AMERY REGIONAL MEDICAL CENTER INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- AMERY REGIONAL MEDICAL CENTER INC (EIN 39-0908320)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-11
- IRS object ID
- 201623169349304362
- Schema version
- 2015v2.1
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-11-11T15:40:32-06:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 135665207 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4200 WELLS FARGO CTR 90 S 7TH | AddressLine1Txt |
| Address Line2 | STREET | AddressLine2Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390908320 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AMERY REGIONAL MEDICAL CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | AMER | BusinessNameControlTxt |
| Phone | 7152688000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8170 33RD AVENUE SOUTH PO BOX 1309 | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 554401309 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DEBRA RUDQUIST | PersonNm |
| Person Title | PRESIDENT & CEO | PersonTitleTxt |
| Phone | 7152688000 | PhoneNum |
| Signature | 2016-11-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ANN LAMOUREUX | PreparerPersonNm |
| PTIN | P00691316 | PTIN |
| Phone | 6123055000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DEBRA RUDQUIST | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8170 33RD AVENUE SOUTH PO BOX 1309 | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 554401309 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $55,342,848 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.AMERYMEDICALCENTER.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1954 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | SEE PART III, LINE 1 - ORGANIZATION'S MISSION" | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 487 | TotalEmployeeCnt |
| Total Volunteers | 29 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $79,333 | PYContributionsGrantsAmt |
| CY Contributions Grants | $51,974 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $50,935,728 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $54,193,515 | CYProgramServiceRevenueAmt |
| PY Investment Income | $90,732 | PYInvestmentIncomeAmt |
| CY Investment Income | $132,342 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,413,667 | PYOtherRevenueAmt |
| CY Other Revenue | $820,256 | CYOtherRevenueAmt |
| PY Total Revenue | $52,519,460 | PYTotalRevenueAmt |
| CY Total Revenue | $55,198,087 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $23,373 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $40,315 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $30,803,652 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $33,444,138 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $20,765,682 | PYOtherExpensesAmt |
| CY Other Expenses | $19,194,327 | CYOtherExpensesAmt |
| PY Total Expenses | $51,592,707 | PYTotalExpensesAmt |
| CY Total Expenses | $52,678,780 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $926,753 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,519,307 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $62,494,933 | TotalAssetsBOYAmt |
| Total Assets EOY | $63,067,420 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $42,425,170 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $40,523,350 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $20,069,763 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $22,544,070 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | AMERY REGIONAL MEDICAL CENTER IS COMMITTED TO PROVIDEACCESSIBLE, COMPREHENSIVE, QUALITY HEALTHCARE AND TO PROMOTE THEHEALTH AND WELLNESS OF ITS COMMUNITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $45,173,302 | ExpenseAmt |
| Grant | $40,315 | GrantAmt |
| Revenue | $54,866,978 | RevenueAmt |
| Desc | SEE SCHEDULE O - EXEMPT PURPOSE AND ACHIEVEMENTS FOR A DESCRIPTION OF PROGRAM SERVICE ACCOMPLISHMENTS | Desc |
| Total Program Service Expenses | $45,173,302 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 487 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JASON LUHRS - CFO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7152688000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 265 GRIFFIN STREET EAST | AddressLine1Txt |
| City | AMERY | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54001 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (28 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| DAN DRAXLER | |||||||||
| DIRECTOR | 1.00 | 0.25 | Yes (X) | $1,200 | $0 | $0 | |||
| HEIDI ERSPAMER | |||||||||
| DIRECTOR & SECRETARY | 1.00 | 0.25 | Yes (X) | $1,200 | $0 | $0 | |||
| JAMES A LEADHOLM JR | |||||||||
| DIRECTOR & VICE CHAIR | 1.00 | 0.25 | Yes (X) | $1,200 | $0 | $0 | |||
| DANIEL LIEN | |||||||||
| DIRECTOR & CHAIR | 1.00 | 0.25 | Yes (X) | $1,200 | $0 | $0 | |||
| RANAE NYGAARD | |||||||||
| DIRECTOR | 0.25 | 0.25 | Yes (X) | $1,200 | $0 | $0 | |||
| DAVID RASMUSSEN | |||||||||
| DIRECTOR | 0.25 | 0.25 | Yes (X) | $1,200 | $0 | $0 | |||
| KATHRYN WALKER | |||||||||
| DIRECTOR | 0.25 | 0.25 | Yes (X) | $1,200 | $0 | $0 | |||
| JEFFREY J ROBERTSON | |||||||||
| DIRECTOR | 1.00 | 40.00 | Yes (X) | $0 | $543,591 | $37,818 | |||
| ROSS R BULLARD | |||||||||
| DIRECTOR & TREASURER | 1.00 | 47.00 | Yes (X) | $0 | $205,098 | $62,623 | |||
| NANCY MAGNINE PAC | |||||||||
| DIRECTOR | 0.25 | 39.75 | Yes (X) | $0 | $144,971 | $46,707 | |||
| MARTIN E RICHARDS MD | |||||||||
| DIRECTOR | 0.25 | 44.75 | Yes (X) | $0 | $445,734 | $58,666 | |||
| ANN SEAGREN MD | |||||||||
| DIRECTOR | 0.25 | 49.75 | Yes (X) | $0 | $222,064 | $69,364 | |||
| TED WEGLEITNER | |||||||||
| DIRECTOR | 0.25 | 39.75 | Yes (X) | $0 | $415,596 | $84,220 | |||
| GEHRIG WILLIAMSON MD | |||||||||
| DIRECTOR | 0.25 | 49.75 | Yes (X) | $0 | $171,038 | $47,665 | |||
| JOANNE L JACKSON | |||||||||
| DIRECTOR-HR,PR & MKTG | 45.00 | $127,056 | $0 | $20,145 | Yes (X) | ||||
| JASON J LUHRS | |||||||||
| CFO | 0.50 | 49.50 | $0 | $176,190 | $41,853 | Yes (X) | |||
| SANDRA M REED | |||||||||
| VP - AMBULATORY CARE | 50.00 | $134,345 | $0 | $29,519 | Yes (X) | ||||
| DEBRA RUDQUIST | |||||||||
| CHIEF EXECUTIVE OFFICER | 50.00 | $0 | $288,998 | $36,885 | Yes (X) | ||||
| JOYCE R SCHAEFER | |||||||||
| VP-PATIENT CARE | 50.00 | $145,465 | $0 | $29,471 | Yes (X) | ||||
| PATRICK SURA MD | |||||||||
| CHIEF MEDICAL OFFICER | 1.00 | 70.00 | $0 | $538,402 | $63,089 | Yes (X) | |||
| AMY M BENSON | |||||||||
| REGISTERED NURSE | 40.00 | $107,023 | $0 | $11,445 | Yes (X) | ||||
| SANDRA D JENSEN | |||||||||
| DIRECTOR OF NURSING | 40.00 | $114,338 | $0 | $13,945 | Yes (X) | ||||
| MARK T MOIOFFER | |||||||||
| PHARMACIST | 32.00 | $133,962 | $0 | $13,389 | Yes (X) | ||||
| MARK A TRYGGESTAD | |||||||||
| DIRECTOR OF PHARMACY | 48.00 | $167,540 | $0 | $17,052 | Yes (X) | ||||
| VICKI D ZIGLINSKI | |||||||||
| DIRECTOR-PATIENT FINANCIAL SERVICES | 40.00 | $106,566 | $0 | $26,895 | Yes (X) | ||||
| J DANIEL NELSON MD | |||||||||
| FORMER DIRECTOR | 0.00 | 50.00 | $0 | $516,198 | $115,783 | Yes (X) | |||
| JAMES QUENAN MD | |||||||||
| FORMER DIRECTOR | 0.00 | 40.00 | $0 | $123,130 | $33,219 | Yes (X) | |||
| DYLAN COE MD | |||||||||
| FORMER DIRECTOR | 0.00 | 40.00 | $0 | $261,147 | $75,672 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,044,695 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,052,157 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $935,425 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 10 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ANESTHETISTS INC | |||||
| 130 S KNOWLES AVE PO BOX 376 | NEW RICHMOND | WI | 54017 | NURSE ANESTHITISTS | $823,274 |
| COMPHEALTH INC | |||||
| PO BOX 972651 | DALLAS | TX | 753972651 | PROFESSIONAL SERVICES | $490,144 |
| HEALOGICS WOUND CARE | |||||
| 3087 MOMENTUM PLACE | CHICAGO | IL | 606895330 | WOUND HEALING MANAGEMENT | $477,698 |
| DIAMOND HEALTHCARE CORP | |||||
| PO BOX 85050 | RICHMOND | VA | 23285 | BEHAVIORAL HEALTH MANAGEMENT | $421,142 |
| WEATHERBY LOCUMS INC | |||||
| PO BOX 972633 | DALLAS | TX | 753972633 | PROFESSIONAL SERVICES | $374,286 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 16 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $51,974 | AllOtherContributionsAmt |
| Total Contributions | $51,974 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE | 621110 | $52,878,470 | $52,878,470 |
| OTHER OPERATING | 900099 | $546,009 | $546,009 |
| CONTRACT SERVICE | 900099 | $369,604 | $369,604 |
| SUBSIDIARY REVENUE | 900099 | $243,845 | $243,845 |
| FITNESS CENTER | 624110 | $155,587 | $155,587 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $54,193,515 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $132,342 | TotalRevenueColumnAmt |
| Exclusion | $132,342 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $87,413 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $144,761 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$57,348 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$57,348 | TotalRevenueColumnAmt |
| Exclusion | -$57,348 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| EHR INCENTIVE REVENUE | 900099 | $673,463 | $673,463 | |
| CAFETERIA AND OTHER | 900099 | $204,141 | $204,141 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $877,604 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $55,198,087 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $54,866,978 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $279,135 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,315 | TotalAmt |
| Program Services | $40,315 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,311,065 | TotalAmt |
| Program Services | $24,944,364 | ProgramServicesAmt |
| Management And General | $4,366,701 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $446,289 | TotalAmt |
| Program Services | $379,802 | ProgramServicesAmt |
| Management And General | $66,487 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,430,819 | TotalAmt |
| Program Services | $2,068,681 | ProgramServicesAmt |
| Management And General | $362,138 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,255,965 | TotalAmt |
| Program Services | $1,068,854 | ProgramServicesAmt |
| Management And General | $187,111 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93,277 | TotalAmt |
| Management And General | $93,277 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,967 | TotalAmt |
| Management And General | $13,967 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,542,472 | TotalAmt |
| Program Services | $3,075,412 | ProgramServicesAmt |
| Management And General | $467,060 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $404,212 | TotalAmt |
| Program Services | $13,983 | ProgramServicesAmt |
| Management And General | $390,229 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $669,285 | TotalAmt |
| Program Services | $469,793 | ProgramServicesAmt |
| Management And General | $199,492 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $337,410 | TotalAmt |
| Program Services | $300,310 | ProgramServicesAmt |
| Management And General | $37,100 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $868,855 | TotalAmt |
| Program Services | $859,855 | ProgramServicesAmt |
| Management And General | $9,000 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $104,046 | TotalAmt |
| Program Services | $64,628 | ProgramServicesAmt |
| Management And General | $39,418 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,427 | TotalAmt |
| Program Services | $3,138 | ProgramServicesAmt |
| Management And General | $4,289 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,304,289 | TotalAmt |
| Program Services | $1,304,289 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,730,679 | TotalAmt |
| Program Services | $3,553,826 | ProgramServicesAmt |
| Management And General | $176,853 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $134,012 | TotalAmt |
| Management And General | $134,012 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| DRUG EXPENSE | $2,946,923 | $2,946,923 | |
| MEDICAL SUPPLY & EQUIP. | $2,472,602 | $2,468,732 | $3,870 |
| EQUIP. RENT & REPAIR | $1,469,533 | $1,031,388 | $438,145 |
| OTHER EXPENSE | $457,018 | $203,418 | $253,600 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $638,320 | TotalAmt |
| Program Services | $375,591 | ProgramServicesAmt |
| Management And General | $262,729 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,678,780 | TotalAmt |
| Program Services | $45,173,302 | ProgramServicesAmt |
| Management And General | $7,505,478 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,014 | BOYAmt |
| EOY | $1,750 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,059,580 | BOYAmt |
| EOY | $18,661,151 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,267,788 | BOYAmt |
| EOY | $6,878,269 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $711,373 | BOYAmt |
| EOY | $702,782 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $544,341 | BOYAmt |
| EOY | $468,782 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $54,559,305 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $28,503,932 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,665,768 | BOYAmt |
| EOY | $26,055,373 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,176,152 | BOYAmt |
| EOY | $8,405,752 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,025,673 | BOYAmt |
| EOY | $1,893,561 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,244 | BOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $62,494,933 | BOYAmt |
| EOY | $63,067,420 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,046,688 | BOYAmt |
| EOY | $7,196,904 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,378,482 | BOYAmt |
| EOY | $33,326,446 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,425,170 | BOYAmt |
| EOY | $40,523,350 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,969,763 | BOYAmt |
| EOY | $22,544,070 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,100,000 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,069,763 | BOYAmt |
| EOY | $22,544,070 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $62,494,933 | BOYAmt |
| EOY | $63,067,420 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $2,519,307 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$45,000 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Total Lobbying Expenditures | $0 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | AMERY REGIONAL MEDICAL CENTER, INC. PAYS FOR CERTAIN CORPORATE AND EMPLOYEE PROFESSIONAL ASSOCIATION MEMBERSHIPS. A PORTION OF SUCH MEMBERSHIP DUES POTENTIALLY COULD BE USED BY THE PROFESSIONAL ASSOCIATIONS FOR LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,072,735 | OtherCostOrOtherBasisAmt |
| Book Value | $1,072,735 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $26,471,173 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,243,809 | DepreciationAmt |
| Book Value | $15,227,364 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $21,286,278 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,467,343 | DepreciationAmt |
| Book Value | $8,818,935 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,729,119 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,792,780 | DepreciationAmt |
| Book Value | $936,339 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $26,055,373 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $55,342,848 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $55,342,848 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$144,761 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$144,761 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $55,198,087 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $52,823,541 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $144,761 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $144,761 | ExpensesNotReportedAmt |
| Expenses Subtotal | $52,678,780 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $52,678,780 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | AMERY REGIONAL MEDICAL CENTER, INC. IS INCLUDED IN THE HEALTHPARTNERS, INC. (HP) CONSOLIDATED AUDITED FINANCIAL STATEMENT. HP'S ACCOUNTING POLICY PROVIDES THAT A TAX BENEFIT FROM AN UNCERTAIN TAX POSITION MAY BE RECOGNIZED WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING RESOLUTIONS OF ANY RELATED APPEALS OR LITIGATION PROCESSES, BASED ON THE TECHNICAL MERITS. HP RECORDED NO LIABILITIES AT DECEMBER 31, 2015 OR 2014 FOR UNRECOGNIZED TAX BENEFITS. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | RENT EXPENSE -144,761. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENT EXPENSE 144,761. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $397,987 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $397,987 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00750 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,537,754 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,583,018 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,954,736 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03700 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,935,741 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,583,018 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,352,723 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04450 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $594,235 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $197,566 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $396,669 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00750 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,047 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $7,047 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $70,586 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $70,586 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $671,868 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $197,566 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $474,302 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00890 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,607,609 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $4,780,584 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,827,025 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05340 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $793,061 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $594,796 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $18,524,576 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $18,659,573 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$134,997 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AMERY REGIONAL MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 265 GRIFFIN STREET EAST | AddressLine1Txt |
| City | AMERY | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54001 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.AMERYMEDICALCENTER.ORG | WebsiteAddressTxt |
| State License | CAH CERT LICENSE 1010 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AMERY REGIONAL MEDICAL CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.AMERYMEDICALCENTER.ORG | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.AMERYMEDICALCENTER.ORG/COMMUNITY_HEALTH_NEEDS_ASSESSMENT.ASPX | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.AMERYMEDICALCENTER.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.AMERYMEDICALCENTER.ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.AMERYMEDICALCENTER.ORG | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Average Negotiated Rates | Yes (X) | AverageNegotiatedRatesInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| AMERY REGIONAL MEDICAL CENTER, INC. | PART V, SECTION B, LINE 5: AS A PART OF COUNTY-WIDE ASSESSMENTS, SURVEYS AND LISTENING SESSIONS INCLUDED:1. STATE, LOCAL, TRIBAL, OR REGIONAL GOVERNMENTAL PUBLIC HEALTH DEPARTMENT(OR EQUIVALENT DEPARTMENT OR AGENCY) WITH KNOWLEDGE, INFORMATION, OREXPERTISE RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY (THE POLK COUNTY 2020 COMMUNITY HEALTH IMPROVEMENT PLAN, CONDUCTED IN COLLABORATION WITH THE POLK COUNTY HEALTH DEPARTMENT).2. MEMBERS OF MEDICALLY UNDERSERVED, LOW ]INCOME, AND MINORITYPOPULATIONS IN THE COMMUNITY, OR INDIVIDUALS OR ORGANIZATIONS SERVING ORREPRESENTING THE INTERESTS OF SUCH POPULATIONS (COMMUNITY SURVEYS). |
| AMERY REGIONAL MEDICAL CENTER, INC. | PART V, SECTION B, LINE 6A: OTHER HOSPITAL FACILITIES INCLUDED IN THE 2015 HEALTHPARTNERS CHNA WERE:- HUDSON HOSPITAL, HUDSON, WI.- WESTFIELDS HOSPITAL, NEW RICHMOND, WI.- LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, STILLWATER, MN.- PARK NICOLLET METHODIST HOSPITAL, ST. LOUIS PARK, MN- REGIONS HOSPITAL, ST. PAUL, MN |
| AMERY REGIONAL MEDICAL CENTER, INC. | PART V, SECTION B, LINE 11: THE 2015 HEALTHPARTNERS CHNA CONDUCTED RESULTED IN THE FOLLOWING PRIORITIES:PRIORITY 1: INCREASE ACCESS TO MENTAL HEALTHPRIORITY 2: PROMOTE POSITIVE BEHAVIORS TO REDUCE OBESITY (NUTRITION / PHYSICAL ACTIVITY)PRIORITY 3: INCREASE ACCESS TO PRIMARY AND PREVENTIVE CAREPRIORITY 4: IMPROVE SERVICE INTEGRATIONPRIORITY 5: PROMOTE CHANGE IN UNHEALTHY LIFESTYLES (TOBACCO / ALCOHOL / SUBSTANCE ABUSE)A FULL REPORT OF ARMC'S 2015 CHNA AND ANNUAL IMPLEMENTATION PLAN UPDATE IS POSTED ON ARMC'S WEBPAGE AT WWW.AMERYMEDICALCENTER.ORG/COMMUNITY_HEALTH_NEEDS_ASSESSMENT.ASPX |
| AMERY REGIONAL MEDICAL CENTER, INC. | PART V, SECTION B, LINE 22D: THE HOSPITAL DETERMINES AGB% (THE MAXIMUM AMOUNTS CHARGED) USING THE "LOOKBACK METHOD" SET FORTH IN FEDERAL REGULATIONS, WHEREBY THE HOSPITAL DIVIDES THE SUM OF ALL ITS CLAIMS FOR MEDICALLY NECESSARY CARE ALLOWED BY HEALTH INSURERS DURING A PRIOR 12 MONTH PERIOD BY THE SUM OF THE ASSOCIATED GROSS CHARGES FOR THOSE CLAIMS. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 6 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - ARMC REHAB SERVICES | ||||
| 220 N KELLER AVENUE | AMERY | WI | 54001 | REHABILITATION |
| 2 - LUCK MEDICAL CLINIC | ||||
| 137 FIRST AVENUE | LUCK | WI | 54853 | RURAL HEALTH CLINIC |
| 3 - TURTLE LAKE MEDICAL CLINIC | ||||
| 550 MARTIN AVENUE | TURTLE LAKE | WI | 54889 | RURAL HEALTH CLINIC |
| 4 - CLEAR LAKE CLINIC | ||||
| 357 THIRD AVENUE | CLEAR LAKE | WI | 54005 | RURAL HEALTH CLINIC |
| 5 - LUCK PT & FITNESS | ||||
| 2547 STATE ROAD 35 SUITE 5 | LUCK | WI | 54853 | PHYSICAL THERAPY |
| 6 - AMERY REGIONAL MEDICAL CENTER WEST | ||||
| 230 DERONDA STREET | AMERY | WI | 54001 | 10 BED INPATIENT DPU OF AMERY |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART III, LINE 2: | ARMC USES A COST TO CHARGE METHODOLOGY. |
| PART III, LINE 3: | ARMC USES THE COST TO CHARGE METHODOLOGY TO DETERMINE AMOUNT REPORTED AS BAD DEBT. ARMC BELIEVES THAT MANY OF THE ACCOUNTS IN BAD DEBT WOULD HAVE QUALIFIED FOR CHARITY IF THE GUARANTORS WOULD HAVE COMPLETED THE FINANCIAL ASSISTANCE PAPERWORK. ARMC IS PROVIDING SERVICES TO INDIVIDUALS/FAMILIES IN ITS SERVICE AREA THAT ARE UNABLE/UNWILLING TO PAY FOR THESE SERVICES. THIS IS COMPARABLE TO PROVIDING CHARITY CARE WHICH ARMC ALSO INCLUDES AS A COMMUNITY BENEFIT. |
| PART III, LINE 4: | ALLOWANCE FOR DOUBTFUL ACCOUNTS AND CHARITY CARE: THE FINANCIAL STATEMENTS DO NOT HAVE A SEPARATE BAD DEBT FOOTNOTE. THE FOLLOWING IS PART OF ARMC'S PATIENT ACCOUNTS RECEIVABLE AND CREDIT POLICY:ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS OR CHARITY CARE, BASED ON ESTABLISHED GUIDELINES FOR IDENTIFYING UNCOLLECTIBLE PATIENT ACCOUNTS AND CLASSIFYING THESE ACCOUNTS AS EITHER DOUBTFUL ACCOUNTS OR CHARITY. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, ARMC'S MANAGEMENT PERIODICALLY ASSESSES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND CHARITY CARE BY TAKING INTO CONSIDERATION BY PAYER CATEGORY, THE EXPECTED NET COLLECTIONS, ACCOUNTS RECEIVABLE AGING, HISTORICAL COLLECTIONS EXPERIENCE, ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. THE PRIMARY SOURCE OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS THE PATIENT RESPONSIBILITY PORTION OF COMMERCIAL ACCOUNTS. THE PRIMARY SOURCE OF THE ALLOWANCE FOR CHARITY CARE IS CHARGES FOR UNINSURED PATIENTS. PATIENTS WHO ARE INSURED ARE ASSESSED SEPARATELY FOR COLLECTABILITY FROM UNINSURED PATIENTS. THE RESULTS OF THESE ASSESSMENTS ARE USED TO ESTABLISH THE NET REALIZABLE VALUE OF PATIENT ACCOUNTS RECEIVABLE AND THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND CHARITY CARE. ARMC PROVIDED MEDICAL CARE WITHOUT CHARGE OR A REDUCED COST TO PATIENTS WHO WERE DETERMINED TO BE UNABLE TO PAY (CHARITY CARE) OF $695,683 AND $778,638 FOR THE YEARS ENDED 12/31/15 AND 12/31/14 RESPECTIVELY, AND PROVIDED MEDICAL CARE TO PATIENTS WHO WERE DETERMINED TO BE ABLE, BUT UNWILLING TO PAY (DOUBTFUL ACCOUNTS) OF $1,896,101 AND $2,289,688 FOR THE YEARS ENDED 12/31/15 AND 12/31/14 RESPECTIVELY. ACCORDINGLY, ARMC DOES NOT SEPARATE ALLOWANCE ACCOUNT FOR DOUBTFUL ACCOUNTS AND CHARITY CARE. |
| PART III, LINE 8: | THE COSTING METHODOLOGY USED IS COST TO CHARGE RATIO AS REQUIRED BY MEDICARE. THE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT BECAUSE ARMC IS INCURRING THE COST OF PROVIDING SERVICES TO MEDICARE PATIENTS AND NOT GETTING PAID COMPLETELY BY MEDICARE FOR THE COST OF PROVIDING THESE SERVICES. |
| PART III, LINE 9B: | ARMC IS COMMITTED TO MEETING THE HEALTHCARE NEEDS OF THE COMMUNITY. AS PART OF THIS MISSION, ARMC ADMINISTERS A FINANCIAL ASSISTANCE PROGRAM TO HELP PATIENTS WHO NEED MEDICAL CARE BUT HAVE DIFFICULTY WITH RELATED MEDICAL EXPENSES. IN ARMC FACILITIES, NON-ELECTIVE PROFESSIONAL MEDICAL SERVICES WILL BE PROVIDED WITHOUT REGARD TO THE PATIENT'S ABILITY TO PAY AND FINANCIAL ASSISTANCE WILL BE MADE AVAILABLE. PROGRAM ELIGIBILITY IS BASED ON INCOME, ASSETS, LIABILITIES, AND FAMILY SIZE UTILIZING A SLIDING DISCOUNT BASED ON THE LATEST HEALTH AND HUMAN/SERVICES (HHS) FEDERAL POVERTY GUIDELINES. PATIENTS IN NEED OF FINANCIAL ASSISTANCE ARE SENT AN APPLICATION AND FOLLOWED UP IN COORDINATION WITH THE HEALTH BENEFITS COUNSELOR. ARMC BELIEVES THAT MANY OF THE ACCOUNTS IN BAD DEBT WOULD HAVE QUALIFIED FOR CHARITY CARE IF THE GUARANTORS WOULD HAVE COMPLETED THE FINANCIAL ASSISTANCE PAPERWORK. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | WI |
| PART VI, LINE 2 | IN 2015, A COMPREHENSIVE, SIX-STEP COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") COLLABORATION WAS CONDUCTED FOR HEALTHPARTNERS AND ITS HOSPITALS (REGIONS HOSPITAL, LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION, HUDSON HOSPITAL, WESTFIELDS HOSPITAL, ARMC, AND PARK NICOLLET METHODIST HOSPITAL) BY COMMUNITY HOSPITAL CONSULTING TO DETERMINE THE GREATEST HEALTH NEEDS IN THE COMMUNITIES THEY SERVE. THESE HOSPITALS SERVE SIMILAR COMMUNITIES AND HAVE OVERLAPPING STUDY AREAS. THE STUDY AREA IS DEFINED AS DAKOTA, HENNEPIN, RAMSEY, SCOTT, AND WASHINGTON COUNTIES IN MINNESOTA AND POLK AND ST. CROIX COUNTIES IN WISCONSIN. ARMC'S SPECIFIC STUDY AREA IS DEFINED AS:- POLK COUNTYDATA ELEMENTS REGARDING ALL SEVEN COUNTIES IN THE STUDY AREA WERE INCLUDED IN THE REPORT FOR COMPARISON, AND WERE ALSO PROVIDED AS AN OPPORTUNITY FOR THE HOSPITALS TO WORK TOGETHER TO MEET THE NEEDS IDENTIFIED IN THE OVERLAPPING COUNTIES.- DEMOGRAPHICS: CHC CONSULTING ANALYZED THE MOST CURRENT DEMOGRAPHICS OF RESIDENTS IN POLK COUNTY, INCLUDING: OVERALL POPULATION, POPULATION BY RACE AND ETHNICITY, MEDIAN AGE, MEDIAN HOUSEHOLD INCOME, POVERTY LEVELS, FOOD INSECURITY, AND EDUCATIONAL ATTAINMENT.- HEALTH DATA COLLECTION: ARMC PARTICIPATED IN A COUNTY-WIDE INITIATIVE TO ANALYZE THE HEALTH OF RESIDENTS IN THE COMMUNITY, THE POLK COUNTY 2020 COMMUNITY HEALTH IMPROVEMENT PLAN VERSION 2014-2016.- COMMUNITY INPUT: AS A PART OF THE COUNTY-WIDE ASSESSMENT, SURVEYS WERE CONDUCTED TO GATHER INPUT FROM COMMUNITY RESIDENTS. IN ADDITION, ARMC CONDUCTED A COMMUNITY CONVERSATION ON AUGUST 20, 2015 TO GAIN INSIGHT SURROUNDING SIGNIFICANT HEALTH NEEDS.FINAL PRIORITIZED NEEDS - MENTAL AND BEHAVIORAL HEALTH - ACCESS AND AFFORDABILITY - CHRONIC DISEASE AND ILLNESS PREVENTION - EQUITABLE CAREA FULL REPORT OF ARMC'S CHNA AND IMPLEMENTATION PLAN IS POSTED ON ARMC'S WEBPAGE AT HTTP://WWW.AMERYMEDICALCENTER.ORG/COMMUNITY_HEALTH_NEEDS_ASSESSMENT.ASPX. |
| PART VI, LINE 3 | ARMC'S PATIENT FINANCIAL SERVICES DEPARTMENT WORKS WITH EACH PATIENT REGARDING ACCOUNT BALANCES LEFT TO PATIENT RESPONSIBILITY. PATIENTS THAT ARE NOT ALREADY ON GOVERNMENT ASSISTANCE OR HAVE LIMITED ASSISTANCE, ARE REFERRED TO ARMC'S HEALTH BENEFITS COUNSELOR, WHO WORKS WITH THEM TO EVALUATE ASSISTANCE OPTIONS AND ASSISTS IN GETTING APPLICATIONS OR CONTACTS WITH THE APPROPRIATE PROGRAMS. IF ADDITIONAL ASSISTANCE IS NEEDED, THE COUNSELOR WILL WORK WITH THE PATIENT TO APPLY FOR FINANCIAL ASSISTANCE WITH ARMC AND HELPS THEM THROUGH THE PROCESS. THE FINANCIAL ASSISTANCE PROGRAM AND APPLICATION ARE LOCATED ON THE ARMC'S INTERNET SITE TO ALLOW PATIENTS DIRECT ACCESS TO THIS INFORMATION. |
| PART VI, LINE 4 | THE AMERY REGIONAL MEDICAL CENTER (ARMC) SERVICE AREA INCLUDES FIFTEEN DIFFERENT ZIP CODES IN NORTHWEST WISCONSIN THAT PRIMARILY REPRESENT POLK COUNTY. IT INCLUDES THREE RURAL HEALTH CLINICS IN LUCK, TURTLE LAKE, & CLEAR LAKE WHICH ARE ALL MEDICALLY UNDERSERVED AREAS. THE ARMC COMMUNITY IS ALSO CONSIDERED A MENTAL HEALTH MEDICALLY UNDERSERVED AREA. THE WOUND CENTER & INPATIENT PSYCH SERVICE DRAWS PATIENTS FROM OUTSIDE ARMC'S NORMAL SERVICE AREA. |
| PART VI, LINE 5 | TEN OF ARMC'S THIRTEEN BOARD MEMBERS LIVE IN ARMC'S SERVICE AREA. ARMC HAS AN OPEN MEDICAL STAFF WHICH INCLUDES PROVIDERS FROM THE COMMUNITY, AND OTHER COMMUNITIES AS WELL AS THE TWIN CITIES. ANY SURPLUS FUNDS GENERATED ARE USED TO PURCHASE EQUIPMENT, BUILD NEW FACILITIES, AND EXPAND SERVICES AVAILABLE IN ARMC'S COMMUNITY. |
| PART VI, LINE 6 | HEALTHPARTNERS AND ARMC HAVE HAD A LONG-STANDING RELATIONSHIP, WITH HEALTHPARTNERS EMPLOYING AND SOURCING PHYSICIANS AND MID-LEVEL PRACTITIONERS TO ARMC FOR ARMC'S PRIMARY CARE CLINICS. AS OF 2014, ARMC BECAME PART OF THE HEALTHPARTNERS FAMILY OF MISSION-DRIVEN NON-PROFIT ORGANIZATIONS. AS PART OF THE HEALTHPARTNERS FAMILY, ARMC USES HEALTHPARTNERS' INTEGRATED ELECTRONIC HEALTH RECORD SYSTEM, PARTICIPATES IN COORDINATED CHNA PROCESSES AND IMPLEMENTATION STRATEGIES, ACCESSES CENTRALIZED SUPPORT SERVICES IN FINANCE, LEGAL, IS&T, AND QUALITY. THE FOUR HEALTHPARTNERS HOSPITALS IN THE ST. CROIX VALLEY - STILLWATER MN AND HUDSON, NEW RICHMOND, AND AMERY WI - WORK TOGETHER TO ESTABLISH ACCESSIBLE AND COORDINATED SPECIALTY SERVICES IN THE VALLEY FOR THE BENEFIT OF VALLEY RESIDENTS. EXAMPLES OF THESE SERVICES INCLUDE RADIATION THERAPY ON THE NEW RICHMOND CAMPUS, BREAST DIAGNOSTICS ON THE STILLWATER CAMPUS, AND GERIATRIC BEHAVIORAL HEALTH SERVICES ON THE ARMC CAMPUS. HEALTHPARTNERS INCLUDES INSURANCE AND HMO (HEALTH MAINTENANCE ORGANIZATION) ENTITIES THAT PROVIDE CARE COORDINATION, DISEASE MANAGEMENT, ON-LINE CARE FOR BASIC CONDITIONS, A 24 HOUR/7 DAY PER WEEK NURSE LINE, AND OTHER SERVICES THAT ENHANCE CARE FOR MEMBERS, PATIENTS AND THE COMMUNITY. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CITY OF AMERY | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 118 CENTER STREET | AddressLine1Txt |
| City | AMERY | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54001 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash Grant | $8,000 | CashGrantAmt |
| Purpose Of Grant | PROGRAM SUPPORT | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | AMERY REGIONAL MEDICAL CENTER, INC. (ARMC) MANAGEMENT STAFF REVIEW THE MISSION AND PURPOSE OF POTENTIAL GRANTEE ORGANIZATIONS TO ASSURE CONSISTENCY WITH ARMC'S MISSION AND PURPOSE. AMOUNTS SUBSEQUENTLY GRANTED ARE SUBJECT TO ARMC'S FORMAL SPENDING APPROVAL AND DOCUMENTATION PROCESS BASED ON AMOUNT OF THE EXPENDITURE. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (16 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JEFFREY J ROBERTSON | ||||||||||||||
| DIRECTOR | $0 | $261,718 | $0 | $500 | $0 | $281,373 | $0 | $5,300 | $0 | $32,518 | $0 | $581,409 | $0 | $0 |
| ROSS R BULLARD | ||||||||||||||
| DIRECTOR & TREASURER | $0 | $178,412 | $0 | $26,686 | $0 | $0 | $0 | $29,475 | $0 | $33,148 | $0 | $267,721 | $0 | $0 |
| NANCY MAGNINE PAC | ||||||||||||||
| DIRECTOR | $0 | $144,971 | $0 | $0 | $0 | $0 | $0 | $19,872 | $0 | $26,835 | $0 | $191,678 | $0 | $0 |
| MARTIN E RICHARDS MD | ||||||||||||||
| DIRECTOR | $0 | $437,652 | $0 | $5,000 | $0 | $3,082 | $0 | $19,875 | $0 | $38,791 | $0 | $504,400 | $0 | $0 |
| ANN SEAGREN MD | ||||||||||||||
| DIRECTOR | $0 | $222,064 | $0 | $0 | $0 | $0 | $0 | $35,049 | $0 | $34,315 | $0 | $291,428 | $0 | $0 |
| TED WEGLEITNER | ||||||||||||||
| DIRECTOR | $0 | $343,418 | $0 | $72,178 | $0 | $0 | $0 | $48,981 | $0 | $35,239 | $0 | $499,816 | $0 | $0 |
| GEHRIG WILLIAMSON MD | ||||||||||||||
| DIRECTOR | $0 | $171,038 | $0 | $0 | $0 | $0 | $0 | $13,208 | $0 | $34,457 | $0 | $218,703 | $0 | $0 |
| JASON J LUHRS | ||||||||||||||
| CFO | $0 | $161,855 | $0 | $14,335 | $0 | $0 | $0 | $13,261 | $0 | $28,592 | $0 | $218,043 | $0 | $0 |
| SANDRA M REED | ||||||||||||||
| VP - AMBULATORY CARE | $134,345 | $0 | $0 | $0 | $0 | $0 | $4,222 | $0 | $25,297 | $0 | $163,864 | $0 | $0 | $0 |
| DEBRA RUDQUIST | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $0 | $247,515 | $0 | $41,483 | $0 | $0 | $0 | $3,833 | $0 | $33,052 | $0 | $325,883 | $0 | $0 |
| JOYCE R SCHAEFER | ||||||||||||||
| VP-PATIENT CARE | $145,465 | $0 | $0 | $0 | $0 | $0 | $4,611 | $0 | $24,860 | $0 | $174,936 | $0 | $0 | $0 |
| PATRICK SURA MD | ||||||||||||||
| CHIEF MEDICAL OFFICER | $0 | $516,772 | $0 | $0 | $0 | $21,630 | $0 | $19,875 | $0 | $43,214 | $0 | $601,491 | $0 | $0 |
| MARK A TRYGGESTAD | ||||||||||||||
| DIRECTOR OF PHARMACY | $167,540 | $0 | $0 | $0 | $0 | $0 | $4,790 | $0 | $12,262 | $0 | $184,592 | $0 | $0 | $0 |
| J DANIEL NELSON MD | ||||||||||||||
| FORMER DIRECTOR | $0 | $486,198 | $0 | $30,000 | $0 | $0 | $0 | $73,636 | $0 | $42,147 | $0 | $631,981 | $0 | $0 |
| JAMES QUENAN MD | ||||||||||||||
| FORMER DIRECTOR | $0 | $109,553 | $0 | $8,867 | $0 | $4,710 | $0 | $19,990 | $0 | $13,229 | $0 | $156,349 | $0 | $0 |
| DYLAN COE MD | ||||||||||||||
| FORMER DIRECTOR | $0 | $259,366 | $0 | $0 | $0 | $1,781 | $0 | $54,852 | $0 | $20,820 | $0 | $336,819 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4B | FormAndLineReferenceDesc |
| Explanation | DEFERRED COMPENSATION IN COLUMN C OF SCHEDULE J, PART II INCLUDES AMOUNTS FROM A NONQUALIFIED 457(F) PLAN FOR THE FOLLOWING DIRECTOR: TED WEGLEITNER $29,106 | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|
| VILLAGE OF LUCK WISCONSIN | |||||||
| A | 396006307 | 2011-04-28 | $8,500,000 | REFINANCE EXISTING DEBT | 0 | 0 | 0 |
| CITY OF AMERY WISCONSIN | |||||||
| B | 396005378 | 2011-04-13 | $8,500,000 | REFINANCE EXISTING DEBT | 0 | 0 | 0 |
| VILLAGE OF CLEAR LAKE WISCONSIN | |||||||
| C | 396006238 | 2011-03-29 | $8,500,000 | REFINANCE EXISTING DEBT | 0 | 0 | 0 |
| TOWN OF BLACK BROOK POLK COUNTY WISCONSIN | |||||||
| D | 391169876 | 2011-05-13 | $6,150,000 | REFINANCE EXISTING DEBT | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Other Spent ProceedsOtherSpentProceedsAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|---|
| A | $1,004,319 | $8,500,000 | $170,000 | $8,330,000 | 2007 | Yes (1) | 0 | Yes (1) | Yes (1) |
| B | $1,004,319 | $8,500,000 | $170,000 | $8,330,000 | 2007 | Yes (1) | 0 | Yes (1) | Yes (1) |
| C | $1,004,319 | $8,500,000 | $170,000 | $8,330,000 | 2007 | Yes (1) | 0 | Yes (1) | Yes (1) |
| D | $730,298 | $6,150,000 | $123,000 | $6,027,000 | 2007 | Yes (1) | 0 | Yes (1) | Yes (1) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Private Bus Use By OthersPrivateBusUseByOthersPct | Total Private Business UseTotalPrivateBusinessUsePct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0.00060 | 0.00060 | Yes (1) | 0 | 0 |
| B | 0 | 0 | 0 | 0 | 0.00060 | 0.00060 | Yes (1) | 0 | 0 |
| C | 0 | 0 | 0 | 0 | 0.00060 | 0.00060 | Yes (1) | 0 | 0 |
| D | 0 | 0 | 0 | 0 | 0.00060 | 0.00060 | Yes (1) | 0 | 0 |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | Yes (1) | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 |
| B | 0 | Yes (1) | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 |
| C | 0 | Yes (1) | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 |
| D | 0 | Yes (1) | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 |
Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | 0 |
| B | 0 |
| C | 0 |
| D | 0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990, SCHEDULE K, PART IV, LINE 2A THRU 2C | FormAndLineReferenceDesc |
| Explanation | REBATE CALCULATION IS NOT DUE BUT EVERY 5 YEARS. THERE IS NO REBATE CACLULATION DUE FOR ANY BONDS LISTED IN SCHEDULE K, PART I. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TOWN OF LINCOLN POLK COUNTY WISCONSIN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 391406159 | BondIssuerEIN |
| Bond Issued | 2011-05-31 | BondIssuedDt |
| Issue Price | $6,150,000 | IssuePriceAmt |
| Purpose | REFINANCE EXISTING DEBT | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $730,298 | RetiredAmt |
| Total Proceeds | $6,150,000 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $123,000 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $1,709,792 | CapitalExpendituresAmt |
| Other Spent Proceeds | $4,317,208 | OtherSpentProceedsAmt |
| Substantial Completion | 2007 | SubstantialCompletionYr |
| Current Refunding | Yes (1) | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00060 | PrivateBusUseByOthersPct |
| Total Private Business Use | 0.00060 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | Yes (1) | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (1) | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | Yes (1) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 4A - EXEMPT PURPOSE AND ACHIEVEMENTS | CORPORATE STRUCTURE, PURPOSE, GOVERNANCE AMERY REGIONAL MEDICAL CENTER (ARMC), A STATE LICENSED 25-BED, LEVEL IV CRITICAL ACCESS HOSPITAL (CAH), IS A WISCONSIN NON-PROFIT CORPORATION RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE ("IRC") SECTION 501(C)(3) AND IS PART OF THE FAMILY OF HEALTHPARTNERS ORGANIZATIONS "HEALTHPARTNERS". FOUNDED IN 1957, HEALTHPARTNERS IS AN INTEGRATED SYSTEM OF HEALTH CARE DELIVERY AND HEALTH CARE FINANCING ORGANIZATIONS, AND IS ONE OF THE LARGEST CONSUMER-GOVERNED ORGANIZATIONS IN THE COUNTRY. HEALTHPARTNERS' MISSION IS TO IMPROVE HEALTH AND WELL-BEING IN PARTNERSHIP WITH OUR MEMBERS, PATIENTS AND COMMUNITY. HEALTHPARTNERS SEEKS TO TRANSFORM HEALTHCARE THROUGH A RELENTLESS FOCUS ON THE TRIPLE AIM - PROVIDING EXCEPTIONAL EXPERIENCE FOR THE INDIVIDUAL, IMPROVING THE HEALTH OF THE POPULATION, AND MAINTAINING AFFORDABILITY, ALL AT THE SAME TIME. HEALTHPARTNERS INCLUDES AN ARRAY OF TAX-EXEMPT AND TAXABLE ORGANIZATIONS WITH HEALTH CARE ACTIVITIES PRIMARILY OPERATING IN MINNESOTA AND WESTERN WISCONSIN. HEALTHPARTNERS PROVIDES A FULL-RANGE OF HEALTH CARE DELIVERY AND HEALTH PLAN SERVICES INCLUDING INSURANCE, PATIENT CARE, ADMINISTRATION AND HEALTH AND WELL-BEING PROGRAMS. HEALTHPARTNERS HEALTH PLAN'S SERVE MORE THAN 1.5 MILLION MEDICAL AND DENTAL MEMBERS NATIONWIDE. HEALTHPARTNERS MEDICAL CARE SYSTEM INCLUDES MORE THAN 1,700 PHYSICIANS, SIX HOSPITALS WITH OVER 1,000 ACUTE CARE BEDS, AND 93 PRIMARY AND SPECIALTY CARE MEDICAL FACILITIES WITH PRACTICES IN MINNESOTA AND WESTERN WISCONSIN. IN ADDITION, HEALTHPARTNERS DENTAL CARE SYSTEM HAS MORE THAN 60 DENTISTS AND 24 DENTAL CLINICS. HEALTHPARTNERS ALSO CONTRACTS WITH OTHER PRIMARY AND SPECIALTY MEDICAL FACILITIES AND DENTAL FACILITIES, PHYSICIAN GROUPS, HOSPITALS AND RELATED HEALTHCARE PROVIDERS LOCATED PRIMARILY IN MINNESOTA AND WESTERN WISCONSIN. HEALTHPARTNERS ALSO PROVIDES MEDICAL EDUCATION AND TRAINING TO MEDICAL PROFESSIONALS AND CONDUCTS RESEARCH AND FUND RAISING ACTIVITIES THAT SUPPORT THE HEALTH CARE DELIVERY SYSTEM. A COMPLETE LISTING OF ALL ORGANIZATIONS WITHIN THE HEALTHPARTNERS FAMILY, AND THE RELATIONSHIP BETWEEN THEM, CAN BE FOUND ON SCHEDULE R WITHIN THIS 990 RETURN. DETAILED INFORMATION ABOUT THE COMMUNITY BENEFIT ACTIVITIES AND ACCOMPLISHMENTS OF EACH TAX-EXEMPT ORGANIZATION CAN BE FOUND IN THE INDIVIDUAL FORM 990 RETURN FOR THAT ORGANIZATION. HEALTHPARTNERS IS DRIVING CHANGE THAT HELPS OUR MEMBERS AND PATIENTS LIVE HEALTHIER LIVES. HEALTHPARTNERS COLLABORATE WITH OTHER PLANS, CARE PROVIDERS AND OTHER COMMUNITY AND BUSINESS ORGANIZATIONS IN THE REGION AND THROUGHOUT THE NATION TO INCREASE ACCESS, CREATE AND SHARE QUALITY MEASURES AND INITIATIVES, PARTICIPATE IN DEVELOPMENT OF PUBLIC POLICY, AND COLLABORATE IN IMPROVEMENTS THAT SUPPORT THE TRIPLE AIM. AMONG HEALTHPARTNERS' SIGNATURE INITIATIVES CONTINUING IN 2015 ARE TOTAL COST OF CARE MEASUREMENTS (DEVELOPMENT OF A NATIONALLY RECOGNIZED METRIC, ENDORSED BY THE NATIONAL QUALITY FORUM, ENABLING MEASUREMENT AND INCENTIVES BASED ON COORDINATION AND EVIDENCE-BASED PRACTICES), MENTAL HEALTH (REDUCING STIGMA, AND ASSURING ACCESS TO HIGH QUALITY CARE IN THE MOST APPROPRIATE SETTINGS), CHILDREN'S HEALTH (IMPROVING CHILD HEALTH BY PROMOTING EARLY BRAIN DEVELOPMENT, PROVIDING FAMILY CENTERED CARE, AND STRENGTHENING COMMUNITIES), AND SUSTAINABILITY (ENERGY EFFICIENCY, WASTE REDUCTION, AND RESOURCE MANAGEMENT). HEALTHPARTNERS, INC. (HPI) IS THE PARENT ENTITY OF HEALTHPARTNERS AND IS A MINNESOTA NON-PROFIT CORPORATION AND LICENSED HEALTH MAINTENANCE ORGANIZATION (HMO) RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(4). HPI IS THE SOLE CORPORATE MEMBER OF HPI-RAMSEY, A MINNESOTA NON-PROFIT CORPORATION RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). IN TURN, HPI-RAMSEY IS THE SOLE CORPORATE MEMBER OF REGIONS HOSPITAL, REGIONS HOSPITAL FOUNDATION, CAPITOL VIEW TRANSITIONAL CARE CENTER, STILLWATER HEALTH SYSTEM (LAKEVIEW HEALTH), RAMSEY INTEGRATED HEALTH SERVICES AND RH-WISCONSIN, INC., ALL OF WHICH ARE NON-PROFIT CORPORATIONS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). RH-WISCONSIN AND GROUP HEALTH PLAN, INC. (GHI) ARE CORPORATE MEMBERS OF ARMC. GHI IS A MINNESOTA NON-PROFIT CORPORATION AND LICENSED HEALTH MAINTENANCE ORGANIZATION (HMO) RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). IN TURN, ARMC IS THE SOLE CORPORATE MEMBER OF THE AMERY REGIONAL MEDICAL CENTER FOUNDATION (FOUNDATION) A WISCONSIN NON-STOCK CORPORATION EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(3). BENEFIT TO THE COMMUNITY: 1. COMMUNITY HEALTH SERVICES: $356,640 - COMMUNITY HEALTH EDUCATION - ARMC HELPS EDUCATE THE LOCAL COMMUNITIES IN REGARDS TO HEALTH ISSUES BY PROVIDING THE FOLLOWING TYPES OF COMMUNITY EDUCATION: BREASTFEEDING, CPR, CARDIAC SUPPORT, DIABETES, EXPECTANT PARENTS/PRE-NATAL, HEALTH FAIRS, NUTRITION COUNSELING, SMOKING CESSATION, WOUND HEALING, AND SPORTS MEDICINE. ARMC ALSO WORKS CLOSELY WITH LOCAL AND COUNTY REPRESENTATIVES TO INFORM THE COMMUNITY ABOUT GOVERNMENTAL BENEFITS AND PROGRAMS AVAILABLE. ARMC PROVIDES EDUCATION AT OUR SCHOOLS BY HOLDING A 3RD GRADE HEALTH FAIR REACHING 215 STUDENTS FROM AMERY, CLEAR LAKE, CLAYTON, AND TURTLE LAKE. ARMC ALSO PROVIDED EDUCATION FOR EARLY CHILDHOOD DEVELOPMENT TARGETING PRE-K, ADOLESCENT SEXUALITY CLASSES AT AMERY SCHOOLS, SEX-EDUCATION CLASSES WERE OFFERED TO AMERY 8TH GRADE GIRLS AND MEDICAL PROFESSIONAL SPEAKERS AT CAREER DAY FOR HIGH SCHOOL STUDENTS. ARMC ALSO PARTICIPATED IN SHADOW TRAINING FOR HIGH SCHOOL STUDENTS WHO ARE INTERESTED IN PURSUING HEALTH CARE AS A CAREER. - COMMUNITY-BASED CLINICAL SERVICES - $3,631 ARMC HOSTED TWO BLOOD DRIVES COLLECTING A TOTAL OF 49 PINTS IN SUPPORT OF THE AMERICAN RED CROSS. BEHAVIORAL HEALTH SCREENED 20 TEENS FOR DEPRESSION AT THE AMERY AND CLAYTON HIGH SCHOOL ARMC CONDUCTED FREE BLOOD PRESSURE CHECKS FOR 2015 AT A COST OF $ 272 ( 3 HEALTH FAIRS TOTALING 12 HRS OF STAFF TIME) AND ALSO PROVIDED OVER 1,800 FREE BLOOD PRESSURE CHECKS AT OUR CLINICS. - HEALTH CARE SUPPORT SERVICES - $ 205,004 ARMC'S PATIENT EMERGENCY FUND, SUPPORTED BY EMPLOYEES AND STAFF, DONATED $ 252 TO HELP 8 INDIVIDUALS RECEIVING CARE AT ARMC IN 2015. FUNDS PROVIDED TO INDIVIDUALS WERE FOR EMERGENT NEEDS RELATED TO THEIR HEALTH INCLUDING EMERGENCY MEDICATIONS AND GAS CARDS. ARMC OPERATES A FITNESS CENTER IN AMERY AND LUCK TO MEET THE WELLNESS NEEDS OF THE COMMUNITIES. THIS SERVICE OPERATES AT A LOSS OF $ 99,291. SOCIAL WORKER, HEALTH BENEFIT COUNSELORS, AND PATIENT FINANCIAL SERVICES REPRESENTATIVES PROVIDE HEALTH CARE SUPPORT SERVICES TO INDIVIDUALS ON A ONE-ON-ONE BASIS. THESE STAFF MEMBERS HELP EDUCATE AND ASSIST INDIVIDUALS WITH ADVANCE DIRECTIVE SUPPORT, INFORMATION AND REFERRAL SERVICES, ENROLLMENT ASSISTANCE IN GOVERNMENT PROGRAMS, FINDING OTHER SOURCES OF PAYMENT, AND ACCESSING SERVICES BEYOND MEDICAL CARE. ARMC SPENT $ 93,728 IN STAFF TIME TO ASSIST 92 PATIENTS TO ENROLL IN PUBLIC MEDICAL PROGRAMS, 14 PATIENTS TO FREE DRUG PROGRAMS, REFER INDIVIDUALS TO COMMUNITY SERVICES/PUBLIC HEALTH ASSISTANCE AND HELP 227 PATIENTS WITH FINANCIAL ASSISTANCE. ARMC OPERATES A VAN TRANSPORTATION SERVICE FOR ITS RURAL PATIENT POPULATION. PATIENTS WHO ARE UNABLE TO ARRANGE THEIR OWN TRANSPORTATION TO ARMC FOR CARE AND TREATMENT MAY SCHEDULE A TRANSPORT. PERSONS WHO USE THE SERVICE ARE ASKED TO PAY $2.00 PER RIDE. OVER 1,300 PATIENTS USED THIS SERVICE IN 2015, WITH REVENUE OF 2,654 AND OPERATING COST OF $ 57,585. 2. HEALTH PROFESSIONAL EDUCATION: $ 7,047 STUDENTS IN NURSING, PHYSICIAN ASSISTANT PROGRAMS, PHYSICAL THERAPY, RADIOLOGIC TECHNOLOGY, (CHIPPEWA VALLEY TECHNICAL COLLEGE), MEDICAL RECORDS, MEDICAL ASSISTANT, LAB TECHNICIAN, NURSE PRACTITIONERS, AND MEDICAL ADMINISTRATIVE ASSISTANTS, ANESTHESIOLOGY, AND DIETITIANS STUDY AT ARMC. WEEKLY MEDICAL CONFERENCES ARE OFFERED BY ARMC MEDICAL STAFF PRESENTING CASES AND EDUCATIONAL TOPICS TO VARIOUS STAFF. ARMC ALSO HAS AN AGREEMENT WITH UW MADISON FOR 4TH YEAR MEDICAL STUDENTS AND UM-DULUTH FOR FIRST YEAR AND SECOND YEAR MEDICAL STUDENT ROTATIONS. IN ADDITION, ARMC ACTIVELY COLLABORATES WITH THE WISCONSIN INDIANHEAD TECHNICAL COLLEGE (WITC) TO HELP EDUCATE AND TRAIN YOUNG NURSES. FOR THE YEAR 2015, ARMC PROVIDED CLINICAL TRAINING FOR 47 NURSES, 7 MED STUDENTS, 1 LAB TECHNICIAN, 3 DIAGNOSTIC TECHNICIAN STUDENTS, 6 PHARMACISTS, 7 MEDICAL ADMINISTRATIVE ASSISTANTS, 5 CRNA'S, 17 THERAPISTS, 1 DIETITIAN, 2 NURSE MIDWIFES, 2 MEDICAL ASSISTANTS, AND 9 BEHAVIORAL HEALTH/PSYCH STUDENTS TOTALING 8,515 HOURS. EACH YEAR ARMC AND THE FOUNDATION PROVIDE SEVEN $1,000 SCHOLARSHIPS TO LOCAL HIGH SCHOOL SENIORS PURSUING A CAREER IN A HEALTH-RELATED FIELD. ARMC'S SHARE OF THE COST WAS $3,500. |
| FORM 990, PART III, LINE 4A | 3. SUBSIDIZED HEALTH SERVICES: ARMC IS COMMITTED TO SERVING OUR COMMUNITIES AND PROVIDING NEEDED SERVICES EVEN IF A FINANCIAL LOSS IS REALIZED. 4. FINANCIAL CONTRIBUTIONS: $65,231 - CASH DONATIONS - ARMC HELPED VARIOUS NON-PROFIT ORGANIZATIONS, COMMUNITY GROUPS, AND SCHOOL PROGRAMS THROUGH CASH DONATIONS TOTALING $ 34,685. - IN-KIND DONATIONS - IN-KIND SERVICES DONATED INCLUDED STAFF HOURS ( 375 HOURS $ 26,916) SPENT IN SUPPORT OF LOCAL COMMUNITY BOARDS OR COMMITTEE WORK (UNITED WAY OF ST. CROIX VALLEY), WITC HEALTH INFORMATION TECHNOLOGY, NATIONAL ALLIANCE ON MENTAL ILLNESS (NAMI) AND MENTAL HEALTH TASK FORCE, AMERY COMMUNITY CLUB, AMERY ECONOMIC DEVELOPMENT, LAKE WAPO/ BT SANITARY DISTRICT COMMISSIONER, AMERY FOOTBALL, POLK COUNTY COMMUNITY HEALTH TASK FORCE, ST. CROIX VALLEY FAMILY RESOURCE CENTER WITC PROGRAM REVIEW COMMITTEE AND ADVISORY COMMITTEE FOR MEDICAL ASSISTANTS, WITC OFFICE OF ADMINISTRATIVE SPECIALIST ADVISORY. ARMC IS ALSO A STRONG ADVOCATE AND MEMBER OF THE ST. CROIX VALLEY SART (SEXUAL ASSAULT RESPONSE TEAM), WHICH FORMED IN ORDER TO HELP THOSE WHO HAVE EXPERIENCED ACUTE RAPE TRAUMA OR DOMESTIC ABUSE. - EXPENSES ABSORBED BY ARMC WHEN PROVIDING MEETING SPACE FOR NON-PROFIT AND COMMUNITY GROUPS LIKE THE AMERICAN CANCER SOCIETY-AMERY, CAREGIVERS SUPPORT GROUP OF POLK COUNTY, GIRL SCOUT LEADERSHIP, BABY & ME-FAMILY RESOURCE CENTER OF ST. CROIX VALLEY, AND CLAYTON AREA 4H CLUB TOTALED $ 1,485. - SPONSORSHIP ACTIVITIES/EVENTS - ARMC SPONSORS EVENTS SUCH AS THE AMERICAN CANCER SOCIETY WALK/RUN ($5000) IN AMERY, LUCK AND FREDERIC; ALZHEIMER'S GREAT WALK IN AMERY ($2500); AMERY FALL FESTIVAL ($2000), CLEAR LAKE HERITAGE DAYS COMMUNITY EVENT ($1500) AND AMERY AREA COMMUNITY CENTER EVENTS ($300) TOTALING $11,300. 5. COMMUNITY BUILDING ACTIVITIES: $ 108,051 ARMC REACHES OUT TO PEOPLE AND COMMUNITIES THROUGHOUT POLK COUNTY, PARTS OF BARRON, BURNETT, AND ST. CROIX COUNTIES AND IS AN INVOLVED MEMBER IN LOCAL AND STATE COMMUNITIES. ARMC'S CONCERN FOR THE GROWTH AND DEVELOPMENT OF THE SURROUNDING COMMUNITIES AS WELL AS INDIVIDUAL WELFARE IS DEMONSTRATED BY PROVIDING EDUCATION AND RESOURCES TO ENCOURAGE POSITIVE COMMUNITY RELATIONS AND IMPROVE THE HEALTH OF ITS LOCAL COMMUNITIES. IMPLEMENTATION OF VARIOUS PROGRAMS IS SPECIFICALLY INTENDED TO IMPROVE THE QUALITY OF LIFE IN THE COMMUNITIES WE SERVE. ARMC PARTICIPATED IN COMMUNITY-BUILDING ACTIVITIES THAT SUPPORTED CHILDREN'S SAFETY, DRUG AWARENESS, ECONOMIC DEVELOPMENT, EMERGENCY PREPAREDNESS, WORK-FORCE DEVELOPMENT, LOCAL ARTISTS (COMMUNITY ART WALL/ART CASE), FITNESS AND HEALTH IN SCHOOLS, RADIO HEALTH EDUCATION PROGRAMS, HEALTH FAIRS, LOCAL FOOD SHELF, AND ADOPT-A-FAMILY PROGRAM FOR FAMILIES IN NEED. PARTNERSHIPS WITH SCHOOLS, CHURCHES AND OTHER ORGANIZATIONS MAKE MANY OF THESE PROGRAMS POSSIBLE. IN ORDER TO HELP COMBAT POVERTY, ARMC PROVIDES THE LOCAL FOOD SHELF, AMERY AREA FOOD SHELF, WITH FREE RENT, HEAT AND SHELVING FOR FOOD ITEMS. IN 2015, A TOTAL OF $ 46,793 WAS PROVIDED TO THIS LOCAL PROGRAM. ARMC CONTINUES TO BE ECO-FRIENDLY AND ENVIRONMENTALLY CONSCIOUS USING SUSTAINABLE INITIATIVES THAT ENSURE THE COMMUNITY'S HEALTH AND WELL-BEING. FROM RECYCLING PROGRAMS TO SUPPORT OF LOCAL GROWN ORGANIC PRODUCE TO THE DESIGN OF ARMC, ARMC EFFORTS ENCOURAGE HEALTHY LIFE CHOICES THROUGHOUT THE COMMUNITY. ENVIRONMENTAL-FRIENDLY ELEMENTS FOUND ON THE GROUNDS OF ARMC INCLUDE LANDSCAPING FOR WILDLIFE AND WATER QUALITY, RAIN GARDENS, GREEN ROOFS, PERVIOUS SURFACES, AND A COMMUNITY WALKING PATH WHICH ENHANCE THE VALUE OF THE NATURAL RESOURCES AND CONTRIBUTES TO THE HEALTH OF THE COMMUNITY. 6. COMMUNITY BENEFIT OPERATIONS: $ 2,171 ARMC HAS WORKED CLOSELY WITH POLK COUNTY AND OTHER AREA MEDICAL FACILITIES TO GATHER DATA AND COSTS ASSOCIATED WITH THE COMMUNITY HEALTH NEEDS ASSESSMENT, AS WELL AS OTHER COSTS ASSOCIATED WITH COMMUNITY BENEFIT STRATEGY AND OPERATIONS. DEDICATED STAFF TIME, RESOURCES, AND OTHER COSTS INVOLVED IN THE REPORTING OF THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR 2015 TOTAL $ 2,171. PLEASE REFER TO FORM 990 SCHEDULE H NARRATIVE IN THIS REPORT FOR MORE DETAIL. 7. ORGANIZATION AWARDS AND ACHIEVEMENTS PRACTICE GREEN HEALTH AWARD - NORTH AMERICAN AWARD GREEN PROFESSIONAL AWARD FROM THE WISCONSIN SUSTAINABLE BUSINESS COUNCIL FREEDOM AWARD FOR SERVICE MEMBERS TOP PERFORMER IN UCARE'S PAY FOR PERFORMANCE PROGRAM - RECOGNIZED FOR PERFORMANCE PROGRAM RESULTS, OUTSTANDING QUALITY OF DISABILITY CARE AND CULTURAL COMPETENCY. |
| FORM 990, PART VI, SECTION A, LINE 6 | RH WISCONSIN, INC. IS THE CLASS A MEMBER AND GHI IS THE CLASS B MEMBER OF ARMC. |
| FORM 990, PART VI, SECTION A, LINE 7A | ARMC'S BOARD OF DIRECTORS IS COMPRISED OF NOT MORE THAN 13 PERSONS APPOINTED AS FOLLOWS: - 7 COMMUNITY REPRESENTATIVES APPOINTED BY THE CLASS A MEMBER (RH-WISCONSIN), FROM RECOMMENDATIONS BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. - 3 REPRESENTATIVES APPOINTED BY THE CLASS B MEMBER (GHI). - 3 HEALTH CARE PROVIDERS NOMINATED BY THE PHYSICIAN GROUP STAFFING ARMC'S PRIMARY CARE CLINIC, AND APPOINTED BY THE CLASS B MEMBER (GHI). - THE PRESIDENT AND CHIEF MEDICAL OFFICER OF ARMC SIT IN EX-OFFICIO CAPACITIES, WITHOUT THE RIGHT TO VOTE. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE CLASS A AND CLASS B MEMBERS (RH WISCONSIN, INC. AND GHI RESPECTIVELY) BOTH MUST APPROVE THE DECISIONS OF THE BOARD OF DIRECTORS AS FOLLOWS: - AMENDMENT OF ARTICLES OR BYLAWS IMPACTING MEMBERSHIP - RESIGNATION OF A MEMBER - DISSOLUTION - ANY CHANGE IN THE FUNDAMENTAL NATURE OR PURPOSE - MERGER OR CONSOLIDATION WITH ANOTHER CORPORATION - DISPOSITION OF SUBSTANTIALLY ALL ASSETS. ONLY THE CLASS A MEMBER MUST APPROVE THE DECISIONS OF THE BOARD OF DIRECTORS AS FOLLOWS: - AMENDMENT OF ARTICLES OR BYLAWS NOT IMPACTING MEMBERSHIP - ANNUAL OPERATING AND CAPITAL BUDGETS AND STRATEGIC PLANS - ESTABLISHMENT OF NEW ENTITIES OR SIGNIFICANT RELATIONSHIPS WITH OTHER ENTITIES - UNBUDGETED EXPENDITURES IN EXCESS OF AMOUNTS ESTABLISHED BY THE MEMBER - GUARANTEEING THE DEBT OF ANY OTHER PERSON OR ENTITY - A LOAN OR OTHER INDEBTEDNESS IN EXCESS OF AMOUNTS ESTABLISHED BY THE MEMBER - TRANSFER OF ASSETS TO ANOTHER ENTITY - APPOINTMENT OF THE PRESIDENT AND THE BOARD CHAIR. |
| FORM 990, PART VI, SECTION B, LINE 11 | ARMC'S 990 RETURN HAS A COMPREHENSIVE REVIEW PROCESS THAT IS FOLLOWED BEFORE IT IS PRESENTED TO THE GOVERNING BODY OF ARMC. THE REVIEW PROCESS INCLUDES A LAYERED REVIEW BY THE TAX DEPARTMENT OF GROUP HEALTH PLAN, INC. (GHI), THE MANAGEMENT TEAM OF ARMC, GHI'S INTERNAL LEGAL DEPARTMENT AND ARMC'S OUTSIDE INDEPENDENT ACCOUNTANTS. EACH ONE OF THOSE AREAS HAS AN OPPORTUNITY TO REVIEW, ASK QUESTIONS AND MAKE COMMENTS BACK TO THE TAX DEPARTMENT OF GHI BEFORE THE FORM 990 IS COMPLETED AND PRESENTED TO THE GOVERNING BODY OF ARMC. ARMC MAKES AVAILABLE TO THE GOVERNING BODY (BOARD OF DIRECTORS) A COPY OF THE 990 FOR REVIEW AND COMMENT PRIOR TO THE FILING OF THE 990 RETURN. THIS COPY WILL BE PROVIDED IN A MAILING TO THE BOARD MEMBERS PRIOR TO THE FILING OF THE 990. THIS COPY IS PROVIDED IN A PRE-MEETING PACKET, AND IS AN AGENDA ITEM AT A MEETING OF THE FULL BOARD OF DIRECTORS. THIS PROCESS IS NOTED AND DOCUMENTED IN THE WRITTEN MINUTES OF THE MEETING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ARMC BOARD OF DIRECTORS MONITORS POTENTIAL CONFLICTS OF INTEREST OF ITS BOARD MEMBERS, OFFICERS AND KEY EMPLOYEES, BY MAINTAINING A CONFLICT OF INTEREST POLICY. ANNUALLY, UNDER THE POLICY, ALL BOARD MEMBERS, PRINCIPAL OFFICERS, MEMBERS OF A COMMITTEE WITH BOARD DELEGATED POWERS AND KEY EMPLOYEES ARE PROVIDED WITH A COPY OF THE POLICY AND REQUESTED TO COMPLETE A QUESTIONNAIRE IDENTIFYING ANY POTENTIAL CONFLICTS OF INTERESTS. A REPORT OF THESE POTENTIAL CONFLICTS IS SHARED WITH THE CHAIR AND THE CEO. BOARD AGENDAS AND EXECUTIVE DECISIONS ARE DOCUMENTED IN RELATION TO THIS POLICY. |
| FORM 990, PART VI, SECTION B, LINE 15 | ARMC'S CEO AND ITS OFFICERS ARE EMPLOYED BY REGIONS HOSPITAL (REGIONS) OR BY GROUP HEALTH PLAN, INC. (GHI), BOTH OF WHICH ARE RELATED ORGANIZATIONS, OR BY ARMC. GHI, REGIONS, AND ARMC HAVE AN ANNUAL PROCESS TO REVIEW THE MARKET COMPARABILITY OF THE TOTAL COMPENSATION OF ARMC'S CEO AND OTHER OFFICERS. EVERY THREE YEARS, THE INDEPENDENT COMPENSATION COMMITTEE OF THE GHI BOARD OF DIRECTORS (THE "COMMITTEE"), RETAINS AN EXTERNAL COMPENSATION EXPERT TO CONDUCT AN EXTENSIVE MARKET COMPARABILITY REVIEW FOR ALL OFFICERS OF THE ORGANIZATION. THE REVIEW INCLUDES ALL COMPONENTS OF TOTAL COMPENSATION: BASE SALARY, ANNUAL INCENTIVES, BENEFITS AND PERQUISITES. THE MARKET SURVEY RESULTS ARE PRESENTED TO, REVIEWED BY AND APPROVED BY THE APPROPRIATE COMMITTEE. BASED ON THIS DATA, EITHER THE EXECUTIVE COMMITTEE OF REGIONS, THE COMPENSATION COMMITTEE OF GHI OR THE ARMC EXECUTIVE COMMITTEE (THE "COMMITTEES") DETERMINE MINIMUM AND MAXIMUM TOTAL COMPENSATION RANGES FOR EACH EMPLOYED OFFICER. IN INTERIM YEARS, GHI'S HUMAN RESOURCES STAFF, UNDER THE COMMITTEES' DIRECTION, UPDATES CHANGES IN THE SALARY STRUCTURE BASED ON THE SAME INDEPENDENT STUDIES PERFORMED BY THE COMPENSATION CONSULTANT FOR THE COMMITTEE. FOR CERTAIN POSITIONS FULL INDEPENDENT REVIEWS ARE PERFORMED TO SET SALARY RANGES BASED ON THE COMPETITIVE MARKET DATA SPECIFIC TO THOSE POSITIONS. THE COMMITTEES REVIEW AND APPROVE EACH YEAR'S COMPENSATION RESULTS. IN ALL CASES, THE COMMITTEES' MEMBERS COMPLETE AN ANNUAL CONFLICT OF INTEREST SURVEY TO ASSURE THE COMMITTEES MEMBERS' INDEPENDENCE AND THIS IS UPDATED AT ANY MEETING AT WHICH DECISIONS ARE BEING MADE. STAFF (OTHER THAN THE SECRETARY TO THE BOARD) IS NOT IN THE ROOM DURING DELIBERATIONS OR VOTE INCLUDING EXECUTIVE SESSIONS, AND CONTEMPORANEOUS MINUTES ARE KEPT. WITH ARMC'S BOARD OF DIRECTORS INPUT, THE ST CROIX VALLEY EXECUTIVE LEADER CONDUCTS THE ANNUAL PERFORMANCE REVIEW AND, WITH ARMC'S BOARD APPROVAL, DETERMINES THE COMPENSATION OF THE ARMC CEO. THE ARMC BOARD HAS DELEGATED TO THE CEO THE ACCOUNTABILITY TO CONDUCT ANNUAL PERFORMANCE REVIEWS AND DETERMINE THE COMPENSATION OF ALL ARMC-EMPLOYED OFFICERS WITHIN THE COMPENSATION RANGES DETERMINED BY THE COMMITTEE. ANY EXCEPTIONS TO COMPENSATION IN EXCESS OF THE APPROVED RANGES ARE APPROVED BY THE ARMC EXECUTIVE COMMITTEE. TOTAL COMPENSATION IS APPROPRIATELY DOCUMENTED ON THE FORM 990 AND ON THE EMPLOYEE'S W-2. |
| FORM 990, PART VI, SECTION C, LINE 18 | ARMC 990 RETURNS ARE MADE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION FROM ARMC OR HEALTHPARTNERS, INC. |
| FORM 990, PART VI, SECTION C, LINE 19 | ARMC MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| 990, PART VII, SEC A, LN 1A, COL (B) - RELATED ORGANIZATION AVERAGE HOURS | DIRECTORS AND OFFICERS OF ARMC ARE EMPLOYED AND COMPENSATED BY GHI, INC., REGIONS HOSPITAL OR ARMC. REPORTED AVERAGE HOURS WORKED ARE BASED ON THEIR TOTAL COMPENSATION FROM ALL RELATED ORGANIZATIONS. |
| FORM 990, PART XI, LINE 9: | FIXED ASSET VALUATION ADJUSTMENT -45,000. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (28 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| HEALTHPARTNERS INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411693838 | HYBRID STAFF MODEL/NETWORK MODEL HEALTH MAINTENANCE ORGANIZATION | MN | 501(C)(4) | N/A | 0 | ||
| HPI - RAMSEY | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411793333 | CORPORATE PLANNING AND OVERSIGHT | MN | 501(C)(3) | 0 | 509(A)(3) TYPE I | HEALTHPARTNERS INC | |
| GROUP HEALTH PLAN INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 410797853 | STAFF MODEL HEALTH MAINTENANCE ORGANIZATION | MN | 501(C)(3) | 0 | 170(B)(1) (A)(III) | HEALTHPARTNERS INC | |
| HEALTHPARTNERS INSTITUTE FOR EDUCATION AND RESEARCH | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411670163 | HEALTHCARE EDUCATION & RESEARCH | MN | 501(C)(3) | 0 | 509(A)(3) TYPE I | HEALTHPARTNERS INC | |
| CAPITOL VIEW TRANSITIONAL CARE CENTER | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 412011453 | POST HOSPITALIZATION PATIENT CARE | MN | 501(C)(3) | 0 | 170(B)(1) (A)(III) | HPI - RAMSEY | |
| REGIONS HOSPITAL | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 410956618 | HOSPITAL | MN | 501(C)(3) | 0 | 170(B)(1) (A)(III) | HPI - RAMSEY | |
| REGIONS HOSPITAL FOUNDATION | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411888902 | PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT | MN | 501(C)(3) | 0 | 170(B)(1) (A)(VI) | HPI - RAMSEY | |
| RHSC INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411891928 | HEALTHCARE STAFFING | MN | 501(C)(3) | 0 | 509(A)(3) TYPE II | HEALTHPARTNERS INC | |
| RH-WISCONSIN | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 202287016 | CORPORATE PLANNING AND OVERSIGHT | WI | 501(C)(3) | 0 | 509(A)(3) TYPE I | HPI - RAMSEY | |
| PHYSICIANS NECK AND BACK CLINICS | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 270684883 | SPECIALTY PATIENT CARE | MN | 501(C)(3) | 0 | 509(A)(3) TYPE II | GROUP HEALTH PLAN INC | |
| HUDSON HOSPITAL INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 390804125 | HOSPITAL | WI | 501(C)(3) | 0 | 170(B)(1) (A)(III) | RH-WISCONSIN & GROUP HEALTH PLAN INC | |
| HUDSON HOSPITAL FOUNDATION INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 391279567 | PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT | WI | 501(C)(3) | 0 | 170(B)(1) (A)(VI) | HUDSON HOSPITAL INC | |
| WESTERN WISCONSIN EMERGENCY MEDICAL SERVICES COMPANY | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 263616590 | PROVIDE MEDICAL TRANSPORT SERVICES | WI | 501(C)(3) | 0 | 509(A)(3) TYPE II | RH-WISCONSIN | |
| LAKEVIEW MEMORIAL HOSPITAL FOUNDATION | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411386635 | PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT | MN | 501(C)(3) | 0 | 509(A)(3) TYPE II | STILLWATER HEALTH SYSTEM | |
| LAKEVIEW MEMORIAL HOSPITAL ASSOCIATION INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 410811697 | HOSPITAL | MN | 501(C)(3) | 0 | 170(B)(1) (A)(III) | STILLWATER HEALTH SYSTEM | |
| STILLWATER MEDICAL GROUP | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 830379473 | PHYSICIANS GROUP | MN | 501(C)(3) | 0 | 509(A)(2) | STILLWATER HEALTH SYSTEM | |
| STILLWATER HEALTH SYSTEM | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 300221189 | CORPORATE PLANNING AND OVERSIGHT | MN | 501(C)(3) | 0 | 509(A)(3) TYPE II | HPI - RAMSEY | |
| WESTFIELDS HOSPITAL INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 390808442 | HOSPITAL | WI | 501(C)(3) | 0 | 170(B)(1) (A)(III) | RH-WISCONSIN & GROUP HEALTH PLAN INC | |
| WESTFIELDS HOSPITAL FOUNDATION INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 391770913 | PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT | WI | 501(C)(3) | 0 | 509(A)(3) TYPE I | WESTFIELDS HOSPITAL INC | |
| RAMSEY INTEGRATED HEALTH SERVICES | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411503090 | IN-HOME PATIENT CARE | MN | 501(C)(3) | 0 | 509(A)(2) | HPI - RAMSEY | |
| PARK NICOLLET HEALTH SERVICES | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 363465840 | CORPORATE PLANNING AND OVERSIGHT | MN | 501(C)(3) | 0 | 509(A)(2) | HEALTHPARTNERS INC | |
| PARK NICOLLET FOUNDATION | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 237346465 | GRANTS TO SERVE THE COMMUNITY | MN | 501(C)(3) | 0 | 170(B)(1) (A)(VI) | PARK NICOLLET HEALTH SERVICES | |
| PARK NICOLLET METHODIST HOSPITAL | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 410132080 | HOSPITAL | MN | 501(C)(3) | 0 | 170(B)(1) (A)(III) | PARK NICOLLET HEALTH SERVICES | |
| PARK NICOLLET INSTITUTE | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 410961862 | HEALTHCARE RESEARCH | MN | 501(C)(3) | 0 | 170(B)(1) (A)(III) | PARK NICOLLET HEALTH SERVICES | |
| PARK NICOLLET HEALTH CARE PRODUCTS | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 010638901 | HEALTHCARE PRODUCTS | MN | 501(C)(3) | 0 | 509(A)(3) TYPE I | PARK NICOLLET HEALTH SERVICES | |
| PARK NICOLLET CLINIC | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 410834920 | HEALTHCARE | MN | 501(C)(3) | 0 | 170(B)(1) (A)(III) | PARK NICOLLET HEALTH SERVICES | |
| PNMC HOLDINGS | |||||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 411741792 | HEALTHCARE REAL ESTATE | MN | 501(C)(3) | 0 | 509(A)(3) TYPE I | PARK NICOLLET CLINIC | |
| AMERY REGIONAL MEDICAL CENTER FOUNDATION INC | |||||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 391726539 | PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT | WI | 501(C)(3) | Yes (1) | 170(B)(1) (A)(VI) | AMERY REGIONAL MEDICAL CENTER INC & GROUP HEALTH PLAN INC | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AMERY REGIONAL MEDICAL CENTER PHARMACY LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 265 GRIFFIN STREET E | AddressLine1Txt |
| City | AMERY | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54001 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390908320 | EIN |
| Primary Activities | PHARMACEUTICAL | PrimaryActivitiesTxt |
| Legal Domicile State | WI | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AMERY REGIONAL MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Share Of Total Income | $23,421 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $106,513 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | Yes (1) | GeneralOrManagingPartnerInd |
| Ownership | 0.50000 | OwnershipPct |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| HEALTHPARTNERS ADMINISTRATORS INC | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411629390 | THIRD PARTY ADMINISTRATOR | MN | HEALTHPARTNERS INC | C | 0 |
| HEALTHPARTNERS ASSOCIATES INC | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 522365151 | MEDICAL CLINIC STAFFING AND ASSET MANAGEMENT | MN | HEALTHPARTNERS ADMINISTRATORS INC | C | 0 |
| HEALTHPARTNERS SERVICES INC | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411683568 | MEDICAL CLINIC STAFFING AND ASSET MANAGEMENT | MN | HEALTHPARTNERS ADMINISTRATORS INC | C | 0 |
| HEALTHPARTNERS INSURANCE COMPANY | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411683523 | MEDICAL AND DENTAL INSURANCE | MN | HEALTHPARTNERS ADMINISTRATORS INC | C | 0 |
| DENTAL SPECIALTIES INC | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 451297583 | PROFESSIONAL DENTAL SERVICES | MN | HEALTHPARTNERS ADMINISTRATORS INC | C | 0 |
| HEALTHPARTNERS CENTRAL MINNESOTA CLINICS INC | |||||||||
| 8170 33RD AVE S PO BOX 1309 | MPLS | MN | 554401309 | 411236798 | MEDICAL CLINIC STAFFING | MN | HEALTHPARTNERS ADMINISTRATORS INC | C | 0 |
| PARK NICOLLET ENTERPRISES | |||||||||
| 6500 EXCELSIOR BLVD | ST LOUIS PARK | MN | 55426 | 411656735 | REAL ESTATE FOR RELATED ORGANIZATIONS | MN | PARK NICOLLET HEALTH SERVICES | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (4 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt |
|---|---|
| AMERY REGIONAL MEDICAL CENTER FOUNDATION | |
| C | $0 |
| AMERY REGIONAL MEDICAL CENTER FOUNDATION | |
| N | $0 |
| AMERY REGIONAL MEDICAL CENTER FOUNDATION | |
| O | $0 |
| HEALTHPARTNERS INC - CLAIMSHEALTHCARE SERVICES | |
| L | $181,141 |