2014-08-06T16:02:06-05:00 2013-12-31 390758449 WIPFLI LLP PO BOX 8010 WAUSAU WI 544028010 990 2013-01-01 391528430 BAY AREA MEDICAL CENTER INC BAYA 7157354200 3100 SHORE DRIVE MARINETTE WI 54143 DAN CARLSON CFO 7157354200 2014-08-01 1 KIM HELLER P00766668 7158453111 2014-08-01 2013 2015-11-30 17:44:51Z DAN CARLSON 3100 SHORE DRIVE MARINETTE WI 54143 123465641 0 X WWW.BAMC.ORG X 1985 WI BAY AREA MEDICAL CENTER (BAMC) IS A REGIONAL HEALTH CARE FACILITY PROVIDING A WIDE RANGE OF MEDICAL SERVICES TO THE RESIDENTS OF MARINETTE AND MENOMINEE COUNTIES AND THE SURROUNDING AREAS. BAMC'S PRIMARY EXEMPT PURPOSE IS THE PROVISION OF HEALTH CARE SERVICES. 9 9 810 0 2525115 0 38859 25576 121323103 117098235 2037961 1793687 390529 3768542 123790452 122686040 0 0 0 0 63495048 59857201 0 0 0 56234484 58345842 119729532 118203043 4060920 4482997 155931655 157404669 62700730 55223349 93230925 102181320 X WE ARE YOUR MEDICAL CENTER, STRIVING TO EXCEED YOUR EXPECTATIONS BY PROVIDING COMPASSIONATE, COST-EFFECTIVE, QUALITY HEALTHCARE TO ALL. 0 0 94758937 113786353 INPATIENT HOSPITAL SERVICES FOR MEDICAL, SURGICAL AND OBSTETRICS/GYNECOLOGY PATIENTS - BAMC PROVIDED CARE FOR 3,642 PATIENTS WHO WERE ADMITTED AS INPATIENTS DURING 2013. THESE SERVICES INCLUDED 24/7 CARE FOR PATIENTS ADMITTED WITH MEDICAL CONDITIONS WARRANTING A HOSPITAL STAY, PATIENTS ADMITTED FOR SURGICAL PROCEDURES EXTENSIVE ENOUGH TO REQUIRE A STAY OVERNIGHT OR FOR SEVERAL DAYS FOLLOWING THE PROCEDURES, AND PATIENTS ADMITTED FOR THE DELIVERY OF NEWBORNS.OUTPATIENT SURGICAL SERVICES - BAMC PERFORMED 3,085 OUTPATIENT SURGICAL PROCEDURES FOR PATIENTS DURING 2013. THESE PROCEDURES INCLUDED ORTHOPEDIC, UROLOGICAL, GENERAL SURGERY, GYNECOLOGY, AND ENT SURGERIES.EMERGENCY SERVICES - BAMC OPERATES AN EMERGENCY DEPARTMENT, WHICH INCLUDES AN AMBULANCE SERVICE STAFFED WITH PARAMEDICS, TO RESPOND TO EMERGENCY CARE NEEDS OF THE AREA. IT IS THE ONLY EMERGENCY DEPARTMENT AVAILABLE IN THE COMMUNITY. THE EMERGENCY DEPARTMENT IS STAFFED WITH EMERGENCY CARE PHYSICIANS ON A 24/7 BASIS AND THE DEPARTMENT SAW 20,468 PATIENT VISITS IN 2013, WITH 2,502 OF THESE VISITS RESULTING IN PATIENTS BEING ADMITTED TO THE HOSPITAL FOR INPATIENT CARE. THE AMBULANCE SERVICE HAD 3,305 PATIENT TRANSPORTS IN 2013. 94758937 1 0 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 85 0 810 1 1 1 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X DAN CARLSON CFO 7157354200 3100 SHORE DR MARINETTE WI 54143 TONY FURTON CHAIR 1.00 X X 0 0 0 PAT KRAH VICE CHAIR 0.80 X X 0 0 0 WILLIAM MALLORY MD SEC/TREAS 0.80 X X 0 0 0 MARY GATZKE DNP BOARD MEMBER 0.80 X 0 0 0 MARC JAMO BOARD MEMBER 0.80 X 0 0 0 CHARLES KALHOEFER BOARD MEMBER 0.80 X 0 0 0 JIM KORONKIEWICZ BOARD MEMBER 0.80 X 0 0 0 TIM RENNES BOARD MEMBER 0.80 X 0 0 0 BOB SORENSON BOARD MEMBER 0.80 X 0 0 0 BERNADINE VAN COURT COO 40.00 X 301088 0 37482 C DANIEL CARLSON CFO 40.00 X 277972 0 68936 EDWARD HARDING CEO 40.00 X 513998 0 82526 THOMAS LEOW MD PHYSICIAN 40.00 X 1096109 0 67661 MICHAEL KARKKAINEN MD PHYSICIAN 40.00 X 1325097 0 95651 MOHAMED EL-JACK MD PHYSICIAN 40.00 X 1085118 0 118840 EDGAR MASSABNI MD PHYSICIAN 40.00 X 863207 0 76938 BRANDON SCHARER MD PHYSICIAN 40.00 X 745619 0 30994 6208208 0 579028 46 0 1 0 BELLIN MEMORIAL 744 S WEBSTER AVE GREEN BAY WI 543053400 PROFESSIONAL LAB FEES 1346323 KAUFMAN HALL & ASSOC INC 5202 OLD ORCHARDS RD - SUITE N700 SKOKIE IL 60077 CONSULTANT FOR STRATEGIC PARTNER NEGOTIA 647065 VON BRIESEN & ROPER SC 411 E WISCONSIN AVE - SUITE 1000 MILWAUKEE WI 532024409 LEGAL SERVICES 632964 INFINITY HEALTHCARE 111 E WISCONSIN AVE - SUITE 2100 MILWAUKEE WI 53202 OCCUPATIONAL HEALTH SERVICE PHYSICIAN FE 615959 EXECUTIVE HEALTH RESOURCES 15 CAMPUS BLVD - SUITE 200 NEWTON SQUARE PA 19073 MEDICAL RECORDS 486355 25 25576 25576 NET PATIENT REVENUE 900099 112187885 112187885 RETAIL PHARMACY 446110 2349805 2349805 SPACE LEASED FOR MEDICAL PURPOSES 621110 1396660 1396660 OTHER MISCELLANEOUS ACTIVITIES 900099 358523 358523 CAFETERIA 900099 211982 211982 593380 201808 175310 216262 117098235 1669094 1669094 68855 78928 -10073 -10073 -10073 776389 48877 0 700673 776389 -651796 124593 124593 INTEREST RATE SWAP VALUATION ADJU 900099 3778615 3778615 3778615 122686040 113786353 2525115 6348996 1282001 1282001 43176861 35447725 7729136 1798255 1466573 331682 13600084 10735976 2864108 725753 725753 94791 94791 8906009 4505156 4400853 166195 96737 69458 20414010 19155779 1258231 1381468 885580 495888 2842 2776 66 152869 122590 30279 1443619 1443619 6559689 5323975 1235714 961703 769185 192518 BAD DEBTS 6515550 6515550 REPAIRS AND MAINTENANCE 4409444 1697268 2712176 NR/WUPOMS 3621834 3621834 WI HOSPITAL ASSESSMENT 2944058 2944058 46008 24556 21452 118203043 94758937 23444106 0 3695 3645 10785263 12242944 17129763 17111293 1577441 0 2878227 2829614 1421356 1617298 120434292 70272865 54117762 50161427 64102933 69496395 2658743 3351764 1256472 590289 155931655 157404669 10897674 10451925 36745000 35570000 15058056 9201424 62700730 55223349 X 92948862 101873463 282063 307857 93230925 102181320 155931655 157404669 X 4482997 3707814 759584 X X 0 1 X 1 0 X 0 0 0 0 0 1 9855 0 0 0 9855 0 PART II-B, LINE 1: PORTION OF AHA ($5,130) AND WHA (4,725) DUES = $9,855. 1713485 1713485 74625208 38062708 36562500 1523519 1825791 -302272 41607824 30384366 11223458 964256 964256 50161427 ACCRUED POSTRETIREMENT BENEFITS 2456495 DEFERRED COMPENSATION 564657 INTEREST RATE SWAP VALUATION 3607238 CAPITAL LEASE OBLIGATION 123664 AMOUNTS PAYABLE TO THIRD-PARTY REIMBURSEMENT PROGRAM 2449370 9201424 X 119134283 -3621834 -3621834 122756117 -70077 -70077 122686040 114660137 78928 78928 114581209 3621834 3621834 118203043 PART X, LINE 2: TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE ORGANIZATION DETERMINES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON 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 ORGANIZATION HAS NOT RECORDED ANY ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS AS OF DECEMBER 31, 2013 AND 2012. THE ORGANIZATION IS ALSO ENGAGED, TO A LIMITED EXTENT, IN ACTIVITIES THAT THE INTERNAL REVENUE SERVICE (IRS) CONSIDERS UNRELATED TO ITS EXEMPT PURPOSE AND, THEREFORE, TAXABLE. THESE ACTIVITIES, HOWEVER, ANNUALLY RESULT IN NET OPERATING LOSSES FOR INCOME TAX PURPOSES. THE ORGANIZATION DOES NOT PRESENTLY ANTICIPATE THAT A TAX BENEFIT FROM THESE NET OPERATING LOSSES WILL BE REALIZED IN THE FUTURE. ANY POTENTIAL DEFERRED TAX ASSET RESULTING FROM THE AVAILABILITY OF NET OPERATING LOSS CARRYFORWARDS IS OFFSET BY A VALUATION ALLOWANCE OF EQUAL AMOUNT. ACCORDINGLY, THE ACCOMPANYING FINANCIAL STATEMENTS DO NOT INCLUDE A PROVISION FOR INCOME TAXES. NO DEFERRED TAX ASSETS AND LIABILITIES HAVE BEEN RECOGNIZED SINCE NO OTHER DIFFERENCES EXIST BETWEEN THE FINANCIAL TAX BASIS OF REPORTING THE ORGANIZATION'S ASSETS AND LIABILITIES. THE ORGANIZATION'S FEDERAL TAX RETURNS FOR TAX YEARS 2010 AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. PART XI, LINE 2D - OTHER ADJUSTMENTS: DECREASE IN EQUITY IN NORTHREACH HEALTHCARE LLC AND WISCONSIN UPPER PENINSULA ONCOLOGY MANAGEMENT SERVICES, INC. -3,621,834. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -78,928. TEMPORARILY RESTRICTED CONTRIBUTIONS 8,851. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 78,928. PART XII, LINE 4B - OTHER ADJUSTMENTS: DECREASE IN EQUITY IN NORTHREACH HEALTHCARE LLC AND WISCONSIN UPPER PENINSULA ONCOLOGY MANAGEMENT SERVICES, INC. 3,621,834. 1 1 1 X 1 X 1 1 0 1 1 2318912 2318912 0.02080 15103318 10196074 4907244 0.04390 17422230 10196074 7226156 0.06470 84600 84600 0.00080 84600 84600 0.00080 17506830 10196074 7310756 0.06550 1 2712391 22669353 25773491 -3104138 X 1 1 1 1 BAY AREA MEDICAL CENTER INC 3100 SHORE DRIVE MARINETTE WI 54143 X X X BAY AREA MEDICAL CENTER 1 1 X X X X X X X X X 13 1 0 1 X WWW.BAMC.ORG X X X X X X X 0 0 1 1 100.000000000000 1 200.000000000000 1 X X X 1 1 X X X 1 0 X X X X 1 X 0 0 BAY AREA MEDICAL CENTER PART V, SECTION B, LINE 3: BAMC HELD TWO HEALTH CARE ROUND TABLES THAT BROUGHT COMMUNITY GROUPS TOGETHER TO NOT ONLY SHARE THEIR RESEARCH BUT BEGIN THE PROCESS OF GREATER COLLABORATION TO ACCOMPLISH SIMILAR GOALS. BAMC ALSO PARTICIPATED IN THREE OF THE INITIATIVES AS A PARTICIPANT GROUP FACILITATOR FOR THE TRI CITY UNITED WAY STUDY AND AS A PARTICIPANT IN THE MARINETTE COUNTY ASSESSMENT. A BRIEF DESCRIPTION OF THESE OTHER AGENCY RESEARCH EFFORTS ARE IN THE BAY AREA COMMUNITY HEALTH NEEDS ASSESSMENT REPORT. BAY AREA MEDICAL CENTER PART V, SECTION B, LINE 7: THERE WERE ITEMS IDENTIFIED IN THE CHNA WHICH WERE NOT ADDRESSED BY BAY AREA MEDICAL CENTER, INC; HOWEVER, ALL ITEMS WERE CONSIDERED IF A NEED WAS BROUGHT TO THE ATTENTION OF THE GROUP DURING THE INFORMATION GATHERING PHASE OF THE CHNA PROCESS. SEVERAL OF THE ITEMS WHICH WERE NOT ADDRESSED PRIMARILY WERE NOT ADDRESSED DUE TO THE FINANCIAL CONSTRAINT OF PROVIDING THE SERVICE FOR A LIMITED POPULATION OF PEOPLE WITHIN THE PRIMARY SERVICE AREA. BAY AREA MEDICAL CENTER, INC. ALSO CONSIDERED STAFFING RESOURCES IN ADDITION TO FINANCIAL CONSIDERATIONS TO ENSURE THAT THERE ARE ENOUGH PERSONNEL RESOURCES AVAILABLE FOR ANY PROGRAMS THAT MAY NOT CURRENTLY BE OFFERED BY THE HOSPITAL. DUE TO THE FINANCIAL AND STAFFING CONSTRAINTS, THE HOSPITAL HAS DETERMINED THE TOP THREE PRIORITIES THAT THEY WILL FOCUS THEIR ATTENTION ON, AS THESE ISSUES WERE THE MOST CRITICAL AND SIGNIFICANT WORK NEEDS TO BE DONE IN THESE AREAS. OVER THE NEXT THREE YEARS AS THE IMPLEMENTATION STRATEGY IS IMPLEMENTED, THE HOSPITAL PLANS TO CONTINUALLY EVALUATE THE BENEFITS PROVIDED TO THE COMMUNITY MEMBERS TO ENSURE THAT HEALTH NEEDS ARE MET WHENEVER POSSIBLE. BAY AREA MEDICAL CENTER PART V, SECTION B, LINE 14G: A FINANCIAL BROCHURE IS OFFERED TO PATIENTS UPON REGISTRATION AND BILLING STATEMENTS REFERENCE THE POLICY BUT DO NOT INCLUDE DETAIL. BAY AREA MEDICAL CENTER PART V, SECTION B, LINE 20D: IT MATCHES OR EXCEEDS THE COMMERCIAL INSURANCE RATE PAID BY THE GREATEST NUMBER OF OUR NEGOTIATED COMMERCIAL INSURANCE MANAGED CARE PLANS. 2 BAY AREA MOBILITY CENTER 3117 SHORE DRIVE MARINETTE WI 54143 REHABILITATION SERVICES AND OCCUPATIONAL HEALTH BAY AREA REHAB SERVICES - CRIVITZ WI 218 S US HWY 141 SUITE 100 CRIVITZ WI 54114 REHABILITATION SERVICES AND OCCUPATIONAL HEALTH PART I, LINE 7: BAY AREA UTILIZES A COST TO CHARGE RATIO. PART I, LINE 7G: TWIN COUNTIES FREE CLINIC PART I, LN 7 COL(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 $6,515,550. BAY AREA MEDICAL CENTER UTILIZED A COST TO CHARGE RATIO FOR DETERMINING THE COST OF BAD DEBT EXPENSE. PART II BAY AREA ACTIVELY PROVIDED OR PARTICIPATED IN THE FOLLOWING COMMUNITY-BASED ACTIVITIES AND PROGRAMS DURING 2013 AND 2012:- PROMOTED GENERAL HEALTH EDUCATION SERVICES SUCH AS HEALTH FAIRS, CANCER EDUCATION, HEALTHY HEART EDUCATION, AND HEALTHY EATING.- OFFERED HEALTH INFORMATION ON BAY AREA'S WEBSITE AND THROUGH HEALTH-RELATED PUBLICATIONS DISTRIBUTED AT NO CHARGE AND NEWSLETTERS MAILED TO OVER 5,000 HOUSEHOLDS A MONTH.- OFFERED BLOOD PRESSURE SCREENINGS, CHOLESTROL TESTING, AND GLUCOSE TESTING.- PROVIDED SKIN CANCER SCREENINGS AND FREE MAMMOGRAMS.- PROVIDED ADVANCE DIRECTIVES AND LIVING WELL ASSISTANCE.- PROVIDED GUIDANCE, REFERRAL, AND ENROLLMENT ASSISTANCE FOR PUBLIC MEDICAL PROGRAMS, CERTIFIED COUNSELING FOR AFFORDABLE CARE ACT HEALTH EXCHANGE APPLICANTS, AND OTHER FAMILY SUPPORT ASSISTANCE.- PROVIDED SPACE AND FREE LAB TESTING AND DIAGONSTIC SERVICES TO SUPPORT A FREE COMMUNITY PHYSISICAN CLINIC.- PROVIDED EMERGENCY CAB FARE FOR PATIENTS WITH TRANSPORTATION NEEDS RELATED TO THEIR HEALTH CARE SERVICES.- PROMOTED PARTICIPATION IN BLOOD DRIVES BY EMPLOYEES AND THE GENERAL PUBLIC.- CONTRIBUTED TO THE EDUCATION OF STUDENT NURSES AND OTHER HEALTH CARE PROFESSIONALS.- SPONSORED AND ORGANIZED THE BAMC MENOMINEE RIVER CENTURY BIKE RIDE WHICH ATTRACTS OVER 1,000 RIDERS.- SPONSORED AND SUPPORTED CHAMBER OF COMMERCE AND EDUCATIONAL LEADERSHIP PROGRAMS.- PROVIDED ATHLETIC TRAINING SERVICES, CONCUSSION EVALUATIONS, AND SPORTS PHYSICALS TO AREA SCHOOL SYSTEMS AND SPORTS PROGRAMS.- PROVIDED FINANCIAL AND STAFF SUPPORT FOR COMMUNITY RUNS AND WALKS. PART III, LINE 4: BAY AREA 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, BAY AREA 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 THIRD-PARTY PAYORS HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO HAVE FINANCIAL DIFFICULTIES THAT MAKE 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 WITH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), BAY AREA 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. PART III, LINE 8: AMOUNTS ABOVE USE STANDARD MEDICARE DETERMINATION OF ALLOWABLE AND UNALLOWABLE DEPARTMENTS, STANDARD/RECOMMENDED MEDICARE ALLOCATION OF ADMINISTRATION AND GENERAL DEPARTMENTS COSTS TO ALLOWABLE AND UNALLOWABLE DEPARTMENTS BY THE USE OF BAY AREA MEDICAL CENTER'S MEDICARE COST REPORT. THE MEDICARE COST REPORT WAS CALCULATED ON A COST TO CHARGE RATIO. THE COST TO CHARGE RATIO FOLLOWS THE REGULATIONS FOR FILING THE MEDICARE COST REPORT. PART III, LINE 9B: BAY AREA MEDICAL CENTER WILL PROVIDE NEEDED HOSPITAL CARE TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY FOR THESE SERVICES. COMMUNITY CARE IS ALLOCATED TO PATIENTS BASED ON SET GUIDELINES ESTABLISHED BY THE ORGANIZATION. A FULL OR PARTIAL ADJUSTMENT WILL BE DETERMINED BY COMPARING THE PATIENT'S FINANCIAL STATUS TO A SLIDING FEE SCHEDULE BASED ON THE MOST RECENTLY PUBLISHED FEDERAL POVERTY GUIDELINES.IT IS THE POLICY OF BAY AREA MEDICAL CENTER TO WRITE-OFF BOTH PARTIAL AND FULL PATIENT BALANCES FOR ACCOUNTS THAT QUALIFY FOR COMMUNITY CARE. THERE ARE NO FURTHER COLLECTIONS EFFORTS RELATED TO THOSE WHO QUALIFY FOR A FULL COMMUNITY CARE WRITE-OFF. PATIENTS THAT HAVE HAD PARTIAL WRITE-OFFS THAT DO NOT COOPERATE WITH COLLECTION EFFORTS ON THE BALANCES REMAINING WILL BE REFERRED TO A THIRD-PARTY COLLECTION AGENCY. IF STILL UNCOLLECTIBLE, THE PATIENT ACCOUNT WILL BE WRITTEN OFF TO BAD DEBT. PART VI, LINE 2: BAY AREA MEDICAL CENTER USES A BI-ANNUAL COMMUNITY SURVEY AND ALSO PARTICIPATES IN THE MARINETTE & MENOMINEE COUNTY HEALTH ASSESSMENT INITIATIVES. PART VI, LINE 3: - BROCHURES ARE PROVIDED TO EVERY PATIENT.- THE INFORMATION IS AVAILABLE ON THE ORGANIZATION'S WEBSITE.- ONE ON ONE MEETINGS WITH FINACIAL ADVISORS ARE ALSO AVAILABLE. PART VI, LINE 4: BAY AREA MEDICAL CENTER SERVES MARINETTE COUNTY, WI AND MENOMINEE COUNTY, MI. THERE ARE NO OTHER HOSPITALS LOCATED IN THESE COUNTIES. PART VI, LINE 5: - THE BAMC BOARD IS MADE UP ENTIRELY OF RESIDENTS OF THE TWO COUNTIES IT SERVES. IN FACT EACH MEMBER MUST BE RATIFIED BY THE COUNTY BOARD OF THEIR RESIDENCE. - BAMC HOSTS QUARTERLY MEETINGS WITH LOCAL MENTAL HEALTH PROFESSIONALS TO SUPPORT THIS INITIATIVE. WE ARE ALSO MEMBERS OF THE MICHIGAN HEALTHCARE CONSORTIUM IN THE UPPER PENINSULA.- ANY SURPLUS FUNDS ARE USED FOR IMPROVEMENTS TO THE FACILITY, EQUIPMENT, STAFF DEVELOPMENT AND PATIENT CARE. - BAMC PROVIDES DIRECT FINANCIAL SUPPORT TO THE TWIN COUNTIES FREE CLINIC. - BAMC HAS WORKING ARRANGEMENTS WITH A TWO YEAR TECHNICAL SCHOOL AND TWO YEAR COLLEGE TO OFFER NURSING AND OTHER MEDICAL PROFESSIONAL STUDENTS INTERNSHIPS IN THEIR PREPARATION FOR HEALTH CARE CAREERS. - BAMC PROVIDES SUPPORT TO LOCAL AREA VOLUNTEER RESCUE SQUAD UNITS THAT WORK WITH THE HOSPITAL-BASED AMBULANCE SERVICE.WHILE THERE IS A GROWING AGREEMENT IN THE UNITED STATES ABOUT WHAT CONSTITUTES A NON-PROFIT HOSPITAL'S "COMMUNITY BENEFIT," THIS IS A WORK IN PROGRESS. OUR HOSPITAL 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 LOCALLY.BEYOND INPATIENT HOSPITALIZATIONS, WE PROVIDE LOCAL ACCESS TO MANY HEALTH SERVICES: AMBULANCE SERVICES, BIRTHING CENTER, DIALYSIS CENTER, DIAGNOSTICS, EMERGENCY SERVICES, INPATIENT CARE, LABORATORY SERVICES, OCCUPATIONAL HEALTH & REHABILITATION SERVICES, SURGICAL SERVICES AND WOMENS' SERVICES. X X X X X 0 1 0 0 0 0 0 0 0 BERNADINE VAN COURT COO 213321 0 35408 0 52359 0 23789 0 13693 0 338570 0 0 0 C DANIEL CARLSON CFO 209463 0 35291 0 33218 0 30072 0 38864 0 346908 0 0 0 EDWARD HARDING CEO 374196 0 57024 0 82778 0 48345 0 34181 0 596524 0 0 0 THOMAS LEOW MD PHYSICIAN 392229 0 650270 0 53610 0 28928 0 38733 0 1163770 0 0 0 MICHAEL KARKKAINEN MD PHYSICIAN 390508 0 617613 0 316976 0 56727 0 38924 0 1420748 0 0 0 MOHAMED EL-JACK MD PHYSICIAN 392229 0 463908 0 228981 0 80107 0 38733 0 1203958 0 0 0 EDGAR MASSABNI MD PHYSICIAN 642721 0 0 0 220486 0 38698 0 38240 0 940145 0 0 0 BRANDON SCHARER MD PHYSICIAN 198568 0 519933 0 27118 0 20929 0 10066 0 776614 0 0 0 PART I, LINE 4B THE FOLLOWING INDIVIDUALS PARTICIPATED IN AND RECEIVED PAYMENT FROM A NON-QUALIFIED RETIREMENT PLAN: CONTRIBUTIONS TO 457F PLAN: THOMAS LEOW, M.D. $46,000; MICHAEL KARKKAINEN, M.D. $115,416; MOHAMED EL-JACK, M.D. $99,349; EDGAR MASSABNI, M.D. $ 46,000; BRANDON SCHARER, M.D. $23,000; BERNADINE VAN COURT $10,213; DANIEL CARLSON $27,646; EDWARD HARDING $58,080. PAYMENTS FROM 457F PLAN: THOMAS LEOW, M.D. $6; MICHAEL KARKKAINEN, M.D. $4,164; MOHAMED EL-JACK, M.D. $20; EDGAR MASSABNI, M.D. $9; BRANDON SCHARER, M.D. $4; BERNADINE VAN COURT $1,259; DANIEL CARLSON $1,668; EDWARD HARDING $1,094 DISTRIBUTIONS THAT WERE PREVIOUSLY TAXED FROM 457(F) PLANS: THOMAS LEOW, M.D. $17,335; MICHAEL KARKKAINEN, M.D. $46,831; MOHAMED EL-JACK, M.D. $65,434; EDGAR MASSABNI, M.D. $25,668; BRANDON SCHARER, M.D. $10,465; BERNADINE VAN COURT $8,949; DANIEL CARLSON $15,208; EDWARD HARDING $34,583 A WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337955 97710V7Q5 2008-02-20 40000000 TO FUND PURCHASE OF HOSPITAL BUILDINGS, FIXTURES, AND CAPITAL EQUIPMENT. 0 0 0 A 4430000 40000000 13677860 738720 25583420 2008 0 1 1 1 A 0 0 0 0 0.00470 0.00470 0 0 0 A 0 0 0 0 1 1 PIPER JAFFRAY 30.000000000000 0 0 0 0 0 A 0 FORM 990, PART VI, SECTION A, LINE 7A BAY AREA MEDICAL CENTER'S BY-LAWS INDICATE THAT THE BOARD OF DIRECTORS OF THE CORPORATION SHALL BE NINE (9), FOUR OF WHOM SHALL BE RATIFIED BY MARINETTE COUNTY, FOUR OF WHOM SHALL BE RATIFIED BY MENOMINEE COUNTY, AND ONE OF WHOM SHALL BE AN AT-LARGE DIRECTOR SELECTED BY THE BOARD OF DIRECTORS. IN ADDITION THE EXECUTIVE COMMITTEE SHALL DETERMINE THE NUMBER OF RESERVE DIRECTORS TO NOMINATE AND SHALL NOMINATE INDIVIDUALS TO FILL THE NUMBER OF RESERVE DIRECTOR POSITIONS SO CREATED. THE RESERVE DIRECTORS SHALL HAVE NO VOTING RIGHTS. FORM 990, PART VI, SECTION A, LINE 7B MARINETTE COUNTY, WISCONSIN AND MENOMINEE COUNTY, MICHIGAN RATIFY BAMC BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 11 THE BOARD OF DIRECTORS ARE PROVIDED A COPY OF THE FORM 990 TO REVIEW AT A BOARD MEETING PRIOR TO WHEN THE FORM 990 IS FILED. FORM 990, PART VI, SECTION B, LINE 12C BOARD OF DIRECTORS - PERSONS WITH ACTUAL OR POTENTIAL CONFLICTS OF INTEREST SHALL FILE FORMAL STATEMENTS DISCLOSING ACTUAL OR POTENTIAL CONFLICTS WHENEVER AN ACTUAL OR POTENTIAL CONFLICT ARISES; BEFORE ANY TRANSACTIONS CONSTITUTING A CONFLICT OR POTENTIAL CONFLICT IS CONSUMMATED; AND ONCE EACH CALENDAR YEAR SO LONG AS THE CONFLICT OR POTENTIAL CONFLICT CONTINUES TO EXIST. THE DISCLOSURE STATEMENT SHALL INCLUDE A DESCRIPTION OF THE RELATIONSHIP OR INTEREST CAUSING THE CONFLICT OR POTENTIAL CONFLICT, THE ROLE IN THE RELATIONSHIP OR TRANSACTION PLAYED BY THE PERSON HAVING THE CONFLICT, AND THE BENEFITS AND DETRIMENTS ACCRUING TO THE HOSPITAL AND TO THE PERSON HAVING THE CONFLICT AS A RESULT OF THE CONTRACT, TRANSACTION, OR RELATIONSHIP. ANY MEMBER OF THE BOARD OF DIRECTORS HAVING AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST ON ANY MATTER SHALL NOT VOTE OR USE HIS/HER PERSONAL INFLUENCE ON THE MATTER CONSITUTING A CONFLICT. THE INTERESTED DIRECTOR MAY, HOWEVER, BE COUNTED FOR THE PURPOSE OF DETERMING WHETHER A QUORUM OF THE BOARD, OR OF A COMMITTEE OF THE BOARD, EXISTS. THE MATTER CONSITUTING THE CONFLICT SHALL BE APPROVED IF IT IS APPROVED BY A MAJORITY OF DISINTERESTED DIRECTORS VOTING ON THE MATTER. THE CONFLICT OF INTEREST POLICY SHALL BE REVIEWED ANNUALLY FOR THE INFORMATION AND GUIDANCE OF THE BOARD OF DIRECTORS AND THAT ANY NEW MEMBERS OF THE SAID BOARD OF DIRECTORS BE ADVISED OF THE POLICY UPON ENTERING ON THE DUTIES OF HIS/HER OFFICE. IN ADDITION TO THE BOARD OF DIRECTORS BEING HELD TO THE CONFLICT OF INTEREST POLICY, COPIES OF THE POLICY ARE PROVIDED TO ALL MANAGEMENT EMPLOYEES. CONFLICT OF INTEREST DISCLOSURE FORMS ARE COMPLETED ANNUALLY BY ALL DIRECTORS, OFFICERS AND KEY EMPLOYEES. THE COMPLETED FORMS ARE KEPT ON FILE BY ADMINISTRATION. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTOR'S COMPENSATION COMMITTEE REVIEWS COMPARABLE COMPENSATION INFORMATION ON OTHER HOSPITALS AND ESTABLISHES BAMC'S EXECUTIVE COMPENSATION LEVELS. MEMBERS OF THE COMPENSATION COMMITTEE DO NOT HAVE A CONFLICT OF INTEREST AND THE CONCLUSIONS ARE SUBSTANTIATED. THE REVIEW PROCESS TAKES PLACE AT LEAST ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 THE ANNUAL AUDITED FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC BY PROVIDING THEM TO MARINETTE COUNTY, WISCONSIN AND MENOMINEE COUNTY, MICHIGAN. FORM 990, PART XI, LINE 9: INCREASE IN BENEFICIAL INTEREST IN BAMC FOUNDATION, INC. 68,123. ASSETS RELEASED FROM RESTRICTIONS -44,997. CHANGE IN POSTRETIREMENT BENEFIT OBLIGATION OTHER THAN EXPENSE 697,813. RECLASSIFICATION OF ACCUMULATED LOSS ON DESIGNATED CASHFLOW HEDGE 38,645. FORM 990, PART XI, LINE 2C THE PROCESS OF OVERSIGHT AND SELECTION OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. FORM 990, PART IV, LINE 12 BAY AREA MEDICAL CENTER WAS AUDITED AS PART OF A COMBINED AUDIT. BAMC ASSETS MADE UP 99% OF TOTAL ASSETS IN THE COMBINED AUDIT. FORM 990, PART XI, LINE 2B AND 2C BAY AREA MEDICAL CENTER WAS AUDITED AS PART OF A COMBINED AUDIT. SEE EXPLANATION TO PART IV, LINE 12. BAY AREA MEDICAL CENTER FOUNDATION INC 3100 SHORE DRIVE MARINETTE WI 54143 392020734 FUNDRAISING FOR BAMC, INC. WI 501 (C) 3 LINE 11A, I BAY AREA MEDICAL CENTER INC 1 NORTHSHORE HEALTH NETWORK INC 3100 SHORE DRIVE MARINETTE WI 54143 271389366 NEGOTIATING MANAGED CARE CONTRACTS FOR THE BENEFIT OF BAY AREA WI BAY AREA MEDICAL CENTER C -89 10629 1.00000 1 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1