2013-08-13T08:42:27-05:00 2012-09-30 390758449 WIPFLI LLP 3703 OAKWOOD HILLS PARKWAY EAU CLAIRE WI 54701 990 2011-10-01 391091432 REEDSBURG AREA MEDICAL CENTER REED 6085246487 2000 NORTH DEWEY AVENUE REEDSBURG WI 53959 ROBERT VAN MEETEREN 6085246487 2013-07-25 1 PAUL TRACZEK CPA P01368830 7158323407 2013-07-25 2011 2016-02-24 21:20:13Z ROBERT VAN MEETEREN 2000 NORTH DEWEY AVENUE REEDSBURG WI 53959 46653201 0 X WWW.RAMCHEALTH.COM X 1967 WI REEDSBURG AREA MEDICAL CENTER (RAMC) IS A NON-PROFIT, NON-STOCK CORPORATION WHICH EXISTS FOR THE BENEFIT OF THE PEOPLE OF REEDSBURG AND SURROUNDING AREAS. RAMC'S MISSION IS TO PROVIDE QUALITY , COMPASSIONATE AND EFFECTIVE HEALTH CARE GOING BEYOND THE EXPECTED IN ALL WE DO. OUR MAIN FUNCTION IS TO PROVIDE PRIMARY CARE SERVICES CONSISTING OF, BUT NOT LIMITED TO ACUTE CARE, OBSTETRICS, URGENT/EMERGENCY CARE, DIAGNOSTIC SERVICES, REHABILITATION, SURGICAL SERVICES, COMMUNITY OUTREACH AND WELLNESS. DIVERSIFICATION AND EXPANSION OF SERVICES ARE CONSIDERED IN RESPONSE TO THE NEEDS OF THOSE WE SERVE. RAMC PROVIDES SIGNIFICANT 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 - CARE THAT WITHOUT OUR HOSPITAL, WOULD NOT BE AVAILABLE. 11 11 526 150 0 0 628549 271658 41990137 45065851 597115 796240 1416721 482041 44632522 46615790 486102 254925 0 0 24088105 23987903 0 0 30425 18496162 20228057 43070369 44470885 1562153 2144905 60753708 63644587 28366482 28181788 32387226 35462799 X REEDSBURG AREA MEDICAL CENTER, ALWAYS THERE, GOING BEYOND THE EXPECTED TO PROVIDE COMPASSIONATE, QUALITY AND EFFICIENT HEALTHCARE. 0 0 38619422 254925 45043836 INPATIENT SERVICES INCLUDE MULTICARE (MEDICAL/SURGICAL), OBESTETRICS/NURSERY AND INTENSIVE CARE UNITS AT REEDSBURG AREA MEDICAL CENTER (RAMC). WITHIN THESE UNITS, RAMC PROVIDED SHORT-TERM CARE FOR 4,875 PATIENT DAYS (1,467 DISCHARGED PATIENTS) DURING THE FISCAL YEAR ENDING 9/30/12. THIS INCLUDED 305 MEDICARE SWING BED DAYS FOR 52 PATIENTS, 581 OBSERVATION DAYS AND 247 BIRTHS.RAMC'S URGENT CARE AND EMERGENCY CARE IS HERE FOR OUR COMMUNITY WHENEVER THEY NEED US. URGENT CARE HAS HOURS OF AVAILABILITY FOR MINOR MEDICAL NEEDS SEVEN DAYS A WEEK AND THE EMERGENCY ROOM IS OPEN AND PHYSICIAN STAFFED 24 HOURS A DAY, SEVEN DAYS A WEEK. A MULTIDISCIPLINARY TEAM OF SKILLED PROFESSIONALS, ALONG WITH UP-TO-DATE DIAGNOSTIC TECHNOLOGY, ARE AVAILABLE 24 HOURS A DAY. THE STAFF AT RAMC IS HERE TO MEET PATIENTS' PHYSICAL, SOCIAL, EDUCATIONAL, EMOTIONAL, AND SPIRITUAL NEEDS. IN THE FISCAL YEAR ENDING 9/30/12, 9,046 PATIENTS WERE SEEN IN THE EMERGENCY ROOM (RESULTING IN 1,157 INPATIENT ADMISSIONS) AND 3,932 VISITED URGENT CARE.IN OUR COMMITMENT TO PROVIDING HIGH-QUALITY, EFFECTIVE, LOCAL HEALTHCARE, RAMC HAS MADE SEVERAL UPDATES TO VARIOUS DEPARTMENTS THROUGHOUT OUR ORGANIZATION. DURING THIS PAST FISCAL YEAR GREAT STRIDES WERE MADE TOWARD FULLY IMPLEMENTING A 100% ELECTRONIC MEDICAL RECORD (EMR) SYSTEM. JANUARY SAW THE LAUNCH OF COMPUTERIZED PHYSICIAN ORDER ENTRY (CPOE) WHICH ENABLES PHYSICIANS TO ENTER ALL ORDERS FOR TREATMENT AND TESTING DIRECTLY INTO THE PATIENT'S ELECTRONIC MEDICAL RECORD. THE RESULTS AND OUTCOMES OF THESE TESTS AND TREATMENTS ARE ALSO RECORDED ELECTRONICALLY. OTHER FEATURES ALREADY IMPLEMENTED INCLUDE ELECTRONIC PATIENT CHARTING, MEDICATION SCANNING AND DISPENSING, IMAGING, REMOTE MONITORING AND SPEECH RECOGNITION DICTATION CAPABILITIES. THERE IS STILL MORE WORK TO BE DONE, BUT THE COMPLETED PHASES HAVE ALREADY RESULTED IN ENHANCED PATIENT CARE, QUALITY AND SAFETY. OTHER ACCOMPLISHMENTS INCLUDE THE ADDITION OF THREE NEW PHYSICIANS - DR. FOCHIOS (ORTHOPEDICS), DR. HIBBETT (SURGERY), AND DR. SCHAD (OBSTETRICS), A NEW NEUROSURGERY MICROSCOPE, AND THE OPENING OF A WOUND CARE CLINIC. RAMC IS DEDICATED TO PROVIDING A WIDE RANGE OF HIGH QUALITY AND UP-TO-DATE SERVICES. ADDITIONAL SERVICES AVAILABLE INCLUDE, BUT ARE NOT LIMITED TO, LABORATORY, REHABILITATION, SLEEP MEDICINE, OCCUPATIONAL MEDICINE, SURGICAL SERVICES, CONSULTING, MASSAGE THERAPY, ORTHOPEDICS, OBSTETRICS, PARISH NURSING, CHEMOTHERAPY, VOLUNTEER SERVICES, COMMUNITY OUTREACH AND WELLNESS., 38619422 1 1 0 0 0 0 0 0 0 1 1 0 1 0 0 1 1 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 1 0 0 0 0 1 60 0 1 526 1 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X X JOSEPH SVETLIK 6085246487 2000 NORTH DEWEY AVENUE REEDSBURG WI 53959 JAN GERLACH 0.50 X X 2109 0 0 KURT MUCHOW 0.50 X X 2284 0 0 JAMES SEBRANEK 0.50 X X 3036 0 0 CHRIS WENNINGER 0.50 X X 4730 0 0 DEANNA BENISH MD 0.50 X 3390 0 0 JEFF STEEL 0.50 X 1246 0 0 WIN BYERS 0.50 X 2137 0 0 KATHERINE CAMPBELL 0.50 X 1221 0 0 ERIC MOLBERG 0.50 X 1626 0 0 ERIC SAUEY 0.50 X 1539 0 0 PAMELA WELCH 0.50 X 1400 0 0 ROBERT VAN MEETEREN 40.00 X 212888 0 27464 JOSEPH SVETLIK 40.00 X 158299 0 53564 JAMES CLAY 40.00 X 273022 0 11748 GERRY CHRABASZCZ 40.00 X 293518 0 24362 KEVIN MCBRIDE 40.00 X 263834 0 22843 CHRISTOPHER BJORKLUND 40.00 X 265353 0 25265 KENNETH OLSON 40.00 X 254572 0 25183 1746204 0 190429 11 0 1 0 AMERICAN EXPRESS PO BOX 650448 DALLAS TX 75265 SUPPLIES 2755050 ACUTE CARE PO BOX 3288 DES MOINES IA 50316 ER PHYSICIANS 1360774 SHARED IMAGING SERVICES PO BOX 45686 MADISON WI 537444686 MEDICAL IMAGING 955904 REEDSBURG PHYSICIANS GROUP 1900 N DEWEY AVE REEDSBURG WI 53959 PHYSICIANS 473891 JULES AND ASSOCIATES 515 S FIGUEROA ST STE 1950 LOS ANGELES CA 90071 LEASED EQUIPMENT 458900 15 92169 179489 271658 PATIENT SERVICE REVENU 621400 44279833 44279833 CAFETERIA REVENUE 722310 764003 764003 OTHER 900099 22015 22015 45065851 822375 822375 482041 0 482041 482041 482041 11276 37411 -26135 -26135 -26135 46615790 45065851 0 1278281 254925 254925 1027904 1027904 21066 21066 17042154 15162645 1879509 626492 556710 69782 4033124 3583897 449227 1237163 1045073 192090 56013 56013 30650 30650 3099416 3099416 220329 220329 365157 365157 177784 177784 1705700 1705700 79855 58433 21422 2436373 2436373 164539 164539 MEDICAL SUPPLIES 4771423 4771423 CONTRACTED SERVICES 2831642 2359826 471816 REPAIR & MAINTENANCE 1207359 1155568 51791 BAD DEBT EXPENSE 1019591 1019591 2062226 1409842 621959 30425 44470885 38619422 5821038 30425 2412 4797049 5531028 7037035 7793538 100000 98511 1550573 1515144 1686712 1691814 51760922 22787510 29547451 28973412 10947773 12166713 4000129 4677737 1086986 1194278 60753708 63644587 4783363 5533644 983574 1096429 21068564 20361722 1530981 1189993 28366482 28181788 X 31315193 34265503 1072033 1197296 32387226 35462799 60753708 63644587 X 2144905 930668 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1688684 219469 1908153 0 1800000 -111316 1688684 1.00000 0 0 26703 26703 36305969 13348213 22957756 14443769 9072603 5371166 984481 366694 617787 28973412 LOAN GRANT RECEIVABLE 37833 C BOND FUNDS 4639904 C 4677737 46615790 44470885 2144905 785801 144867 930668 3075573 46615790 0 46615790 0 46615790 44470885 0 44470885 0 44470885 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE CORPORATIONS ARE NONPROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE CORPORATIONS ARE ALSO EXEMPT FROM STATE INCOME TAXES PURSUANT TO SIMILAR STATE OF WISCONSIN TAX LAWS. IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE CORPORATIONS ASSESS 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 COMBINED FINANCIAL STATEMENTS. THE CORPORATIONS RECORDED NO ASSETS OR LIABILITIES FOR UNCERTAIN TAX POSITIONS OR UNRECOGNIZED BENEFITS IN 2012 AND 2011. FEDERAL RETURNS FOR THE YEARS ENDED SEPTEMBER 30, 2009, AND BEYOND REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE CORPORATIONS' POLICY IS TO RECOGNIZE INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN INCOME TAX EXPENSE WHEN INCURRED. AS OF SEPTEMBER 30, 2012 AND 2011, THERE WERE NO MATERIAL TAX PENALTIES, OR INTEREST RELATED TO TAX PENALTIES, RECORDED BY THE CORPORATIONS IN THE COMBINED FINANCIAL STATEMENTS. 1 1 1 X 1 X 1 1 0 1 1 837395 0 837395 0.01880 5580703 5363397 217306 0.00490 6418098 5363397 1054701 0.02370 283315 283315 0.00640 149444 149444 0.00340 4748814 2680528 2068286 0.04650 257853 0 257853 0.00580 5439426 2680528 2758898 0.06210 11857524 8043925 3813599 0.08580 1300 1300 0.00000 15175 15175 0.00030 69552 26000 43552 0.00100 650 650 0.00000 12250 12250 0.00030 12244 2800 9444 0.00020 111171 28800 82371 0.00180 0 511017 255509 11838430 11721217 117213 X 1 1 1 1 REEDSBURG AREA MEDICAL CENTER INC

2000 NORTH DEWEY AVENUE REEDSBURG WI 53959

X X X X REEDSBURG AREA MEDICAL CENTER INC 1 1 1 150.000000000000 1 400.000000000000 1 X X X X 1 1 X X X 1 1 X X X X X 1 X 0 0 PART I, LINE 6A: REEDSBURG AREA MEDICAL CENTER, INC. PREPARES A COMMUNITY BENEFIT REPORT ANNUALLY AND FILES IT WITH THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THE REPORT IS AVAILABLE TO THE GENERAL PUBLIC ON WHA'S DATABASE AND WEBSITE. PART I, LINE 7: THE COSTING 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 SERVICES 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. THE COSTING METHOD FOR SUBSIDIZED HEALTH SERVICES IS BASED ON ALLOCATED EXPENSES FROM THE MEDICARE COST REPORT WHICH IS SIMILAR TO A DIRECT COST ACCOUNTING SYSTEM FOR THESE SERVICES NOTED AS SUBSIDIZED HEALTH SERVICES. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES AT REEDSBURG AREA MEDICAL CENTER, INC. INCLUDE THE OPERATION OF THE HOSPITAL INPATIENT DEPARTMENTS THAT OPERATE AT A LOSS FROM OPERATIONS, BUT ARE CONSIDERED VITAL HOSPITAL AND CLINIC SERVICES SUCH AS THE INTENSIVE CARE UNIT AND MEDICAL/SURGICAL NURSING UNIT. A LARGE PORTION OF THESE SERVICES ARE ACCESSED BY COMMUNITY MEMBERS THROUGH THE HOSPITAL'S EMERGENCY SERVICES DEPARTMENT. IT IS THE GOAL OF REEDSBURG AREA MEDICAL CENTER 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 REEDSBURG AREA MEDICAL CENTER 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 $1,019,591. PART II: RAMC IS COMMITTED TO THE HEALTH OF OUR COMMUNITY AND THE IMPORTANT PART WE PLAY IN MAINTAINING AND IMPROVING THE OVERALL HEALTH OF OUR CONSTITUENTS. WE TAKE AN ACTIVE ROLE IN EQUIPPING OUR COMMUNITY MEMBERS WITH THE SKILLS NEEDED TO CREATE BETTER HEALTH. RAMC PROVIDES HEALTH CARE SERVICES AND OTHER FINANCIAL SUPPORT THROUGH VARIOUS PROGRAMS THAT ARE DESIGNED, AMONG OTHER MATTERS, TO ENHANCE THE HEALTH OF THE COMMUNITY, INCLUDING THE HEALTH OF LOW-INCOME PATIENTS. CONSISTENT WITH OUR MISSION, CARE IS PROVIDED TO PATIENTS REGARDLESS OR THEIR ABILITY TO PAY, INCLUDING PROVIDING SERVICES TO THOSE PERSONS WHO CANNOT AFFORD HEALTH INSURANCE BECAUSE OF INADEQUATE RESOURCES OF ARE UNDERINSURED. COMMUNITY BENEFITS ALSO INCLUDE UNPAID COSTS OF TREATING THE ELDERLY, HEALTH SCREENINGS, COMMUNITY EDUCATION AND OTHER HEALTH-RELATED SERVICES. OUR COMMUNITY BUILDING ACTIVITIES WORK TO ADDRESS UNDERLYING HEALTH DETERMINANTS AND SUPPORT PROGRAMS MEANT TO IMPROVE HEALTH BEFORE INTERVENTION IS REQUIRED AS WELL AS PROVIDING RESOURCES FOR THOSE LOOKING TO IMPROVE THEIR CURRENT HEALTH SITUATION. RAMC EMPLOYEES ARE ACTIVE IN EDUCATING THE COMMUNITY ON A WIDE VARIETY OF HEALTH TOPICS AND PARTICIPATE ON NUMEROUS LOCAL BOARDS. HEALTH-RELATED BOARD POSITIONS RANGE FROM THOSE FOCUSING ON AREA DENTAL AND EMERGENCY MEDICAL SERVICES TO THE RURAL WISCONSIN HEALTH COOPERATIVE AND SAUK COUNTY HEALTH BOARDS. MANY EMPLOYEES ARE ALSO MEMBERS OF COMMUNITY SERVICE BOARDS AND VOLUNTEER GROUPS. RAMC IS MINDFUL OF AND PROACTIVE IN DEVELOPING OR PARTNERING WITH GROUPS WORKING TO BETTER THE CURRENT ECONOMIC AND ENVIRONMENTAL CONDITIONS OF OUR COMMUNITY. RAMC IS ORGANIZED AND OPERATED WITH THE GOAL OF PROMOTING THE HEALTH OF THE COMMUNITY WE SERVE. WE SUPPORT THIS MISSION WITH A BOARD COMPRISED OF LOCAL, INDEPENDENT COMMUNITY MEMBERS, A MEDICAL STAFF ORGANIZED IN THE PUBLIC INTEREST AND OPEN TO ALL QUALIFIED PHYSICIANS AND AN EMERGENCY ROOM AVAILABLE TO ALL, REGARDLESS OF ABILITY TO PAY. THE BOARD TAKES A BALANCED APPROACH WHEN IT SETS POLICY AND STRATEGIC DIRECTION FOR THE HOSPITAL, WORKING TO ALIGN COMMUNITY NEEDS WITH BUSINESS AND FINANCIAL CONCERNS. THE USE OF SURPLUS FUNDS IS LARGELY DETERMINED BY THE BOARD IN ITS ATTEMPT TO MEET ITS GOAL. RAMC IS THE SOLE HOSPITAL IN OUR COMMUNITY AND PROVIDES NUMEROUS VOLUNTEER OPPORTUNITIES FOR AREA RESIDENTS. 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. REEDSBURG AREA MEDICAL CENTER PROVIDES SIGNIFICANT AMOUNTS OF CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS AND IN ADDITION, THE ORGANIZATION BELIEVES THAT IT PROVIDES A CRITICALLY IMPORTANT BENEFIT WHICH IS NOT QUANTIFIED. REEDSBURG AREA MEDICAL CENTER, LIKE MOST COMMUNITY HOSPITALS, WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE CARE LOCALLY WHICH WITHOUT THE HOSPITAL, WOULD NOT BE AVAILABLE LOCALLY. BEYOND INPATIENT HOSPITALIZATIONS, THE ORGANIZATION PROVIDES LOCAL ACCESS TO MANY SERVICES INCLUDING: BIRTHING CENTER, DIAGNOSTICS, EMERGENCY SERVICES, INFUSION SERVICES, SWING BED SERVICES, SURGICAL SERVICES, LABORATORY SERVICES, OCCUPATIONAL HEALTH, REHABILITATION SERVICES, SPECIALTY MEDICINE, SLEEP CENTER, SPEECH PATHOLOGY, SURGICAL SERVICES, AND WOMENS' SERVICES. 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 ORGANIZATION 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 ORGANIZATION 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 COSTING METHODOLOGY USED ON FORM 990 IS BASED ON A COST TO CHARGE RATIO WHICH IS DEVELOPED BASED ON THE ORGANIZATION'S TOTAL OPERATING EXPENSES LESS PROVISION FOR BAD DEBTS DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS 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 ORGANIZATION ALSO 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 ORGANIZATION. PART III, LINE 8: THE TOTAL MEDICARE REVENUE SHOWN IN SCHEDULE H TO THE FORM 990 IS BASED ON THE IRS 990 INSTRUCTIONS AND INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE OF THE ORGANIZATION, AND ALSO DOES NOT CONSIDER ALL CONTRACTUAL ADJUSTMENTS FOR SERVICES REIMBURSED BY THE MEDICARE PROGRAM. AMOUNTS LISTED FOR MEDICARE REVENUES DO NOT INCLUDE PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT AT THE HOSPITAL AS WELL AS ANESTHESIA PROFESSIONAL SERVICES, SURGEON PROFESSIONAL SERVICES, 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 AND SURGERY, 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 REEDSBURG AREA MEDICAL CENTER PROVIDES TO THE COMMUNITY AND SURROUNDING AREAS. THE COSTING METHOD USED ABOVE FOR IRS 990 COMPLIANCE REPORTING IS ALSO BASED ON THE FILED MEDICARE COST REPORT FOR THE YEAR ENDED SEPTEMBER 30, 2012, 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 ORGANIZATION'S COLLECTION AND CHARITY CARE POLICIES, REEDSBURG AREA MEDICAL CENTER MAKES EVERY ATTEMPT TO IDENTIFY AND PROMOTE CHARITY CARE TO PATIENTS. INCLUDED IN THE ORGANIZATION'S CHARITY CARE POLICY IT IS NOTED THAT PATIENTS MAY QUALIFY FOR CHARITY CARE EITHER PRIOR TO ADMISSION OR FOLLOWING DISCHARGE. 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. ONCE THE PATIENT MEETS ALL QUALIFICIATIONS FOR FINANCIAL ASSISTANCE, ALL OR PART OF THE ACCOUNT BALANCE IS WRITTEN OFF AS APPROPRIATE. THE REMAINING BALANCE, IF ANY, IS THE PATIENT'S RESPONSIBILITY AND COLLECTED FOLLOWING THE NORMAL DEBT COLLECTION POLICY. REEDSBURG AREA MEDICAL CENTER, INC. PART V, SECTION B, LINE 13G: IF A PATIENT DID NOT HAVE INSURANCE AND IT APPEARED WOULD HAVE DIFFICULTY PAYING THE HOSPITAL BILL, THE PATIENT WOULD BE INFORMED OF THE POLICY AND OFFERED AN APPLICATION. REEDSBURG AREA MEDICAL CENTER, INC. PART V, SECTION B, LINE 19D: INDIVIDUALS WITHOUT INSURANCE ARE BILLED AT 85% OF GROSS CHARGES WITH THE OPTION OF AN ADDITIONAL 10% DISCOUNT TO 75% OF GROSS CHARGES IF THE CLAIM IS PAID WITHIN 30 DAYS. CLAIMS EXCEEDING $30,000 GROSS CHARGES RECEIVE AN ADDITIONAL 10% DISCOUNT; STEPPED UP TO 40% AT $50,000 GROSS CHARGES, PLUS THE ADDITIONAL 10% IF PAID WITHIN 30 DAYS. IF THERE ARE INDICATORS THAT A PATIENT MAY NOT BE ABLE TO PAY SOME OR ALL OF THE BILL, THEY ARE INFORMED OF THE FAP. PART VI, LINE 2: EVERY THREE YEARS, RAMC CONDUCTS A FORMAL COMMUNITY ASSESSMENT, MEASURING AWARENESS, PREFERENCE, IMAGE AND COMMUNITY NEEDS. WE CONDUCT THIS WITHIN OUR PRIMARY SERVICE AREA - THE CITY OF REEDSBURG AND THE SURROUNDING COMMUNITIES. IN ADDITION, WE HAVE A FEEDBACK SECTION ON OUR WEBSITE, WWW.RAMCHEALTH.ORG, ALLOWING A FORUM FOR WHICH THE PUBLIC CAN PROVIDE SUGGESTIONS AND COMMENTS. RAMC HAS ALSO BEEN BUSY GATHERING DATA FROM THE RECENT SAUK COUNTY HEALTH NEEDS ASSESSMENT. THIS INFORMATION HAS BEEN SEGMENTED INTO OUR MAIN MARKET AREA. IN WORKING WITH A COMMITTEE CONSISTING OF SAUK COUNTY PUBLIC HEALTH, REEDSBURG AREA SCHOOL DISTRICT, CITY OFFICIALS, AMBULANCE, POLICE AND FIRE, AS WELL AS VARIOUS OTHER COMMUNITY MEMBERS INCLUDING BUSINESS AND INDUSTRY, THIS INFORMATION HAS BEEN PRIORITIZED AND WE ARE IN THE PROCESS OF BUILDING A TEAM OF PEOPLE WHO WILL HELP US TO SET ACTIONABLE MEASURABLE GOALS. PART VI, LINE 3: COMMUNITY CARE NOTICES ARE POSTED THROUGHOUT THE FACILITY AND APPLICATIONS ARE AVAILABLE THROUGH BUSINESS SERVICES. THE PATIENT, PATIENT'S REPRESENTATIVE OR HOSPITAL REPRESENTATIVE MAY INITIATE INQUIRIES REGARDING ELIGIBILITY OR APPLICATION FOR ASSISTANCE AT ANY TIME. THE HOSPITAL, WHEN APPROPRIATE, WILL REVIEW THE PATIENT'S FINANCIAL SITUATION TO SEE IF THEY QUALIFY FOR ANY FORM OF ASSISTANCE, SOCIAL SERVICE IS AVAILABLE TO ASSIST IN THIS PROCESS AS WELL. PATIENT ACCOUNTS IS ALSO NOTIFIED WHEN PATIENTS (INPATIENT OR OUTPATIENT) ARE TREATED WHO DO NOT HAVE ANY INSURANCE. THEY DISCUSS WITH THE PATIENT AVAILABLE OPTIONS AND PROVIDE INFORMATION/APPLICATIONS FOR BOTH RAMC CHARITY CARE PROGRAMS AND COUNTY, STATE OR FEDERAL ASSISTANCE PROGRAMS. AT ANY TIME, PATIENTS MAY INQUIRE WITH HOSPITAL PERSONNEL REGARDING QUESTIONS THEY HAVE ON THEIR ABILITY TO PAY. FINANCIAL ADVISORS ARE AVAILABLE TO HELP AS IS OUR CONSUMER ADVOCATE. THE CONSUMER ADVOCATE OFFERS COMPLIMENTARY PATIENT ASSISTANCE SERVICES, INCLUDING, BUT NOT LIMITED TO, MEDICARE, MEDICAID, PRIVATE INSURANCE, INTERPRETATION OF EXPLANATION OF BENEFITS (EOBS) AND DIRECTIONS TO ADDITIONAL CONSUMER RESOURCES. PART VI, LINE 4: RAMC IS LOCATED IN THE CITY OF REEDSBURG, WISCONSIN IN NORTH CENTRAL SAUK COUNTY. THE PRIMARY SERVICE AREA EXTENDS WEST TO CAZENOVIA, EAST TO ROCK SPRINGS, SOUTH TO HILLPOINT AND NORTH FROM WONEWOC TO JUST WEST OF LAKE DELTON. THIS GEOGRAPHIC AREA IS LARGELY RURAL AND CROSSES INTO THREE COUNTIES IN ADDITION TO SAUK COUNTY, COMPRISING APPROXIMATELY 77% OF RAMC'S DISCHARGED PATIENTS. ACCORDING TO THE MOST RECENT U.S. CENSUS DATA, SAUK COUNTY HAS SEEN POPULATION GROWTH OF 11% FROM 2000 TO 2010, WHILE THE STATE OF WISCONSIN EXPERIENCED GROWTH OF 6%. THE CITY OF REEDSBURG GREW AT A RATE 18% AND ITS MINORITY POPULACE INCREASED FROM 3% TO 7% OF TOTAL POPULATION FOR THE SAME TIME PERIOD COMPARED TO 8% FOR SAUK COUNTY AND 17% FOR THE STATE OF WISCONSIN. 24% OF COUNTY RESIDENTS ARE UNDER THE AGE OF 18 (23% STATE), 15% ARE ABOVE THE AGE OF 65 (14% STATE) AND 46% OF SAUK COUNTY LIVES IN RURAL AREAS (30% STATE). THE MEDIAN HOUSEHOLD INCOME REPORTED FOR SAUK COUNTY IS $48,874 ($50,401 STATE) WHILE UNEMPLOYED IS 7.5% (7.5% STATE). 32% OF COUNTY CHILDREN ARE ELIGIBLE FOR FREE SCHOOL LUNCH (33% STATE) WHILE 18% LIVE IN POVERTY (18% STATE). 14% OF COUNTY ADULTS AND 6% OF COUNTY CHILDREN ARE UNINSURED (13% AND 5% RESPECTIVELY FOR WISCONSIN). 9% OF COUNTY RESIDENTS (9% STATE) REPORTED NOT SEEING A DOCTOR FOR THE PRIOR 12 MONTHS DUE TO COST WHILE 26% (25% STATE) HAD NO DENTAL VISIT. BASED ON NUMEROUS DEMOGRAPHIC, BEHAVIORAL, HEALTH AND SOCIAL METRICS, SUCH AS THOSE SHOWN HERE, SAUK COUNTY HAS BEEN RANKED AS THE 42ND HEALTHIEST COUNTY OUT OF ALL 72 WISCONSIN COUNTIES BY THE COUNTY HEALTH RANKINGS AND ROADMAPS PROGRAM. RAMC IS THE ONLY HOSPITAL WITHIN OUR PRIMARY SERVICE AREA; TWO ADDITIONAL HOSPITALS ARE LOCATED IN SAUK COUNTY. PRIMARY COMPETITION IS FROM OTHER COMMUNITY HOSPITALS LOCATED IN NEIGHBORING COMMUNITIES AND COUNTIES. SEVERAL TERTIARY CARE HOSPITALS IN MADISON, WISCONSIN AND THE SURROUNDING AREA PROVIDE ADDITIONAL SPECIALIZED SERVICES NOT AVAILABLE AT RAMC. REPORTS FILED WITH STATES PART VI, LINE 7 WI 0 REEDSBURG AREA SENIOR LIFE CENTER 2350 NORTH DEWEY AVENUE REEDSBURG WI 54959 760775289 501(C)(3) 240000 GENERAL OPERATIONS REEDSBURG AREA MEDICAL CENTER FOUNDATION 2090 RIDGEVIEW DRIVE REEDSBURG WI 54959 391243616 501(C)(3) 14925 FREE CLINIC TUITION ASSISTANCE 19 66163 STIPENDS 14 14587 SCHEDULE I, PART I, LINE 2 GRANTS WERE PROVIDED BY RAMC TO REEDSBURG AREA SENIOR LIFE CENTER AND REEDSBURG AREA MEDICAL CENTER FOUNDATION. RAMC HAS (AT LEAST MONTHLY) ACCESS TO BOTH OF THESE ORGANIZATION'S FINANCIAL RECORDS AND BOARD MEETING MINUTES, ALLOWING FOR REVIEW OF HOW FUNDS ARE ALLOCATED. RAMC ALSO PROVIDES SCHOLARSHIPS AND TUITION ASSISTANCE TO EMPLOYEES PURSUING HEALTH-CARE RELATED HIGHER EDUCATION. THIS ASSISTANCE IS MADE AVAILABLE TO EMPLOYEES FOR STUDIES WHERE PROFESSIONAL STAFF ARE NEEDED AND THE DEMAND FOR THESE POSITIONS IS GREATER THAN THE SUPPLY AVAILABLE. USUALLY, THE SHORTAGE IS NOT ONLY SEEN LOCALLY, BUT ALSO STATE- AND NATION-WIDE. THE INTENTION IS TO HAVE THESE TRAINED PROFESSIONALS CONTINUE AT RAMC WITHIN THEIR NEW POSITION, ACCOMPLISHING OUR MISSION AND COMMITMENT TO PROVIDING HIGH-QUALITY, LOCAL CARE FOR OUR COMMUNITY. PROOF OF THE COST OF TUITION AND SUCCESSFUL COURSE COMPLETION ARE REQUIRED. X X X X X 0 0 0 1 0 1 0 0 0 ROBERT VAN MEETEREN 181447 0 28838 0 2603 0 10564 0 16900 0 240352 0 0 0 JOSEPH SVETLIK 142582 0 15717 0 0 0 36154 0 17410 0 211863 0 0 0 JAMES CLAY 273022 0 0 0 0 0 2533 0 9215 0 284770 0 0 0 GERRY CHRABASZCZ 293278 0 240 0 0 0 12250 0 12112 0 317880 0 0 0 KEVIN MCBRIDE 263420 0 414 0 0 0 12250 0 10593 0 286677 0 0 0 CHRISTOPHER BJORKLUND 265223 0 130 0 0 0 12250 0 13015 0 290618 0 0 0 KENNETH OLSON 253841 0 731 0 0 0 12250 0 12933 0 279755 0 0 0 PART I, LINE 5 PHYSICIAN IS ELIGIBLE AND RECEIVED PAYMENT BASED ON CHARGES GENERATED FROM HEALTH CARE SERVICES PROVIDED BY THIS PHYSICIAN. PART I, LINE 6 OFFICERS RECEIVE BONUS COMPENSATION BASED ON ORGANIZATION NET INCOME AND MEETING TARGETED STRATEGIC PLANNING GOALS. CITY OF REEDSBURG 396005582 2003-06-03 2600000 REFUND PRIOR ISSUE 0 0 0 WISCONSIN HEALTH & EDUCATIONAL FACILITIES 391337855 97710VH43 2006-06-28 11865000 CONSTRUCT & EQUIP FACILITY & REFUND PRIOR ISSUE 0 0 0 WISCONSIN HEALTH & EDUCATIONAL FACILITIES 391337855 97710BXK3 2010-09-16 5800000 REFUND PRIOR ISSUE 0 0 0 WISCONSIN HEALTH & EDUCATIONAL FACILITIES 391337855 97710BXP2 2010-09-16 4273300 REFUND PRIOR ISSUE 0 0 0 1094736 2600000 2600000 1 0 1 1 2375000 11865000 1183280 3522124 237300 6922296 1 1 1 1 5800000 580000 5104000 116000 1 0 1 1 4273300 4180408 85470 7422 1 0 1 1 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 SCHEDULE K, PART III, LINE 4 THE CONSTRUCTION OF THE PROPERTY FINANCED BY 2006A REVENUE BONDS (B) INCLUDE SOME PORTIONS USED IN PRIVATE BUSINESS USED BY ENTITIES OTHER THAN A SECTION 501(C)(3) ORGANIZATION OR STATE OR LOCAL GOVERNMENT. THE PORTION OF THE BUILDING USED BY THESE ENTITIES WAS FINANCED DIRECTLY BY RAMC THROUGH CASH PAYMENTS TOTALING $4,913,708. CONNIE MOLBERG FAMILY MEMBER OF DIRECTOR 42555 EMPLOYMENT COMPENSATION 0 REEDSBURG PHYSICIAN GROUP TWO RAMC DIRECTORS ARE ALSO RPG PARTNERS 536532 PHYSICIAN COMPENSATION 0 BARABOO NATIONAL BANK BANK EMPLOYEE IS RAMC TRUSTEE 26100 BANKING SERVICES 0 FORM 990, PART VI, SECTION B, LINE 11 UPON COMPLETION OF THE FORM 990, THE VICE PRESIDENT OF FINANCE REVIEWS FOR ACCURACY AND COMPLETENESS. UPON HIS APPROVAL, IT IS PRESENTED TO THE BOARD OF DIRECTORS FOR FINAL APPROVAL. THE 990 IS THEN SIGNED BY THE PRESIDENT/CEO AND IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C MEMBERS ANNUALLY DISCLOSE ANY POSSIBLE CONFLICTS OF INTEREST WHEN THEY SIGN THE CONFLICT OF INTEREST POLICIES. MEMBERS ROUTINELY ABSTAIN FROM VOTING ON ANY MATTERS AND EXCUSE THEMSELVES FROM DECISIONS ON MATTERS WITH WHICH THEY HAVE A CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 INDEPENDENT WAGE AND SALARY SURVEYS ARE USED FOR ALL KEY EMPLOYEES, INCLUDING PRESIDENT/CEO. VENDORS USED ARE THE RURAL WISCONSIN HEALTH COOPERATIVE AND WISCONSIN HOSPITAL ASSOCIATION. FORM 990, PART VI, SECTION C, LINE 19 REEDSBURG AREA MEDICAL CENTER'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE REVIEWED AT THE HOSPITAL'S ANNUAL MEETING WHICH IS OPEN TO THE GENERAL PUBLIC. SUMMARIZED FINANCIAL STATEMENT DATA IS ALSO AVAILABLE THROUGH THE WISCONSIN HOSPITAL ASSOCIATION'S WEBSITE. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 785,801. NET CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION 144,867. TOTAL TO FORM 990, PART XI, LINE 5: 930,668. SELECTION OF INDEPENDENT ACCOUNTANT PART XII, LINE 2C THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR THE AUDIT OF ITS FINANCIAL STATEMENTS AND THE BOARD OF DIRECTORS TAKES TIME TO MEET WITH INDEPENDENT ACCOUNTANTS FOLLOWING THE AUDIT EACH YEAR TO REVIEW THE FINANCIAL STATEMENTS AND ITEMS NOTED DURING THE AUDIT WITHOUT MANAGEMENT PRESENT TO ALLOW EVEN MORE OVERSIGHT BY THE BOARD INTO THE ANNUAL AUDIT PROCESS. MEMBERS OF THE BOARD OF DIRECTORS ALSO HAVE THE CONTACT INFORMATION OF THE INDEPENDENT ACCOUNTANT AND ARE ENCOURAGED TO CONTACT THE ACCOUNTANTS DURING THE YEAR WHEN QUESTIONS ARISE. THERE HAS BEEN NO CHANGE TO THESE PROCEDURES DURING THE PAST YEAR. REEDSBURG AREA MEDICAL CENTER FOUNDATION INC 2090 RIDGEVIEW DRIVE REEDSBURG WI 53959 391243616 FUNDRAISING WI 501(C)(3) LINE 7 REEDSBURG AREA MEDICAL CENTER INC 1 PARTNERS OF REEDSBURG AREA MEDICAL CENTER 2000 NORTH DEWEY AVENUE REEDSBURG WI 53959 237373902 FUNDRAISING WI 501(C)(3) LINE 7 REEDSBURG AREA MEDICAL CENTER INC 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0