ASPIRUS RIVERVIEW HOSPITAL & CLINICS INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
ASPIRUS RIVERVIEW HOSPITAL & CLINICS INC (EIN 39-0868982)
Tax period
2010-09-01 to 2011-08-31
Filed
2012-04-06
IRS object ID
201200979349300530
Schema version
2010v3.4
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-04-06T14:53:28-05:00Timestamp
Tax Period End Date2011-08-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1WIPFLI LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 8010AddressLine1
CityWAUSAUCity
StateWIState
ZIP Code544028010ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-09-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN390868982EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1RIVERVIEW HOSPITAL ASSOCIATIONBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlRIVENameControl
Phone7154217463Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1410 Dewey StreetAddressLine1
CityWisconsin RapidsCity
StateWIState
ZIP Code54494ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMICHAEL BOVEEName
TitleVice President - FinanceTitle
Phone7154217463Phone
Date Signed2012-03-30DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameKathleen J LaBrake CPAName
Phone7158453111Phone
Date Prepared2012-03-30DatePrepared
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMichael BoveeNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1410 Dewey StreetAddressLine1
CityWisconsin RapidsCity
StateWIState
ZIP Code54494ZIPCode
FieldValueIRS element (for citing)
Gross Receipts111492484GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.rhahealthcare.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1912YearFormation
State Legal DomicileWIStateLegalDomicile
Activity Or Mission DescriptionTo provide compassionate, affordable, state-of-the-art healthcare to our communities.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members14NbrIndependentVotingMembers
Total Nbr Employees729TotalNbrEmployees
Total Nbr Volunteers425TotalNbrVolunteers
Total Gross UBI823850TotalGrossUBI
Net Unrelated Business Txbl Income-589502NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year367457ContributionsGrantsPriorYear
Contributions Grants Current Year259801ContributionsGrantsCurrentYear
Program Service Revenue Prior Year81628202ProgramServiceRevenuePriorYear
Program Service Revenue CY85270022ProgramServiceRevenueCY
Investment Income Prior Year583453InvestmentIncomePriorYear
Investment Income Current Year3248255InvestmentIncomeCurrentYear
Other Revenue Prior Year-37821OtherRevenuePriorYear
Other Revenue Current Year25856OtherRevenueCurrentYear
Total Revenue Prior Year82541291TotalRevenuePriorYear
Total Revenue Current Year88803934TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year37461910SalariesEtcPriorYear
Salaries Etc Current Year40153677SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year38179095OtherExpensePriorYear
Other Expenses Current Year40417664OtherExpensesCurrentYear
Total Expenses Prior Year75641005TotalExpensesPriorYear
Total Expenses Current Year80571341TotalExpensesCurrentYear
Revenues Less Expenses Prior Year6900286RevenuesLessExpensesPriorYear
Revenues Less Expenses CY8232593RevenuesLessExpensesCY
Total Assets BOY172595461TotalAssetsBOY
Total Assets EOY186452276TotalAssetsEOY
Total Liabilities BOY56442716TotalLiabilitiesBOY
Total Liabilities EOY57524453TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY116152745NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY128927823NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTo provide compassionate, affordable, state-of-the-art healthcare to our communities.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense59149813Expense
Revenue83910216Revenue
DescriptionRiverview Hospital Association owns and operates the following entities: (1) Riverview Hospital, established in 1912; (2) the outpatient Riverview Rehabilitation Center; (3) Riverview Family Clinic - this service includes clinics in Wisconsin Rapids, Nekoosa, and the Rome-Lakes area; (4) the UW Cancer Center Riverview. UWCC-R opened in 2003 in cooperation with UW Comprehensive Cancer Center, Madison; and (5) Riverview Community Dental Clinic. RHA established this clinic in 2009 to serve residents of South Wood County. Riverview Dental Clinic in Wisconsin Rapids is open to patients who have Medicaid or Badger Care insurance coverage. This insurance is not typically accepted by independent dental clinics. Approximately 4,260 persons benefited from this program.Riverview Hospital Association provides community benefits programs and services that address identified community health needs regardless of source or availability of payment, and it provides measurable improvement in health access, health status, and the use of health care resources. In addition, the programs and services considered community benefits should meet one or more of the following criteria: *Supports the organization's community-based mission *Targets the problems of the poor or medically underserved *Impacts the health status of the identified community *Reduces community health costs *Is accessible to the entire target community regardless of their ability to pay *Stimulates external community partnershipsFONEMED is a free, confidential telephone service the community can call after the clinics are closed to get routine health advice or general health information from a Registered Nurse. Approximately 2,689 persons benefited from this program.Coalition Building: The Heatlhy People Wood County Obesity Prevention Team is focusing efforts on building environments and policies which can support healthy behavior change in terms of diet and exercise. Riverview's Health Promotion Coordinator also represents Riverview on the Safe Kids Coalition, working to prevent injury and death in children aged 0-14. The Health Promotion Coordinator represents Riverview on the 3-0 Day Committee (Our Bodies, Our Responsibilities). The Committee organizes a teen conference annually focusing on reducing at-risk behavior in junior and senior high students. Approximately 400 persons benefited from these coalitions.Riverview Dental Clinic in Wisconsin Rapids is open to patients who have Medicaid or Badger Care insurance coverage. This insurance is not typically accepted by independent dental clinics. Approximately 4,260 persons benefited from this program in 2011. Riverview Family Clinic physicians are helping educate area junior high students about sexual responsibility. Two physicians took part in several Wisconsin Rapids East Junior High School health classes, sharing information on the topics of sexually transmitted diseases, pregnancy, and pregnancy prevention. Prior to their visits each semester, the physicians share their presentation with the students' parents during a parent meeting and respond to any questions or concerns that may arise. The physicians' visits have been very well received and greatly appreciated by the students, parents, health class instructor and school administration. Approximately 200-250 students attended this program.The Lifeline program is a 24 hour a day personal response system. A Lifeline unit is installed in the "subscriber's" home and operates through their phone line. He/She wears a "personal help button", which they use to alert Lifeline simply by pressing the button. There is also an Auto Alert personal help button, which alerts Lifeline automatically if the subscriber falls. A Lifeline "Monitor" answers the call through the Lifeline unit and they call the subscriber's. After they determine what kind of help is needed, they call the subscriber's "responders", which are friends, neighbors, or relatives that can check on the subscriber, or if the subscriber needs more professional help the Monitor will call for it immediately. The Lifeline program helps people that would otherwise by unable to remain in their homes. It provides them with freedom and security to do so, while also putting their family at ease. Our program helps many people in Wisconsin Rapids and the surrounding area. This past year approximately 300 people benefited from the Lifeline program that Riverview Medical Center offers.Vulnerable people of all ages including the elderly can remain in their home and be self-sufficient by receiving a home delivered meal that meets their specific nutrition requirements. Health conditions or physical disabilities restrict the ability of individuals to remain independent. The Home Delivered Meals Program provides nutrition that is medically therapeutic to address the special needs of clients diagnosed with diabetes, cardiac and pulmonary issues, retinal disease, gluten intolerance, weight loss due to cancer and chewing and swallowing problems. The program also meets the needs of caretakers of the mentally and physically handicapped or Alzheimer's or other dementia disorders by providing meals to allow them to care for their loved ones. Nutrition education is also offered. Community volunteers deliver hot lunches Monday - Friday as well as brown bag meals for weekends. Food is prepared with consideration for each client's personal preferences as well as dietary restrictions. In 2011, 18,665 meals were delivered. 92% of them were modified to meet specific dietary needs. The Boys and Girls Club of Wisconsin of the Wisconsin Rapids Area will begin the planting of their Community Garden Thursday June 16 at 10:30 am. The Garden is part of the collaboration with Wood County Health Department, Riverview Hospital, and The Neighborhood Table. The Garden Project will be paired with a new morning breakfast program and summer food program. Crops will be utilized in both of these programs as well as part of the "Cooking Show from the Club Kitchen" and the "Gardening Show", both broadcast on local public access. Funding for the Garden was made possible by the US Department of Health and Human Services, Wisconsin Department of Health Services and the Wood County Health Department. Additional funding for the breakfast program and garden was provided by Riverview Hospital through the Champions for Healthy Kids grant form General Mills. Approximately 450 school age children benefited from the project.Description
Total Program Service Expense59149813TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming1Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization1BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109675NumberFormsTransmittedWith1096
Number W2 G Included1NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees729NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members14NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledWIStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1MICHAEL BOVEEBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number7154217462TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1410 DEWEY STAddressLine1
CityWI RAPIDSCity
StateWIState
ZIP Code54494ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (23 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
ROBB SIGLER
BOARD CHAIR - DEC 20112.00XX000
DOUGLAS WENZLAFF
BOARD VICE CHAIR - DEC 20131.00XX000
DAWN NEUMAN
TREASURER - OCT 20122.00XX000
JOHN CLARK MD
SECRETARY - OCT 20122.00XX000
STEVEN BELL
PAST BOARD CHAIR - DEC 20111.00X000
MERCEDES DE LAS ALAS MD
BOARD MEMBER - OCT 201241.00X391381054215
ROBERT BENKOWSKI
BOARD MEMBER - OCT 20121.00X000
COLLEEN DICKMAN
BOARD MEMBER - NOV 20131.00X000
ROY BRANDELL MD
BOARD MEMBER - DEC 20141.00X000
KALIN LAMP
BOARD MEMBER - NOV 20131.00X000
TIMOTHY MANCL
BOARD MEMBER - NOV 20131.00X000
DR MARJORIE MILLER
BOARD MEMBER - DEC 20141.00X000
GREGORY NETTESHEIM
BOARD MEMBER - DEC 20121.00X000
LAWRENCE LEIBERT MD
BOARD MEMBER - DEC 20121.00X000
MARY WOLOSEK
BOARD MEMBER - DEC 20111.00X000
CELSE BERARD
PRESIDENT40.00X434433046053
PEGGY OSE
V.P. - PATIENT SVCS40.00159210029410X
MIKE BOVEE
V.P. - FINANCE40.00182640027236X
RONNIE KIRSCHLING
PHYSICIAN40.001106918076278X
CRAIG FLINDERS
PHYSICIAN40.00401178050349X
THOMAS FERK
PHYSICIAN40.00450859058920X
CHESTON PRICE
PHYSICIAN40.00353359046503X
RICHARD CLASEN
PHYSICIAN40.00347533041427X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3827511TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation430391TotalOtherCompensation
Number Individuals GT100 K19NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
HMP OF WISCONSIN RAPIDS LTD
4535 DRESSLER ROAD NWCANTONOH44718HOSPITALISTS - MTHLY SUBSIDY & MGMT FEE944207
PARK & ASSOCIATES
3610 DEER ROADWISCONSIN RAPIDSWI54494LABORATORY SERVICES574450
INFINITY HEALTHCARE SC
111 E WISCONSIN AVENUE SUTIE 2100MILWAUKEEWI53202Emergency Room Physicians & Medical Dire445703
NATIIONAL WOUND CARE & HYPERBARIC
PO BOX 850001 DEPT 0775ORLANDOFL32885WOUND CARE & HYPERBARIC FEE394183
OMNI GLASS & PAINT
PO BOX 2186OSHKOSHWI54903REPLACING WINDOWS385560
FieldValueIRS element (for citing)
Number Of Contractors GT100 K19NumberOfContractorsGT100K
Fundraising Events52401FundraisingEvents
All Other Contributions207400AllOtherContributions
Total Contributions259801TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
PATIENT SERVICES9000998340565983405659
LAB SERVICE FOR NON PA621500823850823850
FOOD900099276855$276,855
INCOME RECEIVED FROM O900099259101$259,101
HEALTH RELATED PROGRAM900099237061237061

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column267496TotalRevenueColumn
Related Or Exempt Function Income267496RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue85270022TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column2062603TotalRevenueColumn
Exclusion$2,062,603ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real825622Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real811047Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real14575Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column14575TotalRevenueColumn
Exclusion$14,575ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities22958159Securities
Other86432Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities21829553Securities
Other29386Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities1128606Securities
Other57046Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column1185652TotalRevenueColumn
Exclusion$1,185,652ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events7284GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events52401CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses7284FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Gross Income Gaming22561GrossIncomeGaming
Gaming Direct Expenses11280GamingDirectExpenses

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column11281TotalRevenueColumn
Exclusion$11,281ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column88803934TotalRevenueColumn
Related Or Exempt Function Income83910216RelatedOrExemptFunctionIncome
Unrelated Business Revenue823850UnrelatedBusinessRevenue
Exclusion$3,810,067ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total878982Total
Management And General878982ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total29530985Total
Program Services25769083ProgramServices
Management And General3761902ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total885854Total
Program Services664390ProgramServices
Management And General221464ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total6758597Total
Program Services5068948ProgramServices
Management And General1689649ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2099259Total
Program Services1574444ProgramServices
Management And General524815ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total182281Total
Program Services97306ProgramServices
Management And General84975ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total55934Total
Management And General55934ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total250326Total
Management And General250326ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total6022660Total
Program Services5055158ProgramServices
Management And General967502ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total388196Total
Program Services325836ProgramServices
Management And General62360ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total1000416Total
Program Services614356ProgramServices
Management And General386060ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1511745Total
Program Services1506104ProgramServices
Management And General5641ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total93633Total
Program Services27988ProgramServices
Management And General65645ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total90896Total
Program Services27170ProgramServices
Management And General63726ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total2470752Total
Management And General2470752ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total6529046Total
Program Services497826ProgramServices
Management And General6031220ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total379940Total
Program Services108485ProgramServices
Management And General271455ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
SUPPLIES87955958594778200817
DRUGS4741644473035911285
OTHER31073416441302463211
BAD DEBT26539482653948
PROFESSIONAL FEES1417617786613631004

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total725694Total
Program Services402891ProgramServices
Management And General322803ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total80571341Total
Program Services59149813ProgramServices
Management And General21421528ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY10514926BOY
EOY6681930EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY13076058BOY
EOY21287584EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY14138848BOY
EOY13562309EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1722285BOY
EOY1825816EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY476064BOY
EOY441357EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis131166032LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec68101419LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY65839336BOY
EOY63064613EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY66160586BOY
EOY78841449EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY667358BOY
EOY747218EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY172595461BOY
EOY186452276EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY9565520BOY
EOY10934100EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY45365253BOY
EOY46590353EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1511943BOY
EOY0EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY56442716BOY
EOY57524453EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY115635468BOY
EOY128271971EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY517277BOY
EOY655852EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY116152745BOY
EOY128927823EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY172595461BOY
EOY186452276EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses8232593ReconcilationRevenueExpenses
Reconcilation Other Changes4542485ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$11,070OtherActivitiesAmount
Total Lobbying Expenditures IIB11070TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Explanation of Other Lobbying Activities:Part II-B, Line 1i:Percentage of AHA dues used for lobbying in 2011 - $5,110 Percentage of WHA dues used for lobbying in 2011 - $5,960
Part IV, Supplemental Information:Riverview Hospital Association is a member of the Wisconsin Hospital Association (WHA) and American Hospital Assocation (AHA). A portion of the dues paid to these organizations were utilized for lobbying activities. That amount is reported in part II-B.

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1843661OtherCostOrOtherBasis
Book Value1843661BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis65174247OtherCostOrOtherBasis
Depreciation18776197Depreciation
Book Value46398050BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis2068313OtherCostOrOtherBasis
Depreciation1510690Depreciation
Book Value557623BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis61851503OtherCostOrOtherBasis
Depreciation47814532Depreciation
Book Value14036971BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis228308OtherCostOrOtherBasis
Book Value228308BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings63064613TotalOfBookValueLandBuildings
Total Revenue88803934TotalRevenue
Total Expenses80571341TotalExpenses
Excess Or Deficit For Year8232593ExcessOrDeficitForYear
Net Unrealized GL On Investments3889863NetUnrealizedGLOnInvestments
Other$652,622OtherAmount
Total Adjustments4542485TotalAdjustments
Excess Or Deficit Per FS12775078ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt89307609TotRevenueEtcAuditedFinclStmt
Other Revenues811047OtherRevenues
Revenue Not Rptd F990811047RevenueNotRptdF990
Revenue Subtotal88496562RevenueSubtotal
Investment Expenses Not Included250326InvestmentExpensesNotIncluded
Other Revenues Not Included57046OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt307372RevenueNotRptdOnFinStmt
Total Revenue Per Form99088803934TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt81075016TotExpensesEtcAuditedFinclStmt
Other Expenses Included811047OtherExpensesIncluded
Expenses Not Rptd F990811047ExpensesNotRptdF990
Expenses Subtotal80263969ExpensesSubtotal
Investment Expenses Not Included2250326InvestmentExpensesNotIncluded2
Other Expenses Not Included57046OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt307372ExpensesNotRptdOnFinStmt
Total Expenses Per Form99080571341TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Description of Uncertain Tax Positions Under FIN 48:Part X:In order to account for any uncertain income tax positions, ASC Topic 740-10, Accounting for Uncertainty in Income Taxes, requires an organization to assess whether it is more likley than not that a tax position will be sustained upon examination of the technical merits of the position, assuming the tax 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 Association recorded no assets or liabilities for uncertain tax positions or unrecognized tax benefits in 2011 and 2010. Federal returns for years ended August 31, 2010, 2009 and 2008 remain subject to examination by the Internal Revenue Service.
Part XI, Line 8 - Other Adjustments:RECLASSIFICATION OF ACCUMULATED LOSS ON DESIGNATED CASHFLOW HEDGE 652,622.
Part XII, Line 2d - Other Adjustments:MEDICAL BUILDING RENT NET WITH REV 757,722. RENT EXPENSES NET WITH REV 53,325.
Part XII, Line 4b - Other Adjustments:GAIN ON DISPOSAL OF ASSETS 57,046.
Part XIII, Line 2d - Other Adjustments:MEDICAL BUILDING RENT NET WITH REV 757,722. RENT EXPENSES NET WITH REV 53,325.
Part XIII, Line 4b - Other Adjustments:GAIN ON DISPOSAL OF ASSETS 57,046.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1Love LightsNameOfEvent1
Gross Receipts Event141812GrossReceiptsEvent1
Charitable Contributions Event140746CharitableContributionsEvent1
Gross Revenue Event11066GrossRevenueEvent1
Other Direct Expenses Event11066OtherDirectExpensesEvent1
Name Of Event2Christmas at the RidgesNameOfEvent2
Gross Receipts Event217873GrossReceiptsEvent2
Charitable Contributions Event211655CharitableContributionsEvent2
Gross Revenue Event26218GrossRevenueEvent2
Other Direct Expenses Event26218OtherDirectExpensesEvent2
Gross Receipts Total59685GrossReceiptsTotal
Charitable Contributions Total52401CharitableContributionsTotal
Gross Revenue Total Events7284GrossRevenueTotalEvents
Other Direct Expenses Total Events7284OtherDirectExpensesTotalEvents
Direct Expense Summary Events7284DirectExpenseSummaryEvents
Net Income Summary0NetIncomeSummary

Gaming Information GamingInformation

FieldValueIRS element (for citing)
Gross Revenue Other Gaming22561GrossRevenueOtherGaming
Other Direct Expenses Other Gaming11280OtherDirectExpensesOtherGaming
Volunteer Labor Other Gaming1VolunteerLaborOtherGaming
Volunteer Labor Prcnt Other Gaming1.00000VolunteerLaborPrcntOtherGaming
Gross Revenue Total Gaming22561GrossRevenueTotalGaming
Other Direct Expenses Total Gaming11280OtherDirectExpensesTotalGaming
Direct Expense Summary Gaming11280DirectExpenseSummaryGaming
Net Gaming Income Summary11281NetGamingIncomeSummary
FieldValueIRS element (for citing)
States Where Gaming ConductedWIStatesWhereGamingConducted
Licensed1Licensed
License Suspended Etc0LicenseSuspendedEtc
Gaming With Nonmembers1GamingWithNonmembers
Member Of Other Entity0MemberOfOtherEntity
Percentage Of Gaming Own Facility1.00000PercentageOfGamingOwnFacility
Name Of Gaming Rec Keeper PersonDianne PokrandtNameOfGamingRecKeeperPerson

Address Of Gaming Rec Keeper US AddressOfGamingRecKeeperUS

FieldValueIRS element (for citing)
Address Line15849 Sarah CircleAddressLine1
CityWisconsin RapidsCity
StateWIState
ZIP Code54494ZIPCode
FieldValueIRS element (for citing)
Contract With3rd Party For Gam Rev0ContractWith3rdPartyForGamRev
Gaming Manager Name PersonElaine SemrowGamingManagerNamePerson
Gaming Manager Services ProvidedTreasurer of Auxiliary Fundraising EventsGamingManagerServicesProvided
Gaming Manager Is Director OfficerXGamingManagerIsDirectorOfficer
Charitable Distrib Required0CharitableDistribRequired

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense668955TotalCommunityBenefitExpense
Net Community Benefit Expense668955NetCommunityBenefitExpense
Percent Of Total Expense0.00860PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense14579669TotalCommunityBenefitExpense
Direct Offsetting Revenue12989230DirectOffsettingRevenue
Net Community Benefit Expense1590439NetCommunityBenefitExpense
Percent Of Total Expense0.02040PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense15248624TotalCommunityBenefitExpense
Direct Offsetting Revenue12989230DirectOffsettingRevenue
Net Community Benefit Expense2259394NetCommunityBenefitExpense
Percent Of Total Expense0.02900PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense46659TotalCommunityBenefitExpense
Net Community Benefit Expense46659NetCommunityBenefitExpense
Percent Of Total Expense0.00060PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense121897TotalCommunityBenefitExpense
Net Community Benefit Expense121897NetCommunityBenefitExpense
Percent Of Total Expense0.00160PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense397019TotalCommunityBenefitExpense
Direct Offsetting Revenue278689DirectOffsettingRevenue
Net Community Benefit Expense118330NetCommunityBenefitExpense
Percent Of Total Expense0.00150PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense54808TotalCommunityBenefitExpense
Direct Offsetting Revenue22583DirectOffsettingRevenue
Net Community Benefit Expense32225NetCommunityBenefitExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense620383TotalCommunityBenefitExpense
Direct Offsetting Revenue301272DirectOffsettingRevenue
Net Community Benefit Expense319111NetCommunityBenefitExpense
Percent Of Total Expense0.00410PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense15869007TotalCommunityBenefitExpense
Direct Offsetting Revenue13290502DirectOffsettingRevenue
Net Community Benefit Expense2578505NetCommunityBenefitExpense
Percent Of Total Expense0.03310PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$1,332,020BadDebtExpenseAmount
Amount Reimbursed By Medicare18108633AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare21557046CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-3448413MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1Riverview Hospital AssociationBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1410 Dewey StreetAddressLine1
CityWisconsin RapidsCity
StateWIState
ZIP Code54495ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1RIVERVIEW HOSPITAL ASSOCIATIONBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities5NumberOfOtherFacilities

Other Facilities OtherFacilities (5 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
UW Cancer Center Riverview
410 Dewey StreetWisconsin RapidsWI54495Cancer Center
Riverview Family Clinic Wisconsin Rapids
420 Dewey Street PO Box 8080Wisconsin RapidsWI54495Clinic
Riverview Family Clinic Nekoosa
1015 Angelus DriveNekossaWI54457Clinic
Riverview Family Clinic Lakes Area
1160 Rome Center Drive Town of RomeNekossaWI54457Clinic
Riverview Community Dental Clinic
820 Two Mile AvenueWisconsin RapidsWI54494Dental Clinic

Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
Part I, Line 7: Riverview Hospital utilizes a cost to charge ratio. All amounts in Part I, line 7f were reduced by the bad debt amount of $2,653,948.
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 $ 2653948.
Part II: Riverview Hospital Association collaborates with community partners to perform a needs assessment to drive the development of programs provided to the community. Initiatives include: Improving access to dental care, preventing obesity through policy development and environmental change, and reducing at-risk behavior in teens. The Association also offers low-cost lab screenings, childbirth education, cancer education, and Ask-a-Nurse assistance.
Part III, Line 4: Riverview Hospital applies cost to charge ratio to bad debt expense as reported on the financial statements. The carrying amounts of accounts receivable are reduced by allowances that reflect management's best estimate of the amounts that will not be collected. Management provides for uncollectible amounts under terms of third-party reimbursement agreements through a reduction of gross revenue and a credit to accounts receivable. In addition, management provides for probable uncollectible amounts, primarily from uninsured patients and amounts for which patients are personally responsible, through a charge to operations and a credit to a valuation allowance based on its assessment of historical collection likelihood and a current status of individual accounts. Balances that are still outstanding after management has used reasonable collection efforts are written off through a charge to the valuation allowance and a credit to accounts receivable.
Part III, Line 8: Amount of Medicare allowable costs was taken directly from the Medicare cost report.
Part III, Line 9b: For patients qualifying for financial assistance patients will only be billed if they have not provided current proof of eligibility, a spenddown has not been met or there is a private third party payor also on the patient's record.For patients qualifying for charity care, arrangements for reduced or free care are made with a financial counselor. Should the patient default on this arrangement, standard collection practices would apply.
Part VI, Line 2: RHA actively participates in Healthy People Wood County (HPWC). The purpose of HPWC is to establish priorities and recommend strategies to enhance the quality of life, health status, and the environment in Wood County. In order to accomplish this, multiple partners work together to analyze health data, quality of life indicators and the community's perception of health.
Part VI, Line 3: Community Care information is provided on both the website (riverviewhospital.net) and the back of the patient statement. Financial Counselors offer Community Care applications to patients whom they discover during conversations of attempting to establish payment plan arrangement would potentially meet the program qualifications.
Part VI, Line 4: Riverview Hospital Association owns and operates the following entities: (1) Riverview Hospital, established in 1912; (2) the outpatient Riverview Rehabilitation Center; (3) Riverview Family Clinic, This service includes clinics in Wisconsin Rapids, Nekoosa, and the Rome-Lakes area; (4) the UW Cancer Center Riverview. UWCC-R opened in 2003 in cooperation with UW Comprehensive Cancer Center, Madison; and (5) Riverview Community Dental Clinic. RHA established this clinic in 2009 to serve residents of South Wood County. Riverview Dental Clinic in Wisconsin Rapids is open to patients who have Medicaid or Badger Care insurance coverage. This insurance is not typically accepted by independent dental clinics. Approximately 4,260 persons benefited from this program.While many Riverview patients come from Wood County, an increasing number are coming to us from surrounding counties - specifically those along the Interstate 39 corridor: Marathon, Portage, Waupaca, Adams, Juneau, Waushara, Marquette, Columbia, Sauk, and Dane. For the Hospital, over 12.8% of all admissions between April 2010 and March 2011 came from the counties alongside this corridor. For the UW Cancer Center-Riverview over the same period, over 14% of all patients came from these same counties-not including our "home" county of Wood.In the Riverview "service area" there are several federally designated "medically underserved areas." They are Wood County (the central part between Marshfield and Wisc. Rapids), Portage County (part), Adams County (all), Waushara County (all), Marquette County (all), Juneau County (about half, the Northern half), Marathon County (part), and Clark County (all). We have scattered Indian tribal lands in Wood County, Juneau County, and Adams County (all Ho Chunk). These would be considered "medically underserved populations" per federal designation.Other hospitals in our service area include: St. Joseph's Hospital in Marshfield, St. Michael's Hospital in Stevens Point, Moundview Memorial Hospital in Friendship, and Hess Memorial Hospital in Mauston.
Part VI, Line 6: SEE ABOVE FOR ADDITIONAL DETAIL
WIReports Filed With StatesPart VI, Line 7

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Idemnification Gross Up PaymentsXIdemnificationGrossUpPayments
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
MERCEDES DE LAS ALAS MD
3027560715520170730324020218130445596000
CELSE BERARD
397757000366760295170165360480486000
PEGGY OSE
11890400040306084020210080188620000
MIKE BOVEE
17089400011746095690176670209876000
RONNIE KIRSCHLING
10727370003418105696301931501183196000
CRAIG FLINDERS
26916801054030266070332150171340451527000
THOMAS FERK
3135680133502037890387430201770509779000
CHESTON PRICE
2759920470660303010281890183140399862000
RICHARD CLASEN
308407000391260252760161510388960000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePart I, Line 4bReturnReference
ExplanationKirschling - $87,803 Ferk - $117,995 De las Alas - $113,504 Berard - $158,004 Price - $108,763Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
Wisconsin Health and Educational Facilities Authority
39133785597710V8S02008-04-1627266182Hospital addition000
Wisconsin Health and Educational Facilities Authority
39133785597710BZW52010-12-1620296089Refinance 2001 Bond000

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Total ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundIssuance Costs From ProceedsIssuanceCostsFromProceedsYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
27266182264899830493920090011
20296089166353831994820100011

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsPost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
00001
00001

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
000000
000000

Form990 Schedule K Part V Form990ScheduleKPartV

FieldValueIRS element (for citing)
Return Reference2010 CUSIP IDENTIFICATIONReturnReference
ExplanationTHE SERIES 2001 BONDS WERE REFIANCED IN 2010 AND EACH SEPERATE PRINCIPAL AMOUNT WAS ASSIGNED AN INDIVIDUAL CUSIP. THE CUSIPS RANGE FROM 97710BZW5 TO 97710BA93.Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name PersonWOOD TRUST BANKNamePerson
FieldValueIRS element (for citing)
RelationshipSTEVEN BELL IS A BOARD MEMBER AND OWNER OF WOOD TRUST BANKRelationship
Amount Of Transaction253807AmountOfTransaction
Description Of TransactionRIVERVIEW HOSPITAL PAID INVESTMENT MANAGEMENT FEES TO WOOD TRUST BANK.DescriptionOfTransaction
Sharing Of Revenues0SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
Form 990, Part VI, Section A, line 6Members are those community members who have purchased a membership to Riverview Hospital Association. These are life time memberships once purchased, and each year there is very minimal activity related to the purchase of a membership.
Form 990, Part VI, Section A, line 7aMembers of Riverview Hospital Association are able to nominate and vote candidates to the Board of Directors.
Form 990, Part VI, Section A, line 7bAt the annual meeting with the community members, the members vote whether or not they approve the actions of the board.
Form 990, Part VI, Section B, line 11A copy of the 990 is presented to the board at a monthly board meeting and is reviewed in detail with them. Any questions are then answered at that time. Once reviewed, it is then mailed/submitted.
The Board of Directors of the hospital annually re-sign their pledge to adhere to the conflict of interest policy here at Riverview Hospital Association (RHA). The signed attestations are filed and maintained by Gloria Costello, Administrative Secretary. In November of 2011, the Board of Directors named Lisa Rowe-Peplinski, Vice President - Quality Improvement to serve as RHA's Compliance Officer. Over the course of the next year additional education related to conflict of interest will be provided to management with signed agreement forms to be completed.Form 990, Part VI, Section B, line 12c
The following process describes Riverview Hospital Associations (RHA's) compensation practices: Each non-union and non-physician position is evaluated and assigned to a salary grade based on that evaluation. Evaluation criteria include a position's decision-making impact, thinking challenges, thinking problem solving challenges, work environment and entry qualifications. Each salary grade is assigned a pay range based on the market data for the positions in that salary grade. The entire salary range structure will be reviewed at least annually, and based on market data and the Association's budgetary goal's may be adjusted. Such adjustments will occur on or about the start of the Association's fiscal year. This policy covers all non-physicians and non-union positions within Riverview Hospital Association. In addition, salaries of the CEO, Key Employees, and Physicians are determined in conjunction with an independent compensation consultant and industry studies to determine the proper levels of compensation. These results are approved by the Compensation Committee before finalized. Physician compensation is usually based on market data and productivity via an RVU-based approach. Pay for employees in Riverview's three unions is determined via collective bargaining. All approvals are completed by individuals that do not have a conflict of interest with the transaction.Form 990, Part VI, Section B, line 15
Available upon request.Form 990, Part VI, Section C, line 19
Changes in Net Assets or Fund Balances:Net unrealized gains on investments: 3,889,863. RECLASSIFICATION OF ACCUMULATED LOSS ON DESIGNATED CASHFLOW HEDGE 652,622. Total to Form 990, Part XI, Line 5: 4,542,485.Form 990, Part XI, line 5:
The process is consistent with prior years.Form 990, Part XI, Line 2c

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1RIVERVIEW HEALTH CARE FOUNDATION INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 8080AddressLine1
CityWISCONSIN RAPIDSCity
StateWIState
ZIP Code544958080ZIPCode
FieldValueIRS element (for citing)
EIN391509239EIN
Primary ActivitiesTHE FOUNDATION IS OPERATED PRIMARILY FOR THE BENEFIT OF RIVERVIEW HOSPITALPrimaryActivities
Legal Domicile StateWILegalDomicileState
Exempt Code Section501 (C) 3ExemptCodeSection
Public Charity StatusLine 11c, III-FIPublicCharityStatus
Direct Controlling Entity NAN/ADirectControllingEntityNA
Controlled Org0ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

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