UPLAND HILLS HEALTH INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: UPLAND HILLS HEALTH INC (EIN 42-1017512)
Tax period: 2012-10-01 to 2013-09-30
Filed: 2014-08-15
IRS object ID: 201432279349304123
Schema version: 2012v2.1
Source: Download XML · Original 990 at ProPublica

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

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule K
Schedule M
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2014-08-15T15:17:06-05:00	Timestamp
Tax Period End Date	2013-09-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Field	Value	IRS element (for citing)
EIN	390758449	EIN

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	WIPFLI LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	3703 OAKWOOD HILLS PARKWAY	AddressLine1
City	EAU CLAIRE	City
State	WI	State
ZIP Code	54701	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2012-10-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	421017512	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	UPLAND HILLS HEALTH INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	UPLA	NameControl
Phone	6089308000	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	800 COMPASSION WAY	AddressLine1
City	DODGEVILLE	City
State	WI	State
ZIP Code	53533	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	ARTHUR K PUSTINA	Name
Title	VICE PRESIDENT OF FINANCE	Title
Phone	6089308000	Phone
Date Signed	2014-08-14	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	HOLLY POKRANDT CPA	Name
PTIN	P00449155	PTIN
Phone	7158323407	Phone
Date Prepared	2014-08-13	DatePrepared

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2015-11-30 17:44:51Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	LISA SCHNEDLER	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	800 COMPASSION WAY	AddressLine1
City	DODGEVILLE	City
State	WI	State
ZIP Code	53533	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	49613597	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.UPLANDHILLSHEALTH.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1974	YearFormation
State Legal Domicile	WI	StateLegalDomicile
Activity Or Mission Description	AS A HEALTH CARE ORGANIZATION, UPLAND HILLS HEALTH, INC.'S MISSION IS TO CONSISTENTLY MEET OR EXCEED THE EXPECTATIONS OF THOSE WE SERVE, AND OF THOSE WE HOPE TO SERVE, IN A COST-EFFECTIVE MANNER. TO LEAD A PARTNERSHIP WITH THE COMMUNITIES AND OUR MEDICAL STAFF, REFLECTING ADDITIONAL EMPHASIS ON HEALTH EDUCATION, CONTINUING MEDICAL EDUCATION, REHABILITATION, AND THE PREVENTION OF ILLNESS OR INJURY. TO APPROACH THE PATIENT AS A WHOLE PERSON RATHER THAN A SET OF SYMPTOMS OR A DISEASE STATE, FOCUSING ON THE CLINICAL AND EMOTIONAL WELL-BEING OF PATIENTS AND THEIR FAMILIES, AND PROVIDING CARE IN AN ENVIRONMENT COMMITTED TO IMPROVING PATIENT SAFETY. TO PARTICIPATE IN THE PROVISION OF HEALTH SERVICES TO THE POOR, MINORITIES, DISABLED, AND OTHER UNDER SERVED PERSONS IN OUR COMMUNITIES.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	9	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	7	NbrIndependentVotingMembers
Total Nbr Employees	508	TotalNbrEmployees
Total Nbr Volunteers	75	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Net Unrelated Business Txbl Income	0	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	264745	ContributionsGrantsPriorYear
Contributions Grants Current Year	144008	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	45328462	ProgramServiceRevenuePriorYear
Program Service Revenue CY	46205256	ProgramServiceRevenueCY
Investment Income Prior Year	612822	InvestmentIncomePriorYear
Investment Income Current Year	660704	InvestmentIncomeCurrentYear
Other Revenue Prior Year	209805	OtherRevenuePriorYear
Other Revenue Current Year	218429	OtherRevenueCurrentYear
Total Revenue Prior Year	46415834	TotalRevenuePriorYear
Total Revenue Current Year	47228397	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	78363	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	107800	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	24773006	SalariesEtcPriorYear
Salaries Etc Current Year	25673353	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	18869457	OtherExpensePriorYear
Other Expenses Current Year	19179704	OtherExpensesCurrentYear
Total Expenses Prior Year	43720826	TotalExpensesPriorYear
Total Expenses Current Year	44960857	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	2695008	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	2267540	RevenuesLessExpensesCY
Total Assets BOY	81440807	TotalAssetsBOY
Total Assets EOY	83233305	TotalAssetsEOY
Total Liabilities BOY	33055656	TotalLiabilitiesBOY
Total Liabilities EOY	32585908	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	48385151	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	50647397	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	UPLAND HILLS HEALTH, INC.'S MISSION IS TO PROVIDE THE IDEAL PATIENT EXPERIENCE.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	33840575	Expense
Grants	107800	Grants
Revenue	42294503	Revenue
Description	UPLAND HILLS HEALTH, INC. (UPLAND HILLS) PROVIDES HIGH QUALITY, COST EFFECTIVE, PRIMARY HOSPITAL CARE TO ALL PEOPLE IN NEED OF CARE. AMONG THE HOSPITAL INPATIENT AND OUTPATIENT SERVICES PROVIDED ARE DIAGNOSTIC IMAGING, REHABILITATION SERVICES, DIALYSIS, RESPIRATORY CARE, SURGICAL SERVICES, CARDIAC MONITORED CARE, LAB SERVICES, PHARMACY SERVICES, 24 HOUR EMERGENCY ROOM, OBSTETRICAL SERVICES, REGIONAL CLINIC SERVICES, AND MANY OTHERS. UPLAND HILLS ALSO PROVIDES ADDITIONAL SERVICES TO THE COMMUNITY BY PROVIDING OUTREACH PROGRAMS AND SERVICES THAT MEET IDENTIFIED NEEDS IN AN EFFORT TO ENHANCE THE HEALTH AND WELFARE OF THE PEOPLE IN ITS AREA.DURING FISCAL YEAR 2013, UPLAND HILLS HOSPITAL PROVIDED 3,192 DAYS OF INPATIENT CARE, 516 DAYS OF SWING BED CARE, OVER 9,700 EMERGENCY ROOM AND URGENT CARE PATIENT VISITS, OVER 2,000 CLINIC PATIENT VISITS, AND PERFORMED OVER 34,000 OTHER OUTPATIENT PROCEDURES AND SERVICES FOR PATIENTS IN NEED OF MEDICAL CARE.IN ITS EFFORT TO ATTAIN THIS MISSION AND GOAL, AND TO BE A PARTNER IN THE COMMUNITY, UPLAND HILLS PROVIDES:-FREE AND REDUCED COST CARE TO THOSE WITH A DEMONSTRATED NEED.-CARE TO THOSE COVERED UNDER GOVERNMENT ENTITLEMENT PROGRAMS WHICH MAY NOT COVER THE CHARGES OF COSTS OR SERVICES PROVIDED.-HEALTH EDUCATION AND OUTREACH PROGRAMS TO ALL MEMBERS OF THE COMMUNITY AT LITTLE OR NO COST TO THE PARTICIPANTS.-DIABETES SELF MANAGEMENT CLASSES - CLASSES ARE RECOGNIZED BY THE AMERICAN DIABETES ASSOCIATION AS QUALITY SELF-MANAGEMENT CLASSES AND ARE TAUGHT BY A REGISTERED DIETICIAN AND REGISTERED NURSE SPECIALLY TRAINED IN DIABETES EDUCATION.-PROGRAMS FOR NEW AND EXPECTANT PARENTS - CHILDBIRTH EDUCATION, PRE-DELIVERY CONFERENCE, SIBLING CLASS, BREASTFEEDING SUPPORT AND BREASTFEEDING SUPPLIES.-INDOOR FITNESS WALKING IS AVAILABLE AT THE HOSPITAL FACILITY FOR COMMUNITY MEMBERS DURING COLD OR INCLEMENT WEATHER.-SAFE SITTER BABYSITTING TRAINING - MEDICALLY ACCURATE BABYSITTING PREPARATION CLASS DESIGNED FOR BOYS AND GIRLS AGES 11 TO 13. THE PROGRAM TEACHES SITTERS HOW TO HAVE FUN WITH CHILDREN AS WELL AS HOW TO RECOGNIZE A MEDICAL EMERGENCY AND KNOW THE APPROPRIATE ACTION TO TAKE. STUDENTS ALSO LEARN INFANT AND CHILD CPR.THE COST OF PROVIDING CHARITY CARE TO PERSONS UTILIZING OUR HOSPITAL AMOUNTED TO APPROXIMATELY $508,000 IN 2013. IN ADDITION, UPLAND HILLS FURNISHES CARE TO PERSONS COVERED UNDER GOVERNMENT ENTITLEMENT PROGRAMS WHICH PAY AT RATES LESS THAN CHARGES. DISCOUNTS TO THESE PROGRAMS FOR HOSPITAL SERVICES AMOUNTED TO $29,022,095. UPLAND HILLS ALSO PROVIDES ASSISTANCE TO THE FREE CLINIC LOCATED IN DODGEVILLE, WISCONSIN ON AN ANNUAL BASIS.UPLAND HILLS ALSO OPERATES A THERAPY AND WELLNESS CENTER TO PROVIDE FITNESS AND WELLNESS OPPORTUNITIES TO EMPLOYEES AND THE PUBLIC. THE THERAPY AND WELLNESS CENTER HOUSES MODERN EQUIPMENT, INCLUDING CARDIO WORKOUT MACHINES, CIRCUIT TRAINING, AND FREE WEIGHTS. WELLNESS CLASSES AND MASSAGE THERAPY ARE OFFERED TO COMPLEMENT YOUR WELLNESS GOALS. CLASSES HAVE INCLUDED INTRO TO YOGA, ABS AND TONE, SENIOR STRENGTH BUILDING, TAI CHI, AND ZUMBA(R).UPLAND HILLS HOSPITAL HAS ALSO PROVIDED DIALYSIS SERVICES TO LOCAL RESIDENTS SINCE 2008. THE HOSPITAL REVIEWED THE POTENTIAL PROGRAM OPERATIONS OF THE DIALYSIS CENTER AND HEALTHCARE NEEDS IN THE COMMUNITY AND NOTED THAT THE DIALYSIS CENTER IS BUDGETED TO RUN IN A NET LOSS POSITION, HOWEVER IT WAS DETERMINED THAT THIS IS A NEEDED HEALTHCARE SERVICE FOR RESIDENTS OF THE DODGEVILLE, WISCONSIN COMMUNITY AND THE SURROUNDING AREAS AND SO THE BOARD OF DIRECTORS APPROVED THAT DIALYSIS SERVICES SHOULD BE SUPPLEMENTED AND PROVIDED BY UPLAND HILLS TO FURTHER ITS MISSION IN THE COMMUNITY.	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	2332694	Expense
Revenue	2211341	Revenue
Description	UPLAND HILLS HEALTH, INC. (UPLAND HILLS) ALSO SERVES THE COMMUNITY BY OPERATING A 44-BED SKILLED NURSING FACILITY KNOWN AS THE "NURSING AND REHABILITATION CENTER". THE PRIMARY ACTIVITY OF THE NURSING AND REHABILITATION CENTER IS TO PROVIDE SKILLED AND INTERMEDIATE CARE FOR THE AGED AND DISABLED OF THE SURROUNDING AREA. THE CENTER PROVIDED 15,074 DAYS OF RESIDENT CARE IN FISCAL YEAR 2013. THE CENTER OFFERS SKILLED NURSING CARE IN BOTH SHORT TERM REHABILITATION PROGRAMS AND LONG-TERM CARE RESIDENT PROGRAMS. SOME OF THE SPECIALIZED CARE SERVICES OFFERED INCLUDE IV THERAPY CARE, WOUND CARE, PAIN MANAGEMENT, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, AND SPEECH THERAPY AMONG MANY OF THE CARE PROGRAMS PROVIDED. THE CENTER OPERATES IN CONJUNCTION WITH UPLAND HILLS HOSPITAL TO PROVIDE A SMOOTH TRANSITION FOR PATIENTS NEEDING EXTENDED REHABILITATION OR LONG-TERM CARE SERVICES. THE COMBINATION AND COORDINATION OF FACILITIES ALSO ALLOWS THE ORGANIZATION TO SHARE MANY DEPARTMENTS AND SERVICES IN UPLAND HILLS CONTINUED EFFORT TO PROVIDE HIGH QUALITY AND LOW COST CARE TO THE COMMUNITY.	Description

Activity3 Activity3

Field	Value	IRS element (for citing)
Expense	1464345	Expense
Revenue	1556398	Revenue
Description	UPLAND HILLS HEALTH, INC.'S HOSPICE PROGRAM GIVES THOSE PATIENTS WITH LIFE-LIMITING OR TERMINAL ILLNESSES THE OPPORTUNITY TO LIVE PAIN-FREE AND WITH DIGNITY DURING THE LAST STAGE OF THEIR LIFE. TOTAL HOSPICE DAYS OF SERVICE PROVIDED TO PATIENTS IN FISCAL YEAR 2013 WERE 4,422.UPLAND HILLS HEALTH, INC.'S HOMECARE PROGRAM PROVIDES COMPREHENSIVE HEALTHCARE SERVICES IN THE MOST COMFORTABLE SETTING-THE PATIENT'S HOME. IN FISCAL YEAR 2013 THERE WERE 5,632 TOTAL HOMECARE VISITS PROVIDED TO PATIENTS.	Description

Field	Value	IRS element (for citing)
Total Program Service Expense	37637614	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	1	LobbyingActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	1	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	1	ReportProgRelInvest
Report Other Assets	0	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	1	ReportFin48Footnote
Independent Audit Financial Stmt	0	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	1	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Financial Stmt Attached	1	FinancialStmtAttached
Grants To Organizations	1	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	1	TaxExemptBonds
Invest Tax Exempt Bonds	0	InvestTaxExemptBonds
Escrow Account	0	EscrowAccount
On Behalf Of Issuer	0	OnBehalfOfIssuer
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	0	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	0	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	1	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	1	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	1	RelatedOrgControlledEntity
Transaction Related Entity	1	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	75	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Number Of Employees	508	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	1	UnrelatedBusinessIncome
Form990-T Filed	1	Form990-TFiled
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	9	NbrVotingGoverningBodyMembers
Number Independent Voting Members	7	NumberIndependentVotingMembers
Family Or Business Relationship	1	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	1	MembersOrStockholders
Election Of Board Members	1	ElectionOfBoardMembers
Decisions Subject To Approval	1	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	0	InvestmentInJointVenture
States Where Copy Of Return Is Filed	WI	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	ARTHUR K PUSTINA	NamePerson
Telephone Number	6089308000	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	800 COMPASSION WAY	AddressLine1
City	DODGEVILLE	City
State	WI	State
ZIP Code	53533	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (17 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer	Average Hours Per Week RelatedAverageHoursPerWeekRelated	Highest Compensated EmployeeHighestCompensatedEmployee
PEG KOEHLER
DIRECTOR	2.50	X	0	0	0
KATHRYN DALSING MD
DIRECTOR	2.50	X	0	0	0
JOHN THRONSON
DIRECTOR	2.50	X	0	0	0
TODD BURCHILL
DIRECTOR	2.50	X	0	0	0
LINDA TAPLIN STATZ
DIRECTOR	2.50	X	0	0	0
JODY VANDERLOO
PRESIDENT	2.50	X	0	0	0	X
BRAD LAUFENBERG
VICE PRESIDENT	2.50	X	0	0	0	X	1.00
JIM MASSEY
SECRETARY	2.50	X	0	0	0	X
TED GREENHECK
TREASURER	2.50	X	0	0	0	X
PHYLLIS FRITSCH
PRESIDENT AND CEO (THROUGH 6/2013)	51.80		197212	0	27005	X	1.00
LISA SCHNEDLER
PRESIDENT AND CEO (EFFECTIVE 7/2013)	51.80		0	0	0	X	1.00
ARTHUR K PUSTINA
VICE PRESIDENT OF FINANCE	49.20		128615	0	26382	X	1.00
BARBARA HOSTETLER
PHYSICIAN	36.80		421353	0	27170			X
ADAM DACHMAN
PHYSICIAN	40.50		380519	0	10242			X
JEFF PIERCE
CRNA	45.50		274350	0	31616			X
DONALD HART
CRNA	40.60		257299	0	30943			X
ROBERT SCHMUS
PHYSICIAN	31.40		268081	0	24108			X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	1927429	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	177466	TotalOtherCompensation
Number Individuals GT100 K	16	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
MADISON EMERGENCY PHYSICIANS SC INC
1221 JOHN Q HAMMONS DRIVE	MADISON	WI	537444966	24 HOUR EMERGENCY ROOM COVERAGE	2063926
SHARED IMAGING SERVICES INC
PO BOX 45686	MADISON	WI	537445686	X-RAY SCAN SERVICES	798316
RURAL WISCONSIN HEALTH COOPERATIVE INFOR
880 INDEPENDENCE LANE PO BOX 490	SAUK CITY	WI	535830490	COMPUTER SUPPORT	762284
RURAL WISCONSIN HEALTH COOPERATIVE
880 INDEPENDENCE LANE PO BOX 490	SAUK CITY	WI	535830490	AUDIOLOGY HOURS & SUPPLIES, EDUCATION, A	408941
SHARED MEDICAL SERVICES
209 LIMESTONE PASS	COTTAGE GROVE	WI	53527	MRI SERVICES	352185

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	13	NumberOfContractorsGT100K
Related Organizations	77466	RelatedOrganizations
Government Grants	27548	GovernmentGrants
All Other Contributions	38994	AllOtherContributions
Noncash Contributions	31191	NoncashContributions
Total Contributions	144008	TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	ExclusionExclusionAmount
PATIENT SERVICE REVENUE	621990	45514460	45514460
CAFETERIA & NUTRITION	722210	187163	187163
MASSAGE/ACUPUNCTURE	621990	88765	88765
FITNESS CENTER	624100	75836		$75,836
LIFELINE	621990	65882	65882

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	273150	TotalRevenueColumn
Related Or Exempt Function Income	205972	RelatedOrExemptFunctionIncome
Exclusion	$67,178	ExclusionAmount

Field	Value	IRS element (for citing)
Total Program Service Revenue	46205256	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	421042	TotalRevenueColumn
Exclusion	$421,042	ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

Field	Value	IRS element (for citing)
Total Revenue Column	42	TotalRevenueColumn
Exclusion	$42	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	687416	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	523652	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	163764	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	163764	TotalRevenueColumn
Exclusion	$163,764	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	2056159	Securities
Other	45009	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	1824233	Securities
Other	37315	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	231926	Securities
Other	7694	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	239620	TotalRevenueColumn
Exclusion	$239,620	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Income Fundraising Events	10458	GrossIncomeFundraisingEvents
Fundraising Direct Expenses	0	FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	10458	TotalRevenueColumn
Exclusion	$10,458	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	44207	GrossSalesOfInventory
Cost Of Goods Sold	0	CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	44207	TotalRevenueColumn
Exclusion	$44,207	ExclusionAmount

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	47228397	TotalRevenueColumn
Related Or Exempt Function Income	46062242	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$1,022,147	ExclusionAmount

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	X	InfoInScheduleOPartIX

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	107800	Total
Program Services	107800	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	488092	Total
Management And General	488092	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	19410443	Total
Program Services	16336115	ProgramServices
Management And General	3074328	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	551739	Total
Program Services	464352	ProgramServices
Management And General	87387	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	3884650	Total
Program Services	3269379	ProgramServices
Management And General	615271	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	1338429	Total
Program Services	1101506	ProgramServices
Management And General	236923	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	62413	Total
Management And General	62413	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	28715	Total
Management And General	28715	ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	9185	Total
Management And General	9185	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	4909576	Total
Program Services	4385775	ProgramServices
Management And General	523801	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	194204	Total
Program Services	5074	ProgramServices
Management And General	189130	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	3070550	Total
Program Services	2650980	ProgramServices
Management And General	419570	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	644102	Total
Management And General	644102	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	1399074	Total
Program Services	1399074	ProgramServices

Travel Travel

Field	Value	IRS element (for citing)
Total	214842	Total
Program Services	184259	ProgramServices
Management And General	30583	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	41022	Total
Program Services	41022	ProgramServices

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	3302743	Total
Program Services	3302743	ProgramServices

Insurance Insurance

Field	Value	IRS element (for citing)
Total	259280	Total
Program Services	94178	ProgramServices
Management And General	165102	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
MEDICAL SUPPLIES	2666476	2666476
PROVISION FOR BAD DEBTS	1146010	1146010
GENERAL EXPENSES	616946	314874	302072
DUES & SUBSCRIPTIONS	474408	92265	382143

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	140158	Total
Program Services	75732	ProgramServices
Management And General	64426	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	44960857	Total
Program Services	37637614	ProgramServices
Management And General	7323243	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	1607217	BOY
EOY	1794310	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	6456707	BOY
EOY	5420854	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	4029604	BOY
EOY	4829091	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	978704	BOY
EOY	946374	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	537813	BOY
EOY	587240	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	67333593	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	32334857	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	37263573	BOY
EOY	34998736	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	17290	BOY
EOY	17814	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	28896577	BOY
EOY	33231865	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
BOY	72600	BOY
EOY	72600	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	1580722	BOY
EOY	1334421	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	81440807	BOY
EOY	83233305	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	4478067	BOY
EOY	3794128	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	174821	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	27820000	BOY
EOY	27310000	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	411295	BOY
EOY	327598	EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

Field	Value	IRS element (for citing)
BOY	59946	BOY
EOY	31172	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	286348	BOY
EOY	948189	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	33055656	BOY
EOY	32585908	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	48352151	BOY
EOY	50614397	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	33000	BOY
EOY	33000	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	48385151	BOY
EOY	50647397	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	81440807	BOY
EOY	83233305	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	2267540	ReconcilationRevenueExpenses
Reconciliation Unrealized Invest	-77606	ReconciliationUnrealizedInvest
Reconcilation Other Changes	72312	ReconcilationOtherChanges
Info In Schedule O Part XII	X	InfoInScheduleOPartXII
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited

FS Audited Basis FSAuditedBasis

Field	Value	IRS element (for citing)
Financial Statement Consolidated	X	FinancialStatementConsolidated

Field	Value	IRS element (for citing)
Audit Committee	1	AuditCommittee
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor Address US ContributorAddressUS

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)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	Volunteers
Paid Staff Or Management	0	PaidStaffOrManagement
Media Advertisements	0	MediaAdvertisements
Mailings Members	0	MailingsMembers
Publications Or Broadcast	0	PublicationsOrBroadcast
Grants Other Organizations	0	GrantsOtherOrganizations
Direct Contact Legislators	0	DirectContactLegislators
Rallies Demonstrations	0	RalliesDemonstrations
Other Activities	1	OtherActivities
Other Activities	$7,210	OtherActivitiesAmount
Total Lobbying Expenditures IIB	7210	TotalLobbyingExpendituresIIB
Not Described In501c3	0	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	EXPLANATION OF LOBBYING ACTIVITIES:	Identifier
Return Reference	PART II-B, LINE 1:	ReturnReference
Explanation	UPLAND HILLS HEALTH, INC. PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE WISCONSIN HOSPITAL ASSOCIATION (WHA) AND THE AMERICAN HOSPITAL ASSOCIATION (AHA). THESE DUES ARE PRIMARILY TO ACCESS EDUCATIONAL MATERIALS AND FOR STAFF TRAINING AND MATERIALS, HOWEVER A PORTION OF THE ANNUAL DUES WERE USED IN CONJUCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT. UPLAND HILLS HEALTH, INC. IS ALSO A MEMBER OF THE RURAL WISCONSIN HEALTH COOPERATIVE (RWHC). EACH YEAR, UPLAND HILLS HEALTH, INC. PAYS MEMBERSHIP FEES TO THE RWHC. RWHC PROVIDES SUPPORT SERVICES FOR A NUMBER OF ITS MEMBER HOSPITALS THROUGHOUT THE STATE OF WISCONSIN. SOME OF THE MANY SERVICES PROVIDED TO MEMBER HOSPITALS INCLUDE PROVIDING ASSISTANCE TO ORGANIZATIONS IN FINDING GRANT FUNDING FOR NEW PROGRAMS, LEGAL SERVICES, REIMBURSEMENT REVIEW SERVICES, ACCOUNTING ASSISTANCE, CONTRACTING FOR THERAPIST AND EMERGENCY ROOM PATIENT CARE COVERAGE, AND ADMINISTRATIVE CONSULTING SERVICES. AS A PART OF THESE SERVICES, THE RWHC ALSO PROVIDES AN 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 THE PART OF THE MEMBER ORGANIZATIONS. THE WHA, AHA, AND RWHC DETERMINED THAT APPROXIMATELY $7,210 OF THE FEES PAID BY UPLAND HILLS HEALTH, INC. IN 2013 RELATED TO LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE HEALTHCARE ENVIRONMENT IN THE STATE OF WISCONSIN.	Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	213277	BeginningOfYearBalance
Contributions	1000	Contributions
Investment Earnings Or Losses	1504	InvestmentEarningsOrLosses
Other Expenditures	1922	OtherExpenditures
End Of Year Balance	213859	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	210220	BeginningOfYearBalance
Contributions	2000	Contributions
Investment Earnings Or Losses	1057	InvestmentEarningsOrLosses
End Of Year Balance	213277	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	208412	BeginningOfYearBalance
Contributions	1016	Contributions
Investment Earnings Or Losses	792	InvestmentEarningsOrLosses
End Of Year Balance	210220	EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	75366	BeginningOfYearBalance
Contributions	131000	Contributions
Investment Earnings Or Losses	2046	InvestmentEarningsOrLosses
End Of Year Balance	208412	EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	50366	BeginningOfYearBalance
Contributions	25000	Contributions
End Of Year Balance	75366	EndOfYearBalance

Field	Value	IRS element (for citing)
Board Designated EOY Balance	0.00000	BoardDesignatedEOYBalance
Permanent Endowment EOY Balance	0.98370	PermanentEndowmentEOYBalance
Term Endowment EOY Balance	0.01630	TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs	0	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	1	EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R	1	AreRelatedOrgsListedScheduleR

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	194076	OtherCostOrOtherBasis
Book Value	194076	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	46696031	OtherCostOrOtherBasis
Depreciation	16853436	Depreciation
Book Value	29842595	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	19094551	OtherCostOrOtherBasis
Depreciation	14814960	Depreciation
Book Value	4279591	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	1348935	OtherCostOrOtherBasis
Depreciation	666461	Depreciation
Book Value	682474	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	34998736	TotalOfBookValueLandBuildings

Investments Program Related InvestmentsProgramRelated (3 entries)

DescriptionDescription	Book ValueBookValue	Method Of ValuationMethodOfValuation
BOARD DESIGNATED FOR CAPITAL IMPROVEMENTS	31150108	F
UNDER BOND INDENTURE AGREEMENTS	1863326	F
STATE OF WI UNEMPLOYMENT FUNDING	218431	F

Field	Value	IRS element (for citing)
Total Of Book Value Program Related	33231865	TotalOfBookValueProgramRelated

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescription	AmountAmount
SECURITY DEPOSITS	$50,440
DEFERRED COMPENSATION PLAN LIABILITY	$547,599
AMOUNTS PAYABLE TO THIRD-PARTY REIMBURSEMENT PROGRAMS	$350,150

Field	Value	IRS element (for citing)
Total Of Amounts	948189	TotalOfAmounts
Footnote In Part XIII	X	FootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:	PART V, LINE 4:	UPLAND HILLS HEALTH, INC.'S ENDOWMENT CONSISTS OF TWO FUNDS HELD BY UPLAND HILLS HEALTH FOUNDATION, INC. THESE FUNDS WERE ESTABLISHED TO PROVIDE INCOME FOR THE FOUNDATION TO HELP SUPPORT SPECIFIC PROGRAMS OF UPLAND HILLS HEALTH, INC.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:	PART X, LINE 2:	THE HOSPITAL IS A NONPROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE HOSPITAL IS ALSO EXEMPT FROM STATE INCOME TAXES ON RELATED INCOME. THE HOSPITAL IS ALSO ENGAGED, TO A LIMITED EXTENT, IN CERTAIN ACTIVITIES SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME (UBI). UBI IS NOT SIGNIFICANT. THE HOLDING COMPANY IS A TAXABLE ENTITY, WHICH IS CONSIDERED A DISREGARDED ENTITY FOR TAX PURPOSES. THE PRIMARY ACTIVITY OF THE HOLDING COMPANY IS TO INVEST IN A PARTNERSHIP, WHICH IS A LIMITED LIABILITY COMPANY THAT IS ENGAGED IN THE BUSINESS OF SUPPLYING MEDICAL EQUIPMENT AND SUPPLIES TO PATIENTS IN THEIR HOMES OR FACILITIES. INCOME OR LOSS ATTRIBUTABLE TO THIS PARTNERSHIP INTEREST IS PASSED THROUGH TO THE HOSPITAL FOR TAX PURPOSES. EACH YEAR THE HOSPITAL EVALUATES WHETHER THIS INCOME OR A PORTION OF THE INCOME SHOULD BE CONSIDERED AS UNRELATED BUSINESS INCOME AND, AS SUCH, WOULD BE SUBJECT TO FEDERAL AND STATE INCOME TAXES. IF ANY TAX PROVISIONS OR CREDITS ARE DETERMINED TO BE NECESSARY, THE HOSPITAL RECORDS THESE AMOUNTS IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, UPLAND HILLS ASSESSES 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 ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. UPLAND HILLS HAS NOT RECORDED ANY ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS AS OF SEPTEMBER 30, 2013 OR 2012. FEDERAL TAX RETURNS FOR TAX YEARS ENDED SEPTEMBER 30, 2010, AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
FPG Reference Free Care	1	FPGReferenceFreeCare
Pcent200	X	Pcent200
FPG Reference Discounted Care	1	FPGReferenceDiscountedCare
Pcent300	X	Pcent300
Free Disc Care Medically Indigent	1	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	1	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	1	ExpensesExceededBudget
Unable To Provide Care	0	UnableToProvideCare
Annual Community Benefit Report	1	AnnualCommunityBenefitReport
Report Publically Available	1	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	503244	TotalCommunityBenefitExpense
Net Community Benefit Expense	503244	NetCommunityBenefitExpense
Percent Of Total Expense	0.01150	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	5307498	TotalCommunityBenefitExpense
Direct Offsetting Revenue	3375813	DirectOffsettingRevenue
Net Community Benefit Expense	1931685	NetCommunityBenefitExpense
Percent Of Total Expense	0.04410	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	5810742	TotalCommunityBenefitExpense
Direct Offsetting Revenue	3375813	DirectOffsettingRevenue
Net Community Benefit Expense	2434929	NetCommunityBenefitExpense
Percent Of Total Expense	0.05560	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	28493	TotalCommunityBenefitExpense
Direct Offsetting Revenue	7059	DirectOffsettingRevenue
Net Community Benefit Expense	21434	NetCommunityBenefitExpense
Percent Of Total Expense	0.00050	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	179718	TotalCommunityBenefitExpense
Net Community Benefit Expense	179718	NetCommunityBenefitExpense
Percent Of Total Expense	0.00410	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	3983661	TotalCommunityBenefitExpense
Direct Offsetting Revenue	3100992	DirectOffsettingRevenue
Net Community Benefit Expense	882669	NetCommunityBenefitExpense
Percent Of Total Expense	0.02010	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	143567	TotalCommunityBenefitExpense
Net Community Benefit Expense	143567	NetCommunityBenefitExpense
Percent Of Total Expense	0.00330	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	4335439	TotalCommunityBenefitExpense
Direct Offsetting Revenue	3108051	DirectOffsettingRevenue
Net Community Benefit Expense	1227388	NetCommunityBenefitExpense
Percent Of Total Expense	0.02800	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	10146181	TotalCommunityBenefitExpense
Direct Offsetting Revenue	6483864	DirectOffsettingRevenue
Net Community Benefit Expense	3662317	NetCommunityBenefitExpense
Percent Of Total Expense	0.08360	PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

Field	Value	IRS element (for citing)
Total Community Building Expense	491	TotalCommunityBuildingExpense
Net Community Building Expense	491	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Economic Development EconomicDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	3150	TotalCommunityBuildingExpense
Net Community Building Expense	3150	NetCommunityBuildingExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	800	TotalCommunityBuildingExpense
Net Community Building Expense	800	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Total Community Building Expense	4441	TotalCommunityBuildingExpense
Net Community Building Expense	4441	NetCommunityBuildingExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	0	BadDebtExpenseReported
Bad Debt Expense	$498,249	BadDebtExpenseAmount
Amount Attributable To	249124	AmountAttributableTo
Amount Reimbursed By Medicare	11845154	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	12803877	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-958723	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Other	X	Other

Field	Value	IRS element (for citing)
Written Debt Collection Policy	1	WrittenDebtCollectionPolicy
Provision For Charity Care	1	ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

Field	Value	IRS element (for citing)
Business Name Line1	1 CRESTRIDGE ASSISTED LIVING LLC	BusinessNameLine1

Field	Value	IRS element (for citing)
Description Ent Primary Activity	ASSISTED LIVING FACILITY	DescriptionEntPrimaryActivity
Organization Profit Or Ownership	0.49000	OrganizationProfitOrOwnership

Field	Value	IRS element (for citing)
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	1	FacilityNumber

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	UPLAND HILLS HEALTH INC	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	800 COMPASSION WAY	AddressLine1
City	DODGEVILLE	City
State	WI	State
ZIP Code	53533	ZIPCode

Field	Value	IRS element (for citing)
Website Address	WWW.UPLANDHILLSHEALTH.ORG	WebsiteAddress
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Critical Access Hospital	X	CriticalAccessHospital
Er24 Hours	X	Er24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	UPLAND HILLS HEALTH INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
CHNA Conducted	1	CHNAConducted
Community Definition	X	CommunityDefinition
Community Demographics	X	CommunityDemographics
Existing Resources	X	ExistingResources
How Data Obtained	X	HowDataObtained
Community Health Needs	X	CommunityHealthNeeds
Other Health Issues	X	OtherHealthIssues
Identifying Process	X	IdentifyingProcess
Consulting Process	X	ConsultingProcess
Information Gaps	X	InformationGaps
Needs Assessment Conducted	12	NeedsAssessmentConducted
Take Into Account	1	TakeIntoAccount
Other Facilities	0	OtherFacilities
CHNA Widely Available	1	CHNAWidelyAvailable
Own Website	X	OwnWebsite
On Request	X	OnRequest
Adopt Implement Strategy	X	AdoptImplementStrategy
Execute Implement Strategy	X	ExecuteImplementStrategy
Develop Community Plan	X	DevelopCommunityPlan
Participate Community Plan	X	ParticipateCommunityPlan
Include Operational Plans	X	IncludeOperationalPlans
Adopt Budget	X	AdoptBudget
Prioritize Health Needs	X	PrioritizeHealthNeeds
Prioritize Services	X	PrioritizeServices
All Needs Addressed	0	AllNeedsAddressed
Organization Incur Excise Tax	0	OrganizationIncurExciseTax
Eligibility Criteria Explained	1	EligibilityCriteriaExplained
Uses FPG Free	1	UsesFPGFree
FPG Free Percent	200.000000000000	FPGFreePercent
Uses FPG Discounted	1	UsesFPGDiscounted
FPG Discount Percent	300.000000000000	FPGDiscountPercent
Explains Basis	1	ExplainsBasis
Income Level	X	IncomeLevel
Asset Level	X	AssetLevel
Medical Indigency	X	MedicalIndigency
Insurance Status	X	InsuranceStatus
Uninsured Discount	X	UninsuredDiscount
Medicaid Medicare	X	MedicaidMedicare
State Regulation	X	StateRegulation
Explains Application Method	1	ExplainsApplicationMethod
Includes Publicity Measures	1	IncludesPublicityMeasures
Attached To Invoices	X	AttachedToInvoices
Posted In Emergency Room	X	PostedInEmergencyRoom
Posted In Admission Office	X	PostedInAdmissionOffice
Available On Request	X	AvailableOnRequest
Other Publicity	X	OtherPublicity
Actions On Nonpayment	1	ActionsOnNonpayment
Permit Report To Credit Agency	X	PermitReportToCreditAgency
Collection Activities	1	CollectionActivities
Lawsuit	X	Lawsuit
Lien On Residence	X	LienOnResidence
Notify Before Discharge	X	NotifyBeforeDischarge
Notified All Patients	X	NotifiedAllPatients
Documented Determination	X	DocumentedDetermination
Nondiscrim Emergency Care Policy	1	NondiscrimEmergencyCarePolicy
Average Negotiated Rates	X	AverageNegotiatedRates
Amounts Generally Billed	0	AmountsGenerallyBilled
Gross Charges	0	GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	7	NumberOfOtherFacilities

Other Facilities OtherFacilities (7 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType
UPLAND HILLS NURSING AND REHAB CENTER
800 COMPASSION WAY	DODGEVILLE	WI	53533	SKILLED NURSING FACILITY
UPLAND HILLS HEALTH CENTER
800 COMPASSION WAY	DODGEVILLE	WI	53533	OUTPATIENT CLINIC
UPLAND HILLS HEALTH CLINIC - HIGHLAND
551 N MAIN STREET	HIGHLAND	WI	53543	OUTPATIENT CLINIC
UPLAND HILLS HEALTH CLINIC - MONTFORT
202 W US HIGHWAY 18	MONTFORT	WI	53569	OUTPATIENT CLINIC
UPLAND HILLS HEALTH CLINIC - SPRING GREE
156 W JEFFERSON ST	SPRING GREEN	WI	53588	OUTPATIENT CLINIC
UHH THERAPY CLINIC - BARNEVELD
103 QUAIL RIDGE DRIVE	BARNEVELD	WI	53507	OUTPATIENT PHYSICAL THERAPY CLINIC
UHH THERAPY CLINIC - LANDS' END
1 LANDS END LANE	DODGEVILLE	WI	53533	LANDS END EMPLOYEE OUTPATIENT PHYSICAL THERAPY CLINIC

Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)

ExplanationExplanation	IdentifierIdentifier	Return ReferenceReturnReference
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 LESS THE PROVISION FOR BAD DEBTS DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST TO CHARGE RATIO IS APPLIED AGAINST VARIOUS REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER IRS SUGGESTED COSTING METHODS FOR THE FORM 990.
PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES AT UPLAND HILLS HEALTH, INC. INCLUDE THE OPERATION OF THE CLINICS AND THE DIALYSIS CENTER. THE CLINICS ARE OPERATED TO PROVIDE SUPPORT TO THE COMMUNITY BY PROVIDING FAMILY HEALTH, SURGICAL, AND OB/GYN SERVICES TO THE SURROUNDING AREAS, WHICH WOULD OTHERWISE BE UNDERSERVED. SEE PART III, LINE 4A FOR A DESCRIPTION OF THE DIALYSIS SERVICES OFFERED. IT IS THE GOAL OF UPLAND HILLS HEALTH TO PROVIDE THESE SERVICES TO THE COMMUNITY REGARDLESS OF A PATIENT'S ABILITY TO PAY.
PART I, L7 COL(F): THE COSTING METHOD AND CALCULATIONS USED ON FORM 990 ARE BASED ON TOTAL OPERATING EXPENSES EXCLUDING BAD DEBT EXPENSE. THE COMMUNITY BENEFIT EXPENSE PERCENTAGES ARE CALCULATED BY DIVIDING THE COMMUNITY BENEFIT EXPENSE FOR EACH CATEGORY OF COMMUNITY SERVICES PROVIDED BY UPLAND HILLS HEALTH, INC. REPORTED IN THE TABLE ON LINE 7 PART I OF THE SCHEDULE H BY THE TOTAL OPERATING EXPENSES OF THE HOSPITAL LESS THE PROVISION FOR BAD DEBTS OF $1,146,010.
PART II: WHILE THERE IS GROWING AGREEMENT IN THE UNITED STATES ABOUT WHAT CONSTITUTES A NON-PROFIT HOSPITAL'S "COMMUNITY BENEFIT," THESE EFFORTS CONTINUE TO BE A WORK IN PROGRESS. UPLAND HILLS HEALTH, INC. PROVIDES SIGNIFICANT AMOUNTS OF CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS AND IN ADDITION, THE HOSPITAL BELIEVES THAT IT PROVIDES A CRITICALLY IMPORTANT BENEFIT WHICH IS NOT QUANTIFIED. UPLAND HILLS HEALTH, INC., LIKE MOST COMMUNITY HOSPITALS, WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE CARE LOCALLY WHICH WITHOUT THE HOSPITAL, WOULD NOT BE AVAILABLE LOCALLY. BEYOND INPATIENT HOSPITALIZATIONS, THE HOSPITAL PROVIDES LOCAL ACCESS TO MANY SERVICES INCLUDING: BIRTHING CENTER, DIAGNOSTICS, EMERGENCY SERVICES, HOSPICE, HOME CARE, RENAL DIALYSIS, INFUSION SERVICES, SWING BED SERVICES, NURSING HOME SERVICES, CLINICAL SERVICES, LABORATORY SERVICES, OCCUPATIONAL HEALTH, REHABILITATION SERVICES, SPECIALTY MEDICINE, SLEEP CENTER, SPEECH PATHOLOGY, SURGICAL SERVICES, AND WOMENS' SERVICES, TO NAME SOME OF THE MAJOR SERVICES PROVIDED.
PART III, LINE 4: 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 A 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.THE COST TO CHARGE RATIO IS APPLIED AGAINST THE TOTAL CHARGES THAT ARE WRITTEN OFF DURING THE FISCAL YEAR TO ESTIMATE THE COST OF THE CARE OF PATIENTS THAT HAVE ACCOUNTS THAT ARE DEEMED TO BE BAD DEBTS TO THE ORGANIZATION. THE HOSPITAL RECOGNIZES THAT IT ALSO PROVIDES A DISCOUNT TO SELF-PAY OR UNINSURED PATIENTS. THESE AMOUNTS ARE INCLUDED IN THE CONTRACTUAL ADJUSTMENTS 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. THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A SEPARATE FOOTNOTE REGARDING BAD DEBT EXPENSE.
PART III, LINE 8: THE TOTAL MEDICARE REVENUE SHOWN IN SCHEDULE H OF THE FORM 990 IS BASED ON THE IRS 990 INSTRUCTIONS AND INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE OF THE HOSPITAL, AND ALSO DOES NOT CONSIDER ALL CONTRACTUAL ADJUSTMENTS FOR SERVICES REIMBURSED BY THE MEDICARE PROGRAM. AMOUNTS LISTED FOR MEDICARE REVENUES DO NOT INCLUDE PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT AT THE HOSPITAL AS WELL AS ANESTHESIA PROFESSIONAL SERVICES, CLINICAL PHYSICIAN PROFESSIONAL SERVICES, SURGEON PROFESSIONAL SERVICES, OUTPATIENT PHYSICAL THERAPY SERVICES PROVIDED TO NURSING HOME RESIDENTS, AND REVENUES FOR ANY PATIENTS COVERED UNDER MEDICARE ADVANTAGE PLAN PROGRAMS. PHYSICIAN PROFESSIONAL SERVICES ARE REIMBURSED PRIMARILY ON FEE SCHEDULE REIMBURSEMENTS AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY, SURGERY, AND CLINICAL PHYSICIAN 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 UPLAND HILLS HEALTH, INC. PROVIDES TO THE COMMUNITY AND SURROUNDING AREAS. THE COSTING METHOD USED ABOVE FOR IRS 990 COMPLIANCE REPORTING IS ALSO BASED ON THE FILED MEDICARE COST REPORT FOR THE YEAR ENDED SEPTEMBER 30, 2013, AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES, AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICE REVENUES (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE).WHETHER THERE IS A SHORTFALL OR SURPLUS ON SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THESE PEOPLE, WHICH ARE TYPICALLY ELDERLY OR DISABLED 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 III, LINE 9B: UNDER THE HOSPITAL'S COLLECTION AND CHARITY CARE POLICIES, UPLAND HILLS HEALTH, INC. MAKES EVERY ATTEMPT TO IDENTIFY AND PROMOTE CHARITY CARE TO PATIENTS. INCLUDED IN THE HOSPITAL'S CHARITY CARE POLICY IT IS NOTED THAT PATIENTS MAY QUALIFY FOR CHARITY CARE EITHER PRIOR TO ADMISSION OR FOLLOWING DISCHARGE. ALL INPATIENT SELF-PAY ADMISSIONS ARE SCREENED BY THE HOSPITAL'S PATIENT FINANCIAL COUNSELOR OR SOCIAL WORKERS TO ALLOW THESE PATIENTS THE ABILITY TO COMPLETE THEIR APPLICATION DURING THEIR STAY AT THE HOSPITAL, DEPENDING UPON THE PATIENT'S CONDITION, OR THE PATIENT'S RESPONSIBLE PARTY MAY BE CONTACTED TO COMPLETE AND RETURN THE FORMS AT A LATER TIME WHEN THEIR CARE ALLOWS THIS COMPLETION. DURING THE PATIENT ACCOUNT COLLECTION PROCESS, SELF-PAY PATIENTS ARE ALSO INFORMED OF THE HOSPITAL'S COLLECTION POLICIES AS WELL AS THE CHARITY CARE PROGRAM TO ALLOW PATIENTS THE OPPORTUNITY TO COMPLETE THE APPROPRIATE FORMS AND QUALIFY UNDER THE PROGRAM.
PART V, SECTION B, LINE 3: THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) CONSIDERED INFORMATION OBTAINED FROM INTERVIEWS WITH STAKEHOLDERS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY. SEVENTEEN KEY STAKEHOLDERS PARTICIPATED IN THE INTERVIEW PROCESS. THE SEVENTEEN STAKEHOLDERS REPRESENT PUBLIC HEALTH EXPERTS; INDIVIDUALS FROM HEALTH OR OTHER DEPARTMENTS AND AGENICES; LEADERS OR REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS; AND OTHER COMMUNITY MEMBERS. THE CHNA ALSO CONSIDERED MULTIPLE OTHER DATA SOURCES, INCLUDING SECONDARY DATA SOURCES REGARDING DEMOGRAPHICS, HEALTH STATUS INDICATORS, AND MEASURES OF HEALTH CARE ACCESS.	UPLAND HILLS HEALTH, INC.
PART V, SECTION B, LINE 7: THERE WERE ITEMS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WHICH WERE NOT ADDRESSED BY UPLAND HILLS HEALTH, 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. SEVERAL OF THE ITEMS WHICH WERE NOT ADDRESSED PRIMARILY WERE NOT ADDRESSED DUE TO THE FINANCIAL CONSTRAINT OF PROVIDING A NEW SERVICE FOR A LIMITED POPULATION OF PEOPLE WITHIN THE PRIMARY SERVICE AREA OR AT THE PRESENT TIME IT WAS DETERMINED THAT ANOTHER ORGANIZATION MAY BE NEEDED TO MAKE A NEW HEALTH SERVICE A FINANCIALLY VIABLE OPTION IN THE LOCAL COMMUNITY. UPLAND HILLS HEALTH, INC. AGREED TO LIMIT THEIR FOCUS TO TWO PRIMARY GOALS.	UPLAND HILLS HEALTH, INC.
PART V, SECTION B, LINE 14G: THE POLICY WAS OFFERED TO ALL PRIVATE PAY PATIENTS IN THE EMERGENCY DEPARTMENT.	UPLAND HILLS HEALTH, INC.
PART VI, LINE 2: UPLAND HILLS HEALTH, INC. ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES AND AREAS IT SERVES BY REVIEWING LOCAL DEMOGRAPHICS AND TRENDS IN PATIENT SERVICE UTILIZATION TO DETERMINE WHICH SERVICES COULD AND SHOULD BE MADE AVAILABLE TO THE COMMUNITY IN A COST-EFFECTIVE MANNER TO BE CONSISTENT WITH THE HOSPITAL'S MISSION IN THE COMMUNITY. UPLAND HILLS HEALTH, INC. ALSO REVIEWS STATISTICS IN THE HOSPITAL, NURSING HOME, CLINIC, HOME HEALTH, AND OTHER ORGANIZATIONAL DEPARTMENTS TO REVIEW THE CURRENT SERVICES BEING OFFERED AND ENSURE THAT RESOURCES ARE BEING APPROPRIATELY ALLOCATED TO AREAS IN NEED BY COMMUNITY MEMBERS AND PATIENTS. THE HOSPITAL ALSO MEETS WITH LOCAL COMMUNITY MEMBERS AND IT'S PHYSICIAN GROUP TO DETERMINE WHICH SERVICES MAY BENEFIT THE COMMUNITY.DURING FISCAL YEAR 2013 UPLAND HILLS HEALTH, INC. COMPLETED A FORMAL COMMUNITY NEEDS ASSESSMENT TO BETTER UNDERSTAND THE HEALTH NEEDS OF THE COMMUNITY AND TO DEVELOP AN EFFECTIVE IMPLEMENTATION STRATEGY TO ADDRESS PRIORITY NEEDS.
PART VI, LINE 3: UNINSURED AND UNDER INSURED PATIENTS ARE ASKED TO MEET WITH ONE OF THE HOSPITAL'S FINANCIAL COUNSELORS EITHER AT THE TIME SERVICE IS PROVIDED OR WHEN THE PATIENT'S BILL IS GENERATED. THE FINANCIAL COUNSELOR EXPLAINS THE VARIOUS PAYMENT OPTIONS AVAILABLE TO THE PATIENT AS WELL AS THE HOSPITAL'S CHARITY CARE PROGRAM AND OFFERS THE CHARITY CARE APPLICATION WHEN APPROPRIATE. IF OTHER PROGRAMS ARE AVAILABLE TO THE PATIENT, SUCH AS THE WISCONSIN MEDICAID OR BADGERCARE PROGRAMS, THESE PATIENTS ARE REFERRED TO THE APPROPRIATE GOVERNMENT AGENCY FOR FURTHER ASSISTANCE.
PART VI, LINE 4: THE PRIMARY SERVICE AREA FOR UPLAND HILLS HEALTH, INC. ENCOMPASSES ALL PERSONS LIVING WITHIN A 20 TO 30 MILE RADIUS OF THE HOSPITAL. SOME OF THE COMMUNITIES INCLUDED IN THIS AREA ARE DODGEVILLE, MONTFORT, HIGHLAND, COBB, EDMUND, RIDGEWAY, LINDEN, AND MINERAL POINT, WISCONSIN, AMONG MANY OTHERS. UPLAND HILLS HEALTH, INC. IS THE ONLY HOSPITAL LOCATED IN IOWA COUNTY, WISCONSIN. THE HOSPITAL PROVIDES A SIGNFICANT PORTION OF ITS PATIENT SERVICES TO BENEFICIARIES OF THE MEDICARE AND MEDICAID PROGRAMS, ESPECIALLY THOSE BENEFICIARIES WHO RESIDE IN THE HOSPITAL'S LONG-TERM CARE FACILITY, OR PATIENTS WHO RECEIVE HOME HEALTH, HOSPICE, OR DIALYSIS SERVICES FROM UPLAND HILLS HEALTH, INC. IN 2013, THESE MEDICARE AND MEDICAID PATIENTS ACCOUNTED FOR APPROXIMATELY 49 PERCENT OF THE GROSS PATIENT SERVICE REVENUE PROVIDED BY THE HOSPITAL DURING THE YEAR.
PART VI, LINE 6: UPLAND HILLS HEALTH, INC. MAINTAINS AN AFFILIATION AGREEMENT WITH SSM HEALTHCARE OF WISCONSIN, INC. SSM HEALTHCARE OF WISCONSIN, INC. OPERATES ST. MARY'S HOSPITAL IN MADISON, WISCONSIN AS WELL BEING AFFILIATED WITH OTHER AREA COMMUNITY HOSPITALS LOCATED NEAR MADISON, WISCONSIN. ST. MARY'S AND THE SSM HEALTHCARE SYSTEM IS A MULTI-SPECIALTY HEALTH SYSTEM. UPLAND HILLS HEALTH, INC. COLLABORATES WITH SSM HEALTHCARE TO PROMOTE HEALTH AND WELLNESS INITIATIVES IN THE COMMUNITIES SERVED AND THE REGION. AS NOTED PREVIOUSLY IN THE FORM 990, TWO REPRESENTATIVES FROM SSM HEALTHCARE HAVE ROLES ON THE BOARD OF DIRECTORS OF UPLAND HILLS HEALTH, INC. THE AFFILIATION HELPS ENHANCE ACCESSIBILITY OF HEALTH CARE SERVICES OFFERED AT UPLAND HILLS HEALTH, INC. AND MAKES AVAILABLE ADDITIONAL EXPERTISE AND SERVICES WHEN NEEDED TO PROVIDE ACCESS TO EXPANDED SERVICES FOR AREA RESIDENTS.
WI	REPORTS FILED WITH STATES	PART VI, LINE 7

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	1	RecordsMaintained

Recipient Table RecipientTable (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Amount Of Non Cash AssistanceAmountOfNonCashAssistance	Method Of ValuationMethodOfValuation	Description Of Non Cash AssistanceDescriptionOfNonCashAssistance	Purpose Of GrantPurposeOfGrant
COMMUNITY CONNECTIONS FREE CLINIC INC
201 S IOWA STREET	DODGEVILLE	WI	53533	721619112	501(C)(3)	0	98283	COST	MEDICAL SERVICES & SUPPLIES	TO PROVIDE ACCESS TO ADDITIONAL HEALTHCARE SERVICES TO THOSE IN NEED IN THE COMMUNITY.
UPLAND HILLS HEALTH FOUNDATION INC
800 COMPASSION WAY	DODGEVILLE	WI	53533	260596045	501(C)(3)	9517		FMV		MONETARY SUPPORT

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	2	TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations	0	TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	PROCEDURE FOR MONITORING GRANTS IN THE U.S.:	Identifier
Return Reference	PART I, LINE 2:	ReturnReference
Explanation	SCHEDULE I, PART I, LINE 2: UPLAND HILLS HEALTH, INC. HAS A BOARD APPROVED POLICY ON CHARITABLE GIVING FROM UPLAND HILLS HEALTH TO THE COMMUNITY FOR PURPOSES THAT FURTHER THE MISSION OF THE ORGANIZATION. GRANTS TO THE COMMUNITY CONNECTIONS FREE CLINIC ARE IN SUPPORT OF THIS MISSION TO PROVIDE ACCESS TO HEALTHCARE SERVICES TO THOSE IN NEED IN THE COMMUNITY AND SURROUNDING AREAS. EACH YEAR, UPLAND HILLS HEALTH PROVIDES AN AMOUNT THAT IS APPROVED IN THE ANNUAL OPERATING BUDGET BY THE BOARD OF DIRECTORS AND THIS ALLOTED AMOUNT IS GIVEN TO THE FREE CLINIC TO REFER PATIENTS IN NEED OF ADDITIONAL SERVICES TO UPLAND HILLS HEALTH TO BE PROVIDED FREE OF CHARGE. THE ORGANIZATION MONITORS THE AMOUNTS PROVIDED DURING THE YEAR AND ENSURES THAT THE CLINIC IS MADE AWARE OF REMAINING AVAILABLE ALLOCATED AMOUNTS. IF A TIME OF NEED IS DETERMINED FOR THE FREE CLINIC TO RECEIVE ADDITIONAL SERVICES BEYOND THE BUDGETED AMOUNT, THIS WOULD BE APPROVED BY THE BOARD OF DIRECTORS UNDER THE CHARITABLE GIVING POLICY OF UPLAND HILLS HEALTH. PATIENTS OF THE FREE CLINIC MAY ALSO QUALIFY FOR ADDITIONAL SERVICES UNDER THE HOSPITAL'S CHARITY CARE POLICY AT FREE OR REDUCED RATES DEPENDING ON INDIVIDUAL NEEDS. THESE TWO POLICIES ALLOW UPLAND HILLS HEALTH THE ABILITY TO PROVIDE A CONTINUUM OF CARE TO THOSE IN NEED.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Written Employment Contract	X	WrittenEmploymentContract
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	0	SeverancePayment
Supplemental Nonqual Retire Plan	0	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	0	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	0	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	0	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)

TitleTitle	Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
PHYLLIS FRITSCH
PRESIDENT AND CEO (THROUGH 6/2013)	191143	0	0	0	6069	0	7855	0	19150	0	224217	0	0	0
ARTHUR K PUSTINA
VICE PRESIDENT OF FINANCE	127533	0	0	0	1082	0	5192	0	21190	0	154997	0	0	0
BARBARA HOSTETLER
PHYSICIAN	419548	0	0	0	1805	0	9800	0	17370	0	448523	0	0	0
ADAM DACHMAN
PHYSICIAN	379553	0	0	0	966	0	0	0	10242	0	390761	0	0	0
JEFF PIERCE
CRNA	271578	0	0	0	2772	0	9800	0	21816	0	305966	0	0	0
DONALD HART
CRNA	256670	0	0	0	629	0	8250	0	22693	0	288242	0	0	0
ROBERT SCHMUS
PHYSICIAN	265309	0	0	0	2772	0	9233	0	14875	0	292189	0	0	0

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Bond ReferenceBondReferenceCd	Issuer EINIssuerEIN	CUSIP NumberCUSIPNumber	Date IssuedDateIssued	Issue PriceIssuePrice	Description Of PurposeDescriptionOfPurpose	DefeasedDefeased	On Behalf Of IssuerOnBehalfOfIssuer	Pool FinancingPoolFinancing
WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY
A	391337855	977104K98	2006-10-03	20825012	CONSTRUCTION & RENOVATION OF HOSPITAL FACILITIES	0	0	0
WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY
B	391337855	97710VN93	2006-10-03	10300000	CONSTRUCTION & RENOVATION OF HOSPITAL FACILITIES	0	0	0

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Bond ReferenceBondReferenceCd	Amount RetiredAmountRetired	Total ProceedsTotalProceeds	Amount In Reserve FundAmountInReserveFund	Refunding EscrowRefundingEscrow	Issuance Costs From ProceedsIssuanceCostsFromProceeds	Capital ExpendituresCapitalExpenditures	Year Of Subst CompletionYearOfSubstCompletion	Current RefundingCurrentRefunding	Advance RefundingAdvanceRefunding	Final Allocation MadeFinalAllocationMade	Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
A	2875000	20825012	1351698	9340920	414461	9717934	2009	0	1	1	1
B	650000	10300000			225810	10074190	2009	0	0	1	1

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedProperty	Any Lease ArrangementsAnyLeaseArrangements	Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty	Any Research AgreementsAnyResearchAgreements	Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers	Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI	Total Private Business UseTotalPrivateBusinessUse	Bond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTest	Change In Use Bond Financed PropChangeInUseBondFinancedProp	Non Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
A	0	0	0	0	0.00000	0.00000	0.00000	0	0	0
B	0	0	0	0	0.00000	0.00000	0.00000	0	0	0

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiled	Rebate Not Due YetRebateNotDueYet	Exception To RebateExceptionToRebate	No Rebate DueNoRebateDue	Variable Rate IssueVariableRateIssue	Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds	Gross Proceeds Invested In GICGrossProceedsInvestedInGIC	Gross Proceeds InvestedGrossProceedsInvested	Written Proc To Monitor ReqsWrittenProcToMonitorReqs
A	0	0	0	1	0	0	0	0	0
B	1				0	0	0	0	0

Form990 Schedule K Part V Form990ScheduleKPartV (2 entries)

Bond ReferenceBondReferenceCd	Proc To Undertk Corrective ActionProcToUndertkCorrectiveAction
A	0
B	0

Form990 Schedule K Part VI Form990ScheduleKPartVI

Field	Value	IRS element (for citing)
Identifier	SCHEDULE K PART IV, ARBITRAGE, LINE 2C	Identifier
Return Reference	DATE REBATE COMPUTATION PERFORMED	ReturnReference
Explanation	ISSUER NAME: WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 05/15/2010	Explanation

Schedule M IRS990ScheduleM

Other Non Cash Contributions Table OtherNonCashContributionsTable

Field	Value	IRS element (for citing)
Non Cash Checkbox	X	NonCashCheckbox
Description	LEADERSHIP AND PROFESSIONAL DEVELOPMENT TRAINING	Description
Number Of Contributions	1	NumberOfContributions
Noncash Contribs Rptd F990	31192	NoncashContribsRptdF990
Method Of Determining Revenues	FAIR MARKET VALUE	MethodOfDeterminingRevenues

Field	Value	IRS element (for citing)
Any Property That Must Be Held	0	AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts	1	ReviewProcessUnusualNCGifts
Third Parties Used	1	ThirdPartiesUsed

Form990 Schedule M Part II Form990ScheduleMPartII

Field	Value	IRS element (for citing)
Identifier	THIRD PARTY USE:	Identifier
Return Reference	PART I, LINE 32B:	ReturnReference
Explanation	UPLAND HILLS HEALTH, INC. USES A RELATED PARTY, UPLAND HILLS HEALTH FOUNDATION, INC., TO SOLICIT NON-CASH CONTRIBUTIONS. UPLAND HILLS HEALTH FOUNDATION, INC. SOLICITS GIFTS, BEQUESTS, AND GRANTS OF REAL OR PERSONAL PROPERTY FROM INDIVIDUALS, ESTATES, TRUSTS, ASSOCIATIONS, CORPORATIONS, AND OTHER ENTITIES TO FURTHER THE MISSION OF UPLAND HILLS HEALTH, INC.	Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 2	LINDA TAPLIN STATZ AND TODD BURCHILL ARE MEMBERS OF THE BOARD OF DIRECTORS AND REPRESENT SSM HEALTHCARE OF WISCONSIN. THESE INDIVIDUALS ARE EMPLOYEES OF SSM HEALTHCARE OF WISCONSIN AND SERVE ON THE BOARD AT UPLAND HILLS HEALTH, INC. AS A PART OF THE AFFILIATION AGREEMENT BETWEEN UPLAND HILLS HEALTH, INC. AND SSM WISCONSIN, INC. (A NON-PROFIT CORPORATION WHICH OPERATES ST. MARY'S HOSPITAL IN MADISON, WISCONSIN.)
FORM 990, PART VI, SECTION A, LINE 6	SSM HEALTHCARE OF WISCONSIN, INC., UNDER THE TERMS OF THE AFFILIATION AGREEMENT DATED SEPTEMBER 21, 2011, HOLDS A 17.39% EQUITY INTEREST IN UPLAND HILLS HEALTH, INC.
FORM 990, PART VI, SECTION A, LINE 7A	SSM HEALTHCARE OF WISCONSIN, INC. CAN APPOINT TWO MEMBERS TO THE UPLAND HILLS HEALTH, INC. BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7B	THE FOLLOWING DECISIONS BY THE BOARD SHALL REQUIRE BOTH THE APPROVING VOTE OF A MAJORITY OF THE ENTIRE BOARD AND THE APPROVAL OF SSM HEALTHCARE OF WISCONSIN, INC.: (I) APPROVAL OF ANY AMENDMENT OR RESTATEMENT AFFECTING ARTICLE TWELFTH OF THE ARTICLES OF INCORPORATION. (II) APPROVAL OF ANY AMENDMENT OR RESTATEMENT AFFECTING SECTION 1.4, SECTION 2.2, SECTION 2.6, SECTION 3.7, SECTION 5.2, OR ARTICLE X OF THE CORPORATE BYLAWS OF UPLAND HILLS HEALTH, INC.
FORM 990, PART VI, SECTION B, LINE 11	THE FORM 990 IS REVIEWED BY THE VICE PRESIDENT OF FINANCE AND THE BOARD OF DIRECTORS PRIOR TO SUBMISSION.
FORM 990, PART VI, SECTION B, LINE 12C	UPLAND HILLS HEALTH, INC. REQUIRES ALL OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, AND HIGHEST-COMPENSATED EMPLOYEES TO COMPLETE AN ANNUAL DISCLOSURE STATEMENT. THESE STATEMENTS ARE THEN REVIEWED BY THE BOARD OF DIRECTORS, NOTING ANY RELATIONSHIPS THAT COULD POTENTIALLY CREATE A CONFLICT OF INTEREST. IF BOARD MEMBERS HAVE CONFLICTS THAT ARE NOTED, THESE MEMBERS ARE ASKED TO ABSTAIN FROM VOTING ON THOSE MATTERS. CONFLICTS NOTED BY EMPLOYEES ARE REVIEWED BY THE BOARD OF DIRECTORS TO ENSURE THAT ALL TRANSACTIONS ARE CONDUCTED AT ARMS LENGTH.
FORM 990, PART VI, SECTION B, LINE 15	THE BOARD OF DIRECTORS HAS AN ESTABLISHED PROCESS TO REVIEW THE COMPENSATION OF OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES AND TO DEFINE COMPENSATION PRACTICES. COMPARATIVE DATA FROM WAGE SURVEYS, AREA LABOR ADJUSTMENTS, AND MARKET RATES IN OTHER AREA FACILITIES ARE USED IN DETERMINING COMPENSATION. THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS AND APPROVES ANY EXCEPTIONS TO ACROSS-THE-BOARD RAISES AND STANDARD NEW HIRE WAGES. DURING THE REVIEW PROCESS, DECISIONS AFFECTING COMPENSATION AND CONTRACTS ARE ONLY REVIEWED AND APPROVED BY INDIVIDUALS WHO DO NOT HAVE NOTED CONFLICTS. THE DECISIONS AND DELIBERATION ARE ALSO DOCUMENTED FOR KEY EMPLOYEES AND EXECUTIVES (WHICH MAINLY INCLUDE THE HIGHLY COMPENSATED EMPLOYEES OF THE ORGANIZATION) IN THE MINUTES OF THE BOARD OF DIRECTORS UPON APPROVAL BY THE BOARD.
FORM 990, PART VI, SECTION C, LINE 19	UPLAND HILLS HEALTH, INC. MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT ITS BUSINESS LOCATION DURING NORMAL BUSINESS HOURS.
FORM 990, PART IX, LINE 11G	OTHER FEES: PROGRAM SERVICE EXPENSES 4,385,775. MANAGEMENT AND GENERAL EXPENSES 523,801. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,909,576.	OTHER FEES
FORM 990, PART XI, LINE 9:	INCREASE IN EQUITY OF INVESTMENTS IN UNCONSOLIDATED AFFILIATES 72,312.	CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XI, LINE 2C, SELECTION OF INDEPENDENT ACCOUNTANT:	THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS BY AN INDEPENDENT ACCOUNTANT. THE BOARD OF DIRECTORS OF UPLAND HILLS HEALTH, INC. ALSO APPROVES THE SELECTION OF THE INDEPENDENT AUDITORS AND HISTORICALLY HAS USED A PROCESS OF SOLICITATION OF SEALED BIDS FROM INDEPENDENT AUDIT FIRMS WITH HEALTHCARE AUDIT EXPERIENCE EVERY FIVE YEARS SO THAT THE AUDIT FIRM REVIEW IS DONE ON A REGULAR BASIS. THIS PROCESS AND PROCEDURES HAVE NOT CHANGED IN THE CURRENT YEAR.
FORM 990, PART VI, SECTION B, LINE 16B:	UPLAND HILLS HEALTH, INC. DOES NOT HAVE A WRITTEN POLICY REGARDING THE EVALUATION OF PARTICIPATION IN JOINT VENTURE ARRANGEMENTS; HOWEVER, ALL POTENTIAL JOINT VENTURE ARRANGEMENTS ARE REVIEWED BY UPLAND HILLS HEALTH, INC.'S LEGAL COUNSEL PRIOR TO PARTICIPATION. THE LEGAL COUNSEL REVIEWS POTENTIAL JOINT VENTURE ARRANGEMENTS FOR COMPLIANCE WITH THE UPLAND HILLS HEALTH, INC. CORPORATE BY-LAWS AND ALSO REVIEWS FOR COMPLIANCE WITH APPLICABLE FEDERAL TAX LAW TO ENSURE THE SAFEGUARDING OF THE ORGANIZATION'S TAX EXEMPT STATUS. UPON LEGAL COUNSEL CONSENT, UPLAND HILLS HEALTH, INC. WILL PROCEED WITH A FORMAL WRITTEN AGREEMENT FOR ALL JOINT VENTURE ARRANGEMENTS.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

Field	Value	IRS element (for citing)
Business Name Line1	UPLAND HILLS HEALTH HOLDINGS LLC	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	800 COMPASSION WAY	AddressLine1
City	DODGEVILLE	City
State	WI	State
ZIP Code	53533	ZIPCode

Field	Value	IRS element (for citing)
EIN	800809494	EIN
Primary Activities	PARTNERSHIP FOR DURABLE MEDICAL EQUIPMENT PROVIDED TO PATIENTS	PrimaryActivities
Legal Domicile State	WI	LegalDomicileState
Total Income	96722	TotalIncome
EOY Assets	183421	EOYAssets

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	NA	BusinessNameLine1

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

Field	Value	IRS element (for citing)
Business Name Line1	UPLAND HILLS HEALTH FOUNDATION INC	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	800 COMPASSION WAY	AddressLine1
City	DODGEVILLE	City
State	WI	State
ZIP Code	53533	ZIPCode

Field	Value	IRS element (for citing)
EIN	260596045	EIN
Primary Activities	FOUNDATION TO PROVIDE CONTRIBUTIONS AND SUPPORT FOR UPLAND HILLS HEALTH	PrimaryActivities
Legal Domicile State	WI	LegalDomicileState
Exempt Code Section	501(C)(3)	ExemptCodeSection
Direct Controlling Entity NA	N/A	DirectControllingEntityNA
Controlled Org	0	ControlledOrg

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Direct Controlling Entity NADirectControllingEntityNA	Predominant Income TypePredominantIncomeType	Share Of Total IncomeShareOfTotalIncome	Share Of EOY AssetsShareOfEOYAssets	Disproportionate AllocationsDisproportionateAllocations	General Or Managing PartnerGeneralOrManagingPartner	Percentage OwnershipPercentageOwnership
UPLAND HILLS HOMETOWN MEDICAL EQUIPMENT LLC
305 E BUSINESS HWY 151 SUITE C	PLATTEVILLE	WI	53818	680656862	PARTNERSHIP FOR DURABLE MEDICAL EQUIPMENT PROVIDED TO PATIENTS	WI	N/A	RELATED	-24409	36914	0	0	0.30000
CRESTRIDGE ASSISTED LIVING LLC
1402 PANKRANTZ STREET SUITE 110	MADISON	WI	53704	391913656	ASSISTED LIVING	WI	N/A	RELATED	96722	183421	0	0	0.49000

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	0	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	1	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	1	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	1	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	0	LoansOrGuaranteesFromOtherOrg
Dividends Related Organization	0	DividendsRelatedOrganization
Sale Of Assets To Other Org	0	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	0	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	0	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	0	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	0	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	1	PerformOfServicesByOtherOrgs
Sharing Of Facilities	1	SharingOfFacilities
Sharing Of Paid Employees	1	SharingOfPaidEmployees
Reimbursement Paid To Other Org	0	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	0	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	0	OtherTransferToOtherOrg
Other Transfer From Other Org	1	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved	Method Of Amt DeterminationMethodOfAmtDetermination
UPLAND HILLS HEALTH FOUNDATION INC
C	77466	CASH RECEIVED
UPLAND HILLS HOMETOWN MEDICAL EQUIPMENT LLC
R	97000	CASH RECEIVED
CRESTRIDGE ASSISTED LIVING LLC
D	2730845	CASH PAID
UPLAND HILLS HEALTH FOUNDATION INC
B	9517	CASH PAID