2023-11-13T09:50:57-06:00 2022-12-31 381357951 PLANTE & MORAN PLLC 10 S RIVERSIDE PLAZA 9TH FLOOR CHICAGO IL 60606 990 2022-01-01 390973724 FLAMBEAU HOSPITAL INC FLAM 7157622484 98 SHERRY AVENUE PARK FALLS WI 54552 CATHY BUKOWSKI CFO 7157622484 2023-11-08 1 CATHY BUKOWSKI 999009999 1 DAVID LOWENTHAL P00378651 3122071040 2023-11-08 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z MARSHFIELD MEDICAL CENTER-PARK FALLS SUSAN TURNEY MD CEO 1000 N OAK AVENUE MARSHFIELD WI 54449 41045595 0 X WWW.MARSHFIELDCLINIC.ORG X 1961 WI WE ENRICH LIVES TO CREATE HEALTHY COMMUNITIES THROUGH ACCESSIBLE, AFFORDABLE, COMPASSIONATE HEALTH CARE. 9 6 0 125 0 0 566716 774357 35829703 40267702 5235 3066 569 0 36402223 41045125 0 1000 0 0 12362273 22902889 0 0 0 8755816 16604722 21118089 39508611 15284134 1536514 10411282 13266431 4758999 705168 5652283 12561263 WE ENRICH LIVES TO CREATE HEALTHY COMMUNITIES THROUGH ACCESSIBLE, AFFORDABLE, COMPASSIONATE HEALTH CARE. 0 0 32349594 1000 40212863 FLAMBEAU HOSPITAL, INC. IS A NOT-FOR-PROFIT 25-BED COMMUNITY HOSPITAL LOCATED IN PARK FALLS, WISCONSIN THAT PROVIDES INPATIENT CARE AND SWING BED SERVICES ALONG WITH LABORATORY, RADIOLOGY, PHARMACY, REHABILITATION, SURGERY, HOSPICE, HOME HEALTH AND OTHER OUTPATIENT SERVICES. 32349594 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 7 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 9 6 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 0 0 0 X JANETTE TOWNSEND VP OF FINANCE 7153875511 1000 N OAK AVENUE MARSHFIELD WI 54449 MARK BUGHER CHAIR 1.00 9.00 X X 0 26500 0 MARK BRADLEY VICE CHAIR 1.00 5.00 X X 0 9500 0 RUWAN DISSANAYAKE MD SECRETARY 1.00 50.00 X X 0 528556 54315 JOHN BALTUS TREASURER 1.00 0.00 X X 0 0 0 DOUG MATHISON BOARD MEMBER 1.00 1.00 X 0 0 0 SUSAN TURNEY MD BOARD MEMBER/MCHS CEO 1.00 54.00 X 0 3048492 315344 COLLEEN HOERNEMAN BOARD MEMBER 1.00 2.00 X 0 7500 0 WILLIAM MELMS MD BOARD MEMBER/MCHS CMO 1.00 54.00 X 0 829413 57055 MARGARET MINERICK BOARD MEMBER 1.00 1.00 X 0 1000 0 GORDON EDWARDS MCHS CFO/COO - PART YEAR 1.00 54.00 X 0 829645 31752 KATHY BRESSLER MCHS COO 1.00 54.00 X 0 370779 16874 JERARD JENSEN MCHS GENERAL COUNSEL 1.00 54.00 X 0 1058880 65255 0 6710265 540595 0 0 1 0 0 2283 758532 13542 774357 NET PATIENT SERVICE REVENUE 621110 39938938 39938938 MISC OTHER OPERATING REVENUE 621110 273925 273925 CAFETERIA REVENUE 621110 54839 54839 40267702 1536 1536 2000 470 1530 1530 1530 41045125 40212863 0 57905 1000 1000 18478566 18133920 344646 838014 819412 18602 2562691 2522497 40194 1023618 1002216 21402 2467319 2423330 43989 3039 2289 750 171736 162559 9177 7813 7813 769398 766529 2869 97654 96077 1577 3354 3354 614187 614187 I/C PURCHASED SERVICES 6641280 6641280 MEDICAL SUPPLIES 3454832 3453241 1591 BAD DEBT EXPENSE 1812841 1812841 EQUIP. REPAIRS & MAINT. 449351 449151 200 111918 79178 32740 39508611 32349594 7159017 0 X 1082583 387239 0 36961 4442873 7315719 297228 511691 1421 9926 7397328 2511092 4587177 4886236 0 118659 10411282 13266431 140173 346722 0 94270 101201 0 4517625 264176 4758999 705168 X 5244383 12561263 407900 0 5652283 12561263 10411282 13266431 X 1536514 5372466 X 0 1 X 1 1 1 X 621000 621000 2746943 883496 1863447 3970573 1595808 2374765 58812 31788 27024 4886236 ASSET RETIREMENT OBLIGATION 201213 OPERATING LEASE PAYABLE LT 62963 264176 X PART X, LINE 2: THE ORGANIZATION APPLIES FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740, INCOME TAXES (ASC 740), WHICH CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN A COMPANY'S FINANCIAL STATEMENTS. ASC 740 PRESCRIBES A MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN. UNDER ASC 740, TAX POSITIONS WILL BE EVALUATED FOR RECOGNITION, DERECOGNITION, AND MEASUREMENT USING CONSISTENT CRITERIA AND WILL PROVIDE MORE INFORMATION ABOUT THE UNCERTAINTY IN INCOME TAX ASSETS AND LIABILITIES. THE SYSTEM HAS DETERMINED THAT IT DOESN'T HAVE ANY MATERIAL UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2022 OR DECEMBER 31, 2021. 1 1 X 1 X 1 X 1 1 1 0 1 1 212801 0 212801 0.00560 1365736 8583363 0 0.00000 0 0 1578537 8583363 212801 0.00560 75147 0 75147 0.00200 0 0 0 0 0 0 6050 0 6050 0.00020 81197 81197 0.00220 1659734 8583363 293998 0.00780 1 917298 0 6500363 9099382 -2599019 X 1 1 1 1 MARSHFIELD MEDICAL CENTER - PARK FALLS 98 SHERRY AVENUE PARK FALLS WI 54552 1028 X X X X MARSHFIELD MEDICAL CENTER - PARK FALLS 1 0 0 1 X X X X X X X X X 21 1 0 1 1 X HTTPS://TINYURL.COM/MSVJMRW5 X 1 21 1 HTTPS://TINYURL.COM/34UWZWRD 0 1 X 200.000000000000 400.000000000000 X X X X X 1 1 X X X 1 X HTTPS://MARSHFIELDCLINIC.ORG/PATIENT-RESOURCES/BILLING/FINANCIAL-ASSISTANCE X HTTPS://MARSHFIELDCLINIC.ORG/PATIENT-RESOURCES/BILLING/FINANCIAL-ASSISTANCE X HTTPS://MARSHFIELDCLINIC.ORG/PATIENT-RESOURCES/BILLING/FINANCIAL-ASSISTANCE X X X X X X 1 X 0 X X X X 1 X 0 0 MARSHFIELD MEDICAL CENTER - PARK FALLS PART V, SECTION B, LINE 5: COMMUNITY BENEFITS WORKGROUP (CBW)-PARK FALLS IDENTIFIED AND PRIORITIZED COMMUNITY HEALTH PRIORITIES THROUGH A COMPREHENSIVE PROCESS THAT INCLUDED INPUT FROM COMMUNITY PARTNERS AND ORGANIZATION LEADERSHIP. THE MMC-PARK FALLS CHNA AND COMMUNITY HEALTH PRIORITIZATION PROCESS WAS LED BY THE CBW-PARK FALLS. THE CHIEF ADMINISTRATIVE OFFICER (CAO) OF MMC-PARK FALLS CHAIRED THE CBW-PARK FALLS, WHICH INCLUDED LOCAL LEADERSHIP. ALL MEMBERS WERE CHOSEN FOR THEIR COMMITMENT TO GUIDE COMMUNITY BENEFITS EFFORTS AND DESIRE TO IMPROVE HEALTH IN THE PRICE COUNTY COMMUNITIES. THE CHNA INCLUDED PRIMARY AND SECONDARY DATA. PRIMARY DATA INCLUDED A COUNTY-WIDE SURVEY AND COMMUNITY CONVERSATIONS. SECONDARY DATA WAS COMPILED INTO A DATA PACKET, WHICH INCLUDED DATA FROM VARIOUS SOURCES. BOTH PRIMARY AND SECONDARY DATA COLLECTION METHODS WERE UTILIZED, AND VARIOUS EFFORTS WERE MADE TO CONNECT WITH SEVERAL DIFFERENT DEMOGRAPHIC GROUPS TO DEVELOP A THOROUGH UNDERSTANDING OF HEALTH ISSUES FACING MEMBERS OF PRICE COUNTY COMMUNITY. COMMUNITY HEALTH ASSESSMENT SURVEY:PRIMARY DATA COLLECTION BEGAN WITH A COMMUNITY HEALTH SURVEY IN MARCH 2021. AN ELECTRONIC SURVEY WAS WIDELY DISTRIBUTED BY CHNA PARTNERSHIP TO PRICE COUNTY RESIDENTS. AN ABBREVIATED HARDCOPY VERSION OF THE ELECTRONIC COMMUNITY HEALTH SURVEY WAS CREATED FOR RESIDENTS WITH LIMITED ACCESS TO THE INTERNET AND LIMITED HEALTH LITERACY. THE SURVEY ASKED RESIDENTS TO EVALUATE FOURTEEN HEALTH NEEDS BASED ON THE WISCONSIN DEPARTMENT OF HEALTH SERVICES HEALTH PLAN, HEALTHY PEOPLE. COUNTY HEALTH RANKINGS AND ROADMAPS TAKE ACTION MODEL, HEALTHIEST WISCONSIN 2020, AND INCLUDED: MENTAL HEALTH, SUBSTANCE USE, ALCOHOL MISUSE, CHRONIC DISEASE PREVENTION AND MANAGEMENT, OBESITY, PHYSICAL ACTIVITY, INJURY AND VIOLENCE PREVENTION, HEALTHY NUTRITION, HEALTHY GROWTH AND DEVELOPMENT, COMMUNICABLE DISEASE PREVENTION AND CONTROL, TOBACCO USE AND EXPOSURE, ORAL HEALTH, REPRODUCTIVE AND SEXUAL HEALTH, AND ENVIRONMENTAL AND OCCUPATIONAL HEALTH. THE MMC-PARK FALLS CHNA PARTNERS RECOGNIZES THAT HEALTH IS DETERMINED BY MORE THAN HEALTH CARE. TO FURTHER UNDERSTAND THE CONDITIONS THAT AFFECT A WIDE RANGE OF HEALTH, FUNCTIONING, AND QUALITY-OF-LIFE OUTCOMES AND RISKS, A SERIES OF QUESTIONS RELATED TO SOCIAL DETERMINANTS OF HEALTH (SDOH) WERE INCLUDED AND FURTHER ANALYZED. THE SURVEY COLLECTED 305 RESPONSES BETWEEN MARCH THROUGH APRIL 2021 FROM PRICE COUNTY RESIDENTS. OVERALL, RESPONDENTS TENDED TO BE WHITE, FEMALE AND BETWEEN THE AGES OF 55-64. 12.75% OF SURVEY RESPONDENTS ARE RETIRED, AND LESS THAN 2% OF SURVEY RESPONDENTS SAID THEY WERE UNEMPLOYED, DISABLED. KEY INFORMANT INTERVIEWS:KEY INFORMANT INTERVIEWS ARE IN-DEPTH, QUALITATIVE INTERVIEWS WITH INDIVIDUALS WHO KNOW WHAT IS GOING ON IN A COMMUNITY OR SPECIFIC POPULATION GROUP. THE PURPOSE OF THESE INTERVIEWS IS TO COLLECT INFORMATION FROM A WIDE RANGE OF INDIVIDUALS WHO HAVE FIRST-HAND KNOWLEDGE ABOUT THE COMMUNITY AND/OR POPULATION GROUPS. THESE INDIVIDUALS CAN INCLUDE FOR EXAMPLE, RESIDENTS, PROFESSIONALS, ELECTED OFFICIALS AND FAITH LEADERS. FOR THIS ASSESSMENT KEY INFORMANT INTERVIEWS WERE CONDUCTED VIA WEBEX VIDEO CONFERENCING PLATFORM TO OBSERVE COVID-19 PANDEMIC SAFETY PROTOCOLS. THE CBW-PARK FALLS IDENTIFIED A LIST OF 20 POTENTIAL KEY INFORMANTS ACROSS PRICE COUNTY TO INVITE TO COMPLETE AN INTERVIEW. 10 INDIVIDUALS COMPLETED AN INTERVIEW AND RESULTING INSIGHTS WERE COMPILED INTO A SUMMARY REPORT. MARSHFIELD MEDICAL CENTER - PARK FALLS PART V, SECTION B, LINE 6B: THE CHNA WAS CONDUCTED JOINTLY WITH THE PRICE COUNTY HEALTH DEPARTMENT. MARSHFIELD MEDICAL CENTER - PARK FALLS PART V, SECTION B, LINE 11: AFTER COMPLETING EXTENSIVE REVIEW OF THE PRICE COUNTY COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY, KEY INFORMANT INTERVIEW SUMMARY, HEALTHIEST WISCONSIN 2020, COUNTY HEALTH RANKINGS, AND OTHER QUANTITATIVE AND QUALITATIVE DATA, THE TOP COMMUNITY HEALTH PRIORITIES IDENTIFIED BY MARSHFIELD MEDICAL CENTER-PARK FALLS ARE: - ALCOHOL AND SUBSTANCE ABUSE - BEHAVIORAL HEALTH - CHRONIC DISEASE - SOCIAL DETERMINANTS OF HEALTHHEALTH PRIORITY 1: ALCOHOL AND SUBSTANCE USE GOAL 1: REDUCE YOUTH SUBSTANCE USE - SUPPORT ALCOHOL AND OTHER DRUG (AOD) PREVENTION CURRICULUMS IN SCHOOL AND/OR AFTERSCHOOL SETTINGS. - SUPPORT COMMUNITY WIDE ENVIRONMENTAL STRATEGIES, PREVENTION, AND/OR POLICY TO ADDRESS UNDERAGE ALCOHOL USE. GOAL 2: REDUCE COMMUNITY IMPACT RELATED TO SUBSTANCE MISUSE - SUPPORT WORKPLACE DRUG PREVENTION AND RECOVERY EFFORTS. GOAL 3: ENGAGE IN COMMUNITY EFFORTS RELATED TO ALCOHOL AND SUBSTANCE USE PREVENTION EFFORTS. - PARTICIPATE IN COMMUNITY-BASED WORKGROUPS. HEALTH PRIORITY 2: BEHAVIORAL HEALTH GOAL 1: DECREASE SUICIDE RATES FOR HIGH-RISK POPULATIONS - ENHANCE COMMUNITY MEMBER'S SKILLS TO SUPPORT MENTAL HEALTH PROMOTION AND SUICIDE PREVENTION. - SUPPORT SUICIDE PREVENTION COMMUNITY AWARENESS EVENTS. GOAL 2: IMPROVE SOCIAL AND EMOTIONAL DEVELOPMENT OF CHILDREN AND ADOLESCENTS - ENHANCE SCHOOL CAPACITY TO PROVIDE HIGH QUALITY SOCIAL, EMOTIONAL ASSESSMENT, SUPPORT AND LEARNING. GOAL 3: ENGAGE IN COMMUNITY EFFORTS RELATED TO SUPPORTING BEHAVIORAL HEALTH EFFORTS. - PARTICIPATE IN COMMUNITY-BASED WORKGROUPS. HEALTH PRIORITY 3: CHRONIC DISEASE GOAL 1: IMPROVE ACCESS TO HEALTHY FOODS - INCREASE COMMUNITY CAPACITY TO PROVIDE NUTRITIOUS, LOCALLY GROWN FOOD AND ADDRESS FOOD INSECURITY. GOAL 2: ENGAGE IN COMMUNITY EFFORTS RELATED TO CHRONIC DISEASE PREVENTION EFFORTS. - PARTICIPATE IN COMMUNITY-BASED WORKGROUPS. HEALTH PRIORITY 4: SOCIAL DETERMINANTS OF HEALTH GOAL 1: INCREASE KNOWLEDGE AND AWARENESS OF HEALTH EQUITY. - CONDUCT AN ORGANIZATION AND COMMUNITY ASSESSMENT OF HEALTH DISPARITIES AND HEALTH EQUITY AND DEVELOP A WORKPLAN TO ADDRESS THOSE GAPS. GOAL 2: IMPROVE HEALTH OUTCOMES BY CONNECTING CLINICAL PRACTICE TO COMMUNITY EFFORTS TO ADDRESS SOCIAL DETERMINANTS OF HEALTH BARRIERS. - SUPPORT AND CONNECT PATIENTS AND COMMUNITY MEMBERS TO RESOURCES TO ADDRESS SOCIALLY DETERMINED NEEDS. GOAL 3: ENGAGE IN COMMUNITY EFFORTS RELATED TO ADVANCING HEALTH EQUITY AND SOCIAL DETERMINANTS OF HEALTH. - PARTICIPATE IN COMMUNITY-BASED WORKGROUPS. THROUGH THE ASSESSMENT PROCESS, OTHER COMMUNITY HEALTH PRIORITIES WERE IDENTIFIED THAT WILL NOT BE ADDRESSED IN THIS PLAN. THE FOLLOWING WAS CONSIDERED WHILE PRIORITIZING COMMUNITY HEALTH NEEDS; OTHER ORGANIZATIONS ADDRESSING THE SPECIFIC NEED, THE ABILITY OF MMC-PARK FALLS TO IMPACT CHANGE, AVAILABILITY OF RESOURCES, AS WELL AS READINESS OF THE COMMUNITY FOR INTERVENTIONS. THE FOLLOWING HEALTH PRIORITIES WILL NOT BE ADDRESSED BY MMC-PARK FALLS FOR REASONS INDICATED: - COMMUNICABLE DISEASE PREVENTION & CONTROL: INSTEAD OF LEADING THIS CHARGE, STAFF PARTICIPATE IN THE NORTHCENTRAL WISCONSIN HEALTHCARE EMERGENCY READINESS COALITION IN ADDITION TO NUMEROUS COVID-19 WORKGROUPS ACROSS REGIONAL COUNTY AREAS. - ORAL HEALTH: STAFF FROM MMC-PARK FALLS DOES NOT PROVIDE RELATED SERVICES, HOWEVER THE FAMILY HEALTH CENTER OF MARSHFIELD DENTAL CENTER, DOES LEAD THESE EFFORTS LOCALLY, REGIONALLY AND NATIONALLY. ONE OF THE FAMILY HEALTH CENTER DENTAL LOCATIONS IS IN PARK FALLS. PART I, LINE 3C: AN INDIVIDUAL'S ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED ON INCOME AS COMPARED WITH FEDERAL POVERTY GUIDELINES. OTHER ELIGIBILITY FACTORS INCLUDE: ASSET LIMITATIONS, INSURANCE STATUS AND RESIDENCY. ACCOUNT BALANCE IS CONSIDERED FOR MEDICAL INDIGENCE ELIGIBILITY. PART I, LINE 7: EXPLANATION OF COSTING METHODOLOGY USED FOR CALCULATING LINE 7 TABLE: AMOUNTS CALCULATED IN PART I, LINE 7 ARE DETERMINED BASED ON A COST-TO-CHARGE RATIO. OTHER BENEFITS ARE DETERMINED BASED ON THE DIRECT AND INDIRECT COSTS (WHERE ALLOCATED) ASSOCIATED WITH A PROGRAM NET OF EARNED REVENUE. PART II, COMMUNITY BUILDING ACTIVITIES: IN ALIGNMENT WITH THE MARSHFIELD CLINIC HEALTH SYSTEM MISSION STATEMENT, WE ENRICH LIVES, BY PARTICIPATING IN VARIOUS COMMUNITY-BUILDING ACTIVITIES TO IMPROVE THE HEALTH OF THE COMMUNITY, AND BY ADDRESSING SOCIAL DETERMINANTS OF HEALTH AND HEALTH INEQUITIES. DUE TO LINGERING IMPACTS OF COVID-19, DECREASED STAFFING AND CAPACITY, MANY COMMUNITY-BUILDING ACTIVITIES REMAINED LIMITED DURING THIS REPORTING PERIOD. SOME EXAMPLES OF COMMUNITY BUILDING ACTIVITIES INCLUDED:COALITION BUILDING:MARSHFIELD MEDICAL CENTER-PARK FALLS STAFF PARTICIPATED IN FOUR DIFFERENT COMMUNITY COALITIONS WITH THE PURPOSE OF IMPROVING THE HEALTH OF THE COMMUNITY. THESE COALITIONS ARE THE PRICE COUNTY AODA/MENTAL HEALTH COALITION, PRICE COUNTY HEALTH & WELLNESS COALITION, PRICE COUNTY COORDINATION TRANSPORTATION COMMITTEE, AND NORTHWOODS TOBACCO FREE COALITION. COMMUNITY SUPPORT:MARSHFIELD MEDICAL CENTER-PARK FALLS (MMC-PARK FALLS) PROVIDED FUNDING TO SUPPORT A FOOD PROGRAM AT THE PRENTICE SCHOOL DISTRICT TO BE USED TO PURCHASE FOOD ITEMS TO ASSIST FAMILIES WHO ARE FOOD INSECURE BY PROVIDING FOOD OUTSIDE OF TRADITIONAL SCHOOL HOURS. MMC-PARK FALLS PROVIDED FUNDING TO SUPPORT A LOCAL LIBRARY TO CREATE AND IMPLEMENT MINDFULNESS KITS FOR YOUTH AND TEENS. THESE KITS WILL ENCOURAGE A STARTING POINT TO HAVE A CONVERSATION ABOUT MENTAL HEALTH, TO IMPROVE SOCIAL AND EMOTIONAL DEVELOPMENT, AND DECREASE SUICIDE FOR YOUTH AND TEENS IN CRISIS IN PRICE COUNTY. MMC-PARK FALLS IS A SPONSOR OF THE LOCAL FARMERS MARKET IN PRICE COUNTY. MMC-PARK FALLS STAFF PROVIDE RECIPES WEEKLY AT THE MARKET AND A FORM OF NUTRITION EDUCATION TO HELP PEOPLE LEARN HOW TO USE THE LOCALLY GROWN PRODUCE. ENVIRONMENTAL IMPROVEMENTS:MARSHFIELD MEDICAL CENTER-PARK FALLS PROVIDES A MEDICATION DISPOSAL KIOSK IN THE CLINIC PHARMACY THAT IS OPEN TO THE PUBLIC TO ENCOURAGE SAFE DISPOSAL OF MEDICATION IN THE COMMUNITY. MMC-PARK FALLS SUPPORTS HARM REDUCTION METHODS RELATED TO USED SHARPS, BY ACCEPTING USED SHARPS FROM ANYONE IN THE COMMUNITY REGARDLESS OF PATIENT STATUS.ECONOMIC DEVELOPMENT:MARSHFIELD MEDICAL CENTER-PARK FALLS MANAGEMENT STAFF SIT ON THE YMCA STEERING COMMITTEE FOR THE PARK FALLS COMMUNITY. THERE IS A STRONG NEED FOR ADDITIONAL CHILDCARE, AFTER SCHOOL PROGRAMS, ADDITIONAL JOBS, AND TO ENHANCE FAMILY FRIENDLY SERVICES IN THE COMMUNITY.ADVOCACY FOR COMMUNITY HEALTH IMPROVEMENTS AND SAFETY:MARSHFIELD MEDICAL CENTER-PARK FALLS (MMC-PARK FALLS) COLLABORATED WITH COMMUNITY ORGANIZATIONS AND GROUPS FOR COMMUNITY HEALTH IMPROVEMENTS AND SAFETY. EXAMPLES INCLUDED: - PRICE COUNTY AODA/MENTAL HEALTH COALITION AND PRICE COUNTY PUBLIC HEALTH TO CONDUCT BI-ANNUAL PRESCRIPTION DRUG TAKE BACK EVENTS.- MMC-PARK FALLS DONATED A HYDROPONIC GARDEN UNIT TO A LOCAL SCHOOL WITHIN PRICE COUNTY. FUNDS WERE USED TO PURCHASE ONE YEARS' WORTH OF SUPPLIES TO OPERATE AT THE SCHOOL FOR THE FISCAL YEAR 2022. THE HYDROPONIC GARDEN UNIT HELPS IMPROVE THE ACCESS TO HEALTHY FOODS, INCREASES COMMUNITY CAPACITY TO PROVIDE NUTRITIOUS, LOCALLY GROWN FOOD, AND HELPS ADDRESS FOOD INSECURITY IN PRICE COUNTY.- MMC-PARK FALLS PROVIDED FUNDING TO SUPPORT A LOCAL NEWSPAPER AD TO SUPPORT PUBLIC TRANSPORTATION SERVICES FOR COMMUNITY MEMBERS. TRANSPORTATION IS A SOCIAL DETERMINANT OF HEALTH CONCERN FOR PRICE COUNTY RESIDENTS. - MMC-PARK FALLS MANAGEMENT STAFF CHAIRS THE WISCONSIN HOSPITAL ASSOCIATION FOUNDATION BOARD. THIS BOARD FOCUSES ITS GRANT MAKING PRIORITIES ON INITIATIVES THAT HAVE A STATEWIDE IMPACT ON HEALTH CARE IN WISCONSIN.WORKFORCE DEVELOPMENT:MARSHFIELD MEDICAL CENTER-PARK FALLS (MMC-PARK FALLS) STAFF COLLABORATED WITH LOCAL AREA HIGH SCHOOLS TO OFFER PRESENTATIONS FOR HIGH SCHOOL STUDENTS INTERESTED IN MEDICAL AND HEALTHCARE CAREERS. MMC-PARK FALLS FUNCTIONED AS A CLINICAL SITE FOR STUDENT NURSES, STUDENT NURSING ASSISTANTS, PRECEPTORS FOR HEALTHCARE JOBS, MEDICAL RESIDENTS AND INTERNS. PART III, LINE 2: BAD DEBT EXPENSE IS REPORTED AT COST USING A COST-TO-CHARGE RATIO. PART III, LINE 3: NO BAD DEBT IS ESTIMATED TO RELATE TO CHARITY CARE. PART III, LINE 4: PATIENT ACCOUNTS RECEIVABLE ARE REDUCED FOR EXPLICIT PRICE CONCESSIONS AND BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AS AN IMPLICIT PRICE CONCESSION. IN EVALUATING THE COLLECTABILITY OF PATIENTS' ACCOUNTS RECEIVABLE, THE SYSTEM ANALYZES ITS PAST HISTORY AND CONTRACTUAL TERMS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE. FOR RECEIVABLES ASSOCIATED WITH PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE SYSTEM ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ADDITIONAL IMPLICIT DISCOUNT, IF NECESSARY (I.E., FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND CO-PAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID OR FOR PAYORS 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 DEDUCTIBLES AND CO-PAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE SYSTEM RECORDS AN IMPLICIT DISCOUNT 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. THE SYSTEM'S IMPLICIT ALLOWANCE FOR SELF-PAY PATIENTS WAS APPROXIMATELY 61% AND 60% OF SELF-PAY ACCOUNTS RECEIVABLE AS OF DECEMBER 31, 2022 AND DECEMBER 31, 2021, RESPECTIVELY. PART III, LINE 8: THE ALLOWABLE MEDICARE COST ON PART III, LINE 6 IS DETERMINED USING THE CY 2022 MEDICARE COST REPORT. THE REIMBURSEMENT FROM MEDICARE IS DEDUCTED FROM THE ESTIMATED COST USING A COST-TO CHARGE RATIO IN ORDER TO DETERMINE THE SHORTFALL FROM THE MEDICARE PROGRAM. THE SYSTEM TREATS MEDICARE SHORTFALL AS COMMUNITY BENEFIT. THE REASONS FOR THIS TREATMENT INCLUDE (1) NON-NEGOTIABLE MEDICARE RATES ARE SOMETIMES NOT ALIGNED WITH THE TRUE COSTS OF TREATING MEDICARE PATIENTS; (2) THE SYSTEM IS ALLEVIATING THE FEDERAL GOVERNMENT'S BURDEN FOR DIRECTLY PROVIDING MEDICAL SERVICES; AND (3) IRS REV. RUL. 69-545 NOTES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THIS ACTION INDICATES THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. PART III, LINE 9B: THE ORGANIZATION HAS A BILLING AND COLLECTION POLICY WHICH SETS FORTH COLLECTION PRACTICES FOR PATIENTS WHO ARE KNOWN TO BE ELIGIBLE OR PRESUMED TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY. MULTIPLE MEASURES ARE TAKEN TO COMMUNICATE THE AVAILABILITY OF FINANCIAL ASSISTANCE AND DETERMINE WHETHER A PATIENT IS FINANCIAL ASSISTANCE ELIGIBLE BEFORE PURSUING EXTRAORDINARY COLLECTION ACTIONS (ECAS). ECAS MAY INCLUDE: REPORTING TO CONSUMER CREDIT REPORTING AGENCIES PURSUING LEGAL JUDGMENTS, FILING LIENS, GARNISHING WAGES, REQUIRING PREPAYMENT FOR NON-EMERGENCY SERVICES. ECAS WILL NOT BE INITIATED AND FURTHER ACTION WILL NOT BE TAKEN ON EXISTING ECAS ONCE A FINANCIAL ASSISTANCE APPLICATION IS IN PROCESS. IF THE PATIENT IS DETERMINED FINANCIAL ASSISTANCE ELIGIBLE, REASONABLE MEASURES WILL BE TAKEN TO REVERSE ANY ECA ALREADY IN PLACE. PART VI, LINE 2: ALL MARSHFIELD MEDICAL CENTER FACILITIES ASSESSED THE HEALTH CARE NEEDS OF THE COMMUNITIES THEY SERVE BY CONDUCTING STANDARD CHNA PRACTICES, INCLUDING: - REVIEW OF COMMUNITY PARTNERS' REPORTS (I.E. UNITED WAY) - REVIEW OF PUBLICLY AVAILABLE COMMUNITY HEALTH DATA (I.E. COUNTY HEALTH RANKINGS) - COMPLETION OF KEY INFORMANT INTERVIEWS WITH COMMUNITY LEADERS ABOUT THE COMMUNITY'S HEALTH NEEDS - COMPLETION OF COMMUNITY CONVERSATIONS WITH COMMUNITY MEMBERS - PARTICIPATION IN COMMUNITY HEALTH COMMITTEES AND BOARDS PART VI, LINE 3: PATIENT ASSISTANCE CENTER COUNSELORS ASSIST INDIVIDUALS WITH IDENTIFYING, REFERRING AND/OR APPLYING FOR PUBLIC, PRIVATE OR CHARITABLE RESOURCES FOR WHICH THE PATIENT MAY QUALIFY. COUNSELORS ARE AVAILABLE VIA PHONE AND IN PERSON TO ASSIST INDIVIDUALS WITH FINANCIAL ASSISTANCE. INFORMATION ON THE MARSHFIELD CLINIC HEALTH SYSTEM (MCHS) FINANCIAL ASSISTANCE POLICY IS POSTED IN HOSPITAL REGISTRATION AND ADMITTING LOCATIONS AND IN THE HOSPITAL EMERGENCY DEPARTMENT. FINANCIAL ASSISTANCE INFORMATION IS PRINTED ON MONTHLY BILLING STATEMENTS AND INCORPORATED INTO OTHER COMMUNICATIONS IN ORDER TO WIDELY PUBLICIZE THE AVAILABILITY OF FINANCIAL ASSISTANCE, AS DESCRIBED IN THE MCHS BILLING AND COLLECTION POLICY. THE MCHS FINANCIAL ASSISTANCE POLICY (INCLUDING THE PLAIN LANGUAGE SUMMARY), THE FINANCIAL ASSISTANCE APPLICATION AND THE BILLING AND COLLECTION POLICY ARE AVAILABLE IN ENGLISH, SPANISH, HMONG AND ANY OTHER LANGUAGE THAT IS THE PRIMARY LANGUAGE SPOKEN BY THE LESSER OF 1,000 INDIVIDUALS OR 5% OF THE POPULATION OF THE SERVICE AREA.THE MCHS FINANCIAL ASSISTANCE POLICY (INCLUDING THE PLAIN LANGUAGE SUMMARY), THE FINANCIAL ASSISTANCE APPLICATION AND THE BILLING AND COLLECTION POLICY MAY BE OBTAINED FREE OF CHARGE: ON THE HOSPITAL WEBSITE, IN PERSON, FROM FINANCIAL COUNSELORS, BY PHONE AND BY MAIL. PART VI, LINE 4: MARSHFIELD MEDICAL CENTER-PARK FALLS (MMC-PARK FALLS) IS A 25-BED CRITICAL ACCESS HOSPITAL IN PARK FALLS, WISCONSIN. 24-HOUR CARE IS PROVIDED FOR IN-PATIENT AND OUT-PATIENT SERVICES, EMERGENCY AMBULANCE SERVICES, AND HOME HEALTH & HOSPICE SERVICES TO RESIDENTS IN PRICE COUNTY AND NORTHERN WISCONSIN. PRICE COUNTY IS LOCATED IN NORTH CENTRAL WISCONSIN BETWEEN HAYWARD AND MINOCQUA. PRICE COUNTY IS COMPRISED OF TWO CITIES (PARK FALLS AND PHILLIPS), 17 TOWNS (INCLUDING PRENTICE), AND THREE VILLAGES. PRICE COUNTY HAD A TOTAL POPULATION OF 14,050 IN 2021 AND IS 100% RURAL COUNTY WITH ON AVERAGE 11.3 PERSONS PER SQUARE MILE. THERE WERE 17.3% OF RESIDENTS UNDER 18 YEARS, 27.9% WHO WERE 65 YEARS AND OVER, AND 48.3% WHO WERE FEMALE. THE RACIAL MAKE-UP OF PRICE COUNTY WAS 93.5% WHITE ALONE NOT HISPANIC OR LATINO, 2.3% HISPANIC OR LATINO, 0.7% ASIAN ALONE, 0.6% BLACK OR AFRICAN AMERICAN, 1.0% AMERICAN INDIAN AND ALASKA NATIVE ALONE, AND 1.4% TWO OR MORE RACES. THERE WERE 1.7% OF PRICE COUNTY RESIDENTS WHO WERE NOT BORN IN THE UNITED STATES. PRICE COUNTY HAS 10.7% OF INDIVIDUALS WITH A DISABILITY WHO ARE UNDER AGE 65 YEARS, WHICH IS A HIGHER PERCENTAGE THAN FOR WISCONSIN AND THE UNITED STATES. IN PRICE COUNTY, THE HIGH SCHOOL GRADUATION RATE WAS 92.4%. RESIDENTS WHO HAVE A BACHELOR'S DEGREE OR HIGHER WAS AT 16.1%, WHICH IS LOWER THAN WISCONSIN AND THE UNITED STATES. IN 2021, THE MEDIUM HOUSEHOLD INCOME WAS $52,052 WITH 11.7% OF THE POPULATION WAS BELOW THE POVERTY LINE. PART VI, LINE 5: MARSHFIELD MEDICAL CENTER-PARK FALLS FURTHERED ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY WITH THE FOLLOWING: - REPRESENTATION ON THE COORDINATED COMMUNITY RESPONSE COMMITTEE ORGANIZED BY EMBRACE IN PRICE COUNTY. THIS COMMITTEE EXAMINES COMMUNITY ISSUES RELATED TO DOMESTIC ABUSE AND SUPPORTS SYSTEMS THAT HELP VICTIMS IMPROVE OVERALL HEALTH AND OVERCOME THEIR SITUATION.- REPRESENTATION ON THE PRICE COUNTY TRANSPORTATION COORDINATING COMMITTEE.- PARTICIPATED IN MULTIPLE GROUPS WITHIN THE COMMUNITY COALITIONS SERVING PRICE COUNTY, AODA/MENTAL HEALTH COALITION AND HEALTH & WELLNESS COALITION. THE MISSION OF THESE COALITIONS IS TO PROMOTE THE HEALTH AND WELL-BEING OF INDIVIDUALS, FAMILIES AND COMMUNITIES OF PRICE COUNTY THROUGH SPECIFIC INITIATIVES. - PROVIDED FUNDING TO SUPPORT A LOCAL NEWSPAPER AD TO SUPPORT PUBLIC TRANSPORTATION SERVICES FOR COMMUNITY MEMBERS. TRANSPORTATION IS A SOCIAL DETERMINANT OF HEALTH ISSUE FOR PRICE COUNTY RESIDENTS. PART VI, LINE 6: MARSHFIELD CLINIC WAS FOUNDED IN 1916 BY SIX PHYSICIANS PRACTICING IN MARSHFIELD, A RURAL CENTRAL WISCONSIN CITY. AT ITS INCEPTION, CLINIC FOUNDERS SAW RESEARCH AND EDUCATION AS CRITICAL TO THEIR PRACTICE OF HEALTH CARE AND THAT REMAINS SO TODAY. THE CLINIC BECAME A 501(C)(3) NONPROFIT ORGANIZATION IN 1992 AND IN 2014, MARSHFIELD CLINIC HEALTH SYSTEM, INC. (MCHS), WAS FORMED. MCHS TODAY IS AN INTEGRATED HEALTH SYSTEM SERVING WISCONSIN AND MICHIGAN'S UPPER PENINSULA WITH MORE THAN 12,000 EMPLOYEES INCLUDING MORE THAN 1,600 PROVIDERS COMPRISING OVER 170 SPECIALTIES, A HEALTH PLAN, AND RESEARCH AND EDUCATION PROGRAMS. MCHS PRIMARY OPERATIONS INCLUDE: MARSHFIELD CLINIC; MARSHFIELD MEDICAL CENTER HOSPITALS IN MARSHFIELD, EAU CLAIRE, BEAVER DAM, LADYSMITH, MINOCQUA, NEILLSVILLE, RICE LAKE, STEVENS POINT, WESTON, IRON MOUNTAIN, PARK FALLS, AND MARSHFIELD CHILDREN'S HOSPITAL; MARSHFIELD CLINIC RESEARCH INSTITUTE, SECURITY HEALTH PLAN, AND MARSHFIELD CLINIC HEALTH SYSTEM FOUNDATION. UNIQUE TO MCHS IS ITS CENTER FOR COMMUNITY HEALTH ADVANCEMENT (CCHA), WHICH BUILDS BRIDGES BETWEEN THE HEALTHCARE SYSTEM AND THE PLACES IN THE COMMUNITY WHERE PEOPLE LIVE, WORK AND PLAY. THE CCHA WORKS WITH COALITIONS, BUSINESSES, EDUCATIONAL SYSTEMS, LAW ENFORCEMENT AGENCIES, TRIBAL NATIONS, LOCAL GOVERNMENTS, AND OTHER HEALTHCARE PROVIDERS, NONPROFIT ORGANIZATIONS AND OTHER ENTITIES TO IMPROVE COMMUNITY HEALTH. THE CCHA INCLUDES HOSPITAL STAFF WHO ARE CLOSELY INVOLVED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND IMPLEMENTATION STRATEGY (IS) IN THEIR RESPECTIVE COUNTIES. THIS HELPS TO ALIGN COMMUNITY HEALTH PRIORITIES IDENTIFIED IN THE CHNA WITH HEALTH SYSTEM PRIORITIES. 0 1 0 0 0 0 0 0 0 SUSAN TURNEY MD BOARD MEMBER/MCHS CEO 0 1812322 0 910520 0 325650 0 287565 0 27779 0 3363836 0 258588 JERARD JENSEN MCHS GENERAL COUNSEL 0 801522 0 202859 0 54499 0 23031 0 42224 0 1124135 0 0 WILLIAM MELMS MD BOARD MEMBER/MCHS CMO 0 784186 0 5000 0 40227 0 23031 0 34024 0 886468 0 0 GORDON EDWARDS MCHS CFO/COO - PART YEAR 0 560115 0 166037 0 103493 0 9150 0 22602 0 861397 0 0 RUWAN DISSANAYAKE MD SECRETARY 0 398039 0 103133 0 27384 0 21612 0 32703 0 582871 0 0 KATHY BRESSLER MCHS COO 0 285062 0 25000 0 60717 0 8769 0 8105 0 387653 0 0 PART I, LINE 3 THE MARSHFIELD CLINIC HEALTH SYSTEM'S (MCHS) INDEPENDENT COMPENSATION COMMITTEE (THE COMMITTEE) HAS FINAL AUTHORITY FOR APPROVING COMPENSATION AND BENEFITS OF ALL DISQUALIFIED PERSONS EMPLOYED BY ANY OF THE ORGANIZATIONS IN THE SYSTEM. THE COMMITTEE USES COMBINATIONS OF THE FOLLOWING TO EVALUATE COMPENSATION: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE, AND WRITTEN EMPLOYMENT CONTRACTS. PART I, LINE 4B THE FOLLOWING INDIVIDUALS PARTICIPATED IN A 457(F) SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN AND RECEIVED A DISTRIBUTION FROM OR HAD AMOUNTS VEST IN THE PLAN: SUSAN TURNEY, MD - $219,744 THE FOLLOWING INDIVIDUALS PARTICATED IN A 457(F) SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN BUT DID NOT RECEIVE A DISTRIBUTION OR HAVE AN AMOUNT VEST IN THE PLAN. UNDER THE PLAN, AMOUNTS DO NOT VEST UNTIL TWO YEARS AFTER SEPARATION FROM THE ORGANIZATION: RUWAN DISSANAYAKE, MD JERARD JENSEN GORDON EDWARDS WILLIAM MELMS, MD FORM 990, PART IV, LINE 4: MARSHFIELD CLINIC HEALTH SYSTEM (INCLUDING FLAMBEAU HOSPITAL, INC.) IS A MEMBER OF VARIOUS HEALTHCARE ASSOCIATIONS (I.E. WISCONSIN HOSPITAL ASSOCIATION) THAT MAY PERFORM SOME LOBBYING ACTIVITY. ALL ASSOCIATED DUES ARE DISCLOSED ON THE FORM 990 OF MARSHFIELD CLINIC HEALTH SYSTEM, INC. FORM 990, PART V, LINE 2A: ALL PERSONNEL SERVICES FOR FLAMBEAU HOSPITAL, INC. ARE PERFORMED BY EMPLOYEES OF MARSHFIELD CLINIC HEALTH SYSTEM, INC. ALL PHYSICIAN SERVICES FOR FLAMBEAU HOSPITAL, INC. ARE PERFORMED BY EMPLOYEES OF MARSHFIELD CLINIC, INC. FORM 990, PART VI, SECTION A, LINE 6 MCHS HOSPITALS, INC. (A WISCONSIN NONSTOCK, NONPROFIT ORGANIZATION DESCRIBED IN CODE SECTION 501(C)(3)) IS THE SOLE MEMBER OF FLAMBEAU HOSPITAL, INC. FORM 990, PART VI, SECTION A, LINE 7A MCHS HOSPITALS, INC. (AS THE SOLE MEMBER) HAS THE RESERVE POWER TO APPOINT OR REMOVE MEMBER OF THE BOARD OF DIRECTORS OF FLAMBEAU HOSPITAL, INC. FORM 990, PART VI, SECTION A, LINE 7B MCHS HOSPITALS, INC. (THE SOLE MEMBER) HAS THE RIGHT TO APPROVE ANY CHANGES TO THE ARTICLES OF INCORPORATION AND BYLAWS OF FLAMBEAU HOSPITAL, INC. MCHS HOSPITALS, INC. (THE SOLE MEMBER) HAS THE RIGHT TO INITIATE AND APPROVE LONG-TERM BORROWING AND OTHER FORMS OF LONG-TERM INDEBTEDNESS, INITIATE AND APPROVE THE PURCHASE, SALE OR ENCUMBRANCE OF REAL AND PERSONAL PROPERTY AND APPROVE OR DISAPPROVE ANNUAL OPERATING AND CAPITAL BUDGETS. MCHS HOSPITALS, INC. (THE SOLE MEMBER) ALSO HAS THE RIGHT TO INITIATE AND APPROVE ANY OF THE FOLLOWING ACTIONS: MERGER, CONSOLIDATION, AFFILIATION OR JOINT VENTURE WITH ANY OTHER ENTITY OR ENTITIES; LIQUIDATION, REORGANIZATION OR DISSOLUTION OF THE ORGANIZATION; FILING OF A VOLUNTARY PETITION IN BANKRUPTCY; ANY CHANGE IN CONTROL OF THE ORGANIZATION. FORM 990, PART VI, SECTION B, LINE 11B MARSHFIELD CLINIC HEALTH SYSTEM, INC. ENGAGES A PUBLIC ACCOUNTING FIRM TO PREPARE AND REVIEW THE FORM 990 IN ADDITION TO REVIEW BY THE SYSTEM CFO, VP OF FINANCE AND TAX DEPARTMENT. PRIOR TO FILING THE FORM WITH THE IRS, THE CFO AND HIS/HER DESIGNEE WILL PROVIDE TO EACH MEMBER OF THE SYSTEM'S AUDIT AND COMPLIANCE COMMITTEE (A SUBCOMMITTEE OF THE BOARD OF DIRECTORS) A COPY IN ELECTRONIC OR PAPER FORM OF THE COMPLETE FORM 990 (AND ALL REQUIRED SCHEDULES) FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C ALL OFFICERS, BOARD DIRECTORS, AND KEY EMPLOYEES OF EVERY MARSHFIELD CLINIC HEALTH SYSTEM (MCHS) ENTITY, AS WELL AS ANY OTHER PERSON DESIGNATED BY THE AUDIT AND COMPLIANCE COMMITTEE (ACC) TO BE A REQUIRED REPORTER BY VIRTUE OF HIS OR HER POSITION AT A SYSTEM ENTITY, SHALL ANNUALLY COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM. SUCH FORMS SHALL BE DISTRIBUTED AND RECORDED BY THE SYSTEM'S DESIGNATED COMPLIANCE OFFICER. ALL FINANCIAL INTERESTS DISCLOSED AS PART OF THE ANNUAL DISCLOSURE PROCESS SHALL BE REVIEWED BY THE ACC. THE ACC SHALL INFORM THE BOARD OF DISCLOSED FINANCIAL INTERESTS WHICH MAY BEAR UPON OR RELATE TO A TRANSACTION UPON WHICH THE BOARD OR ANOTHER BOARD, COMMITTEE OR OTHER BODY OF A SYSTEM ENTITY, MAY DELIBERATE OR ACT. IN ADDITION TO THE ANNUAL DISCLOSURES, IF AT ANY TIME BETWEEN ANNUAL DISCLOSURES, A REQUIRED REPORTER BECOMES AWARE THAT THE BOARD, OR A BOARD, COMMITTEE OR OTHER BODY, OF ANY SYSTEM ENTITY MAY DELIBERATE OR ACT UPON ANY TRANSACTION THAT MAY HAVE ANY BEARING OF ANY KIND UPON, OR MAY RELATE IN ANY MANNER TO, AN EXISTING, INTENDED OR EXPECTED FINANCIAL INTEREST OF THE REQUIRED REPORTER, HE OR SHE SHALL DISCLOSE THE FINANCIAL INTEREST TO THE RELEVANT SYSTEM ENTITY BOARD, COMMITTE OR BODY CHAIR, AS WELL AS TO THE SYSTEM'S COMPLIANCE OFFICER, IN ADVANCE OF ANY DELIBERATIONS OR ACTION, WRITTEN DISCLOSURE OF THE EXISTENCE, NATURE AND EXTENT OF HIS OR HER FINANCIAL INTEREST. ALL WRITTEN OR ORAL DISCLOSURES OF FINANCIAL INTERESTS SHALL BE RECORDED IN THE MINUTES OF THE BOARD AND BY THE OFFICE OF THE COMPLIANCE OFFICER. THE COMPLIANCE OFFICER SHALL DISCLOSE THE COMPLETED FORMS AS NECESSARY TO THOSE MCHS EMPLOYEES RESPONSIBLE FOR COMPLETION OF THE IRS FORM 990. FORM 990, PART VI, SECTION B, LINE 15 THE SYSTEM'S INDEPENDENT COMPENSATION COMMITTEE (COMPENSATION COMMITTEE) SHALL HAVE FINAL AUTHORITY FOR APPROVING COMPENSATION AND BENEFITS OF ALL DISQUALIFIED PERSONS (AS THAT TERM IS DEFINED IN 4958 OF THE INTERNAL REVENUE CODE (THE CODE)) EMPLOYED BY THE CORPORATION, INCLUDING BUT NOT LIMITED TO THE CORPORATION'S CEO. THE TERM DISQUALIFIED PERSONS INCLUDES (BUT IS NOT LIMITED TO) ANY PERSON (OR THE PERSON'S FAMILY MEMBER) WHO WAS, AT ANY TIME DURING THE 5-YEAR PERIOD ENDING ON THE DATE OF THE TRANSACTION, IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF THE ORGANIZATION. IT SHALL BE THE RESPONSIBILITY OF THE COMPENSATION COMMITTEE TO INSURE THAT THE SYSTEM DOES NOT PAY AN AMOUNT THAT EXCEEDS REASONABLE COMPENSATION FOR ANY DISQUALIFIED PERSON. THE COMPENSATION COMMITTEE AND ITS OPERATING PROCEDURES SHALL BE DESIGNED TO ESTABLISH THE REBUTTABLE PRESUMPTION OF REASONABLENESS OF COMPENSATION OUTLINED IN TREASURY REG. SEC. 53.4958-6 WITH RESPECT TO EACH DISQUALIFIED PERSON. IN DETERMINING REASONABLENESS OF COMPENSATION, THE COMPENSATION COMMITTEE SHALL EVALUATE APPROPRIATE INFORMATION AS TO THE COMPARABILITY OF COMPENSATION, INCLUDING BUT NOT LIMITED TO: COMPENSATION LEVELS PAID BY SIMILARLY SITUATED ORGANIZATIONS FOR COMPARABLE POSITIONS; THE AVAILABILITY OF SIMILAR SERVICES IN THE SYSTEM'S GEOGRAPHIC AREA; CURRENT COMPENSATION SURVEYS COMPILED BY INDEPENDENT FIRMS; AND ACTUAL WRITTEN JOB OFFERS FROM SIMILAR INSTITUTIONS. THE COMPENSATION COMMITTEE SHALL HAVE INDEPENDENT AUTHORITY TO OBTAIN OUTSIDE EXPERT OPINIONS ON THE REASONABLENESS AND FAIR MARKET VALUE OF COMPENSATION AND GATHER OTHER INFORMATION IT CONSIDERS NECESSARY OR APPROPRIATE TO MAKE ITS DECISIONS ON COMPENSATION. THE COMPENSATION COMMITTEE SHALL TIMELY DOCUMENT ITS DETERMINATION OF REASONABLENESS OF COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 FLAMBEAU HOSPITAL, INC. DOES NOT MAKE ITS CURRENT GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UNLESS INCLUDED AS PART OF A FORM THAT IS REQUIRED TO BE PUBLICLY AVAILABLE. FORM 990, PART X, LINE 20: FLAMBEAU HOSPITAL, INC. IS PART OF THE MARSHFIELD CLINIC HEALTH SYSTEM OBLIGATED GROUP. SINCE THE OBLIGATED GROUP IS RESPONSIBLE FOR ALL OUTSTANDING FINANCED DEBT OBLIGATIONS, ALL BOND RELATED REPORTING IS DISCLOSED ON THE FORM 990 OF MARSHFIELD CLINIC HEALTH SYSTEM INC. FORM 990, PART XI, LINE 9: NET ASSETS RELEASED FROM RESTRICTION -408,862. NET ASSET TRANSFERS WITH RELATED ORGANIZATIONS 5,781,328. 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