4A (Expenses $ 56924955 including grants of $ 68822) (Revenue $ 76265385)
"VERNON MEMORIAL HEALTHCARE (""VMH"") OPERATES A 25-BED CRITICAL ACCESS HOSPITAL LOCATED IN VIROQUA, WISCONSIN, FOUR PROVIDER-BASED RURAL HEALTH CLINICS (VIROQUA, LA FARGE, SOLDIERS GROVE, AND WESTBY), AND TWO RETAIL PHARMACY LOCATIONS. VMH MAINTAINS A CLEAR AND CONSISTENT COMMITMENT TO ITS CHARITABLE PURPOSE THROUGH THE PROVISION OF HEALTH AND WELLNESS SERVICES TO THE COMMUNITIES SERVED WITHOUT REGARD TO AGE, RACE, GENDER, CREED, NATIONAL ORIGINAL, ABILITY TO PAY, AND PHYSICAL OR MENTAL HANDICAP. VMH'S DEDICATED WORKFORCE EXEMPLIFY SERVICE IN ALIGNMENT WITH ORGANIZATIONAL VALUE STATEMENTS: GREAT EXPERIENCES. RESPECTING EVERYONE. EXCELLENCE IN EVERYTHING WE DO. ALWAYS A HELPFUL ATTITUDE. TAKING CARE OF ONE ANOTHER.IN RESPONSE TO THE NEEDS OF THE COMMUNITIES SERVED, VMH IS PROUD TO PROVIDE HIGH QUALITY INPATIENT ACUTE CARE FOR MEDICAL, SURGICAL, OBSTETRICAL, AND NEWBORN SERVICE NEEDS. VMH FURTHER SUPPORTS THE NEEDS OF ITS PATIENTS BY OFFERING ACCESS TO SWING BED (SKILLED) NURSING CARE. WITH A CONSTANT FOCUS ON QUALITY AND PATIENT SAFETY, VMH OFFERS OUTPATIENT AND ANCILLARY HEALTHCARE SERVICES INCLUDING 24-HOUR EMERGENCY SERVICES, SURGICAL SERVICES, LABORATORY, X-RAY, ULTRASOUND, CT SCANS, MRI, MAMMOGRAPHY, CARDIAC REHABILITATION, INFUSION AND GASTROINTESTINAL SERVICES, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, AND NUTRITIONAL THERAPY INCLUDING DIABETIC EDUCATION. PATIENTS SERVED BY THE HOSPITAL IN FISCAL 2023 INCLUDED 2,127 ADULT AND PEDIATRIC INPATIENT DAYS AND 117 NEWBORN DELIVERIES. THERE WAS A TOTAL OF 1,979 SURGERY CASES (INPATIENT AND OUTPATIENT COMBINED) AND THERE WERE 96,617 TOTAL OUTPATIENT VISITS. THE VMH EMERGENCY ROOM PROVIDED IMMEDIATE ACCESS TO CARE IN RESPONSE TO 8,164 EMERGENCY ROOM VISITS.AS A PART OF VMH'S MISSION, AND IN KEEPING WITH ITS STATUS AS A NOT-FOR-PROFIT HEALTHCARE ORGANIZATION, VMH HAS ESTABLISHED A PATIENT FINANCIAL ASSISTANCE POLICY THAT SETS FORWARD THE CRITERIA BY WHICH A PATIENT MAY QUALIFY TO RECEIVE CARE AT AMOUNTS LESS THAN THE ESTABLISHED RATES; TO RECEIVE CHARITY CARE. VMH MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE PROVIDED, THE TOTAL HEALTHCARE SERVICES PROVIDED TO PATIENTS UNDER THIS POLICY ARE MEASURED IN BOTH TOTAL CHARGES AND AT THE ESTIMATED COST OF PROVIDING CARE TO PATIENTS WITH BOTH FIGURES REPORTED AND AVAILABLE BY REFERRING TO SCHEDULE H. IN ADDITION, VMH IS A PROVIDER UNDER THE WISCONSIN MEDICAID PROGRAM. UNDER THE PROGRAM, VMH IS LEGALLY BOUND TO ACCEPT THE AMOUNT DETERMINED BY THE STATE OF WISCONSIN AS PAYMENT IN FULL FOR EACH PATIENT'S CHARGES EVEN THOUGH REIMBURSEMENT IS LESS THAN THE COST TO PROVIDE THE CARE, THEREFORE, SERVICE TO PATIENTS UNDER THIS PROGRAM SHOULD ALSO BE CONSIDERED PART OF THE ORGANIZATION'S BENEFIT PROVIDED TO THE COMMUNITY. (FOR ADDITIONAL INFORMATION ON VMH'S CHARITY CARE AND/OR THE COST OF PARTICIPATION IN THE WISCONSIN MEDICAID PROGRAM, PLEASE REFER TO SCHEDULE H OF THE FORM 990.) IN ADDITION, VMH ENGAGES IN A VARIETY OF COMMUNITY BENEFIT ACTIVITIES, PROVIDING A CRITICALLY IMPORTANT COMMUNITY BENEFIT THAT WOULD NOT OTHERWISE BE AVAILABLE IN THE COMMUNITIES SERVED WITHOUT THE EFFORTS AND SPECIALIZED KNOWLEDGE OF THE LOCAL HEALTHCARE TEAM."

4B (Expenses $ 12966621 including grants of $ 0) (Revenue $ 9510896)
VERNON MEMORIAL HEALTHCARE, INC. OPERATES FOUR RURAL HEALTH CLINICS LOCATED IN VIROQUA, LAFARGE, SOLDIERS GROVE, AND WESTBY. TOGETHER, THESE CLINICS STRIVE TO MEET THE HEALTHCARE NEEDS OF PATIENTS AND FAMILIES WHO LIVE AND WORK IN THE COMMUNITIES THEY SERVE. A TOTAL OF 36,006 RURAL HEALTH CLINIC VISITS OCCURRED IN FISCAL YEAR 2023. THE CLINICS ARE DESIGNATED AS RURAL HEALTH CLINICS BY THE MEDICARE AND MEDICAID PROGRAMS AND, BY DEFINITION OF THE REQUIREMENTS FOR THAT DESIGNATION, ARE LOCATED IN RURAL OR UNDERSERVED AREAS OF THE COUNTRY. THESE CLINICS PROVIDE CARE TO A LARGE PORTION OF MEDICARE AND MEDICAID BENEFICIARIES WHO, WITHOUT ACCESS TO CARE LOCALLY, WOULD BE REQUIRED TO TRAVEL FARTHER DISTANCES FOR QUALITY HEALTHCARE.

VERNON MEMORIAL HEALTHCARE, INC.
PART V, SECTION B, LINE 3J: 1. USE OF EPIC ELECTRONIC HEALTH RECORD'S POPULATION HEALTH MANAGEMENT MODULE FOR MONITORING PROCESSES. 2. DIABETIC EDUCATION PROGRAM OFFERS PATIENTS EDUCATION AND SUPPORT ON MANAGING DIABETES AND SUPPORTS OVERALL HEALTH. 3. CARE COORDINATION PROGRAM, WHICH OFFERS SOCIAL WORK SUPPORT TO ASSIST PATIENTS IN REACHING THEIR OPTIMAL HEALTH. 4. PARTNERSHIP WITH VERNON COUNTY PARTNERSHIP COUNCIL, WHICH EXISTS TO DEVELOP AND SUPPORT PROGRAMMING THAT ADDRESSES DRUG, ALCOHOL, AND TOBACCO CONCERNS. 5. VMH OFFERS MENTAL HEALTH SERVICES THROUGH THREE LICENSED CLINICAL SOCIAL WORKERS AND ONE PSYCHIATRIST, WHO ALSO OFFERS CHILD AND ADOLESCENT PSYCHIATRY. WE ARE CURRENTLY RECRUITING ADDITIONAL STAFF.

VERNON MEMORIAL HEALTHCARE, INC.
PART V, SECTION B, LINE 5: DATA WAS COLLECTED BY RANDOM HOUSEHOLD SURVEY TO 6,000 HOUSEHOLDS AND WAS STRATIFIED BY COUNTY TO ASSURE THAT EVERY JURISDICTION WOULD BE REPRESENTED. IN ADDITION, A SUPPLEMENTAL CONVENIENCE SURVEY WAS CONDUCTED TO GENERATE SURVEY RESPONSES FROM POPULATIONS THAT MAY HAVE BEEN UNDER-REPRESENTED IN THE RANDOM HOUSEHOLD SURVEY.

VERNON MEMORIAL HEALTHCARE, INC.
PART V, SECTION B, LINE 6A: THE COMPASS NOW 2021 PARTNERSHIP WAS CONDUCTED IN JOINT EFFORT WITH THE FOLLOWING OTHER HOSPITALS:1. GUNDERSEN HEALTH SYSTEM, LA CROSSE2. MAYO CLINIC HEALTH SYSTEM, LA CROSSE3. GUNDERSEN ST. JOSEPH'S HOSPITAL AND CLINICS, HILLSBORO4. GUNDERSEN TRI-COUNTY HOSPITAL AND CLINICS, WHITEHALL5. TOMAH HEALTH, TOMAH

VERNON MEMORIAL HEALTHCARE, INC.
PART V, SECTION B, LINE 6B: THE COMPASS NOW 2021 PARTNERSHIP WAS CONDUCTED IN JOINT EFFORT WITH THE FOLLOWING ORGANIZATIONS:1. GREAT RIVERS UNITED WAY2. TREMPEALEAU COUNTY HEALTH DEPARTMENT3. MONROE COUNTY HEALTH DEPARTMENT4. GUNDERSEN HEALTH SYSTEM, LA CROSSE, AS WELL AS GUNDERSEN ST. JOSEPH'S HOSPITAL AND CLINICS IN HILLSBORO AND GUNDERSEN TRI-COUNTY HOSPITAL AND CLINICS IN WHITEHALL5. VERNON COUNTY HEALTH DEPARTMENT6. APTIV, INC.7. LA CROSSE COUNTY HEALTH DEPARTMENT8. BUFFALO COUNTY HEALTH DEPARTMENT9. HOUSTON COUNTY HEALTH DEPARTMENT (MINNESOTA)10. COULEECAP11. MAYO CLINIC HEALTH SYSTEM IN BOTH LA CROSSE AND SPARTA 12. LA CROSSE COUNTY HUMAN SERVICES

VERNON MEMORIAL HEALTHCARE, INC.
PART V, SECTION B, LINE 7D: PART V, LINE 7A:HTTPS://WWW.GREATRIVERSUNITEDWAY.ORG/WP-CONTENT/UPLOADS/2021/06/2021-COMPASS-NOW-REPORT_FINAL-WEB.PDFPART V, LINE 7B:HTTPS://WWW.GREATRIVERSUNITEDWAY.ORG/OUR-WORK/COMMUNITY-NEEDS-ASSESSMENT/COMPASS-NOW-REPORT-2021/PART V, LINE 10A:HTTPS://WWW.GREATRIVERSUNITEDWAY.ORG/WP-CONTENT/UPLOADS/2021/06/2021-COMPASS-NOW-REPORT_FINAL-WEB.PDF

VERNON MEMORIAL HEALTHCARE, INC.
"PART V, SECTION B, LINE 11: THREE OF THE KEY ISSUES IDENTIFIED FOR VERNON COUNTY IN THE 2021 COMPASS NOW CHNA INCLUDE: 1. MENTAL HEALTH, 2. POVERTY/LIVABLE WAGES, 3. CHILDCARE. INCREASED ACCESS TO MENTAL HEALTHCARE SERVICES:ACCORDING TO THE 2021 COMMUNITY HEALTHCARE NEEDS ASSESSMENT, VERNON COUNTY FACES CHALLENGES IN ACCESSING HEALTHCARE SERVICES. SPECIFICALLY, 56% OF ADULTS AND 55% OF YOUTH IN THE COUNTY WHO REQUIRE TREATMENT ARE NOT RECEIVING IT. MOREOVER, 5% OF RESPONDENTS FROM THE RANDOM HOUSEHOLD SURVEY (RHS) AND 12% FROM THE CONVENIENCE SURVEY (CS) REPORTED INADEQUATE ACCESS TO MENTAL HEALTH CARE.TO ADDRESS THESE ISSUES, VMH IS EXPANDING ITS BEHAVIORAL HEALTH SERVICES AND SEEKING COLLABORATION WITH LOCAL ORGANIZATIONS TO ENHANCE PATIENT ACCESS WITHIN ITS SERVICE AREA. VMH HAS BOLSTERED ITS BEHAVIORAL HEALTH STAFF AND IS EXPLORING PARTNERSHIPS WITH NEIGHBORING HEALTHCARE PROVIDERS TO OPTIMIZE RESOURCE UTILIZATION AND PROMOTE AWARENESS OF AVAILABLE SERVICES.CURRENTLY, VMH IS WORKING IN CONJUNCTION WITH THE MEDICAL COLLEGE OF WISCONSIN, INC. TO DELIVER CONSULTATIVE CHILD AND ADOLESCENT PSYCHIATRY SERVICES THROUGH THE MCW'S CHILD PSYCHIATRY CONSULTATION PROGRAM.POVERTY/FINANCIAL STABILITYAS PER THE 2021 COMMUNITY HEALTHCARE NEEDS ASSESSMENT, INDICATORS OF POVERTY OR FINANCIAL STABILITY AMONG VERNON COUNTY RESIDENTS INCLUDE:- 11% OF SURVEY PARTICIPANTS FROM VERNON COUNTY REPORT BEING UNINSURED.- 46% OF SURVEY PARTICIPANTS FROM VERNON COUNTY REPORT AN ANNUAL HOUSEHOLD INCOME OF LESS THAN $50,000, WITH 23% REPORTING AN INCOME OF LESS THAN $25,000 PER YEAR.IN THE FISCAL YEAR 2023, VMH CONTINUES TO APPRISE PATIENTS OF AVAILABLE FINANCIAL ASSISTANCE AND CHARITY CARE OPTIONS WHEN THEY UTILIZE HEALTHCARE SERVICES AT VERNON MEMORIAL HEALTHCARE. INFORMATION REGARDING FINANCIAL AID IS DISSEMINATED AT PATIENT REGISTRATION DESKS, VERBALLY COMMUNICATED UPON CHECK-IN, DURING BILLING STATEMENT ISSUANCE, AND THROUGHOUT BILLING INTERACTIONS POST-TREATMENT. THIS INFORMATION IS ALSO ACCESSIBLE ON THE VERNON MEMORIAL HEALTHCARE WEBSITE. MOREOVER, VMH COLLABORATES WITH LOCAL ORGANIZATIONS TO EDUCATE PATIENTS ON AVAILABLE RESOURCES AND PROGRAMS FOR FINANCIAL AID, INCLUDING REFERRALS TO VERNON COUNTY FOR SERVICES SUCH AS HEATING AND FOOD ASSISTANCE, AS WELL AS COPAYMENT SUPPORT FOR MEDICARE PATIENTS.VMH IS COMMITTED TO ENHANCING PUBLIC AWARENESS OF COMMUNITY RESOURCES BENEFICIAL TO FINANCIALLY STRUGGLING FAMILIES, SUCH AS FOOD BANKS AND FREE VACCINE CLINICS. TO ACHIEVE THIS, VERNON MEMORIAL HEALTHCARE IS IMPLEMENTING THE FOLLOWING STRATEGIES FOR RESOURCE DISSEMINATION:- POSTING ON FACEBOOK- DISTRIBUTING PRINTED MATERIALS- PROVIDING WEBSITE LINKS- FACILITATING INTERACTION WITH SOCIAL WORKERSCHILDCAREACCORDING TO THE 2021 COMMUNITY HEALTHCARE NEEDS ASSESSMENT, 10% OF RANDOM HOUSEHOLD SURVEY (RHS) RESPONDENTS AND 22% OF CONVENIENCE SURVEY (CS) RESPONDENTS EXPRESS EITHER ""MODERATE OR ""HIGH"" LEVELS OF CONCERN REGARDING ACCESS TO CHILDCARE.VERNON MEMORIAL HEALTHCARE IS COMMITTED TO COLLABORATING WITH ECONOMIC, EDUCATIONAL, AND COMMUNITY LEADERS TO ADDRESS THE CHILDCARE NEEDS IN THE AREA AND PROVIDE SUPPORT. ADDITIONALLY, THROUGH PARTNERSHIPS WITH CHAMBERS OF COMMERCE, SCHOOL DISTRICTS, AND OTHER RELEVANT ORGANIZATIONS, VERNON MEMORIAL HEALTHCARE WILL ASSIST IN INITIATIVES AIMED AT INCREASING CHILDCARE OPTIONS LOCALLY.IN DECEMBER 2021, VMH SOLD ONE OF ITS COMMUNITY-BASED RESIDENTIAL FACILITY (CBRF) BUILDINGS TO THE VIROQUA SCHOOL DISTRICT AT A FINANCIAL LOSS. SUBSEQUENTLY, THE SCHOOL DISTRICT REFURBISHED THE FACILITY TO ACCOMMODATE CHILDCARE SERVICES, WHICH ARE NOW ACCESSIBLE TO CHILDREN AGED 6 WEEKS TO 11 YEARS OLD."

VERNON MEMORIAL HEALTHCARE, INC.
PART V, SECTION B, LINE 13B: PATIENTS' RELIANCE ON MEDICARE OR MEDICAL ASSISTANCE.

VERNON MEMORIAL HEALTHCARE, INC.
"PART V, SECTION B, LINE 13H: THE ORGANIZATION PROVIDES ""CATASTROPHIC CARE"" FOR PATIENTS NOT MEETING FINANCIAL ASSISTANCE ELIGIBILITY. THESE PATIENTS MAY BE ELIGIBLE FOR ASSISTANCE UNDER CIRCUMSTANCES WHEN MEDICAL BILLS WOULD RESULT IN SEVERE FINANCIAL HARDSHIP. PATIENTS, OR THEIR GUARANTORS, MAY BE ELIGIBLE FOR CATASTROPHIC CARE ASSISTANCE IF THEY INCURRED OUT-OF-POCKET OBLIGATIONS RESULTING FROM MEDICAL SERVICES PROVIDED BY VERNON MEMORIAL HEALTHCARE, INC. THAT EXCEED 25% OF THE ADJUSTED GROSS INCOME AND HAVE ASSETS BELOW THE EQUIVALENT OF 600% OF THE FPL THRESHOLD."

VERNON MEMORIAL HEALTHCARE, INC.
PART V, SECTION B, LINE 15E: LANGUAGE TAGLINES FOR ASSISTANCE

PART I, LINE 3C:
CATASTROPHIC CARE: PATIENTS NOT MEETING FINANCIAL ASSISTANCE ELIGIBILITY THRESHOLDS MAY BE ELIGIBLE FOR ASSISTANCE UNDER CIRCUMSTANCES WHEN MEDICAL BILLS WOULD RESULT IN SEVERE FINANCIAL HARDSHIP. PATIENTS, OR THEIR GUARANTORS, MAY BE ELIGIBLE FOR CATASTROPHIC CARE ASSISTANCE IF THEY INCURRED OUT-OF-POCKET OBLIGATIONS RESULTING FROM MEDICAL SERVICES PROVIDED BY VERNON MEMORIAL HEALTHCARE, INC. THAT EXCEED 25% OF THE ADJUSTED GROSS INCOME AND HAVE ASSETS BELOW THE EQUIVALENT OF 600% OF THE FPL THRESHOLD.

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 LESS THE PROVISION FOR BAD DEBTS DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER IRS COSTING METHODS FOR THE FORM 990.

PART I, LINE 7G:
THE HOSPITAL IS REPORTING THE ACTIVITY OF THEIR 4 RURAL CLINICS ON PART I, LINE 7G AS SUBSIDIZED HEALTH SERVICES. AMOUNTS PRESENTED ARE TOTALS LESS AMOUNTS ALREADY RECORDED AS CHARITY CARE, MEDICAID AND BAD DEBT IN OTHER SECTIONS OF SCHEDULE H.

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 $ 3,562,463.

PART II, COMMUNITY BUILDING ACTIVITIES:
OUR HOSPITAL PROVIDES CHARITY CARE AND OTHER COMMUNITY BENEFITS AS DEFINED BY THE IRS. BUT IN ADDITION, WE BELIEVE THAT WE PROVIDE A CRITICALLY IMPORTANT COMMUNITY BENEFIT WHICH IS NOT QUANTIFIED. OUR HOSPITAL, LIKE MOST RURAL HOSPITALS, WAS CREATED AND IS MAINTAINED IN ORDER TO PROVIDE LOCAL ACCESS TO MANY HEALTH SERVICES: BIRTHING CENTER, DIAGNOSTICS, EMERGENCY SERVICES AND URGENT CARE, HOME CARE, HOSPICE, INFUSION SERVICES, INPATIENT CARE, LABORATORY SERVICES, OCCUPATIONAL HEALTH, REHABILITATION SERVICES, SPECIALTY MEDICINE, SPEECH AND AUDIOLOGY, SURGICAL SERVICES, AND WOMEN'S HEALTH.

PART III, LINE 4:
ACCOUNTS RECEIVABLE AND CREDIT POLICY:IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE ORGANIZATION ANALYZES PAST RESULTS AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. SPECIFICALLY, FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE ORGANIZATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS AND PATIENTS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE ORGANIZATION RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.THE AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A SEPARATE FOOTNOTE REGARDING BAD DEBT EXPENSE.

PART III, LINE 8:
VERNON MEMORIAL HEALTHCARE, INC. IS DESIGNATED AS A CRITICAL ACCESS HOSPITAL AND AS SUCH A PORTION OF ITS REVENUES ARE PAID UNDER A COST REIMBURSEMENT SYSTEM. BASED ON THE INSTRUCTIONS, THE TOTAL MEDICARE REVENUE SHOWN ON THIS FORM 990 INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE THAT IS ACTUALLY RECEIVED BY THE HOSPITAL FROM THE MEDICARE PROGRAM. THE AMOUNTS LISTED FOR MEDICARE DO NOT INCLUDE PHYSICIAN AND MID-LEVEL PRACTITIONER SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT. PHYSICIAN COVERAGE IS REIMBURSED PRIMARILY ON A FEE SCHEDULE REIMBURSEMENT METHODOLOGY AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY 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 VERNON MEMORIAL HEALTHCARE, INC. PROVIDES TO THE COMMUNITY AND SURROUNDING AREA. THE COSTING METHOD USED ABOVE FOR IRS FORM 990 COMPLIANCE REPORTING IS ALSO BASED ON AN OVERALL AVERAGE COST-TO-CHARGE RATIO 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) DIVIDED BY TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBT EXPENSE. THIS RATIO IS THEN MULTIPLIED BY THE TOTAL MEDICARE SERVICES WHICH ARE REIMBURSED ON A COST METHODOLOGY EXCLUDING THE FEE SCHEDULE ITEMS LIKE PHYSICIAN AND MID-LEVEL PRACTITIONER SERVICES WHICH THE HOSPITAL WOULD SHOW A LARGE LOSS ON THESE SERVICES.WHETHER THERE IS A SHORTFALL OR SURPLUS FROM SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THE RECIPIENTS ARE TYPICALLY ELDERLY AND/OR DISABLED MEMBERS OF THE COMMUNITY AND 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 VI, LINE 4:
VERNON MEMORIAL HEALTHCARE DELIVERS MEDICAL SERVICES TO VIROQUA AND ITS NEIGHBORING REGIONS, ENCOMPASSING WESTBY, READSTOWN, SOLDIERS GROVE, CASHTON, AND LAFARGE. THE PRIMARY SERVICE AREA INCLUDES THESE MUNICIPALITIES AND THEIR ADJACENT RURAL LOCALES, CATERING TO A POPULATION OF APPROXIMATELY 28,000. EXTENDING TO DESOTO, FERRYVILLE, HILLSBORO, COON VALLEY, RICHLAND CENTER, GAYS MILLS, VIOLA, AND ONTARIO, THE SECONDARY SERVICE AREA WIDENS THE CATCHMENT TO ACCOMMODATE AN ADDITIONAL 25,000 INDIVIDUALS. CHARACTERIZED BY ITS RURAL LANDSCAPE, THE ENTIRE REGION EXHIBITS AN AGING DEMOGRAPHIC WITH RELATIVELY MODEST INCOME LEVELS.

PART VI, LINE 7, REPORTS FILED WITH STATES
WI

PART III, LINE 9B:
IN ORDER TO PROVIDE THE LEVEL OF AID NECESSARY TO THE GREATEST NUMBER OF PATIENTS IN NEED, AND PROTECT THE RESOURCES NEEDED TO DO SO, THE FOLLOWING GUIDELINES APPLY: 1) SERVICES ARE PROVIDED UNDER CHARITY CARE ONLY WHEN DEEMED MEDICALLY NECESSARY AND AFTER PATIENTS ARE FOUND TO HAVE MET ALL FINANCIAL CRITERIA BASED ON THE DISCLOSURE OF PROPER INFORMATION AND DOCUMENTATION. 2) CHARITY CARE IS NOT AVAILABLE FOR ELECTIVE PROCEDURES. 3) PATIENTS ARE EXPECTED TO CONTRIBUTE PAYMENT FOR CARE BASED ON THEIR INDIVIDUAL FINANCIAL SITUATION; THEREFORE, EACH CASE WILL BE REVIEWED SEPARATELY. 4) CHARITY CARE IS NOT CONSIDERED AN ALTERNATIVE OPTION FOR PAYMENT AND PATIENTS MAY BE ASSISTED IN FINDING OTHER MEANS OF PAYMENT OR FINANCIAL ASSISTANCE BEFORE APPROVAL FOR CHARITY CARE. 5) UNINSURED PATIENTS WHO ARE BELIEVED TO HAVE THE FINANCIAL ABILITY TO PURCHASE HEALTH INSURANCE MAY BE ENCOURAGED TO DO SO IN ORDER TO ENSURE HEALTHCARE ACCESSIBILITY AND OVERALL WELL-BEING.

PART VI, LINE 2:
VERNON MEMORIAL HEALTHCARE UTILIZES A RANGE OF STRATEGIES TO GATHER AND ASSESS DATA PERTAINING TO THE NEEDS OF THE COMMUNITIES IT SERVES. IN ADDITION TO THE FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) CONDUCTED IN COLLABORATION WITH NEIGHBORING HEALTHCARE FACILITIES, THE GREAT RIVERS UNITED WAY, AND COUNTY HEALTH DEPARTMENTS, THE ORGANIZATION EMPLOYS INFORMAL METHODS SUCH AS FOCUS AND ADVISORY GROUPS, CONSULTATIONS WITH LOCAL EMPLOYERS, AND ONLINE SURVEYS. MOREOVER, ACTIVE PARTICIPATION IN LOCAL AND STATE BOARDS AND COMMITTEES ALLOWS THE ORGANIZATION TO STAY ABREAST OF COMMUNITY NEEDS. COLLABORATION WITH VARIOUS COMMUNITY ENTITIES INCLUDING ORGANIZATIONS, CHURCHES, BUSINESSES, AGENCIES, AND SCHOOLS IS ANOTHER AVENUE FOR GAUGING COMMUNITY NEEDS. THE ORGANIZATION'S BOARD MEMBERS, REPRESENTING DIVERSE AREAS SERVED, REGULARLY ENGAGE WITH COMMUNITY MEMBERS TO SOLICIT FEEDBACK ON THE ORGANIZATION'S SERVICES AND ADDRESS COMMUNITY CONCERNS. SOCIAL MEDIA ANALYTICS AND ONLINE TRENDS ARE ALSO ANALYZED TO GLEAN FURTHER INSIGHTS INTO COMMUNITY NEEDS. FINALLY, PATIENT SURVEYS ARE DISTRIBUTED POST-VISIT TO GATHER INPUT ON THE QUALITY OF CARE PROVIDED.

PART VI, LINE 3:
VERNON MEMORIAL HEALTHCARE EMPLOYS VARIOUS STRATEGIES TO GATHER AND ASSESS DATA REGARDING THE REQUIREMENTS OF THE COMMUNITIES IT SERVES. IN ADDITION TO CONDUCTING A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN COLLABORATION WITH NEIGHBORING HEALTHCARE FACILITIES, THE GREAT RIVERS UNITED WAY, AND COUNTY HEALTH DEPARTMENTS, THE ORGANIZATION UTILIZES INFORMAL APPROACHES SUCH AS FOCUS AND ADVISORY GROUPS, DISCUSSIONS WITH LOCAL EMPLOYERS, AND ONLINE SURVEYS. MOREOVER, IT REMAINS ENGAGED WITH COMMUNITY NEEDS BY PARTICIPATING IN LOCAL AND STATE BOARDS AND COMMITTEES. COLLABORATION WITH COMMUNITY ORGANIZATIONS, CHURCHES, BUSINESSES, AGENCIES, AND EDUCATIONAL INSTITUTIONS SERVES AS ANOTHER AVENUE FOR EVALUATING COMMUNITY NEEDS. THE ORGANIZATION'S BOARD MEMBERS, REPRESENTING DIVERSE AREAS SERVED, ACTIVELY ENGAGE WITH COMMUNITY MEMBERS TO COMPREHEND THEIR CONCERNS AND ACCESS THE ORGANIZATION'S SERVICES. ADDITIONALLY, INSIGHTS INTO COMMUNITY NEEDS ARE GLEANED THROUGH ANALYSIS OF SOCIAL MEDIA DATA AND ONLINE TRENDS. PATIENT FEEDBACK IS ALSO SOLICITED THROUGH POST-VISIT SURVEYS TO ASSESS THE QUALITY OF CARE RECEIVED.

PART VI, LINE 5:
VERNON MEMORIAL HEALTHCARE IS DEDICATED TO DELIVERING A WIDE ARRAY OF OUTPATIENT AND INPATIENT MEDICAL SERVICES TO THE COMMUNITIES IT SERVES, WITHOUT DISCRIMINATION BASED ON GENDER ORIENTATION, RACE, COLOR, CREED, RELIGION, AGE, DISABILITY, OR NATIONAL ORIGIN. THEIR COMMITMENT EXTENDS TO OPERATING A 24/7 EMERGENCY ROOM THAT PROVIDES CARE TO ALL, IRRESPECTIVE OF THEIR FINANCIAL MEANS. ADDITIONALLY, THEY OWN AND MANAGE FOUR RURAL HEALTH CLINICS LOCATED IN VIROQUA, WESTBY, SOLDIERS GROVE, AND LAFARGE, ALONG WITH FOUR RETAIL PHARMACIES IN VIROQUA, WESTBY, LAFARGE, AND SOLDIERS GROVE. COLLABORATING WITH LOCAL COMMUNITIES, CHURCHES, BUSINESSES, AND OTHER HEALTHCARE ENTITIES, VERNON MEMORIAL HEALTHCARE AIMS TO ENHANCE THE ACCESSIBILITY OF TOP-NOTCH HEALTHCARE SERVICES. THEY SUPPORT LOCAL COMMUNITIES BY OFFERING CONVENIENT PRIMARY CARE AND PHARMACY SERVICES. THE BOARD OF DIRECTORS, COMPOSED OF INDEPENDENT COMMUNITY MEMBERS FROM THE SERVED AREAS, OVERSEES THE ORGANIZATION. THE MEDICAL TEAM AT VERNON MEMORIAL HEALTHCARE COMPRISES SKILLED PHYSICIANS WHO COLLABORATE CLOSELY WITH THE HOSPITAL TO DELIVER HIGH-QUALITY CARE TO THE SURROUNDING COMMUNITIES. ALL PHYSICIANS AND AFFILIATED STAFF UNDERGO A THOROUGH CREDENTIALING AND ORIENTATION PROCESS. ANY EXCESS FUNDS FROM OPERATIONS ARE REINVESTED IN NEW FACILITIES AND EQUIPMENT OR USED TO EXPAND ESSENTIAL SERVICES TO MEET THE EVOLVING NEEDS OF THE COMMUNITY.