2026-08-17T09:57:05-05:00 2025-09-30 393647910 WIPFLI ADVISORY LLC 1502 LONDON ROAD SUITE 220 DULUTH MN 55812 990 2024-10-01 390992883 MILE BLUFF MEDICAL CENTER MILE 6088476161 1050 DIVISION STREET MAUSTON WI 53948 TOM KAMINSKI CFO 6088476161 2026-08-13 1 1 MICHAEL J PETERSON CPA P01833529 2187224705 2026-08-12 2024 2025-03-06 01:10:19Z DARA BARTELS 1050 DIVISION STREET MAUSTON WI 53948 129208109 0 X WWW.MILEBLUFF.COM X 1923 WI IMPROVE HEALTH AND QUALITY OF LIFE IN THE COMMUNITY. 9 5 889 200 1354238 0 254142 1761304 117314253 124169251 1619035 727276 251993 239465 119439423 126897296 0 0 0 0 62148867 65788572 0 0 0 58479877 61325731 120628744 127114303 -1189321 -217007 114368033 112619582 71338752 69991303 43029281 42628279 X MILE BLUFF MEDICAL CENTER, AS A COMMUNITY HEALTH RESOURCE CENTER, WILL SERVE IN A LEADERSHIP CAPACITY TO FACILITATE THE DELIVERY OF HEALTH CARE AND MEDICAL SERVICES, INCLUDING CARE FOR THE ELDERLY AND HOME CARE TO THE RESIDENTS OF AND VISITORS TO JUNEAU COUNTY AND SURROUNDING COUNTIES. MILE BLUFF MEDICAL CENTER IS COMMITTED TO PROVIDING COMPASSIONATE AND PROGRESSIVE CARE, IMPROVING THE HEALTH AND WELLNESS OF THE COMMUNITY, AND GOING BEYOND EXPECTATIONS IN HEALTHCARE TODAY AND ALWAYS. 0 0 96944622 0 109264586 MILE BLUFF MEDICAL CENTER (MBMC) LEADS DELIVERY OF HEALTHCARE TO ITS REGION THROUGH OVER 700 ASSOCIATES WHO COORDINATE CARE TO DELIVER PATIENT CARE AS AN INTEGRATED UNIT. MBMC AND ITS AFFILIATES WORK SEAMLESSLY TO MEET THE NEEDS OF THE COMMUNITIES THEY SERVE AND MAKE MEDICAL CARE ACCESSIBLE TO THE ENTIRE COMMUNITY IT SERVES. MBMC OPERATES AN EMERGENCY ROOM THAT IS STAFFED 24 HOURS/DAY, SEVEN DAYS A WEEK, PROVIDING EMERGENCY CARE REGARDLESS OF PATIENT ABILITY TO PAY. MBMC PROVIDES CLINICAL SERVICES NEEDED TO OPERATE THE EMERGENCY ROOM AND ON-SITE EMERGENCY MEDICAL CARE. MEDICAL TRANSPORTATION SERVICES ARE AVAILABLE THROUGH AN AREA AMBULANCE SERVICE ALONG WITH AN ON-SITE HELIPAD. THE MEDICAL CENTER PROVIDES HEALTH CARE SERVICES TO PATIENTS AND RESIDENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. SINCE THE MEDICAL CENTER DOES NOT PURSUE COLLECTION OF THESE AMOUNTS, THEY ARE NOT REPORTED AS PATIENT AND RESIDENT SERVICE REVENUE. THE ESTIMATED COST OF PROVIDING THESE SERVICES WAS $230,000 FOR THE YEAR ENDED SEPTEMBER 30, 2025, CALCULATED BY MULTIPLYING THE RATIO OF COST TO GROSS CHARGES FOR THE MEDICAL CENTER BY THE GROSS UNCOMPENSATED CHARGES ASSOCIATED WITH PROVIDING CHARITY CARE TO ITS PATIENTS AND RESIDENTS. MILE BLUFF MEDICAL CENTER OPERATES TWO LONG-TERM CARE FACILITIES, FAIR VIEW NURSING & REHABILITATION IN MAUSTON, WI AND CREST VIEW NURSING AND REHABILITATION IN NEW LISBON, WI. THESE TWO SKILLED NURSING FACILITIES ARE 50 BEDS AND 60 BEDS RESPECTIVELY. CREST VIEW ALSO OPERATES A 12-BED COMMUNITY-BASED RESIDENTIAL FACILITY. 13380014 0 13550427 MBMC MAUSTON PHILLIPS, LLC IS A DIVISION OF MILE BLUFF MEDICAL CENTER. IN ADDITION TO THE FULL SERVICE PHARMACY, THE STORE ALSO OFFERS HOME MEDICAL EQUIPMENT AND SUPPLIES, OVER-THE-COUNTER MEDICATIONS, HEALTH AND WELLNESS SCREENINGS, IMMUNIZATIONS, CARDS, AND GIFTS. THE CONVENIENCE OF DRIVE-THROUGH PRESCRIPTION PICKUP IS ALSO AVAILABLE. PHILLIPS PRESCRIPTION DISPENSING SERVICES ARE AVAILABLE IN MILE BLUFF'S NEW LISBON, NECEDAH, AND ELROY LOCATIONS. WITH AN ORDER FROM A PROVIDER, MANY PRESCRIPTIONS CAN BE FILLED ONSITE OR DELIVERED AT A LATER TIME FOR A MORE CONVENIENT PICKUP OPTION FOR PATIENTS. 110324636 1 1 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 82 0 889 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 9 5 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 WI X DARA BARTELS 6088476161 1050 DIVISION STREET MAUSTON WI 53948 JOE WITMER CHAIR 0.50 X X 0 0 0 JORDAN SCHMIDT VICE CHAIR 0.50 X X 0 0 0 DENNY LOGING TREASURER 0.50 X X 0 0 0 JENNA SEBRANEK MD SECRETARY 40.50 X X 288151 0 49956 DARA BARTELS PRESIDENT, CEO & ACTING CFO 40.50 0.30 X X 461679 0 52451 JAMES GRANNELL MD ORTHOPEDICES/DIRECTOR 40.50 X 644229 0 49251 DANIEL KATTENBRAKER MD DIRECTOR / SLEEP MEDICINE 20.50 X 251147 0 12557 MICHELLE HEREK DIRECTOR 0.50 X 0 0 0 RANDY SCOTT DIRECTOR 0.50 X 0 0 0 LARRY WILLER DIRECTOR (THRU JAN 2025) 0.50 X 0 0 0 THOMAS KAMINSKI CFO 40.50 X 35654 0 6718 SCOTT KNIPRATH COO 40.00 X 236271 0 47136 RHONDA LARSON CHIEF NURSING OFFICER 40.00 X 186264 0 44590 NICHOLAS CONWELL MD EMERGENCY MEDICINE 40.00 X 611371 0 52671 BRIAN SCHULTZ DO GENERAL SURGEON 40.00 X 604579 0 49251 BARRETT SHOULTS MD EMERGENCY MEDICINE 40.00 X 504739 0 48825 ALLEGRA PONSHOCK MD FAMILY PRACTICE 40.00 X 392839 0 33237 4216923 0 446643 100 0 1 0 3RT NETWORKS LLC 103 LENARD ST S WEST SALEM WI 54669 IT SUPPORT 1504481 MARSHFIELD LABORATORIES 1000 NORTH OAK AVE MARSHFIELD WI 54669 LAB SERVICES 424460 RURAL WI HEALTH COOP 880 INDEPENDENCE LANE SAUK CITY WI 53583 RURAL HEALTHCARE COOPERATIVE 277500 ERIC MOORE MD 2211 KEYES AVE MADISON WI 55711 PHYSICIAN SERVICES 251040 WIPFLI LLP PO BOX 3160 MILWAUKEE WI 53201 AUDIT AND CONSULTING SERVICES 165400 14 1761304 1761304 PATIENT SERVICE REVENUE 621400 106205743 106205743 RETAIL PHARMACY 456110 9801826 8447588 1354238 340 B REVENUE 456110 5102839 5102839 3058843 3058843 124169251 722305 722305 239465 0 239465 239465 239465 2314284 1500 2310813 0 3471 1500 4971 4971 126897296 122815013 1354238 966741 2545276 1310789 1234487 49090090 43763213 5326877 1561537 1397300 164237 9315436 8244383 1071053 3276233 2867615 408618 99336 82957 16379 165400 165400 10890139 9232632 1657507 690236 576426 113810 2530506 2113260 417246 1806304 1508469 297835 206719 172634 34085 1311942 1213101 98841 4237697 3918430 319267 501889 419134 82755 MEDICAL SUPPLIES 27299254 22797692 4501562 BAD DEBT EXPENSE 6251072 6251072 DIETARY 703915 587849 116066 REPAIRS & MAINTENANCE 658550 549964 108586 3972772 3317716 655056 127114303 110324636 16789667 0 2806206 4108959 789602 871032 19722916 21624421 4572807 4526200 814268 831592 118255854 76383326 39251120 41872528 15310781 10532543 1929000 1929000 29171333 26323307 114368033 112619582 11973447 11197008 12913625 13947170 46418838 44815125 32842 32000 71338752 69991303 X 41873237 42628279 1156044 0 43029281 42628279 114368033 112619582 -217007 -183995 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 1632974 1632974 75368199 46862242 28505957 41018653 29521084 11497569 236028 236028 41872528 DEFERRED COMPENSATION PLAN INVESTMENTS 13947170 INVESTMENTS UNDER INDENTURE AGREEMENT - PROJECT FUNDS 6208970 ESTIMATED 3RD PARTY COLLECTIBLE 5554200 PREPAID SERVICE CONTRACT 301942 INVESTMENT IN UNCONSOLIDATED AFFILIATES 311025 26323307 PART IV, LINE 2B: PATIENT SECURITY DEPOSITS ARE FOR TENANTS AT TERRACE HEIGHTS. THIS IS A SECURITY DEPOSIT WHEN THEY SIGN THE LEASE AND RETURNED TO THEM WHEN THEY MOVE OUT, UNLESS THERE IS DAMAGE TO THE APARTMENT. 1 1 X 1 X 250.000000000000 1 X 1 1 0 1 1 685501 685501 0.00570 685501 685501 0.00570 102040 2455 99585 0.00080 509111 270 508841 0.00420 30562048 28037088 2524960 0.02090 17708 17708 0.00010 31190907 28039813 3151094 0.02600 31876408 28039813 3836595 0.03170 697 697 0.00000 1850 6908 6908 0.00010 138465 138465 0.00110 1850 146070 146070 0.00120 1 2471371 321278 9845290 12518208 -2672918 X 1 1 1 1 MILE BLUFF MEDICAL CENTER INC 1050 DIVISON STREET MAUSTON WI 53948 WWW.MILEBLUFF.COM X X X MILE BLUFF MEDICAL CENTER INC 1 0 0 1 X X X X X X X X X 24 1 0 0 1 X SEE SUPPLEMENTAL INFORMATION X 1 24 1 SEE SUPPLEMENTAL INFORMATION 0 1 X 250.000000000000 300.000000000000 X X X X 1 1 X X X 1 X HTTPS://WWW.MILEBLUFF.COM/DOCUMENTS/FINANCIAL-ASSISTANCE-POLICY.PDF X HTTPS://WWW.MILEBLUFF.COM/DOCUMENTS/FINANCIAL-ASSISTANCE-APPLICATION-2024.P X HTTPS://WWW.MILEBLUFF.COM/IMAGES/FINANCIAL-ASSISTANCE-AND-SLIDING-FEE-SCALE X X X X X X 1 X 0 X X X X 1 X 0 1 MILE BLUFF MEDICAL CENTER, INC. PART V, SECTION B, LINE 5: AS THE ONLY HOSPITAL IN JUNEAU COUNTY, IT IS THE PRIMARY AREA WE DRAW OUR PATIENTS FROM. HOWEVER, WE DO PROVIDE CARE TO INDIVIDUALS FROM SURROUNDING COUNTIES AND ZIP CODES. FOR THIS ASSESSMENT, WE CHOSE TO EXTEND OUR OUTREACH TO INCLUDE THOSE OTHER AREAS. THIS MARKED THE FIRST TIME WE EXPANDED THE GEOGRAPHIC AREA OF OUR ASSESSMENT BEYOND JUNEAU COUNTY. WE KNOW THAT HEALTH CHALLENGES AND STRENGTHS ARE NOT LIMITED BY COUNTY LINES, AND WE WANTED TO BETTER UNDERSTAND THE WIDER POPULATION WE SERVE. MOST OF THE SURVEY FEEDBACK STILL CAME FROM OUR HOME COUNTY (79.43%). WE RECEIVED LIMITED RESPONSE FROM NEIGHBORING AREAS (7.8% FROM SAUK COUNTY AND 6.73% FROM ADAMS, AND LESS THAN 2% EACH FROM MARQUETTE, MONROE, VERNON, RICHLAND, AND COLUMBIA COUNTIES). WE PLAN TO ASSESS THIS APPROACH AGAIN OUR NEXT CHNA CYCLE. MILE BLUFF MEDICAL CENTER, INC. PART V, SECTION B, LINE 7D: PART V, LINE 7: HTTPS://WWW.MILEBLUFF.COM/DOCUMENTS/CHNA-2024-REPORT.PDFPART V, LINE 10: HTTPS://WWW.MILEBLUFF.COM/DOCUMENTS/CHIP-25-28.PDF MILE BLUFF MEDICAL CENTER, INC. PART V, SECTION B, LINE 11: THE CHNA WAS COMPLETED IN FISCAL YEAR 2025. THE TOP NEEDS IDENTIFIED WERE ACTIVITIES FOR FAMILIES AND YOUTH, CHILDCARE, ECONOMY/JOBS, MENTAL HEALTH RESOURCES, AND TRANSPORTATION. WE RECOGNIZE THE IMPORTANCE OF EACH IDENTIFIED NEED AND ARE COMMITTED TO SUPPORTING COMMUNITY-WIDE IMPROVEMENT EFFORTS. AT THE SAME TIME, WE ARE INTENTIONAL ABOUT DEFINING OUR ROLE WITHIN THE BROADER HEALTH LANDSCAPE. OUR APPROACH FOCUSES ON CONTRIBUTING WHERE OUR HEALTHCARE EXPERTISE, RELATIONSHIPS, AND RESOURCES CAN HAVE THE GREATEST IMPACT, WHILE WORKING IN CLOSE PARTNERSHIP WITH ORGANIZATIONS THAT ARE BEST POSITIONED TO LEAD INITIATIVES. WE ARE NOT EQUIPPED TO SPEARHEAD LARGE-SCALE EFFORTS SUCH AS OPERATING CHILDCARE SERVICES, DEVELOPING TRANSPORTATION SYSTEMS, OR LEADING COUNTY-WIDE ECONOMIC DEVELOPMENT INITIATIVES. THOSE AREAS REQUIRE SPECIALIZED INFRASTRUCTURE, SUSTAINED FUNDING, AND CAPACITY THAT ARE OUTSIDE THE SCOPE OF A HEALTHCARE ORGANIZATION. MILE BLUFF WILL SUPPORT EFFORTS BY: PARTICIPATING IN COUNTY-LED PLANNING AND COMMUNITY ACTION TEAMS, SHARING DATA AND HEALTH-RELATED INSIGHT, SUPPORTING GRANT APPLICATIONS AND COORDINATED STRATEGIES, AND SPONSORING PROGRAMS AND INITIATIVES THAT ALIGN WITH COMMUNITY GOALS. OUR APPROACH SUPPORTS SUSTAINABILITY, AVOIDS DUPLICATION, AND ENSURES THAT EFFORTS REMAIN COORDINATED AND COMMUNITY-DRIVEN. ONGOING EFFORTS TO SUPPORT THESE IDENTIFIED NEEDS INCLUDE: EXPANDING ACCESS TO MENTAL HEALTH SERVICES THROUGH TELEHEALTH AND INTEGRATED CARE; SEEKING OUT EDUCATION AND TRAINING; SUPPORTING SUBSTANCE USE RECOVERY INITIATIVES; SPONSOR SCHOOL PROGRAMS, YOUTH SPORTS, AND EXTRACURRICULAR ACTIVITIES; HEALTH EDUCATION AND WELLNESS SUPPORT IN SCHOOL AND COMMUNITY SETTINGS; PROMOTION OF POSITIVE, ACTIVE LIFESTYLES FOR CHILDREN AND FAMILIES. MILE BLUFF MEDICAL CENTER, INC. PART V, SECTION B, LINE 13H: IN ADDITION TO PROVIDING FREE OR DISCOUNTED CARE BASED ON FEDERAL POVERTY GUIDELINES, WE REVIEW MONTHLY INCOME AND EXPENSES, HELD ASSETS AND LIABILITIES, BANK STATEMENTS, TAXES, ETC. BEING BELOW, OR AT THE 300% POVERTY GUIDELINE DOES NOT ALWAYS ACCURATELY TELL US A PATIENT'S ABILITY TO PAY. A PATIENT COULD BE BELOW 300%, BUT HAVE SUBSTANTIAL ASSETS (REAL ESTATE, VEHICLES, RETIREMENT FUND). CONVERSELY, A PATIENT COULD BE SLIGHTLY OVER THE 300%, BUT AFTER REVIEWING ALL FINANCIAL INFORMATION, THEIR ABILITY TO PAY MAY BE VERY LIMITED. OFFERING DISCOUNTS IN THESE TYPES OF SCENARIOS OFFERS THE PATIENT A REALISTIC PAYMENT AND REDUCES BAD DEBT EXPENSE FOR MILE BLUFF MEDICAL CENTER. MILE BLUFF MEDICAL CENTER, INC. PART V, SECTION B, LINE 16J: OUR ADMISSIONS STAFF IDENTIFIES SELF PAY PATIENTS AT REGISTRATION AND PATIENTS WHO MAY QUALIFY FOR FINANCIAL ASSISTANCE. BUSINESS OFFICE STAFF THEN REVIEWS OUR CHARITY CARE POLICY WITH THESE PATIENTS, AS WELL AS ANY GOVERNMENT PROGRAMS WE FEEL THE PATIENT MAY QUALIFY FOR. OUR CHARITY CARE APPLICATION IS AVAILABLE TO ANYONE WHO REQUESTS IT. ALL SELF PAY PATIENTS ARE DIRECTED TO STAFF WHO PROVIDE OUR CHARITY CARE POLICY/FORMS AND ASSISTANCE TO COMPLETE IF NEEDED. A PLAIN LANGUAGE PAMPHLET EXPLAINING THE COMMUNITY CARE PROGRAM IS OFFERED TO INPATIENTS WHO ARE UNINSURED OR EXPRESS PAYMENT CONCERNS AND IS ON DISPLAY AT ALL REGISTRATION LOCATIONS. WRITTEN NOTIFICATION OF THE PROGRAM AVAILABILITY IS INCLUDED ON ALL BILLING STATEMENTS. INFORMATION IS ALSO POSTED ON MBMC'S WEBSITE, ALONG WITH A LINK TO PRINTABLE INFORMATION AND THE APPLICATION. MILE BLUFF MEDICAL CENTER, INC. PART V, SECTION B, LINE 24: SOME SERVICES ARE CONSIDERED INELIGIBLE FOR FINANCIAL ASSISTANCE SUCH AS: 1. SERVICES WHICH ARE COSMETIC OR ELECTIVE IN NATURE. 2. SERVICES PROVIDED IN A CLINIC SETTING WHICH ARE NOT MEDICALLY NECESSARY. 3. SERVICES RELATED TO A PENDING SETTLEMENT FROM A LIABILITY CLAIM. 4. SERVICES PROVIDED BY PROFESSIONALS WHICH ARE NOT BILLED THROUGH MBMC. FINANCIAL ASSISTANCE ELIGIBLE PATIENTS OBTAINING THE ABOVE SERVICES MAY HAVE BEEN BILLED GROSS CHARGES. 5 1 - CREST VIEW NURSING HOME 612 VIEW ST NEW LISBON WI 53950 SKILLED CARE NURSING FACILITY 2 - FAIR VIEW NURSING HOME 1050 DIVISON ST MAUSTON WI 53948 SKILLED CARE NURSING FACILITY 3 - MILE BLUFF DIALYSIS CENTER 1040 DIVISION ST MAUSTON WI 53948 DIALYSIS CLINIC 4 - TERRACE HEIGHTS RETIREMENT COMMUNITY 1030 DIVISION ST MAUSTON WI 53948 INDEPENDENT LIVING 5 - WISCONSIN DELLS DIALYSIS CENTER 28 COMMERCE ST WISCONSIN DELLS WI 53965 DIALYSIS CLINIC PART I, LINE 3C: IN ADDITION TO PROVIDING FREE OR DISCOUNTED CARE BASED ON FEDERAL POVERTY GUIDELINES, WE REVIEW MONTHLY INCOME AND EXPENSES, HELD ASSETS AND LIABILITIES, BANK STATEMENTS, TAXES, ETC. BEING BELOW, OR AT THE 300% POVERTY GUIDELINE DOES NOT ALWAYS ACCURATELY TELL US A PATIENT'S ABILITY TO PAY. A PATIENT COULD BE BELOW 300%, BUT HAVE SUBSTANTIAL ASSETS (REAL ESTATE, VEHICLES, RETIREMENT FUND).CONVERSELY, A PATIENT COULD BE SLIGHTLY OVER 300%, BUT AFTER REVIEWING ALL FINANCIAL INFORMATION, THEIR ABILITY TO PAY MAY BE VERY LIMITED. OFFERING DISCOUNTS IN THESE TYPES OF SCENARIOS OFFERS THE PATIENT A REALISTIC PAYMENT AND REDUCES BAD DEBT EXPENSE FOR MILE BLUFF MEDICAL CENTER. PART I, LINE 6A: THE ORGANIZATION'S COMMUNITY BENEFIT REPORT IS AVAILABLE TO THE PUBLIC UPON REQUEST. PART I, LINE 7: CHARITY CARE EXPENSE WAS CONVERTED TO COST ON LINE 7A BASED ON AN OVERALL COSTTOCHARGE RATIO ADDRESSING ALL PATIENT SEGMENTS. THE COST FOR SUBSIDIZED HEALTH SERVICES REPORTED ON LINE 7G WAS DETERMINED USING THE MEDICARE COST REPORT. THE BAD DEBT EXPENSE INCLUDED ON FORM G90990, PART IX, LINE 25(A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $6,251,072. 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 $ 6,251,072. PART III, LINE 2: THE AMOUNT ON LINE 2 REPRESENTS IMPLICIT PRICE CONCESSIONS. THE ORGANIZATION DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSION BASED ON ITS HISTORICAL COLLECTION EXPERIENCE WITH THIS CLASS OF PATIENTS. PART III, LINE 3: THE ESTIMATED AMOUNT OF THE ORGANIZATION'S IMPLICIT PRICE CONCESSIONS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY IS CALCULATED BASED ON AN APPROXIMATE 13% OF INDIVIDUALS LIVING BELOW THE POVERTY LEVEL IN THE SERVICE AREA. PART III, LINE 4: THE FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE IS ON PAGES 13 THROUGH 18 OF THE ATTACHED FINANCIAL STATEMENTS. PART III, LINE 8: MILE BLUFF MEDICAL CENTER PROVIDES SERVICES TO PATIENTS UNDER THE MEDICARE PROGRAM KNOWING THEY WILL NOT RECOVER ALL THE COSTS ASSOCIATED WITH PROVIDING THESE SERVICES. PROVIDING THESE SERVICES IS ESSENTIAL TO THESE PATIENTS AND THE COMMUNITY AND INCREASES THEIR ACCESS TO HEALTHCARE SERVICES. THEREFORE, THE MEDICARE SHORTFALL IS CONSIDERED A COMMUNITY BENEFIT. TOTAL REVENUE RECEIVED FROM MEDICARE IS THE GROSS REIMBURSEMENT PLUS SETTLEMENT. BOTH TOTAL REVENUE RECEIVED FROM MEDICARE AND THE MEDICARE ALLOWABLE COSTS ARE REPORTED FROM THE MEDICARE COST REPORT. THE MEDICARE COST REPORT IS COMPLETED BASED ON THE RULES AND REGULATIONS SET FORTH BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES.TO FULFILL ITS MISSION OF COMMUNITY SERVICE, THE MEDICAL CENTER PROVIDES CARE TO PATIENTS AND RESIDENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. THE MEDICAL CENTER DOES NOT PURSUE ANY COLLECTION EFFORTS OF ACCOUNTS FOR PATIENTS WHO ARE KNOWN TO QUALIFY OR HAVE QUALIFIED FOR CHARITY CARE OR FINANCIAL ASSISTANCE. IF A PATIENT REQUESTS FINANCIAL ASSISTANCE AFTER AN ACCOUNT HAS BEEN REFERRED TO FOR COLLECTION ACTION AND IT HAS BEEN LESS THAN 240 DAYS FROM THE FIRST BILLING STATEMENT FOR THAT SERVICE, EXTRAORDINARY COLLECTION ACTION WILL BE SUSPENDED UNTIL THE APPLICATION HAS BEEN PROCESSED, AS LONG AS THE PATIENT FOLLOWS THE REQUIREMENTS OF THE PROGRAM. FOLLOWING A WRITE-OFF, ANY PERSONAL PORTION DUE FOLLOWS THE SAME COLLECTION PROCEDURES AS OTHER ACCOUNTS. IF A PAYMENT PLAN IS SET UP AND THE PATIENT STOPS MAKING THE PAYMENTS AS AGREED UPON, THE PATIENT IS RESPONSIBLE FOR THE ENTIRE AMOUNT AND NORMAL COLLECTION EFFORTS WILL BEGIN. PART III, LINE 9B: MBMC HAS POLICIES AND PROCEDURES IN PLACE TO FOLLOW FOR BILLING AND COLLECTIONS. MBMC WILL NOT ENGAGE IN EXTENSIVE COLLECTION ACTIONS, SUCH AS WAGE GARNISHMENT, LIENS ON PROPERTY OR OTHER LEGAL ACTION WITHOUT FIRST MAKING REASONABLE EFFORTS TO DETERMINE WHETHER A PATIENT IS ELIGIBLE FOR COMMUNITY CARE. REASONABLE EFFORTS INCLUDE I.) EFFORTS TO OBTAIN PAYMENT FROM INSURANCE AND PROGRAMS AVAILABLE TO THE PATIENT AND VERIFY THE PATIENT'S BALANCE OWED. IT IS THE PATIENT'S RESPONSIBILITY TO PROVIDE MBMC WITH ACCURATE INSURANCE AND PROGRAM INFORMATION IN A TIMELY MANNER. II.) DOCUMENTATION THAT MBMC HAS ATTEMPTED TO OFFER THE PATIENT THE OPPORTUNITY TO APPLY FOR COMMUNITY CARE. III.) DOCUMENTATION THAT THE PATIENT DOES NOT QUALIFY FOR COMMUNITY CARE. IV.) DOCUMENTATION THAT THE PATIENT HAS BEEN OFFERED A PAYMENT PLAN BUT HAS NOT HONORED THE TERMS OF THE AGREEMENT. V.) DOCUMENTED EFFORT TO PROVIDE AT LEAST THREE BILLING STATEMENTS BEFORE FACING EXTRAORDINARY COLLECTION ACTIONS. 'PROVIDE' IS THE DATE IT WAS MAILED, EMAILED, OR DELIVERED BY HAND. IT IS THE PATIENT'S RESPONSIBILITY TO PROVIDE MBMC WITH ACCURATE ADDRESS AND EMAIL INFORMATION IN A TIMELY MANNER. PART VI, LINE 2: WE USE THE FOLLOWING TOOLS TO ASSESS HEALTH CARE NEEDS OF THE COMMUNITIES WE SERVE: (1) PATIENT EXIT QUESTIONNAIRES ARE DISTRIBUTED AND REVIEWED (2) ANALYSIS OF DATA RECEIVED FROM THE WHA AND (3) UTILIZATION OF THE INTELLIMED SOFTWARE PROGRAM WHICH ALLOWS US TO ANALYZE DATA FROM FACILITIES COMPARABLE TO MILE BLUFF MEDICAL CENTER (MBMC). PART VI, LINE 3: OUR ADMISSIONS STAFF IDENTIFIES SELF PAY PATIENTS AT REGISTRATION AND PATIENTS WHO MAY QUALIFY FOR FINANCIAL ASSISTANCE. BUSINESS OFFICE STAFF THEN REVIEW OUR CHARITY CARE POLICY WITH THESE PATIENTS, AS WELL AS ANY GOVERNMENT PROGRAMS WE FEEL THE PATIENT MAY QUALIFY FOR. OUR CHARITY CARE APPLICATION IS AVAILABLE TO ANYONE WHO REQUESTS IT. ALL SELF PAY PATIENTS ARE DIRECTED TO STAFF WHO PROVIDE OUR CHARITY CARE POLICY/FORMS AND ASSISTANCE TO COMPLETE IF NEEDED. A PLAIN LANGUAGE PAMPHLET EXPLAINING THE COMMUNITY CARE PROGRAM IS OFFERED TO INPATIENTS WHO ARE UNINSURED OR EXPRESS PAYMENT CONCERNS AND IS ON DISPLAY AT ALL REGISTRATION LOCATIONS. WRITTEN NOTIFICATION OF THE PROGRAM AVAILABILITY IS INCLUDED ON ALL BILLING STATEMENTS. INFORMATION IS ALSO POSTED ON MBMC'S WEBSITE, ALONG WITH A LINK TO PRINTABLE INFORMATION AND THE APPLICATION. PART VI, LINE 4: MILE BLUFF MEDICAL CENTER OPERATES A 40 BED ACUTE CARE GENERAL MEDICAL CENTER PROVIDING SERVICES TO MAUSTON, WISCONSIN, AND THE SURROUNDING COMMUNITIES. MILE BLUFF MEDICAL CENTER IS THE ONLY HOSPITAL IN JUNEAU COUNTY. WE SERVE A POPULATION OF MORE THAN 55,000 RESIDENTS IN A FIVE COUNTY RURAL REGION.THE NEAREST LARGE HOSPITALS ARE 60-70 MILES AWAY (LACROSSE AND MADISON). THE MEDICAL CENTER IS THE LARGEST EMPLOYER IN THE AREA. FARMERS AND SMALL BUSINESS OWNERS MAKE UP THE BULK OF THE WORK FORCE. 8% OF THE COUNTY POPULATION IS ESTIMATED TO BE WITHOUT HEALTH CARE COVERAGE IN 2024 COMPARED TO 6% FOR THE STATE OF WISCONSIN. THE ESTIMATED MEDIAN HOUSEHOLD INCOME IN 2024 WAS $67,270 COMPARED TO $77,485 FOR THE STATE OF WISCONSIN AND DOWN FROM $65,150 IN 2023. 18% OF CHILDREN IN JUNEAU COUNTY LIVE IN POVERTY WHILE 55% QUALIFY FOR FREE OR REDUCED LUNCH. THE PERCENTAGE OF TOTAL RESIDENTS LIVING BELOW THE POVERTY LINE IN 2024 WAS 13% COMPARED TO 10.6% FOR THE STATE OF WISCONSIN. 22.5% OF RESIDENTS OF THE COUNTRY ARE AGED 65 YEARS OR OLDER. MEDICAID RECIPIENTS ACCOUNTED FOR 16.74% AND MEDICARE PATIENTS FOR 50.14% OF THE TOTAL PAYOR MIX AT MBMC. PART VI, LINE 5: MILE BLUFF MEDICAL CENTER OFFERS 40 BEDS IN AN ACUTE CARE SETTING WITH STATE-OF-THE-ART TECHNOLOGY AND PROFESSIONAL SERVICES. THE MEDICAL CENTER OPERATES THE FOLLOWING: 1. FAIR VIEW NURSING & REHABILITATION CENTER - A 50 BED NURSING HOME 2. TERRACE HEIGHTS - A 34 APARTMENT COMPLEX RETIREMENT HOME 3. RURAL HEALTH CLINICS LOCATED IN ELROY, NECEDAH, NEW LISBON, AND MAUSTON, WISCONSIN 4. LAKE DELTON FAMILY MEDICAL CENTER 5. GATEWAY DIALYSIS CENTER AND URGENT CARE 6. CREST VIEW NURSING & REHABILITATION CENTER - A 50 BED NURSING HOME WITH A 12 BED COMMUNITY BASED RESIDENTIAL FACILITY 7. MILE BLUFF PHARMACY 8. MILE BLUFF KENNEDY STREETMILE BLUFF MEDICAL CENTER'S GOVERNING BOARD INCLUDES COMMUNITY LEADERS, CONSUMER REPRESENTATIVES, BUSINESS EXPERTS AND CLINICAL HEALTHCARE EXPERTS. MOST WORK AT, OR OPERATE, LOCAL BUSINESSES. THE BOARD HAS A HISTORY OF COMMITMENT TO ACTING WITH THE HIGHEST INTEGRITY AND HAS BEEN PROACTIVELY EVALUATING OPPORTUNITIES TO VOLUNTARILY ADOPT GOVERNANCE BEST PRACTICES TO ENSURE THE ORGANIZATION CONTINUES TO OPERATE WITH THE HIGHEST OF INTEGRITY FOR THE BENEFIT OF THE COMMUNITY. TO MEET THE NEEDS OF THE COMMUNITY, THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED, LICENSED PHYSICIANS IN THE COMMUNITY. SURPLUS FUNDS ARE REINVESTED IN PATIENT CARE AND FACILITY UPGRADES. WE OFFER SEVERAL EDUCATION OPPORTUNITIES AND HEALTH CARE SERVICES ACROSS OUR COUNTY THROUGHOUT THE COURSE OF THE YEAR AT LITTLE TO NO COST. SOME OF THE SERVICES PROVIDED ARE CHOLESTEROL AND BLOOD PRESSURE SCREENINGS, DIABETIC EDUCATION, SMOKING CESSATION, GRIEF AND DEPRESSION COUNSELING, HEARING LOSS SCREENING, NUTRITIONAL EDUCATION, CPR CLASSES, SIBLING AND BABYSITTING CLASSES, EXERCISE AND WELLBEING, SKIN CHECKS, AND CLASSES DEALING WITH CANCER.CONTRIBUTING TO COMMUNITY EDUCATION: MILE BLUFF MEDICAL CENTER'S NURSING STAFF PARTICIPATE IN COUNTY WIDE COMMUNITY HEALTH FAIRS. THESE EVENTS PROVIDE INFORMATION AND GUIDELINES TO THOSE IN NEED OF MEDICAL INFORMATION. PREVENTIVE CARE A PRIORITY: MILE BLUFF MEDICAL CENTER HAS TAKEN STEPS TO ENHANCE PREVENTIVE CARE FOR PEOPLE OF ALL AGES BY ENSURING THAT THOSE WHO COME HERE FOR PREVENTIVE CARE RECEIVE THE SCREENINGS AND RECOMMENDATIONS APPROPRIATE TO THEIR PERSONAL AND FAMILY HISTORY. WE STRONGLY ENCOURAGE AND RECRUIT VOLUNTEERS TO HELP AT OUR HOSPITAL. TASKS VARY FROM PATIENT CENTERED ACTIVITIES TO SIMPLE CLERICAL WORK. PART VI, LINE 6: N/A PART VI, LINE 7, REPORTS FILED WITH STATES WI X X 0 0 0 0 0 0 0 1 0 JAMES GRANNELL MD ORTHOPEDICES/DIRECTOR 644229 0 0 0 0 0 17250 0 32001 0 693480 0 0 0 NICHOLAS CONWELL MD EMERGENCY MEDICINE 611313 0 0 0 58 0 15835 0 36836 0 664042 0 0 0 BRIAN SCHULTZ DO GENERAL SURGEON 531005 0 73574 0 0 0 17250 0 32001 0 653830 0 0 0 BARRETT SHOULTS MD EMERGENCY MEDICINE 504685 0 0 0 54 0 13624 0 35201 0 553564 0 0 0 DARA BARTELS PRESIDENT, CEO & ACTING CFO 460307 0 0 0 1372 0 17250 0 35201 0 514130 0 0 0 ALLEGRA PONSHOCK MD FAMILY PRACTICE 392839 0 0 0 0 0 3762 0 29475 0 426076 0 0 0 JENNA SEBRANEK MD SECRETARY 242493 0 45658 0 0 0 14805 0 35151 0 338107 0 0 0 SCOTT KNIPRATH COO 235501 0 0 0 770 0 11935 0 35201 0 283407 0 0 0 DANIEL KATTENBRAKER MD DIRECTOR / SLEEP MEDICINE 12285 0 238862 0 0 0 12557 0 0 0 263704 0 0 0 RHONDA LARSON CHIEF NURSING OFFICER 184582 0 0 0 1682 0 9389 0 35201 0 230854 0 0 0 PART I, LINE 3 PROVIDERS THAT ARE ON THE BOARD OF DIRECTORS DO NOT RECEIVE COMPENSATION FOR BEING ON THE BOARD. THE COMPENSATION LISTED REFLECTS THE PROVIDERS' PRACTICE. PROVIDER INCENTIVE REFLECTS PAY BASED UPON CARE PROVIDED TO PATIENTS. PART I, LINE 7 MILE BLUFF MEDICAL CENTER PROVIDED INCENTIVES TO CERTAIN INDIVIDUALS. PROVIDER INCENTIVES ARE VOLUME DRIVEN. GROSS CHARGES FOR CERTAIN PHYSICIAN PROCEDURES ARE ADDED UP QUARTERLY, AND A PERCENTAGE OF THOSE GROSS CHARGES ARE PAID OUT AS AN INCENTIVE. A SERIES OF 3 TO 5 GOALS MUST ALSO BE MET BEYOND FINANCIAL INDICATORS. SOME OF THE PROVIDER'S INCENTIVES ARE BASED ON AN WRVU MODULE. THEY MUST REACH A CERTAIN WRVU THRESHOLD IN ORDER TO RECEIVE AN INCENTIVE. A WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 97712DDM5 2014-05-01 27870296 REFUND BONDS ISSUED 9/21/2000, 1/18/2001, AND 5/23/2007 0 0 0 B WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY 391337855 2022-09-29 24750000 HOSPITAL RENOVATION AND NEW URGENT CARE AND RETAIL PHARMACY IN MAUSTON, WI 0 0 0 A 5770296 27870296 2324888 553833 9860000 15131575 2015 1 0 1 1 B 1445000 24750000 323298 24426702 2024 0 0 0 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: WISCONSIN HEALTH AND EDUCATIONAL FACILITIES AUTHORITY DATE THE REBATE COMPUTATION WAS PERFORMED: 02/10/2024 FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE FORM 990 WAS NOT PROVIDED TO THE GOVERNING BODY BEFORE IT WAS FILED. THE FORM 990 IS REVIEWED BY THE ORGANIZATION'S CEO AND CFO. FORM 990, PART VI, SECTION B, LINE 12C EACH DIRECTOR MUST DISCLOSE TO THE BOARD OF DIRECTORS ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST WHENEVER THE DUALITY OR CONFLICT PERTAINS TO A MATTER BEING CONSIDERED BY THE BOARD. ANY DIRECTOR HAVING DUALITY OF INTEREST OR CONFLICT OF INTEREST ON ANY MATTER MUST ABSTAIN FROM VOTING ON THE MATTER AND IS NOT COUNTED IN DETERMINING THE QUORUM FOR THE VOTE ON THE MATTER. IN ADDITION, THE DIRECTOR WILL NOT USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER, BUT MAY BRIEFLY STATE HIS OR HER POSITION ON THE MATTER AND MAY ANSWER PERTINENT QUESTIONS FROM OTHER DIRECTORS SINCE HIS OR HER KNOWLEDGE MAY BE OF GREAT ASSISTANCE. THE MINUTES OF THE MEETING INVOLVING ANY SUCH SITUATION MUST REFLECT THAT A DISCLOSURE WAS MADE, THE ABSTENTION FROM VOTING, AND THE QUORUM SITUATION. IF A DIRECTOR IS UNCERTAIN AS TO WHETHER HE OR SHE HAS A DUALITY OR CONFLICT OF INTEREST WHICH REQUIRES ABSTENTION, OR IF A DIRECTOR ASSERTS THAT ANOTHER DIRECTOR HAS SUCH A DUALITY OR CONFLICT, THE BOARD, BY MAJORITY VOTE OF THOSE PRESENT OTHER THAN THE DIRECTOR HAVING THE POSSIBLE CONFLICT, WILL DECIDE WHETHER ABSTENTION IS REQUIRED. IF SO, THE DIRECTOR WILL BE DEEMED TO HAVE ABSTAINED. PURCHASES OVER $1,000 FROM ENTITIES INVOLVING A DIRECTOR ARE PROHIBITED WITHOUT PRIOR APPROVAL BY DISINTERESTED DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMPENSATION COMMITTEE REVIEWS THE COMPENSATION FOR THE OFFICERS ANNUALLY. THE COMMITTEE MAKES RECOMMENDATIONS TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS HAS FINAL APPROVAL OF COMPENSATION. BOTH THE EXECUTIVE COMPENSATION COMMITTEE AND THE BOARD OF DIRECTORS HAVE GREATER THAN 50% INDEPENDENCE AS REQUIRED BY THE BYLAWS. THE ANNUAL REVIEW INCLUDES A PERFORMANCE EVALUATION, FAIR MARKET VALUE DATA, AND DOCUMENTATION BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC. HOWEVER, FINANCIAL INFORMATION IS AVAILABLE THROUGH THE PUBLIC DISCLOSURE COPY OF THE 990. MBMC MAUSTON PHILLIPS LLC DBA PHILLIPS PHARMACY 123 E STATE ST MAUSTON WI 53948 813570512 RETAIL PHARMACY WI 10912596 3181683 MILE BLUFF MEDICAL CENTER INC MILE BLUFF MEDICAL CENTER FOUNDATION 1050 DIVISION STREET MAUSTON WI 53948 271865510 SUPPORTING MILE BLUFF MEDICAL CENTER INC. WI 501(C)(3) LINE 12A, I MILE BLUFF MEDICAL CENTER INC 1 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 MILE BLUFF MEDICAL CENTER FOUNDATION INC C 1761304 CASH