2026-08-13T15:10:41-05:00 2025-09-30 393647910 WIPFLI ADVISORY LLC 1502 LONDON ROAD SUITE 220 DULUTH MN 55812 990 2024-10-01 390806404 VERNON MEMORIAL HEALTHCARE INC VERN 6086372101 507 SOUTH MAIN STREET VIROQUA WI 54665 SCOTT LECKEY CFO 6086372101 2026-08-13 1 1 MICHAEL J PETERSON CPA P01833529 2187224705 2026-07-29 2024 2025-03-06 01:10:19Z DAVID HARTBERG 507 SOUTH MAIN STREET VIROQUA WI 54665 97085734 0 X WWW.VMH.ORG X 1946 WI VERNON MEMORIAL HEALTHCARE, INC. IS DEDICATED TO INSPIRING PATIENT-CENTERED, COMPASSIONATE CARE IN OUR COMMUNITY. OUR VISION IS TO BE THE TRUSTED HEALTHCARE PARTNER THAT DELIVERS EXCEPTIONAL CARE TO EVERY GENERATION. WE UPHOLD OUR VALUES OF COMPASSION, EXCELLENCE, COLLABORATION, INTEGRITY, ACCOUNTABILITY, AND SUSTAINABILITY IN EVERY ASPECT OF OUR SERVICE. BY SHOWING AN AUTHENTIC DESIRE TO HELP OTHERS, PURSUING THE HIGHEST QUALITY CARE, WORKING SEAMLESSLY WITH ALL PARTNERS, COMMITTING TO HONESTY, TAKING OWNERSHIP OF OUR ACTIONS, AND CONSERVING RESOURCES TO SUPPORT HEALTH AND WELL-BEING, WE ENSURE THAT EVERY PATIENT RECEIVES THE BEST POSSIBLE CARE, CLOSE TO HOME. 11 11 564 66 0 0 169700 67012 92181470 94048109 2093518 2480445 538894 469693 94983582 97065259 66594 127953 0 0 45965427 50642891 0 0 0 42683817 39976588 88715838 90747432 6267744 6317827 135582722 148995196 20944109 22705912 114638613 126289284 X TO INSPIRE PATIENT-CENTERED, COMPASSIONATE CARE IN OUR COMMUNITY. 0 0 58582830 127953 85079284 VERNON MEMORIAL HEALTHCARE ("VMH") OPERATES A 25-BED CRITICAL ACCESS HOSPITAL LOCATED IN VIROQUA, WISCONSIN, FOUR PROVIDER-BASED RURAL HEALTH CLINICS (VIROQUA, LA FARGE, SOLDIERS GROVE, AND WESTBY), AND TWO RETAIL PHARMACY LOCATIONS. VMH MAINTAINS A CLEAR AND CONSISTENT COMMITMENT TO ITS CHARITABLE PURPOSE THROUGH THE PROVISION OF HEALTH AND WELLNESS SERVICES TO THE COMMUNITIES SERVED WITHOUT REGARD TO AGE, RACE, GENDER, CREED, NATIONAL ORIGINAL, ABILITY TO PAY, AND PHYSICAL OR MENTAL HANDICAP. VMH'S DEDICATED WORKFORCE EXEMPLIFIES SERVICE IN ALIGNMENT WITH ORGANIZATIONAL VALUE STATEMENTS: GREAT EXPERIENCES. RESPECTING EVERYONE. EXCELLENCE IN EVERYTHING WE DO. ALWAYS A HELPFUL ATTITUDE. TAKING CARE OF ONE ANOTHER.IN RESPONSE TO THE NEEDS OF THE COMMUNITIES SERVED, VMH IS PROUD TO PROVIDE HIGH QUALITY INPATIENT ACUTE CARE FOR MEDICAL, SURGICAL, OBSTETRICAL, AND NEWBORN SERVICE NEEDS. VMH FURTHER SUPPORTS THE NEEDS OF ITS PATIENTS BY OFFERING ACCESS TO SWING BED (SKILLED) NURSING CARE. WITH A CONSTANT FOCUS ON QUALITY AND PATIENT SAFETY, VMH OFFERS OUTPATIENT AND ANCILLARY HEALTHCARE SERVICES INCLUDING 24-HOUR EMERGENCY SERVICES, SURGICAL SERVICES, LABORATORY, X-RAY, ULTRASOUND, CT SCANS, MRI, MAMMOGRAPHY, CARDIAC REHABILITATION, INFUSION AND GASTROINTESTINAL SERVICES, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, AND NUTRITIONAL THERAPY INCLUDING DIABETIC EDUCATION. PATIENTS SERVED BY THE HOSPITAL IN FISCAL 2025 INCLUDED 1,996 ADULT AND PEDIATRIC INPATIENT DAYS AND 124 NEWBORN DELIVERIES. THERE WAS A TOTAL OF 1,760 SURGERY CASES (INPATIENT AND OUTPATIENT COMBINED) AND THERE WERE 94,523 TOTAL OUTPATIENT VISITS. THE VMH EMERGENCY ROOM PROVIDED IMMEDIATE ACCESS TO CARE IN RESPONSE TO 7,557 EMERGENCY ROOM VISITS.AS A PART OF VMH'S MISSION, AND IN KEEPING WITH ITS STATUS AS A NOT-FOR-PROFIT HEALTHCARE ORGANIZATION, VMH HAS ESTABLISHED A PATIENT FINANCIAL ASSISTANCE POLICY THAT SETS FORWARD THE CRITERIA BY WHICH A PATIENT MAY QUALIFY TO RECEIVE CARE AT AMOUNTS LESS THAN THE ESTABLISHED RATES; TO RECEIVE CHARITY CARE. VMH MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE PROVIDED, THE TOTAL HEALTHCARE SERVICES PROVIDED TO PATIENTS UNDER THIS POLICY ARE MEASURED IN BOTH TOTAL CHARGES AND AT THE ESTIMATED COST OF PROVIDING CARE TO PATIENTS WITH BOTH FIGURES REPORTED AND AVAILABLE BY REFERRING TO SCHEDULE H IN ADDITION, VMH IS A PROVIDER UNDER THE WISCONSIN MEDICAID PROGRAM. UNDER THE PROGRAM, VMH IS LEGALLY BOUND TO ACCEPT THE AMOUNT DETERMINED BY THE STATE OF WISCONSIN AS PAYMENT IN FULL FOR EACH PATIENT'S CHARGES EVEN THOUGH REIMBURSEMENT IS LESS THAN THE COST TO PROVIDE THE CARE, THEREFORE, SERVICE TO PATIENTS UNDER THIS PROGRAM SHOULD ALSO BE CONSIDERED PART OF THE ORGANIZATION'S BENEFIT PROVIDED TO THE COMMUNITY. (FOR ADDITIONAL INFORMATION ON VMH'S CHARITY CARE AND/OR THE COST OF PARTICIPATION IN THE WISCONSIN MEDICAID PROGRAM, PLEASE REFER TO SCHEDULE H OF FORM 990.) IN ADDITION, VMH ENGAGES IN A VARIETY OF COMMUNITY BENEFIT ACTIVITIES, PROVIDING A CRITICALLY IMPORTANT COMMUNITY BENEFIT THAT WOULD NOT OTHERWISE BE AVAILABLE IN THE COMMUNITIES SERVED WITHOUT THE EFFORTS AND SPECIALIZED KNOWLEDGE OF THE LOCAL HEALTHCARE TEAM. 16440419 0 8968825 VERNON MEMORIAL HEALTHCARE, INC. OPERATES FOUR RURAL HEALTH CLINICS LOCATED IN VIROQUA, LAFARGE, SOLDIERS GROVE, AND WESTBY. TOGETHER, THESE CLINICS STRIVE TO MEET THE HEALTHCARE NEEDS OF PATIENTS AND FAMILIES WHO LIVE AND WORK IN THE COMMUNITIES THEY SERVE. A TOTAL OF 37,799 RURAL HEALTH CLINIC VISITS OCCURRED IN FISCAL YEAR 2025. THE CLINICS ARE DESIGNATED AS RURAL HEALTH CLINICS BY THE MEDICARE AND MEDICAID PROGRAMS AND, BY DEFINITION OF THE REQUIREMENTS FOR THAT DESIGNATION, ARE LOCATED IN RURAL OR UNDERSERVED AREAS OF THE COUNTRY. THESE CLINICS PROVIDE CARE TO A LARGE PORTION OF MEDICARE AND MEDICAID BENEFICIARIES WHO, WITHOUT ACCESS TO CARE LOCALLY, WOULD BE REQUIRED TO TRAVEL FARTHER DISTANCES FOR QUALITY HEALTHCARE. 75023249 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 54 0 564 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 WI X SCOTT LECKEY 6086374964 507 SOUTH MAIN STREET VIROQUA WI 54665 PETER HUGHES CHAIR 1.00 X X 0 0 0 STACI KRING VICE CHAIR 1.00 X X 0 0 0 PAUL LARSEN TREASURER (THRU 12/2024) 1.00 X X 0 0 0 TOM WESTON TREASURER 1.00 X X 0 0 0 VICKI ANDERSON SECRETARY (THRU 12/2024) 1.00 X X 0 0 0 MICHELLE ENGH SECRETARY 1.00 X X 0 0 0 SANDRA MALLIET MEMBER 1.00 X 0 0 0 STEVE MICHAELS MEMBER 1.00 X 0 0 0 JOAN PETERSON MEMBER 1.00 X 0 0 0 KIMBERLY TURNMIRE MEMBER 1.00 X 0 0 0 JAY VOSSETEIG MEMBER 1.00 X 0 0 0 TONYA WAGNER MEMBER 1.00 X 0 0 0 PAUL WOODWARD MEMBER 1.00 X 0 0 0 DAVID HARTBERG CEO 40.00 X 437056 0 40950 SCOTT LECKEY CFO 40.00 X 296993 0 24099 ROBERT LOVEJOY COO 40.00 X 250753 0 31920 TAUQEER QAZI CMO (BEG. 09/2025) 40.00 X 0 0 0 DEBORAH PRIOR ER PHYSICIAN 30.00 X 553961 0 39798 JEFFREY SCHEIDT CRNA 40.00 X 442931 0 42505 ADAM WUENSCH ER PHYSICIAN 40.00 X 423581 0 28310 MITCHELL WILKINS CRNA 30.00 X 327688 0 9585 KENNETH HALLWOOD CRNA 40.00 X 169433 0 3692 KRISTY WILTROUT FORMER CNO 40.00 X 288974 0 20701 3191370 0 241560 91 1 1 0 GUNDERSEN LUTHERAN MEDICAL CENTER 1900 SOUTH AVE NCA1-01 LACROSSE WI 54601 MEDICAL SERVICES 3056574 BURLINGTON HEALTHCARE PROVIDERS PO BOX 180512 DELAFIELD WI 53018 STAFFING SERVICES 886900 MIRON CONSTRUCTION PO BOX 1372 GREEN BAY WI 543051372 REPAIRS AND MAINTANANCE 527657 POELLINGER ELECTRIC 5416 33RD STREET LACROSSE WI 54601 REPAIRS AND MAINTANANCE 458461 S&S MECHANICAL 1815 CALEDONIA ST LACROSSE WI 54603 REPAIRS AND MAINTANANCE 428471 23 67012 67012 HOSPITAL 621990 73066874 73066874 RETAIL PHARMACY 456110 11094942 11094942 CLINIC 621110 8968825 8968825 917468 917468 94048109 2500920 2500920 334957 0 334957 334957 334957 20475 -20475 -20475 -20475 CAFETERIA REVENUE 722514 134736 134736 134736 97065259 94048109 0 2950138 78470 78470 49483 49483 1190304 333148 857156 38271195 33166458 5104737 1052599 966879 85720 7529025 6826183 702842 2599768 2342710 257058 204100 16287 187813 5989 5989 83477 83477 6906617 5604240 1302377 316956 311605 5351 376298 170021 206277 1007982 23076 984906 1598156 1567810 30346 39057 19535 19522 243467 188746 54721 475820 384847 90973 4098785 3315134 783651 393292 80327 312965 PHARMACEUTICALS 11782946 11782946 SUPPLIES 3651520 3636877 14643 BAD DEBT EXPENSE 2487285 2487285 EQUIPMENT RENTAL & MAIN 1723174 1606808 116366 4581667 64374 4517293 90747432 75023249 15724183 0 6289806 8107460 17205110 13304979 192520 208491 8916109 9818297 2718925 2882810 453815 914033 99400906 61116692 37015170 38284214 57657961 66671122 133193 141183 5000113 8662607 135582722 148995196 4804586 7116951 12529851 11511446 3609672 4077515 20944109 22705912 X 114446093 126080793 192520 208491 114638613 126289284 135582722 148995196 6317827 5332844 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 5989 5989 0 PART II-B, LINE 1: VERNON MEMORIAL HEALTHCARE, INC. PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE WISCONSIN HOSPITAL ASSOCIATION AND RURAL WISCONSIN HEALTH COOPERATIVE. THESE DUES ARE PRIMARILY FOR ACCESS TO EDUCATIONAL MATERIALS AND STAFF TRAINING AND DEVELOPMENT. A SMALL PORTION OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT. 1512508 1512508 65938304 41254407 24683897 29329114 19862285 9466829 2620980 2620980 38284214 AMOUNTS RECEIVABLE FROM THIRD-PARTY REIMBURSEMENT PROGRAMS 4387193 OTHER RECEIVABLES 1131075 DEFERRED COMPENSATION PLAN 3084799 DUE FROM FOUNDATION 59540 8662607 DEFERRED COMPENSATION PLAN LIABILITY 3117515 MEDICAL CLAIMS PAYABLE 960000 4077515 99811370 5332844 -2487285 2845559 96965811 83477 15971 99448 97065259 88176670 0 88176670 83477 2487285 2570762 90747432 PART XI, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT EXPENSE NET AGAINST REVENUE -2,487,285. PART XI, LINE 4B - OTHER ADJUSTMENTS: CONTRIBUTIONS TO RESTRICTED NET ASSETS 33,992. NET ASSETS RELEASED FROM RESTRICTIONS -18,021. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE NET AGAINST REVENUE 2,487,285. 1 1 X 1 X 1 X 1 1 1 0 1 1 1299611 1299611 0.01520 8942980 7495945 1447035 0.01690 10242591 7495945 2746646 0.03210 51280 51280 0.00060 845600 845600 0.00990 3265067 1781209 1483858 0.01740 26934 26934 0.00030 4188881 1781209 2407672 0.02820 14431472 9277154 5154318 0.06030 0 2306268 1153134 13686555 13716906 -30351 X 1 1 1 1 VERNON MEMORIAL HOSPITAL INC 507 SOUTH MAIN ST VIROQUA WI 54665 WWW.VMH.ORG 1053 X X X X VERNON MEMORIAL HEALTHCARE INC 1 0 0 1 X X X X X X X X X X 23 1 1 1 1 X SEE PART V, SECTION C, LINE 7D X SEE PART V, SECTION C, LINE 7D X X 1 23 1 SEE PART V, SECTION C, LINE 7D 0 1 X 200.000000000000 400.000000000000 X X 1 1 X X X X 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X X 1 X 0 X X X X 1 X 0 0 VERNON MEMORIAL HEALTHCARE, INC. PART V, SECTION B, LINE 3J: MENTAL HEALTH INITIATIVES:- EXPANDED BEHAVIORAL HEALTH SERVICES BY ADDING NEW PROVIDERS.- CONDUCTED PUBLIC AWARENESS CAMPAIGNS TO REDUCE MENTAL HEALTH STIGMA.- INTEGRATED MENTAL HEALTH SERVICES INTO PRIMARY CARE CLINICS.- ESTABLISHED COMMUNITY CLUBS TO MITIGATE LONELINESS.- TRAINED STAFF ON MENTAL HEALTH SUPPORT.ADDRESSING SOCIAL & ECONOMIC ISSUES:- ORGANIZED QUARTERLY FOOD DRIVES AND DISTRIBUTED HUNGER RESOURCE PACKETS.- COLLABORATED WITH COMMUNITY PARTNERS TO ENHANCE FOOD ACCESS POINTS.- ASSISTED PATIENTS IN ACCESSING FINANCIAL ASSISTANCE PROGRAMS.- CONDUCTED INTERNAL DIVERSITY AND SOCIAL CONDITIONS TRAINING.- EXPANDED COMMUNITY GARDENS AND PARTNERSHIPS WITH FARMERS MARKETS.IMPROVING HEALTHCARE ACCESS:- LAUNCHED PUBLIC AWARENESS CAMPAIGNS FOR PREVENTIVE SCREENINGS.- EDUCATED COMMUNITY MEMBERS ON USING MYCHART FOR SCHEDULING.- CONDUCTED DEDICATED CANCER SCREENING CAMPAIGNS.- UTILIZED TECHNOLOGY TO STREAMLINE SCREENING PROCESSES.- PROVIDED FINANCIAL ASSISTANCE EDUCATION FOR PREVENTIVE SCREENINGS.COMMUNITY COLLABORATION:- PARTNERED WITH LOCAL HEALTH DEPARTMENTS, SCHOOL DISTRICTS, AND AGENCIES.- ENGAGED IN JOINT INITIATIVES TO ADDRESS IDENTIFIED HEALTH NEEDS.- SUPPORTED OTHER ORGANIZATIONS IN MEETING COMMUNITY HEALTH NEEDS.PUBLIC HEALTH CAMPAIGNS:- INCREASED AWARENESS ABOUT MENTAL HEALTH AND AVAILABLE SERVICES.- PROMOTED HEALTHY EATING AND PHYSICAL ACTIVITY.- ADDRESSED SUBSTANCE ABUSE AND ITS IMPACT ON MENTAL HEALTH.- EMPHASIZED THE IMPORTANCE OF TIMELY HEALTHCARE ACCESS. VERNON MEMORIAL HEALTHCARE, INC. PART V, SECTION B, LINE 5: THE SURVEY WAS CONDUCTED USING MIXED METHODS, AND RESPONDENTS COULD EITHER COMPLETE THEIR SURVEY ONLINE OR SUBMIT A PAPER COPY OF THEIR SURVEY RESPONSE. GREAT RIVERS UNITED WAY STAFF AND VOLUNTEERS ENTERED PAPER SURVEY RESPONSES INTO A QUALTRICS SURVEY PORTAL PROVIDED BY COMMUNITY HEALTH SOLUTIONS. THE SURVEY WAS CONDUCTED IN PARTNERSHIP WITH A WIDE RANGE OF COMMUNITY PARTNERS THAT HELPED RAISE AWARENESS AND ENCOURAGE COMMUNITY MEMBERS TO COMPLETE THE SURVEY. IN PLANNING THE SURVEY, THE PROJECT PARTNERS BEGAN WITH A COMMON AIM TO CONDUCT AN INCLUSIVE SURVEY WITH INSIGHTS FROM A WIDE ARRAY OF COMMUNITY MEMBERS. IT SHOULD BE NOTED THAT THE SURVEYS WERE CONDUCTED USING CONVENIENCE SAMPLING. CONVENIENCE SAMPLING IS A PRACTICAL APPROACH FOR OBTAINING INSIGHTS FROM AS MANY PEOPLE AS POSSIBLE, BUT WITHOUT RANDOM SELECTION. THE RESULTS OF A CONVENIENCE SAMPLE ARE INSTRUCTIVE FOR UNDERSTANDING THE SCOPE OF ISSUES AND OPPORTUNITIES IN A COMMUNITY; HOWEVER, RESULTS MIGHT NOT BE STATISTICALLY REPRESENTATIVE OF THE ENTIRE POPULATION OF A COMMUNITY. A TOTAL OF 1,238 INDIVIDUALS SUBMITTED A RESPONSE TO THE SURVEY (ALTHOUGH NOT EVERY RESPONDENT COMPLETED EVERY ITEM). A PROFILE OF THE SURVEY RESPONDENTS IS PROVIDED IN EXHIBIT 1.3. AS SHOWN IN THE EXHIBIT:THE NUMBER OF SURVEYS COMPLETED BY COUNTY RANGED FROM 89 IN HOUSTON COUNTY AND TREMPEALEAU COUNTY TO 536 IN LA CROSSE COUNTY. NOTING THIS WIDE RANGE OF RESPONSES, IT IS IMPORTANT TO VIEW THE SURVEY RESULTS AT THE COUNTY LEVEL AND RECOGNIZE THAT THE HIGHER NUMBER OF RESPONSES FROM LA CROSSE COUNTY AND MONROE COUNTY HAVE A SKEWING EFFECT ON THE REGIONAL RESULTS. THE SURVEY RESPONDENTS WERE PREDOMINANTLY FEMALE (77%), AS IS COMMON IN COMMUNITY SURVEY OF THIS TYPE. BEYOND THE DIFFERENCE IN FEMALE VS. MALE RESPONDENTS, THE DEMOGRAPHIC PROFILE FOR SURVEY RESPONDENTS GENERALLY (THOUGH NOT PRECISELY) REFLECTS THE OVERALL DISTRIBUTION OF THE POPULATION BY SELECTED INDICATORS OF AGE, RACE, ETHNICITY, AND INCOME. VERNON MEMORIAL HEALTHCARE, INC. PART V, SECTION B, LINE 6A: THE COMPASS NOW 2024 PARTNERSHIP WAS CONDUCTED IN JOINT EFFORT WITH THE FOLLOWING OTHER HOSPITALS:1. GUNDERSEN HEALTH SYSTEM, LA CROSSE2. MAYO CLINIC HEALTH SYSTEM, LA CROSSE AND SPARTA3. GUNDERSEN ST. JOSEPH'S HOSPITAL AND CLINICS, HILLSBORO4. GUNDERSEN TRI-COUNTY HOSPITAL AND CLINICS, WHITEHALL5. TOMAH HEALTH, TOMAH VERNON MEMORIAL HEALTHCARE, INC. PART V, SECTION B, LINE 6B: THE COMPASS NOW 2024 PARTNERSHIP WAS CONDUCTED IN JOINT EFFORT WITH THE FOLLOWING ORGANIZATIONS:1. GREAT RIVERS UNITED WAY2. TREMPEALEAU COUNTY HEALTH DEPARTMENT3. MONROE COUNTY HEALTH DEPARTMENT5. VERNON COUNTY HEALTH DEPARTMENT6. LA CROSSE COUNTY HEALTH DEPARTMENT7. BUFFALO COUNTY HEALTH DEPARTMENT8. HOUSTON COUNTY HEALTH DEPARTMENT (MINNESOTA)9. COULEECAP10. LA CROSSE COUNTY HUMAN SERVICES VERNON MEMORIAL HEALTHCARE, INC. PART V, SECTION B, LINE 7D: PART V, SECTION B, LINE 7A:HTTPS://WWW.VMH.ORG/COMMUNITY-INVOLVEMENT/PART V, SECTION B, LINE 7B:HTTPS://WWW.GREATRIVERSUNITEDWAY.ORG/WP-CONTENT/UPLOADS/2024/08/COMPASS-NOW-2024_WEB.PDFPART V, SECTION B, LINE 10A:HTTPS://WWW.VMH.ORG/COMMUNITY-INVOLVEMENT/ VERNON MEMORIAL HEALTHCARE, INC. PART V, SECTION B, LINE 11: BASED ON THE 2024 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IMPLEMENTATION PLAN, HERE IS HOW VERNON MEMORIAL HEALTHCARE (VMH) IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN ITS MOST RECENT CHNA:ADDRESSING SIGNIFICANT NEEDS- MENTAL HEALTH: - ACTIONS TAKEN: - EXPANDED BEHAVIORAL HEALTH SERVICES BY ADDING NEW PROVIDERS. - CONDUCTED PUBLIC AWARENESS CAMPAIGNS TO REDUCE MENTAL HEALTH STIGMA. - INTEGRATED MENTAL HEALTH SERVICES INTO PRIMARY CARE CLINICS. - ESTABLISHED COMMUNITY CLUBS TO MITIGATE LONELINESS. - TRAINED STAFF ON MENTAL HEALTH SUPPORT. - REASON FOR ACTION: HIGH CONCERN ABOUT MENTAL HEALTH AND STIGMA AMONG COMMUNITY MEMBERS.- SOCIAL & ECONOMIC ISSUES: - ACTIONS TAKEN: - ORGANIZED QUARTERLY FOOD DRIVES AND DISTRIBUTED HUNGER RESOURCE PACKETS. - COLLABORATED WITH COMMUNITY PARTNERS TO ENHANCE FOOD ACCESS POINTS. - ASSISTED PATIENTS IN ACCESSING FINANCIAL ASSISTANCE PROGRAMS. - CONDUCTED INTERNAL DIVERSITY AND SOCIAL CONDITIONS TRAINING. - EXPANDED COMMUNITY GARDENS AND PARTNERSHIPS WITH FARMERS MARKETS. - REASON FOR ACTION: SIGNIFICANT CHALLENGES RELATED TO FOOD ACCESS AND ECONOMIC STABILITY, WITH MANY HOUSEHOLDS LIVING AT OR BELOW THE POVERTY LINE.- HEALTHCARE ACCESS: - ACTIONS TAKEN: - LAUNCHED PUBLIC AWARENESS CAMPAIGNS FOR PREVENTIVE SCREENINGS. - EDUCATED COMMUNITY MEMBERS ON USING MYCHART FOR SCHEDULING. - CONDUCTED DEDICATED CANCER SCREENING CAMPAIGNS. - UTILIZED TECHNOLOGY TO STREAMLINE SCREENING PROCESSES. - PROVIDED FINANCIAL ASSISTANCE EDUCATION FOR PREVENTIVE SCREENINGS. - REASON FOR ACTION: DIFFICULTY IN SCHEDULING APPOINTMENTS AND THE NEED TO IMPROVE PARTICIPATION IN PREVENTIVE SCREENINGS. VERNON MEMORIAL HEALTHCARE, INC. PART V, SECTION B, LINE 13B: PATIENTS' RELIANCE ON MEDICARE OR MEDICAL ASSISTANCE. VERNON MEMORIAL HEALTHCARE, INC. PART V, SECTION B, LINE 13H: THE ORGANIZATION PROVIDES "CATASTROPHIC CARE" FOR PATIENTS NOT MEETING FINANCIAL ASSISTANCE ELIGIBILITY. THESE PATIENTS MAY BE ELIGIBLE FOR ASSISTANCE UNDER CIRCUMSTANCES WHEN MEDICAL BILLS WOULD RESULT IN SEVERE FINANCIAL HARDSHIP. PATIENTS, OR THEIR GUARANTORS, MAY BE ELIGIBLE FOR CATASTROPHIC CARE ASSISTANCE IF THEY INCURRED OUT-OF-POCKET OBLIGATIONS RESULTING FROM MEDICAL SERVICES PROVIDED BY VERNON MEMORIAL HEALTHCARE, INC. THAT EXCEED 25% OF THE ADJUSTED GROSS INCOME AND HAVE ASSETS BELOW THE EQUIVALENT OF 600% OF THE FPL THRESHOLD. VERNON MEMORIAL HEALTHCARE, INC. PART V, SECTION B, LINE 15E: LANGUAGE TAGLINES FOR ASSISTANCE SCHEDULE H, PART V, LINE 16A-C: LINE 16A, FINANCIAL ASSISTANCE POLICY:HTTPS://WWW.VMH.ORG/PATIENTS-VISITORS/BILLING-INSURANCE/LINE 16B, FINANCIAL ASSISTANCE APPLICATION:HTTPS://WWW.VMH.ORG/WP-CONTENT/UPLOADS/2025/01/2022-FAP-APPLICATION.PDFLINE 16C, FINANCIAL ASSISTANCE PROGRAM PLAIN LANGUAGE SUMMARY:HTTPS://WWW.VMH.ORG/WP-CONTENT/UPLOADS/2025/01/BRANDING-BROCHURE-FINANCIALASSISTANCEONLINE.PDF 7 1 - HIRSCH CLINIC 407 S MAIN ST SUITE 400 VIROQUA WI 54665 PROVIDER BASED RURAL HEALTH CLINIC 2 - LAFARGE MEDICAL CLINIC 206 N MILL ST LAFARGE WI 54639 PROVIDER BASED RURAL HEALTH CLINIC 3 - VERNON MEMORIAL HEALTHCARE PHARMACY 407 S MAIN ST SUITE 400 VIROQUA WI 54665 PHARMACY 4 - BLAND CLINIC 100 MELBY ST WESTBY WI 54667 PROVIDER BASED RURAL HEALTH CLINIC 5 - VERNON MEMORIAL PHARMACY - LAFARGE 206 N MILL STREET LAFARGE WI 54639 PHARMACY 6 - SOLAR TOWN PHARMACY 104 SUNSET AVE SOLDIERS GROVE WI 54655 PHARMACY 7 - KICKAPOO VALLEY MEDICAL CLINIC 102 SUNSET AVE SOLDIERS GROVE WI 54655 PROVIDER BASED RURAL HEALTH CLINIC PART I, LINE 3C: CATASTROPHIC CARE: PATIENTS NOT MEETING FINANCIAL ASSISTANCE ELIGIBILITY THRESHOLDS MAY BE ELIGIBLE FOR ASSISTANCE UNDER CIRCUMSTANCES WHEN MEDICAL BILLS WOULD RESULT IN SEVERE FINANCIAL HARDSHIP. PATIENTS, OR THEIR GUARANTORS, MAY BE ELIGIBLE FOR CATASTROPHIC CARE ASSISTANCE IF THEY INCURRED OUT-OF-POCKET OBLIGATIONS RESULTING FROM MEDICAL SERVICES PROVIDED BY VERNON MEMORIAL HEALTHCARE, INC. THAT EXCEED 25% OF THE ADJUSTED GROSS INCOME AND HAVE ASSETS BELOW THE EQUIVALENT OF 600% OF THE FPL THRESHOLD. 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 REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER IRS COSTING METHODS FOR THE FORM 990. PART I, LINE 7G: THE HOSPITAL IS REPORTING THE ACTIVITY OF THEIR 4 RURAL CLINICS ON PART I, LINE 7G AS SUBSIDIZED HEALTH SERVICES. AMOUNTS PRESENTED ARE TOTALS LESS AMOUNTS ALREADY RECORDED AS CHARITY CARE, MEDICAID AND BAD DEBT IN OTHER SECTIONS OF SCHEDULE H. 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 $ 5,226,135. PART II, COMMUNITY BUILDING ACTIVITIES: OUR HOSPITAL PROVIDES CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS. IN ADDITION, WE BELIEVE THE HOSPITAL DELIVERS A VITAL COMMUNITY BENEFIT THAT IS NOT EASILY MEASURED. LIKE MANY RURAL HOSPITALS, OUR ORGANIZATION EXISTS TO ENSURE LOCAL ACCESS TO A BROAD RANGE OF ESSENTIAL HEALTH SERVICES THAT WOULD OTHERWISE REQUIRE PATIENTS TO TRAVEL LONG DISTANCES.THESE SERVICES INCLUDE A BIRTHING CENTER; DIAGNOSTIC SERVICES; EMERGENCY AND URGENT CARE; INFUSION SERVICES; INPATIENT CARE; LABORATORY SERVICES; OCCUPATIONAL HEALTH; REHABILITATION SERVICES; SPECIALTY MEDICAL CARE; SPEECH AND AUDIOLOGY SERVICES; SURGICAL SERVICES; AND WOMEN'S HEALTH. BY OFFERING THESE SERVICES LOCALLY, THE HOSPITAL PLAYS A CRITICAL ROLE IN SUPPORTING THE HEALTH, SAFETY, AND WELL-BEING OF THE COMMUNITY IT SERVES. PART III, LINE 4: ACCOUNTS RECEIVABLE AND CREDIT POLICY:IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE ORGANIZATION ANALYZES PAST RESULTS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. SPECIFICALLY, FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE ORGANIZATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS AND PATIENTS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE ORGANIZATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.THE AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A SEPARATE FOOTNOTE REGARDING BAD DEBT EXPENSE. PART III, LINE 8: VERNON MEMORIAL HEALTHCARE, INC. IS DESIGNATED AS A CRITICAL ACCESS HOSPITAL AND AS SUCH A PORTION OF ITS REVENUES ARE PAID UNDER A COST REIMBURSEMENT SYSTEM. BASED ON THE INSTRUCTIONS, THE TOTAL MEDICARE REVENUE SHOWN ON THIS FORM 990 INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE THAT IS ACTUALLY RECEIVED BY THE HOSPITAL FROM THE MEDICARE PROGRAM. THE AMOUNTS LISTED FOR MEDICARE DO NOT INCLUDE PHYSICIAN AND MID-LEVEL PRACTITIONER SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT. PHYSICIAN COVERAGE IS REIMBURSED PRIMARILY ON A FEE SCHEDULE REIMBURSEMENT METHODOLOGY AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND AS SUCH THESE COSTS AND SHORTFALLS SHOULD ALSO BE CONSIDERED AS AN ADDITIONAL BENEFIT THAT VERNON MEMORIAL HEALTHCARE, INC. PROVIDES TO THE COMMUNITY AND SURROUNDING AREA. THE COSTING METHOD USED ABOVE FOR IRS FORM 990 COMPLIANCE REPORTING IS ALSO BASED ON AN OVERALL AVERAGE COST-TO-CHARGE RATIO 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) DIVIDED BY TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBT EXPENSE. THIS RATIO IS THEN MULTIPLIED BY THE TOTAL MEDICARE SERVICES WHICH ARE REIMBURSED ON A COST METHODOLOGY EXCLUDING THE FEE SCHEDULE ITEMS LIKE PHYSICIAN AND MID-LEVEL PRACTITIONER SERVICES WHICH THE HOSPITAL WOULD SHOW A LARGE LOSS ON THESE SERVICES.WHETHER THERE IS A SHORTFALL OR SURPLUS FROM SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THE RECIPIENTS ARE TYPICALLY ELDERLY AND/OR DISABLED MEMBERS OF THE COMMUNITY AND 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: IN ORDER TO PROVIDE THE LEVEL OF AID NECESSARY TO THE GREATEST NUMBER OF PATIENTS IN NEED, AND PROTECT THE RESOURCES NEEDED TO DO SO, THE FOLLOWING GUIDELINES APPLY: 1) SERVICES ARE PROVIDED UNDER CHARITY CARE ONLY WHEN DEEMED MEDICALLY NECESSARY AND AFTER PATIENTS ARE FOUND TO HAVE MET ALL FINANCIAL CRITERIA BASED ON THE DISCLOSURE OF PROPER INFORMATION AND DOCUMENTATION. 2) CHARITY CARE IS NOT AVAILABLE FOR ELECTIVE PROCEDURES. 3) PATIENTS ARE EXPECTED TO CONTRIBUTE PAYMENT FOR CARE BASED ON THEIR INDIVIDUAL FINANCIAL SITUATION; THEREFORE, EACH CASE WILL BE REVIEWED SEPARATELY. 4) CHARITY CARE IS NOT CONSIDERED AN ALTERNATIVE OPTION FOR PAYMENT AND PATIENTS MAY BE ASSISTED IN FINDING OTHER MEANS OF PAYMENT OR FINANCIAL ASSISTANCE BEFORE APPROVAL FOR CHARITY CARE. 5) UNINSURED PATIENTS WHO ARE BELIEVED TO HAVE THE FINANCIAL ABILITY TO PURCHASE HEALTH INSURANCE MAY BE ENCOURAGED TO DO SO IN ORDER TO ENSURE HEALTHCARE ACCESSIBILITY AND OVERALL WELL-BEING. PART VI, LINE 2: VERNON HEALTH USES A VARIETY OF APPROACHES TO UNDERSTAND AND EVALUATE THE NEEDS OF THE COMMUNITIES IT SERVES. ALONGSIDE A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) COMPLETED IN PARTNERSHIP WITH NEIGHBORING HEALTHCARE ORGANIZATIONS, GREAT RIVERS UNITED WAY, AND LOCAL COUNTY HEALTH DEPARTMENTS, THE ORGANIZATION ALSO RELIES ON SEVERAL INFORMAL FEEDBACK CHANNELS. THESE INCLUDE FOCUS GROUPS AND ADVISORY COUNCILS, CONVERSATIONS WITH LOCAL EMPLOYERS, AND ONLINE SURVEYS.ACTIVE INVOLVEMENT ON LOCAL AND STATE BOARDS AND COMMITTEES FURTHER HELPS VERNON HEALTH REMAIN INFORMED ABOUT EVOLVING COMMUNITY PRIORITIES. THE ORGANIZATION ALSO WORKS CLOSELY WITH A WIDE RANGE OF COMMUNITY PARTNERS SUCH AS CHURCHES, BUSINESSES, AGENCIES, SCHOOLS, AND OTHER ORGANIZATIONS TO GAIN ADDITIONAL PERSPECTIVE ON LOCAL NEEDS.BOARD MEMBERS, WHO REPRESENT THE VARIOUS COMMUNITIES SERVED, REGULARLY INTERACT WITH RESIDENTS AND LOCAL COMMUNITIES TO GATHER FEEDBACK ON SERVICES AND BETTER UNDERSTAND COMMUNITY CONCERNS. IN ADDITION, SOCIAL MEDIA METRICS AND ONLINE ENGAGEMENT TRENDS ARE REVIEWED TO IDENTIFY EMERGING ISSUES AND INTERESTS. TO COMPLEMENT THESE EFFORTS, PATIENT SATISFACTION SURVEYS ARE SHARED FOLLOWING VISITS TO CAPTURE DIRECT FEEDBACK ON THE CARE EXPERIENCE. PART VI, LINE 3: VERNON HEALTH USES A COMPREHENSIVE MIX OF METHODS TO COLLECT AND EVALUATE DATA RELATED TO THE NEEDS OF THE COMMUNITIES IT SERVES. ALONG WITH A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) CONDUCTED IN PARTNERSHIP WITH NEIGHBORING HEALTHCARE ORGANIZATIONS, GREAT RIVERS UNITED WAY, AND COUNTY HEALTH DEPARTMENTS, THE ORGANIZATION ALSO RELIES ON INFORMAL FEEDBACK TOOLS SUCH AS FOCUS AND ADVISORY GROUPS, CONVERSATIONS WITH LOCAL EMPLOYERS, AND ONLINE SURVEYS.THE ORGANIZATION STAYS INFORMED ABOUT EVOLVING COMMUNITY PRIORITIES THROUGH ACTIVE PARTICIPATION ON LOCAL AND STATE BOARDS AND COMMITTEES. ADDITIONAL INSIGHT IS GAINED THROUGH COLLABORATION WITH COMMUNITY PARTNERS, INCLUDING ORGANIZATIONS, CHURCHES, BUSINESSES, AGENCIES, AND SCHOOLS. BOARD MEMBERS, WHO REPRESENT THE DIVERSE COMMUNITIES SERVED, REGULARLY ENGAGE WITH RESIDENTS TO BETTER UNDERSTAND THEIR CONCERNS AND EXPERIENCES ACCESSING CARE.FURTHER PERSPECTIVES ON COMMUNITY NEEDS ARE OBTAINED BY REVIEWING SOCIAL MEDIA ANALYTICS AND ONLINE ENGAGEMENT TRENDS. PATIENT INPUT IS ALSO GATHERED THROUGH POST-VISIT SURVEYS, PROVIDING VALUABLE FEEDBACK ON THE QUALITY OF CARE DELIVERED.IN ADDITION, VERNON HEALTH INFORMS AND EDUCATES PATIENTS AND INDIVIDUALS BILLED FOR CARE ABOUT THEIR POTENTIAL ELIGIBILITY FOR FINANCIAL ASSISTANCE PROGRAMS AT THE FEDERAL, STATE, AND LOCAL LEVELS. THIS INFORMATION IS SHARED THROUGH MULTIPLE CHANNELS, INCLUDING REGISTRATION AND INTAKE PROCESSES, BILLING STATEMENTS, FINANCIAL COUNSELING SERVICES, PATIENT FINANCIAL ASSISTANCE POLICIES, WRITTEN MATERIALS, AND ONLINE RESOURCES. STAFF ARE TRAINED TO GUIDE PATIENTS THROUGH AVAILABLE OPTIONS, CONNECT THEM WITH APPROPRIATE ASSISTANCE PROGRAMS, AND SUPPORT APPLICATION PROCESSES TO ENSURE PATIENTS ARE AWARE OF AND ABLE TO ACCESS FINANCIAL SUPPORT RESOURCES WHEN NEEDED. PART VI, LINE 4: VERNON HEALTH SERVES A PREDOMINANTLY RURAL REGION IN SOUTHWESTERN WISCONSIN, WITH A PRIMARY SERVICE AREA CENTERED AROUND VIROQUA AND THE SURROUNDING COMMUNITIES OF WESTBY, READSTOWN, SOLDIERS GROVE, CASHTON, AND LAFARGE, AS WELL AS NEARBY RURAL TOWNSHIPS. THIS PRIMARY SERVICE AREA ENCOMPASSES AN ESTIMATED POPULATION OF APPROXIMATELY 28,000 RESIDENTS.THE ORGANIZATION'S SECONDARY SERVICE AREA EXTENDS TO ADDITIONAL NEIGHBORING COMMUNITIES, INCLUDING DESOTO, FERRYVILLE, HILLSBORO, COON VALLEY, RICHLAND CENTER, GAYS MILLS, VIOLA, AND ONTARIO, INCREASING THE TOTAL POPULATION SERVED BY APPROXIMATELY 25,000 INDIVIDUALS.THE COMMUNITIES SERVED BY VERNON HEALTH ARE LARGELY RURAL IN NATURE AND ARE CHARACTERIZED BY AN AGING POPULATION AND GENERALLY MODEST HOUSEHOLD INCOME LEVELS. THESE DEMOGRAPHIC FACTORS INFLUENCE HEALTHCARE ACCESS, UTILIZATION, AND SERVICE NEEDS ACROSS THE REGION AND ARE KEY CONSIDERATIONS IN THE ORGANIZATION'S PLANNING AND COMMUNITY HEALTH EFFORTS. PART VI, LINE 5: VERNON HEALTH CARRIES OUT ITS MISSION BY PROVIDING A COMPREHENSIVE RANGE OF OUTPATIENT AND INPATIENT MEDICAL SERVICES TO THE COMMUNITIES IT SERVES WITHOUT DISCRIMINATION BASED ON SEXUAL ORIENTATION, RACE, COLOR, CREED, RELIGION, AGE, DISABILITY, OR NATIONAL ORIGIN. THE ORGANIZATION OPERATES A 24/7 EMERGENCY DEPARTMENT THAT PROVIDES CARE TO ALL INDIVIDUALS, REGARDLESS OF THEIR ABILITY TO PAY, ENSURING ACCESS TO ESSENTIAL EMERGENCY SERVICES FOR THE REGION.VERNON HEALTH OWNS AND OPERATES FOUR RURAL HEALTH CLINICS LOCATED IN VIROQUA, WESTBY, SOLDIERS GROVE, AND LAFARGE, AS WELL AS FOUR RETAIL PHARMACIES SERVING THE COMMUNITIES OF VIROQUA, WESTBY, LAFARGE, AND SOLDIERS GROVE. THESE FACILITIES HELP PROMOTE COMMUNITY HEALTH BY OFFERING CONVENIENT ACCESS TO PRIMARY CARE AND PHARMACY SERVICES CLOSE TO HOME.THE ORGANIZATION WORKS CLOSELY WITH LOCAL COMMUNITIES, CHURCHES, BUSINESSES, AND OTHER HEALTHCARE PARTNERS TO IMPROVE ACCESS TO HIGH-QUALITY CARE AND ADDRESS LOCAL HEALTH NEEDS. OVERSIGHT IS PROVIDED BY AN INDEPENDENT BOARD OF DIRECTORS MADE UP OF COMMUNITY MEMBERS FROM ACROSS THE SERVICE AREA, ENSURING DECISIONS REFLECT LOCAL PRIORITIES.VERNON HEALTH MAINTAINS AN OPEN AND QUALIFIED MEDICAL STAFF, WITH PHYSICIANS COLLABORATING CLOSELY WITH HOSPITAL LEADERSHIP TO DELIVER SAFE, HIGH-QUALITY CARE. ALL PHYSICIANS AND AFFILIATED STAFF COMPLETE A THOROUGH CREDENTIALING AND ORIENTATION PROCESS TO MEET PROFESSIONAL AND ORGANIZATIONAL STANDARDS.ANY SURPLUS FUNDS GENERATED FROM OPERATIONS ARE REINVESTED INTO FACILITIES, EQUIPMENT, AND THE EXPANSION OF ESSENTIAL SERVICES, ALLOWING VERNON HEALTH TO CONTINUE MEETING THE EVOLVING HEALTHCARE NEEDS OF THE COMMUNITIES IT SERVES. PART VI, LINE 7, REPORTS FILED WITH STATES WI 1 VERNON MEMORIAL HEALTHCARE FOUNDATION INC 507 S MAIN ST VIROQUA WI 54665 391515716 501(C)(3) 35962 0 OPERATIONS SUPPORT WESTERN TECHNICAL COLLEGE 400 7TH STREET NORTH LA CROSSE WI 54601 396002842 GOV'T ORGANIZATION 0 14574 FAIR MARKET VALUE EDUCATION EQUIPMENT EDUCATION SUPPORT 2 0 SCHOLARSHIPS 12 49483 PART I, LINE 2: CHARITABLE CONTRIBUTIONS MADE BY VERNON MEMORIAL HEALTHCARE (CMH) WILL BE LIMITED TO ELIGIBLE ORGANIZATIONS THAT SET FORWARD A FUNDING REQUEST THAT DEMONSTRATE AN ALIGNMENT WITH THE VMH MISSION, VMH VISION AND VALUES, AND/OR TARGETED TO SUPPORT A NEED SET FORWARD IN THE COMMUNITY HEALTH NEEDS ASSESSMENT FOR THE COMMUNITIES SERVED BY VMN. ALL ELIGIBLE ORGANIZATIONS MUST BE RECOGNIZED AS A 501(C)(3) ENTITY BY THE INTERNAL REVENUE SERVICE. THE MARKETING MANAGER IS RESPONSIBLE FOR EVALUATION OF ALL APPLICATIONS TO DETERMINE ALIGNMENT WITH THIS POLICY AND TO ENSURE THAT VMH MAINTAINS APPROPRIATE OVERALL FISCAL CONTROL ON EXPENDITURE OF COMMUNITY SUPPORT FUNDS. IT IS HER/HIS INDIVIDUAL AUTHORITY TO DENY ANY REQUEST THAT DOES NOT MEET ESTABLISHED CRITERIA OR THAT IS NOT IN ALIGNMENT WITH THE VMH FISCAL NEEDS AND SHE/HE HAS FINAL AUTHORITY FOR THAT DECISION. FOR THOSE APPLICATIONS DEEMED TO MEET THE CRITERIA OF THIS POLICY, THE FOLLOWING TABLE HIGHLIGHTS AUTHORITY LIMITS: MARKETING MANAGER -$5,000 AND BELOW -AND ONE-TIME DONATION -AND TOTAL ANNUAL COMMITMENT REMAINS AT OR BELOW BUDGET CEO -$5,001 AND UP -AND ONE-TIME DONATION -AND TOTAL ANNUAL COMMITMENT REMAINS AT OR BELOW BUDGET BOARD OF DIRECTORS -DONATIONS CAUSE THE ENTITY TO EXCEED THE ANNUAL APPROVED BUDGET VALUE -AND/OR ALL MULTI-YEAR COMMITMENTS X X X 1 0 0 0 0 0 0 1 0 DEBORAH PRIOR ER PHYSICIAN 552663 0 938 0 360 0 18405 0 21393 0 593759 0 0 0 JEFFREY SCHEIDT CRNA 441470 0 1101 0 360 0 14773 0 27732 0 485436 0 0 0 DAVID HARTBERG CEO 397001 0 17454 0 22601 0 14295 0 26655 0 478006 0 0 0 ADAM WUENSCH ER PHYSICIAN 413239 0 805 0 9537 0 578 0 27732 0 451891 0 0 0 MITCHELL WILKINS CRNA 318676 0 5657 0 3355 0 0 0 9585 0 337273 0 0 0 SCOTT LECKEY CFO 290232 0 6401 0 360 0 5367 0 18732 0 321092 0 0 0 KRISTY WILTROUT FORMER CNO 168856 0 7514 0 112604 0 6551 0 14150 0 309675 0 0 0 ROBERT LOVEJOY COO 245138 0 5255 0 360 0 10077 0 21843 0 282673 0 0 0 KENNETH HALLWOOD CRNA 159080 0 10233 0 120 0 637 0 3055 0 173125 0 0 0 PART I, LINE 4A KRISTY WILTROUT, FORMER CNO, RECEIVED A SEVERANCE PAYMENT DURING CALENDAR YEAR 2024 OF $77,069. PART I, LINE 7 THE ORGANIZATION MAINTAINS AN ANNUAL INCENTIVE COMPENSATION PROGRAM FOR EMPLOYEES, INCLUDING CERTAIN EXECUTIVES, UNDER WHICH AWARDS ARE PAID BASED ON THE ACHIEVEMENT OF SPECIFIED ORGANIZATIONAL FINANCIAL PERFORMANCE GOALS. THE FINANCIAL GOALS ARE BASED ON THE BUDGETED NET OPERATING INCOME. PERFORMANCE IMPACTS THAT TOTAL REWARD PAID. BONUS/INCENTIVE PAYMENTS DURING CALENDAR YEAR 2024: - DAVID HARTBERG $17,454 - SCOTT LECKEY $6,401 - ROBERT LOVEJOY $5,255 - KRISTY WILTROUT $7,514 - DEBORAH PRIOR $938 - ADAM WUENSCH $805 - JEFFREY SCHEIDT $1,101 - MITCHEL WILKINS $5,657 - KENNETH HALLWOOD $10,233 A WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 97712DGX8 2014-12-09 19445225 REFINANCE 2005 BONDS 0 0 0 A 8175225 19445225 286481 19158744 2006 1 0 1 1 A 0 0 0 0 0 0 1 A 0 0 0 1 0 0 0 0 1 A 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 12/05/2024 FORM 990, PART VI, SECTION A, LINE 6 ANY PERSON WHO IS EIGHTEEN YEARS OF AGE OR OLDER AND A BONA FIDE RESIDENT OF VERNON COUNTY, WISCONSIN, OR THE AREA WITHIN A RADIUS OF TWENTY-FIVE MILES OF THE CITY OF VIROQUA, WISCONSIN, AND WHO HAS HERETOFORE OR MAY HEREAFTER CONTRIBUTE TEN DOLLARS OR MORE TO VERNON MEMORIAL HEALTHCARE, INC. (THE ORGANIZATION") SHALL BE A MEMBER THEREOF. ALL MEMBERS OF THE ORGANIZATION SHALL BE VOTING MEMBERS. EACH MEMBER SHALL HAVE ONE VOTE ON ANY MATTER SUBMITTED TO A VOTE OF THE MEMBERS OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE DUTIES OF THE MEMBERS OF THE ORGANIZATION SHALL BE: THE ELECTION OF MEMBERS OF THE BOARD OF DIRECTORS OF THE ORGANIZATION, THE REMOVAL OF MEMBERS OF THE BOARD OF DIRECTORS OF THE ORGANIZATION, AND THE CHANGING OF THE NUMBER OF DIRECTORS CONSTITUTING THE BOARD OF DIRECTORS OF THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7B THE DUTIES OF THE MEMBERS OF THE VERNON ORGANIZATION SHALL ALSO INCLUDE: THE AMENDMENT, RESTATEMENT, OR MODIFICATION OF THE ARTICLES OF INCORPORATION OR BYLAWS OF THE ORGANIZATION; AND THE APPROVAL OF THE SALE, LEASE, OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL OF THE ASSETS AND PROPERTY OF THE ORGANIZATION, THE DISSOLUTION OF THE ORGANIZATION, OR ITS MERGER WITH ANOTHER CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS DISTRIBUTED TO THE BOARD OF DIRECTORS OF VERNON MEMORIAL HEALTHCARE, INC. FOR REVIEW AFTER FILING THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD MEMBERS OF VERNON MEMORIAL HEALTHCARE, INC. ARE REQUIRED TO DISCLOSE ALL POSSIBLE CONFLICTS OF INTEREST WHEN FIRST ELECTED TO THE BOARD OF DIRECTORS. DURING THEIR TERMS, IF ANY BUSINESS RELATIONSHIPS ARE ENTERED INTO WHICH MAY AFFECT THEIR INDEPENDENCE AS A MEMBER, THE MEMBER MUST IMMEDIATELY DISCLOSE THESE RELATIONSHIPS. FORM 990, PART VI, SECTION B, LINE 15 TO DETERMINE APPROPRIATE SALARY RANGES FOR UPPER MANAGEMENT POSITIONS, VERNON MEMORIAL HEALTHCARE, INC. UTILIZES BENCHMARK DATA FROM SURVEYS CONDUCTED BY RELEVANT TRADE ORGANIZATIONS. THE CEO HAS THE RIGHT TO AMEND THE AMOUNT DETERMINED FOR THE CFO. THE BOARD HAS THE RIGHT TO AMEND THE AMOUNT FOR THE CEO. A COMMITTEE OF THE BOARD REVIEWS THE DATA FOR THE CEO ANNUALLY TO DETERMINE THE AMOUNT OF HIS COMPENSATION AND ANY CHANGES IN COMPENSATION ARE MAINTAINED IN THE PERSONNEL FILE. FORM 990, PART VI, SECTION C, LINE 19 VERNON MEMORIAL HEALTHCARE, INC. MAKES ITS FINANCIAL STATEMENTS AND GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC ON A PER REQUEST BASIS. THE FORM 990 IS ALSO AVAILABLE TO THE PUBLIC ON A THIRD-PARTY WEBSITE CALLED CANDID. FORM 990, PART XI, LINE 2C: OVERSIGHT OF AUDIT: VERNON MEMORIAL HEALTHCARE, INC. DOES NOT HAVE A SPECIFIC COMMITTEE WHICH ASSUMES THE RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT. THE ENTIRE BOARD OF DIRECTORS IS RESPONSIBLE FOR SELECTION OF THE INDEPENDENT ACCOUNTANT. NO CHANGES HAVE BEEN MADE IN THE PAST YEAR REGARDING THIS OVERSIGHT FUNCTION OF THE GOVERNING BODY. VERNON MEMORIALGUNDERSEN LUTHERAN MEDICAL BUILDING CONDOMINIUM ASSOC LTD 507 S MAIN ST VIROQUA WI 54665 320182492 PROPERTY MANAGEMENT WI N/A C 0.50000 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0