RICHLAND HOSPITAL: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- RICHLAND HOSPITAL (EIN 39-0808498)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-15
- IRS object ID
- 201643219349300324
- 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 L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-11-15T00:00:00-06:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3703 OAKWOOD HILLS PARKWAY | AddressLine1Txt |
| City | EAU CLAIRE | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 54701 | 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 | 390808498 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE RICHLAND HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | RICH | BusinessNameControlTxt |
| Phone | 6086476321 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 333 EAST SECOND STREET | AddressLine1Txt |
| City | RICHLAND CENTER | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53581 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Karen Traynor | PersonNm |
| Person Title | Chief Financial Officer | PersonTitleTxt |
| Phone | 6086476321 | PhoneNum |
| Signature | 2016-11-16 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | PAUL M TRACZEK CPA | PreparerPersonNm |
| PTIN | P01368830 | PTIN |
| Phone | 7158323407 | PhoneNum |
| Preparation | 2016-11-16 | PreparationDt |
| 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 | Bruce Roesler | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 333 EAST SECOND STREET | AddressLine1Txt |
| City | RICHLAND CENTER | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53581 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $54,245,957 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.richlandhospital.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1937 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | THE RICHLAND HOSPITAL, Inc. IS DEDICATED TO CARING, EDUCATING, AND HEALING - TO BE THE COMMUNITY'S "FIRST CHOICE FOR BETTER HEALTH." | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 348 | TotalEmployeeCnt |
| Total Volunteers | 157 | TotalVolunteersCnt |
| Total Gross UBI | $261,512 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$246,461 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $415,215 | PYContributionsGrantsAmt |
| CY Contributions Grants | $583,119 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $38,732,471 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $40,034,322 | CYProgramServiceRevenueAmt |
| PY Investment Income | $625,032 | PYInvestmentIncomeAmt |
| CY Investment Income | $539,711 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$11,284 | PYOtherRevenueAmt |
| CY Other Revenue | -$134,370 | CYOtherRevenueAmt |
| PY Total Revenue | $39,761,434 | PYTotalRevenueAmt |
| CY Total Revenue | $41,022,782 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $35,375 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $35,021 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $20,054,020 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $20,469,981 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $122,922 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $16,308,811 | PYOtherExpensesAmt |
| CY Other Expenses | $15,569,759 | CYOtherExpensesAmt |
| PY Total Expenses | $36,398,206 | PYTotalExpensesAmt |
| CY Total Expenses | $36,074,761 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,363,228 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $4,948,021 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $72,044,064 | TotalAssetsBOYAmt |
| Total Assets EOY | $74,495,393 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $19,233,479 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $17,461,995 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $52,810,585 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $57,033,398 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE RICHLAND HOSPITAL, Inc. IS DEDICATED TO CARING, EDUCATING, AND HEALING - TO BE THE COMMUNITY'S "FIRST CHOICE FOR BETTER HEALTH." | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $29,164,729 | ExpenseAmt |
| Grant | $35,021 | GrantAmt |
| Revenue | $36,663,295 | RevenueAmt |
| Desc | The Richland Hospital, Inc. (the "Hospital") operates a 25-bed critical access hospital in Richland Center, WI. Patients served by The Richland Hospital in 2015 included 3,167 adults and pediatrics inpatient days, 504 swing bed patient days, 332 newborn patient days, 36,955 total outpatient visits, and 5,724 emergency room visits. As a part of the Hospital's mission as a not-for-profit healthcare organization in the communities served, the Richland Hospital provides care to patients who meet certain criteria under its community care policy without charge or at amounts less than its established rates. The Richland Hospital, Inc. maintains records to identify and monitor the level of charity care it provides. In the current year, the total healthcare services provided to patients under the community care policy aggregated approximately $1,060,861 in total charges. The estimated cost of providing care to patients under the community care policy was $481,080. In addition, The Richland Hospital, Inc. is a provider under the Wisconsin Medicaid Program. Under this program, the hospital is legally bound to accept the amount determined by the State of Wisconsin as payment in full for each patient's charges even though reimbursement is less than the cost to provide the care; therefore, service to patients under this program should also be considered part of the organization's benefit provided to the community. (For additional information on the hospital's charity care program and practices and cost of participation in the Wisconsin Medicaid program, please refer to Schedule H of the Form 990.) The Richland Hospital, Inc. also engages in a variety of community building activities that would not otherwise, without the efforts and specialized knowledge of the local community hospital, be provided for the benefit of the residents of Richland Center, Wisconsin and the surrounding communities. In 2015, the Richland Hospital hosted health fairs, participated in local wellness events, conducted educational seminars and provided informational packets for members of our community. Our target audience was the entire family: men, women, children, and infants. The Richland Hospital hosted a Ladies Night Out event, a Men's Night Out, and a toddler wellness event in Richland Center. In addition, Richland Hospital hosted a Ladies Night Out in Spring Green. Each of the events was free to attend, open to the public and drew an average of 50 people each. Items donated included: staff time, materials, space, giveaways and equipment.Additionally, The Richland Hospital, Inc. participated in other free events open to the public and conducted screenings and provided free health and wellness information. Those events include: Richland County Fair, Senior Fest, Greater Richland Cancer Elimination Walk, and Weston Health Fair. The Richland Hospital saw an average of 250 people at each of these events. In response to requests to local employers, Richland Hospital provided staff time, educational materials, and giveaways at no charge for employee health fairs for Wisconsin Maximum Security Prison in Boscobel, WI; Riverdale School District in Muscoda, WI; and UW Richland Student Welcome. An average of 80 people were helped by hospital representatives at each event. The Richland Hospital provided free breastfeeding support groups for new moms and hosted eleven diabetes support group meetings. Educational materials were provided free of charge. Healthcare professionals spoke to the public at community events that were free and open to the public and they provided individual counseling as well to help people understand the services available locally. Registered Dietitians presented information at Richland Middle School four times and at Richland Center High School once in 2015. Educational materials were provided free of charge in a variety of venues. They covered a wide range of healthcare topics including: cancer, diabetes, heart disease, infant and child development, nutrition, exercise, smoking cessation, breast health, advanced directives, colonoscopies, joint and muscle degeneration, women's health and more.The Blood Center of Wisconsin held multiple drives in the hospital's lower level at no cost. In addition, employees could donate blood while on work time and did not have to punch out. Home Health United held multiple Grief Support Group meetings in the hospital's lower level at no cost. These meetings were open to everyone and free of charge. The Richland Hospital provided promotions, snacks and beverages as well.The Hospital also participates in health education awareness and career building activities such as clinical training experience, speakers at local schools, and participation in career fairs for area middle and high schools and for adults. In addition, Richland Hospital provides Club Scrub, an experience designed for 7th and 8th graders that are interested in learning about healthcare careers. The 4 week program takes the students into various departments where they learn about careers in the setting they are provided in. Surgeons, nurses, technicians, and other staff members participate to provide a wonderful experience for the kids. Participation is free and open to all students in our market, but there is a limit of 25 kids for the club. The Hospital recognizes that it is important to educate local community members on these careers as a career building initiative so that local primary care and access to care will be continued in the future with well-trained and educated community members in health care related fields.Finally, while there is growing agreement in the United States about what constitutes a non-profit hospital's "community benefit", this remains a work in progress. The Richland Hospital provides significant charity care and other community benefits as defined by the IRS. But in addition, the Hospital believes that it provides a critically important community benefit which is not easily able to be quantified. Through its hospital services, like most rural hospitals, the Richland Hospital Inc. was created and is maintained in order to provide care locally. Without this hospital, this care would not be available locally and the economic well-being of the surrounding communities would be negatively affected by the loss of professional, technical, and service jobs.The Richland Hospital is committed to working closely with community partners to improve the overall health of the people in our community. Community Partners include: Richland Fit, Aging and Disability Resource Center, Richland County Public Health, Richland Free Clinic, and Richland County Health & Human Services. We are dedicated to caring, educating and healing - we want to be the community's first choice for better health. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,727,728 | ExpenseAmt |
| Revenue | $2,290,726 | RevenueAmt |
| Desc | The Richland Hospital, Inc. also operates two rural health clinics located in Spring Green and Muscoda, WI. During 2015 these two clinics provided a total of 8,243 visits to patients in both communities. The clinics are designated rural health clinics by the Medicare and Medicaid programs and as such by definition are located in designated rural or underserved areas of the country by health care practitioners. These clinics provide care to a large portion of Medicare and Medicaid beneficiaries who without access to care locally would be required to travel farther distances for quality healthcare. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $30,892,457 | 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 | Yes (1) | 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 | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | 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 | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| 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 | Yes (1) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | 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 | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 50 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 348 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| 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 | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | 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 | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | 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 | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Karen Traynor | PersonNm |
| Phone | 6086476321 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 333 EAST SECOND STREET | AddressLine1Txt |
| City | RICHLAND CENTER | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53581 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| David May MD | |||||||
| CHIEF OF STAFF | 5.00 | Yes (X) | $5,000 | $0 | $0 | ||
| KEVIN WHITNEY MD | |||||||
| DIRECTOR | 1.50 | Yes (X) | $0 | $0 | $0 | ||
| Joseph Hinke | |||||||
| DIRECTOR | 1.50 | Yes (X) | $0 | $0 | $0 | ||
| Melissa Sprecher | |||||||
| DireCTOR | 1.50 | Yes (X) | $0 | $0 | $0 | ||
| JERRY GANDER | |||||||
| DIRECTOR | 1.50 | Yes (X) | $0 | $0 | $0 | ||
| Jerry MCCAULEY | |||||||
| DIRECTOR | 1.50 | Yes (X) | $0 | $0 | $0 | ||
| DENNIS HAMILTON | |||||||
| Vice-Chair | 1.75 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Robert Nugent | |||||||
| Chair | 1.75 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Dottie Behling | |||||||
| Treasurer | 1.75 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| John Poole | |||||||
| Secretary | 1.75 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| KAREN TRAYNOR | |||||||
| CFO | 40.00 | $186,776 | $0 | $7,333 | Yes (X) | ||
| Bruce Roesler | |||||||
| CEO (Effective 3/5/2015) | 40.00 | $192,266 | $0 | $19,000 | Yes (X) | ||
| Terri Potter | |||||||
| CEO (through 3/13/2015) | 40.00 | $79,758 | $0 | $0 | Yes (X) | ||
| Allan Mottram MD | |||||||
| ER PhySICIAN | 39.00 | $330,037 | $0 | $20,300 | Yes (X) | ||
| E RACHEL SHANNON-GOODRICH CRNA | |||||||
| ANESTHETIST | 46.00 | $322,849 | $0 | $33,549 | Yes (X) | ||
| MUHAMMAD S KHAN MD | |||||||
| ER PHYSICIAN | 49.00 | $345,676 | $0 | $33,549 | Yes (X) | ||
| BRYAN MCCARVEL | |||||||
| ANESTHESIA DIRECTOR | 44.00 | $351,033 | $0 | $33,549 | Yes (X) | ||
| Bruce Moths MD | |||||||
| ER PHYSICIAN | 42.00 | $298,172 | $0 | $33,549 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,111,567 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $180,829 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 24 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | 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 |
|---|---|---|---|---|---|
| THE RICHLAND MEDICAL CENTER LTD | |||||
| 301 EAST SECOND STREET | RICHLAND CENTER | WI | 53581 | physicians/clinic mgmt services | $1,120,376 |
| ALBET J ALTER JR | |||||
| W9107 SR 39 | BLANCHARDVILLE | WI | 53516 | RADIOLOGY SERVICES | $187,630 |
| WHITNEY SLEEP DIAGNOSTIC & CONSULTANT | |||||
| 119 GRAYSTONE PLAZA STE 102 | DETROIT LAKES | MN | 56501 | SLEEP STUDY SERVICES | $180,000 |
| Meriter Health Systems | |||||
| 36 South Brooks St | Milwaukee | WI | 53288 | Lab Services | $176,325 |
| Wipfli LLP | |||||
| PO Box 8010 | Wausau | WI | 54402 | Accounting/Audit Fees/Financial Services | $110,608 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $261,149 | RelatedOrganizationsAmt |
| Government Grants | $14,737 | GovernmentGrantsAmt |
| All Other Contributions | $307,233 | AllOtherContributionsAmt |
| Total Contributions | $583,119 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| PATIENT SERVICE REVENUE | 621990 | $39,062,988 | $38,954,021 | $108,967 | |
| CONTRACTED THERAPY | 621990 | $257,722 | $257,722 | ||
| MEDICAL RECORDS | 621990 | $190,940 | $72,265 | $118,675 | |
| MEALS | 722320 | $162,329 | $79,150 | $83,179 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $360,343 | TotalRevenueColumnAmt |
| Exclusion | $360,343 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $40,034,322 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $417,271 | TotalRevenueColumnAmt |
| Exclusion | $417,271 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $849,554 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $983,924 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$134,370 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$134,370 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $1,130 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$135,500 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $12,351,191 | SecuritiesAmt |
| Other | $10,500 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $12,236,672 | SecuritiesAmt |
| Other | $2,579 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $114,519 | SecuritiesAmt |
| Other | $7,921 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $122,440 | TotalRevenueColumnAmt |
| Exclusion | $122,440 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $41,022,782 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $38,954,021 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $261,512 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,224,130 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,021 | TotalAmt |
| Program Services | $35,021 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $410,375 | TotalAmt |
| Management And General | $410,375 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,620,891 | TotalAmt |
| Program Services | $13,392,379 | ProgramServicesAmt |
| Management And General | $2,140,995 | ManagementAndGeneralAmt |
| Fundraising | $87,517 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $534,096 | TotalAmt |
| Program Services | $457,901 | ProgramServicesAmt |
| Management And General | $73,203 | ManagementAndGeneralAmt |
| Fundraising | $2,992 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,807,361 | TotalAmt |
| Program Services | $2,406,857 | ProgramServicesAmt |
| Management And General | $384,776 | ManagementAndGeneralAmt |
| Fundraising | $15,728 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,097,258 | TotalAmt |
| Program Services | $918,148 | ProgramServicesAmt |
| Management And General | $173,110 | ManagementAndGeneralAmt |
| Fundraising | $6,000 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $401,834 | TotalAmt |
| Management And General | $401,834 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,670 | TotalAmt |
| Management And General | $88,670 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,894,123 | TotalAmt |
| Program Services | $3,334,863 | ProgramServicesAmt |
| Management And General | $550,691 | ManagementAndGeneralAmt |
| Fundraising | $8,569 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $143,723 | TotalAmt |
| Program Services | $250 | ProgramServicesAmt |
| Management And General | $143,473 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $285,072 | TotalAmt |
| Program Services | $172,911 | ProgramServicesAmt |
| Management And General | $110,549 | ManagementAndGeneralAmt |
| Fundraising | $1,612 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $313,393 | TotalAmt |
| Management And General | $313,393 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,526,346 | TotalAmt |
| Program Services | $1,469,980 | ProgramServicesAmt |
| Management And General | $56,366 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,948 | TotalAmt |
| Program Services | $35,834 | ProgramServicesAmt |
| Management And General | $13,114 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,077 | TotalAmt |
| Program Services | $66,730 | ProgramServicesAmt |
| Management And General | $10,843 | ManagementAndGeneralAmt |
| Fundraising | $504 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,622,402 | TotalAmt |
| Program Services | $2,622,402 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $90,545 | TotalAmt |
| Management And General | $90,545 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES | $5,237,106 | $5,147,301 | $89,805 |
| EQUIPMENT RENTAL & MAIN | $772,063 | $764,423 | $7,640 |
| Bad debt expense | $614,999 | $614,999 | |
| Dietary Expense | $250,207 | $250,207 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -$797,749 | TotalAmt |
| Program Services | -$797,749 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,074,761 | TotalAmt |
| Program Services | $30,892,457 | ProgramServicesAmt |
| Management And General | $5,059,382 | ManagementAndGeneralAmt |
| Fundraising | $122,922 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,273 | BOYAmt |
| EOY | $1,107 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,035,026 | BOYAmt |
| EOY | $15,860,282 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,461,652 | BOYAmt |
| EOY | $8,625,265 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $158,516 | BOYAmt |
| EOY | $112,993 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,374,655 | BOYAmt |
| EOY | $1,551,757 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $297,697 | BOYAmt |
| EOY | $270,283 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $58,177,973 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $32,596,046 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,165,738 | BOYAmt |
| EOY | $25,581,927 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,169,655 | BOYAmt |
| EOY | $16,293,206 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,674,651 | BOYAmt |
| EOY | $3,493,963 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,705,201 | BOYAmt |
| EOY | $2,704,610 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $72,044,064 | BOYAmt |
| EOY | $74,495,393 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,925,876 | BOYAmt |
| EOY | $3,358,631 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $367,581 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,750,000 | BOYAmt |
| EOY | $13,960,000 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $190,022 | BOYAmt |
| EOY | $143,364 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,233,479 | BOYAmt |
| EOY | $17,461,995 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,422,650 | BOYAmt |
| EOY | $56,636,588 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $327,935 | BOYAmt |
| EOY | $336,810 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $60,000 | BOYAmt |
| EOY | $60,000 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,810,585 | BOYAmt |
| EOY | $57,033,398 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $72,044,064 | BOYAmt |
| EOY | $74,495,393 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $4,948,021 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$320,578 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$404,630 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| 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 |
| Other Activities | $4,664 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $4,664 | 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 | THE RICHLAND HOSPITAL, INC. (THE "HOSPITAL") PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THESE DUES ARE PRIMARILY FOR ACCESS TO EDUCATIONAL MATERIALS AND STAFF TRAINING AND DEVELOPMENT. THE WHA HAD NOTIFIED THE HOSPITAL THAT APPROXIMATELY $2,062 OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT. THE HOSPITAL IS ALSO A MEMBER OF THE RURAL WISCONSIN HEALTH COOPERATIVE (RWHC). EACH YEAR, THE HOSPITAL PAYS MEMBERSHIP FEES TO RWHC. THE RWHC PROVIDES SUPPORT SERVICES FOR A NUMBER OF ITS MEMBER HOSPITALS THROUGHOUT THE STATE OF WISCONSIN. SOME OF THE MANY SERVICES PROVIDED TO MEMBER HOSPITALS INCLUDE PROVIDING ASSISTANCE TO ORGANIZATIONS IN SECURING GRANT FUNDING FOR NEW OR EXISTING HEALTHCARE PROGRAMS, LEGAL SERVICES, REIMBURSEMENT REVIEW SERVICES, ACCOUNTING ASSISTANCE, CONTRACTING FOR THERAPIST COVERAGE, AND ADMINISTRATIVE CONSULTING SERVICES. AS A PART OF THESE SERVICES, RWHC ALSO DOES PROVIDE ANALYSIS OF CURRENT HEALTHCARE ISSUES IN AN EFFORT TO PROMOTE AND BETTER HEALTHCARE FOR HOSPITALS IN RURAL COMMUNITIES THROUGHOUT WISCONSIN. ONE OF THESE EFFORTS ALSO INCLUDES SOME LOBBYING ON BEHALF OF THE MEMBER ORGANIZATIONS. IT WAS DETERMINED THAT APPROXIMATELY $2,602 OF THE FEES PAID BY THE HOSPITAL IN 2015 RELATED TO LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE HEALTHCARE ENVIRONMENT IN THE STATE OF WISCONSIN. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $71,176 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $704 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $71,880 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $70,473 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $703 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $71,176 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $70,005 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $468 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $70,473 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $69,671 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $334 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $70,005 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $69,549 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $122 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $69,671 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.83500 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.16500 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $941,726 | OtherCostOrOtherBasisAmt |
| Book Value | $941,726 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $41,379,303 | OtherCostOrOtherBasisAmt |
| Depreciation | $20,154,765 | DepreciationAmt |
| Book Value | $21,224,538 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $609,073 | OtherCostOrOtherBasisAmt |
| Depreciation | $469,746 | DepreciationAmt |
| Book Value | $139,327 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,613,997 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,625,706 | DepreciationAmt |
| Book Value | $2,988,291 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $633,874 | OtherCostOrOtherBasisAmt |
| Depreciation | $345,829 | DepreciationAmt |
| Book Value | $288,045 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $25,581,927 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| DEFERRED COMPENSATION PLAN LIABILITY | $327,303 |
| Bond amortization Premium - net against long-term debt | -$183,939 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $143,364 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $41,081,722 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $984,845 | OtherRevenueAmt |
| Revenue Not Reported | $984,845 | RevenueNotReportedAmt |
| Revenue Subtotal | $40,096,877 | RevenueSubtotalAmt |
| Other Revenues Not Included | $925,905 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $925,905 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $41,022,782 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $36,393,929 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $983,924 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $983,924 | ExpensesNotReportedAmt |
| Expenses Subtotal | $35,410,005 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $664,756 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $664,756 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $36,074,761 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part V, Line 4: | THE ENDOWMENT FUNDS MAINTAINED BY THE RICHLAND HOSPITAL, INC. HAVE BEEN RESTRICTED BY DONORS TO BE MAINTAINED IN PERPETUITY, THE INCOME OF WHICH IS EXPENDABLE TO SUPPORT SCHOLARSHIP PROGRAMS OF THE HOSPITAL. |
| Part XI, Line 2d - Other Adjustments: | RENTAL EXPENSES INCLUDED WITH EXPENSES ON FINANCIAL STATEMENTS 983,924. Net assets released from restrictions 921. |
| Part XI, Line 4b - Other Adjustments: | CONTRIBUTIONS FROM RELATED ORGANIZATIONS 261,149. SCHOLARSHIP & GRANT EXPENSE NET AGAINST GRANT REVENUE ON FINANCIAL STATEMENT 49,757. Provision for bad debts net against revenue on financial statements 614,999. |
| Part XII, Line 2d - Other Adjustments: | RENTAL EXPENSES INCLUDED WITH EXPENSES ON FINANCIAL STATEMENTS 983,924. |
| Part XII, Line 4b - Other Adjustments: | SCHOLARSHIP & GRANT EXPENSE NET AGAINST GRANT REVENUE ON FINANCIAL STATEMENT 49,757. Provision for bad debts net against revenue on financial statements 614,999. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| 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 | $489,411 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $489,411 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01380 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,248,945 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,867,519 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,381,426 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06720 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,738,356 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,867,519 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,870,837 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08100 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $78,743 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $21,160 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $57,583 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00160 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,359,856 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,958,887 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,400,969 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03950 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,296 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $14,296 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,452,895 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,980,047 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,472,848 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04150 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,191,251 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,847,566 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,343,685 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12250 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $465 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $465 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $465 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $465 | NetCommunityBenefitExpnsAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $283,720 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $141,860 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $12,832,453 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $12,905,545 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$73,092 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 0 | WrittenDebtCollectionPolicyInd |
| 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 | THE RICHLAND HOSPITAL INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 333 EAST SECOND STREET | AddressLine1Txt |
| City | RICHLAND CENTER | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53581 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.richlandhospital.com | WebsiteAddressTxt |
| State License | 1045 | 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 | The Richland Hospital 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 | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | 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.richlandhospital.com/wp-content/uploads/2013/12/2013_chna_comple | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 13 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | www.richlandhospital.com/wp-content/uploads/2013/12/2013_chna_comple | 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 | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| 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 |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | http://www.richlandhospital.com/about/patients-visitors/community-care-fina | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | http://www.richlandhospital.com/wp-content/uploads/2013/12/community_care_a | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | http://www.richlandhospital.com/wp-content/uploads/2013/12/community_care_b | 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 |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| 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 All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | Yes (1) | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| The Richland Hospital, Inc. | Part V, Section B, Line 5: In addition to the work done as part of the 2013 CHNA process, THE RICHLAND HOSPITAL, INC. ENGAGED IN AN EXTENSIVE ASSESSMENT OF THE HEALTH NEEDS OF THE COMMUNITY IN ITS 2014 STRATEGIC PLANNING PROCESS with a focus on 2014 through 2016 strategy development. THE ASSESSMENT INCLUDED DIRECT FEEDBACK FROM THE RESIDENTS OF THE MARKET AREA SERVED AS WELL AS USE OF OTHER SOURCES OF DATA RELATED TO COMMUNITY HEALTH NEEDS. IT INCLUDED PERFORMING PROJECTIONS OF DEMAND FOR HEALTHCARE SERVICES AND ASSESSING WHAT IS AVAILABLE IN THE MARKET AREA TO MEET THOSE DEMANDS.IN ADDITION, THE RICHLAND MEDICAL CENTER, LTD. PHYSICIANS AND PROVIDERS WHO OFFER PRIMARY AND SECONDARY LEVEL CARE, INCLUDING PREVENTIVE HEALTHCARE FOR THE PERSONS RESIDING IN THE MARKET AREA, PARTICIPATED IN A PLANNING SESSION WHERE DATA GATHERED WAS REVIEWED AND they PROVIDED THEIR INPUT INTO NEEDS OF THE PATIENTS THEY SERVE. THE PLAN WAS PROVIDED IN DRAFT FORM TO PERSONS REPRESENTING THE AGING AND DISABILITIES RESOURCE CENTER, RICHLAND COUNTY PUBLIC HEALTH, RICHLAND FIT, RICHLAND FREE CLINIC, AND RICHLAND COUNTY HEALTH AND HUMAN SERVICES. WE THEN MET WITH THESE PERSONS TO DISCUSS OUR PLANS AND COMMUNITY PRIORITIES. APPENDIX B CONTAINS A FULL SUMMARY OF THEIR COMMENTS.RANDOM SAMPLE TELEPHONE SURVEY OF RESIDENTS OF THE MARKET AREA SERVED BY THE RICHLAND HOSPITAL, INC. RANDOMLY SURVEYED 250 HOUSEHOLDS IN ITS MARKET AREA REGARDING HEALTHCARE SERVICES AND NEEDS. PERSONS OF ALL INCOME LEVELS WERE INCLUDED IN THE SURVEY PROCESS. THIS PRODUCED SURVEY RESULTS THAT ARE AT THE 94 PERCENT CONFIDENCE LEVEL WITH A MARGIN OF ERROR OF + SIX PERCENTAGE POINTS. |
| The Richland Hospital, Inc. | Part V, Section B, Line 11: After considering the community health needs that were identified through the 2013 assessment process, The Richland Hospital, Inc. concluded the following were priorities: 1. Ensuring access to care: The Richland Hospital, Inc., is a community partner in the Richland FIT initiative devoted to tackling obesity in the community. 2. Preventing and reducing obesity: The Richland Hospital, Inc. designates a significant amount of resources to community health improvement, which includes wellness initiatives. Many of these resources will be directed to the plan that is in the process of being developed. 3. Community Health and Wellness: The Richland Hospital, Inc. designates a significant amount of resources to community health improvement, which includes wellness initiatives. Many of these resources will be directed to the plan that is in the process of being developed. In 2014, The Richland Hospital, Inc. expounded on their existing implementation plans designed to meet the three priorities identified in the 2013 Community Health Needs Assessment as components of the organizational strategic plan.1. Ensuring Access to Care:- Richland Hospital Certified Application Counselors continued to assist uninsured people find health coverage in the Health Insurance Marketplace. Weekly appointments were offered to help people fill out their paperwork or to gain a better understanding of what was available through the new program.- The Richland Hospital Medical Imaging and Laboratory departments provided services for the Richland Community Free Clinic.- The Richland Hospital, Inc. maintains Rural Health Clinics in Muscoda and Spring Green, Wisconsin. Both have status with "Governors Shortage Designation for Rural Health Clinics."- Athletic trainers provided weekly coverage at the local high school and at home sporting events to ensure that local and visiting athletes have immediate access to healthcare in the event that they are injured during practice or competition.- The Richland Hospital, Inc. continued working with the Richland Medical Center to create a plan to ensure that general surgery services would be available after the retirement of the current general surgeon leading to a successful recruitment of a highly qualified candidate that will launch his Richland Center practice in 2017.- A series of Community Grief Support sessions were hosted for those grieving the loss of someone in their life. In addition, a specialized grief support group was hosted for those suffering the loss of a partner. 2. Preventing and reducing obesity:- A conditioning presentation was hosted guiding participants through a series of progressive exercises and training techniques intended to improve mobility, stability, strength, and power to help golfers improve their game. The presentation was available to the public.- A free pre-diabetes education class was offered to the public. - Monthly Diabetes support groups were hosted. - The Richland Hospital, Inc. maintained active participation with the Richland County's Richland FIT coalition through a standing Richland Hospital employee serving on the steering committee. - Richland Hospital staff assisted with two activity-based events offered in collaboration with Richland FIT and Richland Center Parks and Recreation- Quarterly grocery tours were led by members of the clinical nutrition department - In partnership with Richland FIT and Richland Center Master Gardeners, staff from The Richland Hospital helped plan and prepare a new community garden on the site of a previous community center near two low income apartment complexes. Raised beds and platform beds were built, filled and made ready for members of the community to plant and harvest. 3. Community Health and Wellness:- Two regional ladies night out events were hosted, one in Spring Green and one in Richland Center. Both provided women with an opportunity to ask questions related to Women's Health of at lease two providers in an informal, anonymous format.- A conditioning presentation was hosted guiding participants through a series of progressive exercises and training techniques intended to improve mobility, stability, strength, and power to help golfers improve their game. The presentation was available to the public.- A free pre-diabetes education class was offered to the public. - Monthly Diabetes support groups were hosted. - The Richland Hospital, Inc. actively joined the Richland County's Richland FIT coalition by adding a Richland Hospital employee to the steering committee. - The Richland Hospital, Inc. provided free smoking cessation classes. - In partnership with Richland FIT and Richland Center Master Gardeners, staff from The Richland Hospital helped plan and prepare a new community garden on the site of a previous community center near two low income apartment complexes. Raised beds and platform beds were built, filled and made ready for members of the community to plant and harvest.The Richland Hospital, Inc. is committed to working collaboratively with other healthcare providers and community organizations to address the unmet community health needs that were identified through the CHNA. As with all healthcare organizations, adequate resources are not available to address every unmet health need in the communities served. There are community health needs that the hospital was unable to address either individually or through partnerships with other organizations that also serve these communities. Unmet healthcare needs identified through the CHNA which have not been addressed by the hospital in 2015 include: 1) the shortage of mental health and dental care professionals and 2) the higher than State average of excess drinking. Access to dental health professionals is being undertaken by members of the Richland Center Dental Association. The school districts have underage drinking programs in place to address the adolescent component of alcohol use. The shortage of mental health professionals continues to be an unmet need, though has not been addressed due to availability of resources in the service area. The hospital is committed to periodically reviewing the needs identified as unmet, as well as newly identified needs throughout the year, and addressing them in accordance with the hospital's mission, vision, and resources. |
| The Richland Hospital, Inc. | Part V, Section B, Line 13h: In addition to the federal poverty guidelines, The Richland Hospital, Inc. considers the following when determining eligibility for providing "free or "discounted" care to individuals:- Patient is homeless- Patient is eligible for other state or local assistance programs that are unfunded- Patient is eligible for assistance under the Crime Victims Act or Sexual Assault Act- Patient is deceased, and without a spouse, and no estate has been filed with the court system within 12 months of expiration or if it determined patient does not have assets requiring the filing of an estate- Patient receives a bankruptcy determination within the six months immediately preceding the application date if applicant is looking for consideration on any Active Account not discharged as a part of the bankruptcy determination- Patient's valid address is considered low income or subsidized housing and patient authorizes the applicable housing authority to validate income level directly to the Hospital- Patient is on military active duty |
| The Richland Hospital, Inc. | Part V, Section B, Line 16i: The hospital also provided financial assistance information in brochures located in the cashiers office. Brochures can also be found at both of the Rural Health Clinics. Further information regarding the financial assistance policy is also available through phone conversations with financial counselors at the hospital. BROCHURES ARE ALSO AVAILABLE AT THE REHAB DEPARTMENT, FREE CLINIC, AND RICHLAND COUNTY RESOURCE AND DISABILITY OFFICE. |
| The Richland Hospital, Inc. | Part V, Section B, Line 20e: THE HOSPITAL'S BUSINESS OFFICE STAFF ALSO MAKES AN ATTEMPT TO CONTACT EACH PATIENT WITH A BALANCE GREATER THAN $300 AND THE COMMUNITY CARE PROGRAM IS MENTIONED ON THE PHONE CALL. |
| The Richland Hospital, Inc. | Part V, Section B, Line 22d: THE HOSPITAL FOLLOWS A CALCULATION TO DETERMINE AN AMOUNT GENERALLY BILLED ("AGB") TO CHARGE UNINSURED PATIENTS. THE CALCULATION OF AGB SHALL EQUAL AMOUNTS GENERALLY BILLED TO INDIVIDUALS WITH INSURANCE COVERING THAT CARE. AGB SHALL BE CALCULATED ANNUALLY AND WILL BE BASED ON THE IMMEDIATELY PRECEDING 12-MONTH PERIOD SPANNING DECEMBER THROUGH NOVEMBER. CALCULATIONS INCLUDE PAYMENTS FOR DEDUCTIBLES AND CO-PAYMENTS. THE AGB AS CALCULATED SHALL BE EFFECTIVE ON THE 14TH DAY OF JANUARY OF EACH YEAR AND APPLIED TO ANY APPLICATION DETERMINATIONS MADE ON OR AFTER THAT DATE REGARDLESS OF THE ORIGINAL DATE OF SERVICE OR THE ORIGINAL DATE OF APPLICATION. THE AGB PERCENTAGE IS EQUAL TO THE SUM OF ALL CLAIMS PAYMENTS FOR MEDICALLY NECESSARY CARE FOR HEALTHCARE COVERED BY MEDICARE AND PRIVATE INSURERS DIVIDED BY GROSS CHARGES RELATED TO CLAIMS. |
| The Richland Hospital, Inc. | Part V, Section B, Line 23: In 2015, underinsured were eligible for a percentage discount based on their federal poverty level. An AGB calculation was not done. Uninsured were not charged more than the AGB. In 2016, the AGB applies to both underinsured and uninsured. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 2 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - MUSCODA HEALTH CENTER | ||||
| 1075 NORTH WISCONSIN AVENUE | MUSCODA | WI | 53573 | RURAL HEALTH CLINIC |
| 2 - SPRING GREEN MEDICAL CENTER | ||||
| 150 EAST JEFFERSON STREET | SPRING GREEN | WI | 53588 | RURAL HEALTH CLINIC |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3c: | In addition to the federal poverty guidelines, The Richland Hospital, Inc. considers the following when determining eligibility for providing "free or "discounted" care to individuals:- Patient is homeless- Patient is eligible for other state or local assistance programs that are unfunded- Patient is eligible for assistance under the Crime Victims Act or Sexual Assault Act- Patient is deceased, and without a spouse, and no estate has been filed with the court system within 12 months of expiration or if it determined patient does not have assets requiring the filing of an estate- Patient receives a bankruptcy determination within the six months immediately preceding the application date if applicant is looking for consideration on any Active Account not discharged as a part of the bankruptcy determination- Patient's valid address is considered low income or subsidized housing and patient authorizes the applicable housing authority to validate income level directly to the Hospital- Patient is on military active duty |
| Part I, Line 6a: | THE RICHLAND HOSPITAL, INC. PREPARES A COMMUNITY BENEFIT REPORT ANNUALLY AND FILES IT WITH THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THE REPORT IS AVAILABLE TO THE GENERAL PUBLIC ON WHA'S DATABASE AND WEBSITE. |
| Part I, Line 7: | THE COSTING METHODOLOGY USED ON FORM 990 IS BASED ON A COST-TO-CHARGE RATIO WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBT DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST VARIOUS REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER IRS SUGGESTED COSTING METHODS FOR THE FORM 990. |
| Part I, Line 7g: | SUBSIDIZED HEALTH SERVICES AT THE RICHLAND HOSPITAL, INC. INCLUDEs the operation of the Hospital emergency room department, the intensive care inpatient unit, AND THE OPERATION OF TWO RURAL HEALTH CLINICS. THESE SERVICES ARE UNAVAILABLE TO MEMBERS OF THE COMMUNITY OTHER THAN THROUGH THE RICHLAND HOSPITAL, INC. and are primarily utilized for emergency services. The Emergency Room department operates 24-hours per day, seven days per week and is staffed primarily by board certified emergency room physicians. As part of the patient services provided to the community, the hospital has designated a portion of its inpatient unit as a certified intensive care unit known as the "special care unit." This unit requires a higher acuity of nursing and has dedicated staff to provide this care to patients. A significant portion of the admissions to the unit come from emergency admissions to the hospital so it is considered a subsidized health service provided to the community by the hospital. THE CLINICS ARE DESIGNATED RURAL HEALTH CLINICS BY THE MEDICARE AND MEDICAID PROGRAMS AND AS SUCH BY DEFINITION ARE LOCATED IN DESIGNATED RURAL OR UNDERSERVED AREAS OF THE COUNTRY BY HEALTHCARE PRACTITIONERS. THESE CLINICS PROVIDE CARE TO A LARGE PORTION OF MEDICARE AND MEDICAID BENEFICIARIES WHO WITHOUT ACCESS TO CARE LOCALLY WOULD BE REQUIRED TO TRAVEL FARTHER DISTANCES FOR QUALITY HEALTHCARE. IT IS THE GOAL OF THE RICHLAND HOSPITAL, INC. TO PROVIDE THESE SERVICES TO THE COMMUNITY REGARDLESS OF THE PATIENT'S ABILITY TO PAY. |
| Part I, Line 7, Column (f): | The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 614,999. |
| Part II, Community Building Activities: | The Richland Hospital, Inc. engages in a variety of community building activities that would otherwise not be met or provided without the efforts and specialized knowledge of the local community hospital to the residents of Richland Center, Wisconsin, and the surrounding areas. Some of the community building activities that the hospital participates in are the local health and wellness fairs, support groups, providing educational materials to community members, safe sitter classes, and local blood pressure screenings. In addition, the Hospital is a community partner and active member of the Richland FIT program. Richland FIT conducted a STUDY WHICH CREATED a strategic and implementation plan focusing on the high obesity rates in Richland County. The effort to develop the plan and do necessary related research was funded by the University of Wisconsin Partnership program in 2011, and implementation and measurement of outcomes is in process. The Hospital also takes an active role in wellness through its support of local athletes and maintains contracts with area school systems to provide athletic trainers for coverage at scheduled sporting events. This sports medicine program provides outreach services to Richland Center, Riverdale (Muscoda), and Ithaca school districts as well as to the local UW-Richland Center campus. Services provided include in-school injury prevention and assessments clinics, daily practice coverage (frequency varies with each school), "home" event coverage as requested by schools, and emergency action plan development for each school. The program provides skinfold testing for the wrestling programs in accordance with WIAA mandates. Finally, the program provides education for local EMS squads on the appropriate transport of injured athletes. The Richland Hospital, INC.'S sports medicine program is operated at a loss each year, an investment in the community that was in excess of $100,000 in 2015. The program has direct ties to one of the priorities identified both by the Richland FIT needs assessment but also by the Hospital's 2013 CHNA, the high obesity rate for youth and young adults in Richland County. The hospital also participates in health education awareness and career building activities such as clinical training experience, speakers at local schools, and career fairs. The hospital recognizes that it is important to educate local community members on these careers as a career building initiative so that local primary care and access to care will be continued in the future with well-trained and educated community members in healthcare related fields. A new document was developed in 2014 and introduced to support the business plan for Community Health and Wellness for the Hospital. The web of relationships assists in defining existing relationships and provides a mechanism for prioritizing health and wellness activities. |
| Part III, Line 2: | The costing methodology used on Form 990 is based on a cost-to-charge ratio, which is developed based on the hospital's total operating expenses excluding the provision for bad debt, divided by gross patient service revenue. This cost-to-charge ratio is applied against the total charges that are written off during the year to estimate the cost of care of patients who have accounts that are deemed to be bad debts to the hospital. The hospital also recognizes that it also provides a discount to self-pay or uninsured patients. These amounts are excluded from gross patient service revenue on the consolidated financial statements and are not included in the ratio as described above and approved by the IRS for use on Form 990. If considered, these additional write-off amounts to uninsured accounts would also increase the estimated bad debt expense amount associated with these uncollectible accounts to the hospital. |
| Part III, Line 3: | Management provides for probable uncollectible amounts, primarily uninsured patients and amounts patients are personally responsible for, through a charge to operations and a credit to a valuation allowance based on its assessment of historical collection likelihood and the current status of individual accounts. Balances that are still outstanding after the hospital has used reasonable collection efforts are written off through a charge to the valuation allowance and credit to accounts receivable. Many times patients do not complete the required charity care application and are transferred to collection services even though the hospital provides this information to all patients and assists patients with the application. Due to no responses from some patients, a significant amount of bad debts could be considered as charity care. |
| Part III, Line 4: | In evaluating the collectability of accounts receivable, the Hospital analyzes past results and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for uncollectible accounts and provision for bad debts. Management regularly reviews data about these major payor sources of revenue in evaluating the sufficiency of the allowance for uncollectible accounts. Specifically, for receivables associated with services provided to patients who have third-party coverage, the Hospital analyzes contractually due amounts and provides an allowance for uncollectible accounts and a provision for bad debts for expected uncollectible deductibles and copayments on accounts for which the third-party payor has not yet paid, or for payors and patients who are known to be having financial difficulties that make the realization of amounts due unlikely. For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Hospital records a significant provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates, if negotiated) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for uncollectible accounts. The audited financial statements do not contain a separate footnote regarding bad debt expense. |
| Part III, Line 8: | THE RICHLAND HOSPITAL, INC. IS DESIGNATED AS A CRITICAL ACCESS HOSPITAL AND, AS SUCH, A PORTION OF ITS REVENUE is PAID UNDER A COST REIMBURSEMENT SYSTEM. THE TOTAL MEDICARE REVENUE SHOWN BASED ON THE IRS 990 INSTRUCTIONS INCLUDES ONLY A PORTION OF THE TOTAL MEDICARE REVENUE OF THE HOSPITAL. THE AMOUNTS LISTED FOR MEDICARE DO NOT INCLUDE PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT, RADIOLOGIST SERVICES, AND SURGICAL ANESTHESIA SERVICES AT THE RICHLAND HOSPITAL, INC. PHYSICIAN COVERAGE IS REIMBURSED PRIMARILY ON FEE SCHEDULE REIMBURSEMENT AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND, AS SUCH, THESE COSTS AND SHORTFALLS SHOULD ALSO BE CONSIDERED AS AN ADDITIONAL BENEFIT THAT THE RICHLAND HOSPITAL, INC. PROVIDES TO THE COMMUNITIES IT SERVES. THE COSTING METHOD USED ABOVE FOR IRS Form 990 COMPLIANCE REPORTING IS ALSO BASED ON AN OVERALL AVERAGE COST-TO-CHARGE RATIO AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICE REVENUE (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE) DIVIDED BY TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBT EXPENSE. THIS RATIO IS THEN MULTIPLIED BY THE TOTAL MEDICARE SERVICES WHICH ARE REIMBURSED ON A COST METHODOLOGY EXCLUDING THE FEE SCHEDULE ITEMS LIKE PHYSICIAN SERVICES AND THE HOSPITAL WOULD SHOW A LARGE LOSS ON THESE SERVICES.WHETHER THERE IS A SHORTFALL OR SURPLUS FROM SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THESE PEOPLE, WHO ARE TYPICALLY ELDERLY MEMBERS OF THE COMMUNITY, ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE PATIENT SERVICES, THE CENTERS FOR MEDICARE AND MEDICAID (CMS) WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY. |
| Part VI, Line 2: | In addition to the comprehensive Community Health Needs Assessment, The Richland Hospital, Inc. assesses the healthcare needs of the community it serves by looking at local and surrounding community demographics to determine the services that are most necessary in order to fulfill its mission. The hospital actively seeks input from members of the Medical Staff regarding existing services, potential need for expanded services, and the potential need for new service lines not offered locally. The hospital monitors the loss of speciality providers in the area and, working collaboratively with Richland Medical Center, carefully participates in a determination of whether and how this new need can best be met. A recent example in 2015 was the loss of a pain management provider. The hospital also reviews hospital statistics of patient visits to determine what types of services offered by the hospital are being utilized. The Hospital has continued to use focus groups for specific service line enhancement, meeting directly with targeted members of the market to understand their healthcare service delivery needs and expectations tied to specific areas of care. In planning to meet community needs, the aging of the population is significant because persons in the age categories that are growing face more challenges related to healthcare than younger populations. In the older population groups, persons visit primary care physicians more frequently and have higher incident rates of heart disease, cancer, and related illnesses. The onset of chronic diseases are higher in this age category, e.g., onset of diabetes, COPD, or heart problems, and must be managed with assistance from the healthcare providers for the remainder of the person's life. Important to note is that as a person ages, travel becomes more challenging, so the ability to get as much of their healthcare needs met locally grows in importance. Having visiting specialists, for example, eliminates the need for a trip to a major medical center for many. In addition, it ensures that persons get the care that they need. An example of a recent service addition is the addition of a locally managed sleep study service which has been well received by patients and physicians alike. The Hospital continues to more fully develop the electronic health record system (EHR) with one of the main goals being improved access to strong clinical documentation including patient medical histories as a means to support a more efficient and effective patient experience. Training our community members to use and access their personal health information through the EHR portal is another example of the hospital's work to improve our patient's health status through access and information. In turn, the electronic health record system provides for a more complete medical history should that patient require treatment at other healthcare facilities. In response to increased patient demands for access to primary ambulatory clinic care, the hospital completed construction of a replacement clinic facility in Muscoda, Wisconsin, in 2012 as a means to better serve the needs of the patients in Muscoda and the surrounding rural communities. |
| Part VI, Line 3: | Consistent with the Mission of The Richland Hospital, Inc., health-related services are provided to patients regardless of their ability to pay. The Hospital is committed to providing free or discounted care to qualified individuals that are in need of medically necessary treatment even if that person is uninsured, underinsured, Health Insurance Exchange Qualified, ineligible for other government programs, or unable to pay based on their individual financial situation. When a patient requests financial assistance and has an adjusted gross income that is less than 150% of the federal poverty level, they are provided care without charge. When an uninsured or Health Insurance Exchange eligible patient's adjusted gross income is 151% to 300% of the federal poverty level, they are provided care at the Amount Generally Billed rate. Underinsured patients at 150% to 300% of the federal poverty level are eligible for a discount based on a sliding scale. To be Eligible under this Program, patients must cooperate with the hospital to explore alternative means of assistance and, if necessary, including application or actions needed to secure coverage by Medicare, Medicaid, and the Marketplace. Patients will be required to provide necessary information and documentation when applying for a Program discount, or for other private or public payment programs. The Financial Counselor is available to assist patients with the application process. Applications and all supporting documentation is reviewed by the Financial Counselor for eligibility and approved by the Patient Accounting Supervisor. Free radiology, laboratory, and other diagnostic ancillary services are also provided to patients who are referred to the hospital by The Richland Center Free Clinic. The Hospital also offers an automatic 10% discount on all private pay accounts. A prompt pay discount of an additional 5% is also available. The Richland Hospital, Inc. communicates the availability and terms of the Program to all patients, through means which include, but are not limited to:-Posted signs within waiting rooms, emergency rooms, and financial services departments-Community Care Program application offered to individual prior to discharge-Periodic notifications with patient bills or statements and other oral and written correspondence including "plain language summary" of the Program-Posted policies on the HOSPITAL's website-Brochures written in plain language are available for patients to take with them or to be given to patients by hospital team members and will be made available for use by the local Aging and Disability Resource Center personnel and at the Richland Community Free Clinic-Designated staff knowledgeable on the Program will be available at defined hours to answer patient questions and/or may refer patients to the ProgramRegistration clerks at the hospital, and at the two hospital-owned clinics, are trained to inquire with self-pay patients upon registration if they would like further information on these policies or would like to meet with a member of the business office staff. During the collection process, The Richland Hospital, INC. makes an effort to provide information and includes charity care program materials with each statement that is sent. Social services and business office staff at the hospital are also available to provide information to patients on other government programs such as the Medicaid program or to refer patients to personnel at Richland County or other State of Wisconsin or county agencies that may provide access to care. The Hospital supports staff that have obtained designation as Certified Application Counselors to provide patients and community members one-on-one assistance in navigating the health insurance marketplace. This service began in 2013 and continues through 2015, providing service within the hospital, upon request, but also working with a community coalition which provides an opportunity for one-stop assistance in researching and signing up with an insurance plan that best meets their needs. |
| Part VI, Line 4: | The Richland Hospital, Inc. is located in Richland Center, Wisconsin, which is a community of approximately 5,000 people and is located 50 minutes from Madison, Wisconsin. The HOSPITAL operates a 25-bed, acute care critical access hospital and two rural health clinics located in neighboring communities. The Richland Hospital, INC. offers a wide variety of services in order to fulfill many of the needs of the individuals in the local community. Among services provided are: diagnostic care, 24-hour emergency room, obstetrics, rehabilitation, surgical care, and diabetes self-care programs, along with other specialty services, which include: audiology, cardiology, orthopedics, chemotherapy, clinical services, among others. Care is offered to patients regardless of pay source and regardless of a patient's ability to pay. The communities served by the Richland Hospital are defined by the following zip codes: 53506 - Avoca53556 - Lone Rock53518 - Blue River53573 - Muscoda53581 - Richland Center53588 - Spring GreenThey are geographically contiguous communities. According TO data published by Intellimed, the Richland Hospital, INC. had an overall inpatient market share of 51.7 percent and outpatient market share of 40.8 percent in these zip codes. No other healthcare provider providing the same services had a market share as high as or higher than the Richland Hospital, INC. (Intellimed combines statewide healthcare data from Wisconsin Hospital Association in a web-based support engine that allows us to analyze our market.) Socio-Demographic Profile of the Market Area Served BY The Richland Hospital, INC. serves persons who are representative of the population of the market area. A higher percentage of the population served is elderly; this is due to the fact that persons 65 years of age and older are hospitalized at nearly three times the overall rate. Somethings to note related to planning for meeting community health needs includes the following:- The overall population of the market area is projected to remain very stable, with negligible growth or decline projected over the next five years.- The residents of the market area are aging significantly. There is a projected 6.3% growth in the population aged 45 to 64 and a projected 5.1% growth in the population aged 65 years of age and older. There is a corresponding 11.5% projected decline in the 25 to 44 year old population. Persons in the 0 to 14 age group are also projected to decrease by 0.7%.During 2015, Medicare and Medicare Advantage plan beneficiaries accounted for over 46 percent of all gross patient service revenue at The Richland Hospital, INC. and Medicaid beneficiaries accounted for approximately 15 percent of all gross patient service revenue. Medicare and Medicaid beneficiaries made up the largest portion of patients that are served by The Richland Hospital, INC. over the previous few years. |
| Part VI, Line 5: | The Richland Hospital, Inc. is accredited through the joint commission ("TJC"). The TJC is an organization that evaluates hospital performance standards, focusing on the quality of healthcare. Accreditation through the joint commission is recognized nationwide as a symbol of quality, as it requires rigorous performance standards. To earn and maintain accreditation, the hospital is evaluated through an unannounced survey process covering nearly 600 standards related to quality patient care, safety, infection control, and ongoing performance-improvement activities, among others. All hospitals surveyed by the joint commission are evaluated against the same criteria, regardless of size or location. The activities of The Richland Hospital, INC. are supported locally by a volunteer board of directors which oversee the operations of the hospital. The board of directors is made up of community members that reside in Richland Center, WI, and the surrounding area which is the hospital's primary patient service area. The hospital also extends medical staff privileges to a majority of all qualified physicians in the community and surrounding areas who wish to better serve their patients by providing care at The Richland Hospital, INC. Any surpluses in operations that are achieved by the hospital operating in an effective manner and controlling the cost of healthcare are primarily reserved for future building and capital purchase needs. The Richland Hospital, INC. recognizes that it is important to save these reserves during years of surplus so that in times of economic downturn, if a large capital addition is needed, the HOSPITAL will not have to pass higher costs on to members of the community. The hospital further achieves its goal of providing true community support by providing charity care as described throughout Schedule H and providing services to members of other programs which often reimburse the hospital below the cost of providing this care such as Champus, Tricare, and the Wisconsin Health Insurance Risk Sharing Program or "HIRSP" (the HIRSP program reimburses the hospital at rates similar to the Medicaid program and is for patients that have pre-existing illnesses which make it difficult to obtain insurance from commercial insurance carriers in the marketplace). |
| Part VI, Line 7, Reports Filed With States | WI |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | SCHOLARSHIPS FOR HEALTHCARE EDUCATION | GrantTypeTxt |
| Recipient | 31 | RecipientCnt |
| Cash Grant | $23,250 | CashGrantAmt |
| Non Cash Assistance | $0 | NonCashAssistanceAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | THE RICHLAND HOSPITAL, INC. FOLLOWS A STANDARD PROCEDURE ON ISSUANCE OF SCHOLARSHIP FUNDS WHICH IS DETERMINATED BY THE BOARD OF DIRECTORS AND MANAGEMENT OF THE RICHLAND HOSPITAL, INC. and THE RICHLAND HOSPITAL FOUNDATION, INC. THESE SEPARATE ORGANIZATIONS HAVE ESTABLISHED CRITERIA FOR REVIEW OF APPLICATIONS FOR PROSPECTIVE SCHOLARSHIP RECIPIENTS TO ENSURE THAT SCHOLARSHIPS ARE BEING GRANTED FOR HEALTH EDUCATION RELATED PURPOSES AND TO A QUALIFIED STUDENT STUDYING AT AN ACCREDITED TECHNICAL COLLEGE, COLLEGE, OR UNIVERSITY. (A LARGE PORTION OF THE FUNDING FOR SCHOLARSHIPS IS ALSO GOVERNED BY DONOR AGREEMENTS AS NOTED IN SCHEDULE D TO THE FORM 990 RELATED TO ENDOWMENT FUNDS.) | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | 0 | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | 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 (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KAREN TRAYNOR | ||||||||||||||
| CFO | $183,333 | $0 | $0 | $0 | $3,443 | $0 | $7,333 | $0 | $0 | $0 | $194,109 | $0 | $0 | $0 |
| Bruce Roesler | ||||||||||||||
| CEO (Effective 3/5/2015) | $188,094 | $0 | $0 | $0 | $4,172 | $0 | $0 | $0 | $19,000 | $0 | $211,266 | $0 | $0 | $0 |
| Allan Mottram MD | ||||||||||||||
| ER PhySICIAN | $324,639 | $0 | $0 | $0 | $5,398 | $0 | $0 | $0 | $20,300 | $0 | $350,337 | $0 | $0 | $0 |
| E RACHEL SHANNON-GOODRICH CRNA | ||||||||||||||
| ANESTHETIST | $317,580 | $0 | $0 | $0 | $5,269 | $0 | $10,600 | $0 | $22,949 | $0 | $356,398 | $0 | $0 | $0 |
| MUHAMMAD S KHAN MD | ||||||||||||||
| ER PHYSICIAN | $339,825 | $0 | $0 | $0 | $5,851 | $0 | $10,600 | $0 | $22,949 | $0 | $379,225 | $0 | $0 | $0 |
| BRYAN MCCARVEL | ||||||||||||||
| ANESTHESIA DIRECTOR | $346,000 | $0 | $0 | $0 | $5,033 | $0 | $10,600 | $0 | $22,949 | $0 | $384,582 | $0 | $0 | $0 |
| Bruce Moths MD | ||||||||||||||
| ER PHYSICIAN | $292,321 | $0 | $0 | $0 | $5,851 | $0 | $10,600 | $0 | $22,949 | $0 | $331,721 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 1a | FormAndLineReferenceDesc |
| Explanation | Health club dueS gross ups, when applicable, were added to the individual's compensation at fair market value. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| Cory Nugent | |||
| Son of Robert Nugent, Board Chair | $35,982 | Employee Compensation | 0 |
| Jenna Sebranek MD | |||
| Daughter of Jerry Gander, Director | $15,000 | Recruitment Assistance Agreement, Forgiveable Sign-on Loan | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section B, line 11 | A COPY OF FORM 990 WAS EMAILED OR MAILED TO ALL MEMBERS OF THE HOSPITAL'S BOARD OF DIRECTORS BEFORE IT WAS FILED. ALL BOARD MEMBERS WERE GIVEN THE OPPORTUNITY TO RESPOND WITH COMMENTS PRIOR TO THE FINAL SUBMISSION OF THE FORM 990 TO THE INTERNAL REVENUE SERVICE. |
| Form 990, Part VI, Section B, line 12c | THE RICHLAND HOSPITAL, INC. REQUIRES ALL OFFICERS, DIRECTORS, TRUSTEES, and KEY EMPLOYEES TO COMPLETE ITS ANNUAL DISCLOSURE STATEMENT. THESE QUESTIONNAIRES ARE THEN REVIEWED BY THE BOARD OF DIRECTORS, NOTING ANY RELATIONSHIPS THAT COULD POTENTIALLY CREATE A CONFLICT OF INTEREST. ANY INDIVIDUALS WITH NOTED CONFLICTS ARE ASKED TO ABSTAIN FROM VOTING OR ACTING ON THOSE MATTERS. |
| Form 990, Part VI, Section B, line 15 | THE BOARD OF DIRECTORS HAS AN ESTABLISHED PROCESS TO ANNUALLY REVIEW THE COMPENSATION FOR THE CHIEF EXECUTIVE OFFICER AND TO DEFINE APPROPRIATE MARKET AND PERFORMANCE BASED ADJUSTMENTS. COMPARATIVE DATA IS OBTAINED FROM EITHER THE WISCONSIN HOSPITAL ASSOCIATION EXECUTIVE COMPENSATION SURVEY OR OTHER REPUTABLE THIRD-PARTY HEALTHCARE DATA SOURCES TO USE IN THE ESTABLISHMENT OF A MARKET FOR THIS KEY POSITION. THE PERSONNEL COMMITTEE OF THE BOARD OF DIRECTORS FULFILLS THIS ROLE. THE BOARD OF DIRECTORS HAS DELEGATED THE AUTHORITY AND RESPONSIBILITY FOR THE ONGOING MAINTENANCE OF OTHER KEY EMPLOYEES AND THE OVERALL ORGANIZATIONAL COMPENSATION MODEL TO THE CHIEF EXECUTIVE OFFICER AND HUMAN RESOURCE DIRECTOR. COMPARATIVE MARKET DATA IS OBTAINED VIA THE RURAL WISCONSIN HEALTH COOPERATIVE AND THE WISCONSIN SOCIETY OF HOSPITAL HUMAN RESOURCE ADMINISTRATORS VIA INDEPENDENT SALARY SURVEYS THAT PROVIDE BENCHMARK INFORMATION FOR HEALTHCARE JOB CLASSES. THIS DATA IS USED TO ESTABLISH SALARY RANGES FOR ALL JOB CLASSES WITHIN THE ORGANIZATION. THE BOARD OF DIRECTORS ANNUALLY AUTHORIZES THE OVERALL INCREASE TO THE SALARY BUDGET FOR THE ORGANIZATION WITH THE CEO MAINTAINING DELEGATED AUTHORITY FOR IMPLEMENTATION WITHIN THE ORGANIZATIONAL COMPENSATION MODEL. DURING THE REVIEW PROCESS, DECISIONS AFFECTING COMPENSATION AND CONTRACTS ARE ONLY REVIEWED AND APPROVED BY INDIVIDUALS WHO DO NOT HAVE NOTED CONFLICTS. |
| Form 990, Part VI, Section C, line 19 | THE RICHLAND HOSPITAL, INC. MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT ITS HOSPITAL BUSINESS LOCATION DURING NORMAL BUSINESS HOURS. |
| Form 990, Part IX, line 11g | Other Purchased Services: Program service expenses 768,324. Management and general expenses 550,691. Fundraising expenses 8,569. Total expenses 1,327,584. Medical Imaging Purchased Services: Program service expenses 1,165,881. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,165,881. Clinical Purchased Services: Program service expenses 778,881. Management and general expenses 0. Fundraising expenses 0. Total expenses 778,881. Laboratory Purchased Services: Program service expenses 276,546. Management and general expenses 0. Fundraising expenses 0. Total expenses 276,546. Surgical Purchased Services: Program service expenses 345,231. Management and general expenses 0. Fundraising expenses 0. Total expenses 345,231. |
| Form 990, Part XI, line 9: | NET CHANGE IN UNRESTRICTED NET ASSETS OF supporting organizations -152,566. NET CHANGE IN TEMPORARILY RESTRICTED NET ASSETS OF FOUNDATION 9,085. CONTRIBUTIONS FROM RELATED ORGANIZATIONS -261,149. |
| FORM 990, PART XII, LINE 2C: SELECTION OF INDEPENDENT ACCOUNTANT | THE FINANCE COMMITTEE of The Richland Hospital, Inc., WHICH IS A SUB-COMMITTEE TO THE HOSPITAL'S BOARD OF DIRECTORS, REVIEWS THE ANNUAL AUDIT PROCESS WITH THE INDEPENDENT ACCOUNTANTS. BOARD MEMBERS ARE ALSO GIVEN THE NAMES AND CONTACT INFORMATION OF THE INDEPENDENT ACCOUNTANTS AT THE ANNUAL FINANCE COMMITTEE'S REVIEW MEETING OF THE AUDITED FINANCIAL STATEMENTS SO THAT THEY MAY INQUIRE, IF NEEDED, WITH THE ACCOUNTANTS THROUGHOUT THE YEAR. A BOARD MEMBER IS ALSO SELECTED ANNUALLY FOR REVIEW AND INQUIRY BY THE INDEPENDENT ACCOUNTANTS FOR SEPARATE AND PRIVATE INTERVIEW AS A PART OF THE AUDIT PROCESS. THESE FUNCTIONS ALLOW A GREATER AMOUNT OF OVERSIGHT BY THE BOARD INTO THE ANNUAL AUDIT PROCESS. THERE HAS BEEN NO CHANGE TO THESE PROCEDURES DURING THE PAST YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| THE RICHLAND HOSPITAL FOUNDATION INC | ||||||||||
| 333 EAST SECOND STREET | RICHLAND CENTER | WI | 53581 | 391567249 | FOUNDATION | WI | 501(c)(3) | Line 9 | N/A | 0 |
| PARTNERS OF RICHLAND HOSPITAL INC | ||||||||||
| 333 EAST SECOND STREET | RICHLAND CENTER | WI | 53581 | 391693458 | AUXILIARY | WI | 501(c)(3) | Line 9 | N/A | 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 | Yes (1) | 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 | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |