2011-08-15T14:26:30-05:00 2010-09-30 KPMG LLP 303 EAST WACKER DRIVE CHICAGO IL 606015212 990 2009-10-01 390837206 LAKEVIEW MEDICAL CENTER INC OF RICE LAKE LAKE 7152341515 1700 west stout street RICE LAKE WI 54868 Jackie Klein 2011-08-11 3126651000 2009 2016-02-24 21:20:13Z X EDWARD H WOLF 1700 west stout street RICE LAKE WI 54868 60313888 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 6 512 203 0 63293 121749 59242842 59608642 892130 483224 2193453 -21557 62391718 60192058 221807 0 0 0 26993201 28654289 0 0 0 25486815 25783132 52701823 54437421 9689895 5754637 97278419 104956226 36013213 37936383 61265206 67019843 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. false false 7318076 25078379 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, 2010 THERE WERE 3,582 SURGICAL CASES. 4484208 8183847 LAKEVIEW MEDICAL CENTER PROVIDES INPATIENT ROOM, BOARD AND CARE TO MEDICAL AND SURGICAL PATIENTS. FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2010 THIS UNIT HAD 2,030 DISCHARGES AND 6,289 PATIENT DAYS. 2567632 7627782 LAKEVIEW MEDICAL CENTER PHARMACY SUPPLIES PHARMACEUTICALS TO THE VARIOUS DEPARTMENTS, BOTH INPATIENT AND OUTPATIENT, OF LAKEVIEW MEDICAL CENTER. 30100196 18718634 44470112 true true false false false false false false false true false true false false false false false false true false true false false true false false false false false false false false false false false false false true false false false true 31 0 true 512 true false false false false false false false false false 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 SUE ZAHRBOCK 1.0 X 0 0 0 MARY BITZ 1.0 X 0 0 0 JAMES DORRANCE 1.0 X X 0 0 0 SANDY BONNEVILLE 1.0 X 0 0 0 DR BRAD BEKKUM 1.0 X X 0 305448 20818 PAUL CHASE 1.0 X 0 0 0 DAVID HILDEBRAND 1.0 X 0 0 0 DAN DEGROOT 1.0 X 0 209308 36600 DR PAUL LISS 1.0 X 0 401603 73399 Dr Douglas Reding 1.0 X 0 565295 72902 Dr Peter Neal 1.0 X 0 433517 89573 EDWARD WOLF 40.0 X 236846 0 37634 CYNTHIA ARTS-STRENKE 40.0 X 158558 0 31040 JACQUELINE KLEIN 40.0 X 151447 0 24193 Ken Engel 40.0 X 132158 0 3950 Sherry Johnson 40.0 X 109259 0 3344 Andrew Daigle 40.0 X 188754 0 20304 Daniel O'Connell 40.0 X 186358 0 14509 James Kiffmeyer 40.0 X 198482 0 18744 1361862 1915171 447010 12 false true false Cerner Corporation PO Box 412702 KANSAS CITY MO 64141 computer consulting 708170 The revere group 3266 paysphere circle CHICAGO IL 60674 computer consulting 363430 aramark management 22506 network place CHICAGO IL 606731225 management services 309139 sartori consulting po box 1265 WAUSAU WI 544021265 advertising agency 161403 aureus radiology po box 3037 OMAHA NE 681030037 contracted employees 145339 5 5162 5521 24936 86130 121749 NET PATIENT SERVICE REVENUE 624100 56502281 56502281 LEASING REVENUE 624100 2715810 2715810 LIFELINE PROGRAM 624100 119470 119470 OCCUPATIONAL/INDUSTRIAL HEALTH 624100 67258 67258 EMPLOYEE MEALS 624100 92705 92705 111118 85006 26112 59608642 477715 469998 0 0 78060 112163 -34103 -34103 -34103 5509 0 5509 5509 5509 11063 5521 9667 1396 1396 11150 11150 11150 0 0 60192058 59489825 572767 0 0 0 0 745878 745878 0 20979376 18309430 2669946 1065304 926569 138735 4339294 3659990 679304 1524437 1325909 198528 331509 331509 235838 235838 58186 58186 0 0 0 4856266 2253232 2603034 152493 152493 8710475 8277024 433451 0 0 3659471 1821238 1838233 117736 117736 0 0 167660 167660 0 5128779 5128779 152619 152619 PROVISION FOR BAD DEBTS 1861245 1861245 FOOD AND PROVISIONS 253334 253334 DUES AND SUBSCRIPTIONS 97521 36457 61064 54437421 44470112 9967309 0 1530 2530 46267836 42345712 6822267 8033403 684095 666791 300568 366855 84692746 32144189 41933425 52548557 1268698 992378 97278419 104956226 4287997 5928616 716000 500000 30565810 30814091 443406 693676 36013213 37936383 X 60522020 66267615 743186 752228 61265206 67019843 97278419 104956226 X false true true X false X false false false RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 5471594 5471594 37110069 10413373 26696696 0 0 0 29274428 21392888 7881540 12836655 337928 12498727 52548557 0 DEFERRED COMPENSATION 478480 PAYABLE TO THIRD PARTY REIMBURSEMENT PROGRAM 215196 693676 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, 2010 or 2009. Voices/Hospice 16584 5521 11063 9667 0 16584 5521 11063 9667 9667 1396 true true true X false false true false true true 274624 0 274624 0.00520 9338249 6900000 2438249 0.04640 0 0 0 9612873 6900000 2712873 0.05160 371675 37500 334175 0.00640 69304 0 69304 0.00130 2092481 2004413 88068 0.00170 0 0 0 4451 0 4451 2537911 2041913 495998 0.00940 12150784 8941913 3208871 0.06100 true 979201 171300 14670880 16506211 -1835331 X false 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 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 a payment plan include: * Maximum of 60 months * Level payments or a front-end-loaded arrangement is acceptable * Lower initial payments with a balloon payment is not appropriate * Minimum of $25 per month (ie: $5 per month on a $25 balance is not appropriate) 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 services 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. Subsidized health services at Lakeview Medical Center, Inc. of Rice Lake include the operation of the Home Care and Hospice. These services are operated to provide support to the community and the surrounding areas, which would otherwise be underserved. It is the goal of Lakeview Medical Center, Inc. of Rice Lake to provide these services to the community regardless of a patient's ability to pay. The amount of Provision for Bad Debts that was removed from total expenses reported on Form 990, Part IX, Line 24 was $1,861,245. The reduced total expense amount of $52,576,176 was used to calculate the percentages reported on Schedule H, Part I, line 7, column (f). 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 the organization has used reasonable collection efforts are written off through a charge to the valuation allowance and a credit to accounts receivable. Many times patients do not complete the required charity care application and are transferred to collection services even though the organization provides this this information to all patients and assistance with the applications. Due to no responses from some patients a significant amount of bad debts could be considered as charity care. The total Medicare revenue shown in Schedule H to the form 990 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 schedule reimbursements at rates that are often below the costs of caring for patients. The costing method used above for IRS compliance reporting is also based on the filed Medicare cost report for the year ended September 30, 2010, 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. 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 complete 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. 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 to be consistent with Lakeview Medical Center's mission in the community. 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. Uninsured and under insured patients are asked to meet 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. 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. Gerry Lisi, Director of Ambulatory Care for Lakeview Medical Center received the 2010 Wisconsin Victim Witness Professional Service Award for his years of service on behalf of sexual assault victims. Lisi received this award in recognition of his efforts toward creating, maintaining and expanding the Sexual Assault Nurse Examiner (SANE) program at Lakeview Medical Center. The SANE program supports community efforts to address the crime of sexual assault by establishing a process for accurate evidence collection and support for sexual assault survivors. 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. 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 Board 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. 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 & 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. 408 participants from 20 area businesses lost a total of 3,848 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. 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. 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. WI X X false false false false false false false false false DR BRAD BEKKUM 0 289332 0 15450 0 666 0 20818 0 0 0 326266 0 0 DAN DEGROOT 0 207996 0 100 0 1212 0 28648 0 7952 0 245908 0 0 DR PAUL LISS 0 399797 0 0 0 1806 0 52728 0 20671 0 475002 0 0 EDWARD WOLF 199493 0 101 0 37252 0 27000 0 10634 0 274480 0 0 0 CYNTHIA ARTS-STRENKE 136949 0 101 0 21508 0 20406 0 10634 0 189598 0 0 0 JACQUELINE KLEIN 135152 0 101 0 16194 0 18393 0 5800 0 175640 0 0 0 Andrew Daigle 164321 0 101 0 24332 0 9670 0 10634 0 209058 0 0 0 Daniel O'Connell 166757 0 101 0 19500 0 9390 0 5119 0 200867 0 0 0 James Kiffmeyer 182500 0 101 0 15881 0 8110 0 10634 0 217226 0 0 0 Dr Douglas Reding 0 552077 0 11166 0 2052 0 52728 0 20174 0 638197 0 0 Dr Peter Neal 0 431577 0 0 0 1940 0 69228 0 20345 0 523090 0 0 Supplemental Information to Form 990 The Lakeview Medical Center Home Health Care Program announced that it has been named to the 2010 Homecare Elite(TM), a compilation of the top-performing home health agencies in the united states. This annual review identifies the top 500 agencies overall. Winners are ranked by an analysis of performance measures in quality outcomes, quality improvement, and financial performance. The 2010 Homecare Elite is the only performance recognition of its kind in the Home Health industry. The 2010 Homecare Elite is brought to the industry by OCS Homecare, the leading provider of homecare information, and Decisionhealth, publisher of Homecare's most respected independent newsletter Home Health Line. The data used for this analysis was compiled from publicly available information. the entire list of the 2009 homecare elite agencies can be viewed by visiting the OCS web site at www.ocshomecare.com. Part III, Line 4d - Other Program Services The other program services of Lakeview medical center include imaging, women's inpatient and outpatient care, and all indirect expenses associated with furthering the exempt purpose. Supplemental Information to Form 990 Form 990, Part VI 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 A, Line 11 The Form 990 is compiled by the accounting department and then prepared and signed 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 (President, COO and CFO), and Managers of Materials Management, Information Technology, Lab, Imaging, Community Relations/Marketing and Plant Operations. Part VI, Section B, Line 15a & b The board of directors determines and approves the CEO'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 adminstrative team and/or the CEO. Part VI, Section C, line 19 The organizations governing documents, conflict of interest policy and financial statements are available upon request. Supplemental Information to Form 990 Form 990, Part X Form 990, Part X, Line 2 includes $25,524,076. held in cash accounts to be used at a later date for program purposes, such as the construction of the new hospital and purchase of equipment. This amount consists of: health insurance trust $ 40,680. board designated 7,373,653. restricted building fund 16,759,304. lifeline 443,544. gifts, grants, bequests 521,684. hospice 375,867. home health care 9,344. ------------ total $25,524,076. ============ Marshfield Clinic 1000 North Oak Avenue Marshfield WI 54449 390452970 Medical Care WI 501(C)(3) 3 NA Volunteer Partners of Lakeview Medical C 1100 N Main Street 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 false true false false true false false false true false false false false