2025-08-14T15:50:00-05:00 2024-09-30 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2023-10-01 421017512 UPLAND HILLS HEALTH INC UPLA 6089308000 800 COMPASSION WAY DODGEVILLE WI 53533 DANIELLE MOYER VP OF FINANCE 6089308000 2025-08-12 1 1 MICHAEL J PETERSON CPA P01833529 7158323407 2025-08-11 2023 2025-03-06 01:10:19Z LISA SCHNEDLER 800 COMPASSION WAY DODGEVILLE WI 53533 114182313 0 X WWW.UPLANDHILLSHEALTH.ORG X 1974 WI PROVIDE INNOVATIVE, INDIVIDUALIZED AND COMPASSIONATE CARE FOR EVERY STAGE IN LIFE. 11 11 779 98 29104 0 3229068 330116 93248479 107535885 2336520 4183346 476566 495489 99290633 112544836 0 0 0 0 47149013 53260229 0 0 0 37174317 41709228 84323330 94969457 14967303 17575379 158366790 179763329 36228030 38283527 122138760 141479802 X OUR MISSION: WE ARE A COMMUNITY-MINDED HEALTHCARE SYSTEM PROVIDING INNOVATIVE, INDIVIDUALIZED AND COMPASSIONATE CARE FOR EVERY STAGE IN LIFE. OUR VISION: TO EXEMPLIFY THE HIGHEST STANDARD OF COMMUNITY HEALTHCARE AND INSPIRE PATIENTS TO TAKE AN ACTIVE ROLE IN THEIR HEALTH THROUGH WELLNESS-ORIENTED CARE. 0 0 71868577 0 99555424 UPLAND HILLS HEALTH, INC. PROVIDES HIGH QUALITY, COST-EFFECTIVE, PRIMARY HOSPITAL CARE TO ALL PEOPLE IN NEED OF CARE. AMONG THE HOSPITAL INPATIENT AND OUTPATIENT SERVICES PROVIDED ARE DIAGNOSTIC IMAGING, REHABILITATION SERVICES, RESPIRATORY CARE, SURGICAL SERVICES, CARDIAC MONITORED CARE, LAB SERVICES, PHARMACY SERVICES, 24-HOUR EMERGENCY ROOM, OBSTETRICAL SERVICES, REGIONAL CLINIC SERVICES, AND MANY OTHERS. UPLAND HILLS ALSO PROVIDES ADDITIONAL SERVICES TO THE COMMUNITY BY PROVIDING OUTREACH PROGRAMS AND SERVICES THAT MEET IDENTIFIED NEEDS IN AN EFFORT TO ENHANCE THE HEALTH AND WELFARE OF THE PEOPLE IN ITS AREA. DURING FISCAL YEAR 2024, UPLAND HILLS HEALTH HOSPITAL PROVIDED 3,358 DAYS OF INPATIENT CARE, 426 DAYS OF SWING BED CARE, OVER 14,585 EMERGENCY ROOM AND URGENT CARE PATIENT VISITS, OVER 74,400 CLINIC PATIENT VISITS, AND OVER 170,000 OTHER OUTPATIENT PROCEDURES AND SERVICES FOR PATIENTS IN NEED OF MEDICAL CARE.IN ITS EFFORT TO ATTAIN THIS MISSION AND GOAL, AND TO BE A PARTNER IN THE COMMUNITY, UPLAND HILLS PROVIDES:- HEALTH EDUCATION AND OUTREACH PROGRAMS TO MEMBERS OF THE COMMUNITY AT LITTLE OR NO COST TO THE PARTICIPANTS.- DIABETES SELF-MANAGEMENT CLASSES - CLASSES ARE RECOGNIZED BY THE AMERICAN DIABETES ASSOCIATION AS QUALITY SELF-MANAGEMENT CLASSES AND ARE TAUGHT BY A REGISTERED DIETICIAN WHO IS SPECIALLY TRAINED IN DIABETES EDUCATION.- PROGRAMS FOR NEW AND EXPECTANT PARENTS - CHILDBIRTH EDUCATION, PRE-DELIVERY CONFERENCE, SIBLING CLASS, BREASTFEEDING SUPPORT AND BREASTFEEDING SUPPLIES.- INDOOR FITNESS WALKING IS AVAILABLE AT THE HOSPITAL FACILITY FOR COMMUNITY MEMBERS DURING COLD OR INCLEMENT WEATHER.- SAFE SITTER BABYSITTING TRAINING - MEDICALLY ACCURATE BABYSITTING PREPARATION CLASS DESIGNED FOR BOYS AND GIRLS AGES 11 TO 13. THE PROGRAM TEACHES SITTERS HOW TO HAVE FUN WITH CHILDREN AS WELL AS HOW TO RECOGNIZE A MEDICAL EMERGENCY AND KNOW THE APPROPRIATE ACTION TO TAKE. STUDENTS ALSO LEARN INFANT AND CHILD CPR.THE COST OF PROVIDING CHARITY CARE TO PERSONS UTILIZING OUR HOSPITAL AMOUNTED TO APPROXIMATELY $573,000 IN 2024. IN ADDITION, UPLAND HILLS HEALTH FURNISHES CARE TO PERSONS COVERED UNDER GOVERNMENT ENTITLEMENT PROGRAMS WHICH PAY AT RATES LESS THAN CHARGES. DISCOUNTS TO THESE PROGRAMS FOR HOSPITAL SERVICES AMOUNT TO $76,000,000. UPLAND HILLS HEALTH ALSO PROVIDES ASSISTANCE TO THE FREE CLINIC LOCATED IN DODGEVILLE, WISCONSIN ON AN ANNUAL BASIS.UPLAND HILLS ALSO OPERATES A THERAPY AND WELLNESS CENTER TO PROVIDE FITNESS AND WELLNESS OPPORTUNITIES TO EMPLOYEES AND THE PUBLIC. UPLAND HILLS HAS TWO THERAPY AND WELLNESS CENTERS AVAILABLE FOR PATIENTS, EMPLOYEES, VOLUNTEERS AND THE GENERAL PUBLIC AT LOW-COST MEMBERSHIP RATES. THESE CENTERS HOUSE MODERN EQUIPMENT, INCLUDING CARDIO WORKOUT MACHINES, CIRCUIT TRAINING, AND FREE WEIGHTS. PERSONAL TRAINING, MASSAGE THERAPY AND ACUPUNCTURE SERVICES ARE OFFERED TO COMPLEMENT YOUR WELLNESS GOALS. 4527383 0 2571308 THE FOCUS OF UPLAND HILLS HOSPICE IS MAINTAINING QUALITY OF LIFE BY RELIEVING PAIN AND ADDRESSING THE PHYSICAL, EMOTIONAL AND SPIRITUAL FEELINGS THAT THE PATIENT AND FAMILY MEMBERS FEEL WHEN FACED WITH A TERMINAL ILLNESS. HOSPICE CARE IS AVAILABLE FOR TERMINALLY ILL PEOPLE WHO ARE NO LONGER SEEKING CURATIVE TREATMENT AND WHOSE LIFE EXPECTANCY IS MEASURED IN MONTHS RATHER THAN YEARS. OUR HOSPICE SERVICES CAN BE PROVIDED AT HOME OR IN A HOSPITAL, NURSING HOME OR FREESTANDING FACILITY FOR PATIENTS WITH ANY TERMINAL ILLNESS SUCH AS CANCER, HEART DISEASE, COPD, RENAL FAILURE, ALZHEIMER'S, STROKE OR AIDS. IN FISCAL YEAR 2024, THERE WERE 7,022 TOTAL HOSPICE VISITS PROVIDED TO PATIENTS.UPLAND HILLS HEALTH, INC.'S HOMECARE PROGRAM PROVIDES COMPREHENSIVE HEALTHCARE SERVICES IN THE MOST COMFORTABLE SETTING-THE PATIENT'S HOME. IN FISCAL YEAR 2024, THERE WERE 5,725 TOTAL HOMECARE VISITS PROVIDED TO PATIENTS. 4378215 0 4937869 UPLAND HILLS HEALTH, INC. (UPLAND HILLS) ALSO SERVES THE COMMUNITY BY OPERATING A 44-BED SKILLED NURSING FACILITY KNOWN AS THE "NURSING AND REHABILITATION CENTER". THE PRIMARY ACTIVITY OF THE NURSING AND REHABILITATION CENTER IS TO PROVIDE SKILLED AND INTERMEDIATE CARE FOR THE AGED AND DISABLED OF THE SURROUNDING AREA. THE CENTER PROVIDED 11,710 DAYS OF RESIDENT CARE IN FISCAL YEAR 2024. THE CENTER OFFERS SKILLED NURSING CARE IN BOTH SHORT-TERM REHABILITATION PROGRAMS AND LONG-TERM CARE RESIDENT PROGRAMS. SOME OF THE SPECIALIZED CARE SERVICES OFFERED INCLUDE IV THERAPY CARE, WOUND CARE, PAIN MANAGEMENT, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, AND SPEECH THERAPY AMONG MANY OTHER CARE PROGRAMS PROVIDED. THE CENTER OPERATES IN CONJUNCTION WITH UPLAND HILLS HOSPITAL TO PROVIDE A SMOOTH TRANSITION FOR PATIENTS NEEDING EXTENDED REHABILITATION OR LONG-TERM CARE SERVICES. THE COMBINATION AND COORDINATION OF FACILITIES ALSO ALLOWS THE ORGANIZATION TO SHARE MANY DEPARTMENTS AND SERVICES IN UPLAND HILLS HEALTH'S CONSTITUTED EFFORT TO PROVIDE HIGH QUALITY AND LOW-COST CARE TO THE COMMUNITY. 80774175 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 91 0 779 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 1 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 WI X DANIELLE MOYER 6089308000 800 COMPASSION WAY DODGEVILLE WI 53533 JIM MASSEY CHAIR 2.50 X X 0 0 0 SANDY FISCHER VICE CHAIR 2.50 X X 0 0 0 TED GREENHECK VICE CHAIR (TERM JAN) 2.50 1.00 X X 0 0 0 JOHN THRONSON TREASURER 2.50 X X 0 0 0 BRAD LAUFENBERG SECRETARY 2.50 X X 0 0 0 DAVID ENGELS TRUSTEE (TERM JAN) 2.50 X 0 0 0 CHRISTOPHER KINONEN MD TRUSTEE 2.50 X 0 0 0 ALAN HOLTER DVM TRUSTEE 2.50 X 0 0 0 JAMES MEACHAM TRUSTEE 2.50 X 0 0 0 JEAN MLSNA TRUSTEE 2.50 X 0 0 0 KYLE NONDORF TRUSTEE 2.50 X 0 0 0 ANDREA POTTERTON TRUSTEE 2.50 X 0 0 0 ALLISON STROUD TRUSTEE 2.50 X 0 0 0 JODY VANDERLOO TRUSTEE (TERM JAN) 2.50 X 0 0 0 LISA SCHNEDLER PRESIDENT AND CEO 44.00 1.00 X 401114 0 27818 ARTHUR KARL PUSTINA VP OF OPERATIONS 45.00 X 257704 0 35659 DANIELLE MOYER VP OF FINANCE 44.00 1.00 X 112838 0 41219 JENIFER DANKYI PHYSICIAN 40.00 X 420951 0 49433 JARED LINEBARGER PHYSICIAN 40.00 X 456293 0 45973 TIMOTHY RAICHLE PHYSICIAN 40.00 X 446729 0 45123 ANTHONY VILLARE PHYSICIAN 40.00 X 628127 0 46873 PATRICK RYBERG PHYSICIAN 40.00 X 454068 0 43173 3177824 0 335271 74 0 1 0 MADISON EMERGENCY PHYSICIANS SC INC 1221 JOHN Q HAMMONS DR MADISON WI 53744 24HR EMERGENCY ROOM COVERAGE 2702458 SHARED IMAGING SERVICES INC 944 WATER STREET SAUK CITY WI 53583 X-RAY SCAN SERVICE 2218929 MQ3 LLC 57 ARBOREDGE WAY FITCHBURG WI 53711 IT SUPPORT SERVICES 1572127 MEDICAL SOLUTIONS 1010 N 102ND STREET SUITE 300 OMAHA NE 68114 CONTRACTED STAFFING 1198091 SSM HEALTH 7153 SOLUTION CENTER CHICAGO IL 606777001 LABORATORY SERVICES 633657 24 329260 856 330116 PATIENT SERVICE REVENUE 621990 93914980 93885876 29104 PHARMACY 456110 11520671 11520671 340B/PHARMACY REVENUE 456110 1277697 1277697 DIETARY 722513 229372 229372 FITNESS CENTER 624100 98634 98634 494531 52351 442180 107535885 3828953 3828953 1090358 620524 469834 469834 469834 893688 477658 559011 457942 334677 19716 354393 354393 25655 0 25655 25655 112544836 107064601 29104 5121015 X 1433614 1433614 39717188 35185060 4532128 1102651 982077 120574 8329139 7233056 1096083 2677637 2287995 389642 202110 108365 93745 26967 26967 5612 5612 60097 60097 13192480 12114293 1078187 419668 411912 7756 1659129 1066739 592390 222353 25093 197260 1173966 1173966 323425 293386 30039 1094425 718986 375439 5821620 3651942 2169678 580268 371246 209022 MEDICAL SUPPLIES 10157772 10141989 15783 REPAIRS & MAINTENANCE 2548128 1930181 617947 EQUIPMENT RENTAL & LEAS 1742011 1638487 103524 LICENSES & SUBSCRIPTION 1560312 536778 1023534 918885 902624 16261 94969457 80774175 14195282 0 3243760 3284252 1219315 2471370 9720367 16066048 492183 608814 2192326 2615421 1068538 1889301 136674577 66953669 56078958 69720908 20281 20403 606174 505145 83724888 82581667 158366790 179763329 6094883 8801335 117575 91447 12404611 11213325 89900 73900 16066516 15513393 1454545 2590127 36228030 38283527 X 122138760 141816556 0 -336754 122138760 141479802 158366790 179763329 X 17575379 1892433 -126770 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 5612 5612 0 PART II-B, LINE 1: UPLAND HILLS HEALTH, INC. PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE WISCONSIN HOSPITAL ASSOCIATION (WHA) AND THE AMERICAN HOSPITAL ASSOCIATION (AHA). THESE DUES ARE PRIMARILY TO ACCESS EDUCATIONAL MATERIALS AND FOR STAFF TRAINING AND MATERIALS, HOWEVER A PORTION OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT. UPLAND HILLS HEALTH, INC. IS ALSO A MEMBER OF THE RURAL WISCONSIN HEALTH COOPERATIVE (RWHC). EACH YEAR, UPLAND HILLS HEALTH, INC. 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 PROVIDES AN ANALYSIS OF CURRENT HEALTHCARE ISSUES IN AN EFFORT TO PROMOTE AND BETTER HEALTHCARE FOR HOSPITALS IN RURAL COMMUNITIES THROUGHOUT WISCONSIN. ONE OF THESE EFFORTS ALSO INCLUDES SOME LOBBYING ON THE PART OF THE MEMBER ORGANIZATIONS. THE WHA, AHA, AND RWHC DETERMINED THAT APPROXIMATELY $5,612 OF THE FEES PAID BY UPLAND HILLS HEALTH, INC. IN FY 2024 RELATED TO LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE HEALTHCARE ENVIRONMENT IN THE STATE OF WISCONSIN. 0 0 207444 25284 25284 207444 253649 9164 55369 207444 268756 -15107 253649 269943 1751 -2938 268756 265834 4109 269943 0.00000 1.00000 0.00000 0 1 1 2150907 2150907 90759399 43171482 47587917 33577416 23782187 9795229 10186855 10186855 69720908 DEFERRED COMPENSATION PLAN ASSETS 1984173 BOARD-DESIGNATED FOR CAPITAL IMPROVEMENTS 80149494 STATE OF WI UNEMPLOYMENT FUNDING 448000 82581667 DEFERRED COMPENSATION PLAN LIABILITY 1984173 AMOUNTS RECEIVABLE FROM THIRD PARTY REIMBURSEMENT PROGRAMS 605954 2590127 PART V, LINE 4: UPLAND HILLS HEALTH, INC.'S ENDOWMENT CONSISTS OF TWO FUNDS HELD BY UPLAND HILLS HEALTH FOUNDATION, INC. THESE FUNDS WERE ESTABLISHED TO PROVIDE INCOME FOR THE FOUNDATION TO HELP SUPPORT SPECIFIC PROGRAMS OF UPLAND HILLS HEALTH, INC. 1 1 X 1 X 1 X 1 1 0 1 1 577019 577019 0.00610 9077797 5310637 3767160 0.03970 9654816 5310637 4344179 0.04580 16202 16202 0.00020 8233674 5663147 2570527 0.02710 94415 94415 0.00100 8344291 5663147 2681144 0.02830 17999107 10973784 7025323 0.07410 0 319784 159892 31180176 30608136 572040 X 1 1 1 1 UPLAND HILLS HEALTH INC 800 COMPASSION WAY DODGEVILLE WI 53533 WWW.UPLANDHILLSHEALTH.ORG 1056 X X X X UPLAND HILLS HEALTH INC 1 0 0 1 X X X X X X X X X 21 1 0 1 1 X SEE SUPPLEMENTAL INFORMATION X 1 21 1 SEE SUPPLEMENTAL INFORMATION 0 1 X 200.000000000000 400.000000000000 X X X X X X 1 1 X X X 1 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X SEE PART V, PAGE 8 X X X X X X X 1 X 0 X X X X 1 X 0 0 UPLAND HILLS HEALTH, INC. PART V, SECTION B, LINE 5: DUE TO THE COVID-19 PANDEMIC, IN-PERSON COMMUNITY FORUMS WERE NOT POSSIBLE, SO UPLAND HILLS HEALTH LED VIRTUAL TOWN HALL MEETINGS IN MAY & JUNE 2022. FORUMS THAT WERE A COMPONENT OF A REGULARLY SCHEDULED MEETING OF A COMMUNITY GROUP (E.G., LIONS CLUB) WERE WELL ATTENDED, WHILE VIRTUAL TOWN HALL FORUMS THAT WERE NOT A PART OF AN OTHER SCHEDULED COMMUNITY GATHERING WERE NOT AS WELL ATTENDED. IN JULY 2022, THE CHNA PARTNERS DEVELOPED AND CONDUCTED A SURVEY OF RESIDENTS THROUGHOUT THE UPLAND HILLS HEALTH SERVICE AREA. THE SURVEY WAS AVAILABLE ELECTRONICALLY ON THE UPLAND HILLS HEALTH WEBSITE, AS WELL AS GOVERNMENTAL, SCHOOL DISTRICT, PUBLIC HEALTH AND SOCIAL MEDIA APPLICATIONS. UPLAND HILLS HEALTH, INC. PART V, SECTION B, LINE 6B: COMMUNITY CONNECTIONS FREE CLINIC, SOUTHWESTERN WISCONSIN COMMUNITY ACTION PROGRAM, IOWA COUNTY HEALTH DEPARTMENT, AND AGING & DISABILITY RESOURCE CENTER OF SOUTHWEST WISCONSIN UPLAND HILLS HEALTH, INC. PART V, SECTION B, LINE 7D: PART V, LINE 7A:HTTPS://WWW.UPLANDHILLSHEALTH.ORG/ABOUT-US/PART V, LINE 10A:HTTPS://WWW.UPLANDHILLSHEALTH.ORG/ABOUT-US/ UPLAND HILLS HEALTH, INC. PART V, SECTION B, LINE 11: IDENTIFIED NEEDS WERE PRIORITIZED BASED ON THE LEVEL OF IMPORTANCE TO COMMUNITY MEMBERS AND THE HOSPITAL AND ITS PARTNERS' ABILITIES TO MAKE A SIGNIFICANT IMPACT. WE ALSO COMPARED OUR PRIORITIES TO THOSE THAT WERE ESTABLISHED BY THE IOWA COUNTY HEALTH DEPARTMENT, THE AGING AND DISABILITY RESOURCE CENTER (ADRC), AND SOUTHWESTERN WISCONSIN COMMUNITY ACTION PROGRAM, TO ENSURE THAT NEEDED SYNERGY WOULD BE MAXIMIZED. THE PRIORITIES WE WILL ADDRESS OVER THE THREE YEARS OF THE CHNA INVOLVE THE FOLLOWING ACTION PLAN ITEMS IDENTIFIED IN THE CHNA IMPLEMENTATION STRATEGY: 1. MENTAL HEALTH AND ALCOHOL/ CHEMICAL DEPENDENCY; 2. ACCESS TO TRANSPORTATION; 3. HEALTHY EATING/ WEIGHT LOSS AND EXERCISE (HEALTHY LIVING); 4. AGING CONCERNS. UPLAND HILLS HEALTH, INC. PART V, SECTION B, LINE 13B: PROPENSITY TO PAY UPLAND HILLS HEALTH, INC. PART V, SECTION B, LINE 16J: EACH APPLICABLE ADMISSION AREA HAS A POLICY AVAILABLE FOR THE PATIENT AS NEEDED AND UPON REQUEST. PART V, SECTION B, LINES 16A - 16C: PART V, LINE 16A, FAP: HTTPS://WWW.UPLANDHILLSHEALTH.ORG/WP-CONTENT/UPLOADS/2023/12/FINANCIAL-ASSISTANCE-POLICY-FINAL-10.1.23-ENGLISH.PDFPART V, LINE 16B FAP APPLICATION:HTTPS://WWW.UPLANDHILLSHEALTH.ORG/WP-CONTENT/UPLOADS/2023/12/UC-APPLICATION-FINAL-FOR-FILLABLE-PDF-10.1.23-FAA-ENGLISH.PDFPART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY:HTTPS://WWW.UPLANDHILLSHEALTH.ORG/WP-CONTENT/UPLOADS/2023/12/FINANCIAL-ASSISTANCE-POLICY-SUMMARY-FINAL-10.1.23.PDF 13 1 - UPLAND HILLS HEALTH SPECIALTY CLINIC 800 COMPASSION WAY DODGEVILLE WI 53533 OUTPATIENT CLINIC 2 - UPLAND HILLS NURSING AND REHAB CENTER 800 COMPASSION WAY DODGEVILLE WI 53533 SKILLED NURSING FACILITY 3 - UPLAND HILLS HEALTH INC 218 E SWAYNE STREET SUITE 100 DODGEVILLE WI 53533 HOME HEALTH AND HOSPICE 4 - MINERAL POINT MEDICAL CENTER OF UPLAND HIL 1050 BRANGER DRIVE MINERAL POINT WI 53565 OUTPATIENT CLINIC 5 - DODGEVILLE MEDICAL CENTER OF UPLAND HILLS 1204 JOSEPH STREET DODGEVILLE WI 53533 OUTPATIENT CLINIC 6 - UPLAND HILLS HEALTH - BARNEVELD 103 QUAIL RIDGE DRIVE BARNEVELD WI 53507 OUTPATIENT CLINIC 7 - CRESTRIDGE ASSISTED LIVING 219 E GRACE STREET DODGEVILLE WI 53533 ASSISTED LIVING/MEMORY CARE FACILITY 8 - UPLAND HILLS HEALTH - MINERAL POINT THERAP 1050 BRANGER DRIVE MINERAL POINT WI 53565 OUTPATIENT CLINIC 9 - UPLAND HILLS HEALTH - MONTFORT 202 W US HIGHWAY 18 MONTFORT WI 53569 OUTPATIENT CLINIC 10 - UPLAND HILLS HEALTH - MOUNT HOREB 1809 SPRINGDALE STREET MOUNT HOREB WI 53572 OUTPATIENT CLINIC 11 - UPLAND HILLS HEALTH - SPRING GREEN 156 W JEFFERSON ST SPRING GREEN WI 53588 OUTPATIENT CLINIC 12 - UPLAND HILLS HEALTH - HIGHLAND 723 N MAIN STREET HIGHLAND WI 53543 OUTPATIENT CLINIC 13 - MOUNT HOREB THERAPY & WELLNESS CENTER 1883 SPRINGDALE STREET MOUNT HOREB WI 53572 OUTPATIENT CLINIC PART I, LINE 7: THE COSTING METHOD USED ON FORM 990 IS BASED ON A COST-TO-CHARGE RATIO WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBT DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST VARIOUS REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER IRS SUGGESTED COSTING METHODS FOR THE FORM 990. PART I, LINE 7G: WOMEN'S AND CHILDREN'S SERVICES (EXP. $2,199,911 WITH OFFSETTING REVENUE OF $986,786) AND CONTINUING CARE (EXP. $6,033,763 WITH OFFSETTING REVENUE OF $4,676,361). PART II, COMMUNITY BUILDING ACTIVITIES: UPLAND HILLS HEALTH HOSPITAL, LIKE MOST RURAL HOSPITALS, WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE LOCAL ACCESS TO MANY HEALTH SERVICES: BIRTHING CENTER, DIAGNOSTICS, EMERGENCY SERVICES AND URGENT CARE, HOME CARE, HOSPICE, INFUSION SERVICES, INPATIENT CARE, LABORATORY SERVICES, OCCUPATIONAL HEALTH, REHABILITATION SERVICES, SPECIALTY MEDICINE, SPEECH AND AUDIOLOGY, SURGICAL SERVICES, BEHAVIOR HEALTH, DME, AND WOMEN'S HEALTH. PART III, LINE 2: THE AMOUNT IS CALCULATED BY MULTIPLYING THE TOTAL CHARGES FOR SERVICES WRITTEN OFF AS BAD DEBT BY THE COST-TO-CHARGE RATIO. 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 DO NOT COMPLETE REQUIRED CHARITY CARE APPLICATIONS AND ARE TRANSFERRED TO COLLECTION SERVICES EVEN THOUGH THE HOSPITAL PROVIDES THIS INFORMATION TO ALL PATIENTS AND AIDS WITH THE APPLICATION. DUE TO NO RESPONSES FROM SOME PATIENTS A SIGNIFICANT AMOUNT OF BAD DEBTS COULD BE CONSIDERED AS CHARITY CARE AND THE HOSPITAL HAS REFLECTED AN AMOUNT OF THESE ADDITIONAL BAD DEBTS IN PART III OF SCHEDULE H OF FORM 990. PART III, LINE 4: IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE UPLAND HILLS HEALTH, INC. ANALYZES PAST RESULTS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF PATIENT REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. SPECIFICALLY, FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, UPLAND HILLS HEALTH, INC. ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS 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 DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), UPLAND HILLS HEALTH, INC. 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 UNCOLLECTIBLE ACCOUNTS. THE AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A SEPARATE FOOTNOTE REGARDING BAD DEBT EXPENSE. PART III, LINE 8: THE TOTAL MEDICARE REVENUE SHOWN IN SCHEDULE H OF FORM 990 IS BASED ON THE IRS 990 INSTRUCTIONS AND INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE OF THE HOSPITAL, AND ALSO DOES NOT CONSIDER ALL CONTRACTUAL ADJUSTMENTS FOR SERVICES REIMBURSED BY THE MEDICARE PROGRAM. AMOUNTS LISTED FOR MEDICARE REVENUES DO NOT INCLUDE PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT AT THE HOSPITAL AS WELL AS ANESTHESIA PROFESSIONAL SERVICES, CLINICAL PHYSICIAN PROFESSIONAL SERVICES, SURGEON PROFESSIONAL SERVICES, OUTPATIENT PHYSICAL THERAPY SERVICES PROVIDED TO NURSING HOME RESIDENTS, AND REVENUES FOR ANY PATIENTS COVERED UNDER MEDICARE ADVANTAGE PLAN PROGRAMS. PHYSICIAN PROFESSIONAL SERVICES ARE REIMBURSED PRIMARILY ON FEE SCHEDULE REIMBURSEMENTS AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY, SURGERY, AND CLINICAL PHYSICIAN SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND AS SUCH THESE COSTS AND SHORTFALLS SHOULD ALSO BE CONSIDERED AS AN ADDITIONAL BENEFIT THAT UPLAND HILLS HEALTH, INC. PROVIDES TO THE COMMUNITY AND SURROUNDING AREAS. THE COSTING METHOD USED ABOVE FOR IRS FORM 990 COMPLIANCE REPORTING IS ALSO BASED ON THE FILED MEDICARE COST REPORT FOR THE YEAR ENDED SEPTEMBER 30, 2024, AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES, AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICE REVENUES (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE).WHETHER THERE IS A SHORTFALL OR SURPLUS ON SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THESE PEOPLE, WHICH ARE TYPICALLY ELDERLY OR DISABLED MEMBERS OF THE COMMUNITY, ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE PATIENT SERVICES, THE CENTERS FOR MEDICARE AND MEDICAID (CMS) WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY. PART III, LINE 9B: UNDER THE HOSPITAL'S COLLECTION AND CHARITY CARE POLICIES, UPLAND HILLS HEALTH, INC. MAKES EVERY ATTEMPT TO IDENTIFY AND PROMOTE CHARITY CARE TO PATIENTS. INCLUDED IN THE HOSPITAL'S CHARITY 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 PATIENT FINANCIAL COUNSELOR OR SOCIAL WORKERS TO ALLOW THESE PATIENTS THE ABILITY TO COMPLETE THEIR APPLICATION DURING THEIR STAY AT THE HOSPITAL, DEPENDING UPON THE PATIENT'S CONDITION, OR 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 POLICIES AS WELL AS THE CHARITY CARE PROGRAM TO ALLOW PATIENTS THE OPPORTUNITY TO COMPLETE THE APPROPRIATE FORMS AND QUALIFY UNDER THE PROGRAM. PART VI, LINE 2: UPLAND HILLS HEALTH, INC. ASSESSES THE HEALTHCARE NEEDS OF THE COMMUNITIES AND AREAS IT SERVES BY REVIEWING LOCAL DEMOGRAPHICS AND TRENDS IN PATIENT SERVICE UTILIZATION TO DETERMINE WHICH SERVICES COULD AND SHOULD BE MADE AVAILABLE TO THE COMMUNITY IN A COST-EFFECTIVE MANNER CONSISTENT WITH THE HOSPITAL'S MISSION IN THE COMMUNITY. UPLAND HILLS HEALTH, INC. ALSO REVIEWS STATISTICS IN THE HOSPITAL, NURSING HOME, CLINICS, HOME HEALTH, HOSPICE, AND OTHER ORGANIZATIONAL DEPARTMENTS TO EVALUATE THE CURRENT SERVICES BEING OFFERED AND ENSURE THAT RESOURCES ARE BEING APPROPRIATELY ALLOCATED TO AREAS IN NEED BY COMMUNITY MEMBERS, PROVIDERS, AND PATIENTS. THE ORGANIZATION ALSO MEETS WITH LOCAL COMMUNITY MEMBERS AND ITS PHYSICIAN GROUP TO DETERMINE WHICH SERVICES MAY BENEFIT THE COMMUNITY.DURING FISCAL YEAR 2022 UPLAND HILLS HEALTH, INC. COMPLETED A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TO BETTER UNDERSTAND THE HEALTH NEEDS OF THE COMMUNITY AND TO DEVELOP AN EFFECTIVE IMPLEMENTATION STRATEGY TO ADDRESS PRIORITY NEEDS. DURING THE FISCAL YEAR, EFFORTS HAVE BEEN MADE TO FOCUS ON THE ISSUES THAT WERE IDENTIFIED IN THE CHNA. PART VI, LINE 3: UNINSURED AND UNDER INSURED PATIENTS ARE ASKED TO MEET WITH ONE OF THE HOSPITAL'S FINANCIAL COUNSELORS EITHER AT THE TIME SERVICE IS PROVIDED OR WHEN THE PATIENT'S BILL IS GENERATED. THE FINANCIAL COUNSELOR EXPLAINS THE VARIOUS PAYMENT OPTIONS AVAILABLE TO THE PATIENT AS WELL AS THE HOSPITAL'S CHARITY CARE PROGRAM AND OFFERS THE CHARITY CARE APPLICATION WHEN APPROPRIATE. IF OTHER PROGRAMS ARE AVAILABLE TO THE PATIENT, SUCH AS THE WISCONSIN MEDICAID OR BADGER CARE PROGRAMS, THESE PATIENTS ARE REFERRED TO THE APPROPRIATE GOVERNMENT AGENCY FOR FURTHER ASSISTANCE. PART VI, LINE 4: THE PRIMARY SERVICE AREA FOR UPLAND HILLS HEALTH, INC. ENCOMPASSES ALL PERSONS LIVING WITHIN A 20 TO 30 MILE RADIUS OF THE HOSPITAL. COMMUNITIES IN THIS AREA INCLUDE DODGEVILLE, MONTFORT, HIGHLAND, COBB, EDMUND, RIDGEWAY, LINDEN, SPRING GREEN, BARNEVELD, LIVINGSTON, AND MINERAL POINT, WISCONSIN, AMONG MANY OTHERS. UPLAND HILLS HEALTH, INC. IS THE ONLY HOSPITAL LOCATED IN IOWA COUNTY, WISCONSIN. THE HOSPITAL PROVIDES A SIGNIFICANT PORTION OF ITS PATIENT SERVICES TO BENEFICIARIES OF THE MEDICARE AND MEDICAID PROGRAMS, ESPECIALLY THOSE BENEFICIARIES WHO RESIDE IN THE HOSPITAL'S LONG-TERM CARE FACILITY, OR PATIENTS WHO RECEIVE HOME HEALTH, OR HOSPICE SERVICES FROM UPLAND HILLS HEALTH, INC. IN 2024, THESE MEDICARE AND MEDICAID PATIENTS ACCOUNTED FOR APPROXIMATELY 62 PERCENT OF PATIENT SERVICE REVENUE AT THE HOSPITAL DURING THE YEAR. PART VI, LINE 5: UPLAND HILLS HEALTH, INC. FURTHERS ITS EXEMPT PURPOSE OF PROMOTING THE HEALTH OF THE COMMUNITY IN MANY WAYS, EXAMPLES OF WHICH INCLUDE THE OVERSIGHT BY A COMMUNITY BOARD, THE SPONSORSHIP OF HEALTH EVENTS, THE ESTABLISHMENT OF A SCHOLARSHIP PROGRAM FOR LOCAL STUDENTS SEEKING DEGREES IN HEALTH-RELATED PROFESSIONS, AND PROVISION OF SERVICES FREE OF CHARGE FOR PATIENTS OF THE COMMUNITY CONNECTIONS FREE CLINIC. IN 2024, THE HOSPITAL PROVIDED FREE LAB AND IMAGING SERVICES TO FREE CLINIC WHICH TOTALED $63,406 OF INTERNAL EXPENSES. PART VI, LINE 6: UPLAND HILLS HEALTH, INC. MAINTAINS AN AFFILIATION AGREEMENT WITH SSM HEALTHCARE OF WISCONSIN, INC. SSM HEALTHCARE OF WISCONSIN, INC. OPERATES ST. MARY'S HOSPITAL IN MADISON, WISCONSIN AS WELL AS BEING AFFILIATED WITH OTHER AREA COMMUNITY HOSPITALS LOCATED NEAR MADISON, WISCONSIN. ST. MARY'S AND THE SSM HEALTHCARE SYSTEM ARE A MULTI-SPECIALTY HEALTH SYSTEM. UPLAND HILLS HEALTH INC. COLLABORATES WITH SSM HEALTHCARE TO PROMOTE HEALTH AND WELLNESS INITIATIVES IN THE COMMUNITIES SERVED AND THE REGION. AS NOTED PREVIOUSLY IN THE FORM 990, TWO REPRESENTATIVES FROM THE SSM HEALTHCARE ORGANIZATION HOLD SEATS ON THE BOARD OF TRUSTEES OF UPLAND HILLS HEALTH, INC. THE AFFILIATION HELPS ENHANCE ACCESSIBILITY OF HEALTH CARE SERVICES OFFERED AT UPLAND HILLS HEALTH, INC. AND MAKES AVAILABLE ADDITIONAL EXPERTISE AND SERVICES, WHEN NEEDED, TO PROVIDE ACCESS TO EXPANDED SERVICES FOR AREA RESIDENTS. PART VI, LINE 7, REPORTS FILED WITH STATES WI X X X 0 0 0 0 0 0 0 0 0 ANTHONY VILLARE PHYSICIAN 626321 0 0 0 1806 0 13200 0 33673 0 675000 0 0 0 JARED LINEBARGER PHYSICIAN 455663 0 0 0 630 0 11250 0 34723 0 502266 0 0 0 PATRICK RYBERG PHYSICIAN 453648 0 0 0 420 0 11250 0 31923 0 497241 0 0 0 TIMOTHY RAICHLE PHYSICIAN 444923 0 0 0 1806 0 13200 0 31923 0 491852 0 0 0 JENIFER DANKYI PHYSICIAN 420573 0 0 0 378 0 11250 0 38183 0 470384 0 0 0 LISA SCHNEDLER PRESIDENT AND CEO 398342 0 0 0 2772 0 13449 0 14369 0 428932 0 0 0 ARTHUR KARL PUSTINA VP OF OPERATIONS 252370 0 0 0 5334 0 10549 0 25110 0 293363 0 0 0 DANIELLE MOYER VP OF FINANCE 112675 0 0 0 163 0 4774 0 36445 0 154057 0 0 0 A WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 2017-12-22 18781216 REFUNDING OF 2006 BONDS 0 0 0 A 7440955 18781216 236471 18544445 300 2018 1 0 1 1 A 0 0 0 0 0 0 1 A 0 0 0 1 0 0 0 0 1 A 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 12/01/2022 FORM 990, PART I, LINE 1 (CONTINUATION): QUALITY CARE YOU CAN TRUST - FOR OVER 100 YEARS, UPLAND HILLS HEALTH HAS BEEN DEDICATED TO THE PROMISE OF OFFERING THE HIGHEST STANDARD OF HEALTHCARE. OUR COMMUNITY-MINDED STAFF PLACES EMPHASIS ON PROVIDING QUALITY, COMPREHENSIVE HEALTHCARE, WHILE OFFERING A COMFORTABLE, NEIGHBORLY WELCOME TO EVERYONE WHO WALKS THROUGH OUR DOORS. HERE, NEIGHBORS CARE FOR NEIGHBORS AND FAMILY IS THE CENTER OF LIFE. PATIENT-FIRST CARE - EVERY PATIENT. EVERY TIME. THIS IS OUR COMMITMENT. WE ARE COMMITTED TO PROVIDING THE SAFEST AND BEST POSSIBLE EXPERIENCE FOR EVERY PATIENT THAT ENTERS OUR CLINICS, OUR HOSPITAL, OUR NURSING AND REHAB CENTER, OUR MEDICAL EQUIPMENT STORE, OR WHO INVITES US INTO THEIR HOME THROUGH HOME CARE OR HOSPICE SERVICES. OUR ORGANIZATIONAL VALUES REFLECT THIS COMMITMENT: SENSIBLE APPROACH DECISIONS IN A PRACTICAL WAY, GUIDED BY COMMON SENSE. HOLISTIC FOCUS ON THE PATIENT AS A WHOLE PERSON AND NOT A SET OF SYMPTOMS. AFFORDABLE BRING CARE TO ALL WHO NEED IT. RESPECTFUL TREAT ALL AS WE'D WANT TO BE TREATED. INSPIRATIONAL BE THE STANDARD OF COMMUNITY HEALTH AND WELLNESS. NURTURING PROVIDE MEDICAL CARE WITH SUPPORT AND ENCOURAGEMENT. GENUINE SHOW HONEST CONCERN FOR THOSE WE SERVE AND PASSION FOR WHAT WE DO. HEALTHCARE THAT EXCEEDS EXPECTATIONS FORM 990, PART VI, SECTION A, LINE 4 IN APRIL 2024, THE BOARD APPROVED AN AMENDMENT TO THE BYLAWS OF UPLAND HILLS HEALTH, INC. TO INCREASE THE NUMBER OF DIRECTORS FROM 10 TO 11 (ARTICLE 12, SECTION 12.1). THE BOARD ALSO MODIFIED SECTION 2.3 AND 2.6 IN REGARD TO BOARD VACANCIES PURSUANT TO APPOINTED TRUSTEES OF SSMHC/WI. FORM 990, PART VI, SECTION A, LINE 6 SSM HEALTHCARE OF WISCONSIN, INC., UNDER THE TERMS OF THE AFFILIATION AGREEMENT DATED SEPTEMBER 21, 2011, HOLDS A 17.39% EQUITY INTEREST IN UPLAND HILLS HEALTH, INC. FORM 990, PART VI, SECTION A, LINE 7A SSM HEALTHCARE OF WISCONSIN, INC. CAN APPOINT TWO MEMBERS TO THE UPLAND HILLS HEALTH, INC. BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING DECISIONS BY THE BOARD SHALL REQUIRE BOTH THE APPROVING VOTE OF A MAJORITY OF THE ENTIRE BOARD AND THE APPROVAL OF SSM HEALTHCARE OF WISCONSIN, INC.: (I) APPROVAL OF ANY AMENDMENT OR RESTATEMENT AFFECTING ARTICLE TWELVE OF THE ARTICLES OF INCORPORATION. (II) APPROVAL OF ANY AMENDMENT OR RESTATEMENT AFFECTING SECTION 1.5 SECTION 2.2, SECTION 2.6, SECTION 3.7, SECTION 5.2, OR ARTICLE X OF THE CORPORATE BYLAWS OF UPLAND HILLS HEALTH, INC. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE CEO AND VICE PRESIDENT OF FINANCE PRIOR TO FILING. THE BOARD DOES RECEIVE A COPY OF THE FORM 990 AFTER FILING WITH AN OPPORTUNITY TO REVIEW AND ASK QUESTIONS. FORM 990, PART VI, SECTION B, LINE 12C UPLAND HILLS HEALTH INC. REQUIRES ALL OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES TO COMPLETE AN ANNUAL DISCLOSURE STATEMENT. THESE STATEMENTS ARE THEN REVIEWED BY THE BOARD OF DIRECTORS, NOTING ANY RELATIONSHIPS THAT COULD POTENTIALLY CREATE A CONFLICT OF INTEREST. IF BOARD MEMBERS HAVE CONFLICTS THAT ARE NOTED, THESE MEMBERS ARE ASKED TO ABSTAIN FROM VOTING ON THOSE MATTERS. CONFLICTS NOTED BY EMPLOYEES ARE REVIEWED BY THE BOARD OF DIRECTORS TO ENSURE THAT ALL TRANSACTIONS ARE CONDUCTED AT ARM'S LENGTH. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS HAS AN ESTABLISHED PROCESS TO REVIEW THE COMPENSATION OF OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, AND HIGHLY COMPENSATED EMPLOYEES AND TO DEFINE COMPENSATION PRACTICES. COMPARATIVE DATA FROM WAGE SURVEYS, AREA LABOR ADJUSTMENTS, AND MARKET RATES IN OTHER AREA FACILITIES ARE USED IN DETERMINING COMPENSATION. THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS AND APPROVES ANY EXCEPTIONS TO ACROSS-THE-BOARD RAISES AND STANDARD NEW HIRE WAGES. DURING THE REVIEW PROCESS, DECISIONS AFFECTING COMPENSATION AND CONTRACTS ARE ONLY REVIEWED AND APPROVED BY INDIVIDUALS WHO DO NOT HAVE NOTED CONFLICTS. THE DECISIONS AND DELIBERATION ARE ALSO DOCUMENTED FOR KEY EMPLOYEES AND EXECUTIVES (WHICH MAINLY INCLUDE THE HIGHLY COMPENSATED EMPLOYEES OF THE ORGANIZATION) IN THE MINUTES OF THE BOARD OF DIRECTORS UPON APPROVAL BY THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 UPLAND HILLS HEALTH, INC. MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT ITS BUSINESS LOCATION DURING NORMAL BUSINESS HOURS. FORM 990, PART IX, LINE 11G IMAGING SERVICES: PROGRAM SERVICE EXPENSES 3,043,678. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,043,678. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 5,403,395. MANAGEMENT AND GENERAL EXPENSES 1,078,187. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,481,582. ER SERVICES: PROGRAM SERVICE EXPENSES 3,045,620. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,045,620. LAB SERVICES: PROGRAM SERVICE EXPENSES 621,600. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 621,600. FORM 990, PART XI, LINE 9: INTER-AFFILIATE TRANSFERS -126,770. UPLAND HILLS HEALTH HOLDINGS LLC 800 COMPASSION WAY DODGEVILLE WI 53533 800809494 PATNERSHIP FOR DURABLE MEDICAL EQUIPMENT PROVIDED TO PATIENTS WI 4975515 1557698 UPLAND HILLS HEALTH INC CRESTRIDGE ASSISTED LIVING LLC 1402 PANKRANTZ STREET SUITE 110 MADISON WI 53704 391913656 ASSISTED LIVING WI 3289676 4707875 UPLAND HILLS HEALTH INC UPLAND HILLS HEALTH FOUNDATION INC 800 COMPASSION WAY DODGEVILLE WI 53533 260596045 FOUNDATION TO PROVIDE CONTRIBUTIONS & SUPPORT FOR UPLAND HILLS HEALTH, INC. WI 501(C)(3) LINE 7 UPLAND HILLS HEALTH INC 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0