2025-11-10T10:04:23-06:00 2025-03-31 420714325 RSM US LLP 227 WEST FIRST STREET SUITE 700 DULUTH MN 55802 990 2024-04-01 391536207 MEDICAL SERVICES INC MEDI 7159344321 11040 N STATE ROAD 77 HAYWARD WI 548436391 LUKE BEIRL CEO 7159344321 2025-11-06 1 1 JULIE BOYER P01278549 2187275025 2025-11-06 2024 2025-03-06 01:10:19Z TAMARACK HEALTH HAYWARD MEDICAL CENTER LUKE BEIRL 11040 N STATE ROAD 77 HAYWARD WI 548436391 106530142 0 X HTTPS:WWW.TAMARACKHEALTH.ORG X 1986 WI IMPROVE THE HEALTH AND WELLBEING FOR THE PEOPLE OF OUR REGION. 11 10 646 80 0 0 48855 1604835 85494646 94518517 1150126 1786532 161272 357628 86854899 98267512 0 90639 0 0 46152652 50855691 0 0 0 35455267 37842485 81607919 88788815 5246980 9478697 127173544 144256296 22012122 29307758 105161422 114948538 X IMPROVE THE HEALTH AND WELLBEING FOR THE PEOPLE OF OUR REGION. 0 0 78758221 90639 94764724 TAMARACK HEALTH HAYWARD MEDICAL CENTER IS A 25-BED CRITICAL ACCESS HOSPITAL, 50 BED NURSING HOME, AND 40 APARTMENT RCAC FACILITY. THE HOSPITAL CAMPUS ALSO CONTAINS TWO ATTACHED PRIMARY CARE CLINICS; ONE THAT IS OWNED AND OPERATED BY TAMARACK HEALTH HAYWARD MEDICAL CENTER AND ANOTHER THAT IS OWNED AND OPERATED BY ESSENTIA HEALTH. THESE CLINICS EMPLOY APPROXIMATELY 20 FULL-TIME PHYSICIANS, AND ADDITIONAL PART-TIME SPECIALTY CARE PHYSICIANS WHO DO ROUNDS AND SEE PATIENTS AT THE HOSPITAL THROUGHOUT THE MONTH. THE HOSPITAL, NURSING HOME AND ASSISTED LIVING EMPLOY CLOSE TO 605 EMPLOYEES. IN FY '24-'25 THE HOSPITAL HAD 991 INPATIENT ADMISSIONS AND 2,887 IP DAYS, 776 OBSERVATION ADMISSIONS WITH 16,113 HOURS OF CARE, AND 33 TCU ADMISSIONS WITH 338 CENSUS DAYS OF CARE. THE NURSING HOME HAD 46 ADMISSIONS WITH 13,008 CENSUS DAYS, AND THE ASSISTED LIVING HAD 13,912 RESIDENT DAYS WITH AN AVERAGE MONTHLY CENSUS OF 38.12 FOR THE FISCAL YEAR WITH 40 TOTAL APARTMENTS. THE EMERGENCY ROOM IS STAFFED BY A PHYSICIAN 24/7/365 SEEING 10,165 PATIENTS. AIR AND GROUND AMBULANCES ARE AVAILABLE FOR THOSE REQUIRING A HIGHER LEVEL OF TRAUMA CARE. AS A RESULT OF A 2015 COMMUNITY HEALTH NEEDS ASSESSMENT, AN URGENT CARE WAS OPENED IN 2017. IT SERVED 6,683 PATIENTS DURING ITS EIGHTH FULL FISCAL YEAR OF OPERATION. THE OPERATING ROOM PERFORMED 1,573 CASES AND ENDOSCOPY PERFORMED 1,139 PROCEDURES. THE HOSPITAL HAS ADDED SEVERAL SPECIALTY SERVICES OVER THE LAST SEVERAL YEARS. ORTHOPEDICS OPENED IN APRIL 2018 WITH A SPORTS MEDICINED CERTIFIED SURGEON ADDED IN FEBRUARY 2020. WOUND CARE WAS ADDED IN LATE 2018. UROLOGY WAS ADDED IN AUGUST 2019. IN FY '20-'21, PODIATRY, GENERAL SURGERY, AND ADVANCED PAIN MANAGEMENT WERE ADDED. EAR, NOSE, AND THROAT (ENT) WAS ADDED IN FY '22-'23. OUR SPECIALTY SERVICES PROGRAMS HAD 10,585 CLINIC VISITS AND 949 SURGERIES IN FY '24-'25. A FAMILY MEDICINE/PRIMARY CARE CLINIC WAS OPENED IN MAY 2022 AND WAS CERTIFIED AS A RURAL HEALTH CLINIC (RHC) IN DECEMBER 2022. IT SERVED 10,644 PATIENTS IN ITS SECOND FULL YEAR OF OPERATION. A SECOND FAMILY MEDICINE/PRIMARY CARE CLINIC WAS OPENED IN AUGUST 2024 IN CABLE, WISCONSIN. THE CLINIC SERVED 860 PATIENTS IN ITS FIRST PARTIAL YEAR OF OPERATION. RADIOLOGY EXAMS TOTAL 35,780, AND LAB EXAMS TOTAL 109,775 PER YEAR. HAYWARD MEDICAL CENTER PERFORMED 158 DELIVERIES LAST YEAR WITH 286 NEWBORN DAYS. HAYWARD IS A POPULAR VACATION HOME DESTINATION AND ATTRACTS TOURISTS THROUGHOUT THE YEAR. HAYWARD IS ALSO A POPULAR RECREATIONAL AREA ATTRACTING MOUNTAIN BIKERS, SKIERS, BOATING, FISHING, AND GENERAL OUTDOOR ACTIVITIES. MEDICAL PROFESSIONALS ARE ATTRACTED TO THIS POPULAR RECREATIONAL AREA BY THE QUALITY OF LIFE THEY FIND HERE. 78758221 1 1 0 1 0 0 0 0 0 0 1 1 0 1 1 1 1 0 0 0 1 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 42 0 1 646 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X HEATHER SHEEHAN 7159344245 11040 N STATE ROAD 77 HAYWARD WI 548436391 LUKE BEIRL DIRECTOR/CEO-MSI/INTERIM PRES-REI 37.00 3.00 X X 581241 0 70546 MARY HANSEN DIRECTOR 1.00 X 0 0 0 GREGG LUNDBERG DIRECTOR 1.00 X 0 0 0 HARRY MALCOLM MD DIRECTOR 1.00 X 0 0 0 STACEY MCKINNEY DIRECTOR 1.00 X 0 0 0 DODSON THOMPSON DO DIRECTOR/CHIEF OF STAFF 1.00 X 0 0 0 JOHN WILL DIRECTOR 1.00 X 0 0 0 JOHN GARRETT TREASURER 1.00 1.00 X X 0 0 0 KYLAH ECKES SECRETARY 1.00 1.00 X X 0 0 0 NED WOLF VICE CHAIR 1.00 2.00 X X 0 0 0 RICH HOBAN CHAIR 1.00 2.00 X X 0 0 0 KENT DUMONSEAU CFO - REI 1.00 39.00 X 0 475431 58699 HEATHER SHEEHAN COO 39.00 1.00 X 243282 0 58981 AINDREA LINDSAY CCO 40.00 X 236600 0 58196 PAUL TONKIN PHYSICIAN 40.00 X 867475 0 64809 BRIAN DONAHUE PHYSICIAN 40.00 X 1007185 0 65745 SARAH FOWLER PHYSICIAN 40.00 X 584994 0 65322 DAVID LYNN PHYSICIAN 40.00 X 636434 0 66756 MATTHEW VINCENT CRNA 40.00 X 470015 0 65410 JASON DOUGLAS FORMER PRESIDENT (DIR. & OFFICER) 0.00 X 0 1228098 55866 4627226 1703529 630330 63 1 1 0 MARKET & JOHNSON 2350 GALLOWAY STREET PO BOX 63 EAU CLAIRE WI 54702 CONTRACTOR FOR BUILDING PROJECTS 11478378 REGIONAL ENTERPRISES INC 1615 MAPLE LANE ASHLAND WI 54806 PRO FEES/RENT 4139815 MEDICAL SOLUTIONS PO BOX 310737 DES MOINES IA 50331 TRAVEL STAFFING 926025 KBK SERVICES INC PO BOX 546 ASHLAND WI 54806 CONTRACTOR FOR BUILDING PROJECTS 555376 SHARED MEDICAL TECHNOLOGY 202 W NEWTON ST RICE LAKE WI 54868 PRO FEES 446712 22 1588688 16147 10145 1604835 HOSPITAL 621500 87956924 87956924 NURSING HOME 623000 4664917 4664917 ASSISTED LIVING 623000 1891043 1891043 DIABETES 621500 5633 5633 94518517 1250605 1250605 61371 74290 -12919 -12919 -12919 8702306 21961 8173702 14638 528604 7323 535927 535927 EARNINGS IN CMDI 900099 238953 238953 CAFETERIA 900099 124340 124340 MISCELLANEOUS 900099 7254 7254 370547 98267512 94764724 0 1897953 90639 90639 1478577 1478577 35943581 34675963 1267618 1589280 1515738 73542 9399300 8862744 536556 2444953 2275446 169507 159789 159789 91315 91315 6766 6766 2721442 2407575 313867 201598 400 201198 995071 578612 416459 3859167 3859167 1166453 1102195 64258 440459 374034 66425 570282 536065 34217 6513101 6057184 455917 242491 242491 DRUGS 6973859 6973859 MEDICAL SUPPLIES 6027578 6027335 243 IMPLICIT PRICE CONCESSI 4198640 4198640 REPAIRS & MAINTENANCE 1735700 1709413 26287 1938774 1372379 566395 88788815 78758221 10030594 0 5743 4603 23232943 27452021 12267115 13669632 2504063 2770012 1598117 1680435 102843197 46298457 51857443 56544740 11251665 11266026 7789692 8864982 230099 16666763 21773746 127173544 144256296 8331319 7665417 13125886 20502385 554917 1139956 22012122 29307758 X 105161422 114948538 105161422 114948538 127173544 144256296 X 9478697 519779 -211360 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 6766 6766 0 PART II-B, LINE 1: TAMARACK HEALTH HAYWARD MEDICAL CENTER PAYS DUES TO CERTAIN ORGANIZATIONS RELATED TO THE INDUSTRY WHICH HAVE LOBBYING EXPENSES. THE AMOUNT LISTED IS THE PERCENTAGE OF THE DUES PAID THAT WERE USED FOR LOBBYING. 1214757 1214757 74339128 31529926 42809202 20818736 12806947 8011789 6470576 1961584 4508992 56544740 MUTUAL FUNDS 6396268 F ALTERNATIVE INVESTMENTS 2468714 F 8864982 ASSETS LIMITED AS TO USE 20540425 INTEREST RATE SWAP 244249 RIGHT-OF-USE LEASE ASSET 989072 21773746 THIRD-PARTY PAYOR SETTLEMENTS 150884 OPERATING LEASE LIABILITY 989072 1139956 X 94444258 519779 -4410000 -3890221 98334479 -66967 -66967 98267512 84657142 66967 66967 84590175 4198640 4198640 88788815 PART X, LINE 2: THE HOSPITAL IS A NONPROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES. NONPROFIT ORGANIZATIONS MAY BECOME SUBJECT TO INCOME TAXES IF QUALIFICATION AS A TAX-EXEMPT ENTITY CHANGES, IF UNRELATED BUSINESS INCOME IS GENERATED AND IN CERTAIN OTHER INSTANCES. NONPROFIT ORGANIZATIONS ARE REQUIRED TO ASSESS THE CERTAINTY OF THEIR TAX POSITIONS RELATED TO THESE MATTERS AND, IN SOME CASES, RECORD LIABILITIES FOR POTENTIAL TAXES, INTEREST AND PENALTIES ACCOMPANIED BY FOOTNOTE DISCLOSURES. THE HOSPITAL HAS NOT IDENTIFIED ANY UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE THE ACCRUAL OF AN INCOME TAX PROVISION. GENERALLY, THE HOSPITAL IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY THE U.S. FEDERAL OR STATE TAX AUTHORITIES FOR YEARS BEFORE 2022. PART XI, LINE 2D - OTHER ADJUSTMENTS: IMPLICIT PRICE CONCESSIONS -4,198,640. LOSS ON INTEREST RATE SWAPS -211,360. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -74,290. GAIN ON DISPOSAL OF FIXED ASSETS 7,323. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 74,290. GAIN ON DISPOSAL OF FIXED ASSETS -7,323. PART XII, LINE 4B - OTHER ADJUSTMENTS: IMPLICIT PRICE CONCESSIONS 4,198,640. NORTH AMERICA 0 0 INVESTMENT 519039 CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENT 1706696 0 0 0 0 0 0 2225735 0 2225735 0 0 0 0 1 0 1 1 X 1 X 1 X 1 0 1 0 1 1 778204 778204 0.00920 12624028 9489456 3134572 0.03710 13402232 9489456 3912776 0.04630 115378 115378 0.00140 13732907 9349321 4383586 0.05180 94620 94620 0.00110 13942905 9349321 4593584 0.05430 27345137 18838777 8506360 0.10060 11236 11236 0.00010 11236 11236 0.00010 1 4198640 0 18081884 19070761 -988877 X 1 1 1 1 TAMARACK HEALTH HAYWARD MEDICAL CENTER 11040 N STATE ROAD 77 HAYWARD WI 54843 HTTPS://WWW.TAMARACKHEALTH.ORG/ 1040 X X X X N/A TAMARACK HEALTH HAYWARD MEDICAL CENTER 1 0 0 1 X X X X X X X X X 24 1 0 1 1 X SEE PART V, PAGE 8 X X 1 24 1 SEE PART V, PAGE 8 0 1 X 100.000000000000 200.000000000000 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 1 X 0 X X X X 1 X 0 0 TAMARACK HEALTH HAYWARD MEDICAL CENTER PART V, SECTION B, LINE 5: WE WERE ABLE TO GATHER VALUABLE INFORMATION FROM COMMUNITY STAKEHOLDERS THAT INCLUDED REPRESENTATIVES FROM OVER 30 AGENCIES, BUSINESSES AND NON-PROFIT ORGANIZATIONS. FROM THE COMMUNITY STAKEHOLDERS, WE DEVELOPED A STEERING TEAM OF 13 DEDICATED INDIVIDUALS TO REVIEW ALL OF THE INFORMATION THAT WAS COLLECTED AND SUPPORT THE DEVELOPMENT OF THIS PLAN.WE HAVE LAUNCHED EVERY CHNA WITH A COMMUNITY SURVEY. THE SURVEY FOR THIS CYCLE INCLUDED NEW QUESTIONS AND ALIGNED DEMOGRAPHIC QUESTIONS TO CENSUS SURVEYS. WE ALSO INCREASED PAPER DISTRIBUTION TO MAKE THE SURVEY ACCESSIBLE TO MORE COMMUNITY MEMBERS AS WELL AS INTENTIONALLY WORKING TO REACH ALL DEMOGRAPHICS IN SAWYER COUNTY, INCLUDING UNDERSERVED POPULATIONS. -A DIGITAL SURVEY WAS DISTRIBUTED THROUGHOUT SAWYER COUNTY AND PORTIONS OF BAYFIELD AND WASHBURN COUNTIES. PAPER COPIES OF THE SURVEY WERE PROVIDED TO THE LAC COURTE OREILLES COMMUNITY HEALTH CENTER, LIBRARIES, AND THE SAWYER COUNTY MEALS ON WHEELS PROGRAM.-THE SURVEY WAS OPEN FOR ONE MONTH BETWEEN APRIL 29 AND MAY 31, 2024.-THE DISTRIBUTION WAS DESIGNED TO ENCOURAGE BROAD PARTICIPATION IN ORDER TO REPRESENT THE OVERALL POPULATION OF THE COUNTY, ENSURING ALL ZIP CODES, RACES, ETHNICITIES AND AGES WERE REPRESENTED.-COMMUNICATION METHODS TO PROMOTE THE SURVEY INCLUDED A PRESS RELEASE TO AREA NEWSPAPERS, RADIO STATIONS AND CHAMBERS OF COMMERCE OFFICES. TAMARACK HEALTH AND SAWYER COUNTY HEALTH & HUMAN SERVICES SOCIAL MEDIA AND WEBSITES SHARED THE INFORMATION AND AGENCY PARTNERS AND AREA SCHOOLS WERE ENCOURAGED TO SEND TO THEIR CLIENTS AND STUDENTS.-615 INDIVIDUALS TOOK THE SURVEY WITH 557 COMPLETING THE ONLINE SURVEY AND 58 PEOPLE SUBMITTING A PAPER SURVEY.-ALTHOUGH SURVEY RESPONDENT DEMOGRAPHICS ALIGNED WELL TO SAWYER COUNTY CENSUS DATA, THERE WAS A DISPARITY IN MALE SURVEY RESPONDENTS. SAWYER COUNTY CENSUS DATA HAS A RELATIVELY EVEN SPLIT WITH 51.9% MALE TO 48.1% FEMALE. HOWEVER, THE MALE SURVEY RESPONDENTS WERE SIGNIFICANTLY UNDERREPRESENTED AT 24.2% VERSUS FEMALE RESPONSE OF 73.6% (2.1% CHOSE NOT TO ANSWER).THE STEERING COMMITTEE WAS COMPRISED OF THE FOLLOWING INDIVIDUALS:ALICIA CARLSON - SAWYER COUNTY HEALTH & HUMAN SERVICESANN LARSON - SHERMAN & RUTH WEISS COMMUNITY LIBRARYASHLEY KAMLA - TAMARACK HEALTHBRITNE LONGTINE - LCO COMMUNITY HEALTH CENTERCARRIE ROBERTS - NORTHLAKES COMMUNITY CLINICCRYSTAL NORDBY - NEW DAY ADVOCACY CENTERDARRIN WHITE - NAMEKAGON TRANSITGRACE BALDRIDGE - HAYWARD UNITED METHODIST CHURCHJILLIAN STONE - HAYWARD WESLEYAN CHURCHKATHY MULLALLY - NORTHWEST CONNECTION FAMILY RESOURCE CENTERMARIE BASTY - BIZHIKI WELLNESS CENTERROBERT JOZWIAK - HAYWARD COMMUNITY FOOD SHELFSARA KRESS - TAMARACK HEALTH TAMARACK HEALTH HAYWARD MEDICAL CENTER PART V, SECTION B, LINE 6B: SAWYER COUNTY HEALTH AND HUMAN SERVICES TAMARACK HEALTH HAYWARD MEDICAL CENTER PART V, SECTION B, LINE 7D: HMC DID A SOCIAL MEDIA POST AS WELL AS GAVE PAPER COPIES OF THE REPORT TO THE PARTNERING ORGANIZATIONS THAT IT WORKED ON THE CHNA WITH, FOR AVAILABILITY AT THEIR LOCATIONS. TAMARACK HEALTH HAYWARD MEDICAL CENTER PART V, SECTION B, LINE 11: TAMARACK HEALTH HAYWARD MEDICAL CENTERPARTNERED WITH SAWYER COUNTY PUBLIC HEALTH TO COMPLETE THE COMMUNITY HEALTH NEEDS ASSESSMENT AND DEVELOP AND IMPLEMENT THE 2026-2028 COMMUNITY HEALTH IMPROVEMENT PLAN.THE FOLLOWING PRIORITY AREAS WERE IDENTIFIED:1. SUBSTANCE ABUSE (DRUG USE AND ALCOHOL USE)2. MENTAL HEALTH (INCLUDE SODICAL ISOLATION AS A CONTRIBUTING FACTOR)3. BASIC NEEDS (SHELTER/HOUSING, TRANSPORTATION, FOOD, HEALTH CARE, LIVABLE WAGES, CHILDCARE)THESE PRIORITIES WILL BE ADDRESSED BY THE FOLLOWING STRATEGIES:1. CONDUCT ROOT CAUSE AND GAP ANALYSES OF THE 3 PRIORITY AREAS2. INCREASE AGENCY COLLABORATION AND AWARENESS OF SERVICES AND PROGRAMS3. IMPROVE COMMUNITY AWARENESS OF SERVICES AND PROGRAMSHMC WILL BE ADDRESSING THESE NEEDS BEGINNING IN THE 2025 TAX YEAR. DURING THE 2024 TAX YEAR, HMC ADDRESSED THE NEEDS IDENTIFIED IN THE 2023-2025 CHNA:YEAR 3 PROGRESS: APRIL 1, 2024 - MARCH 31, 2025GOAL 1: CREATE A HEALTH AND WELLNESS COUNTY WIDE RESOURCE DATABASE TO SHARE SERVICES, EDUCATIONAL OPPORTUNITIES, PROGRAMS, SUPPORT GROUPS, ETC. THAT ARE AVAILABLE IN SAWYER COUNTY.-SAWYER COUNTY PUBLIC HEALTH CONTINUES TO INCREASE INFORMATION AVAILABLE ON THE WEBSITE, HTTPS://SAWYER.WI.NETWORKOFCARE.ORG/. THEY REGULARLY REACH OUT TO COMMUNITY ORGANIZATIONS TO ADD EVENTS AND LISTINGS, DEVELOP CONTENT AND MAKE IMPROVEMENTS TO THE SITE INCLUDING A FOCUS ON MAKING IT MORE USER FRIENDLY. -TAMARACK HEALTH CONTINUES TO CONTRIBUTE WEBSITE CONTENT, PRODUCE AND SUPPLY ADVERTISING MATERIALS TO PROMOTE THE SITE AND PAY A PORTION, $5000/ANNUALLY TO SUPPORT SITE MAINTENANCE AND HOSTING FEES.-SAWYER COUNTY NETWORK OF CARE STATISTICS FOR JAN 1 -DEC. 31, 2024:1. 10,714 TOTAL SITE VISITS2. 20,150 TOTAL PAGE VIEWS3. 55 AVERAGE PAGE VIEWS/DAY4. AVERAGE LENGTH OF TIME ON SITE: 5:44 MINUTES-SAWYER COUNTY NETWORK OF CARE WEB ANALYTICS JAN. 1 MARCH 31, 2025 ARE SHOWING VERY STRONG GROWTH OVER 2024 STATS:1. 8,196 TOTAL SITE VISITS2. 9,930 TOTAL PAGE VIEWS3. 110 AVERAGE PAGE VIEWS/DAY4. AVERAGE LENGTH OF TIME ON SITE: 4:49 MINUTES -TOP SEARCHES ON THE SITE:1. RECOVERY2. STRESS3. ALZEHEIMER'S DISEASE4. ASSISTIVE DEVICES-PRINTED 600 RACK CARDS TO PROMOTE SITE AND FEATURES, INCLUDES QR CODE FOR EASY ACCESS. PRINTING OF CARDS COST $107.36 BY ADVANCE PRINTING ON 4/4/24GOAL 2: CREATE COMMUNITY ACTION GROUP(S) FOR EACH AGE AND FOCUS AREA. GROUPS WILL PRIORITIZE IDENTIFIED FOCUS AREAS, DEVELOPING GOALS AND CREATING ACTIONABLE STEPS TO IMPROVE THE IDENTIFIED NEEDS.CHILDREN & YOUNG ADULTS: HEALTH EDUCATION PREVENTION & ADULTS: ALCOHOL & DRUG RECOVERY GROUPS/SERVICESSUPPORTING ALL AGE GROUPS: THE MISSION OF THE GIWII-MINOBIMAADIZIMIN (WE WANT TO LIVE WELL) PREVENTION COALITION FOCUSES ON PROMOTING POSITIVE MENTAL HEALTH AND PREVENT SUBSTANCE USE. THE COALITION WILL MOVE OUR COMMUNITIES FORWARD TOGETHER THROUGH PREVENTION, EDUCATION, COMMUNITY ACTION AND TREATMENT AWARENESS. A MAJOR GOAL OF THE COALITION IS TO REDUCE STIGMA ASSOCIATED WITH MENTAL HEALTH AND/OR SUBSTANCE USE TREATMENT. SIMULTANEOUS, THE COALITION STRIVES TO RAISE AWARENESS OF LOCAL RESOURCES FOR SUBSTANCE USE TREATMENT. THE PREVENTION COALITION IS ONE OF THE MOST ACTIVE GROUPS, MEETING ONCE A MONTH TO DISCUSS GOALS AND PROJECTS THAT MEMBERS ARE IMPLEMENTING WITHIN THE COMMUNITY. -TOPICS INCLUDED:1. REDUCING DISPARITIES2. FOCUS ON COMMUNITY AND RESPECTING CULTURES3. BREAK DOWN STIGMAS, EMBRACE THE POSITIVE-INFORMATION SHARED TO INCREASE AWARENESS OF ACTIVITIES AND PROGRAMS:1. YOUTH DIVERSION PROGRAM FOCUSING ON PREVENTION2. SOBER ACTIVITIES OFFERED BY THE LCO BOYS & GIRLS CLUB3. FENTANYL AWARENESS INITIATIVE4. SOBER LIVING OPTIONS AND INITIATIVES5. NARCAN TRAINING OPPORTUNITIES AS OF 9/25/24 OVER 80 PEOPLE HAVE COMPLETED THE FREE TRAINING THAT HAS BEEN OFFERED AS PART OF THE TRIBAL OVERDOSE PREVENTION GRANT6. GRANT OPPORTUNITIES SOUGHT TO SUPPORT YOUTH JUSTICE SOBER ACTIVITIES7. FIVE NARCAN VENDING MACHINES PURCHASED FOR COMMUNITY WITH GRANT FUNDS. LOCATIONS HAVE BEEN SELECTED AND PERMISSION RECEIVED, DETAIL TO BE PROVIDED IN NEXT REPORT. -THE COALITION IS A GREAT EXAMPLE OF WORK THAT WILL CONTINUE IN THE NEXT CHIP. WE PLAN TO USE THIS GROUP TO HELP STRATEGY #1: CONDUCT ROOT CAUSE AND GAP ANALYSES OF SUBSTANCE ABUSE.FENTANYL AWARENESS CAMPAIGN COMMUNITY SPEAKS - APRIL 9, 2024-A COMMUNITY WIDE EVENT TO RAISE AWARENESS OF THE DANGERS OF FENTANYL OCCURRED ON APRIL 9, 2024. -SPEAKERS PRESENTED TOPICS ON: RECOVERY IS POSSIBLE, DON'T BE FOOLED BY FENTANYL, THE CHARACTER OF ETHICS & CONNECTIONS BETWEEN CYBERTECHNOLOGY & DRUG ADDICTION/OVERDOSE-THE EVENT HOSTED 171 ATTENDEES, SUPPORTED BY 15 VENDORS.-TAMARACK HEALTH EMERGENCY DEPARTMENT REPRESENTATIVES ATTENDED THE EVENT AS A VENDOR AND PROVIDED EDUCATION ON SUBSTANCE ABUSE. SUPPORTING ALL AGE GROUPS: NATIONAL NIGHT OUT SAWYER COUNTY - AUGUST 1, 2024-COORDINATED BY SAWYER COUNTY SHERIFF'S DEPARTMENT WITH TAMARACK HEALTH HAYWARD MEDICAL CENTER COMMUNITY TEAM-TAMARACK HEALTH SPONSORED THE FOOD, SUPPORTED THE SET-UP AND PROVIDED BIKE HELMETS TO AREA CHILDREN AND ENCOURAGED BIKE SAFETY PRACTICES-COMMUNITY EDUCATION BY MEMBERS OF THE PREVENTION TASK FORCE FOCUSED ON VAPING-COMMUNITY EDUCATION BY TAMARACK HEALTH WAS PROVIDED BY THE TRAUMA COMMITTEE AND PROVIDED STOP THE BLEED EDUCATIONSUPPORTING ALL AGE GROUPS: TREATING OPIOID USE DISORDER (OUD) - SEPTEMBER 24, 2024-CONTINUED MEDICAL EDUCATION OFFERING BY THE WISCONSIN MEDICAL SOCIETY TO TAMARACK HEALTH PROVIDERS-KEYNOTE PRESENTER FAMILY MEDICINE PHYSICIAN: KRISTIE JOHNSON, MD-LEARNING OBJECTIVES INCLUDED:1. REVIEW THE PREVALENCE OF OUD2. DISCUSS HOW OUD CAN BE TREATED BY THE PRIMARY CARE PROVIDER3. EXPLAIN WHY PRIMARY CARE PROVIDERS SHOULD CONSIDER PRESCRIBING, OR EXPANDING THEIR PRESCRIBING PRACTICES WHERE APPLICABLETAMARACK HEALTH WORKED WITH SAWYER COUNTY AND OTHER COMMUNITY AGENCIES TO DEVELOP A COLLABORATIVE PARTNERSHIP TO HELP MITIGATE ISSUES RELATED TO CRISIS SITUATIONS WITHIN THE COUNTY. PARTICIPANTS INCLUDE ALL LAW ENFORCEMENT AGENCIES INCLUDING REPRESENTATIVES FROM SAWYER COUNTY SHERIFF'S DEPT., CITY OF HAYWARD, TOWN AND HAYWARD AND LCO LAW ENFORCEMENT, NORTHLAND COUNSELING, SAWYER COUNTY HEALTH AND HUMAN SERVICES AND ADULT PROTECTIVE SERVICES AND TAMARACK HEALTH HAYWARD MEDICAL CENTER INCLUDING EMERGENCY PREPAREDNESS, ED NURSE MANAGER AND THE DIRECTORS OF NURSING AND SOCIAL SERVICES. ADDITIONAL AGENCIES ARE INVITED ON AN AD HOC BASIS AND THE GROUP MEETS QUARTERLY FOR APPROXIMATELY 90 MINUTES.-TOPICS INCLUDED:1. TRANSPORTATION FOR BEHAVIORAL HEALTH PATIENTS2. HOMELESS WITHIN THE COMMUNITY3. CHILD PROTECTIVE SERVICES REMOVAL OF INFANTS4. LAW ENFORCEMENT RESPONSE AND TAMARACK HEALTH NEEDS DURING 12/30/24 LOCKDOWNADULTS: GENERAL -TAMARACK HEALTH HAYWARD AND ASHLAND MEDICAL CENTERS PARTNERED WITH REGIONAL HOSPICE SERVICES TO OFFER EDUCATION TO COMPLETE ADVANCE DIRECTIVES. THE EDUCATION IS OPEN TO EVERYONE, BUT FOCUSED ON ENGAGING COMMUNITY MEMBERS OVER AGE 60. THE TRAINING OCCURRED AT HMC ON JULY 23, 2024 AND AT AMC ON AUGUST 1, 2024.ADULTS: MENTAL HEALTH TRAUMA INFORMED CAREWE CONTINUE TO DISCUSS AND DEVELOP TRAINING TO EDUCATE HEALTHCARE, SOCIAL SERVICES ORGANIZATIONS, LAW ENFORCEMENT AND OTHERS ON TRAUMA INFORMED CARE.TAMARACK HEALTH HAYWARD MEDICAL CENTER REPRESENTATIVES INCLUDE:-LEE ANN KRAUSE, SOCIAL SERVICES DIRECTOR-TRACY JENSEN, CLINICAL NURSE EDUCATOR-CHERIE MORGAN, MARKETING DIRECTORSAWYER COUNTY HEALTH & HUMAN SERVICES REPRESENTATIVES INCLUDE:-JULIA LYONS, DIRECTOR-JULIE MCCALLUM, HEALTH OFFICER-JAKE WHITE, AMERICORPS PUBLIC HEALTH SPECIALISTJANUARY 2024 - SAWYER COUNTY HEALTH AND HUMAN SERVICES HAD EDUCATIONAL PRESENTATION FROM TAMARACK HEALTH ASHLAND MEDICAL CENTER BEHAVIORAL HEALTH REPRESENTATIVE SHERRI PAULSON, MSED, LCSW.REPRESENTATIVES FROM SAWYER COUNTY HEALTH & HUMAN SERVICES AND TAMARACK HEALTH HAYWARD MEDICAL CENTER (IDENTIFIED ABOVE) MET ON JULY 2 AND AUGUST 13, 2024 TO CONTINUE DISCUSSIONS ON DEVELOPING TRAINING TO EDUCATE HEALTHCARE, SOCIAL SERVICES ORGANIZATIONS, LAW ENFORCEMENT AND OTHERS ON TRAUMA INFORMED CARE.-FOLLOWING THE AUGUST MEETING IT WAS DETERMINED THAT DUE TO SIGNIFICANT EDUCATION PRIORITIES FOR TAMARACK HEALTH STAFF, THIS PRIORITY COULD NOT BE FULFILLED WITHIN THE ORGANIZATION AT THIS TIME.-TRAUMA INFORMED CARE - CRISIS INTERVENTION TRAINING, APRIL 1-2, 2025PROVIDED BY THE NATIONAL ALLIANCE ON MENTAL ILLNESS (NAMI)1. EVEN THOUGH THIS TRAINING TOOK PLACE IN THE NEXT FISCAL YEAR, IT IS IMPORTANT TO ACKNOWLEDGE THE ONGOING WORK RELATED TO IMPROVING AWARENESS AND HIGHLIGHTING THE IMPORTANCE OF TRAUMA INFORMED CARE. 2. THE CRISIS INTERVENTION TRAINING WAS VERY SUCCESSFUL WITH 24 ATTENDEES FROM COMMUNITY AGENCIES INCLUDING REPRESENTATIVES FROM SAWYER COUNTY HEALTH AND HUMAN SERVICES AND TAMARACK HEALTH. SEE PART V, PAGE 8 FOR CONTINUATION. PART V, LINE 16A, FAP WEBSITE: HTTPS://WWW.TAMARACKHEALTH.ORG/PATIENTS-VISITORS/BILLING-INSURANCE-RESOURCES/FINANCIAL-ASSISTANCE/ PART V, LINE 16B, FAP APPLICATION FORM WEBSITE: HTTPS://RES.CLOUDINARY.COM/DPMYKPSIH/IMAGE/UPLOAD/TAMARACK-SITE-442/MEDIA/680CDC2B4B584BBD9A567C8B393B946D/2025-TAMARACK-HEALTH-FINANCIAL-ASSISTANCE-APPLICATION.PDF PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY: HTTPS://RES.CLOUDINARY.COM/DPMYKPSIH/IMAGE/UPLOAD/TAMARACK-SITE-442/MEDIA/19C77EF038DA4875A13632E8E065A506/2025-TAMARACK-HEALTH-FAP-PLAIN-LANGUAGE-SUMMARY.PDF PART V, LINE 16I, FAP TRANSLATION: DUE TO THE SMALL SIZES OF THE LIMITED ENGLISH PROFICIENCY (LEP) POPULATIONS OF THE COMMUNITIES SERVED BY THE ORGANIZATION, THE ORGANIZATION WAS NOT REQUIRED TO TRANSLATE THE FINANCIAL ASSISTANCE POLICY (FAP), THE FAP APPLICATION FORM, OR THE PLAIN LANGUAGE SUMMARY OF THE FAP TO OTHER LANGUAGES. PART V, LINE 7A, CHNA - HOSPITAL'S WEBSITE: HTTPS://WWW.TAMARACKHEALTH.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ PART V, LINE 10, IMPLEMENTATION PLAN WEBSITE: HTTPS://WWW.TAMARACKHEALTH.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ PART V, SECTION B, LINE 11, CONTINUED: 3. THE TRAINING INCLUDED A HISTORICAL TRAUMA SPEAKER, BACKGROUND INFORMATION ON MENTAL HEALTH, TRAUMA INFORMED CARE, DE-ESCALATION TECHNIQUES AND ADDITIONAL TOPICS. GOAL 3: EXPLORE OFFERING CHRONIC DISEASE MANAGEMENT SKILL BUILDING USING THE STANFORD CURRICULUM OF LIVING BETTER WITH CHRONIC DISEASE FOR YOUNG ADULTS THROUGH SENIORS.-TAMARACK HEALTH CONTINUES TO EXPAND PRIMARY CARE ACCESS IN ASHLAND, HAYWARD AND CABLE. AS EXPANSION PROJECTS STABILIZE, WE HOPE TO ENGAGE PROVIDERS, CLINIC LEADERS AND MEDICAL PROFESSIONALS TO BEGIN TO ADDRESS THIS NEED.COMMUNITY HEALTH NEEDS NOT ADDRESSED/ADDITIONAL IDENTIFIED PRIORITIES: THE COMMUNITY HEALTH IMPROVEMENT PLAN COMMITTEE IDENTIFIED SEVERAL OTHER HEALTH CONCERNS PREVALENT IN OUR COMMUNITIES WHICH INCLUDED, BUT WERE NOT LIMITED TO: COMMUNICABLE DISEASE, INJURY AND VIOLENCE, NUTRITION, GROWTH AND DEVELOPMENT, PHYSICAL HEALTH, TABACCO USE. ENVIRONMENTAL AND OCCUPATION, ORAL HEALTH, REPRODUCTIVE AND SEXUAL ISSUES, ETC.STAKEHOLDERS WERE ASKED TO RANK THESE HEALTH CONCERNS BY PRIORITY, AND WHILE ALL ARE IMPORTANT AND DEMAND TO BE ACKNOWLEDGED, THE COMMITTEE DECIDED TO USE AVAILABLE RESOURCES IN THE MOST EFFICIENT WAY POSSIBLE. THIS MEANT PRIORITIZING THREE ISSUES FOR THE GREATEST IMPACT, RATHER THAN TRYING TO DO A LITTLE IN EACH AREA. 2 1 - WATER'S EDGE 11040 N STATE ROAD 77 HAYWARD WI 54843 NURSING HOME 2 - WATER'S EDGE 11040 N STATE ROAD 77 HAYWARD WI 54843 ASSISTED LIVING FACILITY PART I, LINE 7: COSTS ARE CALCULATED USING FINANCIAL DATA AND THE COST TO CHARGE RATIO FROM THE AS FILED MEDICARE COST REPORT. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES INCLUDE RESPIRATORY THERAPY, REHAB SERVICES, OBSERVATION BEDS, NURSING HOME AND ASSISTED LIVING. PART I, LN 7 COL(F): IMPLICIT PRICE CONCESSIONS FROM FINANCIAL STATEMENTS IS $4,198,640. PART II, COMMUNITY BUILDING ACTIVITIES: MANY PROGRAMS HAVE BEEN DESIGNED TO HELP PATIENTS OF THE COMMUNITY. BLOOD DRIVES, PALS CLASSES, NRP CLASS, MOM & INFANT MONTHLY NETWORK MEETINGS, PRENATAL YOGA, PARKINSON'S SUPPORT GROUP, ALSO COURSE, ACLS CLASSES, STABLE COURSE, AND BLS CLASSES ARE EXAMPLES OF THE COMMUNITY ACTIVITIES HAYWARD HOSPITAL IS CURRENTLY INVOLVED IN. IN ADDITION, COMMUNITY BENEFIT OPERATIONS THAT THE HOSPITAL IS INVOLVED WITH INCLUDE COMMUNITY SUPPERS, BIRKIE MEDICAL DIRECTORSHIP, BIRKIE MEDICAL TEAM, NATIONAL NIGHT OUT, TEAM BIRKIE CARE, SECURE PATIENT TRANSPORT, AND SPORTS PHYSICALS. THE ACTIVITIES HAVE BEEN REPORTED ON SCHEDULE H, PART I, LINE 7E.WORKFORCE DEVELOPMENT - HMC PURCHASED A LARGE, MULTI-ROOM HOME IN DECEMBER 2018 TO HOUSE MEDICAL STUDENTS AND LOCUM PROVIDERS WITH THE INTENT TO ATTRACT MEDICAL STUDENTS TO COME TO HAYWARD FOR THEIR RESIDENCY AND SEEK EMPLOYMENT IN THE HAYWARD AREA AFTER GRADUATION. PART III, LINE 2: REVENUES GENERALLY RELATE TO CONTRACTS WITH PATIENTS IN WHICH THE PERFORMANCE OBLIGATIONS ARE TO PROVIDE HEALTH CARE SERVICES TO THE PATIENTS. REVENUES ARE RECORDED DURING THE PERIOD THE PERFORMANCE OBLIGATIONS TO PROVIDE HEALTH CARE SERVICES ARE SATISFIED. THE COMPANY'S PERFORMANCE OBLIGATIONS FOR INPATIENT SERVICES ARE GENERALLY SATISFIED OVER PERIODS THAT AVERAGE APPROXIMATELY THREE DAYS, AND REVENUES ARE RECOGNIZED BASED ON CHARGES INCURRED IN RELATION TO TOTAL EXPECTED CHARGES. PERFORMANCE OBLIGATIONS FOR OUTPATIENT SERVICES ARE GENERALLY SATISFIED OVER A PERIOD OF LESS THAN ONE DAY.REVENUES ARE BASED UPON THE ESTIMATED AMOUNTS THE COMPANY EXPECTS TO BE ENTITLED TO RECEIVE FROM PATIENTS, INCLUDING PAYMENTS MADE BY THIRD-PARTY PAYORS ON BEHALF OF PATIENTS. ESTIMATES OF CONTRACTUAL ALLOWANCES UNDER MANAGED CARE AND COMMERCIAL INSURANCE PLANS ARE BASED UPON THE PAYMENT TERMS SPECIFIED IN THE RELATED CONTRACTUAL AGREEMENTS. REVENUES RELATED TO UNINSURED PATIENTS AND UNINSURED COPAYMENTS AND DEDUCTIBLE AMOUNTS FOR PATIENTS WHO HAVE HEALTH CARE COVERAGE MAY HAVE DISCOUNTS APPLIED (UNINSURED DISCOUNTS AND CONTRACTUAL DISCOUNTS). THE COMPANY ALSO RECORDS ESTIMATED IMPLICIT PRICE CONCESSIONS (BASED PRIMARILY ON HISTORICAL COLLECTION EXPERIENCE) RELATED TO UNINSURED ACCOUNTS TO RECORD SELF-PAY REVENUES AT THE ESTIMATED AMOUNTS THE COMPANY EXPECTS TO COLLECT.UNDER THE PROVISIONS OF ACCOUNTING STANDARDS UPDATE (ASU) NO. 2014-09, WHEN THERE IS AN UNCONDITIONAL RIGHT TO PAYMENT, SUBJECT ONLY TO THE PASSAGE OF TIME, THE RIGHT IS TREATED AS A RECEIVABLE. PATIENT ACCOUNTS RECEIVABLE, INCLUDING BILLED ACCOUNTS AND UNBILLED ACCOUNTS FOR WHICH THE COMPANY HAS THE UNCONDITIONAL RIGHT TO PAYMENT, AND ESTIMATED AMOUNTS DUE FROM THIRD-PARTY PAYORS FOR RETROACTIVE ADJUSTMENTS ARE RECEIVABLES IF THE COMPANY'S RIGHT TO CONSIDERATION IS UNCONDITIONAL AND ONLY THE PASSAGE OF TIME IS REQUIRED BEFORE PAYMENT OF THAT CONSIDERATION IS DUE. FOR PATIENT ACCOUNTS RECEIVABLE, THE ESTIMATED UNCOLLECTIBLE AMOUNTS ARE GENERALLY CONSIDERED IMPLICIT PRICE CONCESSIONS THAT ARE A DIRECT REDUCTION TO PATIENT ACCOUNTS RECEIVABLE RATHER THAN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THE COMPANY DETERMINES THIS ESTIMATE OF IMPLICIT PRICE CONCESSIONS BASED ON HISTORICAL COLLECTION EXPERIENCE WITH CERTAIN CLASSES OF PATIENTS USING A PORTFOLIO APPROACH AS A PRACTICAL EXPEDIENT TO ACCOUNT FOR PATIENT CONTRACTS AS COLLECTIVE GROUPS RATHER THAN INDIVIDUALLY. THE FINANCIAL STATEMENT EFFECTS OF USING THIS PRACTICAL EXPEDIENT ARE NOT MATERIALLY DIFFERENT FROM AN INDIVIDUAL CONTRACT APPROACH.THE PRIMARY COLLECTIONS RISKS RELATE TO UNINSURED PATIENT ACCOUNTS, INCLUDING PATIENT ACCOUNTS FOR WHICH THE PRIMARY INSURANCE CARRIER HAS PAID THE AMOUNTS COVERED BY THE APPLICABLE AGREEMENT, BUT THE PATIENT RESPONSIBILITY AMOUNTS (DEDUCTIBLES AND COPAYMENTS) REMAIN OUTSTANDING. IMPLICIT PRICE CONCESSIONS RELATE PRIMARILY TO AMOUNTS DUE DIRECTLY FROM PATIENTS. ESTIMATED IMPLICIT PRICE CONCESSIONS ARE RECORDED FOR ALL UNINSURED ACCOUNTS, REGARDLESS OF THE AGING OF THOSE ACCOUNTS. ACCOUNTS ARE WRITTEN OFF WHEN ALL REASONABLE INTERNAL AND EXTERNAL COLLECTION EFFORTS HAVE BEEN PERFORMED. PART III, LINE 3: AT TAMARACK HEALTH HAYWARD MEDICAL CENTER, IMPLICIT PRICE CONCESSIONS ARE CONSIDERED THE UNWILLINGNESS TO PAY, WHILE CHARITY CARE AND FREE CARE ARE INABILITY TO PAY. PART III, LINE 4: SEE FOOTNOTE 1 ON PAGE 8-9 OF THE AUDITED FINANCIAL STATEMENTS PART III, LINE 8: THE COSTING METHODOLOGY USED IN DETERMINING THE MEDICARE ALLOWABLE COST REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT AS REFLECTED IN THE AMOUNT REPORTED IN PART III, LINE 6:THE HOSPITAL FOLLOWED MEDICARE'S PRESCRIBED METHODS OF DETERMINING COSTS PAYABLE UNDER TITLE XVIII (MEDICARE) IN COMPLETING ITS ANNUAL MEDICARE COST REPORT (COST REPORT) USING DATA AVAILABLE FROM THE INSTITUTION'S BASIC ACCOUNTS, AS USUALLY MAINTAINED, TO ARRIVE AT EQUITABLE AND PROPER PAYMENT FOR SERVICES. THE COST REPORT WAS COMPLETED USING THE HOSPITAL'S TRIAL BALANCE OF EXPENSES, AS WELL AS OTHER STATISTICAL AND FINANCIAL RECORDS MAINTAINED BY THE HOSPITAL. AS REQUIRED BY MEDICARE REGULATIONS, CERTAIN RECLASSIFICATIONS AND ADJUSTMENTS TO COSTS WERE INCLUDED IN THE COST REPORT TO DETERMINE MEDICARE ALLOWABLE COSTS.AFTER MEDICARE ALLOWABLE COSTS ARE DETERMINED, THE COST REPORT PROVIDES FOR THE STEP DOWN METHOD OF COST FINDING. THIS METHOD PROVIDES FOR ALLOCATING THE COST OF SERVICES RENDERED BY EACH GENERAL SERVICE COST CENTER TO OTHER COST CENTERS, WHICH UTILIZE THE SERVICES. ONCE THE COSTS OF A GENERAL SERVICE COST CENTER HAVE BEEN ALLOCATED, THAT COST CENTER IS CONSIDERED CLOSED. ONCE CLOSED, IT DOES NOT RECEIVE ANY OF THE COSTS SUBSEQUENTLY ALLOCATED FROM THE REMAINING GENERAL SERVICE COST CENTERS. AFTER ALL COSTS OF THE GENERAL SERVICE COST CENTERS HAVE BEEN ALLOCATED TO THE REMAINING COST CENTERS, THE TOTAL COSTS OF THESE REMAINING COST CENTERS ARE FURTHER DISTRIBUTED TO THE DEPARTMENTAL CLASSIFICATION TO WHICH THEY PERTAIN, E.G., HOSPITAL GENERAL INPATIENT ROUTINE, SUBPROVIDER, ANCILLARY, ETC.AFTER THE STEP-DOWN PROCESS, THE COST REPORT PROVIDES FOR THE APPORTIONMENT OF COSTS TO THE MEDICARE PROGRAM BASED ON A NUMBER OF DIFFERENT METHODOLOGIES INCLUDING PER PATIENT DAY, PER VISIT, AND PERCENTAGE OF CHARGES, AS MOST PREVALENT. MEDICARE COSTS AS DETERMINED BY THE COST REPORT METHODOLOGIES DESCRIBED PREVIOUSLY WERE UTILIZED TO COMPLETE THE APPLICABLE MEDICARE ALLOWABLE COSTS OF CARE FOR SCHEDULE H (FORM 990) PART III SECTION B LINE 6. PART III, LINE 9B: TAMARACK HEALTH HAYWARD MEDICAL CENTER'S BILLING AND COLLECTION POLICY STATES:A. SUBJECT TO COMPLIANCE WITH THE PROVISIONS OF THIS POLICY, TAMARACK HEALTH MAY TAKE ANY AND ALL LEGAL ACTIONS, INCLUDING EXTRAORDINARY COLLECTION ACTIONS, TO OBTAIN PAYMENT FOR MEDICAL SERVICES PROVIDED.B. ALL PATIENTS WILL BE OFFERED A PLAIN LANGUAGE SUMMARY AND AN APPLICATION FORM FOR FINANCIAL ASSISTANCE UNDER THE FAP AS PART OF THE DISCHARGE OR INTAKE PROCESS FROM A HOSPITAL.C. AT LEAST THREE SEPARATE STATEMENTS FOR COLLECTION OF SELF-PAY ACCOUNTS SHALL BE MAILED OR EMAILED TO THE LAST KNOWN ADDRESS OF EACH RESPONSIBLE INDIVIDUAL(S); PROVIDED, HOWEVER, THAT NO ADDITIONAL STATEMENTS NEED BE SENT AFTER A RESPONSIBLE INDIVIDUAL(S) SUBMITS A COMPLETE APPLICATION FOR FINANCIAL ASSISTANCE UNDER THE FAP OR HAS PAID IN FULL. AT LEAST 60 DAYS SHALL HAVE ELAPSED BETWEEN THE FIRST AND LAST OF THE REQUIRED THREE MAILINGS. IT IS THE RESPONSIBLE INDIVIDUAL(S) OBLIGATION TO PROVIDE A CORRECT MAILING ADDRESS AT THE TIME OF SERVICE OR UPON MOVING. IF AN ACCOUNT DOES NOT HAVE A VALID ADDRESS, THE DETERMINATION FOR "REASONABLE EFFORT" WILL HAVE BEENMADE. ALL SINGLE PATIENT ACCOUNT STATEMENTS OF SELF-PAY ACCOUNTS WILL INCLUDE BUT NOT LIMITED TO:1. AN ACCURATE SUMMARY OF THE HOSPITAL SERVICES COVERED BY THE STATEMENT;2. THE CHARGES FOR SUCH SERVICES;3. THE AMOUNT REQUIRED TO BE PAID BY THE RESPONSIBLE INDIVIDUAL(S) (OR, IF SUCH AMOUNT IS NOT KNOWN, A GOOD FAITH ESTIMATE OF SUCH AMOUNT AS OF THE DATE OF THE INITIAL STATEMENT); AND4. A CONSPICUOUS WRITTEN NOTICE THAT NOTIFIES AND INFORMS THE RESPONSIBLE INDIVIDUAL(S) ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE UNDER THE HOSPITAL FAP INCLUDING THE TELEPHONE NUMBER OF THE DEPARTMENT AND DIRECT WEBSITE ADDRESS WHERE COPIES OF DOCUMENTS MAY BE OBTAINED.D. AT LEAST ONE OF THE STATEMENTS MAILED OR EMAILED WILL INCLUDE WRITTEN NOTICE THAT INFORMS THE RESPONSIBLE INDIVIDUAL(S) ABOUT THE ECAS THAT ARE INTENDED TO BE TAKEN IF THE RESPONSIBLE INDIVIDUAL(S) DOES NOT APPLY FOR FINANCIAL ASSISTANCE UNDER THE FAP OR PAY THE AMOUNT DUE BY THE BILLING DEADLINE. SUCH STATEMENT MUST BE PROVIDED TO THE RESPONSIBLE INDIVIDUAL(S) AT LEAST 30 DAYS BEFORE THE DEADLINE SPECIFIED IN THE STATEMENT. A PLAIN LANGUAGE SUMMARY WILL ACCOMPANY THIS STATEMENT. IT IS THE RESPONSIBLE INDIVIDUAL(S) OBLIGATION TO PROVIDE A CORRECT MAILING ADDRESS AT THE TIME OF SERVICE OR UPON MOVING. IF AN ACCOUNT DOES NOT HAVE A VALID ADDRESS, THE DETERMINATION FOR "REASONABLE EFFORT" WILL HAVE BEEN MADE.E. TAMARACK HEALTH OFFERS PAYMENT PLANS THAT BEAR NO INTEREST. GENERALLY, BALANCES REQUIRE A MINIMUM PAYMENT OF $25.00 PER MONTH AND MUST BE PAID IN FULL WITHIN 24 MONTHS.F. PRIOR TO INITIATION OF ANY ECAS, AN ORAL ATTEMPT WILL BE MADE TO CONTACT RESPONSIBLE INDIVIDUAL(S) BY TELEPHONE AT THE LAST KNOWN TELEPHONE NUMBER, IF ANY, AT LEAST ONCE DURING THE SERIES OF MAILED OR EMAILED STATEMENTS IF THE ACCOUNT REMAINS UNPAID. DURING ALL CONVERSATIONS, THE PATIENT OR RESPONSIBLE INDIVIDUAL(S) WILL BE INFORMED ABOUT THE FINANCIAL ASSISTANCE THAT MAY BE AVAILABLE UNDER THE FAP.G. ECAS MAY BE COMMENCED AS FOLLOWS:1. IF ANY RESPONSIBLE INDIVIDUAL(S) FAIL TO APPLY FOR FINANCIAL ASSISTANCE UNDER THE FAP BY 120 DAYS AFTER THE FIRST POST DISCHARGE STATEMENT, AND THE RESPONSIBLE INDIVIDUAL(S) HAVE RECEIVED A STATEMENT WITH A BILLING DEADLINE DESCRIBED IN SECTION III.E ABOVE, THEN TAMARACK HEALTH OR COLLECTION AGENCY MAY INITIATE ECAS.2. IF ANY RESPONSIBLE INDIVIDUAL(S) SUBMITS AN INCOMPLETE APPLICATION FOR FINANCIAL ASSISTANCE UNDER THE FAP PRIOR TO THE APPLICATION DEADLINE, THEN ECAS MAY NOT BE INITIATED UNTIL AFTER EACH OF THE FOLLOWING STEPS HAS BEEN COMPLETED:A. PFS PROVIDES THE RESPONSIBLE INDIVIDUAL(S) WITH A WRITTEN NOTICE THAT DESCRIBES THE ADDITIONAL INFORMATION ORDOCUMENTATION REQUIRED UNDER THE FAP IN ORDER TO COMPLETE THE APPLICATION FOR FINANCIAL ASSISTANCE, WHICH NOTICE WILL INCLUDE A COPY OF THE PLAIN LANGUAGE SUMMARY.B. PFS PROVIDES THE RESPONSIBLE INDIVIDUAL(S) WITH AT LEAST 30 DAYS' PRIOR WRITTEN NOTICE OF THE ECAS THAT TAMARACK HEALTH OR COLLECTION AGENCY MAY INITIATE AGAINST THE RESPONSIBLE INDIVIDUAL(S) IF THE FAP APPLICATION IS NOT COMPLETED OR PAYMENT IS NOT MADE; PROVIDED, HOWEVER, THAT THE COMPLETION DEADLINE FOR PAYMENT MAY NOT BE SET PRIOR TO 120 DAYS AFTER THE FIRST POST DISCHARGE STATEMENT.C. IF THE RESPONSIBLE INDIVIDUAL(S) WHO HAS SUBMITTED THE INCOMPLETE APPLICATION COMPLETES THE APPLICATION FOR FINANCIAL ASSISTANCE, AND PFS DETERMINES DEFINITIVELY THAT THE RESPONSIBLE INDIVIDUAL(S) IS INELIGIBLE FOR ANY FINANCIAL ASSISTANCE UNDER THE FAP, TAMARACK HEALTH WILL INFORM THE RESPONSIBLE INDIVIDUAL(S) IN WRITING THE DENIAL AND INCLUDE A 30 DAYS' PRIOR WRITTEN NOTICE OF THE ECAS THAT TAMARACK HEALTH OR COLLECTION AGENCY MAY INITIATE AGAINST THE RESPONSIBLE INDIVIDUAL(S); PROVIDED, HOWEVER, THAT THE BILLING DEADLINE MAY NOT BE SET PRIOR TO 120 DAYS AFTER THE FIRST POST DISCHARGE STATEMENT.D. IF THE RESPONSIBLE INDIVIDUAL(S) WHO HAS SUBMITTED THE INCOMPLETE APPLICATION FAILS TO COMPLETE THE APPLICATION BY THE COMPLETION DEADLINE SET IN THE NOTICE PROVIDED PURSUANT TO SECTION III.G.3.B ABOVE, THEN ECAS MAY BE INITIATED.E. IF AN APPLICATION, COMPLETE OR INCOMPLETE, FOR FINANCIAL ASSISTANCE UNDER THE FAP IS SUBMITTED BY A RESPONSIBLEINDIVIDUAL(S), AT ANY TIME PRIOR TO THE APPLICATION DEADLINE, TAMARACK HEALTH WILL SUSPEND ECAS WHILE SUCH FINANCIALASSISTANCE APPLICATION IS PENDING.I. AFTER THE COMMENCEMENT OF ECAS IS PERMITTED UNDER SECTION III.G ABOVE, COLLECTION AGENCIES SHALL BE AUTHORIZED TO REPORT UNPAID ACCOUNTS TO CREDIT AGENCIES, AND TO FILE JUDICIAL OR LEGAL ACTION, GARNISHMENT, OBTAIN JUDGMENT LIENS AND EXECUTE UPON SUCH JUDGMENT LIENS USING LAWFUL MEANS OF COLLECTION; PROVIDED, HOWEVER, THAT PRIOR APPROVAL OF PFS SHALL BE REQUIRED BEFORE INITIAL LAWSUITS MAY BE INITIATED. TAMARACK HEALTH AND EXTERNAL COLLECTION AGENCIES MAY ALSO TAKE ANY AND ALL LEGAL OTHER ACTIONS INCLUDING BUT NOT LIMITED TO TELEPHONE CALLS, EMAILS, TEXTS, MAILING NOTICES, AND SKIP TRACING TO OBTAIN PAYMENT FOR MEDICAL SERVICES PROVIDED.IV. POLICY AVAILABILITYCONTACT OUR PFS DEPARTMENT FOR INFORMATION REGARDING ELIGIBILITY OR THE PROGRAMS THAT MAY BE AVAILABLE TO YOU, TO REQUEST A COPY OF THE FAP, APPLICATION FORM, OR COLLECTION POLICY TO BE MAILED TO YOU. FULL DISCLOSURE OF THE FAP, FAP APPLICATION FORM, OR COLLECTION POLICY MAY BE FOUND AT WWW.TAMARACKHEALTH.ORG/PATIENTS-VISITORS/BILLING-SERVICES/FINANCIAL-ASSISTANCE. FINANCIAL ASSISTANCE APPLICATIONS ARE AVAILABLE BY THE FOLLOWING:1. IN PERSON AT 1615 MAPLE LANE, ASHLAND, WI 54806 OR 11040 NORTH STATE ROAD 77, HAYWARD, WI 548432. BY TELEPHONE AT (715) 685-5500 OR (715) 934-42673. ONLINE AT WWW.TAMARACKHEALTH.ORG/PATIENTS-VISITORS/BILLING-SERVICES/FINANCIAL-ASSISTANCE PART VI, LINE 2: NEEDS ASSESSMENT:FACILITY STAFF PARTICIPATE IN THE COMMUNITY NEEDS ASSESSMENT PROCESS WITH THE SAWYER COUNTY HEALTH DEPARTMENT, COMMUNITY HEALTH CLINICS, ASSISTED LIVING FACILITY, AND PHYSICIANS FROM THE COMMUNITY. FOLLOWING THE COMPLETION OF THE ASSESSMENT, VARIOUS WORK GROUPS ARE CONVENED. APPROPRIATE STAFF MEMBERS FROM THE FACILITY THEN WORK WITH COMMUNITY MEMBERS TO DEVELOP PROGRAMS AND APPROACHES TO ADDRESS THE IDENTIFIED HEALTH ISSUES. SOME EXAMPLES INCLUDE ABUSE OF PRESCRIPTION DRUGS, SEXUAL ABUSE PREVENTION PROGRAMS, UNDERAGE ALCOHOL USE, TRANSPORT ISSUES, TELEHEALTH, PATIENT ADVOCACY PROGRAM, AND REDUCED COST CLINIC. SENIOR LEADERS OF THE ORGANIZATION, ALONG WITH OUR BOARD OF DIRECTORS, CONTINUALLY EVALUATE THE NEED FOR ADDITIONAL SERVICES IN OUR COMMUNITY. WE ALSO HAVE A PATIENT FAMILY ADVISORY COMMITTEE (PFAC) WE UTILIZE TO PROVIDE COMMUNITY/PATIENT FEEDBACK REGARDING SERVICES/NEEDS, ETC. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:ALL PATIENTS ARE BILLED THE SAME, HOWEVER, IF A PATIENT BECOMES DELINQUENT ON A BILL, A LETTER IS SENT TO THE PATIENT ASKING THAT THE PATIENT CONTACT PATIENT FINANCIAL SERVICES FOR ASSISTANCE. PATIENTS HAVE THE OPTION TO DISCUSS PAYMENT OPTIONS WITH PATIENT FINANCIAL SERVICES AND POSSIBLE ELIGIBILITY FOR CHARITY CARE. PART VI, LINE 4: COMMUNITY INFORMATION:HAYWARD WISCONSIN IS LOCATED IN NORTHERN WISCONSIN AND CONSISTS OF A HIGH MEDICARE AND MEDICAID POPULATION. THE MEDICARE AND MEDICAID POPULATION ACCOUNTS FOR 64% OF THE HOSPITAL'S GROSS REVENUES AND 51% OF ITS NET PATIENT SERVICE REVENUES. HAYWARD IS CONSIDERED A SUMMER VACATION DESTINATION THAT BRINGS LARGE CROWDS DURING THE SUMMER MONTHS. THE EMERGENCY DEPARTMENT SERVES A LARGE NUMBER OF PATIENTS THAT RANGE FROM COMMERCIAL INSURANCE, MEDICARE, MEDICAID, IHS (INDIAN HEALTH SERVICES), ETC. HAYWARD HOSPITAL IS FOCUSED ON PROVIDING HIGH QUALITY HEALTHCARE IN A RURAL LOCATION. MANY SERVICES ARE PROVIDED BY HAYWARD HOSPITAL, ALLOWING LESS PATIENT TRAVEL AT A TIME WHEN THE PATIENT IS LIKELY NOT FEELING WELL. THE HAYWARD COMMUNITY IS AN AGING POPULATION AND WE RECOGNIZE THAT NEED AND HAVE COMMITTED MILLIONS OF DOLLARS INTO SERVICES FOR THE OLDER POPULATION. WE BELIEVE HAYWARD HOSPITAL PROVIDES EXCEPTIONAL CARE IN A RURAL LOCATION. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH:OPEN MEDICAL STAFF. COMMUNITY CALL PROGRAM FOR MEDICAL STAFF. LOCAL COMMUNITY BOARD WITH 12 VOTING MEMBERS. NONPROFIT STATUS WITH PROFITS (IF ANY) USED FOR ADDITIONAL SERVICES, CAPITAL PURCHASES SUCH AS A CT SCANNER, LAB EQUIPMENT, ELECTRONIC HEALTH RECORD, IMPROVED INPATIENT SERVICES, OB PROGRAM, CONTINUED EDUCATION FOR ALL STAFF, GROWING SENIOR SERVICES PROGRAM AND A FOCUS ON THE NEEDS OF THE COMMUNITY. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM:MEDICAL SERVICES, INC. IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. PART VI, LINE 7, REPORTS FILED WITH STATES WI 1 AMERICAN BIRKEBEINER SKI FOUNDATION PO BOX 911 HAYWARD WI 54843 391503175 501(C)(3) 6450 0 OPERATIONS HAYWARD COMMUNITY SCHOOL DISTRICT 15930 WEST 5TH STREET HAYWARD WI 54843 396017410 GOVERNMENTAL 50000 0 CAPITAL GRANT FITNESS CENTER 2 0 PART I, LINE 2: THE HOSPITAL REQUIRES RECIPIENTS TO PROVIDE DOCUMENTATION SUPPORTING EXPENDITURE OF RELATED GRANT FUNDS RECEIVED. EXPENDITURES ARE REQUIRED TO QUALIFY FOR THE PURPOSE THE GRANT/AWARD WAS GIVEN OR THE FUNDS ARE REQUIRED TO BE RETURNED. 1 0 0 0 0 0 0 0 0 JASON DOUGLAS FORMER PRESIDENT (DIR. & OFFICER) 0 405802 0 231665 0 590631 0 8083 0 47783 0 1283964 0 0 BRIAN DONAHUE PHYSICIAN 990535 0 15000 0 1650 0 17250 0 48495 0 1072930 0 0 0 PAUL TONKIN PHYSICIAN 852100 0 15000 0 375 0 17250 0 47559 0 932284 0 0 0 DAVID LYNN PHYSICIAN 621059 0 15000 0 375 0 17250 0 49506 0 703190 0 0 0 LUKE BEIRL DIRECTOR/CEO-MSI/INTERIM PRES-REI 493630 0 87370 0 241 0 17250 0 53296 0 651787 0 0 0 SARAH FOWLER PHYSICIAN 573919 0 10000 0 1075 0 17250 0 48072 0 650316 0 0 0 MATTHEW VINCENT CRNA 469765 0 0 0 250 0 17250 0 48160 0 535425 0 0 0 KENT DUMONSEAU CFO - REI 0 370829 0 104015 0 587 0 17250 0 41449 0 534130 0 0 HEATHER SHEEHAN COO 202175 0 40809 0 298 0 10464 0 48517 0 302263 0 0 0 AINDREA LINDSAY CCO 196616 0 39697 0 287 0 10179 0 48017 0 294796 0 0 0 PART I, LINE 3 HMC CEO, LUKE BEIRL, WAS INTERIM CEO OF AMC DURING FY 2025. DURING THAT TIME, LUKE'S COMPENSATION WAS DETERMINED BY AMC BOARD OF DIRECTORS WHO UTILIZED DATA PREPARED BY INDEPENDENT COMPENSATION CONSULTANT WHICH INCLUDES 990 COMPARABLE DATA. PART I, LINE 4A OFFICER JASON DOUGLAS RECEIVED PAY TOTALING $590,470, A BONUS OF $25,000 AND BENEFITS TOTALING $953 IN CALENDAR YEAR 2024 RELATED TO A TERMINATION AGREEMENT. UNDER THE TERMS OF THE AGREEMENT, DOUGLAS RECEIVED THE PAY AND BONUS IN A LUMP SUM IN FEBRUARY OF 2024, AND TOTAL BENEFITS OF $1,143 WERE PAID OUT OVER 12 MONTHS FROM HIS SEPARATION DATE. DOUGLAS WAS PAID BY RELATED ENTITY, MEMORIAL MEDICAL CENTER, INC. DBA TAMARACK HEALTH ASHLAND MEDICAL CENTER. A TOWN OF HAYWARD WISCONSIN 396031517 2020-07-15 10000000 PROPERTY AND EQUIPMENT 0 0 0 B TOWN OF HAYWARD WISCONSIN 396031517 2020-07-15 3100000 REFINANCE 0 0 0 C TOWN OF HAYWARD WISCONSIN 396031517 2023-09-07 10000000 PROPERTY AND EQUIPMENT 0 0 0 D CITY OF HAYWARD WISCONSIN 396005464 2023-09-07 3200000 PROPERTY AND EQUIPMENT 0 0 0 A 2216830 10000000 149019 9850981 2021 0 0 1 1 B 2931285 3100000 62793 3037207 2010 1 0 1 1 C 256500 10000000 179412 9820588 2024 0 0 1 1 D 82080 3200000 57412 3142588 2024 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 D 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 1 0 1 1 JOHNSON BANK 11.000000000000 0 0 0 0 1 B 0 0 1 0 0 0 0 0 1 C 0 0 1 0 1 1 JOHNSON BANK 15.000000000000 0 0 0 0 1 D 0 0 1 0 1 1 JOHNSON BANK 15.000000000000 0 0 0 0 1 A 1 B 1 C 1 D 1 SARAH DUMONSEAU FAMILY MEMBER OF OFFICER KENT DUMONSEAU 140368 EMPLOYMENT 0 HALEY STELLMACHER FAMILY MEMBER OF OFFICER LUKE BEIRL 79918 EMPLOYMENT 0 FORM 990, PART VI, SECTION A, LINE 6 REGIONAL ENTERPRISES, INC. IS THE SOLE CORPORATE MEMBER OF MEDICAL SERVICES, INC. FORM 990, PART VI, SECTION A, LINE 7A THE PRESIDENT OF REI SHALL BE AN EX OFFICIO MEMBER OF THE MSI BOARD WITH FULL VOTING PRIVILEGES. FORM 990, PART VI, SECTION A, LINE 7B AS THE SOLE MEMBER OF MEDICAL SERVICES, INC., REGIONAL ENTERPRISES, INC. HAS THE FOLLOWING RESERVE POWERS: A. TO MAKE, AMEND, OR REPEAL MSI'S BYLAWS AND ARTICLES OF INCORPORATION. B. TO APPROVE ANY CHANGE IN MSI'S PHILOSOPHY, MISSION OR VISION STATEMENTS, AND APPROVE THE LONG-RANGE GOALS AND STRATEGIC PLAN FOR MSI. C. TO APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGET. D. TO APPROVE ALL BUILDING PROGRAMS THAT EXCEED $500,000 IN VALUE. E. TO SELECT AND RETAIN AN INDEPENDENT AUDITING FIRM. F. TO APPOVE THE PURCHASE, SALE, LEASE, DISPOSITION, OR ALIENATION OF ANY REAL PROPERTY OWNED BY MSI. ANY SUCH ACTION SHALL BE JOINTLY APPROVED BY THE BOARD OF DIRECTORS OF MEMORIAL MEDICAL CENTER OF ASHLAND, WISCONSIN. G. TO APPROVE ANY PLAN OF DISSOLUTION OR MERGER, CONSOLIDATION, ACQUISITION OR DISPOSITION OF REAL PROPERTY OR RELOCATION OF THE FACILITIES OF MSI. ANY SUCH ACTION SHALL BE JOINTLY APPROVED BY THE BOARD OF DIRECTORS OF MEMORIAL MEDICAL CENTER OF ASHLAND, WISCONSIN. H. TO AUTHORIZE THE PRESIDENT OF REI TO RECOMMEND TO THE BOARD OF MSI, THE INDIVIDUAL WHO WILL SERVE AS THE CHIEF EXECUTIVE OFFICER FOR MSI, SUBJECT TO RATIFICATION BY THE MSI BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B THE FINANCE AND ACCOUNTING TEAM REVIEW THE 990 PRIOR TO FILING TO CONFIRM ACCURACY OF INFORMATION. THE 990 IS REVIEWED BY THE BOARD OF DIRECTORS BEFORE IT IS FILED. IF ANY CHANGES ARE MADE, A FINAL COPY OF THE 990 IS PROVIDED TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C EACH DIRECTOR AND OFFICER SHALL DISCLOSE TO THE BOARD OF DIRECTORS, OR TO THE OTHER MEMBERS OF ANY COMMITTEE CONSIDERING A PROPOSED BUSINESS TRANSACTION OR ARRANGEMENT, THE EXISTENCE AND NATURE OF ANY FINANCIAL INTEREST SUCH PERSON OR A MEMBER OF SUCH PERSON'S FAMILY MAY HAVE WITH RESPECT TO SUCH PROPOSED TRANSACTION OR ARRANGEMENT. EACH DIRECTOR AND PRINCIPAL OFFICER SHALL PROMPTLY MAKE DISCLOSURES AS MAY BE NECESSARY TO KEEP THE BOARD OR COMMITTEE FULLY APPRISED OF SUCH PERSON'S FINANCIAL INTERESTS. DISCLOSURE SHALL ALSO BE ACCOMPLISHED ON AN ANNUAL BASIS BY HAVING EACH DIRECTOR AND PRINCIPAL OFFICER EXECUTE AND DELIVER TO MSI A CERTIFICATE REGARDING CONFLICTS OF INTEREST. IF ANY DIRECTOR OR PRINCIPAL OFFICER DISCLOSES A POTENTIAL FINANCIAL INTEREST TO THE BOARD OF DIRECTORS OR ANY COMMITTEE REGARDING A PROPOSED TRANSACTION OR ARRANGEMENT, THE BOARD OR COMMITTEE SHALL FIRST DETERMINE WHETHER THE PROPOSED TRANSACTION OR ARRANGEMENT COULD BE CONSIDERED AN INSIDER TRANSACTION. IF THE BOARD OR COMMITTEE IS CERTAIN THAT THE TRANSACTION OR ARRANGEMENT WILL NOT INVOLVE AN INSIDER, THE INTERESTED PERSON SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE FINANCIAL INTEREST IS DISCUSSED. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. IF IT IS DETERMINED NO CONFLICT EXISTS, THE INTERESTED PERSON MAY REJOIN THE MEETING AND PARTICIPATE IN THE DISCUSSIONS AND ACTIONS REGARDING THIS AGENDA ITEM. THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER MSI CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE, THE BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN MSI'S BEST INTEREST AND WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO MSI. IF THE BOARD OR COMMITTEE BELIEVES AN ALTERNATE TRANSACTION COULD BE CONSIDERED THAT WOULD BE MORE ADVANTAGEOUS TO MSI, THE CHAIRPERSON OF THE BOARD OR COMMITTEE SHALL APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION. FURTHER ACTION BY THE BOARD OR COMMITTEE SHALL BE TABLED UNTIL SUCH TIME AS THE DISINTERESTED PERSON HAS BEEN ABLE TO REPORT HIS OR HER FINDINGS TO THE APPROPRIATE GOVERNING BODY. THE BOARD OR COMMITTEE SHALL NOT APPROVE ANY TRANSACTION OR ARRANGEMENT THAT IS NOT IN THE BEST INTERESTS OF MSI AND THAT IS NOT FAIR AND REASONABLE TO MSI. ONCE DISCUSSION AND/OR ACTION REGARDING THE AGENDA ITEM RELATING TO THE DIRECTOR'S FINANCIAL INTEREST HAS BEEN COMPLETED, THE INTERESTED PERSON MAY REJOIN THE BOARD OR COMMITTEE MEETING. IF THE TRANSACTION OR ARRANGEMENT INVOLVES OR MAY INVOLVE AN INSIDER, THE BOARD OR COMMITTEE SHALL FOLLOW THE PROCEDURES ABOVE AND THE INSIDER SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE INSIDER TRANSACTION IS DISCUSSED. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE WHETHER THE TRANSACTION OR ARRANGEMENT UNDER CONSIDERATION COULD CONSTITUTE AN INSIDER TRANSACTION. AS PART OF THIS CONSIDERATION, THE BOARD OR COMMITTEE SHALL ALSO CONSIDER WHETHER THEIR ACTION COULD BE CONSTRUED TO BE AN EXCESS BENEFIT TRANSACTION SUBJECT TO INTERMEDIATE SANCTIONS. IN DETERMINING WHETHER A TRANSACTION OR ARRANGEMENT IS AN EXCESS BENEFIT TRANSACTION, THE BOARD OR COMMITTEE CONSIDERING THE TRANSACTION OR ARRANGEMENT SHOULD REVIEW APPROPRIATE DATA AS TO COMPARABILITY (SUCH AS COMPENSATION LEVELS PAID BY SIMILARLY SITUATED ORGANIZATIONS IN THE REGION, NATIONAL COMPENSATION STUDIES, COMPETING OFFERS RECEIVED BY THE INSIDER, ASSET APPRAISALS OR RENTAL ANALYSES BY QUALIFIED APPRAISERS AND OTHER INFORMATION THAT MAY BE OBTAINED ABOUT COMPARABLE AGREEMENTS, PURCHASES, SALES AND LEASES). THE BOARD OR COMMITTEE MAY RELY ON SUCH INFORMATION OR DATA PROVIDED BY MSI'S MANAGEMENT. THE BOARD OR COMMITTEE SHALL NOT APPROVE ANY TRANSACTION OR ARRANGEMENT THAT IS AN EXCESS BENEFIT TRANSACTION. IF THE BOARD OR COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT A DIRECTOR OR PRINCIPAL OFFICER HAS FAILED TO DISCLOSE A FINANCIAL INTEREST, IT SHALL INFORM THE DIRECTOR OR PRINCIPAL OFFICER OF THE BASIS FOR SUCH BELIEF AND AFFORD THE DIRECTOR OR PRINCIPAL OFFICER AN OPPORTUNITY TO EXPLAIN WHY DISCLOSURE WAS NOT MADE. IF, AFTER HEARING THE RESPONSE OF THE DIRECTOR OR PRINCIPAL OFFICER AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED IN THE CIRCUMSTANCES, THE BOARD OR COMMITTEE DETERMINES THAT THE DIRECTOR HAS IN FACT FAILED TO DISCLOSE A FINANCIAL INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY AND/OR CORRECTIVE ACTION, WHICH MAY INCLUDE, BUT NOT BE LIMITED TO: SUSPENSION OF VOTING RIGHTS, RECISION OF ANY AGREEMENTS, AND TERMINATION OF DIRECTOR OR OFFICER STATUS. FORM 990, PART VI, SECTION B, LINE 15 HMC PARTICIPATES IN SALARY SURVEYS SPECIFIC TO ADMINISTRATOR POSITIONS. HMC ALSO HAS AN INDEPENDENT COMPENSATION CONSULTING FIRM TO GATHER FAIR MARKET COMPENSATION DATA FOR ALL C LEVEL POSITIONS. THIS INFORMATION IS USED TO DEVELOP SALARY RANGES FOR THE ADMINISTRATIVE STAFF. THE BOARD OF DIRECTORS PARTICIPATES IN DEVELOPMENT OF RANGES AND ESTABLISHMENT OF SALARIES FOR THE FOUR SENIOR LEADERS OF THE ORGANIZATION AS DESCRIBED IN CORPORATE BYLAWS AND BOARD POLICIES. ANY CHANGES TO THE BENEFIT PACKAGE MUST BE APPROVED BY THE HMC BOARD OF DIRECTORS. THE BOARD APPROVES ALL COMPENSATION CHANGES FOR THE CEO AS OUTLINED IN CORPORATE BYLAWS AND BOARD POLICIES. CHANGES IN COMPENSATION FOR THE OTHER SENIOR LEADERS ARE DETERMINED BY THE CEO USING RANGES ESTABLISHED AND APPROVED BY THE BOARD, IN CONJUNCTION WITH SALARY SURVEY INFORMATION. FORM 990, PART VI, SECTION C, LINE 19 THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE BY REQUEST FROM THE PUBLIC RELATIONS DIRECTOR FOR THE SAME PERIOD OF DISCLOSURE SET FORTH IN SECTION 6104(D). THE GOVERNING DOCUMENTS ARE CONFIDENTIAL AND NOT AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9: LOSS ON INTEREST RATE SWAPS -211,360. MEMORIAL MEDICAL CENTER INC 1615 MAPLE LANE ASHLAND WI 54806 237013497 HEALTH CARE WI 501(C)(3) LINE 3 REGIONAL ENTERPRISES INC 0 REGIONAL ENTERPRISES INC 1615 MAPLE LANE ASHLAND WI 54806 391555837 SUPPORT WI 501(C)(3) LINE 12A, I MEMORIAL MEDICAL CENTER INC 0 REI MEDICAL CLINICS INC 1615 MAPLE LANE ASHLAND WI 54806 391701306 SUPPORT WI 501(C)(3) LINE 12A, I REGIONAL ENTERPRISES INC 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0