2024-03-05T14:35:06-06:00 2023-06-30 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2022-07-01 391370626 SOUTHWEST HEALTH CENTER INC SOUT 6083482331 1400 EASTSIDE RD PLATTEVILLE WI 538189800 JESSE SOOKOCHOFF CFO 6083482331 2024-03-04 1 JESSE SOOKOCHOFF 999009999 0 MICHAEL J PETERSON CPA P01833529 2187224705 2024-02-29 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z DANIEL ROHRBACH 1400 EASTSIDE RD PLATTEVILLE WI 538189800 158832895 0 X WWW.SOUTHWESTHEALTH.ORG X 1981 WI OFFER AN INTEGRATED CONTINUUM OF HEALTH CARE SERVICES. AS THE PROVIDER OF CHOICE OF THE PEOPLE OF SOUTHWEST WISCONSIN, VALUE IS OUR DRIVING FORCE. CONTINUALLY IMPROVING OUR SERVICES ENABLES US TO SURPASS EXPECTATIONS WHILE ACHIEVING COST-EFFECTIVE CLINICAL QUALITY. IN COLLABORATION WITH OUR COMMUNITY, AREA PHYSICIANS, AND OTHERS, WE RESPOND TO NEEDS BY MAINTAINING A FISCALLY STRONG ORGANIZATION THAT ENSURES A MEANINGFUL IMPACT ON THE LIVES OF THOSE WE SERVE. 10 8 625 30 0 0 841526 2711507 94156020 107952948 3690235 1477081 1100759 477356 99788540 112618892 46263 42459 0 0 49492628 55544697 0 0 0 32851027 39379784 82389918 94966940 17398622 17651952 134479207 156184981 20947578 23337506 113531629 132847475 X CARING. FOR LIFE. 0 0 78793946 42459 100939145 SOUTHWEST HEALTH CENTER, INC. (THE ORGANIZATION") PROVIDES INPATIENT, OUTPATIENT, EMERGENCY, OUTPATIENT BEHAVIORAL HEALTH, AND CLINICAL HEALTH CARE SERVICES AND OTHER FINANCIAL SUPPORT THROUGH VARIOUS PROGRAMS THAT ARE DESIGNED, AMONG OTHER MATTERS, TO ENHANCE THE HEALTH OF THE COMMUNITY INCLUDING THE HEALTH OF LOW INCOME PATIENTS. CONSISTENT WITH THE MISSION OF THE ORGANIZATION, CARE IS PROVIDED TO PATIENTS REGARDLESS OF THEIR ABILITY TO PAY, INCLUDING PROVIDING SERVICES TO THOSE PERSONS WHO ARE EITHER UNDERINSURED OR WHO 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 THE ORGANIZATION'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, GENERALLY BASED ON FEDERAL POVERTY GUIDELINES, ARE PROVIDED CARE AT A SIGNIFICANTLY REDUCED RATE, DETERMINED BASED ON QUALIFYING CRITERIA AS DEFINED IN THE ORGANIZATION'S CHARITY CARE POLICY AND FROM APPLICATIONS COMPLETED BY PATIENTS AND THEIR FAMILIES. THE AMOUNT OF CHARGES FORGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER THIS POLICY FOR FY2023 TOTALED $233,920.84. IN ADDITION, DISCOUNTS TO THE MEDICAID PROGRAM FOR HOSPITAL AND CLINIC SERVICES AMOUNTED TO $18,395,978. (SEE ADDITIONAL INFORMATION ON THE COST TO THE HOSPITAL OF PROVIDING SERVICES TO MEDICAID AND CHARITY CARE RECIPIENTS IN SCHEDULE H OF THE FORM 990.)BENEFITS FOR SERVING THE COMMUNITY ALSO INCLUDE:- A COMMUNITY HEALTH INFORMATION PUBLICATION THAT CONTAINS A BROAD RANGE OF PRACTICAL INFORMATION TO IMPROVE HEALTH AND WELLNESS AND IS MAILED TO 15,000+ LOCAL HOUSEHOLDS- OFFERING HEALTH SCREENINGS AND INFORMATION TO HUNDREDS OF AREA CONSUMERS OVER 65 YEARS OLD AT LOCAL SENIOR HEALTH FAIRS- ATTENDANCE TO SEVERAL HEALTH FAIRS AT OUR LOCAL UNIVERSITY, OUTREACHING TO LOCAL COLLEGE STUDENTS- A DIABETES MONTHLY SUPPORT GROUP- PROVIDING OF SPACE FOR LOCAL SUPPORT GROUPS LIKE ALCOHOLICS ANONYMOUS, PARKINSON'S SUPPORT GROUP, GILDA'S CLUB, AND LOCAL BLOOD DRIVES- A BI-WEEKLY HEALTH INFORMATION COLUMN IN A LOCAL NEWSPAPER- QUARTERLY EDITORIAL IN PUBLICATIONS THAT COVER THREE COUNTIES IN WISCONSIN, AND TWO IN IOWA- HOSTING OF A WEBSITE WITH IMPORTANT HEALTH INFORMATION- PROMOTIONS AND BLOGS/ARTICLES ON OUR SOCIAL MEDIA FACEBOOK PAGE- PROMOTION HEALTH RESOURCES THAT PROVIDES PATIENTS, FAMILY MEMBERS, AND COMMUNITY MEMBERS ANSWERS TO HEALTH QUESTIONS AND OTHER RESOURCES - SPONSORING OF SEGMENTS ON THE LOCAL RADIO SUPPORTING DIFFERENT COMMUNITY AND CITY ORGANIZATIONS AND EVENTS- HOSTING OF AN ANNUAL COMMUNITY EVENT THAT PROMOTES A SAFE PLACE FOR FAMILIES TO COME HEAR ABOUT HEALTH INFORMATION IN OUR LOCAL CITY PARK- SPONSORSHIPS OF LOCAL ATHLETIC TEAMS IN CITY SPORTS CLUBS- SUPPORT FOR LOCAL SCHOOL PROGRAM TO PROVIDE FOOD BAGS THAT GO HOME WITH STUDENTS IN NEED OVER HOLIDAYS AND BREAKSFOR FISCAL YEAR 2023, TOTAL HOSPITAL PATIENT DAYS WERE 3,466 AND TOTAL OUTPATIENT PROCEDURES WERE 180,415. SOME KEY STATISTICS INCLUDED IN THESE TOTALS WERE 2,524 ACUTE INPATIENT AND NURSERY DAYS, 265 SWING BED INPATIENT DAYS, AND 13,215 EMERGENCY ROOM/URGENT CARE VISITS. THE ORGANIZATION ALSO PROVIDES CLINICAL SERVICES AT TWO PRIMARY CARE CLINICS LOCATED IN PLATTEVILLE AND CUBA CITY, WISCONSIN AS WELL AS SPECIALTY PHYSICIAN SERVICES IN THE AREAS OF GENERAL SURGERY, ORTHOPEDICS, WOMEN'S HEALTH, PAIN MANAGEMENT AND EYECARE SERVICES. 1438510 0 7033229 THE ORGANIZATION PROVIDES INPATIENT BEHAVIORAL HEALTH SERVICES WITH A FOCUS ON SENIOR BEHAVIORAL SCIENCES AT SOUTHWEST HEALTH BEHAVIORAL SERVICES (SBS) CENTER. THE PRIMARY PATIENTS SERVED BY THIS CENTER ARE PATIENTS OVER THE AGE OF 55 AND ARE PRIMARILY MEDICARE AND MEDICAID PROGRAM BENEFICIARIES WHICH OFTEN REIMBURSE THE ORGANIZATION AT RATES BELOW THE COST OF TREATING THESE PATIENTS. HOWEVER, THE ORGANIZATION FEELS THAT IT IS THEIR MISSION IN THE COMMUNITY TO PROVIDE THESE SERVICES TO PATIENTS IN NEED. SBS IS PROUD TO OFFER THESE SERVICES IN A MODERN FACILITY AT A TIME WHEN MANY DISTINCT PART PSYCHIATRIC UNITS ARE CLOSING DUE TO POOR REIMBURSEMENT FROM THIRD-PARTY PAYORS. SBS CENTER IS STAFFED BY A FULL-TIME PSYCHIATRIST, A NURSE PRACTITIONER, AND PROFESSIONAL NURSING AND SOCIAL SERVICES STAFF. PATIENTS OF SBS ALSO HAVE FULL ACCESS TO ALL OF THE DIAGNOSTIC, THERAPY, AND EMERGENCY SERVICES OF THE SOUTHWEST HEALTH CENTER HOSPITAL.THE TOTAL SBS CENTER PATIENT DAYS WERE 1,680 FOR FISCAL YEAR ENDING FY2023. 80232456 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 31 0 625 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X JESSE SOOKOCHOFF 6083482331 1400 EASTSIDE RD PLATTEVILLE WI 538189800 DANIEL ROHRBACH CEO 40.00 0.50 X X 573950 0 61034 LOU SCHWEIGERT CHAIRMAN 2.00 X X 12000 0 0 JOSEPH ROSEMEYER DC VICE CHAIRMAN 2.00 X X 12000 0 0 DONALD TUESCHER TREASURER 2.00 X X 10200 0 0 ANGELA UDELHOFEN SECRETARY 2.00 X X 10200 0 0 DONNA HOPPENJAN BOARD MEMBER 2.00 X 10200 0 0 STEVE LITTLE BOARD MEMBER 2.00 X 10200 0 0 JAMES SCHNELLER BOARD MEMBER 2.00 X 10200 0 0 KEVIN CARR MD BOARD MEMBER/PHYSICIAN 40.00 X 502370 0 35070 BRUCE KROLL BOARD MEMBER 2.00 X 5100 0 0 JESSE SOOKOCHOFF CFO 40.00 0.50 X 258514 0 14266 STEVEN MCCARTHY COO 40.00 0.50 X 343253 0 45215 JOSHUA LINDSEY PHYSICIAN 40.00 X 1382967 0 71307 MARK BOGNER PHYSICIAN 40.00 X 493302 0 55460 KENT KRAMER PHYSICIAN 40.00 X 452107 0 62946 KYLE QUILLIN PHYSICIAN 40.00 X 497269 0 48315 JESSICA SCHMID PHYSICIAN 40.00 X 464113 0 47447 5047945 0 441060 82 0 1 0 MARKET & JOHNSON 2350 GALLOWAY ST EAU CLAIRE WI 54702 CONTRACTING 3158949 SHARED IMAGING SERVICES PO BOX 88450 MILWAUKEE WI 53288 IMAGING SERVICES 1347996 RULE CONSTRUCTION LTD 3696 STATE ROAD 23 DODGEVILLE WI 53533 CONTRACTING 1299426 WIITTS LLC 1808 W BELTLINE HWY MADISON WI 53708 IT SOFTWARE AND SERVICES 688762 SSM HEALTH 477 N LINDBERGH BLVD ST LOUIS MO 63141 LABORATORY TESTS 514275 19 2510607 200900 2711507 HOSPITAL PATIENT REVENUE 621990 65585466 65585466 CLINIC REVENUE 621110 33548266 33548266 PSYCHIATRIC REVENUE 623990 7033229 7033229 PHARMACY REVENUE 621990 1719426 1719426 66561 66561 107952948 1692199 1692199 29363 881 28482 28482 28482 45878599 119405 46157740 55382 -279141 64023 -215118 -215118 CAFETERIA REVENUE 900099 189460 189460 EHR INCENTIVE REVENUE 900099 19426 19426 239988 239988 448874 112618892 107972374 0 1935011 13459 13459 29000 29000 1915862 920903 994959 40608377 35490903 5117474 1476894 1237637 239257 9018442 7486717 1531725 2525122 2087375 437747 332512 332512 82163 7018 75145 6071 6071 8023321 5901801 2121520 369015 53965 315050 710119 554805 155314 1278200 34052 1244148 2497969 2204948 293021 78610 49426 29184 385645 125602 260043 369740 312769 56971 4488820 3797033 691787 204772 204772 PHARMACEUTICALS 9052655 9052655 MEDICAL SUPPLIES 8281565 7857956 423609 BAD DEBT EXPENSE 2665099 2665099 DUES AND SUBSCRIPTIONS 362246 82699 279547 191262 61862 129400 94966940 80232456 14734484 0 1979 2079 22914502 26486052 12947173 15542104 1388564 1439217 421844 978202 94551615 48324001 39914308 46227614 54378316 59074753 2107194 1808469 405327 356833 0 4269658 134479207 156184981 9029085 11152974 2208114 2051276 8066534 7204278 199027 0 1444818 2928978 20947578 23337506 X 112795373 132071763 736256 775712 113531629 132847475 134479207 156184981 X 17651952 2133507 -469613 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 6071 6071 0 PART II-B, LINE 1: THE ORGANIZATION PAYS ANNUAL ASSOCIATION MEMBERSHIP DUES TO THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THESE DUES ARE PAID PRIMARILY TO ACCESS EDUCATIONAL MATERIALS AND FOR STAFF TRAINING AND MATERIALS. THE WHA HAS NOTIFIED SOUTHWEST HEALTH CENTER, INC. THAT $3,093 OF THE ANNUAL DUES WERE USED IN CONJUNCTION WITH LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE OVERALL HEALTH CARE ENVIRONMENT. THE ORGANIZATION IS ALSO A MEMBER OF THE RURAL WISCONSIN HEALTH COOPERATIVE (RWHC). EACH YEAR, THE ORGANIZATION PAYS MEMBERSHIP FEES TO RWHC. THE 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 DOES PROVIDE ANALYSIS OF CURRENT HEALTH CARE ISSUES IN AN EFFORT TO PROMOTE AND BETTER HEALTH CARE FOR HOSPITALS IN RURAL COMMUNITIES THROUGHOUT WISCONSIN. ONE OF THESE EFFORTS ALSO INCLUDES SOME LOBBYING ON THE PART OF THE MEMBER ORGANIZATIONS. THE RWHC DETERMINED THAT $2,978 OF THE FEES PAID BY SOUTHWEST HEALTH CENTER, INC. IN 2022 RELATED TO LOBBYING ACTIVITIES WITH THE GOAL OF IMPROVING THE HEALTH CARE ENVIRONMENT IN THE STATE OF WISCONSIN. 736256 68456 29000 775712 828130 -60874 31000 736256 703096 154034 29000 828130 711129 18967 27000 703096 683547 27582 711129 0.00000 0.47445 0.52555 0 0 2537616 2537616 57408597 24040818 33367779 49621 34675 14946 32805548 24248508 8557040 1750233 1750233 46227614 DEFERRED COMPENSATION 2928978 2928978 X 111986095 2133507 123147 2256654 109729441 2889451 2889451 112618892 92078370 881 881 92077489 2889451 2889451 94966940 PART V, LINE 4: TO PROVIDE SCHOLARSHIP FUNDS TO BE AVAILABLE TO AREA STUDENTS SEEKING TO FURTHER THEIR EDUCATION IN A HEALTH CARE RELATED FIELD. PART X, LINE 2: SOUTHWEST HEALTH CENTER, INC. IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. IT IS ALSO EXEMPT FROM STATE INCOME TAXES ON RELATED INCOME. SOUTHWEST HEALTH CENTER, INC. IS ALSO ENGAGED, TO A LIMITED EXTENT, IN CERTAIN ACTIVITIES SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME (UBI). INCOME TAXES ON UBI ARE NOT SIGNIFICANT. THE OTHER SUBSIDIARIES OF SOUTHWEST HEALTH ARE TAXABLE CORPORATIONS AND INCLUDE SOUTHWEST MEDICAL SERVICES, INC. AND SOUTHWEST SENIOR ENTERPRISES, INC. SOUTHWEST HEALTH ANNUALLY EVALUATES THE ACTIVITY IN THESE TAXABLE SUBSIDIARIES TO DETERMINE ANY NEED FOR AN ESTIMATED PROVISION OR CREDIT FOR INCOME TAXES OR RELATED DEFERRED TAX ASSETS OR LIABILITIES. IF ANY TAX PROVISIONS OR CREDITS ARE DETERMINED TO BE NECESSARY, SOUTHWEST HEALTH RECORDS THESE AMOUNTS IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. DEFERRED INCOME TAXES HAVE BEEN PROVIDED UNDER THE LIABILITY METHOD. DEFERRED TAX ASSETS AND LIABILITIES ARE DETERMINED BASED ON THE DIFFERENCE BETWEEN FINANCIAL STATEMENT AND TAX BASES OF ASSETS AND LIABILITIES, AS MEASURED BY THE ENACTED TAX RATES WHICH WILL BE IN EFFECT WHEN THESE DIFFERENCES ARE EXPECTED TO REVERSE, NET OF ANY VALUATION ALLOWANCES. DEFERRED TAX EXPENSE IS THE RESULT OF CHANGES IN THE DEFERRED TAX ASSET AND LIABILITY. DEFERRED TAX ASSETS ARE REDUCED BY A VALUATION ALLOWANCE WHEN, IN THE OPINION OF MANAGEMENT, IT IS MORE LIKELY THAN NOT THAT SOME PORTION OR ALL OF THE DEFERRED TAX ASSETS WILL NOT BE REALIZED. AT JUNE 30, 2023 AND 2022, SOUTHWEST HEALTH RECORDED A VALUATION ALLOWANCE AGAINST ALL OF ITS DEFERRED TAX ASSETS RELATED TO SOUTHWEST SENIOR ENTERPRISES, INC. TO REFLECT THE AMOUNT THAT MANAGEMENT BELIEVES WILL ULTIMATELY BE REALIZED. REALIZATION OF DEFERRED TAX ASSETS IS DEPENDENT ON SUFFICIENT FUTURE TAXABLE INCOME DURING THE PERIOD THAT DEDUCTIBLE TEMPORARY DIFFERENCES AND CARRYFORWARDS ARE EXPECTED TO BE AVAILABLE TO REDUCE TAXABLE INCOME. BASED ON MANAGEMENT'S PROJECTIONS, THE NET DEFERRED TAX ASSETS WILL NOT BE RECOVERED WITH PROJECTED TAXABLE INCOME. PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 881. OTHER EXPENSES -1,397. FOUNDATION EXPENSES 123,663. PART XI, LINE 4B - OTHER ADJUSTMENTS: FOUNDATION EXPENSES 224,352. BAD DEBT EXPENSE 2,665,099. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 881. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 2,665,099. FOUNDATION EXPENSES 224,352. 1 1 X 1 X 1 X 500.000000000000 1 1 0 1 1 96245 96245 0.00100 11726559 6655086 5071473 0.05490 11822804 6655086 5167718 0.05590 49634 49634 0.00050 10859913 4130449 6729464 0.07290 37336 37336 0.00040 10946883 4130449 6816434 0.07380 22769687 10785535 11984152 0.12970 29000 29000 0.00030 29000 29000 0.00030 0 1096536 548268 19553638 19256597 297041 X 1 1 2 1 SOUTHWEST HEALTH CENTER INC 1400 EASTSIDE ROAD PLATTEVILLE WI 53818 WWW.SOUTHWESTHEALTH.ORG 1059 X X X X A 2 SOUTHWEST HEALTH CENTER INC - SBS 1185 NORTH ELM STREET PLATTEVILLE WI 53818 WWW.SOUTHWESTHEALTH.ORG 1063 X X PSYCHIATRIC HOSPITAL A SOUTHWEST HEALTH CENTER INC 0 0 1 X X X X X X X X X X 21 1 0 0 1 X SEE SUPPLEMENTAL INFORMATION X 1 21 1 SEE SUPPLEMENTAL INFORMATION 0 1 X 200.000000000000 500.000000000000 X X X X 1 1 X X X X 1 X HTTPS://WWW.SOUTHWESTHEALTH.ORG/SERVICES/PATIENT-FINANCIAL-SERVICES/ X HTTPS://WWW.SOUTHWESTHEALTH.ORG/SERVICES/PATIENT-FINANCIAL-SERVICES/ X HTTPS://WWW.SOUTHWESTHEALTH.ORG/SERVICES/PATIENT-FINANCIAL-SERVICES/ X X X X X X 1 X 0 X X X X 1 X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: SOUTHWEST HEALTH CENTER, INC., - FACILITY 2: SOUTHWEST HEALTH CENTER, INC. - SBS SOUTHWEST HEALTH CENTER, INC. PART V, SECTION B, LINE 3J: ACTION PLAN TO ADDRESS COMMUNITY HEALTH NEEDS. SOUTHWEST HEALTH CENTER, INC. PART V, SECTION B, LINE 5: SOUTHWEST HEALTH ALREADY DOES A GREAT DEAL TO ADDRESS THESE NEEDS, ADDITIONAL ACTIONS HAVE BEEN PUT IN PLACE WITH THE GOALS OF EMPOWERING PEOPLE, CONNECTING PEOPLE WITH SERVICES, AND CREATING HEALTHY PHYSICAL AND SOCIAL ENVIRONMENTS AND PROMOTING A CULTURE OF WELLNESS. IN ORDER TO DO THAT SOUTHWEST HEALTH HAS IMPROVED ITS COMMUNITY OUTREACH PROGRAMS, BOLSTERED ACCESS TO SPECIFIC SERVICES, FORMULATED NEW STAFF EDUCATION, INCREASED RECREATION ALTERNATIVES, ENCOURAGED INCREASED COMMUNITY ADVOCACY WHENEVER POSSIBLE, AND INCREASED COMMUNITY COLLABORATION AMONG OTHER THINGS.SOUTHWEST HEALTH CENTER, INC.PART V, SECTION B, LINE 7A:HTTPS://WWW.SOUTHWESTHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/PART V, SECTION B, LINE 10A:HTTPS://WWW.SOUTHWESTHEALTH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ SOUTHWEST HEALTH CENTER, INC. PART V, SECTION B, LINE 11: SOUTHWEST HEALTH'S SOCIAL DETERMINANTS OF HEALTH TASKFORCE CONTINUES TO EXAMINE AND IDENTIFY WAYS TO IMPACT THE VARIOUS FACTORS THAT INFLUENCE A PERSON'S HEALTH AND WELL-BEING. THE TASKFORCE'S MISSION IS TO IDENTIFY, EDUCATE, ADVOCATE, AND SERVE AS A RESOURCE REGARDING THE NON-MEDICAL FACTORS CONTRIBUTING TO HEALTH OUTCOMES DISPARITIES. THESE FACTORS ARE THE CONDITIONS IN THE ENVIRONMENT WHERE INDIVIDUALS ARE BORN, LIVE, LEARN, WORK, WORSHIP, PLAY, AND AGE THAT ARE SHAPED BY THE DISTRIBUTION OF MONEY, POWER, AND RESOURCES. THESE ATTRIBUTES ARE SEEN AS PRIMARILY RESPONSIBLE FOR COMMUNITY HEALTH NEEDS AND INEQUITIES. THE COMMUNITY HEALTH NEEDS ASSESSMENT HELPED THE TASKFORCE IDENTIFY FOCUS AREAS THAT AFFECT SURROUNDING COMMUNITIES, SUCH AS OUTREACH AND EDUCATION, CONNECTION TO SUPPORT AND RESOURCES, IMPRESS ACCESSIBILITY, AND PROMOTING LIFESTYLE CHANGES THAT PROMOTE A CULTURE OF WELL-BEING. BEYOND THE ORGANIZATION'S EXPANSION OF CLINICAL CARE TO RURAL COMMUNITIES IN KIELER AND CUBA CITY, SOUTHWEST HEALTH'S SDOH TASKFORCE HAS SPENT TIME FOCUSING ON THE FOLLOWING AREA THAT IMPACTS OUR PATIENTS, THEIR FAMILIES, AND OUR COMMUNITIES' ABILITY TO FLOURISH:-EDUCATING STAFF, PROVIDERS, AND COMMUNITY MEMBERS ON ISSUES SUCH AS HEALTH LITERACY, IMPROVING CHILDCARE INFRASTRUCTURE, SUICIDE PREVENTION, MENTAL HEALTH STIGMA, OPIOID MISUSE DISORDER, LGBTQ HEALTHCARE AND OTHER AREAS -MEETING MONTHLY TO ASSESS COMMUNITY DATA AND REVIEW SHORT AND LONG-TERM ACTION PLANS. -INVITING SOUTHWEST HEALTH'S PATIENT AND FAMILY ADVISORY COUNCIL MEMBERS TO TASKFORCE MEETINGS AS AN ONGOING OPPORTUNITY TO CONVERSE WITH COMMUNITY MEMBERS. -PARTNERING WITH OTHER COMMUNITY ORGANIZATIONS SUCH AS SWCAP, FAMILY ADVOCATES, AND CESA 3 TO STAY CONNECTED TO NON-MEDICAL FACTORS THAT IMPACT COMMUNITY MEMBERS.-PROVIDING RESOURCES AT COMMUNITY EVENTS LIKE BERRY FEST THAT REFRAME HEALTH OUTCOMES AS A COMBINATION OF INDIVIDUAL LIFESTYLE & CHOICES AND ENVIRONMENTAL & SOCIAL FACTORS. -SPONSORED AND VOLUNTEERED TIME AT A REGIONAL MENTAL HEALTH SUMMIT WITH THE SOUTHWESTERN WISCONSIN BEHAVIORAL HEALTH PARTNERSHIP FOCUSING.-PARTNERED WITH AREA SCHOOL DISTRICTS TO IMPLEMENT THE PREVENTATIVE MODEL SOURCES OF STRENGTH TO EDUCATION STAFF AND STUDENTS ON PROTECTIVE FACTORS. -EDUCATED FAMILY MEDICINE PROVIDERS ON SOURCES OF STRENGTH AND DONATED TRUSTED ADVISOR POSTERS FOR EXAM ROOMS. SOUTHWEST HEALTH CENTER, INC. PART V, SECTION B, LINE 13H: DETERMINATIONS FOR FINANCIAL ASSISTANCE ELIGIBILITY WILL REQUIRE PATIENTS TO OBTAIN MEDICAID APPROVAL/DENIAL LETTER ALONG WITH SUBMITTING A COMPLETED FINANCIAL ASSISTANCE APPLICATION. 8 2 - SOUTHWEST HEALTH - PLATTEVILLE CLINIC 1450 EASTSIDE ROAD PLATTEVILLE WI 53818 PHYSICIAN CLINIC 2 - THE PHARMACY AT SOUTHWEST HEALTH 1450 EASTSIDE ROAD PLATTEVILLE WI 53818 RETAIL PHARMACY 3 - SOUTHWEST HEALTH - THE EYE CENTER 1450 EASTSIDE ROAD PLATTEVILLE WI 53818 OPHTHALMOLOGY CLINIC AND RETAIL EYE CENTER 4 - SOUTHWEST HEALTH - CUBA CITY CLINIC 2388 HWY 80 CUBA CITY WI 53807 PHYSICIAN CLINIC 5 - LANCASTER EYE CENTER 1509 IHM STREET LANCASTER WI 53813 EYE CENTER 6 - KIELER CLINIC 3695 PRISM LANE KIELER WI 53812 PHYSICIAN CLINIC 7 - MCGREGOR PLAZA EYE CENTER 170 MCGREGOR PLAZA PLATTEVILLE WI 53818 EYE CENTER 8 - DARLINGTON EYE CENTER 346 MAIN STREET DARLINGTON WI 53530 EYE CENTER 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 ORGANIZATION'S TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBTS 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: THE COST OF SUBSIDIZED SERVICES IS BASED ON THE COST ALLOCATIONS FROM THE MEDICARE COST REPORT. ALLOWABLE COSTS ARE ASSIGNED DIRECTLY TO DEPARTMENTS THROUGHOUT THE YEAR AND THEN THE COST REPORT USES THE ALLOCATION METHODOLOGY TO ASSIGN ALL OTHER COSTS TO CALCULATE SERVICE LINE COSTS. SUBSIDIZED HEALTH SERVICES INCLUDE THE OPERATION OF THE HOSPITAL'S INPATIENT MEDICAL/SURGICAL NURSING UNIT. THESE SERVICES ARE UNAVAILABLE TO MEMBERS OF THE COMMUNITY OTHER THAN THROUGH SOUTHWEST HEALTH CENTER, INC. IT HAS BEEN THE GOAL OF SOUTHWEST HEALTH CENTER, INC. TO PROVIDE THESE SERVICES TO THE COMMUNITY REGARDLESS OF THE PATIENT'S ABILITY TO PAY. 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 $ 2,665,099. PART II, COMMUNITY BUILDING ACTIVITIES: SOUTHWEST HEALTH CENTER PROVIDES CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS. IN ADDITION, THE ORGANIZATION BELIEVES IT ALLOWS FOR A CRITICALLY IMPORTANT BENEFIT, WHICH IS NOT QUANTIFIED. LIKE MOST COMMUNITY HOSPITALS, SOUTHWEST HEALTH CENTER WAS CREATED AND IS MAINTAINED TO PROVIDE HIGH-QUALITY CARE LOCALLY, WITHOUT WHICH AREA RESIDENTS WOULD BE REQUIRED TO TRAVEL GREAT DISTANCES AT A HIGH PERSONAL COST AND OFTEN IN POOR WEATHER. OUR ORGANIZATION'S VISION (CREATING A HEALTHIER SOUTHWEST WISCONSIN) PROPELS OR ORGANIZATION FORWARD, EXPANDING ACCESS TO EVER-HIGH QUALITY CARE, MORE SERVICES, MORE PROFESSIONALS AND PRACTITIONERS, AND GREATER CONTRIBUTIONS TO THE COMMUNITY FOR OUTREACH AND EDUCATION. BEYOND INPATIENT HOSPITALIZATION, SOUTHWEST HEALTH PROVIDES LOCAL ACCESS TO MANY SERVICES, INCLUDING PRIMARY MEDICAL CARE, WIDE-RANGING DIAGNOSTIC SERVICES, EMERGENCY, AND URGENT CARE SERVICES, INFUSION SERVICES SWING BED SERVICES, CLINICAL, LABORATORY, OCCUPATIONAL HEALTH, REHABILITATION, SPECIALTY, SLEEP MEDICINE, SPEECH THERAPY, GENERAL SURGERY SERVICES INCLUDING (ENT, OB/GYN, UROLOGY, ORTHOPEDICS, ETC.) INPATIENT AND OUTPATIENT PSYCHIATRIC SERVICES, OB/GYN, NUTRITION AND DIABETES EDUCATION/COUNSELING, EMERGENCY MEDICAL AND AMBULANCE SERVICES, OPTOMETRY AND ADVANCED OPHTHALMOLOGY CARE, EXERCISE PHYSIOLOGY AND SPORTS MEDICINE, ORTHOPEDICS. WE ARE STEWARDS OF HEALTH CARE FOR OUR REGION, AND PEOPLE TURN TO SOUTHWEST HEALTH FOR A TRUSTED PERSON IN THEIR HEALTHCARE. 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 OPERATING EXPENSES EXCLUDING THE PROVISION FOR BAD DEBT, DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST THE TOTAL CHARGES THAT ARE WRITTEN OFF DURING THE YEAR TO ESTIMATE THE COST OF CARE OF PATIENTS WHO HAVE ACCOUNTS THAT ARE DEEMED TO BE BAD DEBTS TO THE HOSPITAL. PART III, LINE 3: 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, SOME AMOUNT OF BAD DEBTS COULD BE CONSIDERED AS CHARITY CARE. PART III, LINE 4: PATIENT ACCOUNTS RECEIVABLE AND CREDIT POLICY: PATIENT ACCOUNTS RECEIVABLE ARE REPORTED AT THE AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH SOUTHWEST HEALTH EXPECTS TO BE ENTITLED, IN EXCHANGE FOR PROVIDING PATIENT CARE SERVICES. PATIENT ACCOUNTS RECEIVABLE ARE RECORDED IN THE ACCOMPANYING CONSOLIDATED STATEMENTS OF FINANCIAL POSITION NET OF CONTRACTUAL ADJUSTMENTS AND IMPLICIT PRICE CONCESSIONS WHICH REFLECTS MANAGEMENT'S ESTIMATE OF THE TRANSACTION PRICES. SOUTHWEST HEALTH ESTIMATES THAT TRANSACTION PRICE BASED ON NEGOTIATED CONTRACTUAL AGREEMENTS, HISTORICAL EXPERIENCE, AND CURRENT MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS AND IS RECORDED THROUGH A REDUCTION OF GROSS REVENUE AND A CREDIT TO PATIENT ACCOUNTS RECEIVABLE. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO NET PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE. THE AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A SEPARATE FOOTNOTE REGARDING BAD DEBT EXPENSE. PART III, LINE 8: THE TOTAL MEDICARE REVENUE SHOWN IN SCHEDULE H TO THE FORM 990 IS BASED ON THE IRS 990 INSTRUCTIONS AND INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE OF THE ORGANIZATION, 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 AMBULANCE SERVICES, ANESTHESIA PROFESSIONAL SERVICES, PSYCHIATRIC INPATIENT PHYSICIAN PROFESSIONAL SERVICES, SURGICAL PROFESSIONAL SERVICES, REVENUES FOR ANY PATIENTS COVERED UNDER MEDICARE ADVANTAGE PLAN PROGRAMS, OR PHYSICAL THERAPY SERVICES PROVIDED TO NURSING HOME RESIDENTS. THESE PHYSICIAN PROFESSIONAL SERVICES, AMBULANCE SERVICES, AND NURSING HOME THERAPY SERVICES ARE REIMBURSED PRIMARILY ON FEE SCHEDULE REIMBURSEMENTS AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY PHYSICIAN, PHYSICAL THERAPY, AND AMBULANCE 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 SOUTHWEST HEALTH CENTER PROVIDES TO THE COMMUNITY AND SURROUNDING AREAS. THE COSTING METHOD USED ABOVE FOR IRS 990 COMPLIANCE REPORTING IS ALSO BASED ON THE FILED MEDICARE COST REPORT FOR THE YEAR ENDED JUNE 30, 2023, 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). ADDITIONALLY, THE AMOUNTS ABOVE DO NOT INCLUDE AMOUNTS PAID FOR INPATIENT MEDICAL/SURGICAL NURSING UNIT SERVICES AS THESE ARE INCLUDED IN THE SUBSIDIZED HEALTH SERVICES ON PAGE 1 OF SCHEDULE H. WHETHER THERE IS A SHORTFALL OR SURPLUS ON SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THESE PEOPLE, WHO ARE TYPICALLY ELDERLY OR DISABLED MEMBERS OF THE COMMUNITY, ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTH CARE 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 ORGANIZATION'S COLLECTION AND CHARITY CARE POLICIES, SOUTHWEST HEALTH CENTER, INC. MAKES EVERY ATTEMPT TO IDENTIFY AND PROMOTE CHARITY CARE TO PATIENTS. INCLUDED IN THE ORGANIZATION'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 ORGANIZATION'S PATIENT FINANCIAL COUNSELORS 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, 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 ORGANIZATION'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: SOUTHWEST HEALTH ASSESSES HEALTH NEEDS FROM THE COUNTY AND STATE DEPARTMENTS IN OUR SERVICE AREA. OUR SERVICE AREA INCLUDES: GRANT, IOWA, AND LAFAYETTE COUNTIES. AS A NON-PROFIT HEALTH CARE SYSTEM SERVING LARGE PORTIONS OF ALL THREE COUNTIES, OUR ACTIVITIES MAY DIFFER FROM WHAT THE EACH COUNTY HEALTH DEPARTMENT CURRENTLY OFFERS. OVER THE PAST THREE YEARS, SOUTHWEST HEALTH HAS OPENED CLINICS IN CUBA CITY AND KIELER, WI. WE ARE ALSO IN PROCESS OF OPENING A CLINIC SERVING THE DARLINGTON AREA. THESE SATELLITE CLINICS ARE BRIDGING THE GAP BETWEEN RURAL COMMUNITIES AND ACCESSIBLE HEALTHCARE. SOUTHWEST HEALTH HAS ADDED NUMEROUS SAME-DAY AND PRIMARY CARE FAMILY MEDICINE PROVIDERS AS WELL AS FORMED A PARTNERSHIP WITH UW HEALTH OUT OF MADISON TO CONTINUE GIVING ACCESS TO HEALTHCARE IN RURAL COMMUNITIES. PART VI, LINE 3: UNINSURED AND UNDER INSURED PATIENTS ARE OFFERED TO MEET WITH ONE OF THE ORGANIZATION'S PATIENT FINANCIAL COUNSELOR'S ANYTIME THEY PRESENT CONCERN WITH ABILITY TO PAY A BILL. THIS CAN BE AT THE TIME SERVICE IS PROVIDED, OR AFTER THE PATIENT'S BILL IS GENERATED. THE REPRESENTATIVES ARE AVAILABLE IN PERSON OR OVER THE PHONE, DEPENDING ON THE PATIENT'S PREFERENCE. THE REPRESENTATIVE EXPLAINS THE OPTIONS AVAILABLE TO THE PATIENT INCLUDING PAYMENT OVER TIME AS WELL AS THE HOSPITAL'S CHARITY CARE PROGRAM AND OFFERS ASSISTANCE IN COMPLETING CHARITY CARE APPLICATION WHEN APPROPRIATE. IF OTHER PROGRAMS ARE AVAILABLE TO THE PATIENT, SUCH AS THE WISCONSIN MEDICAL ASSISTANCE OR BADGERCARE PROGRAMS, THESE PATIENTS ARE REFERRED TO THE APPROPRIATE GOVERNMENT AGENCY FOR FURTHER ASSISTANCE. PART VI, LINE 4: SOUTHWEST HEALTH OPERATES FACILITIES IN PLATTEVILLE, CUBA CITY, DARLINGTON, LANCASTER, AND KIELER AND HAS BROKEN GROUND FOR A NEW CLINIC IN DARLINGTON, WISCONSIN. THE PRIMARY SERVICES AREA FOR SOUTHWEST HEALTH ENCOMPASSES ALL PEOPLE LIVING WITHIN A 35-MILE RADIUS OF PLATTEVILLE, WISCONSIN, INCLUDING PLATTEVILLE, CUBA CITY, DICKEYVILLE, BELMONT, ELLENBORO, REWEY, LIVINGSTON, KIELER, PARTS OF DUBUQUE, EAST DUBUQUE, AND GALENA. PART VI, LINE 5: MOST OF THE ORGANIZATIONS GOVERNING BODY IS COMPRISED OF PEOPLE WHO RESIDE IN THE SOUTHWEST HEALTH'S AREA OF PRIMARY SERVICE. THEY ARE NEITHER EMPLOYEES NOR CONTRACTORS. SURPLUS FUNDS OF THE ORGANIZATION ARE INVESTED BACK INTO THE FACILITY OR ADDITIONAL EQUIPMENT IS PURCHASED TO ENSURE HEALTH CARE NEEDS ARE MEET AND EVOLVED OVER TIME. STAFF MEMBERS ARE OFTEN MEMBERS OF THE SOUTHWEST HEALTH COMMITTEES THAT GOVERN MONEY TO FUND THE PROJECT. SOUTHWEST HEALTH'S EMPLOYEES THAT CARE FUND IS AN EMPLOYEE-FUNDED FOR EMPLOYEE-DRIVEN PROJECTS THAT BENEFIT EMPLOYEE HEALTH. PART VI, LINE 6: N/A PART VI, LINE 7, REPORTS FILED WITH STATES WI 1 SCHOLARSHIPS 23 29000 PART I, LINE 2: THE ORGANIZATION HAS A FOUNDATION BOARD THAT PROVIDES OVERSIGHT AND APPROVES SCHOLARSHIPS TO INDIVIDUALS. ELIGIBILITY FOR THE SCHOLARSHIP IS MONITORED BY THE ORGANIZATION. X 1 1 X X X X 0 1 0 0 0 0 0 0 0 JOSHUA LINDSEY PHYSICIAN 1381427 0 1300 0 240 0 24400 0 46907 0 1454274 0 0 0 DANIEL ROHRBACH CEO 497340 0 76250 0 360 0 15250 0 45784 0 634984 0 0 0 MARK BOGNER PHYSICIAN 490870 0 1300 0 1132 0 15250 0 40210 0 548762 0 0 0 KYLE QUILLIN PHYSICIAN 495777 0 1300 0 192 0 15250 0 33065 0 545584 0 0 0 KEVIN CARR MD BOARD MEMBER/PHYSICIAN 499486 0 1300 0 1584 0 15250 0 19820 0 537440 0 0 0 KENT KRAMER PHYSICIAN 450447 0 1300 0 360 0 15250 0 47696 0 515053 0 0 0 JESSICA SCHMID PHYSICIAN 462597 0 1300 0 216 0 15250 0 32197 0 511560 0 0 0 STEVEN MCCARTHY COO 296450 0 46251 0 552 0 15198 0 30017 0 388468 0 0 0 JESSE SOOKOCHOFF CFO 223669 0 34605 0 240 0 11289 0 2977 0 272780 0 0 0 PART I, LINE 1A COMPANION TRAVEL TO AHA RURAL HEALTH GOVERNANCE CONFERENCE FOR CAITLIN ROSEMEYER (JOSEPH ROSEMEYER), JOY CARR (KEVIN CARR), AMY SOOKOCHOFF (JESSE SOOKOCHOFF), NOT INCLUDED IN TAXABLE COMPENSATION A WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 2012-08-20 18009846 REFUNDING OF SERIES 2004A BONDS FOR HOSPITAL REPLACEMENT 0 0 0 B WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 2017-02-03 17222000 REFUNDING OF SERIES 2013 BONDS AND CAPITAL PURCHASES 0 0 0 A 1554241 18009846 318905 17690941 2005 0 1 1 1 B 1138776 17222000 218511 10369680 6633809 2018 1 0 0 1 A 0 0 0 0 0.00010 0.00010 0 0 1 B 0 0 0 0 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 FORM 990, PART VI, SECTION B, LINE 11B THE MEMBERS OF THE BOARD OF DIRECTORS ARE PROVIDED A COPY OF THE FORM 990 FOR REVIEW PRIOR TO SUBMISSION. RESPONSES ON THE 990 ARE ALSO REVIEWED BY THE CEO AND CHIEF ADMINISTRATIVE & FISCAL OFFICER OF THE ORGANIZATION PRIOR TO ITS SUBMISSION TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C MEMBERS OF THE BOARD OF DIRECTORS DISCLOSE ANY CONFLICTS OF INTEREST BY COMPLETING A QUESTIONNAIRE AND DISCLOSURE FORM ANNUALLY. EMPLOYEES ARE REQUIRED TO REVIEW THE CONFLICT OF INTEREST POLICY UPON HIRE AND AT ANNUAL INTERVALS. IF ANY SIGNIFICANT CONFLICTS ARISE WITH MEMBERS OF THE BOARD OF DIRECTORS, MANAGEMENT, OR KEY EMPLOYEES, IT IS PROPERLY DOCUMENTED AND FOLLOWED UP ON BY THE APPROPRIATE GOVERNING GROUP OR DEPARTMENT WITHIN THE ORGANIZATION ACCORDING TO THE CONFLICT OF INTEREST POLICY. ANY BOARD MEMBERS WITH NOTED CONFLICTS ARE ASKED TO ABSTAIN FROM VOTING ON ANY POTENTIALLY CONFLICTED ITEMS. FORM 990, PART VI, SECTION B, LINE 15 THE CEO'S COMPENSATION IS REVIEWED ANNUALLY AND IS COMPARED TO SURVEY DATA RECEIVED FROM THE RURAL WISCONSIN HEALTH COOPERATIVE AND FROM THE WISCONSIN HOSPITAL ASSOCIATION. THE CEO'S COMPENSATION IS APPROVED BY THE BOARD OF DIRECTORS ON AN ANNUAL BASIS. COMPENSATION OF THE ORGANIZATION'S OFFICERS AND OTHER EMPLOYEES IS ALSO COMPARED TO SURVEY DATA RECEIVED FROM THE RURAL WISCONSIN HEALTH COOPERATIVE AND FROM THE WISCONSIN HOSPITAL ASSOCIATION. THE OFFICERS' COMPENSATION IS APPROVED BY THE CEO ON AN ANNUAL BASIS, AND DOCUMENTATION REGARDING THEIR COMPENSATION ADJUSTMENTS IS MAINTAINED. FORM 990, PART VI, SECTION C, LINE 19 THE ABBREVIATED FINANCIAL STATEMENTS ARE MADE PUBLICLY AVAILABLE THROUGH THE WISCONSIN HOSPITAL ASSOCIATION, AND THE COMPLETE AUDITED CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN EQUITY IN UNCONSOLIDATED AFFILIATES -469,613. SWR1 INC 1045 HILL STREET WATERTOWN WI 53098 851449153 NURSING HOME WI 501(C)(3) LINE 3 N/A 0 SOUTHWEST SENIOR ENTERPRISES INC 1400 EASTSIDE ROAD PLATTEVILLE WI 53818 205501580 SENIOR CARE CAMPUS & ACTIVITIES WI SOUTHWEST HEALTH CENTER INC C -52215 -265399 1.00000 1 SOUTHWEST MEDICAL SERVICES INC 1400 EASTSIDE ROAD PLATTEVILLE WI 53818 INACTIVE-MANAGEMENT OF RESIDENTIAL FACILITY WI SOUTHWEST HEALTH CENTER INC S 1.00000 1 SOUTHWEST HEALTH DEVELOPMENT OWNERS ASSOCIATION 1400 EASTSIDE ROAD PLATTEVILLE WI 53818 922563840 MANAGEMENT OF COMMON AREAS IN A WI SOUTHWEST HEALTH CENTER INC C 25 1.00000 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0