Westfields Hospital Foundation Inc.

“The foundation's 990 return has a comprehensive review process that is followed before it is presented to the governing body of the foundation. The review process includes a layered review by the tax department of group health plan, inc. (ghi), the management team of the foundation, ghi's internal legal department and the foundation'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 the foundation. Once that review process has been completed, it is the policy of the foundation to make available to the board of directors of the foundation a copy of the 990 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.”

“The foundation monitors potential conflicts of interest on the part of its board members and officers by maintaining a conflict of interest policy. Under the policy, all board members and officers annually are provided with a copy of the policy and 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 and general counsel.”

“The foundation has no employees. All officers, directors and key employees are paid by ghi, park nicollet health services, regions hospital or westfields hospital, related organizations which have an annual process to review the market comparability of the total compensation of the foundation's president and its other officers. Every three years, under the direction of the ghi 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, ghi's 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 w2 statements. 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 had 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.”

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

“All directors and officers of the foundation are employed and compensated by group health plan, inc. Or regions hospital. Reported average hours worked are based on their total compensation from all related organizations.”

“Organization and governance westfields hospital foundation, inc. (foundation) is a wisconsin non-stock corporation. The foundation is 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, inc. Along with group health plan, inc. (ghi), are the corporate members of westfields hospital, inc. (westfields hospital), a wisconsin state licensed 25-bed, level iv critical access hospital and a wisconsin non-profit organization exempt from federal income tax under irc 501(c)(3). Westfiedls hospital is the sole corporate member of the foundation. The foundation was incorporated in 1993 to operate for the benefit of westfields hospital. Westfields hospital is licensed by the state of wisconsin, department of health and human services to provide primary, acute and emergency medical care and numerous outpatient services. The hospital is also recognized by the centers for medicare and medicaid services as a critical access hospital. Westfields hospital works to improve the health of its patients and community by providing high quality health care which meets the needs of all people. The foundation supports this mission with its focus on raising funds to benefit westfields hospital. Contributions to the foundation are tax deductible. In 2013, the foundation held its fifth annual golf outing, and used funds from the event to fulfill the mission of the foundation, by purchasing surgical medical equipment for westfields hospital. The foundation also had its first sharing at work campaign in 2013. The campaign is designed for westfields hospital staff to pledge donations to pre-designated funds, which directly support westfields hospital. Westfields hospital has reserve powers respecting certain major actions of the foundation.”

“Fasb 124 - fair market valuation adjustment 159,655.”