2015-10-26T08:43:08-05:00 2014-12-31 390758449 WIPFLI LLP 3703 OAKWOOD HILLS PARKWAY EAU CLAIRE WI 54701 990 2014-01-01 390806828 MEMORIAL HOSPITAL INC MEMO 7157433101 216 SUNSET PLACE NEILLSVILLE WI 54456 RYAN NEVILLE CEO 7157433101 2015-10-23 1 HOLLY POKRANDT CPA P00449155 7158323407 2015-10-08 2014 2016-02-25 16:41:14Z RYAN NEVILLE 216 SUNSET PLACE NEILLSVILLE WI 54456 25122622 0 X WWW.MEMORIALMEDCENTER.ORG X 1954 WI MEMORIAL HOSPITAL, INC.'S MISSION IS TO PROVIDE THE COMMUNITIES WE SERVE THE BEST EXPERIENCE IN HEALTH CARE, EDUCATION, AND PREVENTION SUPPORTED BY OUR PILLARS OF PEOPLE, SERVICE, QUALITY AND SAFETY, FINANCE, COMMUNITY, AND GROWTH...ONE PATIENT AT A TIME. MEMORIAL HOSPITAL, INC. PROVIDES SERVICES THROUGH ITS 25-BED CRITICAL ACCESS HOSPITAL, ASSISTED LIVING, AS WELL AS 3 RURAL HEALTH CLINICS LOCATED IN NEILLSVILLE, LOYAL, AND GREENWOOD, WISCONSIN. TO FULFILL COMMUNITY NEEDS, MEMORIAL HOSPITAL, INC. FACILITATES EDUCATIONAL SEMINARS AND SUPPORT GROUPS LED BY MEDICAL AND PROFESSIONAL STAFF AT GREATLY REDUCED-RATES; PROVIDES FREE HEALTH SCREENINGS AT GIVEN TIMES THROUGHOUT THE YEAR; STAFF BOOTHS AT COMMUNITY EVENTS; SERVES AS AN EDUCATION SITE FOR STUDENTS IN HIGH SCHOOL, TECHNICAL COLLEGE, AND UNIVERSITIES; AS WELL AS OTHER NEEDS AS DETERMINED. MEMORIAL HOSPITAL, INC. ALSO ADMINISTERS A CHARITY CARE PROGRAM HELPING TO ENSURE AFFORDABLE ACCESS TO HEALTH CARE. 10 7 265 74 488001 -192936 71691 142543 22646139 24174112 19382 87046 427462 464289 23164674 24867990 0 0 0 0 14826273 15109918 0 0 0 10768913 10423636 25595186 25533554 -2430512 -665564 15264297 15247440 5157450 5841327 10106847 9406113 X TO PROVIDE THE COMMUNITIES WE SERVE THE BEST EXPERIENCE IN HEALTH CARE, EDUCATION, AND PREVENTION, SUPPORTED BY OUR PILLARS OF PEOPLE, SERVICE, QUALITY AND SAFETY, FINANCE, COMMUNITY, AND GROWTH...ONE PATIENT AT A TIME. 0 0 13866557 21057752 MEMORIAL HOSPITAL, INC. (THE "HOSPITAL"), A 25-BED RURAL HOSPITAL, IS A NONPROFIT, NONSTOCK WISCONSIN CORPORATION PROVIDING SERVICES TO NEILLSVILLE, WISCONSIN, AND THE SURROUNDING COMMUNITIES. HOSPITAL INPATIENT SERVICES IN 2014 INCLUDED 687 ACUTE CARE PATIENT DAYS, 91 OBSERVATION DAYS, AND 408 SWING BED PATIENT DAYS.EMERGENCY ROOM VISITS TOTALED 2,299 AND SURGERIES AND PROCEDURES TOTALED 1,011 IN 2014.OTHER HOSPITAL SERVICES PROVIDED IN 2014 INCLUDED BUT WERE NOT LIMITED TO: ATHLETIC TRAINING, DIETARY, PAIN MANAGEMENT, PHARMACY, PHYSICAL THERAPY, RADIOLOGY, LABORATORY, CARDIAC REHABILITATION, RESPIRATORY THERAPY, OCCUPATIONAL THERAPY, AND DIABETIC EDUCATION. 5823739 2590802 MEMORIAL HOSPITAL, INC. ALSO OWNS AND OPERATES THREE CLINICS LOCATED IN NEILLSVILLE, LOYAL, AND GREENWOOD, WISCONSIN. TOTAL CLINIC VISITS FOR 2014 WAS 22,001. OF THE TOTAL VISITS, 2,338 WERE URGENT CARE CLINIC VISITS. 767823 386230 THE ASSISTED LIVING FACILITY IS AN ALTERNATIVE FOR SENIORS WHO CAN NO LONGER LIVE SAFELY IN THEIR OWN HOME, YET DO NOT NEED 24-HOUR MEDICAL SUPERVISION. SUNSET GARDENS IS A HOUSING AND HEALTH CARE ALTERNATIVE, COMBINING INDEPENDENCE WITH PERSONAL CARE, IN A WARM, DIGNIFIED, HOME-LIKE ATMOSPHERE. SUNSET GARDENS HAS 11 PRIVATE ROOMS AND 2 DOUBLE ROOMS, FOR A COUPLE OR SIBLINGS. MEALS, SNACKS, HOUSEKEEPING, LAUNDRY, CABLE TELEVISION, AND MAINTENANCE SERVICES ARE PROVIDED. SOCIAL AND RECREATIONAL PROGRAMS AND A CHAPEL ARE ALSO PROVIDED. HEALTH CARE SERVICES INCLUDE A REGISTERED NURSE ON-SITE OR ON-CALL 24-HOURS PER DAY, MEDICATION MANAGEMENT, AND PERSONAL CARE SERVICES PROVIDED BY CERTIFIED NURSING ASSISTANTS (SUCH AS ASSISTANCE WITH BATHING, DRESSING, AND GROOMING). THE ASSISTED LIVING PROVIDED APPROXIMATELY 4,663 RESIDENT DAYS DURING 2014. 20458119 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 0 0 0 1 53 0 265 1 1 1 0 0 0 0 0 0 0 0 0 X 10 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 1 1 0 WI X KELLY SILBERNAGEL 7157433101 216 SUNSET PLACE NEILLSVILLE WI 54456 X ROBERT BARTH PRESIDENT 1.00 X X 800 0 0 RICK SZYMANSKI VICE-PRESIDENT 1.00 0.50 X X 575 0 0 KEVIN GRAP SECRETARY 1.00 X X 450 0 0 TREVOR WUETHRICH BOARD MEMBER 1.00 X 275 0 0 DOROTHY WELSH BOARD MEMBER 1.00 X 25 0 0 MARY KAY MILLS BOARD MEMBER 1.00 0.50 X 500 0 0 JAMES CHADWICK BOARD MEMBER 1.00 X 400 0 0 GARY WEIRAUCH BOARD MEMBER 1.00 X 550 0 0 RUSSELL RATSCH BOARD MEMBER 1.00 0.50 X 525 0 0 BARBARA PETKOVSEK BOARD MEMBER 1.00 X 150 0 0 DR TIMOTHY MEYER CHIEF MEDICAL OFFICER 32.00 X 314709 0 15885 JODI JOHNSON CHIEF NURSING OFFICER (THROUGH 03/2014) 40.00 X 24284 0 9363 DAVID BALTZER INTERIM CEO (THROUGH 03/2014) 40.00 X 49000 0 1000 ROGER SNEATH INTERIM CFO 40.00 X 217221 0 0 RYAN NEVILLE PRESIDENT & CEO (EFFECTIVE 03/2014) 40.00 X 173854 0 36233 DR DAVID CARLSON PHYSICIAN 33.00 X 678770 0 29249 DR GRACE CRUZ-APOLINARIO PHYSICIAN 32.00 X 414792 0 41273 DR JAMES STANGA PHYSICIAN 32.00 X 361204 0 40759 DR SHARON HAYWARD PHYSICIAN 32.00 X 426154 0 31102 DR KENNETH WEIMER PHYSICIAN 32.00 X 248048 0 39081 2912286 0 243945 9 0 1 0 EMCARE INC 7032 COLLECTION CENTER DRIVE CHICAGO IL 60693 ER COVERAGE 743965 CPSI PO BOX 850309 MOBILE AL 36685 IT SERVICES 601639 WI ANETHESIA SERVICE LLC W5844 ROLLING HILL DRIVE NEILLSVILLE WI 54456 ANETHESIA SERVICES 506170 HEALTHPRO STAFFING & PLACEMENTS 1602 HIDDEN HILL DRIVE VERONA WI 53593 PHARMACY STAFFING 365174 KELLY SERVICES INC 1212 SOLUTIONS CENTER CHICAGO IL 60677 NON-MEDICAL TEMPORARY STAFFING 225952 9 102050 17353 23140 142543 HOSPITAL REVENUE 621110 21081464 21057752 23712 CLINIC REVENUE 621110 2590802 2590802 ASSISTED LIVING REVENUE 623000 386230 386230 115616 115616 24174112 7630 7630 328338 5710 247702 6930 80636 -1220 79416 79416 DIET,MAINT,HSKG,LNDRY 812900 464289 464289 464289 24867990 24034784 488001 202662 X 845799 364241 481558 11013483 9159462 1854021 332886 276848 56038 2224843 1850495 374348 692907 568375 124532 58254 58254 93542 93542 3183539 2647281 536258 79068 79068 785545 598262 187283 89902 89902 462464 254423 208041 66282 41656 24626 73727 53182 20545 1222613 672617 549996 287652 87800 199852 MEDICAL SUPPLIES 2088929 2088929 BAD DEBT 1154000 1154000 EQUIPMENT RENTAL & MAIN 699277 561706 137571 ADMIN HOSPITAL TAX EXPE 78842 78842 25533554 20458119 5075435 0 265291 388985 1852747 1856313 3058075 2961357 669388 652732 271266 209613 17721807 11273729 7378259 6448078 1769271 2730362 15264297 15247440 3872367 3234967 330000 0 0 1436609 955083 1169751 5157450 5841327 X 10106847 9406113 10106847 9406113 15264297 15247440 -665564 -69229 34059 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 4849 4849 0 PART II-B, LINE 1: MEMORIAL HOSPITAL, INC. 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 HAS NOTIFIED MEMORIAL HOSPITAL, INC. THAT $1,501 OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTH CARE ENVIRONMENT. MEMORIAL HOSPITAL, INC. IS ALSO A MEMBER OF THE RURAL WISCONSIN HEALTH COOPERATIVE (RWHC). EACH YEAR, MEMORIAL HOSPITAL, INC. PAYS MEMBERSHIP FEES TO THE RWHC. THE RWHC PROVIDES SUPPORT SERVICES FOR A NUMBER OF ITS MEMBER HOSPITALS THROUGHOUT THE STATE OF WISCONSIN. SOME OF THE MANY SERVICES PROVIDED TO MEMBER HOSPITALS INCLUDE PROVIDING ASSISTANCE TO ORGANIZATIONS IN FINDING GRANT FUNDING FOR NEW PROGRAMS, LEGAL SERVICES, REIMBURSEMENT REVIEW SERVICES, ACCOUNTING ASSISTANCE, CONTRACTING FOR THERAPIST AND EMERGENCY ROOM PHYSICIAN COVERAGE, AND ADMINISTRATIVE CONSULTING SERVICES. AS A PART OF THESE SERVICES, THE RWHC ALSO DOES PROVIDE ANALYSIS ON CURRENT HEALTH CARE ISSUES IN AN EFFORT TO PROMOTE BETTER HEALTH CARE FOR HOSPITALS IN RURAL COMMUNITIES THROUGHOUT WISCONSIN. ONE OF THESE EFFORTS ALSO INCLUDES SOME LOBBYING ON THE PART OF THE MEMBER ORGANIZATIONS. THE RWHC DETERMINED THAT $3,348 OF THE FEES PAID IN 2014 RELATED TO LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE HEALTH CARE ENVIRONMENT IN THE STATE OF WISCONSIN. 20673 20673 10957898 6976529 3981369 6481015 4063259 2417756 262221 233941 28280 6448078 INVESTMENT IN CENTRAL MN DIAGNOSTIC, INC. 352622 DEFERRED COMPENSATION PLAN ASSETS 1177740 AMOUNTS RECEIVABLE FROM THIRD-PARTY REIUMBURSEMENT PROGRAMS 1100000 OTHER RECEIVABLES 100000 2730362 DEFERRED COMPENSATION LIABILITY 1169751 1169751 X PART X, LINE 2: IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, MEMORIAL HOSPITAL, INC. DETERMINES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE LIKELY THAN NOT RECOGNITION THRESHOLD, THE BENEFIT OF THE TAX POSITION IS NOT RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS. MEMORIAL HOSPITAL, INC. HAS NOT RECORDED ANY ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS AS OF DECEMBER 31, 2014 OR 2013. FEDERAL RETURNS FOR THE YEARS ENDED DECEMBER 31, 2011, AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. 1 1 1 X 49.000000000000 1 X 1 1 0 1 1 162549 162549 0.00670 2946821 1641837 1304984 0.05350 3109370 1641837 1467533 0.06020 60992 60992 0.00250 26692 26692 0.00110 8882038 3704457 5177581 0.21240 3974 3974 0.00020 5207 5207 0.00020 8978903 3704457 5274446 0.21640 12088273 5346294 6741979 0.27660 3132 3132 0.00010 698 698 0.00000 3652 3652 0.00010 12625 12625 0.00050 516 516 0.00000 20623 20623 0.00070 0 727919 291168 3804225 3829268 -25043 X 1 1 1 1 MEMORIAL HOSPITAL INC 216 SUNSET PLACE NEILLSVILLE WI 54456 WWW.MEMORIALMEDCENTER.ORG 1026 X X X X MEMORIAL HOSPITAL INC 1 0 0 1 X X X X X X X X X 13 1 1 1 1 X WWW.MEMORIALMEDCENTER.ORG X 1 13 0 1 0 1 X 49.000000000000 300.000000000000 X X X 1 1 X X X X 1 X X X X X 1 X 0 X X X X 1 X 0 0 MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 5: REPRESENTATIVES FROM MEMORIAL HOSPITAL, INC. AND MINISTRY OUR LADY OF VICTORY HOSPITAL PARTNERED WITH THE CLARK COUNTY PUBLIC HEALTH DEPARTMENT TO ESTABLISH THE "HEALTH CARE PARTNERSHIP FOR CLARK COUNTY." IN ADDITION TO THE FOUNDING ORGANIZATIONS, OTHER PARTICIPATING MEMBERS REPRESENT A VARIETY OF CLARK COUNTY BASED ORGANIZATIONS. THE PARTNERSHIP WAS AWARDED A GRANT TO PILOT COMMUNITY ASSESSMENT TOOLS THAT BROUGHT SPECIAL PUBLIC HEALTH EXPERTISE AND KNOWLEDGE TO THE PROCESS. MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 6A: THE CHNA WAS CONDUCTED IN JOINT EFFORT WITH MINISTRY OUR LADY OF VICTORY HOSPITAL (STANLEY, WISCONSIN). MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 11: THE FOLLOWING ITEMS WERE ITEMS IDENTIFIED IN THE CHNA FOR MEMORIAL HOSPITAL, INC. (THE "HOSPITAL") AND ARE BEING ADDRESSED AS FOLLOWS: HEALTHY LIFE STYLES-PHYSICAL ACTIVITY AND HEALTHY EATING: SUPPORT, PROMOTION, AND ASSIST IN DISTRIBUTION OF SEVERAL HUNDRED COPIES OF THE "ROADMAP TO A HEALTHIER YOU" WHICH ENCOMPASSES JOINT USE AGREEMENTS FOR RECREATIONAL FACILITIES THROUGHOUT CLARK COUNTY. THE HOSPITAL SUPPORTS THE HEALTH CARE PARTNERSHIP IN ITS EFFORTS TO PROMOTE AND GROW HEALTHY AND ACTIVE LIFESTYLE CLUBS IN THE COUNTY. THE HOSPITAL LEADS THE EFFORTS FOR THE MC MILERS PROGRAM WHICH IS A HEALTHY LIFESTYLE PROGRAM THAT ENCOURAGES THE HOSPITAL STAFF AND THE COMMUNITY TO ENGAGE IN PHYSICAL ACTIVITY WHILE TRACKING THEIR MILES OF WALKING TO IMPROVE HEALTH. THE HOSPITAL HAS SUPPORTED AND IS WORKING WITH THE HEALTH CARE PARTNERSHIP TO DEVELOP PLANS TO FURTHER EXPAND NUTRITIONAL OFFERINGS THROUGH THE FOOD PANTRIES OF CLARK COUNTY, ALONG WITH MAKING A MONETARY DONATION. THE HOSPITAL HAS PROVIDED PROMOTION OF NUTRITION AND ACTIVE LIFESTYLES THROUGH THE HOSPITAL CONNECTIONS NEWSLETTER THAT GOES OUT TO ALL OF CLARK COUNTY, 11,000 PLUS COPIES. MEN'S AND WOMEN'S HEALTH NIGHTS WERE HELD BY THE HOSPITAL IN 2014 AND SPEAKERS AND EDUCATIONAL MATERIALS WERE PROVIDED TO ATTENDEES THAT SUPPORTED HEALTHY LIVING CONCEPTS. THERE WERE 125 ATTENDEES BETWEEN BOTH EVENTS. THE HOSPITAL HAS A WELLNESS COMMITTEE AND PROGRAM THAT IT PROVIDES THE HOSPITAL STAFF. THIS PROGRAM ENCOURAGES WELLNESS THROUGH ACTIVITY, NUTRITION, AND CARE OF ONE'S SELF.MENTAL HEALTH: THE HOSPITAL HAS SUPPORTED THE GRANT WRITING INITIATIVES IN REGARDS TO MENTAL HEALTH NEEDS FOR CLARK COUNTY WITH LETTERS OF SUPPORT. THE HOSPITAL PROVIDED ITS SUPPORT TO THE GRANT FUNDING THAT WAS AWARDED AND HELPED TO SUPPORT THE CREATION AND START-UP FOR THE MENTAL HEALTH TASK FORCE FOR CLARK COUNTY. MEMORIAL HOSPITAL, INC. IS AN ACTIVE PARTICIPANT ON THE MENTAL HEALTH TASK FORCE. THROUGH THE MENTAL HEALTH TASK FORCE, THE HOSPITAL HAD A STAFF PERSON COMMIT TO PARTICIPATING IN A TRAIN THE TRAINER PROGRAM KNOWN AS "QPR" WHICH STANDS FOR "QUESTION PERSUADE REFER." THIS IS A TRAINING TO HELP EDUCATE ON SIGNS OF DEPRESSION. THE TRAINING WILL BE DONE BY TRAINED INDIVIDUALS TO COMMUNITY GROUPS/CLUBS ALL THROUGHOUT CLARK COUNTY ON DEPRESSION. THE HOSPITAL TRAINER THEN WILL GO OUT IN 2015 AND DO A MINIMUM OF 2 TRAININGS. THE HOSPITAL BEGAN RESEARCHING THE POTENTIAL OF MENTAL HEALTH AS A SERVICE LINE TO PROVIDE COUNSELING/MENTAL HEALTH SERVICES TO CLARK COUNTY.PREVENTATIVE SCREENINGS: THE HOSPITAL HAS WORKED TO BUILD PUBLIC AWARENESS TO RISK FACTORS SUCH AS DIABETES, HYPERTENSION, AND HEART DISEASE AT WOMEN'S AND MEN'S HEALTH EVENTS HELD IN 2014. THE HOSPITAL HAS PROVIDED INFORMATION IN MARKETING VENUES THAT SUPPORTS PREVENTATIVE SCREENING UTILIZATION.TRANSPORTATION: THE HEALTH CARE PARTNERSHIP HAD DIFFERENT COUNTY TRANSPORTATION VENUES ATTEND MEETINGS AND WERE GIVEN THEIR TRANSPORTATION OPTIONS. THIS INFORMATION WAS THEN PASSED ON TO THE HOSPITAL FOR EDUCATION. THE HOSPITAL HAS PROVIDED ITS SUPPORT AS NEEDED TO GRANTS TO SUPPORT TRANSPORTATION SERVICES AS NEEDED.THERE WERE ITEMS IDENTIFIED IN THE CHNA WHICH WERE NOT ADDRESSED BY MEMORIAL HOSPITAL, INC.; HOWEVER, ALL ITEMS WERE CONSIDERED IF A NEED WAS BROUGHT TO THE ATTENTION OF THE GROUP DURING THE INFORMATION GATHERING PHASE OF THE CHNA PROCESS. SEVERAL OF THE ITEMS WHICH WERE NOT ADDRESSED PRIMARILY WERE NOT ADDRESSED DUE TO THE FINANCIAL CONSTRANT OF PROVIDING A NEW SERVICE FOR A LIMTED POPULATION OF PEOPLE WITHIN THE PRIMARY SERVICE AREA OR AT THE PRESENT TIME IT WAS DETERMINED THAT A PARTNER ORGANIZATION MAY BE NEEDED TO MAKE A NEW HEALTH SERVICE A FINANCIALLY VIABLE OPTION IN THE LOCAL COMMUNITY. MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 16I: A LETTER DESCRIBING THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS SENT TO PATIENTS FOR EVERY SERVICE PROVIDED WHERE THEY ARE REGISTERED AS A PRIVATE PAY PATIENT. A LETTER IS ALSO SENT TO PATIENTS AGAIN WHEN NO PAYMENT HAS BEEN RECEIVED AFTER TWO STATEMENTS. MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 22D: MAXIMUM AMOUNTS THAT CAN BE CHARGED TO INDIVIDUALS ARE AS FOLLOWS:PATIENTS WHOSE INCOME IS 49% OR LESS OF THE FEDERAL POVERTY GUIDELINES RECEIVE FREE CARE.PATIENTS WHOSE INCOME IS BELOW 200% OF THE FEDERAL POVERTY GUIDELINES RECEIVE THE LOWEST NEGOTIATED COMMERCIAL RATE.PATIENTS WHOSE INCOME IS BELOW 300% OF THE FEDERAL POVERTY GUIDELINES RECEIVE A 10% DISCOUNT FROM GROSS CHARGES. PART V, SECTION B, LINE 16 FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 16A WEBSITE: WWW.MEMORIALMEDCENTER.ORG MEMORIAL HOSPITAL, INC. PART V, SECTION B, LINE 16B WEBSITE: WWW.MEMORIALMEDCENTER.ORG 4 MEMORIAL MEDICAL CENTER 216 SUNSET PLACE NEILLSVILLE WI 54456 PROVIDER-BASED RURAL HEALTH CLINIC SUNSET GARDENS 216 SUNSET PLACE NEILLSVILLE WI 54456 ASSISTED LIVING FACILITY GREENWOOD FAMILY MEDICAL CENTER 201 SOUTH MAIN GREENWOOD WI 54437 PROVIDER-BASED RURAL HEALTH CLINIC LOYAL CLINIC - MEMORIAL MEDICAL CENTER 502 EAST ELM STREET LOYAL WI 54446 PROVIDER-BASED RURAL HEALTH CLINIC PART I, LINE 3C: MEMORIAL HOSPITAL, INC. GENERALLY USES 49% OF FEDERAL POVERTY GUIDELINES FOR OFFERING CARE FREE OF CHARGE AND A SLIDING SCALE GOING UP TO 300% OFFERING CARE AT REDUCED CHARGES. IT SHOULD ALSO BE NOTED THAT MEMORIAL HOSPITAL, INC., AS A PART OF ITS COMMUNITY CARE POLICY, WILL ALSO CONSIDER AN ADMINISTRATIVE REVIEW OF OTHER OUTSTANDING BALANCES OF AN INDIVIDUAL. THE HOSPITAL WILL DETERMINE ON AN INDIVIDUAL BASIS IF ADDITIONAL DISCOUNTS CAN BE PROVIDED TO PATIENTS. A PATIENT MAY HAVE A SIGNIFICANT OR LONG-TERM NEED OF MEDICAL BILLS THAT MAY REQUIRE ADDITIONAL COMMUNITY SUPPORT TO HELP A PATIENT THROUGH A DIFFICULT TIME. PART I, LINE 6A: MEMORIAL 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 THE WHA'S WEBSITE. PART I, LINE 7: THE COSTING METHOD USED ON FORM 990 IS BASED ON A COST-TO-CHARGE RATIO WHICH IS DEVELOPED BASED ON THE 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 VARIOUS REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER IRS SUGGESTED COSTING METHODS FOR THE FORM 990. PART I, LINE 7G: THE COST OF SUBSIDIZED HEALTH SERVICES IS BASED ON COST ALLOCATIONS FROM THE MEDICARE COST REPORT. ALLOWABLE COSTS ARE ASSIGNED DIRECTLY TO DEPARTMENTS THROUGHOUT THE YEAR AND THEN THE COST REPORT USES THE ALLOCATION METHODOLOGY TO ASSIGN ALL OTHER COSTS TO CALCULATE SERVICE LINE COSTS. SUBSIDIZED HEALTH SERVICES INCLUDE THE OPERATION OF THREE FAMILY PRACTICE CLINICS, HOSPITAL INPATIENT UNIT, LABOR & DELIVERY, AND EMERGENCY ROOM. IT IS THE GOAL OF MEMORIAL HOSPITAL, INC. TO PROVIDE THESE SERVICES TO THE COMMUNITY REGARDLESS OF A 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 $ 1,154,000. PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITY THAT THE HOSPITAL SERVES. THROUGH COLLABORATION WITH LOCAL ORGANIZATIONS, THE HOSPITAL PROVIDES INFORMATION TO THE COMMUNITY REGARDING VARIOUS ISSUES THAT AFFECT HEALTH SUCH AS BABYSITTING CLASSES, SERVING ON PUBLIC HEALTH BOARDS, WORKING WITH DISASTER PREPAREDNESS, CPR CLASSES, DIABETIC SUPPORT GROUPS, PRESCRIPTION ASSISTANCE, STRESS MANAGEMENT, PREVENTATIVE SERVICES, AND OTHERS. 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 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 ASSISTANCE WITH THE APPLICATIONS. DUE TO NO RESPONSES FROM SOME PATIENTS, A SIGNIFICANT AMOUNT OF BAD DEBTS COULD BE CONSIDERED AS CHARITY CARE. PART III, LINE 4: PATIENT RECEIVABLES AND CREDIT POLICY: IN EVALUATING THE COLLECTABILITY OF PATIENT 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 DEDUCTIBLE 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 PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF THEIR 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 INCLUDE A SEPARATE FOOTNOTE REGARDING BAD DEBT EXPENSE. PART III, LINE 8: MEMORIAL HOSPITAL, INC. IS DESIGNATED A CRITICAL ACCESS HOSPITAL AND AS SUCH A PORTION OF ITS REVENUES ARE PAID UNDER A COST REIMBURSEMENT SYSTEM. BASED ON THE INSTRUCTIONS, THE TOTAL MEDICARE REVENUE SHOWN ON THIS FORM 990 INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE THAT IS ACTUALLY RECEIVED BY THE HOSPITAL FROM THE MEDICARE PROGRAM. THE AMOUNTS LISTED FOR MEDICARE DO NOT INCLUDE PHYSICIAN AND MID-LEVEL PRACTITIONER SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT OR ANESTHESIA SERVICES AT THE HOSPITAL. PHYSICIAN COVERAGE IS REIMBURSED PRIMARILY ON A FEE SCHEDULE REIMBURSEMENT METHODOLOGY AT RATES THAT ARE OFTEN BELOW THE COST OF PROVIDING CARE TO PATIENTS. EMERGENCY AND ANESTHESIA SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND THEREFORE THESE COSTS AND SHORTFALLS SHOULD ALSO BE CONSIDERED AS AN ADDITIONAL BENEFIT THAT THE HOSPITAL PROVIDES TO THE COMMUNITY AND SURROUNDING AREA OF NEILLSVILLE, WISCONSIN. THE COSTING METHOD USED ABOVE FOR IRS 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. THIS RATIO IS THEN MULTIPLIED BY THE TOTAL MEDICARE SERVICES WHICH ARE REIMBURSED ON A COST METHODOLOGY EXCLUDING THE FEE SCHEDULE ITEMS LIKE PHYSICIAN AND MID-LEVEL PRACTITIONER SERVICES WHICH THE HOSPITAL WOULD SHOW A LARGE LOSS ON THESE SERVICES.WHETHER THERE IS A SHORTFALL OR SURPLUS FROM SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THE RECIPIENTS ARE TYPICALLY ELDERLY AND/OR DISABLED MEMBERS OF THE COMMUNITY AND 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 III, LINE 9B: UNDER THE HOSPITAL'S CHARITY CARE POLICY, MEMORIAL HOSPITAL, INC., MAKES EVERY ATTEMPT TO IDENTIFY AND PROMOTE CHARITY CARE TO PATIENTS. INCLUDED IN THE HOSPITAL'S POLICY IT IS NOTED THAT PATIENTS MAY QUALIFY FOR CHARITY CARE EITHER PRIOR TO ADMISSION OR FOLLOWING DISCHARGE. UNINSURED PATIENTS ARE GIVEN THE OPPORTUNITY TO FILL OUT A CHARITY CARE APPLICATION AT THE TIME OF ADMISSION AND ALL PATIENTS ARE ASKED TO FILL OUT A CHARITY CARE APPLICATION DURING THE COLLECTION PROCESS PRIOR TO SENDING ANY ACCOUNTS TO A COLLECTION AGENCY. IF THE PAPERWORK IS NOT RECEIVED, THE ACCOUNT IS HANDLED THROUGH THE NORMAL COLLECTION PROCESS. PART VI, LINE 2: THE HOSPITAL ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES AND AREAS IT SERVES BY REVIEWING LOCAL DEMOGRAPHICS AND TRENDS IN PATIENT SERVICE UTILIZATION TO DETERMINE WHICH SERVICES COULD AND SHOULD BE MADE AVAILABLE TO THE COMMUNITY IN A COST-EFFECTIVE MANNER. THE HOSPITAL RECENTLY COLLABORATED WITH ANOTHER AREA HOSPITAL TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE CHNA FOCUSED ON DETERMINING THE KEY HEALTH CARE PRIORITIES IN THE COMMUNITY. THE HOSPITAL ALSO SEEKS ONGOING INPUT FROM LOCAL COMMUNITY MEMBERS AND STAFF MEMBERS TO DETERMINE WHICH SERVICES MAY BENEFIT THE COMMUNITY. PART VI, LINE 3: ALL PATIENTS WHO REGISTER WITHOUT INSURANCE ARE SENT A PRIVATE PAY LETTER NOTIFYING THEM TO CONTACT A FINANCIAL SERVICES REPRESENTATIVE AT THE HOSPITAL IF THEY NEED ASSISTANCE IN PAYING THEIR BILL. THE LETTER ALSO HIGHLIGHTS THE CHARITY CARE PROGRAM AND GIVES THE WEBSITE WHERE THE APPLICATION CAN BE FOUND. THE FINANCIAL SERVICES REPRESENTATIVE THEN DISCUSSES THE OPTIONS AVAILABLE TO THE PATIENT. PART VI, LINE 4: THE HOSPITAL SERVES IN A COUNTY IN WHICH 28% OF THE POPULATION EARNS LESS THAN 200% OF THE FEDERAL POVERTY LEVEL AND 25% OF THE POPULATION ARE UNINSURED. THE COMMUNITY HAS A HIGH POPULATION OF ELDERLY AND AMISH/MENNONITE. TRANSPORTATION IS HIGHLY UNDERDEVELOPED AND UNAVAILABLE. THE COUNTY IS DESIGNATED AS A HEALTH PROFESSIONAL SHORTAGE AREA AND MEDICALLY UNDERSERVED AREA. THE HOSPITAL SERVES ROUGHLY A 25 MILE RADIUS WITH A POPULATION TOTAL OF APPROXIMATELY 15,000. PART VI, LINE 5: WHILE THERE IS GROWING AGREEMENT IN THE UNITED STATES ABOUT WHAT CONSTITUTES A NON-PROFIT HOSPITAL'S COMMUNITY BENEFIT, THIS IS A WORK IN PROGRESS. OUR HOSPITAL PROVIDES CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS. BUT IN ADDITION, WE BELIEVE THAT WE PROVIDE A CRITICALLY IMPORTANT COMMUNITY BENEFIT WHICH IS NOT QUANTIFIED. OUR HOSPITAL, LIKE MOST RURAL HOSPITALS, WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE CARE LOCALLY. BEYOND INPATIENT HOSPITALIZATIONS, WE PROVIDE LOCAL ACCESS TO MANY HEALTH SERVICES: DIAGNOSTICS, EMERGENCY SERVICES & URGENT CARE, INFUSION SERVICES, LABORATORY SERVICES, OCCUPATIONAL HEALTH, REHABILITATION SERVICES, SPECIALTY MEDICINE, SLEEP CENTER, SPEECH AND AUDIOLOGY, SURGICAL SERVICES, AND WOMENS HEALTH SERVICES. PART VI, LINE 7, REPORTS FILED WITH STATES WI X X X 0 1 0 1 0 0 0 0 0 DR TIMOTHY MEYER CHIEF MEDICAL OFFICER 185156 0 129553 0 0 0 4500 0 11385 0 330594 0 0 0 ROGER SNEATH INTERIM CFO 217221 0 0 0 0 0 0 0 0 0 217221 0 0 0 RYAN NEVILLE PRESIDENT & CEO (EFFECTIVE 03/2014) 173854 0 0 0 0 0 1816 0 34417 0 210087 0 0 0 DR DAVID CARLSON PHYSICIAN 411168 0 267602 0 0 0 4500 0 24749 0 708019 0 0 0 DR GRACE CRUZ-APOLINARIO PHYSICIAN 189224 0 225568 0 0 0 4500 0 36773 0 456065 0 0 0 DR JAMES STANGA PHYSICIAN 327042 0 34162 0 0 0 4500 0 36259 0 401963 0 0 0 DR SHARON HAYWARD PHYSICIAN 325508 0 100646 0 0 0 0 0 31102 0 457256 0 0 0 DR KENNETH WEIMER PHYSICIAN 199052 0 48996 0 0 0 4500 0 34581 0 287129 0 0 0 PART I, LINE 4B MEMORIAL HOSPITAL, INC. OFFERS AN EXECUTIVE 457(F) RETIREMENT PLAN, ESTABLISHED IN 2006, IN WHICH THE EMPLOYER MAY MAKE DISCRETIONARY CREDITS TO THE DEFERRED COMPENSATION ACCOUNT OF THE PARTICIPANTS. THE AMOUNT CONTRIBUTED TO THE PARTICIPANTS IS DETERMINED ON AN ANNUAL BASIS BY THE EMPLOYER. THERE WERE NO DISTRIBUTIONS IN THE CURRENT YEAR. PART I, LINE 5 DURING 2014, THE FOLLOWING PHYSICIANS RECEIVED COMPENSATION THAT WAS PARTLY BASED ON THE GROSS CHARGES RECOGNIZED FOR THEIR PROFESSIONAL SERVICES: DR. JAMES STANGA $1,850; DR. TIMOTHY MEYER $33,741; DR. GRACE CRUZ-APOLINARIO $187,755; DR. DAVID CARLSON $263,152; DR. SHARON HAYWARD $30,000; AND DR. KENNETH WEIMER $26,011. ALL OTHER BONUSES RECEIVED DURING THE YEAR WERE NOT BASED ON REVENUES OF THE ORGANIZATION. CHELSEA BARTH DAUGHTER OF ROBERT BARTH, BOARD PRESIDENT 45967 EMPLOYMENT COMPENSATION 0 JAMIE BARTH DAUGHTER-IN-LAW OF ROBERT BARTH, BOARD PRESIDENT 45744 EMPLOYMENT COMPENSATION 0 FORM 990, PART VI, SECTION B, LINE 11 THE DIRECTOR OF FINANCE DETAIL REVIEWS THE FORM 990 PRIOR TO SUBMISSION. ALSO, BEFORE THE RETURN WAS FILED, A DRAFT COPY WAS MADE AVAILABLE TO THE BOARD OF DIRECTORS FOR REVIEW AND COMMENTS. FORM 990, PART VI, SECTION B, LINE 12C MEMORIAL HOSPITAL, INC. RELIES ON THE ANNUAL DISCLOSURE OF KEY INDIVIDUALS TO THE BOARD OF DIRECTORS AND MONITORS PURCHASES AND ABSTENTIONS FROM NECESSARY VOTES THROUGHOUT THE YEAR. ALL MANAGERS AND MEDICAL STAFF ARE REQUIRED TO DISCLOSE AND FOLLOW THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15 A COMMITTEE OF THE BOARD OF DIRECTORS HAS BEEN DESIGNATED TO REVIEW ALL EXECUTIVE PAY CHANGES. MARKET DATA IS PROVIDED TO THE COMMITTEE IN THEIR EVALUATION OF PAY CHANGES. COMPARABILITY DATA WAS USED AND THE RESULTS OF ANY EXECUTIVE PAY CHANGES WERE DOCUMENTED. NO ONE WITH A CONFLICT OF INTEREST WAS INCLUDED IN THE DECISION MAKING OF EXECUTIVE COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 ALL DOCUMENTS ARE AVAILABLE UPON REQUEST. DOCUMENTS ARE ALSO DISCUSSED AT COMMUNITY MEETINGS AND EMPLOYEE FORUMS. FORM 990, PART VII, LINE 1A, EXPLANATION FOR HOURS WORKED: SOME OFFICERS AND BOARD MEMBERS ALSO PROVIDED SERVICE TO COUNTRY VIEW, INC., A RELATED ORGANIZATION. THESE HOURS ARE REFLECTED IN LINE 2 OF COLUMN B. FORM 990, PART IX, LINE 11G CONTRACTED LABORATORY SERVICES: PROGRAM SERVICE EXPENSES 107,481. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 107,481. CONTRACTED EMERGENCY ROOM PHYSICIANS: PROGRAM SERVICE EXPENSES 935,428. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 935,428. CONTRACTED ANESTHESIA SERVICES: PROGRAM SERVICE EXPENSES 471,597. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 471,597. CONTRACTED RADIOLOGY SERVICES: PROGRAM SERVICE EXPENSES 418,127. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 418,127. OTHER CONTRACTED PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 714,648. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 714,648. CONTRACTED ADMINISTRATIVE SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 536,258. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 536,258. FORM 990, PART XII, LINE 2C: THE BOARD OF DIRECTORS IS RESPONSIBLE FOR THE SELECTION OF AN INDEPENDENT AUDITOR AND MANAGEMENT OVERSEES THE AUDIT PROCESS. THIS PROCESS DID NOT CHANGE IN 2014. COUNTRY VIEW INC 216 SUNSET PLACE NEILLSVILLE WI 54456 391411586 HUD HOUSING WI 501(C)(3) LINE 9 MEMORIAL HOSPITAL INC 1 THE FOUNDATION OF MEMORIAL HOSPITAL INC 216 SUNSET PLACE NEILLSVILLE WI 54456 383800811 FUNDRAISING WI 501(C)(3) LINE 7 MEMORIAL HOSPITAL INC 1 0 0 1 0 0 0 0 0 0 0 0 1 0 0 1 0 1 0 0 THE FOUNDATION OF MEMORIAL HOSPITAL INC C 102050 COST