCE ORGANIZATION MN 501(C)(3) 170(B)(1) (A)(III) HEALTHPARTNERS INC 0 HEALTHPARTNERS INSTITUTE FOR EDUCATION AND RESEARCH 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411670163 HEALTHCARE EDUCATION & RESEARCH MN 501(C)(3) 509(A)(3) TYPE I HEALTHPARTNERS INC 0 CAPITOL VIEW TRANSITIONAL CARE CENTER 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 412011453 POST HOSPITALIZATION PATIENT CARE MN 501(C)(3) 170(B)(1) (A)(III) HPI - RAMSEY 0 REGIONS HOSPITAL 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 410956618 HOSPITAL MN 501(C)(3) 170(B)(1) (A)(III) HPI - RAMSEY 0 REGIONS HOSPITAL FOUNDATION 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411888902 PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT MN 501(C)(3) 170(B)(1) (A)(VI) HPI - RAMSEY 0 RHSC INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411891928 HEALTHCARE STAFFING MN 501(C)(3) 509(A)(3) TYPE II HEALTHPARTNERS INC 0 RH-WISCONSIN 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 202287016 CORPORATE PLANNING AND OVERSIGHT WI 501(C)(3) 509(A)(3) TYPE I HPI - RAMSEY 0 PHYSICIANS NECK AND BACK CLINICS 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 270684883 SPECIALTY PATIENT CARE MN 501(C)(3) 509(A)(3) TYPE II GROUP HEALTH PLAN INC 0 HUDSON HOSPITAL INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 390804125 HOSPITAL WI 501(C)(3) 170(B)(1) (A)(III) RH-WISCONSIN & GROUP HEALTH PLAN INC 0 WESTERN WISCONSIN EMERGENCY MEDICAL SERVICES COMPANY 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 263616590 PROVIDE MEDICAL TRANSPORT SERVICES WI 501(C)(3) 509(A)(3) TYPE II RH-WISCONSIN 0 LAKEVIEW MEMORIAL HOSPITAL FOUNDATION 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 411386635 PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT MN 501(C)(3) 509(A)(3) TYPE II STILLWATER HEALTH SYSTEM 0 LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION INC 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 410811697 HOSPITAL MN 501(C)(3) 170(B)(1) (A)(III) STILLWATER HEALTH SYSTEM 0 STILLWATER MEDICAL GROUP 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 830379473 PHYSICIANS GROUP MN 501(C)(3) 509(A)(2) STILLWATER HEALTH SYSTEM 0 STILLWATER HEALTH SYSTEM 8170 33RD AVE S PO BOX 1309 MPLS MN 554401309 300221189 CORPORATE PLANNING AND OVERSIGHT MN 501(C)(3) 509(A)(3) TYPE II HPI - 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