2012-08-14T15:06:49-05:00 2011-09-30 KPMG LLP 4200 WELLS FARGO CTR 90 S 7TH ST MINNEAPOLIS MN 55402 990 2010-10-01 390837206 LAKEVIEW MEDICAL CENTER INC OF RICE LAKE LAKE 7152341515 1700 west stout street RICE LAKE WI 54868 Jackie Klein 2012-08-13 6123055000 2010 2016-02-24 21:20:13Z EDWARD H WOLF 1700 west stout street RICE LAKE WI 54868 67501509 false X www.lakeviewmedical.com X 1919 WI Lakeview Medical Center serves the community by providing services intended to enhance the health of the people in the surrounding region. 11 6 525 214 0 0 121749 60701 59608642 66929460 483224 -250458 -21557 28011 60192058 66767714 0 0 0 0 28654289 31035869 0 0 0 25783132 29636505 54437421 60672374 5754637 6095340 104956226 128620549 37936383 35137164 67019843 93483385 X LAKEVIEW MEDICAL CENTER PROVIDES MEDICAL, SURGICAL, EMERGENCY, OUTPATIENT, DIALYSIS, AMBULANCE, HOSPICE, AND HOME HEALTH SERVICES. IT ALSO SERVES THE COMMUNITY BY PROVIDING SERVICES INTENDED TO ENHANCE THE HEALTH OF THE PEOPLE IN THE SURROUNDING REGION. true true 7800889 15457031 LAKEVIEW MEDICAL CENTER PROVIDES INPATIENT AND OUTPATIENT SURGICAL SERVICES FOR ORTHOPEDIC, UROLOGY, WOMEN'S HEALTH, ENT AND GENERAL SURGERY. FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2011 THERE WERE 3,697 SURGICAL CASES. 4876678 4660865 LAKEVIEW MEDICAL CENTER PROVIDES INPATIENT ROOM, BOARD AND CARE TO MEDICAL AND SURGICAL PATIENTS. FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2011 THIS UNIT HAD 2,413 DISCHARGES AND 6,857 PATIENT DAYS. 3397848 10991918 Lakeview Medical Center laboratory performs lab tests for inpatients and outpatients. On October 1, 2010, Lakeview consolidated its lab with Marshfield Clinic-Rice Lake Center and has assumed all lab operations for the Rice Lake campus. For the fiscal year ended September 30, 2011, there were 288,831 tests performed by the lab. 32630958 35819646 48706373 true true false false false false false false false false true false false false true false false true false false false false false false true false true true false false true false false false false false false false false false false false false false true false false false false true X 23 0 true 525 true false false false false false false false false false false X 11 6 false false false false true true true true true false false true true true true true true true true false WI X JACQUELINE KLEIN 7152366129 1700 W STOUT STREET RICE LAKE WI 54868 DR BRAD BEKKUM 1.0 X X 0 321502 47994 JAMES DORRANCE 1.0 X X 0 0 0 MARY BITZ 1.0 X 0 0 0 SANDY BONNEVILLE 1.0 X 0 0 0 PAUL CHASE 1.0 X 0 0 0 DAVID HILDEBRAND 1.0 X 0 0 0 SUE ZAHRBOCK 1.0 X 0 0 0 DR PETER NEAL 1.0 X 0 346537 51856 DR CHARLES T STEWART 1.0 X 0 543756 51566 DR LAURA NELSON 1.0 X 0 340983 49364 DAN DEGROOT 1.0 X 0 204422 36254 DR DOUGLAS REDING 1.0 X 0 581156 51676 DR PAUL LISS 1.0 X 0 402822 50456 JACQUELINE KLEIN 40.0 X 160981 0 26515 EDWARD WOLF 40.0 X 270884 0 38175 CYNTHIA ARTS-STRENKE 40.0 X 172571 0 27306 JAMES KIFFMEYER 40.0 X 124016 0 13039 WENDY BROMBEREK 40.0 X 118538 0 20980 DENNIS MOE 40.0 X 114619 0 15306 SHERRY JOHNSON 40.0 X 112995 0 8292 KEN ENGEL 40.0 X 135095 0 15839 1209699 2741178 504618 16 false true false Cerner Corporation PO Box 412702 KANSAS CITY MO 64141 Computer consulting 839670 The Revere Group 3266 Paysphere circle CHICAGO IL 60674 Computer consulting 363430 Aramark Management 22506 Network Place CHICAGO IL 606731225 Management services 378587 Quadramed Corporation PO 1915 MERRIFIED VA 221161915 Software support 348411 Aureus Radiology po box 3037 OMAHA NE 681030037 Contracted employees 130037 6 5700 18027 17196 19778 60701 NET PATIENT SERVICE REVENUE 624100 63846249 63846249 LEASING REVENUE 624100 2584538 2584538 LIFELINE PROGRAM 624100 139088 139088 OCCUPATIONAL/INDUSTRIAL HEALTH 624100 37971 37971 EMPLOYEE MEALS 624100 175078 175078 146536 75494 71042 66929460 237152 237152 0 0 50366 24205 26161 26161 26161 220740 708350 -487610 -487610 -487610 580 18027 451 129 129 2510 789 1721 1721 0 0 0 66767714 66683340 0 23673 0 0 0 0 731615 731615 0 22214371 19167792 3046579 2417124 2102776 314348 3825685 3298618 527067 1847074 1517542 329532 331509 331509 186126 186126 80372 80372 0 0 0 6421371 3034541 3386830 335949 335949 9634175 8956732 677443 0 0 3539652 1259364 2280288 131580 131580 0 0 225749 225749 0 6111056 6111056 151254 151254 PROVISION FOR BAD DEBTS 2065602 2065602 0 FOOD AND PROVISIONS 286257 286257 DUES AND SUBSCRIPTIONS 135853 66001 69852 60672374 48706373 11966001 0 2530 2230 42345712 27395340 8033403 9500266 666791 659098 366855 418694 105948529 16031590 52548557 89916939 992378 727982 104956226 128620549 5928616 4133030 500000 500000 30814091 30043170 693676 460964 37936383 35137164 X 66267615 93483385 752228 0 67019843 93483385 104956226 128620549 X 6095340 20368202 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 5255530 5255530 0 68238334 4083223 64155111 0 0 0 0 0 23379895 11595485 11784410 0 9074770 352882 8721888 89916939 0 DEFERRED COMPENSATION 460964 460964 FASB ASC 740 FOOTNOTE: Effective October 1, 2007, the organization adopted financial accounting standards board (FASB) accounting standards codification (ASC) 740, income taxes, which clarifies the accounting for uncertainty in income taxes recognized in a company's financial statements. ASC 740 prescribes a more-likely-than-not recognition threshold and measurement attribute for the financial statement recognition and measurement of a tax position taken or expected to be taken. Under ASC 740, tax positions will be evaluated for recognition, derecognition, and measurement using consistent criteria and will provide more information about the uncertainty in income tax assets and liabilities. Based on an analysis prepared by the organization, it was determined that the application of ASC 740 had no material effect on the organization at September 30, 2011. VOICES FOR HOSP 18607 18027 580 451 0 18607 18027 580 451 451 129 true true true X false false true false true true 499800 0 499800 0.00850 9463425 6855159 2608266 0.04450 0 0 0 0.00000 9963225 6855159 3108066 0.05300 378371 15620 362751 0.00620 22805 0 22805 0.00040 0 0 0 0.00000 0 0 0 0.00000 35364 0 35364 0.00060 436540 15620 420920 0.00720 10399765 6870779 3528986 0.06020 6881 6881 0.00010 2359 2359 0.00010 9240 9240 0.00020 true 967309 232154 15936500 19954432 -4017932 X true false 1 1 LAKEVIEW MEDICAL CENTER INC OF RICE LAKE

1700 W Stout Street RICE LAKE WI 54868

X X X LAKEVIEW MEDICAL CENTER INC OF RICE LAKE 1 false true true 200. false true X true true X X X X X true X X X true X X X X X X X true X false false Part I, Line 3C: Lakeview Medical Center, Inc. of Rice Lake uses the federal poverty guidelines at 200% to determine eligibility for providing free care as stated in line 3A. For self-pay individuals who don't qualify for free care per our policy, we offer a 6% discount (our highest commercial discount). We also offer an interest free payment plan, with the approval of the credit supervisor based on the patient's circumstances and ability to pay. The guidelines for the payment plan include: maximum of 60 months, level payments or a front-end-loaded arrangement (i.e., lower initial payments with a balloon payment is not acceptable) and a minimum of $25 per month (i.e., $5 per month on a $25 balance is not appropriate). Part I, Line 7, column F: The amount of bad debt expense that was removed from total expenses reported on Form 990, Part IX, line 25, was $2,065,602. The reduced total expense amount of $58,606,772 was used to calculate the percentages reported on Schedule H, Part I, Line 7, column F. Part I, Line 7: The costing method used on Form 990 is based on a cost to charge ratio which is developed based on the hospital's total operating expenses less the provision for bad debts divided by gross patient service revenues. This cost to charge ratio is applied against various revenue and expense categories to compute the estimated community benefit expense under IRS suggested costing methods for the Form 990. Part II: Community Building Activities Promoting the Health in the Communities Served Lakeview Medical Center joined with Barron County in the Barron County Community Health Improvement Process to identify local health concerns and address local health priorities linked to state and national priorities. The information gathered from this process was used to identify and prioritize community health issues and needs. Lakeview Medical Center has focused education efforts in the community based on this information. Lakeview Medical Center's specific efforts have focused on the programs "Be Well Barron County" which is an initiative to increase physical activity and decrease obesity rates of Barron County residents and the "Not on Tobacco" (NOT) program Lakeview sponsors, for supplying information to help kids already using tobacco to quit. Part III, Line 4: Management provides for probable uncollectible amounts, primarily uninsured patients and amounts patients are personally responsible for, through a charge to operations and a credit to a valuation allowance based on an assessment of historical collection likelihood and the current status of individual accounts. Balances that are still outstanding after the organization has used reasonable collection efforts are written off through a charge to the valuation allowance and a credit to accounts receivable. A number of patients are truly unable to pay their out-of-pocket liability, but do not complete the process required to apply for financial assistance under Lakeview's charity care policy even though Lakeview provides this information to them and assistance with the application. Without a completed application they are transferred to collection services and treated as bad debt expense. These patients would qualify for charity care if they completed the charity application, so the bad debt expense associated would treating them should be attributable to charity care and a community benefit. Part III, Line 8: The total Medicare revenue shown in Schedule H is based on the IRS 990 instructions and includes only a portion of the gross Medicare revenue of the organization and also does not consider all contractual adjustments for services reimbursed by the Medicare program. Amounts listed for Medicare revenues do not include lab and therapy services reimbursed on fee schedules at rates that are often below the costs of caring for patients. The costing method used for IRS compliance reporting is also based on the filed Medicare cost report for the year ended September 30, 2011, and does not consider Medicare non-allowable expenses, as it is based on total hospital patient service revenues (ignoring contractual adjustments on fee schedule reimbursed items and non-allowable medicare expenses as noted above). Whether there is a shortfall or surplus on services provided to Medicare beneficiaries, these people, which are typically elderly or disabled members of the community, are an underserved population who experience issues with access to healthcare services. Without tax-exempt hospitals providing Medicare patient services, the Centers for Medicare and Medicaid (CMS) would bear the burden of directly providing services to the elderly and disabled members of the community. Part III, Line 9b: Under the organization's collection and charity care policies, Lakeview Medical Center, Inc. of Rice Lake, makes every attempt to identify and promote charity care to patients. Included in the organization's charity care policy it is noted that patients may qualify for charity care either prior to admission or following discharge. All inpatient self-pay admissions are screened by the hospital's patient financial counselor or social workers to allow these patients the ability to get assistance with their application during their stay at the hospital. Depending upon the patient's condition, the patient or the patient's responsible party may be contacted to complete and return the forms at a later time when their care allows this completion. During the patient account collection process, self-pay patients are also informed of the hospital's collection policies as well as the charity care program to allow patients the opportunity to complete the appropriate forms and qualify under the program. The organization also publishes information regarding its charity care program on its website. A description of the charity care program is included in the "welcome" booklet that patients receive upon admission. NEEDS ASSESSMENT: LAKEVIEW MEDICAL CENTER, INC. OF RICE LAKE ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES AND AREAS IT SERVES BY REVIEWING LOCAL DEMOGRAPHICS AND TRENDS IN PATIENT SERVICE UTILIZATION TO DETERMINE WHICH SERVICES COULD AND SHOULD BE MADE AVAILABLE TO THE COMMUNITY IN A COST-EFFECTIVE MANNER. IN 2011, LAKEVIEW MEDICAL CENTER JOINED WITH BARRON COUNTY IN THE BARRON COUNTY COMMUNITY HEALTH IMPROVEMENT PROCESS (CHIPP) TO COLLECTIVELY IDENTIFY LOCAL HEALTH CONCERNS AND ADDRESS LOCAL HEALTH PRIORITIES LINKED TO STATE AND NATIONAL PRIORITIES. PARTNERS TO JOIN LAKEVIEW MEDICAL CENTER AND BARRON COUNTY PUBLIC HEALTH IN OUR COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND CHIPP PROCESS' ARE THE FOLLOWING ORGANIZATIONS: WISCONSIN DEPARTMENT OF HEALTH, MARSHFIELD CLINIC, MARSHFIELD CLINIC DENTAL CENTER, MAYO CLINIC HEALTH SYSTEMS, AND THE CUMBERLAND CLINIC AND HOSPITAL. OUR STEERING COMMITTEE MEMBERS HAVE SHOWN COMMITMENT DEDICATING FOUR HOURS PER MONTH TO MEET AND STRENGTHEN OUR PARTNERSHIPS AND DEVELOP A PLAN TO IMPROVE THE HEALTH OF BARRON COUNTY RESIDENTS. THE COMMITTEE HAS IDENTIFIED A NAME FOR THE INITIATIVE, THRIVE BARRON COUNTY (THRIVE BC), GROWING TOGETHER IN HEALTH. OUR MISSION: THRIVE BC WILL WORK TO ENGAGE COMMUNITY MEMBERS AND ORGANIZATIONS TO FOCUS RESOURCES AND DEVELOP AND STRENGTHEN PARTNERSHIPS TO ESTABLISH SUSTAINABLE, SAFE AND HEALTHY COMMUNITIES. OUR VISION: COMMUNITY MEMBERS AND ORGANIZATIONS WORKING TOGETHER TO IMPROVE THE QUALITY OF LIFE FOR EVERYONE IN BARRON COUNTY. TO MEET OUR VISION WE WILL MEET REGULARLY AND SYSTEMATICALLY COLLECT, ASSEMBLE, ANALYZE, AND MAKE AVAILABLE INFORMATION ON THE HEALTH OF THE COMMUNITY. OUR COALITION HAS COLLECTED SECONDARY DATA THROUGH BOTH AN ONLINE AND PAPER SURVEY CONCERNING DISEASE, DEATH, DISABILITY, INJURY AND COMMUNITY OPINIONS. THE SURVEY WAS TRANSLATED TO SOMALIAN AND SPANISH TO INCLUDE FEEDBACK FROM UNDERSERVED POPULATIONS IN THE COUNTY. ONE THOUSAND ONE HUNDRED AND THIRTEEN RESPONSES OUT OF THE COUNTY POPULATION OF 45,850 WERE COMPLETED. ALONG WITH THE SECONDARY DATA, THE COMMITTEE IS ANALYZING STATE AND NATIONAL DATA BASED ON THE 12 WISCONSIN HEALTH PRIORITIES. THIS DATA WILL BE PRESENTED TO COMMUNITY MEMBERS, LEADERS AND EXPERTS AT A SEPTEMBER 26, 2012 MEETING WHERE ATTENDEES WILL SELECT THE TOP THREE HEALTH PRIORITIES FOR BARRON COUNTY. FROM THESE PRIORITIES, LAKEVIEW MEDICAL CENTER WILL DEVELOP ITS COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP). LAKEVIEW MEDICAL CENTER'S CHIP WILL BE STRUCTURED TO ACCOMPLISH THE FOLLOWING: -INCREASE COMMUNITY AWARENESS -GENERATE COMMUNITY INNOVATIVE IDEAS -INTEGRATE ISOLATED EFFORTS, BUILD ON EXISTING SERVICES -CONSERVE RESOURCES, PREVENT DUPLICATION OF EFFORTS -IDENTIFY PRIORITY HEALTH PROBLEMS, FACTORS THAT CAN BE IMPACTED -DEVELOP COMPREHENSIVE STRATEGIES THAT WILL WORK IN OUR COMMUNITY -IMPLEMENT THE STRATEGIES AND MEASURE SUCCESS PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: UNINSURED AND UNDER INSURED PATIENTS ARE ASKED TO TALK WITH THE HOSPITAL'S PATIENT FINANCIAL COUNSELOR EITHER AT THE TIME SERVICE IS PROVIDED OR WHEN THE PATIENT'S BILL IS GENERATED. THE FINANCIAL COUNSELOR EXPLAINS THE VARIOUS PAYMENT OPTIONS AVAILABLE TO THE PATIENT AS WELL AS THE HOSPITAL'S CHARITY CARE PROGRAM AND OFFERS THE CHARITY CARE APPLICATION WHEN APPROPRIATE. IF OTHER PROGRAMS ARE AVAILABLE TO THE PATIENT, SUCH AS THE WISCONSIN MEDICAL ASSISTANCE OR BADGERCARE PROGRAMS, THESE PATIENTS ARE REFERRED TO THE APPROPRIATE GOVERNMENT AGENCY FOR FURTHER ASSISTANCE. COMMUNITY INFORMATION: THE PRIMARY SERVICE AREA FOR LAKEVIEW MEDICAL CENTER ENCOMPASSES ALL PERSONS LIVING WITHIN A 30 TO 40 MILE RADIUS OF THE HOSPITAL. SOME OF THE COMMUNITIES INCLUDED IN THIS AREA ARE RICE LAKE, CAMERON, BARRON, BIRCHWOOD, LADYSMITH, CUMBERLAND, CHETEK AND SPOONER, WISCONSIN, AMONG MANY OTHERS. THE HOSPITAL PROVIDES A SIGNIFICANT PORTION OF ITS PATIENT SERVICES TO BENEFICIARIES OF THE MEDICARE AND MEDICAL ASSISTANCE PROGRAMS. THESE MEDICARE AND MEDICAL ASSISTANCE PATIENTS ACCOUNTED FOR APPROXIMATELY 65% OF THE HOSPITAL'S GROSS PATIENT SERVICE REVENUE FOR THE YEAR. COMMUNITY BUILDING ACTIVITIES: THE SEXUAL ASSAULT NURSE EXAMINER (SANE) PROGRAM: THE SANE PROGRAM AT LAKEVIEW MEDICAL CENTER SUPPORTS COMMUNITY EFFORTS TO ADDRESS THE CRIME OF SEXUAL ASSAULT BY ESTABLISHING A PROCESS FOR ACCURATE EVIDENCE COLLECTION AND SUPPORT FOR SEXUAL ASSAULT SURVIVORS. NOT ON TOBACCO (NOT) PROGRAM: LAKEVIEW MEDICAL CENTER JOINED THE SAFE AND STABLE FAMILY COALITION AND LED THE EFFORT TO SECURE A GRANT FROM THE RICE LAKE AREA HEALTH FOUNDATION TO REDUCE THE TOBACCO USE IN THE GREATER RICE LAKE AREA. THROUGH THE GRANT THE NOT ON TOBACCO (NOT) PROGRAM WAS IMPLEMENTED IN BARRON HIGH SCHOOL AND THE RESTORATIVE JUSTICE PROGRAM ADOPTED THE NOT PROGRAM AS A SANCTIONED WORKSHOP FOR REHABILITATION. ALSO, DUE TO THE HIGH STATISTICS OF SMOKING DURING PREGNANCY, LAKEVIEW MEDICAL CENTER HAS IMPLEMENTED THE FIRST BREATH PROGRAM. LAKEVIEW MEDICAL CENTER HAS BEEN REWARDED MINI-GRANTS THROUGH THE SAFE AND STABLE FAMILY COALITION TO HELP INCENTIVE PARTICIPANTS IN THE PROGRAM. THE PREGNANCY HELP CENTER HAS PARTNERED WITH LAKEVIEW MEDICAL CENTER TO UTILIZE THIS FREE PROGRAM FOR THEIR CLIENTS. ANOTHER ALARMING STATISTIC SHOWS HIGH NUMBERS OF MOTHERS WHO QUIT SMOKING DURING PREGNANCY, BUT START SMOKING AFTER DELIVERY. WITH THIS HEALTH ISSUE, LAKEVIEW MEDICAL CENTER RECEIVED A GRANT TO IMPLEMENT A SMOKING CESSATION PROGRAM TARGETED TO THIS POPULATION. A SYSTEM HAS BEEN IMPLEMENTED TO CONNECT THE PATIENTS TO THIS PROGRAM. WORKSITE WELLNESS COMMITTEE: A WORKSITE WELLNESS COMMITTEE WAS FORMED AT LAKEVIEW MEDICAL CENTER TO SHARE BEST EVIDENCED - BASED PRACTICES FOR EMPLOYEE HEALTH IMPROVEMENTS WITH LOCAL EMPLOYERS. A COMMUNITY OUTREACH SERIES IS OFFERED WHICH BRINGS PHYSICIANS AND PATIENTS TOGETHER IN A CASUAL ENVIRONMENT TO ANSWER QUESTIONS ABOUT SPECIFIC HEALTH NEEDS. 50 PLUS 50 PLUS IS A FREE WELLNESS EVENT FOR THOSE OVER 50. THE EVENT OFFERS A VARIETY OF HEALTH SCREENINGS, COMMUNITY RESOURCES, EDUCATIONAL PRESENTATIONS AND ENTERTAINMENT. THIS EVENT IS COORDINATED BY A COALITION OF COMMUNITY AGENCIES LED BY LAKEVIEW MEDICAL CENTER. UNITED WAY MEMBER A HOSPITAL REPRESENTATIVE IS A MEMBER OF THE RICE LAKE UNITED WAY COALITION SERVING THE COMMUNITY BY ISSUING COMMUNITY IMPROVEMENT GRANTS. SHARPS CONTAINERS THE ORGANIZATION HAS A LONG STANDING COMMITMENT TO BEING ENVIRONMENTALLY SENSITIVE. THERE ARE MANY EXAMPLES OF HOW THIS IS DEMONSTRATED, ONE OF WHICH IS OUR PARTICIPATION IN THE SHARPS PROGRAM. THE HOSPITAL SERVES AS A DROP-OFF SITE FOR SHARPS, SUCH AS NEEDLES TO INJECT INSULIN. THIS PROVIDES THE OPPORTUNITY FOR COMMUNITY MEMBERS AND BUSINESSES TO DISPOSE OF THEIR USED HAZARDOUS MEDICAL SUPPLIES FREE OF CHARGE, KEEPING THEM OUT OF LANDFILLS. RICE LAKE FREE CLINIC THE HOSPITAL OFFERS FREE RADIOLOGY AND LAB SERVICES TO THE FREE CLINIC SERVING THE UNDERSERVED POPULATION IN THE AREA. PREVENT WITH INTENT PROGRAM THE PREVENT WITH INTENT PROGRAM IS A NEW WELLNESS PROGRAM OFFERED IN PARTNERSHIP WITH LAKEVIEW MEDICAL CENTER'S HEALTH PROMOTION TEAM AND THE RICE LAKE FREE CLINIC. THIS PROGRAM HAS BEEN GRANTED FUNDS FROM THE HEALTHIER RICE LAKE FOUNDATION. PRE AND POST SCREENINGS WILL BE OBTAINED TO SHOW OUTCOMES. OUR GOAL IS TO ASSESS THE EFFECTIVENESS OF A LIFESTYLE INTERVENTION PROGRAM (PREVENT WITH INTENT) DESIGNED TO TREAT THE METABOLIC SYNDROME IN A COMMUNITY SETTING PREVENT WITH INTENT IS A 12-WEEK PROGRAM THAT AIMS TO ASSIST PARTICIPANTS IN CREATING AN ACTION PLAN TO IMPLEMENT HEALTHY CHANGES IN THEIR LIVES AND PROVIDE THEM WITH THE TOOLS AND SUPPORT THEY NEED TO BE SUCCESSFUL. PROGRAM GOALS INCLUDE LOSING 7% OF THE PARTICIPANTS' CURRENT WEIGHT AND INCREASING PHYSICAL ACTIVITY LEVELS TO AT LEAST 150 MINUTES PER WEEK. THE PROGRAM WILL CONSIST OF FOUR BASIC COMPONENTS: 1. WEEKLY GROUP EDUCATIONAL SESSIONS 2. EXERCISE AT THE HEALTH AND WELLNESS CENTER (MEMBERSHIP INCLUDED AS PART OF THE PROGRAM) 3. LAKEVIEW MEDICAL CENTER FITNESS CLASSES 4. NUTRITIONAL CONSULTATIONS WITH A REGISTERED DIETITIAN LAKEVIEW MEDICAL CENTER WILL PROVIDE THE FOLLOWING: -DIETITIANS AND HEALTH PROMOTIONS STAFF FOR THE WEEKLY GROUP MEETINGS -LIFESTYLE COACH AVAILABLE TO PARTICIPANTS AT THE HEALTH AND WELLNESS CENTER FIVE DAYS A WEEK -HEALTH AND WELLNESS CENTER MEMBERSHIP FOR ALL PARTICIPANTS FOR THE DURATION OF THE PROGRAM -PARTICIPANT MATERIALS -INCENTIVES FOR PARTICIPANTS BASED ON ATTENDANCE AND GOAL ACCOMPLISHMENT THE LAKEVIEW MEDICAL CENTER PROMOTIONS DEPARTMENT'S INTENTION IS TO BUILD A SUSTAINABLE PROGRAM FOR OUR COMMUNITY THAT IS IN ALIGNMENT WITH ONE OF THE TOP HEALTH CONCERNS IDENTIFIED BY THE COMMUNITY HEALTH IMPROVEMENT PLANS AND PROCESSES (CHIPP) OF BARRON COUNTY: OBESITY, NUTRITION AND PHYSICAL ACTIVITY. THE OUTCOMES OBTAINED WILL BE SHARED WITH LOCAL CIVIC GROUPS AND OTHER COMMUNITY ORGANIZATIONS TO SHARE THE PROGRAM'S SUCCESSES AND LAKEVIEW MEDICAL CENTER'S COMMITMENT TO THE HEALTH OF OUR COMMUNITIES. PREVENT WITH INTENT PILOT PROGRAM OUTCOMES: -ALL PARTICIPANTS AVERAGED 2 OR MORE VISITS TO THE HEALTH AND WELLNESS CENTER PER WEEK PLUS ADDITIONAL ACTIVITY AT HOME -PARTICIPANTS LOST AN AVERAGE OF 6.5% OF THEIR WEIGHT IN 12 WEEKS. -ALL BUT ONE PARTICIPANT LOST WEIGHT -SIX OUT OF TEN (60%) OF PARTICIPANTS REACHED THEIR WEIGHT LOSS GOAL OF 7% OF THEIR BODY WEIGHT AND ACTIVITY GOAL OF 150 MINUTES PER WEEK -ALL PARTICIPANTS INCREASED THEIR PHYSICAL ACTIVITY LEVELS TO AN AVERAGE OF 150 MINUTES PER WEEK -80% LOWERED THEIR BLOOD PRESSURE. ONE AVOIDED BLOOD PRESSURE MEDICATIONS DUE TO HER WEIGHT LOSS AND DECREASED BLOOD PRESSURE. -PARTICIPANTS DECREASED ABDOMINAL GIRTH BY AN AVERAGE OF 3.6 INCHES PRE AND POST SURVEY RESULTS: -PRE: 62% OF PARTICIPANTS RATED THEIR HEALTH AS FAIR OR POOR. POST: 80% OF PARTICIPANTS RATED THEIR HEALTH AS GOOD/VERY GOOD -PRE: 15% OF PARTICIPANTS FELT THEIR HEALTH WAS GOOD 28 OR MORE OF 30 DAYS. POST: 60% FELT THEIR HEALTH WAS GOOD 28 OR MORE DAYS OUT OF 30 DAYS -INCREASED AVERAGE FRUIT AND VEGETABLE CONSUMPTIONS FROM 1.7 SERVINGS PER DAY TO 3.6 SERVINGS PER DAY -INCREASED AVERAGE WATER INTAKE FROM 4 GLASSES PER DAY TO 6 GLASSES -30% OF PARTICIPANTS DECREASED SCREEN TIME; 40% ARE UNDER THE RECOMMENDED LIMIT OF 2 HOURS PER DAY COMPARED TO 15% BEFORE PROGRAM -ALL PARTICIPANTS ARE AVERAGING 150 MINUTES OR MORE OF PHYSICAL ACTIVITY COMPARED TO LESS THAN ONE HOUR PER WEEK BEFORE THE PROGRAM HEALTH AND WELLNESS CENTER THE HEALTH AND WELLNESS CENTER IS THE ONLY ONE IN THE AREA OFFERING COMMUNITY MEMBERS THE OPPORTUNITY TO EXERCISE WHILE BEING SUPERVISED BY MEDICALLY TRAINED STAFF. ATHLETIC TRAINER LAKEVIEW MEDICAL CENTER OFFERED AN ATHLETIC TRAINER TO STUDENT ATHLETES FREE OF CHARGE TO MINIMIZE INJURIES AND EXPEDITE HEALING. RADIOLOGY STUDENT EDUCATION AND WITC NURSING ORIENTATION LAKEVIEW MEDICAL CENTER IS COMMITTED TO SUPPORT THE TRAINING OF FUTURE MEDICAL PROFESSIONALS TO IMPACT PROJECTED MEDICAL STAFF SHORTFALLS. WORKSITE WEIGHT LOSS CHALLENGE IN LIGHT OF RISING OBESITY ISSUES IN THE COUNTY THIS PROGRAM WAS DEVELOPED. 350 PARTICIPANTS FROM 20 AREA BUSINESSES LOST A TOTAL OF 3,241 POUNDS DURING THIS 12 - WEEK CHALLENGE. THROUGHOUT THE 12 WEEKS, FITNESS CLASSES AND NUTRITIONAL EDUCATION WAS OFFERED FREE OF CHARGE OR AT A NOMINAL FEE. OTHER INFORMATION: LAKEVIEW MEDICAL CENTER INC. OF RICE LAKE PROVIDES SIGNIFICANT CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS. IN ADDITION, THE ORGANIZATION BELIEVES THAT IT PROVIDES A CRITICALLY IMPORTANT BENEFIT WHICH IS NOT QUANTIFIED. LAKEVIEW MEDICAL CENTER, LIKE MOST COMMUNITY HOSPITALS, WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE CARE LOCALLY WHICH WITHOUT THE HOSPITAL, WOULD NOT BE AVAILABLE LOCALLY. BEYOND INPATIENT HOSPITALIZATIONS, THE HOSPITAL PROVIDES LOCAL ACCESS TO MANY SERVICES INCLUDING: BIRTHING CENTER, DIAGNOSTICS, EMERGENCY SERVICES, HOSPICE, HOME CARE, DIALYSIS, INFUSION SERVICES, HEALTH AND WELLNESS SERVICES, LABORATORY SERVICES, OCCUPATIONAL HEALTH, REHABILITATION SERVICES, SLEEP CENTER, SPEECH PATHOLOGY, SURGICAL SERVICES AND WOMENS' SERVICES, TO NAME SOME OF THE MAJOR SERVICES PROVIDED. LAKEVIEW MEDICAL CENTER IS GOVERNED BY AN ELEVEN MEMBER BOARD OF DIRECTORS, INCLUDING SIX COMMUNITY MEMBERS. AFFILIATED HEALTH CARE SYSTEM ROLES: MARSHFIELD CLINIC IS THE SOLE CORPORATE MEMBER OF LAKEVIEW MEDICAL CENTER. MARSHFIELD CLINIC IS A MULTI-SPECIALTY PHYSICIAN AND HEALTHCARE ORGANIZATION COMPRISED OF OVER 40 SITES, INCLUDING A SITE IN RICE LAKE, WISCONSIN. THE INTEGRATION OF LAKEVIEW MEDICAL CENTER AND MARSHFIELD CLINIC HAS ENHANCED THE ACCESS AND QUALITY OF HEALTH CARE THROUGHOUT RICE LAKE AND THE SURROUNDING COMMUNITIES WHILE ACHIEVING ECONOMIC EFFICIENCIES. ALL STATES WHICH ORGANIZATION FILES A COMMUNITY BENEFIT REPORT: WI X X false false false false false false false false false DR BRAD BEKKUM 0 290676 0 29660 0 1166 0 30728 0 17266 0 369496 0 0 DR PETER NEAL 0 327019 0 0 0 19518 0 30729 0 21127 0 398393 0 0 DR CHARLES T STEWART 0 543126 0 0 0 630 0 30729 0 20837 0 595322 0 0 DR LAURA NELSON 0 323607 0 0 0 17376 0 30728 0 18636 0 390347 0 0 DAN DEGROOT 0 203110 0 100 0 1212 0 27977 0 8277 0 240676 0 0 DR DOUGLAS REDING 0 573604 0 5500 0 2052 0 30729 0 20947 0 632832 0 0 DR PAUL LISS 0 399830 0 0 0 2992 0 30728 0 19728 0 453278 0 0 JACQUELINE KLEIN 144038 101 0 16842 0 11825 0 14690 0 187496 0 0 0 EDWARD WOLF 230138 0 101 0 40645 0 16352 0 21823 0 309059 0 0 0 CYNTHIA ARTS-STRENKE 153001 101 0 19469 0 12616 0 14690 0 199877 0 0 0 KEN ENGEL 116233 101 0 18761 0 9804 0 6036 0 150935 0 0 0 Supplemental Information to Form 990 PART III, LINE 2 On October 1, 2010, Lakeview Medical Center and Marshfield Clinic consolidated laboratory services with Lakeview overseeing the revenue and billing functions. This resulted in a significant change in the Lakeview Medical Center laboratory financial performance. PART III, LINE 3 On September 30, 2011, Lakeview Medical Center closed its satellite hemodialysis unit located in Spooner, Wisconsin and consolidated the service at its main campus in Rice Lake. PART III, LINE 4D - OTHER PROGRAM SERVICES The other program services of Lakeview Medical Center include Imaging, Women's Health inpatient and outpatient care and all indirect expenses associated with furthering the exempt purpose. PART VI, SECTION A, LINE 6 Marshfield Clinic is the sole corporate member of Lakeview Medical Center. PART VI, SECTION A, LINE 7A Marshfield Clinic is the sole corporate member of Lakeview Medical Center and has the authority to elect board members. PART VI, SECTION A, LINE 7B Marshfield Clinic is the sole corporate member of Lakeview Medical Center and the decisions of the governing body are subject to the approval of Marshfield Clinic. PART VI, SECTION B, LINE 11 The Form 990 is prepared by the Finance department, then reviewed by KPMG LLP. The completed 990, including required schedules is emailed to and reviewed by the board members before filing. PART VI, SECTION B, LINE 12 On an annual basis, board members, top management, and employees who have contact with suppliers sign a statement acknowledging their understanding and adherence to the conflict of interest policy. In addition to the requirement of an annual completed disclosure form, it is the continuing responsibility of the disclosing individuals to scrutinize their transactions and outside business interests and relationships for potential conflicts of interest and to immediately make such disclosures. The individuals required to complete the disclosure form include: board members, administration (CAO, COO and CFO), and managers of materials management, information technology, lab, imaging, community relations/marketing and plant operations. PART VI, SECTION B, LINES 15A AND 15B The board of directors determines and approves the CAO's salary based on survey's comparability data and an outside consulting firm has been used at times. Salaries of other management employees are based on market surveys analyzed by the human resources department and approved by the administrative team and/or the CAO. PART VI, SECTION C, LINE 19 The organization's governing documents, conflict of interest policy and financial statements are available upon request. PART XI, LINE 5 Marshfield Clinic paid for a portion ($23,945,201) of Lakeview Medical Center's new hospital building and transferred those assets to Lakeview Medical Center within the fiscal year. Lakeview Medical Center provided a cash distribution of $3,577,000 to Marshfield Clinic. Marshfield Clinic 1000 North Oak Avenue Marshfield WI 54449 390452970 Medical Care WI 501(C)(3) 3 NA Volunteer Partners of Lakeview Medical C 1700 West Stout Steet Rice Lake WI 54868 391329084 Support Org. WI 501(C)(3) 11, iii-o NA Security Health Plan of Wisconsin Inc 1515 N St Josephs Ave Marshfield WI 54449 391572880 HMO WI 501(C)(4) N/A NA The Heritage Foundation 1000 N Oak Ave Marshfield WI 54449 391865942 Honor Individ WI 501(C)(3) 11-Type 1 NA Flambeau Hospital Inc 98 Sherry Ave Park Falls WI 54552 390973724 Hospital WI 501(C)(3) 3 NA Marshfield Food Safety 201056380 Food Testing WI NA RELATED 0 0 false false Diagnostic Treatment Ctr 200691634 Medical Svcs WI NA RELATED 0 0 false false false false false false false true true false true true false false false false true true true true