2025-08-15T10:23:42-05:00 2024-09-30 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2023-10-01 390992883 MILE BLUFF MEDICAL CENTER MILE 6088476161 1050 DIVISION STREET MAUSTON WI 53948 TOM KAMINSKI CFO 6088476161 2025-08-15 1 1 MICHAEL J PETERSON CPA P01833529 2187224705 2025-08-14 2023 2025-03-06 01:10:19Z DARA BARTELS 1050 DIVISION STREET MAUSTON WI 53948 139175513 0 X WWW.MILEBLUFF.COM X 1923 WI IMPROVE HEALTH AND QUALITY OF LIFE IN THE COMMUNITY. 11 7 918 200 1203766 0 515437 254142 114513996 117314253 639560 1619035 987662 251993 116656655 119439423 0 0 0 0 68350829 62148867 0 0 0 48963079 58479877 117313908 120628744 -657253 -1189321 114325269 114368033 70016748 71338752 44308521 43029281 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. AS PART OF THIS MISSION, THE MILE BLUFF MEDICAL CENTER INTENDS TO FACILITATE CONFIDENTIAL DELIVERY OF QUALITY HEALTH CARE IN A PROFESSIONAL AND TIMELY MANNER BY MAINTAINING DEDICATED, COMPASSIONATE AND WELL TRAINED MEDICAL STAFF AND EMPLOYEES PROGRESSIVE, PROFESSIONAL MANAGEMENT AND MODERN EQUIPMENT AND FACILITIES CONSISTENT WITH FISCALLY SOUND BUSINESS PRACTICES. 0 0 92344030 101294288 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 $329,000 FOR THE YEAR ENDED SEPTEMBER 30, 2024, 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. 12745054 14816199 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, GIFTS AND A COFFEE BAR. THE CONVENIENCE OF DRIVE-THROUGH PRESCRIPTION PICKUP IS ALSO AVAILABLE. PHILLIPS PRESCRIPTION DISPENSING SERVICES ARE AVAILABLE IN MILE BLUFF'S MAUSTON, 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. 105089084 1 1 0 0 0 0 0 0 1 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 92 0 918 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 11 7 0 0 1 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 BARBARA JO WOLFF CFO 40.50 0.00 X X 157502 0 17028 DARA BARTELS PRESIDENT, CEO & ACTING CFO 40.50 0.30 X X 513084 0 53786 DANIEL KATTENBRAKER MD CHAIR 20.50 0.00 X X 194122 0 9702 RANDY SCOTT VICE CHAIR 0.50 0.00 X X 0 0 0 LARRY WILLER TREASURER 0.50 0.00 X X 0 0 0 JENNA SEBRANEK MD FAMILY MEDICINE, CHIEF OF STAFF 40.50 0.00 X 256133 0 50244 JAMES GRANNELL ORTHOPEDICES/DIRECTOR 40.50 0.00 X 624998 0 50736 MICHELLE HEREK DIRECTOR 0.50 0.00 X 0 0 0 DENNY LOGING DIRECTOR 0.50 0.00 X 0 0 0 REBECCA RICHARDS-BRIA DIRECTOR 0.50 0.00 X 0 0 0 JORDAN SCHMIDT DIRECTOR 0.50 0.00 X 0 0 0 JOE WITMER DIRECTOR 0.50 0.00 X 0 0 0 RHONDA LARSON CHIEF NURSING OFFICER 40.00 0.00 X 201150 0 47411 SCOTT KNIPRATH COO 40.00 0.00 X 255143 0 45700 TIMOTHY NAPIER SURGEON 40.00 0.00 X 693332 0 48013 BRIAN SCHULTZ SURGEON 40.00 0.00 X 550005 0 50736 FLORIN PENCIU HOSPITAL MEDICINE 40.00 0.00 X 413134 0 29367 JOHN MURPHY FAMILY MEDICINE 40.00 0.00 X 413072 0 50736 BRYAN MYERS FAMILY MEDICINE 40.00 0.00 X 411769 0 47004 4683444 0 500463 100 0 1 0 MARKET & JOHNSON INC PO BOX 360 EAU CLAIRE WI 54702 GENERAL CONTRACTOR 2061880 3RT NETWORKS LLC 103 LENARD ST S WEST SALEM WI 54669 IT SUPPORT 1675296 MARSHFIELD LABORATORIES 1000 NORTH OAK AVE MARSHFIELD WI 54669 LAB SERVICES 787772 ENABLECOMP LLC PO BOX 7988 CAROL STREAM IL 601977988 BILLING SERVICES 462009 STATE COLLECTION SERVICE 2509 S STOUGHTON RD MADISON WI 53716 COLLECTIONS SERVICES 408185 14 254142 254142 PATIENT SERVICE REVENUE 621400 99523407 99523407 RETAIL PHARMACY 456110 12355623 11151857 1203766 340 B REVENUE 456110 3664342 3664342 1770881 1770881 117314253 751634 751634 251993 0 251993 251993 251993 20598104 5387 19736090 0 862014 5387 867401 867401 119439423 116110487 1203766 1871028 X 2986187 1751700 1234487 46065231 41790829 4274402 1520213 1382379 137834 8321691 7500630 821061 3255545 2898014 357531 177907 148723 29184 123445 103195 20250 12257283 10246581 2010702 436621 364997 71624 3431977 2868991 562986 1727278 1443933 283345 172915 144550 28365 1279138 1182768 96370 3954652 3656710 297942 1063305 888879 174426 MEDICAL SUPPLIES 27071112 22630329 4440783 BAD DEBT EXPENSE 2526983 2526983 DIETARY 746523 624062 122461 REPAIRS & MAINTENANCE 610165 510073 100092 2900573 2424758 475815 120628744 105089084 15539660 0 0 2806206 22206324 789602 17141483 19722916 4162153 4572807 246280 814268 111424218 72173098 34505856 39251120 27647874 15310781 1929000 1929000 6486299 29171333 114325269 114368033 11593391 11973447 10367642 12913625 47724715 46418838 31000 32842 300000 0 70016748 71338752 X 44271785 41873237 36736 1156044 44308521 43029281 114325269 114368033 -1189321 -89919 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 1632974 1632974 65249178 44602921 20646257 35976053 27570177 8405876 8566013 8566013 39251120 DEFERRED COMPENSATION PLAN INVESTMENTS 12913625 INVESTMENTS UNDER INDENTURE AGREEMENT - PROJECT FUNDS 10694035 ESTIMATED 3RD PARTY COLLECTIBLE 4959790 PREPAID SERVICE CONTRACT 603883 29171333 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 663312 663312 0.00560 663312 663312 0.00560 107400 1620 105780 0.00090 693046 693046 0.00590 19477497 18319043 1158454 0.00980 24026 24026 0.00020 20301969 18320663 1981306 0.01680 20965281 18320663 2644618 0.02240 340 340 0.00000 154 154 0.00000 8139 8139 0.00010 166047 166047 0.00140 174680 174680 0.00150 1 2526983 399280 8211382 12727575 -4516193 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 21 1 0 1 1 SEE SUPPLEMENTAL INFORMATION X 1 21 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/IMAGES/COMMUNITY-CARE-FINANCIAL-ASSISTANCE.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: A COMMUNITY HEALTH NEEDS ASSESSMENT FORUM WAS HELD WITH INPUT FROM: JUNEAU COUNTY PUBLIC HEALTH, UW EXTENSION, JUNEAU COUNTY HUMAN SERVICES, MEDICAL PROVIDERS, LOCAL PUBLIC SCHOOLS, LOCAL BUSINESS LEADERS, AND THE JUNEAU COUNTY ECONOMIC DEVELOPMENT CORP. FAMILY HEALTH LA CLINICA WAS CONSULTED REPRESENTING MEDICALLY UNDERSERVED, ESPECIALLY THOSE NEEDING DENTAL SERVICES, BEHAVIORAL HEALTH ASSESSMENT AND SUBSTANCE ABUSE TREATMENT. THE JUNEAU COUNTY AGING AND DISABILITY RESOURCE CENTER WAS CONSULTED REPRESENTING MEDICALLY UNDERSERVED AND LOW INCOME THAT ARE AFFECTED BY AGING, DISABILITY, MENTAL HEALTH OR SUBSTANCE ABUSE ISSUES. ALSO CONSULTED WERE S.E.A. OF CHANGE, JUNEAU COUNTY SUICIDE PREVENTION COALITION, AND SOUTH CENTRAL ALLIANCE FOR TOBACCO PREVENTION. MILE BLUFF MEDICAL CENTER, INC. PART V, SECTION B, LINE 6B: JUNEAU COUNTY PUBLIC HEALTH DEPARTMENT MILE BLUFF MEDICAL CENTER, INC. PART V, SECTION B, LINE 7D: LINE 7 - CHNA WEBSITE: HTTPS://WWW.MILEBLUFF.COM/DOCUMENTS/2021-CHNA-REPORT.PDFLINE 10 - IMPLEMENTATION STRATEGY:HTTPS://WWW.MILEBLUFF.COM/DOCUMENTS/CHIP-2021-2023.PDF MILE BLUFF MEDICAL CENTER, INC. PART V, SECTION B, LINE 11: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED IN FISCAL YEAR 2022, IDENTIFYING HOUSING, ACCESS TO CARE, AND DAYCARE AS KEY COMMUNITY NEEDS. IN RESPONSE, WE CONTINUED TO SUPPORT THESE NEEDS BY STRENGTHENING RELATIONSHIPS WITH LOCAL ORGANIZATIONS AND COMMUNITY LEADERS. THROUGH COLLABORATIVE EFFORTS, WE CONTRIBUTED TO INITIATIVES AIMED AT EXPANDING HOUSING OPTIONS AND IMPROVING THE AVAILABILITY OF CHILDCARE. WE ALSO CONTINUED OUR EFFORTS TO IMPROVE ACCESS TO CARE BY ENHANCING SERVICES AND AVAILABILITY TO BETTER REACH RESIDENTS AND IMPROVE THE HEALTH AND WELL-BEING OF OUR COMMUNITY. 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 COST-TO-CHARGE RATIO ADDRESSING ALL PATIENT SEGMENTS. THE COST FOR SUBSIDIZED HEALTH SERVICES REPORTED ON LINE 7G WAS DETERMINED USING THE MEDICARE COST REPORT. 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 $ 2,526,983. 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 14.3% 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. 6.7% OF THE COUNTY POPULATION IS ESTIMATED TO BE WITHOUT HEALTH CARE COVERAGE IN 2023. THE ESTIMATED MEDIAN HOUSEHOLD INCOME IN 2023 WAS $65,150 WHILE THE PERCENTAGE OF RESIDENTS LIVING IN POVERTY WAS 14.3%. 21.4% OF COUNTY RESIDENTS ARE AGED 65 YEARS OR OLDER. MEDICAID RECIPIENTS ACCOUNTED FOR 16.3% AND MEDICARE PATIENTS FOR 50.58% 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. MILE BLUFF DIALYSIS CENTER 6. WISCONSIN DELLS DIALYSIS CENTER 7. CREST VIEW NURSING & REHABILITATION CENTER - A 60 BED NURSING HOME WITH A 12 BED COMMUNITY BASED RESIDENTIAL FACILITY 8. PHILLIPS PHARMACYMILE 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 GOVERNANCEBEST 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 TIMOTHY NAPIER SURGEON 299894 0 380411 0 13027 0 16500 0 31513 0 741345 0 0 0 JAMES GRANNELL ORTHOPEDICES/DIRECTOR 624998 0 0 0 0 0 16500 0 34236 0 675734 0 0 0 BRIAN SCHULTZ SURGEON 530005 0 20000 0 0 0 16500 0 34236 0 600741 0 0 0 DARA BARTELS PRESIDENT, CEO & ACTING CFO 462991 0 48668 0 1425 0 16500 0 37286 0 566870 0 0 0 JOHN MURPHY FAMILY MEDICINE 412804 0 0 0 268 0 16500 0 34236 0 463808 0 0 0 BRYAN MYERS FAMILY MEDICINE 401676 0 10000 0 93 0 16500 0 30504 0 458773 0 0 0 FLORIN PENCIU HOSPITAL MEDICINE 413134 0 0 0 0 0 16340 0 13027 0 442501 0 0 0 JENNA SEBRANEK MD FAMILY MEDICINE, CHIEF OF STAFF 233324 0 22809 0 0 0 12959 0 37285 0 306377 0 0 0 SCOTT KNIPRATH COO 230039 0 24334 0 770 0 8414 0 37286 0 300843 0 0 0 RHONDA LARSON CHIEF NURSING OFFICER 180314 0 19143 0 1693 0 10125 0 37286 0 248561 0 0 0 DANIEL KATTENBRAKER MD CHAIR 12285 0 181837 0 0 0 9702 0 0 0 203824 0 0 0 BARBARA JO WOLFF CFO 137223 0 19950 0 329 0 0 0 17028 0 174530 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 4720296 27870296 2324888 553833 9860000 15131575 2015 1 0 1 1 B 835000 24750000 323298 16100871 8325831 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 A, LINE 4 SUMMARY OF CHANGES TO ORGANIZATIONAL BYLAWS: SECTION 1.2 CLARIFIED THE CORPORATE PURPOSE AND TAX-EXEMPT STATUS REFERENCES. IMPROVED CLARITY ON COMPLIANCE WITH SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. SECTION 2.2 INCREASED THE NUMBER OF BOARD DIRECTORS FROM 9 TO 13. REDEFINED BOARD COMPOSITION TO INCLUDE 4 PHYSICIAN-NOMINATED CLASS P DIRECTORS, 1 EX OFFICIO CHIEF OF MEDICAL STAFF (VOTING), AND 6 INDEPENDENT CLASS I DIRECTORS. SECTION 2.2.2 DEFINED AND REINFORCED IRS COMMUNITY BOARD REQUIREMENTS AND CLARIFIED THAT PHYSICIANS AND EMPLOYEES CANNOT MAKE UP A MAJORITY OF THE BOARD. SECTION 2.2.4 ADDED LANGUAGE TO PREVENT CORPORATION EMPLOYEES FROM SERVING ON THE BOARD, WITH AN EXCEPTION FOR EMPLOYED PHYSICIANS UNDER IRS GUIDELINES. SECTION 2.3 CLARIFIED ELECTION METHODS, TERM LENGTHS (3 YEARS), AND STAGGERED TERMS FOR BALANCED TURNOVER. SPECIFIED THAT TERM LIMITS (4 CONSECUTIVE TERMS) DO NOT APPLY TO EX OFFICIO DIRECTORS. SECTION 2.3.3 ADDED ATTENDANCE REQUIREMENT: DIRECTORS MUST ATTEND AT LEAST 75% OF MEETINGS ANNUALLY OR RISK REMOVAL OR NON-RENEWAL. SECTION 2.11 ADDED A NEW PROVISION REQUIRING A SUPERMAJORITY VOTE (75%) FOR MAJOR CORPORATE ACTIONS, INCLUDING MERGERS, DISSOLUTION, AND PRESIDENT SELECTION OR REMOVAL. REQUIRED 5-DAY PRIOR NOTICE OF AGENDA ITEMS REQUIRING SUPERMAJORITY VOTE. SECTION 2.13 ADDED NEW LANGUAGE ALLOWING FOR ACTIONS WITHOUT A MEETING IF APPROVED IN WRITING BY ALL DIRECTORS. INCLUDED PROVISIONS FOR ELECTRONIC SIGNATURES. SECTION 2.14 CLARIFIED USE OF COMMUNICATION EQUIPMENT FOR BOARD MEETINGS, DEFINING VALID PARTICIPATION VIA TELEPHONE OR ELECTRONIC MEANS. SECTION 2.18 ADDED LANGUAGE OUTLINING CONFLICT OF INTEREST DISCLOSURE REQUIREMENTS AND VOTING ABSTENTIONS. PROHIBITED PURCHASES OVER $1,000 FROM ENTITIES INVOLVING A DIRECTOR WITHOUT PRIOR APPROVAL BY DISINTERESTED DIRECTORS. SECTION 4.2 CLARIFIED EXECUTIVE COMMITTEE AUTHORITY AND SCOPE OF DECISIONS DURING INTERIM PERIODS. SPECIFIED MATTERS THAT CANNOT BE ACTED ON (E.G., AMENDING BYLAWS, ELECTING OFFICERS). SECTION 4.3 UPDATED FINANCE COMMITTEE COMPOSITION AND RESPONSIBILITIES, INCLUDING SERVING AS AUDIT COMMITTEE AND HOLDING INDEPENDENT AUDITOR MEETINGS OUTSIDE MANAGEMENT PRESENCE. SECTION 4.5 REVISED STRUCTURE OF THE LONG-RANGE PLANNING COMMITTEE, EMPHASIZING ROLE IN STRATEGIC PLANNING AND ANNUAL PLAN REVIEW. SECTION 4.6 SUBSTANTIALLY RESTRUCTURED PHYSICIAN OPERATIONS COMMITTEE. CLARIFIED AUTHORITY AND MEMBERSHIP SELECTION PROCESS. ASSIGNED DUTIES SUCH AS PHYSICIAN RECRUITMENT PLAN DEVELOPMENT, TEMPLATE AGREEMENT REVIEW, COMPENSATION INPUT, AND RECOMMENDATIONS FOR CLASS P DIRECTOR CANDIDATES. SECTION 4.7 CONFIRMED COMPOSITION AND PURPOSE OF THE EXECUTIVE COMPENSATION COMMITTEE, ENSURING A MIX OF CLASS I AND CLASS P DIRECTORS. SECTION 5.15.2 EXPANDED DUTIES AND RESPONSIBILITIES OF THE PRESIDENT (CEO), INCLUDING AUTHORITY OVER STAFF STRUCTURE, COMMUNICATIONS WITH THE BOARD, LIAISON ROLE WITH THE MEDICAL STAFF, AND COMMUNITY REPRESENTATION. SECTION 6.16.3 ADDED CLARITY AROUND MEDICAL STAFF GOVERNANCE UNDER THE BYLAWS. AFFIRMED MEDICAL STAFF AUTHORITY OVER APPOINTMENTS, PRIVILEGES, AND PEER REVIEW. ENCOURAGED MEDICAL STAFF PARTICIPATION ON THE BOARD. SECTION 8 CONFIRMED THE FISCAL YEAR REMAINS OCTOBER 1 THROUGH SEPTEMBER 30. SECTION 9 UPDATED INDEMNIFICATION PROVISIONS FOR DIRECTORS, OFFICERS, AND VOLUNTEERS, INCLUDING AUTHORITY FOR THE BOARD TO APPROVE EXPENSE REIMBURSEMENT AND DEFENSE COST COVERAGE. SECTION 10 REVISED DISSOLUTION CLAUSE TO CLARIFY CHARITABLE ASSET DISTRIBUTION TO A 501(C)(3) ENTITY OR GOVERNMENT BODY. SECTION 11 AMENDED PROCESS FOR BYLAW CHANGES TO REQUIRE A SUPERMAJORITY VOTE AT A DULY NOTICED MEETING. 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. 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. FORM 990, PART IX, LINE 11G CONTRACTED SERVICES & OTHER FEES: PROGRAM SERVICE EXPENSES 10,246,581. MANAGEMENT AND GENERAL EXPENSES 2,010,702. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,257,283. MBMC MAUSTON PHILLIPS LLC DBA PHILLIPS PHARMACY 123 E STATE ST MAUSTON WI 53948 813570512 RETAIL PHARMACY WI 13333368 2826179 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 254142 CASH