2011-08-02T13:59:17-05:00 2010-09-30 KPMG LLP 191 West Nationwide Blvd Ste 500 Columbus OH 432152568 990 2009-10-01 391030310 Watertown Regional Medical Center Inc WATE 9202614210 125 Hospital Drive Watertown WI 53098 John Graf 2011-07-27 6142492300 2009 2016-02-24 21:20:13Z John Kosanovich 125 Hospital Drive Watertown WI 53098 142336547 false X www.uwhpwatertown.com X 1965 WI To provide the best in healthcare to our patients with state of the art technology, advanced expertise, and personalized compassionate care in a healing environment that is convenient to home and work. 13 10 816 190 1763790 0 95768 73720 82802235 86663956 1374402 384222 1555938 504651 85828343 87626549 75321 17500 0 0 41334416 42633447 0 0 0 38214691 41797802 79624428 84448749 6203915 3177800 116692666 122630706 46724243 46967102 69968423 75663604 TO PROVIDE THE BEST IN HEALTHCARE TO OUR PATIENTS. HOSPITAL, OPERATES A COMMUNITY HOSPITAL WITH 95 APPROVED BEDS PROVIDING A FULL RANGE OF ACUTE CARE AND HOME HEALTH SERVICES IN WATERTOWN, WISCONSIN AND SURROUNDING COMMUNITIES. THE HOSPITAL ALSO OWNS AND OPERATES PHYSICIAN PRACTICE CLINICS AND SENIOR HOUSING CAMPUSES. THE HOSPITAL HAS A COMMITMENT TO PROVIDE SERVICES TO ALL, INCLUDING THE UNDERSERVED AND THOSE AFFECTED BY POVERTY. THE HOSPITAL PROVIDES A WIDE RANGE OF COMMUNITY OUTREACH SERVICES SUCH AS IMMUNIZATION CLINICS, HEALTH EDUCATION PROGRAMS, HEALTH SCREENINGS, AND VARIOUS HEALTHCARE SUPPORT GROUPS. false false 56957806 74403582 Operations of an acute care hospital facility including inpatient, emergency room, surgery and outpatient with a full array of ancillary services. 15651600 10081883 Operations of clinics in Watertown and surrounding communities. 1575166 1522787 Operations of senior living facilities. 722925 655704 Home Health Care 722925 655704 74907497 true true false false false false false false false true true false false false false false false false true false true false true true true false false false false false false false false false true false false false false false false false false false true 141 0 816 true true true false false false false false false false false false false false 13 10 false false false false false false false true true true false true true true true true false true true false WI X JIM BIRD 9202624230 125 HOSPITAL DR Watertown WI 53098 John Kosanovich 40.0 X X 321853 0 49012 Jeff Baum 2.0 X 0 0 0 Lyle Wuestenberg 2.0 X 0 0 0 Donna O'Brien 2.0 X 0 0 0 Daphne Holterman 2.0 X 0 0 0 Juliet Slavens DDS 2.0 X 0 0 0 Fred Albertz 2.0 X 0 0 0 Kathleen Hargarten MD 2.0 X 0 0 0 Ron Sokovich 40.0 X 346654 0 30766 Sandhya Garg MD 2.0 X 0 0 0 Michael Dallman 2.0 X 0 0 0 Mike Sullivan MD 2.0 X 0 0 0 Tim Schuler 2.0 X 0 0 0 John Graf 40.0 X 191429 0 32196 Jennifer Laughlin 40.0 X 111243 0 25434 Duane Floyd 40.0 X 123050 0 28277 Jacklynn Lesniak 40.0 X 143067 0 28076 Jeff Meade MD 24.0 X 94664 0 10788 LORI SCHWENKNER 40.0 X 48437 0 10671 John McGuinness 40.0 X 373082 0 35665 Rhonda Miller 40.0 X 390449 0 22005 Tahmina Aafreen 40.0 X 301349 0 40443 James Milford 40.0 X 258962 0 22504 John Basarich 40.0 X 245748 0 45470 2949987 0 381307 27 false true false Metropolitan Watertown LLC 225 S Executive Dr BROOKFIELD WI 53005 Anesthesia Services 2280330 Quest Diagnostics Inc 2750 Monroe Blvd NORRISTOWN PA 19403 Laboratory Services 486089 Starizon Inc 31 river overlook KEYSTONE CO 80435 Patient Experience 413495 University of Wisconsin Med Founda jeff sears 5171 MF centennial bldg MADISON WI 537052281 Hospitalist Physicia 908115 University of Wisconsin Med Founda 555 zor shrine place MADISON WI 53719 Cardiology Physician 507109 22 12928 60792 73720 HOSPITAL 621110 74403582 74179303 224279 HOME HEALTH CARE 621400 655704 618879 36825 WATERTOWN AREA CLINCS 621300 10081883 8579197 1502686 SENIOR LIVING FACILITIES 621300 1522787 1522787 86663956 1306442 1306442 0 0 1429974 1224980 204994 204994 204994 52555541 53462111 15650 -906570 -15650 -922220 16736 7257 9479 9479 0 0 CAFETERIA REVENUE 722310 206600 206600 MEALMOBILE 624210 62872 62872 CANCER CENTER 541610 20706 20706 290178 87626549 84983744 1763790 1727515 0 17500 17500 0 0 1218197 1218197 0 0 31778872 28600985 3177887 0 1983017 1784715 198302 5383889 4845500 538389 2269472 2042525 226947 0 0 0 0 0 0 9687075 8718369 968706 0 0 0 0 0 0 0 0 2234858 2011372 223486 0 5532156 4978940 553216 0 MEDICAL SUPPLIES AND DRUGS 8456997 7611297 845700 LISCENSE AND TAXES 1818400 1636560 181840 PROVISION FOR BAD DEBT 3970946 3573851 397095 FISCAL & ADMIN. SERVICE 10024535 9020331 1004204 NON OPERATING EXPENSES 72835 65552 7283 84448749 74907497 9541252 0 12396635 8916531 9938600 11489345 1905679 2013572 2048427 3095189 101382489 51022504 51739115 50359985 37532471 45269161 636652 603346 70087 168577 425000 715000 116692666 122630706 10516865 11741856 364586 486207 29806379 29137830 6036413 5601209 46724243 46967102 X 69669416 75535521 299007 128083 69968423 75663604 116692666 122630706 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1257192 0 1257192 45570677 0 16736220 28834457 50655708 0 32032496 18623212 3898912 0 2253788 1645124 50359985 0 RESIDENT DEPOSIT PAYABLE 5601209 5601209 87626549 84448749 3177800 2446184 71197 2517381 5695181 89998884 2446184 2446184 87552700 73849 73849 87626549 84375914 84375914 72835 72835 84448749 Reconciliation Items Form 990, Schedule D, Part XI, Line 8 Interest Rate Swap 23,838 Temporarily Restricted Unrealized Gain 47,359 Total -------- 71,197 Form 990, Schedule D, Part XII, Line 4b Non-Operating losses reclassed to expense 72,835 Temporarily restricted investment income 1,014 Total -------- 73,849 Form 990, Schedule D, Part XIII, Line 4b Non-Operating Losses 72,835 Love Lights 8430 8430 2309 Magic at market 3165 3165 1643 5 5141 5141 3305 16736 16736 7257 7257 9479 true true true X 125. true X true true false true true 476444 476444 0.00590 6384997 6384997 0.07930 6861441 6861441 0.08520 91024 725260 128150 597110 0.00740 220 53896 53896 0.00070 13019 2055078 1557217 497861 0.00620 1560 409848 54398 355450 0.00440 105823 3244082 1739765 1504317 0.01870 105823 10105523 1739765 8365758 0.10390 14251 14251 0.00020 699 699 130 426 426 44348 44348 0.00060 1599 1599 28292 28292 0.00040 130 89615 89615 0.00120 true 1683681 336736 13895425 18433224 -4537799 X true true UWHP Watertown Regional Medical Center

125 Hospital Dr Watertown WI 53098

X X X Costs included in part i, line 7 were calculated using the cost to charge ratio. The amount of bad debt expense excluded from the the total expenses used to calculate Part I, Line 7, Column (f) was $3,970,946. This reduced the total expenses to $80,477,803. The Medicare cost to charge ratio, computed from the 9/30/2010 Medicare Cost Report, was used to compute the cost of the bad debt expense. The hospital estimated that 20% of its bad debt expense would be classified as charity care if the forms were filled out with proper documentation. When accounts are transferred to collection the hospital does not know if the patients may possibly qualify for Community Care because they may have neglected their bills. Many accounts go to collection because the hospital never has any contact with the patient. The hospital sends them statements and calls them, but the patients never pay or respond. The Hospital provides care without charge or at amounts less than the Hospital's established rates to patients who meet certain criteria under its charity care policy. The Hospital maintains records to identify and monitor the level of charity care it provides. These records include the amount of charges forgone for services and supplies furnished under its charity care policy. Because the Hospital does not pursue collection of amounts determined to qualify as charity care, they are not reported as revenue. The following information measures the level of charity care provided for the years ended September 30: Charges Foregone, based on established rates 2010=$1,123,685 2009=$1,344,586 100% of the Medicare shortfall should be treated as community benefit. Watertown Regional Medical Center is committed to serving all patients, regardless of ability to pay or if the payments to be received will be less than the cost to provide the service, which is the case for Medicare and Medicaid patients. The figures on line 6 of part iii come from the 9/30/2010 Medicare Cost Report. Medicare allowable costs relating to payments on line 5 of part iii are based upon the medicare cost report. This shortfall should be treated as a community benefit since it reflects unreimbursed costs to the health system for providing medical services to the medicare residents of the community. When patients qualify for charity care, the Hospital gives up collection efforts on the amount that is classified as charity care. If a patient receives partial charity care, the non-charity portion of their bill is still subject to normal collection efforts, which can include being sent to a collection agency if the patient fails to make payments to the Hospital. Using public health data provided by the State of Wisconsin, local health departments and the University of Wisconsin, UW Health Partners Watertown Regional Medical Center (WRMC) completes regular community health assessments. These assessments are performed in cooperation with the local public health offices. Public health data is used to identify the region's top health and safety needs. Each need is then ranked according to the number of people affected and also quantified in terms of regional cost burden. Finally, we rate the community health needs in terms of how well they match with the organization's strategic priorities and resources to calculate overall priority scores. This year, the organization has identified the following as our community's top health and safety needs: a. Heart Disease b. Overweight and Obesity c. Cancer prevention and screening d. Access to care for the under and uninsured. WRMC uses multiple methods to educate patients about eligibility for financial assistance. Local referring providers are familiar with WRMC's charity care policies and often get patients in contact with WRMC financial counselors as the care process is initiated. Our front office/reception staff at each point of entry is educated on billing and assistance procedures and can serve as an immediate resource for patients, referring patients to financial counselors to provide personalized counseling when necessary. Our financial assistance policies are available on our website, and the numbers for our financial counselors are publicized in phone books and other directories. Once admitted to the medical center, each patient receives a Patient Handbook, which clearly outlines billing procedures and financial assistance resources. These policies and resources are also available 24/7 on our website at uwhpwatertown.com. WRMC serves the residents of Dodge and Jefferson counties in a service area of roughly 120,000 lives. Basic county demographic information is as follows: Dodge County Jefferson County - Residents below Poverty 8.1% 7.6% - with HS Diploma 82.3% 84.7% - Speak Language other than English 4.6% 6.1% - Residents over age 65 13.6% 12.5% - Residents uninsured 7.4% 3.0% WRMC is active in community health improvement in the region. Our involvement toward improving three of our health priorities (Obesity, heart disease and access to care) is outlined below. WRMC plays a leading role in Get Healthy Watertown, a community entity working to combat our region's obesity problem by helping families and businesses to adopt healthy lifestyle practices. With Get Healthy Watertown, we've developed an annual community weight loss challenge called Weigh to Win. To date, we have helped community members to lose more than 6,000 pounds. Most importantly, these community members have gained the knowledge to continue their healthy lifestyles for years to come. Heart disease is a major challenge for the WRMC service area. In addition to providing free heart risk screenings and education for adults, we've started to work with area youth to develop healthy habits years before heart disease presents itself. Our Ready Set Fit program takes health professionals into 4th grade classrooms, providing interactive learnings on exercise, nutrition and healthy lifestyles. For high school aged children, who are starting to make independent lifestyle choices, we offer a health camp, where students enjoy a day of active exercise and healthy cooking to learn to enjoy healthy lifestyle choices. Access to care is one of our top priorities, and we are proud to support two local free clinics who provided much needed care to uninsured and under insured community members. We provide leadership, staff expertise, and financial funding to the Watertown Area Cares Clinic (WACC), a new free clinic developed to meet the overwhelming needs of other local free clinics. WRMC provides lab and diagnostic services (free of charge) to meet the needs of the WACC as well as another local free clinic, the Rock River Free Clinic. WRMC is governed by a community board of directors who represent the diverse needs of the Watertown region. We have a board of directors sub-committee which oversees our community benefit plan and activities. This committee is made up of community members who represent underserved populations, such as the elderly, low-income, Spanish speaking population and youth. This committee also oversees our Community Health Fund, which provides grants to non-profits who further our health and safety mission. Each fiscal year, our board allocates a percentage of net revenue to a Community Health Fund. Community non-profits with health and safety related missions apply for and receive grant funds to further their missions of enhancing the health of the community. WRMC does have an open medical staff. WI true SCHOLARSHIP AWARDS (SEE PART IV FOR DETAILS) 12 17500 N/A N/A Procedures for Monitoring the use of grant funds in the United States Schedule I, Part I, Line 2 Annually, a team develops and submits a grant request to granting organizations to request funding for initiatives which meet identified health needs. The team develops a proposal with objectives, tactics and budget outlined. The team monitors progress toward stated objectives and budget and sends quarterly updates to the granting organization. In addition, the grant outcomes are reviewed annually with Community Benefit Committee members. X true false X X X X X false false false false false false false false false John Kosanovich 281820 0 37868 0 2165 0 33340 0 15672 0 370865 0 0 0 Ron Sokovich 330124 0 0 0 16530 0 14000 0 16766 0 377420 0 0 0 John Graf 179062 0 12301 0 66 0 15619 0 16577 0 223625 0 0 0 Duane Floyd 117080 0 5925 0 45 0 10256 0 18021 0 151327 0 0 0 Jacklynn Lesniak 136333 0 6700 0 34 0 11713 0 16363 0 171143 0 0 0 John McGuinness 252865 0 120197 0 20 0 18899 0 16766 0 408747 0 0 0 Rhonda Miller 250561 0 139842 0 46 0 20281 0 1724 0 412454 0 0 0 Tahmina Aafreen 175456 0 125876 0 17 0 20573 0 19870 0 341792 0 0 0 James Milford 180679 0 78257 0 26 0 18761 0 3743 0 281466 0 0 0 John Basarich 172128 0 73604 0 16 0 28783 0 16687 0 291218 0 0 0 WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTHOR 391337855 97710vqw1 2003-12-11 4400000 2003 hospital remodeling false false WISCONSIN HEALTH & EDUCATIONAL FACILITIES AUTHOR 391337855 97710vp36 2006-10-26 15000000 2006 HOSPITAL EXPANSION false false 4400000 110779 4289221 2004 false false true true 15000000 1258570 924944 12816486 2008 false false true true false false false false true 0.00000 0.00000 0.00000 true false false false false true 0.00000 0.00000 0.00000 true true true false false false true true true true jpmorgan chase 28. false false true Watertown Emergency Physicians SC Board Member is President 315029 see schedule o false Meade Medical Clinic Officer is Owner 165216 see schedule o false University of Wisconsin Health Care Board Member is Officer 100000 see schedule o false Governing Body and Management Form 990, Part VI, Line 9 Jeff Baum (Board Chairman) Wisconsin Aviation, Inc. 1741 River Drive Watertown, WI 53094 Lyle Wuestenberg (Board Vice-Chair) J & L Tire 4585 Linmar Lane Johnson Creek, WI 53038 Donna O'Brien N1237 County E Watertown, WI 53098 Daphne Holterman Rosy-Lane Holsteins LLC W3757 Ebenezer Road Watertown, WI 53094 Juliet Slavens, DDS N7730 French Road Johnson Creek, WI 53038 Fred Albertz 508 Highland Blvd. Johnson Creek, WI 53038 Kathleen Hargarten, MD 2924 N. Interlaken Drive Oconomowoc, WI 53066 Ron Sokovich, MD Urology Clinic Medical Office Building-West, Suite 2002 123 Hospital Drive Watertown, WI 53098 Sandhya Garg, MD UWHC 600 Highland Avenue H4/837 Madison, WI 53792-8310 Michael Dallman UWHC 600 Highland Avenue H4/836 Mail #8370 Madison, WI 53792 Mike Sullivan, MD Watertown Family Practice Associates, SC 127 Hospital Drive Watertown, WI 53098 Form 990 Review Process Form 990, Part VI, Line 11a The finance committee reviews the 990 in detail and a copy of the 990 is available for review by all board members before it is filed. Conflict of Interest Policy FORM 990, PART VI, LINE 12c Each year the Hospital's Conflict of Interest policy, along with the Conflict of Interest form, is sent to each Board member. Board members are asked to review the policy, complete the form, and return them to Administration where they are kept on file. Compensation Process FORM 990, PART VI, LINE 15b To determine the compensation of each officer of the corporation, a compensation committee and external data are used to determine a fair and reasonable salary. Outside sources include the opinion of an independent compensation consultant, use of a compensation survey, and the written employment contract for each officer, if applicable. The salary must be approved each year by the compensation committee. Governing Documents Available to Public FORM 990, PART VI, LINE 19 Audited financial statements are available to the public through the EMMA website: http://emma.msrb.org/. The governing documents, conflict of interest policies, and audited financial statements are available for public inspection upon request. Business Transactions Involving Interested Persons FORM 990, SCHEDULE L, PART IV, COLUMN D Dr. Hargarten's physician group provides physicians services to the Emergency Room of Watertown Regional Medical Center, INC. Dr. Meade provided rental property to Watertown Regional Medical Center, Inc. Mr. Dallman is Vice President of Regional Development for University of Wisconsin Health Care, Inc. which has an affiliation agreement with Watertown Regional Medical Center, Inc.