2017-05-15T16:00:02-05:00 2016-06-30 390758449 WIPFLI LLP 3703 OAKWOOD HILLS PARKWAY/PO BOX 690 EAU CLAIRE WI 547020690 990 2015-07-01 391370626 SOUTHWEST HEALTH CENTER INC SOUT 6083482331 1400 EAST SIDE RD PLATTEVILLE WI 538189800 DAN ROHRBACH ADMINISTRATOR 6083482331 2017-05-12 1 PAUL M TRACZEK CPA P01368830 7158323407 2017-05-12 2015 2021-01-29 14:40:06Z DAN ROHRBACH 1400 EAST SIDE RD PLATTEVILLE WI 538189800 64992072 0 X WWW.SOUTHWESTHEALTH.ORG X 1981 WI SOUTHWEST HEALTH CENTER, INC. OFFERS AN INTEGRATED CONTINUUM OF HEALTH CARE SERVICES. AS THE PROVIDER OF CHOICE OF THE PEOPLE OF SOUTHWEST WISCONSIN, VALUE IS OUR DRIVING FORCE. CONTINUALLY IMPROVING OUR SERVICES ENABLES US TO SURPASS EXPECTATIONS WHILE ACHIEVING COST-EFFECTIVE CLINICAL QUALITY. IN COLLABORATION WITH OUR COMMUNITY, AREA PHYSICIANS, AND OTHERS, WE RESPOND TO NEEDS BY MAINTAINING A FISCALLY STRONG ORGANIZATION THAT ENSURES A MEANINGFUL IMPACT ON THE LIVES OF THOSE WE SERVE. 9 7 611 77 26690 30622 697 191740 46847130 56837662 877231 589126 76750 78780 47801808 57697308 100753 180152 0 0 25511199 30729807 0 0 0 17904377 21478102 43516329 52388061 4285479 5309247 78151334 85414128 32636114 33174004 45515220 52240124 X CARING. FOR LIFE. 1 0 40536830 180152 45188769 SOUTHWEST HEALTH CENTER, INC. (THE ORGANIZATION")PROVIDES INPATIENT, OUTPATIENT, EMERGENCY, AND CLINICAL HEALTH CARE SERVICES AND OTHER FINANCIAL SUPPORT THROUGH VARIOUS PROGRAMS THAT ARE DESIGNED, AMONG OTHER MATTERS, TO ENHANCE THE HEALTH OF THE COMMUNITY INCLUDING THE HEALTH OF LOW INCOME PATIENTS. CONSISTENT WITH THE MISSION OF THE ORGANIZATION, CARE IS PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY, INCLUDING PROVIDING SERVICES TO THOSE PERSONS WHO ARE EITHER UNDERINSURED OR WHO CANNOT AFFORD HEALTH INSURANCE BECAUSE OF INADEQUATE RESOURCES. HEALTH CARE SERVICES TO PATIENTS UNDER GOVERNMENT PROGRAMS, SUCH AS MEDICAID HOSPITAL SERVICES, ARE ALSO CONSIDERED PART OF THE ORGANIZATION'S BENEFIT PROVIDED TO THE COMMUNITY, SINCE A SUBSTANTIAL PORTION OF SUCH SERVICES ARE REIMBURSED AT AMOUNTS LESS THAN THE COSTS OF PROVIDING CARE. PATIENTS WHO MEET CERTAIN CRITERIA FOR CHARITY CARE, GENERALLY BASED ON FEDERAL POVERTY GUIDELINES, ARE PROVIDED CARE AT A SIGNIFICANTLY REDUCED RATE, DETERMINED BASED ON QUALIFYING CRITERIA AS DEFINED IN THE ORGANIZATION'S CHARITY CARE POLICY AND FROM APPLICATIONS COMPLETED BY PATIENTS AND THEIR FAMILIES. THE AMOUNT OF CHARGES FORGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER THIS POLICY FOR 2016 TOTALED $246,526. IN ADDITION, DISCOUNTS TO THE MEDICAID PROGRAM FOR HOSPITAL AND CLINIC SERVICES AMOUNTED TO $7,759,651. (SEE ADDITIONAL INFORMATION ON THE COST TO THE HOSPITAL OF PROVIDING SERVICES TO MEDICAID AND CHARITY CARE RECIPIENTS IN SCHEDULE H OF THE FORM 990.)BENEFITS FOR SERVING THE COMMUNITY ALSO INCLUDE:- A COMMUNITY HEALTH INFORMATION NEWSLETTER THAT CONTAINS A BROAD RANGE OF PRACTICAL INFORMATION TO IMPROVE HEALTH AND WELLNESS AND IS MAILED TO 15,000+ LOCAL HOUSEHOLDS- OFFERING HEALTH SCREENINGS AND INFORMATION TO HUNDREDS OF AREA CONSUMERS OVER 65 YEARS OLD AT LOCAL SENIOR HEALTH FAIRS- A DIABETES HEALTH FAIR THAT EDUCATES THE COMMUNITY ON THIS DISEASE- A DIABETES MONTHLY SUPPORT GROUP- PROVIDING OF SPACE FOR AN AEROBICS CLASS THAT IS HELD TWICE PER WEEK- A WEEKLY HEALTH INFORMATION COLUMN IN A LOCAL NEWSPAPER- SPONSOR OF A PUBLIC WOMEN'S DAY THAT PROVIDED HEALTH INFORMATION- HOSTING OF A WEBSITE WITH IMPORTANT HEALTH INFORMATION- PROMOTION OF A HEALTH RESOURCE CENTER THAT PROVIDES PATIENTS, FAMILY MEMBERS, AND COMMUNITY MEMBERS ANSWERS TO HEALTH QUESTIONS AND OTHER RESOURCES TO HELP THEM LEARN ABOUT ANY HEALTH TOPIC- SPONSORING OF SEGMENTS ON THE LOCAL RADIO THAT PROVIDE WELLNESS FACTS AND INFORMATION TO THE COMMUNITYFOR 2016, TOTAL HOSPITAL PATIENT DAYS WERE 2,981 AND TOTAL OUTPATIENT PROCEDURES WERE 106,800. SOME KEY STATISTICS INCLUDED IN THESE TOTALS WERE 1,723 ACUTE INPATIENT DAYS, 615 SWING BED INPATIENT DAYS, 327 NURSERY DAYS, AND 10,369 EMERGENCY ROOM/URGENT CARE VISITS. THE ORGANIZATION ALSO PROVIDES CLINICAL SERVICES AT TWO PRIMARY CARE CLINICS LOCATED IN PLATTEVILLE AND CUBA CITY, WISCONSIN AS WELL AS SPECIALTY PHYSICIAN SERVICES IN THE AREAS OF GENERAL SURGERY, ORTHOPEDICS, WOMEN'S HEALTH, AND EYECARE SERVICES. 2872877 5594378 THE ORGANIZATION'S NURSING HOME PROVIDES LONG-TERM CARE SERVICES FOR THE AGED AND DISABLED MEMBERS OF THE COMMUNITY. HEALTH CARE SERVICES TO MEDICAID NURSING HOME RESIDENTS ARE CONSIDERED PART OF THE ORGANIZATION'S BENEFIT PROVIDED TO THE COMMUNITY, SINCE A SUBSTANTIAL PORTION OF SUCH SERVICES ARE REIMBURSED AT AMOUNTS LESS THAN THE COSTS OF PROVIDING CARE. FOR 2016, TOTAL NURSING HOME RESIDENT DAYS WERE 27,001. INCLUDED IN THIS TOTAL WAS 13,181 DAYS FOR RESIDENTS COVERED UNDER THE MEDICAID AND FAMILY CARE PROGRAMS.THE NURSING HOME OFFERS SKILLED NURSING CARE IN BOTH SHORT-TERM REHABILITATION PROGRAMS AND LONG-TERM CARE RESIDENT PROGRAMS. SOME OF THE SPECIALIZED CARE SERVICES OFFERED INCLUDE IV THERAPY CARE, WOUND CARE, PAIN MANAGEMENT, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, AND SPEECH THERAPY. THE NURSING HOME OPERATES IN CONJUNCTION WITH THE HOSPITAL TO PROVIDE A SMOOTH TRANSITION FOR PATIENTS NEEDING EXTENDED REHABILITATION OR LONG-TERM CARE SERVICES. THE COOPERATION OF FACILITIES ALSO ALLOWS THE ORGANIZATION TO SHARE MANY DEPARTMENTS AND SERVICES IN SOUTHWEST HEALTH CENTER'S CONTINUED EFFORT TO PROVIDE HIGH QUALITY AND LOW COST CARE TO THE COMMUNITY.BASED ON THE 2016 MEDICARE COST REPORT, ADDITIONAL EXPENSES OF APPROXIMATELY $2,891,861 WERE ALLOCATED TO THE NURSING HOME THAT ARE INCLUDED IN THE HOSPITAL'S EXPENSES ON LINE 4A OF PART III OF THE 990, AND THESE EXPENSES INCLUDE ALLOCATIONS FOR EMPLOYEE BENEFITS, ADMINISTRATIVE FUNCTIONS, BUILDING DEPRECIATION, DIETARY, AND OTHER SHARED OVERHEAD EXPENSES. 2348959 6027825 THE ORGANIZATION PROVIDES BEHAVIORAL HEALTH SERVICES IN THE FORM OF INPATIENT, OUTPATIENT, AND CLINICAL COUNSELING SETTINGS WITH A FOCUS ON SENIOR BEHAVORIAL SCIENCES AT THE "SENIOR BEHAVORIAL SCIENCES" (SBS) CENTER. THE PRIMARY PATIENTS SERVED BY THIS CENTER ARE PATIENTS OVER THE AGE OF 55 AND ARE PRIMARILY MEDICARE AND MEDICAID PROGRAM BENEFICIARES WHICH OFTEN REIMBURSE THE ORGANIZATION AT RATES BELOW THE COST OF TREATING THESE PATIENTS. HOWEVER, THE ORGANIZATION FEELS THAT IT IS THEIR MISSION IN THE COMMUNITY TO PROVIDE THESE SERVICES TO PATIENTS IN NEED. THE SBS IS PROUD TO OFFER THESE SERVICES IN A MODERN FACILITY AT A TIME WHEN MANY DISTINCT PART PSYCHIATRIC UNITS ARE CLOSING DUE TO POOR REIMBURSEMENT FROM THIRD-PARTY PAYORS. THROUGH A GRANT PROVIDED BY THE HELEN BADER FOUNDATION, SBS ALSO OFFERS A MEMORY CLINIC TO WORK WITH SENIOR PATIENTS WHO ARE HAVING DIFFICULTIES WITH MEMORY AS THEY CONTINUE TO WORK TO LIVE ON THEIR OWN AS LONG AS POSSIBLE. THE SBS CENTER IS STAFFED BY A FULL-TIME PYSCHIATRIST, A NURSE PRACTITIONER, AND PROFESSIONAL NURSING AND SOCIAL SERVICES STAFF. PATIENTS OF THE SBS ALSO HAVE FULL ACCESS TO ALL OF THE DIAGNOSTIC, THERAPY, AND EMERGENCY SERVICES OF THE SOUTHWEST HEALTH CENTER HOSPITAL.THE TOTAL SBS CENTER PATIENT DAYS WERE 2,384 IN 2016.BASED ON THE 2016 MEDICARE COST REPORT, ADDITIONAL EXPENSES OF APPROXIMATELY $555,084 WERE ALLOCATED TO THE SBS CENTER THAT ARE INCLUDED IN THE HOSPITAL'S EXPENSES ON LINE 4A OF PART III OF THE 990, AND THESE EXPENSES INCLUDE ALLOCATIONS FOR EMPLOYEE BENEFITS, ADMINISTRATIVE FUNCTIONS, BUILDING DEPRECIATION, DIETARY, AND OTHER SHARED OVERHEAD EXPENSES. 45758666 1 1 0 1 0 0 0 0 0 1 1 0 1 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 39 0 611 1 1 1 0 0 0 0 0 0 0 X 9 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X JESSE SOOKOCHOFF 6083482331 1400 EAST SIDE RD PLATTEVILLE WI 538189800 LOU SCHWEIGERT BOARD MEMBER 2.00 X 0 0 0 KEVIN CARR MD EX-OFFICIO/PHYSICIAN 40.00 X 489869 0 35034 BARBARA KARRMAN BOARD MEMBER 2.00 0.50 X 0 0 0 JOSEPH ROSEMEYER DC SECRETARY 2.00 X X 0 0 0 JAMES SCHNELLER CHAIRMAN 2.00 X X 0 0 0 DOUGLAS ROGERS CPA VICE-CHAIRMAN 2.00 X X 0 0 0 LOU SCHWEIGERT TREASURER 2.00 X X 0 0 0 DAN ROHRBACH CEO 50.00 0.50 X X 302997 0 34789 ANGELA UDELHOFEN BOARD MEMBER 2.00 X 0 0 0 MATTHEW STREETER CHIEF ADMIN & FIN OFFICER 50.00 0.50 X 140760 0 28548 JAMES YURCEK PHYSICIAN 40.00 X 516363 0 35378 MARK BOGNER PHYSICIAN 40.00 X 445890 0 34572 KIM MACKEY PHYSICIAN 40.00 X 436527 0 35146 JOSHUA LINDSAY PHYSICIAN 40.00 X 646521 0 35378 MITCHELL LEWIS PHYSICIAN 40.00 X 415562 0 53126 3394489 0 291971 26 0 1 0 SHARED IMAGING SERVICES PO BOX 88450 MILWAUKEE WI 53288 RADIOLOGY SERVICES 717352 CMT ANESTHESIA 4834 US HWY 151 PLATTEVILLE WI 53818 ANESTHESIA SERVICES 656023 HORIZON HEALTH PO BOX 840839 DALLAS TX 75284 BEHAVIORAL HEALTH SERVICES 525082 RURAL WI HEALTH COOPERTATIVE 880 INDEPENDENCE LANE SAUK CITY WI 53583 SPEECH THERAPIST & ORGANIZATIONAL SERVIC 270191 WIPFLI LLP PO BOX 3160 MILWAUKEE WI 53201 FINANCIAL SERVICES 203365 5 191740 82000 191740 HOSPITAL PATIENT REVENUE 621990 28157881 28131191 26690 CLINIC REVENUE 621110 16198715 16198715 PSYCHIATRIC REVENUE 623990 6027825 6027825 NURSING HOME REVENUE 623000 5594378 5594378 PHARMACY REVENUE 621990 729816 729816 129047 129047 56837662 449729 449729 111688 32908 78780 78780 78780 7371030 30223 7214293 47563 156737 -17340 139397 139397 57697308 56810972 26690 667906 180152 180152 506753 506753 23990097 21900985 2089112 787057 718518 68539 3947900 3604108 343792 1498000 1341726 156274 31901 31901 99503 99503 256072 256072 4314232 3355031 959201 282437 282437 44947 44947 747356 747356 3342907 3216757 126150 59908 19069 40839 230403 186650 43753 2949130 2949130 204107 204107 MEDICAL SUPPLIES 4422506 4173590 248916 PHARMACEUTICALS 1652913 1652913 BAD DEBT EXPENSE 1573612 1573612 MISCELLANEOUS EXPENSE 1266168 682318 583850 52388061 45758666 6629395 0 13783 12772 6319898 6180166 9044154 9276349 531100 782866 657700 734847 66549112 32716111 33707112 33833001 26947224 33658408 255000 275000 675363 660719 78151334 85414128 4737553 6200503 758073 27322017 25856879 572000 308000 4544 50549 32636114 33174004 X 45515220 51345839 526249 368036 45515220 52240124 78151334 85414128 X 5309247 -507984 1923641 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 2823 2823 0 PART II-B, LINE 1: THE ORGANIZATION PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THESE DUES ARE PAID PRIMARILY TO ACCESS EDUCATIONAL MATERIALS AND FOR STAFF TRAINING AND MATERIALS. THE WHA HAS NOTIFIED SOUTHWEST HEALTH CENTER, INC. THAT $184 OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTH CARE ENVIRONMENT. THE ORGANIZATION IS ALSO A MEMBER OF THE RURAL WISCONSIN HEALTH COOPERATIVE (RWHC). EACH YEAR, THE ORGANIZATION 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 FINDING GRANT FUNDING FOR NEW PROGRAMS, LEGAL SERVICES, REIMBURSEMENT REVIEW SERVICES, ACCOUNTING ASSISTANCE, CONTRACTING FOR THERAPIST AND EMERGENCY ROOM PATIENT CARE COVERAGE, AND ADMINISTRATIVE CONSULTING SERVICES. AS A PART OF THESE SERVICES, THE RWHC ALSO DOES PROVIDE ANALYSIS OF CURRENT HEALTH CARE ISSUES IN AN EFFORT TO PROMOTE AND BETTER HEALTH CARE FOR HOSPITALS IN RURAL COMMUNITIES THROUGHOUT WISCONSIN. ONE OF THESE EFFORTS ALSO INCLUDES SOME LOBBYING ON THE PART OF THE MEMBER ORGANIZATIONS. THE RWHC DETERMINED THAT $2,639 OF THE FEES PAID BY SOUTHWEST HEALTH CENTER, INC. IN 2016 RELATED TO LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE HEALTH CARE ENVIRONMENT IN THE STATE OF WISCONSIN. 0 716701 716701 0.51350 0.48650 0 0 1362582 1362582 40833483 16517138 24316345 31921 24207 7714 22589622 15929867 6659755 1731504 244899 1486605 33833001 BOARD DESIGNATED FUNDS FOR CAPITAL IMPROVEMENTS 31245995 F AMOUNTS HELD UNDER BOND INDENTURE AGREEMENTS 459763 F DEFERRED COMPENSATION PLAN ASSETS 46105 F DONOR AND FOUNDATION RESTRICTED FUNDS 1906545 F 33658408 FAIR VALUE OF INTEREST RATE SWAP AGREEMENT 4444 DEFERRED COMPENSATION PLAN LIABILITY 46105 50549 PART V, LINE 4 SOUTHWEST HEALTH CENTER, INC. BECAME THE CUSTODIAN OF ENDOWMENT FUNDS AS OF JUNE 30, 2016 UPON THE DISSOLUTION OF SOUTHWEST HEALTH CENTER FOUNDATION, INC. THE ENDOWMENT FUNDS WERE PREVIOUSLY SETUP IN THE NAME OF THE CURTIS FAMILY TO PROVIDE SCHOLARSHIP FUNDS TO BE AVAILABLE TO AREA STUDENTS SEEKING TO FURTHER THEIR EDUCATION IN A HEALTH CARE RELATED FIELD. 1 1 X 1 X 300.000000000000 1 X 500.000000000000 1 1 0 1 1 119830 119830 0.00230 7174599 4469368 2705231 0.05160 7294429 4469368 2825061 0.05390 4433925 2648619 1785306 0.03410 2500 2500 0.00000 4436425 2648619 1787806 0.03410 11730854 7117987 4612867 0.08800 7890 7890 0.00020 7890 7890 0.00020 0 833307 416653 12540786 12312703 228083 X 1 1 2 1 SOUTHWEST HEALTH CENTER INC 1400 EAST SIDE ROAD PLATTEVILLE WI 53818 WWW.SOUTHWESTHEALTH.ORG 1059 X X X X AMBULANCE SERVICE A 2 SOUTHWEST HEALTH CENTER INC - SBS 1185 NORTH ELM STREET PLATTEVILLE WI 53818 WWW.SOUTHWESTHEALTH.ORG 1063 X X PSYCHIATRIC HOSPITAL A SOUTHWEST HEALTH CENTER INC 0 0 1 X X X X X X X X X X 15 1 0 0 1 X WWW.SOUTHWESTHEALTH.ORG/COMMUNITY-HEALTH-NEEDS X X 1 15 1 HTTPS://WWW.SOUTHWESTHEALTH.ORG/OUR-LOCATIONS/COMMUNITY-HEALTH-NEEDS-ASSESS 0 0 1 X 300.000000000000 X X X X X 1 1 X X X 1 X HTTP://WWW.SOUTHWESTHEALTH.ORG/SERVICES/PATIENT-FINANCIAL-SERVICES/ X HTTPS://WWW.SOUTHWESTHEALTH.ORG/WP-CONTENT/UPLOADS/2015/06/PLAIN-LANGUAGE-S X X X X X 1 X 0 X X X 1 X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: SOUTHWEST HEALTH CENTER, INC., - FACILITY 2: SOUTHWEST HEALTH CENTER, INC. - SBS SOUTHWEST HEALTH CENTER, INC. PART V, SECTION B, LINE 3J: ACTION PLAN TO ADDRESS COMMUNITY HEALTH NEEDS. SOUTHWEST HEALTH CENTER, INC. PART V, SECTION B, LINE 5: THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) SOUGHT INPUT FROM DIVERSE STAKEHOLDERS, INCLUDING HEALTH CARE PROVIDERS, COMMUNITY LEADERS, AND THE PUBLIC. A KEY STAKEHOLDER SURVEY WAS CREATED ONLINE WITH A LINK DISSEMINATED VIA EMAIL. RESPONSES AS WELL AS THE SURVEY TOOL ITSELF ARE INCLUDED IN THE REPORT. A SEPARATE SURVEY WAS CREATED IN A HARD COPY VERSION AND DIVERSE MEMBERS OF THE GENERAL PUBLIC WERE ASKED TO COMPLETE THE SURVEY AT COMMUNITY EVENTS, SUCH AS FAIRS AND LARGE GATHERINGS. THE CHNA PROCESS ALSO RELIED SIGNIFICANTLY ON HEALTH DATA FROM VARIOUS CREDIBLE SOURCES TO PROVIDE ACTUAL COMPARATIVE RISKS FOR MORBIDITY AND MORTALITY ON A WIDE RANGE OF HEALTH ISSUES FROM CANCER AND HEART DISEASE, SMOKING, ACCIDENTS, AND THE ENVIRONMENT. SOUTHWEST HEALTH CENTER, INC. PART V, SECTION B, LINE 7D: A COPY OF THE CHNA IS ALSO ATTACHED TO THE FORM 990 RETURN. SOUTHWEST HEALTH CENTER, INC. PART V, SECTION B, LINE 11: IN ADDITION TO ONGOING DAILY SHARING OF VITAL HEALTH INFORMATION, CARING FOR INDIGENT OR LOW INCOME COMMUNITY MEMBERS, PROVIDING NON-REIMBURSED CARE, AND EDUCATING OUR PATIENTS, THEIR FAMILIES, AND OUR COMMUNITIES ON INDIVIDUAL AND COLLECTIVE HEALTH ISSUES, WE ADDRESS PRIORITY COMMUNITY HEALTH NEEDS BY ENGAGING OUR CONSTITUENCIES, EMPOWERING THEM, CONNECTING THEM TO SERVICES AND RESOURCES, AND BY WORKING TO CREATE A LOCAL CULTURE OF HEALTH AND WELLNESS. THAT INCLUDES REDUCING BARRIERS TO GAINING ACCESS TO CARE, CREATING OPPORTUNITIES FOR SCREENINGS AND EARLY INTERVENTION, IMPROVING PATIENT ADVOCACY AND INFORMATION, PROVIDING EDUCATION, AND ELIMINATING STIGMAS. WE ALSO WORK TO RAISE AWARENESS OF EXISTING CLINICAL AND AOTHER VITAL SERVICES, OFFER SERVICES LOCALLY FREE OF CHARGE OR AT LOW COST, OFFER PROGRAMS TARGETING POPULATIONS, AND RECRUIT AND RETAIN LOCAL PROVIDERS NECESSARY TO DELIVER COST EFFECTIVE CARE. FINALLY, WE'RE ALSO BOOSTING OUR EFFORTS TO MORE EFFECTIVELY PROMOTE HEALTH, HEALTHY EATING AND HEALTHY ACTIVITY, AND WE'RE FOSTERING COMMUNITY COLLABORATION TO INCREASE KNOWLEDGE ON HEALTH ISSUES, FROM HEALTHY EATING AND PHYSICAL ACTIVITY TO IMPACTING SUBSTANCE ABUSE AND CREATING OPPORTUNITIES FOR EDUCATION THAT WILL CHANGE THE UNDERLYING CAUSES OF DISEASE. 5 1 - EPIONE PAVILION 808 SOUTH WASHINGTON STREET CUBA CITY WI 53807 SKILLED NURSING FACILITY 2 - SOUTHWEST HEALTH - PLATTEVILLE CLINIC 1450 EASTSIDE ROAD PLATTEVILLE WI 53818 PHYSICIAN CLINIC 3 - SOUTHWEST HEALTH - CUBA CITY CLINIC 808 SOUTH WASHINGTON STREET CUBA CITY WI 53807 PHYSICIAN CLINIC 4 - SOUTHWEST HEALTH - THE EYE CENTER 1450 EASTSIDE ROAD PLATTEVILLE WI 53818 OPHTHALMOLOGY CLINIC AND RETAIL EYE CENTER 5 - THE PHARMACY AT SOUTHWEST HEALTH 1450 EASTSIDE ROAD PLATTEVILLE WI 53818 RETAIL PHARMACY PART I, LINE 3C: ALTHOUGH FEDERAL POVERTY GUIDELINES ARE USED FOR CALCULATING DISCOUNTED CARE TO BE PROVIDED UNDER THE ORGANIZATION'S CHARITY CARE POLICY, THESE GUIDELINES ARE NOT USED TO DETERMINE FREE CARE GIVEN. ALTHOUGH FREE CARE IS GENERALLY NOT GIVEN, A 95% DEDUCTION FROM BILLED CHARGES IS GRANTED TO PATIENTS UNDER 100% OF THE FEDERAL POVERTY GUIDELINES. PART I, LINE 7: THE COSTING METHOD USED ON FORM 990 IS BASED ON A COST TO CHARGE RATIO WHICH IS DEVELOPED BASED ON THE ORGANIZATION'S TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBTS 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: THE COST OF SUBSIDIZED SERVICES IS BASED ON THE COST ALLOCATIONS FROM THE MEDICARE COST REPORT. ALLOWABLE COSTS ARE ASSIGNED DIRECTLY TO DEPARTMENTS THROUGHOUT THE YEAR AND THEN THE COST REPORT USES THE ALLOCATION METHODOLOGY TO ASSIGN ALL OTHER COSTS TO CALCULATE SERVICE LINE COSTS. SUBSIDIZED HEALTH SERVICES INCLUDE THE OPERATION OF THE HOSPITAL'S INPATIENT MEDICAL/SURGICAL NURSING UNIT. THESE SERVICES ARE UNAVAILABLE TO MEMBERS OF THE COMMUNITY OTHER THAN THROUGH SOUTHWEST HEALTH CENTER, INC. IT HAS BEEN THE GOAL OF SOUTHWEST HEALTH CENTER, INC. TO PROVIDE THESE SERVICES TO THE COMMUNITY REGARDLESS OF THE PATIENT'S ABILITY TO PAY. PART II, COMMUNITY BUILDING ACTIVITIES: WHILE THERE IS GROWING AGREEMENT IN THE UNITED STATES ABOUT WHAT CONSTITUTES A NON-PROFIT HOSPITAL'S "COMMUNITY BENEFIT," THESE EFFORTS CONTINUE TO BE A WORK IN PROGRESS. SOUTHWEST HEALTH CENTER, INC. PROVIDES SIGNIFICANT CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS AND IN ADDITION, THE ORGANIZATION BELIEVES THAT IT PROVIDES A CRITICALLY IMPORTANT BENEFIT WHICH IS NOT QUANTIFIED. SOUTHWEST HEALTH CENTER, INC., LIKE MOST COMMUNITY HOSPITALS, WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE CARE LOCALLY WHICH WITHOUT THE HOSPITAL, WOULD NOT BE AVAILABLE LOCALLY. BEYOND INPATIENT HOSPITALIZATIONS, THE ORGANIZATION PROVIDES LOCAL ACCESS TO MANY SERVICES INCLUDING: DIAGNOSTICS, EMERGENCY SERVICES, INFUSION SERVICES, NURSING HOME SERVICES, SWING BED SERVICES, CLINICAL SERVICES, LABORATORY SERVICES, OCCUPATIONAL HEALTH, REHABILITATION SERVICES, SPECIALTY MEDICINE, SLEEP CENTER, SPEECH PATHOLOGY, SURGICAL SERVICES, PSYCHIATRIC SERVICES, AND WOMEN'S SERVICES, AND HEALTH EDUCATION (SUCH AS FOOD, NUTRITION, AND DIABETES COUNSELING) TO NAME SOME OF THE MAJOR SERVICES PROVIDED. PART III, LINE 4: PATIENT AND RESIDENT ACCOUNTS RECEIVABLE AND CREDIT POLICY: IN EVALUATING THE COLLECTIBILITY OF PATIENT AND RESIDENT ACCOUNTS RECEIVABLE, SOUTHWEST HEALTH CENTER, INC. ANALYZES PAST RESULTS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. SPECIFICALLY, FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS OR RESIDENTS WHO HAVE THIRD-PARTY COVERAGE, SOUTHWEST HEALTH CENTER, INC. ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS AND PATIENTS OR RESIDENTS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE LIKELY. 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), SOUTHWEST HEALTH CENTER, INC. 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 CONTRACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A SEPARATE FOOTNOTE REGARDING BAD DEBT EXPENSE. PART III, LINE 8: THE TOTAL MEDICARE REVENUE SHOWN IN SCHEDULE H TO THE FORM 990 IS BASED ON THE IRS 990 INSTRUCTIONS AND INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE OF THE ORGANIZATION, AND ALSO DOES NOT CONSIDER ALL CONTRACTUAL ADJUSTMENTS FOR SERVICES REIMBURSED BY THE MEDICARE PROGRAM. AMOUNTS LISTED FOR MEDICARE REVENUES DO NOT INCLUDE PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT AT THE HOSPITAL AS WELL AS AMBULANCE SERVICES, ANESTHESIA PROFESSIONAL SERVICES, PSYCHIATRIC PHYSICIAN PROFESSIONAL SERVICES, SURGICAL PROFESSIONAL SERVICES, REVENUES FOR ANY PATIENTS COVERED UNDER MEDICARE ADVANTAGE PLAN PROGRAMS, OR PHYSICAL THERAPY SERVICES PROVIDED TO NURSING HOME RESIDENTS. THESE PHYSICIAN PROFESSIONAL SERVICES, AMBULANCE SERVICES, AND NURSING HOME THERAPY SERVICES ARE REIMBURSED PRIMARILY ON FEE SCHEDULE REIMBURSEMENTS AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY PHYSICIAN, PHYSICAL THERAPY, AND AMBULANCE 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 SOUTHWEST HEALTH CENTER PROVIDES TO THE COMMUNITY AND SURROUNDING AREAS. THE COSTING METHOD USED ABOVE FOR IRS 990 COMPLIANCE REPORTING IS ALSO BASED ON THE FILED MEDICARE COST REPORT FOR THE YEAR ENDED JUNE 30, 2016, AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES, AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICE REVENUES (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE). ADDITIONALLY, THE AMOUNTS ABOVE DO NOT INCLUDE AMOUNTS PAID FOR INPATIENT MEDICAL/SURGICAL NURSING UNIT SERVICES AS THESE ARE INCLUDED IN THE SUBSIDIZED HEALTH SERVICES ON PAGE 1 OF SCHEDULE H. WHETHER THERE IS A SHORTFALL OR SURPLUS ON SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THESE PEOPLE, WHO ARE TYPICALLY ELDERLY OR DISABLED MEMBERS OF THE COMMUNITY, ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTH CARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE PATIENT SERVICES, THE CENTERS FOR MEDICARE AND MEDICAID (CMS) WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY. PART III, LINE 9B: UNDER THE ORGANIZATION'S COLLECTION AND CHARITY CARE POLICIES, SOUTHWEST HEALTH CENTER, INC. MAKES EVERY ATTEMPT TO IDENTIFY AND PROMOTE CHARITY CARE TO PATIENTS. INCLUDED IN THE ORGANIZATION'S CHARITY CARE POLICY IT IS NOTED THAT PATIENTS MAY QUALIFY FOR CHARITY CARE EITHER PRIOR TO ADMISSION OR FOLLOWING DISCHARGE. ALL INPATIENT SELF-PAY ADMISSIONS ARE SCREENED BY THE ORGANIZATION'S PATIENT FINANCIAL COUNSELORS OR SOCIAL WORKERS TO ALLOW THESE PATIENTS THE ABILITY TO COMPLETE THEIR APPLICATION DURING THEIR STAY AT THE HOSPITAL. DEPENDING UPON THE PATIENT'S CONDITION, THE PATIENT'S RESPONSIBLE PARTY MAY BE CONTACTED TO COMPLETE AND RETURN THE FORMS AT A LATER TIME WHEN THEIR CARE ALLOWS THIS COMPLETION. DURING THE PATIENT ACCOUNT COLLECTION PROCESS, SELF-PAY PATIENTS ARE ALSO INFORMED OF THE ORGANIZATION'S COLLECTION POLICIES AS WELL AS THE CHARITY CARE PROGRAM TO ALLOW PATIENTS THE OPPORTUNITY TO COMPLETE THE APPROPRIATE FORMS AND QUALIFY UNDER THE PROGRAM. PART VI, LINE 2: SOUTHWEST HEALTH CENTER, INC. ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES AND AREAS IT SERVES BY REVIEWING LOCAL DEMOGRAPHICS AND TRENDS IN PATIENT SERVICE UTILIZATION TO DETERMINE WHICH SERVICES COULD AND SHOULD BE MADE AVAILABLE TO THE COMMUNITY IN A COST-EFFECTIVE MANNER. IN FISCAL YEAR 2016, SOUTHWEST HEALTH CENTER, INC. COLLABORATED WITH OTHER AREA HOSPITALS TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THROUGH THE CHNA PROCESS THE ORGANIZATION CONSIDERED: HEALTH STATISTICS, MEDICAL RESOURCES, SAFETY FACTORS, SOCIO-ECONOMIC INDICATORS, ACCESS TO RESOURCES, AND ENVIRONMENTAL QUALITY. THE ORGANIZATION ALSO SEEKS ONGOING INPUT FROM LOCAL COMMUNITY MEMBERS, LOCAL CLINICAL PHYSICIAN GROUPS, AND MEMBERS OF ITS STAFF TO DETERMINE WHICH SERVICES MAY BENEFIT THE COMMUNITY. SOUTHWEST HEALTH CENTER, INC. ALSO USES STATISTICS IN THE HOSPITAL AND CLINICS TO REVIEW THE CURRENT SERVICES BEING OFFERED AND ENSURE THAT RESOURCES ARE BEING APPROPRIATELY ALLOCATED TO AREAS IN NEED BY COMMUNITY MEMBERS AND PATIENTS. DURING FISCAL YEARS 2015 AND 2016, SOUTHWEST HEALTH CENTER, INC. CONTINUED TO BUILD ON THE PREVIOUS EFFORTS WHILE ALSO CREATING NEW OPPORTUNITIES TO PROACTIVELY IMPACT THE IDENTIFIED HEALTH NEEDS OF THE COMMUNITIES IT SERVES. PART VI, LINE 3: UNINSURED AND UNDER INSURED PATIENTS ARE ASKED TO MEET WITH ONE OF THE ORGANIZATION'S FINANCIAL COUNSELORS EITHER AT THE TIME SERVICE IS PROVIDED OR WHEN THE PATIENT'S BILL IS GENERATED. THE FINANCIAL COUNSELORS EXPLAIN THE VARIOUS PAYMENT OPTIONS AVAILABLE TO THE PATIENT AS WELL AS THE ORGANIZATION'S CHARITY CARE PROGRAM AND OFFERS THE CHARITY CARE APPLICATION WHEN APPROPRIATE. IF OTHER PROGRAMS ARE AVAILABLE TO THE PATIENT, SUCH AS THE WISCONSIN MEDICAID OR BADGERCARE PROGRAMS, THESE PATIENTS ARE REFERRED TO THE APPROPRIATE GOVERNMENT AGENCY FOR FURTHER ASSISTANCE. PART VI, LINE 4: THE PRIMARY SERVICE AREA FOR SOUTHWEST HEALTH CENTER, INC. ENCOMPASSES ALL PERSONS LIVING WITHIN A 20 TO 30 MILE RADIUS OF THE FACILITIES IT OPERATES IN PLATTEVILLE AND CUBA CITY, WISCONSIN. SOME OF THE COMMUNITIES INCLUDED IN THIS AREA ARE PLATTEVILLE, CUBA CITY, DICKEYVILLE, TENNYSON, POTOSI, BELMONT, ELLENBORO, AND REWEY, WISCONSIN, AMONG MANY OTHERS. SOUTHWEST HEALTH CENTER, INC. PROVIDES A SIGNIFICANT PORTION OF ITS PATIENT SERVICES TO BENEFICIARIES OF THE MEDICARE AND MEDICAID PROGRAMS. IN THE CURRENT YEAR, THESE MEDICARE AND MEDICAID PATIENTS ACCOUNTED FOR APPROXIMATELY 67 PERCENT OF THE GROSS PATIENT SERVICE REVENUE PROVIDED BY THE ORGANIZATION DURING THE YEAR. PART VI, LINE 5: A MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYISICANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS. SURPLUS FUNDS OF THE ORGANIZATION ARE INVESTED BACK INTO THE FACILTY AND ITS EQUIPMENT TO ENSURE THE NEEDED SERVICES ARE CONTINUED TO BE PROVIDED IN THE COMMUNITY. PART VI, LINE 7, REPORTS FILED WITH STATES WI 1 SOUTHWEST HEALTH CENTER FOUNDATION INC 1400 EAST SIDE RD PLATTEVILLE WI 538189800 391977502 501(C)(3) 117090 BOOK TO COVER OPERATING EXPENSES. PART I, LINE 2: THE ORGANIZATION PROVIDES BOARD APPROVED CAPITAL DISTRIBUTIONS TO SOUTHWEST HEALTH CENTER FOUNDATION, INC. TO COVER THE COST OF THEIR OPERATING EXPENSES; NO FORMAL MONITORING IS REQUIRED. X X X X 0 0 0 0 0 0 0 0 0 KEVIN CARR MD EX-OFFICIO/PHYSICIAN 320353 0 169516 0 0 0 13250 0 21784 0 524903 0 0 0 DAN ROHRBACH CEO 271497 0 31500 0 0 0 13250 0 21539 0 337786 0 0 0 MATTHEW STREETER CHIEF ADMIN & FIN OFFICER 130486 0 10274 0 0 0 7324 0 21224 0 169308 0 0 0 JAMES YURCEK PHYSICIAN 516363 0 0 0 0 0 13250 0 22128 0 551741 0 0 0 MARK BOGNER PHYSICIAN 420325 0 25565 0 0 0 13250 0 21322 0 480462 0 0 0 KIM MACKEY PHYSICIAN 358642 0 77885 0 0 0 13250 0 21896 0 471673 0 0 0 JOSHUA LINDSAY PHYSICIAN 516429 0 130092 0 0 0 13250 0 22128 0 681899 0 0 0 MITCHELL LEWIS PHYSICIAN 361662 0 53900 0 0 0 13250 0 39876 0 468688 0 0 0 A WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 2012-08-20 18009846 REFUNDING OF SERIES 2004A BONDS FOR HOSPITAL REPLACEMENT 0 0 0 B WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 2012-08-20 5466102 REFUNDING OF SERIES 2010 BONDS FOR HOSPITAL REPLACEMENT 0 0 0 C WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 2013-12-06 7200000 RENOVATION AND ADDITION TO HOSPITAL FACILITIES 0 0 0 A 3723225 18009846 318905 17690941 2005 0 1 1 1 B 708976 5466102 98595 5367507 2005 1 0 1 1 C 306868 7200000 127152 7072848 2014 0 0 1 1 A 0 0 0 0 0.00010 0.00010 0.00020 0 0 0 B 0 0 0 0 0.00000 0.00010 0.00010 0 0 0 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 C 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 X AMBULANCE AND MEDICAL EQUIPMENT 2 82000 PURCHASE PRICE OF SI 0 0 0 0 FORM 990, PART III, LINE 2 SOUTHWEST HEALTH CENTER, INC ADDED AMBULANCE SERVICES AND OPENED A NEW RETAIL PHARMACY DURING 2016. FORM 990, PART VI, SECTION B, LINE 11 THE MEMBERS OF THE BOARD OF DIRECTORS ARE PROVIDED A COPY OF THE FORM 990 FOR REVIEW PRIOR TO SUBMISSION. RESPONSES ON THE 990 ARE ALSO REVIEWED BY THE CEO AND CHIEF ADMINISTRATIVE & FISCAL OFFICER OF THE ORGANIZATION PRIOR TO ITS SUBMISSION TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C MEMBERS OF THE BOARD OF DIRECTORS DISCLOSE ANY CONFLICTS OF INTEREST BY COMPLETING A QUESTIONNAIRE AND DISCLOSURE FORM ANNUALLY. EMPLOYEES ARE REQUIRED TO REVIEW THE CONFLICT OF INTEREST POLICY UPON HIRE AND AT ANNUAL INTERVALS. IF ANY SIGNIFICANT CONFLICTS ARISE WITH MEMBERS OF THE BOARD OF DIRECTORS, MANAGEMENT, OR KEY EMPLOYEES, IT IS PROPERLY DOCUMENTED AND FOLLOWED UP ON BY THE APPROPRIATE GOVERNING GROUP OR DEPARTMENT WITHIN THE ORGANIZATION ACCORDING TO THE CONFLICT OF INTEREST POLICY. ANY BOARD MEMBERS WITH NOTED CONFLICTS ARE ASKED TO ABSTAIN FROM VOTING ON ANY POTENTIALLY CONFLICTED ITEMS. FORM 990, PART VI, SECTION B, LINE 15 THE CEO'S COMPENSATION IS REVIEWED ANNUALLY AND IS COMPARED TO SURVEY DATA RECEIVED FROM THE RURAL WISCONSIN HEALTH COOPERATIVE AND FROM THE WISCONSIN HOSPITAL ASSOCIATION. THE CEO'S COMPENSATION IS APPROVED BY THE BOARD OF DIRECTORS ON AN ANNUAL BASIS. COMPENSATION OF THE ORGANIZATION'S OFFICERS AND OTHER EMPLOYEES IS ALSO COMPARED TO SURVEY DATA RECEIVED FROM THE RURAL WISCONSIN HEALTH COOPERATIVE AND FROM THE WISCONSIN HOSPITAL ASSOCIATION. THE OFFICERS' COMPENSATION IS APPROVED BY THE CEO AND HUMAN RESOURCES DIRECTOR ON AN ANNUAL BASIS, AND DOCUMENTATION REGARDING THEIR COMPENSATION ADJUSTMENTS IS MAINTAINED. FORM 990, PART VI, SECTION C, LINE 19 THE ABBREVIATED FINANCIAL STATEMENTS ARE MADE PUBLICLY AVAILABLE THROUGH THE WISCONSIN HOSPITAL ASSOCIATION, AND THE COMPLETE AUDITED CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: INCREASE IN INVESTMENT OF UNCONSOLIDATED AFFILIATES 112,692. TRANSFER OF NET ASSETS FROM SOUTHWEST HEALTH CENTER, FOUNDATION, INC. 1,810,849. INTEREST RATE SWAP VALUATION ADJUSTMENT 100. PART XII, LINE 2C: AUDIT COMMITTEE AND SELECTION OF AN INDEPENDENT ACCOUNTANT: THE ORGANIZATION ANSWERED "YES" TO QUESTION 2C UNDER PART XII OF THE 990, INDICATING THAT THE ORGANIZATION DOES HAVE A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THE COMMITTEE THAT ASSUMES THIS RESPONSIBILITY IS THE ORGANIZATION'S FINANCE COMMITTEE. THIS COMMITTEE MAKES RECOMMENDATIONS TO THE BOARD OF DIRECTORS REGARDING THE SELECTION OF THE INDEPENDENT ACCOUNTANT, AND THE BOARD OF DIRECTORS MAKES THE FINAL APPROVAL. THE BOARD OF DIRECTORS ALSO MEETS WITH THE AUDITORS ANNUALLY AND APPROVES THE AUDIT REPORT. THE PROCESS USED BY THIS COMMITTEE HAS NOT CHANGED IN THE PAST YEAR. SOUTHWEST HEALTH CENTER FOUNDATION INC 1400 EAST SIDE ROAD PLATTEVILLE WI 53818 391977502 FUNDRAISING WI 501(C)(3) LINE 11C, III-FI N/A 0 SOUTHWEST SENIOR ENTERPRISES INC 1400 EAST SIDE ROAD PLATTEVILLE WI 53818 205501580 SENIOR CARE CAMPUS & ACTIVITIES WI N/A C -43217 -344077 1.00000 0 SOUTHWEST MEDICAL SERVICES INC 1400 EAST SIDE ROAD PLATTEVILLE WI 53818 INACTIVE-MANAGEMENT OF RESIDENTIAL FACILITY WI N/A S 1.00000 0 0 1 1 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 1 SOUTHWEST HEALTH CENTER FOUNDATION INC B 117093 COST SOUTHWEST HEALTH CENTER FOUNDATION INC S 1810849 COST