2021-11-15T12:46:26-06:00 2020-12-31 135565207 KOMG LLP 4200 WELLS FARGO CTR 90 S 7TH MINNEAPOLIS MN 55402 990 2020-07-01 390973724 FLAMBEAU HOSPITAL INC FLAM 7157622484 98 SHERRY AVENUE PARK FALLS WI 54552 GORDON EDWARDS MCHS CFO/COO 7157622484 2021-11-15 1 GORDON EDWARDS 999009999 MONROE J GIERL P01413237 6123055000 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z MARSHFIELD MEDICAL CENTER-PARK FALLS SUSAN TURNEY MD CEO 1000 N OAK AVENUE MARSHFIELD WI 54449 16936414 0 X WWW.MARSHFIELDCLINIC.ORG X 1961 WI SEE SCHEDULE OWE ENRICH LIVES TO CREATE HEALTHY COMMUNITIES THROUGH ACCESSIBLE, AFFORDABLE, COMPASSIONATE HEALTH CARE. 8 5 242 125 0 0 372115 754721 26632665 16077807 -909595 15023 13249 88863 26108434 16936414 24000 312568 0 0 13715933 7113342 0 0 0 12430178 5435085 26170111 12860995 -61677 4075419 23202731 21843979 12181496 7773252 11021235 14070727 WE ENRICH LIVES TO CREATE HEALTHY COMMUNITIES THROUGH ACCESSIBLE, AFFORDABLE, COMPASSIONATE HEALTH CARE. 0 0 11648552 312568 16077851 FLAMBEAU HOSPITAL, INC. IS A NOT-FOR-PROFIT 25-BED COMMUNITY HOSPITAL LOCATED IN PARK FALLS, WISCONSIN THAT PROVIDES INPATIENT CARE AND SWING BED SERVICES ALONG WITH LABORATORY, RADIOLOGY, PHARMACY, REHABILITATION, SURGERY, HOSPICE, HOME HEALTH AND OTHER OUTPATIENT SERVICES. 11648552 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 47 0 1 242 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 5 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X CATHY BUKOWSKI VP OF FINANCE 7153875511 1000 N OAK AVENUE MARSHFIELD WI 54449 MARK BUGHER CHAIR 1.00 9.00 X X 0 32500 0 MARK BRADLEY VICE CHAIR 1.00 5.00 X X 0 8500 0 CHUCK NASON SECRETARY 1.00 4.00 X X 0 4750 0 JOHN BALTUS TREASURER 1.00 0.00 X X 0 0 0 SUSAN SUTTER BOARD MEMBER 1.00 0.00 X 0 0 0 SUSAN TURNEY MD BOARD MEMBER/MCHS CEO 1.00 54.00 X 0 2834416 291778 RUWAN DISSANAYAKE MD BOARD MEMBER 1.00 50.00 X 0 492987 47500 NARAYANA MURALI MD BOARD MEMBER/MCHS CSO 1.00 54.00 X 0 1082372 50238 ROGER STRAND CHAIRPERSON (THRU AUG 2020) 1.00 0.00 X X 0 0 0 JULIA RUFF VICE CHAIR/TRS (THRU AUG 2020) 1.00 0.00 X X 0 0 0 CAROL MADER SECRETARY (THRU AUG 2020) 1.00 0.00 X X 0 0 0 THOMAS PREBBLE MD BOARD MEMBER (THRU AUG 2020) 1.00 0.00 X 0 0 0 SCOTT CARPENTER MD BOARD MEMBER (THRU AUG 2020) 1.00 0.00 X 0 0 0 LOUAY DANIAL MD BOARD MEMBER (THRU AUG 2020) 1.00 0.00 X 0 0 0 DAVE DEDA BOARD MEMBER (THRU AUG 2020) 1.00 0.00 X 0 0 0 MOQUIN DOUG BOARD MEMBER (THRU AUG 2020) 1.00 0.00 X 0 0 0 BECKY MICHELS BOARD MEMBER (THRU AUG 2020) 1.00 0.00 X 0 0 0 KRISTEN REUKAUF BOARD MEMBER (THRU AUG 2020) 1.00 0.00 X 0 0 0 GAYLE STANGLE BOARD MEMBER (THRU AUG 2020) 1.00 0.00 X 0 0 0 MATTHEW THOMAS MD BOARD MEMBER (THRU AUG 2020) 1.00 0.00 X 0 0 0 LAURIE WAGNER BOARD MEMBER (THRU AUG 2020) 1.00 0.00 X 0 0 0 WILLIAM MELMS MD CHIEF MEDICAL OFFICER 1.00 54.00 X 0 607112 45360 JERARD JENSEN MCHS GENERAL COUNSEL 1.00 54.00 X 0 986292 46087 GORDON EDWARDS MCHS CFO/COO 1.00 54.00 X 0 1003980 50671 BRANDON BAY CFO 50.00 0.00 X 128369 0 6881 SARA BABLICK DIRECTOR OF PHARMACY 50.00 0.00 X 165330 0 38986 ROBERT PFLANZ SENIOR DIRECTOR SUPP SVCS 50.00 0.00 X 123569 0 39319 JANE EATON-NYMAN CHIEF INTEGRATION OFFICER 50.00 0.00 X 212963 0 35997 ELIZABETH SCHREIBER DIRECTOR OF NURSING 50.00 0.00 X 142433 0 38027 772664 7052909 690844 0 0 1 0 MARSHFIELD CLINIC INC 1000 N OAK AVE MARSHFIELD WI 54449 MEDICAL SERVICES 1317709 ALEXANDER KORITTNIG 442 S 3RD AVE PARK FALLS WI 54552 MEDICAL SERVICES 578028 FUSION MEDICAL STAFFING PO BOX 82674 LINCOLN NE 68501 MEDICAL SERVICES 457243 TRIAGE LLC PO BOX 3291 OMAHA NE 68103 MEDICAL SERVICES 404783 SHARED MEDICAL TECHNOLOGY 202 W NEWTON ST RICE LAKE WI 54868 MEDICAL SERVICES 332492 8 5629 726135 22957 754721 NET PATIENT SERV REV 621110 15989841 15989841 MISC OTHER OP REV 621110 52264 52264 CAFETERIA REV 621110 35702 35702 16077807 15023 15023 88819 0 88819 88819 88819 VENDING REVENUE 900099 44 44 44 16936414 16077851 0 103842 X 312568 312568 5332839 4617129 715710 194129 194129 1189393 1177393 12000 396981 396981 49100 49100 2610821 2247264 363557 8722 438 8284 94597 79227 15370 171184 160465 10719 48316 43407 4909 10574 10574 600568 600568 87876 87876 MEDICAL SUPPLIES 1167648 1157154 10494 EQUIPMENT REPAIRS & MAI 314477 313579 898 BAD DEBT EXPENSE 197547 197547 ALL OTHER EXPENSES 50151 28749 21402 23504 23504 12860995 11648552 1212443 0 X 351656 7030982 12016067 7238266 0 0 3848835 1970358 0 0 0 0 0 0 245867 317512 64876 94215 5343251 584192 6249106 4759059 0 0 0 0 426324 433587 0 0 0 0 23202731 21843979 1685713 924548 0 0 3931524 146000 0 0 0 0 0 0 480088 344314 0 0 6084171 6358390 12181496 7773252 X 10029772 13122000 991463 948727 11021235 14070727 23202731 21843979 X 4075419 -1025927 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 625140 625140 2745024 153619 2591405 1914275 417026 1497249 58812 13547 45265 4759059 ASSET RETIREMENT OBLIGATION 201213 THIRD PARTY PAYOR SETTLEMENT 830341 MEDICARE REFUNDABLE ADVANCE 5326836 6358390 X PART X, LINE 2: THE ORGANIZATION APPLIES FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740, INCOME TAXES (ASC 740), WHICH CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN A COMPANY'S FINANCIAL STATEMENTS. ASC 740 PRESCRIBES A MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN. UNDER ASC 740, TAX POSITIONS WILL BE EVALUATED FOR RECOGNITION, DERECOGNITION, AND MEASUREMENT USING CONSISTENT CRITERIA AND WILL PROVIDE MORE INFORMATION ABOUT THE UNCERTAINTY IN INCOME TAX ASSETS AND LIABILITIES. THE SYSTEM HAS DETERMINED THAT IT DOESN'T HAVE ANY MATERIAL UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2020 OR SEPTEMBER 30, 2019. 1 1 X 1 X 1 X 1 1 1 0 1 1 182040 0 182040 0.01420 1523240 860413 662827 0.05160 0 0 0.00000 1705280 860413 844867 0.06580 0 0 0.00000 0 0 0.00000 0 0 0.00000 0 0 0.00000 27569 13802 13767 0.00110 27569 13802 13767 0.00110 1732849 874215 858634 0.06690 2 2 1 115051 0 4226705 5724742 -1498037 X 1 1 1 1 MARSHFIELD MEDICAL CENTER-PARK FALLS 98 SHERRY AVENUE PARK FALLS WI 54552 1028 X X X X MARSHFIELD MEDICAL CENTER-PARK FALLS 1 0 1 1 X X X X X X X X X 18 1 0 1 1 X SEE SUPPLEMENTAL INFORMATION X 1 18 1 SEE SUPPLEMENTAL INFORMATION 0 1 X 200.000000000000 400.000000000000 X X X X X 1 1 X X X 1 X HTTPS://MARSHFIELDCLINIC.ORG/PATIENT-RESOURCES/BILLING/FINANCIAL-ASSISTANCE X HTTPS://MARSHFIELDCLINIC.ORG/PATIENT-RESOURCES/BILLING/FINANCIAL-ASSISTANCE X HTTPS://MARSHFIELDCLINIC.ORG/PATIENT-RESOURCES/BILLING/FINANCIAL-ASSISTANCE X X X X X X 1 X 0 X X X X 1 X 0 0 PART V, LINE 2: EFFECTIVE AUGUST 1, 2020, MCHS ACQUIRED THE ASSETS OF ASCENSION ST. CLARE'S HOSPITAL IN WESTON, WISCONSIN WHICH INCLUDED THE REMAINING 50% INTEREST IN FLAMBEAU HOSPITAL, INC. PART V, LINE 5: FLAMBEAU HOSPITAL WORKED CLOSELY WITH THE PRICE COUNTY HEALTH DEPARTMENT IN ORDER TO HAVE INPUT FROM A BROAD SPECTRUM OF COMMUNITY PROFESSIONALS. INDIVIDUALS INCLUDED IN THE FOLLOWING ALL PROVIDED VALUABLE INPUT THROUGH THEIR ATTENDANCE AT THE COMMUNITY NEEDS FORUM: PRICE COUNTY BOARD OF SUPERVISORS, PRICE COUNTY AGING AND DISABILITY RESOURCE CENTER UNIT, PRICE COUNTY CHILDREN AND YOUTH UNIT, PRICE COUNTY BEHAVIORAL HEALTH UNIT, PRICE COUNTY PUBLIC HEALTH UNIT, PRICE COUNTY SHERIFF'S DEPARTMENT, PARK FALLS POLICE DEPARTMENT, CHEQUAMEGON SCHOOL DISTRICT, PHILLIPS SCHOOL DISTRICT, EXTENSION PRICE COUNTY, PHILLIPS PUBLIC LIBRARY, NEW HORIZONS NORTH, EMBRACE, FLAMBEAU HOME HEALTH & HOSPICE, FALMBEAU HOSPITAL, LIMBERG & ASSOCIATES COUNSELING, LLC, MARSHFIELD CLINIC HEALTH SYSTEM AND ASCENSION WISCONSIN. PART V, LINE 6B: PRICE COUNTY, PRICE COUNTY PUBLIC HEALTH AND FLAMBEAU HOSPITAL. PART V, LINE 11: FLAMBEAU HOSPITAL IMPLEMENTED MANY STRATEGIES COLLABORATIVELY WITH COMMUNITY AND OTHER HEALTHCARE PARTNERS. COMMUNITY CHANGE IS A LONG-TERM PROCESS THAT NO ONE ORGANIZATION CAN ACCOMPLISH ALONE, THEREFORE PARTNERSHIPS ARE ESSENTIAL FOR SUCCESS. THE FOLLOWING WERE IDENTIFIED BY THE FLAMBEAU PRICE COUNTY COMMUNITY HEALTH ASSESSMENT:A. MENTAL HEALTHB. YOUTHC. ALCOHOL, OTHER DRUG ABUSE (AODA)D. PARENTINGE. ECONOMIC INSTABILITYF. INJURY/VIOLENCEG. CHRONIC DISEASE PREVENTIONDUE TO THE INTERCONNECTED NATURE OF THE TOP IDENTIFIED HEALTH PRIORITIES, FLAMBEAU CHOSE TO COMBINE A NUMBER OF HEALTH PRIORITIES AND ARE AS FOLLOWS ALONG WITH THE GOALS AND STRATEGIES IDENTIFIED TO ACHIEVE THEM: ALCOHOL, OTHER DRUG ABUSE (AODA).STRATEGY 1: ENSURE PROPER DISPOSAL OF MEDICATIONS. BE TWEEN JULY 2019- JUNE 2020, 8.5 POUNDS OF UNWANTED MEDICATIONS WERE COLLECTED AND OVER 100 DOTERRA DISPOSAL KITS WERE DISTRIBUTED IN THE COMMUNITY.STRATEGY 2: COMMUNITY AWARENESS OF AODA ISSUES. IN MARCH 2020, TWO COMMUNITY TOWN HALLS WERE HELD COVERING AODA ISSUES. THE THIRD PLANED TOWN HALL WAS CANCELED DUE TO COVID 19.STRATEGY 3: SCREENING BRIEF AND INTERVENTION. MENTAL HEALTH.STRATEGY 1: STRENGTHENING PARENTING SUPPORTS. THROUGH A PARTNERSHIP WITH UW DIVISION OF EXTENSION PRICE COUNTY, PARENT CAF SUPPORT GROUPS WERE PILOTED IN FALL 2019. SEVEN CAFS WERE HELD WITH AN AVERAGE ATTENDANCE OF 10-15 ADULTS AND BETWEEN 8-10 CHILDREN AT A CAF. PRICE COUNTY STRONGLY EMBRACED THE PARENT CAF IN ITS PILOT LOCATION. EVEN THOUGH COVID-19 CAUSED CANCELLATIONS OF MONTHLY MEETINGS IN THE LAST QUARTER, REVIEWS OF THE PROGRAM WERE LARGELY POSITIVE, WITH PARTICIPANTS FEELING THAT THEIR SUPPORT CIRCLE HAD GROWN AND THAT THEY HAD GREATER CONFIDENCE IN THEIR PARENTING SKILLS.STRATEGY 2: IMPROVE SOCIAL CONNECTEDNESS. FLAMBEAU HOSPITAL SUPPORTED A SUMMER EVENT SERIES WAS HELD JUNE- AUGUST 2019 WITH SIX CONCERTS AND ONE MOVIE SCREENING. FURTHER, FLAMBEAU HOSPITAL RECEIVED A BADER PHILANTHROPIES GRANT FOR SIP AND SWIPE. THE PROGRAM RECEIVED 6 DEVICES TO USE FOR THE PROGRAM AIMED AT INCREASING TECHNOLOGY SKILLS AMONG OLDER ADULTS TAUGHT BY YOUTH. HELD 3 EVENTS, ONE AT PHILLIPS LIBRARY (6 PARTICIPANTS), TWO AT PARK FALLS LIBRARY (1 AND 4 PARTICIPANTS).STRATEGY 3: SUPPORT MENTAL HEALTH TRAINING. IN OCTOBER 2019, FLAMBEAU HOSPITAL PROVIDED SPONSORSHIP FUNDING FOR THE SOURCES OF STRENGTH CURRICULUM TRAINING FOR TWO PRICE COUNTY SCHOOL DISTRICTS. AFTER THIS, ALL THREE SCHOOL DISTRICTS IN PRICE COUNTY ARE IMPLEMENTING THIS CURRICULUM IN HIGH SCHOOLS. A TRAINING OF STUDENTS REPRESENTING NUMEROUS SOCIAL CIRCLES KICKED OFF THE SCHOOL YEAR AND THEN THOSE STUDENTS INITIATED A STREAM OF AWARENESS CAMPAIGNS TO INCLUDE THE REST OF THEIR SCHOOL. THE MOST VISIBLE CAMPAIGN WAS CONDUCTED THROUGH THE SOCIAL MEDIA OF ONE OF THE SCHOOLS, HIGHLIGHTING THE STRENGTH OF EVERY SINGLE STUDENT AND STAFF MEMBER IN THE DISTRICT BEFORE CHALLENGING THE NEXT SCHOOL TO DO THE SAME.CHRONIC DISEASE PREVENTION.STRATEGY 1: BUILDING AN ACTIVE PRICE COUNTY.STRATEGY 2: SUPPORTING A HEALTHY FOOD CULTURE.STRATEGY 3: SUPPORTING HEALTHY AGING. THE FOLLOWING HEALTH PRIORITIES WILL NOT BE ADDRESSED BY FLAMBEAU HOSPITAL FOR REASONS INDICATED: 1. YOUTH: YOUTH WILL BE AN INTENDED AUDIENC E OF MENTAL HEALTH AND AODA IMPLEMENTATION EFFORTS.2. PARENTING: PARENTING WILL BE ADDRES SED AS PART OF THE CHOSEN MENTAL HEALTH PRIORITY. 3.INJURY/VIOLENCE: THE IMPLEMENTATION STRATEGY WILL SUPPORT REDUCTION OF INJURY AND VIOLENCE AS IT PERTAINS TO MENTAL HEALTH AND AODA USE. AT THE SAME TIME, FLAMBEAU HOSPITAL AND PRICE COUNTY PUBLIC HEALTH WILL PROVIDE STRONG SUPPORT AND COLLABORATION WITH EXISTING COMMUNITY EFFORTS AND THE NON-PROFIT ORGANIZATION EMBRACE, WHICH SPECIFICALLY ADDRESSES DOMESTIC VIOLENCE IN OUR COMMUNITY.4. ECONOMIC INSTABILITY: PRICE COUNTY PUBLIC HEALTH'S AND FLAMBEAU HOSPITAL'S CAPACITY TO ADDRESS ECONOMIC INSTABILITY AS A SEPARATE PRIORITY AREA IS LIMITED. SOME ASPECTS OF ECONOMIC INSTABILITY MAY BE ADDRESSED THROUGH THE SELECTED PRIORITIES AND IMPLEMENTATION STRATEGIES. PART I, LINE 3C: AN INDIVIDUAL'S ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED ON INCOME AS COMPARED WITH FEDERAL POVERTY GUIDELINES. OTHER ELIGIBILITY FACTORS INCLUDE: ASSET LIMITATIONS, INSURANCE STATUS AND RESIDENCY. ACCOUNT BALANCE IS CONSIDERED FOR MEDICAL INDIGENCE ELIGIBILITY. PART I, LINE 7: EXPLANATION OF COSTING METHODOLOGY USED FOR CALCULATING LINE 7 TABLE:AMOUNTS CALCULATED IN PART I, LINE 7 ARE DETERMINED BASED ON A COST-TO-CHARGE RATIO. OTHER BENEFITS ARE DETERMINED BASED ON THE DIRECT AND INDIRECT COSTS (WHERE ALLOCATED) ASSOCIATED WITH A PROGRAM NET OF EARNED REVENUE. PART II, COMMUNITY BUILDING ACTIVITIES: MARSHFIELD MEDICAL CENTER-PARK FALLS (MMC-PF) PARTICIPATED IN VARIOUS COMMUNITY BUILDING ACTIVITIES WITH THE PURPOSE TO IMPROVE THE HEALTH OF THE COMMUNITY, INCLUDING ADDRESSING SOCIAL DETERMINATES OF HEALTH AND HEALTH INEQUITIES. DUE TO COVID-19, MANY COMMUNITY BUILDING ACTIVITIES WERE LIMITED OR CANCELED DURING THIS REPORTING PERIOD. HOWEVER, STAFF DID PARTICIPE IN REGIONAL COMMUNITY GROUPS COORDINATING EFFORTS TO ADDRESS COVID-19. SOME EXAMPLES OF COMMUNITY BUILDING ACTIVITIES INCLUDED: COALITION BUILDING: MMC-PF STAFF PARTICIPATED IN TWO DIFFERENT COMMUNITY COALITIONS WITH THE PURPOSE OF IMPROVING THE HEALTH OF THE COMMUNITY. THESE COALITIONS ARE THE PRICE COUNTY AODA/MENTAL HEALTH COALITION AND THE PRICE COUNTY HEALTH & WELLNESS COALITION. COMMUNITY SUPPORT: MMC-PF STAFF TRAINED COMMUNITY DENTISTS ON RESPIRATORY FIT TESTING SO THAT THE DENTAL CENTER COULD PROVIDE NEW EMPLOYEE FIT TESTING MOVING FORWARD. MMC-PF PROVIDED FUNDING TO SUPPORT COMMUNITY NEEDS AS A RESPONSE TO THE COVID-19 PANDEMIC. ORGANIZATIONS RECEIVING FROM THE SUPPORT WERE FAMILY WORSHIP CENTER, PHILLIPS SCHOOL DISTRICT AND PRENTICE SCHOOL DISTRICT. ADVOCACY FOR COMMUNITY HEALTH IMPROVEMENTS AND SAFETY: MMC-PF COLLABORATED WITH COMMUNITY ORGANIZATIONS AND GROUPS FOR COMMUNITY HEALTH IMPROVEMENTS AND SAFETY. EXAMPLES INCLUDED: BI-ANNUAL PRESCRIPTION DRUG TAKE BACK EVENTS CONDUCTED BY PRICE COUNTY AODA/MENTAL HEALTH COALITION AND PRICE COUNTY PUBLIC HEALTH; A PERMANENT MEDICATION DISPOSAL BOX AT MMC-PF PHARMACY LOCATION. PART III, LINE 2: BAD DEBT EXPENSE IS REPORTED AT COST USING A COST-TO-CHARGE RATIO. PART III, LINE 4: PATIENT ACCOUNTS RECEIVABLE ARE REDUCED FOR EXPLICIT PRICE CONCESSIONS AND BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AS AN IMPLICIT PRICE CONCESSION. IN EVALUATING THE COLLECTABILITY OF PATIENTS' ACCOUNTS RECEIVABLE, THE SYSTEM ANALYZES ITS PAST HISTORY AND CONTRACTUAL TERMS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE. FOR RECEIVABLES ASSOCIATED WITH PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE SYSTEM ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ADDITIONAL IMPLICIT DISCOUNT, IF NECESSARY (I.E., FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND CO-PAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID OR FOR PAYORS 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 DEDUCTIBLES AND CO-PAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE SYSTEM RECORDS AN IMPLICIT DISCOUNT IN THE PERIOD OF SERVICE ON 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. THE SYSTEM'S IMPLICIT ALLOWANCE FOR SELF-PAY PATIENTS WAS APPROXIMATELY 55% AND 41% OF SELF-PAY ACCOUNTS RECEIVABLE AS OF DECEMBER 31, 2020 AND SEPTEMBER 30, 2019, RESPECTIVELY. PART III, LINE 8: THE ALLOWABLE MEDICARE COST ON PART III, LINE 6 IS DETERMINED USING THE CY 2020 MEDICARE COST REPORT. THE REIMBURSEMENT FROM MEDICARE IS DEDUCTED FROM THE ESTIMATED COST USING A COST-TO-CHARGE RATIO IN ORDER TO DETERMINE THE SHORTFALL FROM THE MEDICARE PROGRAM. THIS MEDICARE SHORTFALL LISTED ON LINE 7 IS NOT CURRENTLY TREATED AS COMMUNITY BENEFIT, HOWEVER, REPRESENTS SERVICES THAT ARE ESSENTIAL TO VARIOUS UNDERSERVED POPULATIONS IN THE COMMUNITY. PART III, LINE 9B: THE ORGANIZATION HAS A BILLING AND COLLECTION POLICY WHICH SETS FORTH COLLECTION PRACTICES FOR PATIENTS WHO ARE KNOWN TO BE ELIGIBLE OR PRESUMED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY. MULTIPLE MEASURES ARE TAKEN TO COMMUNICATE THE AVAILABILITY OF FINANCIAL ASSISTANCE AND DETERMINE WHETHER A PATIENT IS FINANCIAL ASSISTANCE ELIGIBLE BEFORE PURSUING EXTRAORDINARY COLLECTION ACTIONS (ECAS). ECAS MAY INCLUDE: REPORTING TO CONSUMER CREDIT REPORTING AGENCIES, PURSUING LEGAL JUDGMENTS, FILING LIENS, GARNISHING WAGES, REQUIRING PREPAYMENT FOR NON-EMERGENCY SERVICES. ECAS WILL NOT BE INITIATED AND FURTHER ACTION WILL NOT BE TAKEN ON EXISTING ECAS ONCE A FINANCIAL ASSISTANCE APPLICATION IS IN PROCESS. IF THE PATIENT IS DETERMINED FINANCIAL ASSISTANCE ELIGIBLE, REASONABLE MEASURES WILL BE TAKEN TO REVERSE ANY ECA ALREADY IN PLACE. PART VI, LINE 2: ALL MARSHFIELD CLINIC HEALTH SYSTEM FACILITIES ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES BY CONDUCTING STANDARD CHNA PRACTICES, INCLUDING: - REVIEW OF PUBLICLY AVAILABLE COMMUNITY HEALTH DATA (I.E. COUNTY HEALTH RANKINGS) - COMPLETION OF KEY INFORMANT INTERVIEWS WITH COMMUNITY LEADERS ABOUT THE COMMUNITY'S HEALTH NEEDS - PARTICIPATION IN COMMUNITY HEALTH COMMITTEES AND BOARDS PART VI, LINE 3: PATIENT ASSISTANCE CENTER COUNSELORS ASSIST INDIVIDUALS WITH IDENTIFYING, REFERRING AND/OR APPLYING FOR PUBLIC, PRIVATE OR CHARITABLE RESOURCES FOR WHICH THE PATIENT MAY QUALIFY. COUNSELORS ARE AVAILABLE VIA PHONE AND IN PERSON TO ASSIST INDIVIDUALS WITH FINANCIAL ASSISTANCE.INFORMATION ON THE MARSHFIELD CLINIC HEALTH SYSTEM (MCHS) FINANCIAL ASSISTANCE POLICY IS POSTED IN HOSPITAL REGISTRATION AND ADMITTING LOCATIONS AND IN THE HOSPITAL EMERGENCY DEPARTMENT. FINANCIAL ASSISTANCE INFORMATION IS PRINTED ON MONTHLY BILLING STATEMENTS AND INCORPORATED INTO OTHER COMMUNICATIONS IN ORDER TO WIDELY PUBLICIZE THE AVAILABILITY OF FINANCIAL ASSISTANCE, AS DESCRIBED IN THE MCHS BILLING AND COLLECTION POLICY. THE MCHS FINANCIAL ASSISTANCE POLICY (INCLUDING THE PLAIN LANGUAGE SUMMARY), THE FINANCIAL ASSISTANCE APPLICATION AND THE BILLING AND COLLECTION POLICY ARE AVAILABLE IN ENGLISH, SPANISH, HMONG AND ANY OTHER LANGUAGE THAT IS THE PRIMARY LANGUAGE SPOKEN BY THE LESSER OF 1,000 INDIVIDUALS OR 5% OF THE POPULATION OF THE SERVICE AREA.THE MCHS FINANCIAL ASSISTANCE POLICY (INCLUDING THE PLAIN LANGUAGE SUMMARY), THE FINANCIAL ASSISTANCE APPLICATION AND THE BILLING AND COLLECTION POLICY MAY BE OBTAINED FREE OF CHARGE: ON THE HOSPITAL WEBSITE, IN PERSON, FROM FINANCIAL COUNSELORS, BY PHONE AND BY MAIL. PART VI, LINE 4: MARSHFIELD MEDICAL CENTER-PARK FALLS (MMC-PF) IS A 25-BED CRITICAL ACCESS HOSPITAL IN PARK FALLS, WISCONSIN. 24-HOUR CARE IS PROVIDED FOR IN-PATIENT AND OUT-PATIENT SERVICES, EMERGENCY AMBULANCE SERVICES, AND HOME HEALTH & HOSPICE SERVICES TO RESIDENTS IN PRICE COUNTY AND NORTHERN WISCONSIN. PRICE COUNTY IS LOCATED IN NORTH CENTRAL WISCONSIN BETWEEN HAYWARD AND MINOCQUA. PRICE COUNTY IS COMPRISED OF TWO CITIES (PARK FALLS AND PHILLIPS), 17 TOWNS (INCLUDING PRENTICE) AND THREE VILLAGES. PRICE COUNTY HAD A TOTAL POPULATION OF 13,351 IN 2019 AND IS 100% RURAL COUNTY WITH, ON AVERAGE, 11.3 PERSONS PER SQUARE MILE. THERE WERE 17.9% OF RESIDENTS UNDER 18 YEARS, 26.5% WHO WERE 65 YEARS AND OVER, AND 48.9% WHO WERE FEMALE. THE RACIAL MAKE-UP OF PRICE COUNTY WAS 93.7% WHITE ALONE NOT HISPANIC OR LATINO, 1.9% HISPANIC OR LATINO, 0.7% ASIAN ALONE, 0.7% BLACK OR AFRICAN AMERICAN, 0.8% AMERICAN INDIAN AND ALASKA NATIVE ALONE, AND 1.6% TWO OR MORE RACES. THERE WERE 1.8% OF PRICE COUNTY RESIDENTS WHO WERE NOT BORN IN THE UNITED STATES. PRICE COUNTY HAS 10.4% OF INDIVIDUALS WITH A DISABILITY WHO ARE UNDER AGE 65 YEARS, WHICH IS A HIGHER PERCENTAGE THAN FOR WISCONSIN AND THE UNITED STATES. IN PRICE COUNTY, THE HIGH SCHOOL GRADUATION RATE WAS 91.8%. THE PERCENTAGES OF RESIDENTS WHO HAVE A BACHELOR'S DEGREE OR HIGHER WAS AT 16.5%, WHICH IS LOWER THAN WISCONSIN AND THE UNITED STATES. IN 2019, THE MEDIUM HOUSEHOLD INCOME WAS $47,956, WITH 14.9% OF THE POPULATION WAS BELOW THE POVERTY LINE. PART VI, LINE 5: MARSHFIELD MEDICAL CENTER-PARK FALLS (MMC-PF) FURTHERED ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY WITH THE REPRESENTATION ON THE: COORDINATED COMMUNITY RESPONSE COMMITTEE ORGANIZED BY EMBRACE IN PRICE COUNTY. THIS COMMITTEE EXAMINES COMMUNITY ISSUES RELATED TO DOMESTIC ABUSE AND SUPPORTS SYSTEMS THAT HELP VICTIMS IMPROVE OVERALL HEALTH AND OVERCOME THEIR SITUATION. PRICE COUNTY COMMUNITY BIOETHICS COMMITTEE, PRICE COUNTY EMERGENCY MANAGEMENT COMMITTEE, PRICE COUNTY TRANSPORTATION COORDINATING COMMITTEE AND PRICE COUNTY PROJECT LIFESAVER. BOARD OF DIRECTORS FOR THE ANNMARIE FOUNDATION SERVING PHILLIPS. MMC-PF ALSO PARTICIPATED IN MULTIPLE GROUPS WITHIN THE TWO COMMUNITY COALITIONS SERVING PRICE COUNTY, AODA/MENTAL HEALTH COALITION AND HEALTH & WELLNESS COALITION. THE MISSIONS OF THESE COALITIONS IS TO PROMOTE THE HEALTH AND WELL-BEING OF INDIVIDUALS, FAMILIES AND COMMUNITIES OF PRICE COUNTY THROUGH SPECIFIC INITIATIVES. PART VI, LINE 6: MARSHFIELD CLINIC WAS FOUNDED IN 1916 BY SIX PHYSICIANS PRACTICING IN MARSHFIELD, A RURAL CENTRAL WISCONSIN CITY. AT ITS INCEPTION, CLINIC FOUNDERS SAW RESEARCH AND EDUCATION AS CRITICAL TO THEIR PRACTICE OF HEALTH CARE AND THAT REMAINS SO TODAY. THE CLINIC BECAME A 501(C)(3) NONPROFIT ORGANIZATION IN 1992 AND IN 2014, MARSHFIELD CLINIC HEALTH SYSTEM, INC. WAS FORMED. THE HEALTH SYSTEM'S MISSION IS TO ENRICH LIVES AND CREATE HEALTHY COMMUNITIES THROUGH ACCESSIBLE, AFFORDABLE, COMPASSIONATE HEALTH CARE. THE HEALTH SYSTEM TODAY IS AN INTEGRATED SYSTEM SERVING WISCONSIN AND BEYOND, WITH MORE THAN 12,000 EMPLOYEES INCLUDING OVER 1,400 PROVIDERS COMPRISING MORE THAN 170 SPECIALTIES AND SUBSPECIALTIES. ITS ENTITIES PROVIDE SERVICE AND HEALTH CARE TO MORE THAN TWO MILLION RESIDENTS THROUGH MORE THAN 60R 50 LOCATIONS IN 40 WISCONSIN COMMUNITIES IN NORTHERN, CENTRAL AND WESTERN WISCONSIN. PRIMARY OPERATIONS INCLUDE: MARSHFIELD CLINIC; MARSHFIELD MEDICAL CENTER HOSPITALS IN MARSHFIELD, EAU CLAIRE, BEAVER DAM, LADYSMITH, MINOCQUA, NEILLSVILLE, RICE LAKE, WESTON, PARK FALLS, AND MARSHFIELD CHILDREN'S HOSPITAL; MARSHFIELD CLINIC RESEARCH INSTITUTE, SECURITY HEALTH PLAN AND MARSHFIELD CLINIC HEALTH SYSTEM FOUNDATION. THE CLINIC OPERATES SEVERAL DENTAL CLINICS IN NORTHERN, CENTRAL AND WESTERN WISCONSIN, PROVIDING GENERAL FAMILY DENTISTRY AND DENTAL HYGIENE SERVICES TO MORE THAN 60,000 UNIQUE PATIENTS PER YEAR. THESE CENTERS WERE LAUNCHED THROUGH A COLLABORATION INCLUDING MARSHFIELD CLINIC, FAMILY HEALTH CENTER OF MARSHFIELD, INC., AND FEDERAL AND STATE AGENCIES, TO ADDRESS THE NEED FOR DENTAL CARE IN UNDERSERVED AREAS. THE CENTERS SERVE ALL PATIENTS REGARDLESS OF ABILITY TO PAY OR INSURANCE STATUS - UNINSURED/UNDERINSURED, PRIVATE PAY AND COMMERCIAL INSURANCE. THE HEALTH SYSTEM DEEPLY BELIEVES IN PROMOTING COMMUNITY HEALTH THROUGH BUILDING AND SUSTAINING STRONG INTERNAL AND EXTERNAL PARTNERSHIPS AND COLLABORATIONS. FOR THIS REASON, THE HEALTH SYSTEM AND ITS AFFILIATED ENTITIES WORK TOGETHER INTERNALLY AND EXTERNALLY WITH COMMUNITY PARTNERS, STAKEHOLDERS AND RESIDENTS TO IMPROVE COMMUNITY HEALTH. UNIQUE TO THE HEALTH SYSTEM IS ITS CENTER FOR COMMUNITY HEALTH ADVANCEMENT (CCHA), WHICH BUILDS BRIDGES BETWEEN THE HEALTH SYSTEM AND AREAS IN THE COMMUNITY WHERE PEOPLE LIVE, WORK AND PLAY. THE CCHA WORKS WITH COALITIONS, BUSINESSES, EDUCATIONAL SYSTEMS, LAW ENFORCEMENT AGENCIES, TRIBAL NATIONS, LOCAL GOVERNMENTS, AND OTHER HEALTHCARE PROVIDERS, NONPROFIT ORGANIZATIONS AND OTHER ENTITIES TO IMPROVE COMMUNITY HEALTH. THE CCHA INCLUDES HOSPITAL STAFF WHO ARE CLOSELY INVOLVED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND IMPLEMENTATION STRATEGY (IS) IN THEIR RESPECTIVE COUNTIES. THIS HELPS TO ALIGN COMMUNITY HEALTH PRIORITIES IDENTIFIED IN THE CHNA WITH HEALTH SYSTEM PRIORITIES. 1 0 0 CHARITY CARE 20 312568 PART I, LINE 2: MARSHFIELD CLINIC HEALTH SYSTEM (INCLUDING FLAMBEAU HOSPITAL) PROVIDES EMERGENCY AND MEDICALLY NECESSARY HEALTH CARE SERVICES FOR FREE OR AT DISCOUNTED RATES TO PATIENTS WHO MEET CERTAIN ELIGIBILITY CRITERIA. PATIENTS SEEKING FINANCIAL ASSISTANCE APPLY BY COMPLETING A FINANCIAL ASSISTANCE APPLICATION. FREE CARE IS AVAILABLE FOR PATIENTS WITH INCOME AND EXCESS ASSET VALUES AT OR BELOW 200% OF THE FEDERAL POVERTY GUIDELINES. 1 X 0 1 0 0 0 0 0 0 0 SUSAN TURNEY MD BOARD MEMBER/MCHS CEO 0 1736862 0 647870 0 449684 0 270161 0 21617 0 3126194 0 241400 NARAYANA MURALI MD BOARD MEMBER/MCHS CSO 0 747104 0 272924 0 62344 0 21519 0 28719 0 1132610 0 0 GORDON EDWARDS MCHS CFO/COO 0 747640 0 210274 0 46066 0 21519 0 29152 0 1054651 0 0 JERARD JENSEN MCHS GENERAL COUNSEL 0 772789 0 171649 0 41854 0 21519 0 24568 0 1032379 0 0 WILLIAM MELMS MD CHIEF MEDICAL OFFICER 0 548327 0 43847 0 14938 0 21519 0 23841 0 652472 0 0 RUWAN DISSANAYAKE MD BOARD MEMBER 0 356702 0 103989 0 32296 0 21519 0 25981 0 540487 0 0 JANE EATON-NYMAN CHIEF INTEGRATION OFFICER 210384 0 0 0 2579 0 7667 0 28330 0 248960 0 0 0 SARA BABLICK DIRECTOR OF PHARMACY 165134 0 0 0 196 0 6848 0 32138 0 204316 0 0 0 ELIZABETH SCHREIBER DIRECTOR OF NURSING 141155 0 0 0 1278 0 5889 0 32138 0 180460 0 0 0 ROBERT PFLANZ SENIOR DIRECTOR SUPP SVCS 121465 0 0 0 2104 0 5181 0 34138 0 162888 0 0 0 PART I, LINE 4B 457(F) PLAN SUSAN TURNEY, MD - $278,676 RUWAN DISSANAYAKE, MD - $10,000 NARAYANA MURALI, MD - $10,000 WILLIAM MELMS, MD - $10,000 JERARD JENSEN - $10,000 GORDON EDWARDS - $10,000 FORM 990, PART IV, LINE 4: MARSHFIELD CLINIC HEALTH SYSTEM (INCLUDING FLAMBEAU HOSPITAL) IS A MEMBER OF VARIOUS HEALTHCARE ASSOCIATIONS (I.E. WISCONSIN HOSPITAL ASSOCIATION) THAT MAY PERFORM SOME LOBBYING ACTIVITY. ALL ASSOCIATED DUES ARE DISCLOSED ON THE FORM 990 OF MARSHFIELD CLINIC HEALTH SYSTEM, INC. FORM 990, PART VI, SECTION A, LINE 4 EFFECTIVE AUGUST 1, 2020, MCHS ACQUIRED THE ASSETS OF ASCENSION ST. CLARE'S HOSPITAL IN WESTON, WISCONSIN WHICH INCLUDED THE REMAINING 50% INTEREST IN FLAMBEAU HOSPITAL, INC. FORM 990, PART VI, SECTION A, LINE 6 MCHS HOSPITALS, INC. (A WISCONSIN NONSTOCK, NONPROFIT ORGANIZATION DESCRIBED IN CODE SECTION 501(C)(3)) IS THE SOLE MEMBER OF FLAMBEAU HOSPITAL, INC. FORM 990, PART VI, SECTION A, LINE 7A MCHS HOSPITALS, INC. (AS THE SOLE MEMBER) HAS THE RESERVE POWER TO APPOINT OR REMOVE MEMBER OF THE BOARD OF DIRECTORS OF FLAMBEAU HOSPITAL, INC. FORM 990, PART VI, SECTION A, LINE 7B MCHS HOSPITALS, INC. (THE SOLE MEMBER) HAS THE RIGHT TO APPROVE ANY CHANGES TO THE ARTICLES OF INCORPORATION AND BYLAWS OF FLAMBEAU HOSPITAL, INC. MCHS HOSPITALS, INC. (THE SOLE MEMBER) HAS THE RIGHT TO INITIATE AND APPROVE LONG-TERM BORROWING AND OTHER FORMS OF LONG-TERM INDEBTEDNESS, INITIATE AND APPROVE THE PURCHASE, SALE OR ENCUMBRANCE OF REAL AND PERSONAL PROPERTY AND APPROVE OR DISAPPROVE ANNUAL OPERATING AND CAPITAL BUDGETS. MCHS HOSPITALS, INC. (THE SOLE MEMBER) ALSO HAS THE RIGHT TO INITIATE AND APPROVE ANY OF THE FOLLOWING ACTIONS: MERGER, CONSOLIDATION, AFFILIATION OR JOINT VENTURE WITH ANY OTHER ENTITY OR ENTITIES; LIQUIDATION, REORGANIZATION OR DISSOLUTION OF THE ORGANIZATION; FILING OF A VOLUNTARY PETITION IN BANKRUPTCY; ANY CHANGE IN CONTROL OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B MARSHFIELD CLINIC HEALTH SYSTEM, INC. ENGAGES A PUBLIC ACCOUNTING FIRM TO PREPARE AND REVIEW THE FORM 990 IN ADDITION TO REVIEW BY THE SYSTEM CFO/COO AND TAX DEPARTMENT. PRIOR TO FILING THE FORM WITH THE IRS, THE CFO AND HIS/HER DESIGNEE WILL PROVIDE TO EACH MEMBER OF THE SYSTEM'S AUDIT AND COMPLIANCE COMMITTEE (A SUBCOMMITTEE OF THE BOARD OF DIRECTORS) A COPY IN ELECTRONIC OR PAPER FORM OF THE COMPLETE FORM 990 (AND ALL REQUIRED SCHEDULES) FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C ALL OFFICERS, BOARD DIRECTORS, AND KEY EMPLOYEES OF EVERY MARSHFIELD CLINIC HEALTH SYSTEM (MCHS) ENTITY, AS WELL AS ANY OTHER PERSON DESIGNATED BY THE AUDIT AND COMPLIANCE COMMITTEE (ACC) TO BE A REQUIRED REPORTER BY VIRTUE OF HIS OR HER POSITION AT A SYSTEM ENTITY, SHALL ANNUALLY COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM. SUCH FORMS SHALL BE DISTRIBUTED AND RECORDED BY THE SYSTEM'S DESIGNATED COMPLIANCE OFFICER. ALL FINANCIAL INTERESTS DISCLOSED AS PART OF THE ANNUAL DISCLOSURE PROCESS SHALL BE REVIEWED BY THE ACC. THE ACC SHALL INFORM THE BOARD OF DISCLOSED FINANCIAL INTERESTS WHICH MAY BEAR UPON OR RELATE TO A TRANSACTION UPON WHICH THE BOARD OR ANOTHER BOARD, COMMITTEE OR OTHER BODY OF A SYSTEM ENTITY, MAY DELIBERATE OR ACT. IN ADDITION TO THE ANNUAL DISCLOSURES, IF AT ANY TIME BETWEEN ANNUAL DISCLOSURES, A REQUIRED REPORTER BECOMES AWARE THAT THE BOARD, OR A BOARD, COMMITTEE OR OTHER BODY, OF ANY SYSTEM ENTITY MAY DELIBERATE OR ACT UPON ANY TRANSACTION THAT MAY HAVE ANY BEARING OF ANY KIND UPON, OR MAY RELATE IN ANY MANNER TO, AN EXISTING, INTENDED OR EXPECTED FINANCIAL INTEREST OF THE REQUIRED REPORTER, HE OR SHE SHALL DISCLOSE THE FINANCIAL INTEREST TO THE RELEVANT SYSTEM ENTITY BOARD, COMMITTE OR BODY CHAIR, AS WELL AS TO THE SYSTEM'S COMPLIANCE OFFICER, IN ADVANCE OF ANY DELIBERATIONS OR ACTION, WRITTEN DISCLOSURE OF THE EXISTENCE, NATURE AND EXTENT OF HIS OR HER FINANCIAL INTEREST. ALL WRITTEN OR ORAL DISCLOSURES OF FINANCIAL INTERESTS SHALL BE RECORDED IN THE MINUTES OF THE BOARD AND BY THE OFFICE OF THE COMPLIANCE OFFICER. THE COMPLIANCE OFFICER SHALL DISCLOSE THE COMPLETED FORMS AS NECESSARY TO THOSE MCHS EMPLOYEES RESPONSIBLE FOR COMPLETION OF THE IRS FORM 990. FORM 990, PART VI, SECTION B, LINE 15 THE SYSTEM'S INDEPENDENT COMPENSATION COMMITTEE (COMPENSATION COMMITTEE) SHALL HAVE FINAL AUTHORITY FOR APPROVING COMPENSATION AND BENEFITS OF ALL DISQUALIFIED PERSONS (AS THAT TERM IS DEFINED IN 4958 OF THE INTERNAL REVENUE CODE (THE CODE)) EMPLOYED BY THE CORPORATION, INCLUDING BUT NOT LIMITED TO THE CORPORATION'S CEO. THE TERM DISQUALIFIED PERSONS INCLUDES (BUT IS NOT LIMITED TO) ANY PERSON (OR THE PERSON'S FAMILY MEMBER) WHO WAS, AT ANY TIME DURING THE 5-YEAR PERIOD ENDING ON THE DATE OF THE TRANSACTION, IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF THE ORGANIZATION. IT SHALL BE THE RESPONSIBILITY OF THE COMPENSATION COMMITTEE TO INSURE THAT THE SYSTEM DOES NOT PAY AN AMOUNT THAT EXCEEDS REASONABLE COMPENSATION FOR ANY DISQUALIFIED PERSON. THE COMPENSATION COMMITTEE AND ITS OPERATING PROCEDURES SHALL BE DESIGNED TO ESTABLISH THE REBUTTABLE PRESUMPTION OF REASONABLENESS OF COMPENSATION OUTLINED IN TREASURY REG. SEC. 53.4958-6 WITH RESPECT TO EACH DISQUALIFIED PERSON. IN DETERMINING REASONABLENESS OF COMPENSATION, THE COMPENSATION COMMITTEE SHALL EVALUATE APPROPRIATE INFORMATION AS TO THE COMPARABILITY OF COMPENSATION, INCLUDING BUT NOT LIMITED TO: COMPENSATION LEVELS PAID BY SIMILARLY SITUATED ORGANIZATIONS FOR COMPARABLE POSITIONS; THE AVAILABILITY OF SIMILAR SERVICES IN THE SYSTEM'S GEOGRAPHIC AREA; CURRENT COMPENSATION SURVEYS COMPILED BY INDEPENDENT FIRMS; AND ACTUAL WRITTEN JOB OFFERS FROM SIMILAR INSTITUTIONS. THE COMPENSATION COMMITTEE SHALL HAVE INDEPENDENT AUTHORITY TO OBTAIN OUTSIDE EXPERT OPINIONS ON THE REASONABLENESS AND FAIR MARKET VALUE OF COMPENSATION AND GATHER OTHER INFORMATION IT CONSIDERS NECESSARY OR APPROPRIATE TO MAKE ITS DECISIONS ON COMPENSATION. THE COMPENSATION COMMITTEE SHALL TIMELY DOCUMENT ITS DETERMINATION OF REASONABLENESS OF COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 FLAMBEAU HOSPITAL, INC. DOES NOT MAKE ITS CURRENT GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UNLESS INCLUDED AS PART OF A FORM THAT IS REQUIRED TO BE PUBLICLY AVAILABLE. FORM 990, PART IX, LINE 11G MEDICAL PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 981,349. MANAGEMENT AND GENERAL EXPENSES 1,995. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 983,344. OTHER MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 1,039,721. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,039,721. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 226,194. MANAGEMENT AND GENERAL EXPENSES 361,562. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 587,756. FORM 990, PART X, LINE 20: FLAMBEAU HOSPITAL, INC. IS PART OF THE MARSHFIELD CLINIC HEALTH SYSTEM OBLIGATED GROUP. SINCE THE OBLIGATED GROUP IS RESPONSIBLE FOR ALL OUTSTANDING FINANCIAL DEBT OBLIGATIONS, ALL BOND RELATED REPORTING IS DISCLOSED ON THE FORM 990 OF MARSHFIELD CLINIC HEALTH SYSTEM, INC. FORM 990, PART XI, LINE 9: NET ASSET TRANSFERS WITH RELATED ORGS -1,025,927. 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