2025-10-07T13:33:03-05:00 2024-12-31 393647910 WIPFLI ADVISORY LLC 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2024-01-01 391027536 BLACK RIVER HEALTH INC BLAC 7152845361 711 WEST ADAMS STREET BLACK RIVER FALLS WI 54615 CATHY BUKOWSKI VP OF FINANCE/CFO 7152845361 2025-10-06 1 1 MICHAEL J PETERSON CPA P01833529 2187224705 2025-10-06 2024 2025-03-06 01:10:19Z BLACK RIVER MEMORIAL HOSPITAL CARL SELVICK 711 WEST ADAMS STREET BLACK RIVER FALLS WI 54615 77814738 0 X WWW.BRMH.NET X 1966 WI TO HELP PATIENT'S IMPROVE THEIR LIVES THROUGH COMPASSIONATE, COMMUNITY-BASED CARE. 9 8 390 42 16423 3863 7340236 58263 65639252 66780361 1618356 3147371 16502 26926 74614346 70012921 5000 5000 0 0 34686206 36471584 0 0 0 29918221 29093448 64609427 65570032 10004919 4442889 100100495 107569105 28162399 31121490 71938096 76447615 X BLACK RIVER HEALTH, INC.'S MISSION IS TO HELP PATIENT'S IMPROVE THEIR LIVES THROUGH COMPASSIONATE, COMMUNITY-BASED CARE. 0 1 46418422 5000 62580933 BLACK RIVER HEALTH, INC. PROVIDES HIGH-QUALITY, COST-EFFECTIVE, PRIMARY, AND MENTAL HEALTH CARE TO ALL PEOPLE IN NEED OF CARE. AMONG THE INPATIENT AND OUTPATIENT SERVICES PROVIDED ARE DIAGNOSTIC IMAGING, REHABILITATION SERVICES, RESPIRATORY CARE, SURGICAL SERVICES, INFUSION THERAPY, LAB SERVICES, PHARMACY SERVICES, 24-HOUR EMERGENCY ROOM AND MANY OTHERS. IN 2024, THE HOSPITAL PROVIDED 3,263 INPATIENT DAYS OF CARE TO ADULTS, PEDIATRICS, SWING BED, AND NURSERY INPATIENTS AS WELL AS 9,542 EMERGENCY ROOM AND 36,245 OUTPATIENT SERVICES TO THOSE IN NEED OF CARE. THE HOSPITAL ALSO SERVES AS A VITAL LINK TO THE COMMUNITY BY PROVIDING OUTREACH PROGRAMS AND SERVICES THAT MEET IDENTIFIED NEEDS IN AN EFFORT TO ENHANCE THE HEALTH AND WELFARE OF THE PEOPLE IN ITS AREA. IN ITS EFFORT TO ATTAIN THIS GOAL THE HOSPITAL PROVIDES:-FREE AND REDUCED-COST CARE TO THOSE WITH A DEMONSTRATED NEED-CARE TO THOSE COVERED UNDER GOVERNMENT ENTITLEMENT PROGRAMS WHICH MAY NOT COVER THE CHARGES OR COST OF SERVICES PROVIDED-HEALTH EDUCATION AND OUTREACH PROGRAMS TO ALL MEMBERS OF THE COMMUNITY AT LITTLE OR NO COST TO THE PARTICIPANTSCHARITY CARE GIVEN TO PERSONS UTILIZING OUR HOSPITAL AMOUNTED TO A TOTAL OF $788,045 IN TOTAL CHARGES. IN ADDITION, WE FURNISH CARE TO PERSONS COVERED UNDER GOVERNMENT ENTITLEMENT PROGRAMS WHICH PAY AT RATES LESS THAN CHARGES. DISCOUNTS TO THESE PROGRAMS FOR HOSPITAL SERVICES AMOUNTED TO $20,785,788.BLACK RIVER HEALTH, INC. ALSO CONDUCTED NUMEROUS EDUCATIONAL AND SUPPORTIVE ACTIVITIES TO ENCOURAGE THE GOOD HEALTH AND WELFARE OF THE MEMBERS OF THE COMMUNITIES IT SERVES. THESE ACTIVITIES INCLUDE:-PROVIDING ASSISTANCE TO HEALTH EDUCATORS BY SPONSORING INTERNSHIPS FOR STUDENT NURSES, RADIOLOGICAL, REHABILITATION, AND LABORATORY TECHNICIAN STUDENTS.-PROVIDING CHILDBIRTH EDUCATIONAL CLASSES-PROVIDING LEADERSHIP TO STATE AND REGION-WIDE HEALTH ORGANIZATIONS INCLUDING THE WISCONSIN HOSPITAL ASSOCIATION, HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION, NURSE EXECUTIVES, HEALTH EDUCATORS, PERINATAL CARE ASSOCIATION AND THE WISCONSIN HEALTHCARE PUBLIC RELATIONS AND MARKETING SOCIETY TO FURTHER HEALTHCARE GOALS OUTSIDE OF OUR DIRECT SERVICE AREA.OTHER SERVICES WE PROVIDE INCLUDE GRIEF SUPPORT GROUP. COALITIONS WE SUPPORT ARE: BREASTFEEDING COALITION, BLACK RIVER AREA SAFETY COUNCIL, TOGETHER FOR JACKSON COUNTY KIDS, AND JACKSON IN ACTION. BLACK RIVER HEALTH, INC.'S WOUND CARE CENTER BEGAN PROVIDING SERVICES TO THE COMMUNITY MAY 2021 AND PERFORMED 5,150 OUTPATIENT PROCEDURES IN 2024.BLACK RIVER HEALTH, INC. REFINED THE 340B DRUG PRICING PROGRAM TO MAXIMIZE COST SAVINGS. THESE SAVINGS WILL ALLOW THE ORGANIZATION TO OFFSET OPERATIONAL COSTS AND SUPPORT THE EXPANSION OF ESSENTIAL HEALTHCARE SERVICES WITHIN OUR COMMUNITY AND THE SURROUNDING AREAS.BLACK RIVER HEALTH, INC. SUCCESSFULLY LAUNCHED AN ELECTRONIC ICU (EICU) MODEL IN COLLABORATION WITH UW HEALTH, ENABLING LOCAL DELIVERY OF ICU-LEVEL CARE THROUGH REAL-TIME REMOTE MONITORING BY INTERNAL MEDICINE SPECIALISTS.BLACK RIVER HEALTH, INC. ESTABLISHED A LOCAL ONCOLOGY SERVICE LINE IN PARTNERSHIP WITH KROHN CLINIC AND GUNDERSEN LUTHERAN. THIS INITIATIVE HAS PROVIDED PATIENTS WITH ACCESS TO ONCOLOGISTS, INFUSION THERAPY, AND DIAGNOSTIC SERVICES WITHIN THEIR OWN COMMUNITY. 950335 0 1826209 BLACK RIVER HEALTHCARE CLINIC OPENED TO BRH EMPLOYEES IN JUNE AND THE GENERAL PUBLIC IN JULY 2020. BLACK RIVER HEALTHCARE CLINIC IS AN INTEGRATED CLINIC OFFERING BEHAVIORAL HEALTH AND PRIMARY CARE SERVICES. IN 2024, BEHAVIORAL HEALTH VISITS WERE 1,674 AND PRIMARY CARE VISITS WERE 6,236. 261738 0 1386370 BLACK RIVER HEALTH, INC.'S INFUSION CENTER BEGAN PROVIDING SERVICES TO THE COMMUNITY IN AUGUST 2021 WHICH INCLUDE INTRODUCING CHEMOTHERAPY TO OUR SERVICE MIX FOR THE FIRST TIME. INFUSION VISITS IN 2024 WERE 1,477. 0 0 830945 OTHER PROGRAMS 0 0 830945 47630495 1 0 0 1 0 0 0 0 0 0 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 39 0 390 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 9 8 0 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X CATHY BUKOWSKI 7152845361 711 WEST ADAMS STREET BLACK RIVER FALLS WI 54615 DR CAROL MARTIN CHIEF OF STAFF/DIR. (THRU 12/2024) 34.00 X X 547412 0 99698 ALEX BRADLEY CHOWN CHAIR (THRU 12/2024) 5.00 X X 0 0 0 TIMOTHY TRANBERG DIRECTOR, CHAIR (BEG. 12/2024) 4.00 X X 0 0 0 MICHELE SEVERSON VICE CHAIR (THRU 12/2024) 4.00 X X 0 0 0 MICHELLE GREENDEER-RAVE TREASURER (THRU 11/2024) 4.00 X X 0 0 0 WALLACE APLAND III DIRECTOR 4.00 X 0 0 0 DR MICHELLE CLARK-FORSTING DIR./CHIEF PHYS. EXEC. (BEG. 12/24) 4.00 X 0 0 0 DR NICHOLAS KITOWSKI DIRECTOR (BEG. 12/2024) 4.00 X 0 0 0 TIMOTHY KUNES DIRECTOR 4.00 X 0 0 0 DR KIRK LANE DIRECTOR (BEG. 12/2024) 4.00 X 0 0 0 KATHERINE POTTER DIRECTOR 4.00 X 0 0 0 DR THOMAS WALKER DIRECTOR 4.00 X 0 0 0 HOLLY WINN CFO 40.00 X 397682 0 87375 CARL SELVICK CEO 40.00 X 476693 0 45717 DR ESTEBAN MILLER PHYSICIAN 42.00 X 474405 0 96808 DR TROY SENNHOLZ PHYSICIAN 28.00 X 385083 0 89040 EDWARD ZHOVTIS ANESTHESIA DEPT DIRECTOR 27.00 X 301719 0 38528 DONALD HART CRNA 27.00 X 267005 0 78875 GREGORY EDDY CRNA 27.00 X 251845 0 77193 MARY BETH WHITE-JACOBS FORMER CEO 40.00 X 129103 0 0 3230947 0 613234 49 1 1 0 WIPFLI 4890 OWEN AYRES COURT SUITE 200 EAU CLAIRE WI 54701 REVENUE CYCLE CODING/BILLING/AUDIT 2528747 MEDICUS EMERGENCY ROOM SERVICES LLC 22 ROULSTON RD WINDHAM NH 03087 EMERGENCY ROOM STAFFING 645566 DIANA WILLIAMS DBA CHAMONIX 712 S ELM ST HINSDALE IL 60521 ED PROVIDER PROFESSIONAL SERVICES 333272 FOCUSONE PO BOX 850861 MINNEAPOLIS MN 55485 PROFESSIONAL STAFFING SERVICES 327678 VON BRIESEN 411 E WISCONSIN AVE SUITE 1000 MILWAUKEE WI 53202 PROFESSIONAL LEGAL SERVICES 307784 9 58263 58263 HOSPITAL PATIENT SERVICE REVENUE 621400 61801079 61801079 CLINIC REVENUE 621400 1826209 1826209 INFUSION REVENUE 621400 1386370 1386370 HOMECARE PATIENT REVENUE 621400 919335 919335 847368 691464 16423 139481 66780361 2446315 2446315 26926 0 26926 26926 26926 8486873 16000 7801817 0 685056 16000 701056 701056 70012921 66624457 16423 3313778 X 5000 5000 1654577 1654577 24066551 19446581 4619970 1068649 898264 170385 7930377 6002050 1928327 1751430 1309105 442325 344522 344522 7340 7340 68278 68278 9381023 5247448 4133575 422133 422133 698448 204807 493641 1641040 657 1640383 462399 446244 16155 100605 76704 23901 106 106 652421 486596 165825 3300550 2461651 838899 282614 282614 MEDICAL SUPPLIES AND PH 6164398 6164261 137 BAD DEBT EXPENSE 3560111 3560111 EQUIPMENT RENTAL & MAIN 496832 462715 34117 FOOD EXPENSE 352439 352439 1158189 505862 652327 65570032 47630495 17939537 0 808821 125166 9944278 2875672 10637367 12089808 1030127 1642500 403628 709922 75909855 47821712 26335723 28088143 47272773 52564217 3667778 9473677 100100495 107569105 5207643 5466374 19458800 18461145 3495956 7193971 28162399 31121490 X 71938096 76447615 71938096 76447615 100100495 107569105 4442889 66630 0 X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 7340 7340 0 PART II-B, LINE 1: BLACK RIVER HEALTH, INC. IS ALSO A MEMBER OF THE RURAL WISCONSIN HEALTH COOPERATIVE (RWHC). EACH YEAR BLACK RIVER HEALTH, INC. PAYS MEMBERSHIP FEES TO THE RWHC. RWHC PROVIDES SUPPORT SERVICES FOR A NUMBER OF ITS MEMBER HOSPITALS THROUGHOUT THE STATE OF WISCONSIN. SOME OF THE MANY SERVICES PROVIDED TO MEMBER HOSPITALS INCLUDE PROVIDING ASSISTANCE TO ORGANIZATIONS IN FINDING GRANT FUNDING FOR NEW PROGRAMS, LEGAL SERVICES, REIMBURSEMENT REVIEW SERVICES, CLINICAL EDUCATION, PROVIDER PRIVILEGING AND CREDENTIALING SERVICES, AND ADMINISTRATIVE CONSULTING SERVICES. AS A PART OF THESE SERVICES, THE RWHC ALSO PROVIDES ANALYSIS ON 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 11.4% OR $4,679 OF THE FEES PAID BY BLACK RIVER HEALTH, INC. WENT TO LOBBYING EFFORTS. BLACK RIVER HEALTH, INC. IS ALSO A MEMBER OF THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THE WHA PROVIDES SUPPORT SERVICES FOR A NUMBER OF MEMBERS WHICH INCLUDE BUT ARE NOT LIMITED TO QUALITY AND SAFETY DATA REPORTING AND RESOURCES, DATA REPOSITORY, AND EDUCATION. THEY ALSO HOST MULTIPLE COUNCILS FOR THEIR MEMBERS. THE WHA DETERMINED THAT 16.4% OR $2,661 OF THE MEMBERSHIP DUES PAID WENT TO LOBBYING. 511499 511499 42173670 23751557 18422113 31770209 24070155 7700054 1454477 1454477 28088143 DEFERRED COMPENSATION PLAN ASSETS 3226610 RIGHT OF USE ASSETS 4767067 AMOUNTS RECEIVABLE FROM THIRD PARTY REIMBURSEMENT PROGRAMS 1480000 9473677 DEFERRED COMPENSATION PLAN LIABILITY 2426904 OPERATING LEASE LIABILITY 4767067 7193971 66451162 66630 66630 66384532 68278 3560111 3628389 70012921 61941643 0 61941643 68278 3560111 3628389 65570032 PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE NET AGAINST REVENUE 3,560,111. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE NET AGAINST REVENUE 3,560,111. 1 1 X 1 X 1 X 1 1 0 1 1 445406 445406 0.00720 10211783 8752577 1459206 0.02350 10657189 8752577 1904612 0.03070 19498 19498 0.00030 275111 275111 0.00440 19938028 10663734 9274294 0.14960 15218 15218 0.00020 20247855 10663734 9584121 0.15450 30905044 19416311 11488733 0.18520 3532 3532 0.00010 6426 6426 0.00010 81455 81455 0.00130 8057 8057 0.00010 72213 72213 0.00120 171683 171683 0.00280 0 1933824 966912 9075925 9118937 -43012 X 1 1 1 1 BLACK RIVER HEALTH INC 711 WEST ADAMS STREET BLACK RIVER FALLS WI 54615 WWW.BRMH.NET 1037 X X X X BLACK RIVER HEALTH INC 1 0 0 1 X X X X X X X X X 22 1 0 1 1 X WWW.BRMH.NET/COMMUNITY-HEALTH-NEEDS-ASSESSMENT X 1 22 1 WWW.BRMH.NET/COMMUNITY-HEALTH-NEEDS-ASSESSMENT 0 1 X 200.000000000000 400.000000000000 X X X X X X X 1 1 X X X X 1 X WWW.BRMH.NET/PATIENTS-VISITORS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/ X WWW.BRMH.NET/PATIENTS-VISITORS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/ X WWW.BRMH.NET/PATIENTS-VISITORS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/ X X X X X X X 1 X 0 X X X X X 1 X 0 0 BLACK RIVER HEALTH, INC. PART V, SECTION B, LINE 5: IN 2024, WE CONTINUED OUR EFFORTS TO IMPLEMENT ACTION ITEMS OUTLINED IN OUR COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP). REGULAR MEETINGS WITH THE PUBLIC HEALTH DEPARTMENT HELPED TO ALIGN MUTUAL AGENCY-SPECIFIC CHIP PRIORITIES. THESE DISCUSSIONS FOCUSED ON COORDINATING STRATEGIES AND RESOURCES TO ADDRESS SHARED HEALTH CONCERNS, PROMOTE CROSS-AGENCY EFFORTS, AND AVOID DUPLICATION. MULTI-AGENCY CAMPAIGNS WERE LAUNCHED TO INCREASE AWARENESS OF JACKSON COUNTY'S HEALTH PRIORITIES, USING DIVERSE COMMUNICATION CHANNELS TO REACH A WIDE RANGE OF COMMUNITY MEMBERS.HOSPITAL REPRESENTATIVE PARTICIPATION OCCURRED IN ONGOING COMMUNITY TASK FORCES, COALITIONS, AND MULTI-AGENCY MEETINGS, GATHERING INPUT FROM A CROSS SECTION OF COMMUNITY REPRESENTATIVES. THESE COLLABORATIVE EFFORTS FOCUSED ON ADDRESSING BROAD COMMUNITY HEALTH PRIORITIES AS WELL AS THE SPECIFIC FOCUS AREAS IDENTIFIED BY BLACK RIVER MEMORIAL HOSPITAL (BRMH).KEY GROUPS INVOLVED INCLUDED THE JACKSON COUNTY CHILDCARE NETWORK, JACKSON COUNTY RESILIENCY ALLIANCE, JACKSON COUNTY CRISIS COLLABORATION, JACKSON COUNTY WORKFORCE CONNECTIONS, JACKSON COUNTY CHRONIC DISEASE COALITION, JACKSON COUNTY HOMELESS COALITION, SERVANT-LED COMMUNITY TRANSPORTATION INITIATIVE, INTERFAITH CAREGIVERS VOLUNTEER AGENCY AND THE COMMUNITY SUPPORT WORKER PROGRAM.MANY OF THESE CROSS-AGENCY INITIATIVES WERE ALIGNED WITH BRMH'S IDENTIFIED PRIORITIES:1. MENTAL HEALTH SUICIDE AND SELF-HARM PREVENTION2. MENTAL HEALTH ACCESS3. HEALTHCARE ACCESS, AVAILABILITY, AND AFFORDABILITY BLACK RIVER HEALTH, INC. PART V, SECTION B, LINE 6B: THE CHNA WAS COMPLETED WITH THE HO-CHUNK NATION AND JACKSON COUNTY DEPARTMENT OF HEALTH & HUMAN SERVICES. BLACK RIVER HEALTH, INC. PART V, SECTION B, LINE 11: PRIORITY 1- MENTAL HEALTH: SUICIDE AND SELF-HARMGOAL 1: DELIVER COMPASSIONATE, HIGH-QUALITY EMERGENCY CARE DURING MENTAL HEALTH CRISES.TACTICS: DESIGN EMERGENCY DEPARTMENT BEHAVIORAL HEALTH CARE AND BUILD PARTNERSHIPS- ON-DEMAND BEHAVIORAL HEALTH SERVICES VIA TELEHEALTH: WE CONTINUED TO PROVIDE ON-DEMAND EMERGENT BEHAVIORAL HEALTH SERVICES THROUGH TELEHEALTH IN THE EMERGENCY DEPARTMENT (ED), INCLUDING NECESSARY REFERRALS TO INPATIENT PSYCHIATRIC CARE WHEN REQUIRED.- ENHANCED REFERRAL PROCESS FOR MENTAL HEALTH CRISES: REFERRAL PROCESS FOR PATIENTS PRESENTING WITH MENTAL HEALTH CRISES IN THE ED HAS BEEN ENHANCED TO ENSURE APPROPRIATE FOLLOW-UP WITH BEHAVIORAL HEALTH PROVIDERS AND EFFECTIVE COLLABORATION WITH PRIMARY CARE PROVIDERS FOR COMPREHENSIVE PATIENT CARE.- UPDATED MENTAL HEALTH RESOURCE INFORMATION: LOCAL MENTAL HEALTH RESOURCE OFFERINGS ARE MAINTAINED AND PROVIDED TO PATIENTS, WITH A KEY FOCUS ON PROMOTING 211 AS THE MOST CURRENT AND ACCESSIBLE REGIONAL RESOURCE FOR MENTAL HEALTH SUPPORT.- COLLABORATION IN JACKSON COUNTY CRISIS TEAM: ONGOING PARTICIPATION IN THE JACKSON COUNTY CRISIS COLLABORATION TEAM CONTINUES TO STRENGTHEN COMMUNITY EFFORTS IN IMPROVING CRISIS RESPONSE AND MENTAL HEALTH SUPPORT.GOAL 2: INCREASE PARTICIPATION IN LOCAL EDUCATIONAL OPPORTUNITIES AND CAMPAIGNS FOCUSED ON SUICIDE AND SELF-HARM AWARENESS.TACTICS: COMMUNITY ENGAGEMENT AND MENTAL HEALTH AWARENESS INITIATIVES- SUPPORT FOR COMMUNITY EVENTS: WE SUPPORTED LOCAL COMMUNITY EVENTS THROUGH GUEST SPEAKERS, FINANCIAL CONTRIBUTIONS, IN-KIND DONATIONS, AND EDUCATIONAL MATERIALS, ALL CONTRIBUTING TO INCREASED ATTENDANCE AND IMPACT, AS REFLECTED IN CBISA DATA.- BRH WEBSITE MENTAL HEALTH RESOURCES: WE ACTIVELY MAINTAINED AND PROMOTED THE BRH WEBSITE'S MENTAL HEALTH RESOURCES, INCLUDING A GUIDED MENTAL HEALTH JOURNAL AND COMPREHENSIVE SERVICE INFORMATION, TO PROVIDE ONGOING SUPPORT AND EDUCATION.- MENTAL HEALTH AWARENESS THROUGH MOMENTUM MAGAZINE: MENTAL HEALTH-RELATED CONTENT WAS DISTRIBUTED THROUGH MOMENTUM MAGAZINE AND OTHER DIGITAL AND PRINT CHANNELS, FOCUSING ON RAISING AWARENESS ABOUT SUICIDE PREVENTION AND THE CRITICAL IMPORTANCE OF SEEKING HELP.- MENTAL WELLNESS WALK-A-THON COLLABORATION: IN PARTNERSHIP WITH LOCAL ORGANIZATIONS, WE SUCCESSFULLY HOSTED THE MENTAL WELLNESS WALK-A-THON IN SEPTEMBER 2024, AIMED AT PROMOTING MENTAL HEALTH SUPPORT AND SHOWCASING LOCAL RESOURCES AVAILABLE TO THE COMMUNITY.PRIORITY 2-MENTAL HEALTH: ACCESSGOAL 1: IMPROVE EFFICIENCY AND COORDINATION OF BEHAVIORAL HEALTH SERVICES BY EXPANDING AND ALIGNING OFFERINGS WITH PATIENT NEEDS.TACTICS: ENHANCE BEHAVIORAL HEALTH SERVICES & AWARENESS:- TELEHEALTH BEHAVIORAL HEALTH SERVICES: EXPANDED OUR OFFERINGS TO INCLUDE BOTH IN-OFFICE TELEHEALTH ROOMS AND OFF-SITE TELEHEALTH OPTIONS, ENSURING GREATER ACCESSIBILITY FOR PATIENTS.- ADDITION OF LICENSED MARRIAGE AND FAMILY THERAPIST (LMFT): LICENSED MARRIAGE AND FAMILY THERAPIST HAS BEEN INTEGRATED INTO OUR BEHAVIORAL HEALTH PRACTICE TO PROVIDE COMPREHENSIVE CARE.- OPERATIONAL IMPROVEMENTS: INCREASED OVERALL EFFICIENCY IN SCHEDULING AND ACCESS TO BEHAVIORAL HEALTH SERVICES FOR OUR PATIENTS.- MARKETING CAMPAIGNS: STRATEGIC MARKETING CAMPAIGNS WERE LAUNCHED TARGETING BOTH REFERRAL SOURCES AND THE GENERAL PUBLIC, AIMED AT RAISING AWARENESS OF OUR LOCAL SERVICES.GOAL 2: DEVELOP STRATEGIC PARTNERSHIPS TO EXPAND BEHAVIORAL HEALTH SERVICES FOR UNDERSERVED POPULATIONS.TACTICS: BEHAVIORAL HEALTH AND ACCESS TO CARE INITIATIVES- SCHOOL-BASED MENTAL HEALTH PLANNING: COLLABORATED WITH AREA SCHOOL DISTRICTS TO ASSESS THE NEED FOR SCHOOL-BASED MENTAL HEALTH SERVICES. A COMPREHENSIVE NEEDS ASSESSMENT WAS COMPLETED, AND A PRELIMINARY PLAN WAS DEVELOPED FOR BOTH TELEHEALTH AND ONSITE SERVICES. IMPLEMENTATION IS TARGETED FOR 2025.- BEHAVIORAL HEALTH SERVICES IN THE EMERGENCY DEPARTMENT: CONTINUED OFFERING ON-DEMAND TELEHEALTH BEHAVIORAL HEALTH SUPPORT WITHIN THE ED, INCLUDING TIMELY ASSESSMENTS AND REFERRALS FOR INPATIENT PSYCHIATRIC CARE WHEN NEEDED.- EXPANDED FINANCIAL ASSISTANCE PROGRAM: ENHANCED PROMOTION OF THE FINANCIAL ASSISTANCE PROGRAM THROUGH TARGETED PATIENT OUTREACH AND COMMUNITY COMMUNICATION EFFORTS. POLICY UPDATES BROADENED ELIGIBILITY CRITERIA BASED ON INCOME, IMPROVING ACCESS TO CARE. EXTERNAL AGENCIES, INCLUDING PUBLIC HEALTH, RECEIVED TRAINING ON THE REVISED POLICY TO IMPROVE COMMUNITY ALIGNMENT AND AWARENESS.- TELEHEALTH CLINIC SERVICES: TELEHEALTH ROOM ADDED TO CLINIC TO REMOVE BARRIERS FOR THOSE WITH BROADBAND CONNECTIVITY ISSUES. PRIORITY 3-HEALTHCARE ACCESS, AFFORDABILITY, AND AVAILABILITYGOAL 1: INCREASE THE EFFICIENCY OF CARE DELIVERY ACROSS ALL BRH SERVICE LINES.TACTICS: REFINE CLINICAL OPERATIONS & CARE COORDINATION - EVALUATION OF CLINICAL STAFFING AND OPERATIONS: CLINICAL DEPARTMENTS CONDUCTED COMPREHENSIVE REVIEWS OF STAFFING MODELS AND OPERATIONAL WORKFLOWS. CMS-REPORTED DATA AND NATIONAL STANDARDS OF PRACTICE WERE ADOPTED TO ALIGN WITH EVIDENCE-BASED BEST PRACTICES. THE QUALITY ASSURANCE PERFORMANCE IMPROVEMENT COMMITTEE OVERSEES OUTCOME TRACKING AND PROCESS IMPROVEMENTS TO ADVANCE QUALITY, EFFICIENCY, AND PATIENT-CENTERED CARE.- EXPANSION OF HOME SERVICES AND THERAPY ACCESS: REFINED OPERATIONS OF THE HOME AND RESPIRATORY EQUIPMENT STORE AND OUTPATIENT IN-HOME THERAPY SERVICES, INCREASING CAPACITY TO SERVE MORE PATIENTS SAFELY AND EFFECTIVELY WITHIN THEIR HOMES.- CONTINUUM OF CARE AGREEMENT WITH HOME HEALTH AGENCY: ESTABLISHED A COLLABORATIVE AGREEMENT ALLOWING A BRH-EMPLOYED RN TO SUPPORT A LOCAL HOME CARE AGENCY. THIS STRENGTHENS THE CONTINUUM OF CARE FOR PATIENTS TRANSITIONING FROM INPATIENT TO HOME-BASED RECOVERY, ENSURING SMOOTHER DISCHARGES AND BETTER POST-ACUTE OUTCOMES.- SUSTAINED AND EXPANDED TELEHEALTH SERVICES: MAINTAINED ROBUST TELEHEALTH OFFERINGS TO ENSURE ACCESS TO SPECIALTY SERVICES, INCLUDING ACUTE MENTAL HEALTH CARE. TELEHEALTH CAPABILITIES CONTINUE TO INCLUDE TELE-STROKE AND TELE-ICU SERVICES, FURTHER ENHANCING ACCESS TO CRITICAL AND TIME-SENSITIVE CARE.- IMPROVED REFERRAL TRACKING AND FOLLOW-UP: ENHANCED REFERRAL AND FOLLOW-UP TRACKING WITHIN THE EMR SYSTEM TO ENSURE TIMELY CONNECTION TO APPROPRIATE PROVIDERS FOLLOWING ED VISITS, IMPROVING CARE CONTINUITY AND REDUCING GAPS IN FOLLOW-UP.- IMPROVED REFERRAL TRACKING AND FOLLOW-UP: ENHANCED REFERRAL AND FOLLOW-UP TRACKING WITHIN THE EMR SYSTEM TO ENSURE TIMELY CONNECTION TO APPROPRIATE PROVIDERS FOLLOWING ED AND BRHCC VISITS, IMPROVING CARE CONTINUITY AND REDUCING GAPS IN FOLLOW-UP.GOAL 2: IMPROVE AFFORDABILITY OF LOCAL, HIGH-QUALITY CARE THROUGH RESPONSIBLE RESOURCE MANAGEMENT AND EXTERNAL FUNDINGTACTICS: ORGANIZATION OF INTERNAL AND EXTERNAL COLLABORATIVE PARTNERS AND FUNDING SOURCES - OPTIMIZED 340B PROGRAM PARTICIPATION: REFINED BRH'S ENGAGEMENT WITH THE 340B DRUG PRICING PROGRAM TO MAXIMIZE COST SAVINGS. SAVINGS ARE REINVESTED TO OFFSET OPERATIONAL COSTS AND SUPPORT THE EXPANSION OF ESSENTIAL HEALTHCARE SERVICES, IMPROVING OVERALL ACCESS AND AFFORDABILITY FOR OUR PATIENTS.- EICU IMPLEMENTATION IN PARTNERSHIP WITH UW HEALTH: SUCCESSFULLY LAUNCHED AN ELECTRONIC ICU (EICU) MODEL IN COLLABORATION WITH UW HEALTH, ENABLING LOCAL DELIVERY OF ICU-LEVEL CARE THROUGH REAL-TIME REMOTE MONITORING BY INTERNAL MEDICINE SPECIALISTS. THIS INNOVATION ENHANCES PATIENT OUTCOMES WHILE REDUCING THE NEED FOR TRANSFERS. GRANT FUNDING WAS SECURED TO HELP COVER EQUIPMENT COSTS.- DEVELOPMENT OF LOCAL ONCOLOGY SERVICES: ESTABLISHED A LOCAL ONCOLOGY SERVICE LINE IN PARTNERSHIP WITH KROHN CLINIC AND GUNDERSEN LUTHERAN. THIS INITIATIVE PROVIDES PATIENTS WITH ACCESS TO ONCOLOGISTS, INFUSION THERAPY, AND DIAGNOSTIC SERVICES WITHIN THE COMMUNITY, REDUCING TRAVEL BURDENS AND IMPROVING CONTINUITY OF CARE.- ORTHOPEDIC SERVICE LINE EXPANSION: INITIATED THE ORTHOPEDIC SERVICE LINE IN 2024 TO MEET GROWING COMMUNITY DEMAND FOR SPECIALIZED CARE. COMPREHENSIVE SERVICE LINE DEVELOPMENT IS SCHEDULED FOR 2025, ENHANCING LOCAL ACCESS AND REDUCING THE NEED FOR OUT-OF-AREA REFERRALS.- FORMATION OF BLACK RIVER HEALTH: ANNOUNCED THE FORMATION OF BLACK RIVER HEALTH, A STRATEGIC COLLABORATION BETWEEN BRH AND KROHN CLINIC AN INDEPENDENT PRACTICE. THIS PARTNERSHIP IS FOCUSED ON DELIVERING COORDINATED, COMPREHENSIVE CARE ACROSS THE CONTINUUM, IMPROVING ACCESS, AND BUILDING RESPONSIVE SERVICE LINES TAILORED TO LOCAL NEEDS.- SUSTAINABLE ENERGY INITIATIVES: CONTINUING TO MANAGE AND EXPLORE SUSTAINABLE ENERGY SOLUTIONS TO REDUCE LONG-TERM OPERATIONAL COSTS AND ADVANCE ENVIRONMENTAL STEWARDSHIP. THESE INITIATIVES SUPPORT FISCAL RESPONSIBILITY AND ALIGN WITH OUR COMMITMENT TO COMMUNITY WELL-BEING. BLACK RIVER HEALTH, INC. PART V, SECTION B, LINE 13B: PROPENSITY TO PAY BLACK RIVER HEALTH, INC. PART V, SECTION B, LINE 13H: THE HOSPITAL WILL CONSIDER THE OTHER DEBTS OF THE PATIENT. A PATIENT'S HOSPITAL BILL THAT IS LARGE IN COMPARISON TO THE PATIENT'S INCOME IS ALSO CONSIDERED FOR CATASTROPHIC CARE. BLACK RIVER HEALTH, INC. PART V, SECTION B, LINE 16J: THE HOSPITAL POSTS A NOTICE IN THE EMERGENCY ROOM, WAITING ROOMS, AND ADMISSIONS OFFICE STATING THAT THE FINANCIAL ASSISTANCE POLICY AND APPLICATION ARE AVAILABLE UPON REQUEST. THE FINANCIAL ASSISTANCE GUIDELINES AND CONTACT INFORMATION ARE ALSO MADE AVAILABLE ON THE HOSPITAL'S WEBSITE. BLACK RIVER HEALTH, INC. PART V, SECTION B, LINE 20E: THE HOSPITAL POSTS A NOTICE IN THE EMERGENCY ROOM, WAITING ROOMS, AND ADMISSIONS OFFICE STATING THAT THE FINANCIAL ASSISTANCE POLICY AND APPLICATION ARE AVAILABLE UPON REQUEST. THE FINANCIAL ASSISTANCE GUIDELINES AND CONTACT INFORMATION ARE ALSO MADE AVAILABLE ON THE HOSPITAL'S WEBSITE. PART I, LINE 6A: BLACK RIVER HEALTH, INC. PREPARES A COMMUNITY BENEFIT REPORT ANNUALLY AND FILES IT WITH THE WISCONSIN HOSPITAL ASSOCIATION (WHA). THE REPORT IS AVAILABLE TO THE GENERAL PUBLIC ON WHA'S DATABASE AND WEBSITE. PART I, LINE 7: 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 LESS THE PROVISION FOR BAD DEBT DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST VARIOUS REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER IRS SUGGESTED COSTING METHODS FOR THE FORM 990. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES AT BLACK RIVER HEALTH, INC. INCLUDE THE OPERATION OF THE HOSPITAL'S CLINIC, INPATIENT NURSING UNIT AND EMERGENCY ROOM. THE SUBSIDIZED INPATIENT UNIT INCLUDES THE MEDICAL/SURGICAL, OBSERVATION, OB AND HOSPITALIST NURSING UNITS. THE HOSPITAL INPATIENT UNIT DEPARTMENT AND EMERGENCY ROOM OPERATES 24-HOURS PER DAY SEVEN DAYS PER WEEK AND IS STAFFED BY A GROUP OF HIGHLY TRAINED STAFF INCLUDING HOSPITALIST PHYSICIANS, REGISTERED NURSES, AND OTHER SUPPORT STAFF. MANY OF THE ADMISSIONS TO THE HOSPITAL INPATIENT NURSING UNIT COME FROM THE HOSPITAL'S EMERGENCY DEPARTMENT WHICH IS OPERATED TO PROVIDE EMERGENCY CARE TO PATIENTS OF THE COMMUNITY AND SURROUNDING AREAS. ALL OF THESE SUBSIDIZED HEALTH SERVICES WORK IN SUPPORT AND COOPERATION WITH THE COMBINED EFFORTS OF BLACK RIVER HEALTH, INC. AND SHARE MANY SUPPORT FUNCTIONS OF THE HOSPITAL IN AN EFFORT TO PROVIDE EXCELLENT, LOW COST CARE TO PATIENTS IN THEIR LOCAL COMMUNITY AND AREA. A SIGNIFICANT PAYOR FOR THESE PROGRAMS IS THE MEDICARE PROGRAM WHICH DOES NOT REIMBURSE THE HOSPITAL FOR THESE SERVICES IN ALL CASES BASED ON COST SO A SIGNIFICANT LOSS IS ABSORBED BY THE HOSPITAL TO PROVIDE THESE SERVICES TO MEMBERS OF THE COMMUNITY. IT IS THE GOAL OF BLACK RIVER HEALTH, INC. TO PROVIDE THESE SERVICES TO THE COMMUNITY REGARDLESS OF A PATIENT'S ABILITY TO PAY.THE COSTING METHODOLOGY FOR SUBSIDIZED HEALTH SERVICES IS BASED ON THE COSTING METHODS USED ON THE HOSPITAL'S MEDICARE COST REPORT. THIS METHODOLOGY PROVIDES FOR A DIRECT ALLOCATION OF EXPENSES AS WELL AS PROVIDING THE SAME DATA TO THE MEDICARE PROGRAM AS WELL AS TO THE IRS FOR FORM 990 PURPOSES. 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 $ 3,560,111. PART II, COMMUNITY BUILDING ACTIVITIES: OUR HOSPITAL PROVIDES FINANCIAL ASSISTANCE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS. BUT IN ADDITION, WE BELIEVE THAT WE PROVIDE A CRITICALLY IMPORTANT COMMUNITY BENEFIT THAT IS NOT QUANTIFIED. OUR HOSPITAL, LIKE MOST RURAL HOSPITALS, WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE LOCAL ACCESS TO MANY HEALTH SERVICES: BIRTHING CENTER, DIAGNOSTICS, EMERGENCY SERVICES AND SAME DAY APPOINTMENTS THROUGH THE BLACK RIVER HEALTHCARE CLINIC, INFUSION SERVICES, INPATIENT CARE, LABORATORY SERVICES, OCCUPATIONAL HEALTH, REHABILITATION SERVICES, SPECIALTY MEDICINE, SPEECH, SURGICAL SERVICES, AND WOMEN'S HEALTH. WE DISCONTINUED OUR HOMECARE AND HOSPICE PROGRAMS IN MAY 2023 AND BEGAN CCM AND TCM SERVICES. IN PARTNERSHIP WITH KROHN CLINIC AND GUNDERSEN LUTHERAN, WE IMPLEMENTED OUR ONCOLOGY SERVICE LINE IN 2024. 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. THE HOSPITAL ALSO RECOGNIZES THAT IT ALSO PROVIDES A DISCOUNT TO SELF-PAY OR UNINSURED PATIENTS. THESE AMOUNTS ARE EXCLUDED FROM GROSS PATIENT SERVICE REVENUE ON THE FINANCIAL STATEMENTS AND ARE NOT INCLUDED IN THE RATIO AS DESCRIBED ABOVE AND APPROVED BY THE IRS FOR USE ON FORM 990. IF CONSIDERED, THESE ADDITIONAL WRITE-OFF AMOUNTS TO UNINSURED ACCOUNTS WOULD ALSO INCREASE THE ESTIMATED BAD DEBT EXPENSE AMOUNT ASSOCIATED WITH THESE UNCOLLECTIBLE ACCOUNTS 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. BALANCES THAT ARE STILL OUTSTANDING AFTER THE HOSPITAL HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND A CREDIT TO ACCOUNTS RECEIVABLE. PART III, LINE 4: ACCOUNTS RECEIVABLE AND CREDIT POLICY: IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES PAST RESULTS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. SPECIFICALLY, FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR BAD DEBTS FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS AND PATIENTS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THE AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A SEPARATE FOOTNOTE REGARDING BAD DEBT EXPENSE. PART III, LINE 8: BLACK RIVER HEALTH, INC. IS DESIGNATED AS A CRITICAL ACCESS HOSPITAL AND AS SUCH A PORTION OF ITS MEDICARE REVENUES ARE PAID UNDER A COST REIMBURSEMENT SYSTEM. THE TOTAL MEDICARE REVENUE SHOWN BASED ON THE IRS 990 INSTRUCTIONS INCLUDES GROSS MEDICARE REVENUE BUT DOES NOT CONSIDER CONTRACTUAL ADJUSTMENTS FOR THE REIMBURSEMENT THAT IS ACTUALLY RECEIVED FROM THE MEDICARE PROGRAM. THE AMOUNTS LISTED FOR MEDICARE ALSO DOES NOT INCLUDE PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT AT THE HOSPITAL AS WELL AS RADIOLOGIST, RESPIRATORY THERAPY, URGENT CARE, OR ANESTHESIA PROFESSIONAL SERVICES. PHYSICIAN COVERAGE IS REIMBURSED PRIMARILY ON A FEE SCHEDULE REIMBURSEMENT AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY 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 BLACK RIVER HEALTH, INC. PROVIDES TO THE COMMUNITY AND SURROUNDING AREA OF JACKSON 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 SERVICES WHICH THE HOSPITAL WOULD SHOW A LARGE LOSS ON THESE SERVICES. PART III, LINE 9B: UNDER THE HOSPITAL'S COLLECTION AND COMMUNITY CARE POLICIES, BLACK RIVER HEALTH, INC. MAKES EVERY ATTEMPT TO IDENTIFY AND PROMOTE CHARITY CARE TO PATIENTS. INCLUDED IN THE HOSPITAL'S COMMUNITY CARE POLICY IT IS NOTED THAT PATIENTS MAY QUALIFY FOR CHARITY CARE EITHER PRIOR TO ADMISSION OR FOLLOWING DISCHARGE. ALL INPATIENT SELF-PAY ADMISSIONS ARE SCREENED BY THE HOSPITAL'S FINANCIAL COUNSELOR TO ALLOW THESE PATIENTS THE ABILITY TO COMPLETE THEIR APPLICATION DURING THEIR STAY AT THE HOSPITAL, DEPENDING UPON THE PATIENT'S CONDITION, OR THE PATIENT'S RESPONSIBLE PARTY MAY BE CONTACTED TO COMPLETE AND RETURN THE FORMS AT A LATER TIME WHEN THEIR CARE ALLOWS THIS COMPLETION. DURING THE PATIENT ACCOUNT COLLECTION PROCESS, SELF-PAY PATIENTS ARE ALSO INFORMED OF THE HOSPITAL'S COLLECTION POLICIES AS WELL AS THE COMMUNITY CARE PROGRAM TO ALLOW PATIENTS THE OPPORTUNITY TO COMPLETE THE APPROPRIATE FORMS AND QUALIFY UNDER THE PROGRAM. INCLUDED IN THE POLICY, IT IS ALSO NOTED THAT THE HOSPITAL RESERVES THE RIGHT TO MAKE OR GRANT ADDITIONAL CHARITY CARE EVEN BEYOND THE INCOME AND ASSET GUIDELINES BASED ON CIRCUMSTANCES OR EVENTS IN A PARTICULAR PATIENT'S LIFE DURING DIFFICULT TIMES. PART VI, LINE 2: EVERY THREE YEARS, BRH CONSIDERS OUR COMMUNITY'S MOST PRESSING HEALTH NEEDS BY CONDUCTING A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE 2022 ASSESSMENT WAS COMPLETED BY A GROUP OF HOSPITAL EMPLOYEES AND INCLUDES QUANTITATIVE AND QUALITATIVE DATA THAT SERVE TO GUIDE BOTH OUR COMMUNITY BENEFIT AND STRATEGIC PLANNING. THROUGH OUR CHNA, BRH HAS IDENTIFIED THE GREATEST HEALTH NEEDS IN OUR HOSPITAL'S COMMUNITIES ENABLING BRH TO ENSURE OUR RESOURCES ARE APPROPRIATELY DIRECTED TOWARD OUTREACH, PREVENTION, EDUCATION, AND WELLNESS OPPORTUNITIES WHERE THE GREATEST IMPACT CAN BE ACHIEVED. DURING THE 2022 ASSESSMENT WE IDENTIFIED THE TOP THREE NEEDS TO BEHAVIORAL HEALTH CARE (INCLUDING MENTAL HEALTH AND SUBSTANCE USE DISORDER), OBESITY, AND DEMENTIA/ALZHEIMER'S CARE. THE ORGANIZATION IS IN THE PROCESS OF PLANNING FOR OUR NEXT CHNA IN 2026. PART VI, LINE 3: UNINSURED AND UNDER INSURED PATIENTS ARE ASKED TO MEET WITH ONE OF THE HOSPITAL'S PATIENT FINANCIAL ADVOCATES EITHER AT THE TIME SERVICE IS PROVIDED OR WHEN THE PATIENT'S BILL IS GENERATED. THE PATIENT FINANCIAL ADVOCATE EXPLAINS THE VARIOUS PAYMENT OPTIONS AVAILABLE TO THE PATIENT AS WELL AS THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM AND OFFERS THE FINANCIAL ASSISTANCE APPLICATION WHEN APPROPRIATE. IF OTHER PROGRAMS ARE AVAILABLE TO THE PATIENT, SUCH AS THE WISCONSIN MEDICAL ASSISTANCE OR BADGER CARE PROGRAMS, THESE PATIENTS ARE REFERRED TO THE APPROPRIATE GOVERNMENT AGENCY FOR FURTHER ASSISTANCE. PART VI, LINE 4: THE PRIMARY SERVICE AREA FOR BLACK RIVER HEALTH, INC. ENCOMPASSES ALL PERSONS LIVING WITHIN A 30-MILE RADIUS OF THE HOSPITAL. THIS AREA INCLUDES JACKSON COUNTY AND PARTS OF EAU CLAIRE, MONROE, LA CROSSE, TREMPEALEAU, WOOD, ADAMS, AND CLARK COUNTIES. SOME OF THE COMMUNITIES INCLUDED IN THIS AREA ARE ALMA CENTER, BLAIR, HIXTON, HUMBIRD, MELROSE, MERRILLAN, SPARTA, OSSEO, TOMAH, NEILLSVILLE, AND WHITEHALL. BLACK RIVER HEALTH, INC. IS THE ONLY HOSPITAL LOCATED IN JACKSON COUNTY, WISCONSIN. THE HOSPITAL PROVIDES A SIGNIFICANT PORTION OF ITS PATIENT CARE SERVICES TO BENEFICIARIES OF THE MEDICARE AND MEDICAID PROGRAMS AS WELL AS THE HO-CHUNK NATION (A LOCAL TRIBAL NATION WITH A LARGE PORTION OF ITS POPULATION RESIDING IN JACKSON COUNTY, WISCONSIN). THE HO-CHUNK NATION ALSO IS ABLE TO ACCESS CARE AT THE HOSPITAL AT REDUCED RATES THROUGH A REGULATION KNOWN AS THE "MEDICARE-LIKE PAYMENTS RULE." THE HOSPITAL ALSO IS A SUPPLIER OF HEALTH CARE SERVICES TO FIVE STATE OPERATED INSTITUTIONS WHICH ARE OPERATED BY THE WISCONSIN DEPARTMENT OF CORRECTIONS. THE STATE OF WISCONSIN ALSO REIMBURSES THE HOSPITAL AT RATES BELOW THE GENERAL PUBLIC TO REDUCE COSTS PASSED ON TO TAXPAYER IN THE STATE. PART VI, LINE 5: AS A COMMUNITY-OWNED HOSPITAL, BLACK RIVER HEALTH, INC. CONTINUES TO BE PROACTIVELY INVOLVED WITH AREA COMMUNITY MEMBERS THROUGH A VARIETY OF EDUCATIONAL FORUMS, SUPPORT GROUPS, WELLNESS AND SAFETY FAIRS, DIABETES FAIR, HO-CHUNK HEALTH FAIR, KIDS' SAFETY CAMP, PRE-NATAL AND BREASTFEEDING CLASSES. OTHER SUPPORT GROUPS NOT ONLY INCLUDE DIABETES AND BEREAVEMENT, BUT WE OFFER A BETTER BREATHERS SUPPORT GROUP AND A BETTER SLEEPERS SUPPORT GROUP. THERE ARE A NUMBER OF LOCAL ORGANIZATIONS THAT ARE REPRESENTED OR FACILITATED BY HOSPITAL STAFF INCLUDING: JACKSON IN ACTION, GREATER BLACK RIVER AREA SAFETY COUNCIL, JACKSON COUNTY HEALTHCARE ALLIANCE, JACKSON COUNTY TOBACCO COALITION, TOGETHER FOR JACKSON COUNTY KIDS, JACKSON COUNTY EMERGENCY MANAGEMENT PLANNING WORKFORCE, AND MANY OTHERS. THE HOSPITAL WELCOMES MEDICAL STUDENTS FOR INTERNSHIPS AND CLINICALS. THE HOSPITAL ALSO PARTICIPATES IN THE MEALS ON WHEELS PROGRAM BY DELIVERING MEALS TO LOCAL SENIORS WHO ARE HOME BOUND. THE HOSPITAL ALSO PROVIDES SUPPORT AND SPONSORSHIP TO THE RED CROSS BLOODMOBILE SEVERAL TIMES A YEAR. PART VI, LINE 6: N/A PART VI, LINE 7, REPORTS FILED WITH STATES WI X X X X 0 1 0 0 0 0 0 0 0 DR CAROL MARTIN CHIEF OF STAFF/DIR. (THRU 12/2024) 545864 0 0 0 1548 0 48398 0 51300 0 647110 0 0 0 DR ESTEBAN MILLER PHYSICIAN 473577 0 0 0 828 0 44818 0 51990 0 571213 0 0 0 CARL SELVICK CEO 371966 0 77000 0 27727 0 39890 0 5827 0 522410 0 0 0 HOLLY WINN CFO 328560 0 67574 0 1548 0 44836 0 42539 0 485057 0 0 0 DR TROY SENNHOLZ PHYSICIAN 384255 0 0 0 828 0 37265 0 51775 0 474123 0 0 0 DONALD HART CRNA 264457 0 1000 0 1548 0 30023 0 48852 0 345880 0 0 0 EDWARD ZHOVTIS ANESTHESIA DEPT DIRECTOR 300171 0 0 0 1548 0 33169 0 5359 0 340247 0 0 0 GREGORY EDDY CRNA 249971 0 1550 0 324 0 28475 0 48718 0 329038 0 0 0 MARY BETH WHITE-JACOBS FORMER CEO 129103 0 0 0 0 0 0 0 0 0 129103 0 0 0 PART I, LINE 4B BLACK RIVER HEALTH HAS CERTAIN EMPLOYEES THAT PARTICIPATE IN A 457(F) PLAN. THERE WERE NO DISTRIBUTIONS IN 2024. HOWEVER, THERE WERE EMPLOYER CONTRIBUTIONS FOR THE FOLLOWING INDIVIDUALS: DR. CAROL MARTIN $27,698 HOLLY WINN $24,136 CARL SELVICK $19,190 DR. ESTEBAN MILLER $24,118 DR. TROY SENNHOLZ $19,717 EDWARD ZHOVTIS $15,169 DONALD HART $13,647 GREGORY EDDY $12,943 A WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 2019-02-01 24000000 HOSPITAL ADDITIONS AND RENOVATIONS; REFUNDING OF 2005 BOND SERIES 0 0 0 A 5416931 24000000 10163311 146704 13689985 2019 1 0 1 1 A 0 0 0 0 0 0 0 A 0 0 0 1 0 0 0 0 0 A 0 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 02/01/2024 MICHAEL JACOBS SON OF MARY BETH WHITE-JACOBS, FORMER CEO 94120 EMPLOYMENT COMPENSATION 0 FORM 990, PART III, LINE 3 OUR HOMECARE AND HOSPICE PROGRAMS WERE DISCONTINUED IN MAY 2023. FORM 990, PART VI, SECTION A, LINE 4 THE ORGANIZATION HAS UPDATED ITS NAME FROM BLACK RIVER MEMORIAL HOSPITAL, INC. TO BLACK RIVER HEALTH, INC. FORM 990, PART VI, SECTION B, LINE 11B THE BOARD OF DIRECTORS OF BLACK RIVER HEALTH, INC. RECEIVED A COPY OF THE 990 FOR REVIEW PRIOR TO THE FILING OF THEIR RETURN. MEMBERS OF THE BOARD WILL DO A FORMAL REVIEW OF THE FORM AFTER FILING. THE HOSPITAL'S CHIEF OFFICERS REVIEWED THE RETURN IN DETAIL PRIOR TO ITS SUBMISSION TO THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C CONFLICTS OF INTEREST ARE REVIEWED ANNUALLY BY THE BOARD OF DIRECTORS. ANY ISSUES WHICH MAY ARISE ARE DISCUSSED AND HANDLED APPROPRIATELY. ANY MEMBER OF THE BOARD OF DIRECTORS WITH NOTED CONFLICTS ARE ASKED TO ABSTAIN FROM VOTING ON ANY POTENTIAL CONFLICTED ISSUES. A SIMILAR PROCESS IS USED BY THE BOARD OF DIRECTORS FOR THE REVIEW OF CONFLICTS OF INTEREST WITH THE CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER OF THE HOSPITAL. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION OF THE CHIEF EXECUTIVE OFFICER IS REVIEWED BY THE BOARD OF DIRECTORS ANNUALLY CONSIDERING COMPENSATION LEVELS AT SIMILAR SITUATED ORGANIZATIONS (TYPICALLY NOT-FOR-PROFIT HEALTH CARE ORGANIZATIONS IN THE SAME REVENUE CATEGORY OR GEOGRAPHICAL AREA). THE COMPENSATION OF ADMINISTRATIVE LEVEL EMPLOYEES IS REVIEWED BY THE CEO AND APPROVED IN THE BUDGET BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 BLACK RIVER HEALTH, INC.'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. SUMMARIZED FINANCIAL STATEMENT DATA IS ALSO AVAILABLE THROUGH THE WISCONSIN HOSPITAL ASSOCIATION'S WEBSITE AND THE HOSPITAL'S ANNUAL REPORT, WHICH IS PUBLISHED ON THE HOSPITAL'S WEBSITE. FORM 990, PART IX, LINE 11G RADIOLOGY FEES: PROGRAM SERVICE EXPENSES 896,075. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 896,075. ANESTHESIOLOGY FEES: PROGRAM SERVICE EXPENSES 71,373. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 71,373. MRI/CT/NUCLEAR MED SERVICES: PROGRAM SERVICE EXPENSES 583,334. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 583,334. PHYSICIANS FEES: PROGRAM SERVICE EXPENSES 1,215,667. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,215,667. LABORATORY SERVICES: PROGRAM SERVICE EXPENSES 191,589. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 191,589. OTHER: PROGRAM SERVICE EXPENSES 2,289,410. MANAGEMENT AND GENERAL EXPENSES 4,133,575. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,422,985.