2011-08-12T08:27:39-05:00 2010-12-31 WIPFLI LLP PO BOX 8010 WAUSAU WI 544028010 990 2010-01-01 391528430 BAY AREA MEDICAL CENTER INC BAYA 7157354200 3100 SHORE DRIVE MARINETTE WI 54143 DAN CARLSON 7157354200 2011-08-04 1 KIM HELLER 7158453111 2011-08-04 2010 2016-02-24 21:20:13Z DAN CARLSON 3100 SHORE DRIVE MARINETTE WI 54143 146023977 0 X WWW.BAMC.ORG X 1985 WI BAY AREA MEDICAL CENTER IS A REGIONAL HEALTH CARE FACILITY PROVIDING A WIDE RANGE OF MEDICAL SERVICES TO THE RESIDENTS OF MARINETTE AND MENOMINEE COUNTIES AND THE SURROUNDING AREAS. BAMC'S PRIMARY EXEMPT PURPOSE IS THE PROVISION OF HEALTH CARE SERVICES. 9 9 845 190 2676732 0 0 0 118549338 120942939 2413183 2014470 2461899 -1562163 123424420 121395246 0 0 0 0 60653067 62824730 0 0 0 53037947 51903764 113691014 114728494 9733406 6666752 130651947 139982823 59087410 59104161 71564537 80878662 X WE ARE YOUR MEDICAL CENTER, STRIVING TO EXCEED YOUR EXPECTATIONS BY PROVIDING COMPASSIONATE, COST-EFFECTIVE, QUALITY HEALTHCARE TO ALL. 0 0 94453870 117621199 INPATIENT HOSPITAL SERVICES FOR MEDICAL, SURGICAL AND OBSTETRICS/GYNECOLOGY PATIENTS - BAMC PROVIDED CARE FOR 4,168 PATIENTS WHO WERE ADMITTED AS INPATIENTS DURING 2010. THESE SERVICES INCLUDED 24/7 CARE FOR PATIENTS ADMITTED WITH MEDICAL CONDITIONS WARRANTING A HOSPITAL STAY, PATIENTS ADMITTED FOR SURGICAL PROCEDURES EXTENSIVE ENOUGH TO REQUIRE A STAY OVERNIGHT OR FOR SEVERAL DAYS FOLLOWING THE PROCEDURES, AND PATIENTS ADMITTED FOR THE DELIVERY OF NEWBORNS.OUTPATIENT SURGICAL SERVICES - BAMC PERFORMED 3,107 OUTPATIENT SURGICAL PROCEDURES FOR PATIENTS DURING 2010. THESE PROCEDURES INCLUDED ORTHOPEDIC, UROLOGICAL, GENERAL SURGERY, GYNECOLOGY, AND ENT SURGERIES.EMERGENCY SERVICES - BAMC OPERATES AN EMERGENCY DEPARTMENT, WHICH INCLUDES AN AMBULANCE SERVICE STAFFED WITH PARAMEDICS, TO RESPOND TO EMERGENCY CARE NEEDS OF THE AREA. IT IS THE ONLY EMERGENCY DEPARTMENT AVAILABLE IN THE COMMUNITY. THE EMERGENCY DEPARTMENT IS STAFFED WITH EMERGENCY CARE PHYSICIANS ON A 24/7 BASIS AND THE DEPARTMENT SAW 21,451 PATIENT VISITS IN 2010, WITH 2,871 OF THESE VISITS RESULTING IN PATIENTS BEING ADMITTED TO THE HOSPITAL FOR INPATIENT CARE. THE AMBULANCE SERVICE HAD 3,149 PATIENT TRANSPORTS IN 2010. 94453870 1 0 0 1 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 58 0 1 845 1 1 1 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X DAN CARLSON CFO 7157354200 3100 SHORE DR MARINETTE WI 54143 X JIM HODGE 0.80 X 1 0 0 CHARLES KALHOEFER 0.80 X 1 0 0 PAT KRAH 0.80 X 1 0 0 CAL NOGLER MD 0.80 X 1 0 0 BOB SCRENSON 0.80 X 1 0 0 TIM RENNES 0.80 X 1 0 0 LOUISE POLICELLO 1.00 X 1 0 0 TONY FURTON 0.80 X 1 0 0 WILLIAM MALLORY MD 0.80 X 1 0 0 BERNADINE VAN COURT 40.00 X 264143 0 37499 C DANIEL CARLSON 40.00 X 255843 0 36112 MARK GREGSON 40.00 X 486154 0 0 THOMAS LEOW MD 40.00 X 1441586 0 40779 MICHAEL KARKKAINEN MD 40.00 X 1291552 0 33307 MOHAMED EL-JACK MD 40.00 X 1083319 0 28568 EDGAR MASSABNI MD 40.00 X 784490 0 33807 SAKTI CHAKRABARTI MD 40.00 X 571589 0 33807 DAVID OLSON 0.00 X 111297 0 6745 6289982 0 250624 39 1 1 0 BELLIN MEMORIAL 744 S WEBSTER AVE GREEN BAY WI 543053400 PROFESSIONAL LAB FEES AND ER NURSE LINE 611634 INFINITY HEALTHCARE 1111 E WISCONSIN AVE SUITE 2100 MILWAUKEE WI 532024809 OCCUPATIONAL HEALTH SERVICE PHYSICIAN FE 459257 PROFESSIONAL BENEFITS ADMIN SUITE 210 15 SPINNING WHEEL ROAD HINSDALE IL 60521 HEALTH AND DENTAL PLAN ADMINISTRATION FE 424373 HEALTHCARE BUSINESS SERVICES 3916 SOUTH BUSINES PARK AVE PO B MARSHFIELD WI 544498989 COLLECTION AGENCY FEES 381171 AHSA LLC PO BOX 945 TRAVERSE CITY MI 49685 LOCUM TENENS STAFFING 319589 21 NET PATIENT REVENUE 900099 116239664 116239664 RETAIL PHARMACY 446110 2417024 2417024 SPACE LEASED FOR MEDIC 621110 1179182 1179182 OTHER MISCELLANEOUS AC 900099 280797 280797 REFERENCE LAB 621500 259708 259708 566564 202353 364211 120942939 1638094 1638094 12477 50545 -38068 -38068 -38068 24947665 6897 24376351 201835 571314 -194938 376376 376376 INTEREST RATE SWAP VAL 900099 -1524095 -1524095 -1524095 121395246 117621199 2676732 1097315 1079751 1079751 42917603 35919604 6997999 1869846 1507068 362778 16957530 13888304 3069226 281838 281838 72441 72441 7194236 3869168 3325068 174569 127597 46972 19626202 18402276 1223926 1303460 948625 354835 187133 126502 60631 2301259 2301259 6313536 5154033 1159503 1018615 847646 170969 BAD DEBTS 5394840 5394840 REPAIRS AND MAINTENANCE 3993066 1924379 2068687 WI HOSPITAL ASSESSMENT 3064353 3064353 NR/WUPOMS 967670 967670 MISCELLANEOUS 10546 10546 114728494 94453870 20274624 0 9878710 13808201 4998911 15505233 16573250 820032 1122477 2669839 2897259 752766 839086 107536445 56222820 52391882 51313625 40994926 50637269 1464269 1660599 1175379 1131057 130651947 139982823 8744912 9315390 40337403 39000000 10005095 10788771 59087410 59104161 X 71302054 80547715 262483 330947 71564537 80878662 130651947 139982823 X 6666752 2647373 X X 0 1 1 X 0 X 0 0 0 0 0 1 8838 0 0 1 75020 83858 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: PORTION OF AHA, WHA, AND MHA DUES = $8,838 LEGAL FEES SUPPORTING LOBBYING ACTIVITIES = $63,020 COMPENSATION PAID TO NANCY DOUGLAS FOR LOBBYING ACTIVITIES = $12,000 1358443 1358443 68433132 29250692 39182440 2054176 1479744 574432 33799509 25492384 8307125 1891185 1891185 51313625 ACCRUED POSTRETIREMENT BENEFITS 4734244 DEFERRED COMPENSATION 706085 INTEREST RATE SWAP VALUATION 3331351 CAPITAL LEASE OBLIGATION 70246 AMOUNTS PAYABLE TO THIRD-PARTY REIMBURSEMENT PROGRAM 1946845 10788771 121395246 114728494 6666752 2270163 377210 2647373 9314125 120643174 -802617 -802617 121445791 -50545 -50545 121395246 113811369 50545 50545 113760824 967670 967670 114728494 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, ASC TOPIC 740-10, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, REQUIRES AN ORGANIZATION TO ASSESS WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OR THE POSITION, ASSUMING THE TAXING 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. MANAGEMENT DOES NOT BELIEVE BAY AREA HAS ANY MATERIAL UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS. PART XI, LINE 8 - OTHER ADJUSTMENTS: INCREASE IN BENEFICIAL INTEREST IN BAMC FOUNDATION, INC. - $34,688 EQUITY TRANSFER TO NORTH SHORE HEALTH NETWORK, INC - $-7,278 ASSETS RELEASED FROM RESTRICTIONS - $-23,224 RECLASSIFICATION OF ACCUMULATED LOSS ON DESIGNATED CASHFLOW HEDGE - $38,645 TEMPORARILY RESTRICTED DONATIONS - $-169,326 RELEASE OF RESTRICTRED ASSETS - AUXILLIARY PART XII, LINE 2D - OTHER ADJUSTMENTS: RELEASE OF RESTRICTED ASSETS - AUXILLIARY - $165,053 DECREASE IN EQUITY IN NORTHREACH HEALTHCARE LLC AND WISCONSIN UPPER PENINSULA ONCOLOGY MANAGEMENT SERVICES, INC.- $-967,670 PART XII, LINE 4B - OTHER ADJUSTMENTS: RENT EXPENSE - $-50,545 PART XIII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES - $50,545 PART XIII, LINE 4B - OTHER ADJUSTMENTS: DECREASE IN EQUITY IN NORTHREACH HEALTHCARE LLC AND WISCONSIN UPPER PENINSULA ONCOLOGY MANAGEMENT SERVICES, INC. - $967,670 1 1 1 X 1 X 1 1 0 1 1 2121684 2121684 0.01940 16002397 2542305 13460092 0.12310 18124081 2542305 15581776 0.14250 100000 100000 0.00090 100000 100000 0.00090 18224081 2542305 15681776 0.14340 1 2442883 24644181 28670759 -4026578 X 1 1 1 1 BAY AREA MEDICAL CENTER

3100 SHORE DRIVE MARINETTE WI 54143

X X X BAY AREA MEDICAL CENTER 1 PART I, LINE 7: BAY AREA UTILIZES A COST TO CHARGE RATIO. PART I, LINE 7G: TWIN COUNTIES FREE CLINIC 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 $ 5394840. PART III, LINE 4: MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY FROM 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 ACCOUNTS RECEIVABLE.ACCOUNTS RECEIVABLE ARE RECORDED IN THE CONSOLIDATED BALANCE SHEETS NET OF CONTRACTUAL ADJUSTMENTS AND AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. PART III, LINE 8: AMOUNTS ABOVE USE STANDARD MEDICARE DETERMINATION OF ALLOWABLE AND UNALLOWABLE DEPARTMENTS, STANDARD/RECOMMENDED MEDICARE ALLOCATION OF ADMINISTRATION AND GENERAL DEPARTMENTS COSTS TO ALLOWABLE AND UNALLOWABLE DEPARTMENTS BY THE USE OF BAY AREA MEDICAL CENTER'S MEDICARE COST REPORT. THE MEDICARE COST REPORT WAS CACLULATED ON A COST TO CHARGE RATIO. THE COST TO CHARGE RATIO FOLLOWS THE REGULATIONS FOR FILING THE MEDICARE COST REPORT. PART VI, LINE 2: BAY AREA MEDICAL CENTER USES A BI-ANNUAL COMMUNITY SURVEY AND ALSO PARTICIPATES IN THE MARINETTE & MENOMINEE COUNTY HEALTH ASSESSMENT INITIATIVES. PART VI, LINE 3: - BROCHURES ARE PROVIDED TO EVERY PATIENT.- THE INFORMATION IS AVAILABLE ON THE ORGANIZATION'S WEBSITE.- ONE ON ONE MEETINGS WITH FINACIAL ADVISORS ARE ALSO AVAILABLE. PART VI, LINE 4: BAY AREA MEDICAL CENTER SERVES MARINETTE COUNTY, WI AND MENOMINEE COUNTY, MI. THERE ARE NO OTHER HOSPITALS LOCATED IN THESE COUNTIES. PART VI, LINE 6: - THE BAMC BOARD IS MADE UP ENTIRELY OF RESIDENTS OF THE TWO COUNTIES IT SERVES. IN FACT EACH MEMBER MUST BE RATIFIED BY THE COUNTY BOARD OF THEIR RESIDENCE. - BAMC HOSTS QUARTERLY MEETINGS WITH LOCAL MENTAL HEALTH PROFESSIONALS TO SUPPORT THIS INITIATIVE. WE ARE ALSO MEMBERS OF THE MICHIGAN HEALTHCARE CONSORTIUM IN THE UPPER PENINSULA.- ANY SURPLUS FUNDS ARE USED FOR IMPROVEMENTS TO THE FACILITY, EQUIPMENT, STAFF DEVELOPMENT AND PATIENT CARE. - BAMC PROVIDES DIRECT FINANCIAL SUPPORT TO THE TWIN COUNTIES FREE CLINIC. - BAMC HAS WORKING ARRANGEMENTS WITH A TWO YEAR TECHNICAL SCHOOL AND TWO YEAR COLLEGE TO OFFER NURSING AND OTHER MEDICAL PROFESSIONAL STUDENTS INTERNSHIPS IN THEIR PREPARATION FOR HEALTH CARE CAREERS. - BAMC PROVIDES SUPPORT TO LOCAL AREA VOLUNTEER RESCUE SQUAD UNITS THAT WORK WITH THE HOSPITAL-BASED AMBULANCE SERVICE.WHILE THERE IS A GROWING AGREEMENT IN THE UNITED STATES ABOUT WHAT CONSTITUTES A NON-PROFIT HOSPITAL'S "COMMUNITY BENEFIT," THIS IS A WORK IN PROGRESS. OUR HOSPITAL 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.BEYOND INPATIENT HOSPITALIZATIONS, WE PROVIDE LOCAL ACCESS TO MANY HEALTH SERVICES: AMBULANCE SERVICES, BIRTHING CENTER, DIALYSIS CENTER, DIAGNOSTICS, EMERGENCY SERVICES, INPATIENT CARE, LABORATORY SERVICES, OCCUPATIONAL HEALTH & REHABILITATION SERVICES, SURGICAL SERVICES AND WOMENS' SERVICES. X 1 1 X X X X X 0 1 0 0 0 0 0 1 0 BERNADINE VAN COURT 178800 0 38497 0 46846 0 11100 0 26399 0 301642 0 0 0 C DANIEL CARLSON 171021 0 37469 0 47353 0 11100 0 25012 0 291955 0 0 0 MARK GREGSON 441000 0 0 0 45154 0 0 0 0 0 486154 0 0 0 THOMAS LEOW MD 394468 0 1002569 0 44549 0 11100 0 29679 0 1482365 0 0 0 MICHAEL KARKKAINEN MD 247930 0 795537 0 248085 0 11100 0 22207 0 1324859 0 0 0 MOHAMED EL-JACK MD 321404 0 538185 0 223730 0 11100 0 17468 0 1111887 0 0 0 EDGAR MASSABNI MD 617160 0 0 0 167330 0 11100 0 22207 0 817797 0 0 0 SAKTI CHAKRABARTI MD 354388 0 0 0 217201 0 11100 0 22707 0 605396 0 0 0 DAVID OLSON 9316 0 92910 0 9071 0 6665 0 80 0 118042 0 0 0 PART I, LINE 7 A PORTION OF OFFICER COMPENSATION PAID IN 2010 AND ACCRUED IN 2010 WAS CONTINGENT ON THE ORGANIZATION ACHIEVING CERTAIN QUALITATIVE GOALS, SUCH AS PATIENT SATISFACTION AND OTHER QUALITY INDICATORS. WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337955 97710V7Q5 2008-02-20 40000000 TO FUND PURCHASE OF HOSPITAL BUILDINGS, FIXTURES, AND CAPITAL EQUIPMENT. 0 0 0 4000000 738720 25583420 2008 0 1 1 1 0 0 0 0 1 0.00470 0.00470 1 0 1 1 PIPER JAFFRAY 30.000000000000 0 0 0 0 0 DAVID A OLSON EXECUFLEX LIFE INSURANCE X 33514 33514 0 1 1 DAN CARLSON EXECUFLEX LIFE INSURANCE X 17069 17069 0 1 1 MICHAEL KARKKAINEN EXECUFLEX LIFE INSURANCE X 922967 922967 0 1 1 THOMAS LEOW EXECUFLEX LIFE INSURANCE X 148927 148927 0 1 1 1122477 FORM 990, PART VI, SECTION A, LINE 7B MARINETTE COUNTY, WISCONSIN AND MENOMINEE COUNTY, MICHIGAN RATIFY BAMC BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 11 THE BOARD OF DIRECTORS ARE PROVIDED A COPY OF THE FORM 990 TO REVIEW AT A BOARD MEETING PRIOR TO WHEN THE FORM 990 IS FILED. FORM 990, PART VI, SECTION B, LINE 12C COPIES OF THE POLICY ARE PROVIDED TO ALL MANAGEMENT EMPLOYEES. CONFLICT OF INTEREST DISCLOSURE FORMS ARE COMPLETED ANNUALLY BY ALL DIRECTORS, OFFICERS AND KEY EMPLOYEES. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTOR'S COMPENSATION COMMITTEE REVIEWS COMPARABLE COMPENSATION INFORMATION ON OTHER HOSPITALS AND ESTABLISHES BAMC'S EXECUTIVE COMPENSATION LEVELS. MEMBER'S OF THE COMPENSATION COMMITTEE DO NOT HAVE A CONFLICT OF INTEREST AND THE CONCLUSIONS ARE SUBSTANTIATED. THE REVIEW PROCESS TAKES PLACE AT LEAST ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 THE ANNUAL AUDITED FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC BY PROVIDING THEM TO MARINETTE COUNTY, WISCONSIN AND MENOMINEE COUNTY, MICHIGAN. FORM 990, PART VII DAVID OLSON TERMINATED PRIOR TO 1/1/2010. HOWEVER, DAVID WAS PAID IN 2010 FOR HIS BONUS EARNED IN 2009, VACATION AND SICK LEAVE CASH OUT, AND LAST WEEK OF PAY FOR 2009. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 2,270,163. INCREASE IN BENEFICIAL INTEREST IN BAMC FOUNDATION, INC. - $34,688 34,688. EQUITY TRANSFER TO NORTH SHORE HEALTH NETWORK, INC - $-7,278 -7,278. ASSETS RELEASED FROM RESTRICTIONS - $-23,224 -23,224. RECLASSIFICATION OF ACCUMULATED LOSS ON DESIGNATED CASHFLOW HEDGE - $38,645 38,645. TEMPORARILY RESTRICTED DONATIONS - $-169,326 169,326. RELEASE OF RESTRICTRED ASSETS - AUXILLIARY 165,053. TOTAL TO FORM 990, PART XI, LINE 5: 2,647,373. CHANGE IN PROCESS FORM 990, PART XI, LINE 2C THE PROCESS OF OVERSIGHT AND SELECTION OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR. COMBINED AUDIT FORM 990, PART IV, LINE 12 BAY AREA MEDICAL CENTER WAS AUDITED AS PART OF A COMBINED AUDIT. BAMC ASSETS MADE UP 99% OF TOTAL ASSETS IN THE COMBINED AUDIT. COMBINED AUDIT FORM 990, PART XI, LINE 2B AND 2C BAY AREA MEDICAL CENTER WAS AUDITED AS PART OF A COMBINED AUDIT. SEE EXPLANATION TO PART IV, LINE 12. BAY AREA MEDICAL CENTER FOUNDATION INC 3100 SHORE DRIVE MARINETTE WI 54143 392020734 FUNDRAISING FOR BAMC, INC. WI 501 (C) 3 LINE 11A, I N/A 0 NORTHREACH HEALTHCARELLC 3100 SHORE DRIVE MARINETTE WI 54143 391999260 PRIMARY CARE PROVIDERS WI 501 (C) 3 LINE 3 N/A 0 1 1 0 0 0 0 0 0 1 1 0 0 1 0 1 1 1 0 NORTHREACH A 334000 COST NORTHREACH J 140000 COST NORTHREACH M 779000 COST NORTHREACH B 1164000 COST