2024-09-12T09:58:05-05:00 2023-12-31 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2023-01-01 390808498 THE RICHLAND HOSPITAL INC RICH 6086476321 333 EAST SECOND STREET RICHLAND CENTER WI 53581 JEFF LONGBRAKE INTERIM CFO 6086476321 2024-09-10 1 0 MICHAEL J PETERSON CPA P01833529 2187224705 2024-09-10 2023 2024-08-08 14:25:15Z BRUCE ROESLER 333 EAST SECOND STREET RICHLAND CENTER WI 53581 85068079 0 X WWW.RICHLANDHOSPITAL.COM X 1937 WI OUR PATIENTS, ABOVE ALL ELSE. 10 8 498 111 1897 0 1523366 91548 67913713 72762581 458532 941222 617086 510795 70512697 74306146 0 0 0 0 38377480 41200766 0 0 121598 28468342 34459327 66845822 75660093 3666875 -1353947 90865253 94077997 8216760 11728079 82648493 82349918 OUR PATIENTS, ABOVE ALL ELSE. 0 0 53676671 0 56793810 THE RICHLAND HOSPITAL, INC. (THE HOSPITAL) OPERATES A 25-BED CRITICAL ACCESS HOSPITAL IN RICHLAND CENTER, WI. PATIENTS SERVED BY THE RICHLAND HOSPITAL IN 2023 INCLUDED 3,168 ADULTS AND PEDIATRICS INPATIENT DAYS, 258 SWING BED PATIENT DAYS, 207 NEWBORN PATIENT DAYS, 61,098 TOTAL OUTPATIENT VISITS, AND 7,409 EMERGENCY ROOM VISITS. THE HOSPITAL ALSO OPERATES A PHYSICIAN CLINIC PROVIDING PRIMARY CARE PROCEDURES SUCH AS CARDIAC TESTS AND ULTRASOUNDS. THE HOSPITAL ENGAGES IN SEVERAL EFFORTS THAT ARE DESCRIBED IN DETAIL ON THE SCHEDULE H ATTACHED TO THE RETURN. 13764733 0 15654887 THE RICHLAND HOSPITAL, INC. ALSO OPERATES THREE RURAL HEALTH CLINICS LOCATED IN RICHLAND CENTER, SPRING GREEN AND MUSCODA, WI. DURING 2023 WE CONVERTED A PROVIDER BASED CLINIC TO A RURAL HEALTH CLINIC, RAISING THE NUMBER OF RURAL HEALTH CLINICS TO THREE. THESE CLINICS PROVIDED OVER 15,199 VISITS TO PATIENTS IN THESE COMMUNITIES. THE CLINICS ARE DESIGNATED RURAL HEALTH CLINICS BY THE MEDICARE AND MEDICAID PROGRAMS AND AS SUCH BY DEFINITION ARE LOCATED IN DESIGNATED RURAL OR UNDERSERVED AREAS OF THE COUNTRY BY HEALTH CARE PRACTITIONERS. 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. 67441404 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 65 0 498 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 10 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 1 1 0 WI X JEFF LONGBRAKE 6086476321 333 EAST SECOND STREET RICHLAND CENTER WI 53581 ROBERT SMITH MD CHIEF OF STAFF 40.00 X 18697 0 723 JOHN ANNEAR CHAIR 3.00 X X 0 0 0 STEVE BAUER VICE CHAIR 1.00 X X 0 0 0 MARILYN RINEHART TREASURER 1.00 X X 0 0 0 SHELLY SCHMIDT SECRETARY 1.00 X X 0 0 0 KAY BALINK MD DIRECTOR (& EMPLOYEE) 26.00 X 168648 0 16371 LAURA MELBY DIRECTOR 1.00 X 0 0 0 TRACI PETERSON DIRECTOR 1.00 1.00 X 0 0 0 JOHN POOLE DIRECTOR 1.00 X 0 0 0 PETER WALSH DIRECTOR 1.00 X 0 0 0 BRUCE ROESLER CEO 40.00 X 352840 0 40235 ELIZABETH MOORE CFO 40.00 X 242468 0 52625 THOMAS BECK ORTHOPEDIC SURGEON 40.00 X 568881 0 29455 BRYAN MCCARVEL CRNA 40.00 X 465463 0 53947 MUHAMMAD KHAN ER PHYSICIAN 40.00 X 415730 0 23946 SHAWN O' BRIEN ER DOCTOR 40.00 X 501397 0 53946 NATHAN SCHWARTZ CRNA 40.00 X 429029 0 12968 3163153 0 284216 74 0 1 0 FASTAFF LLC 5700 S QUEBEC STSUITE 300 GREENWOOD VILLAGE CO 80111 CONTRACTED LABOR-NURSING 2122222 RURAL PHYSICIANS GROUP 5575 DTC PKWY/STE 225 GREENWOOD VILLAGE CO 80111 HOSPITALIST PROVIDER 894963 MEDICAL SOLUTIONS LLC PO BOX 850737 MINNEAPOLIS MN 554850737 CONTRACTED LABOR-NURSING 862890 PSYCHIATRIC MEDICAL CARE LLC 8 CADILLAC DRIVE/SUITE 230 BRENTWOOD TN 37027 PSYCHIATRIC SERVICES & STAFFING 614943 WIPFLI LLP 11 SCOTT STREET/PO BOX 8010 WAUSAU WI 844028010 FINANCIAL & AUDIT SERVICES 433383 10 82146 9402 91548 PATIENT SERVICE REVENUE 621990 71848664 71846767 1897 PHARMACY 340B REVENUE 456110 601930 601930 MEALS 722320 172774 172774 CONTRACTED THERAPY 621990 131741 131741 7472 7472 72762581 642503 642503 474257 29392 444865 444865 444865 10967111 64149 10670361 62180 296750 1969 298719 298719 BAD DEBT RECOVERIES 900099 65930 65930 65930 74306146 72448697 1897 1764004 X 892607 892607 31859984 29144501 2619144 96339 989782 808605 178169 3008 5333062 4295731 1021353 15978 2125331 1686421 432637 6273 263800 263800 71000 71000 10772 10772 12710663 12028655 682008 168040 46180 121860 399428 238447 160981 756726 435432 321294 789565 787340 2225 70869 67143 3726 487377 346014 141363 3150417 2722555 427862 173427 99793 73634 SUPPLIES 9447372 9388084 59288 BAD DEBT EXPENSE 2332425 2332425 EQUIPMENT RENTAL & MAIN 1060667 1055349 5318 DIETARY EXPENSE 328163 328163 2238616 1630566 608050 75660093 67441404 8097091 121598 1638 1538 28014118 29631417 11874810 12411234 2251829 2019116 310499 347439 73811899 49858038 26029294 23953861 16186428 17884764 6196637 7828628 90865253 94077997 5209868 6639943 15079 13394 2444075 4363542 547738 711200 8216760 11728079 X 82504002 80937230 144491 1412688 82648493 82349918 90865253 94077997 X -1353947 984371 71001 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 10772 10772 0 PART II-B, LINE 1: THE RICHLAND HOSPITAL, INC. (THE "HOSPITAL") PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THESE DUES ARE PRIMARILY FOR ACCESS TO EDUCATIONAL MATERIALS AND STAFF TRAINING AND DEVELOPMENT. THE WHA HAD NOTIFIED THE HOSPITAL THAT APPROXIMATELY $2,635 OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT. THE HOSPITAL IS ALSO A MEMBER OF THE RURAL WISCONSIN HEALTH COOPERATIVE (RWHC). EACH YEAR, THE HOSPITAL PAYS MEMBERSHIP FEES TO RWHC. THE RWHC PROVIDES SUPPORT SERVICES FOR A NUMBER OF ITS MEMBER HOSPITALS THROUGHOUT THE STATE OF WISCONSIN. SOME OF THE MANY SERVICES PROVIDED TO MEMBER HOSPITALS INCLUDE PROVIDING ASSISTANCE TO ORGANIZATIONS IN SECURING GRANT FUNDING FOR NEW OR EXISTING HEALTHCARE PROGRAMS, LEGAL SERVICES, REIMBURSEMENT REVIEW SERVICES, ACCOUNTING ASSISTANCE, CONTRACTING FOR THERAPIST COVERAGE, AND ADMINISTRATIVE CONSULTING SERVICES. AS A PART OF THESE SERVICES, RWHC ALSO DOES PROVIDE ANALYSIS OF CURRENT HEALTHCARE ISSUES IN AN EFFORT TO PROMOTE AND BETTER HEALTHCARE FOR HOSPITALS IN RURAL COMMUNITIES THROUGHOUT WISCONSIN. ONE OF THESE EFFORTS ALSO INCLUDES SOME LOBBYING ON BEHALF OF THE MEMBER ORGANIZATIONS. IT WAS DETERMINED THAT APPROXIMATELY $1,913 OF THE FEES PAID BY THE HOSPITAL IN 2023 RELATED TO LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE HEALTHCARE ENVIRONMENT IN THE STATE OF WISCONSIN. THE HOSPITAL IS ALSO A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION (AHA) IN WHICH $6,224 OF THEIR MEMBERSHIP DUES IS DEVOTED TO LOBBYING AND ADVOCATION AT A NATIONAL LEVEL. 74907 2738 77645 75411 -504 74907 76264 -853 75411 75098 1166 76264 72416 2682 75098 0.00000 0.77275 0.22725 0 0 2364453 2364453 46451165 31645905 14805260 609073 609073 0 24195675 17603060 6592615 191533 191533 23953861 INVESTMENT IN UNCONSOLIDATED AFFILIATE 268403 INTEREST IN NET ASSETS OF SUPPORTING ORGANIZATIONS 1332836 DEFERRED COMPENSATION PLAN ASSETS 711200 RIGHT OF USE ASSETS - OPERATING LEASES 4406189 AMOUNTS RECEIVABLE FROM THIRD-PART REIMBURSEMENT PROGRAMS 1110000 7828628 DEFERRED COMPENSATION PLAN LIABILITY 711200 711200 71136865 984371 107051 1091422 70045443 4260703 4260703 74306146 71513666 29392 29392 71484274 4175819 4175819 75660093 PART V, LINE 4: THE ENDOWMENT FUNDS MAINTAINED BY THE RICHLAND HOSPITAL, INC. HAVE BEEN RESTRICTED BY DONORS TO BE MAINTAINED IN PERPETUITY, THE INCOME OF WHICH IS EXPENDABLE TO SUPPORT SCHOLARSHIP PROGRAMS OF THE HOSPITAL. PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES INCLUDED WITH EXPENSES ON FINANCIAL STATEMENTS 29,392. CHANGE IN NET ASSETS OF UNCONSOLIDATED AFFILIATES 77,659. PART XI, LINE 4B - OTHER ADJUSTMENTS: OTHER EXPENSES NET AGAINST REVENUE ON FINANCIAL STATEMENTS 1,843,394. PROVISION FOR BAD DEBTS NET AGAINST REVENUE ON FINANCIAL STATEMENTS 2,332,425. INVESTMENT INCOME RECORDED TO UNRESTRICTED NET ASSETS 2,738. CONTRIBUTIONS FROM FOUNDATION 82,146. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES INCLUDED WITH EXPENSES ON FINANCIAL STATEMENTS 29,392. PART XII, LINE 4B - OTHER ADJUSTMENTS: OTHER EXPENSES NET AGAINST REVENUE ON FINANCIAL STATEMENTS 1,843,394. PROVISION FOR BAD DEBTS NET AGAINST REVENUE ON FINANCIAL STATEMENTS 2,332,425. 1 1 X 1 X 1 X 1 1 1 0 1 1 464878 464878 0.00630 11214362 7200209 4014153 0.05470 11679240 7200209 4479031 0.06100 51369 51369 0.00070 822576 822576 0.01120 6223190 3918352 2304838 0.03140 10609 10609 0.00010 7107744 3918352 3189392 0.04340 18786984 11118561 7668423 0.10440 138756 138756 0.00190 138756 138756 0.00190 0 1073821 536911 23128410 23293988 -165578 X 1 1 1 1 THE RICHLAND HOSPITAL INC 333 EAST SECOND STREET RICHLAND CENTER WI 53581 WWW.RICHLANDHOSPITAL.COM 1045 X X X X THE RICHLAND HOSPITAL INC 1 0 0 1 X X X X X X X X X 22 1 0 1 1 X SEE PART V, SECTION C, LINE 7D X 1 23 1 SEE PART V, SECTION C, LINE 7D 0 1 X 150.000000000000 300.000000000000 X X X X 1 1 X X X 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X 1 X 0 X X X X 1 X 0 0 THE RICHLAND HOSPITAL, INC. PART V, SECTION B, LINE 5: IN 2022, THE RICHLAND HOSPITAL'S DIRECTOR OF COMMUNITY RELATIONS AND MARKETING, RICHLAND COUNTY PUBLIC HEALTH'S LOCAL HEALTH OFFICER, UW-MADISON DIVISION OF EXTENSION RICHLAND COUNTY EXTENSION EDUCATOR, RICHLAND COUNTY DRUG-FREE COMMUNITIES PROJECT DIRECTOR, AND RICHLAND CENTER HIGH SCHOOL PUPIL SERVICES PRINCIPAL PARTNERED TO CONDUCT A COMBINED COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPROVEMENT PLAN. THIS GROUP IS KNOWN AS THE HEALTH ASSESSMENT AND WELLNESS COMMISSION (HAWC).MEMBERS OF THIS COMMISSION INCLUDED: 1. SHAWNA CONNOR, RICHLAND HOSPITAL, DIRECTOR OF COMMUNITY RELATIONS & MARKETING2. CINDY CHICKER, PRESIDENT, PARTNERS OF THE RICHLAND HOSPITAL3. CHELSEA WUNNICKE, UW-MADISON DIVISION OF EXTENSION RICHLAND COUNTY, EXTENSION EDUCATOR4. ROSE KOHOUT, RICHLAND COUNTY HEALTH AND HUMAN SERVICES, PUBLIC HEALTH, COUNTY OFFICER5. ELIZABETH PERKINS, PUPIL SERVICES PRINCIPAL, RICHLAND CENTER HIGH SCHOOL6. CARLENE SHAW, PUBLIC HEALTH NURSE, RICHLAND COUNTY HEALTH & HUMAN SERVICES7. BETSY ROESLER, DRUG-FREE COMMUNITIES PROJECT DIRECTOR, PARTNERS FOR PREVENTION COALITION OF RICHLAND COUNTY8. MEGAN RYAN, RICHLAND HOSPITAL, ADMINISTRATIVE ASSISTANT DATA COLLECTION METHODOLOGY:AT EARLY MEETINGS OF THE HAWC'S IT WAS DETERMINED BY CONSENSUS TO COLLECT CHNA DATA IN 3 WAYS. THE COMMISSION ENVISIONED THIS AS A 3-LEGGED STOOL THAT WOULD SUPPORT OUR RECOMMENDATIONS OF THE TOP HEALTH NEEDS.1. SECONDARY DATA - PURPOSE: UNDERSTAND THE HEALTH ENVIRONMENT & DOCUMENTED REALITIES. HAWC MEMBERS CURATED PUBLISHED & PRIVATE HEALTH DATA.2. COMMUNITY SURVEY - PURPOSE: COLLECT OPINIONS THAT CAN STATISTICALLY REPRESENT RICHLAND COUNTY. THIS SURVEY WAS AVAILABLE ELECTRONICALLY AND IN PRINT; IN BOTH ENGLISH AND SPANISH. .3. STAKEHOLDER DATA WALK AND FOCUS GROUPS - PURPOSE: MULTI-SECTOR STAKEHOLDERS REVIEW COUNTY DATA, THE RESULTS OF THE COMMUNITY SURVEY AND PRIORITIZE NEEDS. BOTH MEETINGS WERE OPEN TO THE PUBLIC. THE RICHLAND HOSPITAL, INC. PART V, SECTION B, LINE 6B: RICHLAND COUNTY HEALTH AND HUMAN SERVICES THE RICHLAND HOSPITAL, INC. PART V, SECTION B, LINE 7D: SCHEDULE H, PART V, LINE 7AHTTPS://WWW.RICHLANDHOSPITAL.COM/ABOUT-US/COMMUNITY-HEALTH-ASSESSMENT/SCHEDULE H, PART V, LINE 10AHTTPS://WWW.RICHLANDHOSPITAL.COM/2023-CHIP-DOCUMENT/ THE RICHLAND HOSPITAL, INC. PART V, SECTION B, LINE 11: IN 2022, THE RICHLAND HOSPITAL AND CLINICS (TRHC) COLLABORATED WITH COUNTY AND AREA AGENCIES, NON-PROFIT ORGANIZATIONS, AND MEMBERS OF THE COMMUNITY IN ORDER TO PRIORITIZE HEALTH NEEDS IN THE GREATER RICHLAND COUNTY, WISCONSIN AREA. WHAT RESULTED WAS OUR 2022 COMMUNITY HEALTH NEEDS ASSESSMENT. THE PURPOSE OF THE CHNA IS TO PROVIDE DATA-DRIVEN DIRECTION TO OUR COMMUNITY HEALTH IMPROVEMENT EFFORTS. THIS COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) SUMMARIZES TRHC'S ACTION PLAN. IT SHOULD BE NOTED THAT TRHC INTENDS TO ENACT ELEMENTS OF THIS PLAN IN COOPERATION WITH THE AFOREMENTIONED COUNTY AND AREA AGENCIES, NON-PROFIT ORGANIZATIONS, SCHOOL DISTRICTS, AND THE GREATER RICHLAND COUNTY COMMUNITY. BASED ON THE RESULTS OF OUR 2022 CHNA REPORT, THREE COMMUNITY HEALTH PRIORITIES ARE IDENTIFIED BELOW. THE FOLLOWING PLAN WILL UTILIZE THE LETTER CODES FOR EACH:M = MENTAL HEALTH S = SUBSTANCE ABUSE TREATMENT AND PREVENTION O = OVERWEIGHT/OBESITY TREATMENT AND PREVENTIONTHE TRHC DIRECTOR OF COMMUNITY RELATIONS AND MARKETING OVERSEES THE RICHLAND HOSPITAL AND CLINICS CHIP. THE FOLLOWING PAGES OUTLINE THE GOALS, MEASUREMENTS, AND DESCRIPTIONS ADDRESSING EACH OF THE HEALTH PRIORITIES IN THIS ACTION PLAN. M = ADDRESSING MENTAL HEALTHDURING THE 2022 DATA WALK EVENTS AND THE SUBSEQUENT CHIP PLANNING EVENT IN APRIL 2023, PARTICIPANTS SHARED THAT THERE IS STIGMA AROUND MENTAL HEALTH ISSUES, A DEFICIT IN MENTAL HEALTH SERVICES AVAILABLE, AND A LACK OF KNOWLEDGE ABOUT EXISTING RESOURCES AVAILABLE THAT CAN IMPROVE MENTAL HEALTH IN THE GREATER RICHLAND COUNTY AREA. 1. INCREASE MENTAL HEALTH SERVICESM1A = EXPLORE EXPANSION OF MENTAL HEALTH SERVICES AT TRHCGOAL: EXPLORE OFFERING SPECIALIZED MENTAL HEALTH SERVICES AT THE RURAL HEALTH CLINICS; EXPAND SERVICES AT TRHC IN RICHLAND CENTERMEASURES: IN 2023: COMPLETE A PRO FORMA FOR MENTAL HEALTH SERVICES AT THE RHCS. IN 2024: EXPLORE OFFERING MENTAL HEALTH VISITS THROUGH A TELEHEALTH PROVIDER. CONTINUE SUPPORT OF THE EXISTING COLLABORATIVE PRACTICE WITH DR. CULLEN. EXPLORE THE OPPORTUNITY TO ADD AN ADDITIONAL PSYCHIATRIC NP AND PHYSICIAN AS CONSULTANTS TO PRIMARY CARE PROVIDERS. DESCRIPTION: THE CLINIC LEADERSHIP TEAM WILL ASSESS THE VIABILITY & NEED FOR ADDITIONAL MENTAL SERVICES IN OUR SERVICE AREA. M1B = CONTINUE TO GROW THE SENIOR LIFE SOLUTIONS (SLS) PROGRAMGOAL: TO GROW THE PROGRAM TO PROVIDE MAXIMUM ACCESS AND INCREASE THE RESILIENCE AND COPING SKILLS OF THE SENIOR POPULATIONMEASURES: PARTICIPATION WILL CONSISTENTLY SHOW AN ADC OF 10 (INCREASED FROM 8 IN 2021). DESCRIPTION: THE RICHLAND HOSPITAL AND CLINICS' SENIOR LIFE SOLUTIONS (SLS) PROGRAM IS AN INTENSIVE OUTPATIENT GROUP COUNSELING PROGRAM THAT IS DESIGNED TO MEET THE UNIQUE NEEDS OF INDIVIDUALS OVER THE AGE OF 65 STRUGGLING WITH ANXIETY AND DEPRESSION, OFTEN RELATED TO AGING. AFTER GROWING THE PROGRAM TO THE MAXIMUM NUMBER OF PATIENTS FOR THE EXISTING MENTAL HEALTH TEAM, TRHC'S GOAL IS TO SUPPORT THE NEED FOR ADDITIONAL STAFF AND FACILITY SPACE. M1C = IMPROVE ACCESS TO INFORMATION ABOUT EXISTING LOCAL MENTAL HEALTH RESOURCESGOAL: PROMOTE LOCAL MENTAL HEALTH RESOURCES AVAILABLE TO COMMUNITY MEMBERS: THE CREATION OF A PROCESS AND PROCEDURE WHERE AGENCIES, ORGANIZATIONS, AND GROUPS CAN EASILY SUBMIT INFORMATION ABOUT SERVICES OR EVENTS TO THE HOSPITAL WITH THE UNDERSTANDING THAT EACH WILL BE ASSESSED AND, IF APPROPRIATE, PROMOTED VIA THE RICHLAND HOSPITAL AND CLINICS' WEBSITE, INTRANET, AND SOCIAL MEDIA PLATFORMS. TRHC IS CURRENTLY PLANNING A WEBSITE AND INTRANET REBUILD PROJECT FOR 2024-25. THE NEXT ITERATION OF OUR WEBSITE WILL CONTAIN EXTENSIVE INFORMATION REGARDING MENTAL HEALTH RESOURCES AVAILABLE TO INDIVIDUALS IN THE GREATER RICHLAND COUNTY AREA. TRHC WILL SERVE AS THE HUB FROM WHICH AREA HEALTH CARE, STATE HEALTH AGENCIES, AND COALITIONS SERVING MENTAL HEALTH SOLUTIONS ORGANIZE EFFORTS IN OUR GREATER SERVICE AREA. THIS HEARKENS BACK TO M1B. TRHC WILL FURTHER EXPAND THE TRANSLATION OF KEY DOCUMENTS INTO SPANISH. CONSISTENT SHARING OF MENTAL HEALTH SUPPORT MESSAGING ON TRHC SOCIAL MEDIA PLATFORMS, YEAR-ROUND. CONSISTENT SPONSORSHIP OF EVENTS HOSTED BY NON-PROFITS ADDRESSING THE MENTAL HEALTH NEEDS OF THE GREATER RICHLAND COUNTY AREA. OFFER QUARTERLY OPPORTUNITIES FOR NON-PROFITS ADDRESSING MENTAL HEALTH NEEDS IN OUR NEW, QUARTERLY, EXTERNAL-FACING 'PATIENTS FIRST' NEWSLETTER, TO INCLUDE NEWS PERTINENT TO RESIDENTS OF THE GREATER RICHLAND COUNTY AREA. TRHC ADVERTISING AND SPONSORSHIP FUNDS WILL BE DEDICATED, IN PART, TO THIS PURPOSEMEASURES: IDENTIFY THE OPPORTUNITIES TO PROMOTE THE LIST OF PROCESSES AND PROCEDURES DEVELOPED IN THE 2019 CHIP (DELAYED DUE TO COVID-19 PANDEMIC) PROMOTE STIGMA ELIMINATION EDUCATION AND MESSAGING SLS MAINTAINS A BINDER CONTAINING A LIST OF LOCAL RESOURCES REGARDING MENTAL HEALTH THIS WILL BE UPDATED FOR 2023-25 PROMOTE AND SPONSOR ESTABLISHED EVENTS MANAGED BY AREA MENTAL HEALTH AGENCIES AND ORGANIZATIONS BE CONSIDERED A SOLID RESOURCE FOR LOCAL MENTAL HEALTH INFORMATION BY THE END OF 2025 SUPPORT REGIONAL AND COMMUNITY PARTNERSHIPS AIMED AT IMPROVING MENTAL HEALTH AND WELL-BEINGDESCRIPTION: TRHC INTENDS TO ENRICH THE HEALTH AND WELLNESS INFORMATION ALREADY AVAILABLE ON OUR WEBSITE AT RICHLANDHOSPITAL.COM TO INCLUDE INFORMATION ABOUT LOCAL MENTAL HEALTH RESOURCES. 2. INCREASE MENTAL HEALTH CONTINUING EDUCATIONM2A = FACILITATION AND SUPPORT FOR CONTINUING EDUCATION OF TRHC PROVIDERS, STAFF, AND MEMBER OF THE GREATER COMMUNITY SEEKING ADDITIONAL FORMAL EDUCATION REGARDING MENTAL ILLNESS/HEALTHGOAL: ALLOCATE EXISTING SPONSORSHIP FUNDING IN THE MARKETING DEPARTMENT TO SUPPORT SAFETALK EDUCATION IN ORDER TO IMPROVE THE MENTAL HEALTH OF THE COMMUNITY. MEASURES: TRHC WILL SPONSOR A MINIMUM OF TWO SAFETALK EDUCATION EVENTS ANNUALLY IN THE GREATER RICHLAND COUNTY AREADESCRIPTION: IN COOPERATION WITH THE TRHC SENIOR LIFE SOLUTIONS, SUICIDE PREVENTION TASK FORCE AND THE WELLNESS COMMITTEE, THE MARKETING DEPARTMENT WILL ENSURE FUNDING TO CONTINUE THE SUCCESSFUL SAFETALK PROGRAM INITIATED IN 2020. THIS SERVICE PROVIDES CONTINUING EDUCATION TO TRHC STAFF AND COMMUNITY MEMBERS ABOUT SUICIDE PREVENTION AWARENESS AND COINCIDES WITH M2B. M2B = SUPPORT THE 2023 PATIENT SAFETY PLAN (PHASE 1)GOAL: PROVIDE INCREASED EDUCATIONAL OPPORTUNITIES TO STAFF AND COMMUNITY MEMBERS FOR IMPROVED SUICIDE PREVENTION AWARENESS MEASURES: YEAR ONE (2023): UPDATE HOSPITAL POLICY AND IN-HOUSE PROCESSES FOR COMPLIANCE WITH TRHC'S NEW ACCREDITING BODY (DNV) AND IMPROVED SUICIDE PREVENTION SCREENING/TREATMENT OF PATIENTS, FOLLOWED BY TRAINING FOR STAFF IN THE IMPLEMENTATION OF NEW PROCESSES. YEAR TWO (2024): PROVIDE ADDITIONAL SUICIDE PREVENTION TRAINING TO PERTINENT STAFF MEMBERS OF INCREASED AWARENESS AND IDENTIFICATION OF THOSE AT RISK FOR SUICIDE, LIKELY VIA LIVINGWORKS YEAR THREE (2025): PROVIDE SUICIDE PREVENTION TRAINING TO COMMUNITY MEMBERS FOR INCREASED AWARENESS AND IDENTIFICATION OF THOSE AT RISK FOR SUICIDE AND HOW TO DIRECT THOSE AT RISK TO APPROPRIATE HELP, LIKELY VIA LIVINGWORKS.DESCRIPTION: THE SUICIDE PREVENTION TASK FORCE IS PLANNING SUPPLEMENTAL EDUCATIONAL OPPORTUNITIES FOR STAFF AND COMMUNITY MEMBERS TO INCREASE AWARENESS OF SIGNS/SYMPTOMS OF SUICIDE RISK AND HOW TO GET THOSE AT RISK APPROPRIATE HELP, IN ADDITION TO PROMOTING REGULARLY OCCURRING MENTAL HEALTH AND SUICIDE PREVENTION AWARENESS DATES. M2C = SUPPORT THE 2023 PATIENT SAFETY PLAN (PHASE 2)GOAL: REFINE AND EDIT NEW POLICY SUICIDE RISK PROTOCOL BASED ON FEEDBACK AND SUPPORTING DATAMEASURES: YEAR ONE (2023): GATHER AND INTERPRET FEEDBACK FROM TEAM MEMBERS AS WELL AS DATA TO ASSESS THE EFFECTIVENESS OF THE NEW PROTOCOL AND SCREENING TOOL (C-SSRS) YEAR TWO (2024): EDIT AND REFINE PROTOCOL AS NEEDED BASED ON ASSESSMENT RESULTS YEAR THREE (2025): CONTINUE TO ASSESS DATA AND REFINE POLICY AS NEEDED TO REMAIN UP TO DATE WITH BEST PRACTICES AND DNV REQUIREMENTSDESCRIPTION: THE SUICIDE PREVENTION TASK FORCE WAS ESTABLISHED AND IS WORKING TO FACILITATE IMPROVED SCREENING AND MANAGEMENT OF PATIENTS AND COMMUNITY MEMBERS AT RISK FOR SUICIDE WHILE SUPPORTING THE CHIP AND DNV COMPLIANCE. AN UPDATED POLICY APPLICABLE TO THE ORGANIZATION AS A WHOLE HAS BEEN IMPLEMENTED. S ADDRESSING SUBSTANCE ABUSE TREATMENT AND PREVENTIONSUBSTANCE ABUSE AND ADDICTION INCLUDE ALL EXCESSIVE USE OF SUBSTANCES INCLUDING ALCOHOL, TOBACCO, PRESCRIPTION DRUGS, E-CIGARETTES, OPIOIDS, AND OTHER DRUGS THAT ARE HARMFUL.1. INCREASE AND SUPPORT MAINTAINING AND CREATING MORE ACCESS TO RESOURCES FOR THOSE BATTLING SUBSTANCE ABUSE. IN THE CHIP FOCUS GROUP MEETINGS HELD AT HHS ON APRIL 11, 2023, PARTICIPANTS IDENTIFIED THAT ADDITIONAL RESOURCES NEED TO BE SUPPORTED.DESCRIPTION CONTINUED AT END OF SCHEDULE H, PART V. THE RICHLAND HOSPITAL, INC. PART V, SECTION B, LINE 13H: IN ADDITION TO THE FEDERAL POVERTY GUIDELINES, THE RICHLAND HOSPITAL, INC. CONSIDERS THE FOLLOWING WHEN DETERMINING ELIGIBILITY FOR PROVIDING "FREE OR "DISCOUNTED" CARE TO INDIVIDUALS:- PATIENT IS HOMELESS- PATIENT IS ELIGIBLE FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS THAT ARE UNFUNDED- PATIENT IS ELIGIBLE FOR ASSISTANCE UNDER THE CRIME VICTIMS ACT OR SEXUAL ASSAULT ACT- PATIENT IS DECEASED, AND WITHOUT A SPOUSE, AND NO ESTATE HAS BEEN FILED WITH THE COURT SYSTEM WITHIN 12 MONTHS OF EXPIRATION OR IF IT DETERMINED PATIENT DOES NOT HAVE ASSETS REQUIRING THE FILING OF AN ESTATE- PATIENT RECEIVES A BANKRUPTCY DETERMINATION WITHIN THE SIX MONTHS IMMEDIATELY PRECEDING THE APPLICATION DATE IF APPLICANT IS LOOKING FOR CONSIDERATION ON ANY ACTIVE ACCOUNT NOT DISCHARGED AS A PART OF THE BANKRUPTCY DETERMINATION- PATIENT'S VALID ADDRESS IS CONSIDERED LOW INCOME OR SUBSIDIZED HOUSING AND PATIENT AUTHORIZES THE APPLICABLE HOUSING AUTHORITY TO VALIDATE INCOME LEVEL DIRECTLY TO THE HOSPITAL- ACCOUNTS RETURNED BY COLLECTION AGENCY- ACCOUNTS CLOSED AS A RESULT OF A COURT-ORDER-PATIENT IS ELIGIBLE FOR FOOD STAMPS OR SUBSIDIZED SCHOOL LUNCH PROGRAM THE RICHLAND HOSPITAL, INC. PART V, SECTION B, LINE 16J: PLAIN LANGUAGE SUMMARY IS INCLUDED IN WRITTEN ACCOUNT COMMUNICATION, PLAIN LANGUAGE SUMMARY IS OFFERED AT REGISTRATION, PLAIN LANGUAGE SUMMARY IS INCLUDED ON STATEMENTS. PART V, SECTION B, LINE 11 (CONTINUED): S1A = SUPPORT/PROMOTE THE AVAILABILITY OF NARCOTICS ANONYMOUS IN RICHLAND CENTERGOAL: ASSIST IN PROVIDING INFORMATION ABOUT THIS PROGRAM TO THOSE WHO WOULD BENEFIT FROM IT. MEASURES: PROVIDE INFORMATION FROM THE PROGRAM THROUGH MATERIALS DISSEMINATION IN THE TRHC EMERGENCY DEPARTMENT AND ON THE TRHC WEBSITE. TRHC CONTINUES TO SUPPORT DRUG TAKE BACK DAY VIA INTERNAL NEWS SHARING AND VIA OUR SOCIAL MEDIA PLATFORMS TRHC SUPPORTS ALL PROGRAMS OF PARTNERS 4 PREVENTION THROUGH SPONSORSHIP, NEWS SHARING AND ATTENDANCE AT EVENTS TRHC WILL CONTINUE TO SUPPORT ALL OTHER NON-PROFIT ORGANIZATIONS WHOSE EFFORTS POSITIVELY AFFECT SUBSTANCE USE TREATMENT AND PREVENTION IN THE GREATER RICHLAND COUNTY AREA.DESCRIPTION: RICHLAND COUNTY HEALTH AND HUMAN SERVICES (RCHHS) BEGAN THIS PROGRAM IN 2017. NARCOTICS ANONYMOUS (NA) IS PATTERNED AFTER ALCOHOLICS ANONYMOUS (AA). GROUPS CONSIST OF INDIVIDUALS ENCOURAGING ONE ANOTHER TO DISCONTINUE DRUG USE AND REMAIN DRUG-FREE. NA UTILIZES A 12-STEP PROCESS TO REFLECT THE DISEASE CONCEPT OF ADDICTION. THROUGH THIS 12-STEP PROGRAM, NA PROVIDES A RECOVERY PROCESS AND SUPPORT GROUP FOR PEOPLE WHO ARE QUITTING SUBSTANCE ABUSE. S1B = PROVIDE ADDICTION MEDICINE IN PRIMARY CARE SETTINGS AT TRHCGOAL: MAINTAIN CURRENT ROSTER OF PROVIDERS WHO ARE MEDICATION ASSISTED TREATMENT (MAT) CERTIFIED; CURRENTLY FOUR PROVIDERS (UP FROM 1 IN 2021)MEASURES: MAT-CERTIFIED PROVIDERS WILL MAINTAIN A BALANCED PRACTICE PROVIDING ACCESS TO PATIENTS SEEKING FAMILY MEDICINE AND TREATMENT OF SUBSTANCE USE DISORDERS (SUDS)DESCRIPTION: PRIMARY MEDICAL FACILITIES PROVIDE A SAFE PLACE FOR INDIVIDUALS WITH SUDS TO ENGAGE IN TREATMENT WITHOUT STIGMA ATTACHED. IN ADDITION, THE PRIMARY CARE SETTING PRESENTS PROVIDERS AN OPPORTUNITY TO BETTER IDENTIFY, ASSESS, INTERVENE, AND SUPPORT PATIENTS WITH SUDS. PHYSICIANS INVOLVED IN THE MAT PROGRAM STRIVE TO HELP RECOVERING HEROIN ADDICTS BUILD A LIFE WORTHY OF LIVING SOBER. IN AN EFFORT TO ADDRESS THE GROWING CONCERN OF HEROIN AND PRESCRIPTION DRUG ADDICTION, INCLUDING OVERDOSES. S2A = INCREASE AWARENESS OF THE ISSUES SURROUNDING SUBSTANCE ABUSE AND HELP CREATE AN ENVIRONMENT OF COLLABORATION FOR INCREASED CHANGE. GOAL: INCREASE EDUCATION AROUND THE SCIENCE OF THE EFFECTS OF SUBSTANCE USE, ESPECIALLY BY YOUTHMEASURES: PROVIDE FINANCIAL SUPPORT AND INCREASED ACCESS FOR NON-PROFIT ORGANIZATIONS SUPPORTING THIS GOAL IN THE GREATER RICHLAND COUNTY AREA SCHOOL DISTRICT-HOSTED EVENTS FAMILY EVENTS HOSTED BY RICHLAND AREA SCHOOL DISTRICT AT THE SMART FARM SPONSORSHIP OF POST-PROM PARTIES AT RICHLAND CENTER HIGH SCHOOL, RIVER VALLEY HIGH SCHOOL, RIVERDALE HIGH SCHOOL AND KICKAPOO HIGH SCHOOL PARTNERS 4 PREVENTION COLLABORATION ON MULTIPLE CAMPAIGNS INCLUDING NARCAN TRAINING, NATIONAL NIGHT OUT, ALCOHOL AWARENESS MONTH EDUCATION, DRUG TAKE BACK DAY, ETC. SUPPORT OF RICHLAND COUNTY CHILDREN AND FAMILY ADVOCACY COUNCIL'S (RCCFAC) EFFORTS IN DECREASING SUBSTANCE ABUSE PROMOTE EDUCATION ABOUT USING ALCOHOL RESPONSIBLY AROUND YOUTH SUPPORT EVENTS THAT ARE SAFEST FOR CHILDRENDESCRIPTION: TRHC WILL INFLUENCE CHANGE IN COMMUNITY EDUCATION REGARDING SUBSTANCE USE AND ABUSE THROUGH INCREASED EDUCATION, AND PROMOTION AND FINANCIAL SUPPORT OF ENDORSED EVENTS ADDRESSING OVERWEIGHT & OBESITY TREATMENT AND PREVENTION ADULT OBESITY IS THE PERCENTAGE OF THE ADULT POPULATION (AGE 20 AND OLDER) THAT REPORTS A BODY MASS INDEX (BMI) GREATER THAN OR EQUAL TO 30 KG/M2.1. PROVIDE OPPORTUNITIES FOR TRHC STAFF AND THEIR FAMILIES TO BE PHYSICALLY ACTIVE AND EAT HEALTHY INCREASE BY 10% EMPLOYEE AND FAMILY PARTICIPATION IN ORGANIZED ACTIVITIES THAT INVOLVE BEING PHYSICALLY ACTIVE AND PROVIDE INFORMATION ON HEALTHY EATING GOAL: THROUGHOUT 2019, THE RICHLAND HOSPITAL AND CLINICS ENCOURAGED ALL EMPLOYEES AND THEIR FAMILIES TO ATTEND AT LEAST TWO HOSPITAL-PROMOTED EVENTS THAT ENCOURAGED PHYSICAL ACTIVITY. AN ESTIMATED 90 EMPLOYEES AND FAMILY MEMBERS TOOK PART IN THESE ACTIVITIES. OUR GOAL DURING 2023-25 IS TO CONTINUE THIS STRATEGY AND IMPROVE RATES OF PARTICIPATION BY 10%.MEASURES: TRACK EMPLOYEE AND FAMILY ATTENDANCE AT HOSPITAL-SPONSORED WALK/RUN EVENTS DURING 2023-25. THE RICHLAND HOSPITAL AND CLINICS WILL SPONSOR A 5K RUN/WALK FOR EMPLOYEES AND COMMUNITY IN FALL OF 2024 AND 2025. DESCRIPTION: MAINTAIN ATTENDANCE AND PROMOTION OF EVENTS THAT ENCOURAGE INCREASED PHYSICAL ACTIVITY FOR STAFF AND THEIR FAMILIES. 1. ENCOURAGE INCREASED PHYSICAL ACTIVITY AND HEALTHY EATING THROUGHOUT OUR COMMUNITYO2A = SUPPORT SUMMER ATHLETIC PROGRAMSGOAL: TRHC ATHLETIC TRAINERS ASSIST RICHLAND CENTER AND MUSCODA SCHOOL DISTRICTS WITH SUMMER STRENGTH TRAINING PROGRAMS. MEASURES: NUMBER OF STUDENTS WHO ATTEND THESE PROGRAMSDESCRIPTION: ATHLETIC TRAINERS OFFER EXPERTISE IN AGE APPROPRIATE STRENGTH TRAINING FOR EACH SCHOOL DISTRICT. O2B = HOST/PARTICIPATE/VOLUNTEER AT COMMUNITY EVENTS THAT PROMOTE ACTIVITY OR HEALTHY EATINGGOAL: IMPROVE AWARENESS ABOUT AVAILABLE OPPORTUNITIES TO BE PHYSICALLY ACTIVE OR TO LEARN ABOUT HEALTHY EATING. TO PROMOTE AND CELEBRATE TRHC'S INVOLVEMENT IN THEM.MEASURES: PROVIDE FREQUENT INFORMATION TO THE PUBLIC ON HEALTH AND FITNESS-RELATED ACTIVITIES VIA MULTIPLE MEDIA SOURCES, INCLUDING RADIO, WEBSITE, FACEBOOK AND PRINT MEDIA.DESCRIPTION: 1. CREATE A PROCESS BY WHICH IT IS EASY FOR SERVICES, GROUPS, GOVERNMENT AGENCIES, AND CLUBS TO SHARE INFORMATION.2. TRHC STAFF GUEST ON WRCO FREQUENTLY.3. WORD OF MOUTH PROMOTION (WOMP): SHARE INFORMATION, WHEN APPROPRIATE, WITH STAFF AND ASK THEM TO SHARE THE INFORMATION WITH THREE PEOPLE.4. RECORD AND DOCUMENT ATTENDANCE AT EVENTS 3 1 - RICHLAND HOSPITAL CLINIC 333 EAST SECOND STREET RICHLAND CENTER WI 53581 RURAL HEALTH CLINIC 2 - MUSCODA HEALTH CENTER 1075 NORTH WISCONSIN AVENUE MUSCODA WI 53573 RURAL HEALTH CLINIC 3 - SPRING GREEN MEDICAL CENTER 150 EAST JEFFERSON STREET SPRING GREEN WI 53588 RURAL HEALTH CLINIC PART I, LINE 3C: ADDITIONALLY, THE RICHLAND HOSPITAL, INC. MAY REFER TO OR RELY ON EXTERNAL SOURCES AND/OR OTHER PROGRAM ENROLLMENT RESOURCES IN THE CASE OF PATIENTS LACKING DOCUMENTATION THAT SUPPORTS ELIGIBILITY OR INDIVIDUAL CIRCUMSTANCE. AT ITS SOLE DISCRETION, WHEN A PATIENT IS UNABLE TO PROVIDE NECESSARY DOCUMENTATION TO SUPPORT AN ELIGIBILITY DETERMINATION, THE RICHLAND HOSPITAL, INC. MAY PROVIDE FREE OR DISCOUNTED SERVICES UNDER THIS PROGRAM WHEN PATIENT: - IS HOMELESS - IS ELIGIBLE FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS THAT ARE UNFUNDED - IS ELIGIBLE FOR FOOD STAMPS OR SUBSIDIZED SCHOOL LUNCH PROGRAM - IS ELIGIBLE FOR ASSISTANCE UNDER THE CRIME VICTIMS ACT OR SEXUAL ASSAULT ACT - IS DECEASED, WITHOUT A SPOUSE, AND NO ESTATE HAS BEEN FILED WITH THE COURT SYSTEM WITHIN 12 MONTHS OF EXPIRATION OR AT THE TIME IT CAN BE DETERMINED PATIENT DOES NOT HAVE ASSETS REQUIRING THE FILING OF AN ESTATE. - RECEIVES A BANKRUPTCY DETERMINATION WITHIN THE SIX MONTHS IMMEDIATELY PRECEDING THE APPLICATION DATE IF APPLICANT IS LOOKING FOR CONSIDERATION ON ANY ACTIVE ACCOUNT NOT DISCHARGED AS A PART OF THE BANKRUPTCY DETERMINATION. - VALID ADDRESS IS CONSIDERED LOW INCOME OR SUBSIDIZED HOUSING AND PATIENT AUTHORIZES THE APPLICABLE HOUSING AUTHORITY TO VALIDATE INCOME LEVEL DIRECTLY TO THE HOSPITAL. PART I, LINE 6A: THE RICHLAND HOSPITAL, INC. PREPARES A COMMUNITY BENEFIT REPORT ANNUALLY AND FILES IT WITH THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THE REPORT IS AVAILABLE TO THE GENERAL PUBLIC ON WHA'S DATABASE AND WEBSITE. PART I, LINE 7: THE COSTING METHODOLOGY 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 DEBT DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST VARIOUS REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER IRS SUGGESTED COSTING METHODS FOR THE FORM 990. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES AT THE RICHLAND HOSPITAL, INC. INCLUDES THE OPERATION OF THE HOSPITAL EMERGENCY ROOM DEPARTMENT AND THE INTENSIVE CARE INPATIENT UNIT. THESE SERVICES ARE UNAVAILABLE TO MEMBERS OF THE COMMUNITY OTHER THAN THROUGH THE RICHLAND HOSPITAL, INC. AND ARE PRIMARILY UTILIZED FOR EMERGENCY SERVICES. THE EMERGENCY ROOM DEPARTMENT OPERATES 24-HOURS PER DAY, SEVEN DAYS PER WEEK AND IS STAFFED PRIMARILY BY BOARD CERTIFIED EMERGENCY ROOM PHYSICIANS. AS PART OF THE PATIENT SERVICES PROVIDED TO THE COMMUNITY, THE HOSPITAL HAS DESIGNATED A PORTION OF ITS INPATIENT UNIT AS A CERTIFIED INTENSIVE CARE UNIT KNOWN AS THE "SPECIAL CARE UNIT." THIS UNIT REQUIRES A HIGHER ACUITY OF NURSING AND HAS DEDICATED STAFF TO PROVIDE THIS CARE TO PATIENTS. A SIGNIFICANT PORTION OF THE ADMISSIONS TO THE UNIT COME FROM EMERGENCY ADMISSIONS TO THE HOSPITAL SO IT IS CONSIDERED A SUBSIDIZED HEALTH SERVICE PROVIDED TO THE COMMUNITY BY THE HOSPITAL. IT IS THE GOAL OF THE RICHLAND HOSPITAL, INC. TO PROVIDE THESE SERVICES TO THE COMMUNITY REGARDLESS OF THE PATIENT'S ABILITY TO PAY. 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 $ 2,332,425. PART II, COMMUNITY BUILDING ACTIVITIES: THE RICHLAND HOSPITAL, INC. IS ACCREDITED THROUGH DNV. THE DNV ACCREDITATION PROCESS DIRECTLY ADDRESSES REGULATORY REQUIREMENTS FOR HOSPITALS, SUCH AS THE US GOVERNMENT'S CENTERS FOR MEDICARE AND MEDICAID (CMS). THE ACCREDITATION PROGRAM IS DESIGNED TO SUPPORT THE DEVELOPMENT AND CONTINUAL IMPROVEMENT OF HEALTHCARE QUALITY AND PATIENT SAFETY IN HEALTHCARE ORGANIZATIONS. IT ALSO ADDRESSES GENERAL SAFETY FOR WORKERS, PATIENTS AND OTHER VISITORS. DNV'S ANNUAL SURVEYS PROVIDE INSIGHT AND UNDERSTANDING ON WHAT IS WORKING EFFECTIVELY AND WHAT CAN BE IMPROVED, AND THE ACCREDITATION PROVIDES ASSURANCE TO YOUR PATIENTS, STAFF AND STAKEHOLDERS THAT YOUR HOSPITAL IS WORKING IN ACCORDANCE TO ESTABLISHED BEST PRACTICES. ALL DNV SURVEYORS HAVE A HEALTHCARE BACKGROUND AND SPECIALIZE IN ONE OF THREE AREAS: MANAGEMENT SYSTEMS, CLINICAL CARE, OR THE PHYSICAL ENVIRONMENT. THEY EMPLOY VARIOUS ASSESSMENT METHODS, INCLUDING STAFF INTERVIEWS, MEDICAL RECORD REVIEW, ORGANIZATIONAL DOCUMENT REVIEW, BUILDING AND OFFSITE VISITS, AND PATIENT INTERVIEWS AND FEEDBACK.THE RICHLAND HOSPITAL, INC. COMMUNITY RELATIONS AND MARKETING STAFF TAKE RESPONSIBILITY FOR SPONSORING AND/OR DEVELOPING COMMUNITY EVENTS. WHEN SOLICITED FOR SPONSORSHIPS FROM COMMUNITY EVENT ORGANIZERS THE DEPARTMENT CONSIDERS WHETHER THE PROPOSED SPONSORSHIP WOULD SUPPORT THE COMMUNITY HEALTH NEEDS OF THE COMMUNITY AS IDENTIFIED IN THE 2022 CHNA. EVENTS OR ORGANIZATIONS SUPPORTING OUR CHNA NEEDS RECEIVE PRIORITY OVER OTHERS. TRHC DISTRIBUTES APPROXIMATELY $20K IN SPONSORSHIP DOLLARS ANNUALLY USING THIS VETTING PROCESS. THE VAST MAJORITY OF TRHC ADVERTISING CAMPAIGNS VIA RADIO, BILLBOARD, SOCIAL MEDIA AND PRINT ARE DEDICATED TO PUBLIC SERVICE ANNOUNCEMENTS GEARED TOWARD EDUCATION, ACCESS TO INFORMATION, AND IMPROVEMENT OF PUBLIC HEALTH.THE FREE COMMUNITY EVENTS DEVELOPED BY TRHC ARE ALSO GEARED TOWARD PHYSICAL ACTIVITY FOR FAMILIES, INCLUDING PROPER NUTRITION AND HEALTH EDUCATION. PART III, LINE 2: THE COSTING METHODOLOGY USED ON FORM 990 IS BASED ON A COST-TO-CHARGE RATIO, WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES, EXCLUDING THE PROVISION FOR BAD DEBT, DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST THE TOTAL CHARGES THAT ARE WRITTEN OFF DURING THE YEAR TO ESTIMATE THE COST OF CARE OF PATIENTS WHO HAVE ACCOUNTS THAT ARE DEEMED TO BE BAD DEBTS TO THE HOSPITAL. THE HOSPITAL ALSO RECOGNIZES THAT IT ALSO PROVIDES A DISCOUNT TO SELF-PAY OR UNINSURED PATIENTS. THESE AMOUNTS ARE EXCLUDED FROM GROSS PATIENT SERVICE REVENUE ON THE CONSOLIDATED FINANCIAL STATEMENTS AND ARE NOT INCLUDED IN THE RATIO AS DESCRIBED ABOVE AND APPROVED BY THE IRS FOR USE ON FORM 990. IF CONSIDERED, THESE ADDITIONAL WRITE-OFF AMOUNTS TO UNINSURED ACCOUNTS WOULD ALSO INCREASE THE ESTIMATED BAD DEBT EXPENSE AMOUNT ASSOCIATED WITH THESE UNCOLLECTIBLE ACCOUNTS TO THE HOSPITAL. PART III, LINE 3: 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 HOSPITAL HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND CREDIT TO ACCOUNTS RECEIVABLE. MANY TIMES, PATIENTS DO NOT COMPLETE THE REQUIRED CHARITY CARE APPLICATION AND ARE TRANSFERRED TO COLLECTION SERVICES EVEN THOUGH THE HOSPITAL PROVIDES THIS INFORMATION TO ALL PATIENTS AND ASSISTS PATIENTS WITH THE APPLICATION. DUE TO NO RESPONSES FROM SOME PATIENTS, A SIGNIFICANT AMOUNT OF BAD DEBTS COULD BE CONSIDERED AS CHARITY CARE. PART III, LINE 4: IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES PAST RESULTS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE 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 UNCOLLECTIBLE ACCOUNTS. SPECIFICALLY, FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE 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 HOSPITAL 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 UNCOLLECTIBLE ACCOUNTS. THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A SEPARATE FOOTNOTE REGARDING BAD DEBT EXPENSE. PART III, LINE 8: THE RICHLAND HOSPITAL, INC. IS DESIGNATED AS A CRITICAL ACCESS HOSPITAL AND, AS SUCH, A PORTION OF ITS REVENUE IS PAID UNDER A COST REIMBURSEMENT SYSTEM. THE TOTAL MEDICARE REVENUE SHOWN BASED ON THE IRS 990 INSTRUCTIONS INCLUDES ONLY A PORTION OF THE TOTAL MEDICARE REVENUE OF THE HOSPITAL. THE AMOUNTS LISTED FOR MEDICARE DO NOT INCLUDE PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT, RADIOLOGIST SERVICES, AND SURGICAL ANESTHESIA SERVICES AT THE RICHLAND HOSPITAL, INC. PHYSICIAN COVERAGE IS REIMBURSED PRIMARILY ON FEE SCHEDULE REIMBURSEMENT 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 THE RICHLAND HOSPITAL, INC. PROVIDES TO THE COMMUNITIES IT SERVES. 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 REVENUE (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 SERVICES AND THE HOSPITAL WOULD SHOW A LARGE LOSS ON THESE SERVICES.WHETHER THERE IS A SHORTFALL OR SURPLUS FROM SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THESE PEOPLE, WHO ARE TYPICALLY ELDERLY MEMBERS OF THE COMMUNITY, ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE PATIENT SERVICES, THE CENTERS FOR MEDICARE AND MEDICAID (CMS) WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY. PART III, LINE 9B: AT THE TIME OF PATIENT PRESENTATION, THE RICHLAND HOSPITAL, INC. WILL GATHER DEMOGRAPHIC AND INSURANCE INFORMATION THAT SUPPORTS THE TIMELY GENERATION AND RELEASE OF INSURANCE CLAIM FORMS AND /OR SELF-PAY STATEMENTS FOR SERVICES RENDERED. SUBJECT TO COMPLIANCE WITH THE PROVISIONS OF THIS POLICY, THE RICHLAND HOSPITAL, INC. MAY TAKE ANY AND ALL LEGAL ACTIONS, INCLUDING EXTRAORDINARY COLLECTION ACTIONS (ECA'S), TO OBTAIN PAYMENT FOR MEDICAL SERVICES PROVIDED. THE RICHLAND HOSPITAL, INC. WILL NOT ENGAGE IN ECA'S, EITHER DIRECTLY OR BY ANY DEBT COLLECTIONS AGENCY OR OTHER PARTY TO WHICH THE HOSPITAL HAS REFERRED THE PATIENT'S DEBT, BEFORE REASONABLE EFFORTS ARE MADE TO DETERMINE WHETHER A RESPONSIBLE INDIVIDUAL^) IS ELIGIBLE FOR ASSISTANCE UNDER THE COMMUNITY CARE PROGRAM, FINANCIAL ASSISTANCE POLICY. AT THE POINT A RESPONSIBLE INDIVIDUAL REQUESTS A COMMUNITY CARE PROGRAM APPLICATION, THE ABOVE PROCEDURE WILL CEASE, AND THE FOLLOWING PROCEDURE WILL TAKE EFFECT.UPON REQUEST, A COMMUNITY CARE PROGRAM APPLICATION WILL BE SENT/GIVEN TO THE RESPONSIBLE INDIVIDUAL ALONG WITH A COVER LETTER DETAILING DOCUMENTATION REQUIRED TO PROCESS THE APPLICATION.APPLICATION MUST BE RETURNED WITHIN 30 DAYS FROM THE DATE THE RESPONSIBLE INDIVIDUAL IS GIVEN OR MAILED THE APPLICATION.IF INCOMPLETE OR INSUFFICIENT DOCUMENTATION IS RECEIVED, RESPONSIBLE INDIVIDUAL WILL BE NOTIFIED IN WRITING OF THE MISSING OR INCOMPLETE DOCUMENTATION. RESPONSIBLE INDIVIDUAL WILL HAVE 30 DAYS FROM THE DATE OF THE NOTIFICATION TO PROVIDE THE MISSING INFORMATION OR DOCUMENTATION. FAILURE TO SUBMIT A COMPLETED APPLICATION OR SUBSEQUENTLY REQUESTED DOCUMENTATION WITHIN 30 DAYS MAY RESULT IN THE APPLICATION BEING DENIED, THE ACCOUNT BEING REFERRED TO AN EXTERNAL COLLECTION AGENCY AND ECA'S MAY COMMENCE. IF A COMMUNITY CARE PROGRAM APPLICATION IS RECEIVED AFTER AN ACCOUNT HAS BEEN REFERRED TO AN EXTERNAL COLLECTION AGENCY, BUT PRIOR TO 240 DAYS FROM THE DATE OF THE FIRST POST-DISCHARGE BILLING STATEMENT, THE EXTERNAL COLLECTION AGENCY WILL BE INSTRUCTED TO DISCONTINUE COLLECTION ACTIVITY UNTIL THE COMMUNITY CARE PROGRAM APPLICATION HAS BEEN PROCESSED. IF THE APPLICATION IS APPROVED FOR A FULL OR PARTIAL DISCOUNT, THE EXTERNAL COLLECTION AGENCY WILL BE NOTIFIED AND INSTRUCTED TO REMOVE OR REVERSE ANY ECAS THAT MAY HAVE BEEN TAKEN AND THE ACCOUNT WILL BE REFERRED BACK TO THE RICHLAND HOSPITAL, INC. RESPONSIBLE INDIVIDUALS APPROVED FOR A PARTIAL DISCOUNT WILL BE NOTIFIED IN WRITING OF THEIR APPROVAL FOR A PARTIAL DISCOUNT AND AN UPDATED STATEMENT REFLECTING THE NEW DISCOUNTED AMOUNT DUE WILL BE INCLUDED. RESPONSIBLE INDIVIDUALS DETERMINED TO BE INELIGIBLE FOR A COMMUNITY CARE PROGRAM DISCOUNT WILL BE NOTIFIED IN WRITING OF THEIR INELIGIBILITY. THE NOTIFICATION TO RESPONSIBLE INDIVIDUALS DETERMINED TO BE INELIGIBLE FOR A COMMUNITY CARE PROGRAM DISCOUNT OR ELIGIBLE FOR A PARTIAL DISCOUNT WILL INCLUDE A PAYMENT PLAN AGREEMENT. RESPONSIBLE INDIVIDUAL WILL BE PROVIDED 30 DAYS TO COMPLETE AND RETURN THE PAYMENT PLAN AGREEMENT. FAILURE TO RETURN A COMPLETED PAYMENT PLAN AGREEMENT WITHIN 30 DAYS COULD RESULT IN THE ACCOUNT BEING REFERRED TO AN EXTERNAL COLLECTION AGENCY AND ECAS MAY COMMENCE. HOSPITAL AND EXTERNAL COLLECTION AGENCIES MAY ALSO TAKE ANY AND ALL LEGAL ACTIONS INCLUDING BUT NOT LIMITED TO TELEPHONE CALLS, EMAILS, TEXTS, MAILING NOTICES AND SKIP TRACING TO OBTAIN PAYMENT FOR MEDICAL SERVICES PROVIDED. PART VI, LINE 2: IN ADDITION TO THE COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED IN 2022, THE RICHLAND HOSPITAL, INC. ASSESSES THE HEALTHCARE NEEDS OF THE COMMUNITY IT SERVES BY LOOKING AT LOCAL AND SURROUNDING COMMUNITY DEMOGRAPHICS TO DETERMINE THE SERVICES THAT ARE MOST NECESSARY IN ORDER TO FULFILL ITS MISSION. THE HOSPITAL ACTIVELY SEEKS INPUT FROM MEMBERS OF THE MEDICAL STAFF REGARDING EXISTING SERVICES, THE POTENTIAL NEED FOR EXPANDED SERVICES, AND THE POTENTIAL NEED FOR NEW SERVICE LINES NOT OFFERED LOCALLY. THE HOSPITAL MONITORS THE LOSS OF SPECIALTY PROVIDERS IN THE AREA AND, COLLABORATIVELY WORKING WITH OUR RURAL HEALTH CLINICS (RICHLAND HOSPITAL CLINICS, SPRING GREEN MEDICAL CENTER, AND MUSCODA HEALTH CENTER), PARTICIPATES IN A DETERMINATION OF WHETHER AND HOW THIS NEW NEED CAN BEST BE MET. THE HOSPITAL ALSO REVIEWS HOSPITAL STATISTICS OF PATIENT VISITS TO DETERMINE WHAT TYPES OF SERVICES OFFERED BY THE HOSPITAL ARE BEING UTILIZED. PART VI, LINE 3: CONSISTENT WITH THE MISSION OF THE RICHLAND HOSPITAL, INC., HEALTH-RELATED SERVICES ARE PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL IS COMMITTED TO PROVIDING FREE OR DISCOUNTED CARE TO QUALIFIED INDIVIDUALS THAT ARE IN NEED OF MEDICALLY NECESSARY TREATMENT EVEN IF THAT PERSON IS UNINSURED, UNDERINSURED, INELIGIBLE FOR OTHER GOVERNMENT PROGRAMS, OR UNABLE TO PAY BASED ON THEIR INDIVIDUAL FINANCIAL SITUATION. WHEN AN UNINSURED OR UNDERINSURED PATIENT REQUESTS FINANCIAL ASSISTANCE AND HAS AN ADJUSTED GROSS INCOME THAT IS AT OR BELOW 150% OF THE FEDERAL POVERTY LEVEL, THEY ARE ELIGIBLE FOR A 100% DISCOUNT ON ANY PATIENT BALANCE. WHEN AN UNINSURED PATIENT'S ADJUSTED GROSS INCOME IS 151 TO 300% OF THE FEDERAL POVERTY LEVEL, THEY ARE PROVIDED CARE AT THE AMOUNT GENERALLY BILLED OR LESS. FOR UNDERINSURED PATIENTS WITH AN ADJUSTED GROSS INCOME OF 151 TO 300%, THE AMOUNT PATIENT IS CHARGED AND RESPONSIBLE FOR PAYING (CO-INSURANCE, DEDUCTIBLES, ETC.) AFTER APPLYING DEDUCTIONS, DISCOUNTS AND PAYMENTS APPLIED BY THE THIRD PARTY PAYER WILL NOT BE GREATER THAN THE AGB. TO BE ELIGIBLE UNDER THIS PROGRAM, PATIENTS MUST COOPERATE WITH THE HOSPITAL TO EXPLORE ALTERNATIVE MEANS OF ASSISTANCE AND IF NECESSARY, INCLUDING APPLICATION OR ACTIONS NEEDED TO SECURE COVERAGE BY MEDICARE, MEDICAID, AND THE MARKETPLACE. PATIENTS WILL BE REQUIRED TO PROVIDE NECESSARY INFORMATION AND DOCUMENTATION WHEN APPLYING FOR A PROGRAM DISCOUNT, OR FOR OTHER PRIVATE OR PUBLIC PAYMENT PROGRAMS. THE FACILITY'S FINANCIAL COUNSELOR IS AVAILABLE TO ASSIST PATIENTS WITH THE APPLICATION PROCESS. APPLICATIONS AND ALL SUPPORTING DOCUMENTATION IS REVIEWED BY THE FACILITY'S FINANCIAL COUNSELOR FOR ELIGIBILITY AND APPROVED BY THE PATIENT ACCOUNTING SUPERVISOR. FREE LABORATORY, LIMITED RADIOLOGY SERVICES, AND OTHER DIAGNOSTIC ANCILLARY SERVICES ARE ALSO PROVIDED TO PATIENTS WHO ARE REFERRED TO THE HOSPITAL BY THE RICHLAND CENTER FREE CLINIC. THE HOSPITAL ALSO OFFERS A 20% PROMPT PAY DISCOUNT FOR UNINSURED PATIENTS.THE RICHLAND HOSPITAL INC. COMMUNICATES THE AVAILABILITY AND TERMS OF THE PROGRAM TO ALL PATIENTS, THROUGH MEANS WHICH INCLUDE, BUT ARE NOT LIMITED TO:1. POSTED SIGNS WITHIN WAITING ROOMS, EMERGENCY ROOMS, AND PATIENT ACCOUNTING AREAS.2. COMMUNITY CARE PROGRAM APPLICATION AND PLAIN LANGUAGE SUMMARY OFFERED TO INDIVIDUALS AT TIME OF REGISTRATION AND DISCHARGE FROM AN INPATIENT ADMISSION. THE COMMUNITY CARE PROGRAM POLICY, COMMUNITY CARE PROGRAM APPLICATION AND THE PLACEMENT FOR COLLECTION POLICY ARE AVAILABLE UPON REQUEST. SPANISH VERSIONS WILL ALSO BE AVAILABLE UPON REQUEST.3. PLAIN LANGUAGE SUMMARY, COMMUNITY CARE PROGRAM POLICY, COMMUNITY CARE PROGRAM APPLICATION AND PLACEMENT FOR COLLECTIONS POLICY INCLUDING SPANISH VERSIONS CAN BE OBTAINED BY:A. REQUESTING IN PERSON AT THE RICHLAND HOSPITAL, INC., RICHLAND HOSPITAL CLINIC, RICHLAND RURAL HEALTH CLINIC, SPRING GREEN MEDICAL CENTER AND MUSCODA HEALTH CENTERB. CONTACTING THE RICHLAND HOSPITAL, INC. PATIENT FINANCIAL SERVICES DEPARTMENT AT 608-647-6321.C. ACCESSING THE RICHLAND HOSPITAL, INC. WEBSITE D. SUBMITTING A WRITTEN REQUEST TO THE RICHLAND HOSPITAL, INC.4. PLAIN LANGUAGE SUMMARY PROVIDED WITH WRITTEN CORRESPONDENCE.5. CONSPICUOUS MESSAGE ON PATIENT STATEMENTS.6. PLAIN LANGUAGE SUMMARY AVAILABLE AT THE LOCAL AGING AND DISABILITY RESOURCE CENTER AND AT THE RICHLAND COMMUNITY FREE CLINIC.7. DESIGNATED STAFF KNOWLEDGEABLE ON THE PROGRAM WILL BE AVAILABLE TO ANSWER PATIENT QUESTIONS AND/OR REFER PATIENTS TO THE PROGRAM.REGISTRATION STAFF AT THE RICHLAND HOSPITAL INC.& RICHLAND HOSPITAL CLINICS ARE TRAINED TO INQUIRE WITH PATIENTS UPON REGISTRATION IF THEY WOULD LIKE INFORMATION ON THIS PROGRAM. DURING THE COLLECTION PROCESS, THE RICHLAND HOSPITAL PROVIDES INFORMATION AND INCLUDES COMMUNITY CARE PROGRAM MATERIALS WITH CORRESPONDENCE. SOCIAL SERVICES AND BUSINESS OFFICE STAFF AT THE HOSPITAL ARE ALSO AVAILABLE TO PROVIDE INFORMATION TO PATIENTS ON OTHER GOVERNMENT PROGRAMS SUCH AS THE MEDICAID PROGRAM OR TO REFER PATIENTS TO PERSONNEL AT RICHLAND COUNTY OR OTHER STATE OF WISCONSIN OR COUNTY AGENCIES THAT MAY PROVIDE ACCESS TO CARE. PART VI, LINE 4: THE RICHLAND HOSPITAL, INC. IS LOCATED IN RICHLAND CENTER, WISCONSIN, WHICH IS A COMMUNITY OF APPROXIMATELY 5,000 PEOPLE AND IS LOCATED 50 MINUTES FROM MADISON, WISCONSIN. THE FACILITY OPERATES A 25-BED, ACUTE CARE CRITICAL ACCESS HOSPITAL AND THREE RURAL HEALTH CLINICS LOCATED IN RICHLAND CENTER AND NEIGHBORING COMMUNITIES. THE RICHLAND HOSPITAL OFFERS A WIDE VARIETY OF SERVICES IN ORDER TO FULFILL MANY OF THE NEEDS OF THE INDIVIDUALS IN THE LOCAL COMMUNITY. AMONG SERVICES PROVIDED ARE: DIAGNOSTIC CARE, 24-HOUR EMERGENCY ROOM, OBSTETRICS, REHABILITATION, SURGICAL CARE, AND DIABETES SELF-CARE PROGRAMS, ALONG WITH OTHER SPECIALTY SERVICES, WHICH INCLUDE: AUDIOLOGY, CARDIOLOGY, ORTHOPEDICS, CHEMOTHERAPY, CLINICAL SERVICES, AMONG OTHERS. CARE IS OFFERED TO PATIENTS REGARDLESS OF PAY SOURCE AND REGARDLESS OF A PATIENT'S ABILITY TO PAY. THE COMMUNITIES SERVED BY THE RICHLAND HOSPITAL AS PRIMARY SERVICE AREA ARE DEFINED BY THE FOLLOWING ZIP CODES: 53556 - LONE ROCK53518 - BLUE RIVER53573 - MUSCODA53581 - RICHLAND CENTER53588 - SPRING GREENTHEY ARE GEOGRAPHICALLY CONTIGUOUS COMMUNITIES. ACCORDING TO 2021 DATA PUBLISHED BY KAAVIO, THE RICHLAND HOSPITAL, INC. HAD AN OVERALL INPATIENT MARKET SHARE OF 70.75 PERCENT AND OUTPATIENT MARKET SHARE OF 71.83 PERCENT IN THESE ZIP CODES. NO OTHER HEALTHCARE PROVIDER PROVIDING THE SAME SERVICES HAD A MARKET SHARE AS HIGH AS OR HIGHER THAN THE RICHLAND HOSPITAL, INC. (KAAVIO COMBINES STATEWIDE HEALTHCARE DATA FROM WISCONSIN HOSPITAL ASSOCIATION IN A WEB-BASED SUPPORT ENGINE THAT ALLOWS US TO ANALYZE OUR MARKET.)SOCIO-DEMOGRAPHIC PROFILE OF THE MARKET AREA SERVED BY THE RICHLAND HOSPITAL, INC. SERVES PERSONS WHO ARE REPRESENTATIVE OF THE POPULATION OF THE MARKET AREA. A HIGHER PERCENTAGE OF THE POPULATION SERVED IS ELDERLY; THIS IS DUE TO THE FACT THAT PERSONS 65 YEARS OF AGE AND OLDER ARE HOSPITALIZED AT NEARLY THREE TIMES THE OVERALL RATE. SOME THINGS TO NOTE RELATED TO PLANNING FOR MEETING COMMUNITY HEALTH NEEDS INCLUDES THE FOLLOWING:- THE OVERALL POPULATION OF THE MARKET AREA IS PROJECTED TO REMAIN VERY STABLE, WITH NEGLIGIBLE GROWTH OR DECLINE PROJECTED OVER THE NEXT FIVE YEARS.- THE OVERALL POPULATION OF RICHLAND COUNTY IS 17,160 AND IS PROJECTED TO REMAIN VERY STABLE, WITH NEGLIGIBLE DECLINE OVER THE NEXT FIVE YEARS. CENSUSREPORTER.ORG ACS2020 DATA TELLS US THAT 45% OF OUR POPULATION IS 50+. DURING 2022, MEDICARE AND MEDICARE ADVANTAGE PLAN BENEFICIARIES ACCOUNTED FOR OVER 52 PERCENT OF ALL GROSS PATIENT SERVICE REVENUE AT THE RICHLAND HOSPITAL, INC. AND MEDICAID BENEFICIARIES ACCOUNTED FOR APPROXIMATELY 16 PERCENT OF ALL GROSS PATIENT SERVICE REVENUE. MEDICARE AND MEDICAID BENEFICIARIES MADE UP THE LARGEST PORTION OF PATIENTS THAT ARE SERVED BY THE RICHLAND HOSPITAL, INC. OVER THE PREVIOUS FEW YEARS. PART VI, LINE 5: THE ACTIVITIES OF THE RICHLAND HOSPITAL, INC. ARE SUPPORTED LOCALLY BY A VOLUNTEER BOARD OF DIRECTORS WHICH OVERSEE THE OPERATIONS OF THE HOSPITAL. THE BOARD OF DIRECTORS IS MADE UP OF COMMUNITY MEMBERS THAT RESIDE IN RICHLAND CENTER, WI, AND THE SURROUNDING AREA WHICH IS THE HOSPITAL'S PRIMARY PATIENT SERVICE AREA. THE HOSPITAL ALSO EXTENDS MEDICAL STAFF PRIVILEGES TO A MAJORITY OF ALL QUALIFIED PHYSICIANS IN THE COMMUNITY AND SURROUNDING AREAS WHO WISH TO BETTER SERVE THEIR PATIENTS BY PROVIDING CARE AT THE RICHLAND HOSPITAL, INC.ANY SURPLUSES IN OPERATIONS THAT ARE ACHIEVED BY THE HOSPITAL OPERATING IN AN EFFECTIVE MANNER AND CONTROLLING THE COST OF HEALTHCARE ARE PRIMARILY RESERVED FOR FUTURE BUILDING AND CAPITAL PURCHASE NEEDS. THE RICHLAND HOSPITAL, INC. RECOGNIZES THAT IT IS IMPORTANT TO SAVE THESE RESERVES DURING YEARS OF SURPLUS SO THAT IN TIMES OF ECONOMIC DOWNTURN, IF A LARGE CAPITAL ADDITION IS NEEDED, THE HOSPITAL WILL NOT HAVE TO PASS HIGHER COSTS ON TO MEMBERS OF THE COMMUNITY. THE HOSPITAL FURTHER ACHIEVES ITS GOAL OF PROVIDING TRUE COMMUNITY SUPPORT BY PROVIDING CHARITY CARE AS DESCRIBED THROUGHOUT SCHEDULE H AND PROVIDING SERVICES TO MEMBERS OF OTHER PROGRAMS WHICH OFTEN REIMBURSE THE HOSPITAL BELOW THE COST OF PROVIDING THIS CARE SUCH AS CHAMPUS AND TRICARE.FINALLY, THE RICHLAND HOSPITAL, INC. COMMUNITY RELATIONS DEPARTMENT MANAGES ALL SPONSORSHIP DOLLARS ANNUALLY AND ALLOCATES TO AREA NON-PROFIT ORGANIZATIONS BASED ON THAT ORGANIZATION'S OR EVENT'S POSITIVE IMPACT ON OUR IDENTIFIED COMMUNITY HEALTH NEEDS. LIKEWISE, ADVERTISING DOLLARS AND EARNED MEDIA PROMOTIONS POSITIVELY AFFECTING IDENTIFIED COMMUNITY HEALTH NEEDS TAKE PRECEDENCE OVER GENERAL 'AWARENESS' CAMPAIGNS (MENTAL HEALTH MONTH, NUTRITION MONTH, OVERDOSE AWARENESS). PART VI, LINE 7, REPORTS FILED WITH STATES WI X X X X 0 0 0 0 0 0 0 0 0 THOMAS BECK ORTHOPEDIC SURGEON 443528 0 121500 0 3853 0 13200 0 16255 0 598336 0 0 0 SHAWN O' BRIEN ER DOCTOR 499915 0 0 0 1482 0 12345 0 41601 0 555343 0 0 0 BRYAN MCCARVEL CRNA 463981 0 0 0 1482 0 12345 0 41602 0 519410 0 0 0 NATHAN SCHWARTZ CRNA 427547 0 0 0 1482 0 11619 0 1349 0 441997 0 0 0 MUHAMMAD KHAN ER PHYSICIAN 411025 0 1000 0 3705 0 13200 0 10746 0 439676 0 0 0 BRUCE ROESLER CEO 317408 0 31715 0 3717 0 12312 0 27923 0 393075 0 0 0 ELIZABETH MOORE CFO 240519 0 0 0 1949 0 10095 0 42530 0 295093 0 0 0 KAY BALINK MD DIRECTOR (& EMPLOYEE) 166040 0 385 0 2223 0 6142 0 10229 0 185019 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S MANAGEMENT AND FINANCE TEAM WORKS WITH THEIR PAID PREPARER TO ACCUMULATE AND ASSEMBLE THE IRS FORM 990. A COPY OF THE COMPLETED FORM WAS EMAILED OR MAILED TO ALL MEMBERS OF THE HOSPITAL'S BOARD OF DIRECTORS BEFORE IT WAS FILED. ALL BOARD MEMBERS WERE GIVEN THE OPPORTUNITY TO RESPOND WITH COMMENTS PRIOR TO THE FINAL SUBMISSION OF THE FORM 990 TO THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE RICHLAND HOSPITAL, INC. REQUIRES ALL OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES TO COMPLETE ITS ANNUAL DISCLOSURE STATEMENT. THESE QUESTIONNAIRES ARE THEN REVIEWED BY THE BOARD OF DIRECTORS, NOTING ANY RELATIONSHIPS THAT COULD POTENTIALLY CREATE A CONFLICT OF INTEREST. ANY INDIVIDUALS WITH NOTED CONFLICTS ARE ASKED TO ABSTAIN FROM VOTING OR ACTING ON THOSE MATTERS. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS HAS AN ESTABLISHED PROCESS TO ANNUALLY REVIEW THE COMPENSATION FOR THE CHIEF EXECUTIVE OFFICER AND TO DEFINE APPROPRIATE MARKET AND PERFORMANCE-BASED ADJUSTMENTS. COMPARATIVE DATA IS OBTAINED FROM EITHER THE WISCONSIN HOSPITAL ASSOCIATION EXECUTIVE COMPENSATION SURVEY OR OTHER REPUTABLE THIRD-PARTY HEALTHCARE DATA SOURCES TO USE IN THE ESTABLISHMENT OF A MARKET FOR THIS KEY POSITION. THE PERSONNEL COMMITTEE OF THE BOARD OF DIRECTORS FULFILLS THIS ROLE. THE BOARD OF DIRECTORS HAS DELEGATED THE AUTHORITY AND RESPONSIBILITY FOR THE ONGOING MAINTENANCE OF OTHER KEY EMPLOYEES AND THE OVERALL ORGANIZATIONAL COMPENSATION MODEL TO THE CHIEF EXECUTIVE OFFICER AND HUMAN RESOURCE DIRECTOR. COMPARATIVE MARKET DATA IS OBTAINED VIA THE RURAL WISCONSIN HEALTH COOPERATIVE AND THE WISCONSIN SOCIETY OF HOSPITAL HUMAN RESOURCE ADMINISTRATORS VIA INDEPENDENT SALARY SURVEYS THAT PROVIDE BENCHMARK INFORMATION FOR HEALTHCARE JOB CLASSES. THIS DATA IS USED TO ESTABLISH SALARY RANGES FOR ALL JOB CLASSES WITHIN THE ORGANIZATION. THE BOARD OF DIRECTORS ANNUALLY AUTHORIZES THE OVERALL INCREASE TO THE SALARY BUDGET FOR THE ORGANIZATION WITH THE CEO MAINTAINING DELEGATED AUTHORITY FOR IMPLEMENTATION WITHIN THE ORGANIZATIONAL COMPENSATION MODEL. DURING THE REVIEW PROCESS, DECISIONS AFFECTING COMPENSATION AND CONTRACTS ARE ONLY REVIEWED AND APPROVED BY INDIVIDUALS WHO DO NOT HAVE NOTED CONFLICTS. FORM 990, PART VI, SECTION C, LINE 19 THE RICHLAND HOSPITAL, INC. MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT ITS HOSPITAL BUSINESS LOCATION DURING NORMAL BUSINESS HOURS. FORM 990, PART IX, LINE 11G OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 3,599,299. MANAGEMENT AND GENERAL EXPENSES 682,008. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,281,307. MEDICAL IMAGING PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 3,780,855. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,780,855. CLINICAL PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 914,737. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 914,737. LABORATORY PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 542,489. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 542,489. SURGICAL PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,672,981. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,672,981. HOSPITALIST PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 897,194. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 897,194. BEHAVIORAL HEALTH PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 621,100. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 621,100. FORM 990, PART XI, LINE 9: NET CHANGE IN RESTRICTED NET ASSETS OF SUPPORTING ORGANIZATIONS -6,658. INCREASE IN EQUITY OF UNCONSOLIDATED AFFILIATE 77,659. RICHLAND HOSPITAL FOUNDATION INC 333 EAST SECOND STREET RICHLAND CENTER WI 53581 391567249 FOUNDATION WI 501(C)(3) LINE 7 N/A 0 PARTNERS OF RICHLAND HOSPITAL INC 333 EAST SECOND STREET RICHLAND CENTER WI 53581 391693458 AUXILIARY WI 501(C)(3) LINE 10 N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 RICHLAND HOSPITAL FOUNDATION C 82146 CASH