2015-07-24T11:17:44-05:00 2014-09-30 390758449 WIPFLI LLP 3703 OAKWOOD HILLS PARKWAY EAU CLAIRE WI 54701 990 2013-10-01 391091432 REEDSBURG AREA MEDICAL CENTER REED 6085246487 2000 NORTH DEWEY AVENUE REEDSBURG WI 53959 ROBERT VAN MEETEREN PRESIDENT/CEO 6085246487 2015-07-20 1 HOLLY POKRANDT CPA P00449155 7158323407 2015-07-07 2013 2016-02-25 16:41:14Z ROBERT VAN MEETEREN 2000 NORTH DEWEY AVENUE REEDSBURG WI 53959 65420653 0 X WWW.RAMCHEALTH.COM X 1967 WI REEDSBURG AREA MEDICAL CENTER (RAMC) IS A NON-PROFIT, NON-STOCK CORPORATION WHICH EXISTS FOR THE BENEFIT OF THE PEOPLE OF REEDSBURG AND SURROUNDING AREAS. RAMC'S MISSION IS TO PROVIDE QUALITY, COMPASSIONATE AND EFFECTIVE HEALTH CARE GOING BEYOND THE EXPECTED IN ALL WE DO. OUR MAIN FUNCTION IS TO PROVIDE PRIMARY CARE SERVICES CONSISTING OF, BUT NOT LIMITED TO ACUTE CARE, OBSTETRICS, URGENT/EMERGENCY CARE, DIAGNOSTIC SERVICES, REHABILITATION, SURGICAL SERVICES, COMMUNITY OUTREACH AND WELLNESS. DIVERSIFICATION AND EXPANSION OF SERVICES ARE CONSIDERED IN RESPONSE TO THE NEEDS OF THOSE WE SERVE. RAMC PROVIDES SIGNIFICANT CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS, BUT IN ADDITION, WE BELIEVE THAT WE PROVIDE A CRITICALLY IMPORTANT COMMUNITY BENEFIT WHICH IS NOT QUANTIFIED. OUR HOSPITAL, LIKE MOST RURAL HOSPITALS, WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE CARE LOCALLY - CARE THAT WITHOUT OUR HOSPITAL, WOULD NOT BE AVAILABLE. 12 8 537 129 0 0 20307 24014 47008555 58427632 1150688 978986 392511 400486 48572061 59831118 481143 512242 0 0 25208360 29201345 0 0 0 20456695 25209946 46146198 54923533 2425863 4907585 65136935 71006994 27390687 27913580 37746248 43093414 X REEDSBURG AREA MEDICAL CENTER, ALWAYS THERE, GOING BEYOND THE EXPECTED TO PROVIDE COMPASSIONATE, QUALITY AND EFFICIENT HEALTHCARE. 1 0 47896356 512242 56871891 INPATIENT SERVICES INCLUDE MULTICARE (MEDICAL/SURGICAL), OBESTETRICS/NURSERY AND INTENSIVE CARE UNITS AT REEDSBURG AREA MEDICAL CENTER (RAMC). WITHIN THESE UNITS, RAMC PROVIDED SHORT-TERM CARE FOR 4,546 PATIENT DAYS (1,398 DISCHARGED PATIENTS) DURING THE FISCAL YEAR ENDING 9/30/14. THIS INCLUDED 320 SWING BED DAYS FOR 46 PATIENTS, 500 OBSERVATION DAYS AND 281 BIRTHS. THE STAFF AT RAMC IS COMMITTED TO MEETING PATIENTS' PHYSICAL, SOCIAL, EDUCATIONAL, EMOTIONAL AND SPIRITUAL NEEDS. RAMC'S EMERGENCY AND URGENT CARE IS HERE FOR THE COMMUNITY WHENEVER THEY MAY NEED IT. URGENT CARE HAS HOURS OF AVAILABILITY FOR MINOR MEDICAL NEEDS SEVEN DAYS A WEEK AND THE EMERGENCY ROOM IS OPEN AND PHYSICIAN STAFFED 24 HOURS A DAY, SEVEN DAYS A WEEK. A MULTIDISCIPLINARY TEAM OF SKILLED PROFESSIONALS, ALONG WITH UP-TO-DATE DIAGNOSTIC TECHNOLOGY, ARE ALL AVAILABLE 24 HOURS A DAY. IN THE FISCAL YEAR ENDING 9/30/14, 9,089 PATIENTS WERE SEEN IN THE EMERGENCY ROOM (RESULTING IN 1,065 INPATIENT ADMISSIONS) AND 4,860 PATIENTS VISITED URGENT CARE.THERE WERE MANY CHANGES FOR RAMC DURING FISCAL YEAR ENDING 9/30/14. ONE OF THE MOST EXCITING HAS BEEN THE FORMAL AFFILIATION BETWEEN RAMC AND THE REEDSBURG PHYSICIANS GROUP, AN ESTEEMED GROUP OF BOARD CERTIFIED PHYSICIANS PROVIDING COMPREHENSIVE HEALTH CARE TO INDIVIDUALS AND THE ENTIRE FAMILY. NOW KNOWN AS RAMC PHYSICIANS GROUP, THIS AFFILIATION ALLOWS THE ENTIRE RAMC FAMILY TO CONTINUE THE SHARED PHILOSOPHY OF TEAM-BASED PATIENT CARE, PROVIDING AN EXCEPTIONAL EXPERIENCE AT EACH VISIT. NEW PROVIDERS DR. CHRISTOPHER ECKERMAN, PODIATRIST, AND AMY BENARDS, DERMATOLOGY PA, ALSO JOINED THE RAMC SPECIALTY GROUP. IN JULY OF 2014, RAMC WENT LIVE WITH THE MYRAMC PATIENT PORTAL, THE FINAL PIECE TO ITS ELECTRONIC MEDICAL RECORDS (EMR) SYSTEM. THIS SECURE, ONLINE TOOL PUTS PATIENT HEALTH INFORMATION IN ONE, EASILY ACCESSIBLE LOCATION. WHEN COMBINED WITH THE PHYSICIAN-SIDE OF THE EMR SYSTEM (LAUNCHED IN FISCAL YEAR 2012), IT ALLOWS FOR QUICKER ACCESS TO TEST RESULTS, MORE EFFICIENT APPOINTMENTS AND CARE AND INCREASED INVESTMENT IN PERSONAL HEALTH FOR PATIENTS. OTHER SIGNIFICANT ACHIEVEMENTS RESULTING IN EXPANDED OR ENHANCED PATIENT SERVICES INCLUDE THE LSVT (LEE SILVERMAN VOICE TREATMENTS) BIG PROGRAM TO MANAGE SYMPTOMS OF PARKINSON'S DISEASE AND THE ADDITION OF VENEFIT TARGETED ENDOVENOUS THERAPY FOR VARICOSE VEINS AND CHRONIC VENOUS INSUFFICIENCY. THESE, AND OTHER PROJECTS, ALLOW RAMC TO PROVIDE INCREASED LEVELS OF PATIENT SAFETY, QUALITY AND SATISFACTION. OTHER SERVICES AVAILABLE TO MEET THE COMMUNITY'S HEALTH CARE NEEDS INCLUDE, BUT ARE NOT LIMITED TO, LABORATORY, REHABILITATION, SLEEP MEDICINE, SURGICAL SERVICES, CONSULTING, MASSAGE THERAPY, ORTHOPEDICS, OBSTETRICS, PARISH NURSING, CHEMOTHERAPY, VOLUNTEER SERVICES, COMMUNITY OUTREACH AND WELLNESS. 47896356 1 1 0 1 0 0 0 0 0 0 1 0 1 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 1 0 0 0 1 56 0 537 1 0 0 0 0 0 0 0 0 0 0 X 12 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X BARRY BORCHERT 6085246487 2000 NORTH DEWEY AVENUE REEDSBURG WI 53959 JAMES SEBRANEK TRUSTEE 0.50 X 2450 0 0 DEANNA BENISH MD TRUSTEE 0.50 X 1750 0 0 WIN BYERS TRUSTEE 0.50 X 2250 0 0 ERIC MOLBERG TRUSTEE 0.50 X 2300 0 0 JAY BRUNKEN TRUSTEE 0.50 X 1200 0 0 PAMELA WELCH TRUSTEE 0.50 X 2800 0 0 KONYA ANTONETTI TRUSTEE 0.50 X 1650 0 0 DAN KLAHN TRUSTEE (EFFECTIVE 1/2014) 0.50 X 650 0 0 KURT MUCHOW CHAIRPERSON 0.50 X X 2200 0 0 KATHERINE CAMPBELL VICE CHAIR 0.50 X X 1900 0 0 ERIC SAUEY TREASURER 0.50 X X 2200 0 0 CHRIS WENNINGER MD SECRETARY 0.50 X X 1500 0 0 BARRY BORCHERT TRUSTEE/CFO (EFFECTIVE 1/2014) 40.00 X X 1350 0 0 JOSEPH SVETLIK VP FINANCE (THRU 1/2014) 40.00 X 165672 0 38385 BOB VAN MEETEREN PRESIDENT/CEO 40.00 X 227600 0 57352 DEAN FOCHIOS ORTHOPEDIC SURGEON 40.00 X 496466 0 22337 KEVIN HIBBETT GENERAL SURGEON 40.00 X 348521 0 14505 CHRISTOPHER BJORKLUND CRNA 40.00 X 269818 0 34698 GERRY CHRABASZCZ ORTHOPEDIC SURGEON 40.00 X 270243 0 33693 KENNETH OLSON CRNA/DIRECTOR OF ANESTHESIA 40.00 X 270427 0 32988 2072947 0 233958 20 0 1 0 WEBER ORTHOPEDICS SC 922 OTT LANE BARABOO WI 53913 SURGEON 759464 WIPFLI LLP PO BOX 8010 WAUSAU WI 54402 ACCOUNTING / CONSULTING SERVICES 120737 2 18364 5650 24014 PATIENT SERVICE REVENUE 621400 56871891 56871891 OTHER 900099 788951 788951 CAFETERIA REVENUE 722310 766790 766790 58427632 325606 325606 400486 0 400486 400486 400486 6240435 2480 5580710 8825 659725 -6345 653380 653380 59831118 56871891 0 2935213 X 422605 422605 89637 89637 511935 511935 21290931 18900274 2390657 796345 706927 89418 5148702 4570579 578123 1453432 1290233 163199 72215 72215 78243 78243 8841105 8050499 790606 272400 272400 776784 5251 771533 175039 175039 1694949 1694949 145541 89726 55815 2745371 2745371 256960 256960 MEDICAL SUPPLIES 5719144 5719144 REPAIR & MAINTENANCE 1286733 1237181 49552 NONMEDICAL SUPPLIES 1270057 559164 710893 BAD DEBT EXPENSE 855849 855849 1019556 958967 60589 54923533 47896356 7027177 0 32815 46228 6275706 5526961 7422401 11510988 96946 95303 1531572 1542039 692258 759873 54921154 27911060 27755759 27010094 12806411 16216793 4854023 5031113 242000 3669044 3025602 65136935 71006994 5456522 7264628 317816 141798 19624880 18770750 812113 520840 1179356 1215564 27390687 27913580 X 36381325 41587356 1364923 1506058 37746248 43093414 65136935 71006994 X 4907585 189755 249826 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 4383 4383 0 PART II-B, LINE 1: REEDSBURG AREA MEDICAL CENTER (RAMC) PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THESE DUES ARE PRIMARILY TO ACCESS EDUCATIONAL MATERIALS AND FOR STAFF TRAINING. THE AHA AND WHA HAVE NOTIFIED RAMC THAT $4,383 OF THE ANNUAL DUES PAID WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT. 26703 26703 36496134 15183174 21312960 17094411 12320658 4773753 1303906 407228 896678 27010094 BOND FUNDS 5031113 C 5031113 DEFERRED COMPENSATION 1215564 1215564 X PART X, LINE 2: IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, REEDSBURG AREA MEDICAL CENTER ASSESSES 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 COMBINED FINANCIAL STATEMENTS. REEDSBURG AREA MEDICAL CENTER RECORDED NO ASSETS OR LIABILITIES FOR UNCERTAIN TAX POSITIONS OR UNRECOGNIZED BENEFITS IN 2014 AND 2013. FEDERAL RETURNS FOR THE YEARS ENDED SEPTEMBER 30, 2011, AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. 1 1 1 X 1 X 1 1 0 1 1 955826 955826 0.01770 5644306 5202370 441936 0.00820 6600132 5202370 1397762 0.02590 188134 15796 172338 0.00320 150327 150327 0.00280 6074602 3010957 3063645 0.05670 438136 438136 0.00810 6851199 3026753 3824446 0.07080 13451331 8229123 5222208 0.09670 13315 13315 0.00020 34305 34305 0.00060 28012 28012 0.00050 18751 2575 16176 0.00030 94383 2575 91808 0.00160 0 408995 204498 14630274 14711943 -81669 X 1 1 1 1 REEDSBURG AREA MEDICAL CENTER 2000 NORTH DEWEY AVENUE REEDSBURG WI 53959 WWW.RAMCHEALTH.COM 1057 X X X X PROVIDER BASED CLINIC AND SPECIALTY CLINIC REEDSBURG AREA MEDICAL CENTER 1 1 X X X X X X X X X 12 1 0 1 X SEE PART V, SECTION B, LINE 5D X X X X X X X X X 1 0 1 1 150.000000000000 1 400.000000000000 1 X X X X 1 1 X X X 0 0 X X 1 X 0 0 REEDSBURG AREA MEDICAL CENTER PART V, SECTION B, LINE 3: THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS INCLUDED A VARIETY OF DATA COLLECTION METHODS USED TO CREATE AN OVERALL DESCRIPTION OF THE ISSUES FACING THE COMMUNITY. THESE METHODS WERE DEVELOPED TO SEEK INPUT FROM DIVERSE COMMUNITY STAKEHOLDERS AS WELL AS GENERAL COMMUNITY MEMBERS AND INCLUDED:1. HEALTH NEEDS ASSESSMENT SURVEYS: THESE SURVEYS WERE CONDUCTED WITH APPROXIMATELY 800 AREA RESIDENTS VIA PAPER AND ONLINE METHOD: INDIVIDUALS PARTICIPATED FROM A VARIETY OF PROFESSIONS INCLUDING HOSPITALS, SCHOOLS, LAW ENFORCEMENT, MENTAL HEALTH, ENVIRONMENTAL HEALTH, BUSINESSES, PUBLIC HEALTH, DISABILITY AND AGING ADVOCATES, ABUSE VICTIM ADVOCATES, AND LONG-TERM CARE PROVIDERS.2. FOCUS GROUPS AND INTERVIEWS: OVER 30 KEY INFORMANTS WERE INTERVIEWED BY THE CENTRAL WI COMMUNITY ACTION COUNCIL ON HEALTH CARE ISSUES IN SAUK COUNTY VIA THREE FOCUS GROUPS AND SEVEN PERSONAL INTERVIEWS.IN ADDITION TO THE DATA GATHERING STRATEGIES NOTED ABOVE, HEALTH DATA WAS GATHERED FROM VARIOUS CREDIBLE SOURCES TO PROVIDE ACTUAL COMPARATIVE RISKS FOR MORBIDITY AND MORTALITY ON A WIDE RANGE OF HEALTH ISSUES. REEDSBURG AREA MEDICAL CENTER PART V, SECTION B, LINE 5D: THE CHNA WAS ALSO PUBLISHED IN RAMC'S NEWSLETTER AND IS AVAILABLE ON THE WEBSITE AT: HTTP://RAMCHEALTH.COM/MEDIA/81214/CHNA-FINAL.PDF. A COPY OF THE CHNA IS ALSO ATTACHED TO THE FORM 990. REEDSBURG AREA MEDICAL CENTER PART V, SECTION B, LINE 14G: IF A PATIENT DID NOT HAVE INSURANCE AND IT APPEARED THAT THEY WOULD HAVE DIFFICULTY PAYING THE HOSPITAL BILL, THE PATIENT WOULD BE INFORMED OF THE POLICY AND OFFERED AN APPLICATION. REEDSBURG AREA MEDICAL CENTER PART V, SECTION B, LINE 20D: INDIVIDUALS WITHOUT INSURANCE ARE BILLED AT 85% OF GROSS CHARGES WITH THE OPTION OF AN ADDITIONAL 10% DISCOUNT TO 75% OF GROSS CHARGES IF THE CLAIM IS PAID WITHIN 30 DAYS. CLAIMS EXCEEDING $30,000 GROSS CHARGES RECEIVE AN ADDITIONAL 10% DISCOUNT; STEPPED UP TO 40% AT $50,000 GROSS CHARGES, PLUS THE ADDITIONAL 10% IF PAID WITHIN 30 DAYS. IF THERE ARE INDICATORS THAT A PATIENT MAY NOT BE ABLE TO PAY SOME OR ALL OF THE BILL, THEY ARE INFORMED OF THE COMMUNITY CARE POLICY OFFERED BY THE HOSPITAL. PART I, LINE 6A: REEDSBURG AREA MEDICAL CENTER (THE "HOSPITAL") 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 METHOD 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. THE COSTING METHOD FOR SUBSIDIZED HEALTH SERVICES IS BASED ON ALLOCATED EXPENSES FROM THE MEDICARE COST REPORT, WHICH IS SIMILAR TO A DIRECT COST ACCOUNTING SYSTEM. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES AT REEDSBURG AREA MEDICAL CENTER INCLUDE THE OPERATION OF THE HOSPITAL INPATIENT DEPARTMENTS THAT OPERATE AT A LOSS FROM OPERATIONS, BUT ARE CONSIDERED VITAL HOSPITAL AND CLINIC SERVICES SUCH AS THE INTENSIVE CARE UNIT AND MEDICAL/SURGICAL NURSING UNIT. A LARGE PORTION OF THESE SERVICES ARE ACCESSED BY COMMUNITY MEMBERS THROUGH THE HOSPITAL'S EMERGENCY SERVICES DEPARTMENT. IT IS THE GOAL OF REEDSBURG AREA MEDICAL CENTER TO PROVIDE THESE SERVICES TO THE COMMUNITY REGARDLESS OF A 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 $ 855,849. PART II, COMMUNITY BUILDING ACTIVITIES: REEDSBURG AREA MEDICAL CENTER IS COMMITTED TO THE HEALTH OF OUR COMMUNITY AND THE IMPORTANT PART WE PLAY IN MAINTAINING AND IMPROVING THE OVERALL HEALTH OF OUR CONSTITUENTS. WE TAKE AN ACTIVE ROLE IN EQUIPPING OUR COMMUNITY MEMBERS WITH THE SKILLS NEEDED TO CREATE BETTER HEALTH. REEDSBURG AREA MEDICAL CENTER PROVIDES HEALTH CARE SERVICES AND OTHER FINANCIAL SUPPORT THROUGH VARIOUS PROGRAMS THAT ARE DESIGNED, AMONG OTHER MATTERS, TO ENHANCE THE HEALTH OF THE COMMUNITY, INCLUDING THE HEALTH OF LOW-INCOME PATIENTS. CONSISTENT WITH OUR MISSION, CARE IS PROVIDED TO PATIENTS REGARDLESS OR THEIR ABILITY TO PAY, INCLUDING PROVIDING SERVICES TO THOSE PERSONS WHO CANNOT AFFORD HEALTH INSURANCE BECAUSE OF INADEQUATE RESOURCES OR ARE UNDERINSURED. COMMUNITY BENEFITS ALSO INCLUDE UNPAID COSTS OF TREATING THE ELDERLY, HEALTH SCREENINGS, COMMUNITY EDUCATION AND OTHER HEALTH-RELATED SERVICES. OUR COMMUNITY BUILDING ACTIVITIES WORK TO ADDRESS UNDERLYING HEALTH DETERMINANTS AND SUPPORT PROGRAMS MEANT TO IMPROVE HEALTH BEFORE INTERVENTION IS REQUIRED AS WELL AS PROVIDING RESOURCES FOR THOSE LOOKING TO IMPROVE THEIR CURRENT HEALTH SITUATION. REEDSBURG AREA MEDICAL CENTER EMPLOYEES ARE ACTIVE IN EDUCATING THE COMMUNITY ON A WIDE VARIETY OF HEALTH TOPICS AND PARTICIPATE ON NUMEROUS LOCAL BOARDS. HEALTH-RELATED BOARD POSITIONS RANGE FROM THOSE FOCUSING ON AREA DENTAL AND EMERGENCY MEDICAL SERVICES TO THE RURAL WISCONSIN HEALTH COOPERATIVE AND SAUK COUNTY HEALTH BOARDS. MANY EMPLOYEES ARE ALSO MEMBERS OF COMMUNITY SERVICE BOARDS AND VOLUNTEER GROUPS. REEDSBURG AREA MEDICAL CENTER IS MINDFUL OF AND PROACTIVE IN DEVELOPING OR PARTNERING WITH GROUPS WORKING TO BETTER THE CURRENT ECONOMIC AND ENVIRONMENTAL CONDITIONS OF OUR COMMUNITY. REEDSBURG AREA MEDICAL CENTER IS ORGANIZED AND OPERATED WITH THE GOAL OF PROMOTING THE HEALTH OF THE COMMUNITY WE SERVE. WE SUPPORT THIS MISSION WITH A BOARD COMPRISED OF LOCAL, INDEPENDENT COMMUNITY MEMBERS, A MEDICAL STAFF ORGANIZED IN THE PUBLIC INTEREST AND OPEN TO ALL QUALIFIED PHYSICIANS AND AN EMERGENCY ROOM AVAILABLE TO ALL, REGARDLESS OF ABILITY TO PAY. THE BOARD TAKES A BALANCED APPROACH WHEN IT SETS POLICY AND STRATEGIC DIRECTION FOR THE HOSPITAL, WORKING TO ALIGN COMMUNITY NEEDS WITH BUSINESS AND FINANCIAL CONCERNS. THE USE OF SURPLUS FUNDS IS LARGELY DETERMINED BY THE BOARD IN ITS ATTEMPT TO MEET ITS GOAL. REEDSBURG AREA MEDICAL CENTER IS THE SOLE HOSPITAL IN OUR COMMUNITY AND PROVIDES NUMEROUS VOLUNTEER OPPORTUNITIES FOR AREA RESIDENTS. 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 EXCLUDING 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 WHO HAVE ACCOUNTS THAT ARE DEEMED TO BE BAD DEBTS TO THE HOSPITAL. THE HOSPITAL ALSO RECOGNIZES THAT IT ALSO PROVIDES A DISCOUNT TO SELF-PAY OR UNINSURED PATIENTS. THESE AMOUNTS ARE INCLUDED IN THE CONTRACTUAL ADJUSTMENTS ON THE FINANCIAL STATEMENTS AND ARE NOT INCLUDED IN THE RATIO AS DESCRIBED ABOVE AND APPROVED BY THE IRS FOR USE ON FORM 990. IF CONSIDERED, THESE ADDITIONAL WRITE-OFF AMOUNTS TO UNINSURED ACCOUNTS WOULD ALSO INCREASE THE ESTIMATED BAD DEBT EXPENSE AMOUNT ASSOCIATED WITH THESE UNCOLLECTIBLE ACCOUNTS TO THE HOSPITAL. PART III, LINE 3: MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY UNINSURED PATIENTS AND AMOUNTS PATIENTS ARE PERSONALLY RESPONSIBLE FOR, THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO A VALUATION ALLOWANCE 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 DO NOT COMPLETE THE REQUIRED CHARITY CARE APPLICATION AND ARE TRANSFERRED TO COLLECTION SERVICES EVEN THOUGH REEDSBURG AREA MEDICAL CENTER 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: PATIENT ACCOUNTS RECEIVALBE AND CREDIT POLICY: IN EVALUATING THE COLLECTABILITY OF PATIENT 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 DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. SPECIFICALLY, FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSTPIAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH 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 HOSIPTAL RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A SEPARATE FOOTNOTE REGARDING BAD DEBT EXPENSE. PART III, LINE 8: THE TOTAL MEDICARE REVENUE SHOWN IN SCHEDULE H TO THE FORM 990 IS BASED ON THE IRS 990 INSTRUCTIONS AND INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE OF THE HOSPITAL, AND ALSO DOES NOT CONSIDER ALL CONTRACTUAL ADJUSTMENTS FOR SERVICES REIMBURSED BY THE MEDICARE PROGRAM. AMOUNTS LISTED FOR MEDICARE REVENUES DO NOT INCLUDE PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT AT THE HOSPITAL AS WELL AS ANESTHESIA PROFESSIONAL SERVICES, SURGEON PROFESSIONAL SERVICES, REVENUES FOR ANY PATIENTS COVERED UNDER MEDICARE ADVANTAGE PLAN PROGRAMS, AND REFERENCE LAB SERVICES FOR PATIENTS OF A NEIGHBORING PHYSICIAN CLINIC. PHYSICIAN PROFESSIONAL SERVICES AND REFERENCE LAB SERVICES ARE REIMBURSED PRIMARILY ON FEE SCHEDULE REIMBURSEMENTS AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY, SURGERY, AND PHYSICIAN 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 REEDSBURG AREA MEDICAL CENTER PROVIDES TO THE COMMUNITY AND SURROUNDING AREAS. THE COSTING METHOD USED ABOVE FOR IRS 990 COMPLIANCE REPORTING IS ALSO BASED ON THE FILED MEDICARE COST REPORT FOR THE YEAR ENDED SEPTEMBER 30, 2014, AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES, AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICE REVENUES (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE).WHETHER THERE IS A SHORTFALL OR SURPLUS ON SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THESE PEOPLE, WHO ARE TYPICALLY ELDERLY OR DISABLED 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 III, LINE 9B: UNDER THE HOSPITAL'S COLLECTION AND CHARITY CARE POLICIES, REEDSBURG AREA MEDICAL CENTER MAKES EVERY ATTEMPT TO IDENTIFY AND PROMOTE CHARITY CARE TO PATIENTS. INCLUDED IN THE HOSPITAL'S CHARITY CARE POLICY IT IS NOTED THAT PATIENTS MAY QUALIFY FOR CHARITY CARE EITHER PRIOR TO ADMISSION OR FOLLOWING DISCHARGE. DURING THE PATIENT ACCOUNT COLLECTION PROCESS, SELF-PAY PATIENTS ARE ALSO INFORMED OF THE HOSPITAL'S COLLECTION POLICIES AS WELL AS THE CHARITY CARE PROGRAM TO ALLOW PATIENTS THE OPPORTUNITY TO COMPLETE THE APPROPRIATE FORMS AND QUALIFY UNDER THE PROGRAM. ONCE A PATIENT MEETS ALL QUALIFICIATIONS FOR FINANCIAL ASSISTANCE, ALL OR PART OF THE ACCOUNT BALANCE IS WRITTEN OFF AS APPROPRIATE. THE REMAINING BALANCE, IF ANY, IS THE PATIENT'S RESPONSIBILITY AND COLLECTED FOLLOWING THE HOSPITAL'S STANDARD DEBT COLLECTION POLICY. PART VI, LINE 2: EVERY THREE YEARS, REEDSBURG AREA MEDICAL CENTER CONDUCTS A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), MEASURING AWARENESS, PREFERENCE, IMAGE AND COMMUNITY NEEDS. THE HOSPITAL CONDUCTS THE CHNA WITHIN THE PRIMARY SERVICE AREA, WHICH INCLUDES THE CITY OF REEDSBURG AND THE SURROUNDING COMMUNITIES. IN ADDITION, THERE IS A FEEDBACK SECTION ON THE HOSPITAL'S WEBSITE, WWW.RAMCHEALTH.ORG, ALLOWING A FORUM FOR WHICH THE PUBLIC CAN PROVIDE SUGGESTIONS AND COMMENTS. REEDSBURG AREA MEDICAL CENTER ALSO GATHERS DATA FROM THE SAUK COUNTY HEALTH NEEDS ASSESSMENT. THIS INFORMATION HAS BEEN SEGMENTED INTO THE HOSPITAL'S PRIMARY SERVICE AREA. IN WORKING WITH A COMMITTEE CONSISTING OF OFFICIALS FROM THE SAUK COUNTY PUBLIC HEALTH DEPARTMENT, REEDSBURG AREA SCHOOL DISTRICT, AND THE CITY OF REEDSBURG (INCLUDING THE CITY'S AMBULANCE, POLICE, AND FIRE DEPARTMENTS), AS WELL AS VARIOUS OTHER COMMUNITY MEMBERS INCLUDING REPRESENTATITVES FROM BUSINESS AND INDUSTRY, THIS INFORMATION HAS BEEN PRIORITIZED AND THE HOSPITAL IS IN THE PROCESS OF BUILDING A TEAM OF PEOPLE WHO WILL HELP SET ACTIONABLE, MEASURABLE GOALS TO BENEFIT THE COMMUNITY. PART VI, LINE 3: CHARITY CARE NOTICES ARE POSTED THROUGHOUT THE FACILITY AND APPLICATIONS ARE AVAILABLE THROUGH BUSINESS SERVICES. THE PATIENT, PATIENT'S REPRESENTATIVE, OR HOSPITAL REPRESENTATIVE MAY INITIATE INQUIRIES REGARDING ELIGIBILITY OR APPLICATION FOR ASSISTANCE AT ANY TIME. THE HOSPITAL, WHEN APPROPRIATE, WILL REVIEW THE PATIENT'S FINANCIAL SITUATION TO SEE IF THEY QUALIFY FOR ANY FORM OF ASSISTANCE. A SOCIAL WORKER IS AVAILABLE TO ASSIST IN THIS PROCESS AS WELL, IF NEEDED. PATIENT FINANCIAL ADVISORS ARE ALSO NOTIFIED WHEN PATIENTS (INPATIENT OR OUTPATIENT) ARE TREATED WHO DO NOT HAVE ANY INSURANCE. THEY DISCUSS WITH THE PATIENT AVAILABLE OPTIONS AND PROVIDE INFORMATION/APPLICATIONS FOR BOTH REEDSBURG AREA MEDICAL CENTER CHARITY CARE PROGRAMS AND COUNTY, STATE, OR FEDERAL ASSISTANCE PROGRAMS. AT ANY TIME, PATIENTS MAY INQUIRE WITH HOSPITAL PERSONNEL REGARDING QUESTIONS THEY HAVE ON THEIR ABILITY TO PAY. FINANCIAL ADVISORS ARE AVAILABLE TO HELP AS IS A CONSUMER ADVOCATE. THE CONSUMER ADVOCATE OFFERS COMPLIMENTARY PATIENT ASSISTANCE SERVICES, INCLUDING, BUT NOT LIMITED TO, MEDICARE, MEDICAID, PRIVATE INSURANCE, INTERPRETATION OF EXPLANATION OF BENEFITS (EOBS), AND DIRECTIONS TO ADDITIONAL CONSUMER RESOURCES. PART VI, LINE 4: REEDSBURG AREA MEDICAL CENTER IS LOCATED IN THE CITY OF REEDSBURG, WISCONSIN, IN NORTH CENTRAL SAUK COUNTY. THE PRIMARY SERVICE AREA EXTENDS WEST TO CAZENOVIA, EAST TO ROCK SPRINGS, SOUTH TO HILLPOINT AND NORTH FROM WONEWOC TO JUST WEST OF LAKE DELTON. THIS GEOGRAPHIC AREA IS LARGELY RURAL AND CROSSES INTO THREE COUNTIES IN ADDITION TO SAUK COUNTY, COMPRISING APPROXIMATELY 77% OF THE HOSPITAL'S DISCHARGED PATIENTS. ACCORDING TO THE MOST RECENT U.S. CENSUS DATA, SAUK COUNTY HAS SEEN POPULATION GROWTH OF 11% FROM 2000 TO 2010, WHILE THE STATE OF WISCONSIN EXPERIENCED GROWTH OF 6%. THE CITY OF REEDSBURG GREW AT A RATE OF 18% AND ITS MINORITY POPULACE INCREASED FROM 3% TO 7% OF TOTAL POPULATION FOR THE SAME TIME PERIOD COMPARED TO 8% FOR SAUK COUNTY AND 17% FOR THE STATE OF WISCONSIN. 24% OF COUNTY RESIDENTS ARE UNDER THE AGE OF 18 (23% STATE), 15% ARE ABOVE THE AGE OF 65 (14% STATE) AND 46% OF SAUK COUNTY LIVES IN RURAL AREAS (30% STATE). THE MEDIAN HOUSEHOLD INCOME REPORTED FOR SAUK COUNTY IS $48,874 ($50,401 STATE) WHILE UNEMPLOYED IS 7.5% (7.5% STATE). 32% OF COUNTY CHILDREN ARE ELIGIBLE FOR FREE SCHOOL LUNCH (33% STATE) WHILE 18% LIVE IN POVERTY (18% STATE). 14% OF COUNTY ADULTS AND 6% OF COUNTY CHILDREN ARE UNINSURED (13% AND 5% RESPECTIVELY FOR WISCONSIN). 9% OF COUNTY RESIDENTS (9% STATE) REPORTED NOT SEEING A DOCTOR FOR THE PRIOR 12 MONTHS DUE TO COST WHILE 26% (25% STATE) HAD NO DENTAL VISIT. BASED ON NUMEROUS DEMOGRAPHIC, BEHAVIORAL, HEALTH AND SOCIAL METRICS, SUCH AS THOSE SHOWN HERE, SAUK COUNTY HAS BEEN RANKED AS THE 42ND HEALTHIEST COUNTY OUT OF ALL 72 WISCONSIN COUNTIES BY THE COUNTY HEALTH RANKINGS AND ROADMAPS PROGRAM. REEDSBURG AREA MEDICAL CENTER IS THE ONLY HOSPITAL WITHIN OUR PRIMARY SERVICE AREA; TWO ADDITIONAL HOSPITALS ARE LOCATED IN SAUK COUNTY. SEVERAL TERTIARY CARE HOSPITALS IN MADISON, WISCONSIN, AND THE SURROUNDING AREA PROVIDE ADDITIONAL SPECIALIZED SERVICES NOT AVAILABLE AT REEDSBURG AREA MEDICAL CENTER. PART VI, LINE 5: REEDSBURG AREA MEDICAL CENTER IS ORGANIZED AND OPERATED WITH THE GOAL OF PROMOTING THE HEALTH OF THE COMMUNITY WE SERVE. WE SUPPORT THIS MISSION WITH A BOARD COMPRISED OF LOCAL, INDEPENDENT COMMUNITY MEMBERS, A MEDICAL STAFF ORGANIZED IN THE PUBLIC INTEREST AND OPEN TO ALL QUALIFIED PHYSICIANS, AND AN EMERGENCY ROOM AVAILABLE TO ALL, REGARDLESS OF ABILITY TO PAY. THE BOARD TAKES A BALANCED APPROACH WHEN IT SETS POLICY AND STRATEGIC DIRECTION FOR THE HOSPITAL, WORKING TO ALIGN COMMUNITY NEEDS WITH BUSINESS AND FINANCIAL CONCERNS. THE USE OF SURPLUS FUNDS IS LARGELY DETERMINED BY THE BOARD IN EFFORTS TO MEET THIS GOAL. SURPLUS FUNDS ARE USED TO PURCHASE EQUIPMENT AND TO PROVIDE SERVICES THAT WILL MOST EFFECTIVELY MEET THE IDENTIFIED HEALTH NEEDS OF THE COMMUNITY AND ALLOW FOR COMPREHENSIVE CARE CLOSE TO HOME. WHILE THERE IS GROWING AGREEMENT IN THE UNITED STATES ABOUT WHAT CONSTITUTES A NON-PROFIT HOSPITAL'S "COMMUNITY BENEFIT," THESE EFFORTS CONTINUE TO BE A WORK IN PROGRESS. REEDSBURG AREA MEDICAL CENTER PROVIDES SIGNIFICANT AMOUNTS OF CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS AND IN ADDITION, WE BELIEVE THAT IT PROVIDES A CRITICALLY IMPORTANT BENEFIT WHICH IS NOT QUANTIFIED. REEDSBURG AREA MEDICAL CENTER, LIKE MOST COMMUNITY HOSPITALS, WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE CARE LOCALLY, WHICH WITHOUT THE HOSPITAL, WOULD NOT BE AVAILABLE LOCALLY. BEYOND INPATIENT HOSPITALIZATIONS, REEDSBURG AREA MEDICAL CENTER PROVIDES LOCAL ACCESS TO MANY SERVICES INCLUDING: BIRTHING CENTER, DIAGNOSTICS, EMERGENCY SERVICES, INFUSION SERVICES, SWING BED SERVICES, SURGICAL SERVICES, LABORATORY SERVICES, OCCUPATIONAL HEALTH, REHABILITATION SERVICES, SPECIALTY MEDICINE, SLEEP CENTER, SPEECH PATHOLOGY, AND WOMENS' SERVICES. PART VI, LINE 7, REPORTS FILED WITH STATES WI 1 REEDSBURG AREA SENIOR LIFE CENTER 2350 NORTH DEWEY AVENUE REEDSBURG WI 54959 760775289 501(C)(3) 400000 GENERAL OPERATIONS REEDSBURG AREA MEDICAL CENTER FOUNDATION 2090 RIDGEVIEW DRIVE REEDSBURG WI 54959 391243616 501(C)(3) 10000 FREE CLINIC WISCONSIN MEDICAL SOCIETY FOUNDATION 330 E LAKESIDE STREET MADISON WI 54715 396045649 501(C)(3) 6000 CONTRIBUTION TO HONORING CHOICES WISCONSIN PROJECT 3 0 TUITION ASSISTANCE 34 74303 EDUCATIONAL STIPENDS 21 15334 PART I, LINE 2: GRANTS WERE PROVIDED BY REEDSBURG AREA MEDICAL CENTER (RAMC) TO REEDSBURG AREA SENIOR LIFE CENTER AND REEDSBURG AREA MEDICAL CENTER FOUNDATION. RAMC HAS (AT LEAST MONTHLY) ACCESS TO BOTH OF THESE ORGANIZATION'S FINANCIAL RECORDS AND BOARD MEETING MINUTES, ALLOWING FOR REVIEW OF HOW FUNDS ARE ALLOCATED. RAMC ALSO PROVIDES SCHOLARSHIPS AND TUITION ASSISTANCE TO EMPLOYEES PURSUING HEALTH-CARE RELATED HIGHER EDUCATION. THIS ASSISTANCE IS MADE AVAILABLE TO EMPLOYEES FOR STUDIES WHERE PROFESSIONAL STAFF ARE NEEDED AND THE DEMAND FOR THESE POSITIONS IS GREATER THAN THE SUPPLY AVAILABLE. USUALLY, THE SHORTAGE IS NOT ONLY SEEN LOCALLY, BUT ALSO STATE- AND NATION-WIDE. THE INTENTION IS TO HAVE THESE TRAINED PROFESSIONALS CONTINUE AT RAMC WITHIN THEIR NEW POSITION, ACCOMPLISHING OUR MISSION AND COMMITMENT TO PROVIDING HIGH-QUALITY, LOCAL CARE FOR OUR COMMUNITY. PROOF OF THE COST OF TUITION AND SUCCESSFUL COURSE COMPLETION ARE REQUIRED. X X X X X 0 0 0 1 0 0 0 0 0 JOSEPH SVETLIK VP FINANCE (THRU 1/2014) 151244 0 14428 0 0 0 18342 0 20043 0 204057 0 0 0 BOB VAN MEETEREN PRESIDENT/CEO 193822 0 31673 0 2105 0 35828 0 21524 0 284952 0 0 0 DEAN FOCHIOS ORTHOPEDIC SURGEON 496466 0 0 0 0 0 962 0 21375 0 518803 0 0 0 KEVIN HIBBETT GENERAL SURGEON 348521 0 0 0 0 0 3231 0 11274 0 363026 0 0 0 CHRISTOPHER BJORKLUND CRNA 269593 0 225 0 0 0 12750 0 21948 0 304516 0 0 0 GERRY CHRABASZCZ ORTHOPEDIC SURGEON 269973 0 270 0 0 0 12750 0 20943 0 303936 0 0 0 KENNETH OLSON CRNA/DIRECTOR OF ANESTHESIA 270142 0 285 0 0 0 12750 0 20238 0 303415 0 0 0 PART I, LINE 5 CERTAIN PHYSICIANS ARE ELIGIBLE AND RECEIVE PAYMENT BASED ON CHARGES GENERATED FROM HEALTH CARE SERVICES PROVIDED BY EACH PHYSICIAN. A CITY OF REEDSBURG 396005582 2003-06-03 2600000 REFUND PRIOR ISSUE 0 0 0 B WISCONSIN HEALTH & EDUCATIONAL FACILITIES 391337855 97710VH43 2006-06-28 11865000 CONSTRUCT & EQUIP FACILITY & REFUND PRIOR ISSUE 0 0 0 C WISCONSIN HEALTH & EDUCATIONAL FACILITIES 391337855 97710BXK3 2010-09-16 5800000 REFUND PRIOR ISSUE 0 0 0 D WISCONSIN HEALTH & EDUCATIONAL FACILITIES 391337855 97710BXP2 2014-02-19 4273300 REFUND PRIOR ISSUE 0 0 0 A 1505262 2600000 2600000 1 0 1 1 B 3605000 11865000 1183280 3522124 237300 6922296 1 0 1 1 C 570000 5800000 580000 5104000 116000 1 0 1 1 D 87288 4273300 4273300 1 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 D 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 1 0 0 0 0 B 0 0 0 1 0 0 0 0 0 C 0 1 0 0 0 0 0 0 0 D 0 1 0 0 1 0 0 0 0 A 0 B 0 C 0 D 0 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: WISCONSIN HEALTH & EDUCATIONAL FACILITIES DATE THE REBATE COMPUTATION WAS PERFORMED: 06/28/2011 SCHEDULE K, PART III, LINE 4 THE CONSTRUCTION OF THE PROPERTY FINANCED BY 2006A REVENUE BONDS (B) INCLUDE SOME PORTIONS USED IN PRIVATE BUSINESS USED BY ENTITIES OTHER THAN A SECTION 501(C)(3) ORGANIZATION OR STATE OR LOCAL GOVERNMENT. THE PORTION OF THE BUILDING USED BY THESE ENTITIES WAS FINANCED DIRECTLY BY RAMC THROUGH CASH PAYMENTS TOTALING $4,913,708. CONNIE MOLBERG FAMILY MEMBER OF DIRECTOR 46892 EMPLOYMENT COMPENSATION 0 REEDSBURG PHYSICIAN GROUP (RPG) TWO RAMC DIRECTORS ARE ALSO RPG PARTNERS 3795505 PHYSICIAN COMPENSATION 0 LINDSEY MUCHOW FAMILY MEMBER OF DIRECTOR 57362 EMPLOYMENT COMPENSATION 0 MOY BORCHERT ERBS & ASSOC FORMER DIRECTOR/CURRENT CFO IS ALSO PART OWNER 31160 ACCOUNTING 0 FORM 990, PART III, LINE 2 EFFECTIVE JANUARY 1, 2014, REEDSBURG AREA MEDICAL CENTER INTEGRATED A PHYSICIAN CLINIC AND IS OPERATING THE CLINIC AS A PROVIDER-BASED DEPARTMENT OF THE HOSPITAL. FORM 990, PART VI, SECTION B, LINE 11 UPON COMPLETION OF THE FORM 990, MANAGEMENT REVIEWS FOR ACCURACY AND COMPLETENESS. UPON APPROVAL, THE FORM 990 IS PRESENTED TO THE BOARD OF DIRECTORS FOR FINAL APPROVAL PRIOR TO SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ANNUALLY DISCLOSE ANY POSSIBLE CONFLICTS OF INTEREST WHEN THEY SIGN THE CONFLICT OF INTEREST POLICIES. BOARD MEMBERS ROUTINELY ABSTAIN FROM VOTING ON ANY MATTERS AND EXCUSE THEMSELVES FROM DECISIONS ON MATTERS WITH WHICH THEY HAVE A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 INDEPENDENT WAGE AND SALARY SURVEYS ARE USED FOR ALL KEY EMPLOYEES, INCLUDING PRESIDENT/CEO. VENDORS USED ARE THE RURAL WISCONSIN HEALTH COOPERATIVE AND WISCONSIN HOSPITAL ASSOCIATION. FORM 990, PART VI, SECTION C, LINE 19 REEDSBURG AREA MEDICAL CENTER'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE REVIEWED AT THE HOSPITAL'S ANNUAL MEETING, WHICH IS OPEN TO THE GENERAL PUBLIC. SUMMARIZED FINANCIAL STATEMENT DATA IS ALSO AVAILABLE THROUGH THE WISCONSIN HOSPITAL ASSOCIATION'S WEBSITE. FORM 990, PART IX, LINE 11G EMERGENCY ROOM PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,594,495. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,594,495. MOB PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,483,996. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,483,996. PHARMACY PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 184,388. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 184,388. LAB/RADIOLOGY PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,571,306. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,571,306. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 3,216,314. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,216,314. ADMINISTRATIVE PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 790,606. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 790,606. FORM 990, PART XI, LINE 9: NET CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION 174,826. DISTRIBUTION FROM SPONSORED ORGANIZATION 75,000. FORM 990, PART XII, LINE 2C: SELECTION OF AN INDEPENDENT ACCOUNTANT: THE HOSPITAL HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE BOARD OF DIRECTORS TAKES TIME TO MEET WITH INDEPENDENT ACCOUNTANT FOLLOWING THE AUDIT EACH YEAR TO REVIEW THE FINANCIAL STATEMENTS AND ITEMS NOTED DURING THE AUDIT WITHOUT MANAGEMENT PRESENT TO ALLOW EVEN MORE OVERSIGHT BY THE BOARD INTO THE ANNUAL AUDIT PROCESS. MEMBERS OF THE BOARD OF DIRECTORS ALSO HAVE THE CONTACT INFORMATION OF THE INDEPENDENT ACCOUNTANT AND ARE ENCOURAGED TO CONTACT THE ACCOUNTANT DURING THE YEAR WHEN QUESTIONS ARISE. THERE HAS BEEN NO CHANGE TO THESE PROCEDURES DURING THE PAST YEAR. REEDSBURG AREA MEDICAL CENTER FOUNDATION INC 2090 RIDGEVIEW DRIVE REEDSBURG WI 53959 391243616 FUNDRAISING WI 501(C)(3) LINE 7 REEDSBURG AREA MEDICAL CENTER 1 PARTNERS OF REEDSBURG AREA MEDICAL CENTER 2000 NORTH DEWEY AVENUE REEDSBURG WI 53959 237373902 FUNDRAISING WI 501(C)(3) LINE 7 REEDSBURG AREA MEDICAL CENTER 1 0 1 1 0 0 0 0 0 0 0 0 1 1 0 1 0 1 0 0