2025-08-14T13:14:43-05:00 2024-09-30 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2023-10-01 391140373 PRAIRIE RIDGE HEALTH INC PRAI 9206232200 1515 PARK AVENUE COLUMBUS WI 539251618 MELISSA MANGAN VP OF FINANCE & CFO 9206232200 2025-08-12 1 1 MICHAEL J PETERSON CPA P01833529 2187224705 2025-08-07 2023 2025-03-06 01:10:19Z JOHN RUSSELL 1515 PARK AVENUE COLUMBUS WI 539251618 92703416 0 X WWW.PRAIRIERIDGE.HEALTH X 1970 WI ACCREDITED ACUTE CARE HOSPITAL PROVIDING A FULL ARRAY OF HEALTH CARE SERVICES TO PATIENTS. 11 9 508 119 0 0 259549 241161 73817865 83667432 1461736 2042897 0 0 75539150 85951490 0 0 0 0 37104901 43119303 0 0 194905 31376806 35240930 68481707 78360233 7057443 7591257 123602795 137845681 28644749 31326612 94958046 106519069 X BY BUILDING CARING RELATIONSHIPS WITH THOSE WE SERVE, WE GUIDE THE JOURNEY TO HEALTH AND WELLNESS. 0 0 63322158 0 83227920 PRAIRIE RIDGE HEALTH, INC. (PRH) IS A WISCONSIN NONPROFIT, NONSTOCK CORPORATION THAT IS LICENSED AS A 25-BED CRITICAL ACCESS HOSPITAL (CAH). PRAIRIE RIDGE HEALTH, INC. PROVIDES INPATIENT, OUTPATIENT, AND CLINIC MEDICAL SERVICES TO PATIENTS. FOR THE FISCAL YEAR ENDED 9/30/24, 830 ACUTE ADMISSIONS RESULTED IN 2,413 INPATIENT DAYS. IN ADDITION, THERE WERE 155 DELIVERIES, 276 NEWBORN DAYS, AND 124 INPATIENT SURGERIES. ON THE OUTPATIENT SIDE, PRH PROVIDES A MULTITUDE OF SERVICES INCLUDING EMERGENCY ROOM, LAB, RADIOLOGY, REHABILITATION, SURGERY, INFUSION THERAPY, AND NUTRITION SERVICES. FOR THE FISCAL YEAR ENDED 9/30/24, PRH SAW 17,507 PATIENTS IN THE EMERGENCY ROOM AND URGENT CARE. 683 PATIENTS HAD OUTPATIENT SURGERY AND 983 GASTROINTESTINAL PROCEDURES WERE PERFORMED.PRH ALSO OPERATES THREE PHYSICIAN CLINICS LOCATED IN COLUMBUS, BEAVER DAM, AND MARSHALL. OUR EXPERIENCED AND CARING PROVIDERS SPECIALIZE IN ORTHOPEDICS, GENERAL SURGERY, OB/GYN, FAMILY MEDICINE, INTERNAL MEDICINE AND PHYSICAL AND OCCUPATIONAL THERAPY AND IMAGING SERVICES. FOR THE FISCAL YEAR ENDED 9/30/24, THERE WERE 31,422 CLINIC VISITS, 6,116 THERAPY VISITS AND 763 IMAGING SCANS.THE HOSPITAL PROVIDES HEALTH CARE SERVICES TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. SINCE THE HOSPITAL DOES NOT PURSUE COLLECTION OF THESE AMOUNTS, THEY ARE NOT REPORTED AS PATIENT SERVICE REVENUE. THE ESTIMATED COST OF PROVIDING THESE SERVICES WAS $427,000 FOR THE YEAR ENDED SEPTEMBER 30, 2024, CALCULATED BY MULTIPLYING THE RATIO OF COST TO GROSS CHARGES FOR THE HOSPITAL BY THE GROSS UNCOMPENSATED CHARGES ASSOCIATED WITH PROVIDING CHARITY CARE TO ITS PATIENTS. 63322158 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 47 0 508 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 9 0 0 0 0 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 WI X MELISSA MANGAN VP OF FINANCE & CFO 9206231368 1515 PARK AVENUE COLUMBUS WI 53925 GARY GALVIN MD CHIEF OF STAFF/GENERAL SURGEON 40.00 X 563727 0 52704 LESLIE ALZUHN-HANSEN MD DIRECTOR/OB/GYN PHYSICIAN 40.00 X 395720 0 52704 JENNIFER HOMMAN CHAIR 0.40 X X 0 0 0 JO ANN EVANS VICE CHAIR 0.40 X X 0 0 0 RANDALL BOBHOLZ TREASURER 0.40 X X 0 0 0 PETE SIMON SECRETARY 0.40 X X 0 0 0 ERIN JONES DIRECTOR 0.40 X 0 0 0 MATT KINSELLA DIRECTOR 0.40 X 0 0 0 KYLE NONDORF DIRECTOR 0.40 X 0 0 0 JULIE SANITER DIRECTOR 0.40 X 0 0 0 DAWIT TESFASILASSIE DIRECTOR 0.40 X 0 0 0 JOHN D RUSSELL PRESIDENT & CEO 40.00 X 636537 0 57004 MELISSA MANGAN VP OF FINANCE & CFO 40.00 X 214772 0 51856 ANN ROUNDY SR VP CULTURE, STRATEGY & GROWTH 40.00 X 326873 0 56110 JAMIE HENDRIX VP PATIENT CARE SERVICES 40.00 X 305784 0 56614 ELIZABETH ZEECK MD DERMATOLOGIST 40.00 X 509004 0 48071 KATHERYN KALDOR MD OB/GYN PHYSICIAN 40.00 X 400593 0 52704 ROBB WHINNEY DO GENERAL SURGEON 40.00 X 369848 0 29077 SEAN ACKERMAN MD PSYCHIATRIST 40.00 X 350454 0 3829 COLIN MILLAR CLINIC PHYSICIAN 40.00 X 296932 0 19919 MATTHEW NIESEN ORTHOPEDIC SURGEON 0.00 X 335467 0 1617 4705711 0 482209 51 1 1 0 MADISON EMERGENCY PHYSICIANS SC 700 S PARK STREET MADISON WI 53715 ER PHYSICIAN SERVICES 2582560 J H FINDORFF & SON INC 7311 W GREENFIELD AVE STE 308 MILWAUKEE WI 53214 CONSTRUCTION SERVICES 2521127 COLUMBIA ANESTHESIA LLC W3767 MONSON RD RIO WI 53960 ANESTHESIA SERVICES 1405208 SHARED IMAGING SERVICES LLC 915 17TH STREET PRAIRIE DU SAC WI 53578 NUCLEAR MEDICINE & ULTRASOUND SERVICES 1304518 SSM HEALTH CARE OF WI 2901 LANDMARK PLACE STE 300 MADISON WI 53713 HEALTHCARE SERVICES 737327 21 159097 82064 241161 NET PATIENT REVENUE 621110 80607211 80607211 PHARMACY REVENUE 456110 1645133 1645133 CLINIC RENTAL REVENUE 531120 461019 461019 CAFETERIA REVENUE 722514 439512 439512 514557 514557 83667432 1902573 1902573 6884750 7500 6737276 14650 147474 -7150 140324 140324 85951490 83227920 0 2482409 X 2770403 2252338 518065 30557318 23988289 6427605 141424 862143 696768 161221 4154 6850812 5538445 1281102 31265 2078627 1680767 388703 9157 209632 170431 39201 56857 56857 9542 9542 11072806 8939265 2128541 5000 608397 494627 113770 2076917 1688533 388384 1164698 946899 217799 42901 34879 8022 124762 101432 23330 505130 410671 94459 4698897 3820203 878694 357437 290596 66841 MEDICAL SUPPLIES 6360995 5171489 1189506 REPAIRS & MINOR EQUIPME 2989430 2430407 559023 BAD DEBT 2404361 2404361 EQUIPMENT RENTAL EXPENS 868363 705979 162384 1689805 1555779 130121 3905 78360233 63322158 14843170 194905 573557 737438 28657655 20272871 8207 0 12117660 16686521 40000 0 1180000 2052000 1138305 1254816 532144 615978 107999157 48887557 48202323 59111600 29220055 34203716 1932889 2910741 123602795 137845681 8590156 11562613 19795193 18427644 259400 1336355 28644749 31326612 X 93284557 104307683 1673489 2211386 94958046 106519069 123602795 137845681 X 7591257 3431869 537897 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 9542 9542 0 PART II-B, LINE 1: A PERCENTAGE OF DUES PAID TO AMERICAN HOSPITAL ASSOCIATION, RURAL WISCONSIN HEALTH COOPERATIVE, WISCONSIN HOSPITAL ASSOCIATION, AND WISCONSIN INSTITUTE OF CPAS ARE CONSIDERED LOBBYING. THESE ORGANIZATIONS ADVOCATE ON BEHALF OF THEIR MEMBER HOSPITALS IN IMPROVING THE ENVIRONMENT AND CONDITIONS OF HEALTHCARE. 706495 138391 194513 1039399 604511 12663 89321 706495 744571 9654 -149624 604511 583281 6704 154586 744571 496979 34815 51487 583281 0.00000 0.50165 0.49835 0 1 1 5651479 5651479 69498160 36169812 33328348 19768544 12642948 7125596 13080974 74797 13006177 59111600 OPERATING LEASE OBLIGATION 699355 DUE TO THIRD-PARTY REIMBURSEMENT PROGRAMS 637000 1336355 X PART V, LINE 4: THE ENDOWMENT FUNDS ARE HELD BY PRAIRIE RIDGE HEALTH FOUNDATION, A RELATED ORGANIZATION. THE ENDOWMENT CONSISTS OF FIVE FUNDS, FOUR ESTABLISHED TO BENEFIT THE HOSPITAL AND ONE ESTABLISHED FOR HEALTHCARE SCHOLARSHIPS. THESE FUNDS ARE MAINTAINED BY THE FOUNDATION IN VARIOUS INVESTMENTS, AND THE FOUNDATION IS RESPONSIBLE FOR ALL INVESTMENT DECISIONS. PART X, LINE 2: THE ORGANIZATION BELIEVES THAT IT HAS APPROPRIATE SUPPORT FOR ANY TAX POSITIONS TAKEN AFFECTING ITS ANNUAL FILING REQUIREMENTS AND, AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION WOULD RECOGNIZE FUTURE ACCRUED INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS AND LIABILITIES IN INCOME TAX EXPENSE, IF SUCH INTEREST AND PENALTIES ARE INCURRED. 1 1 X 1 X 1 X 1 1 1 0 1 1 427000 427000 0.00560 7420307 4375282 3045025 0.04010 7847307 4375282 3472025 0.04570 51701 4476 47225 0.00060 19013 19013 0.00030 12929560 3010012 9919548 0.13060 111201 111201 0.00150 13111475 3014488 10096987 0.13300 20958782 7389770 13569012 0.17870 4986 4986 0.00010 560 560 0.00000 5546 5546 0.00010 1 912552 17979998 18019342 -39344 X 1 1 1 1 PRAIRIE RIDGE HEALTH 1515 PARK AVENUE COLUMBUS WI 53925 WWW.PRAIRIERIDGE.HEALTH 1042 X X X PRAIRIE RIDGE HEALTH INC 1 0 0 1 X X X X X X X X X 21 1 0 0 1 X SEE SUPPLEMENTAL INFO X X 1 21 1 SEE SUPPLEMENTAL INFO 0 1 X 200.000000000000 400.000000000000 X X 1 1 X X X 1 X WWW.PRAIRIERIDGE.HEALTH/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE X WWW.PRAIRIERIDGE.HEALTH/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE X WWW.PRAIRIERIDGE.HEALTH/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE X X X X X X X 1 X 0 X X X X 1 X 0 0 PRAIRIE RIDGE HEALTH, INC. PART V, SECTION B, LINE 5: PRAIRIE RIDGE HEALTH COLLABORATED WITH COMMUNITY PARTNERS TO CONDUCT SURVEYS, REVIEW DATA AND TO FORMULATE GOALS AND STRATEGIES FOR OUR COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). INTERVIEWS WITH COLUMBIA COUNTY RESIDENTS, KEY COMMUNITY MEMBERS AND LEADERS IN BUSINESS, HEALTHCARE, PUBLIC SERVICE, SCHOOLS, AND MANY OTHER INDUSTRIES WERE CONDUCTED TO IDENTIFY CONCERNS AND HEALTHCARE NEEDS IN THE COMMUNITIES WE SERVE, AS WELL AS TO ASSESS THE NUMBER OF AREA - BASED PROGRAMS AND ORGANIZATIONS THAT ALREADY EXIST TO ADDRESS COMMUNITY NEEDS. PRAIRIE RIDGE HEALTH, INC. PART V, SECTION B, LINE 7D: PART V, SECTION B, LINES 7 AND 10:WWW.PRAIRIERIDGE.HEALTH/RESOURCES/PUBLICATIONS PRAIRIE RIDGE HEALTH, INC. PART V, SECTION B, LINE 11: 2022 CHNA STRATEGIC IMPLEMENTATION PLAN ACTIVITIES DONE TOWARDS EACH INITIATIVE INCLUDE BUT IS NOT LIMITED TO:PRIORITY #1: INCREASING PRIMARY CARE ACCESSGOAL: INCREASE PRIMARY CARE ACCESS BY 4 NEW PROVIDERS IN COLUMBIA COUNTY OR 14.35%, REDUCING THE RATIO OF PHYSICIANS TO RESIDENTS FROM 2300:1 TO 1970:1. STRATEGY #1: INVESTING IN NEW PROVIDERS PRAIRIE RIDGE HEALTH HAS IDENTIFIED PRIMARY CARE ACCESS AS A KEY AREA OF NEED FOR THE COMMUNITIES WE SERVE. OUR EMPLOYEE SERVICES TEAM IS ACTIVELY WORKING ON RECRUITING AND ONBOARDING NEW FAMILY MEDICINE PROVIDERS, INCLUDING PHYSICIANS AND ADVANCED PRACTICE PROVIDERS. ACTION: PRIMARY CARE ACCESS CONTINUES TO BE A FOCUS FOR PRAIRIE RIDGE HEALTH. IN 2024, PRAIRIE RIDGE HEALTH ADDED TWO PRIMARY CARE PROVIDERS. DURING THAT TIME, ONE PROVIDER RETIRED. WE CONTINUE TO RECRUIT NEW FAMILY MEDICINE PHYSICIANS AND ADVANCED PRACTICE PROVIDERS SINCE ACCESS TO PRIMARY CARE IS AN AREA OF NEED FOR OUR COMMUNITIES.STRATEGY #2: COLLABORATION WITH THE EMERGENCY DEPARTMENT WORK WITH LEADERS IN THE EMERGENCY DEPARTMENT TO ENSURE THAT:-EDUCATION AND BROCHURES ARE READILY AVAILABLE IN THE WAITING ROOM AND EXAM ROOMS SHOWCASING OUR PRIMARY CARE PROVIDERS AND THEIR LOCATIONS.-ENSURE THAT EMERGENCY DEPARTMENT STAFF DISCUSS PRIMARY CARE OPTIONS WITH UNATTACHED PATIENTS. ACTION: PRAIRIE RIDGE HEALTH CREATED FLYERS AND INFORMATIONAL MATERIALS FOR THE EMERGENCY DEPARTMENT TO DISCUSS WITH PATIENTS ABOUT OUR PRIMARY CARE TEAM THAT ARE EASY TO READ AND PROVIDE INFORMATION ON HOW PATIENTS CAN GET ESTABLISHED WITH ONE OF OUR PROVIDERS. WE ALSO IMPROVED WEBSITE FUNCTIONALITY TO MAKE FINDING PRIMARY CARE PROVIDERS EASIER. A PREVIOUS VERSION OF THE PRAIRIERIDGE.HEALTH WEBSITE WAS CONFUSING AND MADE IT HARD FOR PATIENTS TO SEARCH FOR AND FIND PROVIDERS. STRATEGY #3: COLLABORATION WITH THE PRAIRIE RIDGE HEALTH OCCUPATIONAL HEALTH TEAMPROVIDE THE OCCUPATIONAL HEALTH TEAM THAT PROVIDES ON-SITE SERVICES FOR LOCAL BUSINESSES, WITH BASIC INFORMATION ON THE SCOPE OF PRIMARY CARE MEDICINE AS WELL AS A LIST OF PROVIDERS AND WAYS TO ACCESS PRIMARY CARE IN THE COUNTY. ACTION: THE OCCUPATIONAL HEALTH TEAM NOW INCLUDES PRIMARY CARE FLYERS IN THEIR HEALTH FOLDERS.STRATEGY #4: PUBLIC EDUCATION-THE MARKETING TEAM WILL UTILIZE SOCIAL MEDIA, RADIO, PRINT ADS AND BILLBOARDS TO INCREASE AWARENESS ABOUT PRIMARY CARE OPTIONS AT PRAIRIE RIDGE HEALTH AND THE IMPORTANCE OF PREVENTATIVE CARE. ACTION: WE UTILIZED SOCIAL MEDIA, RADIO, AND PRINT ADS TO PROMOTE NEW PRIMARY CARE PROVIDERS AND INTRODUCE THEM TO OUR COMMUNITIES. THE TEAM PLACED PRIMARY CARE PROVIDER FLYERS AT CLINIC AND HOSPITAL REGISTRATION DESKS AND WAITING AREAS, THE EMERGENCY DEPARTMENT, AND WITH CLINICIANS.PRIORITY #2: INCREASING DIABETES DIAGNOSESGOAL: INCREASE NEW DIABETES DIAGNOSES BY .2% OR 100 OR ABOUT 33 PEOPLE PER YEAR.STRATEGY #1: STANDARDIZE SCREENING MEASURES -THE AMERICAN DIABETES ASSOCIATION RECOMMENDS SCREENING BEGIN AT 35, REGARDLESS OF BMI. OUR CURRENT BASIC SCREENING AUTO-ENROLLMENT IS:PATIENTS WITHOUT A DIABETES DIAGNOSIS AGE 40 AND UP WITH A BMI OVER 25 HAVE A TRIGGER THAT PROMPTS THE PROVIDER TO ORDER A A1C OR FASTING GLUCOSE TEST. ADDITIONAL TRIGGERS ARE AVAILABLE BASED ON A PATIENT'S RISK PROFILE.ACTION: A BROCHURE FOCUSED ON HEALTH SCREENINGS IS CURRENTLY BEING DEVELOPED AND WILL HIGHLIGHT RECOMMENDED SCREENINGS FOR:DIABETESCOLON CANCERBREAST CANCERSKIN CANCERLUNG CANCERBONE DENSITYSTRATEGY #2: COLLABORATION WITH LOCAL BUSINESSES AND OCCUPATIONAL HEALTH -WORK WITH LOCAL BUSINESSES, INCLUDING PHARMACIES TO PROVIDE DIABETES SCREENING EDUCATION AND INFORMATION ABOUT PRAIRIE RIDGE HEALTH SERVICES.-PROVIDE THE OCCUPATIONAL HEALTH TEAM WITH GENERAL DIABETES EDUCATION, INCLUDING SCREENING GUIDELINES AND WAYS TO GET SCREENED.ACTION: THIS HAS BEEN COMPLETED, AND WE CONTINUE TO MEET WITH THE OCCUPATIONAL HEALTH TEAM REGARDING ADDITIONAL NEEDS.STRATEGY #3: PUBLIC EDUCATION- THE MARKETING TEAM WILL WORK WITH THE DIABETES EDUCATORS TO UTILIZE SOCIAL MEDIA, RADIO, PRINT ADS AND BILLBOARDS TO INCREASE AWARENESS ABOUT THE IMPORTANCE OF DIABETES SCREENING AND OPTIONS FOR SERVICES AT PRAIRIE RIDGE HEALTH. -SUPPORT THE NUTRITION AND DIABETES EDUCATION TEAM WITH THEIR ANNUAL DIABETES FAIR THAT OCCURS EVERY NOVEMBER. ACTION: A DIABETES HEALTH FAIR WAS HELD IN NOVEMBER 2023. THE EVENT INCLUDED SPEAKERS, A COOKING DEMONSTRATION, BLOOD PRESSURE SCREENING, DIABETES SCREENINGS, AND CARDIO DRUMMING EXERCISES. THE EVENT WAS PROMOTED THROUGH PRINT ADVERTISING, RADIO ANNOUNCEMENTS, AND SOCIAL MEDIA POSTS. HEALTHY RECIPES AND BLOG POSTS WERE ADDED TO THE WEBSITE. KRIS BRAKER, APNP, A PRIMARY CARE PROVIDER, PRESENTED A "DIETS AND NUTRITION" TALK IN MAY 2024 TO A GROUP OF WOMEN AGE 50+. THE TALK INCLUDED GENERAL INFORMATION ABOUT NUTRITION AND INCLUDED HELPFUL INFORMATION ABOUT A VARIETY OF POPULAR DIETS. SHE ALSO ANSWERED QUESTIONS AND PROVIDED EDUCATION, HANDOUTS, AND MORE. DURING 2024, THE DIABETES AND WELLNESS SUPPORT GROUP CONTINUED TO MEET MONTHLY. TOPICS COVERED INCLUDED: THE DIABETES PLATE METHOD; HEART AND DIABETES-FRIENDLY MEAL AND SNACK IDEAS; ESTIMATING INDIVIDUAL NEEDS FOR CALORIES, PROTEIN AND CARBOHYDRATES; CONTINUOUS GLUCOSE MONITORS; IDENTIFYING AND TREATING HYPOGLYCEMIA; IDENTIFYING AND TREATING HYPERGLYCEMIA; AND MORE.STRATEGY #4: PROVIDER EDUCATION-ENGAGE AND SUPPORT THE DIABETES EDUCATION TEAM TO PROVIDE TRAINING FOR THE PRIMARY CARE TEAM AND CLINIC STAFF ON DIABETES SCREENING AND RESOURCES FOR NEWLY DIAGNOSED PATIENTS. ACTION: THE TEAM UPDATED WEBSITE CONTENT FEATURING THE DIABETES TEAM, REVISED SERVICE OFFERINGS AND PHILOSOPHY. WE ALSO SHARED INFORMATION ABOUT UPDATES, DIABETES TECHNOLOGY SUPPORT, AND MEDICATION CHANGES WITH THE PRIMARY CARE TEAM AT IN-PERSON MEETINGS AND THROUGH NEWSLETTERS. ADDITIONAL INFORMATION WAS PROVIDED TO PRIMARY CARE AND OB/GYN PROVIDERS ABOUT GESTATIONAL DIABETES AND MONITORING DURING PREGNANCY.[CONTINUED LATER IN SCHEDULE H, PART V DISCLOSURES...] PRAIRIE RIDGE HEALTH, INC. PART V, SECTION B, LINE 13H: PATIENTS WHOSE FAMILY INCOME EXCEEDS 400% OF THE FPL MAY BE ELIGIBLE TO RECEIVE DISCOUNTED RATES BASED ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES, SUCH AS CATASTROPHIC ILLNESS OR MEDICAL INDIGENCE, AT THE DISCRETION OF PRH; HOWEVER, THE DISCOUNTED RATES SHALL NOT BE GREATER THAN THE AMOUNTS GENERALLY BILLED TO (RECEIVED BY PRH FOR) PATIENTS COVERED BY MEDICARE, MEDICAID AND ALL PRIVATE HEALTH INSURERS.PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED BASED ON INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE:1. HOMELESS OR RECEIVED CARE FROM A HOMELESS OR FREE CLINIC;2. PATIENT IS DECEASED WITH NO KNOWN ESTATE;3. ACCOUNTS UNCOLLECTIBLE DUE TO DISCHARGE OF DEBTOR BY BANKRUPTCY;4. ALL DATES OF SERVICE WITHIN 30-DAYS PRIOR TO WHEN A PATIENT HAS BEEN APPROVED FOR MEDICAL ASSISTANCE;5. OUT-OF-STATE MEDICAL ASSISTANCE COVERAGE NOT CONTRACTED WITH PRH OR ARE LISTED AS NO FUNDS AVAILABLE;6. QUALIFICATION FOR TREATMENT UNDER THE MEMORANDUM OF UNDERSTANDING BETWEEN COLUMBIA COUNTY HEALTH AND HUMAN SERVICES AND PRH. PRAIRIE RIDGE HEALTH, INC. PART V, SECTION B, LINE 16J: THE FINANCIAL ASSISTANCE POLICY IS PROVIDED TO PATIENTS UPON ADMISSION. SCHEDULE H, PART V, SECTION B, LINE 11 - CONTINUED DISCLOSURE PRIORITY #3: INCREASING COLORECTAL SCREENINGGOAL: INCREASE COLORECTAL SCREENING BY .5% OR AN ADDITIONAL 135 (45 PER YEAR) COLONOSCOPIES.STRATEGY #1: STANDARDIZE SCREENING MEASURES -THE AMERICAN CANCER SOCIETY RECOMMENDS THAT PEOPLE AT AVERAGE RISK OF COLORECTAL CANCER (MEANING, NO SIGNIFICANT RISK OR FAMILY HISTORY) SHOULD START REGULAR SCREENINGS AT AGE 45. ACTION: PRAIRIE RIDGE HEALTH CREATED PATIENT EDUCATION MATERIALS AND ELECTRONIC MESSAGE BOARD DISPLAYS THAT TALKED ABOUT THE NEW, LOWER SCREENING AGE GUIDELINES FOR COLORECTAL SCREENING. INFORMATIONAL MATERIALS INCLUDED THE TAG LINE "45 IS THE NEW 50." THESE MATERIALS APPEAR IN OUR HOSPITAL, CLINICS, AND WEBSITE. STRATEGY #2: COLLABORATION WITH LOCAL BUSINESSES AND OCCUPATIONAL HEALTH -WORK WITH LOCAL BUSINESSES, INCLUDING PHARMACIES TO PROVIDE INFORMATION ON COLORECTAL SCREENINGS AND OPTIONS.-PROVIDE THE OCCUPATIONAL HEALTH TEAM WITH GENERAL COLORECTAL CANCER EDUCATION, INCLUDING SCREENING GUIDELINES AND WAYS TO GET SCREENED.ACTION: OCCUPATIONAL HEALTH OFFERS AMERICAN CANCER SOCIETY SCREENING BROCHURES IN THEIR NEW PATIENT FOLDERS.STRATEGY #3: PUBLIC EDUCATION- THE MARKETING TEAM WILL UTILIZE SOCIAL MEDIA, RADIO, PRINT ADS AND BILLBOARDS TO INCREASE AWARENESS ABOUT THE IMPORTANCE OF COLORECTAL SCREENING AND OPTIONS FOR SERVICES AT PRAIRIE RIDGE HEALTH AND IN THE COMMUNITY. ACTION: SOCIAL MEDIA, PRINT ADVERTISEMENTS, RADIO ADS, AND INTERNAL SIGNAGE HAVE BEEN UTILIZED TO PROMOTE COLORECTAL SCREENING OPTIONS.ACTION: WE HAD A SMALL DECREASE IN COLONOSCOPY SCREENINGS FOR FISCAL YEAR 2024 FROM THE PREVIOUS YEAR SINCE WE ONLY HAD ONE GENERAL SURGEON FOR ALMOST THE ENTIRE YEAR. A SECOND SURGEON BEGAN IN AUGUST 2024. HOWEVER, PRAIRIE RIDGE HEALTH CONTINUED TO CREATE PATIENT EDUCATION MATERIALS, ELECTRONIC MESSAGE BOARD ADVERTISEMENTS, AND SOCIAL MEDIA POSTS THAT TALKED ABOUT THE NEW, LOWER SCREENING AGE GUIDELINES AND IMPORTANCE OF COLORECTAL SCREENINGS. STRATEGY #4: COLLABORATION WITH PRAIRIE RIDGE HEALTH CLINICS- WORK WITH LEADERS IN THE PRAIRIE RIDGE HEALTH CLINICS TO ENSURE THAT:- EDUCATION AND BROCHURES ARE READILY AVAILABLE IN THE WAITING ROOM AND EXAM ROOMS EXPLAINING THE IMPORTANCE OF COLORECTAL SCREENING AND OPTIONS FOR SERVICES AT PRAIRIE RIDGE HEALTH AND IN THE COMMUNITY. ACTION: THE CLINIC TEAM CONTINUES TO OFFER HANDOUTS IN EXAM ROOMS AND WAITING ROOMS ON COLORECTAL CANCER SCREENING OPTIONS, INCLUDING AT-HOME SCREENING TESTS.- CONTINUE TO ENGAGE PATIENTS THROUGH THEIR PRIMARY CARE PROVIDERS THROUGH PHONE CALLS AND LETTERS ENCOURAGING PATIENTS DUE FOR SCREENING.ACTION: CLINIC AND SURGERY TEAMS CONTINUE TO UTILIZE THESE PROTOCOLS.NO HOSPITAL FACILITY CAN ADDRESS ALL THE HEALTH NEEDS PRESENT IN ITS COMMUNITY. PRAIRIE RIDGE HEALTH'S IMPLEMENTATION STRATEGY FOCUSES ON THE COMMUNITY HEALTH NEEDS PREVIOUSLY SPECIFIED AND WILL NOT FOCUS ON THE FOLLOWING NEEDS IDENTIFIED:1. ALCOHOL ABUSE AND EXCESSIVE DRINKING CONTINUES TO FLUCTUATE AND HAS BEEN SINCE 2003. THIS IS A STATEWIDE ISSUE AND PRAIRIE RIDGE HEALTH IS AWARE OF THIS NEED IN THE COUNTY. HOWEVER, AT THIS TIME, PRAIRIE RIDGE HEALTH DOES NOT HAVE THE STAFF OR RESOURCES TO PROPERLY ADDRESS THIS NEED.2. SMOKING/TOBACCO USE IS BEING ADDRESSED BY HEALTH EXPERTS AT A STATE LEVEL THROUGH THE IMPLEMENTATION OF A STATEWIDE SMOKING BAN, EFFECTIVE JULY 2010, AND REMEDIATION PROGRAMS. IN ADDITION, PRAIRIE RIDGE HEALTH OFFERS SMOKING CESSATION CLASSES.3. DRUG ABUSE, SPECIFICALLY OPIOID ABUSE, IS CURRENTLY BEING ADDRESSED BY PARCC - PREVENTION AND RECOVERY COLUMBIA COUNTY COALITION. THESE PROGRAMS AIM AT ELIMINATING THE ABUSE OF OPIOIDS FROM A PREVENTION FOCUS. PRAIRIE RIDGE HEALTH OFFERS MEDICATION-ASSISTED TREATMENT (MAT) FOR OPIOD DISORDER AND DURING FISCAL YEAR 2024 WE ASSISTED 56 UNIQUE PATIENTS THROUGH TREATMENT. WHILE IT IS NOT A 2022 CHNA INITIATIVE, PRAIRIE RIDGE HEALTH IS ALREADY WORKING ON THE FOLLOWING:MAMMOGRAPHY SCREENINGS CONTINUE TO BE BELOW NATIONAL AVERAGES IN COLUMBIA COUNTY. THE PRAIRIE RIDGE HEALTH TEAM HAS BEEN DEDICATED TO INCREASING SCREENING RATES SINCE THE 2016 CHNA AND CONTINUES TO OFFER WALK-IN SCREENING MAMMOGRAMS ONCE PER MONTH. REDUCING OBESITY AND INCREASING PHYSICAL ACTIVITY HAVE BEEN PRIORITIES ON EVERY CHNA SINCE THE FIRST ONE COMPLETED IN 2013. ALTHOUGH THOSE GOALS ARE NOT ON THE 2022 CHNA, OUR PRIMARY CARE AND SPECIALTY TEAMS WILL CONTINUE TO WORK ON THEM THROUGH EDUCATION, SCREENING, NUTRITION SERVICES, PHYSICAL AND OCCUPATIONAL THERAPIES.ACCESS TO MENTAL AND BEHAVIORAL HEALTH IS A RECOGNIZED NEED IN COLUMBIA COUNTY. PRAIRIE RIDGE HEALTH IS AWARE OF THIS NEED IN THE COUNTY. PRAIRIE RIDGE HEALTH HIRED ANOTHER PSYCHOTHERAPIST DURING FY2024. WE HOPE TO EXPAND THAT TEAM TO INCLUDE MORE COUNSELORS IN THE COMING YEARS. VISIT WWW.PRAIRIERIDGE.HEALTH FOR UPDATED INFORMATION ON THIS SERVICE OR VISIT COLUMBIA COUNTY'S BEHAVIORAL HEALTH AND LONG-TERM SUPPORT PROGRAM.THE LACK OF DENTAL CARE IN THE COUNTY PROVES TO BE A LARGE ISSUE, BUT THE HOSPITAL CANNOT DIRECTLY IMPACT THIS METRIC. MANY OF THE FOCUS GROUP PARTICIPANTS MENTIONED A LACK OF DENTISTS. MANY PEOPLE DO NOT RECEIVE THE DENTAL CARE THEY NEED BECAUSE THEY EITHER CANNOT MAKE AN APPOINTMENT, DO NOT HAVE THE TRANSPORTATION TO GET TO AN APPOINTMENT, DO NOT HAVE INSURANCE AND CANNOT AFFORD DENTAL CARE, OR THEIR INSURANCE IS NOT ACCEPTED. THIS FURTHER EXACERBATES THE METRIC OF POOR DENTAL HEALTH. THE HOSPITAL WILL CONTINUE TO WORK WITH LOCAL DENTISTS WHEN A PATIENT PRESENTS TO THE EMERGENCY DEPARTMENT OR EXPRESSES A NEED. 2 1 - PRAIRIE RIDGE HEALTH CLINIC 134 CORPORATE DRIVE BEAVER DAM WI 53916 PHYSICIAN CLINIC 2 - PRAIRIE RIDGE HEALTH CLINIC 301 W MAIN STREET SUITE A MARSHALL WI 53559 PHYSICIAN CLINIC PART I, LINE 3C: PATIENTS WHOSE FAMILY INCOME ARE AT OR BELOW 200% OF THE FPL ARE ELIGIBLETO RECEIVE FREE CARE.PATIENTS WHOSE FAMILY INCOME ARE ABOVE 200% BUT NOT MORE THAN 400% OF THE FPL ARE ELIGIBLE TO RECEIVE SERVICES AT AMOUNTS NO GREATER THAN THE AMOUNTS GENERALLY BILLED.PATIENTS WHOSE FAMILY INCOME EXCEEDS 400% OF THE FPL MAY BE ELIGIBLE TO RECEIVE DISCOUNTED RATES BASED ON A CASE-BY-CASE BASIS BASED ON THEIR SPECIFIC CIRCUMSTANCES, SUCH AS CATASTROPHIC ILLNESS OR MEDICAL INDIGENCE, AT THE DISCRETION OF PRH; HOWEVER, THE DISCOUNTED RATES SHALL NOT BE GREATER THAN THE AMOUNTS GENERALLY BILLED TO (RECEIVED BY PRH FOR) PATIENTS COVERED BY MEDICARE, MEDICAID AND ALL PRIVATE HEALTH INSURERS.PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED BASED ON INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE:1. HOMELESS OR RECEIVED CARE FROM A HOMELESS OR FREE CLINIC;2. PATIENT IS DECEASED WITH NO KNOWN ESTATE;3. ACCOUNTS UNCOLLECTIBLE DUE TO DISCHARGE OF DEBTOR BY BANKRUPTCY;4. ALL DATES OF SERVICE WITHIN 30-DAYS PRIOR TO WHEN A PATIENT HAS BEEN APPROVED FOR MEDICAL ASSISTANCE;5. OUT-OF-STATE MEDICAL ASSISTANCE COVERAGE NOT CONTRACTED WITH PRH OR ARE LISTED AS NO FUNDS AVAILABLE;6. QUALIFICATION FOR TREATMENT UNDER THE MEMORANDUM OF UNDERSTANDING BETWEEN COLUMBIA COUNTY HEALTH AND HUMAN SERVICES AND PRH. PART I, LINE 6A: PRAIRIE RIDGE 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 WEBSITE. PART I, LINE 7: THE COSTING METHOD USED ON FORM 990 IS BASED ON A COST-TO-CHARGE RATIO WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES 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. THE COSTING METHODOLOGY FOR SUBSIDIZED HEALTH SERVICES FOR LINE 7G ON THE FIRST PAGE OF SCHEDULE H OF THE FORM 990 IS BASED ON COST ALLOCATIONS FROM THE MEDICARE COST REPORT. THIS ALLOCATION METHOD AND PRINCIPLES OF ALLOCATION WERE USED TO DERIVE A SPECIFIC AMOUNT OF COST ALLOCATION TO THE VARIOUS PROGRAMS AND COST CENTERS OPERATED BY THE ORGANIZATION. MEDICAID FOR LINE 7B WAS CALCULATED USING THE RATIO OF COST TO CHARGE METHODOLOGY.THE COMMUNITY BENEFIT REPORTED ON LINES 7E, 7F, AND 7I ARE BASED ON ACTUAL COST. PART I, LINE 7G: THE ORGANIZATION INCLUDES THE FOLLOWING SERVICES AS THEIR CALCULATED SUBSIDIZED SERVICES FOR PURPOSES OF SCHEDULE H. IN DETERMINING THE NET AMOUNTS REPORTED ON SCHEDULE H, THE ORGANIZATION UTILIZES THE FORMAT OF WORKSHEET 6 PROVIDED BY THE IRS. SERVICES INCLUDE: ICU, INPATIENT UNIT, MARSHALL CLINIC. 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 $ 2,404,361. PART II, COMMUNITY BUILDING ACTIVITIES: PRAIRIE RIDGE HEALTH PARTICIPATES IN THE COMMUNITY CHAMBER OF COMMERCE, OFFERS A COMMUNITY SHARPS DISPOSAL PROGRAM AND PROVIDES MEDICATION TAKE BACK DAYS THROUGHOUT THE YEAR. PART III, LINE 2: THE AMOUNT REPORTED ON LINE 2 REPRESENTS IMPLICIT PRICE CONCESSIONS. THE HOSPITAL DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSIONS BASED ON ITS HISTORICAL COLLECTION EXPERIENCE WITH THIS CLASS OF PATIENTS. PART III, LINE 3: THE ORGANIZATION HAS A THOROUGH FINANCIAL ASSISTANCE POLICY AND ESTIMATES THAT NO AMOUNT OF BAD DEBT IS ATTRIBUTABLE TO THOSE THAT MAY QUALIFY FOR THE ASSISTANCE UNDER SUCH POLICY. PART III, LINE 4: THE FINANCIAL STATEMENT FOOTNOTE REGARDING IMPLICIT PRICE CONCESSIONS MAY BE FOUND ON PAGES 15-17 OF THE AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: THE TOTAL MEDICARE REVENUE SHOWN IN SCHEDULE H TO THE FORM 990 IS BASED ON THE IRS 990 INSTRUCTIONS AND INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE OF THE ORGANIZATION, AND ALSO DOES NOT CONSIDER ALL CONTRACTUAL ADJUSTMENTS FOR SERVICES REIMBURSED BY THE MEDICARE PROGRAM. AMOUNTS LISTED FOR MEDICARE REVENUES DO NOT INCLUDE PHYSICIAN SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT AT THE HOSPITAL AS WELL AS ANESTHESIA PROFESSIONAL SERVICES, RESPIRATORY THERAPY PHYSICIAN PROFESSIONAL SERVICES, AND REVENUES FOR ANY PATIENTS COVERED UNDER MEDICARE ADVANTAGE PLAN PROGRAMS. PHYSICIAN PROFESSIONAL SERVICES ARE REIMBURSED PRIMARILY ON FEE SCHEDULE REIMBURSEMENTS AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY AND CLINICAL PHYSICIAN 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 PRAIRIE RIDGE HEALTH PROVIDES TO THE COMMUNITY AND SURROUNDING AREAS. THE COSTING METHOD USED ABOVE FOR IRS 990 COMPLIANCE REPORTING IS ALSO BASED ON THE FILED MEDICARE COST REPORT FOR THE YEAR ENDED SEPTEMBER 30, 2024, 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).WHETHER THERE IS A SHORTFALL OR SURPLUS ON SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THESE PEOPLE, WHICH ARE TYPICALLY ELDERLY OR DISABLED MEMBERS OF THE COMMUNITY, ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE PATIENT SERVICES, THE CENTERS FOR MEDICARE AND MEDICAID (CMS) WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY. PART III, LINE 9B: UNDER THE ORGANIZATION'S COLLECTION AND CHARITY CARE POLICIES, PRAIRIE RIDGE HEALTH MAKES EVERY ATTEMPT TO IDENTIFY AND PROMOTE CHARITY CARE TO PATIENTS. INCLUDED IN THE ORGANIZATION'S CHARITY CARE POLICY IT IS NOTED THAT PATIENTS MAY QUALIFY FOR CHARITY CARE EITHER PRIOR TO ADMISSION OR FOLLOWING DISCHARGE. ALL INPATIENT SELF-PAY ADMISSIONS ARE SCREENED BY THE HOSPITAL'S PATIENT FINANCIAL COUNSELOR OR SOCIAL WORKERS TO ALLOW THESE PATIENTS THE ABILITY TO COMPLETE THEIR APPLICATION DURING THEIR STAY AT THE HOSPITAL, DEPENDING UPON THE PATIENT'S CONDITION, 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 CHARITY CARE PROGRAM TO ALLOW PATIENTS THE OPPORTUNITY TO COMPLETE THE APPROPRIATE FORMS AND QUALIFY UNDER THE PROGRAM. PART VI, LINE 2: PRAIRIE RIDGE HEALTH ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES AND AREAS IT SERVES BY REVIEWING LOCAL DEMOGRAPHICS AND TRENDS IN PATIENT SERVICE UTILIZATION TO DETERMINE WHICH SERVICES COULD AND SHOULD BE MADE AVAILABLE TO THE COMMUNITY IN A COST-EFFECTIVE MANNER TO BE CONSISTENT WITH PRAIRIE RIDGE HEALTH'S MISSION IN THE COMMUNITY. PRAIRIE RIDGE HEALTH ALSO REVIEWS STATISTICS IN THE HOSPITAL, CLINIC, AND OTHER ORGANIZATIONAL DEPARTMENTS TO REVIEW THE CURRENT SERVICES BEING OFFERED AND ENSURE THAT RESOURCES ARE BEING APPROPRIATELY ALLOCATED TO AREAS IN NEED BY COMMUNITY MEMBERS AND PATIENTS. THE ORGANIZATION ALSO MEETS WITH LOCAL COMMUNITY MEMBERS AND ITS PHYSICIAN GROUP TO DETERMINE WHICH SERVICES MAY BENEFIT THE COMMUNITY. A FORMAL COMMUNITY NEEDS ASSESSMENT WAS COMPLETED DURING FY22 AND APPROVED BY THE BOARD ON AUGUST 25, 2022. PART VI, LINE 3: UNINSURED AND UNDER INSURED PATIENTS ARE ASKED TO MEET WITH ONE OF THE ORGANIZATION'S FINANCIAL COUNSELORS EITHER AT THE TIME SERVICE IS PROVIDED OR WHEN THE PATIENT'S BILL IS GENERATED. THE FINANCIAL COUNSELOR EXPLAINS THE VARIOUS PAYMENT OPTIONS AVAILABLE TO THE PATIENT AS WELL AS THE HOSPITAL'S CHARITY CARE PROGRAM AND OFFERS THE CHARITY CARE APPLICATION WHEN APPROPRIATE. IF OTHER PROGRAMS ARE AVAILABLE TO THE PATIENT, SUCH AS THE WISCONSIN MEDICAL ASSISTANCE OR BADGERCARE PROGRAMS, THESE PATIENTS ARE REFERRED TO THE APPROPRIATE GOVERNMENT AGENCY FOR FURTHER ASSISTANCE. PART VI, LINE 4: PRAIRIE RIDGE HEALTH'S SERVICE AREA INCLUDES COLUMBUS, FALL RIVER, CAMBRIA, DOYLESTOWN, FRIESLAND, MARSHALL, RANDOLPH, RIO, WATERLOO, BEAVER DAM, SUN PRAIRIE AND OTHER SURROUNDING COMMUNITIES. PRAIRIE RIDGE HEALTH BORDERS THREE COUNTIES, COLUMBIA, DANE, AND DODGE, BUT PRIMARILY DEFINES ITS COMMUNITY AS THE SOUTHERN RIGHT SECTOR OF COLUMBIA COUNTY AND ADJACENT COMMUNITIES. ACCORDING TO THE MOST RECENT CENSUS, THIS SERVICE AREA HAD AN ESTIMATED POPULATION OF 57,133 PEOPLE. THE ORGANIZATION PROVIDES A SIGNIFICANT PORTION OF ITS PATIENT SERVICES TO BENEFICIARIES OF THE MEDICARE AND MEDICAL ASSISTANCE PROGRAMS, ESPECIALLY THOSE BENEFICIARIES WHO ARE ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY AND RURAL SURROUNDING AREAS WHO OTHERWISE WOULD HAVE A DIFFICULT TIME TRAVELING TO LARGER FACILITIES AND IN SOME CASES COULD BE MORE THAN 20+ MILES AWAY FROM PRAIRIE RIDGE HEALTH. IN FISCAL YEAR 2024, THESE MEDICARE AND MEDICAL ASSISTANCE PATIENTS ACCOUNTS FOR JUST OVER 55 PERCENT OF THE GROSS PATIENT SERVICE REVENUE PROVIDED BY THE ORGANIZATION DURING THE YEAR. PART VI, LINE 5: PRAIRIE RIDGE HEALTH HAS AN 11-MEMBER BOARD OF DIRECTORS, 4 OF WHICH ARE COMMUNITY MEMBERS THAT RESIDE IN COLUMBIA COUNTY. PRH ALSO MAINTAINS AN OPEN MEDICAL STAFF. SURPLUS FUNDS ARE USED TO REINVEST IN EQUIPMENT, TECHNOLOGY, AND INFRASTRUCTURE IN ORDER TO ENSURE THAT PRH IS ABLE TO SUPPORT THE PROMOTION OF COMMUNITY HEALTH WELL INTO THE FUTURE. WHILE THERE IS GROWING AGREEMENT IN THE UNITED STATES ABOUT WHAT CONSTITUTES A NON-PROFIT HOSPITAL'S COMMUNITY BENEFIT, THESE EFFORTS CONTINUE TO BE A WORK IN PROGRESS. PRAIRIE RIDGE HEALTH, INC. PROVIDES SIGNIFICANT CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS AND, IN ADDITION, THE ORGANIZATION BELIEVES THAT IT PROVIDES A CRITICALLY IMPORTANT BENEFIT WHICH IS NOT QUANTIFIED. PRAIRIE RIDGE HEALTH, LIKE MOST COMMUNITY HOSPITALS, WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE CARE LOCALLY WHICH, WITHOUT THE HOSPITAL AND CLINICS, WOULD NOT BE AVAILABLE LOCALLY. BEYOND INPATIENT HOSPITALIZATIONS, THE ORGANIZATION PROVIDES LOCAL ACCESS TO MANY SERVICES INCLUDING: BIRTHING CENTER, DIAGNOSTICS, EMERGENCY SERVICES, SWING BED SERVICES, LABORATORY SERVICES, REHABILITATION SERVICES, SPECIALTY MEDICINE, SPEECH PATHOLOGY, SURGICAL SERVICES, LIFELINE, OCCUPATIONAL HEALTH, WOMEN'S SERVICES, PRIMARY CARE AND OUTPATIENT PSYCHIATRY TO NAME SOME OF THE MAJOR SERVICES PROVIDED. PART VI, LINE 6: THE HOSPITAL SIGNED A MASTER AGREEMENT AND AFFILIATION AGREEMENT WITH SSM HEALTHCARE OF WISCONSIN (SSM WISCONSIN). AS PART OF THIS AFFILIATION, SSM WISCONSIN HAS THE RIGHT TO APPOINT THREE DIRECTORS TO THE HOSPITAL'S BOARD OF DIRECTORS. THE AGREEMENT ALSO SPECIFIES CERTAIN BOARD RESOLUTIONS THAT MUST BE APPROVED BY THE SSM WISCONSIN BOARD MEMBERS. IN THE EVENT OF LIQUIDATION, DISSOLUTION OR SALE OF THE HOSPITAL, SSM WISCONSIN WOULD RECEIVE 40 PERCENT OF THE NET PROCEEDS. PART VI, LINE 7, REPORTS FILED WITH STATES WI X X 1 0 0 0 0 0 0 0 0 JOHN D RUSSELL PRESIDENT & CEO 531335 0 86272 0 18930 0 16500 0 40504 0 693541 0 0 0 GARY GALVIN MD CHIEF OF STAFF/GENERAL SURGEON 499396 0 49697 0 14634 0 12200 0 40504 0 616431 0 0 0 ELIZABETH ZEECK MD DERMATOLOGIST 462304 0 46400 0 300 0 7567 0 40504 0 557075 0 0 0 KATHERYN KALDOR MD OB/GYN PHYSICIAN 318303 0 32000 0 50290 0 12200 0 40504 0 453297 0 0 0 LESLIE ALZUHN-HANSEN MD DIRECTOR/OB/GYN PHYSICIAN 318303 0 32000 0 45417 0 12200 0 40504 0 448424 0 0 0 ROBB WHINNEY DO GENERAL SURGEON 143327 0 89383 0 137138 0 12200 0 16877 0 398925 0 0 0 ANN ROUNDY SR VP CULTURE, STRATEGY & GROWTH 276467 0 39945 0 10461 0 14670 0 41440 0 382983 0 0 0 JAMIE HENDRIX VP PATIENT CARE SERVICES 261295 0 34576 0 9913 0 14940 0 41674 0 362398 0 0 0 SEAN ACKERMAN MD PSYCHIATRIST 298050 0 0 0 52404 0 923 0 2906 0 354283 0 0 0 MATTHEW NIESEN ORTHOPEDIC SURGEON 36923 0 31780 0 266764 0 0 0 1617 0 337084 0 0 0 COLIN MILLAR CLINIC PHYSICIAN 239419 0 18329 0 39184 0 3687 0 16232 0 316851 0 0 0 MELISSA MANGAN VP OF FINANCE & CFO 182301 0 25670 0 6801 0 10238 0 41618 0 266628 0 0 0 PART I, LINE 4A THE ORGANIZATION DISCLOSED THE SEVERANCE PAYMENT RECORDED BELOW ON THE PRIOR YEAR RETURN. BECAUSE THEY ARE A FISCAL YEAR END FILER, THEY PROVIDED THE INFORMATION BECAUSE THE PAYMENT WAS MADE IN FISCAL YEAR 2023 AND CALENDAR YEAR 2023. THE COMPENSATION RECORDED ON PART II OF SCHEDULE J INCLUDES THE SEVERANCE PAYMENT TO MATTHEW NIESEN. A CITY OF COLUMBUS WISCONSIN 396005417 2004-12-14 10000000 FINANCE THE IMPROVEMENT AND PURCHASE EQUIPMENT FOR THE HOSPITAL FACILITY 0 0 0 B CITY OF COLUMBUS WISCONSIN 396005417 2005-06-06 2000000 FINANCE THE IMPROVEMENT OF THE EXISTING HOSPITAL FACILITY 0 0 0 C CITY OF COLUMBUS WISCONSIN 396005417 2013-12-12 8000000 FINANCE THE RENOVATION AND PURCHASE EQUIPMENT FOR THE HOSPITAL FACILITIES 0 0 0 D CITY OF COLUMBUS WISCONSIN 396005417 2014-06-25 2000000 FINANCE THE RENOVATION AND PURCHASE EQUIPMENT FOR THE HOSPITAL FACILITIES 0 0 0 A 8328934 10000000 200000 9800000 2006 0 0 1 1 B 1677587 2000000 40000 1960000 2006 0 0 1 1 C 1735815 8000000 8000000 2015 0 0 1 1 D 441676 2000000 2000000 2016 0 0 1 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 C 0 0 0 0 0 0 1 D 0 0 0 0 0 0 1 A 0 0 0 0 0 0 0 0 1 B 0 0 0 0 0 0 0 0 1 C 0 0 0 0 1 0 0 0 1 D 0 0 0 0 1 0 0 0 1 A 1 B 1 C 1 D 1 A CITY OF COLUMBUS WISCONSIN 396005417 2019-05-14 10000000 FINANCE THE RENOVATION AND PURCHASE EQUIPMENT FOR THE HOSPITAL FACILITIES 0 0 0 A 1288863 10000000 10000000 2020 0 0 1 1 A 0 0 0 0 0 0 1 A 0 0 0 0 1 0 0 0 1 A 1 FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE/LONG RANGE PLANNING COMMITTEE SHALL CONSIST OF THE CHAIR, THE VICE CHAIR, THE SECRETARY, AND THE TREASURER OF THE CORPORATION, THE CHIEF OF THE MEDICAL STAFF, AND ONE CLASS S DIRECTOR. NO EMPLOYED PHYSICIAN, OTHER THAN THE CHIEF OF THE MEDICAL STAFF, SHALL SERVE ON THE EXECUTIVE/LONG RANGE PLANNING COMMITTEE. THE CLASS S DIRECTOR SHALL BE SELECTED BY SSMWI FROM TIME TO TIME, AND SSMWI SHALL HAVE THE RIGHT TO SUBSTITUTE ANOTHER CLASS S DIRECTOR FOR ANY MEETING OF THE COMMITTEE THAT THE DESIGNATED CLASS S DIRECTOR IS UNABLE TO ATTEND. THE PRESIDENT WILL PARTICIPATE AS A NON-VOTING MEMBER OF THE COMMITTEE. THE CHAIR OF THE BOARD SHALL BE CHAIR OF THE COMMITTEE. THE EXECUTIVE/LONG RANGE PLANNING COMMITTEE SHALL HAVE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE CORPORATION DURING THE INTERIM BETWEEN MEETINGS OF THE BOARD OF DIRECTORS, EXCEPT THE POWER TO: (I) ELECT OFFICERS OF THE CORPORATION, OR (II) FILL VACANCIES IN THE BOARD OF DIRECTORS OR IN THE EXECUTIVE/LONG RANGE PLANNING COMMITTEE, OR (III) AMEND OR REPEAL ANY PROVISIONS OF THESE BYLAWS OR THE ARTICLES OF INCORPORATION OF THE CORPORATION, EXCEPT AS OTHERWISE PROVIDED FOR IN THESE BYLAWS, OR(IV) APPROPRIATE FUNDS OF THE CORPORATION NOT INCLUDED IN THE BUDGET EXCEEDING AN AMOUNT FOR ANY ONE PURPOSE IN ANY ONE FISCAL YEAR FIXED OR AUTHORIZED BY THE BOARD FROM TIME TO TIME, OR (V) ADOPT PROGRAMS WHICH WOULD INVOLVE CONTINUING ACTIVITY OR SUPPORT BY THE CORPORATION FOR MORE THAN ONE FISCAL YEAR, OR (VI) TAKE ANY ACTION REQUIRING THE APPROVALS SET FORTH IN SECTION 4.10 OF THE BYLAWS. FORM 990, PART VI, SECTION A, LINE 7A SSM HEALTH CARE OF WISCONSIN, INC. APPOINTS THREE DIRECTORS TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING DECISIONS BY THE BOARD OF DIRECTORS REQUIRE PRIOR WRITTEN APPROVAL OF SSM HEALTH CARE OF WISCONSIN, INC.: APPROVAL OF ANY AMENDMENT OR RESTATEMENT OF THE CORPORATION'S RESTATED ARTICLES OF INCORPORATION OR OF THE RESTATED BYLAWS; APPROVAL OF THE SALE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION; APPROVAL OF ANY MERGER OR CONSOLIDATION INVOLVING THE CORPORATION AND APPROVAL OF THE DISSOLUTION OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B THE BOARD OF DIRECTORS ARE GIVEN THE OPPORTUNITY TO REVIEW THE RETURN BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. THE FORM 990 IS REVIEWED BY EITHER THE SENIOR ACCOUNTANT OR FINANCE MANAGER FOR COMPLETION AND ACCURACY AND BY THE CHIEF FINANCIAL OFFICER. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS CHECKS COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY WHENEVER THERE IS A CHANGE IN PEOPLE GOVERNING ANY PART OF THE HOSPITAL OPERATIONS. SHOULD A CONFLICT ARISE, THE INTERESTED DIRECTOR OR OFFICER MUST PROMPTLY DISCLOSE THE CONFLICT IN WRITING TO THE BOARD OF DIRECTORS AND THE INTERESTED PERSON DOES NOT VOTE ON THE MATTER. FORM 990, PART VI, SECTION B, LINE 15 ON AN ANNUAL BASIS THE BOARD OF DIRECTORS REVIEWS MARKET DATA FOR THE PRESIDENT & CEO, VP OF FINANCE & CFO AND ALL OTHER KEY EMPLOYEES. A REVIEW OF THE CRITERIA NECESSARY FOR INCENTIVE COMPENSATION IS ALSO DONE ANNUALLY. THE PROCESS AND DETERMINATION ARE DOCUMENTED IN THE PERSONNEL FILES AND BOARD MINUTES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 5,532,185. MANAGEMENT AND GENERAL EXPENSES 1,272,470. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,804,655. OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 1,627,699. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,627,699. OTHER FEES: PROGRAM SERVICE EXPENSES 1,779,381. MANAGEMENT AND GENERAL EXPENSES 856,071. FUNDRAISING EXPENSES 5,000. TOTAL EXPENSES 2,640,452. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN THE FOUNDATION 537,897. PRAIRIE RIDGE HEALTH FOUNDATION INC 1515 PARK AVENUE COLUMBUS WI 53925 391656161 SUPPORT PRAIRIE RIDGE HEALTH, INC. WI 501(C)(3) LINE 7 N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 PRAIRIE RIDGE HEALTH FOUNDATION INC C 159097 CASH