RICHLAND HOSPITAL: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
RICHLAND HOSPITAL (EIN 39-0808498)
Tax period
2014-01-01 to 2014-12-31
Filed
2015-11-12
IRS object ID
201503169349300925
Schema version
2014v5.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2015-11-12T08:12:00-06:00ReturnTs
Tax Period End2014-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390758449PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1WIPFLI LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line13703 OAKWOOD HILLS PARKWAYAddressLine1Txt
CityEAU CLAIRECityNm
State AbbreviationWIStateAbbreviationCd
ZIP54701ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN390808498EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THE RICHLAND HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlRICHBusinessNameControlTxt
Phone6086476321PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1333 EAST SECOND STREETAddressLine1Txt
CityRICHLAND CENTERCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53581ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKAREN TRAYNORPersonNm
Person TitleCHIEF FINANCIAL OFFICERPersonTitleTxt
Phone6086476321PhoneNum
Signature2015-10-16SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonPAUL M TRACZEK CPAPreparerPersonNm
PTINP01368830PTIN
Phone7158323407PhoneNum
Preparation2015-10-16PreparationDt
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerBRUCE ROESLERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1333 EAST SECOND STREETAddressLine1Txt
CityRICHLAND CENTERCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53581ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$48,825,282GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.RICHLANDHOSPITAL.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1937FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionTHE RICHLAND HOSPITAL, INC. IS DEDICATED TO CARING, EDUCATING, AND HEALING - TO BE THE COMMUNITY'S "FIRST CHOICE FOR BETTER HEALTH."ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee330TotalEmployeeCnt
Total Volunteers164TotalVolunteersCnt
Total Gross UBI$226,764TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$209,539NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$570,826PYContributionsGrantsAmt
CY Contributions Grants$415,215CYContributionsGrantsAmt
PY Program Service Revenue$38,020,875PYProgramServiceRevenueAmt
CY Program Service Revenue$38,732,471CYProgramServiceRevenueAmt
PY Investment Income$552,022PYInvestmentIncomeAmt
CY Investment Income$625,032CYInvestmentIncomeAmt
PY Other Revenue-$255,738PYOtherRevenueAmt
CY Other Revenue-$11,284CYOtherRevenueAmt
PY Total Revenue$38,887,985PYTotalRevenueAmt
CY Total Revenue$39,761,434CYTotalRevenueAmt
PY Grants And Similar Paid$23,290PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$35,375CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$19,925,735PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$20,054,020CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$111,719CYTotalFundraisingExpenseAmt
PY Other Expenses$15,844,801PYOtherExpensesAmt
CY Other Expenses$16,308,811CYOtherExpensesAmt
PY Total Expenses$35,793,826PYTotalExpensesAmt
CY Total Expenses$36,398,206CYTotalExpensesAmt
PY Revenues Less Expenses$3,094,159PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$3,363,228CYRevenuesLessExpensesAmt
Total Assets BOY$70,035,131TotalAssetsBOYAmt
Total Assets EOY$72,044,064TotalAssetsEOYAmt
Total Liabilities BOY$20,600,044TotalLiabilitiesBOYAmt
Total Liabilities EOY$19,233,479TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$49,435,087NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$52,810,585NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE RICHLAND HOSPITAL, INC. IS DEDICATED TO CARING, EDUCATING, AND HEALING - TO BE THE COMMUNITY'S "FIRST CHOICE FOR BETTER HEALTH."MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$29,943,370ExpenseAmt
Grant$35,375GrantAmt
Revenue$35,586,420RevenueAmt
DescTHE RICHLAND HOSPITAL, INC. (THE "HOSPITAL") OPERATES A 25-BED CRITICAL ACCESS HOSPITAL IN RICHLAND CENTER, WI. PATIENTS SERVED BY THE RICHLAND HOSPITAL, INC. IN 2014 INCLUDED 3,041 ADULTS AND PEDIATRICS INPATIENT DAYS, 709 SWING BED PATIENT DAYS, 351 NEWBORN PATIENT DAYS, 37,141 TOTAL OUTPATIENT VISITS, AND 5,678 EMERGENCY ROOM VISITS.AS A PART OF THE HOSPITAL'S MISSION AS A NOT-FOR-PROFIT HEALTHCARE ORGANIZATION IN THE COMMUNITIES SERVED, THE RICHLAND HOSPITAL, INC. PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS COMMUNITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. THE RICHLAND HOSPITAL, INC. MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. IN THE CURRENT YEAR, THE TOTAL CHARGES PROVIDED TO PARENTS UNDER THE COMMUNITY CARE POLICY AGGREGATED APPROXIMATELY $1,358,237 IN TOTAL CHARGES. THE ESTIMATED COST OF PROVIDING CARE TO PATIENTS UNDER THE COMMUNITY CARE POLICY WAS APPROXIMATELY $673,000. IN ADDITION, THE RICHLAND HOSPITAL, INC. IS A PROVIDER UNDER THE WISCONSIN MEDICAID PROGRAM. UNDER THIS PROGRAM, THE HOSPITAL IS LEGALLY BOUND TO ACCEPT THE AMOUNT DETERMINED BY THE STATE OF WISCONSIN AS PAYMENT IN FULL FOR EACH PATIENT'S CHARGES. THE UNPAID COST POSTED BY THE HOSPITAL IN ACCEPTANCE OF LOWER PAYMENTS BY THE MEDICAID PROGRAM IN 2014 AGGREGATED APPROXIMATELY $7.1 MILLION. (FOR ADDITIONAL INFORMATION ON THE HOSPITAL'S CHARITY CARE PROGRAM AND PARTICIPATION IN THE WISCONSIN MEDICAID PROGRAM, PLEASE REFER TO SCHEDULE H OF THE FORM 990.)THE RICHLAND HOSPITAL, INC. ALSO ENGAGES IN A VARIETY OF COMMUNITY BUILDING ACTIVITIES THAT WOULD NOT OTHERWISE, WITHOUT THE EFFORTS AND SPECIALIZED KNOWLEDGE OF THE LOCAL COMMUNITY HOSPITAL, BE PROVIDED FOR THE BENEFIT OF THE RESIDENTS OF RICHLAND CENTER, WISCONSIN, AND THE SURROUNDING COMMUNITIES. IN 2014, THE RICHLAND HOSPITAL, INC. HOSTED HEALTH FAIRS, PARTICIPATED IN LOCAL WELLNESS EVENTS, CONDUCTED EDUCATIONAL SEMINARS, AND PROVIDED INFORMATIONAL PACKETS FOR MEMBERS OF OUR COMMUNITY. OUR TARGET AUDIENCE WAS THE ENTIRE FAMILY: MEN, WOMEN, CHILDREN, AND INFANTS. THE RICHLAND HOSPITAL, INC. HOSTED A WOMEN'S HEALTH FAIR AND A TODDLER WELLNESS EVENT IN RICHLAND CENTER. EACH OF THE EVENTS WAS FREE TO ATTEND, OPEN TO THE PUBLIC, AND DREW MORE THAN 75 PEOPLE EACH. ITEMS DONATED INCLUDED: STAFF TIME, MATERIALS, SPACE, GIVEAWAYS, AND EQUIPMENT.THE RICHLAND HOSPITAL, INC. PROVIDED FREE BREASTFEEDING AND DIABETES SUPPORT GROUP MEETINGS. EDUCATIONAL MATERIALS WERE PROVIDED FREE OF CHARGE. HEALTHCARE PROFESSIONALS SPOKE TO THE PUBLIC AT COMMUNITY EVENTS THAT WERE FREE AND OPEN TO THE PUBLIC AND THEY PROVIDED INDIVIDUAL COUNSELING AS WELL TO HELP PEOPLE UNDERSTAND THE SERVICES AVAILABLE LOCALLY. EDUCATIONAL MATERIALS WERE PROVIDED FREE OF CHARGE IN A VARIETY OF VENUES. THEY COVERED A WIDE RANGE OF HEALTHCARE TOPICS INCLUDING: CANCER, DIABETES, HEART DISEASE, INFANT AND CHILD DEVELOPMENT, NUTRITION, EXERCISE, SMOKING CESSATION, BREAST HEALTH, ADVANCED DIRECTIVES, COLONOSCOPIES, JOINT AND MUSCLE DEGENERATION, WOMEN'S HEALTH, AND MORE.THE BLOOD CENTER OF WISCONSIN HELD MULTIPLE DRIVES IN THE HOSPITAL'S LOWER LEVEL AT NO COST. IN ADDITION, EMPLOYEES COULD DONATE BLOOD WHILE ON WORK TIME AND DID NOT HAVE TO PUNCH OUT. HOME HEALTH UNITED HELD MULTIPLE GRIEF SUPPORT GROUP MEETINGS IN THE HOSPITAL'S LOWER LEVEL AT NO COST. THESE MEETINGS WERE OPEN TO EVERYONE AND FREE OF CHARGE. THE RICHLAND HOSPITAL, INC. PROVIDED PROMOTIONS, SNACKS, AND BEVERAGES AS WELL.THE HOSPITAL ALSO PARTICIPATES IN HEALTH EDUCATION AWARENESS AND CAREER BUILDING ACTIVITIES SUCH AS CLINICAL TRAINING EXPERIENCE, SPEAKERS AT LOCAL SCHOOLS, AND PARTICIPATION IN CAREER FAIRS FOR AREA MIDDLE AND HIGH SCHOOLS AND FOR ADULTS. THE HOSPITAL RECOGNIZES THAT IT IS IMPORTANT TO EDUCATE LOCAL COMMUNITY MEMBERS ON THESE CAREERS AS A CAREER BUILDING INITIATIVE SO THAT LOCAL PRIMARY CARE AND ACCESS TO CARE WILL BE CONTINUED IN THE FUTURE WITH WELL-TRAINED AND EDUCATED COMMUNITY MEMBERS IN HEALTHCARE RELATED FIELDS.FINALLY, WHILE THERE IS GROWING AGREEMENT IN THE UNITED STATES ABOUT WHAT CONSTITUTES A NON-PROFIT HOSPITAL'S "COMMUNITY BENEFIT", THIS REMAINS A WORK IN PROGRESS. THE RICHLAND HOSPITAL, INC. PROVIDES SIGNIFICANT CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS. BUT IN ADDITION, THE HOSPITAL BELIEVES THAT IT PROVIDES A CRITICALLY IMPORTANT COMMUNITY BENEFIT WHICH IS NOT EASILY ABLE TO BE QUANTIFIED. THROUGH ITS HOSPITAL SERVICES, LIKE MOST RURAL HOSPITALS, THE RICHLAND HOSPITAL, INC. WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE CARE LOCALLY. WITHOUT THIS HOSPITAL, THIS CARE WOULD NOT BE AVAILABLE LOCALLY AND THE ECONOMIC WELL-BEING OF THE SURROUNDING COMMUNITIES WOULD BE NEGATIVELY AFFECTED BY THE LOSS OF PROFESSIONAL, TECHNICAL, AND SERVICE JOBS.THE RICHLAND HOSPITAL, INC. IS COMMITTED TO WORKING CLOSELY WITH COMMUNITY PARTNERS TO IMPROVE THE OVERALL HEALTH OF THE PEOPLE IN OUR COMMUNITY.COMMUNITY PARTNERS INCLUDE: RICHLAND FIT, AGING AND DISABILITY RESOURCE CENTER, RICHLAND COUNTY PUBLIC HEALTH, RICHLAND FREE CLINIC, AND RICHLAND COUNTY HEALTH & HUMAN SERVICES. WE ARE DEDICATED TO CARING, EDUCATING, AND HEALING WE WANT TO BE THE COMMUNITY'S FIRST CHOICE FOR BETTER HEALTH.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$1,524,182ExpenseAmt
Revenue$2,131,969RevenueAmt
DescTHE RICHLAND HOSPITAL, INC. ALSO OPERATES TWO RURAL HEALTH CLINICS LOCATED IN SPRING GREEN AND MUSCODA, WI. DURING 2014, THESE TWO CLINICS PROVIDED A TOTAL OF 7,955 VISITS TO PATIENTS IN BOTH COMMUNITIES. THE CLINICS ARE DESIGNATED RURAL HEALTH CLINICS BY THE MEDICARE AND MEDICAID PROGRAMS AND, AS SUCH, BY DEFINITION ARE LOCATED IN DESIGNATED RURAL OR UNDERSERVED AREAS OF THE COUNTRY BY HEALTHCARE PRACTITIONERS. THESE CLINICS PROVIDE CARE TO A LARGE PORTION OF MEDICARE AND MEDICAID BENEFICIARIES WHO WITHOUT ACCESS TO CARE LOCALLY WOULD BE REQUIRED TO TRAVEL FARTHER DISTANCES FOR QUALITY HEALTHCARE.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$31,467,552TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer EntYes (1)BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document49IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee330EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org DocumentsYes (1)ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldWIStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonKAREN TRAYNORPersonNm
Phone6086476321PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1333 EAST SECOND STREETAddressLine1Txt
CityRICHLAND CENTERCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53581ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
BRYAN MYERS MD
CHIEF OF STAFF5.00Yes (X)$0$0$0
KEVIN WHITNEY MD
DIRECTOR1.50Yes (X)$0$0$0
RICHARD MARSHALL
DIRECTOR1.50Yes (X)$0$0$0
MELISSA SPRECHER
DIRECTOR1.50Yes (X)$0$0$0
JERRY GANDER
DIRECTOR1.50Yes (X)$0$0$0
JERRY MCCAULEY
DIRECTOR1.50Yes (X)$0$0$0
DENNIS HAMILTON
CHAIR1.50Yes (X)$0$0$0Yes (X)
ROBERT NUGENT
VICE-CHAIR1.50Yes (X)$0$0$0Yes (X)
DOTTIE BEHLING
SECRETARY1.50Yes (X)$0$0$0Yes (X)
DWAYNE HILTBRAND
TREASURER1.50Yes (X)$0$0$0Yes (X)
MICHAEL DELFS
CEO (THROUGH 6/2014)40.00$124,382$0$15,019Yes (X)
KAREN TRAYNOR
CFO40.00$158,441$0$10,069Yes (X)
TERRI POTTER
CEO (EFFECTIVE 6/2014)40.00$167,158$0$0Yes (X)
JEREL BERRES MD
ER DIRECTOR29.00$265,981$0$35,873Yes (X)
E RACHEL SHANNON-GOODRICH CRNA
ANESTHETIST40.00$315,323$0$34,264Yes (X)
MUHAMMAD S KHAN MD
ER PHYSICIAN45.00$319,677$0$34,464Yes (X)
BRYAN MCCARVEL
ANESTHESIA DIRECTOR40.00$328,073$0$35,959Yes (X)
BRUCE MOTHS MD
ER PHYSICIAN36.00$260,394$0$34,529Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,939,429TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$200,177TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K17IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
THE RICHLAND MEDICAL CENTER LTD
301 EAST SECOND STREETRICHLAND CENTERWI53581PHYSICIANS/CLINIC MGMT SERVICES$1,460,136
ALBET J ALTER JR
W9107 SR 39BLANCHARDVILLEWI53516RADIOLOGY SERVICES$212,450
MERITER HEALTH SYSTEMS
36 SOUTH BROOKS STMILWAUKEEWI53288LAB SERVICES$197,706
PAUL C MARISKANISH
315 W MAIN STPLATTEVILLEWI53818ER SERVICES$140,459
WHITNEY SLEEP DIAGNOSTIC & CONSULTANT
119 GRAYSTONE PLAZA STE 102DETROIT LAKESMN56501SLEEP STUDY SERVICES$140,000
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K7CntrctRcvdGreaterThan100KCnt
Related Organizations$376,312RelatedOrganizationsAmt
Government Grants$16,280GovernmentGrantsAmt
All Other Contributions$22,623AllOtherContributionsAmt
Total Contributions$415,215TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
PATIENT SERVICE REVENUE621990$37,806,942$37,718,389$88,553
CONTRACTED THERAPY621990$243,331$243,331
MEDICAL RECORDS621990$198,208$72,265$125,943
MEALS722320$142,139$64,686$77,453

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$341,851TotalRevenueColumnAmt
Exclusion$341,851ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$38,732,471TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$473,700TotalRevenueColumnAmt
Exclusion$473,700ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$1,048,278RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$1,059,562RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$11,284RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$11,284TotalRevenueColumnAmt
Unrelated Business Revenue$1,260UnrelatedBusinessRevenueAmt
Exclusion-$12,544ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$8,052,438SecuritiesAmt
Other$103,180OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$7,957,813SecuritiesAmt
Other$46,473OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$94,625SecuritiesAmt
Other$56,707OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$151,332TotalRevenueColumnAmt
Exclusion$151,332ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$39,761,434TotalRevenueColumnAmt
Related Or Exempt Func Income$37,718,389RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$226,764UnrelatedBusinessRevenueAmt
Exclusion$1,401,066ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$35,375TotalAmt
Program Services$35,375ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$475,069TotalAmt
Management And General$475,069ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$14,255,281TotalAmt
Program Services$12,745,482ProgramServicesAmt
Management And General$1,435,143ManagementAndGeneralAmt
Fundraising$74,656FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$538,538TotalAmt
Program Services$481,501ProgramServicesAmt
Management And General$54,217ManagementAndGeneralAmt
Fundraising$2,820FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$3,761,808TotalAmt
Program Services$3,363,389ProgramServicesAmt
Management And General$378,718ManagementAndGeneralAmt
Fundraising$19,701FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,023,324TotalAmt
Program Services$886,945ProgramServicesAmt
Management And General$131,184ManagementAndGeneralAmt
Fundraising$5,195FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$793,642TotalAmt
Management And General$793,642ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$88,555TotalAmt
Management And General$88,555ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$3,816,398TotalAmt
Program Services$3,138,940ProgramServicesAmt
Management And General$669,658ManagementAndGeneralAmt
Fundraising$7,800FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$160,819TotalAmt
Program Services$50ProgramServicesAmt
Management And General$160,769ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$247,099TotalAmt
Program Services$158,502ProgramServicesAmt
Management And General$87,050ManagementAndGeneralAmt
Fundraising$1,547FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$260,183TotalAmt
Management And General$260,183ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,649,619TotalAmt
Program Services$1,585,800ProgramServicesAmt
Management And General$63,819ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$53,960TotalAmt
Program Services$37,637ProgramServicesAmt
Management And General$16,323ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$47,371TotalAmt
Program Services$36,728ProgramServicesAmt
Management And General$10,643ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,779,114TotalAmt
Program Services$2,779,114ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$99,448TotalAmt
Management And General$99,448ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
SUPPLIES$5,378,270$5,292,598$85,672
BAD DEBT EXPENSE$791,721$791,721
EQUIPMENT RENTAL & MAIN$764,569$755,727$8,842
DIETARY EXPENSE$243,611$243,611

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total-$865,568TotalAmt
Program Services-$865,568ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$36,398,206TotalAmt
Program Services$31,467,552ProgramServicesAmt
Management And General$4,818,935ManagementAndGeneralAmt
Fundraising$111,719FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,496BOYAmt
EOY$1,273EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$11,729,525BOYAmt
EOY$16,035,026EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$7,047,123BOYAmt
EOY$7,461,652EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$214,580BOYAmt
EOY$158,516EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,292,890BOYAmt
EOY$1,374,655EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$384,773BOYAmt
EOY$297,697EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$57,678,122LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$30,512,384LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$29,103,855BOYAmt
EOY$27,165,738EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$11,456,167BOYAmt
EOY$12,169,655EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$4,918,751BOYAmt
EOY$4,674,651EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$3,885,971BOYAmt
EOY$2,705,201EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$70,035,131BOYAmt
EOY$72,044,064EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$3,966,776BOYAmt
EOY$3,925,876EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$482,419BOYAmt
EOY$367,581EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$15,755,000BOYAmt
EOY$14,750,000EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$395,849BOYAmt
EOY$190,022EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$20,600,044BOYAmt
EOY$19,233,479EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$48,814,806BOYAmt
EOY$52,422,650EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$560,281BOYAmt
EOY$327,935EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$60,000BOYAmt
EOY$60,000EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$49,435,087BOYAmt
EOY$52,810,585EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$70,035,131BOYAmt
EOY$72,044,064EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$3,363,228ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$278,262NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$265,992OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$4,516OtherActivitiesAmt
Total Lobbying Expenditures$4,516TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationTHE RICHLAND HOSPITAL, INC. (THE "HOSPITAL") PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THESE DUES ARE PRIMARILY FOR ACCESS TO EDUCATIONAL MATERIALS AND STAFF TRAINING AND DEVELOPMENT. THE WHA HAD NOTIFIED THE HOSPITAL THAT APPROXIMATELY $2,002 OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT. THE HOSPITAL IS ALSO A MEMBER OF THE RURAL WISCONSIN HEALTH COOPERATIVE (RWHC). EACH YEAR, THE HOSPITAL PAYS MEMBERSHIP FEES TO RWHC. THE RWHC PROVIDES SUPPORT SERVICES FOR A NUMBER OF ITS MEMBER HOSPITALS THROUGHOUT THE STATE OF WISCONSIN. SOME OF THE MANY SERVICES PROVIDED TO MEMBER HOSPITALS INCLUDE PROVIDING ASSISTANCE TO ORGANIZATIONS IN SECURING GRANT FUNDING FOR NEW OR EXISTING HEALTHCARE PROGRAMS, LEGAL SERVICES, REIMBURSEMENT REVIEW SERVICES, ACCOUNTING ASSISTANCE, CONTRACTING FOR THERAPIST COVERAGE, AND ADMINISTRATIVE CONSULTING SERVICES. AS A PART OF THESE SERVICES, RWHC ALSO DOES PROVIDE ANALYSIS OF CURRENT HEALTHCARE ISSUES IN AN EFFORT TO PROMOTE AND BETTER HEALTHCARE FOR HOSPITALS IN RURAL COMMUNITIES THROUGHOUT WISCONSIN. ONE OF THESE EFFORTS ALSO INCLUDES SOME LOBBYING ON BEHALF OF THE MEMBER ORGANIZATIONS. IT WAS DETERMINED THAT APPROXIMATELY $2,514 OF THE FEES PAID BY THE HOSPITAL IN 2014 RELATED TO LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE HEALTHCARE ENVIRONMENT IN THE STATE OF WISCONSIN.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$70,473BeginningYearBalanceAmt
Investment Earnings Or Losses$703InvestmentEarningsOrLossesAmt
End Year Balance$71,176EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$70,005BeginningYearBalanceAmt
Investment Earnings Or Losses$468InvestmentEarningsOrLossesAmt
End Year Balance$70,473EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$69,671BeginningYearBalanceAmt
Investment Earnings Or Losses$334InvestmentEarningsOrLossesAmt
End Year Balance$70,005EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$69,549BeginningYearBalanceAmt
Investment Earnings Or Losses$122InvestmentEarningsOrLossesAmt
End Year Balance$69,671EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$69,400BeginningYearBalanceAmt
Investment Earnings Or Losses$149InvestmentEarningsOrLossesAmt
End Year Balance$69,549EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.84300PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.15700TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$941,726OtherCostOrOtherBasisAmt
Book Value$941,726BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$41,352,403OtherCostOrOtherBasisAmt
Depreciation$18,689,166DepreciationAmt
Book Value$22,663,237BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$609,073OtherCostOrOtherBasisAmt
Depreciation$375,670DepreciationAmt
Book Value$233,403BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$14,193,973OtherCostOrOtherBasisAmt
Depreciation$11,143,710DepreciationAmt
Book Value$3,050,263BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$580,947OtherCostOrOtherBasisAmt
Depreciation$303,838DepreciationAmt
Book Value$277,109BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$27,165,738TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (4 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
UNDER BOND INDENTURE AGREEMENT$2,248,024F
FUNDED DEPRECIATION$2,184,457F
UNEMPLOYMENT RESERVE$160,413F
RESTRICTED INVESTMENTS$81,757F
FieldValueIRS element (for citing)
Total Book Value Securities$4,674,651TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
DEFERRED COMPENSATION PLAN LIABILITY$388,015
BOND AMORTIZATION PREMIUM - NET AGAINST LONG-TERM DEBT-$197,993
FieldValueIRS element (for citing)
Total Liability$190,022TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$39,634,107TotalRevEtcAuditedFinclStmtAmt
Other Revenue$1,092,361OtherRevenueAmt
Revenue Not Reported$1,092,361RevenueNotReportedAmt
Revenue Subtotal$38,541,746RevenueSubtotalAmt
Other Revenues Not Included$1,219,688OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$1,219,688RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$39,761,434TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$36,614,392TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$1,059,562OtherExpensesIncludedAmt
Expenses Not Reported$1,059,562ExpensesNotReportedAmt
Expenses Subtotal$35,554,830ExpensesSubtotalAmt
Other Expenses Not Included$843,376OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$843,376ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$36,398,206TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:THE ENDOWMENT FUNDS MAINTAINED BY THE RICHLAND HOSPITAL, INC. HAVE BEEN RESTRICTED BY DONORS TO BE MAINTAINED IN PERPETUITY, THE INCOME OF WHICH IS EXPENDABLE TO SUPPORT SCHOLARSHIP PROGRAMS OF THE HOSPITAL.
PART X, LINE 2:IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE RICHLAND HOSPITAL, INC. DETERMINES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE LIKELY THAN NOT RECOGNITION THRESHOLD, THE BENEFIT OF THE TAX POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. THE RICHLAND HOSPITAL, INC. RECORDED NO ASSETS OR LIABILITIES FOR UNCERTAIN TAX POSITIONS IN 2014 AND 2013. FEDERAL TAX RETURNS FOR TAX YEARS 2011 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE.
PART XI, LINE 2D - OTHER ADJUSTMENTS:RENTAL EXPENSES INCLUDED WITH EXPENSES ON FINANCIAL STATEMENTS 1,059,562. NET ASSETS RELEASED FROM RESTRICTIONS 32,799.
PART XI, LINE 4B - OTHER ADJUSTMENTS:CONTRIBUTIONS FROM RELATED ORGANIZATIONS 376,312. SCHOLARSHIP & GRANT EXPENSE NET AGAINST GRANT REVENUE ON FINANCIAL STATEMENT 51,655. PROVISION FOR BAD DEBTS NET AGAINST REVENUE ON FINANCIAL STATEMENTS 791,721.
PART XII, LINE 2D - OTHER ADJUSTMENTS:RENTAL EXPENSES INCLUDED WITH EXPENSES ON FINANCIAL STATEMENTS 1,059,562.
PART XII, LINE 4B - OTHER ADJUSTMENTS:SCHOLARSHIP & GRANT EXPENSE NET AGAINST GRANT REVENUE ON FINANCIAL STATEMENT 51,655. PROVISION FOR BAD DEBTS NET AGAINST REVENUE ON FINANCIAL STATEMENTS 791,721.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent150Yes (X)Percent150Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$673,487TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$673,487NetCommunityBenefitExpnsAmt
Total Expense0.01890TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,437,972TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,025,481DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,412,491NetCommunityBenefitExpnsAmt
Total Expense0.06780TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,111,459TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,025,481DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,085,978NetCommunityBenefitExpnsAmt
Total Expense0.08670TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$29,617TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,310DirectOffsettingRevenueAmt
Net Community Benefit Expns$28,307NetCommunityBenefitExpnsAmt
Total Expense0.00080TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,970,601TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,477,615DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,492,986NetCommunityBenefitExpnsAmt
Total Expense0.04190TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$9,649TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$9,649NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,009,867TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,478,925DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,530,942NetCommunityBenefitExpnsAmt
Total Expense0.04300TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$11,121,326TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$6,504,406DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,616,920NetCommunityBenefitExpnsAmt
Total Expense0.12970TotalExpensePct

Economic Development EconomicDevelopmentGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$200TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$200NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,393TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,393NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$9,048TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$9,048NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$10,641TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$10,641NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$392,578BadDebtExpenseAmt
Bad Debt Expense Attributable$196,289BadDebtExpenseAttributableAmt
Reimbursed By Medicare$12,468,965ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$12,543,762CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$74,797MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection Policy0WrittenDebtCollectionPolicyInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THE RICHLAND HOSPITAL INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1333 EAST SECOND STREETAddressLine1Txt
CityRICHLAND CENTERCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53581ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.RICHLANDHOSPITAL.COMWebsiteAddressTxt
State License1045StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1THE RICHLAND HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Information GapsYes (X)InformationGapsInd
CHNA Conducted13CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.RICHLANDHOSPITAL.COM/WP-CONTENT/UPLOADS/2013/12/2013_CHNA_COMPLEOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt13ImplementationStrategyAdptYr
Strategy Posted Website0StrategyPostedWebsiteInd
Strategy AttachedYes (1)StrategyAttachedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care150.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.000000000000FPGFamilyIncmLmtDscntCarePct
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
FAP Notice DisplayedYes (X)FAPNoticeDisplayedInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit Report To Credit AgencyYes (X)PermitReportToCreditAgencyInd
Collection ActivitiesYes (1)CollectionActivitiesInd
Reporting To Credit AgencyYes (X)ReportingToCreditAgencyInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Other Actions TakenYes (X)OtherActionsTakenInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
THE RICHLAND HOSPITAL, INC.PART V, SECTION B, LINE 5: THE RICHLAND HOSPITAL, INC. ENGAGED IN AN EXTENSIVE ASSESSMENT OF THE HEALTH NEEDS OF THE COMMUNITY IN ITS STRATEGIC PLANNING PROCESS. THE ASSESSMENT INCLUDED DIRECT FEEDBACK FROM THE RESIDENTS OF THE MARKET AREA SERVED AS WELL AS USE OF OTHER SOURCES OF DATA RELATED TO COMMUNITY HEALTH NEEDS. IT INCLUDED PERFORMING PROJECTIONS OF DEMAND FOR HEALTHCARE SERVICES AND ASSESSING WHAT IS AVAILABLE IN THE MARKET AREA TO MEET THOSE DEMANDS.IN ADDITION, THE RICHLAND MEDICAL CENTER, LTD. PHYSICIANS AND PROVIDERS WHO OFFER PRIMARY AND SECONDARY LEVEL CARE, INCLUDING PREVENTIVE HEALTHCARE FOR THE PERSONS RESIDING IN THE MARKET AREA, PARTICIPATED IN A PLANNING SESSION WHERE DATA GATHERED WAS REVIEWED AND THEY PROVIDED THEIR INPUT INTO NEEDS OF THE PATIENTS THEY SERVE. THE PLAN WAS PROVIDED IN DRAFT FORM TO PERSONS REPRESENTING THE AGING AND DISABILITIES RESOURCE CENTER, RICHLAND COUNTY PUBLIC HEALTH, RICHLAND FIT, RICHLAND FREE CLINIC, AND RICHLAND COUNTY HEALTH AND HUMAN SERVICES. WE THEN MET WITH THESE PERSONS TO DISCUSS OUR PLANS AND COMMUNITY PRIORITIES. APPENDIX B CONTAINS A FULL SUMMARY OF THEIR COMMENTS.RANDOM SAMPLE TELEPHONE SURVEY OF RESIDENTS OF THE MARKET AREA SERVED BY THE RICHLAND HOSPITAL, INC. RANDOMLY SURVEYED 250 HOUSEHOLDS IN ITS MARKET AREA REGARDING HEALTHCARE SERVICES AND NEEDS. PERSONS OF ALL INCOME LEVELS WERE INCLUDED IN THE SURVEY PROCESS. THIS PRODUCED SURVEY RESULTS THAT ARE AT THE 94 PERCENT CONFIDENCE LEVEL WITH A MARGIN OF ERROR OF + SIX PERCENTAGE POINTS.
THE RICHLAND HOSPITAL, INC.PART V, SECTION B, LINE 11: AFTER CONSIDERING THE COMMUNITY HEALTH NEEDS THAT WERE IDENTIFIED THROUGH THE 2013 ASSESSMENT PROCESS, THE RICHLAND HOSPITAL, INC. CONCLUDED THE FOLLOWING WERE PRIORITIES: 1. ENSURING ACCESS TO CARE: THE RICHLAND HOSPITAL, INC., IS A COMMUNITY PARTNER IN THE RICHLAND FIT INITIATIVE DEVOTED TO TACKLING OBESITY IN THE COMMUNITY. 2. PREVENTING AND REDUCING OBESITY: THE RICHLAND HOSPITAL, INC. DESIGNATES A SIGNIFICANT AMOUNT OF RESOURCES TO COMMUNITY HEALTH IMPROVEMENT, WHICH INCLUDES WELLNESS INITIATIVES. MANY OF THESE RESOURCES WILL BE DIRECTED TO THE PLAN THAT IS IN THE PROCESS OF BEING DEVELOPED. 3. COMMUNITY HEALTH AND WELLNESS: THE RICHLAND HOSPITAL, INC. DESIGNATES A SIGNIFICANT AMOUNT OF RESOURCES TO COMMUNITY HEALTH IMPROVEMENT, WHICH INCLUDES WELLNESS INITIATIVES. MANY OF THESE RESOURCES WILL BE DIRECTED TO THE PLAN THAT IS IN THE PROCESS OF BEING DEVELOPED. IN 2014, THE RICHLAND HOSPITAL, INC. EXPOUNDED ON THEIR EXISTING IMPLEMENTATION PLANS DESIGNED TO MEET THE THREE PRIORITIES IDENTIFIED IN THE 2013 COMMUNITY HEALTH NEEDS ASSESSMENT. 1. ENSURING ACCESS TO CARE:- RICHLAND HOSPITAL CERTIFIED APPLICATION COUNSELORS HELPED UNINSURED PEOPLE FIND HEALTH COVERAGE IN THE NEW HEALTH INSURANCE MARKETPLACE. WEEKLY APPOINTMENTS WERE OFFERED TO HELP PEOPLE FILL OUT THEIR PAPERWORK OR TO GAIN A BETTER UNDERSTANDING OF WHAT WAS AVAILABLE THROUGH THE NEW PROGRAM.- THE RICHLAND HOSPITAL MEDICAL IMAGING AND LABORATORY DEPARTMENTS PROVIDED SERVICES FOR THE RICHLAND COMMUNITY FREE CLINIC.- THE RICHLAND HOSPITAL, INC. MAINTAINS RURAL HEALTH CLINICS IN MUSCODA AND SPRING GREEN, WISCONSIN. BOTH HAVE STATUS WITH "GOVERNORS SHORTAGE DESIGNATION FOR RURAL HEALTH CLINICS."- THE SURGICAL DEPARTMENT BEGAN PREPARATIONS FOR STAFF TRAINING AND EQUIPMENT NEEDS TO ADEQUATELY SUPPORT BRINGING ANTERIOR HIP REPLACEMENT SURGERY TO THE COMMUNITY.- THE BIRTH CENTER CONDUCTED AN ONLINE SURVEY AND OFFERED COMMUNITY FOCUS GROUPS IN SPRING GREEN, MUSCODA, AND RICHLAND CENTER, WISCONSIN, TO GATHER INSIGHTS ABOUT HOW TO BETTER MEET THE NEEDS OF EXPECTANT MOTHERS. - ATHLETIC TRAINERS PROVIDED WEEKLY COVERAGE AT THE LOCAL HIGH SCHOOL AND AT HOME SPORTING EVENTS TO ENSURE THAT LOCAL AND VISITING ATHLETES HAVE IMMEDIATE ACCESS TO HEALTHCARE IN THE EVENT THAT THEY ARE INJURED DURING PRACTICE OR COMPETITION.- THE RICHLAND HOSPITAL, INC. BEGAN WORKING WITH THE RICHLAND MEDICAL CENTER TO CREATE A PLAN TO ENSURE THAT GENERAL SURGERY SERVICES WOULD BE AVAILABLE AFTER THE RETIREMENT OF THE CURRENT GENERAL SURGEON.- THE HOSPITAL EXPANDED THE SWING BED PROGRAM BY DEVELOPING AN ACTIVITY PLAN UTILIZING VOLUNTEERS. THE ACTIVITIES OF DAILY LIVING PROMOTE MAINTENANCE THE ENHANCEMENT OF EACH PATIENT'S QUALITY OF LIFE.- A SERIES OF COMMUNITY GRIEF SUPPORT SESSIONS WERE HOSTED FOR THOSE GRIEVING THE LOSS OF SOMEONE IN THEIR LIFE. IN ADDITION, A SPECIALIZED GRIEF SUPPORT GROUP WAS HOSTED FOR THOSE SUFFERING THE LOSS OF A PARTNER.- A PROVIDER IN SPRING GREEN BECAME THE ONLY PHYSICIAN IN THE AREA TO PROVIDE NEXPLANON BIRTH CONTROL IMPLANT WHICH PROVIDES UP TO THREE YEARS OF PREGNANCY PREVENTION.- THE MEDICAL IMAGING DEPARTMENT, THE SPRING GREEN MEDICAL CENTER, AND THE MUSCODA HEALTH CENTER BECAME FULLY DIGITAL FROM A RADIOGRAPHY STANDPOINT. IMAGES CAN BE TAKEN AND READ BY A RADIOLOGIST IN AS LITTLE AS SEVEN SECONDS. THIS GREATLY IMPROVES THE SPEED OF CARE THAT CAN BE PROVIDED TO PATIENTS. AT THE RURAL HEALTH CLINICS IN SPRING GREEN AND MUSCODA, IMAGES CAN BE SENT TO SPECIALISTS FOR SECOND OPINIONS AND FOR CONSULTATIONS WITH GREAT EASE. 2. PREVENTING AND REDUCING OBESITY:- A CONDITIONING PRESENTATION WAS HOSTED GUIDING PARTICIPANTS THROUGH A SERIES OF PROGRESSIVE EXERCISES AND TRAINING TECHNIQUES INTENDED TO IMPROVE MOBILITY, STABILITY, STRENGTH, AND POWER TO HELP GOLFERS IMPROVE THEIR GAME. THE PRESENTATION WAS AVAILABLE TO THE PUBLIC.- A FREE LADIES NIGHT OUT EVENT WAS HOSTED. LOCAL BUSINESSES, ORGANIZATIONS, AND SERVICE GROUPS PROVIDED INFORMATION AND OPPORTUNITIES TO BE ACTIVE AND WELL WITHIN OUR COMMUNITY. - A FREE SWIMMING DAY AT SYMONS RECREATION COMPLEX WAS SPONSORED. THE EVENT WAS OPEN TO THE PUBLIC AND DESIGNED TO PROMOTE AN ACTIVE LIFESTYLE FOR FAMILIES.- A FREE PRE-DIABETES EDUCATION CLASS WAS OFFERED TO THE PUBLIC. - THE DIABETES EDUCATION TEAM BEGAN OFFERING A NEW OPTION TO TYPE 2 DIABETICS.- MONTHLY DIABETES SUPPORT GROUPS WERE HOSTED. - THE RICHLAND HOSPITAL, INC. ACTIVELY JOINED THE RICHLAND COUNTY'S RICHLAND FIT COALITION BY ADDING A RICHLAND HOSPITAL EMPLOYEE TO THE STEERING COMMITTEE. 3. COMMUNITY HEALTH AND WELLNESS:- A CONDITIONING PRESENTATION WAS HOSTED GUIDING PARTICIPANTS THROUGH A SERIES OF PROGRESSIVE EXERCISES AND TRAINING TECHNIQUES INTENDED TO IMPROVE MOBILITY, STABILITY, STRENGTH, AND POWER TO HELP GOLFERS IMPROVE THEIR GAME. THE PRESENTATION WAS AVAILABLE TO THE PUBLIC.- A FREE LADIES NIGHT OUT EVENT WAS HOSTED. LOCAL BUSINESSES, ORGANIZATIONS, AND SERVICE GROUPS PROVIDED INFORMATION AND OPPORTUNITIES TO BE ACTIVE AND WELL WITHIN OUR COMMUNITY. - A FREE SWIMMING DAY AT SYMONS RECREATION COMPLEX WAS SPONSORED. THE EVENT WAS OPEN TO THE PUBLIC AND DESIGNED TO PROMOTE AN ACTIVE LIFESTYLE FOR FAMILIES.- A FREE PRE-DIABETES EDUCATION CLASS WAS OFFERED TO THE PUBLIC. - THE DIABETES EDUCATION TEAM BEGAN OFFERING A NEW OPTION TO TYPE 2 DIABETICS. - MONTHLY DIABETES SUPPORT GROUPS WERE HOSTED. - THE RICHLAND HOSPITAL, INC. ACTIVELY JOINED THE RICHLAND COUNTY'S RICHLAND FIT COALITION BY ADDING A RICHLAND HOSPITAL EMPLOYEE TO THE STEERING COMMITTEE. - THE RICHLAND HOSPITAL, INC. PROVIDED FREE SMOKING CESSATION CLASSES. - THE RICHLAND HOSPITAL, INC. PROVIDED A MUSIC 'N MOTION CLASS. THE CLASS IS DESIGNED TO HELP IMPROVE THE LIVES OF PEOPLE LIVING WITH PARKINSON'S DISEASE, STROKE, MULTIPLE SCLEROSIS, ATAXIA, MUSCULAR DYSTROPHY, NEUROPATHY, AND OTHER NEUROLOGICAL DISEASES. THE RICHLAND HOSPITAL, INC. IS COMMITTED TO ADDRESSING MANY OF THE UNMET COMMUNITY HEALTH NEEDS THAT WERE IDENTIFIED THROUGH THE CHNA. AS WITH ALL HEALTHCARE ORGANIZATIONS, ADEQUATE RESOURCES ARE NOT AVAILABLE TO ADDRESS EVERY UNMET HEALTH NEED IN THE COMMUNITIES SERVED. THERE ARE COMMUNITY HEALTH NEEDS THAT THE HOSPITAL WAS UNABLE TO ADDRESS EITHER INDIVIDUALLY OR THROUGH PARTNERSHIPS WITH OTHER ORGANIZATIONS THAT ALSO SERVE THESE COMMUNITIES. UNMET HEALTHCARE NEEDS IDENTIFIED THROUGH THE CHNA WHICH HAVE NOT BEEN ADDRESSED BY THE HOSPITAL IN 2014 INCLUDE: 1) THE SHORTAGE OF MENTAL HEALTH AND DENTAL CARE PROFESSIONALS, 2) THE LIMITED ACCESS TO HEALTHY FOOD REPORTED, AND 3) THE HIGHER THAN STATE AVERAGE OF EXCESS DRINKING. ACCESS TO DENTAL HEALTH PROFESSIONALS IS BEING UNDERTAKEN BY MEMBERS OF THE RICHLAND CENTER DENTAL ASSOCIATION. THE SCHOOL DISTRICTS HAVE UNDERAGE DRINKING PROGRAMS IN PLACE TO ADDRESS THE ADOLESCENT COMPONENT OF ALCOHOL USE. THROUGH THE RICHLAND FIT COALITION, ACCESS TO FRESH VEGETABLES IN SEASON IS BEING ADDRESSED WITH COMMUNITY GARDEN DEVELOPMENT SLATED FOR 2015. THE SHORTAGE OF MENTAL HEALTH PROFESSIONALS CONTINUES TO BE AN UNMET NEED, THOUGH HAS NOT BEEN ADDRESSED DUE TO AVAILABILITY OF RESOURCES IN THE SERVICE AREA. THE HOSPITAL IS COMMITTED TO PERIODICALLY REVIEWING THE NEEDS IDENTIFIED AS UNMET, AS WELL AS NEWLY IDENTIFIED NEEDS THROUGHOUT THE YEAR, AND ADDRESSING THEM IN ACCORDANCE WITH THE HOSPITAL'S MISSION, VISION, AND RESOURCES.
THE RICHLAND HOSPITAL, INC.PART V, SECTION B, LINE 16I: THE HOSPITAL ALSO PROVIDED FINANCIAL ASSISTANCE INFORMATION IN BROCHURES LOCATED IN THE CASHIERS OFFICE. BROCHURES CAN ALSO BE FOUND AT BOTH OF THE RURAL HEALTH CLINICS. FURTHER INFORMATION REGARDING THE FINANCIAL ASSISTANCE POLICY IS ALSO AVAILABLE THROUGH PHONE CONVERSATIONS WITH FINANCIAL COUNSELORS AT THE HOSPITAL. BROCHURES ARE ALSO AVAILABLE AT THE REHAB DEPARTMENT, FREE CLINIC, AND RICHLAND COUNTY RESOURCE AND DISABILITY OFFICE.
THE RICHLAND HOSPITAL, INC.PART V, SECTION B, LINE 20E: THE HOSPITAL'S BUSINESS OFFICE STAFF ALSO MAKES AN ATTEMPT TO CONTACT EACH PATIENT WITH A BALANCE GREATER THAN $300 AND THE COMMUNITY CARE PROGRAM IS MENTIONED ON THE PHONE CALL.
THE RICHLAND HOSPITAL, INC.PART V, SECTION B, LINE 22D: THE HOSPITAL FOLLOWS A CALCULATION TO DETERMINE AN AMOUNT GENERALLY BILLED ("AGB") TO CHARGE UNINSURED PATIENTS. THE CALCULATION OF AGB SHALL EQUAL AMOUNTS GENERALLY BILLED TO INDIVIDUALS WITH INSURANCE COVERING THAT CARE. AGB SHALL BE CALCULATED ANNUALLY AND WILL BE BASED ON THE IMMEDIATELY PRECEDING 12-MONTH PERIOD SPANNING DECEMBER THROUGH NOVEMBER. CALCULATIONS INCLUDE PAYMENTS FOR DEDUCTIBLES AND CO-PAYMENTS. THE AGB AS CALCULATED SHALL BE EFFECTIVE ON THE 14TH DAY OF JANUARY OF EACH YEAR AND APPLIED TO ANY APPLICATION DETERMINATIONS MADE ON OR AFTER THAT DATE REGARDLESS OF THE ORIGINAL DATE OF SERVICE OR THE ORIGINAL DATE OF APPLICATION. THE AGB PERCENTAGE IS EQUAL TO THE SUM OF ALL CLAIMS PAYMENTS FOR MEDICALLY NECESSARY CARE FOR HEALTHCARE COVERED BY MEDICARE AND PRIVATE INSURERS DIVIDED BY GROSS CHARGES RELATED TO CLAIMS.
PART V, SECTION B, LINE 16FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY
THE RICHLAND HOSPITAL, INC. PART V, SECTION B, LINE 16A WEBSITE:HTTP://WWW.RICHLANDHOSPITAL.COM/ABOUT/PATIENTS-VISITORS/COMMUNITY-CARE-FINA
THE RICHLAND HOSPITAL, INC. PART V, SECTION B, LINE 16B WEBSITE:HTTP://WWW.RICHLANDHOSPITAL.COM/WP-CONTENT/UPLOADS/2013/12/COMMUNITY_CARE_A
THE RICHLAND HOSPITAL, INC. PART V, SECTION B, LINE 16C WEBSITE:HTTP://WWW.RICHLANDHOSPITAL.COM/WP-CONTENT/UPLOADS/2013/12/COMMUNITY_CARE_B
FieldValueIRS element (for citing)
Facility2FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
MUSCODA HEALTH CENTER
1075 NORTH WISCONSIN AVENUEMUSCODAWI53573RURAL HEALTH CLINIC
SPRING GREEN MEDICAL CENTER
150 EAST JEFFERSON STREETSPRING GREENWI53588RURAL HEALTH CLINIC

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 6A:THE RICHLAND HOSPITAL, INC. PREPARES A COMMUNITY BENEFIT REPORT ANNUALLY AND FILES IT WITH THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THE REPORT IS AVAILABLE TO THE GENERAL PUBLIC ON WHA'S DATABASE AND WEBSITE.
PART I, LINE 7:THE COSTING METHODOLOGY USED ON FORM 990 IS BASED ON A COST-TO-CHARGE RATIO WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBT DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST VARIOUS REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER IRS SUGGESTED COSTING METHODS FOR THE FORM 990.
PART I, LINE 7G:SUBSIDIZED HEALTH SERVICES AT THE RICHLAND HOSPITAL, INC. INCLUDES THE OPERATION OF THE HOSPITAL EMERGENCY ROOM DEPARTMENT, THE INTENSIVE CARE INPATIENT UNIT, AND THE OPERATION OF TWO RURAL HEALTH CLINICS. THESE SERVICES ARE UNAVAILABLE TO MEMBERS OF THE COMMUNITY OTHER THAN THROUGH THE RICHLAND HOSPITAL, INC. AND ARE PRIMARILY UTILIZED FOR EMERGENCY SERVICES. THE EMERGENCY ROOM DEPARTMENT OPERATES 24-HOURS PER DAY, SEVEN DAYS PER WEEK AND IS STAFFED PRIMARILY BY BOARD CERTIFIED EMERGENCY ROOM PHYSICIANS. THE HOSPITAL ALSO WORKS IN CONJUNCTION WITH A LOCAL CLINIC ORGANIZATION TO PROVIDE A THIRD YEAR RESIDENT PHYSICIAN AN OPPORTUNITY TO PROVIDE SERVICES TO PATIENTS IN THE EMERGENCY MEDICAL SETTING AS PART OF THEIR PHYSICIAN TRAINING EXPERIENCE. AS PART OF THE PATIENT SERVICES PROVIDED TO THE COMMUNITY, THE HOSPITAL HAS DESIGNATED A PORTION OF ITS INPATIENT UNIT AS A CERTIFIED INTENSIVE CARE UNIT KNOWN AS THE "SPECIAL CARE UNIT." THIS UNIT REQUIRES A HIGHER ACUITY OF NURSING AND HAS DEDICATED STAFF TO PROVIDE THIS CARE TO PATIENTS. A SIGNIFICANT PORTION OF THE ADMISSIONS TO THE UNIT COME FROM EMERGENCY ADMISSIONS TO THE HOSPITAL SO IT IS CONSIDERED A SUBSIDIZED HEALTH SERVICE PROVIDED TO THE COMMUNITY BY THE HOSPITAL. THE CLINICS ARE DESIGNATED RURAL HEALTH CLINICS BY THE MEDICARE AND MEDICAID PROGRAMS AND AS SUCH BY DEFINITION ARE LOCATED IN DESIGNATED RURAL OR UNDERSERVED AREAS OF THE COUNTRY BY HEALTHCARE PRACTITIONERS. THESE CLINICS PROVIDE CARE TO A LARGE PORTION OF MEDICARE AND MEDICAID BENEFICIARIES WHO WITHOUT ACCESS TO CARE LOCALLY WOULD BE REQUIRED TO TRAVEL FARTHER DISTANCES FOR QUALITY HEALTHCARE. IT IS THE GOAL OF THE RICHLAND HOSPITAL, INC. TO PROVIDE THESE SERVICES TO THE COMMUNITY REGARDLESS OF THE PATIENT'S ABILITY TO PAY.
PART I, LINE 7, COLUMN (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 $ 791,721.
PART II, COMMUNITY BUILDING ACTIVITIES:THE RICHLAND HOSPITAL, INC. ENGAGES IN A VARIETY OF COMMUNITY BUILDING ACTIVITIES THAT WOULD OTHERWISE NOT BE MET OR PROVIDED WITHOUT THE EFFORTS AND SPECIALIZED KNOWLEDGE OF THE LOCAL COMMUNITY HOSPITAL TO THE RESIDENTS OF RICHLAND CENTER, WISCONSIN, AND THE SURROUNDING AREAS. SOME OF THE COMMUNITY BUILDING ACTIVITIES THAT THE HOSPITAL PARTICIPATES IN ARE THE LOCAL HEALTH AND WELLNESS FAIRS, SUPPORT GROUPS, PROVIDING EDUCATIONAL MATERIALS TO COMMUNITY MEMBERS, SAFE SITTER CLASSES, AND LOCAL BLOOD PRESSURE SCREENINGS. IN ADDITION, THE HOSPITAL IS A COMMUNITY PARTNER AND ACTIVE MEMBER OF THE RICHLAND FIT PROGRAM. RICHLAND FIT CONDUCTED A STUDY WHICH CREATED A STRATEGIC AND IMPLEMENTATION PLAN FOCUSING ON THE HIGH OBESITY RATES IN RICHLAND COUNTY. THE EFFORT TO DEVELOP THE PLAN AND DO NECESSARY RELATED RESEARCH WAS FUNDED BY THE UNIVERSITY OF WISCONSIN PARTNERSHIP PROGRAM IN 2011, AND IMPLEMENTATION AND MEASUREMENT OF OUTCOMES IS IN PROCESS. THE HOSPITAL ALSO TAKES AN ACTIVE ROLE IN WELLNESS THROUGH ITS SUPPORT OF LOCAL ATHLETES AND MAINTAINS CONTRACTS WITH AREA SCHOOL SYSTEMS TO PROVIDE ATHLETIC TRAINERS FOR COVERAGE AT SCHEDULED SPORTING EVENTS. THIS SPORTS MEDICINE PROGRAM PROVIDES OUTREACH SERVICES TO RICHLAND CENTER, RIVERDALE (MUSCODA), AND ITHACA SCHOOL DISTRICTS AS WELL AS TO THE LOCAL UW-RICHLAND CENTER CAMPUS. SERVICES PROVIDED INCLUDE IN-SCHOOL INJURY PREVENTION AND ASSESSMENTS CLINICS, DAILY PRACTICE COVERAGE (FREQUENCY VARIES WITH EACH SCHOOL), "HOME" EVENT COVERAGE AS REQUESTED BY SCHOOLS, AND EMERGENCY ACTION PLAN DEVELOPMENT FOR EACH SCHOOL. THE PROGRAM PROVIDES SKINFOLD TESTING FOR THE WRESTLING PROGRAMS IN ACCORDANCE WITH WIAA MANDATES AND IMPACT CONCUSSION SCREENING SERVICES TO ESTABLISH A BASELINE FOR ATHLETES. FINALLY, THE PROGRAM PROVIDES EDUCATION FOR LOCAL EMS SQUADS ON THE APPROPRIATE TRANSPORT OF INJURED ATHLETES. THE RICHLAND HOSPITAL, INC.'S SPORTS MEDICINE PROGRAM IS OPERATED AT A LOSS EACH YEAR, AN INVESTMENT IN THE COMMUNITY THAT WAS IN EXCESS OF $100,000 IN 2014. THE PROGRAM HAS DIRECT TIES TO ONE OF THE PRIORITIES IDENTIFIED BOTH BY THE RICHLAND FIT NEEDS ASSESSMENT BUT ALSO BY THE HOSPITAL'S 2013 CHNA, THE HIGH OBESITY RATE FOR YOUTH AND YOUNG ADULTS IN RICHLAND COUNTY. THE HOSPITAL ALSO PARTICIPATES IN HEALTH EDUCATION AWARENESS AND CAREER BUILDING ACTIVITIES SUCH AS CLINICAL TRAINING EXPERIENCE, SPEAKERS AT LOCAL SCHOOLS, AND CAREER FAIRS. THE HOSPITAL RECOGNIZES THAT IT IS IMPORTANT TO EDUCATE LOCAL COMMUNITY MEMBERS ON THESE CAREERS AS A CAREER BUILDING INITIATIVE SO THAT LOCAL PRIMARY CARE AND ACCESS TO CARE WILL BE CONTINUED IN THE FUTURE WITH WELL-TRAINED AND EDUCATED COMMUNITY MEMBERS IN HEALTHCARE RELATED FIELDS. AS PART OF BETTER DEFINING ITS COMMUNITY HEALTH AND WELLNESS STRATEGY IN 2014, A NEW DOCUMENT WAS DEVELOPED AND INTRODUCED TO SUPPORT THE BUSINESS PLAN FOR COMMUNITY HEALTH AND WELLNESS FOR THE HOSPITAL. THE WEB OF RELATIONSHIPS ASSISTS IN DEFINING EXISTING RELATIONSHIPS AND PROVIDES A MECHANISM FOR PRIORITIZING HEALTH AND WELLNESS ACTIVITIES.
PART III, LINE 2:THE COSTING METHODOLOGY USED ON FORM 990 IS BASED ON A COST-TO-CHARGE RATIO WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBT DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST THE TOTAL CHARGES THAT ARE WRITTEN OFF DURING THE FISCAL YEAR TO ESTIMATE THE COST OF THE CARE OF PATIENTS THAT HAVE ACCOUNTS THAT ARE DEEMED TO BE BAD DEBTS TO THE HOSPITAL.
PART III, LINE 3:MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY UNINSURED PATIENTS AND AMOUNTS PATIENTS ARE PERSONALLY REPONSIBLE FOR, THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED ON ITS ASSESSMENT OF HISTORICAL COLLECTION LIKELIHOOD AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUTSTANDING AFTER THE HOSPITAL HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO ACCOUNTS RECEIVABLE. MANY TIMES PATIENTS ARE UNABLE TO COMPLETE THE REQUIRED CHARITY CARE APPLICATION AND ARE TRANSFERRED TO COLLECTION SERVICES EVEN THOUGH THE HOSPITAL PROVIDES THIS INFORMATION TO ALL PATIENTS AND ASSISTANCE WITH THE APPLICATIONS. DUE TO NO RESPONSES FROM SOME PATIENTS, A SIGNIFICANT AMOUNT OF BAD DEBTS COULD BE CONSIDERED AS CHARITY CARE.
PART III, LINE 4:IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL 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, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR BAD DEBTS FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS AND PATIENTS 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 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. 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 UNCOLLECTIBLE ACCOUNTS. THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A SEPARATE FOOTNOTE REGARDING BAD DEBT EXPENSE.
PART III, LINE 8:THE RICHLAND HOSPITAL, INC. IS DESIGNATED AS A CRITICAL ACCESS HOSPITAL AND, AS SUCH, A PORTION OF ITS REVENUE IS PAID UNDER A COST REIMBURSEMENT SYSTEM. THE TOTAL MEDICARE REVENUE SHOWN BASED ON THE IRS 990 INSTRUCTIONS INCLUDES ONLY A PORTION OF THE TOTAL MEDICARE REVENUE OF THE HOSPITAL. THE AMOUNTS LISTED FOR MEDICARE DO NOT INCLUDE PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT, RADIOLOGIST SERVICES, AND SURGICAL ANESTHESIA SERVICES AT THE RICHLAND HOSPITAL, INC. PHYSICIAN COVERAGE IS REIMBURSED PRIMARILY ON FEE SCHEDULE REIMBURSEMENT AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND, AS SUCH, THESE COSTS AND SHORTFALLS SHOULD ALSO BE CONSIDERED AS AN ADDITIONAL BENEFIT THAT THE RICHLAND HOSPITAL, INC. PROVIDES TO THE COMMUNITIES IT SERVES. THE COSTING METHOD USED ABOVE FOR IRS FORM 990 COMPLIANCE REPORTING IS ALSO BASED ON AN OVERALL AVERAGE COST-TO-CHARGE RATIO AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICE REVENUE (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE) DIVIDED BY TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBT EXPENSE. THIS RATIO IS THEN MULTIPLIED BY THE TOTAL MEDICARE SERVICES WHICH ARE REIMBURSED ON A COST METHODOLOGY EXCLUDING THE FEE SCHEDULE ITEMS LIKE PHYSICIAN SERVICES AND THE HOSPITAL WOULD SHOW A LARGE LOSS ON THESE SERVICES.WHETHER THERE IS A SHORTFALL OR SURPLUS FROM SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THESE PEOPLE, WHO ARE TYPICALLY ELDERLY MEMBERS OF THE COMMUNITY, ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE PATIENT SERVICES, THE CENTERS FOR MEDICARE AND MEDICAID (CMS) WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY.
PART VI, LINE 2:IN ADDITION TO THE COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT, THE RICHLAND HOSPITAL, INC. ASSESSES THE HEALTHCARE NEEDS OF THE COMMUNITY IT SERVES BY LOOKING AT LOCAL AND SURROUNDING COMMUNITY DEMOGRAPHICS TO DETERMINE THE SERVICES THAT ARE MOST NECESSARY IN ORDER TO FULFILL ITS MISSION. THE HOSPITAL ACTIVELY SEEKS INPUT FROM MEMBERS OF THE MEDICAL STAFF REGARDING EXISTING SERVICES, POTENTIAL NEED FOR EXPANDED SERVICES, AND THE POTENTIAL NEED FOR NEW SERVICE LINES NOT OFFERED LOCALLY. THE HOSPITAL ALSO REVIEWS HOSPITAL STATISTICS OF PATIENT VISITS TO DETERMINE WHAT TYPES OF SERVICES OFFERED BY THE HOSPITAL ARE BEING UTILIZED. THE HOSPITAL HAS CONTINUED TO USE FOCUS GROUPS FOR SPECIFIC SERVICE LINE ENHANCEMENT, MEETING DIRECTLY WITH TARGETED MEMBERS OF THE MARKET TO UNDERSTAND THEIR HEALTHCARE SERVICE DELIVERY NEEDS AND EXPECTATIONS TIED TO SPECIFIC AREAS OF CARE. IN RECENT MONTHS, OB SERVICES IS JUST ONE EXAMPLE OF THE USE OF FOCUS GROUPS. IN PLANNING TO MEET COMMUNITY NEEDS, THE AGING OF THE POPULATION IS SIGNIFICANT BECAUSE PERSONS IN THE AGE CATEGORIES THAT ARE GROWING FACE MORE CHALLENGES RELATED TO HEALTHCARE THAN YOUNGER POPULATIONS. IN THE OLDER POPULATION GROUPS, PERSONS VISIT PRIMARY CARE PHYSICIANS MORE FREQUENTLY AND HAVE HIGHER INCIDENT RATES OF HEART DISEASE, CANCER, AND RELATED ILLNESSES. THE ONSET OF CHRONIC DISEASES ARE HIGHER IN THIS AGE CATEGORY, E.G., ONSET OF DIABETES, COPD, OR HEART PROBLEMS, AND MUST BE MANAGED WITH ASSISTANCE FROM THE HEALTHCARE PROVIDERS FOR THE REMAINDER OF THE PERSON'S LIFE. IMPORTANT TO NOTE IS THAT AS A PERSON AGES, TRAVEL BECOMES MORE CHALLENGING, SO THE ABILITY TO GET AS MUCH OF THEIR HEALTHCARE NEEDS MET LOCALLY GROWS IN IMPORTANCE. HAVING VISITING SPECIALISTS, FOR EXAMPLE, ELIMINATES THE NEED FOR A TRIP TO A MAJOR MEDICAL CENTER FOR MANY. IN ADDITION, IT ENSURES THAT PERSONS GET THE CARE THAT THEY NEED. AN EXAMPLE OF A RECENT SERVICE ADDITION IS THE ADDITION OF A LOCALLY MANAGED SLEEP STUDY SERVICE WHICH HAS BEEN WELL RECEIVED BY PATIENTS AND PHYSICIANS ALIKE. THE HOSPITAL CONTINUES TO MORE FULLY DEVELOP THE ELECTRONIC HEALTH RECORD SYSTEM (EHR) WITH ONE OF THE MAIN GOALS BEING IMPROVED ACCESS TO STRONG CLINICAL DOCUMENTATION INCLUDING PATIENT MEDICAL HISTORIES AS A MEANS TO SUPPORT A MORE EFFICIENT AND EFFECTIVE PATIENT EXPERIENCE. TRAINING OUR COMMUNITY MEMBERS TO USE AND ACCESS THEIR PERSONAL HEALTH INFORMATION THROUGH THE EHR PORTAL IS ANOTHER EXAMPLE OF THE HOSPITAL'S WORK TO IMPROVE OUR PATIENT'S HEALTH STATUS THROUGH ACCESS AND INFORMATION. IN TURN, THE ELECTRONIC HEALTH RECORD SYSTEM PROVIDES FOR A MORE COMPLETE MEDICAL HISTORY SHOULD THAT PATIENT REQUIRE TREATMENT AT OTHER HEALTHCARE FACILITIES. IN RESPONSE TO INCREASED PATIENT DEMANDS FOR ACCESS TO PRIMARY AMBULATORY CLINIC CARE, THE HOSPITAL COMPLETED CONSTRUCTION OF A REPLACEMENT CLINIC FACILITY IN MUSCODA, WISCONSIN, IN 2012 AS A MEANS TO BETTER SERVE THE NEEDS OF THE PATIENTS IN MUSCODA AND THE SURROUNDING RURAL COMMUNITIES.
PART VI, LINE 3:CONSISTENT WITH THE MISSION OF THE RICHLAND HOSPITAL, INC., HEALTH-RELATED SERVICES ARE PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL IS COMMITTED TO PROVIDING FREE OR DISCOUNTED CARE TO QUALIFIED INDIVIDUALS THAT ARE IN NEED OF MEDICALLY NECESSARY TREATMENT EVEN IF THAT PERSON IS UNINSURED, UNDERINSURED, HEALTH INSURANCE EXCHANGE QUALIFIED, INELIGIBLE FOR OTHER GOVERNMENT PROGRAMS, OR UNABLE TO PAY BASED ON THEIR INDIVIDUAL FINANCIAL SITUATION. WHEN A PATIENT REQUESTS FINANCIAL ASSISTANCE AND HAS AN ADJUSTED GROSS INCOME THAT IS LESS THAN 150% OF THE FEDERAL POVERTY LEVEL, THEY ARE PROVIDED CARE WITHOUT CHARGE. WHEN AN UNINSURED OR HEALTH INSURANCE EXCHANGE ELIGIBLE PATIENT'S ADJUSTED GROSS INCOME IS 151% TO 300% OF THE FEDERAL POVERTY LEVEL, THEY ARE PROVIDED CARE AT THE AMOUNT GENERALLY BILLED RATE. UNDERINSURED PATIENTS AT 150% TO 300% OF THE FEDERAL POVERTY LEVEL ARE ELIGIBLE FOR A DISCOUNT BASED ON A SLIDING SCALE. TO BE ELIGIBLE UNDER THIS PROGRAM, PATIENTS MUST COOPERATE WITH THE HOSPITAL TO EXPLORE ALTERNATIVE MEANS OF ASSISTANCE AND, IF NECESSARY, INCLUDING APPLICATION OR ACTIONS NEEDED TO SECURE COVERAGE BY MEDICARE, MEDICAID, AND THE MARKETPLACE. PATIENTS WILL BE REQUIRED TO PROVIDE NECESSARY INFORMATION AND DOCUMENTATION WHEN APPLYING FOR A PROGRAM DISCOUNT, OR FOR OTHER PRIVATE OR PUBLIC PAYMENT PROGRAMS. THE FINANCIAL COUNSELOR IS AVAILABLE TO ASSIST PATIENTS WITH THE APPLICATION PROCESS. APPLICATIONS AND ALL SUPPORTING DOCUMENTATION IS REVIEWED BY THE FINANCIAL COUNSELOR FOR ELIGIBILITY AND APPROVED BY THE PATIENT ACCOUNTING SUPERVISOR. FREE RADIOLOGY, LABORATORY, AND OTHER DIAGNOSTIC ANCILLARY SERVICES ARE ALSO PROVIDED TO PATIENTS WHO ARE REFERRED TO THE HOSPITAL BY THE RICHLAND CENTER FREE CLINIC. THE HOSPITAL ALSO OFFERS AN AUTOMATIC 10% DISCOUNT ON ALL PRIVATE PAY ACCOUNTS. A PROMPT PAY DISCOUNT OF AN ADDITIONAL 5% IS ALSO AVAILABLE. THE RICHLAND HOSPITAL, INC. COMMUNICATES THE AVAILABILITY AND TERMS OF THE PROGRAM TO ALL PATIENTS, THROUGH MEANS WHICH INCLUDE, BUT ARE NOT LIMITED TO:-POSTED SIGNS WITHIN WAITING ROOMS, EMERGENCY ROOMS, AND FINANCIAL SERVICES DEPARTMENTS-COMMUNITY CARE PROGRAM APPLICATION OFFERED TO INDIVIDUAL PRIOR TO DISCHARGE-PERIODIC NOTIFICATIONS WITH PATIENT BILLS OR STATEMENTS AND OTHER ORAL AND WRITTEN CORRESPONDENCE INCLUDING "PLAIN LANGUAGE SUMMARY" OF THE PROGRAM-POSTED POLICIES ON THE HOSPITAL'S WEBSITE-BROCHURES WRITTEN IN PLAIN LANGUAGE ARE AVAILABLE FOR PATIENTS TO TAKE WITH THEM OR TO BE GIVEN TO PATIENTS BY HOSPITAL TEAM MEMBERS AND WILL BE MADE AVAILABLE FOR USE BY THE LOCAL AGING AND DISABILITY RESOURCE CENTER PERSONNEL AND AT THE RICHLAND COMMUNITY FREE CLINIC-DESIGNATED STAFF KNOWLEDGEABLE ON THE PROGRAM WILL BE AVAILABLE AT DEFINED HOURS TO ANSWER PATIENT QUESTIONS AND/OR MAY REFER PATIENTS TO THE PROGRAMREGISTRATION CLERKS AT THE HOSPITAL, AND AT THE TWO HOSPITAL-OWNED CLINICS, ARE TRAINED TO INQUIRE WITH SELF-PAY PATIENTS UPON REGISTRATION IF THEY WOULD LIKE FURTHER INFORMATION ON THESE POLICIES OR WOULD LIKE TO MEET WITH A MEMBER OF THE BUSINESS OFFICE STAFF. DURING THE COLLECTION PROCESS, THE RICHLAND HOSPITAL, INC. MAKES AN EFFORT TO PROVIDE INFORMATION AND INCLUDES CHARITY CARE PROGRAM MATERIALS WITH EACH STATEMENT THAT IS SENT. SOCIAL SERVICES AND BUSINESS OFFICE STAFF AT THE HOSPITAL ARE ALSO AVAILABLE TO PROVIDE INFORMATION TO PATIENTS ON OTHER GOVERNMENT PROGRAMS SUCH AS THE MEDICAID PROGRAM OR TO REFER PATIENTS TO PERSONNEL AT RICHLAND COUNTY OR OTHER STATE OF WISCONSIN OR COUNTY AGENCIES THAT MAY PROVIDE ACCESS TO CARE. TWO EMPLOYEES ARE CERTIFIED APPLICATION COUNSELORS TO PROVIDE PATIENTS AND COMMUNITY MEMBERS ONE-ON-ONE ASSISTANCE IN NAVIGATING THE HEALTH INSURANCE MARKETPLACE. THESE EMPLOYEES BEGAN PROVIDING SERVICE IN LATE 2013 AND CONTINUED THROUGH 2014, PROVIDING THIS SERVICE WITHIN THE HOSPITAL, UPON REQUEST, BUT ALSO WORKING WITH A COMMUNITY COALITION WHICH PROVIDES AN OPPORTUNITY FOR ONE-STOP ASSISTANCE IN RESEARCHING AND SIGNING UP WITH AN INSURANCE PLAN THAT BEST MEETS THEIR NEEDS.
PART VI, LINE 4:THE RICHLAND HOSPITAL, INC. IS LOCATED IN RICHLAND CENTER, WISCONSIN, WHICH IS A COMMUNITY OF APPROXIMATELY 5,000 PEOPLE AND IS LOCATED 50 MINUTES FROM MADISON, WISCONSIN. THE HOSPITAL OPERATES A 25-BED, ACUTE CARE CRITICAL ACCESS HOSPITAL AND TWO RURAL HEALTH CLINICS LOCATED IN NEIGHBORING COMMUNITIES. THE RICHLAND HOSPITAL, INC. OFFERS A WIDE VARIETY OF SERVICES IN ORDER TO FULFILL MANY OF THE NEEDS OF THE INDIVIDUALS IN THE LOCAL COMMUNITY. AMONG SERVICES PROVIDED ARE: DIAGNOSTIC CARE, 24-HOUR EMERGENCY ROOM, OBSTETRICS, REHABILITATION, SURGICAL CARE, AND DIABETES SELF-CARE PROGRAMS, ALONG WITH OTHER SPECIALTY SERVICES, WHICH INCLUDE: AUDIOLOGY, CARDIOLOGY, ORTHOPEDICS, CHEMOTHERAPY, CLINICAL SERVICES, AMONG OTHERS. CARE IS OFFERED TO PATIENTS REGARDLESS OF PAY SOURCE AND REGARDLESS OF A PATIENT'S ABILITY TO PAY. THE COMMUNITIES SERVED BY THE RICHLAND HOSPITAL ARE DEFINED BY THE FOLLOWING ZIP CODES: 53506 AVOCA53556 LONE ROCK53518 BLUE RIVER53573 MUSCODA53581 RICHLAND CENTER53588 SPRING GREENTHEY ARE GEOGRAPHICALLY CONTIGUOUS COMMUNITIES. ACCORDING TO DATA PUBLISHED BY INTELLIMED, THE RICHLAND HOSPITAL, INC. HAD AN OVERALL INPATIENT MARKET SHARE OF 51.7 PERCENT AND OUTPATIENT MARKET SHARE OF 40.8 PERCENT IN THESE ZIP CODES. NO OTHER HEALTHCARE PROVIDER PROVIDING THE SAME SERVICES HAD A MARKET SHARE AS HIGH AS OR HIGHER THAN THE RICHLAND HOSPITAL, INC. (INTELLIMED COMBINES STATEWIDE HEALTHCARE DATA FROM WISCONSIN HOSPITAL ASSOCIATION IN A WEB-BASED SUPPORT ENGINE THAT ALLOWS US TO ANALYZE OUR MARKET.) SOCIO-DEMOGRAPHIC PROFILE OF THE MARKET AREA SERVED BY THE RICHLAND HOSPITAL, INC. SERVES PERSONS WHO ARE REPRESENTATIVE OF THE POPULATION OF THE MARKET AREA. A HIGHER PERCENTAGE OF THE POPULATION SERVED IS ELDERLY; THIS IS DUE TO THE FACT THAT PERSONS 65 YEARS OF AGE AND OLDER ARE HOSPITALIZED AT NEARLY THREE TIMES THE OVERALL RATE. SOMETHINGS TO NOTE RELATED TO PLANNING FOR MEETING COMMUNITY HEALTH NEEDS INCLUDES THE FOLLOWING:- THE OVERALL POPULATION OF THE MARKET AREA IS PROJECTED TO REMAIN VERY STABLE, WITH NEGLIGIBLE GROWTH OR DECLINE PROJECTED OVER THE NEXT FIVE YEARS.- THE RESIDENTS OF THE MARKET AREA ARE AGING SIGNIFICANTLY. THERE IS A PROJECTED 6.3% GROWTH IN THE POPULATION AGED 45 TO 64 AND A PROJECTED 5.1% GROWTH IN THE POPULATION AGED 65 YEARS OF AGE AND OLDER. THERE IS A CORRESPONDING 11.5% PROJECTED DECLINE IN THE 25 TO 44 YEAR OLD POPULATION. PERSONS IN THE 0 TO 14 AGE GROUP ARE ALSO PROJECTED TO DECREASE BY 0.7%.DURING 2014, MEDICARE AND MEDICARE ADVANTAGE PLAN BENEFICIARIES ACCOUNTED FOR APPROXIMATELY 44 PERCENT OF ALL GROSS PATIENT SERVICE REVENUE AT THE RICHLAND HOSPITAL, INC. AND MEDICAID BENEFICIARIES ACCOUNTED FOR APPROXIMATELY 16 PERCENT OF ALL GROSS PATIENT SERVICE REVENUE. MEDICARE AND MEDICAID BENEFICIARIES MAKE UP THE LARGEST PORTION OF PATIENTS THAT ARE SERVED BY THE RICHLAND HOSPITAL, INC. OVER THE PREVIOUS FEW YEARS.
PART VI, LINE 5:THE RICHLAND HOSPITAL, INC. IS ACCREDITED THROUGH THE JOINT COMMISSION ("TJC"). THE TJC IS AN ORGANIZATION THAT EVALUATES HOSPITAL PERFORMANCE STANDARDS, FOCUSING ON THE QUALITY OF HEALTHCARE. ACCREDITATION THROUGH THE JOINT COMMISSION IS RECOGNIZED NATIONWIDE AS A SYMBOL OF QUALITY, AS IT REQUIRES RIGOROUS PERFORMANCE STANDARDS. TO EARN AND MAINTAIN ACCREDITATION, THE HOSPITAL IS EVALUATED THROUGH AN UNANNOUNCED SURVEY PROCESS COVERING NEARLY 600 STANDARDS RELATED TO QUALITY PATIENT CARE, SAFETY, INFECTION CONTROL, AND ONGOING PERFORMANCE-IMPROVEMENT ACTIVITIES, AMONG OTHERS. ALL HOSPITALS SURVEYED BY THE JOINT COMMISSION ARE EVALUATED AGAINST THE SAME CRITERIA, REGARDLESS OF SIZE OR LOCATION. THE ACTIVITIES OF THE RICHLAND HOSPITAL, INC. ARE SUPPORTED LOCALLY BY A VOLUNTEER BOARD OF DIRECTORS WHICH OVERSEE THE OPERATIONS OF THE HOSPITAL. THE BOARD OF DIRECTORS IS MADE UP OF COMMUNITY MEMBERS THAT RESIDE IN RICHLAND CENTER, WI, AND THE SURROUNDING AREA WHICH IS THE HOSPITAL'S PRIMARY PATIENT SERVICE AREA. THE HOSPITAL ALSO EXTENDS MEDICAL STAFF PRIVILEGES TO A MAJORITY OF ALL QUALIFIED PHYSICIANS IN THE COMMUNITY AND SURROUNDING AREAS WHO WISH TO BETTER SERVE THEIR PATIENTS BY PROVIDING CARE AT THE RICHLAND HOSPITAL, INC. ANY SURPLUSES IN OPERATIONS THAT ARE ACHIEVED BY THE HOSPITAL OPERATING IN AN EFFECTIVE MANNER AND CONTROLLING THE COST OF HEALTHCARE ARE PRIMARILY RESERVED FOR FUTURE BUILDING AND CAPITAL PURCHASE NEEDS. THE RICHLAND HOSPITAL, INC. RECOGNIZES THAT IT IS IMPORTANT TO SAVE THESE RESERVES DURING YEARS OF SURPLUS SO THAT IN TIMES OF ECONOMIC DOWNTURN, IF A LARGE CAPITAL ADDITION IS NEEDED, THE HOSPITAL WILL NOT HAVE TO PASS HIGHER COSTS ON TO MEMBERS OF THE COMMUNITY. THE HOSPITAL FURTHER ACHIEVES ITS GOAL OF PROVIDING TRUE COMMUNITY SUPPORT BY PROVIDING CHARITY CARE AS DESCRIBED THROUGHOUT SCHEDULE H AND PROVIDING SERVICES TO MEMBERS OF OTHER PROGRAMS WHICH OFTEN REIMBURSE THE HOSPITAL BELOW THE COST OF PROVIDING THIS CARE SUCH AS CHAMPUS, TRICARE, AND THE WISCONSIN HEALTH INSURANCE RISK SHARING PROGRAM OR "HIRSP" (THE HIRSP PROGRAM REIMBURSES THE HOSPITAL AT RATES SIMILAR TO THE MEDICAID PROGRAM AND IS FOR PATIENTS THAT HAVE PRE-EXISTING ILLNESSES WHICH MAKE IT DIFFICULT TO OBTAIN INSURANCE FROM COMMERCIAL INSURANCE CARRIERS IN THE MARKETPLACE).
PART VI, LINE 7, REPORTS FILED WITH STATESWI

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeSCHOLARSHIPS FOR HEALTHCARE EDUCATIONGrantTypeTxt
Recipient25RecipientCnt
Cash Grant$19,875CashGrantAmt
Non Cash Assistance$0NonCashAssistanceAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationTHE RICHLAND HOSPITAL, INC. FOLLOWS A STANDARD PROCEDURE ON ISSUANCE OF SCHOLARSHIP FUNDS WHICH IS DETERMINATED BY THE BOARD OF DIRECTORS AND MANAGEMENT OF THE RICHLAND HOSPITAL, INC.; THE RICHLAND HOSPITAL FOUNDATION, INC.; AND THE PARTNERS OF THE RICHLAND HOSPITAL, INC. THESE THREE SEPARATE ORGANIZATIONS HAVE ESTABLISHED CRITERIA FOR REVIEW OF APPLICATIONS FOR PROSPECTIVE SCHOLARSHIP RECIPIENTS TO ENSURE THAT SCHOLARSHIPS ARE BEING GRANTED FOR HEALTH EDUCATION RELATED PURPOSES AND TO A QUALIFIED STUDENT STUDYING AT AN ACCREDITED TECHNICAL COLLEGE, COLLEGE, OR UNIVERSITY. (A LARGE PORTION OF THE FUNDING FOR SCHOLARSHIPS IS ALSO GOVERNED BY DONOR AGREEMENTS AS NOTED IN SCHEDULE D TO THE FORM 990 RELATED TO ENDOWMENT FUNDS.)ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation Required0SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
KAREN TRAYNOR
CFO$149,695$0$7,732$0$1,014$0$6,353$0$3,716$0$168,510$0$0$0
TERRI POTTER
CEO (EFFECTIVE 6/2014)$149,936$0$0$0$17,222$0$0$0$0$0$167,158$0$0$0
JEREL BERRES MD
ER DIRECTOR$253,440$0$1,732$0$10,809$0$10,400$0$25,473$0$301,854$0$0$0
E RACHEL SHANNON-GOODRICH CRNA
ANESTHETIST$210,746$0$1,731$0$102,846$0$10,400$0$23,864$0$349,587$0$0$0
MUHAMMAD S KHAN MD
ER PHYSICIAN$316,949$0$1,732$0$996$0$10,400$0$24,064$0$354,141$0$0$0
BRYAN MCCARVEL
ANESTHESIA DIRECTOR$224,571$0$1,732$0$101,770$0$10,400$0$25,559$0$364,032$0$0$0
BRUCE MOTHS MD
ER PHYSICIAN$257,799$0$1,690$0$905$0$10,400$0$24,129$0$294,923$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 1AFormAndLineReferenceDesc
ExplanationHEALTH CLUB DUES GROSS UPS, WHEN APPLICABLE, WERE ADDED TO THE INDIVIDUAL'S COMPENSATION AT FAIR MARKET VALUE.ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THE RICHLAND MEDICAL CENTER LTDBusinessNameLine1Txt
FieldValueIRS element (for citing)
Relationship DescriptionBRYAN MYERS, MD AND KEVIN WHITNEY, MD ARE SHAREHOLDERSRelationshipDescriptionTxt
Transaction$1,460,136TransactionAmt
TransactionFEES FOR PROFESSIONAL SERVICES.TransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 4THE SECOND AMENDED AND RESTATED BYLAWS APPROVED DURING 2014 INCLUDE THE FOLLOWING CHANGES: 1. LANGUAGE HAS BEEN INCLUDED THAT WILL ALLOW FOR ANY MEMBER OF THE BOARD OF DIRECTORS TO HAVE THEIR FINAL TERM EXTENDED BY ONE YEAR. 2. THE FREQUENCY OF BOARD MEETINGS WILL BE CHANGED FROM MONTHLY TO NOT LESS THAN 10 TIMES PER YEAR. 3. THE TITLES PRESIDENT AND VICE PRESIDENT WILL BE CHANGED TO CHAIR AND VICE CHAIR. 4. THE REQUIRED MAILING TIMELINE WILL BE MOVED FROM 5 DAYS PRIOR TO THE MEETING TO 3 DAYS PRIOR TO THE MEETING. 5. THE MEETING LOCATION RESTRICTION WILL BE REMOVED AND WILL HAVE THE LATITUDE TO HOLD A MEETING IN ANY COUNTY WHERE THE HOSPITAL PROVIDES CLINICAL FUNCTION INSTEAD OF BEING RESTRICTED TO RICHLAND COUNTY, WI. 6. SAFETY COMMITTEE WILL BE REMOVED AS A BOARD COMMITTEE.
FORM 990, PART VI, SECTION B, LINE 11A COPY OF FORM 990 WAS EMAILED OR MAILED TO ALL MEMBERS OF THE HOSPITAL'S BOARD OF DIRECTORS BEFORE IT WAS FILED. ALL BOARD MEMBERS WERE GIVEN THE OPPORTUNITY TO RESPOND WITH COMMENTS PRIOR TO THE FINAL SUBMISSION OF THE FORM 990 TO THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12CTHE RICHLAND HOSPITAL, INC. REQUIRES ALL OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES TO COMPLETE ITS ANNUAL DISCLOSURE STATEMENT. THESE QUESTIONNAIRES ARE THEN REVIEWED BY THE BOARD OF DIRECTORS, NOTING ANY RELATIONSHIPS THAT COULD POTENTIALLY CREATE A CONFLICT OF INTEREST. ANY INDIVIDUALS WITH NOTED CONFLICTS ARE ASKED TO ABSTAIN FROM VOTING OR ACTING ON THOSE MATTERS.
FORM 990, PART VI, SECTION B, LINE 15ATHE BOARD OF DIRECTORS HAS AN ESTABLISHED PROCESS TO ANNUALLY REVIEW THE COMPENSATION FOR THE CHIEF EXECUTIVE OFFICER AND TO DEFINE APPROPRIATE MARKET AND PERFORMANCE BASED ADJUSTMENTS. COMPARATIVE DATA IS OBTAINED FROM EITHER THE WISCONSIN HOSPITAL ASSOCIATION EXECUTIVE COMPENSATION SURVEY OR OTHER REPUTABLE THIRD-PARTY HEALTHCARE DATA SOURCES TO USE IN THE ESTABLISHMENT OF A MARKET FOR THIS KEY POSITION. THE PERSONNEL COMMITTEE OF THE BOARD OF DIRECTORS FULFILLS THIS ROLE. THE BOARD OF DIRECTORS HAS DELEGATED THE AUTHORITY AND RESPONSIBILITY FOR THE ONGOING MAINTENANCE OF THE OVERALL ORGANIZATIONAL COMPENSATION MODEL TO THE CHIEF EXECUTIVE OFFICER. COMPARATIVE MARKET DATA IS OBTAINED VIA THE RURAL WISCONSIN HEALTH COOPERATIVE AND THE WISCONSIN SOCIETY OF HOSPITAL HUMAN RESOURCE ADMINISTRATORS VIA INDEPENDENT SALARY SURVEYS THAT PROVIDE BENCHMARK INFORMATION FOR HEALTHCARE JOB CLASSES. THIS DATA IS USED TO ESTABLISH SALARY RANGES FOR ALL JOB CLASSES WITHIN THE ORGANIZATION. THE BOARD OF DIRECTORS ANNUALLY AUTHORIZES THE OVERALL INCREASE TO THE SALARY BUDGET FOR THE ORGANIZATION WITH THE CEO MAINTAINING DELEGATED AUTHORITY FOR IMPLEMENTATION WITHIN THE ORGANIZATIONAL COMPENSATION MODEL. DURING THE REVIEW PROCESS, DECISIONS AFFECTING COMPENSATION AND CONTRACTS ARE ONLY REVIEWED AND APPROVED BY INDIVIDUALS WHO DO NOT HAVE NOTED CONFLICTS.
FORM 990, PART VI, SECTION C, LINE 19THE RICHLAND HOSPITAL, INC. MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT ITS HOSPITAL BUSINESS LOCATION DURING NORMAL BUSINESS HOURS.
FORM 990, PART IX, LINE 11GOTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,332,604. MANAGEMENT AND GENERAL EXPENSES 669,658. FUNDRAISING EXPENSES 7,800. TOTAL EXPENSES 2,010,062. MEDICAL IMAGING PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,014,065. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,014,065. CLINICAL PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 792,271. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 792,271.
FORM 990, PART XI, LINE 9:NET CHANGE IN UNRESTRICTED NET ASSETS OF SUPPORTING ORGANIZATIONS 310,577. DISTRIBUTIONS FROM SCHOLARSHIP FUNDS INCLUDED IN CHANGE IN NET ASSETS -30,000. NET CHANGE IN TEMPORARILY RESTRICTED NET ASSETS OF FOUNDATION -170,257. CONTRIBUTIONS FROM RELATED ORGANIZATIONS -376,312.
FORM 990, PART XII, LINE 2C: SELECTION OF INDEPENDENT ACCOUNTANTTHE FINANCE COMMITTEE OF THE RICHLAND HOSPITAL, INC., WHICH IS A SUB-COMMITTEE TO THE HOSPITAL'S BOARD OF DIRECTORS, REVIEWS THE ANNUAL AUDIT PROCESS WITH THE INDEPENDENT ACCOUNTANTS. BOARD MEMBERS ARE ALSO GIVEN THE NAMES AND CONTACT INFORMATION OF THE INDEPENDENT ACCOUNTANTS AT THE ANNUAL FINANCE COMMITTEE'S REVIEW MEETING OF THE AUDITED FINANCIAL STATEMENTS SO THAT THEY MAY INQUIRE, IF NEEDED, WITH THE ACCOUNTANTS THROUGHOUT THE YEAR. A BOARD MEMBER IS ALSO SELECTED ANNUALLY FOR REVIEW AND INQUIRY BY THE INDEPENDENT ACCOUNTANTS FOR SEPARATE AND PRIVATE INTERVIEW AS A PART OF THE AUDIT PROCESS. THESE FUNCTIONS ALLOW A GREATER AMOUNT OF OVERSIGHT BY THE BOARD INTO THE ANNUAL AUDIT PROCESS. THERE HAS BEEN NO CHANGE TO THESE PROCEDURES DURING THE PAST YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationInd
THE RICHLAND HOSPITAL FOUNDATION INC
333 EAST SECOND STREETRICHLAND CENTERWI53581391567249FOUNDATIONWI501(C)(3)LINE 9N/A0
PARTNERS OF RICHLAND HOSPITAL INC
333 EAST SECOND STREETRICHLAND CENTERWI53581391693458AUXILIARYWI501(C)(3)LINE 9N/A0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

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