2013-08-15T08:04:14-05:00 2012-12-31 861065772 DELOITTE TAX LLP 555 EAST WELLS STREET SUITE 1400 MILWAUKEE WI 53202 990 2012-01-01 390806367 MERITER HOSPITAL INC MERI 6084176000 202 SOUTH PARK STREET MADISON WI 537151596 KEVIN BOREN 6084176000 2013-08-15 1 RACHEL BECKER P00966076 4142713000 2012 2016-02-24 21:20:13Z JAMES WOODWARD 202 SOUTH PARK STREET MADISON WI 537151596 413155474 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. 15 12 3133 733 166299 -9366 540243 587378 373350414 378521188 6212005 8381083 6017488 12640795 386120150 400130444 112400 116904 0 0 175789629 181215529 0 0 991399 164649055 170216300 340551084 351548733 45569066 48581711 605180203 682175251 297376374 313942372 307803829 368232879 X MERITER HOSPITAL, INC. IS DEDICATED TO PROVIDING EXCEPTIONAL HEALTH CARE AND LIVING BY ITS MISSION TO HEAL, TEACH AND SERVE. 1 0 311142771 116904 387591160 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. 311142771 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 1 0 0 0 0 0 1 1 1 0 0 1 173 0 1 3133 1 1 1 0 0 0 0 0 0 0 0 0 0 X 15 12 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 WI X X KEVIN BOREN 6084175811 202 SOUTH PARK STREET MADISON WI 53715 X JAMES WOODWARD 18.00 32.00 X X 0 814221 41166 DAVE BOYER 3.00 4.00 X X 12500 12500 0 VIRGINIA GRAVES 2.00 2.00 X X 0 0 0 LONDA DEWEY END 0612 1.00 1.00 X 0 0 0 BARBARA SWAN 1.00 1.00 X 0 0 0 BRADLEY MANNING MD 1.00 1.00 X 0 0 0 CATE RANHEIM MD START 0312 1.00 50.00 X 0 214582 4794 CATHERINE DURHAM 1.00 1.00 X 0 0 0 DAN RASHKE END 0612 1.00 1.00 X 0 0 0 EILEEN MERSHART 1.00 1.00 X 0 0 0 GEORGE KAMPERSCHROER 1.00 1.00 X 0 0 0 HOLLY CREMER-BERKENSTADT 1.00 1.00 X 0 0 0 JULIE SCHURR MD 1.00 1.00 X 0 0 0 LAURENCE ROTHSTEIN MD 1.00 1.00 X 0 0 0 MARGARET NOREUIL RN PHD 1.00 1.00 X 0 0 0 MICHAEL GOLDROSEN MD 1.00 1.00 X 0 0 0 PAT RICHTER 1.00 1.00 X 0 0 0 PAUL PEERCY PHD END 0912 1.00 1.00 X 0 0 0 RICHARD LYNCH END 0612 1.00 1.00 X 0 0 0 SUSAN TOTH MD END 0212 1.00 50.00 X 0 434473 34355 LYNNE MYERS END 0412 2.00 43.00 X 0 504783 25189 LINDA HOFF 35.00 15.00 X 0 452934 37088 KEVIN BOREN 35.00 15.00 X 0 292584 31272 GEOFFREY PRIEST MD 40.00 10.00 X 0 470743 52230 KERRA GUFFEY 45.00 5.00 X 0 373782 34027 TAMARA SAUNAITIS 45.00 5.00 X 0 324330 27645 SUE ERICKSON 45.00 5.00 X 0 284663 45278 PATRICIA GRUNWALD 45.00 5.00 X 0 343688 47939 LOUIS S BRYSH 50.00 0.00 X 274291 0 43306 WILLIAM J HERBERT 50.00 0.00 X 200503 0 48585 DENISE M GOMEZ 50.00 0.00 X 174617 0 14509 SHERRY L CASALI 50.00 0.00 X 170351 0 37295 ROGER SLATTER END 1112 50.00 0.00 X 296813 0 16373 MARGO FRANCISCO 0.00 0.00 X 0 155538 564 ROBERT COATS 0.00 0.00 X 0 513991 0 BARBARA PINEKENSTEIN 0.00 0.00 X 0 144484 0 1129075 5337296 541615 85 1 1 0 JH FINDORFF AND SON INC 300 SOUTH BEDFORD STREET MADISON WI 53703 CONSTRUCTION 9743092 UNIVERSITY OF WISCONSIN HOSPITAL & CLINI 750 HIGHLAND AVENUE MADISON WI 53792 INTERNS, RESIDENTS, MED-FLIGHT,&TEACHING 4391751 UNIVERSITY OF WISCONSIN MEDICAL FOUNDATI 750 HIGHLAND AVENUE MADISON WI 53792 INTERNS AND RESIDENTS 3218253 SPM MARKETING COMMUNICATIONS 15 WEST HARRIS SUITE 300 LA GRANGE IL 60525 ADVERTISING AND MARKETING SERVICES 2062582 EPIC 1979 MILKY WAY LANE VERONA WI 53593 INFORMATION SYSTEMS 2026874 73 587378 587378 PATIENT SERVICE REV. 621400 369454627 369454627 MNGT CONTRACT SERVICE 621110 1825086 1825086 CAFETERIA REVENUE 722210 1053620 4023 1049597 CHILD CARE REVENUE 624410 816483 816483 PARKING REVENUE 722210 797322 797322 4574050 3830550 123368 620132 378521188 8710634 3274 8707360 2699788 2743248 -43460 -43460 35634 -79094 9625314 97238 9650124 401979 -24810 -304741 -329551 -329551 433037 229679 203358 203358 INCOME FROM UNCONSOLID 900099 6070403 6070403 6410494 6410494 12480897 400130444 387591160 166299 11785607 76904 76904 40000 40000 12500 12500 140953342 135526638 5426704 6004994 5773802 231192 24176001 23245225 930776 10068692 9681047 387645 15203708 244619 14959089 525387 525387 18021613 17208511 813102 359595 340788 18807 1410328 857188 553140 11223300 10636321 586979 199084 188672 10412 8717716 8717716 979999 979999 23080903 21873772 1207131 734917 696481 38436 MEDICAL SUPPLIES 49199871 46626718 2573153 STATE REV ASSESSMENT 11558515 11558515 EQUIPMENT RENTAL AND MA 5499210 5211601 287609 BAD DEBT EXPENSE 3276265 3104916 171349 20225889 18251053 1963436 11400 351548733 311142771 39414563 991399 160196 153077 32132295 47092142 31548904 24740068 89463830 121604435 3387821 3491652 3353641 3052438 502905009 288630989 208253663 214274020 200324078 231422874 36555775 36344545 605180203 682175251 38663872 41717353 21889 213556070 226356749 3581233 9641372 41575199 36205009 297376374 313942372 X 301394600 362492778 6106227 5437099 303002 303002 307803829 368232879 605180203 682175251 X 48581711 6180910 5666429 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 9418769 9418769 269950111 130161738 139788373 633404 270995 362409 206552005 158198256 48353749 16350720 16350720 214274020 DUE FROM MERITER FOUNDATION, INC. 6975223 OTHER LONG TERM ASSETS 3023195 INVESTMENTS IN JOINT VENTURES 25385731 LOAN RECEIVABLE NET OF CURRENT 960396 36344545 RETIREMENT LIABILITY 35364476 INSURANCE RESERVES 581000 ASSET RETIREMENT OBLIGATION 259533 36205009 X DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: 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, 2012 AND 2011, THE HOSPITAL DOES NOT HAVE A LIABILITY FOR UNRECOGNIZED TAX BENEFITS. 1 1 1 X 1 X 500.000000000000 1 1 0 1 1 19831 6837523 6837523 0.01960 25275 58321237 38553457 19767780 0.05680 1074 2474919 2036490 438429 0.00130 46180 67633679 40589947 27043732 0.07770 82 17723 829470 8988 820482 0.00240 54 3403 7791700 1387385 6404315 0.01840 4 3067 1703000 1703000 0.00490 0 122 12681 729168 12125 717043 0.00210 262 36874 11053338 1408498 9644840 0.02780 262 83054 78687017 41998445 36688572 0.10550 2 5535 5535 0.00000 16 3549 15770 15770 0.00000 1 1192 1192 0.00000 2 130 5682 5682 0.00000 6 71 34672 34672 0.00010 27 3750 62851 62851 0.00010 0 741613 0 73354354 75896131 -2541777 X 1 1 1 1 MERITER HOSPITAL INC

202 S PARK STREET MADISON WI 53715

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 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

2501 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, INC.; MERITER HOSPITAL, INC. 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, 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 $ 3276265. PART II: 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, TO THE 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 4: THE AUDITED FINANCIAL STATEMENTS CONTAIN A REFERENCE TO THE HOSPITAL'S BAD DEBT EXPENSE POLICY ON PAGES 16-17 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 COMMUNITY BENEFIT.THE COST OF SERVICES PROVIDED UNDER THE CHARITY CARE PROGRAM WAS CALCULATED USING A COST TO CHARGE RATION AS DEFINED BY THE WISCONSIN HOSPITAL ASSOCIATION (WHA) FOR THE ANNUAL COMMUNITY BENEFIT INVENTORY FOR SOCIAL ACCOUNTABILITY (CIBSA) STATEWIDE SURVEY. 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." 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. DIR., 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 ASSOCIATIONSHIVA BIDAR-SIELAFF, CO-CHAIR, LATINO HEALTH COUNCILTOM LUEDTKE, CORP EVENTS DIR., AMERICAN HEART ASSOCIATIONLANNIA 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, NEIGHBORHOOD SERVICES COORD, COMMUNITY DEVELOPMENT DIVISION, CITY OF MADISONJULIE WILLEMS VAN DIJK, RN, PH.D UW-MADISON, POPULATION HEALTH DEPT.SHARON MASON-BOERSMA, SOCIAL WORKER JOINING FORCES FOR FAMILIES-DANE COUNTYASTRA IHEUKUMERE, MAYORAL AIDE CITY OF MADISON, MAYOR'S OFFICELISETTE KHALIL, DEVELOPMENT DIR WISCONSIN WOMEN'S HEALTH FOUNDATIONHEDI RUDD, PROGRAM COORD URBAN LEAGUE OF GREATER MADISON, PROMISE ZONEJEFF BURKHART, EXEC DIR LITERACY NETWORK 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 5C: THE HOSPITAL CONDUCTED A PUBLIC LAUNCH OF A HEALTHDANE WEBSITE - IN ADDITION TO POSTING ON MERITER.COM 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 CONCERN AREAS 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 IN 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 HYPERTENSION). 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 UNIVERSITY OF WISCONSIN 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%) 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%.14 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 IN THE 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. REPORTS FILED WITH STATES PART VI, LINE 7 WI 1 MERITER FOUNDATION INC 202 S PARK STREET MADISON WI 537151596 237098688 501(C)(3) 48886 HOSPITAL PROGRAMS 1 0 HOSPITAL SCHOLARSHIPS 20 40000 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, 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 X X 1 1 0 0 0 0 1 1 0 JAMES WOODWARD 0 596623 0 161675 0 55923 0 16842 0 24324 0 855387 0 161675 CATE RANHEIM MD START 0312 0 208639 0 3000 0 2943 0 3072 0 1722 0 219376 0 0 SUSAN TOTH MD END 0212 0 433742 0 0 0 731 0 2895 0 31460 0 468828 0 0 LYNNE MYERS END 0412 0 214525 0 131742 0 158516 0 16128 0 9061 0 529972 0 89078 LINDA HOFF 0 335123 0 72923 0 44888 0 25762 0 11326 0 490022 0 0 KEVIN BOREN 0 207886 0 67478 0 17220 0 14173 0 17099 0 323856 0 0 GEOFFREY PRIEST MD 0 329342 0 110022 0 31379 0 23941 0 28289 0 522973 0 0 KERRA GUFFEY 0 267183 0 78889 0 27710 0 16611 0 17416 0 407809 0 0 TAMARA SAUNAITIS 0 262676 0 58500 0 3154 0 8906 0 18739 0 351975 0 0 SUE ERICKSON 0 207319 0 54213 0 23131 0 29225 0 16053 0 329941 0 0 PATRICIA GRUNWALD 0 240984 0 72154 0 30550 0 31644 0 16295 0 391627 0 0 LOUIS S BRYSH 198015 0 48501 0 27775 0 24054 0 19252 0 317597 0 0 0 WILLIAM J HERBERT 168516 0 31348 0 639 0 31498 0 17087 0 249088 0 0 0 DENISE M GOMEZ 148578 0 25870 0 169 0 13304 0 1205 0 189126 0 0 0 SHERRY L CASALI 144435 0 25663 0 253 0 22020 0 15275 0 207646 0 0 0 ROGER SLATTER END 1112 221299 0 51910 0 23604 0 14835 0 1538 0 313186 0 0 0 MARGO FRANCISCO 0 0 0 27888 0 127650 0 564 0 0 0 156102 0 0 ROBERT COATS 0 0 0 424778 0 89213 0 0 0 0 0 513991 0 424778 BARBARA PINEKENSTEIN 0 0 0 127773 0 16711 0 0 0 0 0 144484 0 127773 SUPPLEMENTAL INFORMATION PART III PART I, LINE 4A: SEVERANCE PAYMENTS: LYNNE MYERS - $89,708 MARGO FRANCISCO - $127,650 SUPPLEMENTAL INFORMATION PART III PART I, LINE 4B: SELECT INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN, NO PAYMENTS FROM THIS PLAN WERE RECEIVED IN 2012. SUPPLEMENTAL INFORMATION PART III 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 2008C 391337855 97710BBK7 2008-05-21 34940000 CURRENT REFUNDING OF 2006 SERIES C 0 0 0 B WISC HEALTH & EDUCATIONAL FACILITIES 2009 391337855 97710BKL5 2009-07-28 50000000 CONSTRUCT & EQUIP HOSPITAL FACILITIES 0 0 0 C WISC HEALTH & EDUCATIONAL FACILITIES 2011 391337855 97710BG71 2011-06-08 40000000 CONSTRUCT & EQUIP HOSPITAL FACILITIES 0 0 0 D WISC HEALTH & EDUCATIONAL FACILITIES 2012A 391337855 2012-08-09 19250000 REFUNDING 2008A REVENUE BOND 0 0 0 A 34940000 34940000 2009 1 0 1 1 B 50000000 3649677 1627314 44898623 2009 0 0 1 1 C 39633991 6088 556800 39083279 2011 0 0 0 1 D 19250000 2009 1 0 1 1 A 0 1 0 0 0 0 1 B 0 0 0 0 0 0 1 C 0 0 0 0 0 0 1 D 0 1 0 0 0 0 1 A 0 0 0 0 1 0 NA 0 0 0 NA 0 0 0 B 0 0 0 0 0 0 NA 0 0 0 NA 0 0 0 C 0 0 0 0 0 0 NA 0 0 0 NA 0 0 0 D 0 0 0 0 0 1 PIPER JAFFREY 0 0 0 NA 0 0 0 A 1 B 1 C 1 D 1 A WISC HEALTH & EDUCATIONAL FACILITIES 2012B 391337855 2012-08-09 25950000 REFUNDING 2008B REVENUE BOND 0 0 0 B WISC HEALTH & EDUCATIONAL FACILITIES 2012C 391337855 2012-08-09 20000000 CONSTRUCT & EQUIP HOSPITAL FACILITIES 0 0 0 A 25950000 2009 1 0 1 1 B 20000000 6744 6729385 13277359 0 0 0 1 A 0 1 0 0 0 0 1 B 0 1 0 0 0 0 1 A 0 0 0 0 1 1 PIPER JAFFREY 0 0 0 NA 0 0 0 B 0 0 0 0 0 0 NA 0 0 0 NA 0 0 0 A 1 B 1 RICHARD LYNCH BOARD MEMBER 9743092 CONSTRUCTION 0 DANIEL RASHKE BOARD MEMBER 50000 SERVICES PERFORMED BY TASC 0 NEW PROGRAM SERVICES FORM 990, PART III, LINE 2 IN 2012, MERITER CONTINUED TO MEET PATIENT NEEDS BY EXPANDING PRIMARY CARE COVERAGE AND ACCESS THROUGH THE OPENING OF TWO CLINICS IN FITCHBURG AND STOUGHTON. THE CLINICS ARE STAFFED BY FIVE FAMILY MEDICINE PHYSICIANS. MERITER ACQUIRED WISCONSIN HEART (INCLUDING ITS 14 PROVIDERS) IN AN EFFORT TO STRENGTHEN CARDIAC SERVICES THROUGHOUT SOUTH CENTRAL WISCONSIN, AND ALSO ADDED DERMATOLOGY, NEUROLOGY AND ALLERGY/IMMUNOLOGY DEPARTMENTS TO ITS GROWING LIST OF SPECIALTY SERVICES. MERITER HOSPITAL INVESTED IN A DAVINCI ROBOT, USED BY GENERAL SURGEONS, TO PERFORM LESS INVASIVE SURGERY WITH FASTER RECOVERY TIMES FOR ITS PATIENTS. FORM 990, PART VI, SECTION A, LINE 2 DAVE BOYER, GEORGE KAMPERSCHROER, LONDA DEWEY AND DANIEL RASHKE 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 2012 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. COMPENSATION FOR SUSAN TOTH, M.D. AND CATE RANHEIM, M.D. FORM 990, PART VII: THE COMPENSATION PAID TO SUSAN TOTH, M.D. AND CATE RANHEIM, M.D. REFLECT PAYMENT FOR THEIR SERVICES AS PHYSICIAN TO MERITER MEDICAL GROUP, INC., A RELATED ORGANIZATION, NOT REMUNERATION FOR THEIR PARTICIPATION ON THE BOARD OF TRUSTEES OF MERITER HOSPITAL OR MERITER HEALTH SERVICES. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: SWAP GAIN 385,798. MINIMUM PENSION AND UNRECOGNIZED RETIREE MED BENEFITS 4,653,813. ASSETS RELEASED FROM RESTRICTION 300,459. RELEASED FOR CAPITAL AND OTHER 1,056,118. TEMPORARY RESTRICTED TRANSFERS - FOUNDATION -90,000. NET ASSETS RELEASED FOR CAPITAL - FOUNDATION -50,132. OTHER -589,627. MERITER HEALTH SERVICES INC 202 SOUTH PARK STREET MADISON WI 537151596 391412318 PARENT OF MERITER ENTITIES - SUPPORT NONPROFIT SUBSIDIARIES WI 501(C)(3) LINE 11B, II 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 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 11B, II MERITER HOSPITAL INC 1 SHARED MAGNETIC RESONANCE IMAGING FACILITY INC 1104 JOHN NOLEN DRIVE MADISON WI 53713 391534744 MEDICAL TECHNOLOGY WI 501(C)(3) LINE 11A, I 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 INC 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 MERITER HOSPITAL INC C 48719 719391 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 0 0 0 0 0 1 0 1 1 0 0 1 0 0 1 MERITER MANAGEMENT SERVICES INC A 83408 FAIR VALUE MERITER FOUNDATION INC C 587378 COST MERITER MANAGEMENT SERVICES INC D 1244074 COST MERITER MEDICAL GROUP INC D 102815449 COST MERITER HEALTH ENTERPRISES INC J 1327979 FAIR VALUE MERITER MANAGEMENT SERVICES INC J 613044 FAIR VALUE MERITER FOUNDATION INC J 78372 FAIR VALUE MERITER FOUNDATION INC M 979999 FAIR VALUE MERITER HEALTH ENTERPRISES INC M 10607587 FAIR VALUE MERITER HEALTH SERVICES INC M 897794 FAIR VALUE MERITER MANAGEMENT SERVICES INC M 13719993 FAIR VALUE MERITER MEDICAL GROUP INC M 1347739 FAIR VALUE MERITER MEDICAL GROUP INC L 87403 FAIR VALUE PHYSICIANS PLUS INSURANCE INC P 62000 FAIR VALUE MERITER HEALTH ENTERPRISES INC L 1840718 FAIR VALUE MERITER FOUNDATION INC S 1419915 FAIR VALUE