2025-11-13T17:15:54-06:00 2024-12-31 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2024-01-01 391834962 GRANT REGIONAL HEALTH CENTER INC GRAN 6087232143 507 SOUTH MONROE STREET LANCASTER WI 53813 JOEL GEHLING CFO 6087232143 2025-09-23 1 1 MICHAEL J PETERSON CPA P01833529 2187224705 2025-09-23 2024 2025-03-06 01:10:19Z JOEL GEHLING 507 SOUTH MONROE STREET LANCASTER WI 53813 67901770 0 X WWW.GRANTREGIONAL.COM X 1955 WI WE ARE THE REGION'S FIRST CHOICE FOR EXCEPTIONAL HEALTHCARE SERVICES. 9 8 353 90 251632 31092 629305 1120178 49974485 52519697 619603 1129641 6676 15711 51230069 54785227 41000 40500 0 0 28377279 30858609 0 0 0 20626735 21202487 49045014 52101596 2185055 2683631 78164623 78987358 35969572 34028668 42195051 44958690 X TOGETHER WE ARE DEDICATED TO IMPROVE THE HEALTH AND WELLNESS OF ALL GENERATIONS THROUGH HIGH QUALITY, COMPASSIONATE, AND PATIENT-CENTERED CARE. 1 1 42403411 40500 52079365 GRANT REGIONAL HEALTH CENTER, INC. ("GRANT REGIONAL") PROVIDES HEALTH CARE SERVICES AND OTHER SUPPORT THROUGH VARIOUS PROGRAMS THAT ARE DESIGNED, AMONG OTHER MATTERS, TO ENHANCE THE HEALTH OF THE COMMUNITY, INCLUDING THE HEALTH OF LOW-INCOME PATIENTS. THE ORGANIZATION OPERATES A CRITICAL ACCESS HOSPITAL WHICH PROVIDES INPATIENT ACUTE CARE AND SWING BED SERVICES; ALONG WITH AN EMERGENCY DEPARTMENT, WHICH IS OPEN TWENTY-FOUR HOURS PER DAY; AND OTHER OUTPATIENT SERVICES. AMONG THE SERVICES PROVIDED ARE DIAGNOSTIC CARE INCLUDING LABORATORY AND RADIOLOGY SERVICES, OBSTETRICS, REHABILITATION, SURGICAL SERVICES, AND WALK-IN CARE. GRANT REGIONAL ALSO HAS RELATIONSHIPS WITH REGIONAL CENTERS IN MADISON, WISCONSIN AND DUBUQUE, IOWA WHO COME TO THE FACILITY ON A REGULAR BASIS TO PROVIDE SPECIALTY SERVICES. GRANT REGIONAL'S LOCAL AND CONTRACTED SPECIALTY SERVICES INCLUDE, BUT ARE NOT LIMITED TO: AUDIOLOGY, OPHTHALMOLOGY, ORTHOPEDICS, ENT, AND NEUROLOGY. DURING 2024, GRANT REGIONAL HAD 882 ROUTINE MED/SURG PATIENT DAYS, 1,190 SWING BED DAYS, 227 NURSERY DAYS, 273 OBSTETRIC DAYS, AND 35 DAYS OF ROUTINE HOSPICE CARE FOR INPATIENT CARE AND PROVIDED 8,643 VISITS TO PATIENTS NEEDING EMERGENCY OR URGENT CARE IN THE EMERGENCY DEPARTMENT. IN ADDITION TO THE FAMILY PRACTICE CLINIC IN LANCASTER, GRANT REGIONAL ALSO OPERATES THREE SATELLITE CLINICS IN POTOSI, FENNIMORE, AND CASSVILLE. OUR FOUR HOMETOWN CLINICS PROVIDE IMPORTANT HEALTHCARE SERVICES FOR SURROUNDING COMMUNITIES. THE CLOSE PROXIMITY HELPS THOSE WHO HAVE DIFFICULTY WITH TRANSPORTATION GET THE IMPORTANT HEALTH CARE THEY REQUIRE WITH LESS TRAVEL.CONSISTENT WITH THE MISSION OF GRANT REGIONAL, CARE IS PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY, INCLUDING PROVIDING SERVICES TO THOSE PERSONS WHO ARE EITHER UNDERINSURED OR CANNOT AFFORD HEALTH INSURANCE BECAUSE OF INADEQUATE RESOURCES. HEALTH CARE SERVICES TO PATIENTS UNDER GOVERNMENT PROGRAMS, SUCH AS MEDICAID HOSPITAL SERVICES, ARE ALSO CONSIDERED PART OF GRANT REGIONAL'S BENEFIT PROVIDED TO THE COMMUNITY, SINCE A SUBSTANTIAL PORTION OF SUCH SERVICES ARE REIMBURSED AT AMOUNTS LESS THAN THE COSTS OF PROVIDING CARE.PATIENTS WHO MEET CERTAIN CRITERIA FOR CHARITY CARE, BASED ON FEDERAL POVERTY GUIDELINES, ARE PROVIDED CARE AT A SIGNIFICANTLY REDUCED RATE, DETERMINED BASED ON QUALIFYING CRITERIA AS DEFINED IN GRANT REGIONAL'S COMMUNITY CARE POLICY, AND FROM APPLICATIONS COMPLETED BY PATIENTS. THE AMOUNT OF CHARGES FOREGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER THIS POLICY FOR 2024 TOTALED APPROXIMATELY $338,000. IN ADDITION, PATIENT CHARGES TO BENEFICIARIES OF THE WISCONSIN MEDICAID PROGRAM WERE REDUCED BY APPROXIMATELY $6,017,000 IN DISCOUNTS IN 2024. (SEE ALSO SCHEDULE H TO THE FORM 990 FOR ADDITIONAL INFORMATION ON THE COST OF PROVIDING THESE MEDICAL SERVICES TO MEMBERS OF THE COMMUNITY.)IN ADDITION TO THE VARIOUS INPATIENT, OUTPATIENT, AND CHARITY CARE SERVICES, GRANT REGIONAL PROVIDED NUMEROUS BENEFITS TO ITS SURROUNDING COMMUNITIES. GRANT REGIONAL PROVIDED EDUCATION ON TOPICS SUCH AS BREASTFEEDING, CANCER, DIABETES, HEART DISEASE, AND WOMEN'S HEALTH. HEALTH SCREENINGS INCLUDING BLOOD PRESSURE, CHOLESTEROL, DIABETES, HEARING, MAMMOGRAPHY, AND WOMEN'S HEALTH WERE ALSO PROVIDED. (SEE ALSO SCHEDULE H TO THE FORM 990 FOR INFORMATION ON THE COST OF PROVIDING THESE SERVICES IN THE COMMUNITY AND SURROUNDING AREAS.)GRANT REGIONAL ALSO PROVIDES ON-THE-JOB EDUCATION TO COLLEGE STUDENTS PURSUING CAREERS IN HEALTH CARE. STUDENTS ARE MENTORED DURING THEIR TIME AT THE FACILITY BY EMPLOYEES OF GRANT REGIONAL AND GRANT REGIONAL PROVIDES PRACTICAL EXPERIENCE THROUGH ITS CARE ENVIRONMENT FOR STUDENTS TO USE THROUGHOUT THEIR FUTURE CAREERS. 42403411 1 1 0 1 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 90 0 353 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 X 9 8 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X JOEL GEHLING 6087232143 507 SOUTH MONROE STREET LANCASTER WI 53813 TOM GILDERSLEEVE CHAIR 1.00 X X 0 0 0 JASON KENNEY VICE-CHAIR 1.00 X X 0 0 0 ANDY BUTTLES SECRETARY 1.00 X X 2250 0 0 ROBERT HOFFMAN SECRETARY (THRU 5/24) 1.00 X X 0 0 0 CRAIG BIERMAN DIRECTOR 0.50 X 2500 0 0 RICH DHYANCHAND DIRECTOR 0.50 X 2500 0 0 JESSICA HERMSEN DIRECTOR 0.50 X 2000 0 0 MARK HOEHNE DIRECTOR (THRU 5/24) 0.50 X 0 0 0 SARAH KIRSCHBAUM DIRECTOR 0.50 X 2250 0 0 DR ERIC STADER DIRECTOR/PHYSICIAN 24.00 X 190000 0 0 KRIS WOLF DIRECTOR 0.50 X 0 0 0 DAVID SMITH PRESIDENT/CEO (THRU 1/24) 40.00 X 0 0 0 JOEL GEHLING CHIEF FINANCIAL OFFICER 40.00 X 210340 0 30154 TAMARA CHAMBERS PRESIDENT/CEO 40.00 X 271539 0 16502 THERESA HOLLINGER CHIEF NURSING OFFICER 40.00 X 130579 0 19184 RADLEY KAMPS CHIEF OPERATING OFFICER 40.00 X 188342 0 11716 DARREN W PERTTU GENERAL SURGEON 40.00 X 825133 0 52309 DALE R CHILSON OTOLARYNGOLOGIST/ENT 40.00 X 786178 0 40677 BRADLEY G BINSFELD ORTHOPEDIC SURGEON 40.00 X 711749 0 31880 KIMBERLY A PERTTU FAMILY PRACTICE PHYSICIAN WITH OB 40.00 X 537370 0 24612 ELI T JAMES FAMILY PRACTICE PHYSICIAN WITHOUT OB 40.00 X 430758 0 55332 4293488 0 282366 45 0 1 0 UNITYPOINT HEALTH PO BOX 83381 CHICAGO IL 606910381 EPIC/REFERENCE LABS 553230 MIDWEST BUILDERS INC 1410 5TH STREET PO BOX 178 FENNIMORE WI 53809 NEW FENNIMORE CLINIC PROJECTS 538257 RURAL WISCONSIN HEALTH COOP 800 INDEPENDENCE LANE SAUK CITY WI 53583 HEALTHCARE SERVICES 457897 SHARED IMAGING SERVICES PO BOX 88450 MILWAUKEE WI 53288 NUCLEAR MEDICINE SERVICES 348353 THE FINLEY HOSPITAL LABORATORY 350 NORTH GRANDVIEW DUBUQUE IA 52001 REFERENCE LABS 334549 21 50368 608305 461505 1120178 NET PATIENT REVENUE 621400 52065556 51917621 147935 DIETARY 621400 161744 161744 THERAPEUTIC SERVICE REVENUE 812900 103697 103697 188700 188700 52519697 718043 718043 71675 42001 29674 29674 29674 13445202 8500 13042104 0 403098 8500 411598 411598 18475 50368 32438 -13963 -13963 54785227 52079365 251632 1334052 30000 30000 10500 10500 889857 11500 878357 23238813 20675341 2563472 877300 734311 142989 4361252 3552563 808689 1491387 1202644 288743 81349 81349 96350 96350 5603 5603 63601 63601 3415230 2763682 651548 259330 31512 227818 694049 413497 280552 1995389 1995389 515029 481372 33657 39923 33633 6290 127991 101493 26498 902419 765876 136543 3596473 3052299 544174 303980 85659 218321 MEDICAL SUPPLIES 6300024 6281702 18322 EQUIPMENT RENTAL AND RE 1169278 1124609 44669 BAD DEBT EXPENSE 854257 854257 SUBSCRIPTIONS AND LICEN 339806 106316 233490 442406 90645 351761 52101596 42403411 9698185 0 243241 244871 16058230 17631250 6232983 8254535 952420 1008999 2203159 1515819 69939278 34762539 37714962 35176739 13625857 14580937 1133771 574208 78164623 78987358 3473687 2976142 60184 113064 32395575 30939462 40126 0 35969572 34028668 X 41928366 44687387 266685 271303 42195051 44958690 78164623 78987358 X 2683631 335335 -255327 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 5603 5603 0 PART II-B, LINE 1: GRANT REGIONAL HEALTH CENTER, INC. PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THESE DUES ARE PRIMARILY TO ACCESS EDUCATIONAL MATERIALS AND FOR STAFF TRAINING. THE WHA HAS NOTIFIED GRANT REGIONAL THAT $2,550 OF THE ANNUAL DUES PAID WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTHCARE ENVIRONMENT. GRANT REGIONAL HEALTH CENTER, INC. IS ALSO A MEMBER OF THE RURAL WISCONSIN HEALTH COOPERATIVE (RWHC). EACH YEAR, GRANT REGIONAL HEALTH CENTER, INC. PAYS MEMBERSHIP FEES TO THE RWHC AND IN RETURN, THE RWHC PROVIDES VARIOUS SERVICES FOR 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. THESE EFFORTS ALSO INCLUDE LOBBYING ON THE PART OF MEMBER ORGANIZATIONS. THE RWHC DETERMINED THAT $2,069 OF THE FEES PAID BY GRANT REGIONAL HEALTH CENTER, INC. DURING 2024 RELATED TO LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE HEALTHCARE ENVIRONMENT IN THE STATE OF WISCONSIN. GRANT REGIONAL HEALTH CENTER, INC. IS ALSO A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION (AHA). THE MEMBERSHIP PROVIDES REAL-TIME HEALTH CARE NEWS, ADVOCACY FOR ISSUES THAT IMPACT CAHS AND RHCS, AND DATA DERIVED FROM AHA SPONSORED SURVEYS. AHA HAS DETERMINED THAT $984 OF THE FEES PAID BY GRANT REGIONAL HEALTH CENTER, INC. DURING 2024 ARE RELATED TO LOBBYING ACTIVITIES. 1 1 2176260 2176260 49450827 21515803 27935024 18240108 13246736 4993372 72083 72083 35176739 53153566 335335 -854257 -518922 53672488 63601 1049138 1112739 54785227 51258177 74439 74439 51183738 63601 854257 917858 52101596 PART XI, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT EXPENSE -854,257. PART XI, LINE 4B - OTHER ADJUSTMENTS: CONTRIBUTIONS TO RESTRICTED NET ASSETS 259,945. RENTAL EXPENSES NET AGAINST RENTAL INCOME -42,001. FUNDRAISING EXPENSES -32,438. NET ASSETS RELEASED FROM RESTRICTIONS 255,327. GRANTS RECEIVED FOR PPE PURCHASES 608,305. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES NET AGAINST RENTAL INCOME 42,001. FUNDRAISING EXPENSES 32,438. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 854,257. GOLF OUTING 30942 25742 5200 5893 4274 1349 1625 WINTER SPECTACULAR 37901 24626 13275 1470 7339 6292 4196 68843 50368 18475 7363 4274 8688 6292 5821 32438 -13963 1 1 X 1 X 1 X 1 1 1 0 1 1 180822 180822 0.00350 4607557 1101905 3505652 0.06840 4788379 1101905 3686474 0.07190 245866 57117 188749 0.00370 916933 2700 914233 0.01780 7750975 2457059 5293916 0.10330 58214 58214 0.00110 8971988 2516876 6455112 0.12590 13760367 3618781 10141586 0.19780 6022 6022 0.00010 55666 55666 0.00110 18700 18700 0.00040 249 249 0.00000 76540 76540 0.00150 45309 45309 0.00090 202486 202486 0.00400 0 456368 0 15666812 15725478 -58666 X 1 1 1 1 GRANT REGIONAL HEALTH CENTER INC 507 SOUTH MONROE STREET LANCASTER WI 53813 WWW.GRANTREGIONAL.COM 1025 X X X X PROVIDER-BASED RURAL HEALTH CLINIC GRANT REGIONAL HEALTH CENTER INC 1 0 0 1 X X X X X X X X X 24 1 1 1 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 300.000000000000 X X X X X X 1 1 X X X X 1 X HTTPS://WWW.GRANTREGIONAL.COM/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE/ X HTTPS://WWW.GRANTREGIONAL.COM/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE/ X HTTPS://WWW.GRANTREGIONAL.COM/PATIENTS-AND-VISITORS/FINANCIAL-ASSISTANCE/ X X X X X X X 1 X 0 X X X X 1 X 0 0 GRANT REGIONAL HEALTH CENTER, INC. PART V, SECTION B, LINE 5: THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) ENGAGED DIFFERENT SECTORS OF THE COMMUNITY AT VARIOUS LEVELS OF PARTICIPATION. COMMUNITY PARTICIPANTS WERE DEFINED AS KEY PARTNERS, STAKEHOLDERS, OR GENERAL COMMUNITY. DEFINITIONS AND PARTICIPATION LEVELS ARE DESCRIBED AS FOLLOWS:1. KEY PARTNERS AREA HOSPITALS AND COUNTY PUBLIC HEALTH DEPARTMENTS: THIS GROUP MET REGULARLY TO CONDUCT THE CHNA. TASKS REQUIRED OF THIS GROUP INCLUDED IDENTIFYING PROCESSES, CREATING SURVEYS, IDENTIFYING TARGET AUDIENCES FOR PARTICIPATION IN THE SURVEYS, ASSEMBLING AND REVIEWING RESULTS OF DATA, IDENTIFYING COMMUNITIES FOR FOCUS GROUPS, AND CONDUCTING FOCUS GROUPS. 2. STAKEHOLDERS: INDIVIDUALS WITH A VESTED INTEREST IN THE COMMUNITY, AND INDIVIDUALS WHO REPRESENT A LARGER DEMOGRAPHIC (I.E.: SOCIAL WORKERS, FREE CLINIC WORKERS, SCHOOL PRINCIPALS, GOVERNMENT OFFICIALS). PARTICIPANTS WERE ASKED TO IDENTIFY THE SECTOR OR SECTORS OF THE POPULATION THEY REPRESENTED, INCLUDING: BUSINESS, HEALTH CARE, FAITH-BASED, EDUCATION, YOUTH-SERVING, AGRICULTURE, GOVERNMENT, AGING, DISABILITIES, LOW INCOME, MINORITY, EDUCATION, OR OTHER. 3. GENERAL COMMUNITY: INDIVIDUALS AND COMMUNITY MEMBERS REPRESENTING THEIR OWN INTERESTS WERE REACHED IN TWO WAYS: A GENERAL SURVEY COMPLETED AT PUBLIC EVENTS (COUNTY FAIRS, LOCAL FESTIVALS) AND FOCUS GROUPS. COMMUNITY MEMBERS COMPLETING THE WRITTEN SURVEY IDENTIFIED THEMSELVES BY AGE AND NUMBER OF CHILDREN IN HOUSEHOLD. FOCUS GROUPS PARTICIPANT WERE IDENTIFIED BY GENDER. GRANT REGIONAL HEALTH CENTER, INC. PART V, SECTION B, LINE 6A: THE CHNA WAS CONDUCTED IN JOINT EFFORT WITH THE FOLLOWING OTHER HOSPITALS:1. CROSSING RIVERS HEALTH OF PRAIRIE DU CHIEN2. GUNDERSEN BOSCOBEL AREA HOSPITAL AND CLINICS OF BOSCOBEL3. SOUTHWEST HEALTH OF PLATTEVILLE GRANT REGIONAL HEALTH CENTER, INC. PART V, SECTION B, LINE 6B: THE CHNA WAS CONDUCTED IN JOINT EFFORT WITH THE FOLLOWING OTHER ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES: 1. GRANT COUNTY HEALTH DEPARTMENT2. CRAWFORD COUNTY HEALTH DEPARTMENT GRANT REGIONAL HEALTH CENTER, INC. PART V, SECTION B, LINE 7D: PART V, SECTION B, LINE 7A:HTTPS://WWW.GRANTREGIONAL.COM/ABOUT-US/CHNA/PART V, SECTION B, LINE 10:HTTPS://WWW.GRANTREGIONAL.COM/ABOUT-US/CHNA/ GRANT REGIONAL HEALTH CENTER, INC. PART V, SECTION B, LINE 11: GRANT REGIONAL HEALTH CENTER IS COMMITTED TO ADDRESSING THE SIGNIFICANT HEALTH NEEDS OF OUR SERVICE AREA THROUGH SUPPORTING VARIOUS PROGRAMS AND SERVICES. GRANT REGIONAL COMPLETES THE ASSESSMENT AND THEN CONSIDERS WHAT RESOURCES ARE APPROPRIATE AND AVAILABLE TO MAKE AN IMPACT ON THESE NEEDS. DURING THIS PAST CHNA, GRANT REGIONAL HAS PROVIDED COMMUNITY EDUCATION, ESTABLISHED PARTNERSHIPS, INTRODUCED NEW SERVICES AND RECRUITED NEW PROVIDERS TO BETTER MEET THE HEALTHCARE NEEDS OF THOSE IN OUR SURROUNDING COMMUNITIES. (SEE GRANT REGIONAL'S IMPLEMENTATION PLAN) GRANT REGIONAL DOES HAVE CERTAIN LIMITATIONS BASED ON OUR STRENGTHS AND RESOURCES AVAILABLE. EVEN THOUGH SUBSTANCE ABUSE WAS IDENTIFIED AS AN IMPORTANT CONCERN, GRANT REGIONAL DOES NOT OFFER REHABILITATIVE SERVICES RELATED TO TREATMENT AND RECOVERY. GRANT REGIONAL DOES OFFER AND CONTINUES TO EXPAND BEHAVIORAL HEALTH SERVICES TO MEET THOSE NEEDS AND DEMANDS OF OUR COMMUNITY. GRANT REGIONAL ALSO OFFERS VERY LIMITED CANCER CARE AND TREATMENT. HOWEVER, WE ARE VERY PROUD TO HAVE EXPANDED OUR DIAGNOSTIC CAPABILITIES INCLUDING BREAST MRI, 3D MAMMOGRAPHY, AND STEREOTACTIC BREAST BIOPSY THAT WE OFFER OUR REGION. GRANT REGIONAL HEALTH CENTER, INC. PART V, SECTION B, LINE 13B: SOME PATIENTS MAY EXCEED 300% OF THE FEDERAL POVERTY GUIDELINES, BUT MAY STILL BE ELIGIBLE FOR CHARITY CARE WHEN ADDITIONAL CRITERIA SUCH AS CATASTROPHIC MEDICAL COSTS ARE CONSIDERED. CATASTROPHIC MEDICAL CARE COSTS ARE DETERMINED ON A CASE-BY-CASE BASIS TO PATIENTS WHO DUE TO A SIGNIFICANT OR RECURRENCE OF MEDICAL BILLS MAY NEED ADDITIONAL COMMUNITY SUPPORT TO HELP A PATIENT OR THEIR FAMILY THROUGH A DIFFICULT TIME. GRANT REGIONAL HEALTH CENTER, INC. PART V, SECTION B, LINE 13H: MEDICARE/MEDICAID ELIGIBILITY IS UTILIZED ALONG WITH ANY GOVERNMENT OR PUBLIC PROGRAMS WITH SIMILAR QUALIFYING CRITERIA SUCH AS HOUSING ASSISTANCE PROGRAMS, INMATES, HOMELESS, DECEASED, ETC. AS DEFINED IN THE FAP POLICY. GRANT REGIONAL HEALTH CENTER, INC. PART V, SECTION B, LINE 16J: THE FAP, FAP APPLICATION, AND FAP SUMMARY ARE ALSO AVAILABLE IN SPANISH LANGUAGE ON THE WEBSITE AND UPON REQUEST. GRANT REGIONAL HEALTH CENTER, INC. PART V, SECTION B, LINE 23: THE HOSPITAL FOLLOWS ITS NORMAL PROCEDURES FOR COLLECTION OF THESE ACCOUNTS, INCLUDING DISCOUNTS BASED ON INCOME/ASSET LEVELS, PROMPT PAYMENT, OR MEDICAL INDIGENCE. 3 1 - POTOSI-TENNYSON MEDICAL CLINIC 114 US-61 POTOSI WI 53820 RURAL HEALTH CLINIC 2 - COMMUNITY CLINIC CASSVILLE 222 W AMELIA ST CASSVILLE WI 53806 RURAL HEALTH CLINIC 3 - COMMUNITY CLINIC LANCASTER 507 S MONROE ST LANCASTER WI 53813 RURAL HEALTH CLINIC PART I, LINE 3C: GRANT REGIONAL HEALTH CENTER, INC. USES THE FEDERAL POVERTY GUIDELINES AS ONE MEANS OF DETERMINING ELIGIBILITY FOR CHARITY CARE. THE FEDERAL POVERTY GUIDELINES ARE UPDATED AND PUBLISHED ANNUALLY BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. GRANT REGIONAL REVIEWS AND UPDATES OUR POLICY AND PRACTICES ANNUALLY. AS A GENERAL RULE, A PATIENT'S INCOME, BASED ON FAMILY SIZE, MUST BE AT OR BELOW 300% OF THE FEDERAL POVERTY GUIDELINES TO BE ELIGIBLE FOR THE CHARITY CARE PROGRAM. A SLIDING SCALE BASED ON THE PATIENT'S INCOME LEVEL UNDER THE FEDERAL POVERTY GUIDELINES WILL BE USED TO DETERMINE THE PRECISE AMOUNT OF CHARITY CARE FOR WHICH A PATIENT WILL BE ELIGIBLE. SOME PATIENTS MAY EXCEED 300% OF THE FEDERAL POVERTY GUIDELINES BUT MAY STILL BE ELIGIBLE FOR CHARITY CARE WHEN ADDITIONAL CRITERIA SUCH AS CATASTROPHIC MEDICAL COSTS ARE CONSIDERED. CATASTROPHIC MEDICAL CARE COSTS ARE DETERMINED ON A CASE-BY-CASE BASIS TO PATIENTS WHO DUE TO A SIGNIFICANT OR RECURRENCE OF MEDICAL BILLS MAY NEED ADDITIONAL COMMUNITY SUPPORT TO HELP A PATIENT OR THEIR FAMILY THROUGH A DIFFICULT TIME. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES AT GRANT REGIONAL HEALTH CENTER, INC. INCLUDE THE ADULTS & PEDIATRICS UNIT. IT IS THE GOAL OF GRANT REGIONAL HEALTH CENTER, INC. TO PROVIDE THESE SERVICES TO THE COMMUNITY REGARDLESS OF A PATIENT'S ABILITY TO PAY. SUBSIDIZED SERVICES ALSO INCLUDES INPATIENT ADULTS & PEDIATRICS AS WELL. 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 $ 854,257. PART II, COMMUNITY BUILDING ACTIVITIES: GRANT REGIONAL HEALTH CENTER, INC. ALSO ENGAGES IN A VARIETY OF COMMUNITY BUILDING ACTIVITIES THAT WOULD OTHERWISE NOT BE PROVIDED TO RESIDENTS OF LANCASTER, WISCONSIN AND SURROUNDING AREAS WITHOUT THE EFFORTS AND SPECIALIZED KNOWLEDGE OF THE LOCAL COMMUNITY HOSPITAL. SOME OF THE COMMUNITY BUILDING ACTIVITIES OF GRANT REGIONAL HEALTH CENTER, INC. INCLUDE (WITHOUT LIMITATION) PARTICIPATION IN LOCAL HEALTH AND WELLNESS FAIRS, SPONSORSHIP AND PROVIDING SPACE TO SUPPORT GROUPS, PROVISION OF EDUCATIONAL MATERIALS TO COMMUNITY MEMBERS, AND LOCAL BLOOD PRESSURE SCREENINGS. THESE ACTIVITIES WERE DETERMINED BY MEMBERS OF THE COMMUNITY, ASKED BY COMMUNITY REPRESENTATIVES, AND CAME OUT OF OUR COMMUNITY NEEDS ASSESSMENT DIRECTING GRANT REGIONAL HEALTH CENTER, INC. TO PROVIDE THESE SERVICES SINCE THE HOSPITAL HAS THE EXPERTISE IN THESE AREAS. THE HOSPITAL ALSO PARTICIPATES IN HEALTH EDUCATION AWARENESS AND CAREER BUILDING ACTIVITIES SUCH AS CLINICAL TRAINING EXPERIENCE, FACILITY TOURS TO STUDENTS, SPEAKERS AT LOCAL SCHOOLS, AND CAREER FAIRS. THE HOSPITAL RECOGNIZES THAT IT IS IMPORTANT TO EDUCATE LOCAL COMMUNITY MEMBERS ON THESE CAREERS AS A CAREER BUILDING INITIATIVE SO THAT LOCAL PRIMARY CARE AND ACCESS TO CARE WILL BE CONTINUED IN THE FUTURE WITH WELL-TRAINED AND EDUCATED COMMUNITY MEMBERS IN HEALTHCARE RELATED FIELDS. 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 PATIENT SERVICES REVENUE DIVIDED BY OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBTS. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST THE TOTAL CHARGES THAT WERE 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. 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. THESE AMOUNTS ARE REVIEWED AND ADJUSTED MONTHLY. BALANCES THAT ARE STILL OUTSTANDING AFTER MANAGEMENT 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 SIGNIFICANT AMOUNT OF BAD DEBTS COULD BE CONSIDERED AS CHARITY CARE. PART III, LINE 4: ACCOUNTS RECEIVABLE AND CREDIT POLICY: IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, GRANT REGIONAL HEALTH CENTER, INC. ANALYZES PAST RESULTS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OR REVENUE TO ESTIMATE FOR IMPLICIT PRICE CONCESSIONS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE IMPLICIT PRICE CONCESSIONS. SPECIFICALLY, FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, GRANT REGIONAL HEALTH CENTER, INC. ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES IMPLICIT PRICE CONCESSIONS 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, COINSURANCE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), GRANT REGIONAL HEALTH CENTER, INC. RECORDS PRICE CONCESSIONS 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 ADJUSTED OFF ACCOUNTS RECEIVABLE. THE AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A SEPARATE FOOTNOTE REGARDING BAD DEBT EXPENSE. PART III, LINE 8: GRANT REGIONAL HEALTH CENTER, INC. IS DESIGNATED A CRITICAL ACCESS HOSPITAL AND AS SUCH A PORTION OF ITS REVENUES ARE 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 GRANT REGIONAL HEALTH CENTER, INC., SPECIALTY PHYSICIAN SERVICES SUCH AS GYNECOLOGY SERVICES IN THE SPECIALTY CLINIC, OR ANESTHESIA (CRNA) 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, CLINICAL, AND ANESTHESIA 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 GRANT REGIONAL HEALTH CENTER, INC. PROVIDES TO THE COMMUNITY AND SURROUNDING AREA OF GRANT COUNTY, 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 REVENUES (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 FROM SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THE RECIPIENTS ARE TYPICALLY ELDERLY AND/OR DISABLED MEMBERS OF THE COMMUNITY AND 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: A PATIENT THAT IS FINANCIALLY RESPONSIBLE FOR THEIR MEDICAL BILLS AND IS NOT COVERED BY AN INSURANCE PLAN WILL RECEIVE A 35% PAYMENT DISCOUNT IF THEY PAY THEIR BALANCE DUE IN FULL WITHIN 25 DAYS OF THE INITIAL SETTLEMENT DATE. GRANT REGIONAL HEALTH CENTER, INC. WILL HONOR SUCH PAYMENT AS PAYMENT IN FULL FOR SERVICES BILLED. WHEN A PATIENT'S INCOME IS LESS THAN 300% OF THE FEDERAL POVERTY LEVEL FOR THEIR FAMILY SIZE, THE PATIENT MAY ACCESS THE 35% DISCOUNT WITH A WRITTEN PAYMENT ARRANGEMENT TO BE PAID WITHIN A TWELVE-MONTH PERIOD UPON APPROVAL OF THE HOSPITAL'S BUSINESS OFFICE MANAGER. HOWEVER, THE PATIENT WILL FIRST BE REFERRED TO THE PATIENT FINANCIAL COUNSELOR. THE PATIENT WILL THEN COMPLETE A FINANCIAL APPLICATION AND SUPPLY SUPPORTING DOCUMENTATION. ONCE THE APPLICATION IS COMPLETED THE BUSINESS OFFICE MANAGER WILL REVIEW AND APPROVE. THE PAYMENT AGREED UPON WILL BE IN ACCORDANCE WITH THE BUSINESS OFFICE'S PAYMENT PLAN POLICY. A LETTER WILL BE SENT TO THE PATIENT ACCEPTING THE FINANCIAL APPLICATION AND PAYMENT AGREEMENT TERMS. PART VI, LINE 2: TO COMPLETE THE COMMUNITY HEALTH NEEDS ASSESSMENT, GRANT REGIONAL HEALTH CENTER PARTNERED WITH GUNDERSEN BOSCOBEL AREA HOSPITAL & CLINICS, SOUTHWEST HEALTH, AND CROSSING RIVERS HEALTH, IN ADDITION TO GRANT AND CRAWFORD COUNTY HEALTH DEPARTMENTS. TOGETHER, WE SURVEYED OUR COMMUNITIES AND GATHERED DATA FROM COMMUNITY, STATE, AND COUNTY SOURCES, THEN INTEGRATED AND ANALYZED IT TO COMPILE A COMPREHENSIVE VIEW OF OUR REGION'S HEALTH. THROUGH THIS ASSESSMENT, WE HOPE TO BETTER UNDERSTAND LOCAL HEALTH CHALLENGES, IDENTIFY HEALTH TRENDS IN OUR COMMUNITY, DETERMINE GAPS AND DEVELOP A PLAN TO DO OUR PART IN ADDRESSING THOSE GAPS AND HEALTH NEEDS IN OUR SERVICE AREA. WE ARE PROUD OF THE PROGRESS AND WORK THAT HAS BEEN DONE SINCE THE LAST CHNA AND WILL CONTINUE TO BUILD ON THAT MOMENTUM. OUR GOAL IS TO MOVE FORWARD TO DEVELOP NEW HOSPITAL AND COMMUNITY INITIATIVES IN THE NEXT THREE YEARS THAT FOCUS ON THE HEALTH PRIORITIES WE HAVE IDENTIFIED THROUGH THIS IMPORTANT PROCESS. PART VI, LINE 3: CONSISTENT WITH THE MISSION OF GRANT REGIONAL HEALTH CENTER, INC., HEALTH-RELATED SERVICES ARE PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY, INCLUDING PROVIDING SERVICES TO THOSE PERSONS WHO CANNOT AFFORD HEALTH INSURANCE BECAUSE OF INADEQUATE RESOURCES OR THOSE WHO ARE UNDERINSURED. WHEN A PATIENT'S INCOME IS LESS THAN 300% OF THE FEDERAL POVERTY LEVEL, THEY ARE PROVIDED CARE WITHOUT CHARGE OR AT A REDUCED RATE. THIS IS DETERMINED UPON APPROVAL BY THE BUSINESS OFFICE MANAGER AT THE FACILITY AFTER THE PATIENT HAS MET WITH A PATIENT FINANCIAL COUNSELOR AT THE FACILITY AND HAS COMPLETED A FINANCIAL APPLICATION, AND SUPPLIED THE NECESSARY DOCUMENTATION TO SUPPORT A FINANCIAL NEED FOR CARE UNDER GRANT REGIONAL'S COMMUNITY CARE POLICY. INFORMATION ON THE HOSPITAL'S CHARITY CARE POLICIES IS POSTED AT THE HOSPITAL PATIENT REGISTRATION DESK AND REGISTRATION CLERKS AT THE HOSPITAL ARE TRAINED TO INQUIRE WITH SELF-PAY PATIENTS UPON REGISTRATION IF THEY WOULD LIKE FURTHER INFORMATION ON THESE POLICIES OR WOULD LIKE TO MEET WITH A MEMBER OF THE BUSINESS OFFICE STAFF. DURING THE COLLECTION PROCESS, GRANT REGIONAL HEALTH CENTER MAKES AN EFFORT TO ALSO PROVIDE INFORMATION AND SEND CHARITY CARE APPLICATION INFORMATION TO THE MAJORITY OF PRIVATE PAY OR SELF-PAY PATIENTS THAT DO NOT RESPOND WITH PAYMENT ON THE FIRST OR SECOND PATIENT STATEMENT THAT IS SENT ITEMIZING THE BALANCE OF THEIR HOSPITAL BILL. SOCIAL SERVICES AND BUSINESS OFFICE STAFF AT THE HOSPITAL ARE ALSO AVAILABLE TO PROVIDE INFORMATION TO PATIENTS ON OTHER GOVERNMENT PROGRAMS SUCH AS THE MEDICAL ASSISTANCE PROGRAM TO PATIENTS OR TO REFER PATIENTS TO PERSONNEL AT GRANT COUNTY OR OTHER STATE OF WISCONSIN OR COUNTY AGENCIES THAT MAY PROVIDE ACCESS TO CARE FOR ELIGIBLE PATIENTS OR PROVIDE OTHER INFORMATION TO PATIENTS. PART VI, LINE 4: GRANT REGIONAL HEALTH CENTER, INC. IS LOCATED IN LANCASTER, WISCONSIN, WHICH IS A COMMUNITY OF ABOUT 4,000 PEOPLE. LANCASTER IS LOCATED 30 MINUTES FROM DUBUQUE, IOWA AND 1 HOUR 30 MINUTES FROM MADISON, WISCONSIN. THE FACILITY OPERATES A 25-BED, ACUTE CARE CRITICAL ACCESS HOSPITAL. GRANT REGIONAL HEALTH CENTER OFFERS A WIDE VARIETY OF SERVICES IN ORDER TO FULFILL MANY OF THE NEEDS OF THE INDIVIDUALS IN THE LOCAL COMMUNITY. AMONG SERVICES PROVIDED ARE: DIAGNOSTIC CARE, 24-HOUR EMERGENCY ROOM, OBSTETRICS, REHABILITATION, SURGICAL CARE, AND DIABETES SELF-CARE PROGRAMS, ALONG WITH OTHER SPECIALTY SERVICES, WHICH INCLUDE AUDIOLOGY, CARDIOLOGY, AND ORTHOPEDICS, AMONG OTHERS. CARE IS OFFERED TO PATIENTS REGARDLESS OF PAY SOURCE AND REGARDLESS OF A PATIENT'S ABILITY TO PAY. DURING 2024, MEDICARE AND MEDICARE ADVANTAGE PLAN BENEFICIARIES ACCOUNTED FOR APPROXIMATELY 47 PERCENT OF ALL GROSS PATIENT SERVICE REVENUE AT GRANT REGIONAL HEALTH CENTER AND MEDICAID BENEFICIARIES ACCOUNTED FOR APPROXIMATELY 11 PERCENT OF ALL GROSS PATIENT SERVICE REVENUE. MEDICARE AND MEDICAID BENEFICIARIES MAKE UP THE LARGEST PORTION OF PATIENTS THAT ARE SERVED BY GRANT REGIONAL HEALTH CENTER OVER THE PREVIOUS FEW YEARS. PART VI, LINE 5: GRANT REGIONAL HEALTH CENTER, INC. IS ACCREDITED THROUGH THE JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATIONS. THE JOINT COMMISSION IS AN ORGANIZATION THAT EVALUATES HOSPITAL PERFORMANCE STANDARDS, FOCUSING ON THE QUALITY OF HEALTH CARE. ACCREDITATION THROUGH THE JOINT COMMISSION IS RECOGNIZED NATIONWIDE AS A SYMBOL OF QUALITY, AS IT REQUIRES RIGOROUS PERFORMANCE STANDARDS. TO EARN AND MAINTAIN ACCREDITATION, GRANT REGIONAL IS EVALUATED THROUGH AN UNANNOUNCED SURVEY PROCESS COVERING NEARLY 600 STANDARDS RELATED TO QUALITY PATIENT CARE, SAFETY, INFECTION CONTROL, AND ONGOING PERFORMANCE-IMPROVEMENT ACTIVITIES, AMONG OTHERS. ALL HOSPITALS SURVEYED BY THE JOINT COMMISSION ARE EVALUATED AGAINST THE SAME CRITERIA, REGARDLESS OF SIZE OR LOCATION.GRANT REGIONAL HEALTH CENTER HAS ACHIEVED A FIVE-STAR RATING BY THE CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) AS ANNOUNCED BY MEDICARE.GOV ON HOSPITAL COMPARE. THE HOSPITAL CONSUMER ASSESSMENT OF HEALTHCARE PROVIDERS AND SYSTEMS (HCAHPS) SUMMARY STAR RATING COMBINES INFORMATION FROM PATIENT SURVEYS ABOUT DIFFERENT ASPECTS OF THEIR EXPERIENCE OF CARE. THE RATINGS, PUBLISHED BY CMS ARE DESIGNED TO HELP CONSUMERS COMPARE HOSPITALS, BY EVALUATING SAFETY, QUALITY AND PATIENT EXPERIENCES AT MORE THAN 4,500 HOSPITALS NATIONWIDE. GRANT REGIONAL IS ONE OF ONLY NINE PERCENT OF ELIGIBLE HOSPITALS IN THE UNITED STATES TO RECEIVE THE FIVE-STAR RATING FOR PATIENT EXPERIENCE. THE NATIONAL AVERAGE IS THREE OUT OF FIVE STARS.THE ACTIVITIES OF GRANT REGIONAL ARE SUPPORTED LOCALLY BY A VOLUNTEER BOARD OF DIRECTORS WHICH OVERSEE THE OPERATIONS OF THE HOSPITAL. THE BOARD OF DIRECTORS IS MADE UP OF COMMUNITY MEMBERS WHO RESIDE IN LANCASTER, WI AND THE SURROUNDING COMMUNITIES WHICH IS GRANT REGIONAL'S PRIMARY PATIENT SERVICE AREA. THE HOSPITAL ALSO EXTENDS MEDICAL STAFF PRIVILEGES TO A MAJORITY OF ALL QUALIFIED PHYSICIANS IN THE COMMUNITY AND SURROUNDING AREAS WHICH WISH TO BETTER SERVE THEIR PATIENTS BY PROVIDING CARE AT GRANT REGIONAL. ANY SURPLUSES IN OPERATIONS THAT ARE ACHIEVED BY THE ORGANIZATION OPERATING IN AN EFFECTIVE MANNER AND CONTROLLING THE COST OF HEALTHCARE ARE PRIMARILY RESERVED FOR FUTURE BUILDING AND CAPITAL PURCHASE NEEDS. GRANT REGIONAL RECOGNIZES THAT IT IS IMPORTANT TO SAVE THESE RESERVES DURING YEARS OF SURPLUS SO THAT IN ANY TIMES OF ECONOMIC DOWNTURN IF A LARGE CAPITAL ADDITION IS NEEDED THE ORGANIZATION WILL NOT HAVE TO PASS HIGHER COSTS ON TO MEMBERS OF THE COMMUNITY. THESE FUNDS ARE TRANSFERRED TO A FUNDED DEPRECIATION INVESTMENT ACCOUNT REGULARLY THROUGHOUT EACH FISCAL YEAR WHERE SURPLUSES IN OPERATIONS ARE ACHIEVED. THE HOSPITAL FURTHER ACHIEVES ITS GOAL OF PROVIDING TRUE COMMUNITY SUPPORT BY EXTENDING CHARITY CARE AS DESCRIBED THROUGHOUT SCHEDULE H AND PROVIDING SERVICES TO MEMBERS OF OTHER PROGRAMS WHICH OFTEN REIMBURSE THE HOSPITAL BELOW THE COST OF PROVIDING THIS CARE SUCH AS CHAMPUS, TRICARE, AND THE WISCONSIN HEALTH INSURANCE RISK SHARING PROGRAM OR "HIRSP" (THE HIRSP PROGRAM REIMBURSES THE HOSPITAL AT RATES SIMILAR TO THE MEDICAID PROGRAM AND IS FOR PATIENTS THAT HAVE PRE-EXISTING ILLNESSES WHICH MAKE IT DIFFICULT TO OBTAIN INSURANCE FROM COMMERCIAL INSURANCE CARRIERS IN THE MARKETPLACE). PART VI, LINE 7, REPORTS FILED WITH STATES WI 1 SOUTHWEST WISCONSIN TECHNICAL COLLEGE FOUNDATION 1800 BRONSON BLVD FENNIMORE WI 53809 391828080 501(C)(3) 25000 0 GENERAL SUPPORT HEALTHY WISCONSIN ALLIANCE 5510 RESEARCH PARK DRIVE STE 200 MADISON WI 53711 203809620 501(C)(4) 5000 0 GENERAL SUPPORT 1 1 FOUNDATION SCHOLARSHIPS 7 9500 MARTIN SCHOLARSHIPS 2 1000 PART I, LINE 2: GRANT REGIONAL HEALTH CENTER HAS A FOUNDATION COMMITTEE THAT REVIEWS REQUESTS FOR DONATIONS FROM OR OFFERS TO PROVIDE ASSISTANCE TO GRANT REGIONAL HEALTH CENTER, INC. (THE "HOSPITAL") TO FURTHER THE MISSION OF THE HOSPITAL, AS WELL AS SCHOLARSHIPS FOR SCHOLARSHIP APPLICANTS SEEKING TO FURTHER THEIR EDUCATION. THESE GRANTS ARE APPROVED BY THE FOUNDATION COMMITTEE DURING REGULARLY SCHEDULED BOARD OF DIRECTORS' MEETINGS THROUGHOUT THE YEAR. X X X X 0 0 0 0 0 0 0 0 0 DARREN W PERTTU GENERAL SURGEON 623456 0 167066 0 34611 0 18975 0 33334 0 877442 0 0 0 DALE R CHILSON OTOLARYNGOLOGIST/ENT 743282 0 42500 0 396 0 18975 0 21702 0 826855 0 0 0 BRADLEY G BINSFELD ORTHOPEDIC SURGEON 658427 0 53232 0 90 0 18975 0 12905 0 743629 0 0 0 KIMBERLY A PERTTU FAMILY PRACTICE PHYSICIAN WITH OB 308600 0 188675 0 40095 0 18975 0 5637 0 561982 0 0 0 ELI T JAMES FAMILY PRACTICE PHYSICIAN WITHOUT OB 318519 0 112179 0 60 0 18798 0 36534 0 486090 0 0 0 TAMARA CHAMBERS PRESIDENT/CEO 271539 0 0 0 0 0 14935 0 1567 0 288041 0 0 0 JOEL GEHLING CHIEF FINANCIAL OFFICER 210340 0 0 0 0 0 8018 0 22136 0 240494 0 0 0 RADLEY KAMPS CHIEF OPERATING OFFICER 188342 0 0 0 0 0 10359 0 1357 0 200058 0 0 0 DR ERIC STADER DIRECTOR/PHYSICIAN 190000 0 0 0 0 0 0 0 0 0 190000 0 0 0 A WISCONSIN HEALTH AND EDUCATIONS FACILITIES AUTHORITY 391337855 2022-05-10 34825500 CAPITAL EXPENDITURES 0 0 0 A 3723475 34825500 177045 5000000 29648455 2018 0 0 0 1 A 0 0 0 0 0.00010 0.00010 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 FORM 990, PART III, LINE 2 GRANT REGIONAL OPENED A NEW FAMILY PRACTICE CLINIC IN FENNIMORE IN JANUARY 2024. THE CLINIC FEATURES LOCAL CARE AND CONVENIENCE INCLUDING FAMILY PRACTICE, LABORATORY AND RADIOLOGY SERVICES ON THE MAIN LEVEL THAT ANY PATIENT OR AREA CLINIC CAN UTILIZE. REHABILITATION SERVICES INCLUDE PHYSICAL THERAPY WITH A GYM/TREATMENT SPACE ON THE LOWER LEVEL WITH GROUND FLOOR ACCESS. OTHER NEW SERVICES INCLUDE: ACUTE MIGRAINE TREATMENT, EEG SERVICES AND LUNG CANCER SCREENINGS. WE ALSO ADDED A THIRD OUTPATIENT BEHAVIORAL HEALTH COUNSELOR IN 2024 SERVING AGES 12+. FORM 990, PART III, LINE 3 GRANT REGIONAL IS NO LONGER OFFERING UROLOGY SERVICES. FORM 990, PART VI, SECTION A, LINE 7A UNDER THE TERMS OF THE CORPORATE AND MEDICAL STAFF BYLAWS OF GRANT REGIONAL HEALTH CENTER, INC., THE MEDICAL STAFF APPOINTS ONE MEMBER OF THE BOARD OF DIRECTORS TO BE THE APPOINTED MEDICAL STAFF REPRESENTATIVE ON THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B THE BOARD OF DIRECTORS WAS PROVIDED ACCESS TO A COPY OF THE FORM 990 PRIOR TO THE FILING OF THE RETURN WITH THE IRS. THE FORM 990 IS ALSO REVIEWED BY SENIOR MANAGEMENT OF GRANT REGIONAL HEALTH CENTER, INC. PRIOR TO SUBMISSION TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C CONFLICTS OF INTEREST ARE CONSIDERED TO EXIST IN SITUATIONS WHERE EMPLOYEE'S ACTIONS OR ACTIVITIES INVOLVE: - THE OBTAINING OF AN IMPROPER PERSONAL GAIN OR ADVANTAGE BY REASON OF AN EMPLOYEE'S POSITION WITH GRANT REGIONAL; - AN ADVERSE EFFECT UPON THE INTERESTS OF GRANT REGIONAL HEALTH CENTER, INC.; - THE OBTAINING BY A THIRD PARTY OF AN IMPROPER GAIN, OR OF AN ADVANTAGE TO THE DETRIMENT OF GRANT REGIONAL; OR - THE APPEARANCE OF ANY OF THE ABOVE. ANY RELATED ISSUES TO A CONFLICT OF INTEREST SHALL BE DISCLOSED TO THE APPROPRIATE SUPERVISOR, COMPLIANCE OFFICER, OR HOTLINE. COMPLIANCE WITH THE POLICY IS MONITORED BY HAVING BOARD MEMBERS, OFFICERS, AND EMPLOYEES DISCLOSE ANNUALLY IN A WRITTEN STATEMENT ANY ISSUES THAT MAY GIVE RISE TO A CONFLICT OF INTEREST. IF ANY CONFLICTS ARE KNOWN BY BOARD MEMBERS, THESE BOARD MEMBERS ARE ASKED TO ABSTAIN FROM VOTING ON ANY CONFLICTED MATTERS. FORM 990, PART VI, SECTION B, LINE 15 GRANT REGIONAL HEALTH CENTER, INC. USES THE RURAL WISCONSIN HEALTH COOPERATIVE SURVEY TO DETERMINE PROPER COMPENSATION FOR ITS TOP MANAGEMENT PERSONNEL AND TO REVIEW FOR COMPARABILITY FACTORS. THE RURAL WISCONSIN HEALTH COOPERATIVE SURVEY IS A COMPILATION OF AVERAGE SALARIES AND COMPENSATION AMOUNTS FOR VARIOUS POSITIONS AT ITS MEMBER HOSPITALS WHICH INCLUDE A LARGE NUMBER OF RURAL AND COMMUNITY HOSPITALS LOCATED THROUGHOUT WISCONSIN. GRANT REGIONAL HEALTH CENTER, INC. ALSO PARTICIPATES IN THE ANNUAL WISCONSIN HOSPITAL ASSOCIATION COMPENSATION SURVEY TO ALLOW ACCESS TO SALARY AND BENEFIT COMPARABILITY DATA EACH YEAR. GRANT REGIONAL HEALTH CENTER WILL ALSO UTILIZE MGMA (MEDICAL GROUP MANAGEMENT ASSOCIATION) WAGE SURVEY DATA AS WELL FOR BROADER COMPARABLES FOR THOSE POSITIONS. WHEN GRANT REGIONAL'S BUDGET PROCESS IS BEING REVIEWED EACH YEAR, AN AVERAGE WAGE INCREASE IS COMPARED WITH THIS DATA AND PRESENTED TO THE BOARD OF DIRECTORS TO REVIEW BEFORE SETTING TARGET OR BUDGETED PERFORMANCE OR MARKET VALUE ADJUSTED TO COMPENSATION EACH YEAR. GRANT REGIONAL ALSO REVIEWS THIS DATA WHEN IT DETERMINES THAT NEW POSITIONS SHOULD BE ADDED TO BETTER MEET PATIENT SERVICE NEEDS IN THE COMMUNITY. FORM 990, PART VI, SECTION C, LINE 19 GRANT REGIONAL HEALTH CENTER, INC. WILL MAKE A COPY OF ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. SUMMARIZED FINANCIAL STATEMENTS ARE AVAILABLE TO THE GENERAL PUBLIC AT ANY TIME FOLLOWING THE SUBMISSION OF THE WISCONSIN HOSPITAL SURVEY TO THE WISCONSIN HOSPITAL ASSOCIATION. FORM 990, PART XI, LINE 9: NET ASSETS RELEASED FROM RESTRICTIONS -255,327. GRANT REGIONAL HEALTH CENTER AUXILIARY 507 SOUTH MONROE STREET LANCASTER WI 53813 753031038 VOLUNTEERS WI 501(C)(3) LINE 10 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0