2015-08-17T16:17:20-05:00 2014-09-30 390758449 WIPFLI LLP 3703 OAKWOOD HILLS PARKWAY/PO BOX 690 EAU CLAIRE WI 547020690 990 2013-10-01 260596045 UPLAND HILLS HEALTH FOUNDATION INC UPLA 6089308000 800 COMPASSION WAY DODGEVILLE WI 53533 ARTHUR K PUSTINA VICE PRESIDENT OF FINANCE 6089308000 2015-08-17 1 PAUL M TRACZEK CPA P01368830 7158323407 2015-08-17 2013 2016-02-25 16:41:14Z LISA SCHNEDLER 800 COMPASSION WAY DODGEVILLE WI 53533 101805 0 X WWW.UPLANDHILLSHEALTH.ORG/FOUNDATION X 2007 WI TO SOLICIT, RECEIVE, AND ACCEPT GIFTS AND BEQUESTS ON BEHALF OF UPLAND HILLS HEALTH, INC. 11 10 0 29 0 0 87059 89984 0 0 7861 6337 1529 2457 96449 98778 77466 11121 0 0 0 0 0 0 0 3135 40 80601 11161 15848 87617 1018193 1120399 203331 217920 814862 902479 X THE PRIMARY PURPOSE OF THE UPLAND HILLS HEALTH FOUNDATION, INC. IS TO RECORD AND FACILITATE PHILANTHROPIC GIVING FOR UPLAND HILLS HEALTH, INC. BY SERVING AS THE GATEWAY FOR ALL PHILANTHROPY, THE FOUNDATION OFFICE WILL MAINTAIN A COMPLETE GIVING HISTORY FOR DONORS TO UPLAND HILLS HEALTH, ENSURING THAT CONTRIBUTORS ARE APPROPRIATELY ACKNOWLEDGED, AND THAT THE PHILANTHROPY FIGURES PRESENTED TO EXTERNAL SOURCES ARE AS COMPLETE AS POSSIBLE. 0 0 11121 11121 THE UPLAND HILLS HEALTH FOUNDATION, INC. IS OPERATED TO PROVIDE SUPPORT AND PERFORM FUNCTIONS FOR UPLAND HILLS HEALTH, INC., WHICH PROVIDES HEALTH CARE SERVICES TO THE RESIDENTS OF IOWA COUNTY, WISCONSIN, AND THE SURROUNDING AREAS. 11121 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 11 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 0 0 0 0 WI X ARTHUR K PUSTINA 6089308000 800 COMPASSION WAY DODGEVILLE WI 53533 DICK JOSH DIRECTOR 1.00 X 0 0 0 BRAD LAUFENBERG DIRECTOR 1.00 1.00 X 0 0 0 MARK MASTERS DIRECTOR 1.00 X 0 0 0 DAVID WILKE DIRECTOR 1.00 X 0 0 0 MARTHA BOYER DIRECTOR 1.00 X 0 0 0 ANDREA POTTERTON DIRECTOR 1.00 X 0 0 0 DEBRA MORGAN PRESIDENT 1.00 X X 0 0 0 SKIP LEE VICE PRESIDENT 1.00 X X 0 0 0 GEORGE STAUFFER TREASURER 1.00 X X 0 0 0 MARY JO CENITI SECRETARY 1.00 X X 0 0 0 LISA SCHNEDLER PRESIDENT/CEO - UHH 1.00 51.00 X X 0 122014 26111 ARTHUR K PUSTINA VP OF FINANCE - UHH 1.00 53.80 X 0 139459 17204 0 261473 43315 0 0 1 0 0 16476 73508 1000 89984 6337 6337 5484 3027 2457 2457 98778 0 0 8794 11121 11121 40 40 11161 11121 40 0 977523 1094129 40670 26270 1018193 1120399 203331 217920 203331 217920 X 122117 213156 482363 478941 210382 210382 814862 902479 1018193 1120399 87617 0 X X 0 1 X 1 0 X 453088 168067 131362 87059 89984 929560 453088 168067 131362 87059 89984 929560 21870 907690 7782 7074 7718 7861 6337 36772 4631 3364 3872 1529 2457 15853 982185 0.92420 0.92430 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 213859 1088 214947 213277 1000 1504 -1922 213859 210220 2000 1057 213277 208412 1016 792 210220 75366 131000 2046 208412 0.00000 0.97880 0.02120 0 0 0 DUE TO UPLAND HILLS HEALTH, INC. 217920 217920 X PART V, LINE 4: UPLAND HILLS HEALTH FOUNDATION, INC.'S ENDOWMENT FUND CONSISTS OF TWO FUNDS HELD IN THE NAMES OF THE INDIVIDUAL DONORS. THESE FUNDS WERE ESTABLISHED TO PROVIDE INCOME FOR THE FOUNDATION TO HELP SUPPORT SPECIFIC PROGRAMS OF UPLAND HILLS HEALTH, INC. PART X, LINE 2: IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, UPLAND HILLS HEALTH FOUNDATION, INC. 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 ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. UPLAND HILLS HEALTH FOUNDATION, INC. HAS NOT RECORDED ANY ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS AS OF SEPTEMBER 30, 2014 OR 2013. FEDERAL TAX RETURNS FOR TAX YEARS ENDED SEPTEMBER 30, 2011, AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. 1 UPLAND HILLS HEALTH INC 800 COMPASSION WAY DODGEVILLE WI 53533 421017512 501(C)(3) 11121 CASH DONATED N/A TO ASSIST IN THE DELIVERY OF HEALTHCARE SERVICES TO INDIVIDUALS IN THE DODGEVILLE AREA. 1 0 PART I, LINE 2: UPLAND HILLS HEALTH FOUNDATION, INC'S BOARD OF DIRECTORS REVIEWS REQUESTS FOR DONATIONS FROM OR OFFERS TO PROVIDE ASSISTANCE TO UPLAND HILLS HEALTH, INC. TO FURTHER THE MISSION OF UPLAND HILLS HEALTH, INC. THESE GRANTS ARE APPROVED BY THE FOUNDATION'S BOARD OF DIRECTORS DURING ITS REGULARLY SCHEDULED BOARD OF DIRECTORS' MEETINGS THROUGHOUT THE YEAR. 0 0 0 0 0 0 0 0 0 ARTHUR K PUSTINA VP OF FINANCE - UHH 0 131860 0 2199 0 5400 0 5340 0 11864 0 156663 0 0 PART I, LINE 3 COMPENSATION PLANS AND POLICIES FOR THE OFFICERS NOTED ARE DETERMINED AND REVIEWED BY UPLAND HILLS HEALTH FOUNDATION, INC.'S PARENT ORGANIZATION, UPLAND HILLS HEALTH, INC. PROCEDURES OF UPLAND HILLS HEALTH, INC. INCLUDE COMPENSATION SURVEYS, WRITTEN EMPLOYMENT AGREEMENTS, AND APPROVAL BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 6 UPLAND HILLS HEALTH, INC. IS THE SOLE CORPORATE MEMBER OF UPLAND HILLS HEALTH FOUNDATION, INC. FORM 990, PART VI, SECTION A, LINE 7A UPLAND HILLS HEALTH, INC., THE SOLE CORPORATE MEMBER OF UPLAND HILLS HEALTH FOUNDATION, INC., CAN APPOINT OR REMOVE MEMBERS OF THE GOVERNING BODY AND CAN ALSO DETERMINE THE NUMBER OF GOVERNING MEMBERS. FORM 990, PART VI, SECTION A, LINE 7B CHANGES TO THE GOVERNING DOCUMENTS OF UPLAND HILLS HEALTH FOUNDATION, INC. REQUIRE APPROVAL OF ITS SOLE CORPORATE MEMBER UPLAND HILLS HEALTH, INC. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF FORM 990 WAS PROVIDED TO THE ORGANIZATION'S BOARD OF DIRECTORS PRIOR TO FINAL SUBMISSION. RESPONSES ON THE 990 ARE ALSO REVIEWED BY THE VICE PRESIDENT OF FINANCE OF UPLAND HILLS HEALTH, INC. PRIOR TO ITS SUBMISSION TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C UPLAND HILLS HEALTH FOUNDATION, INC. REQUIRES OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, AND HIGHEST-COMPENSATED EMPLOYEES TO COMPLETE AN ANNUAL DISCLOSURE STATEMENT. THESE STATEMENTS ARE THEN REVIEWED BY THE BOARD OF DIRECTORS, NOTING ANY RELATIONSHIPS THAT COULD POTENTIALLY CREATE A CONFLICT OF INTEREST. IF BOARD MEMBERS HAVE CONFLICTS OF INTEREST THAT ARE NOTED, THESE MEMBERS ARE ASKED TO ABSTAIN FROM VOTING ON THOSE MATTERS. FORM 990, PART VI, SECTION B, LINE 15 THE TWO OFFICERS OF UPLAND HILLS HEALTH FOUNDATION, INC. ARE EMPLOYED BY UPLAND HILLS HEALTH, INC. THE COMPENSATION LISTED IN FORM 990, PART VII RELATES TO ALL THE SERVICES THEY PERFORM AS AN EMPLOYEE OF UPLAND HILLS HEALTH, INC. THE BOARD OF DIRECTORS OF UPLAND HILLS HEALTH, INC. HAS ESTABLISHED A PROCESS TO REVIEW THE COMPENSATION OF THE OFFICERS. COMPARATIVE DATA FROM WAGE SURVEYS, AREA LABOR ADJUSTMENTS, AND MARKET RATES IN OTHER AREA FACILITIES ARE USED IN DETERMINING COMPENSATION. THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS OF UPLAND HILLS HEALTH, INC. REVIEWS AND APPROVES ANY EXCEPTIONS TO ACROSS-THE-BOARD RAISES AND STANDARD NEW HIRE WAGES. DURING THE REVIEW PROCESS, DECISIONS AFFECTING COMPENSATION AND CONTRACTS ARE ONLY REVIEWED AND APPROVED BY INDIVIDUALS WHO DO NOT HAVE NOTED CONFLICTS. THE DECISIONS AND DELIBERATION ARE ALSO DOCUMENTED IN THE MINUTES OF THE BOARD OF DIRECTORS UPON APPROVAL BY THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 UPLAND HILLS HEALTH FOUNDATION, INC. MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT ITS BUSINESS LOCATION DURING NORMAL BUSINESS HOURS. FORM 990, PART XII, LINE 2C, OVERSIGHT OF AUDIT: THE BOARD OF DIRECTORS OF UPLAND HILLS HEALTH, INC. ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE CONSOLIDATED FINANCIAL STATEMENTS BY AN INDEPENDENT ACCOUNTANT. THE BOARD OF DIRECTORS OF UPLAND HILLS HEALTH, INC. ALSO APPROVES THE SELECTION OF THE INDEPENDENT AUDITORS AND HISTORICALLY HAS USED A PROCESS OF SOLICITATION OF SEALED BIDS FROM INDEPENDENT AUDIT FIRMS WITH HEALTHCARE AUDIT EXPERIENCE EVERY FIVE YEARS SO THAT THE AUDIT FIRM REVIEW IS DONE ON A REGULAR BASIS. THIS PROCESS AND PROCEDURES HAVE NOT CHANGED IN THE CURRENT YEAR. FORM 990, PART VI, LINE 14, DOCUMENT RETENTION AND DESTRUCTION POLICY: UPLAND HILLS HEALTH FOUNDATION, INC. ANSWERED "NO" TO THE QUESTION REGARDING A WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY, BECAUSE THIS SPECIFIC ORGANIZATION DOES NOT HAVE SUCH A POLICY IN PLACE. HOWEVER, UPLAND HILLS HEALTH FOUNDATION, INC. FOLLOWS THE WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY OF UPLAND HILLS HEALTH, INC. FORM 990, PART VII, SECTION A, RELATED PARTY OFFICERS: EXPLANATION OF HOURS WORKED: THE TWO OFFICERS OF UPLAND HILLS HEALTH FOUNDATION, INC. ARE EMPLOYED BY UPLAND HILLS HEALTH, INC. IN ADDITION TO THE HOURS WORKED AS AN OFFICER OF UPLAND HILLS FOUNDATION, INC., THEY ALSO WORK A MINIMUM OF AN AVERAGE OF 40 HOURS PER WEEK PERFORMING OTHER SERVICES FOR UPLAND HILLS HEALTH, INC. THE HOURS LISTED ON THE FORM 990 RELATE TO THEIR ROLE AS AN OFFICER, WHILE THE COMPENSATION LISTED RELATES TO ALL THE SERVICES THEY PERFORM AS AN EMPLOYEE OF UPLAND HILLS HEALTH, INC. DETAIL OF HOURS WORKED/SERVED: LISA SCHNEDLER, PRESIDENT & CEO OF UPLAND HILLS HEALTH, INC. WORKED APPROXIMATELY 52.00 HOURS PER WEEK AS FOLLOWS: UPLAND HILLS HEALTH, INC. - 51.00 HOURS UPLAND HILLS HEALTH FOUNDATION, INC. - 1 HOUR A. KARL PUSTINA, VICE PRESIDENT OF FINANCE OF UPLAND HILLS HEALTH, INC., WORKED APPROXIMATELY 54.80 HOURS PER WEEK AS FOLLOWS: UPLAND HILLS HEALTH, INC. - 53.80 HOURS UPLAND HILLS HEALTH FOUNDATION, INC. - 1 HOUR BRAD LAUFENBERG, BOARD MEMBER, PROVIDED AN AVERAGE OF 2.0 HOURS OF SERVICE PER WEEK AS FOLLOWS: UPLAND HILLS HEALTH, INC. - 1 HOUR UPLAND HILLS HEALTH FOUNDATION, INC. - 1 HOUR UPLAND HILLS HEALTH HOLDINGS LLC 800 COMPASSION WAY DODGEVILLE WI 53533 800809494 PARTNERSHIP FOR DURABLE MEDICAL EQUIPMENT PROVIDED TO PATIENTS WI 0 0 UPLAND HILLS HEALTH INC UPLAND HILLS HEALTH INC 800 COMPASSION WAY DODGEVILLE WI 53533 421017512 HOSPITAL WI 501(C)(3) LINE 3 N/A 0 0 1 1 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0