2014-10-21T09:52:39-05:00 2013-12-31 861065772 DELOITTE TAX LLP 555 EAST WELLS STREET SUITE 1400 MILWAUKEE WI 53202 990 2013-01-01 390806367 MERITER HOSPITAL INC MERI 6084176000 202 SOUTH PARK STREET MADISON WI 537151596 BETH ERDMAN CFO 6084176000 2014-10-21 1 RACHEL BECKER P00966076 4142713000 2013 2015-11-30 17:44:51Z JAMES WOODWARD 202 SOUTH PARK STREET MADISON WI 537151596 428447741 0 X WWW.MERITER.COM X 1898 WI MERITER HOSPITAL, INC. IS A NOT FOR PROFIT, LOCALLY GOVERNED COMMUNITY HOSPITAL. MERITER HOSPITAL PROVIDES A COMPREHENSIVE ARRAY OF PATIENT-FOCUSED INPATIENT AND OUTPATIENT SERVICES TO MEET THE HEALTH-RELATED NEEDS OF OUR COMMUNITY. 16 12 3107 508 50858 -775185 587378 225340 378521188 386834240 8381083 10498408 12640795 10034961 400130444 407592949 116904 203518 0 0 181215529 183210637 0 0 927149 170216300 167714315 351548733 351128470 48581711 56464479 682175251 732436308 313942372 289641337 368232879 442794971 X MERITER HOSPITAL, INC. IS DEDICATED TO PROVIDING EXCEPTIONAL HEALTH CARE AND LIVING BY ITS MISSION TO HEAL, TEACH AND SERVE. 1 0 312305228 203518 393312118 MERITER HOSPITAL, INC. IS A 448-BED COMMUNITY HOSPITAL THAT WAS RECOGNIZED IN 2010 AND 2011 AS A THOMPSON REUTER 100 TOP HOSPITALS AND PATIENTS RATED IN THE TOP 10 PERCENT IN THE NATION IN TERMS OF THEIR OVERALL HOSPITAL RATING AND WILLINGNESS TO RECOMMEND TO FAMILY AND FRIENDS. THIS YEAR MERITER DEDICATED SIGNIFICANT TIME AND RESOURCES TO IMPLEMENT AN ELECTRONIC MEDICAL RECORD SYSTEM INCLUDING MYCHART, MERITER CARE AND CARE EVERYWHERE IN FURTHER EFFORTS TO IMPROVE PATIENT SAFETY, QUALITY CARE AND OPERATIONAL EFFICIENCY. AS WISCONSIN'S FIFTH LARGEST HOSPITAL, MERITER HOSPITAL, INC. SERVES THE COMMUNITY BY PROVIDING A COMPREHENSIVE ARRAY OF SERVICES AND IS PROUD TO DELIVER MORE BABIES THAN ANY OTHER HOSPITAL IN THE STATE; TO RECEIVE CYCLE III ACCREDITATION FROM THE SOCIETY OF CHEST PAIN CENTERS; AND TO BE AWARDED A THREE-YEAR ACCREDITATION IN COMPUTED TOMOGRAPHY (CT). MERITER MEDICAL STAFF PROVIDES PATIENTS WITH THE GREATEST CHOICE OF HEALTH CARE PROVIDERS INCLUDING MERITER MEDICAL GROUP, INC., UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION PHYSICIANS AND CERTIFIED NURSE-MIDWIVES AND A WIDE ARRAY OF INDEPENDENT MEDICAL PROVIDERS. MERITER PROVIDES SOLUTIONS TO MANY HEALTH CARE NEEDS SUCH AS THE REGION'S ONLY HOSPITAL-BASED DENTAL CLINIC, CHILD AND ADOLESCENT PSYCHIATRY SERVICES, SEXUAL ASSAULT NURSE EXAMINER (SANE) SERVICES; AND PROVIDES SUPPORT TO NEW FAMILIES THROUGH THE BREASTFEEDING HELP LINE AND MOTHER-BABY HOUR, A FREE EDUCATIONAL SUPPORT PROGRAM.IN 2013, MERITER WAS A 2013 RECIPIENT OF THE NATIONAL RESEARCH CORPORATIONS' INNOVATIVE BEST PRACTICE AWARD. FOR THE THIRD CONSECUTIVE YEAR, MERITER WAS NAMED "MOST WIRED" BY HOSPITALS & HEALTH NETWORKS MAGAZINE. 312305228 1 1 0 0 0 0 0 0 0 0 1 0 0 1 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 0 0 0 0 0 0 0 0 1 1 1 0 0 1 163 0 1 3107 1 1 1 0 0 0 0 0 0 0 0 0 0 X 16 12 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 WI X BETH ERDMAN 6084175811 202 SOUTH PARK STREET MADISON WI 53715 X JAMES WOODWARD CEO/PRESIDENT 29.00 21.00 X X 0 1104727 37377 DAVE BOYER CHAIR THROUGH 6/13; BOARD MEMBER 3.00 4.00 X X 9375 9375 0 VIRGINIA GRAVES VICE CHAIR/CHAIR 3.00 3.00 X X 6250 6250 0 GEORGE KAMPERSCHROER VICE CHAIR 2.00 1.00 X X 0 0 0 BARBARA FINLEY BOARD MEMBER 1.00 1.00 X 0 0 0 HOLLY CREMER-BERKENSTADT BOARD MEMBER 1.00 1.00 X 0 0 0 CATHERINE DURHAM BOARD MEMBER 1.00 1.00 X 0 0 0 EILEEN MERSHART BOARD MEMBER 1.00 1.00 X 0 0 0 PAT RICHTER END 06-13 BOARD MEMBER 1.00 1.00 X 0 0 0 JULIE SCHURR MD BOARD MEMBER 1.00 1.00 X 0 0 0 LAURENCE ROTHSTEIN MD BOARD MEMBER 1.00 1.00 X 0 0 0 BRADLEY MANNING MD BOARD MEMBER 1.00 1.00 X 0 0 0 MARGARET NOREUIL RN PHD BOARD MEMBER 1.00 2.00 X 0 0 0 MICHAEL GOLDROSEN MD BOARD MEMBER 1.00 1.00 X 0 0 0 BARBARA SWAN BOARD MEMBER 1.00 1.00 X 0 0 0 SEAN DILWEG START 06-13 BOARD MEMBER 1.00 1.00 X 0 0 0 CATE RANHEIM MD BOARD MEMBER 49.00 1.00 X 0 260120 5477 LINDA HOFF END 12-13 CFO/SECRETARY/TREASURER 35.00 15.00 X 0 1028826 49026 KEVIN BOREN END 11-13 HSP CFO/ASST TREASURER 35.00 15.00 X 0 318178 33791 GEOFFREY PRIEST MD CMO/ASST SECRETARY 40.00 10.00 X 0 489061 43820 SUE ERICKSON EXECUTIVE/ASST TREASURER 49.00 1.00 X 0 320564 46818 BETH ERDMAN START 12-13 SECRETARY/TREASURER 35.00 15.00 X 0 179279 24519 KERRA GUFFEY CHIEF INFORMATION OFFICER 38.00 12.00 X 0 416259 36693 TAMARA SAUNAITIS CHIEF HUMAN RESOURCE OFFICER 45.00 5.00 X 0 342598 36414 PATRICIA GRUNWALD CHIEF NURSING OFFICER 49.00 1.00 X 0 372869 51988 MARY REINKE END 09-13 CHIEF PLANNING AND MARKETING OFFICER 50.00 0.00 X 0 330226 8685 LOUIS S BRYSH PHYSICIAN 50.00 0.00 X 272214 0 43165 ROGER SLATER FORMER EXECUTIVE 0.00 0.00 X 0 214770 64 WILLIAM J HERBERT DIR PHARMACY & MTL SVCS 50.00 0.00 X 208089 0 52265 SUSAN TOTH FORMER BOARD MEMBER 0.00 50.00 X 0 449492 28392 DENISE GOMEZ DIR APPLICATIONS & HIM 50.00 0.00 X 188897 0 32034 SHERRY CASALI DIR EMERGENCY SERVICES 50.00 0.00 X 176008 0 36121 CHRISTINA JACKSON DIR PAT CARE SYS SUPPORT 50.00 0.00 X 171002 0 26571 1031835 5842594 593220 99 1 1 0 JH FINDORFF AND SON INC 300 SOUTH BEDFORD STREET MADISON WI 53703 CONSTRUCTION 6527528 UNIVERSITY OF WISCONSIN HOSPITAL AND CLI 750 HIGHLAND AVENUE MADISON WI 53792 INTERNS, RESIDENTS, MED-FLIGHT AND TEACH 4244926 EPIC 1979 MILKY WAY LANE VERONA WI 53593 INFORMATION SYSTEMS 3155662 UW MEDICAL FOUNDATION 750 HIGHLAND AVENUE MADISON WI 53792 INTERNS AND RESIDENTS 3151836 UNIVERSITY OF WISCONSIN 750 HIGHLAND AVENUE MADISON WI 53792 MEDICAL SERVICES 1598836 54 225340 225340 PATIENT SERVICE REVENUE 622110 376369975 376369975 340B REBATES 622000 3100190 3100190 MGT CONTRACT SERVICE 541600 1797363 1797363 5566712 4891329 39833 635550 386834240 10350337 1424 10348913 2675907 2686871 -10964 -10964 7580 -18544 16974053 1114431 16984008 956405 -9955 158026 148071 148071 444275 227508 216767 216767 INCOME FROM UNCONSOLIDATED SUBS 900099 6936494 6936494 CAFETERIA REVENUE 722210 1219809 0 2021 1217788 CHILD CARE REVENUE 624410 844063 844063 828792 828792 9829158 407592949 393312118 50858 14004633 164518 164518 39000 39000 15625 15625 141599245 136558312 5040933 5013576 4835093 178483 26513798 25569907 943891 10068393 9709958 358435 14960813 260521 14700292 -56340 -56340 16722713 16118151 604562 390317 374080 16237 1261440 927296 334144 12009136 11509556 499580 148619 142436 6183 9701197 9701197 899999 899999 22664717 21721865 942852 716189 686396 29793 MEDICAL SUPPLIES 51661323 49512212 2149111 0 STATE REVENUE ASSESSMEN 11551824 11551824 0 0 TEST FEES 10350000 10350000 0 EQUIPMENT RENTAL & MAIN 5573649 5341785 231864 0 9158719 6932318 2199251 27150 351128470 312305228 37896093 927149 153077 157101 47092142 42431403 24740068 33050779 121604435 147555936 3491652 4635740 3052438 3465292 519309809 309369228 214274020 209940581 231422874 252846623 36344545 38352853 682175251 732436308 41717353 43012846 21889 28867 226356749 215663272 9641372 11468856 36205009 19467496 313942372 289641337 X 362492778 437286276 5437099 5204693 303002 304002 368232879 442794971 682175251 732436308 X 56464479 -3585874 21683487 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 10885926 10885926 281542822 139221816 142321006 639372 343706 295666 218230595 169194336 49036259 8011094 609370 7401724 209940581 DUE FROM MERITER FOUNDATION 7059911 OTHER LONG TERM ASSETS 2734701 INVESTMENTS IN JOINT VENTURES 28558241 38352853 RETIREMENT LIABILITY 18193588 INSURANCE RESERVES 556000 ASSET RETIREMENT OBLIGATION 717908 19467496 X PART X, LINE 2: THE HOSPITAL ACCOUNTS FOR INCOME TAXES IN ACCORDANCE WITH ASC SUBTOPIC 740-10, INCOME TAXES - OVERALL. THIS GUIDANCE ADDRESSES THE DETERMINATION OF HOW TAX BENEFITS CLAIMED OR EXPECTED TO BE CLAIMED ON A TAX RETURN SHOULD BE RECORDED IN THE FINANCIAL STATEMENTS. UNDER ASC 740-10, THE HOSPITAL MUST RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFITS RECOGNIZED IN THE FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN FIFTY PERCENT LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. ASC 740-10 ALSO PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES ON INCOME TAXES, AND ACCOUNTING IN INTERIM PERIODS, AND REQUIRES INCREASED DISCLOSURES. AS OF DECEMBER 31, 2013 AND 2012, THE HOSPITAL DOES NOT HAVE A LIABILITY FOR UNRECOGNIZED TAX BENEFITS. THE HOSPITAL FILES INFORMATIONAL TAX RETURNS IN THE U.S. FEDERAL JURISDICTION. THE HOSPITAL IS SUBJECT TO U.S. FEDERAL TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS AFTER 2008. THERE ARE NO CURRENT OR ONGOING EXAMINATIONS BY ANY TAXING AUTHORITY AS OF DECEMBER 31, 2013 AND 2012 THE HOSPITAL'S POLICY IS TO RECORD INTEREST AND PENALTIES ON UNCERTAIN TAX PROVISIONS AS INCOME TAX EXPENSE. AS OF DECEMBER 31, 2013 AND 2012, THE HOSPITAL HAS NO ACCRUED INTEREST OR PENALTIES RELATED TO UNCERTAIN TAX POSITIONS. 1 1 1 X 1 X 500.000000000000 1 1 0 1 1 13293 5952970 0 5952970 0.01670 25051 57626801 37427023 20199778 0.05670 963 2417279 2285415 131864 0.00040 39307 65997050 39712438 26284612 0.07380 71 19759 777969 9047 768922 0.00220 55 4780 5851435 6300 5845135 0.01640 4 2750 2155000 0 2155000 0.00610 0.00000 115 5706 614282 400 613882 0.00170 245 32995 9398686 15747 9382939 0.02640 245 72302 75395736 39728185 35667551 0.10020 0.00000 1 3344 3344 0.00000 6 6427 6427 0.00000 1 1980 1980 0.00000 0.00000 2 130 6933 6933 0.00000 1 50 126 126 0.00000 5 24 6386 6386 0.00000 0.00000 16 204 25196 25196 0 1071757 0 73354354 75831998 -2477644 X 1 1 1 1 MERITER HOSPITAL INC 202 S PARK STREET MADISON WI 53715 WWW.MERITER.COM 316 X X X X X MERITER HOSPITAL INC 1 1 X X X X X X X X X 12 1 1 1 X X X X X X X X X 0 0 1 1 200.000000000000 1 500.000000000000 1 X X X 1 1 X X X X X X 1 X 1 X X X X X X 1 X 0 0 MERITER HOSPITAL, INC. PART V, SECTION B, LINE 3: FOUR FOCUS GROUPS WERE SCHEDULED IN AUGUST 2012 TO SEEK INPUT AND PRIORITIZE THE HEALTH ISSUES. HEALTHY DANE USED THE HEALTHY PEOPLE 2020 CATEGORIES TO GUIDE THE INVITATION LIST OF KEY COMMUNITY STAKEHOLDERS. FORTY-ONE COMMUNITY STAKEHOLDERS PARTICIPATED IN THE FOCUS GROUPS. A HEALTHY DANE MEMBER SERVED AS THE FOCUS GROUP HOST AND PRESENTED HCI DATA ON THE TOP SIX HEALTH ISSUES. FOCUS GROUP MEMBERS WERE ASKED TO COMPLETE A COMMUNITY ADVISORY PRIORITIZATION MATRIX AND SELECT THE RATING (5-STRONGLY AGREE, 4-AGREE, 3-NEUTRAL, 2-DISAGREE, 1-STRONGLY DISAGREE) THAT BEST DESCRIBED THEIR AGREEMENT WITH THE FOLLOWING STATEMENTS:-IN MY OPINION, THIS IS A SERIOUS HEALTH NEED WITHIN THIS COMMUNITY (SEVERITY)-IN MY OPINION, ADDRESSING THIS HEALTH NEED IS VERY IMPORTANT TO THIS COMMUNITY (IMPORTANCE)-IN MY OPINION, ADDRESSING THIS HEALTH NEED WILL IMPROVE THE QUALITY OF LIFE WITHIN THIS COMMUNITY (IMPACT)-IN MY OPINION, THERE ARE NO RESOURCES FOR ADDRESSING THIS HEALTH NEED WITHIN THIS COMMUNITY (EXISTING RESOURCES)ATTENDEES INCLUDED:BOB POWER, EXEC DIREC,COLONIAL CLUB SENIOR CENTERCHRISTINE RADER, DIVISION DIR,MARCH OF DIMESBONNIE LOUGHRAN, EXEC DIR,NAMI OF DANE COUNTYBRENDA DOTTL, RN,STOUGHTON HOSPITAL HOME HEALTHALISON PRANGE, EXEC DIR,AMERICAN CANCER SOCIETYCARRIE WALL, EXEC DIR, YMCA OF DANE COUNTYNICOLE L VESELY, PROGRAM COORD UW HEALTHJENNIFER ELLESTAD, COMM ADVOCACY, DEAN CLINICKRISTIN BURKI, DIRECTOR OF SERVICES,DOMESTIC ABUSE INTERVENTION SERVICESSALLY ZIRBEL DONISCH, HEALTH SERVICES,MADISON METROPOLITAN SCHOOL DISTRICTBRADLEY D. SCHROEDER, EMPLOYEE BENEFIT SPECIALIST,STOUGHTON BUSINESS OWNER-INSURANCECINDY MCGLYNN, DIRECTOR,STOUGHTON SENIOR CENTERAMY L. MILLER, COMMUNITY EDUCATION DIRECTOR,OREGON SCHOOL DISTRICTDONNA OLSON, MAYOR,CITY OF STOUGHTON-GOVERNMENTCATHY RIGDON, DIRECTOR, STOUGHTON EMERGENCY MANAGEMENT SERVICESLYNN GREEN, EXEC DIR, DANE COUNTY HUMAN SERVICESDR. FLOYD ROSE, EXEC DIR,100 BLACK MEN OF MADISONKELLY ANDERSON, EXEC DIR , RAPE CRISIS CENTERMICHELLE HEITZINGER, EXEC DIR, SUSAN G. KOMEN OF SOUTH CENTRAL WIEVA BRUMMEL, LEARNING COORDINATOR,WISCONSIN PERINATAL ASSOCIATIONDAN FOLEY, EXEC DIR, NEIGHBORHOOD HOUSE COMMUNITY CENTERBOBBY PETERSON, EXEC DIR, ABC FOR HEALTHPENNY KASPRZAK, ASSOC DIRL AMERICAN DIABETES ASSOCIATION,SHIVA BIDAR-SIELAFF, CO-CHAIR, LATINO HEALTH COUNCILTOM LUEDTKE, CORP EVENTS DIR, AMERICAN HEART ASSOCIATION,LANNIA SYREN STENZ, EXEC DIR,GILDA'S CLUB OF MADISONKEN TAYLOR, EXEC DIR, WISCONSIN COUNCIL ON CHILDREN AND FAMILIESSANDY ERICKSON, DIRECTOR COMMUNITY IMPACT, UNITED WAY DANE COUNTYSTEVE HINIKER, EXEC DIR, 1000 FRIENDSKENT CRAIG, EXEC DIR, CENTRO HISPANOMURIEL NAGLE, DIRECTOR OF HEALTH PROMOTION,UNIVERSITY HEALTH SERVICESLORRI WENDORF-CORRIGAN, NEIGHORHOOD SERVICES COORD, COMMUNITY DEVELOPMENT DIVISION, CITY OF MADISON,JULIE WILLEMS VAN DIJK, RN, PHD UW-MADISON, POPULATION HEALTH DEPT. MERITER HOSPITAL, INC. PART V, SECTION B, LINE 4: UNIVERSITY OF WISCONSIN HOSPITAL AND CLINICS, ST. MARY'S HOSPITAL - SSM HEALTHCARE, STOUGHTON HOSPITAL MERITER HOSPITAL, INC. PART V, SECTION B, LINE 5D: THE HOSPITAL CONDUCTED A PUBLIC LAUNCH OF A HEALTHYDANE WEBSITE (HEALTHYDANE.ORG), IN ADDITION TO POSTING ON MERITER.COM, FOUND AT WWW.MERITER.COM/ABOUT-MERITER/COMMUNITY-GIVING/COMMUNITY-HEALTH-NEEDS-ASSESSMENT. MERITER HOSPITAL, INC. PART V, SECTION B, LINE 7: MERITER DOES NOT ADDRESS ALL NEEDS IDENTIFIED IN THE ASSESSMENT. THESE AREAS INCLUDE: CANCER, SEXUALLY TRANSMITTED INFECTIONS, STROKE/UNCONTROLLED HYPERTENSION, ASTHMA , DRUGS/UNINTENTIONAL POISONINGS. MANY OF THESE CONCERNS AREA BEING ADDRESSED BY MERITER AND OTHER COMMUNITY ORGANIZATIONS THROUGH PROGRAMS AND SERVICES ALTHOUGH NOT AS A PRIORTITY AREA. AS MERITER FOCUSES ON THE MANY FACTORS ITS PRIORITY AREAS AFFECTING BIRTH OUTCOMES AND DIABETES, AREAS SUCH AS HYPERTENSION, CANCER AND ASTHMA WILL LIKELY BE IMPROVED FROM THE EFFORTS. CERTAINLY, THESE HEALTH NEEDS ARE IMPORTANT AND MERIT FOCUSED ATTENTION. HOWEVER, DUE TO LIMITED RESOURCES, MERITER CANNOT ADDRESS ALL CONCERNS AT THE SAME LEVEL WITHIN THIS IMPLEMENTATION PLAN. FURTHERMORE, SOME OF THE ISSUES ARE BEING ADDRESSED BY OTHER HOSPITALS IN THE AREA (SPECIFICALLY ASTHMA AND HYPERTENSITON). 7 MAX W POHL DENTAL CLINIC 202 S PARK ST MADISON WI 53715 DENTAL SERVICES MERITER REHABILITATION MEDICINE 202 S PARK ST MADISON WI 53715 REHABILITATION SERVICES WOMAN CARE CLINIC 20 S PARK ST MADISON WI 53715 GYNECOLOGICAL SERVICES CHILD & ADOLESCENT PSYCHIATRY 8001 RAYMOND ROAD MADISON WI 53719 INPATIENT PSYCHIATRY SERVICES MERITER NEWSTART 1015 GAMMON LANE MADISON WI 53719 SUBSTANCE ABUSE TREATMENT PROGRAM MERITER WELLNESS CENTER 501 W BELTLINE HIGHWAY SUITE 207 MADISON WI 53713 CARDIOVASCULAR AND PULMONARY REHABILITATION AND NUTRITION CENTER FOR PERINATAL CARE 202 S PARK ST MADISON WI 53715 PREGNANCY CARE PART I, LINE 6A: A COMMUNITY BENEFIT REPORT IS FILED ON BEHALF OF MERITER HEALTH SERVICES; MERITER HOSPITAL IS A SUBSIDIARY. THE COMMUNITY BENEFIT TEXT IN THIS RETURN REPRESENTS THE HOSPITAL. PART I, LINE 7: COSTING METHODOLOGY: THE RATIO OF COSTS TO CHARGES IS BASED ON WORKSHEET 3 OF SCHEDULE H. PART I, LN 7 COL(F): BAD DEBT EXPENSE OF $5,030,287 IS NOT INCLUDED IN THE TOTAL OPERATING EXPENSES FOR PURPOSES OF CALCULATING THE PERCECNTAGE OF TOTAL EXPENSE IN PART I, LINE 7, COLUMN F. PART II, COMMUNITY BUILDING ACTIVITIES: MERITER STRIVES TO HELP CREATE A HEALTHY COMMUNITY INCLUDING A SAFE ENVIRONMENT, INTERCONNECTED NEIGHBORHOODS WITH ADEQUATE AND AFFORDABLE HOUSING, STRONG SCHOOLS AND A PREPARED AND DIVERSE WORKFORCE.THROUGH PARTNERSHIPS WITH AREA NON-PROFIT ORGANIZATIONS AND COMMUNITY GROUPS, MERITER IS WORKING TO STRENGTHEN THE COMMUNITY THROUGH SPONSORSHIPS AND INVOLVEMENT IN BAYVIEW COMMUNITY FOUNDATION, GREENBUSH DAY COMMUNITY CELEBRATION, NEIGHBORHOOD HOUSE, AND HABITAT FOR HUMANITY, AND SUPPORT OF A NEIGHBORHOOD HOUSING INITIATIVE. ALL OF THESE GROUPS, AND OTHERS, CREATE OPPORTUNITIES FOR SAFE AND AFFORDABLE HOUSING, FAMILY-BASED EVENTS, AND STRENGTHENING THE NEIGHBORHOODS THROUGH RAISING AWARENESS OF COMMUNITY RESOURCES AND NEIGHBORHOOD ASSETS. NEIGHBORHOOD HOUSE, IN PARTICULAR, HAS EXPANDED ITS AFTERSCHOOL ACTIVITIES AND SUMMER CAMP PROGRAM. THIS PROGRAM INTRODUCED CHILDREN TO AREAS OF THE COMMUNITY MANY HADN'T EXPERIENCED INCLUDING FIELD TRIPS TO THE UNIVERSITY, ZOO AND TO A LOCAL COMMUNITY GARDEN. BAYVIEW FOUNDATION IS PART OF BAYVIEW TOWNHOMES, A CDA HOUSING COMMUNITY LOCATED NEXT TO MERITER. THE VAST MAJORITY OF BAYVIEW RESIDENTS ARE IMMIGRANTS WITH APPROXIMATELY 80% OF THE TOTAL RESIDENTS IDENTIFYING AS HMONG. THE FOUNDATION'S AFTER-SCHOOL, SCHOOL -AGE AND OTHER PROGRAMS ARE VITALLY IMPORTANT TO ASSISTING THE FAMILIES AND THE CHILDREN WITH ASSIMILATION. THE PROGRAMS PROVIDE AFTER-SCHOOL TUTORING, COMPUTER SKILLS, ENGLISH LANGUAGE COMPETENCY AND SCHOOL READINESS, SUMMER EDUCATIONAL PROGRAMS AND A FREE LENDING LIBRARY. WITHOUT THESE PROGRAMS, THE CHILDREN IN BAYVIEW WOULD FALL DISASTROUSLY BEHIND IN SCHOOL AND LACK THE SOCIAL SKILLS NEEDED FOR ACADEMIC AND EMPLOYMENT SUCCESS. THEY WOULD STRUGGLE WITH BASIC LITERACY, SEVERELY IMPAIRING THEIR ABILITY TO EARN A LIVING OR READ A PHYSICIAN'S INSTRUCTIONS. IT IS WELL DOCUMENTED THAT LITERACY AND EMPLOYMENT STATUS HAVE AN IMPACT ON HEALTH AS A SOCIAL DETERMINANT. MERITER'S EFFORTS IN SUPPORT OF BAYVIEW FOUNDATION, NEIGHBORHOOD HOUSE AND OTHER PROGRAMS ASSOCIATED WITH EMPLOYMENT ARE INVESTMENTS IN THE FUTURE OF THE COMMUNITY. WE HOPE TO CREATE A MORE EDUCATED AND BETTER PREPARED COMMUNITY - WHICH WILL BE HEALTHIER.MERITER LED THE WAY IN ESTABLISHING A WORK-FORCE HOUSING INITIATIVE FOR A RAPIDLY CHANGING NEIGHBORHOOD. THE INITIATIVE, WHICH INCLUDES PARTNERS FROM OTHER AREA EMPLOYERS, HAS GROWN IN TO A SEPARATE ORGANIZATION WHICH PROVIDES HOME-BUYER EDUCATION, BUDGETING, AND OTHER FINANCIAL LITERACY. FINALLY, MERITER IS WORKING WITH COMMUNITY GROUPS SUCH AS THE URBAN LEAGUE TO FUND TRAINING PROGRAMS, SCHOLARSHIPS AND TUTORING PROGRAMS. THROUGH SUPPORT OF EDUCATIONAL PROGRAMS, MERITER IS HELPING INCREASE JOB OPPORTUNITIES FOR AREA RESIDENTS, THEREBY INCREASING JOB SECURITY. PART III, LINE 3: AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE AND REASONABLE EFFORTS TO COLLECT FROM THE PATIENT HAVE BEEN EXHAUSTED, MERITER FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PAST-DUE PATIENT BALANCES WITHIN COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED MERITER. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE MERITER'S POLICIES. AFTER APPLYING THE COST-TO-CHARGE RATION, THE SHARE OF BAD DEBT EXPENSE IN 2013 WAS $3,180,287 AT CHARGED ($1,071,757 AT COST). PART III, LINE 4: THE AUDITED FINANCIAL STATEMENTS CONTAIN A REFERENCE TO THE HOSPITAL'S BAD DEBT EXPENSE POLICY ON PAGES 14-15 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. THE HOSPITAL REPORTS ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRD PARTY PAYERS, PATIENTS AND OTHERS. THE HOSPITAL PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON THE REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. COSTING METHODOLOGY: THE RATIO OF PATIENT CARE COST TO CHARGES IS APPLIED TO THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS THAT ARE REPORTED ON LINE 2. THE RATIO OF COSTS TO CHARGES IS BASED ON WORKSHEET 3 OF SCHEDULE H. PART III, LINE 8: THE MEDICARE SHORTFALL WAS NOT INCLUDED AS A COMMUNITY BENEFIT. PART III, LINE 9B: WE NOTIFY PATIENTS OF THEIR FINANCIAL RESPONSIBILITY AS WELL AS OUR CHARITY CARE POLICY. OUR COLLECTION AGENCIES ARE EDUCATED ON OUR FAHCP (FINANCIAL ASSISTANCE FOR HEALTH CARE PROGRAM) AND WE FOLLOW WHA (WISCONSIN HOSPITAL ASSOCIATION) GUIDELINES. OUR POLICY STATES "PATIENT ACCOUNTS IN THE PROCESS OF FINANCIAL AID REVIEW WILL NOT KNOWINGLY BE SENT TO COLLECTIONS." PART VI, LINE 2: MERITER JOINED THREE OTHER HOSPITALS IN DANE COUNTY, UNIVERSITY OF WISCONSIN HOSPITAL AND CLINICS, STOUGHTON HOSPITAL, AND ST. MARY'S - SSM OF WISCONSIN, ALONG WITH PUBLIC HEALTH MADISON AND DANE COUNTY IN THE ASSESSMENT OF THE HEALTH OF DANE COUNTY. SECONDARY DATA WAS COLLECTED AND AGGREGATED BY HEALTHY COMMUNITIES INSTITUTE. THE DATA WAS VERIFIED IN COMMUNITY FOCUS GROUPS AND THE GROUPS PROVIDED INSIGHT AND IDEAS TO ADDRESS IDENTIFIED NEEDS. PART VI, LINE 3: WE NOTIFY PATIENTS OF THEIR FINANCIAL RESPONSIBILITY AS WELL AS OUR CHARITY CARE POLICY. OUR COLLECTION AGENCIES ARE EDUCATED ON OUR FAHCP (FINANCIAL ASSISTANCE FOR HEALTH CARE PROGRAM) AND WE FOLLOW WHA (WISCONSIN HOSPITAL ASSOCIATION) GUIDELINES. OUR POLICY STATES "PATIENT ACCOUNTS IN THE PROCESS OF FINANCIAL AID REVIEW WILL NOT KNOWINGLY BE SENT TO COLLECTIONS." PART VI, LINE 4: DANE COUNTY IS LOCATED IN SOUTH-CENTRAL WISCONSIN AND IS HOME TO WISCONSIN'S CAPITAL, MADISON, WHICH IS ALSO THE COUNTY SEAT. THE COUNTY IS NEARLY 1,200 SQUARE MILES OF URBAN, SUBURBAN AND RURAL COMMUNITIES. DANE COUNTY HAS APPROXIMATELY 572,000 ACRES (ABOUT 72% OF THE TOTAL LAND) IN AGRICULTURAL USE, AND IT LEADS WISCONSIN IN THE TOTAL MARKET VALUE OF AGRICULTURAL PRODUCTS. CORN IS THE LARGEST CROP, FOLLOWED BY HAY AND SOYBEANS. THE COUNTY HAS THE SECOND LARGEST CATTLE HERD IN THE STATE, INCLUDING 51,000 DAIRY COWS. DESPITE THESE STRONG AGRICULTURAL UNDERPINNINGS, DANE COUNTY IS CLASSIFIED BY THE UNITED STATES CENSUS BUREAU AS A METROPOLITAN AREA. IN ADDITION TO BEING THE CENTER FOR STATE AND COUNTY GOVERNMENT, DANE COUNTY IS ALSO HOME TO WISCONSIN'S FLAGSHIP PUBLIC UNIVERSITY, THE UNIVERSITY OF WISCONSIN - MADISON. AS A RESULT, EDUCATIONAL SERVICES IS THE LARGEST INDUSTRY SUB-SECTOR IN THE COUNTY, FOLLOWED BY FOOD SERVICES, PROFESSIONAL AND TECHNICAL SERVICES, HOSPITALS, AND ADMINISTRATIVE AND SUPPORT SERVICES. DANE COUNTY IS THE SECOND MOST DENSELY POPULATED COUNTY IN WISCONSIN, AND MADISON IS THE SECOND LARGEST CITY IN THE STATE. THE POPULATION OF DANE COUNTY GREW 14.4% BETWEEN 2000 AND 2010, BRINGING THE TOTAL POPULATION TO 488,073. MADISON HAS 233,209 RESIDENTS, ALMOST HALF OF THE COUNTY'S POPULATION. AMONG ITS RESIDENTS ARE MORE THAN 42,000 UW STUDENTS.THE ETHNIC/RACIAL DEMOGRAPHICS OF DANE COUNTY ARE CHANGING. SINCE 2000, THE PERCENTAGE OF THE POPULATION THAT IS WHITE DECREASED FROM 87.4% TO 81.9%. THE GREATEST GROWTH AMONG MINORITY GROUPS WAS SEEN IN THE HISPANIC POPULATION. COMPARED WITH WISCONSIN AS A WHOLE, DANE COUNTY HAS MORE ETHNIC DIVERSITY, A LARGER PERCENT OF FOREIGN-BORN RESIDENTS (7.4%), AND A LARGER PERCENT THAT SPEAKS A LANGUAGE OTHER THAN ENGLISH IN THE HOME (11% IN DANE COUNTY; 14.8% IN MADISON). MINORITIES ARE MORE CONCENTRATED IN THE CITY OF MADISON. OVER HALF OF ALL STUDENTS IN MADISON PUBLIC SCHOOLS ARE OF RACIAL/ETHNIC MINORITY GROUPS. HMONG ARE ONE OF THE LARGEST ASIAN GROUPS IN DANE COUNTY, AND DANE COUNTY HAS ONE OF THE LARGEST HMONG POPULATIONS IN WISCONSIN. EXAMINATION OF DATA FOR DANE COUNTY REVEALS A LARGE GAP IN EDUCATION AND INCOME BETWEEN AN AFFLUENT MAJORITY POPULATION AND A GROWING LOW-INCOME, LESS EDUCATED POPULATION. THE PERCENT OF THE POPULATION THAT HAS AT LEAST A BACHELOR'S DEGREE IS MUCH HIGHER IN DANE COUNTY THAN IN WISCONSIN AND THE U.S., AND IT IS HIGHER YET IN MADISON (DANE COUNTY 45.4%, MADISON 52.2%, WISCONSIN 25.8%, U.S. 27.9%).8 HOWEVER, DANE COUNTY'S CURRENT 86% HIGH SCHOOL GRADUATION RATE IS ONE OF THE LOWEST AMONG WISCONSIN COUNTIES. LATELY, MUCH ATTENTION HAS BEEN PAID TO THE ACHIEVEMENT GAP AND LOWER GRADUATION RATES FOR SOME RACIAL MINORITY GROUPS IN MADISON, BUT OTHER OF DANE COUNTY'S 16 PUBLIC SCHOOL DISTRICTS FACE THE SAME CHALLENGE. IN 2011, THE FOUR-YEAR GRADUATION RATE FOR ALL STUDENTS IN THE MADISON METROPOLITAN SCHOOL DISTRICT WAS 73.7% (NOT INCLUDING GED OR OTHER HIGH SCHOOL CERTIFICATES) BUT THERE WAS CONSIDERABLE VARIATION BY RACIAL GROUP.THE MEDIAN HOUSEHOLD INCOME FOR DANE COUNTY IS $60,519 AS COMPARED TO $51,598 IN WISCONSIN. MADISON'S MEDIAN HOUSEHOLD INCOME IS $52,550, WHICH IS LOWER THAN HOUSEHOLD INCOMES IN THE REMAINDER OF DANE COUNTY. DESPITE THE HIGH MEDIAN HOUSEHOLD INCOME AND A RELATIVELY LOW UNEMPLOYMENT RATE (5.4%), DANE COUNTY IS FACED WITH AN INCREASING NUMBER OF PEOPLE LIVING IN POVERTY. 11.6% OF DANE COUNTY RESIDENTS LIVE BELOW THE FEDERAL POVERTY LEVEL (2006-2010), A STATISTIC THAT IS COMPARABLE TO THE STATE POVERTY RATE. IN MADISON, THE POVERTY RATE IS HIGHER AT 17.9%.ACCORDING TO THE CENTER ON WISCONSIN STRATEGY, 31.5% OF STUDENTS IN DANE COUNTY ARE ELIGIBLE FOR FEDERAL FREE OR REDUCED-PRICE SCHOOL LUNCH IN 2012, AN INCREASE FROM 2000 WHEN ONLY 17.4% OF STUDENTS WERE ELIGIBLE. IN THE CITY OF MADISON, OVER HALF OF ALL PUBLIC SCHOOL STUDENTS ARE ELIGIBLE. POVERTY LEVELS ARE PARTICULARLY STRIKING FOR CHILDREN IN THE COUNTY. TO BE EFFECTIVE, HEALTH PROGRAMS MUST BE MEETING A TANGIBLE NEED OF THE COMMUNITY. TO MEET THE NEED, THEY MUST BE PRESENTED TO AND ACCESSIBLE BY THE VERY PEOPLE WHO NEED THEM MOST. A STUDY OF DEMOGRAPHICS IS NECESSARY TO ENLIGHTEN THE PLANNING AND MARKETING PROCESS AND, ULTIMATELY, TO MOVE THE DIAL TOWARD BETTER COMMUNITY HEALTH. PART VI, LINE 5: MERITER IS A LOCALLY MANAGED AND A LOCALLY GOVERNED HOSPITAL. THE COMMUNITY-BASED BOARD OF DIRECTORS IS COMMITTED TO PROTECTING THE HEALTH OF THE COMMUNITY THROUGH SUSTAINING SEVERAL OF MERITER'S PROGRAMS AND SERVICES THAT ONLY MERITER PROVIDES. SEVERAL YEARS AGO, THE BOARD MADE A PLEDGE TO CONTINUE TO PROVIDE CHILD AND ADOLESCENT PSYCHIATRIC SERVICES EVEN WHEN OTHER PROVIDERS CHOSE NOT TO PROVIDE SUPPORT. SIMILARLY, MERITER PROVIDES THE ONLY HOSPITAL BASED DENTAL RESIDENCY PROGRAM IN THE AREA. THIS SERVICE OFFERS AN OPTION FOR THOSE WHO CANNOT BE SEEN IN A STANDARD DENTAL OFFICE WHETHER THAT REASON IS FOR AN ILLNESS OR A BEHAVIORAL OR COGNITIVE DISABILITY. FURTHERMORE, THE MERITER'S DENTAL CLINIC IS ONE OF ONLY A HANDFUL OF DENTAL CLINICS INT EH COUNTY THAT ACCEPTS MEDICAL ASSISTANCE. BOTH OF THESE SERVICES OFTEN OPERATE AT A LOSS FOR THE ORGANIZATION. HOWEVER, THE BOARD AND LEADERSHIP ARE COMMITTED TO ENSURING THAT MERITER CONTINUE TO PROVIDE THIS RESOURCE TO THE COMMUNITY. PART VI, LINE 7, REPORTS FILED WITH STATES WI 1 MERITER FOUNDATION 202 S PARK STREET MADISON WI 537151596 237098688 501(C)(3) 18160 HOSPITAL PROGRAMS MERITER HEALTH SERVICES 202 S PARK STREET MADISON WI 537151596 391412318 501(C)(3) 86244 HEALTH SERVICES PROGRAMS 2 0 HOSPITAL SCHOLARSHIPS 26 39000 PART I, LINE 2: GRANTS ARE MADE UPON A SPECIFIC PROJECT REQUEST AND ONLY MADE TO ORGANIZATIONS THAT WE HAVE A WORKING RELATIONSHIP WITH AND SHARE A COMMON GOAL OF COMMUNITY BENEFIT. GRANTS ARE ONLY MADE TO 501 (C)(3) ORGANIZATIONS WHICH MUST COMPLETE FORM 990S AND ANNUAL REPORTS. PART III - SCHOLARSHIPS ARE AWARDED TO INDIVIDUALS WHO HAVE SUBMITTED REQUIRED APPLICATION AND SUPPORTING DOCUMENTATION. A SELECTION COMMITTEE REVIEWS THE REQUESTS, EVALUATES EACH APPLICATION BASED UPON FINANCIAL NEED, ACADEMIC RECORD, EXTRA CURRICULAR WORK/VOLUNTEERING, RECOMMENDATION AND ESSAY. X X X 1 1 X X X X X 1 1 0 0 0 0 0 1 0 JAMES WOODWARD CEO/PRESIDENT 0 616060 0 248877 0 239790 0 17666 0 19711 0 1142104 0 0 CATE RANHEIM MD BOARD MEMBER 0 255837 0 4000 0 283 0 3296 0 2181 0 265597 0 0 LINDA HOFF END 12-13 CFO/SECRETARY/TREASURER 0 373164 0 272620 0 383042 0 27504 0 21522 0 1077852 0 0 KEVIN BOREN END 11-13 HSP CFO/ASST TREASURER 0 201002 0 56844 0 60332 0 15932 0 17859 0 351969 0 0 GEOFFREY PRIEST MD CMO/ASST SECRETARY 0 340987 0 88063 0 60011 0 25124 0 18696 0 532881 0 0 SUE ERICKSON EXECUTIVE/ASST TREASURER 0 225995 0 66468 0 28101 0 31539 0 15279 0 367382 0 0 BETH ERDMAN START 12-13 SECRETARY/TREASURER 0 157758 0 21213 0 308 0 17729 0 6790 0 203798 0 0 KERRA GUFFEY CHIEF INFORMATION OFFICER 0 284435 0 94603 0 37221 0 17425 0 19268 0 452952 0 0 TAMARA SAUNAITIS CHIEF HUMAN RESOURCE OFFICER 0 254306 0 86710 0 1582 0 15606 0 20808 0 379012 0 0 PATRICIA GRUNWALD CHIEF NURSING OFFICER 0 245381 0 63725 0 63763 0 34335 0 17653 0 424857 0 0 MARY REINKE END 09-13 CHIEF PLANNING AND MARKETING OFFICER 0 202330 0 27696 0 100200 0 4312 0 4373 0 338911 0 0 LOUIS S BRYSH PHYSICIAN 201657 0 40922 0 29635 0 25241 0 17924 0 315379 0 0 0 ROGER SLATER FORMER EXECUTIVE 0 4273 0 45012 0 165485 0 64 0 0 0 214834 0 0 WILLIAM J HERBERT DIR PHARMACY & MTL SVCS 172963 0 27490 0 7636 0 33275 0 18990 0 260354 0 0 0 SUSAN TOTH FORMER BOARD MEMBER 0 444422 0 5000 0 70 0 3150 0 25242 0 477884 0 0 DENISE GOMEZ DIR APPLICATIONS & HIM 157108 0 25448 0 6341 0 15012 0 17022 0 220931 0 0 0 SHERRY CASALI DIR EMERGENCY SERVICES 144576 0 31050 0 382 0 23314 0 12807 0 212129 0 0 0 CHRISTINA JACKSON DIR PAT CARE SYS SUPPORT 153253 0 17294 0 455 0 10583 0 15988 0 197573 0 0 0 PART I, LINE 1A BUSINESS CLUB DUES WERE PAID FOR ONE PERSON. THE BUSINESS CLUB IS AN IRC SECTION 501(C )(7). THERE WERE 2 CHARTER FLIGHTS RELATED TO THE AFFILIATION WITH UNITYPOINT HEALTH. AIRLINE COSTS (FOR SPOUSE) WERE PAID FOR ONE BOARD MEMEBR AND ONE DOCTOR TO ATTEND THE GOVERANCE INSTITUTE. PART I, LINES 4A-B SEVERANCE PAYMENTS: LINDA HOFF - $262,267; KEVIN BOREN - $12,069, MARY REINKE - $51,440 PART I, LINES 4A-B 2 INDIVIDUALS WERE PAID SUPPLEMENTAL NONQUALIFIED RETIREMENT; JAMES WOODWARD - $ 96,983 AND LINDA HOFF - $20,438 PART I, LINE 7 SYSTEM WIDE PERFORMANCE MEASURES, WITH A FINANCIAL THRESHOLD COMPONENT, MUST BE MET TO QUALIFY FOR THE OVERALL INCENTIVE. ONCE MET, VARIOUS ESTABLISHED GOALS ARE MEASURED WHICH INCLUDE SPECIFIC PERFORMANCE IMPROVEMENT SAVINGS, DAYS CASH ON HAND, OPERATING MARGIN. A WISC HEALTH & EDUCATIONAL FACILITIES 391337855 97710BBH4 2008-05-21 87090000 SERIES 2008A/B/C - CURRENT REFUNDING OF BONDS ISSUED 8/1/2006 AND 8/16/2006 0 0 0 B WISC HEALTH & EDUCATIONAL FACILITIES 391337855 97710BJV5 2009-08-13 49166284 SERIES 2009 - CONSTRUCT & EQUIP HOSPITAL FACILITIES 0 0 0 C WISC HEALTH & EDUCATIONAL FACILITIES 391337855 97710BG71 2011-06-08 39633991 SERIES 2011 - CONSTRUCT & EQUIP HOSPITAL FACILITIES 0 0 0 D WISC HEALTH & EDUCATIONAL FACILITIES 391337855 2012-08-09 45200000 SERIES 2012A AND 2012 B - REFUNDING OF BONDS ISSUED 5/21/2008 0 0 0 A 52150000 87090000 649525 719723 85720752 1 0 1 1 B 1890000 49408076 3674516 825789 44907771 2009 0 0 1 1 C 600000 39640079 579750 39060329 2011 0 0 1 1 D 2285000 45200000 45200000 1 0 1 1 A 0 0 1 0 0 0.00000 0.00000 0 0 1 B 0 0 1 0 0 0.00000 0.00000 0 0 1 C 0 0 1 0 0 0.00000 0.00000 0 0 1 D 0 0 1 0 0 0.00000 0.00000 0 0 1 A 0 0 1 0 1 0 0 0 1 B 0 1 0 0 0 0 0 0 1 C 0 1 0 0 0 0 0 0 1 D 0 1 0 0 0 1 PIPER JAFFREY 9.900000000000 0 0 0 0 1 A 1 B 1 C 1 D 1 SCHEDULE K, PART II, LINE 4 SERIES 2009: THE AMOUNT SHOWN HERE CONSISTS OF $3,673,358 IN A DEBT SERVICE FUND RESERVE FUND, PLUS $1,158 OF DEBT SERVICE FUND DEPOSITS. A WISC HEALTH & EDUCATIONAL FACILITIES 391337855 2012-08-09 20000000 SERIES 2012 C - CONSTRUCT & EQUIP HOSPITAL FACILITIES 0 0 0 A 386000 20023683 15482407 4541276 0 0 0 1 A 0 0 1 0 0 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 FORM 990, PART III, LINE 2 THE FINAL PHASE OF A THREE YEAR CONSTRUCTION PROJECT FOR THE WOMEN'S BIRTHING CENTER AND FAMILY CARE SUITES WAS FINISHED. FORM 990, PART VI, SECTION A, LINE 2 DAVID BOYER AND GEORGE KAMPERSCHROER HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 6 MERITER HEALTH SERVICES, INC. (MHS) IS THE SOLE VOTING MEMBER OF MERITER HOSPITAL, INC. FORM 990, PART VI, SECTION A, LINE 7A MERITER HEALTH SERVICES, INC. (MHS) IS THE SOLE VOTING MEMBER OF MERITER HOSPITAL, INC. AND, AS SUCH, THE MERITER HEALTH SERVICES, INC. BOARD ELECTS THE MEMBERS OF THE MERITER HOSPITAL, INC. BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING ACTIONS REQUIRE THE PRIOR AUTHORIZATION OR APPROVAL OF THE MERITER HEALTH SERVICES, INC. BOARD AS VOTING MEMBER OF THE CORPORATION,: (A) MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION; (B) AMENDMENT OR RESTATEMENT OF THE ARTICLES OF INCORPORATION OF THE CORPORATION; (C) A SALE, LEASE, EXCHANGE, OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, THE PROPERTY AND ASSETS OF THE CORPORATION; (D) THE ESTABLISHMENT, FORMATION, ACQUISITION, MERGER, CONSOLIDATION OR DISSOLUTION OF ANY SUBSIDIARY CORPORATION OF THE CORPORATION; (E) THE ADOPTION OF THE AGGREGATE ANNUAL OPERATING AND CAPITAL BUDGETS OF THE CORPORATION; (F) AGGREGATE BORROWING FOR PERIODS OF ONE (1) YEAR OR LESS FOR ANY PURPOSE IN EXCESS OF A DOLLAR AMOUNT TO BE ESTABLISHED BY THE VOTING MEMBER FROM TIME TO TIME; AND AGGREGATE BORROWING FOR PERIODS OF MORE THAN ONE (1) YEAR FOR ANY PURPOSE IN EXCESS OF A DOLLAR AMOUNT TO BE ESTABLISHED BY THE VOTING MEMBER FROM TIME TO TIME. FOR THE PURPOSE OF THIS SUBPARAGRAPH, THE TERM AGGREGATE BORROWING MEANS BORROWINGS NOT PREVIOUSLY INCLUDED IN THE OPERATING AND/OR CAPITAL BUDGETS, AND INCLUDES BUT IS NOT LIMITED TO LEASE AGREEMENTS AND CONTRACTS FOR SALE; (G) THE PURCHASE, SALE, LEASE, DISPOSITION, HYPOTHECATION, EXCHANGE, GIFT, PLEDGE, AND ENCUMBRANCE OF ANY ASSET, REAL OR PERSONAL, WITH A VALUE IN EXCESS OF A DOLLAR AMOUNT TO BE ESTABLISHED BY THE VOTING MEMBER FROM TIME TO TIME, NOT PREVIOUSLY INCLUDED IN THE CAPITAL BUDGET; (H) THE APPOINTMENT OF THE INDEPENDENT AUDITOR AND CORPORATE COUNSEL. FORM 990, PART VI, SECTION B, LINE 11 MERITER CONTRACTS WITH AN OUTSIDE PUBLIC ACCOUNTING FIRM TO PREPARE ALL INCOME TAX RETURNS. MERITER'S ACCOUNTING DEPARTMENT STAFF COMPLETES AND THE CONTROLLER REVIEWS THE COMPREHENSIVE TAX ORGANIZER PROVIDED BY THE TAX FIRM. THE CONTROLLER AND THE TAX FIRM WORK TOGETHER TO PREPARE TAX RETURNS TO REFLECT INFORMATION THAT AFFECTS THE FORM 990. TWO WEEKS PRIOR TO FILING, THE RETURNS WILL BE POSTED TO THE BOARD GOVERNANCE INTERNAL WEB SITE ACCOMPANIED BY A MEMO HIGHLIGHTING THE KEY POINTS OF INTEREST FOR THE FILING YEAR AND CONTAINING THE ANTICIPATED FILING DATE IN ADDITION TO PROVIDING CONTACT INFORMATION FOR FURTHER INQUIRY BY THE BOARD. FORM 990, PART VI, SECTION B, LINE 12C THE HOSPITAL BOARDS OF DIRECTORS CONSISTENTLY MONITOR AND ENFORCE COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. ON A PROACTIVE BASIS, DECLARATIONS OF POTENTIAL CONFLICTS OF INTEREST ARE SIGNED WHEN EACH DIRECTOR JOINS THE BOARD AND ANNUALLY THEREAFTER. THE CEO AND BOARD CHAIR MONITOR THE POTENTIAL CONFLICTS DISCLOSED BY BOARD MEMBERS AND MANAGE ATTENDANCE AT MEETINGS AND PARTICIPATION IN VOTES ACCORDING TO THE ISSUE ON THE AGENDA. INDIVIDUAL DIRECTORS ALSO MONITOR THEIR POTENTIAL CONFLICTS AND RECUSE THEMSELVES FROM BOARD DISCUSSION AND/OR VOTES AS REQUIRED BY THE CIRCUMSTANCES. THE PROCESS OF MANAGING CONFLICTS OF INTEREST IS RECORDED IN THE MEETING MINUTES. BELOW IS THE 2013 CONFLICT OF INTEREST DISCLOSURE: DRS. ROTHSTEIN AND PRIEST ARE MEMBERS OF PHYSICIAN PLUS INVESTMENT GROUP LLP WHICH IS A 1/5 OWNER OF PHYSICIANS PLUS INSURANCE CORPORATION WHERE MERITER HEALTH SERVICES OWNS THE REMAINING 4/5. DR. ROTHSTEIN IS THE MANAGING PARTNER OF PPIG LLP AND DR. PRIEST IS A NON-VOTING MEMBER OF SAME. DR. MANNING, MERITER HOSPITAL BOARD MEMBER IS A MEMBER OF UW MEDICAL FOUNDATION. DR. GOLDROSEN IS A PARTNER OF ASSOCIATED PHYSICIANS, LLP. MERITER PAYS TEACHING STIPENDS TO UW MEDICAL FOUNDATION PHYSICIANS. FORM 990, PART VI, SECTION B, LINE 15 THE MERITER HEALTH SERVICES, INC. BOARD OF DIRECTORS APPROVES EXECUTIVE COMPENSATION PHILOSOPHY AND STRATEGY. THE BOARD OF DIRECTORS AUTHORIZES A SUB-COMMITTEE OF THE BOARD TO MAKE COMPENSATION DECISIONS WHILE RETAINING OVERSIGHT OF SAID COMMITTEE. AN EXTERNAL HUMAN RESOURCES CONSULTING FIRM IS ENGAGED BY THE BOARD OF DIRECTORS' SUB-COMMITTEE. THIS FIRM COLLECTS AND REVIEWS ALL ORGANIZATIONAL INFORMATION, COMPENSATION DATA, AND BACKGROUND INFORMATION MATCHING ALL EXECUTIVE POSITIONS TO SURVEY BENCHMARKS. USING THIS INFORMATION THE CONSULTING FIRM PRODUCES ESTIMATED MARKET VALUES FOR EACH EXECUTIVE AND RECOMMENDS ANY NECESSARY CHANGES WITH EXECUTIVE COMPENSATION TO THE BOARD COMMITTEE FOR THEIR DECISION. FORM 990, PART VI, SECTION C, LINE 18 BECAUSE THE ORGANIZATION FILED ITS FORM 1023 BEFORE JULY 1987 AND DID NOT HAVE A COPY OF FORM 1023 ON THAT DATE, IT IS NOT REQUIRED TO MAKE ITS FORM 1023 AVAILABLE FOR PUBLIC INSPECTION. FORM 990, PART VI, SECTION C, LINE 19 AS PRIVATE CORPORATIONS, THE GOVERNING DOCUMENTS ARE NOT MADE PUBLIC. THE CONFLICT OF INTEREST POLICY IS NOT GENERALLY MADE PUBLIC, BUT WOULD BE DISCLOSED TO INTERESTED PARTIES IN THE CONTEXT OF ANY ISSUE THAT MIGHT ARISE. FINANCIAL INFORMATION CONTAINED WITHIN THE 990S IS AVAILABLE TO THE PUBLIC ON GUIDESTAR AND ARE AVAILABLE UPON REQUEST OF ADMINISTRATION. FORM 990, PART VII: THE COMPENSATION PAID TO BOARD MEMBERS REFLECTS PAYMENT FOR THEIR SERVICES AS PHYSICIANS TO MERITER MEDICAL GROUP, INC., A RELATED ORGANIZATION, NOT REMUNERATION FOR THEIR PARTICIPATION ON THE BOARD OF TRUSTEES FOR MERITER HOSPITAL, INC. OR MERITER HEALTH SERVICES, INC. FORM 990, PART XI, LINE 9: SWAP GAIN LOSS 5,542,628. MINIMUM PENSION AND UNRECOGNIZED RETIREE MED BENEFITS 15,618,851. ASSETS RELEASED FROM RESTRICTION -555,974. RELEASED FOR CAPITAL AND OTHER 555,974. INVESTMENT GAIN LOSS FOUNDATION 0. TEMPORARY RESTRICTED TRANSFER FOUNDATION 741,910. OTHER -219,902. MERITER HEALTH SERVICES INC 202 SOUTH PARK STREET MADISON WI 537151596 391412318 PARENT OF MERITER ENTITIES - SUPPORT NONPROFIT SUBSIDIARIES WI 501(C)(3) LINE 11, TYPE II: 50 MERITER HOSPITAL INC 1 MERITER FOUNDATION INC 202 SOUTH PARK STREET MADISON WI 537151596 237098688 CHARITABLE SUPPORT FOR HEALTH CARE NEEDS WI 501(C)(3) LINE 7: 170(B)(1)(A) MERITER HEALTH SERVICES INC 0 MERITER MEDICAL GROUP INC 202 SOUTH PARK STREET MADISON WI 537151596 050545222 CLINICAL SUPPORT OF MERITER HOSPITAL, INC. WI 501(C)(3) LINE 11, TYPE II: 50 MERITER HOSPITAL INC 1 SHARED MAGNETIC RESONANCE IMAGING FACILITY 1104 JOHN NOLEN DRIVE MADISON WI 53713 391534744 MEDICAL TECHNOLOGY WI 501(C)(3) LINE 11, TYPE I: 509 MERITER HOSPITAL INC 1 MERITER UWMF PHYSICIAN CONTRACTING LLC 202 SOUTH PARK STREET MADISON WI 537151596 391998819 HEALTH CARE CONTRACTING SERVICES WI N/A MERITER HEALTH ENTERPRISES 202 SOUTH PARK STREET MADISON WI 537151596 391293620 HOME HEALTH AND MEDICAL LAB WI N/A C 0 HCP CORPORATION 202 SOUTH PARK STREET MADISON WI 537151596 391177562 REAL ESTATE MANAGEMENT WI N/A C 409494 1445389 1.00000 1 MERITER MANAGEMENT SERVICES INC 202 SOUTH PARK STREET MADISON WI 537151596 391458235 MANAGEMENT COMPANY WI N/A C 0 PHYSICIANS PLUS INSURANCE INC 22 EAST MIFFLIN STREET MADISON WI 53701 391565691 CENTRALIZED MANAGEMENT SERVICES WI N/A C 0 1 1 1 1 1 0 0 0 0 1 0 1 1 0 0 1 0 0 0 MERITER FOUNDATION INC C 1142149 COST MERITER MEDICAL GROUP D 120580679 FMV MERITER HEALTH ENTERPRISES J 1233800 FMV MERITER MANAGEMENT SERVICES INC J 624766 FMV MERITER FOUNDATION INC J 79888 FMV MERITER FOUNDATION INC M 899999 FMV MERITER HEALTH ENTERPRISES M 10611460 FMV MERITER HEALTH SERVICES M 1640000 FMV MERITER MANAGEMENT SERVICES INC M 12489988 FMV MERITER MEDICAL GROUP M 1307170 FMV MERITER HEALTH SERVICES B 86244 COST MERITER HEALTH ENTERPRISES L 1972620 FMV MERITER MEDICAL GROUP L 68779 FMV PHYSICIANS PLUS INSURANCE CORP P 462835 FMV MERITER MANAGEMENT SERVICES INC D 467654 FMV MERITER HEALTH ENTERPRISES E 177415 FMV MERITER HEALTH SERVICES D 19140606 FMV PHYSICIANS PLUS INSURANCE CORP D 388436 FMV