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RICHLAND HOSPITAL: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
RICHLAND HOSPITAL (EIN 39-0808498)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-11-06
IRS object ID
201803109349300625
Schema version
2017v2.3
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2018-11-06T11:01:54-06:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390758449PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1WIPFLI LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line13703 OAKWOOD HILLS PARKWAYAddressLine1Txt
CityEAU CLAIRECityNm
State AbbreviationWIStateAbbreviationCd
ZIP54701ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN390808498EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THE RICHLAND HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlRICHBusinessNameControlTxt
Phone6086476321PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1333 EAST SECOND STREETAddressLine1Txt
CityRICHLAND CENTERCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53581ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKAREN TRAYNORPersonNm
Person TitleCHIEF FINANCIAL OFFICERPersonTitleTxt
Phone6086476321PhoneNum
Signature2018-10-26SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonPAUL M TRACZEK CPAPreparerPersonNm
PTINP01368830PTIN
Phone7158323407PhoneNum
Preparation2018-10-25PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address137.26.200.211IPv4AddressTxt
FieldValueIRS element (for citing)
IP2018-10-26IPDt
IP Tm13:30:01IPTm
IP TimezoneCDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdDA39A3EE5E6B4B0D3255BFEF95601890AFD80709AtSubmissionCreationDeviceId
At Submission Filing Device Id558C6F47C777A73CECB93EB9107DCB0C387663C8AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerBRUCE ROESLERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1333 EAST SECOND STREETAddressLine1Txt
CityRICHLAND CENTERCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53581ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$78,352,826GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.RICHLANDHOSPITAL.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1937FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionTHE RICHLAND HOSPITAL, INC. IS DEDICATED TO CARING, EDUCATING, AND HEALING.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee348TotalEmployeeCnt
Total Volunteers158TotalVolunteersCnt
Total Gross UBI$4,121TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$10,906NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$312,106PYContributionsGrantsAmt
CY Contributions Grants$274,914CYContributionsGrantsAmt
PY Program Service Revenue$39,140,949PYProgramServiceRevenueAmt
CY Program Service Revenue$42,506,335CYProgramServiceRevenueAmt
PY Investment Income$609,085PYInvestmentIncomeAmt
CY Investment Income$1,625,531CYInvestmentIncomeAmt
PY Other Revenue-$151,311PYOtherRevenueAmt
CY Other Revenue-$273,487CYOtherRevenueAmt
PY Total Revenue$39,910,829PYTotalRevenueAmt
CY Total Revenue$44,133,293CYTotalRevenueAmt
PY Grants And Similar Paid$24,194PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$26,042CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$21,088,890PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$22,753,517CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$128,566CYTotalFundraisingExpenseAmt
PY Other Expenses$16,273,677PYOtherExpensesAmt
CY Other Expenses$17,996,267CYOtherExpensesAmt
PY Total Expenses$37,386,761PYTotalExpensesAmt
CY Total Expenses$40,775,826CYTotalExpensesAmt
PY Revenues Less Expenses$2,524,068PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$3,357,467CYRevenuesLessExpensesAmt
Total Assets BOY$76,331,903TotalAssetsBOYAmt
Total Assets EOY$66,813,200TotalAssetsEOYAmt
Total Liabilities BOY$16,735,757TotalLiabilitiesBOYAmt
Total Liabilities EOY$3,993,772TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$59,596,146NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$62,819,428NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE RICHLAND HOSPITAL IS DEDICATED TO CARING, EDUCATING, AND HEALING - TO BE THE COMMUNITY'S FIRST CHOICE FOR BETTER HEATH.MissionDesc
Significant New Program SrvcYes (1)SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$33,499,705ExpenseAmt
Grant$26,042GrantAmt
Revenue$39,491,091RevenueAmt
DescTHE RICHLAND HOSPITAL, INC. (THE HOSPITAL) OPERATES A 25-BED CRITICAL ACCESS HOSPITAL IN RICHLAND CENTER, WI. PATIENTS SERVED BY THE HOSPITAL IN 2017 INCLUDED 3,140 ADULTS AND PEDIATRICS INPATIENT DAYS, 457 SWING BED PATIENT DAYS, 343 NEWBORN PATIENT DAYS, 35,953 TOTAL OUTPATIENT VISITS, AND 5,911 EMERGENCY ROOM VISITS. AS A PART OF THE HOSPITAL'S MISSION AND IN KEEPING WITH ITS STATUS AS A NOT-FOR-PROFIT HEALTHCARE ORGANIZATION, THE HOSPITAL HAS ESTABLISHED A COMMUNITY (CHARITY) CARE POLICY THAT SETS FORWARD THE CRITERIA BY WHICH A PATIENT MAY QUALIFY TO RECEIVE CARE WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. THE HOSPITAL MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. IN THE CURRENT YEAR, THE TOTAL HEALTHCARE SERVICES PROVIDED TO PATIENTS UNDER THE COMMUNITY CARE POLICY HAS BEEN MEASURED IN BOTH TOTAL CHARGES AND AT THE ESTIMATED COST OF PROVIDING CARE TO PATIENTS UNDER THE COMMUNITY CARE POLICY. BOTH FIGURES ARE REPORTED AND AVAILABLE BY REFERRING TO SCHEDULE H. IN ADDITION, THE HOSPITAL IS A PROVIDER UNDER THE WISCONSIN MEDICAID PROGRAM. UNDER THIS PROGRAM, THE HOSPITAL 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 THE HOSPITAL'S CHARITY CARE PROGRAM AND PRACTICES AND COST OF PARTICIPATION IN THE WISCONSIN MEDICAID PROGRAM, PLEASE REFER TO SCHEDULE H OF THE FORM 990.) THE HOSPITAL ALSO ENGAGES IN A VARIETY OF COMMUNITY BUILDING ACTIVITIES THAT WOULD NOT OTHERWISE, WITHOUT THE EFFORTS AND SPECIALIZED KNOWLEDGE OF THE LOCAL HOSPITAL, BE PROVIDED FOR THE BENEFIT OF THE RESIDENTS OF RICHLAND CENTER, WISCONSIN AND THE SURROUNDING COMMUNITIES. IN 2017, THE HOSPITAL HOSTED HEALTH FAIRS, PARTICIPATED IN LOCAL WELLNESS EVENTS, CONDUCTED EDUCATIONAL SEMINARS, AND PROVIDED INFORMATIONAL PACKETS FOR MEMBERS OF OUR COMMUNITY. OUR TARGET AUDIENCE INCLUDED COMMUNITY MEMBERS OF ALL AGES AND ETHNICITY, MALES, FEMALES, AFFLUENT, AND UNDERSERVED.THE HOSPITAL SUPPORTED SOUTHWEST PARTNERS, A COMMUNITY GROUP COMMITTED TO CREATING OPPORTUNITIES TO ENJOY THE BEAUTIFUL OUTDOORS, SUPPORTING GREAT SCHOOLS, SUPPORTING STRONG BUSINESSES, AND BRINGING INDIVIDUALS TOGETHER. PROJECTS THAT THEY ARE WORKING ON THAT SUPPORT IMPROVED MENTAL HEALTH AND WELLBEING, A DEFINED UNMET NEED FROM THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), FALL UNDER TWO SUBGROUPS. 1. CAREER EDUCATION COOPERATIVE - TO CREATE A REGIONAL SCHOOL-TO-CAREER PATHWAY THAT PREPARES STUDENTS FOR LIVING WAGE CAREER OPPORTUNITIES, EDUCATIONAL GROWTH AND GOOD CITIZENSHIP. IN 2017, THE PROGRAM WAS SUPPORTED WITH RESOURCES THAT INCLUDED STAFF TIME AND TALENT. 2. PINE RIVER TRAILS PROJECTS RICHLAND HOSPITAL EMPLOYEES SERVE AS VOICES ON GROUPS THAT HAVE A FOCUS ON INCREASING PHYSICAL ACTIVITY AND POSITIVELY INFLUENCING HEALTH.A. CANOE AND KAYAKING THE PINE B. BIKING RICHLAND COUNTY C. SNOWSHOE AND CROSS COUNTRY SKI D. SAFE WAYS TO SCHOOLE. COMMUNITY PROSPERITY ALLIANCE WORKS TO SUSTAIN AND IMPROVE THE QUALITY OF LIFE WITH A MISSION TO CREATE A CULTURE OF OPPORTUNITY, OPTIMISM, AND PROSPERITY IN SOUTHWEST WISCONSIN. IN ADDITION, THE HOSPITAL HAS STARTED COMMUNITY AND ECONOMIC DEVELOPMENT CONVERSATIONS AND WORK ACROSS RICHLAND, VERNON, IOWA, AND GRANT COUNTIES. THROUGH STAFF ACTIVITIES AND OTHER EFFORTS, THE HOSPITAL SUPPORTS THE RICHLAND COUNTY CHILDREN AND FAMILY ADVISORY COUNCIL (RCCFAC) WHO HAS ASSUMED THE RESPONSIBILITY TO ADDRESS THE 2016 CHNA PRIORITY: SUBSTANCE ABUSE TREATMENT AND PREVENTION. 1. A MEMBER OF THE RICHLAND HOSPITAL TEAM ACCOMPANIED RICHLAND COUNTY YOUTH TO A WISCONSIN YOUTH SUMMIT WHERE THE KIDS LEARNED HOW TO BEGIN TO CHANGE CULTURE AND ATTITUDES ABOUT SUBSTANCE USE. 2. RCCFAC CREATED 5 PILLARS TO ADDRESS SPECIFIC AREAS OF THE PRIORITY INCLUDING PREVENTION, LAW ENFORCEMENT, WORKPLACE, HARM REDUCTION, AND TREATMENT.3. RCCFAC PLANS TO HAVE RECOVERY HOUSES IN RICHLAND CENTER FOR MEN AND WOMEN THAT ARE PROACTIVE IN ASSISTING INDIVIDUALS IN THE TRANSITION FROM TREATMENT TO BECOMING RESPONSIBLE, PRODUCTIVE, SELF-SUFFICIENT MEMBERS OF SOCIETY. THE HOSPITAL JOINED SOUTHWEST WISCONSIN COMMUNITY ACTION BY SIGNING THE COMMUNITY COALITION PARTNERSHIP AGREEMENT ON MENTAL HEALTH. THE SOUTHWESTERN WISCONSIN COMMUNITY ACTION PROGRAM, WORKING WITH A MULTI-SECTOR NETWORK OF COMMUNITY PARTNERS, HAS BEEN AWARDED FUNDING THROUGH THE ADVANCING A HEALTHIER WISCONSIN (AHW) ENDOWMENT AT THE MEDICAL COLLEGE OF WISCONSIN (MCW). THIS PROJECT WILL FOCUS ON COMMUNITY BASED BEHAVIORAL HEALTH IN IOWA, GRANT, GREEN LAFAYETTE AND RICHLAND COUNTIES AND WILL COLLABORATE WITH SEVERAL LOCAL COMMUNITY PARTNERS INCLUDING ALL SEVEN REGION HOSPITALS, ALL FIVE HEALTH DEPARTMENTS, MANY OTHER SOCIAL SERVICE, HEALTH CARE AND OTHER AGENCIES AND IN PARTNERSHIP WITH THE UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE. THE FIRST YEAR IS FOCUSED ON DEVELOPING IMPLEMENTATION PLANS WITH THE ULTIMATE OUTCOME OF A STATEWIDE IMPROVEMENT IN BEHAVIORAL HEALTH, IMPROVED PHYSICAL HEALTH AMONG THOSE WITH BEHAVIORAL HEALTH CONDITIONS, AND IMPROVED PREVENTION AND HEALTHCARE RESOURCES.THE BEHAVIORAL HEALTH PROBLEMS IN SOUTHWESTERN WISCONSIN SHOW UP IN MANY LOCATIONS INCLUDING EMERGENCY ROOMS, COUNTY JAILS, SCHOOLS, BUSINESSES, FOOD PANTRIES, CLINICS, ETC. AND HAVE A DETRIMENTAL EFFECT ON MANY LIVES. IN PARTICULAR IN THE SOUTHWESTERN COUNTIES OF WISCONSIN THERE IS A SIGNIFICANT PROBLEM IN THE LACK OF ALL TYPES OF MENTAL HEALTH PROVIDERS. ADDITIONALLY, THE HOSPITAL, RCCFAC, AND SWCAP BEGAN WORKING TO BRING A NAMI (NATIONAL ALLIANCE ON MENTAL ILLNESS) SUPPORT GROUP TO RICHLAND COUNTY. THE HOSPITAL HOSTED ONE LADIES HEALTH FAIR EVENT, A HEART HEALTH EVENT, AND A TODDLER WELLNESS EVENT IN RICHLAND CENTER. IN ADDITION, THE HOSPITAL HOSTED ONE LADIES NIGHT OUT IN MUSCODA. THE HOSPITAL CONTINUES TO SERVE AS THE LOCATION FOR SMART RECOVERY. THIS IS A FREE SUPPORT GROUP HELPING PEOPLE LEARN SELF-EMPOWERING TOOLS AND PROVIDING SUPPORT FOR EACH OTHER IN RECOVERY. THE GOAL OF SMART RECOVERY IS FOR YOU TO ACHIEVE A HEALTHY, POSITIVE, AND BALANCED LIFESTYLE SO YOU CAN CONQUER NEW CHALLENGES WHEN YOU FEEL CONFIDENT YOUR ADDICTIVE BEHAVIOR IS BEHIND YOU. EACH OF THE EVENTS WAS FREE TO ATTEND AND OPEN TO THE PUBLIC. ITEMS DONATED INCLUDED: STAFF TIME, MATERIALS, SPACE, GIVEAWAYS, AND/OR EQUIPMENT. ADDITIONALLY, THE HOSPITAL PARTICIPATED IN OTHER FREE EVENTS OPEN TO THE PUBLIC AND CONDUCTED SCREENINGS AND PROVIDED FREE HEALTH AND WELLNESS INFORMATION. THOSE EVENTS INCLUDE: RICHLAND COUNTY GARDEN EXPO, RICHLAND COUNTY FOOD PANTRY, RICHLAND COUNTY FAIR, SENIOR FEST, GREATER RICHLAND CANCER ELIMINATION WALK, RICHLAND ROCKS, AND WESTON HEALTH FAIR. THE HOSPITAL SAW AN AVERAGE OF 250 PEOPLE AT EACH OF THESE EVENTS. RICHLAND CENTER, WI IS PROUD TO BE THE HOME OF RICHLAND ROCKS! DESIGNED TO GET FAMILIES OUTSIDE AND MOVING, RICHLAND ROCKS HAD A TREMENDOUS 2017 THAT SAW MANY COMMUNITY MEMBERS EXPLORING OUR TOWN. INDIVIDUALS AND FAMILIES SEARCH FOR PAINTED ROCKS HIDDEN AROUND TOWN, ENCOURAGED TO KEEP THEM, OR HIDE THEM FOR OTHERS. THE HOSPITAL'S RESPIRATORY REHAB TEAM PROVIDED FOUR FREEDOM FROM SMOKING SESSIONS TO THE PUBLIC THAT, WERE PARTIALLY REIMBURSED BY AN AREA CHARITY, GREATER RICHLAND AREA CANCER ELIMINATION. IN RESPONSE TO REQUESTS TO LOCAL EMPLOYERS, THE HOSPITAL PROVIDED STAFF TIME, EDUCATIONAL MATERIALS, AND GIVEAWAYS AT NO CHARGE FOR EMPLOYEE HEALTH FAIRS FOR WISCONSIN MAXIMUM SECURITY PRISON IN BOSCOBEL, WI; RIVERDALE SCHOOL DISTRICT IN MUSCODA, WI; AND UW RICHLAND STUDENT WELCOME. AN AVERAGE OF 80 PEOPLE WERE HELPED BY HOSPITAL REPRESENTATIVES AT EACH EVENT. THE HOSPITAL PROVIDED SIX FREE BREASTFEEDING SUPPORT GROUPS, 12 FREE NEWBORN EDUCATION AND LABOR SUPPORT CLASSES, AND FREE E-CLASS OPTIONS FOR NEW AND EXPECTING PARENTS. THE HOSPITAL HOSTED 10 DIABETES SUPPORT GROUP MEETINGS. EDUCATIONAL MATERIALS WERE PROVIDED FREE OF CHARGE. HEALTHCARE PROFESSIONALS SPOKE TO THE PUBLIC AT COMMUNITY EVENTS THAT WERE FREE AND OPEN TO THE PUBLIC AND THEY PROVIDED INDIVIDUAL COUNSELING AS WELL TO HELP PEOPLE UNDERSTAND THE SERVICES AVAILABLE LOCALLY. SEE CONTINUATION LATER IN SCHEDULE O FOR REMAINING STATEMENT ON THE PROGRAM SERVICE ACCOMPLISHMENTS.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$1,561,512ExpenseAmt
Revenue$2,200,259RevenueAmt
DescTHE RICHLAND HOSPITAL, INC. ALSO OPERATES TWO RURAL HEALTH CLINICS LOCATED IN SPRING GREEN AND MUSCODA, WI. DURING 2017 THESE TWO CLINICS PROVIDED A TOTAL OF 7,640 VISITS TO PATIENTS IN BOTH 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.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$35,061,217TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org MemYes (1)BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (1)BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document46IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee348EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower Policy0WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldWIStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonKAREN TRAYNORPersonNm
Phone6086476321PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1333 EAST SECOND STREETAddressLine1Txt
CityRICHLAND CENTERCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53581ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
DAVID MAY MD
CHIEF OF STAFF2.00Yes (X)$13,775$0$20
JENNY MYSZKOWSKI MD
DIRECTOR1.50Yes (X)$0$0$0
JERRY GANDER
DIRECTOR1.50Yes (X)$0$0$20
JERRY MCCAULEY
DIRECTOR1.50Yes (X)$0$0$20
TRACI PETERSON
DIRECTOR1.50Yes (X)$0$0$20
ROBERT NUGENT
CHAIR1.75Yes (X)$0$0$20Yes (X)
JOHN POOLE
VICE-CHAIR1.75Yes (X)$0$0$20Yes (X)
JOHN ANNEAR
TREASURER1.75Yes (X)$0$0$0Yes (X)
MARILYN RINEHART
SECRETARY1.75Yes (X)$0$0$20Yes (X)
KAREN TRAYNOR
CFO40.00$192,839$0$12,693Yes (X)
BRUCE ROESLER
CEO40.00$252,032$0$42,322Yes (X)
BRIAN O'NEILL CRNA
ANESTHETIST38.00$308,981$0$35,663Yes (X)
EDITH SHANNON-GOODRICH CRNA
ANESTHETIST36.00$264,175$0$35,850Yes (X)
MUHAMMAD S KHAN MD
ER PHYSICIAN43.00$360,978$0$43,533Yes (X)
BRYAN MCCARVEL
ANESTHESIA DIRECTOR40.00$331,791$0$46,572Yes (X)
ALEX PASQUARIELLO MD
ER PHYSICIAN38.00$287,690$0$28,752Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,012,261TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$245,525TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K21IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
RICHLAND MEDICAL CENTER LTD
301 EAST SECOND STREETRICHLAND CENTERWI53581PHYSICIANS/CLINIC MGMT SERVICES$1,100,617
RURAL PHYSICIANS GROUP-PANNU PLLC
10624 SEASTERN AVEHENDERSONNV89052HOSPITALIST-PHYSICIAN SERVICE$740,170
RURAL WISCONSIN HEALTH COOPERATIVE
880 INDEPENDENCE LANESAUK CITYWI53583LEGAL, CLINICAL & ADMIN RESOURCES$541,346
PSYCHIATRIC MEDICAL CARE LLC
4322 HARDING PIKE 417NASHVILLETN37205PHYSICIAN-STAFF SERVICES$324,326
MERITER LABORATORIES
36 SOUTH BROOKS STMADISONWI53715LAB SERVICES$178,772
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K7CntrctRcvdGreaterThan100KCnt
Related Organizations$136,446RelatedOrganizationsAmt
Government Grants$9,466GovernmentGrantsAmt
All Other Contributions$129,002AllOtherContributionsAmt
Total Contributions$274,914TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
PATIENT SERVICE REVENUE621990$41,695,471$41,691,350$4,121
CONTRACTED THERAPY621990$332,634$332,634
MEALS722320$186,293$186,293
MEDICAL RECORDS621990$185,162$185,162

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$106,775TotalRevenueColumnAmt
Exclusion$106,775ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$42,506,335TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$769,037TotalRevenueColumnAmt
Exclusion$769,037ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$754,900RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$1,028,387RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$273,487RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$273,487TotalRevenueColumnAmt
Exclusion-$273,487ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$34,040,065SecuritiesAmt
Other$7,575OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$33,188,905SecuritiesAmt
Other$2,241OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$851,160SecuritiesAmt
Other$5,334OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$856,494TotalRevenueColumnAmt
Exclusion$856,494ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$44,133,293TotalRevenueColumnAmt
Related Or Exempt Func Income$41,691,350RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$4,121UnrelatedBusinessRevenueAmt
Exclusion$2,162,908ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$26,042TotalAmt
Program Services$26,042ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$513,663TotalAmt
Management And General$513,663ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$16,738,348TotalAmt
Program Services$14,668,552ProgramServicesAmt
Management And General$1,979,650ManagementAndGeneralAmt
Fundraising$90,146FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$572,842TotalAmt
Program Services$502,007ProgramServicesAmt
Management And General$67,750ManagementAndGeneralAmt
Fundraising$3,085FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$3,759,456TotalAmt
Program Services$3,294,577ProgramServicesAmt
Management And General$444,632ManagementAndGeneralAmt
Fundraising$20,247FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,169,208TotalAmt
Program Services$997,301ProgramServicesAmt
Management And General$165,778ManagementAndGeneralAmt
Fundraising$6,129FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$537,260TotalAmt
Management And General$537,260ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$76,445TotalAmt
Management And General$76,445ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$5,804,816TotalAmt
Program Services$4,852,629ProgramServicesAmt
Management And General$944,687ManagementAndGeneralAmt
Fundraising$7,500FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$127,330TotalAmt
Management And General$127,330ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$254,384TotalAmt
Program Services$136,037ProgramServicesAmt
Management And General$117,163ManagementAndGeneralAmt
Fundraising$1,184FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$310,310TotalAmt
Management And General$310,310ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,388,987TotalAmt
Program Services$1,330,928ProgramServicesAmt
Management And General$58,059ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$56,950TotalAmt
Program Services$41,288ProgramServicesAmt
Management And General$15,662ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$151,849TotalAmt
Program Services$137,100ProgramServicesAmt
Management And General$14,474ManagementAndGeneralAmt
Fundraising$275FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,601,798TotalAmt
Program Services$2,601,798ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$83,432TotalAmt
Management And General$83,432ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
SUPPLIES$5,913,466$5,793,768$119,698
EQUIPMENT RENTAL & MAIN$700,006$689,956$10,050
BAD DEBT EXPENSE$540,022$540,022
DIETARY EXPENSE$253,090$253,090

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total-$803,878TotalAmt
Program Services-$803,878ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$40,775,826TotalAmt
Program Services$35,061,217ProgramServicesAmt
Management And General$5,586,043ManagementAndGeneralAmt
Fundraising$128,566FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,086BOYAmt
EOY$1,085EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$14,824,843BOYAmt
EOY$16,563,111EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$8,067,543BOYAmt
EOY$8,341,965EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,545,813BOYAmt
EOY$1,621,793EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$166,172BOYAmt
EOY$126,191EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$59,473,450LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$35,712,032LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$24,615,736BOYAmt
EOY$23,761,418EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$22,051,463BOYAmt
EOY$13,501,748EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$3,529,563BOYAmt
EOY$1,030,076EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,529,684BOYAmt
EOY$1,865,813EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$76,331,903BOYAmt
EOY$66,813,200EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$3,838,372BOYAmt
EOY$3,704,108EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$13,215,000BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
EOY$88,664EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY-$317,615BOYAmt
EOY$201,000EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$16,735,757BOYAmt
EOY$3,993,772EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$59,225,366BOYAmt
EOY$62,257,030EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$310,780BOYAmt
EOY$502,398EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$60,000BOYAmt
EOY$60,000EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$59,596,146BOYAmt
EOY$62,819,428EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$76,331,903BOYAmt
EOY$66,813,200EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$3,357,467ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$31,914NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$166,099OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$5,360OtherActivitiesAmt
Total Lobbying Expenditures$5,360TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationTHE 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 $2,562 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 $2,798 OF THE FEES PAID BY THE HOSPITAL IN 2017 RELATED TO LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE HEALTHCARE ENVIRONMENT IN THE STATE OF WISCONSIN.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$71,787BeginningYearBalanceAmt
Investment Earnings Or Losses$709InvestmentEarningsOrLossesAmt
Grants Or Scholarships-$1,000GrantsOrScholarshipsAmt
End Year Balance$71,496EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$71,880BeginningYearBalanceAmt
Investment Earnings Or Losses$907InvestmentEarningsOrLossesAmt
Grants Or Scholarships-$1,000GrantsOrScholarshipsAmt
End Year Balance$71,787EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$71,176BeginningYearBalanceAmt
Investment Earnings Or Losses$704InvestmentEarningsOrLossesAmt
End Year Balance$71,880EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$70,473BeginningYearBalanceAmt
Investment Earnings Or Losses$703InvestmentEarningsOrLossesAmt
End Year Balance$71,176EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$70,005BeginningYearBalanceAmt
Investment Earnings Or Losses$468InvestmentEarningsOrLossesAmt
End Year Balance$70,473EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY0.83920PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.16080TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$941,726OtherCostOrOtherBasisAmt
Book Value$941,726BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$42,058,890OtherCostOrOtherBasisAmt
Depreciation$23,200,216DepreciationAmt
Book Value$18,858,674BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$609,073OtherCostOrOtherBasisAmt
Depreciation$604,638DepreciationAmt
Book Value$4,435BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$14,721,290OtherCostOrOtherBasisAmt
Depreciation$11,471,170DepreciationAmt
Book Value$3,250,120BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,142,471OtherCostOrOtherBasisAmt
Depreciation$436,008DepreciationAmt
Book Value$706,463BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$23,761,418TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDEFERRED COMPENSATION PLAN LIABILITYDesc
Amt$201,000Amt
FieldValueIRS element (for citing)
Total Liability$201,000TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$44,348,057TotalRevEtcAuditedFinclStmtAmt
Other Revenue$1,028,387OtherRevenueAmt
Revenue Not Reported$1,028,387RevenueNotReportedAmt
Revenue Subtotal$43,319,670RevenueSubtotalAmt
Other Revenues Not Included$813,623OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$813,623RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$44,133,293TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$41,228,266TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$1,028,387OtherExpensesIncludedAmt
Expenses Not Reported$1,028,387ExpensesNotReportedAmt
Expenses Subtotal$40,199,879ExpensesSubtotalAmt
Other Expenses Not Included$575,947OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$575,947ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$40,775,826TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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 1,028,387.
PART XI, LINE 4B - OTHER ADJUSTMENTS:SCHOLARSHIP & GRANT EXPENSE NET AGAINST GRANT REVENUE ON FINANCIAL STATEMENT 35,925. PROVISION FOR BAD DEBTS NET AGAINST REVENUE ON FINANCIAL STATEMENTS 540,022. GRANT REVENUE FOR PROPERTY AND EQUIPMENT 123,230. NET CHANGE IN TEMPORARILY RESTRICTED NET ASSETS OF FOUNDATION 114,446.
PART XII, LINE 2D - OTHER ADJUSTMENTS:RENTAL EXPENSES INCLUDED WITH EXPENSES ON FINANCIAL STATEMENTS 1,028,387.
PART XII, LINE 4B - OTHER ADJUSTMENTS:SCHOLARSHIP & GRANT EXPENSE NET AGAINST GRANT REVENUE ON FINANCIAL STATEMENT 35,925. PROVISION FOR BAD DEBTS NET AGAINST REVENUE ON FINANCIAL STATEMENTS 540,022.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent150Yes (X)Percent150Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$810,696TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$810,696NetCommunityBenefitExpnsAmt
Total Expense0.01990TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,431,789TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,570,531DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,861,258NetCommunityBenefitExpnsAmt
Total Expense0.07020TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,242,485TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,570,531DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,671,954NetCommunityBenefitExpnsAmt
Total Expense0.09010TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$107,298TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,875DirectOffsettingRevenueAmt
Net Community Benefit Expns$105,423NetCommunityBenefitExpnsAmt
Total Expense0.00260TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$38,936TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$38,936NetCommunityBenefitExpnsAmt
Total Expense0.00100TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,547,189TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,541,045DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,006,144NetCommunityBenefitExpnsAmt
Total Expense0.02470TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$104TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$104NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,210TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$6,210NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,699,737TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,542,920DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,156,817NetCommunityBenefitExpnsAmt
Total Expense0.02850TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$12,942,222TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$8,113,451DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,828,771NetCommunityBenefitExpnsAmt
Total Expense0.11860TotalExpensePct

Coalition Building CoalitionBuildingGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$492TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$492NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$14,388TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$852DirectOffsettingRevenueAmt
Net Community Benefit Expns$13,536NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$14,880TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$852DirectOffsettingRevenueAmt
Net Community Benefit Expns$14,028NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$244,366BadDebtExpenseAmt
Bad Debt Expense Attributable$122,183BadDebtExpenseAttributableAmt
Reimbursed By Medicare$15,693,732ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$15,842,894CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$149,162MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection Policy0WrittenDebtCollectionPolicyInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THE RICHLAND HOSPITAL INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1333 EAST SECOND STREETAddressLine1Txt
CityRICHLAND CENTERCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53581ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.RICHLANDHOSPITAL.COMWebsiteAddressTxt
State License1045StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1THE RICHLAND HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted16CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLHTTP://WWW.RICHLANDHOSPITAL.COM/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/OwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLSEE PART V, SECTION C, LINE 7DOtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt16ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLHTTP://WWW.RICHLANDHOSPITAL.COM/WP-CONTENT/UPLOADS/2016/12/RH-CHIP-2017-19-StrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care150.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.000000000000FPGFamilyIncmLmtDscntCarePct
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE SCHEDULE OFAPAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE SCHEDULE OFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Other Actions TakenYes (X)OtherActionsTakenInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr PrvtYes (X)LookBackMedicaidMedcrPrvtInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
THE RICHLAND HOSPITAL, INC.PART V, SECTION B, LINE 5: IN 2016, RICHLAND COUNTY PUBLIC HEALTH'S LOCAL HEALTH OFFICER, RICHLAND COUNTY UW EXTENSION FAMILY LIVING AGENT, AND THE RICHLAND HOSPITAL'S DIRECTOR OF MARKETING PARTNERED TO CONDUCT A COMBINED COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPROVEMENT PLAN. AS A RESULT, A HEALTH ASSESSMENT AND WELLNESS COMMISSION (HAWC) MADE UP OF KEY STAKEHOLDERS IN THE COMMUNITY WAS ESTABLISHED TO CREATE AND OVERSEE THE PROCESS OF ASSESSING OUR COMMUNITY'S HEALTH AND WELLNESS NEEDS.MEMBERS OF THIS COMMISSION INCLUDED: 1. CHRIS DREA, RICHLAND HOSPITAL, DIRECTOR OF MARKETING2. MARIANNE STANEK, RICHLAND COUNTY HEALTH AND HUMAN SERVICES - PUBLIC HEALTH, COUNTY HEALTH OFFICER3. CHELSEA WUNNICKE, UW EXTENSION, RICHLAND COUNTY FAMILY LIVING AGENT4. DR. DAVID MAY, RICHLAND HOSPITAL, MEDICAL STAFF, CHIEF OF STAFF5. CINDY CHICKER, RICHLAND HOSPITAL, ASSISTANT ADMINISTRATOR6. SHAWN TJOSSEM, RICHLAND SCHOOL DISTRICT, SCHOOL PSYCHOLOGIST7. JARRED BURKE, RICHLAND SCHOOL DISTRICT, DISTRICT ADMINISTRATOR8. BETSY ROESLER, RICHLAND COUNTY PUBLIC HEALTH, RICHLAND F.I.T. (FITNESS IN TOTAL) HEALTH AND WELLNESS COORDINATORDATA 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. MAILED TO 2,000 RANDOMLY GENERATED RESIDENCE ADDRESSES IN RICHLAND COUNTY.3. STAKEHOLDER FOCUS GROUPS - PURPOSE: MULTI-SECTOR STAKEHOLDERS REVIEW THE RESULTS OF THE COMMUNITY SURVEY AND PRIORITIZE NEEDS. FOCUS GROUPS WERE BY INVITATION ONLY.
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: HTTP://WWW.CO.RICHLAND.WI.US/DEPARTMENTS/HHS/PUBLICHEALTH/PDFS/RICHLAND%20COUNTY%20HEALTH%20NEEDS%20ASSESSMENT%20CHNA%202016.PDF; HTTP://RICHLAND.UWEX.EDU/2016/11/28/2016-RICHLAND-AREA-COMMUNITY-HEALTH-NEEDS-ASSESSMENT-IS-NOW-AVAILABLE/
THE RICHLAND HOSPITAL, INC.PART V, SECTION B, LINE 11: THE HEALTH ASSESSMENT AND WELLNESS COMMISSION (HAWC) BELIEVES THAT THE 2016 CHNA SATISFACTORILY COLLECTED THE HEALTH NEEDS OF THE RICHLAND COUNTY COMMUNITY. THE PROCESS OF ANALYZING SECONDARY DATA, GATHERING INPUT FROM KEY INFORMANTS AT FOCUS GROUPS, AND CONDUCTING A RANDOM SAMPLE OF RICHLAND COUNTY RESIDENTS VIA THE MAILED SURVEY WAS DESIGNED TO TRIANGULATE THE ACTUAL HEALTH NEEDS OF THE COMMUNITY. THE HAWC MEMBERS BROUGHT A DIVERSE SET OF SKILLS AND PERSPECTIVES TO THE ANALYSIS OF THESE THREE DATA SETS. EVALUATING THE RESULTS FOR BOTH THE STRENGTH OF THE NEED AND THE PRACTICALITY OF A COMMUNITY RESPONSE, THE HAWCS DETERMINED THAT THE TOP HEALTH NEEDS TO BE ADDRESSED IN THE COMMUNITY HEALTH IMPROVEMENT PLAN ARE:1. SUBSTANCE ABUSE PREVENTION & TREATMENT.2. OVERWEIGHT/OBESITY PREVENTION & TREATMENT.3. MENTAL HEALTH CARE.IN 2017, THE THREE PRIORITIES IDENTIFIED IN THE 2016 COMMUNITY HEALTH NEEDS ASSESSMENT WERE USED AS COMPONENTS OF THE OGRANIZATION COMMUNITY HEALTH IMPROVEMENT PLAN. SEE PART III, LINE 4A: PROGRAM SERVICE ACCOMPLISHMENTS FOR ADDITIONAL INFORMATION ON ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA.
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.
THE RICHLAND HOSPITAL, INC.PART V, SECTION B, LINE 20E: ADDITIONAL ELIGIBILITY INFORMATION: -PATIENT IS HOMELESS -PATIENT IS ELIGIBLE FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS THAT ARE UNFUNDED- PATIENT IS ELIGIBLE FOR FOOD STAMPS OR SUBSIDIZED SCHOOL LUNCH PROGRAM - PATIENT IS ELIGIBLE FOR ASSISTANCE UNDER THE CRIME VICTIMS ACT OR SEXUAL ASSAULT ACT -PATIENT 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. -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
FieldValueIRS element (for citing)
Facility2FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - MUSCODA HEALTH CENTER
1075 NORTH WISCONSIN AVENUEMUSCODAWI53573RURAL HEALTH CLINIC
2 - SPRING GREEN MEDICAL CENTER
150 EAST JEFFERSON STREETSPRING GREENWI53588RURAL HEALTH CLINIC

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
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 -PATIENT IS ELIGIBLE FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS THAT ARE UNFUNDED -PATIENT IS ELIGIBLE FOR FOOD STAMPS OR SUBSIDIZED SCHOOL LUNCH PROGRAM -PATIENT IS ELIGIBLE FOR ASSISTANCE UNDER THE CRIME VICTIMS ACT OR SEXUAL ASSAULT ACT -PATIENT 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. -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.
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, THE INTENSIVE CARE INPATIENT UNIT, AND THE OPERATION OF TWO RURAL HEALTH CLINICS. 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. 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 HEALTHCARE 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. 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 II, COMMUNITY BUILDING ACTIVITIES:THE RICHLAND HOSPITAL, INC. ENGAGES IN A VARIETY OF COMMUNITY BUILDING ACTIVITIES THAT WOULD OTHERWISE NOT BE MET OR PROVIDED WITHOUT THE EFFORTS AND SPECIALIZED KNOWLEDGE OF THE LOCAL COMMUNITY HOSPITAL TO THE RESIDENTS OF RICHLAND CENTER, WISCONSIN, AND THE SURROUNDING AREAS. SOME OF THE COMMUNITY BUILDING ACTIVITIES THAT THE HOSPITAL PARTICIPATES IN ARE THE LOCAL HEALTH AND WELLNESS FAIRS, SUPPORT GROUPS, PROVIDING EDUCATIONAL MATERIALS TO COMMUNITY MEMBERS, SAFE SITTER CLASSES, AND LOCAL BLOOD PRESSURE SCREENINGS. IN ADDITION, THE HOSPITAL IS A COMMUNITY PARTNER AND ACTIVE MEMBER OF THE RICHLAND FIT PROGRAM. RICHLAND FIT CONDUCTED A STUDY WHICH CREATED A STRATEGIC AND IMPLEMENTATION PLAN FOCUSING ON THE HIGH OBESITY RATES IN RICHLAND COUNTY. THE EFFORT TO DEVELOP THE PLAN AND DO NECESSARY RELATED RESEARCH WAS FUNDED BY THE UNIVERSITY OF WISCONSIN PARTNERSHIP PROGRAM IN 2011, AND IMPLEMENTATION AND MEASUREMENT OF OUTCOMES IS IN PROCESS. THE HOSPITAL ALSO TAKES AN ACTIVE ROLE IN WELLNESS THROUGH ITS SUPPORT OF LOCAL ATHLETES AND MAINTAINS CONTRACTS WITH AREA SCHOOL SYSTEMS TO PROVIDE ATHLETIC TRAINERS FOR COVERAGE AT SCHEDULED SPORTING EVENTS. THIS SPORTS MEDICINE PROGRAM PROVIDES OUTREACH SERVICES TO RICHLAND CENTER, RIVERDALE (MUSCODA), AND ITHACA SCHOOL DISTRICTS AS WELL AS TO THE LOCAL UW-RICHLAND CENTER CAMPUS. SERVICES PROVIDED INCLUDE IN-SCHOOL INJURY PREVENTION AND ASSESSMENTS CLINICS, DAILY PRACTICE COVERAGE (FREQUENCY VARIES WITH EACH SCHOOL), "HOME" EVENT COVERAGE AS REQUESTED BY SCHOOLS, AND EMERGENCY ACTION PLAN DEVELOPMENT FOR EACH SCHOOL. THE PROGRAM PROVIDES SKINFOLD TESTING FOR THE WRESTLING PROGRAMS IN ACCORDANCE WITH WIAA MANDATES. FINALLY, THE PROGRAM PROVIDES EDUCATION FOR LOCAL EMS SQUADS ON THE APPROPRIATE TRANSPORT OF INJURED ATHLETES. THE RICHLAND HOSPITAL, INC.'S SPORTS MEDICINE PROGRAM IS OPERATED AT A LOSS EACH YEAR, AN INVESTMENT IN THE COMMUNITY THAT WAS IN EXCESS OF $100,000 IN 2015. THE PROGRAM HAS DIRECT TIES TO ONE OF THE PRIORITIES IDENTIFIED BOTH BY THE RICHLAND FIT NEEDS ASSESSMENT BUT ALSO BY THE HOSPITAL'S 2013 CHNA, THE HIGH OBESITY RATE FOR YOUTH AND YOUNG ADULTS IN RICHLAND COUNTY. THE HOSPITAL ALSO PARTICIPATES IN HEALTH EDUCATION AWARENESS AND CAREER BUILDING ACTIVITIES SUCH AS CLINICAL TRAINING EXPERIENCE, SPEAKERS AT LOCAL SCHOOLS, AND CAREER FAIRS. THE HOSPITAL RECOGNIZES THAT IT IS IMPORTANT TO EDUCATE LOCAL COMMUNITY MEMBERS ON THESE CAREERS AS A CAREER BUILDING INITIATIVE SO THAT LOCAL PRIMARY CARE AND ACCESS TO CARE WILL BE CONTINUED IN THE FUTURE WITH WELL-TRAINED AND EDUCATED COMMUNITY MEMBERS IN HEALTHCARE RELATED FIELDS. A NEW DOCUMENT WAS DEVELOPED IN 2014 AND INTRODUCED TO SUPPORT THE BUSINESS PLAN FOR COMMUNITY HEALTH AND WELLNESS FOR THE HOSPITAL. THE WEB OF RELATIONSHIPS ASSISTS IN DEFINING EXISTING RELATIONSHIPS AND PROVIDES A MECHANISM FOR PRIORITIZING HEALTH AND WELLNESS ACTIVITIES.
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 VI, LINE 2:IN REFERRING TO THE COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED IN 2016, 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, POTENTIAL NEED FOR EXPANDED SERVICES, AND THE POTENTIAL NEED FOR NEW SERVICE LINES NOT OFFERED LOCALLY. THE HOSPITAL MONITORS THE LOSS OF SPECIALITY PROVIDERS IN THE AREA AND, WORKING COLLABORATIVELY WITH RICHLAND MEDICAL CENTER, CAREFULLY PARTICIPATES IN A DETERMINATION OF WHETHER AND HOW THIS NEW NEED CAN BEST BE MET. A RECENT EXAMPLE WAS THE IMPENDING LOSS OF A GENERAL SURGEON DUE TO RETIREMENT. THE HOSPITAL ALSO REVIEWS HOSPITAL STATISTICS OF PATIENT VISITS TO DETERMINE WHAT TYPES OF SERVICES OFFERED BY THE HOSPITAL ARE BEING UTILIZED. IN PLANNING TO MEET COMMUNITY NEEDS, THE HOSPITAL WORKS CLOSELY WITH KEY COMMUNITY STAKEHOLDERS TO ASSESS HOW COMMUNITY HEALTH NEED PRIORITIES IDENTIFIED IN 2016 ARE BEING ADDRESSED. THE RICHLAND HOSPITAL CREATED AND ADOPTED A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) THAT SERVES AS A ROAD MAP FOR THE ORGANIZATION TO MAINTAIN A KEEN EYE ON THOSE PRIORITIES. THE HOSPITAL'S COMMUNITY CONNECTIONS TEAM OVERSEES THE CHIP. INDIVIDUAL MEMBERS SERVE AS PRIORITY CHAMPIONS AND WORK WITH GOAL CHAMPIONS TO ENSURE THAT THE HOSPITAL CONTINUES TO PURSUE IMPROVEMENT IN THESE AREAS. THE THREE PRIORITIES IDENTIIED INCLUDED:1. MENTAL HEALTH2. SUBSTANCE ABUSE TREATMENT AND PREVENTION3. OVERWEIGHT / OBESITY TREATMENT AND PREVENTION1. TO ADDRESS MENTAL HEALTH NEEDS, RICHLAND HOSPITAL HAS MADE GROWING THE SENIOR LIFE SOLUTIONS PROGRAM A GOAL UNDER THE MENTAL HEALTH PRIORITY. IN 2017, THE PROGRAM CONTINUED TO GROW WITH THE PLAN TO ADD A SECOND TRACK IN 2018. ADDITIONALLY, RICHLAND HOSPITAL JOINED THE SOUTHWEST WISCONSIN COMMUNITY ACTION PROGRAM'S MENTAL HEALTH COALITION. THE AGING OF THE POPULATION IS SIGNIFICANT BECAUSE PERSONS IN THE AGE CATEGORIES THAT ARE GROWING FACE MORE CHALLENGES RELATED TO HEALTHCARE THAN YOUNGER POPULATIONS. IN THE OLDER POPULATION GROUPS, PERSONS VISIT PRIMARY CARE PHYSICIANS MORE FREQUENTLY AND HAVE HIGHER INCIDENT RATES OF HEART DISEASE, CANCER, AND RELATED ILLNESSES. THE ONSET OF CHRONIC DISEASES ARE HIGHER IN THIS AGE CATEGORY, E.G., ONSET OF DIABETES, COPD, OR HEART PROBLEMS, AND MUST BE MANAGED WITH ASSISTANCE FROM THE HEALTHCARE PROVIDERS FOR THE REMAINDER OF THE PERSON'S LIFE. IMPORTANT TO NOTE IS THAT AS A PERSON AGES, TRAVEL BECOMES MORE CHALLENGING, SO THE ABILITY TO GET AS MUCH OF THEIR HEALTHCARE NEEDS MET LOCALLY GROWS IN IMPORTANCE. HAVING VISITING SPECIALISTS, FOR EXAMPLE, ELIMINATES THE NEED FOR A TRIP TO A MAJOR MEDICAL CENTER FOR MANY. IN ADDITION, IT ENSURES THAT PERSONS GET THE CARE THAT THEY NEED. AN EXAMPLE OF A RECENT SERVICE ADDITION IS THE ADDITION OF SENIOR LIFE SOLUTIONS WHICH HAS BEEN WELL RECEIVED BY PATIENTS AND PHYSICIANS ALIKE. THE HOSPITAL CONTINUES TO MORE FULLY DEVELOP THE ELECTRONIC HEALTH RECORD SYSTEM (EHR) WITH ONE OF THE MAIN GOALS BEING IMPROVED ACCESS TO STRONG CLINICAL DOCUMENTATION INCLUDING PATIENT MEDICAL HISTORIES AS A MEANS TO SUPPORT A MORE EFFICIENT AND EFFECTIVE PATIENT EXPERIENCE. TRAINING OUR COMMUNITY MEMBERS TO USE AND ACCESS THEIR PERSONAL HEALTH INFORMATION THROUGH THE EHR PORTAL IS ANOTHER EXAMPLE OF THE HOSPITAL'S WORK TO IMPROVE OUR PATIENT'S HEALTH STATUS THROUGH ACCESS AND INFORMATION. IN TURN, THE ELECTRONIC HEALTH RECORD SYSTEM PROVIDES FOR A MORE COMPLETE MEDICAL HISTORY SHOULD THAT PATIENT REQUIRE TREATMENT AT OTHER HEALTHCARE FACILITIES. IN RESPONSE TO INCREASED PATIENT DEMANDS FOR ACCESS TO PRIMARY AMBULATORY CLINIC CARE, THE HOSPITAL COMPLETED CONSTRUCTION OF A REPLACEMENT CLINIC FACILITY IN MUSCODA, WISCONSIN IN 2012 AS A MEANS TO BETTER SERVE THE NEEDS OF THE PATIENTS IN MUSCODA AND THE SURROUNDING RURAL COMMUNITIES.
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 RADIOLOGY, LABORATORY, 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 SPANSIH VERSIONS CAN BE OBTAINED BY:A. REQUESTING IN PERSON AT THE RICHLAND HOSPITAL, INC., SPRING GREEN MEDICAL CENTER AND MUSCODA HEALTH CENTERB. CONTACTING THE RICHLAND HOSPITAL, INC. PATIENT ACCOUNTING 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 CLERKS AT THE HOSPITAL, AND AT THE TWO HOSPITAL OWNED 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 TWO RURAL HEALTH CLINICS LOCATED IN 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 ARE DEFINED BY THE FOLLOWING ZIP CODES: 53506 - AVOCA53556 - LONE ROCK53518 - BLUE RIVER53573 - MUSCODA53581 - RICHLAND CENTER53588 - SPRING GREENTHEY ARE GEOGRAPHICALLY CONTIGUOUS COMMUNITIES. ACCORDING TO DATA PUBLISHED BY INTELLIMED, THE RICHLAND HOSPITAL, INC. HAD AN OVERALL INPATIENT MARKET SHARE OF 51.7 PERCENT AND OUTPATIENT MARKET SHARE OF 40.8 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. (INTELLIMED 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 RESIDENTS OF THE MARKET AREA ARE AGING SIGNIFICANTLY. THERE IS A PROJECTED 6.3% GROWTH IN THE POPULATION AGED 45 TO 64 AND A PROJECTED 5.1% GROWTH IN THE POPULATION AGED 65 YEARS OF AGE AND OLDER. THERE IS A CORRESPONDING 11.5% PROJECTED DECLINE IN THE 25 TO 44 YEAR OLD POPULATION. PERSONS IN THE 0 TO 14 AGE GROUP ARE ALSO PROJECTED TO DECREASE BY 0.7%.DURING 2017, MEDICARE AND MEDICARE ADVANTAGE PLAN BENEFICIARIES ACCOUNTED FOR OVER 49 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 RICHLAND HOSPITAL, INC. IS ACCREDITED THROUGH THE JOINT COMMISSION ("TJC"). THE TJC IS AN ORGANIZATION THAT EVALUATES HOSPITAL PERFORMANCE STANDARDS, FOCUSING ON THE QUALITY OF HEALTHCARE. ACCREDITATION THROUGH THE JOINT COMMISSION IS RECOGNIZED NATIONWIDE AS A SYMBOL OF QUALITY, AS IT REQUIRES RIGOROUS PERFORMANCE STANDARDS. TO EARN AND MAINTAIN ACCREDITATION, THE HOSPITAL IS EVALUATED THROUGH AN UNANNOUNCED SURVEY PROCESS COVERING NEARLY 600 STANDARDS RELATED TO QUALITY PATIENT CARE, SAFETY, INFECTION CONTROL, AND ONGOING PERFORMANCE-IMPROVEMENT ACTIVITIES, AMONG OTHERS. ALL HOSPITALS SURVEYED BY THE JOINT COMMISSION ARE EVALUATED AGAINST THE SAME CRITERIA, REGARDLESS OF SIZE OR LOCATION. 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, TRICARE, AND THE WISCONSIN HEALTH INSURANCE RISK SHARING PROGRAM OR "HIRSP" (THE HIRSP PROGRAM REIMBURSES THE HOSPITAL AT RATES SIMILAR TO THE MEDICAID PROGRAM AND IS FOR PATIENTS THAT HAVE PRE-EXISTING ILLNESSES WHICH MAKE IT DIFFICULT TO OBTAIN INSURANCE FROM COMMERCIAL INSURANCE CARRIERS IN THE MARKETPLACE).
PART VI, LINE 7, REPORTS FILED WITH STATESWI

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeSCHOLARSHIPS FOR HEALTHCARE EDUCATIONGrantTypeTxt
Recipient26RecipientCnt
Cash Grant$26,042CashGrantAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationTHE RICHLAND HOSPITAL, INC. FOLLOWS A STANDARD PROCEDURE ON ISSUANCE OF SCHOLARSHIP FUNDS WHICH IS DETERMINED BY THE BOARD OF DIRECTORS AND MANAGEMENT OF THE RICHLAND HOSPITAL, INC. AND THE RICHLAND HOSPITAL FOUNDATION, INC. THESE SEPARATE ORGANIZATIONS HAVE ESTABLISHED CRITERIA FOR REVIEW OF APPLICATIONS FOR PROSPECTIVE SCHOLARSHIP RECIPIENTS TO ENSURE THAT SCHOLARSHIPS ARE BEING GRANTED FOR HEALTH EDUCATION RELATED PURPOSES AND TO A QUALIFIED STUDENT STUDYING AT AN ACCREDITED TECHNICAL COLLEGE, COLLEGE, OR UNIVERSITY. (A LARGE PORTION OF THE FUNDING FOR SCHOLARSHIPS IS ALSO GOVERNED BY DONOR AGREEMENTS AS NOTED IN SCHEDULE D TO THE FORM 990 RELATED TO ENDOWMENT FUNDS.)ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (1)WrittenPolicyRefTAndEExpnssInd
Substantiation Required0SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
KAREN TRAYNOR
CFO$191,289$0$0$0$1,550$0$7,671$0$5,022$0$205,532$0$0$0
BRUCE ROESLER
CEO$228,472$0$20,000$0$3,560$0$9,966$0$32,356$0$294,354$0$0$0
BRIAN O'NEILL CRNA
ANESTHETIST$229,344$0$0$0$79,637$0$2,156$0$33,507$0$344,644$0$0$0
EDITH SHANNON-GOODRICH CRNA
ANESTHETIST$201,240$0$0$0$62,935$0$9,096$0$26,754$0$300,025$0$0$0
MUHAMMAD S KHAN MD
ER PHYSICIAN$359,109$0$0$0$1,869$0$10,800$0$32,733$0$404,511$0$0$0
BRYAN MCCARVEL
ANESTHESIA DIRECTOR$256,094$0$0$0$75,697$0$10,800$0$35,772$0$378,363$0$0$0
ALEX PASQUARIELLO MD
ER PHYSICIAN$277,603$0$0$0$10,087$0$10,800$0$17,952$0$316,442$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 1AFormAndLineReferenceDesc
ExplanationHEALTH CLUB DUES GROSS UPS, WHEN APPLICABLE, WERE ADDED TO THE INDIVIDUAL'S COMPENSATION AT FAIR MARKET VALUE.ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonJENNA SEBRANEK MDPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionDAUGHTER OF JERRY GANDER, DIRECTORRelationshipDescriptionTxt
TransactionRECRUITMENT ASSISTANCE AGREEMENT, FORGIVEABLE SIGN-ON LOANTransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART III, LINE 2DURING 2017, THE HOSPITAL STARTED A SENIOR BEHAVIORAL HEALTH PROGRAM TO PROVIDE MENTAL HEALTH SERVICES ON AN OUTPATIENT BASIS TO THOSE IN NEED. THIS WAS VIEWED AS A MUCH NEEDED SERVICE IN THE COMMUNITY AND THE HOSPITAL ADDED THIS SERVICE IN RESPONSE TO THE STUDIED NEED FOR SUCH CARE.
FORM 990, PART VI, SECTION B, LINE 11BA COPY OF FORM 990 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 12CTHE 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 15THE 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 19THE 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 11GOTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,179,603. MANAGEMENT AND GENERAL EXPENSES 944,687. FUNDRAISING EXPENSES 7,500. TOTAL EXPENSES 3,131,790. MEDICAL IMAGING PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,415,380. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,415,380. CLINICAL PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 594,461. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 594,461. LABORATORY PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 251,330. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 251,330. SURGICAL PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 411,855. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 411,855.
FORM 990, PART XI, LINE 9:NET ASSETS RELEASED FROM RESTRICTIONS -5,238. NET CHANGE IN UNRESTRICTED NET ASSETS OF SUPPORTING ORGANIZATIONS 196,140. NET CHANGE IN TEMPORARILY RESTRICTED NET ASSETS OF FOUNDATION 109,186. LOSS ON ADVANCED REFUNDING -466,187.
FORM 990, PART XII, LINE 2C: SELECTION OF INDEPENDENT ACCOUNTANTTHE FINANCE COMMITTEE OF THE RICHLAND HOSPITAL, INC., WHICH IS A SUB-COMMITTEE TO THE HOSPITAL'S BOARD OF DIRECTORS, REVIEWS THE ANNUAL AUDIT PROCESS WITH THE INDEPENDENT ACCOUNTANTS. BOARD MEMBERS ARE ALSO GIVEN THE NAMES AND CONTACT INFORMATION OF THE INDEPENDENT ACCOUNTANTS AT THE ANNUAL FINANCE COMMITTEE'S REVIEW MEETING OF THE AUDITED FINANCIAL STATEMENTS SO THAT THEY MAY INQUIRE, IF NEEDED, WITH THE ACCOUNTANTS THROUGHOUT THE YEAR. A BOARD MEMBER IS ALSO SELECTED ANNUALLY FOR REVIEW AND INQUIRY BY THE INDEPENDENT ACCOUNTANTS FOR SEPARATE AND PRIVATE INTERVIEW AS A PART OF THE AUDIT PROCESS. THESE FUNCTIONS ALLOW A GREATER AMOUNT OF OVERSIGHT BY THE BOARD INTO THE ANNUAL AUDIT PROCESS. THERE HAS BEEN NO CHANGE TO THESE PROCEDURES DURING THE PAST YEAR.
FORM 990, PART III, LINE 4AREGISTERED DIETITIANS PRESENTED INFORMATION AT RICHLAND MIDDLE SCHOOL AND RICHLAND CENTER HIGH SCHOOL THREE TIMES IN 2017. ADDITIONALLY, THEY SUPPORTED THE RICHLAND FIT POINT OF PURCHASE PROGRAM. THE RICHLAND FIT POINT OF PURCHASE REPRESENTS ONE OF SEVERAL FIT STRATEGIES ONGOING IN THE COUNTY SINCE 2012 WHEN A UW PARTNERSHIP PROGRAM GRANT WAS AWARDED. THE IDEA WAS TO PARTNER WITH FOOD SELLERS AND SERVERS TO CREATE AN ENVIRONMENT WHERE MAKING THE HEALTHY CHOICE IS EASIER. WORKING TOGETHER AS A COALITION, WE AIM TO GET THOSE HEALTHY CHOICES ON THE TABLE IN AN ATTRACTIVE WAY. DIETITIANS ALSO WORKED TO TRAIN PEER EDUCATORS AND INTRODUCE DIABETES EDUCATION AND SUPPORT PROGRAMS TO SURROUNDING COMMUNITIES THROUGH THE DEEP PROGRAM. DEEP IS A MEDICARE-APPROVED, EVIDENCE BASED DIABETES SELF-MANAGEMENT PROGRAM DEVELOPED BY THE UNIVERSITY OF ILLINOIS, CHICAGO THAT HAS BEEN SHOWN TO BE SUCCESSFUL IN HELPING PARTICIPANTS TAKE CONTROL OF THEIR DISEASE & REDUCE THE RISK OF COMPLICATION. DEEP WORKSHOPS MEET ONCE A WEEK. DEEP PROVIDES OPPORTUNITIES FOR PARTICIPANTS TO ACQUIRE THE KNOWLEDGE AND SKILLS NECESSARY TO MAINTAIN A HEALTHY WEIGHT AND TO REDUCE COMPLICATIONS RESULTING FROM DIABETES, SUCH AS KIDNEY FAILURE, AMPUTATION, VISION LOSS, HEART FAILURE, AND STROKE. EDUCATIONAL MATERIALS WERE PROVIDED FREE OF CHARGE IN A VARIETY OF VENUES. THEY COVERED A WIDE RANGE OF HEALTHCARE TOPICS INCLUDING: CANCER, DIABETES, HEART DISEASE, INFANT AND CHILD DEVELOPMENT, NUTRITION, EXERCISE, SMOKING CESSATION, BREAST HEALTH, ADVANCED DIRECTIVES, COLONOSCOPIES, JOINT AND MUSCLE DEGENERATION, WOMEN'S HEALTH, AND MORE. RICHLAND HOSPITAL PROVIDED SIX SAFESITTER (BABYSITTING) COURSES. SAFE SITTER PREPARES STUDENTS IN GRADES 6-8 TO BE SAFE WHEN THEY'RE HOME ALONE, WATCHING YOUNGER SIBLINGS, OR BABYSITTING. COURSE CONTENT INCLUDES SAFETY SKILLS, CHILD CARE SKILLS, FIRST AID & RESCUE SKILLS, AND LIFE & BALANCE SKILLS. RICHLAND HOSPITAL SUPPORTED LOCAL HIGH SCHOOL POST PROM EFFORTS WITH RESOURCES. RICHLAND HOSPITAL REACHED OUT TO LOCAL SCHOOL DISTRICTS TO INQUIRE HOW TO BETTER SUPPORT FARM TO SCHOOL EFFORTS BEING MADE. THE BLOOD CENTER OF WISCONSIN HELD MULTIPLE DRIVES IN THE HOSPITAL'S LOWER LEVEL AT NO COST. IN ADDITION, EMPLOYEES COULD DONATE BLOOD WHILE ON WORK TIME AND DID NOT HAVE TO PUNCH OUT. HOME HEALTH UNITED HELD MULTIPLE GRIEF SUPPORT GROUP MEETINGS IN THE HOSPITAL'S LOWER LEVEL AT NO COST. THESE MEETINGS WERE OPEN TO EVERYONE AND FREE OF CHARGE. THE RICHLAND HOSPITAL PROVIDED PROMOTIONS, SNACKS AND BEVERAGES AS WELL. PROGRAMS INCLUDED: DROP-IN GRIEF SUPPORT GROUP (MONTHLY); WHEN MOURNING DAWNS (WEEKLY INTERACTIVE SESSIONS FOR THOSE GRIEVING A LOSS); SPOUSE / PARTNER LOSS (A SPECIALIZED SERIES), CAMP GLOW HELPING CHILDREN GRIEVE, AND RESOLVE THOUGH SHARING (BEREAVEMENT CARE TRAINING FOR HEALTHCARE PROVIDERS). THE HOSPITAL ALSO PARTICIPATES IN HEALTH EDUCATION AWARENESS AND CAREER BUILDING ACTIVITIES SUCH AS CLINICAL TRAINING EXPERIENCE, SPEAKERS AT LOCAL SCHOOLS, AND PARTICIPATION IN CAREER FAIRS FOR AREA MIDDLE AND HIGH SCHOOLS AND FOR ADULTS. IN ADDITION, RICHLAND HOSPITAL PROVIDES CLUB SCRUB, AN EXPERIENCE DESIGNED FOR 7TH AND 8TH GRADERS THAT ARE INTERESTED IN LEARNING ABOUT HEALTHCARE CAREERS. THE 4 WEEK PROGRAM TAKES THE STUDENTS INTO VARIOUS DEPARTMENTS WHERE THEY LEARN ABOUT CAREERS IN THE SETTING THEY ARE PROVIDED IN. SURGEONS, NURSES, TECHNICIANS, AND OTHER STAFF MEMBERS PARTICIPATE TO PROVIDE A WONDERFUL EXPERIENCE FOR THE KIDS. PARTICIPATION IS FREE AND OPEN TO ALL STUDENTS IN OUR MARKET, BUT THERE IS A LIMIT OF 25 KIDS FOR THE CLUB. THE HOSPITAL RECOGNIZES THAT IT IS IMPORTANT TO EDUCATE LOCAL COMMUNITY MEMBERS ON THESE CAREERS AS A CAREER BUILDING INITIATIVE SO THAT LOCAL PRIMARY CARE AND ACCESS TO CARE WILL BE CONTINUED IN THE FUTURE WITH WELL-TRAINED AND EDUCATED COMMUNITY MEMBERS IN HEALTH CARE RELATED FIELDS. FINALLY, WHILE THERE IS GROWING AGREEMENT IN THE UNITED STATES ABOUT WHAT CONSTITUTES A NON-PROFIT HOSPITAL'S "COMMUNITY BENEFIT", THIS REMAINS A WORK IN PROGRESS. THE RICHLAND HOSPITAL PROVIDES SIGNIFICANT CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS. BUT IN ADDITION, THE HOSPITAL BELIEVES THAT IT PROVIDES A CRITICALLY IMPORTANT COMMUNITY BENEFIT WHICH IS NOT EASILY ABLE TO BE QUANTIFIED. THROUGH ITS HOSPITAL SERVICES, LIKE MOST RURAL HOSPITALS, THE RICHLAND HOSPITAL INC. HAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE CARE LOCALLY. WITHOUT THIS HOSPITAL, THIS CARE WOULD NOT BE AVAILABLE LOCALLY AND THE ECONOMIC WELL-BEING OF THE SURROUNDING COMMUNITIES WOULD BE NEGATIVELY AFFECTED BY THE LOSS OF PROFESSIONAL, TECHNICAL, AND SERVICE JOBS. THE RICHLAND HOSPITAL IS COMMITTED TO WORKING CLOSELY WITH COMMUNITY PARTNERS TO IMPROVE THE OVERALL HEALTH OF THE PEOPLE IN OUR COMMUNITY. COMMUNITY PARTNERS INCLUDE: RICHLAND FIT, AGING AND DISABILITY RESOURCE CENTER, RICHLAND COUNTY PUBLIC HEALTH, RICHLAND FREE CLINIC, AND RICHLAND COUNTY HEALTH & HUMAN SERVICES. WE ARE DEDICATED TO CARING, EDUCATING AND HEALING WE WANT TO BE THE COMMUNITY'S FIRST CHOICE FOR BETTER HEALTH.
SCHEDULE H, PART V, LINE 16A, FAP WEBSITEHTTP://WWW.RICHLANDHOSPITAL.COM/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE-C OMMUNITY-CARE-PAYMENT-PLANS/
SCHEDULE H, PART V, LINE 16B, FAP APPLICATION WEBSITEHTTP://WWW.RICHLANDHOSPITAL.COM/WP-CONTENT/UPLOADS/2017/12/COMMUNITY-CAR E-APPLICATION_01-2016.COLOR_.PDF
PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARYHTTP://WWW.RICHLANDHOSPITAL.COM/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE-C OMMUNITY-CARE-PAYMENT-PLANS/

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationInd
RICHLAND HOSPITAL FOUNDATION INC
333 EAST SECOND STREETRICHLAND CENTERWI53581391567249FOUNDATIONWI501(C)(3)LINE 11N/A0
PARTNERS OF RICHLAND HOSPITAL INC
333 EAST SECOND STREETRICHLAND CENTERWI53581391693458AUXILIARYWI501(C)(3)LINE 11N/A0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd