Westfields Hospital Inc.

“As of october 1, 2013, westfields hospital adopted amended and restated bylaws. This occurred in conjunction with westfields hospital acquiring the assets of new richmond clinic. The changes to the bylaws are not material changes. The prior bylaws provided that the owners of the professional corporation that operated the new richmond clinic had the power to appoint two of its physicians as hospital board members, the new bylaws clarify that the professional corporation has no role in board appointments-physicians are now selected from the physicians staffing the primary care clinic owned by westfields hospital.”

“Rh wisconsin, inc. Is the class a member and group health plan, inc. Is the class b member of westfields.”

“The class a member (rh wisconsin, inc.) appoints three directors to represent the class a member. The class b member (group health plan, inc.) appoints two directors to represent the class b member. Two health care providers are nominated as directors by an unrelated medical group and appointed by majority vote of the full board. Eight community representatives are appointed as directors by the class a member upon recommendation by the executive committee of the board of directors.”

“The class a and class b members (rh wisconsin, inc. And group health plan, inc. Respectively) both must approve the decisions of the board of directors as follows: - amendment of articles or bylaws impacting membership - resignation of a member - dissolution - any change in the fundamental nature or purpose - merger or consolidation with another corporation - disposition of substantially all assets. Only the class a member must approve the decisions of the board of directors as follows: - amendment of articles or bylaws not impacting membership - annual operating and capital budgets and strategic plans - establishment of new entities or significant relationships with other entities - unbudgeted expenditures in excess of amounts established by the member - guaranteeing the debt of any other person or entity - a loan or other indebtedness in excess of amounts established by the member - transfer of assets to another entity - appointment of auditors - appointment of the president and the board chair.”

“Westfields' 990 return has a comprehensive review process that is followed before it is presented to the governing body of westfields. The review process includes a layered review by the tax department of group health plan, inc. (ghi), the management team of westfields, ghi's internal legal department and westfields's outside independent accountants. Each one of those areas has an opportunity to review, ask questions and make comments back to the tax department of ghi before the form 990 is completed and presented to the governing body of westfields. Westfields makes available to the governing body (board of directors) a copy of the 990 for review and comment prior to the filing of the 990 return. This copy will be provided in a mailing to the board members prior to the filing of the 990. Each board member will have an opportunity to comment or ask questions about the 990 before it is filed. This process will be noted and documented in a written memo in the files of the board of directors.”

“Westfields monitors potential conflicts of interest on the part of its board members, officers and key employees by maintaining a conflict of interest policy. Under the policy, all board members, principal officers, members with board delegated powers and key employees are provided annually with a copy of the policy and are required to complete a questionnaire identifying any potential conflicts of interest. The full board is advised of any potential conflicts and the process to be followed in resolving the conflict as recommended by the chair, ceo and general counsel. Board agendas and executive decisions are monitored in relation to this policy.”

“The chief executive officer (ceo) and chief financial officer (cfo) of westfields are employed by regions hospital (regions), a related organization. Regions has an annual process to review the market comparability of the total compensation of its officers. Every three years, under the direction of the regions board of directors' compensation committee (compensation committee), a total compensation market review is completed. The review includes all components of compensation; base salary, annual incentives, benefits and perquisites. The market survey results are presented to, reviewed by and approved by the independent compensation committee. In interim years, regions' human resources staff, under the direction of the compensation committee, updates changes in the salary structure based on the same independent studies performed by the compensation committee. For the chief executive officer and certain other positions full independent reviews are performed. In all cases, committee members complete an annual conflict of interest survey to assure the compensation committee members' independence, staff is not in room during deliberations or vote including executive sessions, and contemporaneous minutes are kept. Total compensation is appropriately documented on the form 990 and w2s. The board of directors has delegated to the compensation committee the accountability to conduct an annual performance evaluation and to determine the compensation of the ceo based on the performance review and the market comparability data, approved by the compensation committee. The board has delegated to the ceo (with authority to further delegate) the accountability to conduct annual performance reviews and determine the compensation of all other officers within the compensation ranges determined by the compensation committee. Any exceptions need to be approved by the compensation committee.”

“Westfields' financial statements and 990 returns are made available to any person who requests the information from westfields or healthpartners, inc.”

“Directors and officers of westfields are employed and compensated by group health plan, inc., regions hospital or westfields. Reported average hours worked are based on their total compensation from all related organizations.”

“I. Organization and governance westfields hospital, inc. (westfields), a state licensed 25-bed, level iv critical access hospital (cah), is a wisconsin non-profit organization exempt from federal income tax under internal revenue code (irc) section 501(c)(3) and is part of the family of healthpartners organizations (healthpartners), an integrated system of health financing, care delivery, and support services providing health plan services to over 1,165,000 members and delivering care to over 4,500,000 patient encounters, primarily in minnesota and western wisconsin. Healthpartners' mission is to improve health and well-being in partnership with our members, patients and community. Healthpartners seeks to transform healthcare through a relentless focus on the triple aim - providing exceptional experience for the individual, improving the health of the population, and improving affordability - all at the same time. Healthpartners includes an array of tax-exempt and taxable entities - including five hospitals and their related foundations, two health maintenance organizations, four non-profit physician groups, home care, transitional care, medical equipment, a third party administrator that serves self insured employers, and many more. A complete listing of all healthpartners organizations, for which hpi is the parent organization and the reporting relationship between each of those organizations, can be found on schedule r within this 990 return. Healthpartners, inc. (hpi) is the parent entity of healthpartners and is a minnesota non-profit corporation and licensed health maintenance organization (hmo) recognized as exempt from federal income tax under irc section 501(c)(4). Hpi is the sole corporate member of hpi-ramsey, a minnesota non-profit corporation recognized as exempt from federal income tax under irc section 501(c)(3). In turn, hpi-ramsey is the sole corporate member of regions hospital, regions hospital foundation, capitol view transitional care center, stillwater health system (lakeview health), ramsey integrated health services and rh-wisconsin, inc., all of which are non-profit corporations exempt from federal income tax under irc section 501(c)(3). Rh-wisconsin and group health plan, inc. (ghi) are corporate members of westfields. Ghi is a minnesota non-profit corporation and licensed health maintenance organization (hmo) recognized as exempt from federal income tax under irc section 501(c)(3). In turn, westfields is the sole corporate member of the westfields hospital foundation a wisconsin non-stock corporation exempt from federal income tax under internal revenue code (irc) section 501(c)(3). As a not-for-profit community hospital serving the new richmond wisconsin area since 1950, westfields continues to play an important role and is positioned well to meet the health care needs of the area. Westfields is a full service medical campus offering emergency services, primary care and specialty clinics, pharmacy, as well as inpatient, outpatient and maternity care. On october 1, 2013, new richmond clinic officially joined westfields adding 17 providers specializing in family medicine, general surgery, ob/gyn and gastroenterology. The combination allows us to expand access to primary care and further develop one electronic medical record across the campus for improved health and easier access to services. Westfields staff members are passionate about helping each patient become the healthiest person possible and are there for care and support every step of the way. Westfields encourages patients and their families - their partners in health - to be actively involved in decisions about their own health care. In 2013 a patient and family advisory council was formed to increase the voice of patients and families in every aspect of care. Research shows that patients and their families who are more involved with their care feel they get better results and are more satisfied. Safety and satisfaction are priorities at wes”

“5. Tobacco use and exposure. "increase access to dental services" was identified as the sixth priority in the communities served by regions hospital, lakeview memorial hospital, hudson hospital and westfields. While this is a concern in the community, the team decided to focus their efforts on the other five priorities because healthpartners has an insurance company it's currently the leading dental care provider to uninsured people in minneapolis/st. Paul. Westfields decided not to prioritize "increase access to dental care" for the following reasons: 1) dental care is not a core service line for the hospitals and 2) healthpartners, the parent organization, already places significant emphasis on dental care services with access through its dental practices and free dental clinics. Thus, the need is being addressed by healthpartners. 2013 implementation activities towards these priorities included existing and new programs and activities are moving forward to address the needs of the community. - continue support with healthpartners overall efforts to implement the mental health anti- stigma campaign. Some of these efforts include collaborating with local service agencies with a vested interest in mental health, supporting the annual nami walk, and utilizing healthpartners' resources and toolkits to raise public awareness of mental illness. - support the yumpower efforts of healthpartners both internally (staff education and engagement) and externally in the community's elementary schools. Yumpower is a kid friendly online resource that provides nutritional advice for healthy eating habits. - continue to partner with the vitality initiative, a local grass roots group, to implement healthy eating promotions, community events, weight loss challenges, and the year?round "walk challenge". - support new richmond community's safe youth campaign, which demonstrates the cause and effects of drunk driving. - continue facilitation of the local cancer support group, in collaboration with the cancer center of western wisconsin. - increase relationships with primary care clinics and primary care physicians, continuing its work of hospital - clinic integration. On october 1, 2013, new richmond clinic officially joined westfields hospital. The combination allows us to further develop one electronic medical record across the campus for improved health and easier access to services. Total 2013 community benefit contribution equaled $2,264,139, which represented 5.6% of the overall net revenue. This figure is reported at cost per the catholic health association (cha) community benefit reporting guidelines and in accordance with the wisconsin hospital association (wha) reporting requirements. Financial assistance and healthcare access for low-income individuals financial assistance is defined as the cost of care delivered to patients who are willing, but unable to pay for the services they receive. This includes patients whose charges are forgiven or reduced because of inability to pay, patients who are unable to pay the balance left by any payer, and patients for whom unusual circumstances or special financial hardship warrant special consideration. Westfields provided $239,527 in financial assistance to 84 low income and uninsured patients. Financial assistance represents about 0.75% of westfields total operating expenses. Care for medicaid patients westfields provides inpatient and outpatient care, including emergency department services, to medicaid patients. Payments received for these services are below the cost of care provided. Westfields expense to cover unreimbursed medicaid costs for 1,812 patients totaled $719,103. Subsidized health services westfields is committed to providing needed services even at a financial loss. In 2013, loss on services for outpatient health services including specialty clinic, oncology, physical therapy, durable medical equipment, respiratory therapy, and regional blood bank totaled $1,070,923. Community hea”

“Professional services: program service expenses 3,693,316. Management and general expenses 703,273. Fundraising expenses 0. Total expenses 4,396,589.”

“Fasb 124 - fair market valuation adjustment 466,409. Rounding 3.”