2026-03-02T15:51:25-06:00 2025-06-30 393647910 WIPFLI ADVISORY LLC 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2024-07-01 390831153 CUMBERLAND MEMORIAL HOSPITAL INC CUMB 7158227500 1705 16TH AVENUE CUMBERLAND WI 54829 ANGIE MARTENS CFO 7158227500 2026-02-27 1 0 MICHAEL J PETERSON CPA P01833529 2187224705 2026-02-27 2024 2025-03-06 01:10:19Z CUMBERLAND HEALTHCARE ANGIE MARTENS 1705 16TH AVENUE CUMBERLAND WI 54829 40371600 0 X WWW.CUMBERLANDHEALTHCARE.COM X 1955 WI ABOVE AND BEYOND CARE, TRUSTED AND CUSTOMIZED TO YOU.VISION: TO BECOME THE TRUSTED PARTNER IN HEALTH AND WELLNESS WITHIN OUR COMMUNITIES SETTING THE STANDARD FOR EXCELLENCE IN RURAL HEALTHCARE.VALUES: WE ARE COMMITTED TO SERVING OUR PATIENTS, COMMUNITY AND EMPLOYEES FROM THE FOUNDATION BUILDING ON PRIDE (POSITIVE ATTITUDE, RESPECT, INTEGRITY, DEPENDABLE/ACCOUNTABLE, EXCELLENCE) 7 7 289 90 0 0 104569 653005 35498768 35989872 787647 68338 1961 498 36392945 36711713 1150 5150 0 0 18874693 19063191 0 0 0 18644389 18750744 37520232 37819085 -1127287 -1107372 65063102 64959292 44968032 45521273 20095070 19438019 X AS AN INDEPENDENT HEALTH TEAM, WE ARE COMMITTED TO GOING BOVE AND BEYOND, BUILDING TRUSTING RELATIONSHIPS, AND GUIDING OUR COMMUNITIES WITH EXCEPTIONAL, CUSTOMIZED HEALTH AND WELLNESS. 0 0 28999489 5150 29888129 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, INPATIENT SERVICES, EMERGENCY SERVICES, PHARMACY - INPATIENT AND RETAIL, THERAPY (PHYSICAL, OCCUPATIONAL AND SPEECH), WOUND CARE, CHEMOTHERAPY, RADIOLOGY, LAB, AMBULANCE SERVICE AND GENERAL SURGERY. DURING FISCAL YEAR 2025, ACUTE CARE DAYS TOTALED 739, SWING BED DAYS TOTALED 821. THE ORGANIZATION PROVIDED 66 INPATIENT AND 264 OUTPATIENT SURGERIES ALONG WITH 304 SCOPE PROCEDURES. THERE WERE ALSO 3,726 EMERGENCY ROOM VISITS, 75,093 LAB TESTS, AND 895 AMBULANCE RUNS. TOTAL RADIOLOGY EXAMS WERE 9,126. 2954382 0 6101743 THE ORGANIZATION OPERATES A HOSPITAL (CUMBERLAND MEMORIAL HOSPITAL) AND TWO RURAL HEALTH CLINICS (LOCATED IN CUMBERLAND AND TURTLE LAKE). CUMBERLAND CLINIC TOTAL VISITS WERE 14,805 AND TURTLE LAKE WERE 2,490. 31953871 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 28 0 289 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 MATT GORES CHAIRPERSON 1.00 X X 2250 0 0 ANN HENDRICKS SECRETARY 1.00 X X 1800 0 0 THOMAS LINGEN MD TRUSTEE 1.00 X 1200 0 0 JOSEPH LESCHISIN TRUSTEE 1.00 X 1600 0 0 JEANETTE OLSEN TRUSTEE 1.00 X 1800 0 0 ROBERT BENEKE TRUSTEE 1.00 X 1600 0 0 JENNIFER TURCOTT TRUSTEE 1.00 X 0 0 0 EMILY DILLEY CEO 40.00 X 230135 0 31201 ROBERT LINDBERG COO 40.00 X 176832 0 38128 ANGIE MARTENS CFO 40.00 X 175816 0 28480 DR CRAIG JENNINGS PHYSICIAN 40.00 X 351315 0 42998 DR AMY BAIR GENERAL SURGEON 40.00 X 413466 0 25162 DR ADAM NETER PHYSICIAN 40.00 X 463919 0 25553 DR TYLER MILLER PHYSICIAN 40.00 X 439247 0 27506 STEFANIE RINEHARDT CRNA 40.00 X 262487 0 53668 MICHAEL GUTSCH FORMER CEO 28.00 X 111399 0 29020 2634866 0 301716 37 1 1 0 ROYAL CONSTRUCTION INC 3653 GREENWAY ST EAU CLAIRE WI 54701 CONSTRUCTION SERVICES 1064802 NORTHERN X-RAY COMPANY 1325 QUINCY ST NE SUITE A2 MINNEAPOLIS MN 55413 MRI/CT SCAN SERVICES 791988 MEDICAL INFORMATION TECHNOLOGY MEDITECH CIRCLE WESTWOOD MA 02472 ELECTRONIC HEALTH RECORD SERVICES 600468 SHARED MEDICAL TECHNOLOGY 2020 W NEWTON ST RICE LAKE WI 54868 ULTRASOUND SERVICES 470900 ROYAL SURGICAL ASSOCIATES 461 E HILLSOBRO BLVD SUITE 200 DEERFIELD BEACH FL 33441 ANESTHESIA SERVICES 358536 12 17500 616004 19501 2500 653005 PATIENT SERVICE REVENUE 621990 34591033 34591033 RETAIL PHARMACY REVENUE 456110 1123854 1123854 NURSING HOME REVENUE 623000 140000 140000 134985 134985 35989872 281762 281762 257634 3178768 30868 3618958 226766 -440190 -213424 -213424 10559 17500 10061 498 498 36711713 35989872 0 68836 X 5150 5150 816679 816679 14461921 12985352 1476569 336129 298308 37821 2416022 2126073 289949 1032440 873565 158875 115071 115071 86570 86570 1757 1757 5609105 5076112 532993 128148 128148 1186593 1129078 57515 979225 979225 413069 413069 79210 69431 9779 1614845 1299182 315663 3283634 2641763 641871 123267 123267 PHARMACEUTICALS 2498489 2498489 BAD DEBT EXPENSE 997695 997695 MEDICAL SUPPLIES 839608 839608 EQUIPMENT RENTAL 260534 260534 533924 440462 93462 37819085 31953871 5865214 0 677251 6141216 5549379 4895736 175000 175000 792081 943313 172331 213440 52470812 10445927 46732999 42024885 8430524 8798054 2533537 1767648 65063102 64959292 2747548 2765775 90839 86374 41202376 41756393 927269 912731 44968032 45521273 X 20095070 19438019 20095070 19438019 65063102 64959292 -1107372 450321 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 1757 1757 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 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 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 2025 WERE RELATED TO LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE HEALTH CARE ENVIRONMENT IN THE STATE OF WISCONSIN. 642030 642030 40429515 4348466 36081049 70634 70634 0 11328633 6026827 5301806 42024885 DEFERRED COMPENSATION PLAN LIABILITIES 265557 OPERATING LEASE LIABILITIES 647174 912731 35674400 450321 -997695 -547374 36221774 489939 489939 36711713 36831451 10061 10061 36821390 997695 997695 37819085 PART XI, LINE 2D - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS NET AGAINST REVENUE -997,695. PART XI, LINE 4B - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES -10,061. CONTRIBUTIONS TO RESTRICTED NET ASSETS 500,000. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES 10,061. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBTS NET AGAINST REVENUE 997,695. GOLF OUTING 28059 17500 10559 300 7500 1920 341 28059 17500 10559 300 7500 1920 341 10061 498 1 1 X 1 X 1 X 1 1 0 1 1 382500 382500 0.01040 3496483 1301994 2194489 0.05960 3878983 1301994 2576989 0.07000 92031 92031 0.00250 82815 82815 0.00220 6825329 4361589 2463740 0.06690 35991 35991 0.00100 7036166 4361589 2674577 0.07260 10915149 5663583 5251566 0.14260 10980 10980 0.00030 10980 10980 0.00030 0 533594 133398 10393137 10439252 -46115 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 24 1 0 0 1 X SEE PART V, SECTION C, LINE 7D X 1 24 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 X 1 X 0 X X X X X 1 X 0 0 CUMBERLAND MEMORIAL HOSPITAL PART V, SECTION B, LINE 5: IN COLLABORATION WITH LOCAL HEALTHCARE PROVIDERS AND COMMUNITY STAKEHOLDERS THROUGH BARRON COUNTY HEALTH SERVICES, CUMBERLAND HEALTHCARE HAS LAUNCHED INITIATIVES TO AMPLIFY COMMUNITY VOICES AND ADDRESS KEY HEALTH CONCERNS. THIS EFFORT INCLUDES ANALYSIS OF DATA COLLECTED FROM A TRIENNIAL COMMUNITY AWARENESS SURVEY, WHICH RECEIVED 1,164 RESPONSES. CUMBERLAND MEMORIAL HOSPITAL PART V, SECTION B, LINE 11: BASED ON THE RESULTS OF THE CHNA, BARRON COUNTY HEALTH SERVICES IS PRIORITIZING MENTAL HEALTH (INCLUDING ACCESS TO MENTAL HEALTH PROVIDERS AND SUICIDE PREVENTION), SUBSTANCE USE (ALCOHOL, PRESCRIPTION DRUGS, AND ILLEGAL SUBSTANCES), AND HEALTHCARE ACCESS (INCLUDING SPECIALTY CARE AND PROVIDER AVAILABILITY).CUMBERLAND HEALTHCARE ACTIVELY PARTICIPATES IN THE BARRON COUNTY HEALTH SERVICES TASK FORCE. KEY STAKEHOLDERS SUCH AS, PUBLIC HEALTH OFFICIALS, LOCAL HOSPITALS, FREE CLINICS, AND CHC STAFF HAVE IDENTIFIED CRITICAL ISSUES, INCLUDING BUT NOT LIMITED TO HIGH OBESITY (BMI OVER 30%), ELEVATED INCIDENCES OF COLORECTAL CANCER, AND BREAST CANCER AS REPORTED IN THE BARRON COUNTY HEALTH RANKINGS AND COUNTY CANCER DATA.FOLLOWING A COMPREHENSIVE REVIEW OF THESE CHALLENGES AND THE RESOURCES AVAILABLE, STAKEHOLDERS HAVE PRIORITIZED EFFORTS TO REDUCE OBESITY AND IMPROVE CANCER SCREENING RATES, PARTICULARLY FOR MAMMOGRAPHY AND COLORECTAL SCREENINGS. CUMBERLAND HEALTHCARE IS DEDICATED TO CONTINUED COLLABORATION, SUPPORTING FUTURE FORUMS AS NEEDED. PENDING APPROVAL BY THE CUMBERLAND HEALTHCARE BOARD OF DIRECTORS, THESE ELEMENTS WILL BE ADDED TO THE STRATEGIC PLAN.THE FOLLOWING ARE NEEDS BEING ADDRESSED THAT ARE IN THE CHNA- OBESITY RATESBARRON COUNTY'S ADULT OBESITY RATE (BMI OVER 30) IS 39%, WHICH EXCEEDS BOTH THE STATE AVERAGE OF 38% AND THE NATIONAL AVERAGE OF 34%. CUMBERLAND HEALTHCARE'S OBJECTIVE IS TO REDUCE THIS RATE BY 0.7% OVER THREE YEARS, FROM 39% TO 38.3% ALIGNING WITH THE HEALTHY PEOPLE 2030 GOAL AND HELPING PUT BARRON COUNTY ON TRACK TO REACH THIS GOAL. THE INCREASING PREVALENCE OF OBESITY POSES SIGNIFICANT CHALLENGES, NOT ONLY IN TERMS OF HEALTHCARE COSTS BUT ALSO IN ITS ASSOCIATION WITH CHRONIC CONDITIONS SUCH AS HEART DISEASE, STROKE, DIABETES, AND CERTAIN TYPES OF CANCER.- BREAST CANCER SCREENINGBARRON COUNTY DATA SHOWS 54% OF WOMEN IN BARRON COUNTY RECEIVED A MAMMOGRAM IN THE PAST TWO YEARS. CUMBERLAND HEALTHCARE'S OBJECTIVE IS TO REDUCE THE FEMALE BREAST CANCER RATE WITHIN BARRON COUNTY BY INCREASING MAMMOGRAPHY RATES BY 2.1%, FROM 71.8% TO 73.8% OVER 3 YEARS ALIGNING WITH THE BARRON COUNTY CANCER DATA TARGET AND HEALTHY PEOPLE 2030 GOAL, PUTTING BARRON COUNTY ON TRACK TO REACH THIS GOAL.- COLORECTAL SCREENINGSCOLORECTAL CANCER (CRC) PRESENTS A SIGNIFICANT HEALTH RISK, WITH A LIFETIME RISK OF APPROXIMATELY 1 IN 24 FOR MEN AND 1 IN 26 FOR WOMEN. ALARMINGLY, INCIDENCE RATES AMONG INDIVIDUALS UNDER AGE 50 HAVE BEEN RISING BY 2.4% ANNUALLY. CUMBERLAND HEALTHCARE'S OBJECTIVE IS TO INCREASE THE PERCENTAGE OF ELIGIBLE INDIVIDUALS IN BARRON COUNTY WHO RECEIVE COLORECTAL CANCER SCREENINGS BY 3.7%, FROM 57.2% TO 61.9% OVER THREE YEARS, ALIGNING WITH THE BARRON COUNTY CANCER DATA TARGET AND HEALTHY PEOPLE 2030 GOAL, PUTTING BARRON COUNTY ON TRACK TO REACH THIS GOAL.THE FOLLOWING ARE NEEDS NOT BEING ADDRESSED THAT ARE IN THE CHNA, AND THE REASONS WHY- PREMATURE DEATH: BARRON COUNTY HAS SLIGHTLY HIGHER PREMATURE DEATHS THAN THE STATE AVERAGE. WHILE NOT A DIRECT FOCUS THIS COULD BE IMPACTED AS A RESULT OF IMPROVING OBESITY RATES, INCREASING MAMMO SCREENINGS AND COLORECTAL SCREENINGS.- POOR HEALTH/POOR PHYSICAL DAYS: CHC HAS A LIMITED ABILITY TO IMPACT POOR/PHYSICAL HEALTH ON ITS OWN. CROSS SECTOR SUPPORT IS NEEDED.- POOR MENTAL HEALTH DAYS/ FREQUENT MENTAL DISTRESS/SUICIDES/FEELINGS OF LONELINESS/FREQUENT PHYSICAL - DISTRESS/MENTAL HEALTH PROVIDERS: DUE TO RECENT CUTS IN MENTAL HEALTH FUNDING, CHC IS CURRENTLY UNABLE TO PROVIDE ADDITIONAL RESOURCES FOR INITIATIVES RELATED TO POOR MENTAL HEALTH DAYS, FREQUENT MENTAL DISTRESS, SUICIDES, AND THE GROWING SENSE OF LONELINESS IN THE COMMUNITY. THESE REDUCTIONS HAVE SIGNIFICANTLY IMPACTED ON ITS ABILITY TO EXPAND SERVICES OR PARTICIPATE IN EXTERNAL EFFORTS, DESPITE ITS DEEP CONCERN FOR THE ISSUE. A PARTNERSHIP WITH NORTHLAKES COMMUNITY CLINIC HAS BEEN FORMED AND CHC REMAINS COMMITTED TO ADVOCATING FOR INCREASED SUPPORT AND RESOURCES TO ADDRESS THESE CRITICAL MENTAL HEALTH CHALLENGES.- LIFE EXPECTANCY: ADDRESSED THROUGH A COMBINATION OF CLINICAL CARE, PREVENTATIVE SERVICES, EDUCATION AND COMMUNITY PARTNERSHIPS AND AS A RESULT OF FY 2026 INITIATIVES SELECTED BY CHC.- ALCOHOL ABUSE & EXCESSIVE DRINKING: THIS CONTINUES TO FLUCTUATE. IN 2024, BARRON COUNTY WAS AT 22% AND IN 2023, 26% AND IN 2025 25%. THIS IS A STATEWIDE ISSUE AND CHC IS AWARE OF THIS NEED IN THE COUNTY. CHC DOES NOT HAVE THE STAFFING OR RESOURCES TO PROPERLY ADDRESS THIS NEED AT THIS TIME. RESOURCES ARE AVAILABLE WITHIN 14 MILES OF CUMBERLAND HEALTHCARE- TEEN BIRTHS: CHC OFFERS TEEN-FRIENDLY CONTRACEPTION, STI (SEXUALLY TRANSMITTED INFECTION) TESTING, COUNSELING, AND EDUCATION SERVICES AT THE FACILITY AND AT THE SCHOOLS AND COMMUNITY CENTERS.- FLU VACCINATIONS: AS PART OF ITS COMMITMENT TO IMPROVING COMMUNITY HEALTH OUTCOMES, CHC ACTIVELY SUPPORTS PREVENTIVE HEALTH MEASURES SUCH AS FLU VACCINATION CLINICS. CHC ALREADY OFFERS AND HELPS TO FACILITATE IMPROVEMENT IN THIS AREA- CHILD CARE COST BURDEN: CHC PLAYS A MEANINGFUL ROLE BY ACKNOWLEDGING THE IMPACT AND SUPPORTING COMMUNITY PARTNERSHIPS. CHC STARTED AND ACTIVELY ENGAGED IN THE DAYCARE TASK FORCE WITHIN CUMBERLAND.- ADULT SMOKING/TOBACCO USE: THIS IS BEING ADDRESSED BY HEALTH EXPERTS AT A STATE LEVEL THROUGH THE IMPLEMENTATION OF A STATEWIDE SMOKING BAN EFFECTIVE SINCE 2010. THIS LAW, 2009 WISCONSIN ACT 12, PROHIBITS SMOKING IN MOST ENCLOSED PUBLIC PLACES AND WORKPLACES INCLUDING BARS, RESTAURANTS, AND OTHER ESTABLISHMENTS. THE LAW ALSO COVERS OUTDOOR AREAS AROUND CERTAIN BUILDINGS, LIKE SCHOOL AND CHILDCARE FACILITIES. IN THE LAST THREE YEARS 2023 (20%) SMOKING HAS DECLINED BY 2% 2025 (18%) IN ADDITION, CUMBERLAND HEALTHCARE OFFERS SMOKING CESSATION THROUGH THE USE OF THE QUIT LINE AND IS A SMOKE FREE CAMPUS.- ACCESS TO PARKS: CHC HAS A 1-MILE WALKING PATH AND PICNIC AREA ON CAMPUS TO PROMOTE EXERCISE IN A NATURE FILLED SPACE PROMOTING PHYSICAL ACTIVITY AND SOCIAL INTERACTION. CHC SUPPORTS THE CUMBERLAND AREA TRAILS ALLIANCE, INC., AND IS WORKING COLLABORATIVELY TO ENHANCE ACCESS TO RECREATIONAL OPPORTUNITIES IN THE COMMUNITY.- FOOD INDEX/FOOD INSECURITY/LIMITED ACCESS TO HEALTHY FOODS -THE HARVEST GRILL IN CUMBERLAND PROVIDES LOCALLY SOURCED, FARM FRESH INGREDIENTS AT A LOW COST TO ITS PATIENTS, COMMUNITY, AND ITS EMPLOYEES- PREVENTABLE HOSPITAL STAYS - CHC CAN IMPACT HOSPITAL STAYS BY PROMOTING ROUTINE CHECKUPS, HEALTH SCREENINGS, VACCINATIONS, AND CHRONIC DISEASE MONITORING. CHRONIC DISEASE MANAGEMENT IS A TOOL IN PLACE THAT FOCUSES ON PREVENTION OR THE "STAYING WELL" SIDE OF HEALTHCARE- UNINSURED - CHC OFFERS CHARITY CARE AND SELF-PAY DISCOUNTS FOR UNINSURED PATIENTS AS A PART OF ITS FINANCIAL ASSISTANCE PROGRAM. CHC OFFERS ASSISTANCE WITH MEDICAID AND MEDICARE APPLICATIONS DURING OPEN ENROLLMENT FOR THOSE ELIGIBLE- MENTAL HEALTH PROVIDERS - CHC IS UNABLE TO PROVIDE MENTAL HEALTH PROVIDERS DUE TO ONGOING STAFFING SHORTAGES AND REDUCTIONS IN MENTAL HEALTH FUNDING. WE DO HAVE A PARTNERSHIP WITHNORTHLAKES COMMUNITY CLINIC FOR REFERRALS- OTHER PRIMARY CARE PROVIDERS - CHC'S STRATEGIC PLAN INDICATES THAT RECRUITMENT IS AT THE TOP OF THE LIST AND HAVE HIRED FOUR FAMILY PRACTICE PHYSICIANS IN THE LAST 24 MONTHS, CONTINUING TO MAKE THIS A TOP PRIORITY- SOME COLLEGE, UNEMPLOYMENT, INCOME INEQUALITY AND BROADBAND ACCESS - CHC HAS LIMITED RESOURCES AND EXPERTISE TO ADDRESS SOCIOECONOMIC FACTORS SUCH AS THESE. LONG-TERM IMPACTS ON EDUCATION OR EMPLOYMENT REQUIRE SUSTAINED EFFORTS BEYOND HEALTHCARE DELIVERY- INJURY DEATHS AND FIREARM FATALITIES - CHC'S FOCUS IS ON IMMEDIATE AND PREVENTATIVE HEALTH NEEDS. THESE CHALLENGES FALL OUTSIDE THE DIRECT SCOPE OF HEALTHCARE SERVICES, THOUGH THE FACILITY REMAINS COMMITTED TO COLLABORATION AND ADVOCACY EFFORTS- MOTOR VEHICLE CRASH DEATHS - HIGH RATES OF UNINTENTIONAL INJURY AND TRAFFIC ACCIDENTS (INCLUDING MOTOR VEHICLE CRASHES AND PEDESTRIAN MOTOR VEHICLES CRASHES) ARE BEING ADDRESSED BY OTHERS, INCLUDING LAW ENFORCEMENT AND STATE LEVEL EXPERTS THROUGH INITIATIVES SUCH AS MANDATORY SEAT BELT LAWS AND SPEED LIMIT ENFORCEMENT. AS A RURAL COMMUNITY, FARM SAFETY CONTINUES TO BE A PRIORITY. THE HOSPITAL SUPPORTS SAFETY EDUCATION THROUGH PARTICIPATION IN ANNUAL EVENTS LIKE NATIONAL NIGHT OUT, BIKE SAFETY, AND CAR SEAT SAFETY CHECKS, ETC.- LACK OF SOCIAL & EMOTIONAL SUPPORT - CHC IS ABLE TO PROVIDE SOME LEVEL OF SUPPORT THROUGH SOCIAL WORK AND PATIENT PORTALDESCRIPTION CONTINUES ON FINAL PAGE OF SCHEDULE H, PART V, SECTION C 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. WE ALSO HAVE STAFF ON SITE TO ANSWER QUESTIONS AND ASSIST WITH THE PAPERWORK 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/ PART V, SECTION B, LINE 11 (CONTINUED): - SUBSTANCE ABUSE - SPECIFICALLY OPIOID ABUSE, IS CURRENTLY BEING ADDRESSED IN BARRON COUNTY THROUGH VARIOUS PROGRAMS, INCLUDING OUTPATIENT TREATMENT, A DRUG AND ALCOHOL COURT, AND COMMUNITY SUPPORT SERVICES. THE BARRON COUNTY DRUG AND ALCOHOL COURT IS SPECIFICALLY DESIGNATED AND STAFFED TO HANDLE CASES INVOLVING DRUG OFFENDERS THROUGH AN INTENSIVE JUDICIALLY MONITORED PROGRAM OF DRUG TREATMENT, REHABILITATIVE SERVICES, AND STRICT COMMUNITY SUPERVISION. THESE PROGRAMS AIM AT ELIMINATING THE ABUSE OF OPIOIDS FROM A PREVENTION FOCUS. ALL PATIENTS THAT ARE TAKING A CONTROLLED SUBSTANCE ARE ON A DRUG MONITORING PLAN.THE CHNA FOR BARRON COUNTY HIGHLIGHTS SIGNIFICANT HEALTH CHALLENGES AND OPPORTUNITIES FOR IMPROVEMENT. IT IS VITAL TO NOTE, THAT WHILE THESE DATA SOURCES ARE THE MOST CURRENT PUBLIC SOURCES AVAILABLE, THE DATA IS STILL DATED, OFTEN USING 2020-2022 DATA. AN ASSUMPTION MUST BE MADE IN THAT IN THE FUTURE, THE SAME DATA GAP WILL OCCUR. THEREFORE, ALL PRIORITY GOALS ARE SET USING THE STARTING POINT OF 2022 (LATEST DATA AVAILABLE). IN ADDITION, CHC PRIMARILY SERVES ONLY PARTS OF BARRON ACCOUNTING FOR AN ESTIMATED POPULATION TO IMPACT 18,351 PEOPLE IN BARRON COUNTY OR 39%CHC'S TOP 3 AREAS OF POTENTIAL FOCUS BASED ON NEED, RESOURCES, AND ABILITY TO IMPACT ARE OBESITY, BREAST CANCER SCREENINGS, AND COLORECTAL CANCER SCREENINGS.CUMBERLAND HEALTHCARE WILL CONTINUE TO BUILD CARING RELATIONSHIPS WITH OUR COMMUNITY PARTNERS TO ADDRESS THE NEEDS OF ALL OUR COMMUNITIES WITH PERSONALIZED, COMPASSIONATE, AND HIGH-QUALITY CARE. TOGETHER, WE CAN CREATE A HEALTHIER COMMUNITY FOCUSING ON GOING ABOVE AND BEYOND FOR ALL PATIENTS AND OUR COMMUNITIES! 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 $ 997,695. 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: THE HOSPITAL IS CLOSELY CONNECTED WITH THE COMMUNITY AND SEEKS TO PROVIDE MANY OTHER OPPORTUNITIES TO ADDRESS NEEDS THAT DO NOT NECESSARILY RISE TO THE NEEDS IDENTIFIED IN THE CHNA. THE FOLLOWING ARE ADDITIONAL EFFORTS PERFORMED BY THE HOSPITAL: - REACH OUT AND READ PROGRAM - AN ONGOING PROGRAM WE HAVE DONE FOR A NUMBER OF YEARS AND ARE CONTINUING TO DO IT. WITH THIS PROGRAM, PROVIDERS GIVE BOOKS TO EACH CHILD AT THEIR ANNUAL WELL CHILD VISIT (OR ANY CHILD VISIT THE PROVIDER CHOOSES). THE FUNDS USED TO PURCHASE THESE BOOKS COME FROM THE ROOTS & WINGS GRANT. - IN THE SPRING WE DID AN EASTER EGG SCAVENGER HUNT ON OUR WALKING PATH - THIS WAS TO BRING AWARENESS OF OUR WALKING TRAIL AND GET CHILDREN MOVING AND EXCITED ABOUT BE OUTSIDE AND GETTING PHYSICAL ACTIVITY. - WE CONTINUE TO PARTNER WITH THE BARRON COUNTRY FREE CLINIC. WITH THIS PARTNERSHIP WE GIVE LAB AND RADIOLOGY SERVICES. THIS HELPS SERVE A NEED OF THOSE WITH LOW INCOME, WHILE MAKING SURE THEY HAVE ACCESS TO HEALTHCARE. - ANNUALLY WE DO A WOMEN'S HEALTH NIGHT - THE EVENING PROVIDES EDUCATIONAL SPEAKERS ON WELLNESS AND SERVICES PROVIDED AT CUMBERLAND HEALTHCARE. - VACCINES HAVE BEEN MADE MORE ACCESSIBLE THROUGH OUR RETAIL PHARMACY; MAPLE RIDGE. THIS ALLOW PATIENTS/CUSTOMERS TO WALK INTO THE PHARMACY FOR VACCINES (NOT ALL BUT A GOOD MAJORITY), WITHOUT NEEDING A CLINIC APPOINTMENT, THUS MAKING HEALTHCARE MORE ACCESSIBLE. - WE HAVE A BRAIN AND STROKE SUPPORT GROUP THAT IS OFFERED TO ANYONE 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 ADAM NETER PHYSICIAN 463739 0 0 0 180 0 10727 0 14826 0 489472 0 0 0 DR TYLER MILLER PHYSICIAN 439147 0 0 0 100 0 12680 0 14826 0 466753 0 0 0 DR AMY BAIR GENERAL SURGEON 413366 0 0 0 100 0 12486 0 12676 0 438628 0 0 0 DR CRAIG JENNINGS PHYSICIAN 351170 0 0 0 145 0 9777 0 33221 0 394313 0 0 0 STEFANIE RINEHARDT CRNA 262357 0 0 0 130 0 8224 0 45444 0 316155 0 0 0 EMILY DILLEY CEO 196682 0 33238 0 215 0 0 0 31201 0 261336 0 0 0 ROBERT LINDBERG COO 165678 0 10914 0 240 0 1248 0 36880 0 214960 0 0 0 ANGIE MARTENS CFO 166089 0 9452 0 275 0 7160 0 21320 0 204296 0 0 0 MICHAEL GUTSCH FORMER CEO 37471 0 0 0 73928 0 1607 0 27413 0 140419 0 73828 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 FROM 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 1,458,137. MANAGEMENT AND GENERAL EXPENSES 532,993. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,991,130. CONTRACTED ER PHYSICIANS: PROGRAM SERVICE EXPENSES 448,474. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 448,474. CONTRACTED - PHARMACY: PROGRAM SERVICE EXPENSES 1,615,260. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,615,260. CONTRACTED RADIOLOGY/NUCLEAR MEDICINE SERVICES: PROGRAM SERVICE EXPENSES 1,303,665. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,303,665. CONTRACTED PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 250,576. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 250,576. 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.