2025-02-27T16:02:29-06:00 2024-06-30 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2023-07-01 390831153 CUMBERLAND MEMORIAL HOSPITAL INC CUMB 7158227500 1705 16TH AVENUE CUMBERLAND WI 54829 ANGIE MARTENS CFO 7158227500 2025-02-27 1 0 MICHAEL J PETERSON CPA P01833529 2187224705 2025-02-27 2023 2025-03-06 01:10:19Z CUMBERLAND HEALTHCARE ANGIE MARTENS 1705 16TH AVENUE CUMBERLAND WI 54829 36986115 0 X WWW.CUMBERLANDHEALTHCARE.COM X 1955 WI PROVIDE EXCEPTIONAL QUALITY CARE, EVERY STEP OF THE WAY. 7 7 282 90 2406 0 570794 104569 31221341 35498768 115337 787647 8837 1961 31916309 36392945 700 1150 0 0 17738188 18874693 0 0 0 17353479 18644389 35092367 37520232 -3176058 -1127287 66360894 65063102 45679643 44968032 20681251 20095070 TO BE AN INDEPENDENT, COMMUNITY-BASED HEALTH SYSTEM DEDICATED TO PROVIDING EXCEPTIONAL QUALITY CARE, EVERY STEP OF THE WAY. 0 0 28778809 1150 28782977 CUMBERLAND MEMORIAL HOSPITAL, INC. D/B/A CUMBERLAND HEALTHCARE (THE ORGANIZATION") IS AN INDEPENDENT, NONPROFIT, FACILITY THAT SERVES NORTHWEST WISCONSIN. THE ORGANIZATION OPERATES A HOSPITAL (CUMBERLAND MEMORIAL HOSPITAL) AND TWO RURAL HEALTH CLINICS (LOCATED IN CUMBERLAND AND TURTLE LAKE). CUMBERLAND MEMORIAL HOSPITAL BECAME A CRITICAL ACCESS HOSPITAL ON AUGUST 19, 2005, LICENSED FOR 25 ACUTE CARE BEDS. SERVICES INCLUDE, BUT ARE NOT LIMITED TO, THERAPY, WOUND CARE, CHEMOTHERAPY, RADIOLOGY, LAB, AMBULANCE SERVICE AND GENERAL SURGERY. DURING FISCAL YEAR 2024, ACUTE CARE DAYS TOTALED 915, SWING BED DAYS TOTALED 350. THE ORGANIZATION PROVIDED 52 INPATIENT AND 261 OUTPATIENT SURGERIES ALONG WITH 303 SCOPE PROCEDURES. THERE WERE ALSO 3,682 EMERGENCY ROOM VISITS, 76,741 LAB TESTS, AND 955 AMBULANCE RUNS. 2941884 0 6712393 THE ORGANIZATION OPERATES A HOSPITAL (CUMBERLAND MEMORIAL HOSPITAL) AND TWO RURAL HEALTH CLINICS (LOCATED IN CUMBERLAND AND TURTLE LAKE). CUMBERLAND CLINIC TOTAL VISITS WERE 16,640 AND TURTLE LAKE WERE 2,452. 31720693 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 26 0 282 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 7 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X ANGIE MARTENS 7158227500 1705 16TH AVENUE CUMBERLAND WI 54829 DR CRAIG JENNINGS PHYSICIAN 40.00 X 434153 0 50462 DR AMY BAIR GENERAL SURGEON 40.00 X 417465 0 26245 DR ADAM NETER PHYSICIAN 40.00 X 334688 0 21867 MICHAEL GUTSCH CEO (THRU FEBRUARY 2024) 40.00 X 278698 0 38291 EMILY DILLEY CEO (BEGIN MARCH 2024) 40.00 X 0 0 0 DR KIMBERLY AUCOIN PHYSICIAN 40.00 X 269809 0 9784 DONALD FULLERTON CRNA 20.00 X 232673 0 42507 ROBERT LINDBERG COO 40.00 X 177755 0 32837 ANGIE MARTENS CFO 40.00 X 175025 0 8964 MATT GORES CHAIRPERSON 1.00 X X 3325 0 0 ANN HENDRICKS SECRETARY 1.00 X X 2600 0 0 THOMAS LINGEN MD TRUSTEE 1.00 X 2400 0 0 JOSEPH LESCHISIN TRUSTEE 1.00 X 2200 0 0 JEANETTE OLSEN TRUSTEE 1.00 X 800 0 0 ROBERT BEHNEKE TRUSTEE 1.00 X 600 0 0 JENNIFER TURCOTT TRUSTEE 1.00 X 0 0 0 2332191 0 230957 30 0 1 0 NORTHERN X-RAY COMPANY 1325 QUINCY STREET NE SUITE A2 MINNEAPOLIS MN 55413 MRI/CT SCAN SERVICES 872460 ROYAL CONSTRUCTION INC 3653 GREENWAY ST EAU CLAIRE WI 54701 CONSTRUCTION SERVICES 853789 CUMBERLAND CLINIC SC 1705 16TH AVENUE CUMBERLAND WI 54829 PHYSICIAN SERVICES 650536 MEDICAL INFORMATION TECHNOLOGY MEDITECH CIRCLE WESTWOOD MA 02472 ELECTRONIC HEALTH RECORD SERVICES 623168 SHARED MEDICAL TECHNOLOGY 2020 W NEWTON ST RICE LAKE WI 54868 ULTRASOUND SERVICES 392393 13 15500 57332 31737 104569 PATIENT SERVICE REVENUE 621990 34437601 34437601 RETAIL PHARMACY REVENUE 456110 655042 655042 NURSING HOME REVENUE 623000 210000 210000 196125 192727 2406 992 35498768 479270 479270 654849 240123 572869 13726 81980 226397 308377 308377 8536 15500 6575 1961 1961 36392945 35495370 2406 790600 X 1150 1150 742153 742153 14116085 12701224 1414861 339827 294015 45812 2666967 2275685 391282 1009661 841080 168581 76705 76705 102607 102607 1706 1706 4572945 4043507 529438 103343 103343 1358231 1318275 39956 973494 973494 423020 423020 123323 116925 6398 1558631 1253956 304675 3472941 2794065 678876 122306 122306 PHARMACEUTICALS 2633727 2633727 MEDICAL SUPPLIES 886900 886900 EQUIPMENT RENTAL 286724 286724 REPAIRS & MAINTENACE 136686 136686 1811100 1713754 97346 37520232 31720693 5799539 0 258271 0 1118005 677251 4548162 5549379 250000 175000 857802 792081 108163 172331 72881717 26148718 46163073 46732999 8215570 8430524 4841848 2533537 66360894 65063102 4647671 2747548 109494 90839 39828531 41202376 1093947 927269 45679643 44968032 X 20681251 20095070 20681251 20095070 66360894 65063102 -1127287 541106 0 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 1706 1706 0 PART II-B, LINE 1: CUMBERLAND MEMORIAL HOSPITAL (THE ORGANIZATION") PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THESE DUES ARE PRIMARILY FOR ACCESS TO EDUCATIONAL MATERIALS AND STAFF TRAINING AND DEVELOPMENT. A PORTION OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTH CARE ENVIRONMENT. THE ORGANIZATION IS ALSO A MEMBER OF THE RURAL WISCONSIN HEALTH COOPERATIVE (RWHC). EACH YEAR, THE ORGANIZATION 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 DOES PROVIDE ANALYSIS ON CURRENT HEALTH CARE ISSUES IN AN EFFORT TO PROMOTE AND BETTER HEALTH CARE FOR HOSPITALS IN RURAL COMMUNITIES THROUGHOUT WISCONSIN. ONE OF THESE EFFORTS ALSO INCLUDES SOME LOBBYING ON THE PART OF THE MEMBER ORGANIZATIONS. A PORTION OF THE FEES PAID BY THE ORGANIZATION IN FY 2024 WERE RELATED TO LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE HEALTH CARE ENVIRONMENT IN THE STATE OF WISCONSIN. 939678 939678 52380912 16612865 35768047 1736236 115755 1620481 15495834 9420098 6075736 2329057 2329057 46732999 DEFERRED COMPENSATION PLAN LIABILITIES 129284 OPERATING LEASE LIABILITIES 797985 927269 35464684 541106 -1475942 -934836 36399520 -6575 -6575 36392945 36050865 6575 6575 36044290 1475942 1475942 37520232 PART XI, LINE 2D - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS NET AGAINST REVENUE -1,475,942. PART XI, LINE 4B - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES -6,575. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES 6,575. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS NET AGAINST REVENUE 1,475,942. GOLF OUTING 24036 15500 8536 300 4000 1075 1200 24036 15500 8536 300 4000 1075 1200 6575 1961 1 1 X 1 X 1 X 1 1 0 1 1 351719 351719 0.00980 3761750 2806185 955565 0.02650 4113469 2806185 1307284 0.03630 110591 0 110591 0.00310 31136 31136 0.00090 6280890 4028713 2252177 0.06250 49787 49787 0.00140 6472404 4028713 2443691 0.06790 10585873 6834898 3750975 0.10420 10280 10280 0.00030 10280 10280 0.00030 0 788327 157665 10391542 10440754 -49212 X 1 1 1 1 CUMBERLAND MEMORIAL HOSPITAL 1705 16TH AVENUE CUMBERLAND WI 54829 SEE SCHEDULE H PART V SUPPLEMENTAL 1058 X X X X AMBULANCE SERVICE; RURAL HEALTH CLINICS CUMBERLAND MEMORIAL HOSPITAL 1 0 0 1 X X X X X X X X X 22 1 1 1 1 X SEE PART V, SECTION C, LINE 7D X X 1 22 1 SEE PART V, SECTION C, LINE 7D 0 1 X 200.000000000000 400.000000000000 X X X 1 1 X X X X 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X 1 X 0 X X X X 1 X 0 0 CUMBERLAND MEMORIAL HOSPITAL PART V, SECTION B, LINE 5: THE 2022 CHNA WAS COMPLETED THROUGH THRIVE BARRON COUNTY, WHICH BRINGS ALL LOCAL COMPETING HEALTHCARE SYSTEMS TOGETHER AND THE BARRON COUNTY DEPARTMENT OF HEALTH & HUMAN SERVICES. OVER 800 SURVEYS WERE SENT OUT ELECTRONICALLY AND IN-PERSON TO BARRON COUNTY RESIDENTS ASKING THEM ABOUT WHAT THEY THOUGHT OUR TOP HEALTH CONCERNS WERE. ONCE THE VOTES WERE TALLIED, THE THRIVE BARRON COUNTY STEERING COMMITTEE MET TO DETERMINE THE HEALTH CONCERNS MOVING FORWARD. CUMBERLAND MEMORIAL HOSPITAL PART V, SECTION B, LINE 6A: THE 2022 CHNA WAS DONE WITH THE FOLLOWING FACILITIES: AMERY REGIONAL MEDICAL CENTER, BARRON COUNTY AGING & DISABILITY RESOURCE CENTER, CUMBERLAND MEMORIAL HOSPITAL, MAYO CLINIC HEALTH SYSTEM AND MARSHFIELD CLINIC HEALTH SYSTEM, BARRON COUNTY PUBLIC HEALTH. CUMBERLAND MEMORIAL HOSPITAL PART V, SECTION B, LINE 6B: CUMBERLAND MEMORIAL HOSPITAL WORKED WITH BARRON COUNTY PUBLIC HEALTH (BARRON, WI) TO IDENTIFY AND PRIORITIZE HEALTH NEEDS. CUMBERLAND MEMORIAL HOSPITAL PART V, SECTION B, LINE 7D: PART V, SECTION B, LINE 7A & 10A:HOSPITAL FACILITIES WEBSITE: HTTPS://CUMBERLANDHEALTHCARE.COM/PATIENTS-VISITORS/COMMUNITY-HEALTH-NEEDS-ASSESSMENT-CUMBERLAND-HEALTHCARE/ CUMBERLAND MEMORIAL HOSPITAL PART V, SECTION B, LINE 11: BARRON COUNTY HAS CREATED A GROUP CALLED THRIVE BARRON COUNTY, WHICH IS MADE UP OF HEALTHCARE FACILITIES IN THE COUNTY, INCLUDING CUMBERLAND MEMORIAL HOSPITAL. TOGETHER THRIVE BARRON COUNTY CONDUCTED A CHNA AND SINCE THEN EACH YEAR A NEW ASSESSMENT WAS DONE. IN 2022, THE TOP THREE HEALTH CONCERNS WERE ALCOHOL, TOBACCO, AND OTHER DRUG ABUSE (ATODA), MENTAL HEALTH AND CHRONIC DISEASE. GROUPS CALLED CHATS (COMMUNITY HEALTH ACTION TEAMS) WERE FORMED TO ADDRESS THE NEEDS IDENTIFIED AND SINCE 2012 HAVE BEEN WORKING TO BETTER SERVE THE NEEDS OF THE COUNTY RESIDENTS. ADDITIONALLY, CUMBERLAND MEMORIAL HOSPITAL ANNUALLY HOLDS THE "KNOW YOUR NUMBERS" HEALTH FAIR WHICH PROVIDES FREE SCREENINGS TO AREA RESIDENTS THAT COULD POTENTIALLY ADDRESS MAJOR MEDICAL CONCERNS.AS WITH ALL HEALTHCARE ORGANIZATIONS, ADEQUATE RESOURCES ARE NOT AVAILABLE TO ADDRESS EVERY UNMET HEALTH NEED IN THE COMMUNITIES CUMBERLAND MEMORIAL HOSPITAL SERVES. THERE WERE ITEMS IDENTIFIED IN THE CHNA WHICH WERE NOT ADDRESSED; HOWEVER, ALL ITEMS WERE CONSIDERED IF A NEED WAS BROUGHT TO THE ATTENTION OF THE STEERING COMMITTEE DURING THE INFORMATION GATHERING PHASE OF THE CHNA PROCESS. SEVERAL OF THE ITEMS WHICH WERE NOT ADDRESSED PRIMARILY WERE NOT ADDRESSED DUE TO THE FINANCIAL CONSTRAINT OF PROVIDING A NEW SERVICE FOR A LIMITED POPULATION OF PEOPLE. OVER THE NEXT THREE YEARS, CUMBERLAND MEMORIAL HOSPITAL WILL CONTINUE TO PLAY A LEADING ROLE IN ADDRESSING THE HEALTH NEEDS OF THOSE WITHIN THE COMMUNITY, CONGRUENT WITH THE HOSPITAL'S MISSION.IN TAX YEAR 2023, THE ORGANIZATION DID THE FOLLOWING TO ADDRESS THE NEEDS: - ATODA: OFFER SMOKING CESSATION. OFFER LOW DOSE CT SCANS FOR EARLY DETECTION OF LUNG CANCER. - MENTAL HEALTH: ENCOURAGED NORTHLAKES COMMUNITY HEALTH CENTER TO BRING MENTAL HEALTH SERVICES TO CUMBERLAND BY LEASING THEM A BUILDING ON OUR OLD CAMPUS AND EVENTUALLY SELLING THE BUILDING TO THEM. OUR EMERGENCY DEPARTMENT HAS A SPECIFIC BEHAVIORAL HEALTH ROOM TO ENHANCE SAFETY FOR BOTH PATIENTS AND STAFF. - CHRONIC DISEASE: - DIABETES PREVENTION PROGRAM OFFERED TO PUBLIC AND BY PROVIDER RECOMMENDATION AS WELL AS PATIENT INDICATORS IN REGISTRIES. TAILORED EDUCATION THAT COVERS NUTRITION, EXERCISE, AND LIFESTYLE CHANGES. MONTHLY FOLLOW-UPS TO SUSTAIN PROGRESS. THE PROGRAM IS SUPPORTED BY A CDC APPROVED CURRICULUM. WEIGHT MANAGEMENT SKILLS, PHYSICAL ACTIVITY AND STRESS MANAGEMENT TIPS ARE PROVIDED. - KNOW YOUR NUMBERS FREE HEALTH FAIR: AN ANNUAL EVENT WHERE COMPREHENSIVE HEALTH SCREENINGS ARE CONDUCTED TO MONITOR KEY HEALTH INDICATORS SUCH AS BLOOD PRESSURE, CHOLESTEROL LEVELS, AND BMI. OFFERED TO ANYONE IN THE COMMUNITY AND SURROUNDING COMMUNITIES. SCREENINGS ARE BLOOD PRESSURE, TOTAL CHOLESTEROL, LDL, HDL, TRIGLYCERIDES, BLOOD GLUCOSE, 1-MINUTE DIABETES RISK TEST, LOWER EXTREMITY STRENGTHENING, AND BODY MASS INDEX. - PODCASTS: SEVERAL EDUCATIONAL PODCASTS WERE MADE THROUGHOUT THE YEAR ADDRESSING: - THE MEDITERRANEAN DIET, PLANT BASED FOODS AND HEALTHY FATS - GLP-1 MEDICATIONS FOR WEIGHT LOSS & DIABETES MANAGEMENT - WOUND WELLNESS GUIDE TO HEALING - IMPORTANCE OF ROUTINE HEALTH SCREENINGS - NAVIGATING DIABETES - OBSTRUCTIVE SLEEP APNEA CAUSES AND EDUCATION - VITAMINS FOR HEALTH - IMPORTANCE OF COLONOSCOPIES- WOMEN'S HEALTH NIGHT ANNUAL EVENT OFFERED TO THE PUBLIC TO PROVIDE EDUCATION AND AWARENESS OF WOMEN'S HEALTH RELATED ISSUES- STEPPING ON FALL RISK EXERCISE CLASS OFFERED TO THE PUBLIC- FARM TO TABLE AND BACK TO SCRATCH COOKING. VEGETABLES ARE GROWN BY US AND LOCALLY SOURCED AND PREPARED IN OUR HARVEST GRILL RESTAURANT AND IS OPEN TO THE COMMUNITY, STAFF AND PATIENTS.- 1-MILE WALKING PATH ON OUR CAMPUS IS FOR THE COMMUNITY AND STAFF. - DIABETES PREVENTION PROGRAM: THIS PROGRAM IS DESIGNED TO EDUCATE AND EMPOWER THE PUBLIC ON PREVENTING DIABETES THROUGH LIFESTYLE CHANGES. OUR RDN FOCUSES ON NUTRITIONAL GOALS AND DIABETES SELF-MANAGEMENT EDUCATION AND OUR RN SPECIALIZES IN MEDICAL MANAGEMENT FOR DIABETIC PATIENTS. OUR PHARMACISTS ASSIST WITH MEDICATION UNDERSTANDING AND TREATMENT PLANS. ALL WORKING WITH THE PATIENT'S PRIMARY CARE PROVIDER. - KNOW YOUR NUMBERS HEALTHFAIR: AN ANNUAL EVENT WHERE COMPREHENSIVE HEALTH SCREENINGS ARE CONDUCTED TO MONITOR KEY HEALTH INDICATORS SUCH AS BLOOD PRESSURE, CHOLESTEROL LEVELS, AND BMI.- EDUCATIONAL PODCASTS: REGULARLY PRODUCED PODCASTS ADDRESSING VARIOUS CHRONIC DISEASE TOPICS TO PROVIDE ONGOING EDUCATION AND SUPPORT TO THE COMMUNITY.- WOMEN'S HEALTH NIGHT: AN ANNUAL EVENT FOCUSED ON RAISING AWARENESS AND EDUCATING THE PUBLIC ABOUT WOMEN'S HEALTH ISSUES, PREVENTIVE CARE AND MANAGEMENT OF CHRONIC DISEASES.- STEPPING ON: A FALL RISK REDUCTION PROGRAM AIMED AT ELDERLY MEMBERS OF THE COMMUNITY, HELPING TO PREVENT FALLS AND RELATED INJURIES.- FARM TO TABLE FOOD AT HARVEST GRILL: OFFERING NUTRITIOUS MEALS SOURCED LOCALLY TO PROMOTE HEALTHY EATING HABITS AMONG PATRONS.- WALKING PATH MAINTENANCE: CONTINUED UPKEEP OF OUR 1-MILE WALKING PATH, PROVIDING A SAFE AND ACCESSIBLE OUTDOOR SPACE FOR PHYSICAL ACTIVITY.- CARDIAC PULMONARY REHAB: COMPREHENSIVE REHABILITATION PROGRAM TAILORED FOR INDIVIDUALS RECOVERING FROM CARDIAC AND PULMONARY CONDITIONS. PROVIDING EDUCATION AND SUPPORT TO THOSE RECOVERING FROM A HEART ATTACK, HEART PROCEDURE, OR HEART CONDITION. PROMOTING RECOVERY AND LONG-TERM HEALTH. THE CUMBERLAND CARDIAC REHAB PROGRAM HAS MET THE STANDARDS AND HAS BEEN AWARDED CERTIFICATION THROUGH THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION. WWW.AACVPR.ORGTHESE INITIATIVES DEMONSTRATE OUR COMMITMENT TO ADDRESSING CHRONIC DISEASES THROUGH PREVENTION, EDUCATION, AND COMMUNITY SUPPORT. CUMBERLAND MEMORIAL HOSPITAL PART V, SECTION B, LINE 16J: THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE THROUGH THE BUSINESS OFFICE STAFF. PATIENTS ARE ENCOURAGED TO CONTACT A FINANCIAL COUNSELOR FOR FURTHER INFORMATION ON THE FINANCIAL ASSISTANCE POLICY. THE HOSPITAL'S WEBSITE ALSO ENCOURAGES PATIENTS TO INQUIRE ABOUT THE FINANCIAL ASSISTANCE POLICY. PART V, LINE 16A, B, C: THE FAP WAS WIDELY AVAILABLE ON A WEBSITE: HTTPS://CUMBERLANDHEALTHCARE.COM/PATIENTS-VISITORS/PATIENT-FINANCIAL-SERVICES/THE FAP APPLICATION FORM WAS WIDELY AVAILABLE ON A WEBSITE: HTTPS://CUMBERLANDHEALTHCARE.COM/PATIENTS-VISITORS/PATIENT-FINANCIAL-SERVICES/A PLAIN LANGUAGE SUMMARY OF THE FAP WAS WIDELY AVAILABLE ON A WEBSITE: HTTPS://CUMBERLANDHEALTHCARE.COM/PATIENTS-VISITORS/PATIENT-FINANCIAL-SERVICES/ 2 1 - CUMBERLAND HEALTHCARE MEDICAL CLINIC 1705 16TH AVENUE CUMBERLAND WI 54829 RURAL HEALTH CLINIC 2 - CUMBERLAND HEALTHCARE TURTLE LAKE CENTER 632 US HWY 8 TURTLE LAKE WI 54889 RURAL HEALTH CLINIC PART I, LINE 7: THE COSTING METHODOLOGY USED ON FORM 990 IS BASED ON A COST-TO-CHARGE RATIO WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES, EXCLUDING THE PROVISION FOR BAD DEBTS DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST HOSPITAL REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER IRS SUGGESTED COSTING METHODS FOR THE FORM 990. THE COSTING METHODOLOGY USED IS BASED ON MEDICARE COST REPORTING METHODS. PART I, LINE 7G: THE COST OF SUBSIDIZED SERVICES IS BASED ON COST ALLOCATIONS FROM THE MEDICARE COST REPORT. ALLOWABLE COSTS ARE ASSIGNED DIRECTLY TO DEPARTMENTS THROUGHOUT THE YEAR AND THEN THE COST REPORT USES THE ALLOCATION METHODOLOGY TO ASSIGN ALL OTHER COSTS TO CALCULATE SERVICE LINE COSTS. SUBSIDIZED HEALTH SERVICES INCLUDED THE CLINICS AND THE EMERGENCY ROOM DEPARTMENT. THESE SERVICES ARE UNAVAILABLE TO MEMBERS OF THE COMMUNITY OTHER THAN THROUGH CUMBERLAND MEMORIAL HOSPITAL. IT HAS BEEN THE GOAL OF CUMBERLAND MEMORIAL HOSPITAL TO PROVIDE THESE SERVICES TO THE COMMUNITY REGARDLESS OF A PATIENT'S ABILITY TO PAY. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 1,475,942. PART II, COMMUNITY BUILDING ACTIVITIES: CUMBERLAND MEMORIAL HOSPITAL PROVIDES SIGNIFICANT CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS AND IN ADDITION, THE HOSPITAL BELIEVES THAT IT PROVIDES A CRITICALLY IMPORTANT COMMUNITY BENEFIT WHICH IS NOT QUANTIFIED. SEE PART 1, LINE 7 FOR THE CALCULATED COST OF PROVIDING COMMUNITY SERVICES. CUMBERLAND MEMORIAL HOSPITAL, LIKE MOST RURAL 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 HEALTH SERVICES: AMBULANCE SERVICES, DIAGNOSTICS, EMERGENCY SERVICES & URGENT CARE, EXTENDED CARE, INPATIENT CARE, LABORATORY SERVICES, OCCUPATIONAL HEALTH, REHABILITATION SERVICES, SPECIALTY MEDICINE, SLEEP CENTER, SPEECH, AND SURGICAL SERVICES. PART III, LINE 2: THE COSTING METHODOLOGY USED ON FORM 990 IS BASED ON A COST-TO-CHARGE RATIO WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES, EXCLUDING THE PROVISION FOR BAD 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 HOSPITAL. THE HOSPITAL ALSO PROVIDES DISCOUNTS TO ELIGIBLE UNINSURED OR UNDERINSURED PATIENTS UNDER ITS CHARITABLE CARE POLICY. 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 OR UNDERINSURED ACCOUNTS WOULD ALSO INCREASE THE ESTIMATED BAD DEBT EXPENSE AMOUNT ASSOCIATED WITH THESE UNCOLLECTIBLE ACCOUNTS TO THE HOSPITAL. PART III, LINE 3: MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY UNINSURED PATIENTS AND AMOUNTS PATIENTS ARE PERSONALLY RESPONSIBLE FOR, THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO A VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF HISTORICAL COLLECTION LIKELIHOOD AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUTSTANDING AFTER THE HOSPITAL HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO ACCOUNTS RECEIVABLE. MANY TIMES, PATIENTS ARE UNABLE TO 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 SMALL AMOUNT OF BAD DEBTS COULD BE CONSIDERED AS CHARITY CARE. PART III, LINE 4: PATIENT ACCOUNTS RECEIVABLE AND CREDIT POLICY: IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, THE ORGANIZATION ANALYZES PAST RESULTS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. SPECIFICALLY, FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE ORGANIZATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE AMOUNTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET BEEN PAID, OR FOR PAYORS AND PATIENTS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE ORGANIZATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A SEPARATE FOOTNOTE REGARDING BAD DEBT EXPENSE. PART III, LINE 8: CUMBERLAND MEMORIAL HOSPITAL IS DESIGNATED A CRITICAL ACCESS HOSPITAL AND AS SUCH A PORTION OF ITS REVENUE IS PAID UNDER A COST REIMBURSEMENT SYSTEM. BASED ON THE INSTRUCTIONS, THE TOTAL MEDICARE REVENUE SHOWN ON THIS FORM 990 INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE THAT IS ACTUALLY RECEIVED BY THE HOSPITAL FROM THE MEDICARE PROGRAM. THE AMOUNTS LISTED FOR MEDICARE DO NOT INCLUDE PHYSICIAN AND MID-LEVEL PRACTITIONER SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT AT CUMBERLAND MEMORIAL HOSPITAL OR AMBULANCE SERVICES. PHYSICIAN COVERAGE IS REIMBURSED PRIMARILY ON A FEE SCHEDULE REIMBURSEMENT METHODOLOGY AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY AND AMBULANCE 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 CUMBERLAND MEMORIAL HOSPITAL PROVIDES TO THE COMMUNITY AND SURROUNDING AREA OF CUMBERLAND, WISCONSIN. THE COSTING METHOD USED ABOVE FOR IRS 990 COMPLIANCE REPORTING IS ALSO BASED ON AN OVERALL AVERAGE COST TO CHARGE RATIO AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICE REVENUE (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE) DIVIDED BY TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBT EXPENSE. THIS RATIO IS THEN MULTIPLIED BY THE TOTAL MEDICARE SERVICES WHICH ARE REIMBURSED ON A COST METHODOLOGY EXCLUDING THE FEE SCHEDULE ITEMS LIKE PHYSICIAN AND MID-LEVEL PRACTITIONER SERVICES WHICH THE HOSPITAL WOULD SHOW A LARGE LOSS ON THESE SERVICES. 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 HEALTH CARE 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 CHARITABLE CARE POLICIES, CUMBERLAND MEMORIAL HOSPITAL MAKES EVERY ATTEMPT TO IDENTIFY AND PROMOTE CHARITY CARE TO PATIENTS. INCLUDED IN THE HOSPITAL'S CHARITABLE 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 FINANCIAL COUNSELOR TO ALLOW THESE PATIENTS THE ABILITY TO COMPLETE THEIR APPLICATION DURING THEIR STAY AT THE HOSPITAL, DEPENDING UPON THE PATIENT'S CONDITION, 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 POLICES AS WELL AS THE CHARITY AND COMMUNITY CARE PROGRAM TO ALLOW PATENTS THE OPPORTUNITY TO COMPLETE THE APPROPRIATE FORMS AND QUALIFY UNDER THE PROGRAM. INCLUDED IN THE POLICY, IT IS ALSO NOTED THAT THE HOSPITAL RESERVES THE RIGHT TO MAKE OR GRANT ADDITIONAL CHARITY CARE ON A CASE-BY-CASE BASIS. PART VI, LINE 2: IN 2020 CUMBERLAND HEALTHCARE ACHIEVED CDC RECOGNITION AS A DIABETES PREVENTION PROGRAM ORGANIZED BY DISTANCE LEARNING CLASS TYPE. OUR DIABETIC PROGRAM CONTINUES WITH CLASSES AND PARTICIPANTS THAT INCLUDES A DIABETES PREVENTION PROGRAM. IN 2024 THIS PROGRAM CONTINUES TO BE LED BY RN'S AND RD'S. WE NOW OFFER THIS PROGRAM VIRTUALLY OR IN PERSON TO MEET THE NEEDS OF OUR COMMUNITY. WE OFFERED OUR ANNUAL KNOW YOUR NUMBERS HEALTH FAIR. THIS CONTINUES WITH FREE HEALTH SCREENINGS FOR THE COMMUNITY OFFERING FREE BLOOD WORK. WE CONTINUE TO GET SPECIALISTS TO COME TO OUR FACILITY TO PROVIDE AS MANY SERVICES LOCALLY AS WE CAN.IN JANUARY 2023 WE FORMED A PARTNERSHIP WITH NORTHLAKES COMMUNITY CLINIC TO DELIVER AND EXPAND BEHAVIORAL HEALTH SERVICES TO THE COMMUNITY.WITH ARE NEW REPLACEMENT CAMPUS THAT OPENED IN APRIL 2023, THE FOLLOWING NEW SERVICES WERE IMPLEMENTED.IN-HOUSE MAGNETIC RESONANCE IMAGING THAT OFFERS HIGH DEFINITION IMAGES, A REDUCTION OF SCAN TIMES, CUTTING-EDGE SOFTWARE AND PATIENT CENTERED DESIGN THAT IMPROVES ACCURACY AND SPEED.A RETAIL PHARMACY (MAPLE RIDGE) INSIDE OF CUMBERLAND HEALTHCARE THAT HELPS THE CONTINUITY OF PATIENT CARE. PHARMACY OFFERS PRESCRIPTION FILLING, MEDICATION COUNSELING, OVER THE COUNTER PRODUCTS, PATIENT SUPPORT, MEDICATION SYNCHRONIZATION PROGRAM, AND A MEDS TO BED PROGRAM THAT DELIVERS HOSPITALIZED PATIENTS' PRESCRIPTIONS AT DISCHARGE BEFORE HEADING HOME. A TEXT MESSAGING SERVICE IS AVAILABLE FOR PRESCRIPTION NOTIFICATION AS WELL AS OUTPATIENT MEDICATION COUNSELING. THE PHARMACY OFFERS RSV AND SHINGLES VACCINES THAT ARE NOT FULLY COVERED BY PATIENTS' INSURANCE IN A CLINIC SETTING BUT COVERED AT 100% IN A PHARMACY.THE HARVEST GRILL IS A FARM TO TABLE NUTRITION SERVICE WITHIN A HEALTHCARE SETTING THAT FOCUSES ON NUTRITIOUS, FRESH AND LOCALLY SOURCED FOOD FOR PATIENTS, VISITORS AND STAFF. SEASONAL, WHOLE FOODS AND ORGANIC PRODUCE THAT CATER TO SPECIFIC DIETARY NEEDS ARE OFFERED. MENUS ARE DESIGNED IN CONSULTATION WITH NUTRITIONISTS AND DIETITIANS TO MEET ALL DIETARY REQUIREMENTS WITH AN EMPHASIS ON HEALING AND WELLNESS.THE CHEF AND REGISTERED DIETITIAN/NUTRITIONIST OFFER EDUCATION TO COMMUNITY MEMBERS ON NUTRITION THAT INVOLVE COOKING, TALKS, AND DEMONSTRATIONS ABOUT THE IMPORTANCE OF SUSTAINABLE, FRESH, LOCALLY SOURCED FOOD AND PROMOTE HEALTHY EATING HABITS. FOOD IS PROMOTED AS A CRUCIAL ELEMENT IN THE HEALING PROCESS AND OVERALL HEALTH AND WELLNESS.IN OCTOBER 2023, A COMMUNITY WALKING PATH WAS CREATED ON THE NEW HEALTHCARE CAMPUS TO PROMOTE HEALTH AND WELLNESS AND COMMUNITY ENGAGEMENT. THE WALKING PATH IS OPEN YEAR ROUND AND IS A SPACE THAT ENCOURAGES PHYSICAL ACTIVITY AND SOCIAL INTERACTION. EVENTS ARE HELD TO ENCOURAGE FAMILY ENGAGEMENT AND THE IMPORTANCE OF PHYSICAL ACTIVITY IN OUR YOUTH.WE CONTINUE TO OFFER HEALTHY FOOD OPTIONS TO COMMUNITY MEMBERS BY PROVIDING WHOLE FOODS AND FRESH AND LOCALLY SOURCED INGREDIENTS. WE OFFER A STROKE AND BRAIN INJURY SUPPORT GROUP FOR COMMUNITY MEMBERS TO MEET MONTHLY THAT OFFERS PEER SUPPORT, EDUCATION, EMPOWERMENT AND A SENSE OF COMMUNITY. MAMMOGRAMS ARE DOWN IN BARRON COUNTY FOR WOMEN OVER THE AGE OF 40, WE HAVE A BILLBOARD REMIND WOMEN TO OBTAIN THIS ROUTINE HEALTH SCREENING. WE CONTINUE TO GIVE FLU VACCINE AND COVID VACCINE TO AREA BUSINESSES AND COMMUNITY MEMBERS. WE OFFER FREE LAB TESTING AT THE RICE LAKE FREE CLINIC. TRAINED EMPLOYEES PROVIDE NON ESCALATION AND DE-ESCALATION TRAINING ALONG WITH CRISIS MANAGEMENT TO STAFF AND COMMUNITY MEMBERS. ATHLETIC HEALTH SERVICES IS PROVIDED TO STUDENTS IN THE CUMBERLAND SCHOOL DISTRICT COMMUNITY TO ALL ATHLETES. REGISTERED NURSES ATTEND WORK GROUPS AND TASK FORCES FOR WISCONSIN EMERGENCY MEDICAL SERVICES FOR CHILDREN AND HOLD POSITIONS ON THE REGIONAL TRAUMA ADVISORY COUNCIL TASK FORCE. PART VI, LINE 3: IF A PATIENT IS IDENTIFIED AS UNINSURED, CUMBERLAND HEALTHCARE STAFF WORKS WITH THE PATIENT AND/OR THEIR FAMILY TO DETERMINE IF THEY ARE ELIGIBLE FOR ANY TYPE OF GOVERNMENT PROGRAMS OR QUALIFY FOR THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. ASSISTANCE INFORMATION IS ALSO PUBLICIZED ON OUR WEBSITE. PART VI, LINE 4: THE HOSPITAL SERVES THE COMMUNITIES OF CUMBERLAND, TURTLE LAKE, AND ALMENA, WI AND SURROUNDING COMMUNITIES WITHIN A 20-MILE RADIUS. THERE ARE THREE OTHER HOSPITALS LOCATED IN THE RURAL AREA THAT THE ORGANIZATION SERVES. WE ALSO HAVE A SATELLITE CLINIC IN TURTLE LAKE WHICH OFFERS FAMILY PRACTICE AND REHAB SERVICES. PART VI, LINE 5: A MAJORITY OF OUR ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA. OUR ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS. WE ALSO PARTICIPATE IN COMMUNITY HEALTH FAIRS AND PROVIDE SERVICE AT SPORTING EVENTS. SURPLUS FUNDS ARE INVESTED BACK INTO THE FACILITY AND ITS EQUIPMENT TO ENSURE THE NEEDED SERVICES ARE CONTINUED TO BE PROVIDED IN THIS COMMUNITY. PART VI, LINE 6: N/A PART VI, LINE 7, REPORTS FILED WITH STATES WI X X X 0 0 0 0 0 0 0 0 0 DR CRAIG JENNINGS PHYSICIAN 433978 0 0 0 175 0 11174 0 39288 0 484615 0 0 0 DR AMY BAIR GENERAL SURGEON 417270 0 0 0 195 0 12574 0 13671 0 443710 0 0 0 DR ADAM NETER PHYSICIAN 334483 0 0 0 205 0 8194 0 13673 0 356555 0 0 0 MICHAEL GUTSCH CEO (THRU FEBRUARY 2024) 250095 0 28346 0 257 0 8257 0 30034 0 316989 0 0 0 DR KIMBERLY AUCOIN PHYSICIAN 269714 0 0 0 95 0 7812 0 1972 0 279593 0 0 0 DONALD FULLERTON CRNA 232648 0 0 0 25 0 9673 0 32834 0 275180 0 0 0 ROBERT LINDBERG COO 163666 0 13987 0 102 0 0 0 32837 0 210592 0 0 0 ANGIE MARTENS CFO 165015 0 9778 0 232 0 6992 0 1972 0 183989 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE RETURN IS REVIEWED BY THE CHIEF FINANCIAL OFFICER AND A FINAL DRAFT IS GIVEN TO THE BOARD MEMBERS OF CUMBERLAND MEMORIAL HOSPITAL. UPON APPROVAL FROM THE BOARD MEMBERS, THE RETURN IS FILED WITH THE INTERNAL REVENUE SERVICE (IRS). FORM 990, PART VI, SECTION B, LINE 12C CUMBERLAND MEMORIAL HOSPITAL REQUIRES ITS BOARD MEMBERS TO SIGN A CONFLICT OF INTEREST STATEMENT ANNUALLY. OFFICERS AND KEY EMPLOYEES OF CUMBERLAND MEMORIAL HOSPITAL, INC. SIGN A CODE OF CONDUCT STATEMENT. IN THE CODE OF CONDUCT STATEMENT, IT MENTIONS THE CONFLICT OF INTEREST. ANY PERSON THAT BELIEVES TO HAVE A CONFLICT SHOULD DISCLOSE AS A MATTER OF RECORD TO THE BOARD ON AN ANNUAL BASIS OR AS THE INTEREST DEVELOPS AND BEFORE IT IS CONSUMMATED. ANY DIRECTOR HAVING A CONFLICT MAY NOT VOTE OR USE PERSONAL INFLUENCE ON THE MATTER. THE DIRECTOR CAN STATE THEIR POSITION ON THE MATTER BEFORE ABSTAINING FROM VOTE. FORM 990, PART VI, SECTION B, LINE 15 EXECUTIVE SALARIES ARE SET ANNUALLY CONSIDERING COMPENSATION LEVELS AT SIMILARLY SITUATED ORGANIZATIONS (TYPICALLY NOT-FOR-PROFIT HEALTH CARE ORGANIZATIONS IN SIMILAR REVENUE CATEGORIES). THE BOARD OF DIRECTORS IS RESPONSIBLE FOR SETTING THE SALARY OF THE CEO BASED ON JOB PERFORMANCE. THE BOARD RELIES UPON COMPARABILITY DATA DEVELOPED BY OUTSIDE CONSULTANTS TO SUPPORT ITS DECISION-MAKING PROCESS AND TO ENSURE COMPETITIVE SALARY LEVELS. ALL OTHER NON-UNION WAGES ARE REVIEWED SEMI-ANNUALLY IN COMPARISON TO THE RURAL WISCONSIN HEALTH COOPERATIVE WAGE SURVEY. THIS WAGE SURVEY INCLUDES WAGE DATA OF 27 RURAL HEALTH CARE ORGANIZATIONS. THE GOAL OF THE ORGANIZATION IS TO REMAIN WITHIN THE WAGE SURVEY AVERAGES, BASED ON YEARS OF SERVICE TO BE COMPETITIVE WITH SIMILAR ORGANIZATIONS. FORM 990, PART VI, SECTION C, LINE 19 CUMBERLAND MEMORIAL HOSPITAL MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 905,781. MANAGEMENT AND GENERAL EXPENSES 529,438. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,435,219. CONTRACTED ER PHYSICIANS: PROGRAM SERVICE EXPENSES 441,404. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 441,404. CONTRACTED - PHARMACY: PROGRAM SERVICE EXPENSES 929,057. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 929,057. CONTRACTED RADIOLOGY/NUCLEAR MEDICINE SERVICES: PROGRAM SERVICE EXPENSES 1,296,340. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,296,340. CONTRACTED PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 470,925. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 470,925. FORM 990, PART XII, LINE 2C, AUDIT OVERSIGHT: CUMBERLAND MEMORIAL HOSPITAL'S ENTIRE BOARD OF DIRECTORS IS RESPONSIBLE FOR THE FINANCIAL STATEMENT AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTANT. THE AUDITED FINANCIAL STATEMENTS ARE REVIEWED BY THE BOARD OF DIRECTORS ANNUALLY AND ANY QUESTIONS OR CONCERNS REGARDING THE STATEMENTS ARE ADDRESSED BY THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.