Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2010
Open to Public Inspection
A For the calendar year, or tax year beginning 01-01-2010 and ending 12-31-2010
BCheck if applicable:
CName of organization
HUDSON HOSPITAL INC
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
405 STAGELINE ROAD
 
Room/suite
City or town, state or country, and ZIP + 4
HUDSON, WI54016
D Employer identification number

39-0804125
E Telephone number

G Gross receipts $ 48,298,328
F Name and address of principal officer:
MARIAN M FURLONG
405 STAGELINE ROAD
HUDSON,WI54016
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.HUDSONHOSPITAL.ORG
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1950
M State of legal domicile: WI
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: SEE SCHEDULE O - EXEMPT PURPOSE AND ACHIEVEMENTS
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 13
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 10
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 403
6 Total number of volunteers (estimate if necessary) .... 6 181
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 0
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 0 0
9 Program service revenue (Part VIII, line 2g) ......... 45,789,449 47,125,935
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 172,761 136,835
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 901,964 750,000
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 46,864,174 48,012,770
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 0 0
14 Benefits paid to or for members (Part IX, column (A), line 4) .... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 21,798,199 25,392,047
16a Professional fundraising fees (Part IX, column (A), line 11e).... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 22,165,440 19,920,540
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 43,963,639 45,312,587
19 Revenue less expenses. Subtract line 18 from line 12...... 2,900,535 2,700,183
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 59,989,870 63,839,334
21 Total liabilities (Part X, line 26)............ 29,811,610 30,724,453
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 30,178,260 33,114,881
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid Preparer's Use Only Preparer's
signatureBig Right Arrow 		Date
right pointing bullet image Preparer’s taxpayer identification number
(see instructions)
Firm’s name (or yours
if self-employed),
address, and ZIP + 4Big Right Arrow




 		EIN right pointing bullet image
Phone no. right pointing bullet image
May the IRS discuss this return with the preparer shown above? (see instructions) .........
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2010)
Form 990 (2010)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III . . . . . . . . . .
1
Briefly describe the organization’s mission: CARING FOR THE HEALTH OF OUR COMMUNITY.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the exempt purpose achievements for each of the organization’s three largest program services by expenses.
Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 40,337,774 including grants of $   ) (Revenue $ 47,763,037 )
SEE SCHEDULE O - EXEMPT PURPOSE AND ACHIEVEMENTS
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services. (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 40,337,774
Form 990 (2010)
Form 990 (2010)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? ........
2
 
No
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part IIClick to see attachment.........................
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete
Schedule D, Part IClick to see attachment.......................
6
Yes
 
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in term, permanent,or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
Yes
 
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, and program service activities outside the United States? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
Form 990 (2010)
Form 990 (2010)
Page 4
Part IV
Checklist of Required Schedules (continued)
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment
20a
Yes
 
b
Did the organization attach its audited financial statement to this return? Note: All Form 990 filers that operate one or more hospitals must attach audited financial statements. ..... Click to see attachment
20b
Yes
 
21
Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II..
21
 
No
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III.....
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
 
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
 
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I......
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II...........................
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? If “Yes,” complete Schedule L, Part III...............
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV .........................
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV...................
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV..
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35
Is any related organization a controlled entity within the meaning of section 512(b)(13)? .....
35
Yes
 
a
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2010)
Form 990 (2010)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V . . . . . . . . . .
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
74
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
403
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
No
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
No
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
No
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
No
Form 990 (2010)
Form 990 (2010)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI . . . . . . . . . .
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year ..............
1a
13
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
10
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? ..
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Does the organization have members or stockholders? ................
6
Yes
 
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
Yes
 
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Does the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? ....
10b
 
 
11a
Has the organization provided a copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Does the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...........................
12b
Yes
 
c
Does the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this is done ....................
12c
Yes
 
13
Does the organization have a written whistleblower policy? ...............
13
Yes
 
14
Does the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line a or b, describe the process in Schedule O. (See instructions.)
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If “Yes,” has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
WI
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you make these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization makes its governing documents, conflict of interest policy, and financial statements available to the public.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
SHEILA PROEHL - CHIEF FINANCIAL OFFICER
405 STAGELINE ROAD
HUDSON,WI54016
(715) 531-6013
Form 990 (2010)
Form 990 (2010)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII . . . . . . . . . .
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) JOHN CLYMER
DIRECTOR - VICE CHAIR
 1.00 X           130 0 0
(2) SUSAN GILBERT
DIRECTOR
 1.00 X           130 0 0
(3) BILL GOLD MD
DIRECTOR - CHAIR
 1.00 X           130 0 0
(4) DENNIS HARTUNG MD
DIRECTOR
 1.00 X           130 0 0
(5) KENNETH HEISER
DIRECTOR
 1.00 X           380 0 0
(6) RUTH MISENKO
DIRECTOR
 1.00 X           130 0 0
(7) MIKE SELLMAN
DIRECTOR
 1.00 X           130 0 0
(8) MARK STANNARD MD
DIRECTOR
 1.00 X           130 0 0
(9) GREG YOUNG MD
DIRECTOR
 1.00 X           130 0 0
(10) MARIAN M FURLONG
DIRECTOR & PRESIDENT
 50.00 X   X       130 276,342 51,337
(11) BURKE KEALEY MD
DIRECTOR
 45.00 X           130 385,356 82,429
(12) BROCK D NELSON
DIRECTOR
 55.00 X           130 548,780 161,919
(13) SCOTT A SCHNUCKLE
DIRECTOR
 50.00 X           130 374,523 96,799
(14) J GLASNAPP
DIRECTOR
 1.00 X           130 0 0
(15) DEBORAH BRISCH-CRAMER
VP - CHIEF NURSING OFFICER
 50.00     X       169,970 0 22,207
(16) STEVE MUELLERLEILE
VP - PLANNING & DEVELOPMENT
 40.00     X       205,929 0 13,179
(17) SHEILA PROEHL
VP - CHIEF FINANCIAL OFFICER
 50.00     X       0 201,847 34,717
Form 990 (2010)
Form 990 (2010)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) MICHELLE M SIMPSON
PHARMACIST
 40.00         X   119,817 0 13,467
(19) KATHRYN M ANDERSON
REGISTERED NURSE
 40.00         X   123,546 0 24,443
(20) DARLA R KLEMENTZ
MANAGER - PHARMACY
 40.00         X   122,359 0 13,403
(21) THOMAS J RICHARD
DIRECTOR - FINANCE & MATERIALS
 40.00         X   118,143 0 13,009
(22) KATHRYN A SMITH
REGISTERED NURSE
 40.00         X   119,290 0 22,950
















1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 981,124 1,786,848 549,859
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet16
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
REGIONS HOSPITAL
PO BOX 64059
ST PAUL,MN55164 		PHYSICIAN & ADMINISTRATIVE STAFFING 1,904,634
HEALTHPARTNERS
PO BOX 1450 NW3600
MINNEAPOLIS,MN554853600 		ADMINISTRATIVE & INFORMATION TECHNOLOGY 1,357,912
GROUP HEALTH INC
PO BOX 64059
ST PAUL,MN55164 		SPECIALTY PHYSICIAN SERVICES 1,050,384
WESTERN WISCONSIN ANESTHESIA ASSOCIATES
329 SOO LINE ROAD
HUDSON,WI54016 		ANESTHESIOLOGIST SERVICES 888,912
EFH COMPANY
2999W COUNTY RD 42 SUITE 206
BURNSVILLE,MN55306 		REMODELLING SERVICES 216,810
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet9
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		 
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet  
Program Service Revenue Business Code
2a PATIENT SERVICE 623,990 46,532,308 46,532,308    
b OTHER HEALTH CARE 623,990 227,136 227,136    
c DIETARY 722,210 160,578 160,578    
d GIFT SHOP 453,220 112,898     112,898
e PROGRAM SUPPORT GRANTS 623,990 93,015 93,015    
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 47,125,935
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 136,835     136,835
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties............MediumBullet        
(i) Real (ii) Personal
6a Gross Rents 1,035,558  
b Less: rental expenses 285,558  
c Rental income or (loss) 750,000  
d Net rental income or (loss).......MediumBullet 750,000 750,000    
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory    
b Less: cost or other basis and sales expenses    
c Gain or (loss)    
d Net gain or (loss)..........MediumBullet        
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a            
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ......MediumBullet  
12 Total revenue. See Instructions....MediumBullet 48,012,770 47,763,037 0 249,733
Form 990 (2010)
Form 990 (2010)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21    
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22    
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 411,285 384,140 27,145  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages 21,239,179 19,830,395 1,408,784  
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) ....        
9 Other employee benefits ....... 3,741,583 3,493,392 248,191  
10 Payroll taxes ...........        
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 16,320   16,320  
c Accounting ........... 48,343   48,343  
d Lobbying ...........        
e Professional fundraising. See Part IV, line 17..    
f Investment management fees ......        
g Other .......... 3,110,230 2,199,897 910,333  
12 Advertising and promotion .... 231,446   231,446  
13 Office expenses ....... 380,201 19,108 361,093  
14 Information technology ...... 213,020 31,535 181,485  
15 Royalties ..        
16 Occupancy ........... 965,771 965,771    
17 Travel ............ 39,191 2,974 36,217  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 2,450 65 2,385  
20 Interest ........... 1,342,163 1,226,026 116,137  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 2,911,290 2,655,000 256,290  
23 Insurance .............. 174,138   174,138  
24 Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a MEDICAL & OFFICE SUPPLY 7,222,819 7,028,338 194,481  
b BAD DEBT 1,481,522 1,481,522    
c EQUIPMENT & MAINTENANCE 1,345,849 850,137 495,712  
d OTHER EXPENSE 302,044 160,392 141,652  
e RECRUITMENT & TRAINING 133,743 9,082 124,661  
f All other expenses        
25 Total functional expenses. Add lines 1 through 24f 45,312,587 40,337,774 4,974,813 0
26 Joint costs. Check here MediumBullet if following
SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation 		       
Form 990 (2010)
Form 990 (2010)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing ..........   1  
2 Savings and temporary cash investments ....... 9,327,709 2 11,449,919
3 Pledges and grants receivable, net .........   3  
4 Accounts receivable, net ......... 5,686,101 4 8,054,963
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5  
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use .............. 864,440 8 954,620
9 Prepaid expenses and deferred charges ............ 1,075,003 9 207,454
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 53,431,279
b Less: accumulated depreciation. ..... 10b 19,435,161 34,521,531 10c 33,996,118
11 Investments—publicly traded securities ..........   11  
12 Investments—other securities. See Part IV, line 11 ......   12  
13 Investments—program-related. See Part IV, line 11 .. 1,385,860 13 1,777,223
14 Intangible assets .........   14  
15 Other assets. See Part IV, line 11 ........... 7,129,226 15 7,399,037
16 Total assets. Add lines 1 through 15 (must equal line 34)... 59,989,870 16 63,839,334
Liabilities 17 Accounts payable and accrued expenses . 5,154,400 17 6,220,318
18 Grants payable ..........   18  
19 Deferred revenue ..........   19  
20 Tax-exempt bond liabilities .......... 24,270,000 20 23,605,000
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities. Complete Part X of Schedule D..... 387,210 25 899,135
26 Total liabilities. Add lines 17 through 25..... 29,811,610 26 30,724,453
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 28,575,827 27 31,195,529
28 Temporarily restricted net assets ..... 1,520,743 28 1,837,662
29 Permanently restricted net assets ..... 81,690 29 81,690
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 30,178,260 33 33,114,881
34 Total liabilities and net assets/fund balances ..... 59,989,870 34 63,839,334
Form 990 (2010)
Form 990 (2010)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI . . . . . . . . . .
1
Total revenue (must equal Part VIII, column (A), line 12) . . .
1
48,012,770
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
45,312,587
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
2,700,183
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
30,178,260
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
236,438
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) . . . . . .
6
33,114,881
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII . . . . . . . . . .
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?..
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O............................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
Yes
 
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
Yes
 
Form 990 (2010)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
HUDSON HOSPITAL INC
 
Employer identification number

39-0804125
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(i)
Name of supported organization 		(ii)
EIN 		(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions)) 		(iv)
Is the organization in col. (i) listed in your governing document? 		(v)
Did you notify the organization in col. (i) of your support? 		(vi)
Is the organization in col. (i) organized in the U.S.? 		(vii)
Amount of support?
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3..            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public Support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public Support (Subtract line 7c from line 6.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)            
13 Total support (Add lines 9, 10c, 11 and 12.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.
SchCMd Bullet Attach to Form 990 or Form 990-EZ. SchCMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
If the organization answered “Yes,” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes,” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes,” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35a (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
HUDSON HOSPITAL INC
 
Employer identification number

39-0804125
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization's direct and indirect political campaign activities on behalf of or in opposition to candidates for public office in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c) except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt funtion activities ....................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2010

Schedule C (Form 990 or 990-EZ) 2010
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check
B Check
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
Organization's
Totals 		(b) Affiliated Group
Totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
  If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:    
  Not over $500,00020% of the amount on line 1e.    
  Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.    
  Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.    
  Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.    
  Over $17,000,000$1,000,000.    
       
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
  Calendar year (or fiscal year
beginning in) 		(a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) Total
             
2a Lobbying non-taxable amount          
             
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		         
             
c Total lobbying expenditures          
             
d Grassroots non-taxable amount          
             
e Grassroots ceiling amount
(150% of line 2d, column (e))		          
             
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2010


Schedule C (Form 990 or 990-EZ) 2010
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
(a)
Yes
No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
No
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? If "Yes," describe in Part IV ..........................
Yes
 
0
j
Total. lines 1c through 1i ...................................
0
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
 
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carryover lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) if BOTH Part III-A, lines 1 and 2 are answered “No” OR if Part III-A, line 3 is answered “Yes”.
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) non-deductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ...........................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; and Part ll-B, line 1i.
Also, complete this part for any additional information.
Identifier Return Reference Explanation
EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: HUDSON HOSPITAL, INC. PAYS FOR CERTAIN CORPORATE PROFESSIONAL ASSOCIATION MEMBERSHIPS. A PORTION OF SUCH MEMBERSHIP DUES POTENTIALLY COULD BE USED BY THE PROFESSIONAL ASSOCIATIONS FOR LOBBYING ACTIVITIES.
Schedule C (Form 990 or 990EZ) 2010

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
HUDSON HOSPITAL INC
 
Employer identification number

39-0804125
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year ....... 3  
2 Aggregate contributions to (during year) ... 490,213  
3 Aggregate grants from (during year) ... 173,294  
4 Aggregate value at end of year ....... 1,919,352  
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06 ........ 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance .... 81,690 81,690 81,690
b Contributions ........      
c Investment earnings or losses ...      
d Grants or scholarships .....      
e Other expenditures for facilities
and programs ........ 		     
f Administrative expenses ....      
g End of year balance ...... 81,690 81,690 81,690
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet  
b
Permanent endowment: SchDMd Bullet  
c
Term endowment: SchDMd Bullet  
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
Yes
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Investments—Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of investment (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   12,136,252 12,136,252
b Buildings ................   29,388,511 12,949,212 16,439,299
c Leasehold improvements ............        
d Equipment ................   11,162,329 6,040,861 5,121,468
e Other .................   744,187 445,088 299,099
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 33,996,118
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) UNAMORTIZED FINANCING COSTS 509,994
(2) NONCURRENT PLEDGES RECEIVABLE 353,640
(3) INVESTMENTS REQUIRED FOR CURRENT MATURITIES 984,721
(4) INVESTMENTS LIMITED AS TO USE 5,248,157
(5) OTHER RECEIVABLES 302,525




Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 7,399,037
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes  
CAPITAL LEASE OBLIGATIONS 2,780
THIRD-PARTY PAYOR SETTLEMENTS 896,355







Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 899,135
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1 48,012,770
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2 45,312,587
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3 2,700,183
4 Net unrealized gains (losses) on investments .......................... 4  
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8 236,438
9 Total adjustments (net). Add lines 4 - 8 ............................. 9 236,438
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10 2,936,621
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1 48,298,328
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d ..................... 2e 0
3 Subtract line 2e from line 1..................... 3 48,298,328
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV): ........... 4b -285,558
c Add lines 4a and 4b....................... 4c -285,558
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5 48,012,770
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1 45,598,145
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV): ............ 2d 285,558
e Add lines 2a through 2d...................... 2e 285,558
3 Subtract line 2e from line 1..................... 3 45,312,587
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV): ............ 4b  
c Add lines 4a and 4b....................... 4c 0
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5 45,312,587
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: PART V, LINE 4: HUDSON HOSPITAL, INC. HOLDS $81,690 OF PERMANENTLY RESTRICTED ASSETS RELATED TO HUDSON HOSPITAL, INC.'S BENEFICIAL INTEREST IN THE NET ASSETS OF HUDSON HOSPITAL FOUNDATION, INC., A RELATED ORGANIZATION OF HUDSON HOSPITAL, INC.
PART XI, LINE 8 - OTHER ADJUSTMENTS:   CONTRIBUTION OF LONG-LIVED ASSETS 30,073. INCREASE IN INTEREST IN NET ASSETS OF HUDSON HOSPITAL FOUNDATION 335,820. TRANSFER OF NET ASSETS TO HUDSON HOSPITAL FOUNDATION, INC. -129,455.
PART XII, LINE 4B - OTHER ADJUSTMENTS:   RENTAL PROPERTY EXPENSE -285,558.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:   RENTAL PROPERTY EXPENSE 285,558.
Schedule D (Form 990) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
HUDSON HOSPITAL INC
 
Employer identification number

39-0804125
Part I
Charity Care and Certain Other Community Benefits at Cost
Yes
No
1a
Does the organization have a charity care policy? If "No," skip to question 6a...........
1a
Yes
 
b
If "Yes," is it a written policy? .......................
1b
Yes
 
2
If the organization has multiple hospitals, indicate which of the following best describes application of the charity care policy to the various hospitals.
3
Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients.
a
Does the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care to low
income individuals? If "Yes," indicate which of the following is the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Does the organization use FPG to determine eligibility for providing discounted care to low income individuals? If
"Yes," indicate which of the following is the family income limit for eligibility for discounted care: .....
3b
Yes
 
c
If the organization does not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization uses an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.
4
Does the organization's policy provide free or discounted care to the "medically indigent"? ......
4
Yes
 
5a
Does the organization budget amounts for free or discounted care provided under its charity care policy? ...
5a
Yes
 
b
If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discounted
care to a patient who was eligibile for free or discounted care?...............
5c
 
 
6a
Does the organization prepare an annual community benefit report?.............
6a
Yes
 
6b
If "Yes," does the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Charity Care and Certain Other Community Benefits at Cost
Charity Care and
Means-Tested Government Programs		 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Charity care at cost (from
Worksheets 1 and 2) .. 		  166 278,373   278,373 0.610 %
b Unreimbursed Medicaid (from
Worksheet 3, column a) . 		  2,294 1,538,735   1,538,735 3.370 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....            
dTotal Charity Care and
Means-Tested Government Programs ..... 		  2,460 1,817,108   1,817,108 3.980 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) .... 		  81,942 605,443 27,471 577,972 1.270 %
f Health professions education
(from Worksheet 5) .. 		  122 112,125   112,125 0.250 %
g Subsidized health services
(from Worksheet 6) .. 		  11,134 1,088,217   1,088,217 2.380 %
h Research (from Worksheet 7)            
i Cash and in-kind contributions
to community groups
(from Worksheet 8) .. 		    38,517   38,517 0.080 %
jTotal Other Benefits ...   93,198 1,844,302 27,471 1,816,831 3.980 %
kTotal. Add lines 7d and 7j. ..   95,658 3,661,410 27,471 3,633,939 7.960 %
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 2
Part II
Community Building Activities Complete this table if the organization conducted any community building activities.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development     7,613   7,613 0.020 %
3 Community support     7,613   7,613 0.020 %
4 Environmental improvements   24 3,405   3,405 0 %
5 Leadership development and training for community members   14 1,078   1,078 0 %
6 Coalition building   400 80,948   80,948 0.180 %
7 Community health improvement advocacy   250 7,227   7,227 0.020 %
8 Workforce development   245 2,156   2,156 0 %
9 Other            
10 Total   933 110,040   110,040 0.240 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Does the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense (at cost).....
2
860,764
3
Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy ..
3
150,000
4
Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
9,210,969
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
9,128,909
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
82,060
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.
Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.
Check the box that describes the method used:
Section C. Collection Practices
9a
Does the organization have a written debt collection policy? ...............
9a
Yes
 
b
If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance? Describe in Part VI......
9b
Yes
 
Part IV
Management Companies and Joint Ventures
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership% 		(e) Physicians'
profit % or stock
ownership %
11 ST CROIX VALLEY SHARED SERVICES
  		HOME HEALTH AND HOSPICE CARE 25.000 % 0 % 0 %
22 WESTERN WISCONSIN CANCER CENTER
  		MEDICAL ONCOLOGY AND RADIATION 23.700 % 0 % 0 %
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 3
Part VFacility Information
Section A. Hospital Facilities
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many hospital facilities did the organization operate during the tax year?1
Name and address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe)
1 HUDSON HOSPITAL INC
405 STAGELINE ROAD
HUDSON,WI54016 		X X     X   X    
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
Name of Hospital Facility:HUDSON HOSPITAL INC
Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1 Yes  
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet those needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20 09
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3 Yes  
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4 Yes  
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5 Yes  
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Development of a community benefit plan for the facility
d Participation in community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the CHNA
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs. 7   No
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8 Yes  
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?.. 9 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for free care: 200.000000000000%
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 5
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care to low income individuals?......... 10 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 300.000000000000%
11 Explained the basis for calculating amounts charged to patients?................. 11 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12 Yes  
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted at all times on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........ 14 Yes  
15 Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments or arrests
e Other (describe in Part VI)
16 Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?................................... 16 Yes  
If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other (describe in Part VI)
17 Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
e Other (describe in Part VI)
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 6
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18 Yes  
If “No,” indicate the reasons why (check all that apply):
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility did not have a policy relating to emergency medical care
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Charges for Medical Care
19 Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
a The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
b The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
c The hospital facility used the Medicare rate for those services
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20   No
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?................................... 21   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 7
Part VFacility Information (continued)

Section C. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many non-hospital facilities did the organization operate during the tax year?  
Name and address Type of Facility (Describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 8
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the description required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 2, 4c, 6i, 7, 11i, 13i, 17l, 18l, 19e, 21d, 25, and 26.
2 Community health needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any community health needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Identifier ReturnReference Explanation
    PART I, LINE 7: THE COSTING METHODOLOGY UTILIZES CMS MEDICARE COST REPORT METHODOLOGY. BAD DEBT IS CALCULATED USING COST CHARGE RATIO FOUND IN THE MEDICARE COST REPORT.
    PART I, LINE 7G: HUDSON HOSPITAL, INC. (HOSPITAL) IS COMMITTED TO PROVIDING NEEDED SERVICES EVEN AT A FINANCIAL LOSS. IN 2010, LOSS ON SERVICES FOR HOSPITAL OUTPATIENT SERVICES INCLUDING RESPIRATORY THERAPY, PHYSICAL THERAPY, ONCOLOGY, EMERGENCY ROOM, OBSERVATION AND PROGRAMS FOR CHANGE TOTALED $1,088,217.
    PART II: THE HOSPITAL IS AN ENERGETIC MEMBER OF THE LOCAL, STATE AND REGIONAL COMMUNITIES. AS THE HOSPITAL SUPPORTS INDIVIDUALS, ORGANIZATIONS, EVENTS AND PROGRAMS, IT LIVES OUT ITS COMMITMENT TO IMPROVE THE HEALTH OF THE COMMUNITY. KNOWING MUCH MORE CAN BE ACCOMPLISHED TOGETHER, THE HOSPITAL'S COMMUNITY BENEFIT PROGRAM BUILT VALUABLE CONNECTIONS WITH INDIVIDUALS AND ORGANIZATIONS FROM PUBLIC, PRIVATE AND NONPROFIT SECTORS TO SHARE SKILLS AND ASSETS. THE HOSPITAL PARTICIPATED IN COMMUNITY-BUILDING ACTIVITIES THAT SUPPORTED ECONOMIC DEVELOPMENT, EMERGENCY PREPAREDNESS, LEADERSHIP DEVELOPMENT, COALITION BUILDING, HEALTH IMPROVEMENT ADVOCACY, AND WORKFORCE DEVELOPMENT INCLUDING THE TOBACCO COALITION, HEALTHWATCH OF ST. CROIX COUNTY, WISCONSIN YOUTH APPRENTICESHIP PROGRAM, WEST CENTRAL REGIONAL TRAUMA ADVISORY COUNCIL (RTAC), THE HEALING ARTS PROGRAM, ST. CROIX VALLEY FOUNDATION PARTNERS FOR THE FUTURE, SOMERSET MIDDLE SCHOOL CAREER ACADEMIC AND PERSONAL AND SOCIAL SKILLS (CAPS) CLASS, AND LEADERSHIP HUDSON.TO HELP LOCAL BUSINESSES AND ORGANIZATIONS BETTER UNDERSTAND THE CHANGES IN THE HEALTH CARE MARKET AS A RESULT OF HEALTH CARE REFORM, THE HOSPITAL AND WESTFIELDS HOSPITAL SPONSORED EXTREME MAKEOVER 2010: WESTERN WISCONSIN HEALTH CARE REFORM EVENT. OVER 225 COMMUNITY STAKEHOLDERS ATTENDED TO DISCUSS THE EMERGING IMPLICATIONS AND WHAT THEY MIGHT MEAN FOR THE COST AND QUALITY OF EMPLOYEE HEALTH CARE IN THE FUTURE; OPPORTUNITIES AND CHALLENGES; PRIORITY ISSUES; AND THE IMPACT ON HOSPITALS, BUSINESSES AND THE STATE. A GROUP OF INDUSTRY EXPERTS FROM MADISON, WI AND KEYNOTE PRESENTER, MARY BRAINERD, PRESIDENT AND CEO, HEALTHPARTNERS, INC. PROVIDED THEIR PERSPECTIVES.THE HOSPITAL CONTINUED ON ITS ECO-FRIENDLY JOURNEY USING SUSTAINABLE BUSINESS PRACTICES IN ORDER TO PROVIDE HEALTH CARE THAT'S HEALTHY. GREEN INITIATIVES INCLUDED THE RECYCLING PROGRAM, COMMUNITY SHARPS DISPOSAL SITE, CREATION OF THE COMMUNITY GARDEN - THE HOSPITAL IN SUPPORT OF HEALTHIER TOGETHER - ST. CROIX COUNTY (FORMERLY CHIP), AND THE COMMUNITY LABYRINTH. THE HOSPITAL ALSO PARTICIPATES IN COMMUNITY SUPPORTED AGRICULTURE (CSA) AND SERVES AS A DISTRIBUTION SITE FOR LOCALLY-GROWN FRESH, ORGANIC PRODUCE FOR THE COMMUNITY AND PARTICIPATING EMPLOYEES.
    PART III, LINE 4: "BAD DEBT" EXPENSE REPRESENTS THE UNPAID OBLIGATION FOR CARE PROVIDED TO PATIENTS WHO HAVE BEEN DETERMINED TO BE ABLE TO PAY, BUT HAVE NOT DEMONSTRATED A WILLINGNESS TO DO SO. BAD DEBT INCLUDES ANY UNPAID PATIENT RESPONSIBILITY THAT MAY INCLUDE, BUT IS NOT LIMITED TO, DEDUCTIBLES, CO-INSURANCE, CO-PAYMENTS AND NON-COVERED SERVICES.THE FOOTNOTE IN THE HOSPITAL'S FINANCIAL STATEMENTS READS AS FOLLOWS: "THE HOSPITAL PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED ON MANAGEMENT'S JUDGMENT. PATIENTS AND RESIDENTS ARE NOT REQUIRED TO PROVIDE COLLATERAL FOR SERVICES PROVIDED. PAYMENT FOR SERVICES IS REQUIRED WITHIN 30 DAYS OF RECEIPT OF INVOICE. PAST-DUE ACCOUNTS ARE INDIVIDUALLY ANALYZED FOR COLLECTABILITY AND THEN TURNED OVER TO COLLECTION AGENTS. ACCOUNTS FOR WHICH NO PAYMENTS HAVE BEEN RECEIVED ARE ANALYZED AND AFTER APPROVAL ARE WRITTEN OFF. IN ADDITION, AN ALLOWANCE IS ESTIMATED FOR OTHER ACCOUNTS BASED ON HISTORICAL EXPERIENCE OF THE HOSPITAL."THE HOSPITAL UTILIZES CMS MEDICARE COST REPORT METHODOLOGY TO DETERMINE BAD DEBT EXPENSE. BAD DEBT IS CALCULATED USING THE COST TO CHARGE RATIO FOUND IN THE MEDICARE COST REPORT.BAD DEBT EXPENSE IS CURRENTLY EXCLUDED FROM THE COMMUNITY BENEFIT CALCULATION PER WISCONSIN HOSPITAL ASSOCIATION (WHA).
    PART III, LINE 8: MEDICARE SURPLUS (SHORTFALL) IN LINE 7 REPRESENTS THE ADDITIONAL 1% OF ALLOWABLE COST THAT CRITICAL ACCESS HOSPITALS RECEIVE. MEDICARE SHORTFALL IS CURRENTLY EXCLUDED FROM THE COMMUNITY BENEFIT CALCULATION PER WHA, BUT CAN BE INCLUDED IN OTHER FINANCIAL REPORTS.THE HOSPITAL BASES ITS MEDICARE COSTING METHODOLOGY ON THE CMS MEDICARE COST REPORT METHODOLOGY; COST TO CHARGE RATIO.
    PART III, LINE 9B: THE HOSPITAL DEBT COLLECTION POLICY CONTAINS PROVISIONS ON COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO BE ELIGIBLE FOR CHARITY CARE OR FINANCIAL ASSISTANCE. THE HOSPITAL BELIEVES THAT DEBT COLLECTION POLICIES, WHETHER IMPLEMENTED BY HOSPITAL STAFF OR HOSPITAL'S AGENTS, SHOULD REFLECT THE HOSPITAL'S MISSION AND VALUES. THE HOSPITAL WILL NOT TOLERATE ABUSIVE, HARASSING, OPPRESSIVE, FALSE, DECEPTIVE, OR MISLEADING LANGUAGE OR COLLECTIONS CONDUCT BY ITS DEBT COLLECTION, ATTORNEY AND AGENCY, AND THEIR AGENTS AND EMPLOYEES, AND HOSPITAL EMPLOYEES RESPONSIBLE FOR COLLECTING MEDICAL DEBT FROM PATIENTS. THE HOSPITAL WILL NOT REFER ANY ACCOUNT TO A THIRD PARTY DEBT COLLECTION AGENCY UNLESS IT HAS CONFIRMED THAT:- THERE IS REASONABLE BASIS TO BELIEVE THAT THE PATIENT OWES THE DEBT.- ALL KNOWN THIRD-PARTY PAYERS HAVE BEEN PROPERLY BILLED, AND THE PATIENT IS RESPONSIBLE FOR THE REMAINING DEBT.- IF THE PATIENT HAS INDICATED AN INABILITY TO PAY THE FULL AMOUNT, THE PATIENT HAS BEEN OFFERED A REASONABLE PAYMENT PLAN. THE HOSPITAL WILL NOT REFER PATIENTS TO DEBT COLLECTION AGENCIES WHO ARE PERFORMING AS SPECIFIED IN THEIR PAYMENT PLANS.- THE PATIENT HAS BEEN GIVEN AN OPPORTUNITY TO SUBMIT A (FINANCIAL ASSISTANCE) CHARITY CARE APPLICATION. IF THE PATIENT HAS SUBMITTED AN APPLICATION FOR CHARITY CARE, ALL COLLECTION ACTIVITY WILL BE SUSPENDED UNTIL THE APPLICATION HAS BEEN PROCESSED.- THE LEVEL OF AUTHORITY REQUIRED TO MAKE DECISIONS REGARDING AUTHORIZING LITIGATION, PAYMENT PLANS, AND CHARITY CARE IS: - BALANCES OVER $25,000 - CEO - BALANCES BETWEEN $10,000 AND $25,000 - CFO - BALANCES BETWEEN $1 AND $10,000 - DIRECTOR OF BUSINESS OPERATIONS
HUDSON HOSPITAL, INC.   PART V, SECTION B, LINE 3: IN 2009, UNDER THE GUIDANCE OF THE ST. CROIX COUNTY COMMUNITY HEALTH IMPROVEMENT PROCESS (CHIP) STEERING COMMITTEE, A FORMAL COMMUNITY NEEDS ASSESSMENT COMPRISED OF QUALITATIVE AND QUANTITATIVE RESEARCH METHODOLOGIES WAS CONDUCTED AND RESULTS REPORTED. THE REPORT USES THE STATE HEALTH PLAN, HEALTHIEST WISCONSIN 2010, AS ITS GUIDE FOR IMPROVEMENT.CHIP PARTNERS ENGAGED IN THREE DIFFERENT ACTIVITIES* TO INFORM DECISIONS ABOUT SETTING PRIORITIES FOR THE COUNTY'S 2009 TO 2014 PLAN:*PHOTOVOICE, AN INNOVATIVE RESEARCH METHOD DEVELOPED BY DR. CAROLINE WANG DURING THE LATE 1990'S WAS SELECTED AS THE QUALITATIVE RESEARCH COMPONENT OF CHIP BECAUSE IT FOCUSES ON SOCIAL ACTION AND DEVELOPING PARTNERSHIPS FOR CHANGE. THE RESEARCH WAS DONE IN PARTNERSHIP WITH WISCONSIN AREA HEALTH EDUCATION CENTERS (AHEC) AND APPROVED BY AND CONDUCTED IN ACCORDANCE WITH THE UNIVERSITY OF WISCONSIN-MADISON INSTITUTIONAL REVIEW BOARD. PHOTOVOICE PLACES CAMERAS IN THE HANDS OF LOCAL RESIDENTS TO ENABLE THEM TO DEPICT THEIR EVERYDAY LIVES THROUGH VISUAL IMAGE. PHOTOVOICE INTENTIONALLY SEEKS TO INCLUDE GROUPS WHO TYPICALLY DO NOT HAVE DIRECT ACCESS TO POLICY MAKERS. IN ST. CROIX COUNTY THREE GROUPS OF SIX WOMEN RAISING CHILDREN WERE RECRUITED: (1) MOTHERS WHO ARE CONCERNED ABOUT MATERNAL AND CHILD HEALTH ISSUES; (2) MOTHERS WHO ARE OF HISPANIC ETHNICITY AND DO NOT SPEAK ENGLISH; AND (3) MOTHERS WHO ARE CONCERNED ABOUT HEALTHY EATING AND ACTIVE LIVING FOR THEIR CHILDREN. CO-PRINCIPAL INVESTIGATOR FOR THE PROJECT, MAGGIE STEDMAN-SMITH, PHD, MPH, RN, COMPILED A FINAL REPORT, USING PHOTOVOICE TO HEAR THE VOICES OF MOTHERS RAISING CHILDREN IN ST. CROIX COUNTY, AND PRESENTED THAT REPORT TO THE HEALTH IMPROVEMENT STEERING COMMITTEE. THE PARTNERS ALSO DISPLAYED A PHOTOVOICE EXHIBIT AT THE PHIPPS CENTER FOR THE ARTS IN HUDSON AND AT OTHER PUBLIC VENUES. PHOTOVOICE RESEARCH PROVIDED IMAGES, OVER 100 PHOTOS, AND ACCOMPANYING OBSERVATIONS FROM THE GROUPS OF MOTHERS ABOUT THEIR HEALTH CARE CONCERNS.WHILE THE GROUPS OF MOTHERS DID NOT VOTE ON THE 11 HEALTH PRIORITIES OF HEALTHIEST WISCONSIN 2010, THEY DID, HOWEVER, ECHO MANY OF THE THEMES IDENTIFIED AS PART OF THOSE PRIORITIES. THE PHOTOVOICE FINAL REPORT SUMMARIZED THE THEMES MOST OFTEN HIGHLIGHTED BY THE THREE GROUPS OF MOTHERS:- ACCESS TO HEALTH CARE SERVICES- IMPROVED NUTRITION AND NUTRITION EDUCATION- ENVIRONMENTAL HEALTH AND SAFETY* CHIP SURVEY ("USE YOUR VOICE")THE ST. CROIX COUNTY PARTNERS DISTRIBUTED SURVEYS BY MAIL TO (5000) ST. CROIX COUNTY HOUSEHOLDS USING RANDOM RESIDENTIAL SORT. SURVEYS WERE MAILED TO A PREDETERMINED NUMBER OF HOUSEHOLDS IN EACH OF THE (12) ZIP CODES INCLUDED. AN EMAIL SURVEY WAS ALSO SENT TO 4,698 OPT-IN USERS IN CITIES SERVED BY AREA NEWSPAPERS (ONLINE SUBSCRIPTIONS). THE SURVEY ASKED RESPONDENTS TO 1) INDICATE THEIR LEVEL OF INTEREST IN EACH OF THE 11 HEALTH PRIORITIES IDENTIFIED BY THE WISCONSIN DEPARTMENT OF HEALTH SERVICES AND 2) RANK THEIR CHOICES FOR THE TOP 3 PRIORITIES. WHEN RANKING THEIR TOP CHOICES, THEY WERE TO ASSUME THAT THEY WERE IN CHARGE OF ALLOCATING RESOURCES TO MAKE CHANGES THAT WILL MAKE A DIFFERENCE IN PEOPLE'S LIVES; THAT THEY HAD LIMITED RESOURCES TO USE IN THIS EFFORT; AND THAT THEY WOULD NEED TO GATHER THE SUPPORT OF THE COMMUNITY IN ORDER TO GET THE WORK DONE. THE SURVEY ALSO GATHERED SOME BASIC DEMOGRAPHIC INFORMATION ABOUT THE 683 INDIVIDUALS WHO COMPLETED THE SURVEY AND ASKED ABOUT RESPONDENTS' OPINIONS ABOUT THE THEN UPCOMING LEGISLATION BANNING SMOKING AT CERTAIN ESTABLISHMENTS IN WISCONSIN. THE SURVEY PRODUCED THE VOTING RESULTS DISPLAYED ON PAGES 8, 9, AND 10 OF THE FULL REPORT. IN ADDITION TO THE PRIORITY RANKINGS, THE SURVEY RESPONDENTS ALSO OFFERED THEIR OPINIONS ABOUT SECONDHAND SMOKE AND ABOUT THE PROPOSED TOBACCO LEGISLATION-WHICH TOOK EFFECT IN JULY OF 2010. BY A WIDE MARGIN, RESPONDENTS FELT THAT SECONDHAND SMOKE IS A SERIOUS HEALTH HAZARD, AND NEARLY 75% OF THE RESPONDENTS SUPPORTED THE TOBACCO LEGISLATION. QUOTATIONS DRAWN FROM COMMENTS OFFERED BY SURVEY RESPONDENTS APPEAR THROUGHOUT THIS REPORT; IDENTIFIED BY THE "USE YOUR VOICE" TAGLINE.*STEERING COMMITTEE REVIEW OF QUANTITATIVE RESEARCHFOLLOWING A SERIES OF MEETINGS TO REVIEW AND DISCUSS DATA AND STATISTICS RELEVANT TO EACH OF THE 11 HEALTH PRIORITIES, THE CHIP STEERING COMMITTEE MET AT THE HOSPITAL ON MAY 28, 2009. AT THAT MEETING, THE GROUP CIRCULATED THE ROOM IN SMALL GROUPS TO DISCUSS DATA DISPLAYS ABOUT EACH HEALTH PRIORITY, AND THEN VOTED ON PRIORITIES ACCORDING TO THREE MEASURES:1. SIZE AND PREVALENCE OF THE ISSUE- HOW MANY PEOPLE DOES THIS AFFECT?- HOW DOES THE PREVALENCE OF THIS ISSUE IN ST. CROIX COUNTY COMPARE WITH ITS PREVALENCE IN OTHER COUNTIES, THE WESTERN REGION, AND THE STATE OF WISCONSIN?- HOW SERIOUS ARE THE CONSEQUENCES? (URGENCY; SEVERITY; ECONOMIC LOSS)2. EFFECTIVENESS OF INTERVENTIONS- HOW LIKELY IS IT THAT ACTIONS TAKEN WILL MAKE A DIFFERENCE?- HOW LIKELY IS IT THAT ACTIONS WILL IMPROVE QUALITY OF LIFE?- HOW LIKELY IS IT THAT PROGRESS CAN BE MADE IN BOTH THE SHORT TERM AND THE LONG TERM?- HOW LIKELY IS IT THAT THE COMMUNITY WILL EXPERIENCE REDUCTION OF LONG-TERM COST?3. COMMUNITY CAPACITY- ARE PEOPLE LIKELY TO SUPPORT ACTIONS AROUND THIS ISSUE? (READY)- WILL IT BE NECESSARY TO CHANGE BEHAVIORS AND ATTITUDES IN RELATION TO THIS ISSUE? (WILLING)- ARE THE NECESSARY RESOURCES AND LEADERSHIP AVAILABLE TO US NOW? (ABLE)OF THE 11 HEALTH PRIORITIES REPRESENTED WITHIN THE STATE HEALTH PLAN, ST. CROIX COUNTY IS FOCUSING ON THE TOP FIVE IDENTIFIED PRIORITIES: ACCESS TO PRIMARY AND PREVENTIVE HEALTH SERVICES; OVERWEIGHT, OBESITY AND LACK OF PHYSICAL ACTIVITY; ADEQUATE & APPROPRIATE NUTRITION; ALCOHOL AND OTHER SUBSTANCE USE AND ADDICTION; AND TOBACCO USE AND EXPOSURE FOR PLAN YEARS 2009-2014.
HUDSON HOSPITAL, INC.   PART V, SECTION B, LINE 4: NEEDS ASSESSMENT IN CONJUNCTION WITH OTHER HOSPITALSIN ADDITION TO THE HOSPITAL, WESTFIELDS HOSPITAL (NEW RICHMOND), BALDWIN AREA MEDICAL CENTER (BALDWIN), AND RIVER FALLS AREA HOSPITAL (RIVER FALLS) ALL HAD REPRESENTATION ON THE STEERING COMMITTEE AT THE TIME THE NEEDS ASSESSMENT WAS DONE. THEY ALL CONTINUE TO BE ACTIVE MEMBERS OF HEALTHIER TOGETHER - ST. CROIX COUNTY, AT VARIOUS LEVELS OF INVOLVEMENT.
HUDSON HOSPITAL, INC.   PART V, SECTION B, LINE 5C: NEEDS ASSESSMENT REPORT AVAILABILITYTHE 2009 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) RESULTS - BOTH EXECUTIVE SUMMARY AND FULL REPORT ARE PUBLICLY AVAILABLE ON THE HOSPITAL AND PUBLIC HEALTH WEB SITES AT WWW.HUDSONHOSPITAL.ORG/COMMUNITY AND WWW.CO.SAINT-CROIX.WI.US/PUBLICHEALTH; AVAILABLE IN PRINT FORM AND AVAILABLE UPON REQUEST. RESULTS WERE ALSO SHARED THROUGH A PRESS RELEASE TO LOCAL PAPERS; EBLAST TO KEY STAKEHOLDERS AND BUSINESS PARTNERS, AND AT A COMMUNITY FORUM HELD ON FEBRUARY 2010, AT WHICH 120 KEY STAKEHOLDERS FROM ACROSS THE COUNTY ATTENDED.
HUDSON HOSPITAL, INC.   PART V, SECTION B, LINE 7: UNADDRESSED IDENTIFIED NEEDSOF THE 11 HEALTH PRIORITIES REPRESENTED WITHIN THE STATE HEALTH PLAN, HEALTHIEST WISCONSIN 2010, ST. CROIX COUNTY WILL FOCUS ON THE TOP FIVE IDENTIFIED PRIORITIES FOR THE COUNTY: ACCESS TO PRIMARY AND PREVENTIVE HEALTH SERVICES; OVERWEIGHT, OBESITY AND LACK OF PHYSICAL ACTIVITY; ADEQUATE & APPROPRIATE NUTRITION; ALCOHOL AND OTHER SUBSTANCE USE AND ADDICTION; AND TOBACCO USE AND EXPOSURE FOR PLAN YEARS 2009-2014. OF THESE FIVE, HUDSON HOSPITAL & CLINICS LEADERSHIP (WITH HOSPITAL BOARD SUPPORT) COMMITTED TO VARIOUS LEVELS OF INVOLVEMENT FOR EACH (LEAD, COLLABORATE, PARTICIPATE, ADVOCATE):- ACCESS TO PRIMARY AND PREVENTIVE HEALTH SERVICES - LEAD/COLLABORATE- OVERWEIGHT, OBESITY, LACK OF PHYSICAL ACTIVITY - LEAD/COLLABORATE- ADEQUATE & APPROPRIATE NUTRITION - LEAD/COLLABORATE- ALCOHOL AND OTHER SUBSTANCE USE AND ADDICTION - COLLABORATE/PARTICIPATE/ADVOCATE- TOBACCO USE AND EXPOSURE - PARTICIPATE/ADVOCATEWHILE THE HOSPITAL HAS CLINICAL EXPERTISE IN ALL THE IDENTIFIED HEALTH PRIORITIES, IT CHOSE TO LEAD/COLLABORATE ON THOSE TOPICS WHERE IT HAS THE GREATEST AMOUNT OF RESOURCES (BOTH STAFF AND MATERIALS); CAN BEST UTILIZE ITS CONTENT EXPERTS, AND HAVE THE GREATEST IMPACT ON OVERALL HEALTH IMPROVEMENT. HOSPITAL STAFF MEMBERS SERVE AS TASK FORCE CHAMPIONS OR WORK GROUP LEADS ON ALL OF THE ABOVE PRIORITIES TO HELP ADVANCE THE PLAN.
HUDSON HOSPITAL, INC.   PART V, SECTION B, LINE 13G: THE HOSPITAL SERVES ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. IN 2010 ALONE, THE HOSPITAL PROVIDED $278,373 IN CHARITY CARE. THE HOSPITAL DEFINES CHARITY CARE 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. TO INFORM AND EDUCATE PATIENTS ON ITS FINANCIAL ASSISTANCE PROGRAM, CHARITY CARE POLICY, AND GOVERNMENT PROGRAMS, THE HOSPITAL HAS DEVELOPED AN EXTENSIVE FINANCIAL COUNSELING PROGRAM. WHEN A PATIENT VISITS THE HOSPITAL'S EMERGENCY DEPARTMENT OR IS ADMITTED TO THE HOSPITAL, BASIC INFORMATION ABOUT INSURANCE STATUS IS REQUESTED. IF A PATIENT DOES NOT HAVE HEALTH INSURANCE, PATIENT FINANCIAL SERVICES IS CONTACTED TO MEET OR FOLLOW-UP WITH THE PATIENT. ALL PATIENTS WITHOUT INSURANCE AUTOMATICALLY QUALIFY FOR A DISCOUNT OF 20%, REGARDLESS OF INCOME. IF THE PATIENT IS INTERESTED IN DETERMINING IF THEY ARE ELIGIBLE FOR FURTHER DISCOUNTS, THEY WILL BE REQUESTED TO PROVIDE ADDITIONAL INFORMATION. ENROLLMENT ASSISTANCE, INFORMATION, AND REFERRAL SERVICES ARE AVAILABLE TO HELP SECURE A PAYMENT SOURCE FOR UNINSURED AND UNDER INSURED PATIENTS. PATIENT FINANCIAL SERVICES, ADMINISTERED BY THE HOSPITAL'S BUSINESS OPERATIONS, EMPLOYS ONE PATIENT FINANCIAL SERVICES REPRESENTATIVE TO OVERSEE ITS FINANCIAL ASSISTANCE PROGRAM AND, ALONG WITH SUPPORT FROM DEPARTMENT STAFF, HELPS PATIENTS ENROLL IN GOVERNMENT PROGRAMS, FIND OTHER SOURCES OF PAYMENT, OR ACCESS SERVICES BEYOND MEDICAL CARE. IN 2010, THE HOSPITAL SPENT $4,185 IN STAFF TIME TO ASSIST 625 PATIENTS ENROLL IN PUBLIC MEDICAL PROGRAMS; $16,840 IN STAFF TIME TO GUIDE OR REFER 1710 PEOPLE TO COMMUNITY SERVICES/PUBLIC HEALTH ASSISTANCE; AND $67,146 IN STAFF TIME TO GUIDE OR REFER 4,869 PATIENTS TO FINANCIAL ASSISTANCE. FINANCIAL INFORMATION (PAYMENT, BILLING AND INSURANCE COVERAGE) AND FINANCIAL ASSISTANCE OPPORTUNITIES ARE NOTED ON THE HOSPITAL'S WEB SITE, ON ALL BILLING STATEMENTS, AND IN THE PATIENT INFORMATION GUIDE, DISTRIBUTED TO ALL NEW PATIENTS. IN ADDITION TO FINANCIAL COUNSELING, THE HOSPITAL HAS STAFF SOCIAL WORKERS AND CASE MANAGERS TO HANDLE CRISIS INTERVENTIONS, EMERGENCY ROOM NEEDS, AND PATIENT AFTERCARE.
    SCHEDULE H, PART I, LINE 6A - COMMUNITY BENEFIT REPORTAS A NOT-FOR-PROFIT HOSPITAL, THE HOSPITAL NEEDS TO BE ACCOUNTABLE FOR ITS TAX EXEMPTION STATUS - ACCOUNTABLE TO ITS BOARD, STAFF, PHYSICIANS, DONORS, KEY STAKEHOLDERS, COMMUNITY PARTNERS AND MOST OF ALL TO THE COMMUNITIES IT SERVES. THE 2010 REPORT TO COMMUNITY MICRO SITE (HUDSONHOSPITAL.ORG/COMMUNITYREPORT) PLUS PRINT REPORT COMMUNICATES THE ACCOMPLISHMENTS AND CHARITABLE WORKS OF THE HOSPITAL IN SUPPORT OF ITS MISSION - "CARING FOR THE HEALTH OF OUR COMMUNITY" AND THE HUDSON HOSPITAL FOUNDATION, INC.'S COMMITMENT AND SUPPORT IN THESE EFFORTS. THE REPORT TELLS THE HOSPITAL'S STORY IN A PERSONAL AND INTERACTIVE WAY. THE STORIES SHARED ARE IMPORTANT AND TOUCHING REMINDERS OF THE HOSPITAL'S AND HUDSON HOSPITAL FOUNDATION, INC.'S COMMITMENT TO MAKE A DIFFERENCE IN THE LIVES OF THOSE SERVED. THESE REAL-LIFE STORIES ARE POWERFUL WHEN TOLD BY THE PEOPLE WHOSE LIVES WERE SAVED, CHANGED, OR SIMPLY TOUCHED BY THE HOSPITAL AND HUDSON HOSPITAL FOUNDATION, INC. EFFORTS AND DEMONSTRATE COMMUNITY BENEFIT IN ACTION.
    SCHEDULE H, PART I, LINE 7F - HEALTH PROFESSIONS EDUCATIONTHE HOSPITAL'S STAFF PROVIDED CLINICAL TRAINING FOR 100 NURSES AND NURSING STUDENTS AND 22 HEALTH PROFESSIONALS INCLUDING EMS FROM SEVEN INSTITUTIONS AT A COST OF $112,125. IN ADDITION, THE HOSPITAL VOLUNTARILY PARTICIPATED IN THE WISCONSIN NURSE RESIDENCY PROGRAM (WNRP). THE PROGRAM IS A STRUCTURED LEARNING EXPERIENCE FOR NEWLY LICENSED REGISTERED NURSES DESIGNED TO PROMOTE EFFECTIVE TRANSITION INTO PROFESSIONAL PRACTICE. THREE NURSES, PAIRED WITH EXPERIENCED HOSPITAL NURSES ACTING AS COACH/SUPPORT PERSON, COMPLETED THE 12-MONTH PROGRAM. EACH YEAR, IN ADDITION, HUDSON HOSPITAL FOUNDATION, INC. PROVIDES (2) $2,000 SCHOLARSHIPS TO LOCAL HIGH SCHOOL SENIORS PURSUING HEALTH-RELATED EDUCATION AND CAREERS.
    PART VI, LINE 2: NEEDS ASSESSMENTTHE MISSION OF THE HOSPITAL IS CARING FOR THE HEALTH OF OUR COMMUNITY. TO BETTER UNDERSTAND AND ADDRESS THE NEEDS OF THOSE THE HOSPITAL SERVES, THE ORGANIZATION REMAINED COMMITTED TO ITS PARTNERSHIP WITH ST. CROIX COUNTY PUBLIC HEALTH AND THE COMMUNITY HEALTH IMPROVEMENT PROCESS. HEALTHIER TOGETHER - ST. CROIX COUNTY (FORMERLY CHIP), FACILITATED BY BOTH ORGANIZATIONS, IS A STRATEGIC, ONGOING, COMMUNITY-BASED APPROACH FOR CREATING AND MAINTAINING HEALTHY COMMUNITIES. A STEERING COMMITTEE OF 25+ MEMBERS REPRESENTING DIVERSE ORGANIZATIONS AND AGENCIES FROM ACROSS THE COUNTY PROVIDES OVERSIGHT AND GUIDANCE. TOGETHER, THE COMMITTEE REGULARLY ASSESSES THE STATE OF THE COUNTY'S HEALTH. HAVING COMPLETED THE COMMUNITY HEALTH NEEDS ASSESSMENT IN THE FALL OF 2009, ACTION AND EVALUATION PLANNING ENSUED IN 2010 AND A FORMAL COMMUNITY HEALTH IMPROVEMENT PLAN WAS COMPLETED AND RELEASED IN JUNE 2011. PLAN IMPLEMENTATION HAS BEGUN AND THE HOSPITAL REMAINS COMMITTED TO PLAN SUCCESS.
    PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE THE HOSPITAL SERVES ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. IN 2010 ALONE, THE HOSPITAL PROVIDED $278,373 IN CHARITY CARE. THE HOSPITAL DEFINES CHARITY CARE 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. TO INFORM AND EDUCATE PATIENTS ON ITS FINANCIAL ASSISTANCE PROGRAM, CHARITY CARE POLICY, AND GOVERNMENT PROGRAMS, THE HOSPITAL HAS DEVELOPED AN EXTENSIVE FINANCIAL COUNSELING PROGRAM. WHEN A PATIENT VISITS THE HOSPITAL'S EMERGENCY DEPARTMENT OR IS ADMITTED TO THE HOSPITAL, BASIC INFORMATION ABOUT INSURANCE STATUS IS REQUESTED. IF A PATIENT DOES NOT HAVE HEALTH INSURANCE, PATIENT FINANCIAL SERVICES IS CONTACTED TO MEET OR FOLLOW-UP WITH THE PATIENT. ALL PATIENTS WITHOUT INSURANCE AUTOMATICALLY QUALIFY FOR A DISCOUNT OF 20%, REGARDLESS OF INCOME. IF THE PATIENT IS INTERESTED IN DETERMINING IF THEY ARE ELIGIBLE FOR FURTHER DISCOUNTS, THEY WILL BE REQUESTED TO PROVIDE ADDITIONAL INFORMATION. ENROLLMENT ASSISTANCE, INFORMATION, AND REFERRAL SERVICES ARE AVAILABLE TO HELP SECURE A PAYMENT SOURCE FOR UNINSURED AND UNDER INSURED PATIENTS. PATIENT FINANCIAL SERVICES, ADMINISTERED BY THE HOSPITAL'S BUSINESS OPERATIONS, EMPLOYS ONE PATIENT FINANCIAL SERVICES REPRESENTATIVE TO OVERSEE ITS FINANCIAL ASSISTANCE PROGRAM AND, ALONG WITH SUPPORT FROM DEPARTMENT STAFF, HELPS PATIENTS ENROLL IN GOVERNMENT PROGRAMS, FIND OTHER SOURCES OF PAYMENT, OR ACCESS SERVICES BEYOND MEDICAL CARE. IN 2010, THE HOSPITAL SPENT $4,185 IN STAFF TIME TO ASSIST 625 PATIENTS ENROLL IN PUBLIC MEDICAL PROGRAMS; $16,840 IN STAFF TIME TO GUIDE OR REFER 1710 PEOPLE TO COMMUNITY SERVICES/PUBLIC HEALTH ASSISTANCE; AND $67,146 IN STAFF TIME TO GUIDE OR REFER 4,869 PATIENTS TO FINANCIAL ASSISTANCE. FINANCIAL INFORMATION (PAYMENT, BILLING AND INSURANCE COVERAGE) AND FINANCIAL ASSISTANCE OPPORTUNITIES ARE NOTED ON THE HOSPITAL'S WEB SITE, ON ALL BILLING STATEMENTS, AND IN THE PATIENT INFORMATION GUIDE, DISTRIBUTED TO ALL NEW PATIENTS. IN ADDITION TO FINANCIAL COUNSELING, THE HOSPITAL HAS STAFF SOCIAL WORKERS AND CASE MANAGERS TO HANDLE CRISIS INTERVENTIONS, EMERGENCY ROOM NEEDS, AND PATIENT AFTERCARE.
    PART VI, LINE 4: COMMUNITY INFORMATIONTHE HOSPITAL SERVES RESIDENTS FROM ST. CROIX AND PIERCE COUNTIES IN WESTERN WISCONSIN AND AREAS OF NEIGHBORING MINNESOTA. OUR PRIMARY SERVICE AREA IS HUDSON, WI 54016 (INCLUDES HUDSON, HUDSON TOWNSHIP, TROY, ST. JOSEPH'S AND NORTH HUDSON). OUR SECONDARY SERVICE AREA INCLUDES WI (BALDWIN, HAMMOND, HOULTON, NEW RICHMOND, PRESCOTT, RIVER FALLS, ROBERTS AND SOMERSET) AND MN (BAYPORT, LAKELAND, AND STILLWATER). 2010 CENSUS LISTS THE POPULATION OF ST. CROIX COUNTY AT 84,345, A 33.6% POPULATION GROWTH SINCE 2000. RAPID GROWTH CONTINUES WITHIN ST. CROIX COUNTY, MUCH IN PART DUE TO ITS CLOSE PROXIMITY TO THE TWIN CITIES (MINNEAPOLIS/ST. PAUL) WHERE MANY RESIDENTS COMMUTE TO WORK. ST. CROIX COUNTY'S POPULATION IS COMPRISED OF: 7.4% UNDER 5 YEARS OLD, 26% UNDER 18, 10% 65 YEARS AND OVER, AND 50% FEMALE. THE POPULATION IS 95.9% WHITE, 0.7% BLACK, 0.4% AMERICAN INDIAN, 1.0% ASIAN AND 2.0% HISPANIC OR LATINO. ST. CROIX COUNTY HAS A HIGH MEDIAN INCOME COMPARATIVELY WITHIN THE STATE - $69,682 AND A POVERTY RATE APPROXIMATELY HALF THAT OF THE REST OF THE STATE - 6.3%.ACCORDING TO THE 2011 COUNTY HEALTH RANKINGS REPORT, ST. CROIX COUNTY RANKED AS THE 2ND HEALTHIEST COUNTY OVERALL IN THE STATE (OUT OF 72).
    PART VI, LINE 6: PROMOTION OF COMMUNITY HEALTHTHE HOSPITAL IS GOVERNED BY A COMMUNITY-BASED BOARD OF DIRECTORS AND THE MEDICAL STAFF IS ORGANIZED IN THE PUBLIC'S INTEREST. THE HOSPITAL AIMS TO BE THE PREMIER PARTNER IN THE COMMUNITY'S QUEST FOR HEALTH AND HAPPINESS. WORKING IN PARTNERSHIP WITH EACH OTHER, THE HEALTHPARTNERS FAMILY OF RELATED HEALTHCARE ORGANIZATIONS, HUDSON PHYSICIANS - WWMA, AND THE COMMUNITY, THE HOSPITAL ACCOMPLISHED A GREAT DEAL IN 2010. ADVANCEMENTS WERE MADE TO ENSURE BETTER HEALTH FOR ALL, IMPROVED PATIENT EXPERIENCE AND AFFORDABLE HEALTH CARE. THE HOSPITAL CONTINUED TO GROW ITS REPUTATION FOR EXCELLENT CLINICAL OUTCOMES AND SERVICE. HIGHLIGHTS INCLUDE: - IMPLEMENTATION OF EPIC ELECTRONIC HEALTH RECORD (EHR) WHICH ADVANCED QUALITY AND EXPERIENCE FOR PATIENTS, CLINICIANS AND MEDICAL STAFF, AND CREATED A REGIONAL HEALTHPARTNERS NETWORK. THE HOSPITAL IS ONE OF THE FEW ITS SIZE NATIONALLY TO HAVE EPIC.- IMPLEMENTATION OF THE START SEEING YELLOW PROGRAM TO PREVENT INPATIENT FALLS.- IMPLEMENTATION OF SURGICAL CARE IMPROVEMENT PROJECT (SCIP) - NATIONAL PATIENT SAFETY INITIATIVE TO REDUCE PATIENT INFECTION RATES. THE HOSPITAL REPORTS SOME OF THE LOWEST SURGICAL INFECTION RATES IN THE REGION (1:201 PROCEDURES - U.S AVERAGE 1:57 PROCEDURES).- ADDITION OF MANY NEW HEALTH CARE PROVIDERS TO THE CAMPUS TEAM, INCLUDING SPECIALISTS IN INTERNAL MEDICINE, PEDIATRIC CARDIOLOGY, ENDOCRINOLOGY, MIDWIFERY, OPHTHALMOLOGY, SPORTS MEDICINE, NEPHROLOGY, FAMILY MEDICINE, THE HOSPITALIST PROGRAM AND OTHERS.- COLLABORATION WITH FIVE OTHER HOSPITALS AND TWO MEDICAL PROVIDER GROUPS TO CREATE THE CANCER CENTER OF WESTERN WISCONSIN (CCWW), LOCATED ON THE WESTFIELDS HOSPITAL CAMPUS, NEW RICHMOND. THE CENTER AND SYSTEM OF COORDINATED CANCER CARE WILL AFFORD PATIENTS REGIONAL ACCESS TO THE AREA'S ONLY RADIATION THERAPY CENTER. GROUNDBREAKING TOOK PLACE IN EARLY AUGUST. CENTER OPENING: MAY 2011. - RECORD-SETTING 532 BABIES WERE BORN IN THE BIRTH CENTER - MARKING THE HIGHEST NUMBER OF BIRTHS IN A SINGLE YEAR SINCE THE HOSPITAL'S FOUNDING IN 1953. BIRTH CENTER GROWTH: 11%.- ACCORDING TO PRESS GANEY SURVEY DATA (1800 HOSPITAL DATABASE), THE HOSPITAL'S BIRTH CENTER NURSING STAFF RANKS AMONG THE BEST IN THE NATION - 99TH PERCENTILE FOR FRIENDLINESS AND ATTITUDE (AMONG TOP 18 HOSPITALS NATIONWIDE).THE HOSPITAL'S DEVOTION TO THE HEALTH OF THE COMMUNITY STARTS WITH PROVIDING EXCEPTIONAL MEDICAL CARE TO EACH PATIENT AND EXTENDS TO FAMILIES AND ORGANIZATIONS THROUGHOUT THE REGION. THROUGH ITS COMMUNITY BENEFIT PROGRAM, WHICH IS INTEGRATED INTO THE ORGANIZATION PLAN, THE HOSPITAL OFFERED SPECIAL HELP AND SUPPORT - FOR INDIVIDUALS OR FAMILIES EXPERIENCING FINANCIAL HARDSHIP TO EFFORTS OR ORGANIZATIONS STRIVING TO IMPROVE THE QUALITY OF LIFE FOR ALL. THE HOSPITAL ENGAGED IN COMMUNITY PARTNERSHIPS WITH SCHOOLS, BUSINESSES, AGENCIES AND OTHER HEALTH PROVIDERS INVESTED IN COMMUNITY PROGRAMS AND SERVICES THAT POSITIVELY SUPPORT AND STRENGTHEN COMMUNITY HEALTH, EDUCATION, ECONOMIC DEVELOPMENT, AND CULTURE. THESE PROGRAMS AND PARTNERSHIPS EMBODY THE HOSPITAL'S MISSION OF "CARING FOR THE HEALTH OF OUR COMMUNITY." TOTAL 2010 COMMUNITY BENEFIT CONTRIBUTION EQUALED $3,743,979 WHICH REPRESENTS 7.8% OF NET REVENUE.
    PART VI, LINE 7: AFFILIATED HEALTH CARE SYSTEMPLEASE SEE SCHEDULE O: DISCUSSION OF EXEMPT PURPOSE AND ACHIEVEMENTS - "I. CORPORATE STRUCTURE, PURPOSE, GOVERNANCE."
REPORTS FILED WITH STATES PART VI, LINE 7 WI,MN
Schedule H (Form 990) 2010
Additional Data


Software ID:  
Software Version:  
Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
HUDSON HOSPITAL INC
 
Employer identification number

39-0804125
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....
1b
 
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
 
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
Yes
 
b
Any related organization? .........................
6b
Yes
 
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported in prior
Form 990 or
Form 990-EZ
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) MARIAN M FURLONG (i)
(ii)		 130
225,586 		0
50,756 		0
0 		0
0 		0
51,337 		130
327,679 		0
0
(2) BURKE KEALEY MD (i)
(ii)		 130
355,756 		0
29,600 		0
0 		0
0 		0
82,429 		130
467,785 		0
0
(3) BROCK D NELSON (i)
(ii)		 130
416,402 		0
131,527 		0
851 		0
83,323 		0
78,596 		130
710,699 		0
0
(4) SCOTT A SCHNUCKLE (i)
(ii)		 130
280,975 		0
82,672 		0
10,876 		0
25,565 		0
71,234 		130
471,322 		0
0
(5) DEBORAH BRISCH-CRAMER (i)
(ii)		 148,389
0 		21,443
0 		138
0 		0
0 		22,207
0 		192,177
0 		0
0
(6) STEVE MUELLERLEILE (i)
(ii)		 178,312
0 		27,221
0 		396
0 		0
0 		13,179
0 		219,108
0 		0
0
(7) SHEILA PROEHL (i)
(ii)		 0
178,226 		0
23,621 		0
0 		0
0 		0
34,717 		0
236,564 		0
0
(8) MICHELLE M SIMPSON (i)
(ii)		 119,263
0 		500
0 		54
0 		0
0 		13,467
0 		133,284
0 		0
0
(9) KATHRYN M ANDERSON (i)
(ii)		 122,840
0 		500
0 		206
0 		0
0 		24,443
0 		147,989
0 		0
0
(10) DARLA R KLEMENTZ (i)
(ii)		 116,442
0 		5,863
0 		54
0 		0
0 		13,403
0 		135,762
0 		0
0
(11) THOMAS J RICHARD (i)
(ii)		 110,206
0 		7,799
0 		138
0 		0
0 		13,009
0 		131,152
0 		0
0
(12) KATHRYN A SMITH (i)
(ii)		 118,473
0 		500
0 		317
0 		0
0 		22,950
0 		142,240
0 		0
0




Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
  PART I, LINE 4B DEFERRED COMPENSATION IN COLUMN C OF SCHEDULE J, PART II INCLUDES AMOUNTS FROM A NONQUALIFIED 457(F) PLAN FOR THE FOLLOWING DIRECTORS: BROCK D. NELSON $ 34,855 SCOTT A. SCHNUCKLE 8,955 -------- TOTAL $ 43,810
  PART I, LINE 6 HUDSON HOSPITAL, INC.'S (HOSPITAL) PRESIDENT AND CHIEF FINANCIAL OFFICER (CFO) ARE EMPLOYEES OF REGIONS HOSPITAL (REGIONS), A RELATED ORGANIZATION. THE HOSPITAL'S OTHER OFFICERS ARE EMPLOYEES OF THE HOSPITAL. BOTH REGIONS AND THE HOSPITAL HAVE MANAGEMENT INCENTIVE PROGRAMS WHICH INCENT AND REWARD BUSINESS LEADERS WHO HELP THE ORGANIZATION ACHIEVE STATED BUSINESS AND/OR HEALTH IMPROVEMENT GOALS FOR A SPECIFIC FISCAL YEAR. THE PROGRAM IS A KEY ELEMENT OF THE PARTICIPANT'S TOTAL COMPENSATION PACKAGE. THE MANAGEMENT INCENTIVE PROGRAM REWARDS ARE BASED ON POSITION IN THE ORGANIZATION (E.G. VICE PRESIDENT, DIRECTOR, MANAGER, OTHER SPECIFICALLY IDENTIFIED LEADERS) AND THE ACHIEVEMENT OF BUSINESS AND HEALTH IMPROVEMENT GOALS ESTABLISHED IN A VARIETY OF AREAS. GOALS WILL BE RELATED TO THE ORGANIZATION'S STRATEGIC PLAN AND WILL BE BALANCED. THESE AREAS MAY INCLUDE BUT ARE NOT LIMITED TO PATIENT SATISFACTION, EMPLOYEE SATISFACTION, WORK ENVIRONMENT, EMPLOYEE AND/OR LEADERSHIP DEVELOPMENT, CARE DELIVERY, PATIENT EDUCATION, SIX AIMS, MARKET SHARE, STRATEGIC CAPABILITIES, FINANCIAL PERFORMANCE (NET MARGIN), ETC., AND WILL BE DEFINED ANNUALLY FOR EACH YEAR'S PROGRAM. A NET MARGIN THRESHOLD MUST BE MET FOR ANY PAYMENT TO BE MADE FROM THE PROGRAM AND THERE IS A CAP ON THE MAXIMUM INCENTIVE POTENTIALLY AVAILABLE TO EACH PARTICIPANT.
Schedule J (Form 990) 2010

Additional Data


Software ID:  
Software Version:  
SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
HUDSON HOSPITAL INC
 
Employer identification number

39-0804125
Identifier Return Reference Explanation
EXEMPT PURPOSE AND ACHIEVEMENTS FORM 990, PART III, LINE 4A I. CORPORATE STRUCTURE, PURPOSE, GOVERNANCE HUDSON HOSPITAL, INC. (HOSPITAL), 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). THE HOSPITAL IS THE SOLE CORPORATE MEMBER OF HUDSON HOSPITAL FOUNDATION, INC., A FOUNDATION WHOSE PURPOSE IS TO SUPPORT THE HOSPITAL. GROUP HEALTH PLAN, INC. AND RH-WISCONSIN, INC. ARE CORPORATE MEMBERS OF THE HOSPITAL. THE HOSPITAL IS PART OF THE HEALTHPARTNERS FAMILY OF CARE. HEALTHPARTNERS, INC., A MINNESOTA NON-PROFIT CORPORATION AND LICENSED HEALTH MAINTENANCE ORGANIZATION (HMO) WHICH IS RECOGNIZED AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE (IRC) SECTION 501(C)(4), 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). HPI-RAMSEY IS THE SOLE CORPORATE MEMBER OF REGIONS HOSPITAL AND REGIONS HOSPITAL'S SISTER ORGANIZATIONS, REGIONS HOSPITAL FOUNDATION, CAPITAL VIEW TRANSITIONAL CARE CENTER (FORMERLY NORTH ST. PAUL TRANSITIONAL CARE CENTER), AND RAMSEY INTEGRATED HEALTH SERVICES, ALL OF WHICH ARE MINNESOTA NON-PROFIT CORPORATIONS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). HPI-RAMSEY IS ALSO THE SOLE CORPORATE MEMBER OF RH-WISCONSIN, INC., A WISCONSIN NON-STOCK CORPORATION THAT IS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). HEALTHPARTNERS, INC. IS ALSO THE SOLE CORPORATE MEMBER OF THE FOLLOWING ORGANIZATIONS THAT ARE EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C) (3): GROUP HEALTH PLAN, INC. (A STAFF MODEL HMO) WHICH IS ITSELF THE SOLE CORPORATE MEMBER OF HEALTHPARTNERS RESEARCH FOUNDATION, PHYSICIANS NECK & BACK CLINICS AND HEALTHPARTNERS CENTRAL MINNESOTA CLINICS, INC. (FORMERLY CENTRAL MINNESOTA GROUP HEALTH, INC.), ALL OF WHICH ARE EXEMPT UNDER SECTION 501(C) (3), HEALTHPARTNERS INSTITUTE FOR MEDICAL EDUCATION, AND RHSC, INC. RH-WISCONSIN, INC. AND GROUP HEALTH PLAN, INC. ARE CORPORATE MEMBERS OF THE HOSPITAL AND WESTFIELDS HOSPITAL, INC., BOTH OF WHICH ARE WISCONSIN NON-PROFIT CORPORATIONS EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). RH-WISCONSIN, INC. IS ALSO THE SOLE CORPORATE MEMBER OF WESTERN WISCONSIN EMERGENCY MEDICAL SERVICES COMPANY, AN AMBULANCE SERVICE WHICH IS A WISCONSIN NON-PROFIT CORPORATION EXEMPT FROM FEDERAL INCOME TAX UNDER IRC SECTION 501(C)(3). TOGETHER, ALL OF THESE RELATED ORGANIZATIONS COMPRISE THE HEALTHPARTNERS FAMILY OF ORGANIZATIONS (HEALTHPARTNERS), WHICH IS AN INTEGRATED HEALTH CARE DELIVERY SYSTEM THAT COMBINES THE PROVISION AND FINANCING OF HEALTH CARE SERVICES, FOR THE PURPOSE OF IMPROVING THE HEALTH OF ITS VARIOUS ENTITIES' MEMBERS, PATIENTS, AND THE BROADER COMMUNITY. HEALTHPARTNERS AND THE HOSPITAL ALSO PARTNER WITH OTHER PLANS, CARE PROVIDERS AND NON-PROFIT ORGANIZATIONS IN THE REGION AND THROUGHOUT THE NATION; TO INCREASE ACCESS, CREATE AND DISSEMINATE QUALITY MEASURES AND INITIATIVES, PARTICIPATE IN DEVELOPMENT OF PUBLIC POLICY AND COLLABORATE ON SYSTEM IMPROVEMENTS. THE HOSPITAL CONTINUES TO WORK IN PARTNERSHIP WITH THE HEALTHPARTNERS FAMILY, HUDSON PHYSICIANS - WWMA, AND THE COMMUNITY TO ALSO PROMOTE COMMUNITY HEALTH THROUGH CLINICAL INITIATIVES, EDUCATION AND OUTREACH, AND COMMUNITY HEALTH IMPROVEMENT EFFORTS SUCH AS HEALTHIER TOGETHER - ST. CROIX COUNTY.
    THE HOSPITAL CONTINUES TO BE AN INTEGRAL PART OF THE HUDSON COMMUNITY AND SURROUNDING AREA - A VITAL AND NECESSARY COMMUNITY RESOURCE SINCE 1953. PROGRAMS AND SERVICES INCLUDE: A REGIONALLY POPULAR BIRTH CENTER, RANKED IN THE TOP 3% OF BIRTHING UNITS (TOP 50 HOSPITALS) NATIONWIDE FOR EXCEPTIONAL CARE DELIVERY; EXPANDED PHASE II CARDIAC REHABILITATION PROGRAM; HEART CARE CLINIC ADDITION - PEDIATRIC CARDIOLOGY (WESTERN WISCONSIN'S ONLY SOURCE FOR THIS SPECIALTY); A NEW INTERNAL MEDICINE CLINIC AND A HOSPITALIST PROGRAM (ONLY HOSPITAL IN WESTERN WISCONSIN TO PROVIDE THIS MODEL OF CARE). OTHER SERVICES INCLUDE: THE EMERGENCY CENTER (WITH MEDICAL HELICOPTER TRANSPORT SERVICE), IMAGING CENTER, REHABILITATION CENTER, SURGERY & PROCEDURE CENTER, CANCER CARE, HEART CARE, NEUROLOGY, ORTHOPAEDICS AND MORE. THE HOSPITAL CAMPUS IS DESIGNED WITH THE LATEST TECHNOLOGY AND AMENITIES TO SUPPORT WHOLE HEALTH AND HEALING FOR PATIENTS AND THEIR FAMILIES - INCLUDING A NATIONALLY ACCLAIMED AND INTERNATIONALLY RECOGNIZED HEALING ARTS PROGRAM. THE PROGRAM, A COLLABORATION BETWEEN THE HOSPITAL AND THE PHIPPS CENTER FOR THE ARTS, IS ONE OF THE MOST COMPREHENSIVE HOSPITAL ARTS PROGRAM IN THE REGION WITH OVER 175 ORIGINAL PIECES OF ART ON DISPLAY AT ANY GIVEN TIME. BEST CARE, BEST EXPERIENCE ACTIVITIES, INCLUDING PROMISES TO PATIENTS AND PROMISES TO EACH OTHER WERE INTRODUCED IN SUPPORT OF A CULTURE OF EXCELLENCE - ONE OF RESPECT, ACCOUNTABILITY FOR EXCELLENCE, AND EMPLOYEE ENGAGEMENT AND INVOLVEMENT. THE HOSPITAL'S OVERALL "ENGAGEMENT INDEX" WAS 86%, AS REPORTED BY TOWERS WATSON, A GLOBAL ORGANIZATIONAL PERFORMANCE CONSULTING FIRM. "HIGH PERFORMING" COMPANIES HAVE ENGAGEMENT INDEXES BEGINNING AT 76%. A PATIENT'S WILLINGNESS TO RECOMMEND IS A LEADING INDICATOR OF SUCCESSFUL CUSTOMER SERVICE. THE HOSPITAL INPATIENT SCORES REMAIN HIGH AT THE 88TH PERCENTILE NATIONAL RANKING (TOP BOX: "WOULD DEFINITELY RECOMMEND") AMONG PRESS GANEY HOSPITALS OF COMPARABLE SIZE. PRESS GANEY IS THE COUNTRY'S LARGEST HOSPITAL DATABASE OF PATIENT SATISFACTION SURVEY DATA. II. BENEFITS TO PATIENTS AND THE COMMUNITY IN 2010 THE HOSPITAL AIMS TO BE THE PREMIER PARTNER IN THE COMMUNITY'S QUEST FOR HEALTH AND HAPPINESS. WORKING IN PARTNERSHIP WITH EACH OTHER, THE HEALTHPARTNERS FAMILY OF ORGANIZATIONS, HUDSON PHYSICIANS (WWMA), THE COMMUNITY, AND THE HOSPITAL ACCOMPLISHED A GREAT DEAL IN 2010. ADVANCEMENTS WERE MADE TO ENSURE BETTER HEALTH FOR ALL, IMPROVED PATIENT EXPERIENCE AND AFFORDABLE HEALTH CARE. THE HOSPITAL CONTINUED TO GROW ITS REPUTATION FOR EXCELLENT CLINICAL OUTCOMES AND SERVICE. HIGHLIGHTS INCLUDE: - IMPLEMENTATION OF EPIC - ELECTRONIC HEALTH RECORD (EHR) WHICH ADVANCED QUALITY AND EXPERIENCE FOR PATIENTS, CLINICIANS AND MEDICAL STAFF, AND CREATED A REGIONAL HEALTHPARTNERS NETWORK. THE HOSPITAL IS ONE OF THE FEW ITS SIZE NATIONALLY TO HAVE EPIC. - IMPLEMENTATION OF THE START SEEING YELLOW PROGRAM TO PREVENT INPATIENT FALLS. - IMPLEMENTATION OF SURGICAL CARE IMPROVEMENT PROJECT (SCIP) - NATIONAL PATIENT SAFETY INITIATIVE TO REDUCE PATIENT INFECTION RATES. THE HOSPITAL REPORTS SOME OF THE LOWEST SURGICAL INFECTION RATES IN THE REGION (1:201 PROCEDURES - U.S AVERAGE 1:57 PROCEDURES). - ADDITION OF MANY NEW HEALTH CARE PROVIDERS TO THE CAMPUS TEAM, INCLUDING SPECIALISTS IN INTERNAL MEDICINE, PEDIATRIC CARDIOLOGY, ENDOCRINOLOGY, MIDWIFERY, OPHTHALMOLOGY, SPORTS MEDICINE, NEPHROLOGY, FAMILY MEDICINE, THE HOSPITALIST PROGRAM AND OTHERS. - COLLABORATION WITH FIVE OTHER HOSPITALS AND TWO MEDICAL PROVIDER GROUPS TO CREATE THE CANCER CENTER OF WESTERN WISCONSIN (CCWW), LOCATED ON THE WESTFIELDS HOSPITAL CAMPUS, NEW RICHMOND. THE CENTER AND SYSTEM OF COORDINATED CANCER CARE WILL AFFORD PATIENTS REGIONAL ACCESS TO THE AREA'S ONLY RADIATION THERAPY CENTER. GROUNDBREAKING TOOK PLACE IN EARLY AUGUST, CENTER OPENING IN MAY 2011. - RECORD-SETTING 532 BABIES WERE BORN IN THE BIRTH CENTER - MARKING THE HIGHEST NUMBER OF BIRTHS IN A SINGLE YEAR SINCE THE HOSPITAL'S FOUNDING IN 1953. BIRTH CENTER GROWTH: 11%. - ACCORDING TO PRESS GANEY SURVEY DATA (1800 HOSPITAL DATABASE), THE HOSPITAL'S BIRTH CENTER NURSING STAFF RANKS AMONG THE BEST IN THE NATION - 99TH PERCENTILE FOR FRIENDLINESS AND ATTITUDE (AMONG TOP 18 HOSPITALS NATIONWIDE). WHILE 2010 CONTINUED TO BE A YEAR OF CHANGE, CHALLENGES AND CHOICES FOR THE HOSPITAL, IT WAS ALSO ONE OF CONTINUED COMMUNITY SUPPORT. CHARITABLE TRADITION CONTINUED AS THE HOSPITAL REACHED OUT TO THOSE IN NEED OF ITS SERVICES. THE HOSPITAL ENGAGED IN COMMUNITY PARTNERSHIPS WITH SCHOOLS, BUSINESSES, AGENCIES AND OTHER HEALTH PROVIDERS INVESTED IN COMMUNITY PROGRAMS AND SERVICES THAT POSITIVELY SUPPORT AND STRENGTHEN COMMUNITY HEALTH, EDUCATION, ECONOMIC DEVELOPMENT, AND CULTURE. THESE PROGRAMS AND PARTNERSHIPS EMBODY THE HOSPITAL'S MISSION OF "CARING FOR THE HEALTH OF OUR COMMUNITY." THE HOSPITAL AND ST. CROIX COUNTY PUBLIC HEALTH CONTINUED TO CO-FACILITATE THE COUNTY-WIDE COMMUNITY HEALTH IMPROVEMENT INITIATIVE NOW KNOWN AS HEALTHIER TOGETHER - ST. CROIX COUNTY (FORMERLY CHIP). SINCE JUNE 2008, THEY HAVE WORKED TOGETHER TO BETTER UNDERSTAND CURRENT AND FUTURE HEALTH CARE NEEDS OF ST. CROIX COUNTY. THE PROCESS INVOLVES ASSESSING, PRIORITIZING AND ADDRESSING HEALTH NEEDS IN THE REGION. HEALTHIER TOGETHER IS A STRATEGIC, COUNTY-WIDE, COMMUNITY-BASED APPROACH FOR CREATING AND MAINTAINING HEALTHY COMMUNITIES. A STEERING COMMITTEE OF 20+ MEMBERS REPRESENTING DIVERSE ORGANIZATIONS FROM ACROSS THE COUNTY PROVIDES OVERSIGHT AND GUIDANCE. THEY WORK TOGETHER TO BETTER ALIGN EFFORTS AMONG COMMUNITY PARTNERS AND CREATE A MORE STRATEGIC FRAMEWORK FOR LOCAL HEALTH IMPROVEMENT ACTIVITIES. FROM THE 2009 COUNTY-WIDE COMMUNITY NEEDS ASSESSMENT (EXECUTIVE SUMMARY AND FULL REPORT ARE PUBLICLY AVAILABLE ON THE HOSPITAL'S WEBSITE), THE TOP 5 HEALTH PRIORITIES WERE IDENTIFIED FOR THE PURPOSE OF EDUCATING AND MOBILIZING AREA ORGANIZATIONS, PLANNING ACTIONS TO IMPROVE PUBLIC HEALTH AND QUALITY OF LIFE, AND GARNERING RESOURCES FOR HEALTH IMPROVEMENT INITIATIVES. THE TOP 5 HEALTH PRIORITIES FOR 2009-2014 ARE: ACCESS TO PRIMARY AND PREVENTIVE HEALTH SERVICES; OVERWEIGHT, OBESITY, AND LACK OF PHYSICAL ACTIVITY; ADEQUATE AND APPROPRIATE NUTRITION; ALCOHOL AND OTHER SUBSTANCE USE AND ADDICTION; AND TOBACCO USE AND EXPOSURE.
    A COMMUNITY FORUM AND MULTIPLE WORKSHOPS WERE HELD IN 2010 TO SHARE ASSESSMENT FINDINGS AND CONTINUE DIALOGUE ABOUT POSSIBLE ROOT CAUSES OF TROUBLING STATISTICS. BEGINNING IN JUNE 2010, FIVE TASK FORCES AND OVER 100 COMMUNITY MEMBERS BEGAN ACTION, IMPLEMENTATION AND EVALUATION PLANNING TO MOVE ST. CROIX COUNTY'S COMMUNITY HEALTH IMPROVEMENT PROCESS FORWARD. THE HEALTHIER TOGETHER - ST. CROIX COUNTY PLAN (RELEASE DATE - JUNE 2011) WAS TO REPRESENT THE COLLECTIVE EFFORT OF MANY DEDICATED INDIVIDUALS WHO WORKED TO FIND CREATIVE WAYS TO IMPROVE HEALTH ACROSS THE COUNTY. THE HOSPITAL PROVIDED A SIGNIFICANT AMOUNT OF INTELLECTUAL, IN-KIND AND FINANCIAL RESOURCES TO THIS INITIATIVE SINCE IT BEGAN. TOTAL 2010 COMMUNITY BENEFIT CONTRIBUTIONS IN SUPPORT OF THE HEALTHIER TOGETHER INITIATIVE ARE VALUED AT $47,282. THE HOSPITAL'S DEVOTION TO THE HEALTH OF THE COMMUNITY STARTS WITH PROVIDING EXCEPTIONAL MEDICAL CARE TO EACH PATIENT AND EXTENDS TO FAMILIES AND ORGANIZATIONS THROUGHOUT THE REGION. THROUGH ITS COMMUNITY BENEFIT PROGRAM, THE HOSPITAL OFFERED SPECIAL HELP AND SUPPORT - FOR INDIVIDUALS OR FAMILIES EXPERIENCING FINANCIAL HARDSHIP TO EFFORTS OR ORGANIZATIONS STRIVING TO IMPROVE THE QUALITY OF LIFE FOR ALL. TOTAL 2010 COMMUNITY BENEFIT CONTRIBUTION EQUALED $3,743,979 WHICH REPRESENTS 7.8% OF NET REVENUE. THIS FIGURE IS REPORTED AT COST PER THE CATHOLIC HEALTH ASSOCIATION (CHA) COMMUNITY BENEFIT REPORTING GUIDELINES AND IN ACCORDANCE WITH WISCONSIN HOSPITAL ASSOCIATION (WHA) REPORTING REQUIREMENTS. TRADITIONAL CHARITY CARE AND HEALTHCARE ACCESS FOR LOW-INCOME INDIVIDUALS - $278,373 CHARITY CARE 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. THE HOSPITAL PROVIDED $278,373 IN FREE OR DISCOUNTED CARE TO 166 LOW INCOME AND UNINSURED PATIENTS. CHARITY CARE REPRESENTS ABOUT 0.6% OF THE HOSPITAL'S TOTAL OPERATING EXPENSES. CARE FOR MEDICAID PATIENTS - $1,538,735 THE HOSPITAL PROVIDES INPATIENT AND OUTPATIENT CARE, INCLUDING EMERGENCY DEPARTMENT SERVICES, TO MEDICAID PATIENTS. PAYMENTS RECEIVED FOR THESE SERVICES ARE BELOW THE COST OF CARE PROVIDED. THE HOSPITAL'S EXPENSE TO COVER UNREIMBURSED MEDICAID COSTS FOR 2,294 PATIENTS TOTALED $1,538,735. SUBSIDIZED HEALTH SERVICES - $1,088,217 THE HOSPITAL IS COMMITTED TO PROVIDING NEEDED SERVICES EVEN AT A FINANCIAL LOSS. IN 2010, LOSS ON SERVICES FOR INPATIENT AND OUTPATIENT HEALTH SERVICES INCLUDING EMERGENCY AND TRAUMA - OBSERVATION, EMERGENCY DEPARTMENT, ONCOLOGY AND HOSPITAL OUTPATIENT SERVICES (PHYSICAL THERAPY, PROGRAMS FOR CHANGE, RESPIRATORY THERAPY) TOTALED $1,088,217. COMMUNITY HEALTH IMPROVEMENT SERVICES - $456,763 THE FOLLOWING ACTIVITIES OR PROGRAMS WERE CARRIED OUT AND SUPPORTED BY THE HOSPITAL IN 2010 FOR THE EXPRESS PURPOSE OF IMPROVING COMMUNITY HEALTH: - COMMUNITY HEALTH EDUCATION ($272,207) OVER 10,000 PEOPLE ATTENDED EDUCATIONAL PROGRAMS, CLASSES, SPECIAL EVENTS, HEALTH FAIRS OR SUPPORT GROUPS TAUGHT OR HOSTED BY MEDICAL AND CLINICS STAFF AND CAMPUS PARTNERS OR WERE HOSPITAL FITNESS CENTER MEMBERS (1:1 EDUCATION AND FITNESS TRAINING). TOTAL COMMUNITY HEALTH EDUCATION EXPENSES TOTALED $272,207. CLASSES INCLUDED ADVANCED DIRECTIVES, PRENATAL/FAMILY PLANNING, BREASTFEEDING, BABY SIGN LANGUAGE, BABY MASSAGE, BABYSITTING CLASSES, DOMESTIC VIOLENCE, FAMILY/PARENTING/SIBLING EDUCATION, HEART DISEASE, MEDICATION SAFETY, MENTAL HEALTH AND DEPRESSION, NUTRITION/WEIGHT MANAGEMENT, SCHOOL-BASED HEALTH EDUCATION AND WORKFORCE DEVELOPMENT - HAND HYGIENE, EFFECTS OF SMOKING, CAREER DAY, ETC., AND YMCA PRESCHOOL SAFETY PROGRAM - RISK WATCH. IN ADDITION, OVER 450 PEOPLE ATTENDED 25 FREE HEALTH SEMINARS ON RELEVANT HEALTH TOPICS. OVER 60 CPR/AED AND FIRST-AID TRAINING CLASSES WERE OFFERED TO 631 PARTICIPANTS, AS YOUNG AS 6TH GRADE. SPECIAL HEALTH EDUCATION PROGRAMS AND EVENTS WERE PRESENTED TO REHABILITATION THERAPY CLINICIANS FROM MN/WI (ORTHOPAEDICS CONFERENCE), SENIOR CITIZENS (FALLS PREVENTION SEMINARS), AREA YOUTH (ANNUAL BIKE SAFETY CLINIC) AND AS PART OF LEADERSHIP HUDSON - A PROGRAM DEDICATED TO PROMOTING AND DEVELOPING DYNAMIC BUSINESS AND COMMUNITY LEADERS. OVER 250 PARTICIPANTS ENJOYED AN EVENING OF ZEN - A HOLISTIC APPROACH TO BETTER HEALTH (MEDITATION, YOGA AND NUTRITION TIPS) OFFERED THROUGHOUT THE YEAR. COMMUNITY-BASED HEALTH FAIRS INCLUDING THE REGIONAL HEALTH & WELLNESS EXPO AND HUDSON'S TASTE OF HOME COOKING SCHOOL ATTRACTED OVER 900 PEOPLE, WHO LEARNED ABOUT RECREATION THERAPY - THE BENEFITS OF MOTION AND MOVEMENT, PORTION CONTROL AND SIMPLE INGREDIENT SUBSTITUTIONS, MEDICATION SAFETY, FREE BLOOD PRESSURE CHECKS AND BLOOD SUGAR TESTING. SUPPORT GROUPS FACILITATED BY HOSPITAL STAFF INCLUDED CANCER, NEW PARENT, SMOKING CESSATION AND WEIGHT AND WELLNESS. 166 PEOPLE PARTICIPATED. OTHER SUPPORT GROUPS OFFERED ON CAMPUS BY COMMUNITY PARTNERS INCLUDED CARDIAC REHAB, CELIAC AND SPRUE, CROHN'S & COLITIS, DIABETES, AND PARKINSON'S DISEASE. HEALTH RESOURCE CENTER (HRC) IS OPERATED BY THE HOSPITAL AT A COST OF $18,220. OVER 1200 PEOPLE UTILIZED MATERIALS OR SERVICES. THE HRC IS A LENDING LIBRARY WHERE PATIENTS, THEIR FAMILY AND FRIENDS, STAFF AND COMMUNITY MEMBERS CAN ACCESS HEALTH AND WELLNESS INFORMATION FROM PRINT RESOURCES, INTERNET SITES, ORGANIZED EVENTS, AND STAFF ASSISTANCE FROM A REGISTERED NURSE. OVER 1200 BOOKS AND MAGAZINES ARE CHECKED OUT ANNUALLY. WELLNESS CLASSES ARE OPEN TO THE COMMUNITY AT NO OR LOW COST. THE HOSPITAL FITNESS CENTER, AN ONSITE COMMUNITY FITNESS CENTER USED BY 120 COMMUNITY MEMBERS INCLUDING PHASE 3 CARDIAC REHAB PROGRAM PARTICIPANTS, WAS AVAILABLE FOR USE. OPERATING COSTS OF $65,463 INCLUDED DEDICATED STAFF TIME TO ADMINISTER FITNESS AND EDUCATION PROGRAMS, SPACE USAGE, AND REDUCED FACILITY MEMBERSHIP FEES. - COMMUNITY BASED CLINICAL SERVICES ($10,804) THE HOSPITAL HOSTED NUMEROUS BLOOD DRIVES IN SUPPORT OF THE AMERICAN RED CROSS AND CONDUCTED FREE BLOOD PRESSURE SCREENS THROUGHOUT THE YEAR AT A COST OF $5,067. THE HOSPITAL WELCOMED THE SURVEY OF THE HEALTH OF WISCONSIN (SHOW) MOBILE EXAM CENTER TO ITS CAMPUS AS A MEANS TO LOCALLY SUPPORT STATEWIDE COMMUNITY HEALTH IMPROVEMENT EFFORTS. SHOW WAS LAUNCHED BY THE UW SCHOOL OF MEDICINE AND PUBLIC HEALTH TO RIGOROUSLY ASSESS AND TRACK RESIDENTS' HEALTH IN DETAIL, IN THIS CASE, THE HEALTH OF ST. CROIX COUNTY HOUSEHOLD RESIDENTS RANDOMLY SELECTED TO PARTICIPATE. OPERATIONAL COSTS TOTALED $1,100. THE FIRST GERIATRIC FALLS PREVENTION SCREENING WAS HELD FOR COMMUNITY MEMBERS AS A FOLLOW-UP TO THE FREE FALLS PREVENTION COMMUNITY HEALTH SEMINARS BEING OFFERED. HOSPITAL STAFF WORKED COLLABORATIVELY ACROSS DEPARTMENTS TO PLAN EVENT AT A COST OF $4,637. - HEALTH CARE SUPPORT SERVICES - ($173,752) IN 2010, OVER 11,600 PEOPLE REALIZED THE BENEFIT OF HEALTH CARE SUPPORT SERVICES AVAILABLE INCLUDING TRANSLATION/INTERPRETER SERVICES, VAN TRANSPORTATION, COUNSELING SERVICES, AND LIFELINE HOME MONITORING SYSTEM, TO NAME A FEW. MORE SPECIFICALLY: ASK-A-NURSE IS A COMMUNITY RESOURCE PROVIDED BY THE HRC. FREE EDUCATION CONSULTS, CUSTOM-RESEARCHED HEALTH INFORMATION, AND REFERRAL TO COMMUNITY SERVICES ARE PROVIDED BY REQUEST VIA DROP-IN OR BY TELEPHONE. ASK-A-NURSE AVERAGES 100 REQUESTS PER MONTH. SERVICE WAS PROVIDED AT A COST OF $11,576. THE HOSPITAL'S GOOD SAMARITAN FUND, SUPPORTED BY HUDSON HOSPITAL FOUNDATION AND EMPLOYEE GIVING, DONATED $2,340 TO HELP 26 INDIVIDUALS RECEIVING CARE ON THE HEALTH CAMPUS. FUNDS PROVIDED WERE FOR URGENT AND EMERGENT NEEDS RELATED TO THEIR HEALTH INCLUDING: DURABLE EQUIPMENT, NON-NARCOTIC PRESCRIPTION DRUGS, GAS CARDS, CLOTHING, ETC. ENROLLMENT ASSISTANCE, INFORMATION AND REFERRAL SERVICES WERE AVAILABLE TO HELP SECURE A PAYMENT SOURCE FOR UNINSURED AND UNDERINSURED PATIENTS. PATIENT FINANCIAL SERVICES, ADMINISTERED BY THE HOSPITAL'S BUSINESS OPERATIONS, EMPLOYS ONE PATIENT FINANCIAL SERVICES REPRESENTATIVE TO OVERSEE ITS FINANCIAL ASSISTANCE PROGRAM AND, ALONG WITH SUPPORT FROM DEPARTMENT STAFF, HELPS PATIENTS ENROLL IN GOVERNMENT PROGRAMS, FIND OTHER SOURCES OF PAYMENT, OR ACCESS SERVICES BEYOND MEDICAL CARE. IN 2010, THE HOSPITAL SPENT $4,185 IN STAFF TIME TO ASSIST 625 PATIENTS ENROLL IN PUBLIC MEDICAL PROGRAMS; $16,840 IN STAFF TIME TO GUIDE OR REFER 1,710 PEOPLE TO COMMUNITY SERVICES/PUBLIC HEALTH ASSISTANCE; AND $67,146 IN STAFF TIME TO GUIDE OR REFER 4,869 PATIENTS TO FINANCIAL ASSISTANCE.
    PROGRAMS FOR CHANGE, THE HOSPITAL'S OUTPATIENT CHEMICAL ADDICTION TREATMENT AND RECOVERY CARE PROGRAM, OFFERED PARENTS AND FAMILY MEMBERS THE OPPORTUNITY TO PARTICIPATE IN EDUCATIONAL LECTURES, GROUP DISCUSSION, AND FAMILY TREATMENT GROUPS FREE OF CHARGE IN SUPPORT OF THEIR LOVED ONE. THE HOSPITAL PROVIDED $26,876 IN STAFF TIME TO SUPPORT THE 245 ATTENDEES. VAN TRANSPORT SERVICES WERE AVAILABLE TO COMMUNITY RESIDENTS WITHIN A 15-MILE RADIUS UPON REQUEST. OPERATING COSTS FOR THE PROGRAM TOTALED $18,439. OVER 1,600 RESIDENTS TOOK ADVANTAGE OF THE SERVICES. HEALTH PROFESSIONS EDUCATION - $112,125 THE HOSPITAL'S STAFF PROVIDED CLINICAL TRAINING FOR 100 NURSES AND NURSING STUDENTS AND 22 HEALTH PROFESSIONALS INCLUDING EMS FROM SEVEN INSTITUTIONS AT A COST OF $112,125. IN ADDITION, THE HOSPITAL VOLUNTARILY PARTICIPATED IN THE WISCONSIN NURSE RESIDENCY PROGRAM (WNRP). THE PROGRAM IS A STRUCTURED LEARNING EXPERIENCE FOR NEWLY LICENSED REGISTERED NURSES DESIGNED TO PROMOTE EFFECTIVE TRANSITION INTO PROFESSIONAL PRACTICE. THREE NURSES, PAIRED WITH EXPERIENCED HOSPITAL NURSES ACTING AS COACH/SUPPORT PERSON, COMPLETED THE 12-MONTH PROGRAM. EACH YEAR, HUDSON HOSPITAL FOUNDATION, INC. PROVIDES (2) $2,000 SCHOLARSHIPS TO LOCAL HIGH SCHOOL SENIORS PURSUING HEALTH-RELATED EDUCATION AND CAREERS. CASH DONATIONS - $5,345 THE HOSPITAL'S CASH DONATIONS TO OTHER TAX-EXEMPT COMMUNITY ORGANIZATIONS IN THE FORM OF SPONSORSHIPS OR MEMBERSHIP DUES TOTALED $5,345. IN-KIND DONATIONS - $38,172 IN-KIND SERVICES PROVIDED INCLUDED STAFF HOURS SPENT IN SUPPORT OF BOARD OR COMMITTEE WORK (HUDSON ROTARY CLUB, ST. CROIX ECONOMIC DEVELOPMENT CORPORATION, ST. CROIX COUNTY SUBSTANCE ABUSE ADVISORY COMMITTEE, UW-RIVER FALLS CHANCELLOR ADVISORY COUNCIL, ST. CROIX VALLEY VISUAL ARTS COUNCIL, AND WISCONSIN HOSPITAL ASSOCIATION); EQUIPMENT AND SUPPLIES (HELP FOR HAITI - MARK DRUFFNER, MD MISSION TRIP); SPECIAL EVENTS PLANNING (HEARTWALK, NAMIWALK, HUDSON RELAY FOR LIFE); AND OVERHEAD EXPENSES OF SPACE PROVIDED TO NOT-FOR-PROFIT COMMUNITY GROUPS FOR MEETINGS.. COMMUNITY-BUILDING ACTIVITIES - $110,040 THE HOSPITAL IS AN ENERGETIC MEMBER OF THE LOCAL, STATE AND REGIONAL COMMUNITIES. AS THE HOSPITAL SUPPORTS INDIVIDUALS, ORGANIZATIONS, EVENTS AND PROGRAMS, IT LIVES OUT ITS COMMITMENT TO IMPROVE THE HEALTH OF THE COMMUNITY. KNOWING MUCH MORE CAN BE ACCOMPLISHED TOGETHER, THE HOSPITAL'S COMMUNITY BENEFIT PROGRAM BUILT VALUABLE CONNECTIONS WITH INDIVIDUALS AND ORGANIZATIONS FROM PUBLIC, PRIVATE AND NONPROFIT SECTORS TO SHARE SKILLS AND ASSETS. THE HOSPITAL PARTICIPATED IN COMMUNITY-BUILDING ACTIVITIES THAT SUPPORTED ECONOMIC DEVELOPMENT, EMERGENCY PREPAREDNESS, LEADERSHIP DEVELOPMENT, COALITION BUILDING, HEALTH IMPROVEMENT ADVOCACY, AND WORKFORCE DEVELOPMENT INCLUDING THE TOBACCO COALITION, HEALTHWATCH OF ST. CROIX COUNTY, WISCONSIN YOUTH APPRENTICESHIP PROGRAM, WEST CENTRAL REGIONAL TRAUMA ADVISORY COUNCIL (RTAC), THE HEALING ARTS PROGRAM, ST. CROIX VALLEY FOUNDATION PARTNERS FOR THE FUTURE, SOMERSET MIDDLE SCHOOL CAREER ACADEMIC AND PERSONAL AND SOCIAL SKILLS (CAPS) CLASS, AND LEADERSHIP HUDSON. TO HELP LOCAL BUSINESSES AND ORGANIZATIONS BETTER UNDERSTAND THE CHANGES IN THE HEALTH CARE MARKET AS A RESULT OF HEALTH CARE REFORM, THE HOSPITAL AND WESTFIELDS HOSPITAL SPONSORED EXTREME MAKEOVER 2010: WESTERN WISCONSIN HEALTH CARE REFORM EVENT. OVER 225 COMMUNITY STAKEHOLDERS ATTENDED TO DISCUSS THE EMERGING IMPLICATIONS AND WHAT THEY MIGHT MEAN FOR THE COST AND QUALITY OF EMPLOYEE HEALTH CARE IN THE FUTURE; OPPORTUNITIES AND CHALLENGES; PRIORITY ISSUES; AND THE IMPACT ON HOSPITALS, BUSINESSES AND THE STATE. A GROUP OF INDUSTRY EXPERTS FROM MADISON, WI AND KEYNOTE PRESENTER, MARY BRAINERD, PRESIDENT AND CEO, HEALTHPARTNERS PROVIDED THEIR PERSPECTIVES. THE HOSPITAL CONTINUED ON ITS ECO-FRIENDLY JOURNEY USING SUSTAINABLE BUSINESS PRACTICES IN ORDER TO PROVIDE HEALTH CARE THAT'S HEALTHY. GREEN INITIATIVES INCLUDED THE RECYCLING PROGRAM, COMMUNITY SHARPS DISPOSAL SITE, CREATION OF THE COMMUNITY GARDEN AT THE HOSPITAL IN SUPPORT OF HEALTHIER TOGETHER, AND THE COMMUNITY LABYRINTH. THE HOSPITAL ALSO PARTICIPATES IN COMMUNITY SUPPORTED AGRICULTURE AND SERVES AS A DISTRIBUTION SITE FOR LOCALLY-GROWN FRESH, ORGANIC PRODUCE FOR THE COMMUNITY AND PARTICIPATING EMPLOYEES. COMMUNITY BENEFIT OPERATIONS - $121,209 COSTS ASSOCIATED WITH DEDICATED STAFF, PROGRAM OPERATIONS, RESOURCE EXPENSES, TRAINING, TRAVEL, WHA SURVEY COMPLETION, COMMUNITY HEALTH IMPROVEMENT PROCESS EXPENSES, COST OF FUNDRAISING FOR COMMUNITY BENEFIT PROGRAMS, 2009 REPORT TO COMMUNITY (PUBLICALLY AVAILABLE ON THE HOSPITAL'S WEBSITE) - ANNUAL COMMUNITY BENEFIT REPORT AND LAUNCH EVENT, AND OTHER PROGRAM EXPENSES TOTALED $121,209. THIS INVESTMENT REFLECTS THE HOSPITAL'S COMMITMENT TO THE COMMUNITY BENEFIT PROGRAM AND REPORTING PROCESS. THE HOSPITAL "TELLS ITS STORY" IN ITS ANNUAL REPORT TO COMMUNITY TITLED "EACH DAY, HEALTHIER TOGETHER." THE REPORT, NOW AN ONLINE MICRO SITE (LIMITED REPORT PRINT QUANTITIES AVAILABLE) SUPPORTS THE HOSPITAL'S GREEN INITIATIVE AND SHARES HOSPITAL ACCOMPLISHMENTS, SUPPORT EFFORTS OF THE HOSPITAL FOUNDATION, AND LIFE-CHANGING VIDEOS FROM MEMBERS OF THE COMMUNITY.
FORM 990, PART VI, SECTION A, LINE 6   AS OF JANUARY 1, 2009, THE CORPORATE MEMBERS OF THE HOSPITAL ARE GROUP HEALTH PLAN, INC. AND RH-WISCONSIN, INC. THESE SAME ENTITIES ARE ALSO THE CORPORATE MEMBERS OF WESTFIELDS HOSPITAL, INC., A CRITICAL ACCESS HOSPITAL IN NEW RICHMOND, WISCONSIN. GROUP HEALTH PLAN, INC. AND RH-WISCONSIN, INC. ARE PART OF THE HEALTHPARTNERS FAMILY OF ORGANIZATIONS.
FORM 990, PART VI, SECTION A, LINE 7A   THE HOSPITAL'S BOARD OF DIRECTORS IS COMPRISED OF NOT MORE THAN THIRTEEN (13) PERSONS APPOINTED AS FOLLOWS (AMENDED BYLAWS, ART. II, SECT. 2): - SEVEN (7) COMMUNITY DIRECTORS NOMINATED BY THE BOARD'S NOMINATING COMMITTEE AND APPOINTED BY RH-WISCONSIN, INC. - THREE (3) DIRECTORS APPOINTED BY GROUP HEALTH PLAN, INC., ONE OF WHOM MAY BE A PHISICIAN AND ONE OF WHOM MAY BE THE CHIEF EXECUTIVE OFFICER OF REGIONS HOSPITAL - ONE (1) DIRECTOR WHO IS A MEMBER OF THE ACTIVE MEDICAL STAFF OF THE HOSPITAL AND APPOINTED BY WESTERN WISCONSIN MEDCIAL ASSOCIATES, S.C. OR BY THE LARGEST ACTIVE PRIMARY CARE PHYSICIAN GROUP SERVING THE HOSPITAL. - ONE (1) DIRECTOR SHALL BE THE HOSPITAL'S CHIEF OF STAFF - ONE (1) DIRECTOR SHALL BE A PHYSICIAN NOMINATED BY THE BOARD'S NOMINATING COMMITTEE AND APPOINTED BY RH-WISCONSIN, INC.
FORM 990, PART VI, SECTION A, LINE 7B   THE HOSPITAL'S CORPORATE MEMBERS - RH-WISCONSIN, INC. AND GROUP HEALTH PLAN, INC. - JOINTLY APPROVE THE FOLLOWING ACTIONS OF THE BOARD OF DIRECTORS OR INITIATE THESE ACTIONS DIRECTLY (AMENDED BYLAWS, ART. III, SECT. 1): - AMENDMENT OF THE ARTICLES, BYLAWS OR OTHER GOVERNING DOCUMENTS - APPROVAL OF THE ADDITION OR DELETION OF MAJOR SERVICE LINES - SALE, LEASE, MORTGAGE OR PLEDGE OF ANY REAL ESTATE OR INTEREST THEREIN, OR OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS - ADOPTION OF AMENDMENT OF A STRATEGIC PLAN, AND CAPITAL AND OPERATING BUDGETS - APPROVAL OF UNBUDGETED CAPITAL EXPENDITURES - APPROVAL OF BORROWING OR LENDING OF FUNDS IN EXCESS OF ONE MILLION DOLLARS - MERGER, CONSOLIDATION, AFFILIATION OR JOINT VENTURE WITH ANY OTHER ENTITY AND TRANSFER OR CONTRIBUTION OF ASSETS AND FUNDS TO SEPARATE ENTITIES - ESTABLISHMENT OR DIVESTITURE OF ENTITIES OF WHICH THE HOSPITAL HAS AN EQUITY OR MANAGEMENT INTEREST, OR ESTABLISMENT OF ANY SIGNIFICANT AND CONTINUING RELATIONSHIP WITH ANY ENTITY - APPOINTMENT AND REMOVAL OF THE HOSPITAL'S PRESIDENT AND CHAIR OF THE BOARD OF DIRECTORS - DISSOLUTION AND DISTRIBUTION OF ASSETS
FORM 990, PART VI, SECTION B, LINE 11   THE HOSPITAL'S 990 RETURN HAS A COMPREHENSIVE REVIEW PROCESS THAT IS FOLLOWED BEFORE IT IS PRESENTED TO THE GOVERNING BODY OF THE HOSPITAL. THE REVIEW PROCESS INCLUDES A LAYERED REVIEW BY THE TAX DEPARTMENT OF GROUP HEALTH PLAN, INC. (GHI), THE MANAGEMENT TEAM OF THE HOSPITAL, GHI'S INTERNAL LEGAL DEPARTMENT AND HEALTHPARTNERS, INC.'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 HOSPITAL. ONCE THAT REVIEW PROCESS HAS BEEN COMPLETED, IT IS THE POLICY OF THE HOSPITAL TO MAKE AVAILABLE TO THE FINANCE AND AUDIT COMMITTEE OF IT'S BOARD OF DIRECTORS, AND TO IT'S BOARD OF DIRECTORS, A COPY OF THE 990 PRIOR TO THE FILING OF THE 990 RETURN. THIS COPY IS PROVIDED TO THE FINANCE AND AUDIT COMMITTEE AND THE FULL BOARD OF DIRECTORS IN A PRE-MEETING PACKET, AND IS AN AGENDA ITEM AT THE COMMITTEE MEETING. THIS PROCESS IS NOTED AND DOCUMENTED IN THE WRITTEN COMMITTEE MINUTES OF THE MEETING. THESE MINUTES ARE PRESENTED TO THE FULL BOARD OF DIRECTORS.
  FORM 990, PART VI, SECTION B, LINE 12C AS REQUIRED BY THE BYLAWS OF THE HOSPITAL, THE BOARD 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 OF A COMMITTEE WITH BOARD DELEGATED POWERS AND KEY EMPLOYEES ANNUALLY ARE PROVIDED WITH A COPY OF THE POLICY AND REQUESTED TO COMPLETE A QUESTIONNAIRE IDENTIFYING ANY POTENTIAL CONFLICTS OF INTEREST. THE GENERAL COUNSEL WILL SUMMARIZE THE FINDINGS FOLLOWING REVIEW OF THE QUESTIONNAIRE AND SUBMIT A REPORT TO THE CHAIR AND HOSPITAL PRESIDENT. BOARD AGENDAS AND EXECUTIVE DECISIONS ARE MONITORED IN RELATION TO THIS POLICY.
  FORM 990, PART VI, SECTION B, LINE 15 THE HOSPITAL'S PRESIDENT AND CHIEF FINANCIAL OFFICER (CFO) ARE EMPLOYEES OF REGIONS HOSPITAL (REGIONS), A RELATED ORGANIZATION WHICH HAS AN ANNUAL PROCESS TO REVIEW THE MARKET COMPARABILITY OF THE TOTAL COMPENSATION OF THE HOSPITAL'S PRESIDENT AND CFO. EACH YEAR, UNDER THE DIRECTION OF THE REGIONS BOARD OF DIRECTORS' COMPENSATION COMMITTEE, AN ANNUAL 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 COMPENSATION COMMITTEE OF REGIONS. THE COMPENSATION COMMITTEE'S MARKET REVIEW PROCESS AND SUBSEQUENT DECISIONS INCLUDE THE FOLLOWING ELEMENTS: - INDEPENDENT BODY - COMMITTEE MEMBERS COMPLETE AN ANNUAL CONFLICT OF INTEREST SURVEY TO ASSURE THE COMMITTEE MEMBERS' INDEPENDENCE - STAFF IS NOT IN ROOM DURING DELIBERATIONS OR VOTE INCLUDING EXECUTIVE SESSIONS - AUTHORIZED BODY - REGIONS' BOARD OF DIRECTORS HAS DELEGATED TO THE COMPENSATION COMMITTEE THE ACCOUNTABILITY AND AUTHORITY TO REVIEW AND APPROVE THE COMPARABILITY DATA OF ALL OFFICERS AND ASSOCIATE MEDICAL DIRECTORS - REGIONS' BOARD OF DIRECTORS HAS DELEGATED TO THE COMPENSATION COMMITTEE THE ACCOUNTABILITY TO CONDUCT AN ANNUAL PERFORMANCE EVALUATION AND TO DETERMINE THE COMPENSATION OF ALL OFFICERS BASED ON THE PERFORMANCE REVIEW AND THE MARKET COMPARABILITY DATA. - COMPARABILITY DATA - EVERY THREE YEARS, THE COMPENSATION COMMITTEE RETAINS AN INDEPENDENT COMPENSATION EXPERT TO CONDUCT AN EXTENSIVE MARKET COMPARABILITY SURVEY FOR ALL OFFICERS OF THE ORGANIZATION. WITH THE INPUT OF THE CONSULTANT, THE COMPENSATION COMMITTEE DETERMINES APPROPRIATE PEER GROUPS INCLUDING BOTH LOCAL AND NATIONAL PEER GROUPS. THE SURVEY CONSIDERS EACH ELEMENT OF TOTAL COMPENSATION AND AGGREGATE TOTAL COMPENSATION. BASED ON THIS DATA, THE COMPENSATION COMMITTEE DETERMINES MINIMUM AND MAXIMUM TOTAL COMPENSATION RANGES FOR EACH OFFICER. IN INTERIM YEARS, THE REGIONS HR DEPARTMENT, UNDER THE COMPENSATION COMMITTEE'S DIRECTION USES THE SAME RECOGNIZED THIRD PARTY SALARY SURVEYS TO DETERMINE MEDIAN SALARY STRUCTURE CHANGES AND AVERAGE SALARY INCREASES. BASED ON THIS UPDATED DATA, THE COMPENSATION COMMITTEE DETERMINES THE TOTAL COMPENSATION RANGES FOR EACH OFFICER. - THE ELEMENTS OF TOTAL COMPENSATION ARE SALARY, INCENTIVES, BENEFITS AND PERQUISITES. - PROPER CONTEMPORANEOUS DOCUMENTATION - MINUTES OF THE COMPENSATION COMMITTEE ARE PREPARED AFTER EACH MEETING AND APPROVED AT THE NEXT MEETING. - TOTAL COMPENSATION IS APPROPRIATELY REPORTED ON THE FORM 990 AND ON THE EMPLOYEE'S W-2. THE HOSPITAL'S OTHER OFFICERS ARE EMPLOYEES OF THE HOSPITAL. THE HOSPITAL COMPENSATION PROGRAM CONSISTS OF: KEY POINTS: - SALARY RANGES ARE DETERMINED BY UTILIZING PUBLISHED SALARY SURVEY DATA AND LOCAL JOB MARKET INFORMATION (TYPICALLY HRRAM'S ANNUAL SURVEY). - RANGES ARE UPDATED ANNUALLY DURING MAY BY THE HOSPITAL'S HR DEPARTMENT. - RANGES ARE POSITION SPECIFIC AND ARE 95-100% OF THE TWIN CITY MARKET OR 100% OF THE WI DATA (THE HIGHER OF THE TWO). - REGIONS COMPENSATION DEPARTMENT IS REFERENCED FOR NON-MATCHING POSITIONS WITH HRRAM DATA. - WISCONSIN HOSPITAL ASSOCIATION (WHA) SALARY SURVEY IS ALSO REFERENCED FOR SENIOR LEADERS AND EXECUTIVE POSITIONS. - PLACEMENT IN THE RANGE IS DETERMINED BY JOB DESCRIPTION REQUIREMENTS, INCLUDING EDUCATION, TRAINING, EXPERIENCE, LENGTH OF TIME IN THE POSITION, AND PERFORMANCE IN THE POSITION. - POSITIONS WITHIN MANAGEMENT COUNCIL UTILIZE THE COMPA-RATIO FOR REVIEW OF SALARY RANGES. TYPICALLY MANAGERS WILL BE 0.90 OR GREATER, DEPENDING ON SKILLS, MANAGEMENT EXPERIENCE, ETC.
  FORM 990, PART VI, SECTION C, LINE 19 THE HOSPITAL FINANCIAL STATEMENTS AND 990 RETURNS ARE MADE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION FROM THE HOSPITAL. THE HOSPITAL'S ARTICLES OF INCORPORATION ARE AVAILABLE TO ANY PERSON WHO REQUESTS THE INFORMATION THROUGH THE WISCONSIN SECRETARY OF STATE'S OFFICE. THE HOSPITAL'S CONFLICT OF INTEREST POLICY CAN BE VIEWED THROUGH THE HUDSON HOSPITAL.ORG WEBSITE.
AVERAGE HOURS - RELATED ORGANIZATIONS FORM 990, PART VII, SECTION A, LINE 1A, COLUMN (B) DIRECTORS AND OFFICERS OF THE HOSPITAL ARE EMPLOYED AND COMPENSATED BY GROUP HEALTH PLAN, INC., REGIONS HOSPITAL, OR THE HOSPITAL. REPORTED AVERAGE HOURS WORKED ARE BASED ON THEIR TOTAL COMPENSATION FROM ALL RELATED ORGANIZATIONS.
CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: CONTRIBUTION OF LONG-LIVED ASSETS 30,073. INCREASE IN INTEREST IN NET ASSETS OF HUDSON HOSPITAL FOUNDATION 335,820. TRANSFER OF NET ASSETS TO HUDSON HOSPITAL FOUNDATION, INC. -129,455. TOTAL TO FORM 990, PART XI, LINE 5: 236,438.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
HUDSON HOSPITAL INC
 
Employer identification number

39-0804125
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income
(e)
End-of-year assets


 		(f)
Direct controlling
entity

















Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled organization
Yes No
(1) HEALTHPARTNERS INC

8170 33RD AVENUE SOUTH PO BOX 1309

MINNEAPOLIS,MN554401309
41-1693838 		HYBRID STAFF MODEL/NETWORK MODEL HEALTH MAINTENANCE ORGANIZATION MN 501(C)(4   N/A
 
No
(2) GROUP HEALTH PLAN INC

8170 33RD AVENUE SOUTH PO BOX 1309

MINNEAPOLIS,MN554401309
41-0797853 		STAFF MODEL HEALTH MAINTENANCE ORGANIZATION MN 501(C)(3) 170(B)(1) (A)(III) HEALTHPARTNERS INC
 
 
No
(3) HUDSON HOSPITAL FOUNDATION INC

8170 33RD AVENUE SOUTH PO BOX 1309

MINNEAPOLIS,MN554401309
39-1279567 		PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT WI 501(C)(3) 170(B)(1) (A)(VI) HUDSON HOSPITAL INC
 
 
No
(4) RH-WISCONSIN

8170 33RD AVENUE SOUTH PO BOX 1309

MINNEAPOLIS,MN554401309
20-2287016 		CORPORATE PLANNING AND OVERSIGHT WI 501(C)(3) 509(A)(3) TYPE II HPI - RAMSEY
 
 
No
(5) HEALTHPARTNERS CENTRAL MINNESOTA CLINICS INC

8170 33RD AVENUE SOUTH PO BOX 1309

MINNEAPOLIS,MN554401309
41-1236798 		PRIMARY AND SPECIALTY PATIENT CARE MN 501(C)(3) 170(B)(1) (A)(III) GROUP HEALTH PLAN INC
 
 
No
(6) HPI - RAMSEY

8170 33RD AVENUE SOUTH PO BOX 1309

MINNEAPOLIS,MN554401309
41-1793333 		CORPORATE PLANNING AND OVERSIGHT MN 501(C)(3) 509(A)(3) TYPE I HEALTHPARTNERS INC
 
 
No
(7) HEALTHPARTNERS INSTITUTE FOR MEDICAL EDUCATION

8170 33RD AVENUE SOUTH PO BOX 1309

MINNEAPOLIS,MN554401309
41-1835843 		MEDICAL EDUCATION MN 501(C)(3) 509(A)(3) TYPE I HEALTHPARTNERS INC
 
 
No
(8) HEALTHPARTNERS RESEARCH FOUNDATION

8170 33RD AVENUE SOUTH PO BOX 1309

MINNEAPOLIS,MN554401309
41-1670163 		HEALTHCARE RESEARCH MN 501(C)(3) 509(A)(3) TYPE I GROUP HEALTH PLAN INC
 
 
No
(9) CAPITAL VIEW TRANSITIONAL CARE CENTER

8170 33RD AVENUE SOUTH PO BOX 1309

MINNEAPOLIS,MN554401309
41-2011453 		POST HOSPITALIZATION PATIENT CARE MN 501(C)(3) 170(B)(1) (A)(III) HPI - RAMSEY
 
 
No
(10) RAMSEY INTEGRATED HEALTH SERVICES

8170 33RD AVENUE SOUTH PO BOX 1309

MINNEAPOLIS,MN554401309
41-1503090 		IN-HOME PATIENT CARE MN 501(C)(3) 509(A)(3) TYPE II HPI - RAMSEY
 
 
No
(11) REGIONS HOSPITAL

8170 33RD AVENUE SOUTH PO BOX 1309

MINNEAPOLIS,MN554401309
41-0956618 		HOSPITAL MN 501(C)(3) 170(B)(1) (A)(III) HPI - RAMSEY
 
 
No
(12) REGIONS HOSPITAL FOUNDATION

8170 33RD AVENUE SOUTH PO BOX 1309

MINNEAPOLIS,MN554401309
41-1888902 		PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT MN 501(C)(3) 170(B)(1) (A)(VI) HPI - RAMSEY
 
 
No
(13) RHSC INC

8170 33RD AVENUE SOUTH PO BOX 1309

MINNEAPOLIS,MN554401309
41-1891928 		HEALTHCARE STAFFING MN 501(C)(3) 509(A)(3) TYPE II HEALTHPARTNERS INC
 
 
No
(14) WESTFIELDS HOSPITAL INC

8170 33RD AVENUE SOUTH PO BOX 1309

MINNEAPOLIS,MN554401309
39-0808442 		HOSPITAL WI 501(C)(3) 170(B)(1) (A)(III) RH-WISCONSIN
 
 
No
(15) WESTFIELDS HOSPITAL FOUNDATION INC

8170 33RD AVENUE SOUTH PO BOX 1309

MINNEAPOLIS,MN554401309
39-1770913 		PROVIDE HOSPITAL PROGRAM FINANCIAL SUPPORT WI 501(C)(3) 509(A)(3) TYPE I WESTFIELDS HOSPITAL INC
 
 
No
(16) PHYSICIANS NECK AND BACK CLINICS

8170 33RD AVENUE SOUTH PO BOX 1309

MINNEAPOLIS,MN554401309
27-0684883 		SPECIALTY PATIENT CARE MN 501(C)(3) 509(A)(3) TYPE II GROUP HEALTH PLAN INC
 
 
No
(17) WWESTERN WISCONSIN EMERGENCY MEDICAL SERVICES COMPANY

8170 33RD AVENUE SOUTH PO BOX 1309

MINNEAPOLIS,MN554401309
26-3616590 		PROVIDE MEDICAL TRANSPORT SERVICES WI 501(C)(3) 509(A)(3) TYPE II RH-WISCONSIN
 
 
No
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization



 		(b)
Primary activity



 		(c)
Legal domicile
(state or
foreign
country)
 		(d)
Direct controlling
entity


 		(e)
Type of entity
(C corp, S corp,
or trust)

 		(f)
Share of total income



 		(g)
Share of
end-of-year
assets

 		(h)
Percentage
ownership
(1) HEALTHPARTNERS ADMINISTRATORS INC
8170 33RD AVENUE SOUTH PO BOX 1309
MINNEAPOLIS,MN554401309
41-1629390 		THIRD PARTY ADMINISTRATOR MN HEALTHPARTNERS INC
  		C      
(2) HEALTHPARTNERS ASSOCIATES INC
8170 33RD AVENUE SOUTH PO BOX 1309
MINNEAPOLIS,MN554401309
52-2365151 		MEDICAL CLINIC STAFFING AND ASSET MANAGEMENT MN HEALTHPARTNERS ADMINISTRATORS INC
  		C      
(3) HEALTHPARTNERS SERVICES INC
8170 33RD AVENUE SOUTH PO BOX 1309
MINNEAPOLIS,MN554401309
41-1683568 		MEDICAL CLINIC STAFFING AND ASSET MANAGEMENT MN HEALTHPARTNERS ADMINISTRATORS INC
  		C      
(4) HEALTHPARTNERS VENTURES INC
8170 33RD AVENUE SOUTH PO BOX 1309
MINNEAPOLIS,MN554401309
41-1838197 		DEVELOP HEALTHCARE BUSINESS OPPORTUNITIES MN HEALTHPARTNERS INC
  		C      
(5) HEALTHPARTNERS INSURANCE COMPANY
8170 33RD AVENUE SOUTH PO BOX 1309
MINNEAPOLIS,MN554401309
41-1683523 		MEDICAL AND DENTAL INSURANCE MN HEALTHPARTNERS ADMINISTRATORS INC
  		C      




Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type(a-r) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) HUDSON HOSPITAL FOUNDATION INC

 B 129,455 CASH AMOUNT
(2) HUDSON HOSPITAL FOUNDATION INC

 C 30,073 CASH AMOUNT
(3) HUDSON HOSPITAL FOUNDATION INC

 L    
(4) HUDSON HOSPITAL FOUNDATION INC

 M    
(5) HUDSON HOSPITAL FOUNDATION INC

 N    
(6)
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Are all
partners
section
501(c)(3)
organizations? 		(e)
Share of
end-of-year
assets 		(f)
Disproprtionate allocations? 		(g)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065) 		(h)
General or
managing
partner?
Yes No Yes No Yes No






























Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
Additional Data


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