2012-05-14T16:46:06-07:00 2011-09-30 990 2010-10-01 391091432 REEDSBURG AREA MEDICAL CENTER REED 6085246487 2000 North Dewey Avenue Reedsburg WI 53959 Robert Van Meeteren 6085246487 2012-05-15 2010 2016-02-24 21:20:13Z Robert Van Meeteren 2000 N Dewey Avenue Reedsburg WI 53959 44999199 0 X www.ramchealth.com X 1976 WI Reedsburg Area Medical Center (RAMC) is a non-profit, non-stock corporation which exists for the benefit of the people of Reedsburg and surrounding areas. RAMC's mission is to provide quality, compassionate and effective health care by going beyond the expected in all we do. Our main function is to provide primary care services consisting of, but not limited to, acute care, obstetrics, urgent/emergency care, diagnostic services, rehabilitation, surgical services, community outreach and wellness. Diversification and expansion of services are considered in response to the needs of those we serve. RAMC provides significant charity care and other community benefits as defined by the IRS. But in addition, we believe that we provide a critically important community benefit which is not quantified. Our hospital, like most rural hospitals, was created and is maintained in order to provide care locally - care that without our hospital, would not be available locally. 11 11 534 200 0 0 67675 628549 40332914 41990137 361360 597115 1259338 1416721 42021287 44632522 482931 486102 0 0 22002955 24088105 0 0 76896 17553020 18496162 40038906 43070369 1982381 1562153 61451815 60753708 29731122 28366482 31720693 32387226 X Reedsburg Area Medical Center (RAMC) is a non-profit, non-stock corporation which exists for the benefit of the people of Reedsburg and surrounding areas. RAMC's mission is to provide quality, compassionate and effective health care by going beyond the expected in all we do. Our main function is to provide primary care services consisting of, but not limited to, acute care, obstetrics, urgent/emergency care, diagnostic services, rehabilitation, surgical services, community outreach and wellness. Diversification and expansion of services are considered in response to the needs of those we serve. RAMC provides significant charity care and other community benefits as defined by the IRS. But in addition, we believe that we provide a critically important community benefit which is not quantified. Our hospital, like most rural hospitals, was created and is maintained in order to provide care locally - care that without our hospital, would not be available locally. 0 1 3112974 0 7301958 Inpatient services include MultiCare (medical/surgical), Obstetrics/Nursery and Intensive Care units at Reedsburg Area Medical Center. Within these units, RAMC provided short-term care for 4,899 patient days (1,487 discharged patients) during the fiscal year ending 9/30/2011. This included 393 Medicare Swing Bed days for 67 patients, 821 observations and 289 births. 2771219 0 16273734 RAMC's Urgent Care and Emergency Care is here for our community whenever they need us. Urgent Care has hours of availability for minor medical needs seven days a week and the Emergency Room is open and physician staffed 24 hours a day, seven days a week. A multi-disciplinary team of skilled professionals, along with up-to-date diagnostic technology, are available 24 hours a day. The staff at RAMC is here to meet patients' physical, social, educational, emotional and spiritual needs. In the fiscal year ending 9/30/2011, 9,148 patients were seen in the Emergency Room (resulting in 1,171 inpatient admissions) and 4,356 visited Urgent Care. 2693702 0 8179958 In our commitment to providing high-quality, effective, local healthcare, RAMC has made several updates to our Radiology department. The most recent is a new Light Speed 64 Slice CT Scanner. This advanced diagnostic system helps physicians reach confident diagnoses and provide a higher level of patient care. It enables the lowering of radiation doses (up to 40%) while maintaining high quality images throughout the body. It also allows for a new offering of cardiac testing at RAMC. It can non-invasively detect fatty or calcium deposits in the coronary arteries that can lead to damage of the heart muscle. A total of 27,313 procedures (2,902 inpatient; 24,411 outpatient) were performed by our Radiology department, including ultrasounds, CT scans, nuclear medicine, mammograms, x-ray, PET CT scans, in-house MRI and bone density tests. 27775520 486103 10234487 RAMC is committed to providing a wide range of high quality and up-to-date services. Additional services available at RAMC include, but are not limited to, laboratory services, rehabilitation, sleep medicine, occupational medicine, surgical services, consulting, massage therapy, orthopedics, parish nursing, chemotherapy, volunteer services, community outreach and wellness. 27775520 486103 10234487 36353415 1 1 0 0 0 0 0 0 0 1 1 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 63 0 1 534 1 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X X Joseph Svetlik 6085246487 2000 North Dewey Ave Reedsburg WI 53959 Winthrup Byers 0 X 2250 0 0 Janice Gerlach 0 X 1800 0 0 Jeff Steel 0 X 1650 0 0 Phyllis Irish 0 X 2450 0 0 Deanna Benish MD 0 X 2420 0 0 Katherine Campbell 0 X 1350 0 0 Eric Molberg 0 X 1450 0 0 James Sebranek 0 X 2250 0 0 Christopher Wenninger MD 0 X 10793 0 0 Kurt Muchow 0 X 1300 0 0 Eric Sauey 0 X 1350 0 0 Robert Van Meeteren 40 X 176056 0 21004 Joseph Svetlik 40 X 145066 0 44952 Dale Turner 40 X 114644 0 31720 Dennis Schommer 28 X 94211 0 30012 Beverly Hoege 40 X 134004 0 23541 Carla Mercer 40 X 96101 0 21245 Gerry Chrabaszcz 40 X 282733 0 21321 Christopher Bjorklund 40 X 267386 0 21736 Eric Newgent MD 40 X 262273 0 21736 Kenneth Olson 40 X 247738 0 21321 Kevin McBride 40 X 247318 0 21736 George Johnson 0 X 183895 0 0 2280488 0 280324 15 1 1 0 Dean Health Plan PO Box 684119 Milwaukee WI 532684119 Health insurance provider 2188147 Acute Care PO Box 4130 Des Moines IA 50333 ER Physicians 1578684 Shared Imaging PO Box 45686 Madison WI 537445686 Radiology/Imaging Services 1021545 Reedsburg Physicians Group 1900 North Dewey Avenue Suite A Reedsburg WI 53959 Physician services 468921 CPSI 6600 Wall Street Mobile AL 36695 Computer Software Support Services 467273 15 0 0 0 0 446554 181995 750 628549 Medicare 622110 13976518 13976518 0 0 Dean Health 622110 6923904 6923904 0 0 Blue Cross 622110 4535443 4535443 0 0 Medicaid 622110 3890899 3890899 0 0 Alliance 622110 3587200 3587200 0 0 9076173 9076173 0 0 41990137 699722 699722 0 0 41314 41314 0 0 0 0 0 0 474984 0 0 0 474984 0 474984 474984 0 0 0 222756 0 366677 0 -143921 -143921 -143921 0 0 0 Cafeteria/Meals Revenue 722310 780672 780672 0 0 Gain on repurchase of bonds 622110 169688 169688 0 0 -8623 -8623 0 0 941737 44632522 44003973 0 0 415080 415080 71022 71022 0 0 0 0 1126663 0 1092952 33711 21066 0 21066 0 16606123 16266435 309893 29795 665065 649714 13861 1490 4449718 4381016 60042 8660 1219470 1165748 50482 3240 0 0 0 0 60112 0 60112 0 28275 0 28275 0 0 0 0 0 0 0 0 0 0 0 3030198 3030198 0 0 239682 239682 0 0 6733239 6733239 0 0 312049 312049 0 0 0 0 0 0 631534 0 631534 0 49676 49676 0 0 0 0 0 0 92150 92150 0 0 1203723 0 1203723 0 0 0 0 0 2369929 0 2369929 0 225657 0 225657 0 Professional Fees 1918875 1918875 0 0 Bad Debts 572532 0 572532 0 Food Expense 441739 441739 0 0 Dues/Licenses/Assessments 427519 427519 0 0 Patient/Community Education 8385 8385 0 0 150888 150888 0 0 43070369 36353415 6640058 76896 0 0 9429807 4797049 0 0 6196269 7037035 0 0 0 0 79426 100000 1683752 1550573 1762564 1686712 50076408 20528957 30548030 29547451 8353318 10947773 0 0 2206942 4000129 0 0 1191707 1086986 61451815 60753708 5118167 4783363 0 0 897706 983574 22875406 21068564 0 0 0 0 839843 1530981 0 0 0 29731122 28366482 X 30543940 31315193 1176753 1072033 0 0 31720693 32387226 61451815 60753708 X 1562153 -895620 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1800000 -111316 0 0 0 1688684 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 26703 26703 0 36226417 12422793 23803624 0 0 0 0 0 12873819 7760963 5112856 0 949469 345201 604268 29547451 Student Loans 36986 C Bond Funds 3963143 C 4000129 44632522 43070369 1562153 -895620 0 0 0 0 -895620 666533 44632522 0 0 0 0 0 44632522 0 0 0 44632522 43070369 0 0 0 0 0 43070369 0 0 0 43070369 SchD_P05_S00_L04 Schedule D, Part V, Line 4 Monies held in this fund are restricted to future capital purchases as approved by the Board of Directors. 1 1 1 X 1 X 1 1 0 1 1 958698 0 958698 0.0226 6410868 3890899 2519969 0.0593 0 0 7369566 3890899 3478667 0.0819 21475 230018 960 229058 0.0054 71 85574 0 85574 0.002 300 728643 269402 459241 0.0108 2191 434557 0 434557 0.0102 0 24037 1478792 270362 1208430 0.0284 0 24037 8848358 4161261 4687097 0.1103 500 1300 0 1300 0.00 200 16568 0 16568 0.0004 24159 0 24159 0.0006 408 9384 0 9384 0.0002 0 1108 51411 0 51411 0.0012 1 323881 0 12303835 13026527 -722692 X 1 1 1 1 Reedsburg Area Medical Center

2000 North Dewey Avenue Reedsburg WI 53959

X X X X Reedsburg Area Medical Center 1 1 1 150 1 400 1 X X X X 1 1 X 1 1 X X X X 1 X 0 1 SchH_P01_S00_L07 Schedule H, Part I, Line 7 RAMC used a cost-to-charge ratio of 0.565699 for the fiscal year ending 9/30/2011. This is derived by dividing total expenses by gross charges (43,070,369 / 76,136,596 = 0.565699). SchH_P01_S00_L072f Schedule H, Part I, Line 7, Column f Bad debt expense of 572,532 included on Form 990, Part IX, line 25, column (A) was removed for the purpose of calculating percent of total expense in column (f). SchH_P02_S00_L00 Schedule H, Part II RAMC annually participates in several community building activities that work to improve the health of our community. Examples include participation in local Chambers of Commerce, local community groups/boards (Lions, Kiwanis, Reedsburg Education Foundation, etc.) and working to reduce our carbon footprint through various activities. New this year is our Consumer Advocate position, who is available at no charge to all patients. The Consumer Advocate offers complimentary patient assistance services, including, but not limited to, Medicare, Medicaid, private insurance, interpretation of Explanation of Benefits (EOBs) and direction to additional consumer resources. SchH_P03_S0A_L04 Schedule H, Part III, Section A, 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 its assessment of historical collection likelihood and the 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 patient accounts receivable. The amount reported on line two (2) is calculated as follows: bad debt expense of 1,093,960.88 less amounts recovered of 521,429.16 = 572,531.72 x cost-to-charge ratio of 0.565699 = 323,880.62. SchH_P03_S0B_L08 Schedule H, Part III, Section B, Line 8 The Medicare allowable costs were obtained from the Medicare Cost Report. SchH_P03_S0C_L09b Schedule H, Part III, Section C, Line 9b Once the patient meets all qualifications for financial assistance, all or part of the account balance is written off, as appropriate. The remaining balance, if any, is the patient's responsibility and collected following the normal debt collection policy. SchH_P05_S0B_L19 Schedule H, Part V, Section B, Line 19 Individuals without insurance are billed at 85% of gross charges with the option of an additional 10% discount to 75% of gross charges if the claim is paid within 30 days. Claims exceeding $30,000 gross charges receive an additional 10% discount. The discount steps up to 40% at $50,000 gross charges plus an additional 10% is paid within 30 days. SchH_P05_S0B_L21 Schedule H, Part V, Section B, Line 21 We are required by Medicare regulations to charge all patients the same at gross charges. Patients without insurance are given at automatic 15% discount with an additional 10% discount if paid within 30 days. SchH_P06_S00_L02 Schedule H, Part VI, Line 2 Every three years, RAMC conducts a formal Community Assessment, measuring awareness, preference, image and community needs. We conduct this within our primary service area - the city of Reedsburg and the surrounding communities. In addition, we have a feedback section on our website, www.ramchealth.com, allowing a forum for which the public can provide suggestions and comments. RAMC has also been busy gathering data from the recent Sauk County Health Needs Assessment. This information has been segmented into our main market area. In working with a committee consisting of Sauk County Public Health, Reedsburg School District, city officials, ambulance, police and fire as well as various other community members including business and industry, this information has been prioritized and we are in the process of building a team of people who will help us to set actionable, measurable goals. SchH_P06_S00_L03 Schedule H, Part VI, Line 3 Community Care notices are posted throughout the facility and applications are available through Business Services. The patient, patient's representative or hospital representative may initiate inquiries regarding eligibility or application for assistance at any time. The hospital, when appropriate, will review the patient's financial situation to see if they qualify for any form of assistance; Social Services is available to assist in this process. Patient Accounts is also notified when patients (inpatient or outpatient) are treated who do not have any insurance. They discuss with the patient available options and provide information/applications for both RAMC Charity Care programs and county, state or federal assistance programs. At any time, patients may inquire with hospital personnel regarding questions they have on their ability to pay. Financial Advisors are available to help as is our Consumer Advocate. The Consumer Advocate offers complimentary patient assistance services, including, but not limited to, Medicare, Medicaid, private insurance, interpretation of Explanation of Benefits (EOBs) and direction to additional consumer resources. SchH_P06_S00_L04 Schedule H, Part VI, Line 4 RAMC is located in the city of Reedsburg, Wisconsin in North Central Sauk County. The primary service area extends west to Cazenovia, east to Rock Springs, south to Hillpoint and north from Wonewoc to just west of Lake Delton. This geographic area covers four counties, the majority being in Sauk County, and is responsible for approximately 75.5% of RAMC's discharged patients. Since 2000, Sauk County has seen a 12.2% population growth while the State of Wisconsin has experienced a 6.0% population growth. Sauk County has also experienced a sizable increase in its minority populations over the past several years, most notably in the Hispanic community. In 2010, 4.3% of Sauk County residents were Hispanic/Latino compared to 5.9% for the State. The median income in Sauk County for 2010 was $50,390 ($51,598 for the State) and the unemployment rate was 3.9% (4.6% for the State). 9.4% of County residents were living below the poverty line (11.6% for the State) and 6.7% received Food Stamp/SNAP benefits in the last 12 months (7.7% for the State). 14.7% of County residents were aged 65 or older (13.7% for the State) and 27.9% were receiving Social Security (27.4% for the State). There are no other hospitals located in RAMC's primary service area. Primary competition is from other community hospitals located in neighboring communities and tertiary care hospitals in Madison that provide specialized services not available at RAMC. SchH_P06_S00_L05 Schedule H, Part VI, Line 5 RAMC is committed to the health of our community and the important part we play in maintaining and improving the overall health of our constituents. We take an active role in equipping our community members with the skills needed to create better health. RAMC provides health care services and other financial support through various programs that are designed, among other matters, to enhance the health of the community, including the health of low-income patients. Consistent with our mission, care is provided to patients regardless of their ability to pay, including providing services to those persons who cannot afford health insurance because of inadequate resources of are underinsured. Community benefits also include unpaid costs of treating the elderly, health screenings, community education and other health-related services. Our community building activities work to address underlying health determinants and support programs meant to improve health before intervention is required as well as providing resources for those looking to improve their current health situation. RAMC employees are active in educating the community on a wide variety of health topics and participate on numerous local boards. Health-related board positions range from those focusing on area dental and emergency medical services to the Rural Wisconsin Health Cooperative and Sauk County Health Boards. Many employees are also members of community service boards and volunteer groups. RAMC is mindful of and proactive in developing or partnering with groups working to better the current economic and environmental conditions of our community. RAMC is organized and operated with the goal of promoting the health of the community we serve. We support this mission with a board comprised of local, independent community members, a medical staff organized in the public interest and open to all qualified physicians and an emergency room available to all, regardless of ability to pay. The Board takes a balanced approach when it sets policy and strategic direction for the hospital, working to align community needs with business and financial concerns. The use of surplus funds is largely determined by the board in its attempt to meet this goal. RAMC is the sole hospital in our community and provides numerous volunteer opportunities for area residents. SchH_P06_S00_L07 Schedule H, Part VI, Line 7 Wisconsin 1 Reedsburg Area Senior Life Center 2350 North Dewey Avenue Reedsburg WI 53959 760775289 501(c)(3) 400080 0 FMV N/A General operations Reedsburg Area Medical Center Foundation 2090 Ridgeview Drive Reedsburg WI 53959 391243616 501(c)(3) 15000 0 FMV N/A Free clinic 2 0 Tuition Assistance 32 63772 0 FMV N/A Stipends 18 7250 0 FMV N/A SchI_P01_S00_L02 Schedule I, Part I, Line 2 Grants were provided by RAMC to Reedsburg Area Senior Life Center and the Reedsburg Area Medical Center Foundation. RAMC has (at least monthly) access to both of these organization's financial records and board meeting minutes, allowing for review of how funds are allocated. RAMC also provides scholarships and tuition assistance to employees pursuing health-care related higher education. This assistance is made available to employees for studies where professional staff are needed and the demand for these positions is greater than the supply available. Usually, the shortage is not only seen locally, but also state- and nation-wide. The intention is to have these trained professionals continue at RAMC within their new position, accomplishing our mission and commitment to providing high-quality, local care for our community. Proof of the cost of tuition and successful course completion are required. X X X X X 0 0 0 1 0 1 0 0 0 George Johnson 183895 0 0 0 0 0 0 0 0 0 183895 0 163333 0 Gerry Chrabaszcz 270393 0 0 0 12340 0 12250 0 9071 0 304054 0 289747 0 Christopher Bjorklund 267386 0 0 0 0 0 12250 0 9486 0 289122 0 275190 0 Eric Newgent MD 225739 0 14715 0 21819 0 12250 0 9486 0 284009 0 257836 0 Kenneth Olson 247738 0 0 0 0 0 12250 0 9071 0 269059 0 258190 0 Kevin McBride 247318 0 0 0 0 0 12250 0 9486 0 269054 0 265214 0 Robert Van Meeteren 173270 0 0 0 2786 0 8878 0 12126 0 197060 0 190956 0 Joseph Svetlik 133152 0 0 0 11914 0 32827 0 12126 0 190019 0 188639 0 Beverly Hoege 134004 0 0 0 0 0 18653 0 4888 0 157545 0 161539 0 SchJ_P01_S00_L05 Schedule J, Part I, Line 5 Physician is eligible and received payment based on charges generated from health care services provided by this physician. SchJ_P01_S00_L06 Schedule J, Part I, Line 6 Officers receive bonus compensation based on organization net income and meeting targeted strategic planning goals. City of Reedsburg 396005582 2003-06-03 2600000 Refund prior issue 0 0 0 Wisconsin Health & Educational Facilities Authority 391337855 97710VH43 2006-06-28 11865000 Construct & equip facility & refund prior issue 0 0 0 Wisconsin Health & Educational Facilities Authority 391337855 97710BXK3 2010-09-16 5800000 Refund prior issue 0 0 0 Wisconsin Health & Educational Facilities Authority 391337855 97710BXP2 2010-09-16 4273300 Refund prior issue 0 0 0 1094736 0 2600000 0 0 2600000 0 0 0 0 0 0 2003 1 0 1 1 2375000 0 11865000 1183280 0 3522124 237300 0 0 6922296 0 0 2009 1 1 1 1 0 0 5800000 580000 0 5104000 116000 0 0 0 0 0 2010 1 0 1 1 0 0 4273300 0 0 4180408 85470 7422 0 0 0 0 2010 1 0 1 1 0 0 0 0 1 0 0 0 1 0 0 0 0 1 0 0 0 1 0 0 0 0 1 0 0 0 1 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 SchK_P03_S00_L04 Schedule K, Part III, Line 4 The construction of the property financed by the 2006A revenue bonds (B) includes some portions used in private business use by entities other than a section 501(c)(3) organization or state or local government. The portion of the building used by these entities was financed directly by RAMC through cash payments totaling $4,913,708. Brooks Schommer Family member of officer 55565 Employment compensation 0 Connie Molberg Family member of director 42313 Employment compensation 0 Reedsburg Physicians Group Two RAMC directors are also RPG partners 473828 Physician call pay 0 Harris Bank Bank employee is RAMC trustee 29214 Banking services 0 F990_P03_S00_L03 Form 990, Part III, Line 3 Due to fiscal considerations, RAMC discontinued its Cardiac Catheterization Lab in FYE 9/30/2011. F990_P06_S0B_L11b Form 990, Part VI, Section B, Line 11b Upon completion of the form 990, the Vice President of Finance reviews for accuracy and completeness. Upon his approval, it is presented to the Board of Directors for final approval. It is then signed by the President/CEO and filed with the IRS. F990_P06_S0B_L12c Form 990, Part VI, Section B, Line 12c Members annually disclose any possible conflicts of interest when they sign the Conflict of Interest policies. Members routinely abstain from voting on any matters and excuse themselves from decisions on matters with which they have a conflict of interest. F990_P06_S0B_L15 Form 990, Part VI, Section B, Line 15 Independent Wage and Salary surveys are used for all key employees, including the CEO/President. Vendors used are the Rural Wisconsin Health Cooperative and Wisconsin Hospital Association. F990_P06_S0C_L19 Form 990, Part VI, Section C, Line 19 Copies of information are made available upon request. F990_P11_S00_L05 Form 990, Part XI, Line 5 Net change in unrealized gains and losses on investments, other than trading securities. Filed Form 8868 and received extended due date to file of May 15, 2012.